Author Interviews
17 Nov Drug Researched To Help Curb Binge Eating
MedicalResearch.com Interview with:
Pietro Cottone, Ph.D.
Associate Professor
Departments of Pharmacology and Psychiatry
Laboratory of Addictive Disorders
Boston University School of Medicine Boston, MA 02118
Medical Research: What is the background for this study? What are the main findings?
Dr. Cottone: Binge-eating disorder affects over ten million people in the USA and it is characterized by excessive consumption of junk food within brief periods of time, accompanied by loss of control, uncomfortable fullness and intense feelings of disgust and embarrassment. Increasing evidence suggests that binge-eating disorder can be regarded as an addiction behavior.
Memantine, a neuroprotective drug which blocks the glutamatergic system in the brain, is an Alzheimer's disease medication, and it has been shown potential to treat a variety of addictive disorders.
We first developed a rodent model of binge eating by providing a sugary, chocolate diet only for one hour a day, while the control group was given the standard laboratory diet. Rats exposed to the sugary diet rapidly develop binge eating behavior, observed as a 4 fold increase in food intake compared to controls. Furthermore, binge eating rats are willing to work to a much greater extent to obtain just the cue associated with the sugary food (not the actual food), as compared to controls. In addition, binge eating subjects exhibit compulsive behavior by putting themselves in a potentially risky situation in order to get to the sugary food, while the control group obviously avoids that risk.
We then tested whether administering memantine could reduce binge eating of the sugary diet, the strength of cues associated with junk food as well as the compulsiveness associated with binge eating. In addition, we studied which area of the brain was mediating the effects of memantine, by injecting the drug directly into the brain of binge eating rats.
Our data show that memantine was able to block binge eating of the sugary diet, the willingness to work to obtain a cue associated with junk food, as well as the risky behavior of rats when the sugary diet was provided in a potentially unsafe environment. When we injected the drug directly into the nucleus accumbens of rats, they stopped binge eating. Importantly, the drug had no effects in control rats eating a standard laboratory diet.
16 Nov Non-Infarct Related Coronary Artery Disease Common in Acute Myocardial Infarction
MedicalResearch.com Interview with:
Manesh Patel, MD
Associate Professor of Medicine
Director Interventional Cardiology and Catheterization Labs
Duke University Health System
Duke Clinical Research Institute
Medical Research: What is the background for this study? What are the main findings?
Dr. Patel: In clinical practice, patients with acute myocardial infarction are found to have non-IRA disease of varying significant and location. The current recommendations are to have patients recover from the acute myocardial infarction and get non-invasive testing to determine revascualrization after 4-6 six weeks in uncomplicated patients. These data demonstrate that non-IRA disease is common (>50% of STEMI patients) and that these patients have an elevated 30-day mortality.
16 Nov Risk of Ebola Transmission By Airline Passengers Remains
MedicalResearch.com Interview with:
Professor Tom Solomon, FRCP PhD
Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections
Director, Institute of Infection and Global Health, University of Liverpool
Medical Research: What is the background for this study? What are the main findings?
Dr. Solomon: Since the Ebola outbreak began there has been concern about transmission to new countries by airline passengers who were infected, but didn’t know it. This was underscored by such transmission to Nigeria, and to USA. Screening for symptoms of Ebola virus disease in airline passengers whose journeys originated from the three most affected countries—Guinea, Liberia, and Sierra Leone—has recently been introduced at some airports.
