Author Interviews, Emory, PAD, Pharmacology / 15.05.2016

MedicalResearch.com Interview with: Shipra Arya MD, SM Assistant Professor, Division of Vascular Surgery Emory University School of Medicine Assistant Professor of Epidemiology (Adjunct) Rollins School of Public Health Staff Physician, Atlanta VA Medical Center Director, AVAMC Vascular Lab and Endovascular Therapy  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Arya: Peripheral Arterial Disease is the next cardiovascular epidemic. It is poorly recognized and not adequately treated compared to heart disease – and research is lacking on the optimal use of statins for PAD patients. Very few randomized clinical trials have been done specifically in PAD patients to assess the impact of statins on cardiovascular outcomes and none on limb related outcomes. The 2013 ACC/AHA guidelines for cholesterol lowering medications recommends high intensity statins for PAD patients extrapolated from the level 2 and 3 evidence and empirically based on CAD and stroke data. In this study we looked at the amputation and mortality risk based on statin dosage in a large cohort of patients from the VA population and found that high intensity statins are associated with a significant reduction in limb loss (~30%) and mortality (~25%) in PAD patients followed by a smaller risk reduction [~23% for amputation risk reduction and 20% reduction in mortality risk] by low-moderate intensity statins as compared to no statin therapy. (more…)
Author Interviews, Heart Disease, JACC, Kidney Disease / 15.05.2016

MedicalResearch.com Interview with: Ambarish Pandey, MD Cardiology Fellow, PGY5 University of Texas Southwestern Medical Center Dallas, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pandey: Previous studies have reported an underutilization of guideline based heart failure therapies among patients with heart failure (HF) and end-stage renal diseases. However, it is not known if the proportional use of these evidence-based medical therapies and associated clinical outcomes among these patients has changed over time. In this study, we observed a significant increase in adherence to heart failure process of care measures over time among dialysis patients with no significant change in clinical outcomes over time. (more…)
Artificial Sweeteners, Author Interviews, Nutrition, Pediatrics, Weight Research / 15.05.2016

MedicalResearch.com Interview with: Meghan Azad PhD Assistant Professor, Department of Pediatrics & Child Health and Community Health Sciences University of Manitoba Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study MedicalResearch.com: What is the background for this study? Dr. Azad: It is well known that maternal nutrition plays a key role in “programming” fetal development and infant weight gain, but the impact of artificial sweetener consumption during this critical period has not been extensively studied.  Some animal research suggests that consuming artificial sweeteners during pregnancy can predispose offspring to develop obesity, but this has never been studied in humans, until now. (more…)
Author Interviews, Education, PLoS / 15.05.2016

MedicalResearch.com Interview with: Mallory Kidwell, B.A. Project Coordinator at the Center for Open Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Open and transparent sharing of research data and materials is a core value of science that facilitates critique, replication, and extension within the scientific community. However, current norms provide few incentives for researchers to share such evidence, resulting in only a small portion of articles with accessible research data and materials. Efforts to improve rates of data sharing are occurring across research disciplines. In January 2014, the journal Psychological Science adopted an intervention to encourage data and materials sharing -- badges to acknowledge open practices, developed and freely distributed by the Center for Open Science. The badges, visual icons placed on publications, certify when the authors of a research publication have followed open practices to make their data or research materials publicly accessible. In the two years prior to adopting badges, we found that only about 3% of publications at Psychological Science reported that the underlying data was publicly accessible. After 2014, the rate of publications reporting data sharing increased dramatically, reaching 39% in the first half of 2015 -- the last time period included in the study. Materials sharing also increased, but to a weaker degree and with greater variability. We also found that, with badges, authors were more likely to follow through in making the data accessible and sharing data that was correct, usable, and complete for other researchers to reuse or reanalyze. A comparison group of journals in psychology showed no change in data sharing rates over the same time period, and among the authors that did report sharing data in the other journals, the data was less likely to actually be available, correct, usable, or complete. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Pulmonary Disease / 15.05.2016

