Author Interviews, Pharmacology, Thyroid Disease, UCLA / 07.04.2017

MedicalResearch.com Interview with: Deborah Chon MD Endocrinology fellow UCLA David Geffen School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study shows that drinking cow's milk concurrently with oral levothyroxine significantly reduces the absorption of the medication. Levothyroxine is used for the physiologic replacement of thyroid hormone in patients with hypothyroidism and for serum TSH suppression in patients with thyroid cancer. It is the mostly commonly prescribed medication in the United States as of 2014. Frequent dose adjustments of levothyroxine have been shown to be a costly burden to the national healthcare system. Previous studies have shown that certain foods and medication, such as calcium supplements, can interfere with levothyroxine absorption. However, this is the first study to demonstrate that ingesting cow?s milk, a common breakfast staple, affects oral levothyroxine absorption. To determine the possible effect of cow's milk ingestion, we measured levothyroxine absorption in humans with and without concurrent milk consumption. Pharmacokinetic studies were conducted in healthy adults without allergies to milk or levothyroxine, and who were not pregnant nor using oral contraceptives. All subjects had no history of known thyroid disease and normal thyroid hormone function at baseline. Following an overnight fast, serum total thyroxine T4 (TT4) concentrations were measured at baseline and at 1, 2, 4, and 6 hours after ingestion of 1,000 ?g of oral levothyroxine alone or when co-administered with 12 oz. of milk (2% fat). There was a four-week washout period between the two study visits. Ten subjects (mean age 33.7?10.2 years, 60% male) completed the study. The serum total T4 absorption over six hours, calculated as area under the curve (AUC), was significantly lower when taking cow?s milk concurrently with levothyroxine compared levothyroxine alone (mean?SD: 67.26?12.13 vs. 73.48?16.96; p = 0.02). Also, peak serum TT4 concentrations were significantly lower in those who ingested levothyroxine concurrently with milk, compared to taking levothyroxine alone (p=0.04). (more…)
Author Interviews, Environmental Risks, Thyroid, Thyroid Disease / 02.04.2017

MedicalResearch.com Interview with: Julie Sosa, MD MA FACS Professor of Surgery and Medicine Chief, Section of Endocrine Surgery Director, Surgical Center for Outcomes Research Leader, Endocrine Neoplasia Diseases Group Duke Cancer Institute and Duke Clinical Research Institute Durham, NC 2771 MedicalResearch.com: What is the background for this study? Response: The incidence of thyroid cancer has dramatically increased world-wide over the last several decades. In the United States, thyroid cancer is the fastest increasing cancer among women and men. This observation has been almost exclusively the result of an epidemic of papillary thyroid cancer, or PTC, which now comprises approximately 90% of new cases. The use of flame retardant chemicals, or Flame Retardant Chemicals, also increased over the last several decades due to the implementation of mandatory and voluntary flammability standards for furniture, electronics, and construction materials. Over time, FRs come out of these products and accumulate in indoor environments where humans are exposed. Animal studies suggest that FRs can disrupt thyroid function, and many contribute to cancer risk. But many human health endpoints have not been investigated. Our work was aimed at investigating whether exposure to Flame Retardant Chemicals could be associated with PTC. To address our research question, we recruited 140 adults, 70 with PTC and 70 who were healthy volunteers without evidence for thyroid cancer or thyroid disease. Then we visited participants’ homes and collected dust samples, a metric that we have previously shown is an indicator of long-term exposure to Flame Retardant Chemicals in the home. (more…)
ASCO, Author Interviews, Boehringer Ingelheim, Journal Clinical Oncology, NYU, Prostate Cancer, Testosterone / 16.03.2017

MedicalResearch.com Interview with: Dr. Stacy Loeb MD Msc Assistant Professor of Urology and Population Health New York University Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association between exposure to testosterone replacement therapy and prostate cancer risk is controversial.  The purpose of our study was to examine this issue using national registries from Sweden, with complete records on prescription medications and prostate cancer diagnoses.  Overall, we found no association between testosterone use and overall prostate cancer risk. There was an early increase in favorable cancers which is likely due to a detection bias, but long-term users actually had a significantly reduced risk of aggressive disease. (more…)
Author Interviews, Endocrinology, Fertility / 15.03.2017

