Microtransplantation Can Be Safe and Effective For Older AML Patients

MedicalResearch.com Interview with:
Huisheng Ai, MD, Director

Department of Hematology and Transplantation,
Affiliated Hospital of the Academy  of Military Medical Sciences,
Beijing, China 

MedicalResearch.com: Which of these results did you find most interesting or surprising?

Response: First, we must stress that microtransplant dramatically improved the outcome of older patients with AML.

As we know, older AML patients often possess unfavorable prognostic factors, organ dysfunction, and slow post-chemotherapy hematopoietic recovery. Therefore, the general treatment outcome is unsatisfactory even though the incidence is increasing by age with low complete remission (CR) rates (34% to 65%) and poor short-term survival (Two years overall survival was about 11% to 25%).

This study involved cases from multiple centers of China, USA and Spain, and found that microtransplant could not only significantly improve complete remission rate in older AML patients among all age groups from 60 to 85, but also improve 1-year and 2-year overall survival and disease free survival especially in patients aged 60 to 75. Second, microtransplant completely overcomes the restriction of HLA typing. The donor could be the patient’s haploidentical family member, or unrelated and fully mismatched one. The incidence of graft-versus-host disease (GVHD) was only 1.1%, even if no any GVHD prevention was given. Other treatment related complications and mortality were also decreased.

These results are much better than those of traditional chemotherapy, myeloablative and non-myeloablative transplant, which provides a more safe and effective treatment choice. We are looking forward to seeing the revision of NCCN guideline for older AML to make microtransplant benefit more older patients.

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People With Low Normal Thyroid Function Live Longer Than Those With High Normal

MedicalResearch.com Interview with:

Arjola Bano, MD, MSc, DSc Researcher in the Departments of Internal Medicine and Epidemiology, Erasmus Medical Center, Rotterdam the Netherlands

Dr. Bano

Arjola Bano, MD, MSc, DSc
Researcher in the Departments of Internal Medicine and Epidemiology,
Erasmus Medical Center, Rotterdam
the Netherlands

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

Response: Thyroid function is clinically defined by the measurements of serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. So far, abnormal TSH and FT4 levels as well as variations within the normal range have been linked to an increased risk of cardiovascular disease and death. However, it remains unclear whether there are differences in life span and years of life lived with and without cardiovascular disease, within the reference range of thyroid function. To investigate this, we performed a prospective study among 7785 middle-aged and elderly people with normal thyroid function. Participants were part of the Rotterdam Study, 65 years on average and 52% females. In our statistical analyses, we accounted for sociodemographic and cardiovascular risk factors. Over a median follow-up of 8.1 years, 789 incident cardiovascular deaths and 1357 deaths occurred. Analyses were performed separately among men and women.

Our study found differences in life expectancy within the reference range of thyroid function. At the age of 50 years, people with low-normal thyroid function lived up to 3.5 years longer than those with high-normal thyroid function. Also, people with low-normal thyroid function lived a longer life without cardiovascular disease than those with high-normal thyroid function.

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Opioid Overdoses Biggest Cause of Decreasing Life Expectancy

MedicalResearch.com Interview with:
Dr. Deborah Dowell, MD MPH
Senior Medical Advisor
Division of Unintentional Injury Prevention
Centers for Disease Control and Prevention

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

Response: Increases in U.S. life expectancy at birth have leveled off from an average of 0.20 years gained per year from 1970 to 2000 to 0.15 years gained per year from 2000 to 2014. U.S. life expectancy decreased from 2014 to 2015 and is now lower than in most high-income countries, with this gap projected to increase.
Drug poisoning (overdose) death rates more than doubled in the United States from 2000-2015; those involving opioids more than tripled. Increases in poisoning have been reported to have reduced life expectancy for non-Hispanic white Americans from 2000-2014. Specific contributions of drug, opioid, and alcohol poisoning to changes in U.S. life expectancy since 2000 were unknown.

