Author Interviews, Duke, Radiology, Thyroid Disease / 03.11.2014

Dr. Jenny Hoang MBBS (Hons) Associate Professor of Radiology and Radiation Oncology Duke University Medical CenterMedicalResearch.com Interview with: Dr. Jenny Hoang MBBS (Hons) Associate Professor of Radiology and Radiation Oncology Duke University Medical Center   Medical Research: What is the background for this study? What are the main findings? Dr. Hoang: The incidental thyroid nodule (ITN) is a very common finding on imaging studies of the neck, chest and cervical spine. The workup of incidental thyroid nodules has led to increased costs from additional procedures and in some cases to increased risk to the patient. Physicians are concerned about the risk of malignancy and a delayed cancer diagnosis, but the majority of incidental thyroid nodules are benign and small incidental thyroid malignancies typically have indolent behavior. The American College of Radiology (ACR) formed the Incidental Thyroid Findings Committee to derive a practical approach to managing ITNs on CT, MRI, nuclear medicine, and ultrasound studies. This white paper describes consensus recommendations representing the Committee’s review of the literature and their practice experience. (more…)
Author Interviews, Biomarkers, Nature, Pancreatic / 03.11.2014

Dr. Murray Korc MD, Professor Department of Medicine, Division of Endocrinology, Biochemistry and Molecular Biology, and the Pancreatic Cancer Signature Center IU Simon Cancer Center, Indiana University School of Medicine Indianapolis, IndianaMedicalResearch.com Interview with Dr. Murray Korc MD, Professor Department of Medicine, Division of Endocrinology, Biochemistry and Molecular Biology, and the Pancreatic Cancer Signature Center IU Simon Cancer Center, Indiana University School of Medicine Indianapolis, Indiana Medical Research: What is the background for this study? What are the main findings? Dr. Korc: Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer with an overall 5-year survival rate of 6%. Currently, there are no highly specific and sensitive biomarkers in the blood that can be used for definitively diagnosing the presence of this cancer. In addition, in spite of the usefulness of CA19-9 in differentiating between patients with pancreatic cancer and chronic pancreatitis, this test may yield a significant number of false positive and false negative results, and it may be influenced by the presence of jaundice. These difficulties are compounded by the fact that patients with pancreatitis are at-risk for developing Pancreatic ductal adenocarcinoma. We decided to carry out a study of microRNAs using plasma from treatment-naïve PDAC patients, chronic pancreatitis patients, and controls without pancreatic disease. We focused on microRNAs because they are known to be present in the blood and to be very stable. We chose to conduct these assays in plasma because we reasoned that there would be fewer confounding factors by comparison with either whole blood or serum. We determined that five microRNAs were elevated in plasma from PDAC patients by comparison with either chronic pancreatitis or controls. Importantly, among these five microRNAs, high levels of miR-10b, miR-155, and miR-106b in the plasma were highly accurate in diagnosing Pancreatic ductal adenocarcinoma with ~95% sensitivity and ~100% specificity. (more…)
Author Interviews, Dermatology / 03.11.2014

psoriasisMedicalResearch.com Interview with: Ellen Slevolden, MD  and Kristin Evensen,MD Department of Dermatology Oslo University Hospital Rikshospitalet, Oslo, Norway Medical Research: What are the main findings of the study? Response: The main finding of our study is that psoriasis may be associated with an increased risk of atherosclerosis and subsequent cardiovascular disease. We found that carotid intima-media thickness was increased in patients with psoriasis compared to healthy controls. Psoriasis patients also had a higher prevalence of carotid plaques. (more…)
Accidents & Violence, Author Interviews, Insomnia / 02.11.2014

Lars Laugsand, MD, PhD, Postdoctoral fellow Department of Public Health Norwegian University of Science in Technology Trondheim, Norway.MedicalResearch.com Interview with: Lars Laugsand, MD, PhD, Postdoctoral fellow Department of Public Health Norwegian University of Science in Technology Trondheim, Norway. Medical Research: What is the background for this study? Dr. Laugsand: Very few prospective studies have assessed the association of insomnia symptoms and risk for injuries. Medical Research: What are the main findings? Dr. Laugsand: We found that increasing number of insomnia symptoms was strongly associated with higher risk for both overall unintentional fatal injuries and fatal motor-vehicle injuries in a dose-dependent manner. Those who reported to suffer from all major insomnia symptoms were at considerably higher risk than those who had no symptoms or only a few symptoms. Among the different insomnia symptoms, difficulties falling asleep appeared to have the strongest and most robust association with fatal injuries. (more…)
Author Interviews, Colon Cancer / 02.11.2014

