Author Interviews, Genetic Research, OBGYNE / 18.02.2019

MedicalResearch.com Interview with: Zhiyong Zhang PhD Key Laboratory for the Physics and Chemistry of Nanodevices Department of Electronics Peking University Beijing China MedicalResearch.com: What is the background for this study? What are the main findings? Response: Down syndrome is caused by the presence of an extra 21st chromosome within the genome and is the most common birth defect (occurring in approximately 1 in 800 births). In the absence of a multiplexed quantitative diagnostic device, pregnant women have been examined with the ultrasound and the indirect biochemical markers (Alpha-fetoprotein, chorionic gonadotropin and free estriol) which are accompanied with a high misdiagnosis rate. And the diagnostic test (such as amniocentesis) following the wrong screening test results will bring harm to both the pregnant women and the fetuses. Through PCR (polymerization chain reaction) amplification of the fetal DNA in the pregnant mother’s peripheral blood and fluorescence read-out, whole-genome sequencing (WGS)-based non-invasive prenatal testing (NIPT) sequences all the genomic DNA segments in parallel and quantitatively compares the percentage of different chromosomes, which increases the sensitivity for prenatal detection of Down syndrome. However, the complex instrumental setups and the resulted high processing cost present challenges for the large-scale application of WGS-based diagnosis at the point of care in the urban and rural areas of developing countries. Hence, beside the costly WGS method, there is an urgent need to develop a cost-effective NIPT biochip with simple instrumental setting, fast detection speed, high sensitivity, and programmable to multiple disease markers. Taking advantages of we have developed a novel field effect transistor (FET) based biosensor that reveals a fast, ultra-sensitive, highly specific and cost-effective methods and someday can be used to detect fetal Down syndrome in NIPT.  (more…)
Author Interviews, Exercise - Fitness, Geriatrics, Nutrition, Protein, Weight Research / 18.02.2019

MedicalResearch.com Interview with: Kristen M. Beavers PhD, MPH, RD Assistant Professor, Department of Health and Exercise Science Department of Biostatistical Sciences Wake Forest School of Medicine Winston-Salem, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Weight loss recommendation for older adults with obesity is controversial, in part because overall weight loss is accompanied by loss of muscle and bone, which may exacerbate age-related risk of disability and fracture. Identification of interventions that can preserve muscle and bone while promoting fat loss should maximize cardiometabolic benefit, while minimizing potential harm to the musculoskeletal system. This randomized controlled trial was originally designed to test whether a higher protein, nutritionally complete meal plan could preserve lean mass and mobility in older adults undergoing a six month intentional weight loss program. Four publications have resulted from this study: * “Effect of an Energy-Restricted, Nutritionally Complete, Higher Protein Meal Plan on Body Composition and Mobility in Older Adults with Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print June 21, 2018 * “Effect of a Hypocaloric, Nutritionally Complete, Higher-Protein Meal Plan on Bone Density and Quality in Older Adults With Obesity,” American Journal of Clinical Nutrition, published online in advance of print Jan. 9, 2019 * “Effect of Intentional Weight Loss on Mortality Biomarkers in Older Adults With Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print Aug. 20, 2018 * “Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity,” Annals of Nutrition and Metabolism, published online in advance of print Feb. 11, 2019 Across the four publications, we found that: * Participants lost about 18 pounds, most of it fat (87 percent), and preserved muscle mass. The control group lost about half a pound. * Even when participants lost weight, they maintained bone mass. In fact, trabecular bone score, a measure of bone quality which predicts fracture risk, seemed to improve. * Fat was lost in the stomach, hips, thighs and rear, which is important for preventing or controlling cardiometabolic diseases such as diabetes and stroke. * Participants’ score on the Healthy Aging Index, which measures biomarkers that predict mortality and longevity, improved by 0.75 points. (more…)
Author Interviews, Dermatology, Eli Lilly / 16.02.2019

