MedicalResearch.com Interview with:
Jim Dupree, MD, MPH
Assistant Professor
Department of Urology, Division of Andrology
University of MichiganMedical Research: What is the background for this study? What are the main findings?
Dr. Dupree: There are increasing discussions in the United States about testosterone therapy and men with clinical hypogonadism (or low testosterone). Yet, to date, there have not been any nationally-representative studies of the prevalence of low testosterone in the United States. Using a validated national health examination program from the CDC, we found that the national prevalence of low testosterone (serum testosterone ≤ 300 ng/dL) in adult males in the US was 28.9%. Among other factors, men who were older, had a higher body mass index (BMI), or had a larger waist circumference were at risk for having lower testosterone levels.
(more…)
MedicalResearch.com Interview with:
Bianca Jones Marlin, PhD
Froemke Laboratory
New York University Langone School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Marlin: Oxytocin is a hormone that plays an important role in the expression of social and parental behaviors, but little is know about how it works in the brain to produce these behaviors. Virgin mice will usually ignore, and sometimes cannibalize newborn mouse pups. Our study has shown that oxytocin works in the auditory cortex of virgin mice to change both their neural responses, and eventually their behaviors, to mirror the maternal response.
(more…)
MedicalResearch.com Interview with:
Mohamed Kabbaj, PHD
Professor of Biomedical Sciences & Neurosciences
College of Medicine
Florida State University
Medical Research: What is the background for this study? What are the main findings?
Dr. Kabbaj: While anxiety and depressive disorders a major public health concern worldwide, so too are the pervasive sex differences that exist within these pathologies. Fluctuations in the predominant female reproductive hormones, estradiol and progesterone, are thought to be a major contributor to the higher prevalence of anxiety and depression in women compared to men. However, many studies in humans and rodents alike have demonstrated that testosterone, the primary male sex hormone, also influences affective status and may yield protective benefits against the development of mood-related disturbances. Indeed, hypogonadal males with low testosterone levels experience increased rates of anxiety and depressive symptoms. In many of these cases, testosterone replacement alone or in addition to antidepressant medication have been shown to effectively improve mood. How this hormone acts in the brain to exert its beneficial effects, however, is much less clear. Interestingly, it is well-known that many of testosterone’s effects in the brain occur via its conversion to estrogen by the enzyme aromatase. What remained unclear was whether or not this conversion to estrogen was critical for testosterone’s protective anxiolytic and antidepressant effects—so Nicole Carrier and Samantha Saland from Dr. Kabbaj’s lab aimed to figure out just that.
To do this, Carrier and Saland targeted an area of the hippocampus in the brain involved in mood regulation where testosterone is known to act to carry out some of its anxiolytic and antidepressant effects in male rats. Here, they inhibited the enzyme responsible for the conversion of testosterone into estrogen and investigated performance in mood-related behaviors. In doing so, they discovered that testosterone’s anxiolytic- and antidepressant-like effects were lost unless this hormone was first converted into estrogen. Importantly, they also found that continuous testosterone and estrogen treatments had very similar effects on the expression of genes within this brain region that are highly implicated in the regulation of mood as well as antidepressant treatments.
(more…)
MedicalResearch.com Interview with: Nan Hee Kim M.D., Ph.D., Professor
Korea University Ansan Hospital,
Gojan1-dong, Danwon-gu, Gyunggi-do, Korea
MedicalResearch: What is the background for this study? Dr. Nan Hee Kim: Many individuals in modern society experience a discrepancy between social and biological time. Especially during the work or school week, we are often forced to be awake against our preferred time. In addition, the increase of light, TV, computer and internet make people stay up late at night. However, night owls (evening persons) have been reported to have more health and behavioral problems than morning persons. Evening persons experience eating disorders, negative mood and insufficient sleep compared to morning persons. They initiate sleep later in the night but need to wake up earlier than their biologic morning due to social demands. There is abundant evidence that short sleep duration and insomnia are significant risk factors for obesity and diabetes. Therefore, we feel the necessity to reveal whether evening persons are associated with metabolic abnormalities in the general population.
MedicalResearch: What are the main findings?Dr. Nan Hee Kim: In middle-aged adults, people who stayed up late had a 1.7-fold increased risk for type 2 diabetes and metabolic syndrome, and a 3.2-fold increase in risk for sarcopenia as compared with morning persons, independent of sleep duration and lifestyle. Evening persons were associated with reduced muscle mass in men and increased fat mass including visceral fat in women.
