Don’t Swallow Pool Water! Diarrhea-Causing Crypto Lurks in Summer Swimming Pools

MedicalResearch.com Interview with:

Radhika Gharpure MPH DVM Epidemic Intelligence Service Officer CDC

Dr. Gharpure

Radhika Gharpure MPH DVM
Epidemic Intelligence Service Officer
CDC

MedicalResearch.com: What is the background for this report? Would you tell us about cryptosporidiosis infections?  Where is is found? How is it transmitted?

Response: The data from our most recent report looked at outbreaks caused by Cryptosporidium (Crypto) in the United States during 2009 – 2017. Outbreaks have increased an average of 13% each year. Crypto, a parasite, is spread through the poop of infected humans or animals. People can get sick after they swallow the parasite in contaminated water or food or after contact with infected people or animals.

Crypto is the leading cause of disease outbreaks in the United States linked to water, specifically outbreaks linked to pools or water playgrounds.

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Decorative Alcohol Bottles May Contain Toxic Levels of Lead and Cadmium

MedicalResearch.com Interview with:
alcohol, bottles, Dr Andrew Turner, PhD

Associate Professor (Reader) in Environmental Sciences
School of Geography, Earth and Environmental Sciences

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: This study was part of a wider study to look at potentially toxic metals in everyday household and consumer products.

The main findings here are that many enameled bottles, mainly used to store alcoholic beverages, contain very high levels of cadmium and lead in the décor.   Continue reading

World Trade Center 9/11 Dust: Altered Gene Expression Links Exposure to Prostate Cancer Risk

MedicalResearch.com Interview with:

Emanuela Taioli, MD, PhD, Director of the Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai Asociate director for Population Science Tisch Cancer Institute

Dr. Taioli

Emanuela Taioli, MD, PhD,
Director of the Institute for Translational Epidemiology
Icahn School of Medicine at Mount Sinai
Asociate director for Population Science
Tisch Cancer Institute 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: An excess incidence of prostate cancer has been identified among World Trade Center responders. We wanted to study if this excess was associated with exposure to WTC dust
The results suggest that respiratory exposure to WTC dust can induce inflammatory and immune responses in prostate tissue. Chronic inflammation could facilitate prostate cancer development

Taken together, our results suggest that World Trade Center prostate cancer cases have a distinct gene expression pattern that may be the result of exposure to specific carcinogens during the WTC attacks. WTC dust-exposed rat prostate displayed unique changes in gene expression and immune cell infiltrates after acute dust exposure, suggesting that the effect of exposure may be measured locally in target organs such as prostate. In addition, some of the genes overexpressed in rat normal prostates as a consequence of exposure are also overexpressed in human prostate cancer tissues, suggesting a link between exposure, local immune dysregulation, and prostate cancer development Continue reading

Turn Off the Smartphone and TV at Night To Reduce Risk of Weight Gain

MedicalResearch.com Interview with:

Lead author: Yong-Moon (“Mark”) Park, MD, PhD Postdoctoral fellow Epidemiology Branch National Institute of Environmental Health Sciences

Dr. Park

Lead author: Yong-Moon (“Mark”) Park, MD, PhD
Postdoctoral fellow
Epidemiology Branch
National Institute of Environmental Health Sciences

Senior author: Dale P. Sandler, PhD Chief, Epidemiology Branch, National Institute of Environmental Health Sciences National Institutes of Health

Dr. Sandler

 

Senior author: Dale P. Sandler, PhD
Chief, Epidemiology Branch, National Institute of Environmental Health Sciences
National Institutes of Health

MedicalResearch.com: What is the background for this study?  

Response: A few studies had suggested that exposure to artificial light while sleeping was associated with obesity. However, the previous studies were cross-sectional, so we really do not know which came first – exposure to artificial light while sleeping or obesity. Another problem was that previous studies did not fully account for other characteristics that could affect this association, such as sleep duration and quality, calorie intake and dietary patterns, and physical activity.

We studied nearly 44,000 women ages 35-74 from across the US who are enrolled in the Sister Study cohort. Women had body weight characteristics measured at baseline and provided self-reported information on weight at baseline and follow-up – on average 5.7 years later.

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Food Food Spending by Lower Economic Groups Has Greater Environmental Impact

MedicalResearch.com Interview with:

Joe F. Bozeman III, MS, CEM, Ph.D. Candidate Chair, Gordon Research Seminar (Industrial Ecology) University of Illinois at Chicago (UIC) Institute for Environmental Science and Policy

Joe F. Bozeman III

Joe F. Bozeman III, MS, CEM, Ph.D. Candidate
Chair, Gordon Research Seminar (Industrial Ecology)
University of Illinois at Chicago (UIC)
Institute for Environmental Science and Policy

MedicalResearch.com: What is the background for this study?  

