MedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh MSc
Associate Professor, University of Alberta
Co-Director, Canadian VIGOUR Centre
Director, Heart Function Clinic
Cardiologist, Mazankowski Alberta Heart Institute
Medical Research: What is the background for this study?
Dr. Ezekowitz: Heart Failure is a prevalent health issue that carries high morbidity and mortality. Most epidemiologic research derives information from hospital discharge abstracts, but emergency department visits are another source of information. Many have assumed this code is accurate in the emergency department but uncertainty remains.
In our study, we assessed patients at their presentation to Emergency Department, which is usually the first medical contact for acutely ill patients with heart failure.
The objective of our study was to compare administrative codes for acute heart failure (I50.x) in the emergency department against a gold standard of clinician adjudication.
Medical Research: What are the main findings?
Dr. Ezekowitz: Emergency department administrative data is highly correlated with a clinician adjudicated diagnosis. The positive predictive value of acute heart failure as the main diagnosis was 93.3% when compared to clinician adjudication, supported by standardized scoring systems and elevated BNP. (more…)
MedicalResearch.com Interview with:Dr Jonathan McGuane PhD.
Robinson Research Institute and Discipline of Obstetrics and Gynaecology
School of Paediatrics and Reproductive Health
University of Adelaide, Adelaide, South Australia, Australia
Medical Research: What is the background for this study?
Dr. McGuane: Epidemiological studies suggest that endometriosis is present more often in women who report having intercourse during menstruation compared to those who don’t (Filer and Wu, J Reprod Med 1989:887-890). The idea for this study came from our research showing that seminal plasma induces marked changes in the immunology of the female reproductive tract, which are essential for optimal implantation of an embryo and subsequent fetal development. However, some of these immunological changes could increase the likelihood of endometrial tissue developing into an endometriotic lesion if it subsequently ends up in the peritoneum via retrograde menstruation (a la Sampson's hypothesis). This could help to explain the epidemiological findings cited above. Our study was designed to explore "proof-of-principle" of this concept by exposing human endometrial tissue directly to seminal plasma or control medium in vitro, and transplanting it under the skin of receptive mice.
Medical Research: What are the main findings?
Dr. McGuane: After two weeks, endometrial tissue exposed to seminal plasma was significantly larger than control tissue. This appeared to be the result of increased cell proliferation and tissue survival. Although we hypothesised that an immune-mediated mechanism would underlie the changes induced by seminal plasma, we did not find much evidence to support this idea; however, more work needs to be done on this aspect of the research.
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MedicalResearch.com Interview with:
Anita L. Nelson, MDProfessor, Department of Obstetrics and Gynecology at Harbor-UCLA Medical Center
Los Angeles BioMedical Research Institute
Harbor-UCLA Medical Center
Torrance, California
Medical Research: What is the background for this study? What are the main findings?
Dr. Nelson: The clinical impact heavy menstrual bleeding has often been expressed in terms of quality of life issues, but many women have heavy and prolonged bleeding that can lead to serious medical problems. The frequency with which women were treated at Harbor-UCLA Medical Center with profoundly low hemoglobin levels prompted us to do a comprehensive review of such women during a recent five year period to remind readers that even in the 21st century, this is not an uncommon problem. Overall 149 woman were treated 168 times for severe anemia (hemoglobin < 5.0 g/dL); 40% had previously been transfused (but not effectively treated). Over a quarter had reactive thrombocytosis which placed them at high risk for thrombosis (DVT, PE, and stroke). Over a third were discharged without therapy to prevent recurrence.
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Medical Research: What is the background for this study?
Dr. Schmiegelow: Use of cardiovascular risk stratification models is highly encouraged by U.S. and European guidelines in order to prevent cardiovascular disease (CVD). Individuals with insulin resistance are likely to progress to type 2 diabetes, but measures of insulin resistance are not included in current risk stratification models, although this might improve prediction of CVD in patients without diabetes. The aim of this study was to evaluate whether measures of insulin resistance would improve CVD risk predictions based solely on traditional CVD risk factors in postmenopausal women without existing CVD or diabetes. The main outcome was risk of developing CVD, defined as non-fatal and fatal coronary heart disease and ischemic stroke, within ten years, and the measures of insulin resistance considered were fasting serum glucose, fasting serum insulin, “homeostasis model assessment-insulin resistance“ (HOMA-IR) and the ratio of triglycerides and high-density lipoprotein-cholesterol (TG/HDL-C).
From the Women’s Health Initiative Biomarkers studies we identified 15,288 postmenopausal women with no history of CVD, atrial fibrillation, or diabetes at baseline (included 1993–1998), who over a mean follow-up of 9.2 years (standard deviation 1.9 years) had 894 first CVD events (5.8%). (more…)
MedicalResearch.com Interview with:
Candace McNaughton, MD MPH
Assistant Professor
Department of Emergency Medicine
Vanderbilt University, Nashville, TN
Medical Research: What is the background for this study?
Dr. McNaughton: Heart failure affects more than 5 million Americans, is a frequent cause of hospitalization, and by 2030 is projected to cost as much $70 billion, so there is a lot of interest in helping patients with heart failure manage their condition. Health literacy, or the ability to use and understand healthcare information, is important for all patients, but the stakes are very high for patients with heart failure. Some people who are highly literate or highly educated in other areas may have difficulty reading and understanding healthcare information. Patients with lower health literacy skills may have difficulty communicating with healthcare providers, navigating the healthcare system, recognizing signs of health decline, and knowing when and who to contact when they do become ill.
