Obesity Links PTSD and Diabetes Risk

MedicalResearch.com Interview with:

Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research

Dr. Scherrer

Jeff Scherrer, Ph.D.
Associate professor; Research director
Department of Family and Community Medicine
Saint Louis University Center for Health Outcomes Research 

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

Response: The rationale for this study comes from evidence that patients with PTSD are more likely to be obese than persons without PTSD and have more difficulty losing weight.

Given the obesity epidemic and substantial role of obesity in risk of type 2 diabetes, we sought to determine if obesity accounted for the existing evidence that PTSD is a risk factor for incident type 2 diabetes.  Other studies have adjusted for obesity or BMI in models that control for obesity/BMI and other confounders simultaneously which prohibits measuring the independent role of obesity on the ass Continue reading

Wisdom Tooth Extraction Can Lead To Persistent Opioid Use

MedicalResearch.com Interview with:

Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan 

Dr. Harbaugh

Calista Harbaugh, MD
House Officer, General Surgery
Clinician Scholar, National Clinician Scholars Program
Research Fellow, Michigan Opioid Prescribing Engagement Network
University of Michigan 

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

Response: Wisdom tooth extraction is one of the most common procedures among teens and young adults, with more than 3.5 million young people having wisdom teeth pulled every year.

This procedure is commonly paired with a prescription for opioid pain medication. As the opioid epidemic sweeps the nation, we must pay attention to the long term effects of opioid prescribing for even routine procedures. This is particularly important for wisdom tooth extraction where there is evidence that opioid pain medications may be no more effective than anti-inflammatories alone.

Using commercial insurance claims, we evaluated the association between receiving an opioid prescription with wisdom tooth extraction and developing new persistent opioid use in the year after the procedure. We found nearly a 3-fold increase in odds of persistent opioid use, attributable to whether or not an opioid was prescribed. This translates to nearly 50,000 young people developing new persistent opioid use each year from routine opioid prescribing for wisdom tooth extraction.

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Parenting Educational Intervention Can Reduce Childhood Obesity

MedicalResearch.com Interview with:

Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Vice Chair of Faculty Affairs, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850

Prof. Paul

Ian M. Paul, M.D., M.Sc.
Professor of Pediatrics and Public Health Sciences
Chief, Division of Academic General Pediatrics
Vice Chair of Faculty Affairs, Department of Pediatrics
Penn State College of Medicine
Hershey, PA 17033-0850

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

Response: 20-25% of 2-5 year old children are overweight or obese in the US, and these children have increased risk of remaining overweight across the lifecourse. To date, research efforts aimed at preventing early life overweight have had very limited success.

In our randomized clinical trial that included 279 mother-child dyads, a responsive parenting intervention that began shortly after birth significantly reduced body mass index z-score compared with controls at age 3 years. Continue reading

Elective Induction at 39 Weeks May Reduce Need for Cesarean Section

MedicalResearch.com Interview with:

George R. Saade, MD Professor Jennie Sealy Smith Distinguished Chair Professor, Obstetrics & Gynecology, and Cell Biology Chief of Obstetrics and Maternal Fetal Medicine Director, Perinatal Research Division Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine UTMB at Galveston

Dr. Saade

George R. Saade, MD
Professor Jennie Sealy Smith Distinguished Chair Professor,
Obstetrics & Gynecology, and Cell Biology
Chief of Obstetrics and Maternal Fetal Medicine
Director, Perinatal Research Division
Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine
UTMB at Galveston

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

Response: Several analyses show that the lowest risk to the baby is if delivered at 39 weeks. As pregnancy goes beyond 39 weeks, the risk to the baby increases. On the other hand, the general belief was that induction of labor at 39 increases the risk of cesarean and may not be good for the baby. The guideline were that induction without medical indication, or what we call elective induction of labor, should not be done. However, the studies on which this belief was based were not appropriately designed or analyzed. These studies compared women who were induced at 39 weeks to those who had spontaneous labor at 39 weeks. This comparison is not appropriate. While induction is a choice, having spontaneous labor at 39 weeks is not by choice.  So the correct comparison should be between women who were induced at 39 weeks to those who were not induced and continued their pregnancy beyond 39 weeks. In other words, they continued until they had spontaneous labor or developed an indication to be delivered (expectantly managed). That is how the study was done. First time pregnant women were randomized between these 2 options. The reason the study was done in first time mothers is that they have the highest risk of cesarean compared with women who had delivered vaginally before.

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New Biomarkers Predictive of Atrial Fibrillation Outcome

MedicalResearch.com Interview with:

John D Horowitz, MBBS, PhD. Director of Cardiology/Clinical Pharmacology Queen Elizabeth Hospital University of Adelaide Australia

Dr. Horowitz

John D Horowitz, MBBS, PhD.
Director of Cardiology/Clinical Pharmacology
Queen Elizabeth Hospital
University of Adelaide
Australia 

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

Response:  Atrial fibrillation (AF) describes intermittent or permanent episodes of irregular pulse, due to rapid electrical activity within the atria (filling chambers) of the heart. During AF, the atria quiver, rather than contract, and the response of the ventricles is often rapid, resulting in palpitations and an increased risk of development of heart failure. AF may occur at any age, but is most common in ageing patients (typically over 75 years). The primary importance of AF is that it markedly increases the risk of thrombus formation in the atrium, with the resultant problem that these thrombi may dislodge (embolise), and commonly block arteries in the brain, causing strokes. Hence patients with AF are usually treated with anticoagulants.

Although AF often occurs in patients with prior damage to their hearts and atrial distension, there has been evidence for about the past 8 years that AF also is caused, at least in part, by inflammatory changes: two components have been identified as possible causes for this inflammation: lack of nitric oxide (NO) effect[ NO is  an anti-inflammatory chemical formed by all tissues in the body],  and excess activity of the pro-inflammatory enzyme myeloperoxidase (MPO).  High concentrations of ADMA, which inhibits NO formation, may result from effects of MPO on tissues. SDMA, which is closely related to ADMA, also exerts pro-inflammatory effects and tends to suppress NO formation.

