Author Interviews, Brigham & Women's - Harvard, Lancet, Weight Research / 15.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26066" align="alignleft" width="103"]Dr. Shilpa Bhupathiraju, PhD Harvard T.H. Chan School of Public Health Dr. Shilpa Bhupathiraju[/caption] Dr. Shilpa Bhupathiraju, PhD Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to investigate the association between body mass index (BMI) and mortality across major global regions. In doing so, we wanted to take into account important methodological limitations which plagued prior reports of BMI and mortality. One such limitation is reverse causality where a low body weight is the result of an underlying illness rather than the cause. Another major problem is confounding due to smoking where smokers have lower body weights than non-smokers but have much higher mortality rates. Therefore, to obtain an unbiased association between BMI and mortality, our primary pre-specified analysis was restricted to never smokers and those who had no existing chronic diseases at the start of the study. In this group, we found that those with a BMI of 22.5-<25 kg/m2 (considered a healthy weight range) had the lowest mortality risk during the time they were followed. The risk of mortality increased significantly with excess body weight. A BMI of 25-<27.5 kg/m2 (in the overweight range) was associated with a 7% higher risk of premature death; BMI of 27.5-<30 kg/m2 (also in the overweight range) was associated with a 20% higher risk; a BMI of 30.0-<35.0 kg/m2 was associated with a 45% higher risk; a BMI of 35.0-<40.0 kg/m2 was associated with a 94% higher risk; and a BMI of 40.0-<60.0 kg/m2 was associated with a nearly 3-fold risk. In general, we found that the association of excess body weight with mortality was greater in younger than older people and in men than women. Most importantly, the associations were broadly consistent in the major global regions we examined, including Europe, North America, Australia and New Zealand, East Asia, and South Asia.
Author Interviews, Biomarkers, CT Scanning, McGill, MRI, Nature / 13.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26102" align="alignleft" width="200"]Dr. Yasser Iturria Medina PhD Post-doctoral fellow Montreal Neurological Institute Dr. Y. M. Medina[/caption] Dr. Yasser Iturria Medina PhD Post-doctoral fellow Montreal Neurological Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: We used over 200 peripheral molecular biomarkers, five different neuroimaging modalities and cognitive/clinical measurements to detect spatiotemporal abnormalities in subjects with dementia or with mild signs of cognitive deterioration. By means of a mathematical framework, we reordered all the biomarkers/descriptors considered, according to how much they change during the disease process. The results suggested that, contrary as suggested by more traditional clinical analyses, there are multiple early signs of neurodegeneration, at the molecular level and at the brain’s macroscopic and cognitive state. In particular, we observed notable early signs of generalized vascular dysregulation, which may be supporting the vascular hypothesis of Alzheimer’s disease. However, we still need to perform deeper analyzes, in order to clarify the complex causal mechanisms that trigger the disease.
Alzheimer's - Dementia, Author Interviews, Endocrinology, Hormone Therapy, Mayo Clinic, Menopause / 13.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26098" align="alignleft" width="125"]Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Dr. Kejal Kantarci[/caption] Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology MedicalResearch.com: What is the background for this study? What are the main findings? Response: A rapid decline in estrogen with menopause may be associated with an increased risk of Alzheimer’s disease risk in women. This study was conducted in newly postmenopausal women who received 17β-Estradiol via a skin patch or conjugated equine estrogen orally or placebo. Those who received 17β-Estradiol patch had reduced β-amyloid deposits, the plaques found in the brains of people with Alzheimer’s disease, three years after the end of the hormone therapies. In the study, women with APOE e4 — one form of the most common gene associated with late-onset Alzheimer's disease — who received the 17β-Estradiol patch had lower levels of β-amyloid deposits than those who received placebo.
