Accidents & Violence, Addiction, Author Interviews, NIH, Opiods, Race/Ethnic Diversity / 27.01.2017

MedicalResearch.com Interview with: Dr Meredith S Shiels Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda, MD MedicalResearch.com: What is the background for this study? Response: In most high-income countries, premature death rates have been declining, due to the overwhelming successes of public health efforts to prevent and treat chronic disease. The US is a major outlier, where death rates overall have plateaued, or even increased, as reported recently by our sister agency, the Centers for Disease Control and Prevention. Of particular concern are recent reports of increasing death rates among Americans during mid-life. To expand upon prior findings, we focused on premature death, which we defined as death occurring between the ages of 25 and 64. We examined finely detailed death certificate data for the entire U.S. population and described changes in death rates during 1999-2014 by cause of death, sex, race, ethnicity, and geography. To provide context to our findings, we compared trends in death rates in the U.S. to England and Wales and Canada. (more…)
Author Interviews, NIH, Nutrition, Weight Research / 20.01.2017

MedicalResearch.com Interview with: Janet M. de Jesus, M.S., R.D. Program Officer, Implementation Science Center for Translation Research and Implementation Science (CTRIS) National Heart, Lung, and Blood Institute MedicalResearch.com: What is the background for the DASH diet? What are the main components? Response: The DASH eating plan was created for a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI). DASH stands for Dietary Approaches to Stop Hypertension. The goal of the original DASH trial was to test the eating plan compared to a typical American diet (at the time in the 1990s) on the effect of blood pressure. The DASH eating plan is rich in fruits, vegetables, and whole grains. It includes low-fat dairy products, poultry, fish, legumes, vegetable oils, and nuts; and limits intake of sweets and sugar-sweetened beverages and high-fat meats. The eating plan is a good source of potassium, magnesium, and calcium. The DASH eating plan was shown to reduce blood pressure and improve lipid profiles. A second DASH trial, “DASH-sodium,” showed that adding sodium reduction to the DASH eating plan reduced blood pressure even more. (more…)
Allergies, Author Interviews, NIH, Pediatrics / 05.01.2017

MedicalResearch.com Interview with: Anna Nowak-Wegrzyn, MD Associate Professor of Pediatrics Icahn School of Medicine at Mount Sinai Jaffe Food Allergy Institute New York, NY 10029 MedicalResearch.com: What is the background for this study? Response: Peanut allergy can be fatal, is usually life-long and has no cure. Considering a dramatic increase in prevalence of peanut allergy over the past decades, affecting estimated 2-3% of infants and young children in the US, there is a dire need for prevention. Prior studies determined that risk of peanut allergy is highest in the infants with severe eczema, those with mutations in filaggrin gene resulting in an impaired skin barrier function and those not eating peanut but exposed to peanut in the household dust. In addition, the prevalence of peanut allergy was 10-fold higher among Jewish children in the United Kingdom compared with Israeli children of similar ancestry. In Israel, peanut-containing foods are usually introduced in the diet when infants are approximately 7 months of age and consumed in substantial amounts, whereas in the United Kingdom children do not typically consume any peanut-containing foods during their first year of life. Based on these observations, a landmark clinical trial (Learning Early about Peanut Allergy, LEAP) has been designed to evaluate whether early introduction of peanut into the diet of infant considered at high risk for peanut allergy can reduce the risk of peanut allergy compared to avoidance of peanut. LEAP and other studies suggested that peanut allergy can be prevented by introduction of peanut-containing foods in infancy. The overall reduction in peanut allergy among the infants in the LEAP trial randomized to an early introduction group compared to those who avoided peanut until age 5 years was 81%. (more…)
Author Interviews, Heart Disease, NIH / 20.12.2016

