MedicalResearch.com Interview with:
Marte Handal PhDDivision of Epidemiology
Norwegian Institute of Public Health
Oslo, NorwayMedical Research: What is the background for this study?
Dr. Handal: The prevalence of depression during pregnancy is estimated to be as high as between 7 and 15%. It is well understood that untreated maternal depression may be harmful to both the mother and the child. When medical treatment of pregnant women is necessary, selective serotonin reuptake inhibitors (SSRIs) is the most common treatment. However, limited information is available on the potential effect of prenatal exposure to SSRIs on the child’s motor development.
Medical Research: What are the main findings?
Dr. Handal: We did find a week association between prolonged maternal use of SSRIs during pregnancy and delayed motor development in the child even after we had taken the mothers history of depression and her symptoms of anxiety and depression during and after pregnancy into account. However, only a few children were in the least developed category, corresponding to clinical motor delay, indicating that clinical importance is limited.
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MedicalResearch.com Interview with:
Ann-Cathrine LarsenMD, PhD-student
University of Copenhagen
Faculty of Health Sciences
Department of Neuroscience and Pharmacology, Eye Pathology Section
Copenhagen
Medical Research: What is the background for this study?
Dr. Larsen: Conjunctival melanoma is an uncommon malignancy with a high mortality. Population-based studies evaluating prognostic features and treatment are rare. The clinicopathological and prognostic features associated with BRAF-mutations in conjunctival melanoma are unclear.
Medical Research: What are the main findings?
Dr. Larsen: Extrabulbar tumor location and invasion of adjacent tissue structures were poor prognostic features. Incisional biopsy and excision without adjuvant therapy were associated with metastatic disease. Younger age at diagnosis, bulbar or caruncular tumor location, T1 stage tumor, lack of clinical melanosis and mixed or non-pigmented tumor color were features associated with BRAF-mutated conjunctival melanoma. Furthermore, Patients with BRAF mutated tumors seem to have an increased risk of distant metastatic disease.
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MedicalResearch.com Interview with:
Michael P. Sherman, MD, FAAP
Professor, Department of Child Health
University of Missouri - Columbia
Women's and Children's Hospital
Columbia, Missouri 65201
Medical Research: What is the background for this study?
Dr. Sherman: We understand eosinophils are inflammatory cells in the lung during asthma attacks. Publications in a Nature journal described how eosinophils come to the lung after airway injury. Since the lung and intestine have the same embryonic source, we theorized that eosinophils would rise in the blood after the onset of necrotizing enterocolitis in preterm human infants. We correctly predicted that a rise in blood eosinophils would predict later complications from this disease.
Medical Research: What are the main findings?
Dr. Sherman: We found that within two days of disease onset infants could have a rise in eosinophils greater than 5% of the total white blood cell count. If this increase persisted for five or more days, the infant was at risk for later medical or surgical complications including feeding problems, bowel blockage, or intestinal rupture Area under the curve = 0.97, CI: .92-1.0). The babies having this finding were smaller and more premature.
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MedicalResearch.com Interview with:
Tanja D de Gruijl PhD
Professor Translational Tumor Immunology
Head Immunotherapy Lab
Department of Medical Oncology
VU University medical center-Cancer Center Amsterdam
Amsterdam, The Netherlands
Medical Research: What is the background for this study? What are the main findings?
Dr. de Gruijl: Patients that have just been diagnosed with melanoma after heaving a suspect mole removed, at this moment in time don’t have any treatment options to eliminate any sub-clinical micrometastases that (sometimes years later) can grow into distant tumors. These patients, even at these early stages of melanoma, nevertheless run a risk of this happening (between 10 and 30%, depending on local tumor penetration and spread) and all they can do is wait and it see if the surgical removal of the tumor came in time. We reasoned that if we could boost immune cells directed against the tumor in the first-line melanoma-draining (i.e. sentinel) lymph node that remained after removal of the primary tumor we could achieve a systemic immune response against the tumor that would provide a body-wide protection against outgrowth of metastases at a later time. We indeed found (and described in publications) that we were able to boost anti-tumor immunity in this way, by locally injecting the immune stimulatory compound CpG-B into the scar at the site where the primary melanoma was surgically removed, in the week leading up to the surgical removal of the sentinel lymph node. CpG-B resembles bacterial DNA and alerts the immune system to a possibly dangerous infection, thus effectively inducing immune activation. We performed two randomized clinical trials and found T cells recognizing protein fragments associated with melanoma tumors to indeed be expanded and activated in the tumor-draining sentinel lymph node but, importantly, also in the blood of the treated patients. In patients who were administered a placebo control these effects were not observed. We are now seven to eleven years on from when we carried out these trials and have performed clinical follow-up on these patients. We are excited to conclude that patients treated with the CpG-B compound have indeed experienced fewer tumor recurrences during that time (only two out of 30) than patients from the control group who show the (expected) higher rate of tumor recurrences (nine out of 22).(more…)
MedicalResearch.com Interview with: Dr Jonas Minet Kinge PhD
Researcher, Department of Health Statistics, Norwegian Institute of Public Health
Associate professor, Department of Health Management and Health Economics University of Oslo
Norwegian Institute of Public Health
Oslo, Norway
Medical Research: What is the background for this study? What are the main findings?Response: Previous studies have shown that the number of people with obesity increases with the gross domestic product (GDP) of a country. Previous research has also indicated that education can be an important factor in this context. The aim of this new study was to explore the assumption from previous studies that obesity is linked to GDP and education, and to include new data from several different countries.
