Brief Interruption of HIV Treatment Did Not Lead To Irreversible Expansion of Viral Reservoir

MedicalResearch.com Interview with:

“HIV-infected T cell” by NIAID is licensed under CC BY 2.0

HIV-infected T-cell
NIAID image

Tae-Wook Chun, Ph.D.
National Institutes of Health
Bethesda, MD 20892 

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

Response: While antiretroviral therapy (ART) has improved the clinical outcome for people living with HIV, persistence of viral reservoirs in the peripheral blood and lymphoid tissues remains a hurdle to complete eradication of virus and cure of the infection. We know the vast majority of people living with HIV will experience plasma viral rebound within weeks of cessation of therapy. Considering that current research on the treatment of people living with HIV has been heavily focused on developing strategies aimed at achieving sustained virologic remission in the absence of ART, it is of great interest to investigate whether treatment interruption results in expansion of the viral reservoir and/or damage to the immune system. Using data from a recently concluded trial that employed short-term analytical treatment interruption (ATI), we found that, as expected, HIV DNA increased in the CD4+ T cells of individuals living with HIV during the treatment interruption phase. However, the size of the HIV reservoirs as well as immune parameters returned to baseline 6–12 months after the participants resumed ART.  Continue reading

Frequent Exertion and Frequent Standing at Work Varies By Industry and Occupation Group

MedicalResearch.com Interview with:
Taylor M. Shockey, MPH

Title 42 Fellow
Division of Surveillance, Hazard Evaluations and Field Studies
NIOSH

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

Response: Research has linked repeated exposure to occupational ergonomic hazards, such as frequent exertion and frequent standing, to injuries and musculoskeletal disorders (MSDs) among workers.

To determine the industry and occupation groups that have the highest prevalence rates of frequent exertion at work and frequent standing at work, NIOSH researchers analyzed 2015 National Health Interview Survey data. The results showed large differences among the groups with the agriculture, forestry, fishing, and hunting industry group having the highest prevalence of frequent exertion and standing at work (70.9%) and the construction and extraction occupation group having the highest prevalence of frequent exertion and standing at work (76.9%). These differences indicate a need for targeted interventions to reduce workplace exposure.

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Fewer Cigarettes But More Vaping Among Today’s Adolescents

MedicalResearch.com Interview with:
“Checking your phone and vaping as you do” by Alper Çuğun is licensed under CC BY 2.0
Richard Allen Miech, PhD
Research Professor, Survey Research Center
Institute for Social Research
University of Michigan 

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

Response: Monitoring the Future conducts annual, nationally-representative surveys of ~45,000 adolescents every year to assess trends in substance use.  We track which drugs are gaining traction among adolescents and which are falling out of favor.  The survey draws separate, nationally-representative samples of 8th, 10th, and 12th grade students from about 400 total schools every year.  Once a recruited school agrees to participate, a field interviewer travels to the school to administer the paper-and-pencil survey, typically in classrooms.  The project is funded by the National Institute of Drug Abuse and is carried out by the University of Michigan.  More details on the project’s survey design and survey procedures can be found in chapter 3 here: http://monitoringthefutu re.org/pubs/monographs/mtf- vol1_2016.pdf

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Cocaine Overdoses Rising Especially Among African Americans

MedicalResearch.com Interview with:
“Cocaine” by Nightlife Of Revelry is licensed under CC BY 2.0Dr. Dave Thomas PhD

Health Scientist Administrator
National Institute on Drug Abuse 

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

Response: At the National Institute on Drug Abuse, we support research on all forms of drug use, and are aware that cocaine misuse is on the rise.  We are aware that various forms of drug use can have greater prevalence by race, sex, age and other population characteristics.

The main finding of this paper is that cocaine overdose rates are on the rise and that that the group hit hardest is the non-Hispanic black population.

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Most Homes Harbor Multiple Allergens

MedicalResearch.com Interview with:

Dr. Salo

Dr. Salo

Dr. Pӓivi Salo, PhD Epidemiologist
National Institute of Environmental Health Sciences
NIH

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

Response: Indoor allergens are important risk factors for asthma and respiratory allergies. Only a few studies have investigated residential allergen exposures on a national scale; the National Health and Nutrition Examination Survey (NHANES) 2005-2006 is the largest and most comprehensive study to date.

MedicalResearch.com: What are the main findings?

