Author Interviews, Dermatology / 22.08.2015

MedicalResearch.com Interview with: Erika Hagstrom, M.D., M.A. Preliminary Internal Medicine PGY-1 Loyola University Medical Center  Medical Research: What is the background for this study? What are the main findings? Dr. Hagstrom: Allocation of funding dollars to research is a critical and daunting task. While many factors may impact research-funding decisions, establishing a transparent priority-setting exercise is paramount. This is particularly important for the National Institutes of Health, which invests over $30 billion for medical research each year. Diseases that have the greatest impact on our population warrant increased research dollars to reduce disease burden. The Global Burden of Disease Study (GBD) is an epidemiological effort to quantify the global burden of disease in a universal metric called disability-adjusted life years (DALYs). Focusing on our particular interest of dermatology, we investigated the 2012-2013 NIH funding for 15 skin diseases and matched this to the corresponding DALY metrics. (more…)
Author Interviews, Infections / 22.08.2015

Nichola Kinsinger, Ph.D Postdoctoral Researcher, Chemical & Environmental Engineering University of California, Riverside USDA National Institute for Food and Agricultural Postdoctoral Fellow DoD Office of Naval Research National Defense Science and Engineering Graduate Research Fellow EIT (Chemical Engineering)MedicalResearch.com Interview with: Nichola Kinsinger, Ph.D Postdoctoral Researcher, Chemical & Environmental Engineering University of California, Riverside USDA National Institute for Food and Agricultural Postdoctoral Fellow DoD Office of Naval Research National Defense Science and Engineering Graduate Research Fellow, EIT (Chemical Engineering) Medical Research: What is the background for this study? What are the main findings? Dr. Kinsinger: Outbreaks observed in produce are becoming increasing common possibly due to contaminated irrigation waters or contaminated waters used during processing.  In 2006 California had spinach-borne E. coli outbreak that impacted 26 states and 200 confirmed sickened.  Leafy greens account for 20% of the outbreaks alone and are of increased concern since they are frequently consumed raw. These outbreaks drew our attention over the past few years and we started applying methods originally developed for studying bacterial adhesion on engineered surfaces to the issue of food safety.  Although food safety is a new area of study for our lab, the project is based upon the concept of pathogen adhesion transport which has been the focus of my advisor’s lab for many years previously.  Rather than the previous scenario looking at pathogen interaction with engineered or mineral surfaces, we are looking at a spinach leaf instead. salad-cdc-image We are using a parallel plate flow chamber system developed by Professor Sharon Walker to evaluate the real time attachment and detachment of the pathogens to the spinach epicuticle layer (surface layer of the leaf) in realistic water chemistries and flow conditions.  Subsequently we can evaluate the efficacy of the rinsing process to kill the bacteria that may remain on the leaf.  Initially we were finding that at low concentrations of bleach, bacteria will detach from the leaf surface allowing for potential cross-contamination later in the process.   However above 500ppb we observed 100% of the attached bacterial cells are killed. So how in commercial rinsing operations that use bleach concentration ranging from 50-200ppm result in outbreaks?  Through this study we analyzed the topography of the leaf and modeled the concentration gradient across the surface of a leaf based on commercial rinsing practices.  We found that even at high bleach concentrations within rinse water result in low bleach concentrations at the leaf surface on the order of 5-1000 ppb bleach, which in our study has shown to that the bacteria can survive when attached to the leaf and/or detach causing concern for cross-contamination.   In this case the very disinfection processes intended to clean, remove, and prevent contamination was found to be a potential pathway to amplifying foodborne outbreaks. (more…)
Aging, Author Interviews, Cognitive Issues, Exercise - Fitness / 22.08.2015

Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of CopenhagenMedicalResearch.com Interview with: Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of Copenhagen Medical Research: What is the background for this study? Response: A sufficient level of physical capability is a precondition for maintaining independence and quality of life. Physical capability can be assessed objectively by tests of physical performance, for instance handgrip strength, chair-rising and postural balance. Physical performance is associated with mortality and disability in late life, so gaining insights into the variance in physical performance is important to promote sustained physical capability and prevent disability. Research has previously found physical activity, health status and socioeconomic position to be associated with physical performance. In addition, early life factors, such as childhood SEP, have been found to be associated with measures of physical performance later in life. The objective of our study was to examine the association between intelligence in early adulthood and midlife physical performance in Danish men. If an association between intelligence in early life and midlife physical performance exists it may indicate that cognitive abilities and physical performance share some of the same neurodevelopmental processes, but may also indicate that intelligence has an independent effect on later physical performance through various pathways. Medical Research: What are the main findings? Response: In our study of more than 2800 Danish men, we found positive associations between intelligence in early adulthood and five objective measures of physical performance in midlife independent of other early life factors. A one standard deviation increase in intelligence score resulted in 1.1 more chair-rises in 30 seconds, a 1 cm higher jump, a 3.7% smaller balance area, a 0.7 kg increase in handgrip-strength, and a 0.5 kg increase in lower back force. (more…)
Author Interviews, Biomarkers, Gastrointestinal Disease, Hepatitis - Liver Disease / 22.08.2015