Author Interviews, Heart Disease, Hospital Readmissions, JACC, NYU/NYMC, Race/Ethnic Diversity / 12.07.2016

MedicalResearch.com Interview with: Matthew Durstenfeld MD Department of Medicine Saul Blecker, MD, MHS Department of Population Health and Department of Medicine New York University School of Medicine NYU Langone Medical Center New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Racial and ethnic disparities continue to be a problem in cardiovascular disease outcomes. In heart failure, minority patients have more readmissions despite lower mortality after hospitalization for heart failure. Some authors have attributed these racial differences to differences in access to care, although this has never been proven. Our study examined patients hospitalized within the municipal hospital system in New York City to see whether racial and ethnic disparities in readmissions and mortality were present among a diverse population with similar access to care. We found that black and Asian patients had lower one-year mortality than white patients; concurrently black and Hispanic patients had higher rates of readmission. These disparities persisted even after accounting for demographic and clinical differences among racial and ethnic groups.
Author Interviews, Cancer, Cancer Research, UCLA / 11.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25998" align="alignleft" width="200"]Karim Chamie MD, MSHS Department of Urology Jonsson Comprehensive Cancer Center David Geffen School of Medicine University of California at Los Angeles Los Angeles, California Dr. Karim Chamie[/caption] Karim Chamie MD, MSHS Department of Urology Jonsson Comprehensive Cancer Center David Geffen School of Medicine University of California at Los Angeles Los Angeles, California MedicalResearch.com: What is the background for this study? Response: With improved cancer outcomes, there are 14 million cancer survivors alive in the United States in 2012. That number is expected to increase to nearly 20 million by 2024. With such a large population, many of these cancer survivors are at risk for developing a second primary malignancy. Multiple primary cancers now account for approximately 17% of all incident cancers reported each year in the United States. Cancer survivors may be especially susceptible to developing second primary malignancies due to a variety of unique factors, including genetic syndromes, common etiologic exposures, and the late effects of chemotherapy and radiotherapy. Given the longer duration of cancer survivorship and the substantial proportion of survivors at risk for developing second primary malignancies, the incidence and mortality from second primary malignancies are likely to increase.
Author Interviews, Brigham & Women's - Harvard, Pancreatic, Weight Research / 10.07.2016

[caption id="attachment_23151" align="alignleft" width="144"]Rakesh K. Jain, Ph.D. A.W.Cook Professor of Radiation Oncology (Tumor Biology) Director, E.L. Steele Laboratory Department of Radiation Oncology Harvard Medical School and Massachusetts General Hospital Boston, MA 02114 Dr. Rakesh Jain[/caption] MedicalResearch.com Interview with; Dr. Rakesh K. Jain, PhD A.W.Cook Professor of Radiation Oncology (Tumor Biology) Director, E.L. Steele Laboratory Department of Radiation Oncology Harvard Medical School and Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death worldwide, and more than half of patients diagnosed with PDAC are overweight or obese. Among patients with PDAC, obesity more than doubles the already high risk of death, and our work aims to reveal the underlying mechanisms. Specifically, we identified that obesity increases desmoplasia – an accumulation of connective tissue and inflammation – hallmark of Pancreatic ductal adenocarcinoma and discovered underlying mechanisms. In our report published online in Cancer Discovery, we describe how interactions among fat cells, immune cells and connective tissue cells in obese individuals create a microenvironment that promotes tumor progression while diminishing the response to chemotherapy. We demonstrated the negative impact of obesity on numerous aspects of tumor growth, progression and treatment response in several animal models of pancreatic ductal adenocarcinoma and confirmed some of our findings in samples from cancer patients. Along with finding that tumors from obese mice or patients exhibited elevated levels of adipocytes or fat cells and of desmoplasia, both of which fuel tumor progression and interfere with treatment response, we identified the underlying causes. The elevated desmoplasia in obese mouse models of PDAC was caused by the activation of pancreatic stellate cells through the angiotensin II type-1 receptor (AT1) signaling pathway. This activation was induced by interleukin-1 beta (IL-1ß) produced by fat cells as well as the immune cells called neutrophils within tumors. Inhibiting AT1 signaling with losartan, which is used clinically to treat hypertension, or the blockade of IL-1ß reduced obesity-associated desmoplasia and tumor growth and increased the response to chemotherapy in the obese mouse model but not in normal weight animals. Analysis of tumors from human PDAC patients revealed increased desmoplasia and fat deposits in samples from obese patients, and data from more than 300 patients showed that excess weight was associated with a reduction in patients.