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AHA Journals, Author Interviews, Occupational Health, Radiology / 20.04.2016

MedicalResearch.com Interview with: Dr. Maria Grazia Andreassi, PhD Director, Genetics Research Unit, CNR Institute of Clinical Physiology Pisa, Italy MedicalResearch.com: What is the background for this study? Response: Over the last 20 years, advances in imaging technology have led to an explosive growth and performance of fluoroscopically-guided cardiovascular procedures, highly effective and often life-saving. However, these procedures requires substantial radiation exposure (e.g. the average effective radiation dose for a percutaneous coronary intervention or an ablation procedure is about 15 mSv, equal to 750 chest x-rays or ~6 years of background radiation) to patients and staff, especially interventional cardiologists and electrophysiologists. In fact, interventional cardiologists and electrophysiologists needs to operate near the patient and the radiation source and accumulate significant lifetime radiation exposure over a long career. The potential hazards of cumulative radiation exposure are the risk of cataract development and cancer induction. Anyway, there is now growing evidence in scientific community of an excess risk for other non-cancer disease even at moderate and low dose levels of ionizing radiation exposure, especially cardiovascular disease and cognitive effects. However, the characterization of health risks of accumulated low-dose radiation is incomplete and largely lacking. Therefore, the purpose of our study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Diabetes, NIH, Nutrition, OBGYNE / 20.04.2016

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch.com: What is the background for this study? Dr. Zhang: Hypertension is one of the most prevalent and preventable risk factors for cardiovascular and kidney diseases, and is one of the leading causes of death in the United States. We have previously reported that the cumulative incidence of hypertension for women with a history of gestational diabetes mellitus (GDM) was 26% higher than those who did not have GDM even 16 years after the index pregnancy. Thus, women with a history of GDM represent a high-risk population for hypertension that could benefit from early prevention. While there is extensive literature on how lifestyle factors may influence blood pressure in the general population, no information is currently available on the role of diet and lifestyle in the development of hypertension specifically in this susceptible population. To address these gaps, we prospectively examined the associations between long-term adherence to three healthy diets with subsequent risk of hypertension among women with a history of gestational diabetes mellitus, specifically the DASH diet, the alternative Mediterranean diet (aMED), and the Alternative Healthy Eating Index (AHEI). (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, UCSF / 20.04.2016

MedicalResearch.com Interview with: Jennifer S. Yokoyama, PhD Assistant Professor, Memory and Aging Center University of California, San Francisco MedicalResearch.com: What is the background for this study? Dr. Yokoyama: Alzheimer’s disease is a common neurodegenerative disease that occurs in older adults. Clinically, Alzheimer’s disease is primarily associated with changes in cognition (e.g., declines in memory, language and visuospatial functioning). Pathologically, Alzheimer’s disease is associated with misfolded amyloid beta and tau proteins and can only be definitively diagnosed at autopsy. It has long been appreciated that there is a link between the immune system and Alzheimer’s disease, and there are multiple sources of evidence that suggest that immune activity may be increased in patients with Alzheimer’s. Although there is strong evidence for an association between immune activity and Alzheimer’s disease there has always been a chicken-egg problem because we don’t know whether the Alzheimer’s disease process triggers the immune response or whether altered immune function promotes the Alzheimer’s disease process. Genetic information can offer important clues about the role of the immune system in Alzheimer’s disease. Each person has a unique genetic fingerprint, and different combinations of gene changes (“variants”) put individuals at higher or lower risk for different diseases. Genetic data enables us to test whether having a certain genetic variant puts people at greater risk for both Alzheimer’s disease and autoimmune diseases, immune system diseases in which the immune system is overactive (e.g., Crohn's disease, ulcerative colitis, rheumatoid arthritis, type 1 diabetes, Celiac's disease, and psoriasis). Rather than only responding to foreign objects such as bacteria and viruses, in autoimmune diseases the immune system also responds to the body’s own material, which do not ordinarily create an immune response, thereby leading to symptoms associated with higher levels of inflammation and other long-term problems. A variant that increases risk for both Alzheimer’s disease and autoimmune diseases would suggest a common biological pathway. MedicalResearch.com: What are the main findings? Dr. Yokoyama: In our study we tested whether there are genetic variants that put people at increased risk for both Alzheimer's disease and autoimmune diseases. We found eight genetic variants that influence people’s risk for both Alzheimer's disease and autoimmune disease. Some of these variants were associated with lower risk of autoimmune disease and Alzheimer’s disease, but two variants were associated with greater risk for both.   (more…)
AACR, Author Interviews, Brigham & Women's - Harvard, Weight Research / 20.04.2016