MedicalResearch.com Interview with: Manfred Boehm M.D. Senior Investigator Laboratory of Cardiovascular Regenerative Medicine Center for Molecular Medicine NHLBI-NIH Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Common atherosclerosis (hardening of blood vessels) is the leading cause for vascular diseases worldwide. Vascular calcification is a critical component of atherosclerosis and an indicator of negative outcomes. This process is highly regulated and dynamic. However, the underlying mechanism is poorly understood and no direct treatment is available to stop or reverse this devastating buildup of calcium crystals in the vessel wall. Arterial calcification due to deficiency of CD73 is a rare inherited vascular disease characterized by extensive calcification of blood vessels caused by mutation in a gene encoding an enzyme that generates a compound called Adenosine outside of cells. The lack of this important enzyme, CD73, activates a compensatory mechanism to generated Adenosine by an alternative enzyme. Unfortunately, increased activity of this other enzyme is causing accelerated vascular calcification. By using the patient’s own cells, this study characterized the compensatory signaling pathway and discovered several new treatment strategies. (more…)
Author Interviews, Genetic Research, Nature, NIH, Weight Research / 09.12.2016

MedicalResearch.com Interview with: Audrey Chu, Ph.D. Division of Intramural Research National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Body shape reflects the underlying adipose tissue distributed throughout different compartments of the body (ectopic fat). Variation in ectopic fat is associated with diabetes, hypertension and heart disease. This is mostly independent of overall adiposity. Ectopic fat can be measured using special x-rays procedures such as CT (“CAT scans”) or MRI and can give more information about fat distribution. Fat distribution characteristics can run in families, suggesting that a person’s genes can help determine the amount of fat that can accumulate in different parts of the body. Identifying genes that are associated with ectopic fat can provide insight into the biological mechanisms leading to differences in cardiometabolic disease risk. In order to understand which genes might be involved, we examined genetic variants across the genome and their association with ectopic fat in the largest study of its kind including over 18,000 individuals of four different ancestral backgrounds. Several new genetic regions were identified in association with ectopic fat in addition to confirming previously known regions. The association of the new regions was specific to ectopic fat, since the majority of the regions were not associated with overall or central adiposity. Furthermore, most of these regions were not associated with type 2 diabetes, lipids, heart disease or blood pressure. The major exception was the region surrounding the UBE2E2 gene, which was associated with diabetes. (more…)
Author Interviews, Infections, MRSA, NIH, Science / 01.12.2016

MedicalResearch.com Interview with: Warren Leonard, M.D. NIH Distinguished Investigator Laboratory of Molecular Immunology NHLBI, NIH MedicalResearch.com: What is the background for this study? Response: TSLP is a cytokine that has been well studied in the context of T cell helper type 2 (TH2) responses and the promotion of atopic diseases. TSLP is naturally expressed at barrier surfaces, such as the skin; however, its role in skin infections was not previously explored. In our study, we investigated whether TSLP plays a role in host defense to Staphylococcus aureus skin infections, using the most common strain of methicillin-resistant S. aureus (MRSA) present in the United States. (more…)
ADHD, Author Interviews, JAMA, Neurological Disorders, NIH / 22.11.2016

MedicalResearch.com Interview with: Gustavo Sudre, PhD Section on Neurobehavioral Clinical Research, Social and Behavioral Research Branch National Human Genome Research Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: ADHD is the most common childhood neuropsychiatric disorder, affecting 7-9% of school age children. It is highly heritable (h2=0.7), but few risk genes have been identified. In this study, we aimed to provide quantitative brain-based phenotypes to accelerate gene discovery and understanding. ADHD is increasingly viewed as resulting from anomalies of the brain’s connectome. The connectome is comprised of the structural connectome (white matter tracts joining different brain regions) and the functional connectome (networks of synchronized functional activity supporting cognition). Here, we identified features of the connectome that are both heritable and associated with ADHD symptoms. (more…)
Allergies, Author Interviews, NIH / 26.10.2016