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 10.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25980" align="alignleft" width="180"]Lisa Soleymani Lehmann, MD, PhD Associate Professor of Medicine and Medical Ethics Director, Center for Bioethics, Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts Dr. Lisa Lehmann[/caption] Lisa Soleymani Lehmann, MD, PhD Associate Professor of Medicine and Medical Ethics Director, Center for Bioethics Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: The background for this study is the Choosing Wisely Campaign from the American Board of Internal Medicine (ABIM). This campaign has asked specialty boards to come up with lists of interventions (e.g., imaging, medications, tests) that patients and doctors should question. When it initially came out, we thought it was a great idea, but wondered if patients and doctors would agree that some of the interventions are low value. It’s hard to cut back on things that patients feel are valuable to their care, especially as patient ratings of their doctor’s care become part of hospital ratings and physician reimbursement.
Author Interviews, NYU/NYMC, Race/Ethnic Diversity, Sleep Disorders, Stroke, Weight Research / 09.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25960" align="alignleft" width="144"]Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine Dr. Azizi Seixas[/caption] Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Compared with whites, blacks are disproportionately affected by strokes. The overwhelming prevalence of obesity among blacks compared to whites has been suggested as a possible explanation for the disproportionate rates of strokes among blacks compared to whites. Recent findings linking insufficient sleep and stroke as well as the disproportionate burden of insufficient sleep among blacks compared to whites might provide a unique mechanism explaining why blacks have higher rates of stroke. However, it is unclear whether insufficient sleep and obesity contributes to the higher rates of stroke among blacks compared to whites. To test our hypothesis, we utilized data from the National Health Interview Survey from 2004-2013 with a sample size of 288,888 individuals from the United States. Using Bayesian Belief Network (BBN) analysis, a form of machine learning analysis, we assessed the mediating effects of BMI on the relationship between short sleep duration (≤6 hrs. total sleep duration), long sleep duration (≥9 hrs. total sleep duration), and stroke, and whether race/ethnicity differences in obesity moderated these relationships.
Author Interviews, Cancer Research, Diabetes, NYU/NYMC, Sleep Disorders / 09.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25960" align="alignleft" width="144"]Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine Dr. Azizi Seixas[/caption] Mr. Lloyd Gyamfi and Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: An association exists between unhealthy sleep duration (short:≤6 hrs. or long sleep: ≥ 9hrs.) and cancer. The specific link between cancer and diabetes is unknown. Evidence suggests that cancer and diabetes may share common risk factors such as age, gender, race, being overweight an alcohol use. Based on the data extracted from the National Health Interview Survey (NHIS) dataset (2004-2013) with a sample size of 283,086, it was identified that individuals who had a history of cancer and who reported long sleep duration did not have increased risk of diabetes diagnosis.
Author Interviews, Health Care Systems, Hospital Readmissions, Yale / 09.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25938" align="alignleft" width="183"]Kumar Dharmarajan, MD, MBA Assistant Professor of Medicine (Cardiology) Cardiovascular Medicine: Center for Outcomes Research & Evaluation (CORE) Yale School of Medicine Dr. Kumar Dharmarajan[/caption] Kumar Dharmarajan, MD, MBA Assistant Professor of Medicine (Cardiology) Cardiovascular Medicine: Center for Outcomes Research & Evaluation (CORE) Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Programs from the Centers for Medicare and Medicaid Services simultaneously promote strategies to lower hospital admissions and readmissions. However, there is concern that hospitals in communities that successfully reduce admissions may be penalized, as patients that are ultimately hospitalized may be sicker and at higher risk of readmission. We therefore examined the relationship between changes from 2010 to 2013 in admission rates and thirty-day readmission rates for elderly Medicare beneficiaries. We found that communities with the greatest decline in admission rates also had the greatest decline in thirty-day readmission rates, even though hospitalized patients did grow sicker as admission rates declined. The relationship between changing admission and readmission rates persisted in models that measured observed readmission rates, risk-standardized readmission rates, and the combined rate of readmission and death.