The currently reported study began with the design of the ARISTOTLE trial, an investigation of the (then) novel anticoagulant apixaban as an alternative to warfarin therapy, as a means of preventing strokes in patients with AF. It was elected to perform a substudy to investigate the potential role of ADMA and SDMA as modulators of risk in patients with atrial fibrillation.

This substudy, performed in just over 5000 patients from the ARISTOTLE trial, essentially asked two questions:

(1) There are several indices of stroke risk in patients with atrial fibrillation, such as the CHADS2 score. These all rely on patient characteristics (eg age, presence of diabetes) rather than chemical changes. We postulated that there would be a direct relationship between clinically based risk scores and ADMA/SDMA concentrations.

(2) More ambitiously, we postulated that ADMA and SDMA concentrations would represent INDEPENDENT risk markers for major adverse effects in atrial fibrillation patients on anticoagulant treatment, namely stroke, major bleeding and risk of mortality. 

ADMA/SDMA concentrations were determined in Adelaide, Australia, while statistical analyses were performed in Uppsala, Sweden.

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Parents’ Religiosity May Influence Suicidal Risk in Children

MedicalResearch.com Interview with:

Priya Wickramaratne PhD Associate Professor of Clinical Biostatistics (in Psychiatry) Department of Psychiatry, College of Physicians and Surgeons Columbia University New York State Psychiatric Institute New York

Dr. Wickramaratne

Priya Wickramaratne PhD
Associate Professor of Clinical
Biostatistics (in Psychiatry)
Department of Psychiatry, College of Physicians and Surgeons
Columbia University
New York State Psychiatric Institute
New York

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

Response: Approximately 12% of adolescents in the United States report having thoughts about attempting suicide. Moreover, suicide is a primary cause of death among females 15 to 19 years of age. Religious and spiritual beliefs have received little attention in previous research examining risk and protective factors of child and adolescent suicide. This study used data from a three-generation study of 214 children and adolescents from 112 nuclear families whose parents were at high or low risk for major depressive disorder to study the association of children and parent’s religious beliefs with risk of suicidal behavior in the children.

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Why Do So Few Women Enter or Complete Surgical Residency?

MedicalResearch.com Interview with:

Erika L. Rangel, MD,MS Instructor, Harvard Medical School Trauma, Burn and Surgical Critical Care Department of Surgery, Center for Surgery and Public Health  Brigham and Women’s Hospital  Harvard T. H. Chan School of Public Health Boston, Massachusetts

Dr. Rangel

Erika L. Rangel, MD,MS
Instructor, Harvard Medical School
Trauma, Burn and Surgical Critical Care
Department of Surgery, Center for Surgery and Public Health
Brigham and Women’s Hospital
Harvard T. H. Chan School of Public Health
Boston, Massachusetts

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

Response: Although women make up half of medical student graduates in 2018, they only comprise a third of applicants to general surgery. Studies suggest that lifestyle concerns and perceptions of conflict between career and family obligations dissuade students from the field.

After entering surgical residencies, women residents have higher rates of attrition (25% vs 15%) and cite uncontrollable lifestyle as a predominant factor in leaving the field. Surgeons face reproductive challenges including stigma against pregnancy during training, higher rates of infertility, need for assisted reproduction, and increased rates of pregnancy complications. However, until recently, studies capturing the viewpoints of women who begin families during training have been limited. Single-institution experiences have described mixed experiences surrounding maternity leave duration, call responsibilities, attitudes of coworkers and faculty, and the presence of postpartum support.

Earlier this year, our group presented findings of the first national study of perspectives of surgical residents who had undergone pregnancy during training. A 2017 survey was distributed to women surgical residents and surgeons through the Association of Program Directors in Surgery, the Association of Women Surgeons and through social media via twitter and Facebook. Responses were solicited from those who had at least one pregnancy during their surgical training.

39% of respondents had seriously considered leaving surgical residency, and 30% reported they would discourage a female medical student from a surgical career, specifically because of the difficulties of balancing pregnancy and motherhood with training (JAMA Surg 2018; July 1; 153(7):644-652).

These findings suggested the challenges surrounding pregnancy and childrearing during training may have a significant impact on the decision to pursue or maintain a career in surgery. The current study provides an in-depth analysis of cultural and structural factors within residency programs that influence professional dissatisfaction.

We found that women who faced stigma related to their pregnancies, who had no formal maternity leave at their programs, and who altered subspecialty training plans due to perceived challenges balancing motherhood with the originally chosen subspecialty were most likely to be unhappy with their career or residency. Continue reading

Altered Bile Acid Metabolites in Mild Cognitive Impairment and Alzheimer’s Disease

MedicalResearch.com Interview with:

Kwangsik Nho, PhD Assistant Professor of Radiology & Imaging Sciences Indiana University School of Medicine Indianapolis, IN, 

Dr. Kwangsik Nho

Kwangsik Nho, PhD
Assistant Professor of Radiology & Imaging Sciences
Indiana University School of Medicine
Indianapolis, IN

MedicalResearch.com: What is the ADNI (Alzheimer’s Disease Neuroimaging Initiative)?

Response: The initial phase (ADNI-1) was launched in 2003 to test whether serial magnetic resonance imaging (MRI), position emission tomography (PET), other biological markers, and clinical and neuropsychological assessment could be combined to measure the progression of mild cognitive impairment (MCI) and early Alzheimer’s Disease (AD). ADNI-1 was extended to subsequent phases (ADNI-GO, ADNI-2, and ADNI-3) for follow-up for existing participants and additional new enrollments. To our knowledge, the ADNI cohort (370 cognitively normal older adults, 98 patients with significant memory concern, 284 early MCI, 505 late MCI, and 305 patients with AD) uniquely has multi-omics data sets including metabolomics and structural and functional neuroimaging data (MRI, PET) as well as rich clinical and fluid biomarker data on the same participants.

