MedicalResearch.com Interview with: Yun Gong, M.D.
Associate Professor
Department of Pathology, Unit 53
M D Anderson Cancer Center
Houston, TX 77030
MedicalResearch.com: What are the main findings of the study?Dr. Gong: Androgen receptor (AR) was positive in 39% of the inflammatory breast cancer (IBC) tumors, approximately one-third of estrogen receptor (ER)-negative and progesterone receptor (PR)-negative tumors and 42.6% triple-negative tumors. AR positivity was significantly associated with lymphovascular invasion but not with other clinicopathologic parameters. There was a trend toward association between AR expression and PR expression.
Univariate survival analysis indicated that patients with AR-negative/ER-negative tumors had significantly worse overall survival and disease-specific survival than the patients with tumors showing other combinations of AR/ER status (i.e., AR-negative/ER-positive, AR-positive/ER-negative, or AR-positive/ER-positive). Notably, the study was performed using post-neoadjuvant IBC surgical specimens.
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MedicalResearch.com Interview with: Shelley S. Magill, M.D., Ph.D.
From the Centers for Disease Control and Prevention
Emory University School of Medicine
Atlanta, Georgia
MedicalResearch.com: What are the main findings of the study?Dr. Magill: The results of this survey show that healthcare-associated infections continue to be a threat to patient safety in U.S. acute care hospitals. Among the more than 11,000 patients included in the survey, approximately 4% (or 1 in 25) had at least one healthcare-associated infection at the time of the survey. We used these results to develop national estimates of healthcare-associated infections. We estimated that in 2011, there were approximately 721,800 healthcare-associated infections in U.S. acute care hospitals. The most common types of infections were surgical site infections (SSIs), pneumonias, and gastrointestinal infections.
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MedicalResearch.com Interview with:Marie Lund MD, PhD student
Department of Epidemiology Research
København S | Denmark
MedicalResearch.com: What are the main findings of the study?Dr. Lund: We found macrolide use in infants to be associated with a 30-fold increased risk of infantile hypertrophic pyloric stenosis (IHPS) with use during the first two weeks after birth and a lower, but significantly increased threefold risk with use during days 14 to 120. Similarly, there was a more than three-fold increased risk of IHPS associated with maternal macrolide use during the first two weeks after birth, but no increased risk with use thereafter. Finally, we found a possible modest association between maternal macrolide use during weeks 28 to birth and infantile hypertrophic pyloric stenosis.
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MedicalResearch.com Interview with: Tim Bongartz, M.D.
Associate Professor of Medicine
Department of Rheumatology
Mayo Clinic, Minnesota
MedicalResearch.com: What are the main study findings?Dr. Bongartz: Dual-energy computed tomography (DECT) is an imaging methods that has been in use for many years to classify the material of renal stones. Our study demonstrates that this technology can be useful in identifying monosodium urate deposits in and around joint, allowing to diagnose patients with gout with overall high sensitivity and specificity. Importantly, a stratified analysis of patient subgroups revealed that DECT is less accurate in diagnosing patients with a first flare of gout, emphasizing the importance of careful patient selection when using this new technology. In a "diagnostic-yield" substudy, we explored the question how much DECT could contribute to correctly diagnose patients where clinicians did have a high level of suspicion for gout, but synovial fluid aspiration results came back negative. In about a third of these patients with negative routine testing, we could confirm a diagnosis of gout through use of DECT.
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MedicalResearch.com Interview with:
Prof. Dr. Bernd Schultes
Endocrinology and Diabetes Internal Medicine
eSwiss Medical & Surgical Center
Brauerstrasse 97
9016 St. Gallen Schweiz
MedicalResearch.com: What...
MedicalResearch.com Interview with:Dr. Kristy Ward
Department of Reproductive Medicine
UCSD School of Medicine
MedicalResearch.com: What are the main findings of this study?Dr. Ward: As the second leading cause of preventable death, obesity is one of the nation’s most serious public health problems. Over two-thirds of the US population is currently overweight or obese and the prevalence continues to increase. A number of studies have linked obesity with an overall elevated risk of cancer and with many individual cancer types. Among obesity related cancers in women, endometrial cancer is most strongly associated with increasing body mass, with 39% of cases in the US attributable to obesity.