MedicalResearch.com Interview with: Lotus Mallbris, MD PhD Dermatologist and Vice President, Head of Global Immunology Drug Development Platform Team Leader at Lilly MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by atopic dermatitis? How common is this condition?  Response:The BREEZE-AD1 and BREEZE-AD2 clinical trials are multicenter, randomized, double-blind, placebo-controlled, Phase 3 studies to evaluate the efficacy and safety of baricitinib monotherapy in adult patients with moderate to severe atopic dermatitis. These are two of five studies that will be part of the placebo-controlled data program intended to support global registrations. Atopic dermatitis, a serious form of eczema, is a chronic, relapsing skin disease characterized by intense itching, dry skin and inflammation that can be present on any part of the body. It affects approximately 1-3 percent of adults worldwide. (more…)
Author Interviews, Inflammation, JAMA, Kidney Disease, Pain Research, Stanford / 16.02.2019

MedicalResearch.com Interview with: Alan Nelson, MPAS, PhD Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine Stanford, California  MedicalResearch.com: What is the background for this study?   Response: The past research literature has provided relatively little information on the appropriate level of concern regarding non-steroidal anti-inflammatory drugs (NSAIDs) and kidney disease risk among younger, apparently healthy patients. Clinicians are generally most concerned about the effects of these medications on the kidneys among patients with existing renal impairment and persons at risk for it, especially older patients. Given that NSAID use appears to be high and rising in the US, we were interested in developing evidence on this topic in a population of working-age adults. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Sleep Disorders / 16.02.2019

MedicalResearch.com Interview with: Cameron S. McAlpine, Ph.D. Banting Postdoctoral Fellow Center for Systems Biology Massachusetts General Hospital Harvard Medical School Boston, MA, 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease is caused by the build up of white blood cells and fat in arteries. We have known for a long time that poor sleep is associated with an increased risk of developing cardiovascular disease. A number of human observational studies have found this correlation. However, the reasons for this correlation have been largely unknown. Our study, performed in mice, provides one possible explanation. We found that when we disturbed the sleep of mice they produced more inflammatory white blood cells. These cells caused larger lesions in their arteries and more advanced cardiovascular disease. We found that his phenomenon is controlled by a hormone produced in the brain that normally suppresses the production of white blood cells. When mice have their sleep disturbed this pathway breakdown causing the increased production of white blood cells. (more…)
Author Interviews, Emory, JAMA, Prostate Cancer, Radiation Therapy / 15.02.2019

MedicalResearch.com Interview with: Deborah Watkins Bruner RN, PhD, FAAN Senior Vice President of Research Emory University Professor and Robert W. Woodruff Chair in Nursing Nell Hodgson Woodruff School of Nursing Professor, Department of Radiation Oncology Emory University School of Medicine MedicalResearch.com: What is the background for this study? Response: In a randomized clinical trial entitled, “Quality of Life in Patients With Low-Risk Prostate Cancer Treated With Hypofractionated vs Conventional Radiotherapy” the NRG Oncology Group previously demonstrated that men with low risk prostate cancer had  similar 5-year disease- free survival of about 85%  when treated with either conventional radiotherapy  (C-RT) of 73.8 Gy in 41 fractions over 8.2 weeks, or with  hypofractionated radiotherapy (H-RT) of 70 Gy in 28 fractions over 5.6  weeks. However, late physician reported side effects of mild bowel and bladder symptoms were increased in patients treated  with H-RT and raised questions if the H-RT arm is acceptable to patients. The current study asked the patient’s directly about their bowel, bladder, sexual function, anxiety, depression and general quality of life using valid patient reported questionnaires. These questionnaires have been found to be more accurate for reporting patient symptoms than physician report alone. (more…)
Author Interviews, Dermatology, JAMA, Johns Hopkins, Microbiome / 15.02.2019

MedicalResearch.com Interview with: Luis Garza, MD-PhD Associate Professor Department of Dermatology Johns Hopkins School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings?  Do you think these findings would be similar with other antibiotics (oral or topical) or with isotretinoin for acne? Response: We prescribe antibiotics frequently for acne. We certainly know it affects our normal and abnormal bacteria on our skin. But we don’t fully understand how well or not people recover from antibiotics.  (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 15.02.2019