Enrique Quintero MD, PhD President, Asociación Española de Gastroenterología (AEG) Chief of Gastroenterology, Hospital Universitario de Canarias Professor of Medicine, Universidad de La Laguna La Laguna. Tenerife SpainMedicalResearch.com Interview with: Enrique Quintero MD, PhD President, Asociación Española de Gastroenterología (AEG) Chief of Gastroenterology, Hospital Universitario de Canarias Professor of Medicine, Universidad de La Laguna La Laguna. Tenerife Spain Medical Research: What is the background for this study? What are the main findings? Dr. Quintero: First degree relatives (FDRs) of patients with colorectal cancer (CRC) are at increased risk of developing the disease compared with the general population. For that reason, clinical practice guidelines recommend colonoscopy every five years starting at the age of 40 years or ten years less than the youngest case in the family. However, this approach has some drawbacks:
  • first, several studies have shown that the benefit of colonoscopy is limited by a low uptake (less than 40%);
  • second, it represents an important colonoscopy burden, as about 70-80% of explorations are normal or without relevant lesions, which implies a high resource consumption; and
  • third, this recommendation is not based on evidence, as no randomized controlled trials have compared the efficacy of screening colonoscopy with that of other strategies.On the other hand, pilot studies have shown that one-time fecal immunochemical tests (FIT) have acceptable capacity to detect advanced neoplasia (defined as cancer or advanced adenoma) in family members of patients with CRC. For these reasons we conducted a prospective randomized trial to compare the efficacy of repeated fecal immunochemical tests versus one-time colonoscopy for detecting advanced colorectal neoplasia in asymptomatic FDRs of patients with colorectal cancer.
The main finding of our study was that cumulative fecal immunochemical tests screening (1 per year, during 3 years), yielded an equivalent detection rate to one-time colonoscopy for cancer, advanced adenoma and advanced neoplasia both by intention-to-screen and per-protocol analysis, after controlling for confounders such as age, gender, index-case age, and number of affected relatives. In fact, FIT detected all cancers and 61% of advanced adenomas. In addition, the study confirmed that the number of subjects requiring colonoscopy to detect one advanced neoplasm was 4 times less in individuals screened by FIT than in those screened by colonoscopy. Therefore, FIT may save a substantial number of unnecessary colonoscopies, preventing harms and lowering costs. (more…)
Author Interviews, General Medicine, Macular Degeneration, Stroke / 31.10.2014

MedicalResearch.com Interview with: Takashi Ueta, M.D., Ph.D. Assistant Professor, Department of Ophthalmology Graduate School and Faculty of Medicine The University of Tokyo Medical Research: What is the background for this study? What are the main findings? Dr. Ueta: In 2009 we had reported an initial systematic review and meta-analysis which include pivotal RCTs but the number of the included studies were only 3 (MARINA, ANCHOR, FOCUS). During the following several years, more trials comparing different dosages and frequencies of ranibizumab treatment were conducted, which made us to update our meta-analysis. Based on our updated meta-analysis, increase in several systemic vascular adverse events was observed: 86% increase in odds ratio (OR) for the risk of cerebrovascular accident (CVA) when 0,5 mg ranibizumab used. 89% increase in OR for the risk of CVA when monthly ranibizumab of any dosage is used. 57% increase in OR for the risk of non-ocular hemorrhage when ranibizumab of any dosage with any frequency is used. (more…)
Author Interviews, Pain Research, Surgical Research / 31.10.2014

