Cholesterol Levels in American Youth Improving, But Only Half Have Ideal Lipid Levels

MedicalResearch.com Interview with:

Amanda Marma Perak, MD, MSAssistant Professor of Pediatrics (Cardiology) and Preventive Medicine

Dr. Marma Perak

Amanda Marma Perak, MD, MS
Assistant Professor of Pediatrics (Cardiology) and
Preventive Medicine

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

Response: Blood cholesterol is a critical initiator of atherosclerotic plaques in the arteries that can lead to heart attack in adulthood. It is well established that these changes in the blood vessels occur already in childhood. Thus, it is important to know the status of cholesterol levels in youth to inform public health efforts aimed at preventing cardiovascular disease in the population.

In the US there have been changes in childhood obesity prevalence (which may worsen cholesterol levels), the food supply (such as reduction of trans fats which may improve cholesterol levels), and other factors in recent years.

We therefore designed a study to examine trends in cholesterol levels among youth in recent years.

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Perception of Malpractice Risk is Contagious Among Colleagues

MedicalResearch.com Interview with:

Dan LyPh.D. Program in Health PolicyHarvard

Dan Ly

Dan Ly, MD, MPP
Ph.D. Program in Health Policy
Harvard

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

Response: There is some mixed evidence regarding whether state level tort reform reduces defensive medicine, or the practicing of medicine in such a way to reduce medical liability. This includes “positive” defensive medicine, or performing certain tests and procedures to reduce such liability. Other research finds that the perception of malpractice risk drives such defensive medicine, including the use of diagnostic imaging, such as CT scans and MRIs.

I was interested in exploring what influenced the perception of this risk, hypothesizing that, for a physician, a report of an injury against one’s colleague might increase the perception of this risk and lead to an increase the use of diagnostic imaging.

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Do Hospitals Designated as Centers of Excellence Have Better Outcomes?

MedicalResearch.com Interview with:

Sameed Khatana, MDFellow, Cardiovascular Medicine, Perleman School of MedicineAssociate Fellow, Leonard Davis Institute of Health EconomicsUniversity of Pennsylvania

Dr. Khatana

Sameed Khatana, MD
Fellow, Cardiovascular Medicine, Perleman School of Medicine
Associate Fellow, Leonard Davis Institute of Health Economics
University of Pennsylvania

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

Response: There has been a growing use of quality metrics and indices in the US healthcare system. Much attention has been paid to quality measurement programs used by public payors, however, the use of such programs by commercial payors is much less studied. “Centers of excellence” are one type of quality designation program that is growing in use by commercial payors where certain hospitals are determined to be “high quality” for a certain disease state or procedure based on meeting certain criteria. For some people, this is even impacting the choice of providers and hospitals they can use by payors.

We evaluated centers of excellence programs from three large commercial payors, Aetna, Cigna and Blue Cross Blue Shield, targeted at cardiovascular diseases and interventions and examined publicly reported outcomes for all hospitals performing percutaneous coronary interventions (cardiac stenting) in New York State. 

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Early Life Maltreatment Linked to Increased Risk of Elder Abuse

MedicalResearch.com Interview with:

XinQi DongDirector, Institute for Health, Health Care Policy, and Aging ResearchHenry Rutgers Distinguished Professor of Population Health SciencesProfessor, Department of Medicine - Division of General Internal Medicine, Robert Wood Johnson Medical School

XinQi Dong

XinQi Dong
Director, Institute for Health, Health Care Policy, and Aging Research
Henry Rutgers Distinguished Professor of Population Health Sciences
Professor, Department of Medicine – Division of General Internal Medicine, Robert Wood Johnson Medical School

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

Response: Interpersonal violence is a substantial public health issue across all socio-demographic and socioeconomic strata globally. A depth of prior studies have found that victims of childhood sexual abuse might have higher risks of re-experiencing sexual violence as adults. But the “re-victimization” phenomenon has been insufficiently examined among the rapidly growing aging populations. There lacks examinations about life-course violence experiences and the accumulative effect of which in older ages.