Medical Research: What are the main findings?
Dr. McNaughton: To our knowledge, this is the first study in which health literacy was measured by nurses when patients were admitted to the hospital for heart failure. Nurses asked patients three questions about whether they have problems learning about their medical condition, their confidence filling out medical forms, and how often they have someone help them read hospital materials. With these three questions, information about the health literacy level of individual patients can be made easily available their healthcare providers.
We found that among 1,379 patients hospitalized for acute heart failure, those with low health literacy had 32% greater risk of death compared to patients with a literacy score of 10 or higher, even after adjusting age, sex, race, insurance status, education, other medical conditions, and how long they were in the hospital. (more…)
MedicalResearch.com Interview with:
Hueiming Liu | BA (Hons), MBBS, MIPH
Research Fellow, Renal & Metabolic Division
The George Institute for Global HealthNSW Australia
Medical Research: What is the background for this study?Dr. Liu: Cardiovascular disease is a major cause of mortality and morbidity worldwide and is projected to be the leading cause of death in 2030. A major part of the problem is large treatment gaps globally. Cardiovascular polypills which are fixed dose combinations of frequently indicated cardiovascular medications for high risk primary prevention and secondary prevention have been trialled internationally to improve provider prescribing and patient medication use. Encouragingly, recent results from randomised controlled trials have shown effectiveness in improving adherence. This study is part of a process evaluation of a pragmatic randomised, controlled trial evaluating a polypill-based strategy for high-risk primary and secondary cardiovascular disease prevention in Australian primary health care. The trial results showed that “ After a median of 18 months, the polypill-based strategy was associated with greater use of combination treatment (70% vs. 47%; relative risk 1.49, (95% confidence interval (CI) 1.30 to 1.72) p < 0.0001; number needed to treat = 4.4 (3.3 to 6.6)) without differences in systolic blood pressure (-1.5 mmHg (95% CI -4.0 to 1.0) p = 0.24) or total cholesterol (0.08 mmol/l (95% CI -0.06 to 0.22) p = 0.26).” Ultimately, the trial was underpowered for clinical outcomes, but in a separate meta-analysis that included 2 other trials using a near identical protocol in other countries, the polypill strategy was associated with significant reductions in blood pressure and LDL cholesterol. A within-trial cost analysis of polypill-based care versus usual care with separate medications showed a statistically significantly lower mean pharmaceutical expenditure and thus potential cost savings to tax payers and the Australian government should the polypill strategy be introduced.
In this qualitative study, we explored health provider and patient attitudes towards the use of a cardiovascular polypill as a health service strategy to improve cardiovascular prevention in Australia through in-depth, semi-structured interviews with 47 health providers and 47 patients involved in the trial.
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MedicalResearch.com Interview with:
Matthias Eiber, MD
Department of Nuclear Medicine
Munich, Germany
Medical Research: What is the background for this study? What are the main findings?
Dr. Eiber: The background of the study is the investigation of a novel 68Ga-PSMA ligand using PET/CT in the workup of patients with recurrent prostate cancer after radical prostatectomy. Hereby, we found substantial higher detection rate compared to other methods. In total 222 (89.5%) patients showed pathological findings in 68Ga-PSMA-ligand PET/CT. Stratified by PSA-level the detection rates were 96.8%,93.0%,72.7% and 57.9% of ≥2,1-<2, 0.5-<1 and 0.2-<0.5ng/mL, respectively.
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MedicalResearch.com Interview with:
Dale N. Gerding, MDResearch Physician, Edward Hines, Jr., VA Hospital
Professor, Department of Medicine of Loyola University Chicago Stritch School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Gerding: Naturally occurring strains of C. difficile lack the genes for production of the toxins that cause C. difficile infection (CDI) and are known as non-toxigenic C. difficile (NTCD). These strains when ingested by patients whose normal microbiota is disrupted by antibiotic treatment will harmlessly colonize the colon and remain in the gut for weeks to months. Specific strains of NTCD found in patients were shown to colonize the gut and prevent C. difficile infection when challenged with toxigenic C. difficile strains in animal models. One such NTCD strain, NTCD-M3, was shown to be safe and well tolerated in human volunteer trials and was used in the present study to determine if it would prevent recurrence of C. difficile infection in patients who had just completed treatment with vancomycin or metronidazole of either their first CDI episode or first recurrence of
C. difficile infection. 168 patients were randomized to receive by mouth in a liquid form, either 10,000 spores/day of NTCD-M3 for 7 days, 10 million spores/day for 7 days, 10 million spores/day for 14 days, or an identical placebo for 14 days. Primary outcome was safety, and secondary outcomes were the percent who colonized the gut with NTCD-M3 in the time period from end of treatment to week 6, and the rate of recurrent CDI in the patients at week 6. The results showed that NTCD-M3 was safe and well tolerated, and colonized the gut of 69% of patients who received it. The C. difficile infection recurrence rate was 30% in the placebo patients and 11% in patients who received any of the NTCD-M3 doses (P<.006). The best dose tested was 10 million spores/day for 7 days which resulted in a recurrence rate of only 5% (p<.01 vs placebo). Colonization of the gut was not permanent, but lasted a maximum of 22 weeks. The summary conclusion is that NTCD-M3 is safe, colonized the gut, and when it colonized the gut, reduced recurrence of C. difficile infection to 2% (p<.001 vs patients who were not colonized).