MedicalResearch.com Interview with: Geoffrey Mueller, Ph.D. Staff Scientist Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences National Institutes of Health Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? What are the main findings? Response: While allergic disease is a wide spread problem, it is actually a select few proteins, called allergens, that initiate allergy symptoms. This study was focused on looking for fundamental biochemical differences between allergens and non-allergens derived from the house dust mite. We found that the mite allergens, as a group, are distinctly different from the non-allergens in that they are more highly produced, and more stable. Previous anecdotal evidence suggested that these properties would lead to more allergens surviving the journey from the source (either mites or pollens) to a person. In addition, the greater stability of allergens may influence the decision making of the immune system to target these proteins as dangerous instead of harmless. (more…)
Alcohol, Author Interviews, NIH, Pharmacology / 12.10.2016

MedicalResearch.com Interview with: Megan Ryan M.B.A. Clinical Program Director, DMD Technology Development Coordinator National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda, MD MedicalResearch.com: What is the background for this study? Response: Alcohol use disorder (AUD) has been linked to the dysregulation of the brain stress systems (e.g. corticotropin-releasing factor, glucocorticoids, and vasopressin) creating a negative emotional state leading to chronic relapsing behavior. Several pre-clinical studies have shown that by blocking the V1b receptor with a V1b receptor antagonist, dependence induced compulsive-like alcohol intake is also blocked. This is the first multi-site trial to assess the efficacy of the V1b receptor antagonist novel compound (ABT-436) for the treatment of alcohol dependence. (more…)
Author Interviews, JAMA, NIH, OBGYNE / 26.09.2016

MedicalResearch.com Interview with: Stefanie N. Hinkle, Ph.D. Staff Scientist | Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thank you for the interest in our research. Nausea and vomiting are very common early in pregnancy and these symptoms can be difficult for women. Before we began this study there was very limited high-quality data on the implications of these difficult symptoms in pregnancy. Our study is unique because we asked women to report their symptoms continuously throughout their pregnancy before they may or may not have gone on to have a loss. We found that among women with 1 or 2 prior pregnancy losses, women who have nausea, and particularly nausea with vomiting, were less likely to have a pregnancy loss. (more…)
Author Interviews, Biomarkers, JAMA, NIH, Parkinson's / 26.09.2016

MedicalResearch.com Interview with: Yong Cheng, PhD, post-doc fellow Section on Cellular Neurobiology Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda, Maryland MedicalResearch.com: What is the background for this study? Response: Parkinson’s disease is the second most neurodegenerative disease after Alzheimer’s disease. The symptoms of the disease are typically movement related. However, the nonmotor features in PD are increasingly recognized. Evidence suggests that inflammation may play a role in the development of AD, and a substantial number of studies have demonstrated altered levels of peripheral blood inflammatory cytokines in patients with  Parkinson’s disease, but findings have been inconsistent for individual cytokines and between studies. Therefore, we undertook a systematic review of the scientific literature, using a meta-analysis to quantitatively summarize clinical data on blood cytokine levels in patients with PD, compared with healthy controls. (more…)
Author Interviews, Diabetes, Diabetologia, NIH, OBGYNE / 21.09.2016

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator NICHD, National Institutes of Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women are at high risk of developing depressive symptoms; at least 10% US women suffering from depression during pregnancy. Gestational diabetes is a common pregnancy complication, affecting 4-7% of pregnancies in the U.S..  Gestational diabetes has  adverse health implications on both women and their children.   Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes and depression during pregnancy and the postpartum period is less understood. (more…)
Author Interviews, Autism, Biomarkers, JAMA, NIH, Pediatrics / 21.09.2016

MedicalResearch.com Interview with: Dr. Yong Cheng, PhD Postdoctoral Fellow NIH MedicalResearch.com: What is the background for this study? Response: Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which affect about 1 in 68 children in the United States, according to data from the Centers for Disease Control and Prevention. Brain-derived neurotrophic factor (BDNF) is an important moderator in neurodevelopment and neuroplasticity, and studies have suggested the involvement of BDNF in ASD. Although some clinical studies show abnormal expression of BDNF in children with ASD, findings have been inconsistent. Therefore, we undertook a systematic review of the scientific literature, using a meta-analysis to quantitatively summarize clinical data on blood BDNF levels in children with ASD, compared with healthy peers. (more…)
Accidents & Violence, Author Interviews, NIH, OBGYNE / 19.09.2016

