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.
(more…)
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:
Philip J. Peters MD DTM&H (Diploma in Tropical Medicine & Hygiene)
Medical Officer,
Division of HIV/AIDS Prevention
US Centers for Disease Control and Prevention
Atlanta Georgia
Medical Research: What is the background for this study? What are the main findings?
Dr. Peters: We recruited participants from the STOP project, an existing multi-site study in North Carolina, New York City, and San Francisco, to analyze self-reported HIV-related risk behaviors among men who have sex with men (MSM). We found that newly diagnosed HIV-positive gay and bisexual men in North Carolina (predominately young and African American) did not always report male sex partners at the time of HIV testing.
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MedicalResearch.com Interview with:
Ramon C. Hermida Dominguez, Ph.D.
Director, Bioengineering & Chronobiology Labs.
Campus Universitario
Vigo, Pontevedra
Medical Research: What is the background for this study? What are the main findings?
Dr. Hermida Dominguez: Independent studies have shown that the asleep blood pressure (BP) mean is abetter predictor of cardiovascular risk than clinic BP or the awake blood pressure mean derived from ambulatory BP monitoring. Moreover, sleep-time hypertension is highly prevalent among patients with type 2 diabetes. In the first manuscript we tested two novel hypotheses:
(i) whether sleep-time BP is a prognostic marker for future development of diabetes; and (ii) whether progressive reduction of sleep-time blood pressure actually reduces the risk of developing diabetes.
The main findings indicate that sleep-time blood pressure is indeed a highly significant prognostic marker for new-onset diabetes, while clinic blood pressure measurements are not. Most important from the therapeutic point of view, the results from our prospective study also indicate lowering asleep blood pressure could indeed be a significant method for reducing the risk of developing diabetes.
On the other hand, multiple clinical trials have shown that bedtime ingestion of hypertension medications of several classes is associated with improved blood pressure measurements control and increased efficacy in lowering asleep BP. In the second manuscript we investigated whether therapy with the entire daily dose of one or more antihypertensive medications at bedtime exerts better reduction in the risk of developing diabetes than ingesting all medications in the morning upon awakening. The results from this randomized clinical trial indicate a significant 57% decrease in the risk of developing diabetes in the bedtime compared to the awakening treatment regimen.
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MedicalResearch.com Interview with:
Dr Marcus Kleber PhD
Post-doctoral researcher at the Vth Department of Medicine of the Medical Faculty Mannheim Heidelberg University
Medical Research: What is the background for this study? What are the main findings?
Dr. Kleber: Most trans fatty acids in our diet are industrially produced. High concentrations of trans fatty acids are hazardous to human health but whether low concentrations are also harmful has not been studied in detail. We measured trans fatty acids in the erythrocyte membranes of our study participants and found relatively low levels that were not associated with increased mortality. To the contrary, we found an association with a reduced risk for sudden cardiac death for higher concentrations of the naturally occurring trans fatty acid trans-palmitoleic acid that is ingested with milk and milk products.
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MedicalResearch.com Interview with:
Meng-Yun Lin, MPH PhD candidate
Department of Health Policy & Management
Boston University School of Public Health
Boston MA 02118
Medical Research: What is the background for this study? What are the main findings?
Response: Racial and ethnic disparities in health care are widely documented, however the process by which they occur is not fully understood. One potential mechanism is through the process of treatment decision making, and racial/ethnic variations in that communication process. Thus, the goal of this study was to examine racial/ethnic differences in the types of information communicated by physicians regarding their rationale for recommendations for care, using national data collected from a diverse group of respondents.
We found that Americans’ experiences with information communicated by physicians regarding rationale behind treatment recommendations vary on some dimensions by race and ethnicity. In general, Blacks and Hispanics receive less information from their doctors than non-minorities do regarding the rationale for treatment decision-making. Specially, Blacks’ and Hispanics’ doctors less often cited their own experiences, or scientific research as a reason for treatment recommendations. Our findings suggest differences in key elements of shared decision making are evident in the care of racial/ethnic minorities.
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MedicalResearch.com Interview with:
Kevin J. Contrera, MPH
MD CandidateJohns Hopkins School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Response: Hearing impairment is common in older adults. The prevalence of clinically significant hearing loss doubles with every decade of life, affecting two-thirds of adults 70 years of age or older. Hearing loss has been shown to be associated with various negative cognitive, mental, and physical health outcomes.