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Childhood Tackle Football Linked To Increased Risk of Depression and Cognitive Issues In Adulthood

MedicalResearch.com Interview with:

Michael Alosco, PhD NRSA Postdoctoral Fellow Boston University Alzheimer’s Disease & CTE Center Boston University School of Medicine 

Dr. Alosco

Michael Alosco, PhD
NRSA Postdoctoral Fellow
Boston University Alzheimer’s Disease & CTE Center
Boston University School of Medicine 

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

Response: TThe goal of this study was to investigate whether playing youth tackle football, particularly before the age of 12, is associated with worse emotional, behavioral, and cognitive difficulties later in life. Participants in this study included 214 former amateur and professional American football players who were part of the LEGEND study at Boston University. Participants had an average age of 51. 43 played high school football, 103 played college football, and there were 68 professional American football players. The former players were divided into two groups: those who began playing tackle football before age 12 and those who began at age 12 or older. Participants received telephone-administered cognitive tests and completed online measures of depression, behavioral regulation, apathy, and executive functioning, such as initiating activity, problem-solving, planning, and organization. Results from former players who started playing tackle football before the age of 12 were compared to those of participants who started playing at age 12 or later.

The study showed that participation in tackle football before age 12 increased the odds for having problems with behavioral regulation, apathy and executive functioning by two-fold and increased the odds for clinically elevated depression scores by three-fold. These findings were independent of the total number of years the participants played football or at what level they played, such as high school, college, or professional. Even when a specific age cutoff was not used, younger age of exposure to tackle football corresponded with worse clinical status.

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Requiring Some Firearms To Be Surrendered May Reduce Domestic Homicides

MedicalResearch.com Interview with:

Professor Michael Siegel, MD, MPH Department of Community Health Sciences Boston University School of Public Health Boston, MA 02118

Dr. Siegel

Professor Michael Siegel, MD, MPH
Department of Community Health Sciences
Boston University School of Public Health
Boston, MA 02118

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

Response: Each year, more than 1,800 people in the U.S. are killed by their intimate partners. Approximately half of these homicides are committed using firearms. While federal law prohibits people subject to domestic violence restraining orders from possessing firearms, there is no requirement that they surrender guns already in their possession.

To close this loophole, several states have enacted laws that not only prohibit gun possession by people subject to restraining orders, but which also explicitly require that they relinquish weapons that they already have.

In this study, we investigated the impact of state domestic violence-related firearm laws and rates of intimate partner homicide, using data from all 50 states over a 25-year period, 1991-2015.

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Cheap Cigarettes in Europe Associated With Increased Infant Mortality

MedicalResearch.com Interview with:

Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London

Dr. Filippidis

Filippos Filippidis MD MPH PhD
Lecturer in Public Health
School of Public Health
Imperial College London
London

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

Response: Smoking kills millions of people every year. It is well established that increasing tobacco prices is the most effective way to reduce tobacco consumption and hence mitigate the devastating effects of tobacco on health. Taxation on tobacco products is high in the European Union, which makes cigarettes less affordable. However, transnational tobacco companies are known to manipulate prices, ensuring that cheap or ‘budget’ cigarettes are still available. This is particularly important for younger smokers and those of low socioeconomic status who are more sensitive in price increases.

Smoking during pregnancy, as well as exposure of pregnant women and babies to cigarette smoke increase infant mortality. There is also evidence that increasing tobacco prices is associated with lower infant mortality. However, researchers typically use average or premium cigarette prices. We analysed 54 million births from 23 European Union countries to see if the differential between average priced and budget cigarettes (i.e. the availability of cigarettes much cheaper than average priced ones) is associated with infant mortality.

We found that increasing average cigarette prices by 1 Euro per pack was associated with 0.23 fewer deaths per 1,000 live births in the same year and an additional 0.16 fewer deaths per 1,000 live births in the following year. A 10% increase in the price differential between budget and average priced cigarettes was associated with 0.07 more deaths per 1,000 live births the following year. This means that 3,195 infant deaths could potentially have been avoided in these 23 countries if there was no price difference between cigarette products over the 10-year study period.

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Hypothermia for 48 or 24 Hours After Out-of-Hospital Cardiac Arrest?

MedicalResearch.com Interview with:

Hans Kirkegaard, MD, PhD, DMSci, DEAA, DLS Research Center for Emergency Medicine and Department of Anesthesiology and Intensive Care Medicine Aarhus University Hospital and Aarhus University Aarhus, Denmark 

Dr. Kirkegaard

Hans Kirkegaard, MD, PhD, DMSci, DEAA, DLS
Research Center for Emergency Medicine and
Department of Anesthesiology and Intensive Care Medicine
Aarhus University Hospital and Aarhus University
Aarhus, Denmark 

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

Response: In 2002, two landmark studies demonstrated that mild therapeutic hypothermia (now known as targeted temperature management, TTM) for 12 or 24 hours improves neurological outcome in adult comatose patients suffering from out of hospital cardiac arrest. Accordingly, international guidelines now recommend TTM for at least 24 hours in this patient group.