MedicalResearch.com Interview with: Matthias Straub Senior Director, Clinical Development Abbott MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Lotus I study provides clinical evidence that oral dydrogesterone is a treatment option for women who undergo in vitro fertilization (IVF) treatment. The current standard of care for IVF globally is micronized vaginal progesterone (MPV), which is administered vaginally. The Lotus I study concludes that oral dydrogesterone is similarly well-tolerated and efficacious compared to MVP, while being easier to administer than MVP. (more…)
Author Interviews, Endocrinology, Lancet, OBGYNE, Pediatrics, Vitamin D / 07.03.2017

MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, the Netherlands  MedicalResearch.com: What is the background for this study? Response: Fetal bone mineralisation requires an adequate transfer of calcium to the fetus by the end of the pregnancy. Considering that vitamin D is required to maintain normal blood concentrations of calcium, adequate 25-hydroxyvitamin D (25[OH]D) concentrations in pregnant women seem to be crucial for bone development of the offspring. Maternal vitamin D deficiency during pregnancy has been associated with abnormal early skeletal growth in offspring and might be a risk factor for decreased bone mass in later life. Several studies have linked vitamin D deficiency in fetal life to congenital rickets, craniotabes, wide skull sutures and osteomalacia. However, the evidence of long-lasting effects of maternal vitamin D deficiency during pregnancy on offspring’s skeletal development is scarce and inconsistent, and has led to contradictory recommendations on vitamin D supplementation during pregnancy. (more…)
Author Interviews, NEJM, OBGYNE, Thyroid Disease, UT Southwestern / 01.03.2017

MedicalResearch.com Interview with: Professor Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center  MedicalResearch.com: What is the background for this study? Response: For several decades now, subclinical thyroid disease, variously defined, has been associated with adverse pregnancy outcomes.  In 1999, two studies are responsible for increasing interest in subclinical thyroid disease during pregnancy because it was associated with impaired neuropsychological development in the fetus.  One study showed that children born to women with the highest TSH levels had lower IQ levels.  The other showed that children of women with isolated low free thyroid hormone levels performed worse on early psychomotor developmental tests. Together, these findings led several experts and professional organizations to recommend routine screening for and treatment of subclinical thyroid disease during pregnancy. Our study was designed to determine whether screening for either of these two diagnoses and treatment with thyroid hormone replacement during pregnancy actually improved IQ in children at 5 years of age. (more…)
Author Interviews, Endocrinology, Environmental Risks, Pediatrics, Thyroid Disease, Toxin Research / 27.02.2017

MedicalResearch.com Interview with: Jana Weiss PhD Department of Environmental Science and Analytical Chemistry Stockholm University MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an earlier publication, we could see an association between elevated concentrations of brominated flame retardants (BFR) in the blood of cats with developed Feline hyperthyroidism, compared to healthy cats (Norrgran et al 2015, ES&T 49:5107-5014). To establish the exposure pathway we now took paired samples from healthy cats and dust from their households. We also analysed the cats food to include another major exposure pathway. In total 17 families participated. They lived in houses in the countryside or in apartments in the city. All families had kids under 12 years of age living at home, thus representing a household with typical child products. The dust was sampled from the living room, the child’s room and from the adult’s bedrooms. We could not see any difference in the composition of compounds between the rooms, but we saw that levels were in general higher in the living room compared to the other two rooms. This was expected as many products being treated with BFRs can be found in the living room. We could see that higher levels of some  brominated flame retardants in the dust were correlated to elevated levels in the cat’s blood. Therefore, this hypothesized exposure pathways is now statistically established. We could also confirm cat food to be the major exposure pathway for naturally brominated compounds coming from the marine food web, such as6-OH-BDE47, a known thyroid hormone disruptor. (more…)
ASCO, Author Interviews, Cognitive Issues, Endocrinology, Journal Clinical Oncology, Prostate Cancer, Testosterone / 27.02.2017

MedicalResearch.com Interview with: Farzin Khosrow-Khavar, M.Sc. Ph.D. Candidate Department of Epidemiology, Biostatistics and Occupational Health, McGill University Center for Clinical Epidemiology - Jewish General Hospital Montreal, QC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown an association between androgen deprivation therapy (ADT) and risk of dementia and Alzheimer’s disease. However, these studies had methodological limitations that may account for this positive association. Using appropriate study design and methodology, we found no association between androgen deprivation therapy and risk of dementia (including Alzheimer’s disease) in patients with prostate cancer. These results were consistent by cumulative duration of  androgen deprivation therapy use and by ADT modality. (more…)
Author Interviews, JAMA, Orthopedics, Osteoporosis, Testosterone / 23.02.2017