The results from this study confirm that there is an association between obesity, education and GDP. The prevalence of obesity increases with rising GDP, but only among individuals with lower levels of education. There is no significant increase in obesity among those with higher education.
This means that:
In countries with low GDP there is more obesity among those with high education.
In countries with high GDP there is more obesity among those with low education.
The study also found that the relationship was somewhat more marked among women than among men.
MedicalResearch.com Interview with:
Dr. Germaine Louis Buck PhD
Senior Investigator and Director of the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institutes of Health Medical Research: What is the background for this study? What are the main findings?
Dr. Germaine Buck: We wanted to develop intrauterine standards for ultrasound measured fetal growth, given that none currently exist for contemporary U.S. pregnant women. Moreover, we wanted to determine if a single standard would be possible for monitoring all pregnant women, or if the standard needed to be tailored to pregnant women’s race/ethnicity. This added step attempted to address the equivocal data about whether or not race/ethnicity is an important determinant of optimal fetal growth.
Analyzing data from 1,737 low risk pregnant women with uncomplicated pregnancies who had 5 ultrasounds done at targeted times during pregnancy, we found significant differences in estimated fetal weight across the 4 maternal race/ethnic groups. These differences were apparent beginning about 16 weeks gestation and continuing throughout pregnancy. The differences in these curves were apparent when assessing infant’s birthweight, as well. Overall, estimated fetal weights while women were pregnant were highest for White mothers followed by Hispanic, Asian, and Black mothers. A 245 gram difference in estimated fetal weight was observed at 39 weeks gestation between pregnant White and Black women. This pattern was then observed for measured birth weight, with highest birthweights for White then Hispanic, Asian, and Black infants.
Other differences emerged by maternal race/ethnicity for individual fetal measurements: longest bone (femur & humerus) lengths were observed for Black fetuses emerging at 10 weeks gestation, larger abdominal circumference for White fetuses emerging at 16 weeks gestation, larger head circumference for White fetuses emerging at 21 weeks gestation, and larger biparietal diameter for White fetuses emerging at 27 weeks gestation in comparison to other groups.
The race/ethnic differences in fetal size were highly significant and across gestation. If a single White standard was used for estimating fetal weight for non-White fetuses in pregnant women, between 5% and 15% of their fetuses would have been misclassified as being in the <5th percentile of estimated fetal weight.
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MedicalResearch.com Interview with:
Timothy Anderson, M.D.
Chief medical resident
Department of Internal Medicine
University of Pittsburgh
Medical Research: What is the background for this study? What are the main findings?
Dr. Anderson: My coauthors and I analyzed the public disclosures of all publicly traded U.S. health care companies listed on the NASDAQ exchange and New York Stock Exchange in January 2014 that specialized in pharmaceuticals, biotechnology, medical equipment and providing health care services. Of the 442 companies with publicly accessible disclosures on boards of directors, 180 – or 41 percent – had one or more academically affiliated directors in 2013. These individuals included chief executive officers, vice presidents, presidents, provosts, chancellors, medical school deans, professors and trustees from 85 non-profit academic research and health care institutions. These individuals received compensation and stock shares from companies which far exceeds payment for other relationships such as consulting. In some cases compensation approaches or exceeds average professor and physician salaries.
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MedicalResearch.com Interview with:
Adela Hruby PhD
Adjunct Instructor, Friedman School of Nutrition Science and Policy
Research Fellow, Harvard School of Public Health
Fellow, Oak...