Our study examined three most common forms of interpersonal violence (child maltreatment, intimate partner violence, and elder abuse) across the life span and found an interconnectedness among them. Individuals with a history of child maltreatment and/or intimate partner violence had two to six times higher risks of elder abuse compared to those without a past experience of the violence.  Continue reading

Mortality Rate Increases With Each Sugary Drink

MedicalResearch.com Interview with:
Jean A. Welsh, RN, MPH, PhD
Departments of Epidemiology and Pediatrics
Emory University
Wellness Department, Children’s Healthcare of Atlanta
Atlanta, Georgia

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

Response: As the evidence has accumulated regarding the health risks associated with sugar-sweetened beverages, I’ve wondered about fruit juices.  Though they have a kind of healthy halo, their main ingredients are the same as sugar-sweetened beverages, sugar and water.  We know that young children drink a lot of fruit juice, and I’ve wondered if older children and adults might switch to drinking more as concern grows about soft drinks and other sugar-sweetened beverages.

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Do Smokers Stick to Cancer Screening Guidelines?

MedicalResearch.com Interview with:

Nina Niu Sanford, M.D. Assistant ProfessorUT Southwestern Department of Radiation OncologyDallas TX 75390

Dr. Sanford

Nina Niu Sanford, M.D. 
Assistant Professor
UT Southwestern Department of Radiation Oncology
Dallas TX 75390 

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

Response: The background of this study is that smoking is associated with increased risk for multiple cancer types, although the most commonly noted association is between smoking and lung cancer – because of this, lung cancer screening guidelines have been established for current smokers and those who have recently quit.

What is less well known is whether patients who smoke are more or less likely to adhere to screening guidelines for other cancer types.

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

Response: In this study, we found that current smokers were less likely to adhere to national screening guidelines for prostate, breast and colorectal cancer, as compared to never smokers. 

MedicalResearch.com: What should readers take away from your report? 

Response: That smokers are less likely to undergo age appropriate cancer screening for several major cancer types.  This is important because they are at baseline higher risk for these cancers thus without screening, would be more likely to present at advanced stage.  We know that current smoking is a risk factor for worse cancer-specific outcomes, and delayed diagnosis could be one of the contributing factors.

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

Response: Further research is needed to identify the barriers to cancer screening among individuals who smoke, such that initiatives can be undertaken to increase uptake of cancer screening among this population.

Citation:

Sanford NN, Sher DJ, Butler S, et al. Cancer Screening Patterns Among Current, Former, and Never Smokers in the United States, 2010-2015. JAMA Netw Open. 2019;2(5):e193759. doi:10.1001/jamanetworkopen.2019.3759

 

May 19, 2019 @ 6:32 pm

 

 

 

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Cancer Survivors: Insurance Patterns Before and After Affordable Care Act

MedicalResearch.com Interview with:

Nina Niu Sanford, M.D. Assistant ProfessorUT Southwestern Department of Radiation OncologyDallas TX 75390

Dr. Sanford

Nina Niu Sanford, M.D. 
Assistant Professor
UT Southwestern Department of Radiation Oncology
Dallas TX 75390 

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

Response: The background for this study is that we know cancer survivors are at risk for uninsurance or underinsurance and the most commonly cited reason for this is cost of insurance.  However, there have been no prior studies assessing from the patient perspective the reasons for not having insurance.

In addition, there has been further recent controversy over the Affordable Care Act, including threats from the current administration to dismantle it.  Thus assessing the impact of the ACA among at risk populations including cancer survivors is timely.

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Roux-en-Y Gastric Bypass Linked to More Hip Fractures

MedicalResearch.com Interview with:

Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density CenterEndocrine Unit, Massachusetts General Hospital 

Dr. Elaine Yu

Elaine W. Yu, MD, MMSc
Assistant Professor,  Harvard Medical School
Director, Bone Density Center
Endocrine Unit, Massachusetts General Hospital

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

Response: Roux-en-Y gastric bypass (RYGB) is a popular surgical weight loss procedure.  We have previously shown that gastric bypass leads to rapid high-turnover bone loss.

Bariatric procedures are being increasingly performed in older adults, and the clinical consequences of gastric bypass-associated skeletal changes in this vulnerable population have been unclear to date.  Thus, we used Medicare claims data to investigate fracture risk among older adults after gastric bypass, and in comparison to adults who received another bariatric procedure called adjustable gastric banding (AGB), which is thought to have fewer negative bone effects.

In our analysis, we found that patients undergoing Roux-en-Y gastric bypass were 73% more likely to fracture than those undergoing AGB. Importantly, we found that hip fracture risk increased nearly 180% after RYGB, and that fracture rates in patients aged 65 or older were similar to the overall group.  Continue reading

Excessive Supplements Linked to Increased Risk of Hip Fractures

MedicalResearch.com Interview with:

Prof. Haakon E Meyer, PhDDepartment of Public Health and Global HealthNorwegian Institute of Public HealthOslo, Norway

Prof. Meyer

Prof. Haakon E Meyer, PhD
Department of Public Health and Global Health
Norwegian Institute of Public Health
Oslo, Norway

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

Response: The use of high dose vitamin supplementation is popular in parts of the population, often without any clear indication and in the absence of clear evidence of benefit.