MedicalResearch.com Interview with: JOÃO L. CAVALCANTE, MD, FASE, FACC, FSCCT, FSCMR Director, Cardiac MRI and Structural CT Labs Director, Cardiovascular Imaging Research Core Lab Minneapolis Heart Institute Abbott Northwestern Hospital Minneapolis, MN, 55407 MIHO FUKUI MD Division of Cardiovascular Diseases, Department of Internal Medicine, Heart & Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota MedicalResearch.com: What is the background for this study? Response: Recent study by Généreux et al (1), using the Placement of Aortic Transcatheter Valves (PARTNER) 2A and 2B data, provided the first framework of a staging system for severe aortic stenosis (AS) that quantifies the extent of structural and functional cardiac change associated with AS and importantly its association with 1-year mortality in patients receiving either surgical or transcatheter AVR (TAVR):
  • Stage 0: No other cardiac damage;
  • Stage 1: LV damage as defined by presence of LV hypertrophy, severe LV diastolic, or LV systolic dysfunction;
  • Stage 2: Left atrium or mitral valve damage or dysfunction;
  • Stage 3: Pulmonary artery vasculature or tricuspid valve damage or dysfunction; and
  • Stage 4: right ventricular damage.
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ALS, Author Interviews, Statins / 15.02.2019

MedicalResearch.com Interview with: Alastair J. Noyce MD, PhD Preventive Neurology Unit, Wolfson Institute of Preventive Medicine Queen Mary University of London, Department of Clinical and Movement Neurosciences, University College London, Institute of Neurology, London UK MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Amyotrophic lateral sclerosis (ALS) or motor neurone disease (MND) is a relentlessly progressive disorder that affects nerves which supply muscles. Over time the nerves die, leading to limb weakness, speech and swallowing problems, and ultimately breathing problems. Patients die on average 3-5 after diagnosis. There is no cure and the underlying disease processes are only understood in part. In this study, we adopted a large-scale approach to exploring causal risk factors for ALS. Causality is important because it implies that if one could modify or induce a change in a risk factor, one would observe a change in the risk of ALS. Observational studies struggle to prove causality definitely. Associations in observational studies can arise because: 1) the risk factor truly changes risk of ALS; or 2) something about ALS changes one’s exposure to the risk factor; or 3) the presence of another factor, which may or may not be known, can induce an association between a risk factor and ALS. Unless scenario 1 represents the truth, then changing the risk factor will not have any effect on risk of ALS. We used a proxy-based approach, known as Mendelian randomisation, to assess hundreds of possible risk factors for ALS for evidence of causality. What emerged from this was a very clear signal linking LDL cholesterol to risk of ALS. (more…)
Author Interviews, Heart Disease, JACC / 13.02.2019

MedicalResearch.com Interview with: Srikanth Yandrapalli, MD Chief Resident in Internal Medicine at New York Medical College at Westchester Medical Center Program  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Risk factors play an important role in the development of and progression of coronary heart disease, thus necessitating strategies to address the leading modifiable risk factors to reduce the burden of coronary heart disease. Data are lacking regarding therecent temporal trends in the prevalence of these risk factors during a first AMI in US young adults. In our study, we report that among young adults in the US with a first acute myocardial infarction, the prevalence rates of major modifiable risk factors were very high with over 90% of patients having at least 1 such risk factor. Significant sex and racial disparities were observed. Sex differences in the rates of certain  risk factors were clearly evident with males having higher rates of smoking, dyslipidemia, and drug abuse, whereas females had higher rates metabolic risk factors like diabetes mellitus, hypertension, and obesity. Sex differences in the rates of certain risk factors narrowed with increasing age and over time. Blacks had higher rates of hypertension, obesity, and drug abuse, Whites had higher rates of smoking, Hispanics had higher rates of diabetes mellitus and patients of Asian/Pacific Islander race had higher rates of dyslipidemia. Prevalence rates progressively increased between 2005 and 2015 except for dyslipidemia for which a decreasing trend was noted more recently. (more…)
Author Interviews, BMJ, Cancer Research, HPV, OBGYNE / 13.02.2019