MedicalResearch.com Interview with: Michael McGeachie, PhD Instructor in Medicine Harvard Medical School Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Dr. McGeachie: In asthma, and in general but particularly in asthma, a person’s level of lung function has a big impact on his or her quality of life, level of respiratory symptoms and complications, and general morbidity. In asthma, low lung function leads to greater severity and frequency of asthma symptoms. Asthma is a common childhood illness, affecting 9-10% of children. Many children grow out of asthma as they become adults, but other asthmatics remain effected through adulthood, which can lead to a lifetime of respiratory symptoms and chronic airway obstruction, including chronic obstructive pulmonary disease (COPD). If you consider lung function longitudinally, throughout development, plateau, and decline, different people and different asthmatics tend to exhibit different patterns of lung function. Healthy, non-asthmatic people tend to have a period of rapid lung function increase in adolescence, a plateau of lung function level in their late teens and early 20s, and starting around 25 or so a slow, gradual decline of lung function that continues throughout old age. We call this Normal Growth of lung function. However, some people exhibit Reduced Growth, where they don’t reach their expected maximum lung function for a person of the same age, sex, height, and race. Others can show Early Decline, who might reach a normal maximum but then begin to decline immediately without a plateau or with a truncated plateau. We hypothesized that these patterns, Reduced Growth and Early Decline, might have different baseline indicators, precursors, outcomes, and risk of developing COPD. (more…)
Author Interviews, Prostate, Prostate Cancer, Testosterone, Urology / 14.05.2016

MedicalResearch.com Interview with: Ryan Flannigan MD FRCSC PGY 5 Urology Resident Department of Urological Sciences University of British Columbia MedicalResearch.com: What is the background for this study? Dr. Flannigan: In the aging population the incidence of both prostate cancer and testosterone deficiency (TD) increase and even overlap in many patients. However, since Huggins’ original research in 1940, we have understood that prostate cancer is largely regulated by the androgen receptor (AR). Thus, the thought of treating someone with exogenous testosterone (T) was concerning for fear of further activation of the androgen receptor, and therefore promoting prostate cancer growth. However, further research has continued to add clarity to this complex interaction between androgens and the prostate. The saturation theory describes the observation that prostate specific antigen (PSA) responds to increasing serum testosterone levels only to a value of approximately 8.7nmol/L, with no inflation of PSA beyond these T levels. This is likely not the whole story when it comes to the interaction of T and the prostate, but it does suggest the prostate may not experience changes in cellular function with serum testosterone beyond low levels. It is also understood that prostate cancer requires AR activation to grow but is not caused by AR activation. Thus, we hypothesized that among those with un-treated prostate cancer, ie. patients on active surveillance, would not experience changes in biochemical recurrence (BCR) or changes in disease progression. In addition, we hypothesized that patients with previously treated prostate cancer would not have viable prostate cancer cells and thus, PSA would not increase. (more…)
Author Interviews, Cancer Research, Colon Cancer, Genetic Research / 14.05.2016

MedicalResearch.com Interview with: Dr. Geoffrey Liu, MD MSC Princess Margaret Hospital/Ontario Cancer Institute University of Toronto Toronto, Ontario Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Liu: Cetuximab is a monoclonal antibody therapy used in metastatic colorectal cancer patients when other chemotherapy options have been exhausted. Currently, the only useful biomarker to determine whether metastatic colorectal cancer patients will benefit from the drug, cetuximab, is whether patients carry a RAS mutation in their tumours. We evaluated additional biomarkers using samples from a Phase III clinical trial led by the Canadian Cancer Trials Group and the Australasian Gastrointestinal Trials Group. Our study identified a germline, heritable biomarker, a FCGR2A polymorphism, that further identifies an additional subgroup of patients who would benefit most from receiving cetuximab. This is important because the drug does have toxicity and is expensive to use; patients who are found not to likely benefit from this drug can go on quickly to try other agents, including participation in clinical trials. (more…)
Author Interviews, Cancer Research, JNCI, Toxin Research / 14.05.2016