(more…)
MedicalResearch.com Interview with:
Elizabeth A. Lawson, M.D., M.M.Sc.
Assistant Professor of Medicine
Harvard Medical School
Director, Interdisciplinary Oxytocin Research Program
Neuroendocrine Unit Massachusetts General Hospital
Boston, MA 02114
Medical Research: What is the background for this study? What are the main findings?
Response: Oxytocin is a hormone produced in the brain that has been shown to reduce food intake in animal studies. The role of oxytocin on appetite and food consumption in humans is not well understood. We therefore performed a randomized, placebo controlled cross-over study of single dose administration of intranasal oxytocin (Syntocinon, Novartis) in healthy men. Subjects presented fasting in the early morning and were randomized to receive 24 IU intranasal oxytocin or placebo. They selected breakfast from a menu and were offered double portions. The caloric content of the food they ate was calculated. They returned for a second visit, which was the same except for this time, they received the other treatment (placebo or oxytocin). There was no difference in how much food the men reported eating in the three days leading up to each of the study visits. On average, the men ate 122 fewer calories and about 9 grams less fat after receiving oxytocin compared to placebo. There was also evidence that oxytocin resulted in greater use of fat as a fuel for the body, and improved insulin sensitivity.
(more…)
MedicalResearch.com Interview with:
Dr. Roy Kim, MD
Depts. Endocrinology and Pediatrics
UT Southwestern Medical Center
Medical Research: What was the problem you were focused on?Dr. Kim: We were focused on the problem of adolescent metabolic syndrome, a major public health problem. Our objective was to determine whether nut intake is linked with any difference in odds for metabolic syndrome in US adolescents.
Medical Research: How is metabolic syndrome defined?Dr. Kim: In general it is diagnosed when there are 3 or more of the following things: increased belly fat, high blood pressure, high fasting glucose, elevated triglycerides, and low HDL cholesterol.
Medical Research: How did you do your study?Dr. Kim: We used data from the National Health and Nutrition Examination Survey (NHANES), years 2003-2010, to examine health status and the diet history for 2,322 US adolescents age 12 to 19 years.
Dr. Kim: Our first major finding was that adolescents who ate at least 12.9 grams of nuts per day - this is the equivalent of about 1 ounce of nuts 3 times per week – had a dramatically lower odds for metabolic syndrome compared to adolescents who ate less than that amount. The odds for nut-consumers was only about 43% of the odds for non-consumers. This remained true after controlling for age, gender, race, income, and dietary factors including sugar, fruit, and vegetable intake.
Our second major finding was that average nut intake is very low among US adolescents – only about 5 grams per day - and more than 75% of US adolescents eat no nuts at all on a typical day.
(more…)
MedicalResearch.com Interview with;
Sebastiano Filetti MD
Dipartimento di Medicina Interna
Università di Roma Roma
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Filetti: Thyroid nodule diagnosis is becoming more and more frequent in clinical practice. This trend stems largely from the incidental discovery of small nodules due to the increased use of diagnostic imaging for purposes unrelated to the thyroid. Ultrasound studies, for example, are widely used for evaluating other structures in the neck, such as the carotid arteries, parathyroid glands, lymph nodes, and salivary glands. Over 90% of detected thyroid nodules are clinically insignificant, in that they have been cytologically proven to be benign or they have no ultrasound features that raise the suspicion of malignancy. However, consensus is lacking regarding the best way to follow these nodules, mainly because little is known about the actual frequency and magnitude of their growth. The results of our study suggest that most benign nodules exhibit no significant size changes over time, and some actually decrease in size. Only a small subgroup of nodules can be expected to grow, about 15% in our series. However, the growth is slow and limited in magnitude. Most important, the occurrence of cancer is very rare in nodules like this, that appear to be benign.
(more…)
MedicalResearch.com Interview with:
Dave Kennaway, PhD Professor
Lloyd Cox Senior Research Fellow,
Head Circadian Physiology Laboratory
School of Paediatrics and Reproductive Health
Robinson Research Institute,
Faculty of Health Sciences, Medical School,
University of Adelaide Australia
MedicalResearch: What is the background for this review? What are the main findings?Dr. Kennaway: There is evidence that melatonin is being prescribed to for sleep disorders in children and adolescents who are developing normally despite the fact that there have been no properly designed studies on the effects of prolonged administration to children. In countries where melatonin has been registered, it is for use as a monotherapy for the short term treatment of primary insomnia, characterised by poor quality of sleep in patients who are aged 55 years and over. Use in Paediatrics is always “off-label”. After more than 50 years of melatonin research in animals there is overwhelming evidence that melatonin administration affects many organ systems. These include important effects on the reproductive organs of rodents, cats, ruminants and primates and melatonin is in fact registered as a veterinary drug for this purpose. The effects of melatonin, however, go beyond the potential reproductive consequences, including effects on cardiovascular, immune and metabolic systems. It is clear that many paediatricians, practitioners and parents are unaware of this.