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 Four Brain-Guided Dimensions of Psychopathology: Mood, Psychosis, Fear, and Disruptive Behavior

MedicalResearch.com Interview with:
MedicalResearch.com Interview with: Dr. Theodore Satterthwaite MD Assistant professor in the department of Psychiatry, and Cedric Xia, a MD-PhD candidate Perelman School of Medicine at the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike other branches of modern medicine, psychiatry still solely replies on patient reports and physician observations for clinical decision-making. Without biologically-based tests, the diagnostic categories for mental health do not carve nature at its joint. This is evident in the high levels of co-morbidity across disorders and heterogeneity within disorders. Through this research, we studied a large sample of adolescents who completed MRI-based functional imaging, and used recently-developed machine learning techniques to uncover specific abnormalities that are highly predictive of a wide variety of psychiatric symptoms. Essentially, we tried to find brain patterns that were predictive of different types of psychiatric symptoms. We discovered four such brain-guided dimensions of psychopathology: mood, psychosis, fear, and disruptive behavior. While each of these dimensions exhibits a unique pattern of brain connectivity, a common feature of brain anomaly is shared across the dimensions. Notably, in all linked dimensions, the default mode network and fronto-parietal network, two brain regions that usually become increasingly distinct as the brain matures, were abnormally connected. This loss of normal brain network segregation supports the hypothesis that many psychiatric illnesses may be disorders of brain development. MedicalResearch.com: What should readers take away from your report? Response: This study shows that we can start to use the brain to guide our understanding of psychiatric disorders in a way that’s fundamentally different than grouping symptoms into clinical diagnostic categories. By moving away from clinical labels developed decades ago, we can begin to let the biology speak for itself. Our ultimate hope is that understanding the biology of mental illnesses will allow us to develop better treatments for our patients. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: This study demonstrates the importance of incorporating vast amounts of biological data to study mental illness across clinical diagnostic boundaries. Moving forward, we hope to integrate genomic data in order to describe pathways from genes to brain to symptoms, which could ultimately be the basis for novel treatments for mental illness. MedicalResearch.com: Is there anything else you would like to add? Response: Future breakthroughs in brain science to understand mental illness requires large amount of data. While the current study takes advantage of one of the largest samples of youth, the size (n=999) remains dwarfed by the complexity of the brain. The neuroscience community is actively working towards collecting higher quality data in even larger samples, so we can validate and build upon the findings. Citation: Cedric Huchuan Xia, Zongming Ma, Rastko Ciric, Shi Gu, Richard F. Betzel, Antonia N. Kaczkurkin, Monica E. Calkins, Philip A. Cook, Angel García de la Garza, Simon N. Vandekar, Zaixu Cui, Tyler M. Moore, David R. Roalf, Kosha Ruparel, Daniel H. Wolf, Christos Davatzikos, Ruben C. Gur, Raquel E. Gur, Russell T. Shinohara, Danielle S. Bassett, Theodore D. Satterthwaite. Linked dimensions of psychopathology and connectivity in functional brain networks. Nature Communications, 2018; 9 (1) DOI: 10.1038/s41467-018-05317-y  <span class="last-modified-timestamp">Aug 8, 2018 @ 1:10 am</span> The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.
Dr. Theodore Satterthwaite MD
Assistant professor in the department of Psychiatry, and
Cedric Xia, a MD-PhD candidate
Perelman School of Medicine at the University of Pennsylvania

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

Response: Unlike other branches of modern medicine, psychiatry still solely replies on patient reports and physician observations for clinical decision-making. Without biologically-based tests, the diagnostic categories for mental health do not carve nature at its joint. This is evident in the high levels of co-morbidity across disorders and heterogeneity within disorders.

Through this research, we studied a large sample of adolescents who completed MRI-based functional imaging, and used recently-developed machine learning techniques to uncover specific abnormalities that are highly predictive of a wide variety of psychiatric symptoms. Essentially, we tried to find brain patterns that were predictive of different types of psychiatric symptoms. We discovered four such brain-guided dimensions of psychopathology: mood, psychosis, fear, and disruptive behavior.

While each of these dimensions exhibits a unique pattern of brain connectivity, a common feature of brain anomaly is shared across the dimensions. Notably, in all linked dimensions, the default mode network and fronto-parietal network, two brain regions that usually become increasingly distinct as the brain matures, were abnormally connected. This loss of normal brain network segregation supports the hypothesis that many psychiatric illnesses may be disorders of brain development. Continue reading

Behavioral Intervention for Underserved Preschool-Age Children on Change in BMI

MedicalResearch.com Interview with:

Shari Barkin, MD, MSHS William K. Warren Foundation Endowed Chair Professor of Pediatrics Division Chief of Academic General Pediatrics Director of Pediatric Obesity Research Vanderbilt University Medical Center

Dr. Barkin

Shari Barkin, MD, MSHS
William K. Warren Foundation Endowed Chair
Professor of Pediatrics
Division Chief of Academic General Pediatrics
Director of Pediatric Obesity Research
Vanderbilt University Medical Center

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

Response: Obesity often begins in childhood and disproportionately affects some populations, including underserved children. Given the challenges associated with achieving effective obesity treatment, the focus needs to be on prevention and needs to start early. Barkin et al conducted the longest behavioral intervention obesity prevention trial with 610 underserved parent-preschool child pairs, testing a three-year pragmatic approach that focused on families based in the communities in which they lived, and partnering with both Metro Parks and Recreation and the Nashville Public Library Foundation. Eligible children were high normal weight or overweight but not obese and lived in neighborhoods with access to neighborhood built environments that included parks and recreation and library branches.  Continue reading

Leg cycling and electrical muscle stimulation for the critically ill? Still many peaks to climb up

MedicalResearch.com Interview with:
“cycling” by Urs Steiner is licensed under CC BY 2.0Guillaume Fossat, Physiotherapist and
Thierry Boulain, M.D.
Médecine Intensive Réanimation
Centre Hospitalier Régional
Orléans, France

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

Response: Critically ill patients may suffer terrific muscle wasting during their intensive care unit stay. In most patients, particularly those with sepsis or other high inflammatory states, this is due to proteolytic pathways runaway that may persist as long as the cause of inflammation has not been eliminated. What is more, forced rest, as the one imposed to severely ill patients who need sedation to tolerate artificial respiratory support also induces muscle deconditioning and mass loss. In short, the more you are severely and acutely ill, the more you breakdown your muscle proteins and use the catabolic byproducts to fuel the rest of your organism. As a result of this sort of autophagy, intensive care unit survivors may have lost tens of muscle mass kilograms at discharge, to the point that they have lost all or parts of their functional autonomy. The personal and social burden is considerable as muscle weakness may persist several years after hospital discharge.