MedicalResearch.com Interview with: Dr. Debra Silverman Sc.D Branch Chief and Senior Investigator in the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology & Genetics National Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Silverman: We know that bladder cancer mortality rates have been elevated in northern New England for at least five decades. Incidence patterns in Maine, New Hampshire and Vermont are similar—about 20% higher than those for the United States overall. Elevated rates have been observed in both men and women, suggesting the role of a shared environmental etiologic factor. A unique feature of northern New England is that a high proportion of the population uses private wells as their primary source of drinking water. The well water may contain low-to-moderate levels of arsenic. There are two possible sources of this arsenic contamination:
  • Naturally occurring arsenic from geological sources (released from rock deep in the earth)
  • Leaching of arsenic-based pesticides used on food crops many years ago. From the 1920s through the 1960s there was extensive agricultural use of arsenic-based pesticides. These compounds were used on food crops such as blueberries, apples and potatoes. Residue from the treatments may have leached into the ground water.
Intake of water containing high levels of arsenic is an established cause of bladder cancer, largely based on studies conducted in highly exposed populations. However, emerging evidence suggests that low-to-moderate levels of exposure may also increase bladder cancer risk. To explore possible reasons for the excess incidence of bladder cancer in northern New England, we conducted a large, comprehensive population-based case-control study in Maine, New Hampshire and Vermont. We examined the role of known and suspected bladder cancer risk factors, with a focus on private well water consumption and arsenic levels in drinking water. The major cause of bladder cancer is cigarette smoking. Some occupational exposures (e.g., exposure to metalworking fluids such as that experienced by metalworkers and some types of machine operators) are also associated with elevated risk. However, smoking and occupational exposures do not appear to explain the New England bladder cancer excess. This study was funded and carried out by researchers in the NCI Division of Cancer Epidemiology and Genetics in collaboration with the Geisel School of Medicine at Dartmouth, the Departments of Health for Maine, New Hampshire, and Vermont, and the US Geological Survey. We reported that heavy consumption of drinking water from private dug wells (which are shallow—less than 50 feet deep—and susceptible to contamination from manmade sources than drilled wells), established prior to 1960 (when arsenic-based pesticides were widely used), may have contributed to the longstanding bladder cancer excess in northern New England. We saw that cumulative arsenic exposure from all water sources showed an increasing risk with increasing exposure (exposure-response relationship). Among the highest exposed participants, risk was twice that of the lowest exposure group. (Cumulative arsenic exposure is a measure of the average daily arsenic intake by number of days of arsenic exposure.) (more…)
Author Interviews, Hospital Acquired, Infections / 14.05.2016

MedicalResearch.com Interview with: Gabriele Messina, MD  Dr.PH  MSc Research Professor of Public Health University of Siena Department of Molecular and Developmental Medicine Area of Public Health. Room: 2057 Siena, Italy MedicalResearch.com: What is the background for this study? Dr. Messina:  Studies conducted in the 1970s and 1980s conferred to environmental surfaces a marginal role in the transmission of health care associated infections (HAIs). Today, it is demonstrated that several pathogens such as C. difficile, VRE (Vancomycin-resistant Enterococcus) and MRSA (Methicillin-resistant Staphylococcus aureus) can survive even for months on inanimate surfaces. Up to 40% of HAIs can be spread by the hands of doctors and hospital staff after touching infected patient and/or contaminated surfaces; furthermore, people hospitalized in rooms previously occupied by patients infected by microorganism that can persist on surfaces present an increased  risk to develop HAIs. (more…)
Author Interviews, Geriatrics, Pharmacology / 13.05.2016

MedicalResearch.com Interview with: Leigh Purvis, MPA Director of Health Services Research AARP Public Policy Institute MedicalResearch.com Editor’s Note: The May AARP Bulletin has a important article “Black Market Meds Are Flooding the Nation’s Pharmacies And Hospitals” by Joe Eaton, discussing the growing problem of counterfeit medications entering the US pharmaceutical supply chain. Ms. Leigh Purvis of the AARP Policy Institute discussed this important issue for the readers of MedicalResearch.com. Ms. Purvis’ areas of expertise include prescription drug pricing, biologic drugs, and Medicare prescription drug coverage.  MedicalResearch.com: Is pharmaceutical theft and fraud a new or growing problem? Ms. Purvis: I think it’s safe to say that pharmaceutical theft is a growing problem. Skyrocketing prices have made pharmaceuticals a lucrative target for criminals. Trucks transporting pharmaceuticals are a common target, although some thieves have stolen prescription drugs directly from manufacturers’ warehouses. Pharmaceutical fraud is also a growing concern. FDA does a great deal to ensure the safety of US pharmaceuticals. However, problems can still arise, particularly when people purchase drugs online. (more…)
Author Interviews, Technology / 13.05.2016