MedicalResearch: What should clinicians and patients take away from your report?Dr. Kennaway: Clinicians and patients need to recognise that melatonin is a hormone and not a drug developed for a specific purpose or illness. There have been no appropriate trials in children addressing the effects of prolonged administration of melatonin in children. Given the extensive literature on the role of the hormone in normal physiology it is unlikely that such trials would ever be approved. Should endocrine or other abnormalities appear in the future in children previously treated with melatonin it will not be tenable to argue that we were surprised.
(more…)
MedicalResearch.com Interview with:
Professor Stephen Peckham
Director, Centre for Health Services Studies
Professor of Health Policy
Department of Health Services Research and Policy
London School of Hygiene and Tropical Medicine
Director, Policy Research Unit in Commissioning and the Healthcare System University of Kent
Medical Research: What is the background for this study? What are the main findings?
Response: Community water fluoridation remains a controversial public health measure. There have been continued debates about both its effectiveness in the prevention of dental caries and also its safety. Previous studies have suggested that there is an association between fluoride ingestion and the incidence of hypothyroidism few population level studies have been undertaken. In April 2014 Public Health England published a monitoring report that used secondary analysis of routine health statistics to identify whether water fluoridation in England was associated with any adverse health outcomes. While hypothyroidism data is available this was not included in their monitoring report. In England approximately 10% of the population lives in areas with community fluoridation schemes and hypothyroidism prevalence can be assessed from general practice data. Tt examine whether there is a relationship – as suggested in smaller studies – we used a cross-sectional study design using secondary data to develop binary logistic regression models of predictive factors for hypothyroidism prevalence at practice level using 2012 data on fluoride levels in drinking water, 2012/13 Quality Outcomes Framework (QOF) diagnosed hypothyroidism prevalence data, 2013 General Practitioner (GP) registered patient numbers, and 2012 practice level Index of Multiple Deprivation scores. We found a positive association between fluoride levels and hypothyroidism. High hypothyroidism prevalence was found to be at least 30% more likely in practices located in areas with fluoride levels in excess of 0.3mg/L. This population study supports earlier hypotheses that fluoride is associated with hypothyroidism. In the UK water is fluoridated at 1ppm (1mg/L) and in areas where water is fluoridated the model predicts that after controlling for other factors, practice populations are significantly more likely to have higher levels of hypothyroidism than those in non-fluoridated areas. Higher levels of fluoride in drinking water, therefore, provide a useful contribution for predicting prevalence of hypothyroidism. For example in contrasting two urban areas we found that practices located in the West Midlands (a wholly fluoridated area) are nearly twice as likely to report high hypothyroidism prevalence in comparison to Greater Manchester (non-fluoridated area).
(more…)
MedicalResearch.com Interview with:
Almudena Zapatero MD PhD
Senior Consultant Dpt Radiation Oncology
Instituto Investigación Sanitaria IIS-IP
Hospital Universitario de la Princesa
Madrid
Medical Research: What is the background for this study? What are the main findings?
Dr. Zapatero: There is a significant body of evidence from randomized trials showing a significant improvement in clinical outcome with the combination of androgen deprivation and conventional-dose radiotherapy (≤70 Gy) in patients with high-risk and intermediate-risk prostate cancer. However, the optimal duration the optimum duration of androgen deprivation in the setting of high-dose radiotherapy remained to be determined.
The results of our trial (DART01/05) show that 2 years of adjuvant androgen deprivation is superior to 4 months androgen deprivation when combined with plus high-dose radiotherapy in terms of biochemical control, freedom from metastasis and overall survival, particularly in patients with high-risk prostate cancer.