Stuart Gordon, M.D. Director of Hepatology at Henry Ford HospitalMedicalResearch.com Interview with: Stuart Gordon, M.D. Director of Hepatology at Henry Ford Hospital Detroit, Michigan Medical Research: What is the background for this study? What are the main findings? Dr. Gordon: The U.S. Centers for Disease Control and Prevention’s Division of Viral Hepatitis estimates 2.7 to 3.9 million people in the United States currently suffer from chronic hepatitis C. But, unfortunately, many of these patients may be unaware of the severity of their liver damage. We looked at evidence of cirrhosis among hepatitis C patients by examining four different parameters: ICD9 codes; liver biopsy reports; evidence of liver failure; and the FIB-4 test, an easily calculated biomarker. By using all four indicators of cirrhosis, we found a far higher prevalence of cirrhosis than would be indicated by any one method. (more…)
Author Interviews, Heart Disease, Kidney Disease / 22.08.2015

Tae-Hyun Yoo MD PhD Department of Internal Medicine, College of Medicine Severance Biomedical Science Institute, Brain Korea 21 PLUS Yonsei University, Seoul, KoreaMedicalResearch.com Interview with: Tae-Hyun Yoo MD PhD Department of Internal Medicine, College of Medicine Severance Biomedical Science Institute, Brain Korea 21 PLUS Yonsei University, Seoul, Korea Medical Research: What is the background for this study? What are the main findings? Dr. Tae-Hyun Yoo: Sarcopenia, reduction in muscle mass, is frequently observed in PEW and is prevalent in chronic kidney disease (CKD) patients. In ESRD patients, sarcopenia is significantly associated with greater mortality. Skeletal muscles produce and release myokines, which  suggested to mediate their protective effects. Irisin, a novel myokine, has been introduced to drive brown-fat-like conversion of white adipose tissue and has beneficial effects of skeletal muscle on energy homeostasis and glucose metabolisms. Therefore, we hypothesized that irisin had significant association with sarcopenia and cardiovascular disease in dialysis patients. In peritoneal dialysis patients, serum irisin was positively correlated with mid-arm muscle circumference and thigh circumference. In addition, serum irisin was a significant independent predictor for carotid atherosclerosis even after adjustment for high-sensitivity C-reactive protein in these patients. This study demonstrated that serum irisin was significantly associated with sarcopenia and carotid atherosclerosis in peritoneal dialysis patients. (more…)
Author Interviews, JAMA, Orthopedics, Surgical Research / 22.08.2015

MedicalResearch.com Interview with: Sandrine Colas, MSc, MPH Department of Epidemiology of Health Products French National Agency for Medicines and Health Products Safety (ANSM) Saint-Denis, France Medical Research: What is the background for this study? What are the main findings? Response: Total hip replacement (THR) is to replace a damaged coxofemoral joint with a prosthetic implant. Primary or secondary degenerative osteoarthritis of the hip joint is the main indication for THR (other indications are essentially trauma, which is more common in the elderly and mostly affects women over 80 years of age). The number of THR has increased in all industrialized countries, particularly on account of the ageng population.Total hip replacement is one of the most common and successful surgical procedures in modern practice. Although results are generally good, revision (consisting in changing one or all components of the implant) is sometimes necessary (about 1% per year). Prosthetic revision is a longer and more complex operation than primary implantation and it has a higher incidence of post-surgical complications. Several prosthetic revision risk factors have been highlighted recently in published studies, but results relating to prosthetic and/or patient characteristics and total hip replacement survivorship tend to vary. The existence of an association between the fixation technique and/or bearing surface and prosthetic survivorship has yet to be established. The main aim of our work was therefore to compare total hip replacement short-term survivorship according to cement type and bearing surface, in a large population of subjects who have undergone total hip replacement for reasons other than trauma (25%) and bone tumor (<0.1%), taking prosthetic revision risk factors (age, gender, comorbidities, concomitant medication, implanting center, etc.) into account. Total hip replacement characteristics are related to early implant survivorship. After 33 months of follow-up, antibiotic-impregnated cemented THRs have a better prognosis. MoM total hip replacemenst have a slightly worse prognosis. (more…)
Author Interviews, Heart Disease, Radiology / 22.08.2015

MedicalResearch.com Interview with: Bjarne Linde Norgaard, MD PhD Department of Cardiology, Aarhus University Hospital Skejby Aarhus, Denmark   Medical Research: What is the background for this study? What are the main findings? Dr. Norgaard: Noninvasive fractional flow reserve derived from standard acquired coronary CT angiography (CTA) (FFRct) in patients with suspected coronary artery disease exhibits high and superior diagnostic performance when compared to coronary CTA alone in identifying lesion-specific ischemia (which is the established metric for decision-making on coronary revascularization). As the presence of coronary calcification may compromise the diagnostic accuracy and specificity of coronary CTA, this study was performed in order to investigate the influence of calcification on the diagnostic performance of FFRct in patients (214) and vessels (333) with suspected coronary artery disease. The main finding in this study was that FFRct provides high and superior diagnostic performance and discrimination of ischemia compared with coronary CTA interpretation alone in patients and vessels with high levels of calcification. (more…)
Author Interviews, Infections, University of Pennsylvania, Vaccine Studies / 22.08.2015