We examined the current growth rate of the epidemic in West Africa, and airline travel patterns to predict how many people with Ebola are likely to attempt to fly. Our research showed that we can expect approximately 29 infected passengers to try and leave West Africa by the end of the year. Based on the incubation period of the virus, and looking at how long people have symptoms before they are hospitalised, we estimated ten of these people with Ebola would have symptoms of the disease as they leave the affected countries, and so would be detected by exit screening. Of the remaining 19, one to two would be expected to fly to the UK, and up to three to the USA, based on current airline passenger data. At most one of these passengers would have developed symptoms by the time they arrive in the UK or USA, and thus would be detected by entry screening
16 Nov Long Term ACEIs May Reduce Risk of ALS
MedicalResearch.com Interview with: Charles Tzu Chi Lee, PhD Associate Prof., Department of Public Health Kaohsiung Medical University, Kaohsiung, Taiwan Sanmin District, Kaohsiung City Taiwan Medical Research: What is the background for this study? What are the main findings? Dr. Lee: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease and most patients die within three to five years after symptoms appear. Studies have suggested angiotensin-converting enzyme inhibitors (ACEIs) may decrease the risk for developing neurodegenerative diseases. But there was still no human study discussing ACEIs use and ALS risk in literature. The study results indicate that when compared with patients who did not use ACEIs, the risk reduction was 17 percent (adjusted odds ratio of 0.83) for the group prescribed ACEIs lower than 449.5 cumulative defined daily dose (cDDD) and 57 percent (adjusted odds ratio 0.43) for the group prescribed ACEIs greater than 449.5 cDDD.16 Nov Oral Sex Can Lead To Oral HPV Infection
MedicalResearch.com Interview with;
Eduardo L. Franco DrPH, FRSC, FCAHS
James McGill Professor Departments of Oncology and Epidemiology & Biostatistics, Director, Division of Cancer Epidemiology, Minda de Gunzburg Chair, Department of Oncology, Division of Cancer Epidemiology Department of Oncology
McGill University, Montreal, Quebec, Canada
Medical Research: What should clinicians and patients take away from your report?
Dr. Franco: Our findings of oral transmission of human papillomavirus (HPV) infection in men are part of a larger molecular epidemiologic study called ‘HPV Infection and Transmission among Couples through Heterosexual Activity’ (HITCH) cohort study. The focus of the HITCH study is to understand how HPV is transmitted within couples via sexual contact and other behaviors. We measure the presence of this virus using highly-sensitive molecular assays for HPV DNA in the genital surfaces (vagina and penis), oral cavity, and hands. We also take a blood sample to look for the presence of antibodies against HPV. We take multiple samples over a period of two years at pre-scheduled visits. We have previously published results focused exclusively on genital transmission. The present report is the first in the HITCH study to look at what happens in terms of characteristics that place male participants to be at risk of oral HPV infection.
To our knowledge, this is the first study to show a high risk of oral HPV infection among men whose female partners had a genital or oral HPV infection, suggesting that transmission may occur through oral or genital routes. We looked at transmission for 36 individual HPV genotypes, which improved our ability to study risk determinants. Risk was also significantly higher among men who had ever smoked, had a high number of lifetime sex partners, or were in non-monogamous relationships. Our results are largely consistent with previous studies that have found male sex practices and smoking to be the most significant risk factors for oral HPV infection.
16 Nov Short Term Sugar Sweetened Drinks May Not Be Detrimental To Adolescent Health
MedicalResearch.com Interview with:
Jill Kanaley, PhD
Professor and Associate Ahair
Department of Nutrition and Exercise Physiology
University of Missouri
Abstract: Background: Adolescents consume more sugar-sweetened beverages than do individuals in any other age group, but it is unknown how the type of sugar-sweetened beverage affects metabolic health in this population.
Objective: The objective was to compare the metabolic health effects of short-term (2-wk) consumption of high-fructose (HF) and high-glucose (HG)–sweetened beverages in adolescents (15–20 y of age).
Design: In a counterbalanced, single-blind fashion, 40 male and female adolescents completed two 2-wk trials that included 1) an HF trial in which they consumed 710 mL of a sugar-sweetened beverage/d (equivalent to 50 g fructose/d and 15 g glucose/d) for 2 wk and 2) an HG trial in which they consumed 710 mL of a sugar-sweetened beverage/d (equivalent to 50 g glucose/d and 15 g fructose/ d) for 2 wk in addition to their normal ad libitum diet. In addition, the participants maintained similar physical activity levels during each trial. The day after each trial, insulin sensitivity and resistance [assessed via Quantitative Insulin Sensitivity Check Index (QUICKI) and homeostatic model assessment of insulin resistance (HOMA-IR) index] and fasting and postprandial glucose, lactate, lipid, cholesterol, insulin, C-peptide, insulin secretion, and clearance responses to HF or HG mixed meals were assessed.
Results: Body weight, QUICKI (whole-body insulin sensitivity), HOMA-IR (hepatic insulin resistance), and fasting lipids, cholesterol, glucose, lactate, and insulin secretion or clearance were not different between trials. Fasting HDL- and HDL3-cholesterol concentrations were w10–31% greater (P , 0.05) in female adolescents than in male adolescents. Postprandial triacylglycerol, HDL-cholesterol, HDL3-cholesterol, and glucose concentrations were not different between HF and HG trials. The lactate incremental area under the curve was w3.7-fold greater during the HF trial (P , 0.05), whereas insulin secretion was 19% greater during the HG trial (P , 0.05).