(more…)
MedicalResearch.com Interview with:
Joshua D. Safer MD, FACP
Director, Endocrinology Fellowship Training and Endocrinology Education
Boston University Medical Center
Associate Professor of Medicine and Molecular Medicine
Boston University School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Safer: This is a review of the current medical literature in favor of the biologic nature of gender identity. The main barrier to medical care for transgender patients is lack of physicians with the knowledge and willingness to provide that care. A major concern of physicians is that this is a mental health issue, meaning that transgender hormone therapy and surgery may be too drastic a response to an individual who should be counseled instead. The review lays out the evidence to make it clear that a major component of gender identity is biologic even if we don’t have the exact details worked out. Therefore, counseling alone cannot address the disconnect between transgender individuals’ gender identity and their physical bodies.
(more…)
MedicalResearch.com Interview with:
John Tower, PhD
Professor, Molecular and Computational Biology Program
Department of Biological Sciences
USC Dana and David Dornsife College of Letters,...
MedicalResearch.com Interview with:
Dr. Andrea Gore PhDGustavus & Louise Pfeiffer Professor
University of Texas Austin/Div of Pharmacology/Toxicology
MedicalResearch.com Editor’s Note: Dr. Gore, Editor-in-Chief of the Journal Endocrinology, has graciously answered several questions regarding the recent concerns of environmental chemicals linked to both early puberty and early menopause.
Medical Research: How can chemicals found inside the home impact onset of menopause?Dr. Gore: It is important to clarify that the cause-and-effect relationship between chemicals and menopause is not established. The timing of menopause in women is due to a variety of factors including genetic traits, nutritional status, and general health or chronic disease. Some research on humans, including the recent study by Grindler et al., also suggests that environmental chemicals may contribute to the timing of earlier menopause. Animal models also suggest an advance in the timing of reproductive failure following earlier life exposures to endocrine-disrupting chemicals (EDCs). [See references below]. The question of exactly how chemicals may change the timing of menopause is therefore unresolved, but based on animal studies it is likely that the mechanisms include effects of endocrine-disrupting chemicals on the expression of genes and proteins involved in ovarian function that may lead to premature loss of follicles (eggs). Because the control of reproduction involves the brain and the pituitary gland, as well as the ovary, it is possible that endocrine-disrupting chemicals also impair how these organs regulate reproductive hormones.
Gore AC, Walker DM, Zama AM, Armenti AE, Uzumcu M. Early
life exposure to endocrine-disrupting chemicals causes lifelong molecular
reprogramming of the hypothalamus and premature reproductive
aging. Mol Endocrinol. 2011;25:2157–2168.
Shi Z, Valdez KE, Ting AY, Franczak A,GumSL, Petroff BK. Ovarian
endocrine disruption underlies premature reproductive senescence
following environmentally relevant chronic exposure to the
aryl hydrocarbon receptor agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin.
Biol Reprod. 2007;76:198–202.
Akkina J, Reif J, Keefe T, Bachand A. Age at natural menopause and
exposure to organochlorine pesticides in Hispanic women. J Toxicol
Environ Health A. 2004;67:1407–1422.
Cooper GS, Savitz DA, Millikan R, Chiu Kit T. Organochlorine
exposure and age at natural menopause. Epidemiology. 2002;13:
729–733.
Hatch EE, Troisi R, Wise LA, et al. Age at natural menopause in
women exposed to diethylstilbestrol in utero. Am J Epidemiol.
2006;164:682–688.
KnoxSS, Jackson T, Javins B, Frisbee SJ, Shankar A, DucatmanAM.
Implications of early menopause in women exposed to perfluorocarbons.
J Clin Endocrinol Metab. 2011;96:1747–1753.
Farr SL, Cai J, Savitz DA, Sandler DP, Hoppin JA, Cooper GS.
Pesticide exposure and timing of menopause: the Agricultural
Health Study. Am J Epidemiol. 2006;163:731–742.
Medical Research: What are the primary sources of exposure to these chemicals?Dr. Gore: Endocrine-disrupting chemicals exposures come from a variety of sources, including plastic containers (e.g. water bottles) and other products, certain foods, personal care products, pesticides, and many others.
(more…)
MedicalResearch.com Interview with:
Roger Hart MD FRANZCOG MRCOG CREI
Winthrop Professor of Reproductive MedicineSchool of Women's and Infants Health
Director of Fertility Specialists of Western Australia
The University of Western Australia Perth Western Australia 6008
Medical Research: What is the background for this study? What are the main findings?Dr. Hart: PCOS is a very common condition affecting approximately 1 in 12 women and has an estimated annual impact upon the health system in the USA of up to $4.36 billion per year. PCOS is a condition that often manifests itself early in girls life with menstrual problems in adolescence and may lead to reduced fertility in later life due to problems with ovulation. Previous studies have suggested that women with this condition may have other problems in later life, however they have generally been small studies over a short duration. We studied women from 15 years of age, who were admitted to a hospital in Western Australia where a diagnosis of PCOS was recorded on admission. We compared them to women who did not have a PCOS diagnosis recorded on admission using our state-wide hospital database system data linkage.