MedicalResearch.com Interview with: Nadine Parker M.Sc
Injury Prevention Research Office
Li Ka Shing Knowledge Institute
Keenan Research Centre
St. Michael’s Hospital
Toronto, Ontario, Canada
Medical Research: What is the background for this study? What are the main findings?
Response: TV toppling injuries in children have become increasingly more common in recent years. Including in countries with developing economies where televisions are becoming more affordable. Unfortunately, most people don’t recognize televisions as a hidden home hazard. These easily preventable injuries can be severe or even fatal. Of the deaths due to TV toppling 96% were caused by a head injury. Most of these injuries occur at home with 75% of them unwitnessed by a parent or caregiver. Often furniture such as dressers are used as TV stands but they are not designed to support the weight of TV sets making them unstable. Unfortunately, curious and resourceful young children like to climb these unstable support furniture leading to a toppling event. Play or pushing and pulling the TV set are also common causes of tip-overs.
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MedicalResearch.com Interview with:
Alvin Thomas, Ph.D.
Assistant Professor
Associate Director Center For Excellence in Diversity
Palo Alto University
Palo Alto, CA 94304
Walking Away Hurt, Walking...
MedicalResearch.com Interview with:
Jane E. Salmon, MDDivision of Rheumatology
Hospital for Special Surgery, and
Weill Cornell Medical College, New York, NYMedical Research: Background on lupus and antiphospholipid antibodies - what are they?Dr. Salmon: Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease that predominantly affects women and presents during their childbearing years. In SLE, the immune system which normally protects one from infection, turns reacts against the self and can cause damage of multiple organs.
Antiphospholipid antibodies (APL) occur in some people with SLE and some without SLE. They are autoantibodies that can damage the placenta and cause arterial and venous thromboses. Patients with APL can have fetal deaths, miscarriages, preeclampsia and/or growth restricted babies.
Pregnancy in patients with SLE, particularly those with antiphospholipid antibodies (APL), and in patients with APL alone, is associated with an increased risk for maternal and fetal morbidity due to preeclampsia (PE) and insufficient placental support of the developing fetus. PE and placental insufficiency are, in turn, associated with adverse pregnancy outcomes (APOs), including maternal complications of PE, intrauterine fetal death, and fetal growth restriction, as well as indicated preterm delivery. Given that APOs affect over one fifth of pregnancies in SLE and/or APL, the ability to identify patients early in pregnancy who are destined for poor outcomes would significantly impact care of this high risk population.
Medical Research: Two bullets about your PROMISSE study:
Dr. Salmon: The PROMISSE Study (Predictors of pRegnancy Outcome: bioMarker In antiphospholipid antibody Syndrome and Systemic lupus Erythematosus). PROMISSE is the largest multi-center, multi-ethnic and multi-racial study to prospectively assess the frequency of APO, clinical, laboratory and biomarker variables that predict APO, in women with SLE and/or APL with inactive or mild/ moderate activity at conception.
Pregnant patients with SLE and/or APL were enrolled at <12 weeks gestation into PROMISSE between September 2003 and August 2013 at 7 sites (n=497) along with matched healthy controls (n=207) and followed every month of pregnancy.(more…)
MedicalResearch.com Interview with:
Wisit Cheungpasitporn, MD
Nephrology Fellow
Departments of Nephrology and Hypertension
Program director: Suzanne Norby, MD
Co-authors: Charat Thongprayoon, MD, Oisin A O'Corragain, MD, Peter J Edmonds, BS, Wonngarm Kittanamongkolchai, MD, Stephen B Erickson, MD
Project mentor: Stephen B. Erickson, MD Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN
Medical Research: What is the background for this study?Dr. Cheungpasitporn: High-fructose corn syrup consumption in the form of sugar-sweetened soda has dramatically increased worldwide and associated with risk factors for chronic kidney disease (CKD) including diabetes mellitus (DM) and metabolic syndrome. Recently, artificial sweeteners have become commonly used in soda marketed as ‘diet’ alternatives. Recent studies have demonstrated that diet soda consumption may also be associated with weight gain, metabolic syndrome and cardiovascular disease. The risks of CKD in individuals with sugar-sweetened or diet soda consumption, however, were conflicting. We therefore conducted a meta-analysis to assess the associations between CKD and the consumption of sugar sweetened and diet soda. The findings of our study were recently published in Nephrology (Carlton). 2014; 19(12):791-7.
Medical Research: What are the main findings?