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MedicalResearch.com Interview with:
Gerardo U. Lopez, M.A.T, M.Ed., Ph.D.
Research Associate
Soil, Water and Environmental Science
The University of Arizona
Tucson, AZ 85721
Medical Research: What is the background for this study? What are the main findings?
Dr. Lopez: The background for this study was based on the missing data gaps on fomite-to-finger transfer in the literature that could be used as input parameters for Quantitative Microbial Risk Assessments (QMRA). This research was supported by the Center for Advancing Microbial Risk Assessment, funded by the U.S. Environmental Agency’s Science To Achieve Results (STAR) program and the U.S. Department of Homeland Security. Two different studies were conducted:
1st “Transfer Efficiency of Bacteria and Viruses from Porous and Nonporous Fomites to Fingers under Different Relative Humidity Conditions” Appl. Environ. Microbial. 2013, 79(18):5728 and
2nd “Evaluation of a Disinfectant Wipe Intervention on Fomite-to-Finger Microbial Transfer”.
This research was supported by The Clorox Company. Based on the findings of these two studies along with other input parameters drawn from previous studies, we were able to develop a risk assessment that focused on forecasting the exposure to Campylobacter jejuni contaminated surfaces during preparation of chicken fillets and how using a disinfectant wipe intervention to clean a contaminated work area decreases the risk of infection following the preparation of raw chicken fillet in a domestic kitchen. The title of our new publication is “Impact of Disinfectant Wipes on the Risk of Campylobacter jejuni Infection During Raw Chicken Preparation in Domestic Kitchens” Accepted for publication in Journal of Applied Microbiology.
Editor's note: For EPA Registered Disinfectant Wipes
The main findings were that the annual risk of C. jejuni infections showed a 99% reduction per person per event from 2 out of 10 to 2 out of 1000.
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MedicalResearch.com Interview with:
Professor James Bainbridge, MA, PhD, FRCOphth
Professor of Retinal Studies, UCL Institute of Ophthalmology
NIHR Research Professor, NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyConsultant Ophthalmologist, Moorfields Eye Hospital NHS Foundation Trust
Medical Research: What is the background for this study? What are the main findings?Prof. Bainbridge : Leber Congenital Amaurosis (LCA) is one of the most common causes of inherited, untreatable blindness in children. There are at least 14 different types of Leber Congenital Amaurosis of which LCA Type 2 (LCA2), caused by defects in the gene RPE65, affects around one in 100,000 people worldwide. Evidence from animal studies support that LCA2 may be amenable to treatment with RPE65 gene replacement therapy.
The main findings of this phase I/II clinical trial confirm our preliminary findings (published in NEJM, 2008) that gene therapy can improve night vision. Improvements peak within the first 12 months after treatment but then decline during the three-year follow-up period which is consistent with the published results and interim findings from other studies of RPE65 gene therapy.
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MedicalResearch.com Interview with:
Thomas P. Dompier, PhD, ATC
President and Injury Epidemiologist
Datalys Center for Sports Injury Research and Prevention, Inc
Indianapolis, IN 46202
Adjunct Faculty Appointments
Ohio University Rocky Mountain University of Health Professions
University of South Carolina
Medical Research: What is the background for this study?
D: Dompler: Per the Institute of Medicine’s recent recommendations to better describe the incidence of concussion in sport across the entire spectrum of youth sports (5-23 years), this study is the first to provide an apples-to-apples comparison using epidemiologic data provided by healthcare providers (athletic trainers) who attended all practices and games and used the same methodology to report concussions and student-athlete exposure information.
Medical Research: What are the main findings?D: Dompler:
a. The main findings are that the risk (how many players out of 100 can expect to suffer at least one concussion during the season) is lowest in the youth, and increases with age.
b. Game concussion rates (how many players out of 1000 exposed during a practice or game, includes multiple concussions to the same player) are highest in college but practice concussion rates are lowest in college during practice. This suggests more can be done during high school and youth practices to reduce concussion frequency (e.g. limiting how much time can be devoted to full contact, reducing player-to-player contact by teaching proper tackling without using full contact drills such as the Oklahoma drill and others).
c. While the rate is higher, there is still a substantial number of concussions that occur during practice (because there are more practices), therefore sports medicine staff should be available at both if possible (this is difficult at the youth level because of cost, however).
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MedicalResearch.com Interview with:
Robert J Canter MD
Associate Professor of Clinical Surgery
Division of Surgical Oncology
University of California at Davis
Medical Research: What is the background for this study?
Dr. Canter: Our data suggest that surgeons are improving in their ability to select patients for surgical intervention in cancer patients near their end of life. Our research suggests that surgeons may be operating on healthier patients who are anticipated to have a better recover from a palliative operation. These are patients who can perform activities of daily living without assistance, for example.
Our interest in the appropriate surgical care of people with late-stage cancer grew from observing terminally ill patients whose acute problems were addressed through surgery, and who then suffered complications resulting in lengthy stays in intensive care units, and even in death.
Unfortunately, it is quite common that this group of disseminated malignancy patients end up dying in the intensive care unit instead of being managed with less invasive interventions with hopes of returning home with their families, including with hospice care.