MedicalResearch.com Interview with: Tony M. Keaveny, Ph.D. Professor, Departments of Mechanical Engineering and Bioengineering; Co-Director, Berkeley BioMechanics Laboratory University of California Berkeley, CA 94720-1740 MedicalResearch.com: What is the background for this study? Response: As men age, they experience decreased serum testosterone concentrations, decreased bone mineral density (BMD) and increased risk of fracture. While prior studies have been performed to determine the effect of testosterone treatment on bone in older men, for various reasons those studies have been inconclusive. The goal of this study was to overcome past limitations in study design and determine if testosterone treatment — versus a placebo — in older men with low testosterone would improve the bone. Specifically, we used 3D quantitative CT scanning to measure changes in BMD and engineering “finite element analysis” to measure changes in the estimated bone strength, both at the spine and hip. The study was performed on over 200 older men (> age 65) who had confirmed low levels of serum testosterone. (more…)
Author Interviews, Heart Disease, JAMA, Testosterone, UCLA / 23.02.2017

MedicalResearch.com Interview with: Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health MedicalResearch.com: What is the background for this study? Response: While we have long known that testosterone levels decrease as men age, very little was known about the effects of testosterone treatment in older men with low testosterone until last year. Our team of researchers from LA BioMed and 12 other medical centers in the U.S., in partnership with the National Institute on Aging, conducted a coordinated group of seven trials known as The Testosterone Trials (TTrials). We studied the effects of testosterone treatment for one year as compared to placebo for men 65 and older with low testosterone. The TTrials are now the largest trials to examine the efficacy of testosterone treatment in men 65 and older whose testosterone levels are low due seemingly to age alone. The first published research from the TTrials last year reported on some of the benefits to testosterone treatment. We have now published four additional studies in the Journal of the American Medical Association (JAMA) and JAMA Internal Medicine that found additional benefits and one potential drawback. (more…)
Author Interviews, Heart Disease, JAMA, Testosterone / 21.02.2017

MedicalResearch.com Interview with: T. Craig Cheetham, PharmD, MS Southern California Permanente Medical Group Department of Research & Evaluation Pasadena, CA 91101 MedicalResearch.com: What is the background for this study? Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California. (more…)
Author Interviews, Biomarkers, Endocrinology, NIH / 10.02.2017

MedicalResearch.com Interview with: Mihail Zilbermint, M.D. Endocrinologist, Office of the Scientific Director Mihail Zilbermint, M.D. Endocrinologist, Office of the Scientific Director Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health  MedicalResearch.com: What is the background for this study? Response: Diagnosing Cushing Syndrome is often difficult and challenging.  Diagnosing hypercortisolemia, could require the use of a combination of any of these tests: 24-hour free urine cortisol monitoring, an overnight dexamethasone suppression test, and measurement of late night salivary cortisol.  Cortisol levels may change daily, requiring that testing be repeated.  Undiagnosed and untreated Cushing Syndrome greatly increases morbidity and mortality risk. Cortisol levels can be detected in hair samples.  Much like hemoglobin A1C is a long-term indicator of blood glucose levels, efforts have been made to determine if hair cortisol could serve as a long-term measure of the body’s glucocorticoid levels.  We sought to compare the results of cortisol levels for Cushing Syndrome patients with data from data on cortisol in hair segments, to gain further information on the role of sampling hair cortisol as an initial or supportive method for diagnosing Cushing Syndrome. (more…)
Author Interviews, Endocrinology, JCEM, Pediatrics, Weight Research / 08.02.2017

MedicalResearch.com Interview with: Alfonso Abizaid PhD Department of Neuroscience Carleton University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bisphenol A (BPA) is a compound considered to be a potential environmental hazard and an endocrine disruptor. We have found an association between exposure to BPA at levels that are considered safe by Health Canada and the EPA early in life, and the development of obesity. In addition, we found that this propensity to develop obesity is due to under development of the hypothalamic projection field of POMC neurons, a set of neurons that regulate satiety and stimulate metabolic rate. In this paper we replicate those findings and also show that this abnormal development is due to BPA altering the secretion of the hormone leptin at critical times where this hormone is important for the post-natal development of these POMC neurons. (more…)
Author Interviews, Endocrinology, JAMA, Kidney Disease / 31.01.2017