Response: This study is actually a part of my dissertation which explores how climate change, human health, and other socioecological factors can be used to manage food-energy-water impacts. After establishing environmental impact and climate change adaptation implications of food consumption across major U.S. demographic groups in a previous study, my colleagues and I decided it would be interesting to investigate how food spending and household income correlate with food-consumption environmental impacts. Our efforts led to the development of a novel quantitative metric (i.e., food-consumption impact per dollar spent [FCI$]) which encompasses land, water, and greenhouse gas emission impacts of basic foods; the amount spent on food; and socioeconomic status. All major food groups are included in this study.

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Proximity to Oil Refineries and Risk of Bladder Cancer

MedicalResearch.com Interview with:

Stephen B. Williams, MD, FACSChief, Division of UrologyAssociate Professor, Urology and RadiologyRobert Earl Cone ProfessorshipDirector of Urologic OncologyDirector of Urologic ResearchCo-Director Department of Surgery Clinical Outcomes Research ProgramUniversity of Texas Medical Branch at Galveston

Dr. Williams

Stephen B. Williams, MD, FACS
Chief, Division of Urology
Associate Professor, Urology and Radiology
Robert Earl Cone Professorship
Director of Urologic Oncology
Director of Urologic Research
Co-Director Department of Surgery Clinical Outcomes Research Program
University of Texas Medical Branch at Galveston

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite prior studies evaluating cancer in those living near and working in oil refineries, there remains a gap in knowledge regarding proximity to oil refineries and risk of bladder cancer.

Aromatic amines have been associated with increased risk of various cancers including bladder cancer. Texas is a home to the largest numbers of oil refineries in the US. Our goal was to evaluate if there was a link between bladder cancer and living in close proximity to an oil refinery in Texas.

Our data did suggest that living within 10 miles of an oil refinery was associated with a small increase in risk of bladder cancer. These data support further research to validate these findings.

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How Much of Your Sunscreen is Absorbed?

MedicalResearch.com Interview with:

David Strauss, MD, PhDDirector, Division of Applied Regulatory ScienceU.S. Food and Drug AdministrationCenter for Drug Evaluation and Research

Dr. Strauss

David Strauss, MD, PhD
Director, Division of Applied Regulatory Science
U.S. Food and Drug Administration
Center for Drug Evaluation and Research

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies.

This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling.

All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL.  Continue reading

Elevated PCBs Associated with Increased Risk of Cardiovascular Disease

MedicalResearch.com Interview with:

Monica Lind, PhD, Professor, Environmental toxicologistOccupational and Environmental MedicineUppsala University HospitalVisiting adress: Dag Hammarskjölds väg 60Uppsala Sweden 

Dr. Lind

Monica Lind, PhD,
Professor, Environmental toxicologist
Occupational and Environmental Medicine
Uppsala University Hospital
Visiting adress: Dag Hammarskjölds väg 60
Uppsala Sweden

MedicalResearch.com: What is the background for this study?

Response: Previous studies in workers exposed to very high levels of polychlorinated biphenyls (PCBs) have suggested hazardous health effects. However, circulating PCB levels are detected in almost all indivuduals in industrialized countries, but the health effects of moderately elevated levels as seen in the general population are not well established.

We investigated levels of PCBs in around 1,000 individuals, all aged 70 years, randomly chosen from the City of Uppsala, Sweden.

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USPSTF: More Research Needed to Determine What Primary Care Providers Can Do to Detect and Treat Lead Poisoning

MedicalResearch.com Interview with:

Alex H. Krist, MD, MPHVice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University

Dr. Krist

Alex H. Krist, MD, MPH
Vice-Chairperson, U.S. Preventive Services Task Force
Professor of family medicine and population healt
Virginia Commonwealth University

 MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential.

In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy.

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Occupational Exposure to Pesticides: Poor Prognosis for Diffuse Large B-Cell Lymphoma Patients

MedicalResearch.com interview with:
Sylvain Lamure, MD, Hematologist, Principal Investigator

Pascale Fabbro-Peray, MD, PhD , Epidemiologist, Senior Investigator
University of Montpellier, France

MedicalResearch.com: What is the background for this study?

Response: Occupational exposure to pesticides is a well-documented associated factor for non-Hodgkin lymphoma. The main biological mechanisms of both pesticides and chemotherapy are genotoxicity and reactive oxygen species generation. Cellular adaptation among patients exposed to low doses of genotoxic and oxidative compounds might hinder chemotherapy efficiency in lymphoma patients. T

hus, we have investigated the association of occupational exposure with response to immunochemotherapy and survival in the subgroup of diffuse large B cell lymphoma, whose treatment is standardized.