David B. Weiner, Ph.D. Professor, Department of Pathology and Laboratory Medicine Chair, Gene Therapy and Vaccine Program, CAMB Co-Leader Tumor Virology Program, Abramson Cancer Program University of Pennsylvania, Perelman School of MedicineMedicalResearch.com Interview with: David B. Weiner, Ph.D. Professor, Department of Pathology and Laboratory Medicine Chair, Gene Therapy and Vaccine Program, CAMB Co-Leader Tumor Virology Program, Abramson Cancer Program University of Pennsylvania, Perelman School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Weiner: MERS, like the Severe Acute Respiratory Syndrome (SARS), is characterized by high fever and severe cough from pneumonia. MERS is caused by an emerging human coronavirus, which is distinct from the SARS coronavirus. Since its identification in 2012, MERS has been linked to over 1,300 infections and close to 400 deaths. It has occurred in the Arabian Peninsula, Europe, and in the US and in Asia. It can be spread in a hospital setting. Scientists now report that a novel synthetic DNA vaccine can, for the first time, induce protective immunity against the Middle EastRespiratory Syndrome (MERS) coronavirus in animal species.   Researchers from the Perelman School of Medicine at the University of Pennsylvania. The NIH, the Public Health agency of Canada, and from a leading company in the development of synthetic DNA vaccine technology, Inovio described the results in a paper  published their work in Science Translational Medicine (STM) this week.  The experimental, preventive vaccine, given six weeks before exposure to the MERS virus, fully protects rhesus macaques from disease. The vaccine also generated potentially protective antibodies in blood drawn from camels, the purported source of MERS transmission in the Middle East. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 21.08.2015

Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine MedicalResearch.com Interview with: Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine     Medical Research: What is the background for this study? What are the main findings? Dr. Marshall: The infant immunization schedule has become crowded. That’s great news, in a sense, because it means that our children have become better protected against more diseases. At the same time, this has led to well child visits during which many shots are recommended, and some parents want to limit the number of injections their children receive at one time. This leads to deferrals, poor timeliness and decreased coverage rates, all of which could impair protection. This study shows that a hexavalent vaccine—one that combines diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccines in one syringe—is safe and just as immunogenic as the currently used component vaccines.  (more…)
Author Interviews, Genetic Research / 21.08.2015

Hendrik Marks Ph.D Group leader Epigenetics of Stem Cells Radboud University, Department of Molecular Biology, RIMLS, Nijmegen, The Netherlands MedicalResearch.com Interview with: Hendrik Marks Ph.D Group leader Epigenetics of Stem Cells Radboud University, Department of Molecular Biology, RIMLS Nijmegen, The Netherlands   Medical Research: What is the background for this study? What are the main findings? Dr. Marks: In mammals, sex is determined by two so-called "sex" chromosome: males have a single X chromosome as well as a Y chromosome, whereas females have two copies of the X chromosome. However, if both X chromosomes were to be active in female cells, these cells would have a double dosis of X-chromosomal gene products as compared to male cells. As this is lethal for almost all cells, female cells shut off one X chromosome in every cell in a process called X inactivation. This process occurs during early embryonic development. A lot is known about how this process is turned on, but is was unclear how such a silencing process spreads along a full chromosome. In order to further study this, we used female mouse embryonic stem cells (mESCs) as a model system and initiated X inactivation by means of differentiation. With the latest technologies, we were able to keep the two X chromosomes apart and measure one of them – with its 166 million base pairs (Mbs) – in detail. Every day we checked which parts of the chromosome had been switched off. The whole process took about eight days, and the inactivation spreads out from the centre of the X chromosome towards the ends. That doesn’t happen gradually but moves jumpwise from domain to domain. Domains are long pieces of DNA (of around 1Mb) that cluster together in knots. As it seems that X inactivation jumps from domain to domain, we now know that these domains are co-regulated. Also, we collected strong evidence that the same process is occurring in human. (more…)
Author Interviews, JAMA, Opiods, Pharmacology / 21.08.2015