Conclusions: Moderate amounts of HF- or HG-sweetened beverages for 2 wk did not have differential effects on fasting or postprandial cholesterol, triacylglycerol, glucose, or hepatic insulin clearance in weight-stable, physically active adolescents.
16 Nov Acute Coronary Syndrome: How Do Patients Without Critical Stenosis Do?
MedicalResearch.com Interview with:
Dr. Marc-Alexander Ohlow, MD,
Adjunct Professor of Medicine
Cardiology Department
Zentralklinik Bad Berka, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Ohlow: This paper reports the finding of a retrospective study including 4.311 consecutive patients with suspected acute coronary syndrome (ACS). Out of them 272 patients with acute onset of chest pain and elevated levels of cardiac necrosis markers did not have significant (≥50% diameter stenosis) coronary artery stenosis on coronary angiography. Aim of this study was to provide further information and understanding of the clinical characteristics and outcome of patients with acute coronary syndrome without critical stenosis, and comparing those with a consecutive series of patients with ACS requiring percutaneous coronary intervention (non-ST-elevation myocardial infarction patients).
Patients presenting without significant coronary stenosis, but with chest pain and elevated troponin level were younger, had less severe angina symptoms, were more likely to be women, had lower level of myocardial necrosis markers (troponin and creatine kinase), and had higher left ventricular ejection fraction compared to patients undergoing angioplasty due to significant coronary obstruction.
16 Nov Effect of Second Generation Drug Eluting Stents on Cardiovascular Events
MedicalResearch.com Interview with:
Marco Valgimigli, MD, PhD
Associate Professor of Medicine
Erasmus MC, Thoraxcenter,
Rotterdam The Netherlands
Medical Research: What is the background for this study? What are the main findings?
Dr. Valgimigli: Drug-Eluting Stents are regarded as more thrombogenic devices as compared to Bare Metal Stents. We have pooled all available datasets comparing a specific second generation Drug-Eluting Stent, namely cobalt chromium everolimus eluting stent (co-Cr EES) versus Bare Metal Stents and found that cardiac mortality along with all other non-fatal endpoints investigated, including myocardial infarction or stent thrombosis were reduced after co-Cr EES.
15 Nov Smart Phone Technology May Improve Medication Adherence
MedicalResearch.com Interview with: Dr. Frederick Kaskel: MD PhD Chief, Division of Pediatric Nephrology, Department of Pediatrics Albert Einstein College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Frederick Kaskel: Non-adherence to medication and medical regimens is a serious and common problem in adolescents with various kidney disorders,...
15 Nov Semen Impairs Efficacy of HIV Microbicides
MedicalResearch.com Interview with
Prof. Dr. Jan Münch
Institute of Molecular Virology
Ulm University Medical Center
Ulm, Germany
Medical Research: What is the background for this study?
Dr. Münch: Most anti-HIV microbicides have potent antiviral activity in vitro but were largely inactive in clinical trials. Here we set out to explore whether the HIV infection enhancing activity of amyloid fibrils in human semen interferes with the antiviral efficacy of microbicides and antiviral drugs.
15 Nov Tdap Vaccination Safety During Pregnancy Studied
MedicalResearch.com Interview
Elyse O. Kharbanda MD MPH
HealthPartners Medical and Dental Group
Medical Research: What is the background for this study? What are the main findings?
Dr. Kharbanda: In 2010, due to a pertussis outbreak and neonatal deaths, the California Department of Public Health recommended that the Tdap vaccine be administered during pregnancy. Tdap is now recommended by the Advisory Committee on Immunization Practices (ACIP) for all pregnant women during each pregnancy. We wanted to assess the impact of this recommendation.
The main findings were that Tdap vaccination during pregnancy was not associated with increased risk for hypertensive disorders of pregnancy, preterm birth, or having a baby who is small for his or her gestational age.
The study found a small increased risk for being diagnosed with chorioamnionitis, an inflammation of the fetal membranes caused by bacterial infection. These findings should be interpreted with caution as the magnitude of the risk was small. In addition, there was no associated risk for preterm birth, which often occurs as a result of chorioamnionitis. Furthermore, among the subset of women with a chorioamnionitis diagnosis whose charts were reviewed, many did not have a clinical picture that was clearly consistent with chorioamnionitis.