The medical records of 2,566 women with a PCOS diagnosis were followed from 1980 onwards until an average of almost 36 years, and these women were matched to 25,660 women without PCOS.
Women with PCOS on average had twice as many hospital admissions and unfortunately were twice as likely to die during the study period.
As expected women with PCOS women had a higher rate of menstrual problems and infertility, and require IVF treatment, have a miscarriage or an ectopic pregnancy, and ultimately require surgical intervention for heavy periods and a hysterectomy.
In pregnancy women with PCOS were more likely to deliver preterm or have a stillbirth.
In addition women with PCOS were four times more likely to develop late onset diabetes, even after taking into consideration obesity. These women wore more likely to have problems with blood pressure and ischemic heart disease, despite being relatively young. They were more likely to develop a deep vein thrombosis and have a diagnosis of asthma.
With regard to mental health women with PCOS were twice as likely to have a diagnosis of stress and anxiety and depression. They were more likely to be a victim of self-harm and be involved with a land transport accidents.
With regard to cancer; cervical cancer was diagnosed less frequently in women with PCOS, but they had an increased risk of cancer of the womb. The incidence of breast and skin cancers was no different between the groups.
(more…)
MedicalResearch.com Interview with:
Abraham Morgentaler, MD
Director and Founder
Men’s Health Boston
Medical Research: What is the background for this study? What are the main findings?
Response: There has been tremendous media attention over the last 15 months to two retrospective studies that reported increased cardiovascular risks with testosterone. Those reports anchored a variety of stories critical of testosterone therapy for non-scientific reasons, such as alleged dangers of direct-to-consumer advertising. In this review we investigated the two recent studies in depth, as well as the broader literature regarding testosterone and cardiovascular issues. One primary finding was that the studies alleging risk were remarkably weak and flawed- one reported low rates of MI and had no control group, and the other had such large data errors (nearly 10% of the all-male population turned out to be female!) that 29 medical societies have called for its retraction. In contrast, there is substantial literature suggesting that testosterone therapy, or naturally occurring higher levels of testosterone, is protective against atherosclerosis, and mortality. Several small randomized controlled trials in men with known heart disease- angina and congestive heart failure- have even shown benefits for men that received testosterone compared with placebo.
(more…)
MedicalResearch.com Interview with:
Vasantha Padmanabhan, MS, PhD
Professor, Departments of Pediatrics, Obstetrics and Gynecology, Molecular and Integrative Physiology, and Environmental Health Sciences
University of Michigan Ann Arbor, Mi 48109
Medical Research: What is the background for this study? What are the main findings?
Response: Controversy exists regarding the human health effects of bisphenol A (BPA), an endocrine-disrupting industrial chemical, present in plastic products, baby bottles, food can liners, and wide array of paper products including cash receipts. BPA has been linked to adverse metabolic effects, including obesity, diabetes and cardiac disease. This study examined if exposure to bisphenol A during pregnancy, at levels humans are exposed to, induces oxidative stress, a major contributor to the development of insulin resistance, type 2 diabetes, metabolic syndrome, and cardiovascular disease. Findings from this multi species study show an association between higher maternal- and cord-blood BPA levels and 3-nitrotyrosine Y (NY), a marker of oxidative stress, in 24 pregnant women. Similar effect on oxidative stress was also found when human-comparable BPA doses were given to pregnant sheep and rats. Similarity of findings between BPA exposure and oxidative stress in the human association study and animals testing study raises concern about potential risk of BPA later in life.
(more…)
MedicalResearch.com interview with:
Caroline M. Apovian, MD
Chair of the Endocrine Society task force that developed “Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline” Boston University School of Medicine
Boston Medical Center
MedicalResearch: What is the background for this report?Dr. Apovian: The Food and Drug Administration has approved four new anti-obesity drugs – lorcaserin, phentermine/topiramate, naltrexone/bupropion and liraglutide – in the past two years. To help clinicians navigate this changing landscape, the Endocrine Society developed its Clinical Practice Guideline to provide strategies for prescribing drugs to manage obesity and promote weight loss.