In the 2000’s, physiotherapy and early rehabilitation during intensive care have emerged as a way to counteract the autophagic muscle wasting and help patients to speed up their return to functional autonomy. Therefore, a standardized early rehabilitation that consists in early muscle exercises, systematic lowering or interruption of sedative drugs dosages to allow prompt patient’s awaking, early transfer to chair and early first walk try, has become the standard of care. However, to what extent, when and how muscles should be exercised during the intensive care unit stay in order to optimize the positive effects of rehabilitation remains a nearly blank clinical research area.

In-bed leg cycling and electrical muscle stimulation, each for their part, have shown encouraging results. In our study, we sought to know if the very early combination of both could improve global muscle strength in survivors at intensive care unit discharge.

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Experimental Injection Reduces Cocaine Craving

MedicalResearch.com Interview with:

Ana-Clara Bobadilla, Ph.D. Postdoctoral scholar in the laboratory of Peter Kalivas, Ph.D MUSC  Photo by Sarah Pack Medical University of South Carolina

Dr. Ana-Clara Bobadilla (Sarah Pack, photographer)

Ana-Clara Bobadilla, Ph.D.
Postdoctoral scholar
in the laboratory of Peter Kalivas, Ph.D
MUSC 

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

Response: The Brain-derived neurotrophic factor (BDNF) is a growth factor that has well-described effects in the survival, growth and differentiation of neurons during development of the central nervous system, but it also maintains a role during adulthood in learning, memory and various disorders such as addiction. Several clinical studies show increased BDNF levels in the serum of cocaine- or alcohol-dependent patients compared to controls (D’Sa et al., 2011; D’Sa et al., 2012). In preclinical research, a wealth of studies shows that chronic exposure to drugs of abuse impacts BDNF expression in different parts of the brain, including the main regions comprised in the reward circuitry, the cortex and the nucleus accumbens (for a comprehensive review, see Li & Wolf, 2015). Conversely, altering BDNF expression or transmission has profound effects on the response of the brain to drugs (see McGinty et al., 2010). Importantly, BDNF effects are often region-specific, meaning that an increase in BDNF expression in one region can decrease the effects of drug exposure in the brain while the same increase in another region can have opposite effects (Li et al., 2013). Because BDNF transmission can modify the expression of a wide range of genes leading to long-term modifications, numerous studies administer BDNF early in the drug exposure protocol and focus on the long-term changes induced by the growth factor.

In this study, we microinjected BDNF directly in the nucleus accumbens minutes before measuring cocaine craving in a well-known rodent model of relapse. We found that BDNF induces a robust decrease in craving that lasts for at least 3 days post-treatment. The inhibitory effect of BDNF is not seen when animals are tested for sucrose, a very strong reward for rats, suggesting that this effect is specific to cocaine.

Moreover, cocaine craving is only decreased when BDNF is microinjected before the craving test, but has no effect when injected a day before the craving test or in the home cage, indicating a time-specificity in addition to the region-specificity previously described.  Continue reading

Following Maria in Puerto Rico Over 1100 Deaths

MedicalResearch.com Interview with:

Dr. Alexis R. Santos-Lozada

Dr. Santos-Lozada

Dr. Alexis R. Santos-Lozada
Director, Graduate Program in Applied Demography
Assistant Teaching Professor, Department of Sociology and Criminology
Research Affiliate, Population Research Institute
College of Liberal Arts
Penn State University

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

Response: Dr. Howard and I have been working on the topic of deaths attributable to Hurricane Maria since November, and provided rapid-response estimates by the end of November about the humanitarian crisis experienced by Puerto Ricans following the Hurricane.

Our main findings are that there are approximately 1,139 deaths in excess of historical patterns between September, October and November in Puerto Rico.

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LUCEMYRA (Lofexidine) Now Available to Reduce Opioid Withdrawal Symptoms

MedicalResearch.com Interview with:

Mark Pirner, MD, PhD Senior Medical Director Clinical Research and Medical Affairs US WorldMeds

Dr. Mark Pirner

Mark Pirner, MD, PhD
Senior Medical Director
Clinical Research and Medical Affairs
US WorldMeds

MedicalResearch.com: What is the background for this announcement? How does lofexidine differ from other opioid withdrawal medications?

Response: LUCEMYRA™ (lofexidine) was FDA-approved on May 16 as the first and only non-opioid, non-addictive medication for the management of opioid withdrawal in adults.
LUCEMYRA mitigates the acute and painful symptoms of opioid withdrawal by suppressing the neurochemical surge in the brain that occurs when opioids are abruptly discontinued.

In clinical studies, patients receiving treatment with LUCEMYRA experienced greater symptom relief and were significantly more likely to complete their withdrawal. LUCEMYRA is not an opioid drug and is not a treatment for opioid use disorder; it should be used as part of a longer-term treatment plan.