In a nationally representative sample of 1,666 adults aged 70 years or older, moderate or greater hearing impairment was associated with a 54% increased risk of mortality. This was after we statistically took into account factors that could influence this association. Essentially, the worse the patient's hearing loss, the greater the risk of death.
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MedicalResearch.com Interview with:Carla L. Black PhD
Immunization Services Division
National Center for Immunization and Respiratory Diseases
CDCMedical Research: What is the background for this study? What are the main findings?
Dr. Black: The Advisory Committee on Immunization Practices (ACIP) recommends that all health-care personnel (HCP) be vaccinated annually against influenza. Vaccination of health-care personnel can reduce influenza-related morbidity and mortality among HCP and their patients. Overall, 77.3% of HCP reported receiving an influenza vaccination in the 2014-15 season, similar to the 75.2% coverage among HCP reported in the 2013-14 season. Coverage was highest among health-care personnel working in hospitals (90.4%) and lowest among HCP working in long-term care (LTC) settings (63.9%).
Flu vaccination coverage was highest in settings with employer flu vaccination requirements and promotion of flu vaccination. Vaccination coverage was 96% among HCP with an employer requirement for vaccination. Among HCP without an employer requirement for vaccination, vaccination coverage was higher for HCP working in settings where vaccination was offered on-site at no cost for one day (73.6%) or multiple days (83.9%) compared with health-care personnel working in settings where vaccination was promoted but not offered on-site (59.5%) or not promoted in any manner (44.0%).
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MedicalResearch.com Interview with:
Christine Bourgeois
Unité UMR 1184 / Centre IMVA
CR1 INSERM, Coordinatrice site Bicêtre
Le Kremlin-Bicêtre Cedex
Medical Research: What is the background for this study? What are the main findings?
Response: Antiretroviral therapy (ART) treatment in HIV infected patients had successfully reduced the development of AIDS (acquired immune deficiency syndrome). However, chronic HIV infection in ART treated patients exhibit rapid uprising of viral load following ART interruption indicating that the virus is not eradicated and persist in some cellular or anatomical sites that are called “reservoir”.
Secondly, ART controlled HIV-infected patients exhibit low grade inflammation developing despite efficient viral control. This low grade inflammation has been associated with non AIDS related pathologies. The aim of our work was to identify site that may combine viral persistence and inflammatory potential. We believed that adipose tissue was a very promising candidate because it included the major targets of HIV infection (CD4 T cells, and macrophages) and exhibited a highly pro-inflammatory potential. Although adipose tissue has been extensively studied as a target of antiretroviral toxicity, we readdress the role of adipose tissue as a reservoir and a site of inflammation. We demonstrated that indeed, adipose tissue from Antiretroviral therapy controlled HIV-infected patients contained infected CD4 T cells that upon in vitro reactivation were able to produce HIV RNA. These results are extremely important because adipose tissue represents 15%-20% of body weight and is diffusely located. We thus identify a large new reservoir.
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MedicalResearch.com Interview with:
Richard S. Legro, MD
Vice Chair of Research and Professor of Obstetrics and Gynecology and Public Health Sciences Penn State College of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Legro: Weight loss is recommended for obese women with PCOS, but there are no randomized studies to show that it improves fertility outcomes.
Both Lifestyle modification and oral contraceptives are also recommended for chronic treatment of women with PCOS so that this study has relevance to all obese women with PCOS.
We designed this study to prospectively examine the effects of these common treatments on reproductive, metabolic and quality of life parameters, as well as on fertility in women seeking pregnancy.
The main findings are summarized in the abstract and conclusion to the study. I would repeat those here. I would highlight that quality of life improved in all treatment groups, but the group that had both oral contraceptives and lifestyle modification had a significant improvement in their physical well-being compared to the oral contraceptive group.
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MedicalResearch.com Interview with:
Benjamin Y. Scheier, MD
Division of Hematology/Oncology
Department of Internal Medicine
University of Michigan, Ann Arbor
Medical Research: What is the background for this study? What are the main findings?
Dr. Scheier: Existing data suggests that PET/CT has use in the detection of metastases from multiple primary tumor types.However, PET/CT lacks data supporting its use in staging asymptomatic patients with early-stage melanoma, may inconsistently impact treatment decisions, and carries a false-positive finding risk that may detract from its use. To evaluate an evolving practice, this study aims to assess the use of PET/CT in detecting occult metastases in SLN-positive melanoma prior to resection. In this retrospective evaluation of patients with melanoma and clinically silent regional lymph nodes treated at the University of Michigan, only 7% had PET/CT findings that ultimately identified metastatic melanoma and precluded LND. Of the 46 patients who underwent a preoperative PET/CT, 15 (33%) had intense uptake distant from the primary tumor and local lymph node basin. Nine of those 15 patients (60%) had abnormalities biopsied prior to LND. Three of the 9 biopsies yielded metastatic melanoma, a false-positive rate of 67% for PET/CT in identifying distant metastases in asymptomatic patients.