Lainie Rutkow, JD, PhD, MPH Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public HealMedicalResearch.com Interview with: Lainie Rutkow, JD, PhD, MPH Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Medical Research: What is the background for this study? What are the main findings? Dr. Rutkow: Rates of prescription drug diversion and misuse, as well as overdose deaths, have increased throughout the United States. CDC estimates that each day, 44 people die from a prescription drug overdose. In the mid-2000s, Florida was viewed as the epicenter of this epidemic, with prescription drug overdose deaths increasing more than 80% from 2003 to 2009. In response, Florida enacted several laws to mitigate prescription drug abuse and diversion. Its pill mill law required pain management clinics to register with the state and prohibited physician dispensing of certain drugs. Florida’s Prescription Drug Monitoring Program (PDMP) collects data about dispensing of prescription drugs and can be accessed by physicians and pharmacists. Little is known about how these laws have affected prescribing of opioids. We applied comparative interrupted time series analyses to pharmacy claims data to examine four outcomes related to opioid prescribing in Florida, with Georgia as a comparison state. We found that in the first year of implementation, Florida’s Prescription Drug Monitoring Program and pill mill law were associated with modest reductions in prescription opioid volume, prescriptions written, and the dose per prescription. These declines were statistically significant among the highest volume prescribers and patients at baseline. (more…)
Author Interviews, Education, Genetic Research, Social Issues / 21.08.2015

Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education   MedicalResearch.com Interview with: Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education     Medical Research: What is the background for this study? What are the main findings? Response: Earlier research has started to illuminate which genetic variants are associated with educational attainment. Subsequent work has taken these variants, combined them into a "polygenic score", and studied how that polygenic score predicts educational attainment. Our research continues this line of inquiry by examining the predictive performance of that polygenic score in a representative sample of US adults who are now in their 30s. A few notable findings include that: (A) the polygenic score predicts educational attainment in the African Americans in our sample and (B) that the polygenic score is associated with neighborhood characteristics. As with earlier research, we are able to show that the higher score sibling from within a family will complete more years of schooling (on average) than their lower score co-sib. (more…)
Author Interviews, Kidney Disease, Lancet, Weight Research / 21.08.2015

Dr. Csaba P. Kovesdy MedicalResearch.com Interview with: Dr. Csaba P. Kovesdy, MD Professor of Medicine University of Tennessee Health Science Center Chief of Nephrology Memphis Veterans Affairs Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Kovesdy: Obesity has reached epidemic proportions in modern societies, and has been linked to adverse outcomes such as diabetes mellitus, hypertension, cardiovascular disease and mortality. In addition, obesity is also associated with chronic kidney disease through a variety of mechanisms. Our population is ageing, and previous studies have suggested that the effect of obesity on certain outcomes like mortality may be different in older vs. younger individuals, but this has not been previously examined for chronic kidney disease. We have this examined the association of granular BMI categories with progressive loss of kidney function in a very large cohort of patients with normal estimated GFR in patients of different ages. We found that the association of a BMI of >30 kg/m2 with progressive loss of kidney function was not present in younger individuals (< 40 years of age), and increased as people aged, with >80 years old displaying the strongest associations between obesity and loss of kidney function. In addition to this we also examined the association of BMI with mortality in different age groups, and found uniform U-shaped associations that did not vary by age. (more…)
AHA Journals, Author Interviews, Stroke / 20.08.2015

Josefine Persson Doctoral student Institute of Neuroscience and Physiology Sahlgrenska Academy University of GothenburgMedicalResearch.com Interview with: Josefine Persson Doctoral student Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Medical Research: What is the background for this study? Response: Stroke is a major global disease that requires extensive care and support from the society and the family. We know from previous research that a stroke often has a wide-spread impact on the daily life of the family. To provide support to a partner is often perceived as natural and important, but can be demanding and have an impact on the spouses own health. The situation for spouses as caregivers is well studied during the first two years after the stroke, while the long-term effects are less well known. By this, we studied the physical and mental health of 248 spouses of stroke survivors, below age 70 at stroke onset, seven years after the stroke event and compared our result with 245 spouses of non-stroke, age- and sex-matched controls. Medical Research:  What are the main findings? Response: The main finding of our study is that caregiver spouses of stroke survivors are at an increased risk of mental and physical health issues even seven years after stroke onset. This is the first study with this long period of follow up and the results show that the restriction on the spouses own activity and social relationships studied in shorter follow up is also obvious for a large proportion of the spouses in a very long perspective. Spouses’ quality of life was most adversely affected by their partners’ level of disability, cognitive difficulties and depressive symptoms. (more…)
Author Interviews, Depression, PNAS / 20.08.2015

Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of WarwickMedicalResearch.com Interview with: Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of Warwick Medical Research: What is the background for this study? Response: Depression is a major public health concern worldwide. We know social factors, such as living alone, can influence whether someone becomes depressed. We also know that social support (having people to talk to) is important for recovery from depression. Our study is slightly different as we looked at the effect of being friends with people on whether you are likely to develop depression or recover from being depressed. To do this, we looked at over 2,000 adolescents in a network of US high school students to see how their mood influenced each other. (more…)
Author Interviews, Biomarkers, Brain Cancer - Brain Tumors, Chemotherapy, Neurology, Radiation Therapy / 20.08.2015