MedicalResearch.com Interview with: Dr. Shuhei Miyashita PhD Lecturer in Intelligent Robotics Department of Electronics University of York, Heslington York, UK MedicalResearch.com: What is the background for this device? What are some of the  obstacles you and your team face in the development? Dr. Miyashita: We are developing medical technology that is less invasive and more autonomous and thus can provide safe and consistent outcomes. The biggest challenge is how to build a capable medical robot that is clinically safe. Addressing this challenge requires finding bio-compatibe materials, safe means of transportation in the body, a way to reconfigure the robot from pill shape to unfolded shape, and precise multi-mode control for the location and function of the robot. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 13.05.2016

MedicalResearch.com Interview with: Michael Miller, MD, FACC, FAHA Professor of Cardiovascular Medicine, Epidemiology & Public Health University of Maryland School of Medicine Staff Physician, Baltimore VAMC Director, Center for Preventive Cardiology University of Maryland Medical Center Baltimore, Maryland MedicalResearch.com: What is the background for this study? Dr. Miller: It has become an article of faith that HDL (the good cholesterol) is an independent risk factor for heart disease. However, previous studies did not examine the importance of HDL after accounting for both LDL (bad cholesterol) and triglycerides (blood fats).  This is important because HDL is associated with LDL and triglycerides. We hypothesized that if HDL is truly an independent risk factor, then low HDL levels in isolation would continue to be linked to an increased risk of heart disease while high HDL levels would continue to protect the heart even if LDL and triglycerides levels were elevated. (more…)
Author Interviews, Cancer Research, Colon Cancer, Immunotherapy, Leukemia, Multiple Sclerosis, Neurology / 13.05.2016

MedicalResearch.com Interview with: PD Dr. Mathias Buttmann Senior Consultant Neurologist and Head of the Multiple Sclerosis Outpatient Clinic University of Wuerzburg Wuerzburg, Germany  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buttmann: The synthetic anthracenedione mitoxantrone is approved for disease-modifying treatment of patients with aggressive forms of relapsing or secondary progressive multiple sclerosis (MS). It has been known for years that this DNA-intercalating agent increases the risk of acute myeloid leukemia. We performed a retrospective cohort study to investigate whether mitoxantrone also increases the risk for other types of malignancies. We included all 677 mitoxantrone-treated  multiple sclerosis patients who were seen at our large German academic MS centre between 1994 and 2007 and collected follow-up information on the occurrence of malignancies, death and causes of death as of 2011. Follow-up was complete in 676 patients. The median age at mitoxantrone initiation was 41 years and the median follow-up duration was 8.7 years. We identified 37 patients with a malignancy after mitoxantrone initiation, among them 4 cases of acute myeloic leukemia and 7 cases of colorectal cancer. Compared to the general population matched for sex, age and year of occurrence, we calculated an 1.5-fold increased incidence of any type of malignancy, a tenfold increased incidence of acute myeloic leukemia and a threefold increased incidence of colorectal cancer, while the incidence of other types of malignancies was not increased. Higher age at mitoxantrone initiation but neither higher cumulative mitoxantrone dose nor treatment with other immuosuppressive agents was identified as a malignancy risk factor. Fifty-five patients had died, among them 12 from a malignancy. Our study confirmed previous reports on an increased incidence of acute myeloic leukemia after mitoxantrone treatment and newly described an association between mitoxantrone therapy and an increased incidence of colorectal cancer. (more…)
Author Interviews, Ophthalmology / 13.05.2016

MedicalResearch.com Interview with: Prof. Dr. med. Hans Hoerauf Direktor der Augenklinik Universitätsmedizin Göttingen Göttingen   MedicalResearch.com: What is the background for this study? Dr. Hoerauf: Two treatment options, anti-vascular endothelial growth factors (anti-VEGFs) and corticosteroids, with different mechanisms of action are available for the treatment of macular edema secondary to Central Retinal Vein Occlusion (CRVO). Our study, COMRADE-C, is the first head-to-head study to investigate the clinical efficacy and safety of the European labels of ranibizumab (anti-VEGF) versus dexamethasone intravitreal implant (corticosteroid) in patients with CRVO over six months. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Genetic Research, PLoS / 13.05.2016