However, side effects can occur, and in a previous published secondary analysis of double blinded randomized controlled trials, we found to our surprise an increased risk of hip fracture in those supplemented with high doses of vitamin B6 in combination with vitamin B12.

This finding was re-assessed in the current study employing data from the large observational Nurses’ Health Study. As in the previous study, we found that a combined high intake of vitamin B6 and B12 was associated with increased risk of hip fracture. Continue reading

Circulating Tumor DNA Linked to Recurrence After Colon Cancer Surgery

MedicalResearch.com Interview with:

Louise OlssonSenior researcherDepartment of Molecular Medicine and SurgeryColorectal SurgeryKarolinski InstituteStockholm, Sweden

Dr. Olsson

Louise Olsson MD PhD
Senior researcher
Department of Molecular Medicine and Surgery
Colorectal Surgery
Karolinski Institute
Stockholm, Sweden 

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

Response: I read a very interesting paper back in 2006 “Detection and quantification of mutation in the plasma of patients with colorectal cancer”. Only some 60 % of patients with early colorectal cancer were detectable in this way whereas patients with stage IV disease all had a high concentration of APC mutations in their plasma. So the prospects of using the method for example, screening of primary colorectal cancer seemed limited but I thought wow, this is the test to detect recurrences and generalized disease during follow-up after surgery for colorectal cancer. After some discussion we started to collect plasma samples from patients at the hospital where I worked and that´s how my research began.

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Over a Million Opioid Prescriptions at Risk of Diversion by Family Members

MedicalResearch.com Interview with:

Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor

Dr. Kao-Ping Chua

Kao-Ping Chua, M.D., Ph.D.
Department of Pediatrics
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan, Ann Arbor

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

Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions.

In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.

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Which Matters More? Pre-Pregnancy Obesity vs Pregnancy Weight Gain?

MedicalResearch.com Interview with:

Dr-Romy GaillardRomy Gaillard MD PhD
LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group
Erasmus MC

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

Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications.

The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known. Continue reading

Pre-Visit Electronic Screening Helps Doctors Counsel Their Adolescent Patients

MedicalResearch.com Interview with:

Cari McCarty, PhDResearch Professor, UWInvestigator, Seattle Children’s Research Institute

Dr. McCarty

Cari McCarty, PhD
Research Professor, UW
Investigator, Seattle Children’s Research Institute 

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

Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care.

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COPD: Aclidinium Bromide (Tudorza Pressair) Has Favorable Safety Profile in Patients with CVD

MedicalResearch.com Interview with:

Robert A. Wise, M.D.Professor of MedicinePulmonary and Critical CareJohns Hopkins University School of MedicineBaltimore, MD 

Dr. Wise

Robert A. Wise, M.D.
Professor of Medicine
Pulmonary and Critical Care
Johns Hopkins University School of Medicine
Baltimore, MD

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

Response: There has been a lingering controversy about the safety of long-acting anti-muscarinic agents (LAMA) as maintenance treatment for COPD in patients who have increased cardiovascular risk.  This study enrolled participants with COPD who also had increased cardiovascular risk or known cardiovascular disease.  Participants were randomly treated with either aclidinium bromide (Tudorza Pressair) or placebo.

Over 3 years of follow up there was no increased risk of adverse cardiovascular events.  Moreover, the medication had a significant benefit in terms of reducing exacerbations and COPD hospitalizations. Continue reading

Over 11 Million US Adults Have Alcoholic Liver Disease

MedicalResearch.com Interview with:

Robert Wong, MD, MS, FACGAssistant Clinical Professor of MedicineDirector, GI Education & ResearchHighland Hospital   I A member of Alameda Health SystemOakland, CA 94602

Dr. Wong

Robert Wong, MD, MS, FACG
Assistant Clinical Professor of Medicine
Director, GI Education & Research
Highland Hospital   I A member of Alameda Health System
Oakland, CA 94602 

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

Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S.  However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder.  Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S

We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease.  Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease.  Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression.

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Could Aspirin Improve Stool Testing for Colon Cancer Screening?