MedicalResearch.com Interview with: Pauline Mendola, PhD Investigator, Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Efforts to monitor and reduce maternal mortality during and around the time of pregnancy largely focus on causes physiologically related to the pregnancy, despite the fact that increasing evidence suggests violent death – including homicide and suicide – are leading causes. In this study, we analyzed US death certificates from 2005-2010 from states that include pregnancy information on the death record in order to estimate rates of pregnancy-associated homicide and suicide, and to determine if risk of violent death was increased for women during pregnancy and postpartum. Given the large proportion of death records with unknown pregnancy status, we adjusted for a range of possible misclassification and found that pregnancy-associated homicide risk ranged from 2.2-6.2 per 100,000 live births, while pregnancy-associated suicide risk ranged from 1.6-4.5 per 100,000 live births. Overall, homicide risk was 1.8 times higher among pregnant/postpartum women compared to non-pregnant women in the population. The risk of suicide was 38% lower among pregnant/postpartum women than the general population. (more…)
Author Interviews, Cannabis, Lancet, NIH / 06.09.2016

MedicalResearch.com Interview with: Dr. Wilson Compton MD, Deputy Director National Institute on Drug Abuse MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study found that overall past year marijuana use by adults in the U.S. increased by more than 30% in the past dozen years, and 10 million more people were using marijuana in 2014 than in 2002. Use of marijuana on a daily (or near daily) basis increased even more markedly. In 2002, 3.9 million adults in the U.S. reported using marijuana daily or nearly every day, and the number more than doubled to 8.4 million by 2014. Along with this increase in use, we found that U.S. adults perceptions of the potential harms from using marijuana greatly decreased. Despite scientific evidence of potential harms, adults are much less convinced about dangers associated with using marijuana. These reductions in perceived harm were strongly associated with the increases in use. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH / 24.08.2016

MedicalResearch.com Interview with: Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown. (more…)
Author Interviews, Environmental Risks, NIH, OBGYNE, Ovarian Cancer / 18.08.2016

MedicalResearch.com Interview with: Clarice Weinberg, Ph.D. Deputy Branch Chief Biostatistics and Computational Biology Branch National Institute of Environmental Health Sciences National Institutes of Health Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of studies have reported a link between genital use of talc powders and ovarian cancer. We wondered whether the practice of douching could contribute to that risk by moving fibers and chemicals into and up the reproductive tract. We are carrying out the Sister Study, a large cohort study that enrolled more than 50,000 women who each had a sister diagnosed with breast cancer and who are consequently at increased risk of ovarian cancer. During the Sister Study enrollment interview, we asked each of them about their douching and use of talc in the previous 12 months. During approximately 6 years of follow up, 154 participants developed ovarian cancer. Our statistical analyses did not show any relationship between talc use and risk of ovarian cancer, but we estimated that women who had said they douched had almost double the risk for ovarian cancer compared to women who did not douche. (more…)
Author Interviews, Autism, Genetic Research, NIH / 16.08.2016

MedicalResearch.com Interview with: Karen Usdin, Ph. D. Senior Investigator Chief, Gene Structure and Disease Section Laboratory of Cell and Molecular Biology National Institute of Diabetes, Digestive and Kidney Diseases National Institutes of Health Bethesda MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our laboratory is interested in the causes and consequences of the unusual repeat expansion mutation that causes the Fragile X-related disorders. However these disorders are challenging to study, in part because the repeat tract is difficult to amplify by PCR. This makes monitoring of repeat length, as well as other factors we are interested in such as methylation status and the presence of AGG interruptions, quite difficult. In our experience, both repeat number and methylation status are very variable in patient stem cells and in disease-relevant cell types derived from them. This variability arises because the repeat is prone to both expansion and contraction and because at different times there can be selection for smaller alleles or against unmethylated ones. Thus the frequent monitoring of repeat length and methylation status is critical for work with patient cells, particularly when those cells are to be used for drug screening or to examine the consequences of expansion. While other assays are available to determine one or more of these parameters, some are cumbersome to use or lack the necessary robustness and sensitivity, whilst others are prohibitively expensive for routine laboratory work. We thus saw a need for assays that are robust, sensitive and cost-effective for preclinical studies. (more…)
Author Interviews, Endocrinology, JCEM, NIH, Vitamin D / 08.08.2016