MedicalResearch.com Interview with: Katarina Truvé PhD Swedish University of Agricultural Sciences and Kerstin Lindblad-Toh Uppsala University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Truvé: Gliomas are malignant brain tumors that are rarely curable. These tumors occur with similar frequencies in both dogs and humans. Gliomas in dogs are strikingly similar at the biological and imaging level to human tumor counterparts. Some dog breeds such as Boxer and Bulldog are at considerably higher risk of developing glioma. Since these breeds at high risk are recently related, they are most likely carrying shared genetic risk factors. Our goal was therefore to use the dog genome to locate genes that may be involved in the development of glioma in both dogs and humans. We found a strongly associated locus and identified three candidate genes, DENR, P2RX7 and CAMKK2 in the genomic region. We have shown that CAMKK2 is lower expressed in glioma tumors than normal tissue in both dogs and human, and it has been reported that the associated canine mutation in P2RX7 results in a decrease in receptor function. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Nutrition, Pediatrics / 13.05.2016

MedicalResearch.com Interview with: Maryam Farvid, Ph.D. Visiting Scientist Department of Global Health and Population Harvard T.H. Chan School of Public Health MedicalResearch: What is the background for this study? What are the main findings? Dr. Farvid: Breast cancer is one of the most frequently diagnosed cancers and is the second leading cause of cancer deaths among women in the United States. While we know many breast cancer risk factors, few of them are easily modified. Further, evidence suggests that exposure to carcinogens and anti-carcinogens in early life may play an important role. According to this study, what women eat as teens or young adults could affect their breast cancer risk in the future. Teenage girls who eat a lot of fruits may have a lower risk of breast cancer later in life. The risk of breast cancer among women who reported the highest amount of dietary fruits during high school, about 2.9 servings of fruit a day, was 25 percent lower, compared with those who had eaten the lowest amount, about 0.5 serving of fruit a day. We also analyzed individual fruit and vegetable intake and risk of breast cancer: greater consumption of apple, banana, and grapes during adolescence, as well as oranges and kale for young adult was significantly associated with a reduced risk. (more…)
Author Interviews, Education, Genetic Research, Nature / 13.05.2016

MedicalResearch.com Interview with: Dr. Daniel J. Benjamin PhD Associate Professor (Research), USC, 2015-present Associate Professor (with tenure), Cornell, 2013-2015 Assistant Professor, Cornell University, 2007-2013 Research Associate, NBER, 2013-present Faculty Research Fellow, NBER, 2009-2013  MedicalResearch.com: What is the background for this study? Dr. Benjamin: Educational attainment is primarily determined by environmental factors, but decades of twin and family studies have found that genetic factors also play a role, accounting for at least 20% of variation in educational attainment across individuals. This finding implies that there are genetic variants associated statistically with more educational attainment (people who carry these variants will tend on average to complete more formal education) and genetic variants associated statistically with less educational attainment (people who carry these variants will tend on average to complete less formal education). But none of these genetic variants had been identified until our 2013 paper on educational attainment. That paper, which studied a sample of roughly 100,000 individuals, identified 3 genetic variants associated with educational attainment, each of which has a very small effect. In the current paper, we expanded our sample to roughly 300,000 individuals, with the goal of learning much more about the genetic factors correlated with educational attainment. (more…)
Author Interviews, Nutrition / 12.05.2016

MedicalResearch.com Interview with: Danielle E. Schoffman PhD Candidate Department of Health Promotion, Education, and Behavior Arnold School of Public Health University of South Carolina Columbia, SC 29208  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, there has been large growth in the fast casual (e.g., Panera, Chipotle) restaurant sector, and there is a general perception among consumers that these restaurants are a healthier and fresher alternative to fast food. When we encourage participants in our research studies to reduce their fast food intake, they often ask if these fast casual restaurants also count. We were interested in looking at the calorie data for entrees at both restaurant types to see if they lined up with these assumptions. We analyzed the calorie content of entrées at 34 fast food and 28 fast casual restaurants, and found that fast food entrées had an average of 760 calories per entrée compared to 561 for fast food entrées . Also, a greater proportion of fast casual restaurant entrées exceeded the median of 640 calories per entrée. (more…)
Artificial Sweeteners, Author Interviews, Brain Injury, JAMA, Neurological Disorders, Ophthalmology / 12.05.2016