In patients with clinically severe obesity (BMI ≥ 40 kg/m2), bariatric surgery results in rapid weight loss and has greater long-term success when compared to non-surgical weight loss methods. Surgical weight loss procedures have been found to reduce obesity-related comorbidites and improve outcomes in clinically severe obese populations. In addition to improved cardiovascular risk factors and mitigation of physical symptoms, there is increasing evidence that cancer risk is reduced after bariatric surgery.
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MedicalResearch.com Interview with: Jill Cameron, PhD
CIHR New Investigator, Associate Professor,
Department of Occupational Science and Occupational Therapy
Graduate Department of Rehabilitation Science
Faculty of Medicine, University of Toronto
Adjunct Scientist, UHN-Toronto Rehabilitation Institute
MedicalResearch.com: What are the main findings of the study?Dr. Cameron: In our study with 399 stroke survivor, caregiver dyads, caregivers reported more psychological wellbeing when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities, had more mastery, gained personally providing care, were in better physical health, and were older reported more psychological wellbeing.
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MedicalResearch.com Interview with
Dr. Karolina Sjöberg Jabbar, MD,
Medicine Policlinic II, Bla Straket 5, Sahlgrenska University Hospital
Gothenburg, Sweden
MedicalResearch.com: What are the main findings of the study? Answer:The main finding of this study is that the presence of mucin proteins in pancreatic cyst fluid, as evaluated by mass spectrometry, can predict with high accuracy (97%) which pancreatic cysts contain premalignant and malignant tumours. This is important, given that pancreatic cystic lesions are an increasingly common incidental finding on imaging. While most of them pose no threat to the patient, a minor proportion has malignant potential, and may be considered precursors to pancreatic cancer.
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MedicalResearch.com Interview with Mònica Bulló PhD
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine
Rovira i Virgili University
Sant Llorenç, Spain
MedicalResearch.com: What are the main findings of the study?Dr Bulló: There is some evidence that different dietary forms of vitamin K could exert varying effects on health, however no study to date has simultaneously evaluated the potential effects of the main vitamin K forms on cancer and cardiovascular mortality. We conducted a prospective, epidemiologic study involving 7,216 elderly subjects at high cardiovascular risk who were followed for about 5 years.The results of the present study show, for the first time that an increase in dietary intake of both forms of vitamin K is related to a lower risk of cardiovascular mortality, cancer mortality or all-cause mortality.
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MedicalResearch.com Interview withMichael Kimlin
Professor of Cancer Prevention Research
Institute of Health and Biomedical Innovation
Queensland University of Technology
Australia
MedicalResearch.com: What are the main findings of the study?Answer: The main findings of this study were that women who where classified as having the highest level of sun exposure in our sample had a significantly larger drop in blood folate levels compared to women with lower sun exposures. This was quite a powerful finding, as all women were supplemented with folate and tested so that so that we knew that each sun exposure group had similar average levels of blood folate at the start of the study. We then measured their sun exposure over a week and took a sample of blood at the end of this week to see how the degree of sun exposure affected folate levels.
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MedicalResearch.com Interview with: Pamela Ling, MD MPH
Associate Professor, Department of Medicine
Director, Tobacco Control Policy Fellowship
Center for Tobacco Research and Education
University of California San Francisco
San Francisco, CA 94143-1390
MedicalResearch.com: What are the main findings of the study?Dr. Ling: We followed a sample of smokers from a nationally representative panel for one year. We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not. Put another way, smokers who had used e-cigarettes at the beginning of the study were equally likely to have quit smoking one year later as those who did not use e-cigarettes. There was no relationship between e-cigarette use and quitting even after taking into account measures of tobacco dependence (number of cigarettes smoked per day, how early in the day a smoker has his first cigarette) and intention to quit smoking.
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MedicalResearch.com Interview with:Craig A. Anderson, Distinguished Professor
Director, Center for the Study of Violence
Department of Psychology
Iowa State University
Ames, IA 50011-3180
MedicalResearch.com: What are the main findings of the study?Dr. Anderson: There are three main findings from this long-term study of violent video game effects.
1. Over time, repeated play and practice of violent video games led to an relative increase in aggressive thought patterns and in physical aggression.