Lars Peter Holst Andersen MD., Ph.d. Fellow / Læge, Ph.d. studerende Department of Surgery Herlev Hospital Gastroenheden, Herlev HospitaMedicalResearch.com Interview with: Lars Peter Holst Andersen MD., Ph.d. Fellow / Læge, Ph.d. studerende Department of Surgery Herlev Hospital Gastroenheden, Herlev Hospital Medical Research: What is the background for this study? Dr. Andersen: The sleep hormone, melatonin is diverse molecule. Several experimental animal studies have documented significant antinociceptive effects in a wide range of pain models. In perioperative medicine, administration of melatonin has demonstrated anxiolytic, analgesic and anti-oxidant effects. Optimization of the analgesic treatment in surgical patients is required due to documented inadequate analgesia and the risk of adverse effects and complications caused by commonly used NSAIDs and opioids. Our goal was to investigate if melatonin was able to reduce pain scores or analgesic use in patients undergoing laparoscopic cholecystectomy. (more…)
Author Interviews, Heart Disease, JACC, Lipids / 31.10.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalResearch.com Interview with Frank B. Hu, MD, PhD Professor of Nutrition and Epidemiology Harvard School of Public Health Professor of Medicine Harvard Medical School Boston, MA 02115 Medical Research: What is the background for this study? What are the main findings? Dr. Hu: There has been much confusion and sensational headlines about the role of different types of fat in coronary heart disease.  A recent meta-analysis suggested that higher saturated fat intake was not associated with coronary heart disease (CHD), but people don't consume saturated fat in isolation from other components of diet. Typically people swap for one type of fat for another. Therefore it is important to look at replacement nutrient when we talk about health effects of saturated fat. Randomized clinical trials have shown that replacing saturated fat with polyunsaturated fat reduces total and LDL cholesterol. Thus it is important to examine whether such replacement confers long-term beneficial effects on heart disease prevention. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the link between dietary intake of linoleic acid (the predominant type of polyunsaturated fat) and heart disease risk in generally healthy people. We identified 13 published and unpublished cohort studies with a total of 310,602 individuals and 12,479 total  coronary heart disease events including 5,882 CHD deaths. We found that dietary linoleic acid intake is inversely associated with  coronary heart disease risk in a dose-response manner—meaning, higher intake of linoleic acid resulted in a lower risk of CHD. Comparing the highest to the lowest level of consumption, dietary linoleic acid was associated with a 15% lower risk of  coronary heart disease events and a 21% lower risk of CHD deaths. These results were independent of common coronary heart disease risk factors such as smoking and other dietary factors such as fiber consumption. (more…)
Author Interviews, Toxin Research / 31.10.2014

Julia A. Taylor, Ph.D. Assistant Research Professor Division of Biological Sciences University of Missouri Columbia, MO 65211MedicalResarch.com Interview with: Julia A. Taylor, Ph.D. Assistant Research Professor Division of Biological Sciences University of Missouri Columbia, MO 65211 Medical Research: What is the background for this study? What are the main findings? Dr. Taylor: Bisphenol A (BPA) is an industrial chemical present in a large number of consumer products, including polycarbonate plastics, food can linings, resins and thermal paper. A 2008 study of BPA levels in human urine concluded that over 90% of the U.S. population is exposed to BPA. BPA is an endocrine disrupter; its estrogenic properties were first described long before its commercial use, but today it is known that it not only acts like an estrogen but also interferes with thyroid hormone, androgen and insulin action. In population-based studies, higher urinary levels of BPA have been linked to a number of human health issues. For example, higher BPA concentrations have been associated with obesity and aggressive and hyperactive behaviors in children, and with cardiovascular disease and diabetes, altered liver and kidney function, and immune and reproductive disorders in adults. It was at one time thought that almost all human exposure occurs via food and drink, but calculations of exposure from these sources do not adequately account for the sometimes high amounts measured in urine, and the fact that BPA concentrations in population-based studies are not lower with increasing fasting time suggests that some other form of ongoing exposure. Our interest here was in thermal paper. BPA has been used as a color developer in thermal paper for many years and can be present in milligram amounts in the paper coating. Because thermal printing is widely used for items such as sales and ATM receipts, airline tickets and luggage labels, thermal paper may represent an important high-concentration source of exposure. We screened thermal paper receipts from 50 in-state vendors and found that 44% used BPA as the color developer, but 52% used another chemical called BPS (bisphenol S) which was present in similar quantities to BPA. Two receipts contained neither BPA nor BPS, and so presumably used an alternative (unidentified) chemical. In preliminary work we measured the transfer of BPA from thermal paper to the hands, and found much higher transfer to hands that were pre-wet using hand sanitizer. We also determined that BPA transferred to hands could then be transferred to food. In our study we asked men and women to first wet their hands with sanitizer before holding the receipts for a few minutes, and then with the same hands pick up french fries and hold them briefly before eating them. We then cleaned one hand but allowed the other to remain “contaminated”. We took blood samples over the next 90 minutes, either from the arm linked to the clean hand or the arm linked to the dirty hand, and collected a urine sample at the end. (more…)
Annals Internal Medicine, Author Interviews, Ebola, Yale / 30.10.2014

Dr. Dan YasminMedicalResearch.com Interview with: Dan Yamin PhD Postdoctoral Associate Yale School of Public Health New Haven, CT 06520   Medical Research: What is the background for this study? Dr. Yamin: With limited resources, West Africa is currently overwhelmed by the most devastating Ebola epidemic known to date. In our research, we seek to address two questions:
  • 1) who is mostly responsible for transmission? and 2) what intervention programs should be applied to contain the current Ebola outbreak?
(more…)
Author Interviews, Cognitive Issues, Psychological Science / 30.10.2014