MedicalResearch.com Interview with:
Prof. Dr. med. Hermann Brenner
Clinical Epidemiology and Aging Research
Division Head
German Cancer Research Center
Foundation under Public Law
Germany 

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

Response: Colorectal cancer is the third most common cancer globally, accounting for almost 900.000 deaths every year. Most of these deaths could be prevented by screening colonoscopy with early detection and removal of precursors of the cancer. However, capacities and use of screening colonoscopy are limited in most parts of the world, and low-cost but reliable noninvasive screening tests are important alternative primary screening tests.

The currently best established noninvasive tests are fecal immunochemical tests for hemoglobin (FITs) which are offered for colorectal cancer screening in an increasing number of countries. Although FITs detect the majority of colorectal cancers they detect approximately one out of four advanced adenomas only, the precursors of most colorectal cancers.

We hypothesized that this proportion could be increased by taking a single pill of aspirin two days prior to collecting the stool sample for FIT, because the well-established antithrombotic effects of aspirin might favor detecting occult bleeding from colorectal cancer or its precursors.

Continue reading

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

Are Commercial Peanut Immunotherapy Products Cost-Effective?

MedicalResearch.com Interview with:

Dr. Marcus Shaker

Dr. Shaker

Marcus S. Shaker, MD
Associate Professor of Pediatrics
Associate Professor of Community and Family Medicine
Dartmouth-Hitchcock Medical Center

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

Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment.  Both have tremendous potential benefit.  The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective.

We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present.  That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing.  Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective.

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What Makes Academic Physicians Satisfied With Their Job?

MedicalResearch.com Interview with:

Arabella L. Simpkin,  MD, MMScAssociate Director, Center for Educational Innovation and Scholarship, MGHAssociate Program Director, Education and Curriculum, Internal Medicine Residency, MGHInstructor in Medicine, Harvard Medical SchoolBoston, MA 02114

Dr. Simpkin

Arabella L. Simpkin,  MD, MMSc
Associate Director, Center for Educational Innovation and Scholarship, MGH
Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH
Instructor in Medicine, Harvard Medical School
Boston, MA 02114

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

Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering.

Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States.

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E-Cigs: New Source of Second-Hand Smoke for Children

"E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping/Cloud Chasing" by Vaping360 is licensed under CC BY 2.0 CC BY 2.0MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH
Department of Medicine
Maine Medical Center
Portland

 

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

Response:  Although e-cigarette aerosols are commonly perceived to be “harmless water vapors” they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure.

We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users. Continue reading

West Nile Virus: Lag Time in Reporting Precludes Accurate Public Health Decisions

MedicalResearch.com Interview with:

Nicholas B. DeFelice, PhDDepartment of Environmental Medicine & Public HealthIcahn School of Medicine at Mount SinaiNew York, New York

Dr. DeFelice

Nicholas B. DeFelice, PhD
Department of Environmental Medicine & Public Health
Icahn School of Medicine at Mount Sinai
New York, New York

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

Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions.

We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported.

For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help

1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding),

2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and

3) identify when to intensify blood donor screening. Continue reading

Some with Elevated Alzheimer’s Biomarkers Interested in Aid-in-Dying Information

MedicalResearch.com Interview with:

Emily Largent, PhD, JD, RNAssistant Professor, Medical Ethics and Health PolicyPerelman School of MedicineLeonard Davis Institute of Health EconomicsUniversity of Pennsylvania

Dr. Largent

Emily Largent, PhD, JD, RN
Assistant ProfessorMedical Ethics and Health Policy
Perelman School of Medicine
Leonard Davis Institute of Health Economics
University of Pennsylvania 

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

Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws.

With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying.

Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.  

Continue reading

Machine Learning Can Analyze Entire Transcriptome To Improve Diagnosis of Difficult Cancers

MedicalResearch.com Interview with:

Steven J.M. Jones, Professor, FRSC, FCAHSCo-Director & Head, BioinformaticsGenome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, Canada

Dr. Jones

Steven J.M. Jones, Professor, FRSC, FCAHS
Co-Director & Head, Bioinformatics
Genome Sciences Centre
British Columbia Cancer Research Centre
Vancouver, British Columbia, Canada and

Jasleen Grewal, BSc.Genome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, CanadaJasleen Grewal, BSc.
Genome Sciences Centre
British Columbia Cancer Research Centre
Vancouver, British Columbia, Canada

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

Response: Cancer diagnosis requires manual analysis of tissue appearance, histology, and protein expression. However, there are certain types of cancers, known as cancers of unknown primary, that are difficult to diagnose based purely on their appearance and a small set of proteins. In our precision medicine oncogenomics program, we needed an accurate approach to confirm diagnosis of biopsied samples and determine candidate tumour types for where the primary site of the cancer was uncertain.  We developed a machine learning approach, trained on the gene expression data of over 10,688 individual tumours and healthy tissues, that has been able to achieve this task with high accuracy.