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High Lead Levels in Refugee Children Resettled in US

MedicalResearch.com Interview with:

Madhav P. Bhatta, PhD, MPHAssociate Professor, Epidemiology & Global HealthCollege of Public HealthKent State UniversityKent, OH 44242

Dr. Bhatta

Madhav P. Bhatta, PhD, MPH
Associate Professor, Epidemiology & Global Health
College of Public Health
Kent State University
Kent, OH 44242

MedicalResearch.com: What is the background for this study?

Response: Lead exposure, especially in children, in any amount is harmful. Lead poisoning is a growing global environmental health problem with increasing lead-related diseases, disabilities, and deaths.  While exposure to lead in US children, in general, has significantly declined in the last three to four decades certain sub-groups of US children such as African Americans, immigrants and resettled refugees, and those from lower socioeconomic backgrounds are still vulnerable to environmental lead exposure.

Previous studies among resettled refugee children in the United States had found 4- to 5-times higher prevalence of elevated blood lead level (EBLL) when compared to US-born children. However, most of the studies were conducted when EBLL was defined as blood lead level ≥ 10 µg/dL. In 2012, the US Centers for Disease Control and Prevention changed the reference value for EBLL to ≥ 5 µg/dL. Moreover, because the countries of origin for US resettled refugees change over time, it is important to have epidemiologic studies that provide the current information on EBLL among these vulnerable new US immigrant children.

Using blood lead level data from the post-resettlement medical screening, our study examined the prevalence of elevated blood lead level at the time of resettlement among former refugee children who were settled in the state of Ohio from 2009-2016. We had a large and diverse sample (5,661 children from 46 countries of origin) of children for the study, which allowed us to assess EBLL in children from several countries of origin that had not been previously studied. Continue reading

Pediatric Blood Lead Levels in Public vs Private New York Housing

MedicalResearch.com Interview with:

Lead paint can crack and form flakes, which can contaminate the surrounding environment. Source: Wikipedia

Lead paint can crack and form flakes, which can contaminate the surrounding environment.
Source: Wikipedia

Ms. Jacqueline Chiofalo, MPA
Director of Policy Research & Analysis
The Institute for Family Health
Astoria, New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Exposure to lead is dangerous and has been banned from use in residential dwellings. However, residual sources of lead still exist. Few studies have examined pediatric lead poisoning between public (NYCHA) and private housing units, and no recent studies performed in New York City. Our study used retrospective chart analysis of routine child lead testing to examine the difference in blood lead levels between the two housing types.

Our data showed that children seen in our health centers who lived in New York City public housing had significantly lower mean blood lead levels and fewer children were found with levels over the CDC reference range of 5 μg/dL compared to children who lived in private housing.  Continue reading

TRAP: Traffic Related Air Pollution Linked to Millions of Pediatric Asthma Cases Worldwide

MedicalResearch.com Interview with:
Ploy Pattanun Achakulwisut, PhD
Postdoctoral Scientist in Climate change, Air pollution, and Public Health
Milken Institute School of Public Health (Anenberg Group
The George Washington University, D.C 

MedicalResearch.com: What is the background for this study?

Response: Dozens of epidemiological studies have found positive and generally statistically significant associations between long-term exposure to traffic-related air pollution (TRAP) and asthma development in children. The evidence is most robust for nitrogen dioxide (NO2), a major component of and commonly used surrogate for the complex TRAP mixture. Recent reviews conducted by the US Environmental Protection Agency and Health Canada concluded that there is “likely a causal relationship” between long-term NO2 exposure and pediatric asthma development.

Using NO2 as a proxy for TRAP, our study provides the first global estimate of the number of new asthma cases among children that are attributable to traffic pollution, using fine spatial-scale global datasets that can resolve within-city and near-roadway NO2 exposures.

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Lead in Topsoil Linked to Cognitive Difficulties in 5 Year Old Boys

MedicalResearch.com Interview with:

Edson R. Severnini PhDAssistant Professor Of Economics And Public PolicyCarnegie Mellon University

Dr. Severnini

Edson R. Severnini PhD
Assistant Professor Of Economics And Public Policy
Carnegie Mellon University

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Although lead has been banned from gasoline, paint, and other substances in the United States and many other countries around the world, the legacy of lead use is a critical environmental and public health issue. Surface soil contamination, in particular, has been long recognized as an important pathway of human lead exposure, and is now a worldwide health concern.

This study estimates the causal effects of exposure to lead in topsoil on cognitive ability among 5-year-old children. We draw on individual level data from the 2000 U.S. Census, and USGS data on lead in topsoil covering a broad set of counties across the United States.