MedicalResearch.com Interview with: Geoffrey A. Block, MD Director of Research at Denver Nephrology Denver, Colorado MedicalResearch.com: What is the background for this study? Response: Secondary hyperparathyroidism is a chronic and progressive disorder characterized by elevations in parathyroid hormone (PTH). It is seen in most patients with advanced chronic kidney disease and has been associated with a number of important adverse health effects such as bone pain, fracture, premature cardiovascular disease, abnormal heart enlargement, pathologic calcium accumulation in blood vessels and tissues and premature death. Currently there are several classes of drugs used to treat high PTH but each are associated with challenging side effects which limit their effectiveness. Active vitamin D compounds are effective in lowering PTH but do so at the expense of causing elevations in other minerals such as calcium and phosphorus which are felt to be harmful. An oral drug known as cinacalcet (Sensipar®) is in the class of medicine known as ‘calcimimetics’ and reduces PTH and simultaneously reduces calcium and phosphorus however it must be taken daily due to its short half-life and is commonly associated with nausea when first initiated or the dose is increased. Clinical trials with cinacalcet are suggestive though not conclusive of a beneficial effect on improving cardiovascular events and prolonging life. (more…)
Author Interviews, Diabetes, Endocrinology, Heart Disease, Lipids, Pharmacology, Weight Research / 30.01.2017

MedicalResearch.com Interview with: Gianluca Iacobellis MD PhD Professor of Clinical Medicine Division of Endocrinology, Diabetes and Metabolism Department of Medicine University of Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that epicardial fat, the visceral fat of the heart, is associated with coronary artery disease, diabetes and obesity. My studies have shown that epicardial fat can be easily measured with non invasive imaging procedures. Remarkably, epicardial fat has recently emerged as therapeutic target responding to medications targeting the fat. Liraglutide, a GLP-1 analog has shown to provide modest weight loss and beneficial cardiovascular effects beyond its glucose lowering action. So , we sought to evaluate the effects of liraglutide on epicardial fat. (more…)
Author Interviews, Endocrinology, Pediatrics / 27.01.2017

MedicalResearch.com Interview with: Adda Grimberg, MD Associate Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania Scientific Director, Diagnostic and Research Growth Center The Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to update the last guidelines for the use of growth hormone (GH) by the Drug and Therapeutics Committee of the Pediatric Endocrine Society (PES), published in 2003, and was the first to be endorsed also by the Ethics Committee of the PES. To facilitate evidence-based decision making, it was the first such GH guidelines to follow the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) group. Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, growth hormone deficiency (GHD), and primary insulin-like growth factor-I deficiency (PIGFD), this guidelines statement focused on these three diagnoses and added recombinant IGF-I therapy to the GH guidelines for the first time. (more…)
Author Interviews, BMJ, Endocrinology, Mayo Clinic, OBGYNE, Thyroid Disease / 27.01.2017

MedicalResearch.com Interview with: Dr. Spyridoula Maraka Assistant professor of medicine Division of Endocrinology and Metabolism Center for Osteoporosis and Metabolic Bone Diseases University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care System Little Rock Arkansas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Subclinical hypothyroidism, a mild thyroid dysfunction, has been associated in pregnancy with multiple adverse outcomes. Our aim was to estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Using a large national US dataset, we identified 5,405 pregnant women diagnosed with subclinical hypothyroidism. Of these, 843 women, with an average pretreatment TSH concentration of 4.8 milli-international units per liter, were treated with thyroid hormone. The remaining 4,562, with an average pretreatment TSH concentration of 3.3 milli-international units per liter, were not treated. Compared with the untreated group, treated women were 38 percent less likely to experience pregnancy loss. However, they were more likely to experience a preterm delivery, gestational diabetes or preeclampsia. Moreover, the benefit of thyroid hormone treatment on pregnancy loss was seen only among women with higher TSH levels (4.1 to 10 mIU/L) before treatment. We also found that for women with lower levels of TSH (2.5–4.0 mIU/L), the risk of gestational hypertension was significantly higher for treated women than for untreated women. (more…)
Author Interviews, Electronic Records, Endocrinology, Thyroid, Thyroid Disease / 25.01.2017

MedicalResearch.com Interview with: Ilya Likhterov, MD Assistant Professor, Otolaryngology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: As our understanding of thyroid cancer improves, the way these patients are diagnosed and treated is changing. It is difficult for clinicians to incorporate every individual scientific study into their practice. These studies are numerous and the results can be conflicting. To address this difficulty, organizations such as the American Thyroid Association (ATA) create summary recommendations that account for the latest research and translate it into a format that is easily usable for physicians. Such clinical practice guidelines are available not just for thyroid cancer care, but in many other fields. The difficulty however, is how to ensure that clinicians have access to the guidelines and incorporate the recommendations into their practice. There are a number of barriers to actually using the guidelines in practice, and we attempt to identify strategies on how to overcome these. (more…)
Author Interviews, Endocrinology, Gender Differences, JCEM / 13.01.2017