MedicalResearch: What are the main findings?Dr. Apovian: In the Clinical Practice Guideline, the Endocrine Society recommends that diet, exercise and behavioral modifications be part of all obesity management approaches. Other tools such as weight loss medications and bariatric surgery can be combined with behavioral changes to reduce food intake and increase physical activity, in appropriate patients. Patients who have been unable to successfully lose weight and maintain a goal weight may be candidates for prescription medication if they meet the criteria on the drug’s label as well as BMI criteria (BMI greater than or equal to 30 or greater than or equal to 27 with at least one comorbidity).
Other recommendations from the CPG include:
If a patient responds well to a weight loss medication and loses 5 percent or more of their body weight after three months, the medication can be continued. If the medication is ineffective or the patient experiences side effects, the prescription should be stopped and an alternative medication or approach considered.
Since some diabetes medications are associated with weight gain, people with diabetes who are obese or overweight should be given medications that promote weight loss or have no effect on weight as first- and second-line treatments. Doctors should discuss medications’ potential effects on weight with patients.
Certain types of medication – angiotensin converting enzyme inhibitors, angiotensin receptor blockers and calcium channel blockers – should be used as a first-line treatment for high blood pressure in obese people. These are effective blood pressure treatments that are less likely to contribute to weight gain than an alternative medication, beta-adrenergic blockers.
When patients need medications that can have an impact on weight such as antidepressants, antipsychotic drugs and medications for treating epilepsy, they should be fully informed and provided with estimates of each option’s anticipated effect on weight. Doctors and patients should engage in a shared-decision making process to evaluate the options.
In patients with uncontrolled high blood pressure or a history of heart disease, the medications phentermine and diethylpropion should not be used.
MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine
UCLA Medicine/GIM
Los Angeles, California 90024
Medical Research: What is the background for this study? What are the main findings?
Dr. Crandall: In a large group of postmenopausal women aged 50-79, we found that women who reporting having hot flashes at baseline had increased risk of hip fracture during the subsequent 8 years of observation, nearly double the risk compared with women who did not have hot flashes at baseline.(more…)
MedicalResearch.com Interview with: Shabbir M. H. Alibhai, MD, MSc and Husayn Gulamhusein, BHSc
Department of Medicine, University Health Network
Toronto, Ontario, Canada
Medical Research: What is the background for this study? What are the main findings?MedicalResearch: In 2009, we published a research letter in JAMA which examined the rate of bone mineral density (BMD) testing in men starting androgen deprivation therapy (ADT) in the province of Ontario, Canada, between 1995 and 2008. Despite being recommended as a tool to better characterize fracture risk and optimize bone health, use of bone mineral density testing was low throughout the study period. This current study focuses on another aspect of bone health, which is the use of bisphosphonates among men undergoing androgen deprivation therapy for prostate cancer. Bisphosphonates are generally safe and effective medications that can reduce fracture risk particularly in those at higher risk of future fracture. Throughout the 17-year study period, we found that rates of new prescriptions for bisphosphonates remained low. Even when focusing on those men who should be receiving bisphosphonates as per Canadian guidelines due to their high risk for future fracture, i.e. those with a prior fragility fracture or prior diagnosis of osteoporosis, prescription rates remained low. Moreover, in all three groups, new bisphosphonate prescriptions dipped between the 2007-09 and 2010-12 time periods. This may be partly due to recent negative media attention regarding the association of bisphosphonates with rare but serious side effects (i.e. osteonecrosis of the jaw and atypical femoral fracture).
(more…)
MedicalResearch.com Interview with:
Prof. h.c.* Dr. Farid Saad
on behalf of Dr. Haider and co-authors
Global Medical Affairs, Andrology
c/o Bayer Pharma AG, D-13342 Berlin
*Gulf Medical University, Ajman, UAE
Medical Research: What is the background for this study?Response: In early 1940s Dr. Charles Huggins demonstrated that in few men with metastatic prostate cancer, castration reduced tumor growth and androgen administration promoted tumor growth. This observation became the corner stone of androgen deprivation therapy (ADT) in men with prostate cancer for the past 7 decades without any clinical evidence to the contrary.
Indeed, normal prostate growth depends on androgens and therefore testosterone and its metabolite DHT are responsible for the biochemical signaling in the prostate cells through interaction with the androgen receptor. Since tumor cells have been transformed from normal epithelial cells, it is no surprise that they retained the expression of the androgen receptor and continue to depend on their growth on the androgen signal. For the past 7 decades, physicians thought that testosterone is a carcinogen for the prostate, despite lack of any biochemical or clinical data. This long period of training physicians on this unproven concept, has precipitated in the minds of many clinicians that testosterone (T) causes prostate cancer. Based on a plethora of clinical data, there is no evidence to support such myth. In fact, many recent studies have debunked this hypothesis based on longitudinal and prospective studies.