We find that higher lead in topsoil increases considerably the probability of 5-year-old boys experiencing cognitive difficulties such as learning, remembering, concentrating, or making decisions. Living in counties with topsoil lead concentration above the national median roughly doubles the probability of 5-year-old boys having cognitive difficulties. This harmful effect does not seem to extend to 5-year-old girls, potentially due to the natural protection of estrogen.  Continue reading

Urban Youth Exposed to Air Pollution Have Greater Risk of Psychotic Experiences

MedicalResearch.com Interview with:
“air pollution, beijing” by 大杨 is licensed under CC BY 2.0Joanne B. Newbury, PhD
ESRC Postdoctoral Fellow
King’s College London
Social, Genetic & Developmental Psychiatry Centre
Institute of Psychiatry, Psychology & Neuroscience
London, United Kingdom

MedicalResearch.com: What is the background for this study?

Response: Urban living is one of the most well-established risk factors for adult psychotic disorders such as schizophrenia. However, less is known about the role of the urban environment in subclinical psychotic experiences in childhood and adolescence, such as hearing voices and extreme paranoia. These early psychotic experiences are a developmental risk factor for adult psychotic disorders and a range of other serious mental health problems such as depression and anxiety.

It is therefore important that we understand what factors might contribute to the development of early psychotic experiences so that we might be able to intervene and prevent their onset and progression.

In a cohort of over 2000 UK-born children (The Environmental Risk Longitudinal Twin Study), we have previously shown that subclinical psychotic experiences are also around twice as common among children and teenagers raised in urban versus rural settings. We have also shown that this appears to be partly explained by social features in urban neighbourhoods such as higher crime levels and lower levels of social cohesion.

However, no studies have examined the potential link between air pollution and psychotic experiences. This is despite air pollution being a major health problem worldwide (particularly in cities), and despite emerging evidence linking air pollution to the brain.  Continue reading

Chemicals in Household Dust May Promote Fat-Cell Development

MedicalResearch.com Interview with:

Christopher D. Kassotis, Ph.D.NRSA Postdoctoral Research ScholarStapleton LabDuke UniversityNicholas School of the EnvironmentDurham, NC 27708 

Dr. Kassotis

Christopher D. Kassotis, Ph.D.
NRSA Postdoctoral Research Scholar
Stapleton Lab
Duke University
Nicholas School of the Environment
Durham, NC 27708 

MedicalResearch.com: What is the background for this study? What are the main findings?

  • So this was something that Heather Stapleton had been curious about for years, as she’s been one of several researchers characterizing the hundreds of chemicals that have been measured in indoor house dust. Before I came to Duke, one of her PhD students had measured the ability of many common indoor contaminants to activate the peroxisome proliferator activated receptor gamma (PPARg). The majority of these chemicals did, often quite well, which led to them testing indoor house dust extracts, also finding that the majority of dust extracts were also able to do so at very low levels. As PPARg is often considered the master regulator of fat cell development, the next obvious question was whether these common contaminants (and house dust) could promote fat cell development in cell models. My first work at Duke evaluated a suite of common indoor contaminants, finding that many of these chemicals could promote fat cell development, and that low levels of house dust extracts did as well.
  • We next explored this more systematically in a group of adults involved in a thyroid cancer cohort (this was just recently published in Science of the Total Environment:
    https://www.sciencedirect.com/science/article/pii/S0048969719307715?dgcid=author
  • In this study we evaluated the extent to which house dust extracts could promote fat cell development in a common cell model, and associated this with the metabolic health of adults living in these homes. We found that the greater extent of fat cell development was associated with significantly greater thyroid stimulating hormone concentrations (control residents only, with no evidence of thyroid dysfunction) and lower free triiodothyronine (T3) and thyroxine (T4). We further found a significant and positive association between extent of fat cell development and the body mass index (BMI) of all adults in the study. So this suggested that the indoor environment might play a role in the BMI and metabolic health of residents, and we next wondered if this would be more pronounced in children, who may be exposed to these contaminants during a critical window of development.
  • The next step, for our current work, was to substantiate these effects in a larger group of households, each with children.
  • Our major conclusions thus far have been that ~80% of house dust extracts promote significant fat cell development in a cell model – either via development from precursor cells into mature fat cells, measured via accumulation of lipids into the cells, or via the proliferation of those precursor fat cells. We also reported positive correlations of fat cell development with the concentrations of 70 different contaminants in the dust from these homes, suggesting that mixtures of contaminants are likely all acting weakly to produce these effects in combination. We’ve also begun to assess the other chemicals present in dust – chemistry can be either targeted (measuring concentrations of specific known chemicals in a sample), or non-targeted, where you try and determine the identity of the other chemicals in a sample. This has greater utility for identifying many more chemicals, though you will often not get chemical concentrations from this, nor absolute confirmed identification – just varying degrees of certainty based on evidence.