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Testosterone May Be Link Between PCOS and Autism

MedicalResearch.com Interview with:

Adriana Cherskov Autism Research Centre Department of Psychiatry University of Cambridge Cambridge

Ms. Cherskov

Adriana Cherskov
Autism Research Centre
Department of Psychiatry
University of Cambridge
Cambridge

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

Response: Autism is a condition that affects social interaction, communication, and may be accompanied by unusually narrow interests or difficulties adjusting to unexpected change. Signs of autism are usually present in childhood and the condition affects about 1-2% of the population. At the Autism Research Centre at the University of Cambridge, our research team is interested in understanding some of the environmental triggers of autism. Previously, our research group has shown that autistic children have elevated levels of “sex steroid” hormones (including testosterone) before they are born.

Polycystic ovary syndrome (PCOS) is a relatively common condition, affecting about one in ten women, which is primarily characterized by increased levels of the sex-steroid hormone testosterone and its precursors. These mothers may also have higher testosterone levels than usual during pregnancy, which may exposure their unborn baby to more of this hormone. Additionally, they may have genetic factors increasing sex steroid hormones that can be passed down to their children. Our research team sought to examine whether women with PCOS therefore may have an increased chance of having a child with autism.

We used anonymized health records from a large database of GP records in the UK and included 8,588 women with PCOS and their first-born children in the study as well as 41,127 women without PCOS as controls. We found that after adjusting for factors such as maternal mental health conditions or metabolic conditions, women with PCOS had a 2.3% change of having an autistic child, compared with 1.7% change for mothers without PCOS. We would like to stress, however, that the increased risk for women with PCOS is still very small, and the likelihood of having an autistic child is still very low.

As part of this research, we have also conducted two other studies, where we found that women with PCOS themselves were twice as likely to have autism and that women with autism were also twice as likely to have PCOS. These findings suggest a common pathway between autism and PCOS which will be important to explore in future research.

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

Response: As mentioned earlier, our findings indicate women with PCOS have an increased chance of having a child with autism, but this increase is still very small, and the chance of having a child with autism is still very low even in this population (2.3% compared with 1.7%). As a result, the main take-away from our research is that we have found further evidence for the role of prenatal testosterone as one of many players in the development of autism and a potentially common pathway between autism and PCOS.

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

Response: This link will help us in the future to understand the cause of both conditions. In this study we were not able to measure testosterone or sex steroid levels in women or their children, and this will be an important step in determining whether it is the sex-steroid hormones themselves, another downstream factor (such as insulin levels which are affected in PCOS), or genetics at the root of this association. Ultimately, both autism and PCOS are very complex conditions with many causative factors. The association we find here is likely just one of these players for both conditions, but it paves the path for future research.

In the future, this research may also help doctors and patients make decisions about treatment, as women with autism at high risk of developing PCOS may be able to start treatment or lifestyle changes early, which can improve PCOS management and quality of life. Alternatively, we underline again that the small increased likelihood of women with PCOS having a child with autism should not cause additional stress or worry in this population, since there are many factors involved in developing autism which will require further research to understand fully. 

Citation: Adriana Cherskov, Alexa Pohl, Carrie Allison, Heping Zhang, Rupert A. Payne, Simon Baron-Cohen. Polycystic ovary syndrome and autism: A test of the prenatal sex steroid theory. Translational Psychiatry, 2018; 8 (1) DOI: 10.1038/s41398-018-0186-7

Aug 5, 2018 @ 10:24 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Decreased Cost-Sharing Increased Patient Adherence

MedicalResearch.com Interview with:

A. Mark Fendrick, M.D. Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy Director, University of Michigan Center for Value-Based Insurance Design Ann Arbor, Michigan 48109-2800

Dr. Fendrick

A. Mark Fendrick, M.D.
Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy
Director, University of Michigan Center for Value-Based Insurance Design
Ann Arbor, Michigan 48109-2800

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

Response: As Americans are being asked to pay more for the medical care, in terms of copayments and deductibles, one in four Americans reports having difficulty paying for their prescription drugs. One potential solution is “value-based insurance design,” or V-BID. V-BID, is built on the principle of lowering or removing financial barriers to essential, high-value clinical services. V-BID plans align patients’ out-of-pocket costs, such as copayments and deductibles, with the value of services to the patient. They are designed with the tenet of “clinical nuance” in mind— in that the clinical benefit derived from a specific service depends on the consumer using it, as well as when, where, and by whom the service is provided.

According to a literature review published in the July 2018 issue of Health Affairs,  The researchers found that value-based insurance design programs which reduced consumer cost-sharing for clinically indicated medications resulted in increased adherence at no change in total spending. In other words, decreasing consumer cost-sharing meant better medication adherence for the same total cost to the insurer. Continue reading

HPV Status Influences Survival in Esophageal Cancer

MedicalResearch.com Interview with:

Barrett's Esophagus -wikipedia

Barrett’s Esophagus -wikipedia

Shan Rajendra MBBCh, MSc , MD, FRCP, FRACP
Professor of Medicine
University of New South Wales
Director of Medicine & Clinical Executive Director
Bankstown-Lidcombe Hospital
Director Gastro-Intestinal Viral Oncology Group
Ingham Institute for Applied Medical Research
Sydney 

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

Response: High-risk human papillomavirus(HPV)  infection has been strongly associated with a subset of Barrett’s dysplasia and oesophageal adenocarcinoma.

The research question was; Does HPV status of Barrett’s high-grade dysplasia and esophageal adenocarcinoma influence survival as in viral positive head and neck cancers?

We therefore sought to determine the prognostic significance of esophageal tumor HPV status and associated viral transcriptional markers (E6/E7 mRNA and p16INK4A) and TP53.

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Forgetting To Do Things? Try Acting in Advance

MedicalResearch.com Interview with:

Dr Antonina Pereira - CPsychol, PhD, FHEA, AFBPsS Head of Department of Psychology & Counselling University of Chichester Chichester, West Sussex UK

Dr. Pereira

Dr Antonina Pereira – CPsychol, PhD, FHEA, AFBPsS
Head of Department of Psychology & Counselling
University of Chichester
Chichester, West Sussex UK

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

Response: Prospective memory (PM) is the ability to remember to perform future activities, such as remembering to take medication or remembering to attend an appointment. Prospective memory tasks pervade our daily lives, and PM failures, although sometimes merely annoying (e.g., forgetting an umbrella at home on a rainy day), can have serious and even life-threatening consequences (e.g., forgetting to turn off the stove).