Response: Our findings show that exposure to multiple allergens is common in U.S. homes; over 90% of homes had three or more detectable allergens, and 73% of homes had at least one allergen at elevated levels. The presence of pets and pests contributed strongly to elevated allergen levels. Housing characteristics also mattered – elevated exposure to multiple allergens was more likely in mobile homes, older homes, rental homes, and homes in rural areas. For individual allergens, exposure levels varied greatly with age, sex, race, ethnicity, and socioeconomic status. Differences were also found between geographic locations and climatic conditions.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Understanding factors that affect allergen levels in homes is important because elevated allergen levels can trigger and exacerbate symptoms in people who suffer from asthma and allergies. We hope that our findings provide beneficial information to a wide audience from patients to clinicians, identifying factors that influence levels of exposure to individual and multiple allergens

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

Response: The relationships between allergen exposures, allergic sensitization, and disease are complex. Further research is needed to determine how allergen exposures interact with other environmental and genetic factors that contribute to asthma and allergies.

MedicalResearch.com: Is there anything else you would like to add?

Response: We also compared allergen exposures and previously reported allergic sensitization patterns from this national survey to provide a more complete picture. The allergy focused component in NHANES 2005-2006, which we developed in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID) and the Centers for Disease Control and Prevention (CDC), allowed national comparisons for the first time. The observed differences and overlaps reflect the complex nature of the relationships between allergen exposures, allergic sensitization, and disease.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Salo P, Wilkerson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, Sever ML, Gergen PJ, Thorne PS, Zeldin DC. 2017. Bedroom allergen exposures in US households. J Allergy Clin Immunol; doi: 10.1016/j.jaci.2017.08.033(link is external) [Online 30 November 2017].

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

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Overeating High-Fructose Corn Syrup Can Raise Both Hunger and Cortisol Levels

MedicalResearch.com Interview with:
“Herring in high fructose corn syrup” by Ray Sawhill is licensed under CC BY 2.0Paolo Piaggi PhD and
Marie Thearle MD
Phoenix Epidemiology and Clinical Research Branch
National Institute of Diabetes and Digestive and Kidney Diseases
National Institutes of Health, Phoenix, Arizona 

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

Response: Changes in food preparation have occurred over the recent decades including wide-spread availability of convenience foods and use of fructose as a sweetener. In addition, there is a growing trend to label certain foods as “healthy”. As the ingestion of added sugars and the prevalence of obesity have steadily increased over time, it has been suggested that the increased consumption of simple sugars may have contributed to the recent obesity epidemic.

We were interested in understanding whether the body responded to overeating foods with a high carbohydrate content differently if the source of the carbohydrate differed. For example, does it matter if we overeat foods containing whole wheat instead of high-fructose corn syrup? To answer this question, we conducted a study investigating changes in metabolism, circulating hormones, and appetite ratings in humans who were overfed a diet containing 75% carbohydrates for 24 hours. The subjects in the study were overfed with a high carbohydrate diet twice – once with a diet where the source of carbohydrates was whole wheat and once with a diet that contained simple sugars, primarily high-fructose corn syrup (HFCS). Note that the diets were given in random order with at least three days of recovery in between the overfeeding periods.

There was no difference in people’s metabolic rate over 24 hours between the whole-wheat versus high-fructose corn syrup diets; however, the diet containing HFCS resulted in increased hunger scores the next morning even though people had overeaten the day prior. These increased hunger scores were comparable to the hunger scores reported after a day of fasting. Also, 24-hour urinary free cortisol concentrations were higher the day after the diet containing high-fructose corn syrup. Cortisol is a hormone released by the adrenal glands in response to physiologic stress.

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Infectious Prions Detected in Skin of Patients With Neurodegenerative Creutzfeldt-Jakob Disease

MedicalResearch.com Interview with:

The brain of one patient who died from sporadic Creutzfeldt-Jacob disease (sCJD) appears nearly identical to the brain of a mouse inoculated with infectious prions taken from the skin of patients who died from sCJD.

The brain of one patient who died from sporadic Creutzfeldt-Jacob disease (sCJD) appears nearly identical to the brain of a mouse inoculated with infectious prions taken from the skin of patients who died from sCJD.
Case Western Reserve University

 

Byron Caughey, Ph.D.
Senior Investigator
Chief, TSE/prion Biochemistry Section
Laboratory of Persistent Viral Diseases
NIH/NIAID Rocky Mountain Laboratories
Hamilton, MT 

 

 

MedicalResearch.com: Would you briefly explain what is meant by Creutzfeldt-Jakob disease?