MedicalResearch.com Interview with: Joao Incio MD Research Fellow in Radiation Oncology Harvard Medical School/MGH Boston, MA MedicalResearch.com: What is the background for this study? Dr. Incio: With  the  current  epidemic  of  obesity,  the  majority  of  pancreatic  cancer  patients  are  overweight  or  obese  at  diagnosis.  Importantly, obesity  worsens treatment  outcomes  in  pancreatic  cancer  patients.  Therefore,  understanding  the  mechanisms  that  underlie  the  poorer  prognosis  of  obese  cancer  patients  is  of  paramount importance.  Obesity  causes  inflammation  and  fibrosis  in  the  normal  pancreas  due  to  the  accumulation  of  dysfunctional  hypertrophic  adipocytes.  Importantly,  desmoplasia  -­  a fibroinflammatory  microenvironment  -­  is  a  hallmark  of  pancreatic  ductal  adenocarcinoma  (PDAC),  and  we  have  shown  that  activation  of  pancreatic  stellate  cells  (PSCs)  via angiotensin-­II  type  1  receptor  (AT1)  pathway  is  a  major  contribution  to  tumor  desmoplasia.  Whether  obesity  affects  desmoplasia  in  PDACs,  and  interferes  with  delivery  and response  of  chemotherapeutics,  was   the focus of our study. (more…)
Author Interviews, Orthopedics, Osteoporosis / 20.04.2016

MedicalResearch.com Interview with: Professor Nicholas C W Harvey, MA MB BChir PhD FRCP Professor of Rheumatology and Clinical Epidemiology Honorary Consultant Rheumatologist MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Harvey:  It is well established that fracture risk is substantially increased by having had a previous fracture. A previous study suggested that fracture risk soon after a spine fracture might be greater than the risk later on, and if the risk varies with time, it would be sensible to identify the time at greatest risk, so intervention can be given. The risk of a second osteoporotic fracture was greatest immediately after the first fracture and thereafter decreased with time though remained higher than the population risk throughout follow up. For example, 1 year after the first fracture the risk of a second fracture was three times higher than the population risk. After 10 years it was two times higher. (more…)
Author Interviews, Exercise - Fitness, Genetic Research / 20.04.2016

MedicalResearch.com Interview with: Nicholas Jones BSc (Hons) MSc ISAK CSCS ASCC DNA Sports Performance Ltd Director MedicalResearch.com: What is the background for this study? Response: Coaches and trainers all know that individuals can respond differently to the same stimulus. One person may be a super responder to X training method, another may be a none-responder to the very same training method. The reasons for this have never been fully explained, however genetics have been discussed and thought to play a role for some time. MedicalResearch.com: What are the main findings? Response: At the beginning of the eight weeks of training, the participants were set two fitness tests to measure their power and endurance. Power was measured by a countermovement jump (CMJ) and endurance by an aerobic three minute cycle test (known as Aero3). After eight weeks, those whose training had been matched to their genes improved their CMJ power test of 7.4% compared to just a 2.6% increase in the mismatched group. In the cycle endurance test, those who trained to their genetic strengths saw an average 6.2% improvement compared to 2.3% for the mismatched group. (more…)
AACR, Author Interviews, Biomarkers, Cancer Research / 19.04.2016