The fulfilment of such delayed intended actions can indeed be an early indicator of Alzheimer’s disease, with prospective memory failures representing one of the most prominent memory concerns in older adulthood and a fundamental requirement for independent living across the lifespan.

We aimed to address this issue by exploring the potential benefits of a purposefully designed technique, encoded enactment, where participants were encouraged to act through the activity they must remember to do.

This particular study was the fruit of an international research collaboration led by the University of Chichester and including members from Radboud University Nijmegen, Sussex Partnership NHS Foundation Trust and the Faculty of Medicine of the University of Lisbon.

Our team has explored the potential benefits of this specific encoding strategy for healthy younger adults, healthy older adults as well as for patients with mild cognitive impairment.

Results were very encouraging: All age groups reported improvement in prospective memory, but this was particularly evident in older patients with mild cognitive impairment, that is, potentially in the early stages of Alzheimer’s disease.

The study suggests that encouraging people in this category to adopt enactment as a means to enhance prospective memory could result in them leading independent, autonomous lives for longer.

Continue reading

Type of Oral Contraceptive Can Influence Effect of Medications on EKG Change

MedicalResearch.com Interview with:

Joe-Elie SALEM, MD-PhD Chef de Clinique Assistant, Médecin délégué du Centre d'Investigation Clinique Paris-Est Institut CardioMétabolisme et Nutrition INSERM

Dr. Salem

Joe-Elie SALEM, MD-PhD
Chef de Clinique Assistant, Médecin délégué du Centre d’Investigation Clinique
Paris-Est
Institut CardioMétabolisme et Nutrition
INSERM

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

Response: The drug-induced long QT syndrome (diLQTS) is a problem for clinicians balancing risk and benefits across multiple therapeutic areas, and for pharmaceutical scientists and regulators evaluating new drug candidates. The prevalent view is that block of a specific ion current, the rapid component of the cardiac delayed rectifier (IKr), is the common mechanism predisposing to diLQTS across drug classes and that patients with mutations in ion channel genes are at especially increased risk. In the very extreme form of diLQTS, a specific form of ventricular arrhythmia potentially lethal, called Torsade de Pointes, can occur. All IKr blocking drugs do not confer the same Torsade de Pointes risk; the risk with antiarrhythmics such as sotalol or dofetilide can be 1-2%, while the risk with IKr-blocking antibiotics such as moxifloxacin is much lower, <1/20,000.

Women are at higher risk of diLQTS than men. Androgens are protective. Influence of hormonal contraception on diTdP and QT prolongation is controversial

MedicalResearch.com: Were you surprised by the study findings, why or why not? 

Response: We were not really surprised because the influence of testosterone (the main androgenic hormone) to shorten the duration of cardiac repolarization was already known. We wanted to see if this effect was also present with contraceptive pills with various androgenic-like activities.

MedicalResearch.com: Can you explain what exactly is “sotalol-induced QTc prolongation”? 

Response: After each heartbeat, the heart recovers to normal. This phenomenon is called ventricular repolarization and can be assessed on the electrocardiogram by measuring the duration of a parameter called QT interval. This QT interval is influenced by many factors one of them being heart rate. QT interval is therefore corrected for the heart rate observed at the time of its measurement (QTc). Sotalol is one of several drugs given to prolong ventricular repolarization, and hence QTc, as a mean to prevent the recurrence of some disturbances of heart beats. These disturbances are called arrhythmias. However, drugs which prolong QTc can also provoke a very rare arrhythmia which can cause cardiac arrest or the heart to stops. Only rare susceptible patients are at risk of having this drug-induced arrhythmia and most patients who receive sotalol and have prolonged QTc are doing well. 

MedicalResearch.com: What were the drug-induced alterations in “ventricular repolarization” seen among the women? 

Response: The alterations of ventricular repolarization were those expected with sotalol: prolongation of QTc interval and changes is the morphology of the T-wave which is part of the QT interval. What we found is that the extent of QTc prolongation and T-wave morphological changes caused by sotalol was greater in women who were receiving the anti-androgenic contraceptive pill drospirenone compared with levonorgestrel. This is in line with the known effect of androgens to shorten ventricular repolarization in men but it was not known to be influenced by the progestin androgenic activity of oral contraceptives in women. 

MedicalResearch.com: What new information does this study provide to the scientific literature on oral contraceptives? 

Response: We did not show that oral contraceptives influence ventricular repolarization. This was not the purpose of the study. Our study, with its limitations, suggests that the type of oral contraceptive can influence the effects of drugs such as sotalol which prolong QTc. Drospirenone, an oral contraceptive with antiandrogenic properties, was associated with greater drug-induced QTc prolongation than levonorgestrel, an oral contraceptive with androgenic activity. Whether this is associated with a greater risk of provoking arrhythmias with antiandrogenic pills is not proven although there are indirect indications from an analysis of the European pharmacovigilance database, that this might be the case. Additional studies need to be performed to better assess this risk.

MedicalResearch.com: What were some limitations of the study? 

Response: The type of oral contraceptive taken by women participating in the study was prescribed by their physician and women receiving different oral contraceptives may have differed in their response to sotalol for other reasons. In other words, oral contraceptives were not administered by chance to the women (the study was not randomized but observational) and this is not the most robust method to examine the influence drugs in general. Also, the level of the natural sex hormones in the blood of the study participants was not measured and it may have influenced QTc interval  

MedicalResearch.com: Why is this study important? 

Response: In spite of its limitations, our study prompts for a more thorough assessment of the influence of progestin androgenic activity of oral contraceptives on drug-induced QTc interval prolongation and the risk of associated arrhythmias. It also emphasizes the importance of androgens as a factor limiting the risk of QTc prolongation in patients receiving drugs which prolong ventricular repolarization.