Author Interviews, Colon Cancer, Cost of Health Care, Gastrointestinal Disease, Vanderbilt / 06.07.2016

MedicalResearch.com Interview with: Erica R. H. Sutton, MD Assistant Professor Department of Surgery, General Vanderbilt MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer is one of the most preventable diseases that we face; however, despite the great strides that we have made in the realm of early detection, many people still do not undergo screenings. We sought to increase the availability of screenings to those in our community who are at high risk for colorectal cancer and uninsured by providing free colonoscopies to them and to examine the cost-effectiveness of this intervention. Over a 12-month period, 682 uninsured people underwent screening colonoscopies, and 9 cancers were detected. Compared to the Surveillance, Epidemiology, and End Results (SEER) registry, our patient population included more early-stage cancers, and our program was found to be cost-neutral.
Author Interviews, Brigham & Women's - Harvard, JAMA, Lipids, Nutrition, Omega-3 Fatty Acids / 06.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25788" align="alignleft" width="180"]Daniel (Dong) Wang, MD, ScD, Research Fellow Department of Nutrition | Harvard T.H. Chan School of Public Health Boston, MA 02115 Dr. Wang[/caption] Daniel (Dong) Wang, MD, ScD, Research Fellow Department of Nutrition | Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been widespread confusion in the biomedical community and the general public about the health effects of specific types of fat in the diet. In particular, the role of unsaturated fats vs. saturated fat in cardiovascular disease prevention remains controversial. Our study is by far the most detailed and powerful examination of this very important research topic, i.e., health effects of specific types of dietary fats, because of very large sample size (more than 120,000 men and women), repeated and validated measurements of diet and lifestyle over an extended follow-up (up to 32 years). In addition, our study is able to examine a much broader range of outcomes, including total mortality and mortality due to cardiovascular disease, cancer, neurodegenerative disease and respiratory disease. We found that different types of dietary fat had different associations with mortality. Consuming higher amounts of unsaturated fats- mainly from plant-based foods like olive oil, canola oil, soybean oil and nuts - was associated with lower mortality, while higher consumption of saturated-found in red meat, butter, cheese, and ice cream- and trans fats- predominantly from hydrogenated oils- was linked with higher mortality compared with the same number of calories from carbohydrates. Most importantly, replacing saturated fats with unsaturated fats conferred substantial health benefits, including lowering risk of all-cause premature death and premature death due to cardiovascular disease, cancer, neurodegenerative disease and respiratory disease.
Author Interviews, Beth Israel Deaconess, JAMA, Neurological Disorders / 06.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25765" align="alignleft" width="160"]Samuel Frank, MD Director of the Huntington’s Disease Society of America Center of Excellence Beth Israel Deaconess Medical Center Boston, MA 02215 Dr. Samuel Frank[/caption] Samuel Frank, MD Director of the Huntington’s Disease Society of America Center of Excellence Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Huntington Disease is a hereditary, progressive neurodegenerative disease characterized by involuntary movements (chorea and dystonia), cognitive dysfunction and psychiatric symptoms. Deutetrabenazine is a novel molecule containing deuterium, which attenuates CYP2D6 metabolism, increases active metabolite half-lives leading to stable systemic exposure. We found that deutetrabenazine significantly reduces chorea. There was also an overall improvement in participants' condition based on patient and clinician measures and improvement in a quality of life measure. There was no worsening, but also no improvement in balance. The improvements in Huntington Disease were seen with a remarkably good safety and tolerability profile.