MedicalResearch.com Interview with: Matejka Rebolj, PhD King’s College London, London, UK   Professor Henry Kitchener, MD FRCOG FRCS University of Manchester, Manchester, UK   MedicalResearch.com: What is the background for this study? Response: We now have reliable and affordable technologies to detect human papillomavirus (HPV), a virus which is universally accepted as the cause of cervical cancer. Various large trials confirmed that cervical screening could be improved by replacing the smear (cytology) test that has been in use for decades, with HPV testing. Many countries are now making the switch. In England, this is planned for the end of 2019. To test how to run HPV testing within the English National Health Service, a pilot was initiated in 2013 in six screening laboratories. We also wanted to determine whether the encouraging findings from the trials could be translated to everyday practice. This is important not only because we will be using different HPV tests, but also because women undergoing screening in trials are much more selected than those who are invited to population-based screening.  (more…)
Annals Internal Medicine, Author Interviews, Exercise - Fitness, Heart Disease, Karolinski Institute, Weight Research / 13.02.2019

MedicalResearch.com Interview with: Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In many countries, disability pensions are granted to working-aged persons who are likely to never work full-time again because of a chronic disease or injury diagnosed by a physician. In addition to serving as an important indicator of chronic disease, disability pensions are associated with high societal costs. Hence, we examined whether cardiorespiratory fitness and obesity (two potentially modifiable factors) were associated with disability pension later in life. Our main findings were that low physical fitness and/or obesity during adolescence, were strongly associated with disability pension later in life due to a wide range of diseases and causes.  (more…)
Author Interviews, Beth Israel Deaconess, Blood Pressure - Hypertension, Salt-Sodium / 13.02.2019

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lightheadedness with standing is an important risk factor for falls. Sodium is often considered a treatment for lightheadedness with standing. We examined this in the setting of a monitored feeding study where adults ate each of 3 different sodium levels for 4 weeks at a time. Participants took 5 day breaks between sodium levels and ate the sodium levels in random order. We tested the hypothesis that lowering sodium would worsen how much lightheadedness the study participants reported. (more…)
Author Interviews, JAMA, Prostate Cancer, Radiation Therapy / 12.02.2019

MedicalResearch.com Interview with: Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Typical external beam radiation courses range up to 8-9 weeks in length (39-45 treatments). There are data that shorter courses, delivering a higher dose per day, may be just as effective. Stereotactic body radiotherapy (SBRT) really pushes this concept by condensing the treatment to just four to five treatments, with a high dose per day. Here, we present the pooled results of the outcomes of 2142 men with low and intermediate risk prostate cancer and a median of 6.9 years of followup. We demonstrate a very favorable efficacy and safety profile. Specifically, the rates of recurrences were 4.5% and 10.2% for low and intermediate risk disease at 7 years, and rates of late severe toxicity were 2.4% for urinary toxicity and 0.4% for gastrointestinal toxicity. (more…)
Author Interviews, MRI, Prostate Cancer, Technology / 12.02.2019

MedicalResearch.com Interview with: Gaurav Pandey, Ph.D. Assistant Professor Department of Genetics and Genomic Sciences Icahn Institute of Data Science and Genomic Technology Icahn School of Medicine at Mount Sinai, New York  MedicalResearch.com: What is the background for this study?  Response: Multiparametric magnetic resonance imaging (mpMRI) has become increasingly important for the clinical assessment of prostate cancer (PCa), most routinely through PI-RADS v2, but its interpretation is generally variable due to its relatively subjective nature. Radiomics, a methodology that can analyze a large number of features of images that are difficult to study solely by visual assessment, combined with machine learning methods have shown potential for improving the accuracy and objectivity of mpMRI-based prostate cancer assessment. However, previous studies in this direction are generally limited to a small number of classification methods, evaluation using the AUC score only, and a non-rigorous assessment of all possible combinations of radiomics and machine learning methods. (more…)
Author Interviews, Hearing Loss / 12.02.2019