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MedicalResearch.com Interview with: Robert D. Daniels Ph.D
Division of Surveillance, Hazard Evaluations, and Field Studies
National Institute for Occupational Safety and Health
Cincinnati, Ohio
Medical Research: What is the background for this study? Dr. Daniels: In 2010, National Institute for Occupational Safety and Health (NIOSH) researchers, with funding assistance from the U.S. Fire Administration, launched a multi-year study to examine whether fire fighters have a higher risk of cancer and other causes of death due to job exposures. Our study was designed to address limitations of previous fire fighter cancer research.
? We included a significantly larger population. With more than 30,000 career fire fighters who served in Chicago, Philadelphia, and San Francisco Fire Departments between 1950 and 2010, it is the largest study of United States fire fighters ever undertaken. In addition, both non-white and female fire fighters are represented.
? We looked not only at deaths from cancer, but also at the diagnosis of certain kinds of cancer, such as testicular and prostate cancer, which have higher survival rates. We also examined other causes of death to better understand the risk for various cancers and illnesses among fire fighters compared to the general public.
? We also examined the relation between cancer and several proxies of exposure, such as the number of fire runs, time spent at fires, and duration of employment of each firefighter (Dahm et al. 2015).
The study was conducted in two parts. The first part was aimed to answer the question: “Is cancer associated with firefighting?” by comparing firefighter cancer risk to that of the general population. The second part focused on the question: “Are higher-exposed firefighters more at risk?” Findings from both parts have been published in the journal, Occupational and Environmental Medicine (Daniels et al. 2014, 2015). (more…)
MedicalResearch.com Interview with: An Do, MD
Assistant Professor
Department of Neurology
University of California, Irvine
Medical Research: What is the background for this study? What are the main findings?
Dr. An Do: In this study, we demonstrated that it is possible for a person with paraplegia due to spinal cord injury to regain brain-controlled walking through the use of a brain-computer interface. This system records EEG signals as a person is thinking about walking. While the person is thinking about walking, EEG signals change in a manner which can be detected by a computer algorithm. Upon detecting that a person is thinking about walking from the EEG signals, the computer sends a command signal to an electrical stimulation system to stimulate the nerves in the legs to continuously generate alternating right and left stepping movements. This stepping stimulation stops when he stops thinking about walking.
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MedicalResearch.com Interview with:
Dr. Sanda Dolcos PhD
Post-doc Fellow
University of Illinois
Medical Research: What is the background for this study?
Dr. Dolcos: With its high prevalence rate, anxiety is a pressing
concern in our society. Identifying psychological and neural markers
indexing resilience against anxiety will help the development of
prevention and intervention programs. It has been recognized that
trait optimism fosters resilience against anxiety, and the
orbitofrontal cortex (OFC) is sensitive to anxiety symptoms, but the
relationship among the factors at these different levels
--personality, brain, and symptoms-- has not been clear.
Medical Research: What are the main findings?
1) trait optimism was associated with lower level of
anxiety
2) trait optimism is positively associated with the left OFC
volume
3) the left OFC volume was negatively linked to anxiety, a
relation partially accounted for by their mutual association with
trait optimism.
(more…)
MedicalResearch.com Interview with:
Phuc Le, Ph.D., M.P.H.
Center for Value-Based Care Research, Medicine Institute
Cleveland, OHMedical Research: What is the background for this study? What are the main findings?
Dr. Phuc Le: The live attenuated herpes zoster vaccine is approved by the FDA for persons aged 50 years and above. However, the Advisory Committee on Immunization Practices recommends it for only persons aged 60 years and older. Therefore, we aimed to analyze the vaccine’s cost-effectiveness among persons aged 50-59 years to see if ACIP’s recommendation is reasonable. We found that the vaccine is not cost-effective among people at aged 50 years, having an incremental costs of $323,000 per QALY gained, which is 3 times more than a commonly accepted threshold ($100,000/QALY).
(more…)
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MedicalResearch.com Interview with:
Brick Johnstone, Ph.D., ABPP
Professor
MU Department of Health Psychology
DC116.88
Columbia, MO 65212
Medical 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.
(more…)