A newly advanced hypothesis was formulated suggesting that “T therapy does not pose a greater risk for development of PCa.” However this hypothesis is met with considerable skepticism. Interestingly, however, no new compelling evidence is available to discredit or dismiss this newly advanced hypothesis.
(more…)
MedicalResearch.com Interview with:with
Stuart M. Sprague, DO, FACP, FASN, FNKF
Chairperson, Division of Nephrology and Hypertension
NorthShore University HealthSystem
Evanston, Illinois 60201
Medical Research: Congratulations, Dr. Sprague, on your presentation of another successful phase 3 clinical trial program at the recently concluded Annual Meeting of the American Society of Nephrology. Your presentation unveiled a new vitamin D repletion therapy that effectively controls secondary hyperparathyroidism in chronic kidney disease. Can you give us a little background for the presented studies?
Dr. Sprague: Thanks! Vitamin D insufficiency is a big problem in chronic kidney decease (or CKD): it afflicts more than 20 million adults in the United States who have stages 1 through 4 CKD. Its prevalence increases with CKD severity and it drives secondary hyperparathyroidism. The studies which I presented evaluated a novel therapy to treat secondary hyperparathyroidism (SHPT) arising from vitamin D insufficiency in patients diagnosed with stage 3 or 4 CKD. This new therapy is a modified-release formulation of calcifediol.
Medical Research: Can you tell us more about vitamin D insufficiency? Dr. Sprague: Vitamin D insufficiency is a condition in which the body has low vitamin D stores. It is characterized by inadequate blood levels of the vitamin D, known as 25-hydroxyvitamin D. An estimated 70-90% of CKD patients have vitamin D insufficiency, which can lead to SHPT and resultant debilitating bone diseases. Vitamin D insufficiency has also been associated with increased mortality in CKD.
(more…)
MedicalResearch.com Interview with:
Dr. Jenny Hoang MBBS (Hons)
Associate Professor of Radiology and Radiation Oncology
Duke University Medical Center
Medical Research: What is the background for this study? What are the main findings?Dr. Hoang: The incidental thyroid nodule (ITN) is a very common finding on imaging studies of the neck, chest and cervical spine. The workup of incidental thyroid nodules has led to increased costs from additional procedures and in some cases to increased risk to the patient. Physicians are concerned about the risk of malignancy and a delayed cancer diagnosis, but the majority of incidental thyroid nodules are benign and small incidental thyroid malignancies typically have indolent behavior.
The American College of Radiology (ACR) formed the Incidental Thyroid Findings Committee to derive a practical approach to managing ITNs on CT, MRI, nuclear medicine, and ultrasound studies. This white paper describes consensus recommendations representing the Committee’s review of the literature and their practice experience. (more…)
MedicalResearch.com Interview with:David R. Ziehr B.S., MD Candidate
Harvard Medical School
Medical Research: What is the background for this study? What are the main findings?Response: Androgen deprivation therapy (ADT), commonly achieved with gonadotropin-releasing hormone agonists or antagonists, is a mainstay of prostate cancer therapy. While randomized controlled trials demonstrate that ADT improves survival among men with unfavorable risk prostate cancer, retrospective studies have suggested that some men with comorbid illnesses such as heart disease may not derive a benefit from—or may even be harmed by—ADT. However, the nature of this harm has not been characterized. We studied over 5000 men with prostate cancer who were treated with brachytherapy (implanted radioactive seeds) with or without ADT. We analyzed the men based on pre-treatment cardiac comorbidity and examined the association between ADT and death from cardiac causes. We found that among men with congestive heart failure or a past myocardial infarction (MI), Androgen deprivation therapy was associated with a three-times greater risk of death from heart disease. However, Androgen deprivation therapy was not associated with greater risk of cardiac mortality in men without heart disease or with a risk factor for heart disease, such as diabetes, hypertension or hyperlipidemia.