Response: Creutzfeldt-Jakob disease (CJD) is an incurable—and ultimately fatal—transmissible, neurodegenerative disorder in the family of prion diseases. Prion diseases can be found in many mammalian species and are due to the conversion of normally harmless prion protein molecules into abnormally folded, aggregated and self-propagating clusters and filaments in the brain. The accumulation of these clusters has been associated with tissue damage that often leaves dying neurons and microscopic sponge-like holes in the brain. In the sporadic and genetic forms of CJD this pathogenic process appears to arise spontaneously in the patient.

However, the transfer of the prion protein aggregates from a Creutzfeldt-Jakob disease patient into another human or experimental animal can initiate the pathogenic process in the recipient. These infectious forms of prion protein are called prions. Human prion diseases include fatal insomnia; kuru; Gerstmann-Straussler-Scheinker syndrome; and variant, familial and sporadic CJD. Sporadic CJD is the most common human prion disease, affecting about one in one million people annually worldwide. Other prion diseases include scrapie in sheep; chronic wasting disease in deer, elk and moose; and bovine spongiform encephalopathy (BSE), or mad cow disease, in cattle.

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Aldosterone-Mineralocorticoid Pathway Linked To Craving For Alcohol

MedicalResearch.com Interview with:

Lorenzo Leggio, M.D., Ph.D. Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory 

Dr. Leggio

Lorenzo Leggio, M.D., Ph.D.
Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a NIAAA intramural laboratory

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

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

Response: Aldosterone is an important hormone involved in the control of blood pressure and electrolytes via its mineralcorticoid receptor (MR). In addition to its roles in the periphery in our body, aldosterone also acts on the brain where the MR is particularly present in regions like the amygdala. The amygdala plays an important role in stress, anxiety and excessive alcohol drinking. Back in 2008, we conducted a small pilot study where we found that alcohol-dependent patients with higher blood aldosterone concentrations have higher alcohol craving.

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Antidepressant May Enhance Drug Delivery to the Brain

MedicalResearch.com Interview with:

Ronald Cannon, Ph.D. Staff scientist at NIH’s National Institute of Environmental Health Sciences

Dr. Cannon

Ronald Cannon, Ph.D.
Staff scientist at NIH’s National Institute of Environmental Health Sciences

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

Response: The protein pump, P-glycoprotein, is a major obstacle to the delivery of therapeutic drugs across the blood-brain barrier and into the central nervous system (CNS). During the last 10 years, our laboratory has studied the regulation of P-glycoprotein with the hope of treating CNS diseases.

MedicalResearch.com: What are the main findings?

Response: Our most recent finding shows that the antidepressant, amitriptyline, suppresses P-glycoprotein pump activity. The discovery is significant because P-glycoprotein restricts most CNS targeted drugs from entering the brain. If fully translatable to human patients, suppression of P-glycoprotein could allow higher levels of CNS therapeutic drugs to reach their intended target.

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Hair Cortisol in the Evaluation of Cushing Syndrome

MedicalResearch.com Interview with:
Mihail Zilbermint, M.D.
Endocrinologist, Office of the Scientific Director

Mihail Zilbermint, M.D. Endocrinologist, Office of the Scientific Director Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health

Eunice Kennedy Shriver
National Institute of Child Health and Human Development
National Institutes of Health 

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

Response: Diagnosing Cushing Syndrome is often difficult and challenging.  Diagnosing hypercortisolemia, could require the use of a combination of any of these tests: 24-hour free urine cortisol monitoring, an overnight dexamethasone suppression test, and measurement of late night salivary cortisol.  Cortisol levels may change daily, requiring that testing be repeated.  Undiagnosed and untreated Cushing Syndrome greatly increases morbidity and mortality risk.

Cortisol levels can be detected in hair samples.  Much like hemoglobin A1C is a long-term indicator of blood glucose levels, efforts have been made to determine if hair cortisol could serve as a long-term measure of the body’s glucocorticoid levels.  We sought to compare the results of cortisol levels for Cushing Syndrome patients with data from data on cortisol in hair segments, to gain further information on the role of sampling hair cortisol as an initial or supportive method for diagnosing Cushing Syndrome.

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