MedicalResearch.com Interview with: Marianne J. Ratcliffe, PhD Associate director of diagnostics AstraZeneca Alderley Park, UK MedicalResearch.com: What is the background for this study? Dr. Ratcliffe: PD-L1 status is informative when considering monotherapy treatment and of growing importance when we consider that treatment decision will, in the near future also include combination therapy, an area of focus for AstraZeneca. The Ventana SP263 test has been developed with AstraZeneca, to support selection of PD-L1 testing within the Durvalumab programme, with full analytical validation at a 25% cut point derived from clinical data indicating this cut point best identifies patients more likely to respond to Durvalumab. The Ventana SP263 assay is commercially available in the US and the EU as a Class I device. The Dako 22C3 test has been approved as companion diagnostic for Pembrolizumab, and the Dako 28-8 has been released as a complementary diagnostic as an aid to physicians considering treatment with Nivolumab. What we didn’t know before our study was whether the three assays identify the same patients, and particularly how to cross compare patients identified with the different cut points specified for the different assays. It was therefore an important question to be addressed through a very thorough scientific assessment. MedicalResearch.com: What are the main findings? Dr. Ratcliffe: Our data, generated in 500 commercial samples, demonstrates that three commercially available PD-L1 tests achieved overall percentage agreement of >90%. This was achieved at multiple assay cut-offs. These results indicate that it may be possible to extrapolate the results from one test to that of another test. Further work is required to confirm this finding. (more…)
Author Interviews, Heart Disease / 19.04.2016

MedicalResearch.com Interview with: Yoosoo Chang MD PhD Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University Seoul, Korea MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chang: Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease (CHD), but its association with subclinical CHD has been largely unexplored. We performed a cross-sectional study of 22,210 apparently healthy, asymptomatic Korean adults who underwent image scans to determine how much calcium had built up in their heart arteries. We found that people who drank 5 cups or more of sugar-sweetened carbonated beverage per day on average had the greater prevalence and higher degree of calcium deposits in the arteries compared to non-drinkers. This association persisted after controlling other factors and was observed across various subgroups, supporting an independently harmful effect of sugar-sweetened carbonated beverage on the cardiovascular health. (more…)
Author Interviews, Neurological Disorders, Psychological Science / 19.04.2016

MedicalResearch.com Interview with: Ezequiel Morsella, Ph.D. Associate Professor of Neuroscience Department of Psychology San Francisco State University Assistant Adjunct Professor Department of Neurology University of California, San Francisco Boardmember, Scientific Advisory Board Institute of Cognitive Neurology (INECO), Buenos Aires MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Morsella: The study is based on Passive Frame Theory, which I discuss below in brief, and on ironic processing, in which one is more likely to think about something (e.g., white bears) when instructed to not think about that thing.  Based on this research, the Reflexive Imagery Task (RIT) reveals that, following the activation of certain "action sets" (i.e., dispositions to act one way or another), conscious thoughts can arise involuntarily and systematically when one is presented with certain stimuli.  In the most basic version of the RIT, subjects are presented with visual objects and instructed to not think of the names of the objects, which is challenging.  In the new study, we show that the effect arises not only for automatic processes (e.g., forms of cued-memory retrieval) but also for processes involving more, in a sense, moving parts (e.g., symbol manipulation, in which symbols are mentally manipulated).  In the study, subjects were first trained to perform a word-manipulation task similar to the game of Pig Latin (e.g., “CAR” becomes “AR-CAY”). This task involves complex symbol manipulations.  After training, though participants were instructed to no longer transform stimulus words in this way, the RIT effect still arose on roughly 40% of the trials. The present experiment provides additional evidence for Passive Frame Theory, a new, comprehensive and internally coherent framework that illuminates the role of conscious processing in the brain. Click here for more information about Passive Frame Theory: https://www.psychologytoday.com/blog/consciousness-and-the-brain/201604/passive-frame-theory-new-synthesis Although consciousness is not "epiphenomenal" (meaning that it serves no function) or omnipresent (e.g., as in panpsychism, which states that consciousness is a property of all matter), in Passive Frame Theory, the role of consciousness is much more passive and less teleological (i.e., less purposeful) than that of other theoretical accounts. The framework reveals that consciousness has few moving parts and no memory, no reasoning, or symbol manipulation, which is relevant to the present study. Consciousness does the same thing, over and over, for various processes, making it seem that it does more than it does.  Hence, consciousness, over time, seems to be more flexible than it actually is. (more…)
Author Interviews, Nature, Neurological Disorders / 19.04.2016