Dr. Cheungpasitporn: Five studies (2 prospective cohort studies, 2 cross-sectional studies and a case-control study) were included in our analysis of the association between consumption of sugar-sweetened soda (≥1-2 drinks of sugary soda/day) and CKD. We found an overall 1.58-fold increase CKD risk in individuals who regularly consumed sugar-sweetened soda with the pooled risk ratio (RR) of 1.58 (95% CI 1.00–2.49). Four studies (2 prospective cohort studies, a cross-sectional studies and a case-control study) were included to assess the association between CKD and diet soda consumption (≥1-2 drinks of diet soda/day). Despite a trend of chronic kidney disease risk in individuals with diet soda consumption with the pooled RR of 1.33 (95% CI 0.82–2.15), this association was not statistically significant.
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MedicalResearch.com Interview with:
Milena Sant, MD
Analytical Epidemiology and Health Impact Unit
Department of Preventive and Predictive Medicine
Fondazione IRCCS Istituto Nazionale dei Tumori
Milan, Italy
Medical Research: What is the background for this study? What are the main findings?
Dr.Milena Sant: Effective treatments for haematological malignanacies are available since early 2000, however in previous studies differences in survival by large European region were evidenced. We used the EUROCARE data to investigate survival time trends and differences across countries within large regions.
The study results highlighted a general improvement in 5-year relative survival, most marked for CML (5-year relative survival improved from 30% to 54% from 1997 to 2006-08; and for NHL, particularly follicular type (from 59 to 74%); less variation was seen for Hodgkin survival; Despite this increase, remarkable differences by country within regions were evident. For instance CML survival varyied from 33% in Eastern European countries to 58%in central and northern European countries
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MedicalResearch.com Interview with:
Brick Johnstone, Ph.D., ABPP
Professor
MU Department of Health Psychology
DC116.88
Columbia, MO 65212Medical Research: What is the background for this study? What are the main findings?Dr. Johnstone:We are interested in identifying the specific religious/spiritual factors associated with health. In general it is known that positive spirituality is associated with better health, and for a small population, negative spiritual beliefs are associated with worse health. We wanted to see about such relationships for individuals who had any degree of negative spirituality (i.e., belief they were being punished, abandoned).
The main finding is that even a minor degree of negative spiritual beliefs is associated with worse health.
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MedicalResearch.com Interview with:
Prof. Andrew B Lemmey
School of Sport, Health and Exercise Sciences
Bangor University
Bangor, Gwynedd, Wales, UK
Medical Research: What is the background for this study?
Prof. Lemmey: Substantial loss of lean mass (LM; mostly skeletal muscle) is common in patients with rheumatoid arthritis (RA), as we and others have shown that even amongst patients with well-controlled disease approximately 67% are significantly muscle wasted. This loss of muscle, termed “rheumatoid cachexia”, is a major contributor to the decreased strength and impaired physical function which continues to characterise RA. Unfortunately, current drug treatments for RA, including use of biologics and the ‘treat-to-target (T2T)’ strategy, do not reverse this LM loss, nor fully restore physical function (Lemmey et al., “Tight control of disease activity fails to improve body composition or physical function in rheumatoid arthritis patients”. Submitted to Rheumatology (Oxford), currently under review). Whilst high-intensity exercise (specifically, progressive resistance training (PRT)) has been shown to be highly effective in restoring both lean mass and function in rheumatoid arthritis patients (Lemmey et al., Arthritis Care & Research 2009;61(12):1726-34), the lack of uptake and adherence to sufficiently intense training (Lemmey et al., Arthritis Care & Research 2012;64(1):71-5) means this form of therapy is not widely adopted. Anabolic nutritional supplementation offers a potential adjunct treatment intervention for increasing LM, and thereby improving physical function, that could be widely accepted. Indeed, our group (Marcora et al., Clinical Nutrition 2005;24(3):442-54) has previously demonstrated that 12 weeks of daily oral protein supplementation improved lean mass and some measures of strength and function in rheumatoid arthritis patients.
Creatine (Cr) is a popular dietary supplement generally shown to have greater benefits on both lean mass and physical function than generic protein supplementation. One study (Willer et al., Rheumatology 2000;39(3):293-8) has investigated the efficacy of Cr supplementation in rheumatoid arthritis patients. In this short uncontrolled trial, twelve patients underwent 3 weeks of supplementation, and although strength increased, no changes in function were found, and body composition changes were not investigated.