14 Nov Statins May Impede Growth of Uterine Fibroids
MedicalResearch.com Interview with:
Mostafa Borahay, MD, FACOG
Assistant Professor, Director of Simulation Education
Department of Obstetrics and Gynecology
University of Texas Medical BranchCo-director of Minimally Invasive Gynecologic Surgery University of Texas Medical Branch
Medical Research: What is the background for this study? What are the main findings?
Dr. Borahay: Uterine fibroids are the most common type of tumor in the female reproductive system, accounting for half of the 600,000 hysterectomies done annually in the U.S. Their estimated annual cost is up to $34 billion in the U.S. alone. Despite this, the exact cause of these tumors is not well understood, as there are several genetic, familial and hormonal abnormalities linked with their development. Even more, we currently don’t have a satisfactory medical treatment for these tumors.
Our team investigated the impact of simvastatin on human uterine fibroid cell growth. Statins, such as simvastatin, are commonly prescribed to lower high cholesterol levels. Statins work by blocking an early step in cholesterol production. Beyond these well-known cholesterol-lowering abilities, statins also combat certain tumors. Statins have previously been shown to have anti-tumor effects on breast, ovarian, prostate, colon, leukemia and lung cancers. However, the effect of statins on uterine fibroids was unknown.
We found that simvastatin impedes the growth of uterine fibroid tumor cells. We also studied the way simvastatin works to suppress these tumors. Simvastatin was shown to inhibit ERK phosphorylation, which is a critical step in the molecular pathway that prompts the growth of new cells. In addition, simvastatin stops the progression of tumor cells that have already begun to grow and induces calcium-dependent cell death mechanisms in fibroid tumor cells. Therefore, we identified a novel pathway by which simvastatin induces the death of uterine fibroid tumor cells.
14 Nov Abdominal Aortic Aneurysms: What Are Risk Factors For Expansion
MedicalResearch.com Interview with:
Rachel Bhak MS
Department of Veterans Affairs Cooperative Studies Program Coordinating Center
West Haven, Connecticut
Medical Research: What is the background for this study? What are the main findings?
Ms. Bhak: Abdominal aortic aneurysms (AAA) and their rupture are potentially fatal, so monitoring and understanding their expansion is of utmost importance. This study sought to characterize factors associated with Abdominal aortic aneurysms expansion, as well as their different growth patterns. The main findings are that current smoking and diastolic blood pressure are associated with increased linear expansion rate, diabetes with a decreased linear expansion rate, and diastolic blood pressure and baseline abdominal aortic aneurysms diameter with an accelerated expansion rate.
14 Nov ACEIs and Risk of Amyotrophic Lateral Sclerosis
MedicalResearch.com Interview with: Charles Tzu Chi Lee, PhD Associate Prof., Department of Public Health Kaohsiung Medical University, Kaohsiung, Taiwan Kaohsiung City 80708, Taiwan Medical Research: What is the background for this study? What are the main findings? Dr. Lee: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease and most patients die within three to five years after symptoms appear. Studies have suggested angiotensin-converting enzyme inhibitors (ACEIs) may decrease the risk for developing neurodegenerative diseases. But. there was still no human study discussing ACEIs use and ALS risk in literature. The study results indicate that when compared with patients who did not use ACEIs, the risk reduction was 17 percent (adjusted odds ratio of 0.83) for the group prescribed ACEIs lower than 449.5 cumulative defined daily dose (cDDD) and 57 percent (adjusted odds ratio 0.43) for the group prescribed angiotensin-converting enzyme inhibitors greater than 449.5 cDDD.14 Nov Dialysis Patients Generally Unprepared For Natural Disasters
MedicalResearch.com Interview with: Naoka Murakami MD PhD Mount Sinai Beth Israel Department of Medicine Medical Research: What is the background of the study? What are the main findings? Dr. Murakami: Dialysis patients live in a complex sociomedical situation and are highly dependent on technologies to sustain their lives; such as transportation, electricity and water for the dialysis apparatus. Interruption of this infrastructure by a natural disaster can result in devastating outcomes. During triage of patients arriving at Mount Sinai Beth Israel in the immediate aftermath of hurricane Sandy, we observed that many dialysis patients did not know about their medications, their comorbid conditions nor their dialysis prescriptions. Therefore we conducted a cross-sectional follow-up study of 357 hemodialysis patients in five dialysis units in lower Manhattan, New York. Using checklists prepared by the National Kidney Foundation and the Department of Homeland Security, we found that 26.3% subjects missed dialysis sessions and 66.1% received dialysis at non-regular dialysis unit(s). We observed that the distribution of a “Dialysis emergency packet” significantly improved retention of medical records at home. Analysis showed that dialysis-specific preparedness, racial ethnicity (non-African American, Hispanic or Caucasian), reception of dialysis in affiliated units, and older age, were associated with a significant reduction in missed dialyses.13 Nov Rheumatoid Arthritis: Evaluating Combination Therapies With Non-Biologics
MedicalResearch.com Interview with:
Diederik De Cock
PhD student - CareRA project
Department Rheumatology
Medical Research: What is the background for this study? What are the main findings?