2. As predicted by social-cognitive theoretical models, the violent video game effect on physical aggression was directly linked to the increase in aggressive thought patterns. That is, one key reason why repeated exposure to violent video games increases aggression is because such exposure changes the way children and adolescents think about people and events that occur in their lives. In a sense, their personality changes, so that they perceive more hostility around them and come to view physically aggressive behavior as a proper solution to even minor conflicts and provocations.
3. These effects of repeated exposure to violent video games were quite general across types of people. Boys and girls, younger children and older adolescents, high aggressive and low aggressive children, all showed pretty much the same effects. In other words, no subgroup was immune to the harmful effects of violent video games.
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MedicalResearch.com Interview with: Elizabeth C. Wick, MD
Assistant Professor,Department of Surgery
The Johns Hopkins Hospital, Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?Dr. Wick: The main finding is the high variability in physician practice for prescribing steroids and the lack of clear guidance as to best practice in the literature.
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MedicalResearch.com Interview with: Dr. Panos N. Papapanou:
Professor of Dental Medicine;
Chairman, Section of Oral and Diagnostic Sciences
Director, Division of Periodontics Section of Oral and Diagnostic Sciences,
College of Dental Medicine, Columbia University, New York, NY
MedicalResearch.com: What are the main findings of the study?Dr. Papapanou: Gene expression signatures in gum tissues obtained from patients with periodontitis identified two fairly robust clusters, suggesting potential differences in pathobiologic processes between the two groups. In addition, the two clusters displayed differences in important features of the disease (e.g., the extent and severity of periodontitis, and the level of colonization by periodontal bacteria). These findings indicate that gene expression patterns may form the basis for a novel, pathobiology-based classification of periodontitis.
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MedicalResearch.com Interview with:Christos S. Mantzoros, MD, DSc, PhD
Beth Israel Deaconess Medical Center and the VA Boston Healthcare
Cynthia R. Davis PhD
Judge Baker Children’s Center in Boston, MA.
MedicalResearch.com: What are the main findings of this study?Answer: These results highlight that chronic stressors in childhood, like child abuse and family violence, parental substance abuse, divorce and separation from a parental figure, can potentially have a long standing impact on brain structures and functioning, such as the hypothalamic-pituitary-adrenal axis. Our work supports the notion of allostatic load, and is the first of its kind to demonstrate links between childhood adversity and central obesity later in life which leads to increased cardio metabolic risk.
This study describes the role of these novel molecules in mediating metabolic dysregulation highlighting them as a novel mechanism linking childhood adversity to obesity.
We have also used more sensitive assessments of childhood adversity, not typically employed in biomedical research, that incorporate the severity of adversities and their chronicity across childhood. Assessments of this nature are better able to detect severe and chronic adversity, and are critical in the measurement of stress, its role in allostatic load and its impact on the brain. Furthermore, the current study and others from our lab show that severe and chronic adversity in childhood is associated with metabolic dysregulation and obesity in adulthood, regardless of lifestyle factors such as diet and exercise and psychosocial factors like depression and social support.
Clinicians and patients need to be aware of the fact that subjects exposed to early life adversity are at increase risk for central obesity and cardio metabolic risk.
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MedicalResearch.com Interview with: Dr. Azi Gazdar, MD
UT Southwestern Medical Center
W. Ray Wallace Distinguished Chair in Molecular Oncology Research
Hamon Center for Therapeutic Oncology, Pathology
MedicalResearch.com: What are the main findings of the study?Dr. Gazdar: We describe the characteristics of lung cancers arising in subjects who inherited a germline mutation that predisposes to lung cancer. The mutation is rare in the general populations, and is inherited equally by both sexes. However it is a potent predisposing gene, and one third of the never smoking carriers will develop lung cancer. Thus, about 1% of patients who develop lung cancer carry the germline mutation. This figure may rise as awareness of the condition and its link to lung cancer is raised among doctors diagnosing lung cancer. However, lung cancers mainly develop in women who are lifetime never smokers. Lung cancer development is much less common among smokers and men, although accurate figures are not yet available. So the risk among carriers is somewhat similar to the BRCA genes predisposing to breast cancer, where a female carrier has about a 50% lifetime chance of developing breast cancer.