MedicalResearch.com Interview with: Dr. Lorenza S. Colzato, Assistant Professor and Dominque Lippelt, Research Master Student Cognitive Neuroscience ResearchProgram Leiden, The Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Our study aimed to investigate whether prior meditation experience could modulate the effect of two types of meditation on two aspects of creative thought. Creativity can be thought of as consisting of two main ingredients: Convergent thinking (finding one solution to a defined problem) and divergent thinking (finding many possible solutions to a problem). In a previous study we found that Open Monitoring meditation and Focused Attention meditaton (FAM) have distinguishable effects on creativity. OMM induces a control state that promotes divergent thinking while Focused Attention meditaton does not improve convergent thinking. Our results confirm and extend these findings. Open Monitoring meditation improved performance on a divergent thinking task, while Focused Attention meditaton did not, and these effects were present in both experienced and novice practitioners, suggesting that one does not have to have many years of meditation experience to benefit from its effects. However, while solving convergent thinking problems experienced practitioners tended to solve more problems through insight as opposed to using an analytical strategy, a way of problem solving that bears similarities to divergent thinking. (more…)
Author Interviews, CDC, Diabetes, OBGYNE / 30.10.2014

Dr. Cora Peterson PhD Health Economist at Centers for Disease ControlMedicalResearch.com: Interview with: Dr. Cora Peterson PhD Health Economist at Centers for Disease Control Medical Research: What is the background for this study? What are the main findings? Dr. Peterson: Women with pregestational diabetes mellitus (PGDM) have increased risk for adverse birth outcomes. Preconception care for women with  pregestational diabetes mellitus reduces the frequency of such outcomes, most likely by improving glycemic control before and during the critical first weeks of pregnancy. Preconception care for women with  pregestational diabetes mellitus includes the following activities:
  • medical or dietary blood sugar control, blood sugar monitoring, screening and treatment of complications due to diabetes,
  • counseling and education about the risks of diabetes in pregnancy, and
  • using effective birth control or contraceptives until appropriate levels of blood sugar are achieved.
In this study, CDC researchers estimated the number of preterm births, birth defects, and perinatal deaths (death between the time a baby is at least 20 weeks old in the mother’s womb to one week after the baby is born) that could be prevented and the money that could potentially be saved if preconception care was available to and used by all women with  pregestational diabetes mellitus before pregnancy. Researchers estimated about 2.2% of births (88,081 births each year) in the United States are to women with pregestational diabetes mellitus, including women who know they have diabetes before they become pregnant and those who are unaware they have diabetes. Preconception care before pregnancy among women with known pregestational diabetes mellitus could potentially generate benefits of up to $4.3 billion by preventing preterm births, birth defects, and perinatal deaths. Up to an additional $1.2 billion in benefits could be produced if women who do not know they have diabetes were diagnosed and received preconception care. (more…)
Author Interviews, Hormone Therapy, Prostate Cancer / 30.10.2014

David R. Ziehr B.S., MD Candidate Harvard Medical SchoolMedicalResearch.com Interview with: David R. Ziehr B.S., MD Candidate Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Response: Androgen deprivation therapy (ADT), commonly achieved with gonadotropin-releasing hormone agonists or antagonists, is a mainstay of prostate cancer therapy. While randomized controlled trials demonstrate that ADT improves survival among men with unfavorable risk prostate cancer, retrospective studies have suggested that some men with comorbid illnesses such as heart disease may not derive a benefit from—or may even be harmed by—ADT. However, the nature of this harm has not been characterized. We studied over 5000 men with prostate cancer who were treated with brachytherapy (implanted radioactive seeds) with or without ADT. We analyzed the men based on pre-treatment cardiac comorbidity and examined the association between ADT and death from cardiac causes. We found that among men with congestive heart failure or a past myocardial infarction (MI), Androgen deprivation therapy was associated with a three-times greater risk of death from heart disease. However, Androgen deprivation therapy was not associated with greater risk of cardiac mortality in men without heart disease or with a risk factor for heart disease, such as diabetes, hypertension or hyperlipidemia. (more…)
Author Interviews, Breast Cancer, Chemotherapy / 30.10.2014