(more…)
MedicalResearch.com Interview with: Maarten C. Bosland, DVSc, PhD
Professor of Pathology
Department of Pathology, College of Medicine
University of Illinois at Chicago
Chicago, IL 60612
Medical Research: What are the main findings of the study?Dr. Bosland:The two main findings are :
(1) that long-term, low-dose testosterone treatment induces prostate cancer in rats (none occurred in control rats) and increases the number of rats with malignant tumors at any site in the body compared to control rats, and
(2) that in rats treated long-term with testosterone after a single prostate-targeted chemical carcinogen treatment a high incidence of prostate cancer is induced, even at a very low testosterone dose. (more…)
MedicalResearch.com Interview with:
Jean-Pascal Fournier, MD, PhD
Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and
Laurent Azoulay, PhD
Centre for Clinical Epidemiology,
Lady Davis Institute, Jewish General Hospital, Montreal,
Department of Oncology, McGill University, Montreal, Quebec, Canada
Medical Research: What are the main findings of the study?Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36).
(more…)
MedicalResearch.com Interview with:Grace Lu-Yao PhD, MPH
Professor of Medicine
Robert Wood Johnson Medical School
Rutgers, The State University of New Jersey
Rutgers Cancer Institute of New Jersey
New Brunswick, NJ 08903-2681
Medical Research: What are the main findings of the study?Dr. Lu-Yao:Primary ADT (ie., use of androgen deprivation as an alternative to surgery, radiation or conservative management for the initial management of prostate cancer) is not associated with improved overall or disease specific survival.
(more…)
MedicalResearch.com Interview with: Robert A. Vigersky, MD
Walter Reed National Military Medical Center
Bethesda, MD
Medical Research: What type of patients do endocrinologists typically treat and why is the demand for their services anticipated to grow?Dr. Vigersky: Endocrinologists are physicians trained in managing, diagnosing, and treating disorders of the endocrine system: thyroid, parathyroid, adrenal glands, hypophyseal and hypothalamic axes, ovaries, testes, and pancreas. Their role involves controlling diabetes mellitus, menopause, hyperthyroidism and other conditions involving metabolism.
A major factor affecting the anticipated demand for health care services is the aging population. In 2010, there were 37.5 million people age 65 or over, constituting about 12.7 percent of the total population, and by 2025 the population age 65 or over will number 62.5 million (17.9 percent of the population). Due to the greater prevalence of many of the diseases in older age groups, like osteoporosis, diabetes, obesity, and thyroid nodules, the growth in the population age 65 or over will exert a major influence on the demand for endocrine services.
Diabetes, by itself, is a major driver of demand. The incidence of Type 2 diabetes rises dramatically with age, and with obesity. In an increasingly overweight population an estimated 22.3 million people in the U.S. are diagnosed with diabetes as of 2012, representing about 7 percent of the population. This estimate is higher than but consistent with those published by the CDC for 2010. The percentage of the population with diagnosed diabetes continues to rise, with one study projecting that as many as one in three U.S. adults could have diabetes by 2050 if current trends continue.
(more…)
MedicalResearch.com Interview with: Jacques Baillargeon, PhD
Director, Epidemiology Division
Associate Professor
Department of Preventive Medicine and Community Health
University of Texas Medical Branch
MedicalResearch: What are the main findings of the study?Dr. Baillargeon: The main findings of the study were that older men who were treated with testosterone did not appear to have an increased risk of Myocardial Infarction. For men with high MI risk, testosterone use appeared to be modestly protective against MI.
(more…)
MedicalResearch.com Interview with:Mojca Jensterle
Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia.
MedicalResearch: What are the main findings of the study?Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass.
31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity.
At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women.
The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold.
(more…)
MedicalResearch.com Interview with: Dr Anju Joham
PhD student, SPHPM
Endocrinologist, Monash Health
MedicalResearch: What is the background for your study?Dr. Joham: This research led by Professor Helena Teede and Dr Anju Joham, from the School of Public Health and Preventive Medicine at Monash University analysed a large-scale epidemiological study, called the Australian Longitudinal Study of Women’s Health (ALSWH).
Polycystic Ovary Syndrome (PCOS) is a condition affecting nearly 20% of Australian women. Women with PCOS may experience irregular menstrual cycles, reduced fertility, increased risk of diabetes, high cholesterol and psychological features such as depression and reduced quality of life.
MedicalResearch: What are the main findings of the study?Dr. Joham: Approximately 6000 women aged between 25-30 years were monitored for nine years, including nearly 500 women with diagnosed PCOS. Our research found that there is a clear link between PCOS and type 2 diabetes. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. In analysing the key contributing factors to the increased diabetes risk, we found that having PCOS was in itself a key contributing factor.
(more…)
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptRejectRead More
Privacy & Cookies Policy
Privacy Overview
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.