MedicalResearch.com Interview with: Quaker Harmon M.D., Ph.D. 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: Vitamin D is important for bone health. In the United States many women are vitamin D deficient. Vitamin D does not naturally occur in many foods, however some foods are fortified with vitamin D. Supplements and sunshine are the most reliable sources of vitamin D. Previous studies suggested that women using birth control pills containing estrogen had higher levels of vitamin D. These studies were generally small and were not always able to examine important factors such as time spent outside. We were interested in examining the association between hormonal contraception and vitamin D levels in a larger group of women. We found that women who use estrogen-containing contraception had a 20% increase in their vitamin D levels. This increase was not due to time spent outside or behaviors related to choice of contraception. The magnitude of increase for hormonal contraception was smaller than for regular use of a supplement containing vitamin D. (more…)
Author Interviews, Endocrinology, NIH / 05.07.2016

MedicalResearch.com Interview with: Dr. Evgenia Gourgari MD Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) & Pediatric Endocrinology Inter-institute Training Program Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Polycystic ovary syndrome (PCOS) is the most common cause of infertility among women of reproductive age ,yet the etiology of this syndrome remains unknown. Women with PCOS can have high androgens, irregular periods, cysts in their ovaries, acne, excessive facial hair. Women with PCOS are also at high risk to develop diabetes. Androgens and cortisol are hormones that produced from the adrenal glands. We wanted to investigate whether a group of women with PCOS have an adrenal disorder as underlying etiology of PCOS. We found a group of women with PCOS produced more adrenal hormones compared to healthy women and these women also had some characteristics of micronodualr adrenal hyperplasia in their adrenals. Our findings suggest that a problem in the adrenal glands mostly involved in their steroid hormone secretion and how this is regulated may be the underlying cause of PCOS in a subgroup of women with this syndrome. MedicalResearch.com: What should readers take away from your report? Response: Some women with PCOS might have a problem with their adrenal gland, but more research is needed to better understand the role of adrenal glands in the development of PCOS syndrome. (more…)
Author Interviews, Colon Cancer, Geriatrics, Kaiser Permanente, NIH / 27.06.2016

MedicalResearch.com Interview with: Carrie N. Klabunde, PhD Office of Disease Prevention Office of the Director NIH Rockville MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many studies of colorectal cancer screening focus on adults 50-75 years of age; few specifically look at screening in the elderly. We wanted to examine colorectal cancer screening use, including follow-up diagnostic testing for those with abnormal fecal blood screening tests, in adults 65 years of age and older. We also wanted to assess whether screening use in this population is influenced more by elderly individual’s chronological age, or their health status (called comorbidity in our study). The study was conducted in three large, integrated healthcare systems: Kaiser Permanente in Northern California and Southern California, and Group Health in Washington state and Idaho. We examined data on nearly 850,000 patients aged 65-89. (more…)
Author Interviews, MRI, Neurological Disorders, Neurology, NIH, Stroke / 22.06.2016

MedicalResearch.com Interview with: Dr. Richard Leigh MD Neuro Vascular Brain Imaging Unit National Institute of Neurological Disorders and Stroke National Institutes of Health, Bethesda, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients who suffer an ischemic stroke have limited treatment options. One of the reasons for this is that our treatments can sometimes make the stroke worse by transforming the ischemic stroke into a hemorrhagic stroke. In our study we identified a new piece of information that we can extract from the patient’s MRI scan that informs us on the risk of having a hemorrhage. (more…)
ASCO, Author Interviews, Breast Cancer, Genetic Research, Journal Clinical Oncology, NIH / 14.06.2016