    Thus far we report approximately 35,000 chemicals in house dust samples across this study, and differential analyses have begun to pick out the few (less than 10 in each case) chemicals most differentially expressed between samples that exhibit high degrees of fat cell development in the lab vs inactive samples, for example, or which are differentially present in the homes of children categorized as obese or overweight. We are now working to confirm identity of these select contaminants that are more likely to be causative factors in the results we have observed.

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Suncreens: FDA Proposed Regulations Would Update Testing and Labeling Requirements

MedicalResearch.com Interview with:

Anna Benevente

Anna Benevente

Anna Benevente
Director of product, labeling, and ingredient review at Registrar Corp (registrarcorp.com), an FDA consulting firm that helps companies comply with FDA regulations.
She has been assisting companies with U.S. FDA regulations since 2009.
She and her team have researched thousands of products to determine whether they meet FDA requirements for compliance.

In February 2019, the U.S. Food and Drug Administration (FDA) published a proposed rule to put into effect a final monograph for over-the-counter (OTC) sunscreen drug products.  If finalized, the rule will update conditions under which OTC sunscreen products may be marketed in the United States.  Given the effect this rule could have on the pharmaceutical and cosmetic industries, MedicalResearch.com sat down with Anna Benevente, Director of Product, Labeling, and Ingredient Review at FDA consulting firm Registrar Corp, to dig deeper into the article they recently published on the rule.

MedicalResearch.com:  What is the background for this announcement?

Response:  FDA issues monographs for specific types of over-the-counter (OTC) drug products, which establish conditions under which a drug may be marketed without FDA approval of a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA). The conditions that are established by the monograph include the active ingredients that have been deemed generally recognized as safe and effective (GRASE) and statements that must appear on the labeling in the form of a Drug Facts panel. Sunscreens have never had an effective final monograph.  Instead, they have been largely regulated under enforcement discretion since 2001, when FDA issued a stay on a final monograph for OTC sunscreen drug products.

The Sunscreen Innovation Act (SIA) of 2014 calls for FDA to establish a final monograph for OTC sunscreen by November 26, 2019. If finalized, the rule proposed in February would lift the stay on the final monograph and amend certain regulations for OTC sunscreen drug products.

MedicalResearch.com:  What is enforcement discretion?

Response: FDA rulemaking can take a considerable amount of time.  During this process, FDA may issue guidance or an enforcement policy that specifies stipulations under which the Agency permits the marketing of certain products in the absence of codified regulations.  While these documents are not legally-binding, they often outline provisions where FDA states that the Agency does not intend to take regulatory action.  These provisions are often incorporated into an FDA rule, as we are seeing in the case of this new rule for sunscreen.

MedicalResearch.com:  Would you explain what GRASE ingredients are?

Response: When FDA establishes a monograph for an OTC drug product, the Agency reviews scientific data on ingredients used for that product and classifies them into three categories:

Category I: The ingredient is generally recognized as safe and effective for its intended use.

Category II: The ingredient is not generally recognized as safe and effective for its intended use.  This ingredient may be not safe as a whole, may be not be safe for the specific intended use, or may not be effective for the specific intended use relative to its health risk.

Category III: There is insufficient scientific data to determine whether the ingredient is safe and effective for its intended use.

While a monograph is still in the rulemaking stage, FDA permits the marketing of products formulated with active ingredients that are deemed Category I or Category III. At this time, industry may submit data to support a Category I designation for a Category III ingredient. When the final monograph is published, FDA no longer uses the terms “Category I”, “Category II”, and “Category III.”  Those ingredients that were deemed Category I become “monograph conditions,” while Category II and III ingredients become “nonmonograph conditions” and may not be marketed after the compliance date identified in the final rule.

Q: What are the main products that would require a label change?

Response:The statement of identity for all sunscreen products would be required to list the sunscreen active ingredients in alphabetical order followed by “Sunscreen” and the product’s dosage form (e.g. “Titanium Dioxide, Zinc Oxide Sunscreen Lotion”).  Additionally, the rule proposes formatting changes to sunscreen labels that would make SPF, broad spectrum, and water resistance statements more prominent.

The rule would require all products over 15 SPF to satisfy broad spectrum testing requirements and the associated labeling requirements for broad spectrum products.  Products under 15 SPF that do not satisfy broad spectrum requirements would be required to include “*See Skin Cancer/Skin Aging Alert” next to the SPF value as a reference to the warning required under 21 CFR 201.327(d)(2).