Melissa Skala, Ph.D. Assistant Professor of Biomedical Engineering Assistant Professor of Cancer Biology Vanderbilt University Nashville, TN 372MedicalResearch Interview with: Melissa Skala, Ph.D. Assistant Professor of Biomedical Engineering Assistant Professor of Cancer Biology Vanderbilt University Nashville, TN 37235 Medical Research: What is the background for this study? What are the main findings? Dr. Skala: We developed a new metabolic imaging technique that is highly sensitive to tumor cell response to anti-cancer drug treatment. We coupled this imaging technique with new, three-dimensional cultures that can be grown from breast tumor biopsies. Together, our data indicate that this approach could be used to perform rapid, low-cost, and accurate drug screens for individualized treatment of cancer patients. (more…)
Author Interviews, Neurological Disorders, Scripps / 30.10.2014

Srinivasa Subramaniam, Ph.D., Assistant Professor Department of Neuroscience The Scripps Research Institute Jupiter, Florida 33458MedicalResearch.com Interview with: Srinivasa Subramaniam, Ph.D., Assistant Professor Department of Neuroscience The Scripps Research Institute Jupiter, Florida 33458   Medical Research: What is the background for this study? What are the main findings? Dr.  Subramaniam: Huntington’s disease (HD) is a genetic disorder occurs due to a mutation in a protein called huntingtin (mHtt), which affects 5-10 people per 100000 populations worldwide. Our research revolves around the question— why mutant huntingtin despite its ubiquitous expression through out the body selectively affects brain regions such as striatum, a region that regulates voluntary movement. We now found that mHtt activates a protein kinase complex, mammalian target of rapamycin complex 1 (mTORC1), which is required for normal functions such as translation of genes into proteins and also organelle recycling. We found the mTORC1 activation is so robust and sustained in the striatum that lead to the severe motor disabilities and premature death of HD mice. Our study indicates a functional relationship between huntingtin and mTOR the developmentally important genes with implication in Huntington’s disease pathogenesis. (more…)
Author Interviews, BMJ, General Medicine, Heart Disease / 30.10.2014

MedicalResearch.com Interview with: Anne Bellemain-Appaix Service de Cardiologie-La Fontonne Hospital, Antibes, France and Gilles Montalescot Professor of  Cardiology Institut de CardiologiePitié-Salpêtrière Hospital Université Paris 6, France ACTION Study Group, Paris, France Medical Research: What is the background for this study? Response: Pretreatment with P2Y12 inhibitors for Non-ST-Elevation Acute Coronary Syndrome (NSTE-ACS) patients, although advised in current guidelines, has been recently questioned in term of benefit/risk ratio (no ischemic benefit and increase in major bleeding). We wanted to answer this question by giving enough power to results in a complete meta-analysis of studies comparing P2Y12 inhibitors pretreatment (defined as its administration before the coronary angiogram) to no pretreatment in NSTE-ACS. (more…)
Author Interviews, BMJ, Orthopedics / 29.10.2014

MedicalResearch.com Interview with: Professor Karl Michaëlsson Professor in Medical Epidemiology, Senior Consultant in Orthopaedic Surgery Uppsala Clinical Research Institute MedicalResearch.com Interview with: Professor Karl Michaëlsson Professor in Medical Epidemiology, Senior Consultant in Orthopaedic Surgery Uppsala Clinical Research Institute Medical Research: What are the main findings of the study? Prof. Michaëlsson: A high milk intake is recommended for the prevention of osteoporotic fractures but milk is also the major dietary source of galactose intake. The addition of galactose by injection or in the diet is an established animal model of aging by induction of oxidative stress and inflammation. Previous research results regarding the importance of milk intake for the prevention of fractures and the influence on mortality rates are conflicting. High milk intake was in our study associated with higher mortality in one cohort of women and in another cohort of men, and with higher fracture incidence in women. In subsamples of two additional cohorts, one in males and one in females, a positive association was seen between milk intake and both urine 8-iso-PGF2α (a biomarker of oxidative stress) and serum interleukin 6 (a main inflammatory biomarker). (more…)
Author Interviews, BMJ, Case Western / 29.10.2014

MedicalResearch.com Interview with: Dr. med. Rainer Erices Institut für Geschichte und Ethik der MedizinMedicalResearch.com Interview with: Dr. med. Rainer Erices Institut für Geschichte und Ethik der Medizin Medical Research: What are the main findings of the study? Dr. Erices: The study presents the results of a first systematic investigation of clinical drug trials carried out by Western pharmaceutical firms in Eastern Germany in the 1980s. The scientific investigation of the East German Health system has only just started. The study shows that in that period of time, around 220 clinical trials were carried out. We now know how many patients took part and what remuneration the GDR received. It continues to be difficult to evaluate these tests. Despite intensive research efforts in different archives, we have been unable to find documentation on how detailed (and systematically) patients were informed about the trial they were taking part in. The responsible institutions repeatedly advised testers to stick to the law during the clinical trials. The law required that these trials should only be carried out on patients which had given their informed consent and had decided to participate voluntarily. However, so far there is no convincing proof that these legal requests were met. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Duke, Race/Ethnic Diversity / 29.10.2014