Jorg Dietrich, MBA MMSc MD PhD Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical SchoolMedicalResearch.com Interview with: Jorg Dietrich, MBA MMSc MD PhD  Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Dietrich: Understanding the adverse effects associated with cancer therapy is an important issue in oncology. Specifically, management of acute and delayed neurotoxicity of chemotherapy and radiation in brain cancer patients has been challenging. There is an unmet clinical need to better characterize the effects of standard cancer therapy on the normal brain and to identify patients at risk of developing neurotoxicity. In this regard, identifying novel biomarkers of neurotoxicity is essential to develop strategies to protect the brain and promote repair of treatment-induced damage. In this study, we demonstrate that standard chemotherapy and radiation in patients treated for glioblastoma is associated with progressive brain volume loss and damage to gray matter – the area of the brain that contains most neurons. A cohort of 14 patients underwent sequential magnetic resonance imaging studies prior to, during and following standard chemoradiation to characterize the pattern of structural changes that occur as a consequence of treatment. (more…)
Author Interviews, Cannabis, Smoking, University Texas / 20.08.2015

Francesca M. Filbey PhD School of Behavioral and Brain Sciences Center for Brain Health University of Texas at Dallas Dallas, TXMedicalResearch.com Interview with: Francesca M. Filbey PhD School of Behavioral and Brain Sciences Center for Brain Health University of Texas at Dallas Dallas, TX Medical Research: What is the background for this study? What are the main findings? Dr. Filbey: Most studies exclude tobacco users from participating, but 70% of marijuana users also use tobacco. We were interested in investigating the combined effects of marijuana and tobacco. Our research targeted the hippocampus because smaller hippocampal size is associated with marijuana use. We chose to study short term memory because the hippocampus is an area of the brain associated with memory and learning. The main finding was surprising. The smaller the hippocampus in the marijuana plus nicotine user, the greater the memory performance. We expected the opposite, which was true of the non-using control group. (more…)
Author Interviews, Memory / 20.08.2015

Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden UniversityMedicalResearch.com Interview with: Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden University  Medical Research: What is the background for this study? What are the main findings? Response: A recent initiative supported by several eminent research institutes and scientists calls for a more critical and active role of the scientific community in evaluating the sometimes far-reaching, sweeping claims from the brain training industry with regard to the impact of their products on cognitive performance. tDCS is a noninvasive brain stimulation technique that has developed into a promising tool to boost human cognition. Previous studies using medical tDCS devices have shown that tDCS promotes working memory (WM) updating in healthy individuals and patients. The aim of the current study was to investigate whether the commercial tDCS headset foc.us (v.1), which is easily and freely available to anyone in the world, does in fact improve cognitive performance, as advertised in the media. Results showed that active stimulation with the commercial device, compared to sham stimulation, significantly decreased working memory performance. The device we tested is just one example of a commercial device that can easily be purchased and, without any control or expert knowledge, used by anyone. The results of our study are straightforward in showing that the claims made by companies manufacturing such devices need to be validated. Even if the consequences of long-term or frequent use of the device are yet to be demonstrated, our findings provide strong support the important role of the scientific community in validating and testing far reaching claims made by the brain training industry. (more…)
AHA Journals, Author Interviews / 20.08.2015

Dr. Dominic PJ Howard BM BCh MA DPhil (Oxon) MRCS Vascular and Endovascular Fellow Flinders Medical Centre Southern Adelaide Local Health NetworkMedicalResearch.com Interview with: Dr. Dominic PJ Howard BM BCh MA DPhil (Oxon) MRCS Vascular and Endovascular Fellow Flinders Medical Centre Southern Adelaide Local Health Network Dr. Howard is I academic vascular surgeon currently based in Oxford, UK. He worked with Professor Peter Rothwell as part of the Oxford Vascular Study.   Medical Research: What is the background for this study? What are the main findings? Dr. Howard: Abdominal aortic aneurysm is a potentially lethal ballooning of the aorta, the body’s largest blood vessel, which supplies blood from the heart to the abdomen and on to the rest of the body. Smoking, high blood pressure, male gender and older age are four key risk factors for abdominal aneurysms. Currently, men 65 and older are screened in the United States and in Europe for the condition based on recommendations from European screening trials and the U.S. Preventive Services Task Force. However, deaths from abdominal aortic aneurysm are moving to older ages. Our study is the first prospective population-based study of ruptured abdominal aortic aneurysm events.  We have found high incidence and death rates for this condition, particularly in older people. Most ruptured aortic aneurysms currently happen in people aged over 75 and this is likely to shift to those aged over 85 during the next few decades. The few ruptured aortic aneurysms that do occur in younger people (aged 65-75) occur almost exclusively in male smokers. Therefore we have calculated that if the national UK screening policy was modified to screen only male current smokers aged 65 and then all men at age 75 this could result in an almost four-fold increase in the number of deaths prevented and a three-fold increase in the number of life-years saved compared to the current UK strategy, with about a 20% reduction in the number of scans required. (more…)
Author Interviews, Lancet, Stroke / 20.08.2015