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Heart Attacks Spike During Holiday Season – How Can You Minimize Your Risk?

MedicalResearch.com Interview with:

Dr. Lowell H. Steen, Jr., M.D. Interventional Cardiologist Loyola University Medical Center

Dr. Steen

Dr. Lowell H. Steen, Jr., M.D.
Interventional Cardiologist
Loyola University Medical Center

Dr. Steen discusses how holiday treats & stress can increase the risk of heart attack.

MedicalResearch.com: What are the main factors that are linked to an increase in heart related adverse events during the Christmas holiday season? Who is most at risk? 

Response: The increase in holiday season heart-related hospitalizations and deaths are due to a variety of behaviors such as putting off seeking medical help until after the holidays, overeating rich foods, strenuous travel, excessive alcohol consumption and stressful family interactions. These factors can all trigger heart issues.

Factors such as age, diabetes, high cholesterol and smoking all increase heart risk. Additionally, those with high blood pressure, which is a leading risk factor for heart disease and stroke, are exceptionally at risk and should celebrate the hectic holiday season with caution.  Continue reading

Risk Factors for Melanoma in Women

MedicalResearch.com Interview with:

One example of malignant melanoma, courtesy of skin cancer foundation

One example of malignant melanoma, courtesy of Skin Cancer Foundation

Reza Ghiasvand, PhD
Oslo Centre for Biostatistics and Epidemiology
Faculty of Medicne
University of Oslo
Oslo, Norway 

MedicalResearch.com: What is the background for this study?

Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age.

It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis.

In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years.

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Federal Government Contributions to Public Health and the Environment over the Past 220 Years: 1798-2018

MedicalResearch.com Interview with:

Dr. Gilbert Rochon, III PH.D., MPH Adjunct Professor, Dept. of Global Health Management & Policy Tulane University’s School of Public Health & Tropical Medicine Senior Consultant with MSF Global Solutions, LLC New Orleans

Dr. Rochon

Dr. Gilbert Rochon, III PH.D., MPH
Adjunct Professor, Dept. of Global Health Management & Policy
Tulane University’s School of Public Health & Tropical Medicine
Senior Consultant with MSF Global Solutions, LLC
New Orleans

MedicalResearch.com: What is the background for this study?

Response: Having observed the frequency with which President Donald Trump characterized changes in regulatory policies and funding levels with respect to public health and the environment as eliminating or curtailing “unnecesssary Obama-era regulations,” I became curious as to the full extent and impact of such deregulation and under-funding of health and environmental safeguards.

In the process, I found it necessary to review federal government contributions to public health and the environment under all previous presidents.  Continue reading

Heavy Exposure to Air Pollution During Pregnancy May Raise Air Pollution Risk

MedicalResearch.com Interview with:
"Cairo Air Pollution with less smog - Pyramids1" by Nina Hale is licensed under CC BY 2.0Lief Pagalan, MSc

Faculty of Health Sciences, Simon Fraser University
Research Trainee, Centre for Hip Health and Mobility
Vancouver Coastal Health Research Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Pregnant women more heavily exposed to air pollution had higher chances of having children with autism spectrum disorder (ASD).

The causes of ASD are not fully understood, but this study adds to the growing evidence that environmental risk factors have a role to play. Our study found an association between autism spectrum disorder in the children of women more heavily exposed to air pollution. We observed these results using well-defined cases of ASD and in Vancouver, Canada, which typically has lower air pollution. These findings are consistent with studies done in the U.S., Israel, and Taiwan, which have also found an increased risk of ASD from exposure to air pollution.  Continue reading

Hot Sun Increases Absorption of Sunscreen Ingredients

MedicalResearch.com Interview with:
Audra Stinchcomb, PhD

Principal Investigator
Professor of Pharmaceutical Sciences
University of Maryland School of Pharmacy

MedicalResearch.com: What is the background for this study?  

Response: We have been studying the heat effects and repeated dose effects on the absorption of drugs across the skin for more than 5 years.  We were curious to see if the effects we saw on gel, cream, and ointment pharmaceuticals also occurred with sunscreen.

Sunscreens are typically used in the hot sun and with reapplication every 80 minutes or so, depending on the product and user.

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Soy Formula Feeding in Infancy Linked with Menstrual Pain in Adulthood

MedicalResearch.com Interview with:

"Baby Bottle" by brokinhrt2 is licensed under CC BY 2.0Kristen Upson, PhD, MPH and
Donna D. Baird, PhD
Epidemiology Branch
National Institute of Environmental Health Sciences
Research Triangle Park, NC 27709 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Menstrual pain is the most common menstrual complaint and can substantially affect the quality of women’s lives. A prior study in young adults who participated in feeding studies as infants reported an increased risk of greater menstrual pain severity in adulthood with soy formula feeding. Since that study, evidence from laboratory animal studies support the disruptive effects of a phytoestrogen present in soy formula, genistein, on reproductive system development, including aspects involved in menstrual pain. The laboratory animal studies also demonstrate that the developmental changes with genistein can persist into adulthood. Given these results, we were interested in further evaluating the association between infant soy formula feeding and menstrual pain in a cohort of young women.