MedicalResearch.com Interview with: Phillip G. Popovich, Ph.D. Professor, Neuroscience Director, Center for Brain and Spinal Cord Repair Ray W. Poppleton Research Designated Chair Department of Neuroscience Wexner Medical Center at The Ohio State University Columbus, Ohio  43210 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Popovich:  People that suffer a spinal cord injury (SCI) at a high spinal level (e.g., cervical SCI), are at increased risk for developing autonomic dysreflexia (AD), a potentially life-threatening condition of sudden onset high blood pressure. In people and animals with SCI, reflexes that are activated by routine stimuli including filling of the bladder or bowel often trigger AD. We recently found that these same reflexes also suppresses the immune system (see Zhang et al., 2013; PMID 23926252) Since people with high level  spinal cord injury also are at increased risk for developing infections (e.g., pneumonia), we set out to understand how SCI changes the autonomic circuitry in the spinal cord that controls immune function. We found that after a period of one month, the number of connections between spinal cord interneurons and autonomic neurons that directly control immune function increases dramatically. Also, this newly formed circuitry is “hyperactive” and discharge of neurons in this circuit causes hormones to be released into the blood and immune organs that overstimulate immune cells, causing them to die. Fortunately, we were able to show that the hyperactive spinal cord circuitry can be silenced. We used a novel technique known as “chemogenetics” to silence excitatory interneurons in the aberrant circuit. When the circuitry was silenced, immune cells were protected in spinal cord injury mice. (more…)
AACR, Author Interviews, Melanoma / 18.04.2016

MedicalResearch.com Interview with: Christin E. Burd, Ph.D. Assistant Professor Departments of Molecular Genetics, and Molecular Virology, Immunology and Medical Genetics The Ohio State University James Comprehensive Cancer Center Columbus, OH 43210 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Burd: Many melanomas develop from benign moles and exposure to ultraviolet sunlight is thought to play a major role in this process. Initially, we were interested in determining how ultraviolet sunlight might cooperate with gene mutations found in moles to initiate melanoma. To examine this, we exposed melanoma-prone mice to a single, non-burning dose of ultraviolet (UV) light.  Our findings were quite unexpected. While the untreated mice naturally developed melanoma at 26 weeks of age, UV-treated subjects got melanoma at just 5 ½ weeks of age. This striking result suggested to us that our model might provide a superior way to test sunscreens. SPF ratings are currently based upon the ability of a sunscreen to protect against skin burning. We know that sunburns are associated with melanoma risk, but whether protection from skin burning is enough to prevent cancer was unclear. By applying a number of commercially available SPF30 sunscreens to our mice before UV exposure, we were able to show that the animals were protected from melanoma. However, we noticed that some SPF30 sunscreens worked better than others. In fact, many SPF30 sunscreens out-performed the one SPF50 sunscreen tested in our initial study. So while all sunscreens protect against melanoma, SPF does not predict which ones are the best. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 18.04.2016

MedicalResearch.com Interview with: Thomas J. Sandora, M.D., M.P.H. Senior Associate Physician in Medicine; Hospital Epidemiologist; Medical Director, Infection Control Boston Children’s Hospital Associate Professor of Pediatrics, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sandora: Giving antibiotics before certain types of operations results in lower rates of surgical site infections. However, there are limited data about which pediatric operations require antibiotic prophylaxis. We examined national variability in antibiotic prophylaxis for the 45 most commonly performed pediatric operations at children's hospitals in the U.S. We found that antibiotic use was considered appropriate for only 64.6% of cases, with a high degree of variability within procedures and between hospitals. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 18.04.2016

MedicalResearch.com Interview with: Dr. Lara B. McKenzie PhD MA Principal Investigator Center for Injury Research and Policy The Research Institute Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. McKenzie: Skateboarding is a popular recreational sport and participation has increased the last several decades, faster than any other sport or recreation activity between 1998 and 2007 (National Sporting Goods Association Sports Participation in 2007). With growing participation, has come an increasing rate of injuries from skateboarding. The study examined data for youth and adolescents 5-19 years of age who were treated in U.S. emergency departments (EDs) for skateboarding-related injuries from 1990-2008. It found that nationally, over the 19-year period, there was an average of 64,572 children and adolescents treated each year for skateboarding-related injuries – about 176 a day. Most patients were male (89 percent), and were injured either at home (38 percent) or in the street and/or highway (30 percent). The most commonly injured body regions were the upper (45 percent) and lower (32 percent) extremities. The most common diagnoses were fractures or dislocations (33 percent), sprains and strains (25 percent) and bruises (20 percent). Children and adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. (more…)
Author Interviews, Cancer Research, HPV, NYU / 18.04.2016