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MedicalResearch.com Interview with:
Dr. Audrey Coilly MDFellow at the Centre Hepato-Biliaire
Paul Brousse Hospital
Villejuif, France
Medical Research: What is the background for this study? What are the main findings?
Dr. Coilly: Hepatitis C (HCV) recurrence used to be a major issue during two decades for patients transplanted with an active HCV infection at the time of transplantation impacting both patient and graft survival. The combination of sofosbuvir and daclatasvir has not been studied after liver transplantation. The main findings are a high efficacy profile with an overall SVR12 rate of 95%. The safety profile is also good. The most frequent adverse event is anemia, particularly when ribavirin is still used.
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MedicalResearch.com Interview with:
Jennifer A. Emond, M.Sc., PhD
Research Instructor
Department of Epidemiology
Geisel School of Medicine at Dartmouth College
Cancer Control Research Program
Lebanon, NH 03756
Medical Research: What is the background for this study? What are the main findings?
Dr. Emond: Several studies have documented a link between consuming alcohol mixed with energy drinks and an increased risk of negative outcomes while drinking, including binge drinking. It is known that mixing energy drinks with alcohol increases the risk for binge drinking--the high caffeine intake consumed when mixing energy drinks with alcohol may cause individuals to feel what is been called "wide-awake drunk," and they may underestimate their level of intoxication. However, most studies to date have been conducted among undergraduate college students, and we wanted to know if those same associations were also observed among adolescents. In our study of 3,342 adolescents and young adults between the ages of 15-23, we also found a positive link between a history of consuming alcohol mixed with energy drinks and abusive alcohol use. Specifically, 22.3% of participants had ever consumed an energy drink mixed with alcohol (including 9.7% of 15-17 year olds), and such a history of mixed use was associated with a more than 4-fold increased likelihood of engaging in binge drinking. Importantly, that association was just as strong among 15-17 year olds as it was among the older participants. One critical component of our study was that we also looked at a validated outcome for alcohol use disorder (i.e., the participants completed the Alcohol Use Disorders Identification Test [AUDIT]), and participants with a history of consuming alcohol mixed with energy drinks were also 4.2 times more likely to meet that clinically defined criteria for alcohol use disorder as defined for adolescents. Again, those associations were observed for all participants, regardless of age.
Our study has limitations. It was cross-sectional, so we cannot prove that mixed use of alcohol and energy drinks causes abusive alcohol use behaviors. However, our study does support that mixed use of alcohol with energy drinks can identify adolescents at risk for alcohol abuse. (more…)
MedicalResearch.com Interview with:
Andre Paixao, MD
Division of Cardiology
Emory University
Atlanta, GA, 30322.
Medical Research: What is the background for this study?
Dr. Paixao: Despite advances in cardiovascular prevention, coronary heart disease remains a major cause of morbidity and mortality. Understanding risk factor burden and control as well as perceived risk prior to acute myocardial infarction (MI) presentation may identify opportunities for system-based interventions to promote adherence to evidence based recommendations and improve overall cardiovascular health.
Medical Research: What are the main findings?Dr. Paixao: Our study assessed predicted risk and risk factor control prior to Myocardial Infarction (MI) presentation in 443,117 patients included in the NCDR ACTION Registry-GWTG. Only 36.1% of patients met all assessed risk factor control metrics (i.e. LDL cholesterol, non-HDL cholesterol, nonsmoking status and aspirin use among those with prior cardiovascular disease). Risk factor control was suboptimal in the primary and secondary prevention groups.
Prior cardiovascular disease was present in 41.6% of patients presenting with an acute MI. Among those without prior cardiovascular disease or diabetes, only 13.4% were classified as high risk based on the Framingham Risk Score. (more…)
MedicalResearch.com Interview with:
Marianna Virtanen PhD
Finnish Institute of Occupational Health,
Helsinki, Turku and Tampere, Finland
Medical Research: What is the background for this study? What are the main findings?
Dr. Virtanen: Diabetes is a common chronic condition among working-aged populations but few studies have investigated work disability associated with diabetes. In this study, we examined trajectories of register-based work disability days over a 5-year period and lifestyle-related factors predicting these trajectories.
Five trajectories described work disability: ‘no/very low disability’ (41.1% among diabetes cases, 48.0% among controls); ‘low–steady’ (35.4%, 34.7%); ‘high–steady’ (13.6%, 12.1%); and two ‘high–increasing’ trajectories (10.0%, 5.2%). Diabetes was associated with ending up to the ’high-increasing disability trajectory’, however, this affected only 10% of the population with diabetes. Obesity and physical inactivity predicted an adverse trajectory similarly among people with diabetes and those without diabetes while smoking was a stronger risk factor for an adverse trajectory in diabetes.
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MedicalResearch.com interview with
Dr. Victoria L. Chiou, MD
Medical Oncology Fellow
Women’s Malignancies Branch
National Cancer Institute
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Chiou: We studied the effects of different treatments in ovarian and breast cancer cell lines with and without BRCA1 mutation in the laboratory. Our discovery that olaparib pretreatment before carboplatin led to decreased carboplatin-induced DNA damage in tumor cells carrying BRCA1 mutation led us to a novel clinical question. We wanted to further understand whether there was an optimal way to deliver a combination of the new tablet formulation of olaparib with carboplatin chemotherapy in women with gynecologic and breast cancers.