MedicalResearch.com Interview with: Dr. T. Dianne Langford PhD Associate Professor, Neuroscience and Neurovirology Lewis Katz School of Medicine Temple University MedicalResearch.com: What is the background for this study? Dr. Langford: The ocular-motor system has been shown to reflect neural damage, and one of ocular-motor functions, near point of convergence (NPC), was reported to worsen after a sport-related concussion (Mucha et al. Am J Sport Med). But the effects of subconcussive head impact, a milder form of head injury in the absence of outward symptoms remains unknown.  Prior to this study, we found that in a controlled soccer heading experimental paradigm decreased NPC function, and even 24h after the headings, NPC was not normalized back to baseline (Kawata et al. 2016 Int J Sport Med). To extend our findings from the human laboratory study, we launched longitudinal clinical studies in collaboration with the Temple football team, to see if repetitive exposure to subconcussive head impacts negatively affects NPC. (more…)
Author Interviews, JAMA, Ophthalmology / 12.05.2016

MedicalResearch.com Interview with: Dr. Brian Boxer Wachler MD Boxer Wachler Vision Institute Beverly Hills, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: As an eye surgeon, I observed patients tended to have more age spots on the left side of their faces.  I was examining a patient with Keratoconus and after I noted her age spots on her left cheeks, I began to look into this phenomenon.  It turns out there are many studies that found more skin cancer on the left side of the face compared to the right side of the face.  In Australia (where people drive on the left side of the road) it’s the opposite – more skin cancer on the right side of the face.   Our study found that cars on average have significantly lower UVA (ultraviolet A) protection in the side windows compared to windshields which have universally high UVA protection.  I believe this can be the missing link that can explain higher rates of skin cancer on the side of the face by the driver’s window. There are also more cataracts in left eyes vs right eyes.  There was no relationship between high-end cars and low-end cars for side window UV protection – in other words many more pricey cars had just as poor side window UV protection as less expensive cars. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 12.05.2016

MedicalResearch.com Interview with: Lucas Ramirez, M.D Resident Physician | LAC-USC Medical Center USC Keck School of Medicine | Class of 2013  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ramirez: Prior studies have shown differences in stroke rates in certain geographical regions among age and racial groups. Few studies have analyzed these differences on a national level.  Our study found that nationally, stroke hospitalization have decreased, though among blacks and young age groups, they have increased. (more…)
Author Interviews, Gastrointestinal Disease, Microbiome, Nature, Technology / 12.05.2016

MedicalResearch.com Interview with: Prof. Dr. Paul Wilmes Associate Professor Head of the Eco-Systems Biology Research Group Luxembourg Centre for Systems Biomedicine University of Luxembourg Luxembourg MedicalResearch.com: What is the background for this intestinal model? Dr. Wilmes: Changes in the human gastrointestinal microbiome are associated with several diseases. To infer causality, experiments in representative models are essential. Widely used animal models exhibit limitations. Therefore, we set out to develop the HuMiX model which allows co-culture of human and microbial cells under conditions representative of the gastrointestinal interface. (more…)
Author Interviews, JAMA, Weight Research / 12.05.2016

MedicalResearch.com Interview with: Shoaib Afzal, MD, PhD Department of Clinical Biochemistry Copenhagen General Population Study Herlev and Gentofte Hospital, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Afzal: Previous findings indicate that while average BMI has increased over time in most countries, the prevalence of cardiovascular risk factors may be decreasing among obese individuals. Thus, the BMI associated with the lowest all-cause mortality may have changed over time. This study included three cohorts from the same general population enrolled at different times: the Copenhagen City Heart Study in 1976-1978 (n = 13,704) and 1991-1994 (n = 9,482) and the Copenhagen General Population Study in 2003-2013 (n = 97,362). The increased risk for all-cause mortality that was associated with obesity compared to normal weight decreased from 30% in 1976-1978 to 0% in 2003-2013, that is, over a 30-year period. In addition, the optimal BMI for lowest all-cause mortality increased by 3.3 from 23.7 in 1976-1978 through 24.6 in 1991-1994 to 27 in 2003-2013. Another interesting finding in this study is that the optimal BMI in relation to lowest mortality is placed in the overweight category in the most recent 2003-2013 cohort. (more…)
Author Interviews, Heart Disease, Transplantation / 12.05.2016