MedicalResearch.com Interview with: Adam S. Jacobson, MD Associate Professor, Department of Otolaryngology-Head and Neck Surgery Associate Director, Head and Neck Surgery NYU Langone Medical Center and Perlmutter Cancer Center MedicalResearch.com Editor’s note: Dr. Jacobson is an Otolaryngologist, an Ear-Nose-Throat (ENT) physician specializing in the diagnosis of head and neck tumors and cancers, including cancers of the mouth and throat. Dr. Jacobson discussed oral (mouth) and pharyngeal (throat) cancers in recognition of Oral, Head and Neck Cancer Awareness Week. MedicalResearch.com: How prevalent is the problem of Oral, Head and Neck Cancer?  Is this type of cancer becoming more frequent? Dr. Jacobson: Oropharynx cancer is currently on the rise.  MedicalResearch.com: Have HPV-induced cancers become more common? (Note HPV or Human Papilloma Virus is a virus associated with various wart infections.) Dr. Jacobson: Yes - Specifically tonsil and base of tongue cancer. (more…)
Author Interviews, Heart Disease / 18.04.2016

MedicalResearch.com Interview with: Gjin Ndrepepa, MD Deutsches Herzzentrum München München, Germany Medical Research: What is the background for this study? Dr. Ndrepepa: Prevention of atherosclerosis or promotion of its regression when it had developed, are among the greatest problems in clinical medicine. Recent imaging studies have shown that high-intensity statin therapy slows progression and may even result in regression of atherosclerosis. Despite the positive results in terms of retardation of progression or regression of atherosclerosis, the number of clinical events in these studies was too small to allow meaningful analysis of the relationship between slow progression or regression of atherosclerosis and morbidity or mortality and to date no specifically designed studies have been performed to investigate the association of progression or regression of the atherosclerosis with the long-term mortality. In the current study we addressed this clinically relevant problem. Medical Research: What are the main findings? Dr. Ndrepepa: In brief, the main findings of current study may be summarized as follows:
  • 1) Progression of atherosclerosis in patients with coronary artery disease treated with statins and other secondary prevention measures was associated with 2.5-fold increase in the adjusted risk of 8-year cardiac mortality compared to patients with no progression/regression of atherosclerosis.
  • 2) Regression of atherosclerosis was associated with a significant decrease in the risk of 8-year all-cause and cardiac mortality (75% and 80% reduction, respectively).
  • 3) Diabetes mellitus increased the odds of progression and decreased the odds of regression of coronary artery atherosclerosis.
(more…)
Author Interviews, Diabetes, Kidney Disease / 17.04.2016

MedicalResearch.com Interview with: Axel C. Carlsson, PhD Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University Uppsala Sweden MedicalResearch.com: What is the background for this study? Dr. Carlsson: Circulating endostatin levels has been shown to be associated with duration of hypertension and cardiovascular events. Moreover, endostatin levels were recently shown to parallel kidney function decline, and has been associated with increased mortality risk in different settings. However, less is known of circulating endostatin in patients with type 2 diabetes.  (more…)
Author Interviews, CMAJ, Opiods / 17.04.2016

MedicalResearch.com Interview with: Dr. Zainab Samaan, MBChB, MSc, DMMD, PhD, MRCPsych Associate Professor Dept of Psychiatry and Behavioural Neurosciences Member Population Genomics Program Member Peter Boris Centre for Addiction Research Associate Faculty Dept of Clinical Epidemiology and Biostatistics McMaster University Hamilton, ON, Canada Medical Research: What is the background for this study? Response: Opioid addiction has become a leading public health concern in North America with Canada leading the way in the amount of opioid use per capita. Opioid addiction has moved from heroin use by young men to prescription pain killers such as oxycodone and fentanyl with devastating impact on individuals and society including increasing number of deaths due to opioid overdose. In addition many people on treatment will also relapse (go back using drugs). We wanted to understand the problem of opioid addiction by investigating the factors that increase the risk of relapse in people with opioid addiction receiving methadone treatment. Medical Research: What are the main findings? Response: People who injected drugs and used benzodiazepines (BDZ) are more likely to relapse faster than people who did not use injection or benzodiazepines. (more…)
AACR, Author Interviews, Cancer Research, Colon Cancer, HPV, MD Anderson / 16.04.2016