We launched our clinical trial to test this important question. Overall, we are pleased that the drug combination of olaparib and carboplatin chemotherapy can be given safely together, with preliminary activity in women with breast and ovarian cancer associated with germline BRCA mutations. We are excited to report the findings of this study, which is the first to report preclinical and clinical data on sequence specificity for this drug combination in this patient population. (more…)
MedicalResearch.com Interview with:
Dr. Alec (Chengcheng) Zhang
Michael L. Rosenberg Scholar in Medical Research
Associate Professor of Physiology and Developmental Biology, Member of the Harold C. Simmons Comprehensive Cancer Center
UT Southwestern Medical Center
Medical Research: What is the background for this study? What are the main findings?
Response:Acute myeloid leukemia (AML) is the most common acute leukemia affecting adults. Treatments for AML yield poor outcomes, especially for the typical senior patients. The medical need for new therapies for AML is underscored by the fact that no new therapies for AML have been approved in over 30 years. There are over 50 experimental agents in clinical trials for the treatment of AML today, although only a few agents have promising data to date. New molecular targets and therapeutic strategies are needed for AML treatment.
In 2012, we published a paper showing that we cloned the human leukocyte immunoglobulin-like receptor B2 (LILRB2) as a receptor for several angiopoietin-like proteins (Angptls) (Zheng et al 2012 Nature 485:656-660). The LILRB family receptors contain immunoreceptor tyrosine-based inhibitory motifs (ITIMs) and are classified as inhibitory receptors because ITIM motifs can recruit phosphatases SHP-1, SHP-2, or SHIP to negatively regulate immune cell activation. Surprisingly, in that work, we showed that PirB, the mouse ortholog of LILRB2, is expressed by AML stem cells (AML-SCs) and supports AML development. Although counterintuitive, this result is consistent with the generally immune-suppressive and thus tumor-promoting roles of the inhibitory receptors in the immune system.
In the current paper, we continued the research and report that a number of receptors containing the ITIMs are crucial for the development of AML. We mainly focus on studying the function and downstream signaling of LAIR1 as a representative ITIM-containing receptor. We found that the deletion of LAIR1 does not affect normal hematopoiesis but abolishes leukemia development in several different mouse leukemia models. We also identified a mechanism by which LAIR1 supports AML development, showing that the LAIR1/SHP-1/CAMK1/CREB pathway sustains the survival and self-renewal of AML cells. Importantly, our findings are well supported by bioinformatics analysis of AML patient databases and experimental results of human leukemia cells. Since certain ITIM-containing receptors are essential for AML cells but not critical for normal hematopoiesis, and blocking their signaling can boost immunity, these ITIM-containing receptors including LAIR1 represent ideal targets for treating AML.
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MedicalResearch.com Interview with:
Juan Carlos Izpisua Belmonte PhD
Professor, Gene Expression Laboratory
Roger Guillemin Chair
Salk Institute For Biological Science
MedicalResearch: What is the background for this study? What are the main findings?Response: Werner protein (WRN) plays roles in DNA replication, transcription, repair as well as telomere maintenance. Mutations in WRN are associated with Werner syndrome. In the current study we discovered that WRN was interacting with proteins implicated in heterochromatin maintenance. We observed that mutations in the WRN protein led to alterations in heterochromatin and those alterations are drivers of the aging process.
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MedicalResearch.com Interview with:
G. Mandela Fernández-GrandonPhD
Natural Resources Institute,
University of Greenwich,
Chatham, United KingdomMedical Research: What is the background for this study?
Response: People often wonder why, when they are out with their friends or family, one person seems to get ravaged by mosquitoes but others come away relatively bite free. Mosquito bites can be a nuisance to many of us but they are no trivial matter. Mosquitoes are one of the most serious threats to public health through the transmission of diseases such as malaria, dengue fever, yellow fever, chikungunya and others.
We knew that mosquitoes rely on odour to find their hosts but until now the link between our body odour and genes had only been shown using human sniffers1. In a strictly controlled laboratory environment, we were able to present the odours of individuals in identical and non-identical twin pairs to mosquitoes allowing them following the odour stream of whichever they found to be more attractive.
Medical Research: What are the main findings?
Response: Mosquitoes are equally attracted to identical twins in a pair but with non-identical twins they display a preference for one individual.
The ability of mosquitoes to distinguish non-identical twins but not identical twins suggests a genetic basis for our odour profile, a genetic difference which plays a role in whether we get bitten more or less than others.
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MedicalResearch.com Interview with:
Terry Boyle, PhDCIHR Fellow, MSFHR Trainee, Honorary UBC Killam Fellow
Cancer Control Research, BC Cancer Agency
School of Population and Public Health, The University of British Columbia
Australian NHMRC Early Career Fellow
The University of Western Australia
Cancer Control Research, BC Cancer Agency
Vancouver BC Canada
Medical Research: What is the background for this study? What are the main findings?
Dr. Boyle: Little is known about what causes non-Hodgkin lymphoma (NHL), so trying to identify risk factors is particularly important for the prevention and control of this cancer. There is really good evidence that people who are physically active have a lower risk of some cancers (such as colon and breast cancers), but not many studies have investigated whether being physical active is associated with the risk of non-Hodgkin lymphoma.