In our study of women ages 23-35 years old, we observed that soy formula feeding during infancy was associated with several indicators of severe menstrual pain in reproductive-age women. This included a 40% increased risk of ever using hormonal contraception for menstrual pain and 50% increased risk of moderate/severe menstrual discomfort with most periods during early adulthood.  Continue reading

South Pacific Island Nation First Country to Ban Environmentally Harmful Sunscreens

MedicalResearch.com Interview with:
"Protect Coral Reefs" by NOAA's National Ocean Service is licensed under CC BY 2.0Ariel Kushmaro and Esti Kramarsky-Winter
Department of Biotechnology Engineering, Ben Gurion University
Beer Sheva, Israel

The Republic of Palau, a South Pacific island nation, became the world’s first country to ban sunscreen products containing environmentally harmful ingredients

MedicalResearch.com: What is the background for this announcement? What are the main findings? 

Response: Coral reefs are important ecosystems that are under threat due to global human driven climate change. In addition to global changes, local hazards such as point pollution by eutrophication, dredging and chemical pollution are exacerbating and promoting reef destruction at local levels. This destruction affects not only island nations that depend on these reefs for protection and livelihood, they affect humanity as a whole as they are an important source for food and novel drugs and new materials.

Our recent studies have shown that chemicals found in most commercial sunscreens and creams used to protect humans from deleterious effects of UV A and UVB wash off into the environment are persistent, have endocrine disruptive effects, and thus deleteriously affect marine organisms including corals.  Continue reading

Why Are Some Homes Prone to Cockroach Infestation?

MedicalResearch.com Interview with:
"Cockroaches at night" by Sigurd Tao Lyngse is licensed under CC BY 2.0Changlu Wang, PhD

The Urban Entomology lab
Department of Entomology
Rutgers University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cockroaches are an important public health pest. They carry pathogens and produce allergens which causes asthma. Some residential communities always have chronic cockroach infestations.

This study is designed to understand the environmental and behavioral factors associated with cockroaches in low-income homes occupied by senior citizens. We found 30% of the 388 surveyed homes had German cockroaches. Sanitation and residents’ tolerance are two factors significantly associated with the presence of cockroaches. A dirty apartment is 2.7 times more likely to have German cockroaches. Gender, ethnicity, and clutter level are not associated with presence of cockroaches. People would be bothered by cockroaches when more than 3 cockroaches are caught in sticky traps when 4 traps were placed per apartment over 2 weeks period.

A high percentage (36%) of residents were unaware of cockroaches when they were caught in traps in their homes. These findings are important for property managers and policy makers in designing better intervention methods to reduce the cockroach infestations.  Continue reading

What Can Be Done About Sundamaged Skin?

MedicalResearch.com Interview with:

Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.  In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.

Dr. Prystowsky

Dr. Janet Prystowsky, MD
Dr. Prystowsky is a leading board-certified dermatologist in
New York City.  

In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.
http://www.janetprystowskymd.com/

MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a ‘safe tan’?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage? 

Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight.

"Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That’s why you’ll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  Continue reading

Why Are So Many People Near-Sighted?

MedicalResearch.com Interview with:
Andrei V. Tkatchenko, M.D., Ph.D.
Associate Professor
Columbia University Medical Center
Edward S. Harkness Eye Institute
New York, NY 10032

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Clear distance vision is rapidly becoming a rare privilege around the world, especially in Asia, due to increasing prevalence of myopia.

Although much effort has been directed towards elucidating the mechanisms underlying refractive eye development and myopia, treatment options for myopia are mostly limited to optical correction, which does not prevent progression of myopia or pathological blinding complications often associated with the disease. During early childhood development, the axial length of the eye normally grows to match its optical power in a process called emmetropization, producing focused images on the retina. However, very often environmental and genetic factors lead to a mismatch between the optical power of the eye and its axial length resulting in the development of myopia if eyes grow too long for their optical power. Experimental studies in many animal species suggest that emmetropization is regulated by optical defocus. The eye can compensate for imposed negative and positive optical defocus by increasing or decreasing its growth rate, respectively. However, the molecular mechanisms underlying emmetropization are poorly understood which prevents development of anti-myopia drugs.

Continue reading

Could Household Cleaners Be Making Children Overweight?