Using a double-blind, placebo controlled design, the current study aimed to investigate the effects of 12 weeks of oral Cr supplementation on body composition (by DXA; dual energy X-ray absorptiometry), strength (knee-extensor and handgrip) and objectively-assessed physical function (chair and walk tests) in patients with RA. Thirty-five patients (Cr=15, Pl=20) completed the study.(more…)
MedicalResearch.com Interview with:
Shannon M. Monnat, PhD
Assistant Professor of Rural Sociology, Demography, and Sociology
Department of Agricultural Economics, Sociology, and Education
The Pennsylvania State University
University Park, PA 16802Medical Research: What is the background for this study? What are the main findings?
Dr. Monnat: Given concurrent rapid increases in opioid prescribing and adolescent prescription opioid misuse since the 1990s and historical problems with opioid abuse in rural areas, we were interested in whether adolescents in rural areas were more likely to abuse prescription opioids than their peers in urban areas. Adolescence is a really crucial time to study substance abuse disorders because most abuse begins during adolescence, and individuals who begin use before age 18 are more likely to develop a long-term disorder as an adult compared to those who first try a substance later in life. The active ingredient in prescription opioids and heroin is the same. Prescription opioids are highly addictive and can be dangerous if utilized incorrectly. Prescription opioid abuse is currently responsible for over 16,000 deaths in the US annually and has an estimated annual cost of nearly $56 billion dollars. Therefore, it is correctly viewed as a major public health problem.
We found that teens living in rural areas are more likely to abuse prescription opioids compared to teens living in large urban areas. Several important factors increased rural teens’ risk of abusing prescription opioids, including that they are more likely to rely on emergency department treatment than their urban peers, they have less risky attitudes and perceptions about substance abuse than their urban peers, and they are less likely to be exposed to drug/alcohol prevention messages outside of the school environment than their urban peers. Rural teens are also buffered by several factors that help to reduce opioid abuse, including stronger religious beliefs, less depression, less peer substance abuse, and less access to illicit drugs. If not for these protective factors, the current epidemic we see in rural areas could be even worse.
We also found that both rural and urban adolescents were most likely to report obtaining the prescriptions they abused from friends or family. However, rural adolescents were less likely than urban adolescents to obtain the pills this way. Rural adolescents were more likely than urban adolescents to report getting the pills they abuse directly from physicians.(more…)
MedicalResearch.com Interview with:
Prof. Danilo Ercolini, PhD
Department of Agricultural Sciences
University of Naples Federico II
Portici - Italy
Medical Research: What is the background for this study? What are the main findings?
Prof. Ercolini: There is a thick body of literature showing that diet can significantly impact the gut microbiota and metabolome.
In a recent study, negligible differences in gut microbiota and feca lshort-chain fatty acids (SCFA) were reported between habitual omnivores and vegans in the USA.
In addition, Mediterranean diet is a recognized healthy dietary pattern but has not previously been related to the composition of the gut microbiota and related metabolome. That’s the background in short.
Here we show how habitual vegetarian and vegan diets promote enrichment of fibre-degrading bacteria in the gut.
Subjects who consume a Mediterranean diet rich in fruit, legumes and vegetables have higher levels of fecal short chain fatty acids, regardless of the diet type.
Low adherence to the Mediterranean diet corresponds to an increase in urinary trimethylamine oxide levels, a potential risk factor for cardiovascular disease.
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MedicalResearch.com Interview with:
Dr. Kathy D. Miller, MD
Indiana University Melvin and Bren Simon Cancer Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Miller: Previous studies had found a small but real benefit with the addition of chemotherapy to anti-estrogen treatment in patients with hormone sensitive disease. The challenge for patients and clinicians has always been that the benefit of chemotherapy is quite small and the toxicity can be substantial. The Oncotype Dx recurrence score assay was developed to identify patients who could safely be treated with anti-estrogen therapy alone (and conversely those who truly need and would derive a much larger benefit from chemotherapy). When the Oncotype Dx RS was applied to samples stored from a previous randomized trial, patients with low risk scores didn't seem to benefit from chemotherapy. While those initial results had some impact on treatment, many were concerned about eliminating chemotherapy on the basis of one small retrospective trial.
The overall trial enrolled 10,253 women. 1626 (15.9%) had a Recurrence Score of 0-10 and were assigned to receive antiestrogen therapy alone without chemotherapy. After five years 99.3% (98.7, 99.6%) for were free of distant relapse (that is to say, 99.3% of women had NOT had recurrence of breast cancer at distant sites in the body). Overall survival was 98%.