Response: Rheumatoid Arthritis (RA) is a chronic systemic auto immune disease characterized by pain and swelling in the joints, mostly in arms and legs. Around 1% of the world population is affected by this hazardous disease. Left untreated this can lead in the short term to loss of quality of life and in the long term to major bone damage and immobility. Rheumatoid Arthritis can not be cured, but the disease can be suppressed.
International guidelines recommend to treat a patient with Rheumatoid Arthritis early, intensive and to target low disease activity, but leave much freedom in choice of medication and strategy. Our CareRA ( Care in early RA) research group, under the leadership of Prof Dr Verschueren and Prof Dr Westhovens tried to untangle long standing questions regarding the management of Rheumatoid Arthritis.
In this RCT, we want to question the benefit of a combination of disease modifying anti rheumatic drugs compared to monotherapy and the benefit of a high starting dose of glucocorticoids versus moderate dose. We choose glucocorticoid therapy over biological therapy because of its widespread use in RA and cost-effectiveness compared to the expensive biological therapy.
Therefore, 290 patients with the presence of poor prognostic markers (disease activity, erosions and serum markers RF/ACPA) were randomzied into 1 of 3 medication schemes:
1. Cobra Classic: methotrexate + sulphasalazine + 60mg glucocorticoid starting dose
2. Cobra Slim: methotrexate + 30mg glucocorticoid starting dose
3. Cobra Avant-Garde: methotrexate + leflunomide + 30 mg glucocorticoid starting dose
The glucocorticoid doses were tapered every week. After 6 or 7 weeks, they were on maintenance dosage and discontinued after 28 weeks.
All patients are followed in a tight control schedule ( a close follow-up scheme), aiming for low disease acitvity.
After 16 weeks, 7 out of 10 patients were in remission, a state where the disease is clinically suppressed. No differences in efficacy outcomes were observed between the three groups. However, the safety profile of the Cobra Slim group is much more favourable because only half of the number of adverse events were observed in this group compared to Classic and Avant-Garde.
13 Nov HIV Transmitted To Woman Via Manicure Tools
MedicalResearch.com Interview with: Luís Fernando de Macedo Brígido M.D. Ph.D. Núcleo de Doenças de Vinculação Sanguínea e Sexual Centro de Virologia Instituto Adolfo Lutz São Paulo Brasil Medical Research: What is the background for this study? What are the main findings? Response: Fomite transmission of HIV, especially in occupational exposure, have been reported, but the use of manicure utensils has not been previously associated to HIV transmission. We report a case where none of the classical modes of transmission were identified, and a detailed review of clinical history and phylogenetic analysis allowed the association of the case’s infection to manicure care episodes at home with an HIV infected women many years ago.13 Nov Colon Cancer: Improved Screening and Chemotherapy Contribute To Improved Survival
MedicalResearch.com Interview with: Xianglin L. Du, MB, MS, Ph.D. Professor of Epidemiology, Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, TX 77030, USA. Medical Research: What is the background for this study? Dr. Du: Widespread use of screening and advances in screening strategies played a key role in colorectal cancer survival improvement. With the increasing evidence on the benefit of fecal occult blood test and sigmoidoscopy during 1990s, the U.S. Preventive Service Task Force for the first time in 1996 recommended the annual use of fecal occult blood test, periodic use of sigmoidoscopy, or routine use of both modalities for all persons aged 50 or older. Because colonoscopy is able to detect lesions in the entire colon and has a high sensitivity for lesions of over 10mm in size, Medicare began to cover colonoscopy since 2001 for individuals with average-risk of colorectal cancer. Advances in chemotherapy, particularly some new therapeutic regimens approved by Food and Drug Administration (FDA) over the past decades also played a key role in survival improvement for patients with colorectal cancer. However, the overall impact of newly approved chemotherapy regimens on survival in population-based elderly patients remains unclear. It is also unknown what proportion of survival improvement was attributable to changes in tumor stage and size due to screening, and what proportion was attributable to more effective chemotherapy regimens. Hence, we studied a large nationwide and population-based cohort of elderly colorectal cancer patients to examine the changes in tumor stage and tumor size from 1992 to 2009, and to further quantify the effects of changes in stage/size and chemotherapy regimens on improved survival over the two decades.13 Nov Omega-3 Fish in Diet May Reduce Cancer Risk
MedicalResearch.com Interview with:
James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke's Mid America Heart Institute
Medical Research: What is the background for this study? What are the main findings?