Professor Mika Kivimäki Chair of Social Epidemiology Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London London MedicalResearch.com Interview with: Professor Mika Kivimäki Chair of Social Epidemiology Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London Medical Research: What is the background for this study? What are the main findings? Prof Kivimäki:  Long working hours have been implicated in the cause of cardiovascular disease, but the evidence is limited. We conducted a systematic review of published studies on this topic and located additional individual-level data by searching open-access data archives and by including unpublished data from IPD-Work, a consortium of prospective cohort studies. This resulted in a pooled sample of over 600,000 men and women who were followed for cardiovascular disease 7-8 years after the assessment of working hours. During the follow-up, more than 4700 participants had a coronary event and 1700 had a stroke. Our findings show that individuals who worked 55 hours or more per week had a 1.3-times higher risk of stroke compared to those working standard 35-40 hours. This finding remained unchanged in analyses adjusted for other stroke risk factors, such as age, sex, socioeconomic position and health behaviours. (more…)
Author Interviews, Multiple Sclerosis, Salt-Sodium / 19.08.2015

Dimitry N. Krementsov PhD Research Associate University of Vermont Burlington, VT 05405MedicalResearch.com Interview with: Dimitry N. Krementsov PhD Research Associate University of Vermont Burlington, VT 05405 Medical Research: What is the background for this study? What are the main findings? Dr. Krementsov:  Multiple sclerosis (MS) is the most common disabling neurologic disorder affecting young adults. The disease is initiated by the individual’s own immune system attacking the central nervous system (brain and spinal cord).Multiple sclerosis is complex and is controlled by the interplay between sex/gender, genetics, and environmental factors. How this happens is not well understood, but an intriguing clue is that MS incidence over the last 50-100 years has been increasing in women and not men, suggesting that a recent environmental change is affecting MS preferentially in females. There are several well-documented risk factors for Multiple Scleroisis, including Epstein-Barr virus infection, low sunlight exposure, low vitamin D, and smoking. Recent studies have suggested the existence of a new risk factor – high intake of dietary salt. In our study, we sought to understand how this environmental factor may interact with genetics and sex. We used an animal model of MS, called experimental autoimmune encephalomyelitis (EAE), in laboratory mice. The advantage of this approach is the ability to precisely control both the genetics and the environment, something that cannot be done in epidemiological studies in humans. Just as in previous studies, we found that when mice were fed a high salt diet, their MS-like disease got worse. Importantly, we found that this was dependent on genetics and sex; when we varied the genetic background of the mice, we saw three different outcomes: 1) an effect of salt in both males and females, 2) an effect only in females, and 3) no effect in either sex. (more…)
Author Interviews, Cannabis, CDC / 19.08.2015

Gillian Schauer, PhD, MPH Lead author and Contractor CDC’s Office on Smoking and HealthMedicalResearch.com Interview with: Gillian Schauer, PhD, MPH Lead author and Contractor CDC’s Office on Smoking and Health Medical Research: What is the background for this study? What are the main findings? Dr. Schauer: Marijuana is the most commonly used federally illicit drug in the United States. State-level policy change legalizing marijuana or one of its constituents for recreational or medical use is increasing. Currently, 23 states and DC have legalized medical use of marijuana. Four states (Alaska, Colorado, Oregon and Washington) and the District of Columbia have legalized recreational and medical use of marijuana.
  • This paper helps fill two important knowledge gaps. It describes how US adults are using marijuana—for example, whether they smoke it, eat it, or use it in a vaporizer—and it describes whether they report using it for medical reasons or for recreational reasons, or both. Data come from the 2014 Summer Styles national consumer online panel survey (sample size of 4,269 adults), and have been published in the American Journal of Preventive Medicine.
  • Nationally, marijuana is primarily consumed in combusted (smoked) form. In 2014, among adults who used marijuana in the past 30 days, 92.1% of adults said they smoked it, 16.1% ate or drank it, and 7.6% used a vaporizer or other electronic device.
  • Among adults who used marijuana in the past 30 days, 10.5% say they used it only for medical reasons, 53.4% used it only for recreational reasons, and 36.1% used it for both.
(more…)
Alcohol, Author Interviews, BMJ, Brigham & Women's - Harvard, Cancer Research / 19.08.2015

Dr. Yin Cao MPH, ScD Postdoctoral Fellow, Department of Nutrition Harvard T. H. Chan School of Public HealthMedicalResearch.com Interview with: Dr. Yin Cao MPH, ScD Postdoctoral Fellow, Department of Nutrition Harvard T. H. Chan School of Public Health Medical Research: What is the background for this study? What are the main findings? Dr. Cao: Light-to-moderate drinking, defined as up to 1 drink (roughly corresponds to a 355ml bottle of beer, or a small [118-148 ml] glass of wine or 44ml of liquor) for women and up to 2 drinks for men, is prevalent in many western countries. It is believed that light-to-moderate drinking may be healthy for the heart. However, the influence of light-to-moderate drinking on risk of overall cancer is less clear, although it is well known that heavy alcohol intake increases risk of several cancers, including cancers of colorectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus. Also because drinkers are more likely to be smokers, and smoking is the major risk factor for all of the alcohol-related cancers (mentioned above) except breast cancer, it is thus difficult to tease out the influence of alcohol on cancer in studies among a mixed population of ever and never smokers. In particular, it is important to know how light and moderate drinking would affect cancer risk particularly among never smokers, who now make up the majority of the population in many western countries. Our main findings are that, light-to-moderate drinking minimally increases risk of overall cancer. For men, the association with alcohol related cancers was primarily observed among smokers, and light to moderate drinking did not appreciably increase risk in never smokers. Among women, even consumption of up to one drink per day was associated with increased risk of alcohol-related cancers (mainly breast cancer) for both never and ever smokers. (more…)
Author Interviews, Diabetes, JAMA, Weight Research / 19.08.2015