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MedicalResearch.com Interview with:
Dr. Wilfried Gwinner
Div. of Nephrology and Hypertension
University of Hanover
Medical School Hannover and
Dr. Uta Erdbruegger
Div. Nephrology and Hypertension Division
University of Virginia, Charlottesville
Medical Research: What is the background for this study? What are the main findings?Dr. Erdbruegger: Controversy exists whether CMV infections or viremia after kidney transplantation affect patient and graft survival.
We aimed to explore the role of CMV in a retrospective study on almost 600 patients followed at our transplant center over a period of up to 10 years post-transplant. The analysis included protocol biopsy findings and causes for graft failure and death.
We observed reduced patient and graft survival in patients with CMV as reported in some of the previous studies. However, we found that patients with CMV had an inferior kidney function and significant chronic allograft changes in the biopsies very early after transplantation – even before the CMV infection. Also, CMV infection was not specifically related to a progression of chronic changes. On the other hand, we confirmed well-established factors like inferior graft function early on, delayed graft function, and higher donor and recipient age as important for patient and graft survival. In none of these analyses, CMV was a significant factor. In summary, this suggests that CMV is rather an epiphenomenon. Alternatively, we might have missed a possible small effect of CMV in our statistics. In any case, our results do not support a significant role of CMV in patient and graft outcomes.
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MedicalResearch.com Interview with:
Dr. Rebecca Prince MBBS
Clinical Research Fellow and first author and
Monika K. Krzyzanowska, MD MPH FRCPC
Medical Oncologist, Princess Margaret Cancer Centre, Associate Professor, Dept of Medicine and Institute of Health Policy, Management & Evaluation, University of Toronto
Senior Adjunct Scientist, Institute for Clinical Evaluative Sciences
Clinical Lead, Quality Care & Access, Systemic Treatment Program, Cancer Care Ontario Toronto, ONMedical Research: What is the background for this study? What are the main findings?
Response: This study was inspired by our previous work using administrative data in which we found that a large proportion of patients receiving chemotherapy in routine practice were visiting the emergency department and being admitted to hospital. Our perception was that the frequency of these events was higher than expected but when we went to look what was expected, ie. how often were people ending up in hospital during treatment in clinic trials, this data was not readily available. This led us to perform a systematic review of the literature including a comparison of hospitalization rates between patients treated in clinical trials and patients in similar clinical scenarios treated in routine practice. We ended up focusing on metastatic lung cancer as that was one of the clinical scenarios where we were able to identify published data from both clinical trials and routine practice.
The main finding of our study is that hospitalizations are very common during chemotherapy. We compared patients with metastatic lung cancer being treated in routine practice and clinical trials and found that that approximately half (51%) of patients treated in routine practice were hospitalized during chemotherapy, compared to 16% of trial patients. We also found that very few clinical trials reported this information which is routinely collected during the trial.
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MedicalResearch.com Interview with:
M.A. Frouws, Study Coordinator ASPIRIN trial
MD PhD Candidate
Datacenter Heelkunde, K6-R
Leiden University Medical Center
Leiden, the Netherlands
Medical Research: What is the background for this study? What are the main findings?
Response: The effect of aspirin on cancer survival has been the topic of many studies for a few decades. Epidemiological evidence shows a dual role in the relation between aspirin and cancer; both preventative and therapeutic effects are suggested. The biological mechanism of the effect of aspirin on cancer is still part of debate. However research up until now was mainly done at a single tumor location, mostly colorectal cancer. Since little is known about the etiology of the effect of aspirin, we have undertaken in this study. The aim of this study was to investigate the effect of the use of aspirin after diagnosis on survival in patients with cancer from the gastrointestinal tract. Stratification in specific localizations in the entire gastro intestinal tract could lead to new insights towards the effect of aspirin as a therapeutic agent.
We studied 13.715 patients and found a really significant survival benefit in patients taking aspirin after diagnosis of gastrointestinal malignancies, except for pancreatic cancer. Survival in patients with gastro intestinal malignancies taking aspirin after diagnosis showed to be twice as high as patients not taking aspirin. At five years after diagnosis, 75% of patients were alive who took aspirin, versus 42% of the patient group not taking aspirin. This effect persisted after correcting for several confounding factors, including age, disease stage and comorbidity.
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MedicalResearch.com Interview with:
Kenneth E. Freedland, PhD
Professor of Psychiatry and Psychology
Washington University School of Medicine
St. Louis, Missouri
Medical Research: What is the background for this study? What are the main findings?