MedicalResearch.com Interview with: Dr. Van K. Morris, MD Assistant Professor, GI Medical Oncology The University of Texas MD Anderson Cancer Center MedicalResearch.com: What is the background for this study? Dr. Morris: Anal cancer is a very rare cancer and accounts for approximately 2% of all gastrointestinal malignancies. Currently, there is no accepted standard of care for patients with metastatic disease, which raises challenges for oncologist who may not have extensive experience caring for patients with metastatic anal cancer given that there are not accepted agents to treat with. This clinical trial was the first clinical trial ever conducted for patients with stage IV disease who had received prior chemotherapy in the past. Given the well-known association with human papilloma virus (HPV) and the development of anal cancer, we were interested in the use of immunotherapy drugs as a new possible way to awaken the immune system to attack this tumor, especially as there may be viral components in the tumor cells which the immune system could potentially recognize. Nivolumab is an immunotherapy drug which has shown activity in other solid tumors like melanoma, kidney cancer, non-small cell lung cancer, and bladder cancer. (more…)
Author Interviews, CT Scanning, Heart Disease, Lifestyle & Health / 16.04.2016

MedicalResearch.com Interview with: Jacquelyn Kulinski, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kulinski: Sedentary behavior, or “sitting disease”, is increasingly recognized as a risk factor for cardiovascular disease, diabetes, cancer and early death.  Many of these associations appear to be independent of exercise activity. The mechanisms through which sedentary behavior influences cardiovascular risk are largely unknown.  Therefore, we investigated the association between accelerometer measured sedentary behavior and coronary artery calcium (CAC), a marker of subclinical heart disease, in over 2,000 participants using data from the Dallas Heart Study (DHS) population. We found a significant association between increasing sitting time and CAC in a population without prior history of cardiovascular disease.  This association was independent of measured exercise activity, traditional risk factors, and even socioeconomic factors.  Each hour of sedentary time was associated with a 16% increase in CAC burden.  Interestingly, the association between exercise and CAC was not significant in the fully-adjusted model.  (more…)
Author Interviews, HPV, Kidney Disease, Transplantation, Vaccine Studies / 15.04.2016

MedicalResearch.com Interview with: Dr. Delphine Robotham MD Division of Pediatric Nephrology Johns Hopkins University School of Medicine Baltimore, Maryland Medical Research: What is the background for this study? What are the main findings? Response: Cervical cancer is the second most common cancer in women worldwide and is almost entirely caused by high risk HPV genotypes.  Vaccines to high risk HPV genotypes have shown great success in protecting healthy women from the sequelae of infection, including cervical cancer and genital warts. Young women with a kidney transplant as well as those with chronic kidney disease have abnormal immune systems and as a result have a significantly increased burden of HPV-related disease making the potential health benefits of the HPV vaccine substantial in this particularly vulnerable population.  This study examined the immune response to the HPV vaccine among girls and young women with kidney disease. The goal of this research was to determine if girls and young women with chronic kidney disease (abnormal kidney function, on dialysis, or post kidney transplant) showed evidence of immune response to the quadrivalent HPV vaccine.  Immune response was determined by measuring the amount of antibody made by the patients against each of the 4 HPV genotypes included in the vaccine.  There are established thresholds of antibody above which patients are believed to have protection from infection.  We found that study participants with chronic kidney disease and those on dialysis had antibody levels above the threshold, indicating the vaccine should be effective in protecting them from HPV related disease.  A significant proportion of patients with kidney transplants showed evidence of inadequate antibody response.  This is important information as it means patients with a kidney transplant, whom we know are at increased risk of developing cervical cancer from HPV infection, may not be protected from HPV infections from the HPV genotypes included in the vaccine. (more…)
Author Interviews, Infections, Outcomes & Safety / 15.04.2016

MedicalResearch.com Interview with: Thomas C King, MD, PhD Department of Pathology and Laboratory Medicine Chief of Pathology and Laboratory Medicine St. Vincent Hospital Worcester, MA MedicalResearch.com: What is the background for this study? What are the main findings? Dr. King: This landmark study provides a broad based, real world appraisal of the reliability of the T-SPOT®.TB test, an interferon gamma release assay (IGRA), based on results in screening workers in 19 U.S. hospitals. The large size of the study (more than 42,000 test results from more than 16,000 healthcare workers analyzed) provides a solid benchmark to assess performance of T-SPOT.TB in serial screening healthcare workers. In recent years, results from several studies have shown that there can be significant differences between using an IGRA and the tuberculin skin test (TST) in terms of accuracy and cost. Several studies have confirmed a risk of high false positive rates and numerous conversion/reversion rates when retesting patients with the TST. (more…)
Accidents & Violence, Author Interviews, Karolinski Institute, Social Issues / 15.04.2016