MedicalResearch.com Interview with: Keith Schneider PhD Director, Center for Biomedical and Brain Imaging Associate Professor Department of Psychological and Brain Sciences University of Delaware MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Absolute pitch is the ability to name a musical note in isolation.  It is rare in the population, approximately 1/10,000 people have it.  The neural mechanisms of this ability have not been clear.  It is not known whether people with absolute pitch encode auditory frequencies differently, or whether absolute pitch derives from the same sensory encoding but different memory connections. We tested 20 people with absolute pitch, 20 matched musicians with the same number of years of musical training, age of onset of musical training, and number of hours of practice per week, as well as 20 controls with minimal musical training. The main findings are that people with absolute pitch have larger early auditory cortex—primary auditory cortex was enlarged about 50% relative to the other two groups, which did not differ significantly from each other.  We also found that the tuning bandwidth of the individual voxels in the early auditory cortical areas was broader in people with absolute pitch. That is, these small bits of the brain responded to a wide range of frequencies than those in the other two groups.  This suggested to us that people with absolute pitch might imply what is known as “ensemble encoding”.  That is, they use a larger network of neurons to encode sounds.   (more…)
Author Interviews, CDC, JAMA, Opiods / 12.02.2019

MedicalResearch.com Interview with: Gery Guy, PhD, MPH Injury Center CDC MedicalResearch.com: What is the background for this study? Response: This study examined opioid prescribing at the national and county-level in 2015 and 2017. During 2015 to 2017, the amount of opioids prescribed decreased 20.1% in the United States. The amount of opioids prescribed per person varies substantially at the county-level. The average amount of opioids prescribed in the highest quartile of counties was nearly 6 times the amount in the lowest quartile. Reductions in opioid prescribing could be related to policies and strategies aimed at reducing inappropriate prescribing, increased awareness of the risks associated with opioids, and release of the CDC Guideline for Prescribing Opioids for Chronic Pain. (more…)
Author Interviews, Cancer Research, Prostate Cancer, Radiation Therapy / 12.02.2019

MedicalResearch.com Interview with: Graham Kelly, BSc (Vet) (Hons, BVSc (Hons), PhD Managing Director and Chief Executive Officer Noxopharm  MedicalResearch.com: What is the background for this announcement? What are the main findings? Response: Veyonda is an experimental drug being developed as a means of enhancing the anti-cancer effect of radiotherapy. The Phase 1b DARRT-1 study is assessing the ability of Veyonda to boost a palliative dose of external beam radiotherapy (EBRT) applied to a single lesion, to result in a systemic response in non-irradiated lesions (known as an abscopal response) in men with metastatic, end-stage prostate cancer. The aim is to provide at the least better palliation, and at best a survival advantage. The reported data concerns the study’s initial dose-finding arm involving three different dosages of Veyonda. This arm involves 12 subjects and the report concerns their clinical status at 12-weeks post-irradiation. The data provide clinical evidence of an abscopal effect in at least half of the eight subjects receiving the two highest Veyonda dosages and demonstrate that the combination of Veyonda and palliative radiotherapy was well-tolerated. The 1200 mg dosage was confirmed as the therapeutic dose. (more…)
Aging, Author Interviews, Genetic Research / 12.02.2019