MedicalResearch.com Interview with: Valentina Petkov, MD, MPH Health Scientist/Program Officer NIH/NCI/DCCPS/Surveillance Research Program MedicalResearch.com: What is the background for this study? Dr. Petkov: The number of breast cancer diagnoses is increasing in older patients because of increasing life expectancy and changing population demographics. Despite high incidence, little is known about breast cancer biology and outcomes in patients older than 70, which are often under-represented in clinical trials. The 21-gene Oncotype DX Breast Recurrence Score assay has been used in clinical practice to predict distant recurrence risk and chemotherapy benefit in lymph node negative, hormonal receptor positive (estrogen and/or progesterone receptor positive) invasive breast cancer since 2004. The goal of our study was to evaluate the role of the 21 gene assay in older patients at population level. We used Surveillance Epidemiology and End Results (SEER) data. We included in the analysis 40,134 patients who were diagnosed with invasive breast cancer between 2004 and 2011, had negative nodes and their tumors were hormonal receptor positive and HER2 negative. Breast Cancer Specific Mortality (BCSM) was assessed at 5 years after diagnosis in patients with low risk (Recurrence Score <18), intermediate risk (Recurrence Score 18-30) and high risk (Recurrence Score >30). (more…)
Asthma, Author Interviews, NEJM, NIH, Pediatrics, Pulmonary Disease / 18.05.2016

MedicalResearch.com Interview with: Dr. James P. Kiley Ph.D National Institutes of Health Bethesda Maryland  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kiley: While a higher proportion of children have asthma compared to adults, the disease is limited to childhood for many individuals who appear to be unaffected as adults. Regardless of whether asthma continues into adulthood or reoccurs during adulthood, the impact of childhood asthma on lung function later in life is unclear. This study demonstrated that in children with chronic persistent asthma at the age of 5-12 years who continued to be followed through their early twenties, 75% of them had some abnormality in the pattern of their lung growth. The study examined the trajectory of lung growth, and the decline from maximum growth, in a large cohort of persons who had persistent, mild-to-moderate asthma in childhood and determined the demographic and clinical factors associated with abnormal patterns of lung growth and decline. (more…)
Author Interviews, CT Scanning, JAMA, Lung Cancer, NIH / 16.05.2016

MedicalResearch.com Interview with: Hormuzd A. Katki, PhD Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Department of Health and Human Services, Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Katki: The National Lung Screening Trial (NLST) showed that 3 annual CT screens reduced lung cancer death by 20% in a subgroup of high-risk smokers.  However, selecting smokers for screening based on their individual lung cancer risk might improve the effectiveness and efficiency of screening.  We developed and validated new lung cancer risk tools, and used them to project the potential impact of different selection strategies for CT lung cancer screening. We found that risk-based selection might substantially increase the number of prevented lung cancer deaths versus current subgroup-based guidelines.  Risk-based screening might also improve the effectiveness of screening, as measured by reducing the number needed to screening to prevent 1 death.  Risk-based screening might also improve the efficiency of screening, as measured by reducing the number of false-positive CT screens per prevented death. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Diabetes, NIH, Nutrition, OBGYNE / 20.04.2016

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch.com: What is the background for this study? Dr. Zhang: Hypertension is one of the most prevalent and preventable risk factors for cardiovascular and kidney diseases, and is one of the leading causes of death in the United States. We have previously reported that the cumulative incidence of hypertension for women with a history of gestational diabetes mellitus (GDM) was 26% higher than those who did not have GDM even 16 years after the index pregnancy. Thus, women with a history of GDM represent a high-risk population for hypertension that could benefit from early prevention. While there is extensive literature on how lifestyle factors may influence blood pressure in the general population, no information is currently available on the role of diet and lifestyle in the development of hypertension specifically in this susceptible population. To address these gaps, we prospectively examined the associations between long-term adherence to three healthy diets with subsequent risk of hypertension among women with a history of gestational diabetes mellitus, specifically the DASH diet, the alternative Mediterranean diet (aMED), and the Alternative Healthy Eating Index (AHEI). (more…)
Author Interviews, Coffee, Fertility, Lifestyle & Health, NIH, OBGYNE / 24.03.2016