Dr. Freedland: Major depression is a common problem in patients with heart failure, and it makes heart failure self-care tasks such as daily weight checks and compliance with dietary restrictions more difficult for these them. Unfortunately, recent clinical trials have shown that both depression and inadequate self-care can be hard to treat in patients with heart failure.
Cognitive behavior therapy (CBT) is often used to treat depression in otherwise healthy individuals, but it hasn’t been tested in patients with heart failure. We added a self-care component to the standard CBT treatment protocol and conducted a clinical trial to determine whether it is effective both for depression and for self-care. We randomized 158 heart failure patients to cognitive behavior therapy or to usual care, and both groups received heart failure education. About 1/3 of the patients in both groups were also taking antidepressant medications. The intervention was effective for depression, with remission rates of 51% in the cognitive behavior therapy group compared to only 20% in the usual care group. However, it was not effective for heart failure self-care.
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MedicalResearch.com Interview with:
Dr Gareth Hagger-Johnson PhD
SeniorResearch associate
Epidemiology & Public Health, Div of Population Health
University College, London
Medical Research: What is the background for this study? What are the main findings?
Response: Even among adults who meet recommended physical activity levels and who sleep for eight hours per night, it is possible to spend the vast majority of the day (up to 15 hours) sitting down. We were concerned about possible harm resulting from sitting for long periods combined with not moving.
Breaks in sitting time have previously been shown to improve markers of good health, such as body mass index and your body’s glucose and insulin responses. But until now, no study has ever examined whether fidgeting might modify an association between sitting time and mortality.
We noticed that The UK Women’s Cohort Study collected data (from 1999 to 2002) on health behavious, chronic disease, physical activity levels, sitting time - and fidgeting (a self-report scale ranging from 0 to 10, where 10 means ‘constantly’). More than 12,000 responses were received. We looked at the data to see who had died over the next 12 years.
Among women with low levels of fidgeting who also sat for 7 or more hours per day (compared to less than 5 hours), there was around a 30% increase in the risk of mortality over 12 years follow-up. Among women with medium or high levels of fidgeting, we did not see this harmful effect of sitting time, even after adjusting for other lifestyle factors including physical activity level.
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MedicalResearch.com Interview with:
Daihai He, PhD
Assistant Professor
Department of Applied Mathematics
Hong Kong Polytechnic UniversityMedical Research: What is the background for this study? What are the main findings?
Response: We studied the patterns of MERS-CoV cases and influenza cases from May 1, 2012 to May 31, 2015 in the Middle East. Our key findings are that the three waves of MERS appear to follow the waves of influenza A in the Middle East during the period. The influenza A(H1N1)pdm wave which occurred in Egypt in early 2014 closely led to the first major MERS wave in May 2014, while the H3N2 wave in late 2014 in Egypt closely led to the third MERS wave in early 2015. The second MERS wave in late 2014 and third MERS wave in early 2015 appeared to be split off by a H3N2 and/or A(H1N1)pdm waves in the region.
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MedicalResearch.com Interview with:
Sophie von Stumm BSc MSc PhD
Department of Psychology
Goldsmiths University of London
London, United Kingdom
Medical Research: What is the background for this study?
Dr. von Stumm: At the Hungry Mind Lab (www.hungrymindlab.com), which I direct, we study individual differences in lifespan cognitive development. In particular, I am interested in factors that influence change in cognitive ability and knowledge. One such factor is breastfeeding, which some previous studies suggested to be associated children's intelligence and IQ gains while others failed to find a relationship.
Medical Research: What are the main findings?
Dr. von Stumm: For this study, which was published last week in PloS One (link:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138676), data were analyzed from more than 11,000 children born in the UK between 1994 and 1996. The children had been repeatedly assessed on IQ: the first time they were tested on intelligence at age 2, and then again repeatedly throughout childhood, overall 9 times, until the age of 16 years. We found that having been breastfed versus not having been breastfed was not meaningfully associated with children's IQ differences at age 2 and also not with differences in children's IQ gains until age 16. That is not to say that breastfeeding may not have other benefits for children's development but our study strongly suggests that breastfeeding is not important for children's IQ. (more…)
MedicalResearch.com Interview with:
Talley Holman, PhD, MBA
Senior eHealth Systems Analyst, Practice Advancement
American Academy of Family Physicians
Leawood, KS 66211 and
John Beasley MD
Professor of Family Medicine
School of Medicine and Public Health and the
Department of Industrial and Systems Engineering
University of Wisconsin Madison, WI
Medical Research: What is the background for this study?