Kevin L Thomas, MD Assistant Professor of Medicine Division of Clinical Cardiac Electrophysiology Duke Clinical Research InstituteMedicalResearch.com Interview with: Kevin L Thomas, MD Assistant Professor of Medicine Division of Clinical Cardiac Electrophysiology Duke Clinical Research Institute   Medical Research: What are the main findings of the study? Dr. Thomas: The number of participants with controlled blood pressure (readings of less than 140/90) increased by 12 percent in the six months between the first and last readings. Mean systolic blood pressure for the population decrease by 4.7mmHg. The number of participants who had high blood pressure in the range of 140-149/90-99 decreased systolic blood pressure by a mean of  8.8mmHg and those with readings in the higher range of 150/100 or above decreased systolic blood pressure by 23.7percent. The study concluded that a program that followed this type of approach was associated with improved blood pressures across a diverse  high-risk community.” (more…)
Author Interviews, Cleveland Clinic, Heart Disease, JACC / 29.10.2014

Professor of Medicine, Cleveland Clinic Lerner College of Medicine at CWRU Director, Cardiomyopathy Program, Kaufman Center for Heart Failure Research Director, Section of Heart Failure and Cardiac Transplantation Medicine Heart and Vascular Institute, Cleveland Clinic Cleveland, OH 44195MedicalResearch.com Interview with: W. H. Wilson Tang, MD FACC FAHA Professor of Medicine, Cleveland Clinic Lerner College of Medicine at CWRU Director, Cardiomyopathy Program, Kaufman Center for Heart Failure Research Director, Section of Heart Failure and Cardiac Transplantation Medicine Heart and Vascular Institute, Cleveland Clinic Cleveland, OH 44195 Medical Research: What are the main findings of the study? Dr. Tang: A chemical byproduct of gut bacteria-dependent digestion, TMAO (trimethylamine N-oxide), was previously shown to contribute to heart disease development. In this study, blood levels of TMAO for the first time are linked to heart failure development and mortality risk. (more…)
Author Interviews, General Medicine, Health Care Systems, Johns Hopkins / 29.10.2014

MedicalResearch.com Interview with: Eric Wan BS and Miceile Barrett BS Johns Hopkins University School of Medicine Baltimore, MD Medical Research: What is the background for this study? What are the main findings? Answer: Access to surgery is limited in resource-poor settings and low-and-middle income countries (LMICs) due to a lack of human and material resources. In contrast, academic hospitals in high-income countries often generate significant amounts of unused and clean medical supplies that cannot be re-used in the operating rooms of high-income countries. Programs such as Supporting Hospitals Abroad with Resources and Equipment (SHARE) provide an avenue for recovery of these supplies and donation to resource-poor hospitals in LMICs. From data collected from SHARE supplies donated by Johns Hopkins, we found that the nationwide impact for these programs to be $15.4 million among US academic hospitals, which accounts for only 19 categories of commonly recovered supplies. When we tracked our donated supplies to hospitals in Ecuador serving the poor, we found that the cost-effectiveness of these donations was US $2.14 per disability-adjusted life-year prevented. (more…)
Author Interviews, Heart Disease, JAMA, Lipids / 29.10.2014

George Thanassoulis, MD MSc FRCP(C) Director, Preventive and Genomic Cardiology FRQ-S Clinician-Scientist/Chercheur-Boursier Clinicien Assistant Professor of Medicine, McGill University McGill University Health Center Montreal, QCMedicalResearch.com Interview with: George Thanassoulis, MD MSc FRCP(C) Director, Preventive and Genomic Cardiology FRQ-S Clinician-Scientist/Chercheur-Boursier Clinicien Assistant Professor of Medicine, McGill University McGill University Health Center Montreal, QC Medical Research: What is the background for this study? What are the main findings? Dr. Thanassoulis: Although LDL-C (i.e. bad cholesterol) has been linked with aortic valve disease in several prior reports, randomized trials to lower cholesterol in aortic valve disease were not effective suggesting that cholesterol may not be important in valve disease. To address this, we performed a Mendelian randomization study, that showed that a genetic predisposition to LDL-C, was associated with both calcium deposits on the aortic valve and aortic stenosis (I.e. Valve narrowing).  These results can be viewed as the effect of a life-long increase in LDL-C on the incidence of aortic valve disease and suggest that increases in LDL-C cause aortic stenosis.   (more…)
Alzheimer's - Dementia, Author Interviews, Sleep Disorders / 29.10.2014