However, there are no studies, only case reports that explore the effect of prolonged cooling. We therefore wanted to set up a trial that could fill out this knowledge gap, we hypothesized that doubling the hypothermia dose to 48 hour would improve neurological outcome without increasing the risk of adverse events considerably.

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Incidence of Sepsis Stable, But Mortality Remains High

MedicalResearch.com Interview with:

Dr. Chanu Rhee MD, Assistant Professor Therapeutics Research and Infectious Disease Epidemiology Group Department of Population Medicine at Harvard Medical School / Harvard Pilgrim Health Care Institute Critical Care and Infectious Disease Physician Transplant/Oncology Infectious Disease service and Medical Intensive Care Unit at Brigham and Women’s Hospital

Dr. Rhee

Dr. Chanu Rhee MD, Assistant Professor
Therapeutics Research and Infectious Disease Epidemiology Group
Department of Population Medicine at Harvard Medical School / Harvard Pilgrim Health Care Institute
Critical Care and Infectious Disease Physician
Transplant/Oncology Infectious Disease service and
Medical Intensive Care Unit at Brigham and Women’s Hospital 


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

Response: Multiple studies suggest that the incidence of sepsis, the syndrome of life-threatening organ dysfunction caused by infection, is increasing over time, while mortality rates are decreasing.  However, reliably measuring sepsis incidence and trends is challenging because clinical diagnoses of sepsis are subjective and insurance claims data, the traditional method of surveillance, can be affected by changing diagnosis and coding practices over time.

In this study, my colleagues and I estimated the current U.S. burden of sepsis and trends using clinical data from the electronic health record systems of a large number of diverse hospitals. The findings, published in JAMA, challenge the use of claims data for sepsis surveillance and suggest that clinical surveillance using electronic health record data provides more objective estimates of sepsis incidence and outcomes.

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Study Finds 5-7 Years Post-Menopausal Hormone Therapy Not Associated with Increased Risk of Mortality

MedicalResearch.com Interview with:

JoAnn E. Manson, MD, DrPH Chief, Division of Preventive Medicine Brigham and Women's Hospital Professor of Medicine and the Michael and Lee Bell Professor of Women's Health Harvard Medical School Boston, Massachusetts  02215

Dr. Manson

JoAnn E. Manson, MD, DrPH
Chief, Division of Preventive Medicine
Brigham and Women’s Hospital
Professor of Medicine and the
Michael and Lee Bell Professor of Women’s Health
Harvard Medical School
Boston, Massachusetts  02215 

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

Response: The current report provides new information on total mortality and the rates of death from specific causes (cardiovascular disease, cancer, other major illnesses) over 18 years of follow-up in the Women’s Health Initiative (WHI) randomized trials of hormone therapy (estrogen + progestin and estrogen alone). This is the first WHI report to focus on all-cause and cause-specific mortality. It includes all of the 27,347 women in the 2 hormone therapy trials with >98% follow-up over 18 years, during which time 7,489 deaths occurred. This is more than twice as many deaths as were included in earlier reports. The report also provides detailed information on differences in results by age group (ages 50-59, 60-69, 70-79) at time of study enrollment.

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Association of Brain White Matter Structure With Autism Spectrum Disorder and ADHD

MedicalResearch.com Interview with:

Dr. Adriana Di Martino, MD Associate Professor, Department of Child and Adolescent Psychiatry NYU Langone Health

Dr. Di Martino

Dr. Adriana Di Martino, MD
Associate Professor, Department of Child and Adolescent Psychiatry
NYU Langone Health

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

Response: While there has been an increased awareness of the co-occurrence of symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children with a primary diagnosis of ASD, only recently has there been an appreciation that a substantial proportion of children with ADHD may also have ASD traits. These symptom domains overlap pose a challenge for accurate recognition and targeted treatments, yet their underlying mechanisms have been unknown.

With more traditional diagnostic group comparisons we detected a significant influence of ASD on white matter organization, but our analyses of the severity of symptoms across individuals revealed an association between autistic traits and white matter organization, regardless of the individual’s diagnosis. These findings were mostly centered around the corpus callosum, a structure that enables communication between the left and right cerebral hemispheres.

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