MedicalResearch.com Interview with: Zheng Chang, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Medical Research: What is the background for this study? What are the main findings? Dr. Chang: More than 30 million people are released from prison worldwide every year. Despite reported decreases in violence in many countries, repeat offending remains high across many high-income and middle-income countries. Because there is considerable inconsistency and inefficiency in identifying those who are at high risk of reoffending and most in need of interventions, we developed and validated a clinical prediction rule to determine this risk in released prisoners. We did a cohort study of 47 326 prisoners released in Sweden between 2001 and 2009. We developed a 14-item model to predict violent reoffending, which includes modifiable risk factors and has been externally validated. The model showed good measures of discrimination and calibration. The study uses the methods to develop the prediction model on the basis of TRIPOD guidelines, and it is a brief, easy to use, and scalable tool. This tool has also been translated into a freely available web application (OxRec). (more…)
Author Interviews, Weight Research / 15.04.2016

MedicalResearch.com Interview with: Keigo Saeki, MD, PhD Nara Medical University School of Medicine Nara, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cold exposure causes higher blood pressure and higher coagulation status, and it may be a trigger of higher mortality from cardiovascular diseases in winter. In contrast, cold exposure may have preventive effect on obesity. Recent study found that most of human have brown adipose tissue (BAT) which play an important role in thermogenesis and in the regulation of body weight. Cold exposure activates thermogenesis in BAT, and increase energy expenditure. However, in real life situation, the association between the amount of cold exposure and obesity stays unclear. The HEIJO-KYO study is a community based study to investigate association between housing environment and health. We found that people living in colder housing environment showed lower abdominal circumference in simple correlation and even after adjustment for physical activity, total energy intake, and socioeconomic status. (more…)
Author Interviews, Fertility, OBGYNE, Pediatrics / 15.04.2016

MedicalResearch.com Interview with: Dr. Kieron Barclay PhD Department of Social Policy London School of Economics MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Barclay: Mean age at childbearing has been increasing in most countries in the OECD since the early 1970s. A wealth of research has shown that childbearing at advanced ages is associated with greater difficulty in terms of getting pregnant, higher rates of miscarriage, stillbirth, and increased risk of poor peri-natal outcomes such as pre-term birth and low birth weight. Studies also indicate that the offspring of older mothers have a greater risk of Alzheimer’s disease, diabetes, and mortality in adulthood. However, from the perspective of any individual woman, delaying childbearing to an older age necessarily also means that she will give birth in a later birth year. The last 40 to 50 years have seen substantial improvements in educational opportunities, and better public health conditions and medical knowledge. As a result, these positive secular trends may outweigh or counterbalance the negative effects of reproductive aging for the child. (more…)
Author Interviews, Cancer Research, PLoS, Vitamin D / 15.04.2016

MedicalResearch.com Interview with: Sharon L. McDonnell MPH GrassrootsHealth Encinitas, California Medical Research: What is the background for this study? What are the main findings? Response: Higher vitamin D levels in the blood have been associated with a lower risk of multiple cancer types including colorectal and breast. Using data from two study cohorts of women aged 55 years and older (N=2,304), we investigated the association between serum 25(OH)D concentration, the marker of vitamin D in the blood, and risk of all non-skin cancers combined across a broad range of 25(OH)D concentrations. We found that women with 25(OH)D concentrations ≥40 ng/ml had a 67% lower risk of cancer compared to women with concentrations <20 ng/ml. We also found that the greatest decrease in risk occurred between ~10-40 ng/ml. These findings suggest that increasing 25(OH)D concentrations to a minimum of 40 ng/ml could substantially reduce  cancer incidence and associated mortality in the population. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, HPV, JNCI, MD Anderson / 15.04.2016