Christian Benedict PhD Associate Professor of Neuroscience Uppsala University Dept. of NeuroscienceMedicalResearch.com Interview with: Christian Benedict PhD Associate Professor of Neuroscience Uppsala University Dept. of Neuroscience   Medical Research: What is the background for this study? Answer: Our study involved ~1500 men who were followed from 1970 to 2010. All participants were 50 years old at the start of study. Medical Research: What are the main findings? Answer: Men with reports of sleep disturbances had a 50%-higher risk to develop Alzheimer's disease during the 40-year follow-up period, than men without reports of sleep disturbances. (more…)
Author Interviews, Cost of Health Care, Health Care Systems / 28.10.2014

Luís A. Nunes Amaral PhD HHMI Early Career Scientist Professor of Chemical & Biological Eng. Professor of Medicine Howard Hughes Medical Institute Northwestern University, Evanston, IllinoisMedicalResearch.com Interview with: Luís A. Nunes Amaral PhD HHMI Early Career Scientist Professor of Chemical & Biological Eng. Professor of Medicine Howard Hughes Medical Institute Northwestern University, Evanston, Illinois

Medical Research: What is the background for this study? What are the main findings? Dr. Amaral: There is a well known difficulty in promoting the rapid adoption of best practices by physicians.  Because of their work load and because of the inability to figure out when some result is a true advance or just hype, doctors tend to stick to what they believe works. Unfortunately, as a 15 year old Institute of Medicine study shows, this lack of adoption of best practices costs society hundreds of thousands of lives a year in the US alone. The typical process for informing doctors of what best practices are (such as continual medical education and other broadcasting approaches) do not work well. We believe that a weakness of typical approaches is that they have a one talking to the many style, and they are out of a medical practice context.  Our hypothesis was that by seeding a few doctors with desired knowledge, one could have spread of the adoption through one-on-one contacts between physicians in the context of treating patients.  We found that this approach has the potential to be very effective. (more…)
Author Interviews, JAMA, Macular Degeneration / 28.10.2014

Ronald Klein, MD, MPH, Professor Department of Ophthalmology and Visual Sciences University of Wisconsin School of Medicine and Public Health Madison WIMedicalResearch.com Interview with: Ronald Klein, MD, MPH, Professor Department of Ophthalmology and Visual Sciences University of Wisconsin School of Medicine and Public Health Madison WI Medical Research: What are the main findings of the study?  Dr. Klein: We found that more severe age-related macular degeneration (AMD) in 1 eye was associated with increased incidence of age-related macular degeneration [levels 1-2: hazard ratio [HR], 4.90 [95%CI, 4.26-5.63] and accelerated progression [levels 2-3: HR, 2.09 [95%CI, 1.42-3.06]; levels 3-4: HR, 2.38 [95%CI, 1.74-3.25] and incidence of late age-related macular degeneration [levels 4-5: HR, 2.46 [95%CI, 1.65-3.66] in its fellow eye. Less severe AMD in 1 eye was associated with less progression of AMD in its fellow eye. We estimated that 51% of participants who develop any age-related macular degeneration maintained age-related macular degeneration severity states within 1 step of each other between eyes and 90% of participants stay within 2 steps. (more…)
Author Interviews, Memory, Mental Health Research / 28.10.2014

Scott A. Small, MD Boris and Rose Katz Professor of Neurology Division of Aging and Dementia Director, Alzheimer's Disease Research Center Taub Institute for Research on Alzheimer's Disease and the Aging Brain Department of Neurology, Columbia University New York, New YorkMedicalResearch.com Interview with: Scott A. Small, MD Boris and Rose Katz Professor of Neurology Division of Aging and Dementia Director, Alzheimer's Disease Research Center Taub Institute for Research on Alzheimer's Disease and the Aging Brain Department of Neurology, Columbia University New York, NY Medical Research: What is the background for this study? Dr. Small: Previous work, including from my lab, had shown that changes in a specific part of the brain—the dentate gyrus—are associated with age-related memory decline. Until now, however, the evidence in humans showed only a correlational link, not a causal one. To see if the dentate gyrus is the source of age-related memory decline in humans, we tested whether compounds called cocoa flavanols can improve the function of this brain region and improve memory. Flavanols extracted from cocoa beans had previously been found to improve neuronal connections in the dentate gyrus of mice. (more…)
Author Interviews, Ebola, Vaccine Studies / 28.10.2014