MedicalResearch.com Interview with: Yurii Aulchenko Co-founder and Chief Scientist of PolyOmica PolyOmica is a research & development company providing services and tools for quantitative genetics and functional genomics. Peter Fedichev Founder and Chief Science Officer of Gero Gero is a data-driven longevity company developing innovative therapies that will strongly extend the healthy period of life also known as healthspan MedicalResearch.com: What is the background for this study? What are the main findings? Peter Fedichev, Gero: Age is the most important risk factor behind age-related diseases and death. Lifespan has increased quite dramatically over the last 150-200 years mostly due to the eradication of early-life mortality. What we find, however, is that the healthspan, understood as the chronic diseases-free period, is also on the rise, but not so much. It appears that lifespan is modifiable by interventions, at least in lab animals. It is therefore crucial to understand if the biology behind human healthspan. Is it the same as that of lifespan? What are the molecular pathways and genetic factors controlling the healthspan? At the end, we would like to develop interventions that extend not only lifespan, but also the healthspan. Everyone wants to stay healthy! Yurii Aulchenko, PolyOmica: We studied the incidence of the most prevalent age-related diseases in the large UK Biobank, one of the best repositories of biologically and medically relevant data from a very large cohort of aging individuals. We observed that the incidence (the chances of) all the major diseases increased exponentially with age. The diseases risk doubling time was about eight years, same as the mortality doubling time from the Gompertz mortality law, discovered as early as in 1825 and used in life insurance ever since. The similar patterns of age-dependent risk acceleration suggest a major common driver behind the diseases, that is most plausibly aging itself. Peter Fedichev, Gero: The incidence of the diseases could, therefore, be used as a biomarker of aging process. We used the age at the onset of the first age-related disease (the end of healthspan) as the target for a genome-wide association study (GWAS) and identified as many as 12 genetic loci associated with human healthspan. (more…)
Author Interviews, Genetic Research, JAMA, Race/Ethnic Diversity, Stroke / 11.02.2019

MedicalResearch.com Interview with: Sandro Marini, MD Research Fellow Jonathan Rosand Laboratory Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The epsilon(ε) 4 allele of the Apolipoprotein E (APOE) gene increases risk for Alzheimer’s disease (AD) and intracerebral hemorrhage (ICH). In both diseases, it is believed to increase risk through the deposition of beta-amyloid within the brain and blood vessels, respectively. The effect of APOE ε4 on both AD and ICH risk changes across populations, for unclear reasons. In our study, we confirmed the role of APOE ε4 for ICH risk in whites and found that the risk-increasing effect of the 4 allele is demonstrable in Hispanics only when balancing out the effect of hypertension. (more…)
Author Interviews, Dermatology, JAMA, Kidney Disease, Melanoma, Transplantation / 11.02.2019

MedicalResearch.com Interview with "Kidney Model 9" by GreenFlames09 is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Donal J. Sexton, MD, PhD Department of Nephrology and Kidney Transplantation Beaumont Hospital Royal College of Surgeons in Ireland Dublin, Ireland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients who receive a kidney transplant as treatment for end stage kidney disease are at risk of malignancy due to immunosuppression. In contrast to other solid organ transplant types, when kidney transplants fail it is possible for recipients to return to dialysis. Immunosuppression is usually reduced or completely stopped when  the allograft fails due to the risk of infection on dialysis. We decided to investigate what the trajectory of risk for non-melanoma skin cancer and invasive cancers overall (composite group) looked like for patients who have received multiple consecutive kidney transplants with intervening periods of graft failure. We compared cancer risk during periods of allograft failure and periods of functioning kidney transplants.   (more…)
Author Interviews, Gender Differences, OBGYNE, Psychological Science, Sexual Health / 11.02.2019

MedicalResearch.com Interview with: Dr. Alexander Lischke, Dipl.-Psych. Universität Greifswald Institut für Psychologie Physiologische und Klinische Psychologie/Psychotherapie University of Greifswald, Germany MedicalResearch.com: What is the background for this study? Response: We know for a long time that cyclic variations in womens' estrogen and progesterone levels affect their emotion recognition abilities by modulating neural activity in brain regions implicated in emotion processing. We also know that oral contraceptives suppress cyclic variations in womens' estrogen and progesterone levels. We, thus, assumed that oral contraceptives would affect womens' emotion recognition abilities due to the aforementioned suppression of cylic variations in estrogen and progesterone levels that modulate neural activity in brain regions during emotion processing. To test this assumption, at least with respect to the behavioral effects of oral contraceptive use on emotion recognition, we performed the current study. We recruited regular cylcling women with and without oral contraceptive use for our study. None of the women were in psychotherapeutical or psychopharmacological treatment at the time of the study. During the study, women performed a emotion recognition task that required the recognition of complex emotional expressions like, for example, pride or contempt. (more…)
Author Interviews, Health Care Systems, JAMA, Stroke, University Texas / 11.02.2019