MedicalResearch.com Interview with:

Dr. Kozyrskyj

Anita Kozyrskyj PhD
Professor in Pediatrics
Faculty of Medicine & Dentistry
School of Public Health
University of Alberta

MedicalResearch.com: What is the background for this study?

Response: Data for this study were collected in the Canadian Healthy Infant Longitudinal Development (CHILD) cohort of over 3,500 full-term infants born between 2009 and 2012. When infants were 3-4 months of age, parents provided a sample of their poop. At that time, parents checked-off responses to questions about their home, including type and frequency of cleaning product use. The infant poop was initially frozen, then thawed later to extract DNA from the sample and identify microbes on the basis of their DNA sequence.  Continue reading

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health

MedicalResearch.com Interview with:
John W. Stanifer, MD MSc
Duke Health

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The key take home for me is that Perfluorinated Chemicals (PFAS) are a globally ubiquitous pollutant with high human exposure and concerning chemical properties that appear to be capable of kidney kidney disease through several plausible different mechanisms; yet, we know almost nothing about long term kidney health outcomes, who is at greatest risk for adverse outcomes, or which communities may be most negatively impacted.

The original impetus for the study was the discovery of GenX in the drinking water of Wilmington NC, a pollutant from a company upstream (see: https://www.newsobserver.com/news/politics-government/state-politics/article199846619.html ). It has been a huge story in NC and every day more and more is being discovered about how pervasive the pollution has become (https://www.usnews.com/news/best-states/north-carolina/articles/2017-12-05/genx-compound-now-detected-in-food-product-in-n-carolina). While this was what caught my attention, as a North Carolinian, I quickly realized that these news stories are all over the place as any quick google search will reveal towns and communities contaminated with these from truly all of the United States. As a health disparities researcher in kidney disease,

I have been studying disparate rural populations in North Carolina, including American Indians, who live in communities with exceptionally high rates of kidney disease, which does not appear to be fully explained by “traditional” risk factors alone such as diabetes, hypertension, obesity, etc. So with that context in mind, I really have begun to focus on these chemicals as potential second-hits or augmenters of kidney disease; we have been doing preliminary studies, in which we have found them in the serum of individuals from these areas, but before we can go further, we really needed to understand what all is known about them and the plausibility that they could cause kidney disease. Therefore, we conducted this comprehensive study to characterize what the potential mechanisms between these chemicals and kidney disease are and where the biggest gaps are.

MedicalResearch.com: Were you surprised by any of the findings?

Response: I was actually surprised by a few things about it. I thought that the link between these chemicals and kidney disease would be pretty weak, with very little to suggest these could be primary drivers of kidney disease. And while the epidemiological studies provided conflicting evidence that mostly but not overwhelmingly pointed toward an association, the toxicology and pharmacokinetic studies demonstrated several key mechanisms that could explain how these chemicals cause kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2– related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.

It was also very interesting to learn that these compounds are taken up by the very same proximal tubule transporters that several known nephrotoxic drugs are taken up, including most notably the herb Aristocholic Acid which was of course responsible for the Balken Endemic Nephropathy that perplexed everyone for so long.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Many gaps still exist. The biggest ones to me are that there are literally 1000s of these compounds, with only slight chemical variations, which make detection and regulation challenging. In fact most are still under proprietary aegis which prevents any type of study on them, and several of the “alternative” or “newer” PFCs (e.g. GEnX) have chemical properties that are particularly concerning, despite being marketed as “less toxic”. It is also very concerning to me that children and adolescents have the highest exposure; yet the long-term consequences are completely unknown and life-course epidemiology studies are very much needed. Finally, in the context of kidney disease, these are like so many other environmental toxins in that we don’t know how they interact to worsen or augment kidney disease in people with other risk factors such as diabetes or hypertension. So for example, wonder if you have diabetic nephropathy and are being exposed to these in high quantities? What does that mean for disparities in kidney disease and outcomes??

None of the authors have any disclosures with regards to this work.

 

Citation:

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health
A Scoping Review

John W. Stanifer, Heather M. Stapleton, Tomokazu Souma, Ashley Wittmer, Xinlu Zhao and L. Ebony Boulware

CJASN September 2018, CJN.04670418; DOI: https://doi.org/10.2215/CJN.04670418 

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Prenatal Exposure to Air Pollution May Affect Newborn’s Thyroid Function

MedicalResearch.com Interview with:

Carrie Breton ScD Associate Professor and Director of the MADRES Center  Division of Environmental Health Los Angeles, CA 90032

Dr. Breton

Carrie Breton ScD
Associate Professor and Director of the MADRES Center
Division of Environmental Health
Los Angeles, CA 90032

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population.

We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. Continue reading