Prof. Clive Maurice Gray Division of Immunology, Institute of Infectious Diseases and Molecular Medicine,National Health Laboratory Services University of Cape Town, Cape Town, South AfricaMedicalResearch.com Interview with: Prof. Clive Maurice Gray   Division of Immunology, Institute of Infectious Diseases and Molecular Medicine,National Health Laboratory Services University of Cape Town, Cape Town, South Africa Medical Research: What is the background for this report? What are the main findings? Prof. Gray: This report is a response on behalf to the International Union of Immunology Societies (IUIS) and is designed to focus a message from the global immunology community to those who are making vaccines and therapies implementing clinical trials and very importantly on Governments and funding bodies. Time is not our side and that vaccine efforts need to be expedited and that production of therapeutics needs to be ramped up. Due to the fact that many people in West Africa are dying, we wish to convey a strong message that to curb this outbreak, therapies and especially vaccines must be rolled out as soon as possible. (more…)
Author Interviews, Heart Disease / 28.10.2014

Dr. Andrea M. Isidori, MD, PhD Consultant - Assistant Professor of Endocrinology Department of Experimental Medicine Medical Pathophysiology Sapienza University of RomeMedicalResearch.com Interview with: Dr. Andrea M. Isidori, MD, PhD Consultant - Assistant Professor of Endocrinology Department of Experimental Medicine Medical Pathophysiology Sapienza University of Rome Medical Research: What is the background for this study? What are the main findings? Dr. Isidori : Our meta-analytic research originated to clarify some controversies emerging from the available human studies. We wanted to analyze if chronic PDE5i administration was cardioprotective and safe, and, if so, where the benefits were mainly seen: cardiac muscle, peripheral vessels, or both. In the last sixteen years pre-clinical and clinical research into the extra-urological effects of PDE5i has expanded dramatically, revealing previously unsuspected indications for these drugs. Several animal studies have shown that PDE5i attenuates cardiac remodeling, with an anti-hypertrophic and anti-fibrotic effect, and protects the heart against different types of injury. Some small clinical trials have demonstrated that chronic PDE5 inhibition improves cardiac performance and geometry in various clinical conditions, including heart failure, myocardial infarction and diabetic cardiomyopathy. We showed that continuous administration of Viagra improves cardiac performance (increase of ejection fraction and cardiac index) and has an anti-remodeling effect (decrease of left ventricular mass and increase of end diastolic volume) without a major impact on vascular parameters (blood pressure and vascular resistance) suggesting that it does indeed have a direct effect on the heart. The novelty of this meta-analysis is the identification of subgroups of patients that may benefit more from PDE5i: patients with cardiac hypertrophy and heart failure. Our study is the first to show in a large patient cohort that chronic PDE5i administration improves cardiac output and decreases heart rate. This could result in longer survival, increased exercise tolerance and a better quality of life. Surprisingly, the magnitude of effects was similar to that seen with the drugs currently used to treat these clinical conditions, and was obtained in a relatively brief period (3 to 12 months). Most strikingly, we found that PDE5is are among the very few drugs that are able to improve diastolic relaxation, thus helping the correct refilling of the ventricle after each contraction, a nearly unique feature in drugs used in cardiology, and with incredible potential for future development in the prevention of heart failure. We also demonstrated their high tolerability and safety in a population that included elderly patients with various stages of cardiac disease and numerous comorbidities who were taking multiple pharmacological treatments. This setting resembles what we normally see in real life, supporting that daily administration is safe and involves no increase in the risk of adverse events compared to on-demand use. (more…)
Author Interviews, Biomarkers / 28.10.2014

Dr. Adam Woolley PhD Department of Chemistry and Biochemistry Brigham Young UniversityMedicalResearch.com Interview with: Dr. Adam Woolley PhD Department of Chemistry and Biochemistry Brigham Young University Medical Research: What is the background for this study? What are the main findings? Dr. Woolley: High-performance biomarker analysis methods are usually complex and expensive. In contrast, simple and inexpensive biomarker detection methods typically have low performance. Our study demonstrates a simple nucleic acid measurement system that requires no detection instrumentation. Nucleic acid mimics of microRNA were quantified with sequence specificity down to 10 pg/mL levels. (more…)