MedicalResearch.com Interview with: Jaimin Trivedi, MD, MPH Instructor Department of Cardiovascular and Thoracic Surgery University of Louisville Louisville, KY 40202 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Trivedi: There is a donor heart shortage in United States and certain donor hearts are likely to be turned down because the donors required cardiopulmonary resuscitation (CPR) prior to procurement. The rationale behind conducting the study was to identify impact of donor CPR and its duration on recipient survival after transplantation. Our findings show that presence of CPR and duration of CPR does not adversely impact the post heart transplant survival. The study also shows that ejection fraction and peak cardiac troponins between the CPR and non-CPR donors were comparable at time of transplant suggesting recovery of cardiac function. (more…)
Author Interviews, Heart Disease, JAMA, Social Issues / 12.05.2016

MedicalResearch.com Interview with: Erica Spatz, MD, MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale University School of Medicine/Yale-New Haven Hospital New Haven, CT 06520 MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Spatz: Rates of heart attack have declined during the last 15 years. But whether communities of different economic status or in different geographic regions experienced similar declines is unknown, especially as efforts to prevent cardiovascular disease and manage heart attacks may not have been equally successful in communities with different resource capacity. Our study shows that trends in the incidence of and mortality from heart attack were similar in low, average and high income communities. However, low-income communities had higher hospitalization rates than average and high income communities throughout the 15 year study period. Interestingly mortality rates were similar. (more…)
Author Interviews, Kaiser Permanente, OBGYNE, Pediatrics, Weight Research / 12.05.2016

MedicalResearch.com Interview with: Anny H. Xiang, PhD Kaiser Permanente Southern California Department of Research & Evaluation MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Xiang: Previous studies have identified a link between maternal obesity, diabetes and/or excessive gestational weight gain and long-term obesity risk in children. Our study examined the interplay among all four factors associated with childhood obesity: pre-pregnancy obesity, gestational weight gain, gestational diabetes and breastfeeding. To our knowledge, the interplay among these factors and their independent contributions to childhood obesity with data from a large and multi-ethnic cohort under current standard clinical care had not been previously studied. The study included 15,710 women who delivered babies at Kaiser Permanente medical facilities in Southern California in 2011. The key findings were:
  • A woman being obese (BMI of 30.0 or higher) prior to getting pregnant increased the odds of her child being overweight at age 2 by more than two-fold compared to women who had a normal pre-pregnancy weight (BMI between 18.5 and 25), after adjusting for weight gain during pregnancy, gestational diabetes and breastfeeding.
  • A woman being overweight (BMI between 25.0 and 29.9) prior to pregnancy was associated with 50 percent increased odds of her child being overweight at age 2.
  • Excessive weight gain during pregnancy was associated with 23 percent increased odds of a child being overweight at age 2 compared to women who had healthy weight gain during pregnancy after adjusting for pre-pregnancy weight, gestational diabetes and breastfeeding.
  • Breastfeeding for at least six months was associated with a 24 percent reduction for the odds of a child being overweight at age 2 regardless of a mother’s pre-pregnancy weight, gestational diabetes or excessive weight gain during pregnancy.
  • Gestational diabetes was not associated with the risk of a child being overweight at age 2. Women with gestational diabetes in this cohort were treated following standard clinical practice and had 40-49 percent lower rate of excessive weight gain during pregnancy and similar breastfeeding rates compared to women without gestational diabetes.
Excessive weight gain was defined according to Institute of Medicine guidelines, with normal-weight women gaining more than 35 pounds, overweight women gaining more than 25 pounds and obese women gaining more than 20 pounds during their pregnancy. Children were considered overweight at age 2 if their BMI was greater than the 85th percentile for their age and sex, based on growth charts from the Centers for Disease Control and Prevention. (more…)
Author Interviews, Biomarkers, Prostate Cancer, Urology / 12.05.2016