Citation: 

Salem J, Dureau P, Bachelot A, et al. Association of Oral Contraceptives With Drug-Induced QT Interval Prolongation in Healthy Nonmenopausal Women. JAMA Cardiol. Published online August 01, 2018. doi:10.1001/jamacardio.2018.2251

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

More Evidence UV Filters in Sunscreens Affect Marine Life

MedicalResearch.com Interview with:
sunscreen creative commonsAdela J. Li, PhD

Research Affiliate
Wadsworth Center, Rm. D597
New York State Dept. of Health
Empire State Plaza
Albany, NY, 12201-0509
On the behalf of Dr. Kelvin Leung 

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

Response: Most people love the beach. In order to block the sun’s damaging UV radiation, people generally slather on a thick layer of sunscreen against sunburn and skin cancer. Sunscreen is suggested to be re-applied every few hours regarding its effectiveness as well as being washed off into the water. These UV filters have been detected in the environment but most studies concluded that individual sunscreen chemicals pose no/low risk to animals or human. However, UV filters constitute a heterogeneous group of chemicals in sunscreens. We are wondering if combination of UV filters would induce higher toxicity than individual compounds, and whether these chemical interactions would develop over time, becoming increasingly dangerous to the living systems.

Our study found seven of the nine UV filters in Shenzhen waters, China — a rapidly urbanized city with over 20 popular recreational beaches, surprisingly, a reservoir and tap water. After exposing artemia to three dominant UV filters and then feeding these artemia to zebrafish adults, concentrations in both were up to 4 times higher when exposed to the mixtures than when exposed to only a single UV filter. A short-term of 25-day dietary exposure to the zebrafish adults did not appear to significantly influence early life stage development of the second generation; however, relatively long exposure over 47 days had significant adverse effects on embryo development. Continue reading

Alarming Increase in Violent and Unintentional Injuries Since 2014

MedicalResearch.com Interview with:

Dr. Angela Sauaia, MD, PhD Professor of Public Health and Surgery University of Colorado Denver Statistical Editor, Journal of Trauma and Acute Care Surgery Statistical Consultant, Department of Surgery Denver Health Medical Cente

Dr. Sauaia

Dr. Angela Sauaia, MD, PhD
Professor of Public Health and Surgery
University of Colorado Denver
Statistical Editor, Journal of Trauma and Acute Care Surgery
Statistical Consultant, Department of Surgery
Denver Health Medical Center 

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

Response: As injury researchers we monitor national trends in injury.

The CDC WISQARS (Web-based Injury Statistics Query and Reporting System) is one of the few available open sources of injury data we can use. During the 1980’s and 1990’s, we saw much improvement in deaths due to most injury mechanisms, such as car accidents fatalities. Our study shows, however, that recent trends seem to be eroding these promising survival gains.

Both violent and unintentional injuries alike seem to be increasing, especially since 2014. We are unclear about the causes of this recent increase in trauma-related deaths, but it is an alarming trend.

Continue reading

When It Comes to LDL-C, “You Really Can’t Be Too Low”

MedicalResearch.com Interview with:

Marc S. Sabatine, MD, MPH  Chairman | TIMI Study Group  Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine Brigham and Women's Hospital  Professor of Medicine | Harvard Medical School

Dr. Marc Sabatine

Marc S. Sabatine, MD, MPH
Chairman | TIMI Study Group
Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine
Brigham and Women’s Hospital
Professor of Medicine | Harvard Medical School

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

Response: Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for cardiovascular disease.

The initial statin trials studied patients with high levels of LDL-C, and showed a benefit by lowering LDL-C.

We and others did studies in patients with so-called “average” levels of LDL-C (120-130 mg/dL), and also showed clinical benefit with lowering.

Continue reading

Genes From Dad Influence How Mom Cares for Babies

MedicalResearch.com Interview with:
“Family” by IsaacVakeroKonor is licensed under CC BY 3.0Professor Rosalind John
Head of Biomedicine Division, Professor
School of Biosciences
Cardiff University
Cardiff UK

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

Response: I have been studying a really remarkable family of genes called “imprinted genes” for the last 20 years. For most genes, we inherit two working copies — one from our mother and one from our father. But with imprinted genes, we inherit only one working copy – the other copy is switched off by epigenetic marks in one parent’s germline. This is really odd because we are all taught at school that two copies of a gene are important to protect us against mutations, and much safer than only one copy. So why turn off one copy?

Maternal care boosted by paternal imprinting in mammals

Maternal care boosted by paternal imprinting in mammals

When my research group were studying these genes in mice, we found out that one of them, called Phlda2, plays an important role in the placenta regulating the production of placental hormones. Placental hormones are critically important in pregnancy as they induce adaptations in the mother required for healthy fetal growth. There was also some indirect evidence that placental hormones play a role in inducing maternal instinct. Women are not born with a maternal instinct –  this behaviour develops during pregnancy to prepare the mother-to-be for the new and demanding role of caring for her baby. This led to my idea that this gene expressed in the offspring’s placenta could influence maternal behaviour, which was entirely novel. 

Until now direct experimental evidence to support the theory that placental hormones trigger this “motherly love” by acting directly on the brain of the mother has been lacking. To test the theory that our imprinted gene could influence the mother’s behaviour by regulating placental hormones, we generated pregnant mice by IVF carrying embryos with different copies of Phlda2. We used IVF to keep all the mothers genetically identical. This resulted in genetically identical pregnant female mice exposed to different amounts of placental hormones – either low, normal or high.

We found that female mice exposed in pregnancy to low amounts of placental hormones were much more focused on nest building (housekeeping) and spent less time looking after their pups or themselves than normal mice. In contrast, female mice exposed to high placental hormones neglected their nests and spent more time looking after their pups and more time self-grooming. We also found changes in the mother’s brain before the pups were born so we know that the change in priorities started before birth. 

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

Response: This study is important because it shows, for the first time, that genes from the dad expressed in the placenta influence the quality of care mothers gives to their offspring. Perhaps more significantly, this study highlights the importance of a fully functional placenta for high quality maternal care.