MedicalResearch.com Interview with: Caroline J. Davidge-Pitts, M.B., Ch.B Mayo Clinic Rochester, Minn. MedicalResearch.com: What is the background for this study? Response: The awareness of transgender healthcare issues has increased, leading to improved coverage of both hormonal and non-hormonal therapies. In endocrinology practices, there is an increased demand for providers who are competent in these areas. We wanted to assess the current status of knowledge and practice in transgender health amongst our current and future endocrinologists. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Infections / 18.12.2016

MedicalResearch.com Interview with: Flaminia Catteruccia PhD Associate Professor of Immunology and Infectious Diseases Department of Immunology and Infectious Diseases Boston, Massachusetts 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mosquito control via lethal insecticides is a key method for reduction of malaria transmission. As insecticide resistance is spreading, new intervention methods are urgent. Our study demonstrates that studies on mosquito biology can provide novel, much needed tools for malaria control. We show how key aspects of mosquito physiology and Plasmodium development can be significantly disrupted in the female Anopheles mosquito by agonists of the insect steroid hormone 20-hydroxyecdysone (20E). Modeling of the data predicts that the integration of 20E agonists in malaria control programs would significantly reduce malaria prevalence to a similar extent as insecticides, but without imposing severe costs to mosquito populations (more…)
Author Interviews, BMJ, Clots - Coagulation, Testosterone, Thromboembolism / 03.12.2016

MedicalResearch.com Interview with: Dr. Carlos Martinez Institute for Epidemiology, Statistics and Informatics GmbH Frankfurt, Germany, MedicalResearch.com: What is the background for this study? Response: A 10-fold increase in testosterone prescriptions per capita in the United States and a 40-fold increase in Canada in men has occurred over the first decade of this century, mainly for sexual dysfunction and/or decreased energy. Recognised pathological disorders of the male reproductive system remain the sole unequivocal indication for testosterone treatment but there has been increasing use in men without pathological hypogonadism. A variety of studies and meta-analyses have provided conflicting evidence as to the magnitude of the risk of cardiovascular events including venous thromboembolism in men on testosterone treatment. In June 2014, the US Food and Drug Administration and Health Canada required a warning about the risk of venous thromboembolism to be displayed on all approved testosterone products. Studies have reported contradictory results on an association between testosterone use and the risk of venous thromboembolism. The effect of timing and duration of testosterone use on the risk of venous thromboembolism was not studied and may explain some of these contradictory findings. (more…)
Author Interviews, Endocrinology, Hormone Therapy, JCEM, Menopause, Osteoporosis / 20.11.2016

MedicalResearch.com Interview with: Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne MedicalResearch.com: What is the background for this study? Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal. We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture. (more…)
Author Interviews, Endocrinology, Hormone Therapy, JCEM / 29.10.2016

MedicalResearch.com Interview with: Mario Philip Reyes Festin, MD World Health Organization Geneva, Switzerland.  MedicalResearch.com: What is the background for this study? Response: Researchers are trying to identify a hormonal male contraceptive that is effective, reversible, safe, acceptable, affordable, and available. Most of the research has been done either by groups of university researchers. However, in the 1990s, WHO undertook two multi-center, multinational studies. The studies were unable to provide evidence to support the development of a commercially viable, and user-acceptable product. (more…)
Author Interviews, Endocrinology, Menopause, Osteoporosis / 27.10.2016

MedicalResearch.com Interview with: Pauline Camacho, MD, FACE Professor, Endocrinology Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Fellowship Program Director, Endocrinology, Medical Director, Osteoporosis Center MedicalResearch.com: What is the background for this report? What is the prevalence and significance of osteoporosis in US women? Response: Osteoporosis is widely prevalent and is increasing in prevalence not only in the US but also around the world. 10.2 million Americans have osteoporosis and that an additional 43.4 million have low bone mass. More than 2 million osteoporosis-related fractures occur annually in the US, more than 70% of these occur in women ( from National Osteoporosis Foundation (NOF) estimates). (more…)
Author Interviews, Endocrinology, Fertility, OBGYNE / 21.10.2016

MedicalResearch.com Interview with: Kavita Vedhara FAcSS Professor of Health Psychology Division of Primary Care School of Medicine University Park,Nottingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy. This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s. However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone. In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months. We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant. If you are trying to obtain a perfect cortisol balance, I use this product that helps to do just that. (more…)
Author Interviews, Endocrinology, OBGYNE, Pharmacology / 19.10.2016