The key finding of this case-control study was that study participants who were in the higher (second, third, and fourth) quartiles of vigorously intense physical activity performance in their lifetimes had about 25 percent to 30 percent lower risk for NHL, compared with those who were in the lowest (first) quartile of vigorously intense physical activity.
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MedicalResearch.com Interview with:
Warren J. Winkelman, MD, MBA, PhD, FRCPC, FAAD
Director, Medical Affairs
Galderma Laboratories, L.P.
Fort Worth TX
MedicalResearch.com: What is the background for this study? What are the main findings?Dr. Winkelman: Rosacea is a common dermatologic facial disorder estimated to affect 16 million Americans. Rosacea is a chronic condition of the central face, including the nose, chin, cheeks and forehead, and is often characterized by flare-ups and remissions. While the cause of rosacea is unknown and there is no cure, its signs and symptoms can become markedly worse in the absence of treatment. Rosacea can be managed with topical and oral medications, and physicians often resort to using these medications in combination for more severe or resistant cases. Doxycycline 40 mg modified release (MR) and metronidazole 1% gel are FDA-approved oral and topical therapies, respectively, indicated to treat the papules and pustules of rosacea. We conducted a phase 2 study to assess the relapse rate, efficacy, and safety of doxycycline 40 mg MR compared to placebo after an initial 12-week once-daily combination regimen of doxycycline 40 mg MR and metronidazole 1% gel in subjects with moderate to severe disease.
Of the 235 subjects enrolled in the study, 71% were women, 94% were white, and 75% had Fitzpatrick skin type I, II or III. The mean age was 47.4 years. The percentage of subjects who achieved a success score of 0 (clear) or 1 (near clear) improved from 0% at baseline to 51% at week 12. Clinician’s erythema assessment scores, inflammatory lesion counts, and quality of life scores also improved. Most subjects reported no or mild scaling, stinging/burning, and dryness. Five adverse events were reported that were considered probably or definitely related to treatment: fungal infection, vulvovaginal mycotic infection, pain in extremity, erythema, and skin exfoliation.
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MedicalResearch.com Interview with:
Dr Nita Forouhi, MRCP, PhD, FFPHM
MRC Programme Leader and Consultant Public Health Physician
MRC Epidemiology Unit
University of Cambridge School of Clinical Medicine
Cambridge Biomedical Campus
Cambridge UK
Medical Research: What is the background for this study? What are the main findings?
Dr. Forouhi: Consumption of soft drinks is known to cause obesity and may contribute to the development of type 2 diabetes. We had previously published findings from the EPIC-InterAct study in 8 European countries that habitual consumption of sugar sweetened beverages increases the risk of developing type 2 diabetes, and we now wanted to probe deeper to understand more about this relationship between sweet beverages and diabetes.
We conducted research in the large EPIC-Norfolk study which included more than 25,000 men and women aged 40–79 years living in Norfolk, UK. Study participants recorded everything that they ate and drank for 7 consecutive days covering weekdays and weekend days, with particular attention to type, amount and frequency of consumption, and whether sugar was added by the participants. During approximately 11 years of follow-up, 847 study participants were diagnosed with new-onset type 2 diabetes.
By using this detailed information on diet, we were able to study several different types of sugary beverages, including sugar-sweetened soft drinks, sweetened tea or coffee and sweetened milk drinks as well as artificially sweetened beverages (ASB) - such as diet soft drinks - and fruit juice, and to examine what would happen if plain water, unsweetened tea or coffee or artificially sweetened beverages were substituted for sugary drinks.
Our study provided three main findings:
First, there was an approximately 22% increased relative risk of developing type 2 diabetes per extra serving per day habitually of each of soft drinks, sweetened milk beverages and ASB consumed, even after accounting for a range of important factors including other lifestyle and social factors and for total energy intake. However, after further accounting for body mass index and waist girth as markers of obesity, there remained a higher risk of diabetes associated with consumption of both soft drinks and sweetened milk drinks, but the link with ASB consumption no longer remained, possibly because artificially sweetened beverages was likely to be consumed by those who were already overweight or obese.
Second, when we estimated the likely effects of replacing a habitual serving of soft drinks with a serving of water or unsweetened tea or coffee, we found that the risk of diabetes could have been cut by 14%; and by replacing a habitual serving of sweetened milk beverage with water or unsweetened tea or coffee, that reduction could have been 20%–25%. However, consuming ASB instead of any sugar-sweetened drink was not likely to reduce the risk of diabetes, when accounting for baseline obesity and total energy intake.
Third, we found that each 5% of higher intake of energy (as a proportion of total daily energy intake) from total sweet beverages (soft drinks, sweetened tea or coffee, sweetened milk beverages, fruit juice) was associated with a 18% higher risk of diabetes. We estimated that if study participants had reduced the energy they obtained from sweet beverages to below 10%, 5% or 2% of total daily energy, 3%, 7% or 15% respectively of new-onset type 2 diabetes cases could have been potentially avoided.
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MedicalResearch.com Interview with:
Shannon M. Dunlay, M.D. M.S.