Author Interviews, Blood Pressure - Hypertension, Mineral Metabolism, UT Southwestern / 06.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25830" align="alignleft" width="172"]Dr-Wanpen-Vongpatanasin.jpg Dr. Vongpatanasin[/caption] Wanpen Vongpatanasin, MD Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Research Director, Hypertension Section Cardiology Division UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inorganic phosphate has been added to our processed food at an enormous amount as food preservatives and flavor enhancer such that typical American diet contains twice as much as the recommended daily allowance. A high phosphate (Pi) diet was recently shown to trigger blood pressure (BP) elevation in otherwise normal rats but the mechanisms are still unknown.We found that rats treated with high phosphate diet that mimics the excess Pi consumed by the general American population developed high BP related to increased sympathetic nerve activity (SNA), resulting in excessive peripheral vasoconstriction. This exaggerated increase in SNA and BP is evident particularly during exercise. This study is conducted in collaboration with Drs. Masaki Mizuno and Scott Smith, the two leading experts in neural control of circulation at UT Southwestern in the Department of Health Care Sciences.
Author Interviews, Endocrinology, NIH / 05.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25861" align="alignleft" width="110"]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 Dr. Evgenia Gourgari[/caption] 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.
Author Interviews, Diabetes, UT Southwestern / 05.07.2016

MedicalResearch.com Interview with: Dr. Eunhee Choi Research scientist in the Yu laboratory and lead author of the study UT SouthWestern Dr. Hongtao Yu, Professor of Pharmacology at UT Southwestern and Investigator with the Howard Hughes Medical Institute (HHMI). MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetes is a metabolic disease. High blood sugar is a common symptom of diabetes, and over time it can lead to serious damage to multiple organs. Insulin, a hormone made by the pancreas, regulates blood sugar. Diabetes can occur either when the pancreas does not produce enough insulin (type 1 diabetes) or when the cells in our body cannot efficiently respond to insulin (type 2 diabetes). Diabetes is now a major global epidemic. The World Health Organization (WHO) estimates that more than 400 million people worldwide have diabetes. Insulin binds the insulin receptor (IR) at the cell surface. The insulin-bound IR can send signals inside the cell and instruct the cell to take up sugar from the blood, thus maintaining healthy blood sugar levels. After insulin has done its job, insulin-bound IR is packaged into small vesicles with a protein coat and dragged into the cell, thus terminating the signals. An adequate level of IR on the cell surface is crucial for insulin signaling and blood sugar metabolism. We have found a new mechanism that keeps IR at the cell surface. Without such a mechanism, IR is prematurely dragged inside the cell before it encounters insulin. Our discovery is quite unexpected. A main interest of our lab is to study the molecular control of cell division. During each cell division, the duplicated sister chromosomes are evenly separated into two daughter cells. A cellular surveillance system called the spindle checkpoint ensures the accuracy of sister-chromosome separation. Three checkpoint proteins, p31comet, MAD2 and BUBR1, are critical for accurate chromosome segregation. In the process of studying this checkpoint, we have unexpectedly discovered that mice lacking p31comet in the liver develop diabetes. Liver cells lacking p31comet do not have IR on the cell surface, and thus cannot respond to insulin. We have further shown that MAD2 directly binds to IR, and along with BUBR1, helps to drag IR inside the cell. p31comet prevents BUBR1 from interacting with IR-bound MAD2, thus keeping IR at the cell surface. In cells lacking p31comet, MAD2 and BUBR1 gain the upper hand and remove IR from the cell surface. Thus, the dynamic tug-of-war between p31comet and MAD2-BUBR1 determines the status of IR at the cell surface.