We have shown in a mouse model that genes in the placenta and placental hormones are important for priming maternal nurturing in an animal model. Human placenta have the same imprinted genes and also manufactures placental hormones. It is possible that problems with the placenta could misprogram maternal nurturing in a human pregnancy and these mothers may not bond well with their newborn. It is also possible that problems with the placenta could contribute to depression in mothers. We are all familiar with postnatal depression but many more mothers experience depression in pregnancy with 1 in 7 mothers reporting clinically significant symptoms. 

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

Response: After we found out that Phlda2 could influence maternal behaviour in mice, we asked whether there were changes in this gene in human placenta from pregnancies where women were either diagnosed with clinical depression or self reported depression in pregnancy. Phlda2 seems to be OK but we found another gene that belongs to the same imprinted gene family called PEG3 that is expressed at lower than normal levels in women with depression. Strangely, this seems to only be in placenta from boys. 

MedicalResearch.com: Is there anything else you would like to add?

Response: To explore this further, we have just started our own human cohort study called “Grown in Wales” at Cardiff University focused on prenatal depression. We are now looking at placental hormones in the mother’s blood and gene expression in the placenta to test the idea that the genes we are studying in mice are misregulated in the placenta of pregnancies where the mothers suffer with depression. This work is now funded by the Medical Research Council.

Citation: 

Maternal care boosted by paternal imprinting in mammals

D. J. Creeth, G. I. McNamara,, S. J. Tunster, R. Boque-Sastre,, B. Allen,, L. Sumption, J. B. Eddy,A. R. Isles, R. M. John PLOS
Published: July 31, 2018

Aug 2, 2018 @ 11:48 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

HIV: Hopeful Results of Doravirine vs Ritonavir-Boosted Darunavir at 96 Weeks

MedicalResearch.com Interview with:
merck

Kathleen Squires MD
Director, Division of Infectious Diseases
Jefferson University Hospitals and
Ming-Tai Lai, PhD
Senior Principal Scientist, Biology Discover
Merck

 

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

Dr. Squires: The DRIVE-FORWARD study is a pivotal, randomized, double-blind, Phase 3 study that evaluated the safety and efficacy of doravirine (DOR), a non-nucleoside reverse transcriptase inhibitor (NNRTI) in treatment-naïve adults with HIV-1 infection. Data from week 48 of this trial have previously been presented demonstrating that doravirine met its primary endpoint of non-inferior efficacy compared to ritonavir-boosted darunavir (DRV+r). In addition, at 48 weeks, a secondary endpoint showed that the doravirine-treated group had statistically significant lower levels of fasting LDL-C and non-HDL-C versus the DRV+r group.

The data presented at AIDS 2018 are week 96 data from the DRIVE-FORWARD trial.
At week 96, the doravirine group demonstrated efficacy of 73.1% compared with 66.0% in the DRV+r group, a treatment difference of 7.1% (95% CI: 0.5, 13.7)  Two participants in the DOR treatment group developed genotypic and phenotypic resistance to DOR through 96 weeks of treatment. The rate of discontinuation of therapy due to adverse events was 1.6 percent in the DOR group and 3.4 percent in the DRV+r group.

Doravirine is a late-stage investigational NNRTI for the treatment of HIV-1 infection in treatment-naïve adults and is being evaluated both as a once-daily single-entity tablet in combination with other antiretroviral agents, and as a once-daily fixed-dose combination regimen with lamivudine (3TC) and tenofovir disoproxil fumarate (TDF). Earlier this year, Merck announced that the FDA accepted for review two New Drug Applications (NDAs) for doravirine for the treatment of HIV-1 infection in treatment-naïve adults. The NDAs are based upon the findings at week 48 of two ongoing Phase 3 trials, DRIVE-FORWARD and DRIVE-AHEAD, evaluating the efficacy and safety of doravirine and the fixed-dose combination regimen of DOR/3TC/TDF, respectively. The FDA has set a target action date of October 23, 2018 for both applications.

Dr. Lai: This study aimed to characterize the mutant viruses selected in treatment-naïve participants through week 48 from DRIVE-FORWARD and DRIVE-AHEAD, and to assess the impact of selected mutations on non-nucleoside reverse transcriptase inhibitor (NNRTI) susceptibility and viral fitness. All of the seven doravirine (DOR)-resistant mutants are either partially susceptible or susceptible to etravirine. Mutants containing the F227C substitution were shown to be hypersusceptible to some nucleoside reverse transcriptase inhibitors (NRTIs) such as azidothymidine (AZT), tenofovir (TFV), lamivudine (3TC), and MK-8591. Among the 12 participants who developed efavirenz (EFV) resistance, 9 of the EFV-resistant clinical mutants were susceptible to DOR with fold-change <2.5.

The majority of DOR-selected viruses identified in the treatment-naïve participants in clinical trials to date retain susceptibility to etravirine and hypersensitivity to some NRTIs, with low replication capacity. In addition, the majority of EFV-selected viruses retain susceptibility to DOR.  Continue reading

Minority-Based Lung Cancer Screening Found High Rates of Cancer

MedicalResearch.com Interview with:

Mary Pasquinelli, MS, APRN Doctor of Nursing Practice Candidate (2018) Lung Cancer Screening Program Director Advanced Practice Nurse, Pulmonary and Medical Oncology Department of Medicine Chicago, Il 60612

Mary Pasquinelli

Mary Pasquinelli, MS, APRN
Doctor of Nursing Practice Candidate (2018)
Lung Cancer Screening Program Director
Advanced Practice Nurse
Pulmonary and Medical Oncology
Department of Medicine
Chicago, Il 60612 

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

 Response: We performed a retrospective analysis of our lung cancer-screening program.

Our program included individuals from a predominantly minority inner city population including Federal Qualified Health Centers.

The main findings were that our screening program found a higher rate of positive screens and lung cancer in our initial screens than that compared to the National Lung Screening Trial.

Continue reading