MedicalResearch.com Interview with: Harrys A. Torres, MD, FACP, FIDSA Associate Professor Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer Center Houston TX 77030 Medical Research: What is the background for this study? What are the main findings? Dr. Torres: Hepatitis C virus (HCV) is an oncogenic virus and is associated with an increased risk of liver cancer and certain types of non-Hodgkin lymphomas. In 2009, at MD Anderson Cancer Center, we set up the first clinic in the United States, and probably in the world, specifically devoted to managing HCV infection in cancer patients. In the clinic, we expected to see a number of patients with liver cancers and non-Hodgkin’s lymphoma, as these have documented associations with HCV. Unexpectedly, we saw a high number of HCV-infected patients with head and neck cancers, and wondered whether there was an undiscovered association between having the infection and head and neck cancers. To explore this, we conducted a case-control study using 409 head and neck cancer subjects (164 oropharyngeal, 245 non-oropharyngeal [oral cavity, nasopharynx, larynx] cancers) and 694 control subjects with other smoking-associated cancers (378 lung, 168 esophagus, and 148 urinary bladder cancers), and compared the prevalence of HCV infection in the two groups. We observed a high prevalence of HCV infection in oropharyngeal (14%) and non-oropharyngeal (20%) cancer patients when compared to control subjects (6.5%). After adjusting for confounders such as smoking, alcohol intake, and socioeconomic status, HCV-infected individuals were 2.04 times more likely to have oropharyngeal cancers and 2.85 times more likely to have non-oropharyngeal cancers. Of note, HCV was associated only with patients with oropharyngeal cancers that tested positive for human papilloma virus, which is one of the main virus linked with increased risk of oropharyngeal cancers. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Women's Heart Health / 15.04.2016

MedicalResearch.com Interview with: Dr. Neha J. Pagidipati Duke Clinical Research Institute Duke University School of Medicine Durham, North Carolina Medical Research: What is the background for this study? What are the main findings? Dr. Pagidipati: Women and men experience coronary artery disease differently, and a great deal of literature has shown that these differences extend to the diagnostic performance of various noninvasive testing modalities. However, little is known about the sex-specific prognostic value of computed tomographic angiography (CTA) and functional stress testing. We used data from the recent PROMISE trial to address this question. The PROMISE trial enrolled 10,003 patients (53% women) with stable symptoms suggestive of coronary artery disease to a diagnostic strategy of CTA vs stress testing, and found no differences in outcomes overall or by sex. We found that in women, a CTA is less likely to be positive, but when it is positive, it appears to have greater predictive value for a future cardiovascular event (all cause death, myocardial infarction, or unstable angina hospitalization) than stress testing. In men, a stress test is less likely to be positive, and though stress testing trended towards being more predictive of future events, there was no statistically significant difference in the prognostic value of either test type. (more…)
Author Interviews, Cancer Research, Inflammation, Microbiome, PLoS, UCLA / 15.04.2016

MedicalResearch.com Interview with: Robert H. Schiestl PhD Department of Environmental Health Sciences, Fielding School of Public Health, Department of Pathology Department of Radiation Oncology Geffen School of Medicine University of California Los Angeles, Los Angeles, California Medical Research: What is the background for this study? What are the main findings? Dr. Schiestl: When we moved from Harvard to UCLA 13 years ago, after 6 years at UCLA our Atm mouse colony lived significantly 4 fold longer and the frequency of DNA deletions was 4.5 fold reduced and the latency of lymphoma 2.5 fold different. Ultimately we identified the reason behind this as a difference in the intestinal bacteria. The Atm deficient mice are hypersensitive to inflammation and the bacteria reduced inflammation. Then I isolated the most prevalent bacterium among the health beneficial bacteria and this bacterium by itself called Lactobacillus johnsonii 456 reduced genotoxicity and all markers of inflammation. (more…)
Author Interviews, Heart Disease / 15.04.2016

MedicalResearch.com Interview with: Dr. Charles Pollack MD MA Thomas Jefferson University Philadelphia, PA 19107 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pollack:: We are continuing research on PRAXBIND in the ongoing global phase III patient study, RE-VERSE AD™. RE-VERSE AD includes two groups of dabigatran patients: those who had serious bleeding or those who required an urgent procedure. At ACC, we presented results from an updated interim analysis from 123 patients enrolled in RE-VERSE AD™, which showed a single 5g of PRAXBIND immediately reversed the anticoagulant effect of dabigatran in all patients evaluated. (more…)