Author Interviews, Blood Pressure - Hypertension, Mineral Metabolism, Nutrition, UT Southwestern / 04.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25830" align="alignleft" width="172"]Dr-Wanpen-Vongpatanasin.jpg Dr. Vongpatanasin[/caption] Dr. Wanpen Vongpatanasin MD The Norman and Audrey Kaplan Chair in Hypertension UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diet rich in fruits, vegetables, and dairy products, known as the DASH diet, is known to reduce blood pressure in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in people with and without high blood pressure . However, the main nutritional ingredient responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of KMg Citrate (KMgCit), K Chloride (KCl), and K Citrate (KCit) to allow dissociation of the three in hypertensive and prehypertensive individuals. This study was conducted in collaboration with Drs. Charles Pak and Orson Moe at UT Southwestern, the two leading experts in the field of Mineral Metabolism. We found that oxidative stress was markedly reduced by KMgCit powder compared to placebo, K Chloride, and K Citrate. On the hand, KMgCit has no significant effects on blood pressure . MedicalResearch.com Editor's note:  DO NOT Take Potassium supplements unless under the direction of your health care provider.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Endocrinology, JAMA / 04.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25685" align="alignleft" width="108"]Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA Dr. Aditya Bardia[/caption] Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response.
Author Interviews, Brigham & Women's - Harvard, Race/Ethnic Diversity, Stroke / 04.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25791" align="alignleft" width="150"]Nilay Kumar M.B.B.S. Attending physician at Cambridge Health Alliance, Cambridge, MA Instructor in Medicine at Harvard Medical School, Boston, MA Dr. Nilay Kumar[/caption] Nilay Kumar M.B.B.S. Attending physician at Cambridge Health Alliance, Cambridge, MA Instructor in Medicine at Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Racial differences in stroke mortality have major health policy implications. A large body of evidence has shown significant racial differences in the incidence of stroke and associated mortality rate (death due to stroke per unit population per year) in the United States. Few studies to date have addressed racial differences in in-hospital outcomes after acute ischemic stroke using population level datasets. Previous studies have shown inconsistent results with respect to racial differences in in-hospital case fatality rate after acute ischemic stroke. Additionally, racial minorities have been known to be less likely to receive evidence based reperfusion therapies for several cardiovascular diseases including acute myocardial infarction and ischemic stroke. Previous studies on racial differences in stroke outcomes have rarely included Asian and Pacific Islanders. Against this background, we aimed to ascertain racial differences in outcomes of acute ischemic stroke hospitalization in the US using a nationally representative sample.
Author Interviews, Baylor College of Medicine Houston, Endocrinology, Sexual Health, Testosterone / 01.07.2016

MedicalResearch.com Interview with: Glenn Cunningham, MD Departments of Medicine and Molecular and Cellular Biology Division of Diabetes, Endocrinology and Metabolism Baylor College of Medicine and Baylor St. Luke's Medical Center Houston, Texas 77030 MedicalResearch.com: What is the background for this study? Response: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of testosterone in symptomatic men ≥65 years with unequivocally low testosterone levels. Previous studies in older men have been limited and the results have been conflicting. Initial results of the Sexual Function Trial showed that testosterone improved sexual activity, sexual desire and erectile function.
Author Interviews, Heart Disease, Nature, Stanford / 30.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25704" align="alignleft" width="151"]Mark Mercola, Ph.D. Professor, Development, Aging and Regeneration Program, Sanford-Burnham-Prebys Medical Discovery Institute Professor, Stanford Cardiovascular Institute and Stanford University School of Medicine La Jolla, California 92037 Dr. Mark Mercola[/caption] Mark Mercola, Ph.D. Professor, Development, Aging and Regeneration Program, Sanford-Burnham-Prebys Medical Discovery Institute La Jolla, California 92037 Professor, Stanford Cardiovascular Institute and Stanford University School of Medicine Stanford, CA, 94305, MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease, especially after heart attack (myocardial infarction) is a major cause of death worldwide, accounting for over 13% of all human mortality. There is a major search for ways to treat the immediate cause or lessen the effect of a heart attack. One way researchers have considered is to boost the blood vessels that nourish the heart muscle. The heart muscle is nourished by many small blood vessels. We found a normal protein that acts as a high level regulator of blood vessel formation in the heart. This protein, known as RBPJ, suppresses the factors that make vessels grow. Therefore, we found that inhibiting this protein made more vessels, and consequently protected the hearts from the damage of a heart attack.