Dr. DiNicolantonio: Daily low-dose aspirin has been shown to decrease the risk for cancer in a meta-analysis of randomized controlled trials, which is likely attributable to its ability to modestly decrease the activity of cyclooxygenase-2 (cox-2), an enzyme which contributes importantly to the genesis and progression of adenocarcinomas. Adenocarcinomas are cancer of the glands, the most common type of breast cancer (invasive ductal carcinoma) is an adenocarcinoma, additionally many cancers of the lung, intestine, esophagus, colon are adenocarcinomas.
We show that an ample dietary intake of long-chain omega-3 fats—the type prominent in fatty fish—would oppose cox-2 activity. Additionally, we cite numerous evidence that a higher intake of long-chain omega-3 fats has been found to reduce the risk for numerous types of cancer - especially when looking at trials that excluded fried or preserved fish (or fish high in omega-6), excluded trials with a high background intake of omega-6, and included trials where the "high" intake group - actually ate 2 servings of fish or more per week. Additionally, basic science as well as randomized data showing that long-chain omega-3s can reduce the number and size of colon polyps supports this argument.
12 Nov Improved Longevity of Hepatitis C Patients Who Respond To Therapy
MedicalResearch.com Interview with:
Adriaan J. van der Meer, MD, PhD
Department of Gastroenterology and Hepatology
Erasmus MC University Medical Center Rotterdam,
Rotterdam, the Netherlands
Medical Research: What is the background for this study? What are the main findings?
Dr. van der Meer: This study was performed in order to assess the association between the virological response to antiviral therapy and the long-term clinical outcome among patients with advanced liver disease, who have the highest risk of cirrhosis-related complications and death due to their chronic viral infection. At the time this study was initiated there was scarce data on the relation between a sustained virological response (SVR; sustained elimination of hepatitis C RNA) and reduced all-cause mortality, the most definite clinical endpoint. With our large international multicenter cohort study we were able to show this association. After 10 years of follow-up the cumulative mortality rate was 9% among patients with SVR as compared to 26% among patients without SVR after antiviral therapy (p<0.001). The current JAMA research letter concerns a related analyses, in which we compared the survival among patients included in our cohort with that of an age- and sex-matched general population. Importantly, the survival among patients with SVR was comparable to the general population, despite the fact that all these patients had histological proof of advanced hepatic fibrosis. In contrast, the survival among patients without SVR was markedly lower as compared to the general population.
12 Nov High Preterm Birth Rates Persist In Upwardly Mobile African American Women
MedicalResearch.com Interview with:
Paula Braveman, MD, MPH
Director, Center on Social Disparities in Health
Professor, Family and Community Medicine
University of California San Francisco
San Francisco, CA 94118
Medical Research: What are the main findings of the study?
Dr. Braveman: There were a couple of striking findings from this study of preterm birth (PTB) among non-Latino White and Black women born in the U.S..
First, we found that women who were poor or socioeconomically disadvantaged in other ways (who had not or whose parents had not graduated from high school or who lived in neighborhoods (census tracts) with highly concentrated (25% or more of residents) poverty) had similarly high preterm birth rates. In addition, we found that while preterm birth rates among White women consistently improved as their socioeconomic status (SES) improved, higher-SES Black women generally did no better –and sometimes did worse—than lower-SES Black women.
12 Nov Hospice Care For Advanced Cancer Decreased Aggressive Care and Costs in Last Year of Life
MedicalResearch.com Interview with:
Ziad Obermeyer, MD, MPhil
Emergency Medicine, Brigham & Women's Hospital
Assistant Professor, Harvard Medical School
Medical Research: What is the background for this study? What are the main findings?
Dr. Obermeyer: More patients with cancer use hospice today than ever before, but there are indications that care intensity outside of hospice is increasing, and length of hospice stay decreasing. We examined how hospice affects health care utilization and costs and found that, in a sample of elderly Medicare patients with advanced cancer, hospice care was associated with significantly lower rates of both health care utilization and total costs during the last year of life.