Advanced Heart Failure and Cardiac Transplantation
Assistant Professor of Medicine and Health Care Policy and Research
Mayo Clinic Rochester
MedicalResearch: What is the background for this study? What are the main findings? Dr. Dunlay: Left ventricular assist devices (LVAD) are increasingly utilized as destination therapy (DT) in patients that are not candidates for heart transplantation. Optimal patient selection is essential in improving outcomes, but many of the factors associated with favorable outcomes remain poorly understood. It is important for us to better understand the role that psychosocial factors may play in outcomes after DT LVAD. Unlike transplant, where the limited organ supply requires choosing candidates with optimal psychosocial characteristics, DT LVAD therapy is more readily available as it does not rely on organ donors. There are no clear guidelines on what constitutes an acceptable psychosocial risk prior to DT LVAD. As a result, many programs will offer DT LVAD to candidates despite psychosocial concerns if it is felt they will otherwise benefit. Data are needed to inform programs about whether such candidates are truly at elevated risk of adverse outcomes.
In our single-center study including 131 patients, we found that several psychosocial characteristics are predictive of readmission after DT LVAD. A history of illegal drug use and depression are associated with a higher risk of readmission, while tobacco use is associated with lower readmission risk. Psychosocial characteristics were not significant predictors of death after DT LVAD.
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MedicalResearch.com Interview with:
Yunhwan Lee, MD, DrPH
Director, Institute on Aging
Professor of Preventive Medicine & Public Health
Ajou University School of Medicine
Suwon, South Korea
Dr. Lee wishes to acknowledge Jinhee Kim, PhD, the lead author of the study.Medical Research: What is the background for this study?
Dr. Lee: We have known for some time that there is a progressive loss of muscle mass with aging, where older people lose on average about 1% of their skeletal muscle mass per year. A decline in muscle mass is serious in that it increases the person’s risk of falls, frailty, disability, and death.
Because there is currently no “cure” for muscle mass loss, prevention is the best strategy. Over the years, researchers have studied various lifestyle factors to identify potentially modifiable behaviors that may prevent or slow the loss of muscle mass. The majority of prior research so far have found that diet, in the form of protein supplementation, and exercise, especially resistance exercise, may confer some benefits.
More recently, the scientific community have begun to pay attention to the positive role of vegetables and fruits intake on the muscle. The role of aerobic exercise on muscle mass is, however, less clear. Also, because people tend to adopt various lifestyles, we were interested in finding out whether those engaging in healthier patterns of diet and exercise retained higher muscle mass. This is why bodybuilders pay such close attention to their diet and make sure their muscle mass is at it's peak. They can also take supplements like SARMs (see SARMS.io for more information about that) to improve muscle mass but their diet has a massive effect on it too. This is where some of the inspiration for this research came from as we knew what an effect food had on bodybuilders so we wondered how it could effect the elderly.
Using data from a nationally representative sample of older adults, we investigated whether those who had healthier diet and participated in regular exercise, individually and in combination, maintained higher muscle mass. We looked at five healthy lifestyle factors that included dietary intake of three food groups (meat, fish, eggs, legumes; vegetables; and fruits) and participation in two types of exercise (aerobic and resistance). (more…)
MedicalResearch.com Interview with:
Jaime L. Tartar PhD
Behavioral Neuroscience Major Chair Division of Social and Behavioral Sciences
Nova Southeastern University
Fort Lauderdale, FloridaMedical Research: What is the background for this study? What are the main findings?
Dr. Tartar: We set out to understand how poor sleep quality can influence emotion processing. Our rationale for this study was that although sleep perturbations are known to impair cognitive performance, it is not currently clear how poor sleep alters emotion processes. However, given that poor sleep quality is closely associated with the development of mood disorders, it is important to understand how sleep quality affects emotional functioning. We specifically examined the possibility that poor sleep quality creates a cognitive bias in memory and interpretation for emotionally negative stimuli. This would result in maladaptive emotional experiences- for example, through enhanced memory for emotionally negative events (which is also a common characteristic of depression). The idea that negative cognitive bias occurs with poor sleep quality is also consistent with the finding that sleep loss increases sensitivity to emotional stimuli as well as increases undesirable mood states like irritability, anger, and hostility. It is particularly noteworthy that sleep perturbations result in increased emotionality since sleep perturbations are shown to result in a decrease in non-emotional cognitive processes (attention and memory). In order to clarify the role of sleep quality on emotion processing, we tested the relationship between sleep quality and a negative cognitive bias through the use of an emotional memory task. We also aimed to contrast these findings with performance on a non-emotional attention task since sleep impairments have previously been shown to cause impairments in (non-emotional) sustained attention. An interesting feature of the study was that we also accounted for potential confounding effects of stress sensitivity and chronotype (ones preferred time of day) since these are both factors known to be related to sleep quality. We found that, compared to those who reported good subjective sleep quality, participants who reported poor subjective sleep quality showed a negative cognitive bias towards emotionally negative stimuli. Also in agreement with previous work, we show that poor sleep quality has a negative effect on affective symptom measures- poor sleep quality relates to increased depressive symptoms, greater state and trait anxiety, and higher total mood disturbance (increased tension, fatigue, confusion and less vigor). Consistent with previous findings, we also found that subjective sleep quality was related to a decrease in performance on a sustained attention task. Although previous research suggests that stress sensitivity and chronotype would be important variables to consider in the impact of sleep perturbations on emotion processing, we did not find any stress, chronotype, or time of testing effects on these measures.