Author Interviews, Emergency Care, Neurological Disorders, NYU/NYMC, Pain Research / 30.06.2016

MedicalResearch.com Interview with: [caption id="attachment_15303" align="alignleft" width="159"]Dr. Mia T. Minen, MD, MPH Director, Headache Services at NYU Langone Medical Center Assistant professor, Department of Neurology Dr. Mia T. Minen[/caption] Mia Minen, MD, MPH Assistant Professor of Neurology NYU Langone Medical Center MedicalResearch.com Editor’s note: The American Headache Society has issued new guidelines on “The Management of Adults With Acute Migraine in the Emergency Department” (1,2) Dr. Minen, Director of Headache Services at NYU Langone Medical Center, discusses these new guidelines below. MedicalResearch.com: What is the background for these new guidelines? How common/severe is the issue of migraine or headache presentation to the ER? Dr. Minen: These guidelines were needed because previous research shows that there are about 1.2. million visits to the emergency department (ED) each year for migraine, and over 25 different medications are sometimes used for treatment. Many of these medications don’t have evidence-based data to back their usage, and opioids are especially likely to be prescribed in between 60 and 70 percent of these cases, despite their lack of efficacy and risks. The American Headache Society convened an expert panel to review the existing evidence on all the medications used to treat migraines in the ED, and we developed these new treatment guidelines.
Author Interviews, Cancer Research, Leukemia, NEJM, Stanford / 29.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25621" align="alignleft" width="200"]Jason R. Gotlib, MD The Clinical Investigator Pathway Hematology Division at Stanford University Medical Cent Dr. Jason R. Gotlib[/caption] Jason R. Gotlib, MD The Clinical Investigator Pathway Hematology Division Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that advanced forms of systemic mastocytosis, which are blood cancers characterized by accumulation of abnormal mast cells in the bone marrow and additional organs, represent a group of orphan diseases with a large unmet need. Approximately 90% of patients harbor the acquired KIT D816V mutation, a mutated receptor tyrosine kinase on the surface of mast cells which a primary driver of disease pathogenesis. Only 1 drug is approved for patients with one form of advanced systemic mastocytosis, termed ‘aggressive systemic mastocytosis, or ‘ASM’. This therapy is imatinib (Gleevec), but it is only approved for patients without the KIT D816V mutation, or with KIT mutation status unknown because the KIT D816V mutation is resistant to imatinib. Therefore, this drug may only be useful for approximately 10% of patients. Other drugs that have been used off-label for systemic mastocytosis (but are not approved for this indication) include interferon-alpha or cladribine, which show some activity, but their evaluation to date has been primarily limited to small case series which are usually retrospective in nature, and include mixed populations of systemic mastocytosis patients who have both early stage disease without organ damage (e.g. indolent systemic mastocytosis) and and advanced stage patients, as included in this trial, who have one or more findings of organ damage. Also, those trials employed differing response criteria and no central adjudication of eligibility and response assessments was undertaken. Midostaurin is a multikinase inhibitor with activity against both wild-type KIT, but most importantly, KIT D816V (in contrast to imatinib). Prior work demonstrated that cell lines transformed with the KIT D816V mutation can be inhibited at relatively low concentrations of midostaurin. These concentrations could also be achieved in vivo (e.g. at concentrations achievable in the blood of patients). Cell lines transformed by KIT D816V could not be inhibited by imatinib.
Author Interviews, Dermatology, JAMA, OBGYNE, Sexual Health, Social Issues, UCSF / 29.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25598" align="alignleft" width="126"]Tami Rowen MD MS Obstetrics, Gynecology and Reproductive Sciences UCSF Dr. Tami Rowen[/caption] Tami Rowen MD MS Obstetrics, Gynecology and Reproductive Sciences UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to answer the question of which women are engaging in genital grooming and understand their motivations. Prior studies have been limited by geography and age thus our goal was to provide a nationally representative sample of women.