Melanie J Davies MB ChB MD FRCP FRCGP Professor of Diabetes Medicine 
NIHR Senior Investigator Leicester Diabetes Unit
Leicester Diabetes Centre Bloom
University of Leicester MedicalResearch.com Interview Invitation Melanie J Davies MB ChB MD FRCP FRCGP Professor of Diabetes Medicine 
NIHR Senior Investigator Leicester Diabetes Unit
Leicester Diabetes Centre Bloom
 University of Leicester   MedicalResearch: What is the background for this study? What are the main findings?
 Dr. Davies: This study was designed to test the efficacy and safety of Liraglutide using a dose of 3mg for weight loss among patients with type 2 diabetes.  It was a large international study in which we compared once daily subcutaneous Liraglutide at a dose of 3mg to Liraglutide 1.8mg which is the current maximum dose licenced in patients with diabetes and placebo.  In all patients we offered a calorie deficit diet and lifestyle advice to increase physical activity.  Our main findings were that the dose of 3mg of Liraglutide resulted in greater weight loss than both other arms of the study indeed 54% of patients at 56 weeks achieved more than 5% weight loss and a further 25% were able to achieve more than 10% weight loss.  The 3mg of Liraglutide compared to the placebo, there were also significant impacts on HbA1c and other cardiovascular risk factors such as systolic blood pressure and lipids as well as improving patient quality of life particularly physical functioning and patient treatment satisfaction.  (more…)
AHA Journals, Author Interviews, Heart Disease, Hospital Readmissions / 19.08.2015

Jason H. Wasfy, MD Assistant Medical Director Massachusetts General Physicians Organization Massachusetts General Hospital MedicalResearch.com Interview with: Jason H. Wasfy, MD Assistant Medical Director Massachusetts General Physicians Organization Massachusetts General Hospital   Medical Research: What is the background for this study? What are the main findings? Dr. Wasfy: Hospital readmission after angioplasty (heart stents) is very common in the United States and is associated with poorer patient outcomes and substantial health care costs.  We can predict which patients will get readmitted, but only with moderate accuracy.  Analyzing the electronic medical records of large health care systems may provide clues about how to predict readmissions more accurately. Medical Research: What should clinicians and patients take away from your report? Dr. Wasfy: Patients who are anxious or have visited the emergency department frequently before the procedure may be at higher risk of readmission.  For those patients, reassurance and support may help them stay out of the hospital.  This has the potential to improve health outcomes after angioplasty and improve value in cardiology care generally.  High quality care for patients with coronary artery disease involves not only procedures and medicines, but also creating a support system for patients to cope with their disease. (more…)
Author Interviews, Cost of Health Care, Infections, JAMA, Pharmacology / 19.08.2015

Jerome A. Leis, MD MSc FRCPC Division of Infectious Diseases, Sunnybrook Health Sciences Centre Physician Lead, Antimicrobial Stewardship Team Faculty Quality Improvement Advisor, Centre for QuIPS Assistant Professor, Department of Medicine, University of Toronto Sunnybrook Health Sciences Centre Toronto, OntarioMedicalResearch.com Interview with: Jerome A. Leis, MD MSc FRCPC Division of Infectious Diseases Sunnybrook Health Sciences Centre Physician Lead, Antimicrobial Stewardship Team Faculty Quality Improvement Advisor, Centre for QuIPS Assistant Professor, Department of Medicine University of Toronto Sunnybrook Health Sciences Centre Toronto, Ontario Medical Research: What is the background for this study? What are the main findings? Dr. Leis: We know that urinary tract infections are frequently diagnosed among general medicine patients who lack symptoms of this infection.  We wondered whether urinalysis ordering practices in the Emergency Department influence diagnosis and treatment for urinary tract infection among these asymptomatic patients.  We found that over half of patients admitted to the general medicine service underwent a urinalysis in the Emergency Department of which over 80% lacked a clinical indication for this test.  Urinalysis results among these asymptomatic patients did influence diagnosis as patients with incidental positive results were more likely to undergo urine cultures and treatment with antibiotics for urinary tract infection.  The study suggests that unnecessary urinalysis ordering contributes to over-diagnosis and treatment of urinary tract infection among patients admitted to general medicine service. (more…)
Author Interviews, Social Issues / 19.08.2015

Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews MedicalResearch.com Interview with: Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews   Medical Research: What is the background for this study? What are the main findings? Response:  Dominance in men is associated with a variety of social outcomes, ranging from high rank attainment of cadets in the military to high levels of sexual activity in teenage boys. Dominant men are also favored as leaders during times of intergroup conflict and are more successful leaders in the business world. Therefore, we wanted to investigate what exactly it is that makes a face look dominant. Our main finding was that maximum dominance was achieved by increasing perceived height and masculinity while maintaining a man's age at around 35 years. (more…)
Author Interviews, Compliance, Race/Ethnic Diversity / 19.08.2015

Louanne Bakk, Ph.D. Assistant Professor Director, Institute on Innovative Aging Policy and Practice School of Social Work The University at Buffalo Buffalo, NY 14260 MedicalResearch.com Interview with: Louanne Bakk, Ph.D Assistant Professor Director, Institute on Innovative Aging Policy and Practice School of Social Work The University at Buffalo Buffalo, NY  14260 Medical Research: What is the background for this study? What are the main findings? Dr. Bakk: Medicare Part D reduces out-of-pocket health care costs and increases access to medications.  While overall the benefit has facilitated the purchase of medications, cost sharing exists and be particularly difficult for more vulnerable populations.  Racial and gender disparities in cost-related nonadherence (CRN)  exist under Medicare Part D plans.  However, it was unknown whether the impact of the coverage gap on older Blacks and females.  This study examined whether the Medicare Part D coverage gap directly and indirectly affects the relationship between race, gender, and CRN. Racial differences in cost-related nonadherence were largely driven by reaching the coverage gap.  In other words, the gap appears to be more difficult for older Blacks than Whites.  Additionally, both reaching and not reaching the coverage gap, poorer health and having a lower income were associated with cost-related nonadherence . (more…)
Author Interviews, OBGYNE, Pediatrics / 19.08.2015

Jennifer B. Kane PhD Assistant professor of Sociology University of California, Irvine MedicalResearch.com Interview with: Jennifer B. Kane PhD Assistant professor of Sociology University of California, Irvine Medical Research: What is the background for this study? Dr. Kane: We know that low-birth-weight babies are more susceptible to later physical and cognitive difficulties and that these difficulties can sharpen the social divide in the U.S. But knowing more about what causes low birth weight can help alleviate this intergenerational perpetuation of social inequality through poor infant health. This study was designed to expand our knowledge of these causes. Medical Research: What are the main findings? Dr. Kane: This study found that risk factors for low birth weight extend far beyond pregnancy—dating all the way back to women’s early life environment as well as to conditions dating back three generations. For example, a woman’s own weight at birth, as well as her education level and marital status pre-pregnancy can have repercussions for two generations, putting her children and grandchildren at higher risk of low birth weight. This study also discovered new pathways of risk that contribute to poor infant health. For example, intergenerational transmissions of maternal education, potentially reflecting parent-child socialization or role modeling, appear to have a long-term influence on birth outcomes of future generations. In addition, this study showed that intra-generational and inter-generational processes work in conjunction with one another to place some infants at higher risk of low birth weight. (more…)
Anesthesiology, Author Interviews, Breast Cancer, Journal Clinical Oncology, Surgical Research / 19.08.2015

Jaclyn Bradley Palmer, MM, MT-BC University Hospitals Of Cleveland Cleveland, OHMedicalResearch.com Interview with: Jaclyn Bradley Palmer, MM, MT-BC University Hospitals Of Cleveland Cleveland, OH  Medical Research: What is the background for this study? What are the main findings? Response: Patients awaiting breast cancer surgery may be understandably anxious. While pharmacologic intervention may reduce anxiety, higher doses of preoperative drugs can depress circulation and respiration, making alternative measures a particular interest. Music therapy is the clinical use of music interventions to accomplish individualized goals within a therapeutic relationship by a board-certified music therapist. While music in surgery has been researched under the label of "music therapy", many of the studied investigations illicit recorded music provided by non-music therapy staff, making it truly "music medicine" practices instead. In this investigation, the effect of both live and recorded music therapy on anxiety, anesthesia requirements, recovery time and patient satisfaction were studied perioperatively. Breast cancer surgery patients were engaged in a brief music therapy session which consisted of one live or recorded preferred song choice, followed by discussion and processing of emotions. Compared to usual care, both live and recorded music therapy groups experienced significantly greater reductions in anxiety (p<.001) with point reductions of 27.5 (42.5%) and 26.7 (41.2%), respectively. During surgery, both music groups listened to music-therapist selected recorded, instrumental harp music, chosen for it's evidence-based therapeutic value of smooth lines, consistent volumes and stable melodies. In measuring the amount of interoperative drug (propofol) needed to reach moderate sedation, the intraoperative music was not found to have an effect in this trial. Patient satisfaction was universally high in all three study groups. Those who received live music preoperatively were discharged an average of 12.5 minutes sooner than those who received recorded music preoperatively, although neither music group was dischanged significantly sooner than the control group. Subjective reactions to the music interventions relayed that music therapy in surgery was an enjoyable addition. (more…)