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MedicalResearch.com Interview with:
Dr. Stephen Wank MD
Digestive Diseases Branch, NIDDK
National Institutes of Health, Bethesda, Maryland
MedicalResearch: What is the background for this study?Dr. Wank: Small intestinal carcinoids are rare and difficult to diagnose because symptoms may be absent or mistaken for more common diseases. Because carcinoids usually grow slowly over several years before spreading or causing symptoms, patients often seek medical attention late with advanced, incurable disease. However, when diagnosed at an early stage, carcinoid can be surgically cured. Presently, there are no long-term effective therapies for surgically non-resectable disease. Although carcinoids occur sporadically, there have been reports of family clusters (more than one blood relative with carcinoid). Hereditary small intestinal carcinoid has not been recognized as a disease and causative genetic factors have not been identified in either sporadic cases or families with multiple affected members.
If small intestinal carcinoid occurs in families on a hereditary basis, we hypothesized that asymptomatic relatives in families with carcinoid are at a high risk of harboring an undiscovered tumor. To test this, we established a clinical research protocol at the National Institutes of Health in Bethesda, Maryland to screen asymptomatic relatives in families with at least two cases of small intestinal carcinoid in the hope of detecting their tumors at an early surgically curable stage. If successful in our endeavor, we would improve the outcome of the disease in these asymptomatic relatives and position ourselves to discover the genetic basis for their disease. Understanding the gene mutations causing small intestinal carcinoid would allow us to screen for the disease with a blood test, help us understand what causes the disease, and treat the disease with specific targeted therapies.
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MedicalResearch.com Interview with
Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University New York, NY 10032
MedicalResearch: What is the background for this study? What are the main findings?Dr. Martins: The background for this study is former studies showing links between nonmedical use of prescription opioids and transition to heroin and other illegal substances, prescription opioid-related and heroin-related fatal overdoses . In addition, a particular public health concern is that the transition to heroin and further injecting heroin may increase the risk of bloodborne infections.
We used data from the National Survey on Drug Use and Health, a large nationally representative household sample of 67,500 people, and self-reported heroin use within the last 12 months, the researchers examined the change in patterns of past-year non-prescription drug and heroin use between 2002-2005 and 2008-2011 across racial and ethnic groups. The most significant rise in heroin use was among Hispanics and non-Hispanic whites, where the rate of heroin use for the latter group increased by 75 percent in 2008-2011 compared to earlier years. Regarding frequency of use, for Hispanics, increases were significant only among those using opioids about 1-29 days in the past year. Among blacks and whites, significant increases in the rate of heroin use were observed among those using prescription opioids more frequently (100-365 days) in the past year.
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MedicalResearch.com Interview with:
Stephen F. Kingsmore MB ChB BAO DSc FRCPath
Dee Lyons/Missouri Endowed Chair in Genomic Medicine,
Children’s Mercy - Kansas City
Medical Research: What is the background for this study?
Response: The background to this study is that genetic diseases are the leading cause of death in infants and, especially, in infants in neonatal intensive care units. Making a molecular (etiologic) diagnosis of the specific genetic disease is critical for optimal care and decision making for acutely ill infants who are likely to have such diseases. However there are over 5000 known genetic diseases and their presentations overlap considerably in infants. Until now it has not been possible to make timely diagnoses in these infants.
Medical Research: What are the main findings?Response: Rapid whole genome sequencing is a new way of making a genetic disease diagnosis in acutely ill newborns in neonatal intensive care units. It appears to be effective for diagnosis.
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MedicalResearch.com Interview with:
Maria Pagano, PhD
Case Western Reserve University School of Medicine
Department of Psychiatry, Division of Child Psychiatry
Cleveland, OHMedicalResearch: What is the background for this study?
Dr. Pagano: Socially anxious adolescents quickly figure out that alcohol and drugs can provide ease and comfort in social situations that are anxiety provoking. Reaching for a substance to change how you feel can quickly become a knee-jerk reaction, can develop into an addiction, and robs youths of learning how to tolerate interpersonal differences and uncomfortable feelings, developing emotional maturity, and cultivating self acceptance.
Adolescents who fear being criticized by their peers are likely to not speak up in group therapies during treatment, which can limit their benefit from treatment. There is a lot of healing that comes sharing your insides with others. Socially anxious patients may not get this healing nor let others really get to know who they are and give input to their lives
Higher peer helping in AA during treatment means getting active in low intensity tasks like putting away chairs, or making coffee at a 12-step meeting. It is less about needing peer assistance or expecting praise or recognition from giving service. It is more about adopting the attitude of "how can I be helpful?"
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MedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh MSc
Associate Professor, University of Alberta
Co-Director, Canadian VIGOUR Centre
Director, Heart Function Clinic
Cardiologist, Mazankowski Alberta Heart Institute
Medical Research: What is the background for this study?
Dr. Ezekowitz: Heart Failure is a prevalent health issue that carries high morbidity and mortality. Most epidemiologic research derives information from hospital discharge abstracts, but emergency department visits are another source of information. Many have assumed this code is accurate in the emergency department but uncertainty remains.
In our study, we assessed patients at their presentation to Emergency Department, which is usually the first medical contact for acutely ill patients with heart failure.
The objective of our study was to compare administrative codes for acute heart failure (I50.x) in the emergency department against a gold standard of clinician adjudication.
Medical Research: What are the main findings?
Dr. Ezekowitz: Emergency department administrative data is highly correlated with a clinician adjudicated diagnosis. The positive predictive value of acute heart failure as the main diagnosis was 93.3% when compared to clinician adjudication, supported by standardized scoring systems and elevated BNP. (more…)