MedicalResearch.com Interview with: Jonathan Shoag MD Urology Resident at Cornell Department of Urology and Dr. Jim C. Hu MD Ronald Lynch Professor of Urologic Oncology Professor of Urology Director, Lefrak Center for Robotic Surgery Attending Urologist, New York-Presbyterian Hospital (Cornell campus) MedicalResearch.com: What is the background for this study? Response: Prostate Specific Antigen (PSA) is a blood test that is used to detect prostate cancers and to follow a cancer’s response to treatment. PSA was widely implemented as a screening tool for prostate cancer in the early 1990s, and became a routine test during an annual physical for men over 40. Doctors started using it because values above a “normal” threshold were associated with a greater risk of prostate cancer. Following the adoption of PSA screening in the early 1990s, there has been a large increase in the number of men diagnosed with cancer, and a decrease of approximately 50% in the rate of prostate cancer death. The PLCO trial was a large randomized trial designed and funded by the National Cancer Institute (NCI) to determine the effect of PSA screening on death from prostate cancer. The trial found that men randomized/assigned to prostate cancer screening had the same number of prostate cancer deaths as men in the control group of the trial, arguing that PSA screening does not decrease prostate cancer mortality. This was a major piece of evidence used by the United States Preventative Services Task Force (USPSTF) to form its 2012 recommendation against PSA screening. The argument was that in spite of the other evidence showing a benefit to PSA testing, including US epidemiologic trends, and another large randomized trial showing PSA screening was effective (the ERSPC), we now had good evidence showing no benefit to PSA testing in the US. Since 2012 we have seen dramatic declines in prostate cancer screening in the US as a result. (more…)
Accidents & Violence, Author Interviews, Cannabis / 11.05.2016

MedicalResearch.com Interview with: Mr. Brian C. Tefft Senior Research Associate AAA Foundation for Traffic Safety MedicalResearch.com: What is the background for this study? What are the main findings? Response: In December 2012, a new law took effect in Washington state that effectively legalized the possession and use of small amounts of marijuana by adults aged 21 years and older for recreational purposes, and also created a legal limit for driving under the influence of marijuana such that having a concentration of 5.00 nanograms or greater of delta-9-tetrahydrocannabinol (THC, the main psychoactive chemical in marijuana) per milliliter of whole blood while driving in the state of Washington is per se driving under the influence. Data from population-based surveys indicate that the proportion of Washington state residents who report using marijuana increased after this law took effect; however, not much was known about the impact of this new law on traffic safety in the state. To investigate the traffic safety impact of the new law, we examined drug test results from drivers involved in motor vehicle crashes that occurred in years 2010 – 2014 in Washington and resulted in the death of at least one person within 30 days of the crash. Specifically, we looked at the proportion of all drivers involved in fatal crashes who had detectable THC in their blood at or shortly after the time of the crash, which generally suggests that the driver had used marijuana within the past few hours. Results showed that from 2010 through 2013, approximately 8-9% of drivers in fatal crashes each year were positive for THC, and that proportion was basically flat from 2010 through 2013. In 2014, the proportion basically doubled, to 17%. Our modelling suggests that an increasing trend in the proportion of drivers who were positive for THC began in late 2013, about 9-10 months after the new law took effect. (more…)
Author Interviews, Pediatrics, Sleep Disorders, Weight Research / 11.05.2016

MedicalResearch.com Interview with: Ofir Turel, Ph.D Professor, Information Systems and Decision Sciences California State University, Fullerton Scholar in Residence, Department of Psychology University of Southern California MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Turel: The study emerged as a response to the growing societal concern regarding potentially problematic information system use” lifestyles”, including videogame addiction, among adolescents. Much research in this domain has focused on negative psychological (e.g., reduced wellbeing, depression) and social/life functioning (e.g., reduction in normal activities, diminished school performance). Less is known regarding potential physiological outcomes of videogame addiction. Interestingly, the increase in videogame addiction-like symptoms among adolescents happened in conjunction with an increase in sleep curtailment and obesity in this population. These are too growing concerns in North America and perhaps elsewhere. Medical research implies that these three phenomena may be related. Hence, we hypothesized that videogame addiction will be associated with increased sleep curtailment and increased abdominal adiposity; and consequently, indirectly, with cardio-metabolic deficits. Our findings suggest that videogame addiction predicts reduced sleep duration which in turn, predicts increased abdominal adiposity. Abdominal adiposity was associated with increased blood pressure, insulin resistance and triglycerides and reduced high density lipoprotein cholesterol levels. Hence, sleep curtailment is an important mediating factor that helps translating videogame addiction into cardio-metabolic deficiencies. (more…)