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Heart Disease, University of Michigan / 29.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25694" align="alignleft" width="186"]Thomas Valley, MD, MSc Fellow, Pulmonary and Critical Care University of Michigan Ann Arbor, MI 48109-2800 Dr. Thomas Valley[/caption] Thomas Valley, MD, MSc Fellow, Pulmonary and Critical Care University of Michigan Ann Arbor, MI 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hospitalizations for cardiovascular condition such as acute myocardial infarction (AMI) and heart failure (HF) are incredibly common and costly. Yet, about 20% of hospitalized patients with these conditions receive substandard care. We assessed whether there was an association between the quality of care a hospital provided for AMI or heart failure and how frequently a hospital used the ICU. We found that hospitals with the highest rates of ICU use for AMI or HF delivered worse quality of care and had higher 30-day mortality for these conditions.
Author Interviews, Heart Disease, PNAS, UT Southwestern / 28.06.2016

[caption id="attachment_25439" align="alignleft" width="200"]Dr-Audrey-Chang credit: UT Southwestern Dr. Audrey Chang[/caption] MedicalResearch.com Interview with: Dr. Audrey Chang, PhD Kamm-Stull Lab UT Southwestern Medical Center AudreyN.Chang@UTSouthwestern.edu MedicalResearch.com: What is the background for this study? What are the main findings? Response: The heart is a singular kind of muscle that contracts and relaxes continuously over a lifetime to pump blood to the body’s organs. Contractions depend on a motor protein myosin pulling on actin filaments in specialized structures. Heart contraction is improved when myosin has a phosphate molecule attached to it (phosphorylation), and a constant amount of phosphorylation is essential for normal heart function. The amount of phosphorylation necessary for optimal cardiac performance is maintained by a balance in the activities of myosin kinase enzymes that add the phosphate and an opposing phosphatase enzyme that removes the phosphate. If the amount of phosphorylation is too low, heart failure results. Animal models with increased myosin phosphorylation have enhanced cardiac performance that resist stresses that cause heart failure. In this recent study reported in PNAS, a new kinase that phosphorylates myosin in heart muscle, MLCK4, was discovered and its crystal structure reported, a first for any myosin kinase family member. Compared to distinct myosin kinases in other kinds of muscles (skeletal and smooth), this cardiac-specific kinase lacks a conserved regulatory segment that inhibits kinase activity consistent with biochemical studies that it is always turned on. Additionally, another related myosin kinase found only in heart muscle (MLCK3) contains a modified regulatory segment, allowing partial activity enhanced by the calcium modulator protein, calmodulin. Thus, both myosin kinases unique to cardiac muscle provide phosphate to myosin in normal beating hearts to optimize performance and prevent heart failure induced by stresses.
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, University Texas / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25624" align="alignleft" width="83"]Timothy Q. Duong, Ph.D Stanley I. Glickman MD Professor of Ophthalmology, Radiology, and Physiology South Texas Veterans Health Care System, VA Southwest National Primate Research Center University of Texas Health Science Center San Antonio, Texas Dr. Timothy Duong[/caption] Timothy Q. Duong, Ph.D Stanley I. Glickman MD Professor of Ophthalmology, Radiology, and Physiology South Texas Veterans Health Care System, VA Southwest National Primate Research Center University of Texas Health Science Center San Antonio, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: A single oral dose of methylene blue increased fMRI response in the bilateral insular cortex during a task that measured reaction time to a visual stimulus. The fMRI results also showed an increased response during short-term memory tasks involving the brain’s prefrontal cortex, which controls processing of memories. Methylene blue was also associated with a 7 percent increase in correct responses during memory retrieval. The findings suggest that methylene blue can regulate certain brain networks related to sustained attention and short-term memory after a single oral low dose.
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