Genome sequencing offers a high-resolution view of the biological landscape of cancers. RNA-Seq in particular quantifies how much each gene is expressed in a given sample. In this study, we used the entire transcriptome, spanning 17,688 genes in the human genome, to train a machine learning method for cancer diagnosis. The resultant method, SCOPE, takes in the entire transcriptome and outputs an interpretable confidence score from across a set of 40 different cancer types and 26 healthy tissues.  Continue reading

Single Higher Dose Radiation Treatment Effective for Metastatic Cancer Pain Relief

MedicalResearch.com Interview with:

Quynh-Nhu Nguyen, MDDepartment of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHouston

Dr. Quynh-Nhu

Quynh-Nhu Nguyen, MD
Department of Radiation Oncology
The University of Texas MD Anderson Cancer Center
Houston

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

 Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases.

The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy)  single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen.  This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases.  This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates.  This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients.  This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy.  Continue reading

Little Consistency Among Leading Nations Regarding Drug Safety Warnings

MedicalResearch.com Interview with:

Dr Barbara Mintzes PhDAssociate Professor The University of Sydney Charles Perkins Centre and School of PharmacyFaculty of Medicine and HealthThe University of Sydney

Dr. Mintzes

Dr Barbara Mintzes PhD
Associate Professor
The University of Sydney Charles Perkins Centre and School of Pharmacy
Faculty of Medicine and Health
The University of Sydney

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

Response: When medicines are approved for marketing, the information available on rare serious harmful effects, longer-term effects, and outcomes in vulnerable populations is often limited. New serious safety concerns often arise when a medicine is already on the market. In many cases these can be  managed for example through dose reductions or avoiding prescribing to at-risk patients. Drug regulatory agencies such as the US FDA often issue safety warnings to let health professionals and the public know  about new evidence of potential harm and often to provide advice on how to avoid this.

We were interested to know how consistent these warnings are between different countries. This is a research project funded by Australia’s National Health and Medical Research Council and the Canadian Institutes of Health Research. We examined warnings for medicines in Australia, Canada the US and the UK over a 10-year period, from 2007 to 2016 inclusive. We were looking at how often regulators issue the same warning if the drug is approved for marketing at the time.  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.

Continue reading

Fentanyl Increasingly Found in Cocaine and Meth Drug Tests

MedicalResearch.com Interview with:

Leah LaRue, PharmD, PMPAssociate Director, Clinical AffairsMillennium Health

Dr. LaRue

Leah LaRue, PharmD, PMP
Associate Director, Clinical Affairs
Millennium Health

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

Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl.

To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time.

Continue reading

Fetal and Early Infant Growth Linked to Persistent Body Fat Patterns

MedicalResearch.com Interview with:

Vincent W. V. Jaddoe, MD, PhDAdjunct Professor of EpidemiologyDepartment of Epidemiology

Dr. Jaddoe

Vincent W. V. Jaddoe, MD, PhD
Adjunct Professor of Epidemiology
Department of Epidemiology

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

Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life.

We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.  Continue reading

How Long Does Protection from DTaP Vaccination Last?

MedicalResearch.com Interview with:

Dr. Matthieu Domenech de Cellès PhDBiostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines,Versailles, France

Dr. Domenech de Cellès

Dr. Matthieu Domenech de Cellès PhD
Biostatistics, Biomathematics, Pharmacoepidemiology, and
Infectious Diseases Unit, Institut Pasteur, Inserm U1181,
University of Versailles St-Quentin-en-Yvelines,
Versailles, France

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

Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination.

Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex.

In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    Continue reading

Early Childhood Infections Associated With Eating Disorders In Adolescence

MedicalResearch.com Interview with:

Lauren Breithaupt, PhDDepartment of PsychologyGeorge Mason UniversityFairfax, Virginia

Dr. Breithaupt

Lauren Breithaupt, PhD
Department of Psychology
George Mason University
Fairfax, Virginia 

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

Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders.

We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    Continue reading