MedicalResearch.com Interview with: Amrou Sarraj, MD, Associate Professor Department of Neurology McGovern Medical School The University of Texas Health Science Center at Houston. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Secondary analyses of trials showing efficacy and safety of thrombectomy within 6-8 hours of stroke onset showed that patients who were transferred to centers performing thrombectomy from another hospital had worse outcomes than patients who presented directly to the thrombectomy centers. We wanted to assess if the thrombectomy outcomes differ between transferred patients and patients directly coming to the thrombectomy centers when patients are selected with advanced perfusion imaging. We found that thrombectomy outcome rates were similar between patients who presented directly vs transferred from another hospital, including functional independence and safety outcomes.  (more…)
Author Interviews, Memory, Sleep Disorders / 11.02.2019

MedicalResearch.com Interview with: Marc Züst, PhD University of Bern Department of Psychology Division of Experimental Psychology and Neuropsychology Switzerland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Slow wave sleep (deep sleep) is known to be very important for memory reorganization. The brain goes through the memory traces that were created during wakefulness and strengthens the important ones, while unimportant ones are weakened or deleted to make room for new learning the next day. This happens during the peaks of the eponymous slow waves, also called up-states, where the brain is highly active and interconnected. Up-states last for about 0.5 sec before transitioning into down-states, where the brain is relatively silent. Based on these findings, we hypothesized that up-states constitute windows of opportunity to learn new information during slow wave sleep: The "channels are open", and the brain is already performing memory functions. The results of our study support this hypothesis. We found that, if we repeatedly managed to synchronize presentation of word pairs with up-states, memory for these pairs was best. Moreover, we find a dose-response function: The more often word pairs hit up-states, the better the memory. On top of that, fMRI during the retrieval test suggests that the same brain regions are involved in sleep learning as are involved in learning during wakefulness. (more…)
Author Interviews, Diabetes, JAMA, Metabolic Syndrome, Stroke / 10.02.2019

MedicalResearch.com Interview with: David Spence M.D., FRCPC, FAHA Professor of Neurology and Clinical Pharmacology Director, Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University London, ON Canada MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The motivation for the study was the chair of the committee that advises the Ontario Drug Benefit which medications to pay for said the IRIS results were not relevant to clinical practice. This because the Insulin Resistance Intervention after Stroke (IRIS) trial reported effects of pioglitazone in patients with stroke or TIA and insulin resistance assessed by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) score for insulin resistance.1 ( However, few clinicians measure a HOMA-iR score, so the clinical impact of that trial was limited. In this study we analyzed the effect of pioglitazone in stroke/TIA patients with prediabetes, which is commonly assessed by clinicians. Prediabetes was defined by the American Diabetes Association: a glycosylated hemoglobin (A1C) of  5.7% to <6.5% (we did not do glucose tolerance tests).  We analyzed primarily the results for patients with 80% adherence, but also did  an intention-to-treat (ITT) analysis.  The reason for focusing on patients with good adherence was that pioglitazone cannot be taken by about 10-20% of patients, because of fluid retention and weight gain (mainly due  to fluid retention).  (The reasoning was that third party payers would not need to pay for the medication in patients who do not take it.) In stroke/TIA patients with good adherence, the benefits of pioglitazone were greater than in the original IRIS trial. We found a 40% reduction of stroke/MI, a 33% reduction of stroke, and an 80% reduction of new-onset diabetes, over 5 years.  Pioglitazone also improved blood pressure, triglycerides and HDL-cholesterol. As expected, pioglitazone was somewhat less beneficial in the ITT analysis. Fluid retention can usually be managed by reducing the dose of pioglitazone; even small doses still have a beneficial effect . Also, amiloride has been shown to reduce fluid retention with pioglitazone.
  1. Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, Guarino PD, Lovejoy AM, Peduzzi PN, Conwit R, Brass LM, Schwartz GG, Adams HP, Jr., Berger L, Carolei A, Clark W, Coull B, Ford GA, Kleindorfer D, O'Leary JR, Parsons MW, Ringleb P, Sen S, Spence JD, Tanne D, Wang D, Winder TR and Investigators IT. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. N Engl J Med. 2016;374:1321-31. 
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Author Interviews, Infections, Vitamin D / 10.02.2019