The specific germline mutation (known as T790M) occurs in a gene known as epidermal growth factor receptor (EGFR) gene. Sporadic mutations in this gene usually predict for effective responses to a class of drugs known as tyrosine kinase inhibitors (TKIs), which are widely used in the treatment of lung cancer. However, the T790M mutation, when it occurs in sporadic tumors not associated with germline inheritance are resistant to TKI therapy. Thus the prediction is that lung cancers arising in carriers with the germline mutation would also be resistant to TKI therapy.
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MedicalResearch.com Interview with: Hannes Devos, PhD
Assistant Professor
Assistant Director Georgia Regents University Driving Simulator Lab Department of Physical Therapy
College of Allied Health Sciences
Georgia Regents University Augusta, GA 30912
MedicalResearch.com: What are the main findings of the study?Dr. Devos: We compared on-road driving performance between 30 active drivers with Huntington disease and 30 age- and gender- matched control drivers. We found that Huntington disease affects all levels of driving skill due to motor and cognitive deficits and leads to unsafe driving, even in the early stages of the disease. Fourteen (47%) drivers with Huntington disease failed the road test compared with none of the controls.
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MedicalResearch.com Interview withMelanie Goldfarb MD
Assistant Professor of Surgery, Endocrine Surgery
University of Southern California
Keck School of Medicine, Los Angeles, California
MedicalResearch.com: What are the main findings of the study?Dr. Goldfarb: Adolescents and young adults (AYAs) who develop thyroid cancer as a secondary cancer are six times more likely to die than AYAs with primary thyroid cancer, though survival with treatment is excellent for both primary and secondary cancers at greater than 95 percent. Additionally, Hispanics, Males, and those of lower socioeconomic status have worse overall survival.
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MedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic
MedicalResearch.com: What are the main findings of the study?Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years) is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment.
We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume).
Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life.
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MedicalResearch.com Interview with: Christian Hampp PhD
Senior Staff Fellow/Epidemiologist at FDA
Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
MedicalResearch.com: What are the main findings of the study?Dr. Hampp:Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use.
We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012. During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies. Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012. Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012.
Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012.
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MedicalResearch.com Interview with: Dr. Nancy Crum-Cianflone MD
Deployment Health Research Department, Naval Health Research Center, San Diego, CA
MedicalResearch.com: What are the main findings of the study?Dr. Nancy Crum-Cianflone: There have been several studies examining the health outcomes of service members who recently deployed to the conflicts in Iraq and Afghanistan. However, none of these studies to date had examined the potential role of military deployment experiences and PTSD on coronary heart disease (CHD) among young US service members. We believed that this would be an important study to undertake since these data would not only be useful to the US military, but may also have implications regarding job-related stressors on the health of young adults in the general population.
After studying over 60,000 current and former US military personnel, we found that those who deployed and experienced combat were at a 60%-90% increased risk of subsequently developing CHD. This finding was noted when we examined both self-reported CHD and medical record validated coronary heart disease. These data suggest that experiences of intense stress may increase the risk for coronary heart disease over a relatively short period among young, previously healthy adults.
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MedicalResearch.com Interview with:Roxanne Pelletier, PhD
Postdoctoral Fellow
Division of Clinical Epidemiology
McGill University Health Centre (MUHC)
687 Pine Avenue West, V Building, Room V2.17
Montreal, Qc
MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks? Dr. Pelletier: Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality.
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MedicalResearch.com Interview with:Judy A. Stevens PhD
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention Atlanta
GA 30341
MedicalResearch.com: What are the main findings of the study?
Dr. Stevens:The fall death rate among persons aged 65 and older has been increasing rapidly. We used vital statistics data to examine the circumstances and contributing conditions to fall deaths.
We found that of 21,649 fall deaths in 2010, the largest proportion (35%) occurred from falling on the same level, followed by falling on stairs or steps (6.5%). From 1999 to 2010, there was a trend toward more specific reporting of falls circumstances. However, information about the circumstances of 49% of the 2010 fall deaths was not available.
In 2010, 49% of fall deaths involved a head injury and 30% involved a hip fracture. The most important contributing causes to fall deaths were circulatory diseases, especially hypertension, and respiratory diseases.
Factors that may partially explain the rapid increase in the fall death rate include changing trends in the death rates for underlying chronic diseases strongly associated with falls, such as reductions in cardiovascular disease deaths, as well as better reporting on death certificates of falls as the underlying cause of death.