Patients who did not enroll in hospice had considerably more aggressive care in their last year of life—most of it related to acute complications like infections and organ failure, and not directly related to cancer-directed treatment. Hospice and non-hospice patients had similar patterns of health care utilization until the week of hospice enrollment, when care began to diverge. Ultimately, non-hospice patients were five times more likely to die in hospitals and nursing homes. These differences in care contributed to a statistically-significant difference in total costs of $8,697 over the last year of life ($71,517 for non-hospice and $62,819 for hospice).
12 Nov Brief Mediterranean Diet Intervention May Have Long Term Benefits
MedicalResearch.com Interview with: Dr. Markos Klonizakis Centre for Sports and Exercise Science Sheffield Hallam University, UK Medical Research: What is the background for this study? What are the main findings? Dr. Klonizakis: It is widely accepted that populations in the Eastern Mediterranean sea have historical lower rates of cardiovascular disease, diabetes and cancer. This has been attributed to a great extent, at following a diet based on dishes and ingredients, which are common in this region and are collectively known as “Mediterranean diet”. Taking into consideration that cardiovascular disease is on the rise, particularly in the Western world, it did make sense to see if such a diet can be adapted for a population that has a largely different culinary tradition and what the results would be if this is combined with exercise of moderate-intensity. We therefore, designed and implemented an 8-week intervention, aiming at older, healthy but previously untrained people, comparing an exercise-only group vs one where exercise was combined with Mediterranean diet. Our work has shown that benefits of this intervention are still evident in the vascular function (measured by the function of the inner vein lining, called the endothelium) and the cardiopulmonary fitness, one year after the end of the intervention.12 Nov Type 2 Diabetes: U-shaped Association of BMI With All-Cause Mortality
Posted at 16:09h
in AHA Journals, Author Interviews, Diabetes, Heart Disease, Metabolic Syndrome, Weight Research
MedicalResearch.com Interview with:
Gang Hu, MD, MPH, PhD, FAHA
Assistant professor & Director
Chronic Disease Epidemiology Lab
Adjunct assistant professor, School of Public Health
LSU Health Sciences Center
Pennington Biomedical Research Center,
Baton Rouge, Louisiana
Medical Research: What is the background for this study? What are the main findings?
Dr. Hu: Many previous studies had small samples, and thus lacked adequate statistical power when the analysis was focused on those who are extremely obese (BMI ≥40 kg/m2). In addition, most epidemiological studies only use a single measurement of BMI at baseline to predict risk of all-cause mortality, which may produce potential bias. The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2.
11 Nov Laundry Detergent Pods Can Be Lethal To Kids
MedicalResearch.com Interview with:
Marcel J Casavant MD FACEP FACMT
Chief of Toxicology, Nationwide Children's Hospita
Medical Director, Central Ohio Poison Center
Clinical Professor, The Ohio State University Colleges of Medicine & Pharmacy
Columbus OH USA 43205-2696
Medical Research: What is the background for this study? What are the main findings?
Dr. Casavant: Laundry detergent pods reached the US market shelves in early 2012; almost immediately parents started calling poison control centers about their children’s exposures to these products. Since then the CDC, the CPSC, the American Association of Poison Centers, and others have issued warnings about these products. Several papers and numerous abstracts have described injuries to various groups of children; we therefore chose to analyze and describe what happened to all US children with exposure to one of these products reported to a poison control center in 2012 and 2013. The main finding: these products are dangerous to children! Over those two years we found more than 17,000 young children exposed to pods, more than 6,000 seen in an emergency department, more than 700 admitted to a hospital, and among these, more than half required intensive care. Two young children died, both in 2013. Our study was published online on November 10, 2014 (http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Laundry-Detergent-Pods-Can-Be-a-Serious-Poisoning-Risk-in-Children.aspx) and will appear in the December 2014 print edition of Pediatrics (volume 134 number 6).
11 Nov Should Beta-Blockers Be Used After Myocardial Infarction?
MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI,
Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
The Leon H. Charney Division of Cardiology,
Associate Professor of Medicine,
New York University School of Medicine,
New York, NY 10016.
Medical Research: What is the background for this study? What are the main findings?
Dr. Bangalore: The evidence to support beta blocker use for patients with myocardial infarction stems from outdated studies performed in the era prior to modern reperfusion and modern medical therapy. It is not know if the mortality benefit of beta blockers for MI are seen in the modern era.