MedicalResearch.com Interview with: Professor Adrian Martineau, B Med Sci DTM&H MRCP PhD FRSB Clinical Professor of Respiratory Infection and Immunity Queen Mary University of London MedicalResearch.com: What is the background for this study? What are the main findings? Response: The World Health Organisation estimates that 10.0 million people developed active tuberculosis in 2017, and that 1.6 million people died of this disease. Multi-drug resistant (MDR) TB is caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB drugs, causing around 500,000 cases and 150,000 deaths per year worldwide. Existing antibiotic treatments for MDR TB are lengthy, costly and often toxic due to their serious side effects. One novel approach to treating MDR TB is to complement antibiotic treatment by using therapies that boost the immune system’s ability to kill TB bacteria. Vitamin D – the sunshine vitamin – is known to help white blood cells to make natural antibiotic substances (antimicrobial peptides) that can punch holes in the cell membranes of TB bacteria. Several clinical trials have investigated the effects of adding vitamin D to antibiotic treatment for TB. In this study we pooled data from 8 of these studies (1850 participants) and analysed them to see if some TB patients benefited more from adding vitamin D to their treatment regimen than others. We found that vitamin D accelerated clearance of TB bacteria from the lungs of patients who had MDR TB; this benefit was not seen in patients who had ‘standard’ drug-sensitive TB. (more…)
Author Interviews, Cancer Research, Dermatology, Global Health, Melanoma / 08.02.2019

MedicalResearch.com Interview with: Dr. Catherine M. Olsen Associate Professor Cancer Control Group QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? Response: Melanoma incidence and mortality rates are increasing globally. Public health campaigns aiming to reduce sun exposure and use of sunbed have been implemented in many parts of the world, but there is significant variability in terms of the history and reach of these campaigns across countries. We examined melanoma incidence rates in eight different countries with different patterns of sun exposure and varying approaches to melanoma control. (more…)
AHA Journals, Author Interviews, Diabetes, Stroke / 08.02.2019

MedicalResearch.com Interview with: Karen C. Johnston MD Professor and Chair, Neurology School of Medicine University of Virginia MedicalResearch.com: What is the background for this study? Response: We know that acute ischemic stroke patient with hyperglycemia at presentation have worse outcomes. We also know if we lower the glucose too low that this is bad for ischemic brain also. T he SHINE trial addressed a world wide debate about whether intensive treatment of hyperglycemia is beneficial. We assessed the efficacy and safety of an intensive glucose control protocol with a target glucose of 80-130 mg/dL compared to a more standard protocol with a target of less than 180 mg/dL. (more…)
Author Interviews, Pharmacology / 08.02.2019

MedicalResearch.com Interview with: Dr. Su Golder, PhD Department of Health Sciences University of York MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Patients and providers need to know about the relative benefits and harms of an intervention. It is not just those adverse events deemed to be serious that are important but also those categorized as minor. Systematic reviews are summaries of the evidence, often used in to inform guidelines and decision-making. It is common for systematic reviews to focus on the potential benefits of an intervention without addressing the adverse effects. This leads to bias and an incomplete picture of the evidence. To aid transparency in systematic reviews, authors should published a protocol, describing what they intend to do. We look at protocols with a completed systematic review published in 2017 or 2018. We found that only 38% said that they would record adverse effects. Equally worrying of those authors that stated in their protocol that they intended to look at adverse effects – only 65% fully reported the adverse outcome exactly as they set out to do.  (more…)