MedicalResearch.com Interview with: Germaine M. Buck Louis, Ph.D., M.S. Office of the Director Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, Maryland 20852. MedicalResearch.com: What is the background for this study? What are the main findings? Response: To understand the association between couples’ lifestyles and risk of pregnancy loss.  Couples were recruited upon discontinuing contraception to try for pregnancy and followed daily for up to one year of trying or until pregnancy.  Pregnant women were followed daily for 7 weeks following conception then monthly. (more…)
Author Interviews, End of Life Care, JAMA, Mental Health Research, NIH / 11.02.2016

MedicalResearch.com Interview with: Scott Y. H. Kim, MD, PhD Department of Bioethics, National Institutes of Health Bethesda, MD 20892 Medical Research: What is the background for this study? Dr. Kim: Euthanasia and/or physician assisted suicide (EAS) of persons suffering from psychiatric disorders is increasingly practiced in some jurisdictions such as Belgium and the Netherlands but very little is known about the practice.  There is an active debate over whether to legalize such a practice in Canada, after a Supreme Court ruling last year that struck down laws banning physician assisted death.  Medical Research: What are the main findings? Dr. Kim: The main findings are that:
  1. Most patients who receive psychiatric euthanasia and/or physician assisted suicide are women, of diverse ages, with a variety of chronic psychiatric conditions accompanied by personality disorders, significant physical problems, and social isolation/loneliness, often in the context of refusals of treatment.  A minority who are initially refused EAS ultimately receive euthanasia and/or physician assisted suicide through a mobile euthanasia clinic.
  2. Given that the patients have chronic, complicated histories requiring considerable physician judgment, extensive consultations are common. But independent psychiatric input does not always occur; disagreement among physicians occurred in one in four cases; and the euthanasia review committees generally defer to the judgments of the physicians performing euthanasia and/or physician assisted suicide.
(more…)
Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, NIH / 03.02.2016

MedicalResearch.com Interview with: Dr. Juan M. Saavedra, MD and Dr. Abdel Elkahloun PhD Comparative genomics and Cancer Genetics Branch National Human Genome Research Institute, National Institutes of Health, Bethesda, MD MedicalResearch: What is the background for this study? What are the main findings? Response: Alzheimer’s disease is the most frequent age-related dementia, a progressing, devastating illness without effective treatment. By the time it is diagnosed, major and irreversible cell injury has already occurred. It is therefore imperative to identify therapeutic agents effective against early, pre-symptomatic injury mechanisms and risk factors increasing vulnerability the disease. We focused on a class of compounds blocking receptors for Angiotensin II, the Angiotensin Receptor Blockers (ARBs). These compounds are commonly used for the treatment of hypertension, a major risk factor for Alzheimer’s disease. We and others have found that in addition to their cardiovascular benefits, ARBs are strongly neuroprotective. The present study was designed to explore in depth the neuroprotective effects of one member of the ARB class, candesartan. To this effect we cultured neurons extracted from the rat brain. These neurons were exposed to high concentrations of glutamate, a recently identified early injury mechanism in Alzheimer’s disease. We found that candesartan prevented glutamate-induced neuronal injury. We conducted in-depth examination of our results by genome-wide expression profile analysis. We found that candesartan normalized glutamate-induced alterations in expression of hundreds of genes, including many involved in neuronal inflammation, cardiovascular disease, diabetes and alterations in amyloid metabolism a hallmark for Alzheimer’s disease. This was evidence of direct neuroprotective effects of relevance for this disorder. When we compared our results with published databases obtained from autopsy samples from Alzheimer’s disease patients, we found impressive correlations. The expression of more than 400 genes altered by glutamate and normalized by candesartan in our cultures was similarly changed in the Alzheimer’s databases. The conclusion was that our cell culture results represented alterations found in the human condition. Our observations provide novel evidence of neuroprotection from early mechanisms of injury in Alzheimer’s disease and support testing candesartan in controlled clinical studies including individuals at the early stages of the illness, to unequivocally demonstrate their therapeutic effect. (more…)