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MedicalResearch.com Interview with:Chung-Jung Chiu DDS PhD
Scientist II, JM USDA Human Nutrition Research Center on Aging
Assistant Professor, School of Medicine
Tufts University Boston MA 02111
MedicalResearch.com: What are the main findings of the study?Answer: In this study, we found that advanced age-related macular
degeneration (AMD) is predictable by using clinically readily available
information. We devised a simple algorithm to summarize the clinical
predictors and showed the validity of our prediction model in both
clinic-based and community-based cohorts. We also develop an
application (App) for the iPhone and iPad as a practical tool for our
prediction model.
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MedicalResearch.com Interview with: Denise Bonds, MD, MPH
National Heart, Lung, and Blood Institute (NHLBI)MedicalResearch.com:What are the main findings of the study?Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin.
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MedicalResearch.com Interview Invitation with:Dr. Thomas Imperiale MD
Professor of Medicine, Indiana University School of Medicine
Research Scientist, Indiana University Center for Health Services and Outcomes Research
Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc.
Core Investigator, VA HSR&D Center for Health Information and Communication
MedicalResearch.com: What are the main findings of the study?Dr. Imperiale: The main findings are the performance characteristics of the multi-target test (sensitivity of 92.3%, specificity of 86.6%) and its performance as compared with the commercial FIT: more sensitive for colorectal cancer and advanced precancerous polyps, but less specific.
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MedicalResearch.com Interview Invitation Dr. Christian Fynbo Christiansen
Clinical Associate Professor
Department of Clinical Epidemiology
Aarhus University Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Christiansen: We included 24,179 critically ill nonsurgical patients receiving mechanical ventilation in intensive care units in Denmark, and matched comparison groups of hospitalized patients and the general population. We assessed psychiatric diagnoses and medication prescriptions before and after critical illness.
We found an increased prevalence of psychiatric diagnoses in the 5 year period before critical illness, compared to both other hospitalized patients and the general population.
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MedicalResearch.com Interview with:Shamez Ladhani, MRCPCH PhD
Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London
MedicalResearch.com: What are the main findings of the study?Dr. Ladhani: Pregnancy was associated with an increased of serious infection by a bacterium called Haemophilus influenzae which is usually associated with respiratory tract infections. Nearly all the H. influenzae were unencapsulated; that is, they did not have an outer sugar capsule which is often required to make the bacterium more virulent. The encapsulated H. influenzae type b (Hib), for example, was the most common cause of bacterial meningitis in your children prior to routine immunisation. We also found that infection with unencapsulated H. influenzae was associated with poor pregnancy outcomes, including miscarriages, stillbirth and premature birth.
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Medical Research.com Interview with:Marc Righini, MD
Division of Angiology and Hemostasis
Geneva University Hospital, Geneva, Switzerland
MedicalResearch.com: What are the main findings of this study?Dr. Righini: The study shows that when compared with a fixed D-Dimer cutoff of 500 ng/ml, the combination of pretest clinical probability assessment with age-adjusted D-dimer cut-off was associated with a larger number of patients in whom Pulmonary Embolism could be excluded, with a low likelihood of recurrent VTE. The benefit was the most important in patients 75 years or older, in whom using the age-adjusted cutoff instead of the 500 ng/ml cutoff increased five-fold the proportion of patients in whom PE could be excluded on the basis of D-dimer measurement.
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MedicalResearch.com Interview with: Cristen J. Willer, PhD
Assistant Professor
Division of Cardiovascular Medicine, Dept of Internal Medicine
Dept of Human GeneticsDept of Computational Medicine and Bioinformatics
University of Michigan Ann Arbor, MI 48109-5618
MedicalResearch.com: What are the main findings of the study?Dr. Willer: We wanted to find new genes related to heart disease, so we examined the DNA of approximately 10,000 Norwegian individuals and found 10 genes that are important regulators of blood cholesterol levels. Nine of these were well known to be related to lipids, but one gene was new. It turned out to be in a region we'd previously noticed to be related to cholesterol, but it was a big region and we hadn't been able to pinpoint the gene yet. Using this new approach, focusing on DNA differences that result in slightly different proteins in people, we zeroed in on the gene. We then altered this gene in mice, and saw the predicted changes in cholesterol levels in mice.
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