MedicalResearch.com Interview with: Hugh S. Taylor, MD Anita O'Keeffe Young Professor of Obstetrics, Gynecology, and Reproductive Sciences and Professor of Molecular, Cellular, and Developmental Biology; Chair of Obstetrics Gynecology, and Reproductive Sciences, Yale School of Medicine Chief of Obstetrics and Gynecology Yale-New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The abstract presented at ASRM featured results from two replicate pivotal Phase 3 clinical trials evaluating the efficacy and safety of Elagolix in premenopausal women who suffer from endometriosis. Elagolix is an investigational, orally administered, gonadotropin-releasing hormone (GnRH) receptor antagonist that blocks endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. Administration results in rapid, reversible, dose-dependent inhibition of luteinizing hormone and follicle-stimulating hormone secretion, leading to reduced ovarian production of the sex hormones, estradiol and progesterone, while on therapy. The data demonstrated dose-dependent superiority in reducing daily menstrual and non-menstrual pelvic pain associated with endometriosis compared to placebo. At month three and month six, patients treated with Elagolix reported statistically significant reductions in scores for menstrual pain (dysmenorrhea) and non-menstrual pelvic pain associated with endometriosis as measured by the Daily Assessment of Endometriosis Pain scale. The safety profile of Elagolix was consistent across both Phase 3 trials and also consistent with prior Elagolix studies. (more…)
Author Interviews, Endocrinology, Lancet, Toxin Research / 18.10.2016

MedicalResearch.com Interview with: Teresa Attina, MD, PhD Research Scientist NYU Langone School of Medicine Department of Pediatrics New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endocrine-disrupting chemicals (EDCs) have been recently documented to contribute substantially to disease and dysfunction in the European Union (EU), with an annual estimated cost of €163 billion, corresponding to 1.28% of EU Gross Domestic Product. Our current study documents even greater annual costs in the US, $340 billion, corresponding to 2.33% of US GDP. These findings speak to the large health and economic benefits to regulating EDCs, which should be weighed against the cost of safer alternatives. The different costs between the EU and the US are due to different exposure levels to EDCs, and policy predicts exposure. US costs are higher mainly because of the widespread use of brominated flame retardants in furniture, whereas Europe restricted its use in 2008. Americans have much higher levels, such that the average American has a serum level of these chemicals that would be in the top 5% of Europeans. As a result, children born to pregnant women have lower IQs, such that more children suffer from intellectual disability. On the other hand, in Americans, levels of certain pesticides in foods are much lower due to the Food Quality Protection Act, which requires additional safety thresholds to protect pregnant women and children from exposure. The costs of pesticide exposures in the US were much lower ($12.6 billion) compared to Europe ($121 billion) because fewer children suffer loss of IQ as a result. (more…)
Alzheimer's - Dementia, Author Interviews, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.10.2016

MedicalResearch.com Interview with: Kevin T. Nead, MD, MPhil Resident, Radiation Oncology Perelman School of Medicine Hospital of the University of Pennsylvania. MedicalResearch.com: What is the background for this study? Response: Androgen deprivation therapy is a primary treatment for prostate cancer and works by lowering testosterone levels. There is a strong body of research suggesting that low testosterone can negatively impact neurovascular health and function. We were therefore interested in whether androgen deprivation therapy is associated with dementia through an adverse impact on underlying neurovascular function. (more…)
Author Interviews, Endocrinology, JCEM, Thyroid Disease / 14.10.2016

MedicalResearch.com Interview with: Antonio C. Bianco, MD, PhD Rush University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard of care for patients with hypothyroidism is treatment with levothyroxine. The dosage of levothyroxine is adjusted for each patient with the goal of normalizing blood levels of TSH. About 15% of the patients treated this way exhibit variable degrees of residual symptoms, despite having a normal TSH level. These symptoms include difficulty losing weight, low energy and depression. However, given the subjective nature of these complains and that the blood levels of TSH are normal, many times such symptoms are dismissed by physicians as non-thyroid related. (more…)
Author Interviews, Endocrinology, JCEM, Kidney Disease, Mineral Metabolism / 03.10.2016

MedicalResearch.com Interview with: Jonas Esche Dipl.-Mol. Biomed University of Bonn Institute of Nutritional and Food Sciences DONALD Study MedicalResearch.com: What is the background for this study? Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization. Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined. (more…)