Our data from randomized trials suggest a significant interaction between reperfusion era status and beta blocker benefit such that in the modern era beta blockers provide no mortality benefit when compared with controls. However, they are associated with short term (30-days) benefit for reduction in recurrent MI and angina but at the expense of increase in the risk of heart failure, cardiogenic shock and drug withdraw due to adverse events. The benefits were only short term (30-days).
11 Nov Smartphone Ophthalmoscopy Can Screen for Diabetic Retinopathy
MedicalResearch.com Interview with:
Dr. Andrea Russo
Medico Chirurgo - Specialista in Oculistica
Università degli Studi di Brescia Brescia Italy
Medical Research: What is the background for this study? What are the main findings?
Dr. Russo: When I finished my residency program in Ophthalmology two years ago I realized that many patients were referred to me to assess and classify diabetic and hypertensive retinopathy. Therefore, I started wondering if there was an ophthalmoscopy method to make General Practitioners and Internist Physicians independent for these screening retinal assessments. I thought that we all own a personal computer connected with a (high quality) camera in our pocket and therefore smartphone ophthalmoscopy was feasible. Both the indirect and direct ophthalmoscopy techniques were suitable, however the latter was much easier to obtain. Furthermore, direct ophthalmoscopy can exploit smartphones’ autofocus and flash LED light making the required optics very simple and inexpensive. I purchased my 3D printer and started realizing very first working prototypes. A few months were required to improve the light path to eliminate internal and corneal reflections. Finally, I patented the optical solution and joined my partner Si14 S.p.A. (Padova, Italy) for the industrialization process.
The main findings are that that smartphone ophthalmoscopy with the D-Eye system can accurately detect retinal lesions for grading diabetic retinopathy. Furthermore, we noticed an amazing convenience in the assessment of babies, since they seem to be spontaneously attracted by the non-disturbing light emitted by the device, making the fundus acquisition straightforward. The advantages of smartphone-based retinal image acquisition for remote, non-hospital settings include portability and immediate upload/analysis. Indeed, telemedicine has the potential to reach patients and communities that currently receive negligible or suboptimal eye care as a result of geographic or sociocultural barriers, or both.
10 Nov Breast Cancer: Overcoming Tumor Resistance With Combinatinon Therapy
MedicalResearch.com Interview with:
Ruth Keri, PhD, Professor and Vice Chair Department of Pharmacology
Case Western Reserve University School of Medicine, and Associate Director for Basic Research in the Case Comprehensive Cancer Center Case Western Reserve University
Medical Research: What is the background for this study?
Dr. Keri: Over the last several decades, the discovery of targeted therapies for certain types of breast cancer, and their use in the clinic, have greatly improved the long-term outcome of patients. Yet some breast cancers don’t respond to these therapies, and ones that do often become resistant over time, resulting in patient relapse and metastatic disease. Why does resistance occur? There are many tricks a tumor employs to evade death. When a drug targets a certain protein or pathway the cancer cell relies on for survival, one potential route of resistance is the cancer cell’s ability to adapt and find another pathway to maintain growth. We reasoned that targeting two separate proteins or pathways important for cancer cell growth may be more effective at preventing or delaying this adaptation.
10 Nov Vegan Dieters Lost the Most Weight
MedicalResearch.com Interview with:
Brie Turner-McGrievy, Ph.D., M.S., R.D.
Assistant Professor
University of South Carolina; Arnold School of Public Health
Department of Health Promotion, Education, and Behavior
Columbia, SC 29208
Medical Research: What is the background for this study? What are the main findings?
Dr. Turner-McGrievy: Several observational studies have examined differences in weight-related outcomes among individuals following vegan, vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous diets. These studies have found lower body weights and less weight gain over time among vegans as compared to other groups. However, no randomized controlled trials have tested the relationship between these diets and body weight. So the goal of our study was to determine the effect of varying plant-based diets on weight loss. Our study found that a similar relationship of weight loss was found among the five diet groups that has been observed in epidemiological studies, with weight loss going from greatest in the vegan group followed by vegetarian, pesco-vegetarian, semi-vegetarian, and omnivorous. At six months, the vegan group lost significantly more weight (-7.5 ± 4.5%) than the omnivorous (-3.1 ± 3.6%, P=0.03), semi-vegetarian (-3.2 ± 3.8%, P=0.03), and pesco-vegetarian (-3.2 ± 3.4%, P=0.03) groups.