Dr. Holman: From an engineering standpoint, tools such as EHRs are designed based on objectives, and the workflows that are created are developed to achieve those objectives. In health care, workflows have not been well understood, so designers have made assumptions when pressed to create tools to address specific situations, problems, or issues. However, the effectiveness of many of these tools is lacking, based on feedback. This led us to take a step back and ask if there is a standard workflow, and if so, what is it?
Dr. Beasley: Physicians (and staff) have noted that the EHR is not doing a good job of supporting their work - and changes are made that appear to disrupt the physician’s workflow. There appears to have been an assumption on the part of designers/implementers that workflow is linear.
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MedicalResearch.com Interview with: Anthony V. D'Amico, MD, PhD
Chief, Division of Genitourinary Radiation Oncology
Professor of Radiation Oncology, Harvard Medical School
Medical Research: What is the background for this study? What are the main findings?
Dr. D'Amico: Controversy exists as to whether androgen deprivation therapy (ADT) used to treat prostate cancer can cause fatal cardiac events.
We found that in men with moderate to severe comorbidity based most often on a history of a heart attack that the use of 6 months of androgen deprivation therapy to treat non metastatic but clinically significant prostate cancer was associated with both an increased risk of a fatal heart attack and shortened survival.
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MedicalResearch.com Interview with:
Susanna C. Larsson PhD, Associate Professor
Associate professor, Nutritional Epidemiology
Institute of Environmental Medicine
Karolinska Institutet
Stockholm, Sweden
Medical Research: What are the main findings?
Dr. Larsson: A high dietary cholesterol intake has been postulated to increase the risk of cardiovascular disease. Egg is a rich source of dietary cholesterol and has been positively associated with risk of heart failure in previous prospective studies. High consumption of eggs has also been associated with a higher risk of myocardial infarction in diabetic patients.
Medical Research: What is the background for this study?
Dr. Larsson: We investigated the association between egg consumption and risk of cardiovascular diseases in two population-based prospective cohort studies of approximately 38,000 Swedish men and 33,000 Swedish women. Findings from our study indicate that egg consumption does not increase the risk of myocardial infarction, ischemic stroke, or hemorrhagic stroke. High egg consumption (one or more times per day) was associated with an elevated risk of heart failure in men but not in women. Egg consumption was not associated with an increased risk of heart failure, myocardial infarction, or stroke in individuals with diabetes.
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MedicalResearch.com Interview with:
Cheryl H. Tan, M.P.H.
Epidemiologist and lead author of the study
National Center on Birth Defects and Developmental Disabilities
CDC
Medical Research: What is the background for this study? What are the main findings?
Response: One in 10 pregnant women in the United States aged 18 to 44 years reports drinking alcohol in the past 30 days and 3.1 percent of pregnant women report binge drinking – defined as 4 or more alcoholic beverages on one occasion. That means about a third of pregnant women who consume alcohol engage in binge drinking.
This is concerning because women who are pregnant or who might be pregnant should avoid drinking alcohol. Alcohol use during pregnancy is associated with an increased risk of birth defects and developmental disabilities in babies, as well as other pregnancy problems, such as miscarriage, stillbirth, and prematurity.
Alcohol consumption during pregnancy causes Fetal alcohol spectrum disorders (FASDs), which are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These conditions include physical problems, behavioral problems, and leaning disabilities. FASDs are completely preventable: if a woman does not drink alcohol during pregnancy, her child has zero risk of an FASD.
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MedicalResearch.com Interview with:
Marte Handal PhD
Division of Epidemiology
Norwegian Institute of Public Health
Oslo, Norway
Medical Research: What is the background for this study?
Dr. Handal: The prevalence of depression during pregnancy is estimated to be as high as between 7 and 15%. It is well understood that untreated maternal depression may be harmful to both the mother and the child. When medical treatment of pregnant women is necessary, selective serotonin reuptake inhibitors (SSRIs) is the most common treatment. However, limited information is available on the potential effect of prenatal exposure to SSRIs on the child’s motor development.
Medical Research: What are the main findings?
Dr. Handal: We did find a week association between prolonged maternal use of SSRIs during pregnancy and delayed motor development in the child even after we had taken the mothers history of depression and her symptoms of anxiety and depression during and after pregnancy into account. However, only a few children were in the least developed category, corresponding to clinical motor delay, indicating that clinical importance is limited.
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