Alzheimer's - Dementia, Author Interviews, Geriatrics, Johns Hopkins / 03.06.2016

MedicalResearch.com Interview with: Halima Amjad, MD, MPH Post-doctoral Fellow Johns Hopkins University School of Medicine Division of Geriatric Medicine and Gerontology MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Amjad: Safety is an important aspect of dementia care. Dementia is underdiagnosed, however, and there is limited understanding of safety issues in people with undiagnosed dementia. We wanted to better understand potentially unsafe activities and living conditions in all older adults with dementia and specifically examine these activities in undiagnosed dementia. We found that in all study participants with probable dementia, the prevalence of driving, cooking, managing finances, managing medications, or going to physician visits alone was over 20%. The prevalence was higher in older adults with probable dementia without a diagnosis, and even after accounting for sociodemographic, medical, and physical impairment factors, the odds of engaging in these activities was over 2.0 in undiagnosed versus diagnosed probable dementia. Potentially unsafe living conditions including unmet needs and performance on cognitive tests were similar between these groups. (more…)
Author Interviews, Cancer Research, Kaiser Permanente, Pediatrics / 03.06.2016

MedicalResearch.com Interview with: Andrea C. Wickremasinghe, MD Neonatologist Kaiser Santa Clara California MedicalResearch.com: What is the background for this study? Response: Neonatal jaundice is common and is often treated with phototherapy. Phototherapy is typically considered to be benign. In the past decade, phototherapy use has increased and it is sometimes started at bilirubin levels below recommended treatment thresholds. Beginning in the 1970’s, in-vitro and in-vivo studies have shown phototherapy to be associated with cellular changes implicated in the pathogenesis of cancer. Epidemiologic studies have yielded mixed results, with some studies showing associations between phototherapy and leukemia and other studies failing to show this association. In this study, we used a large statewide administrative dataset to investigate the relationship between neonatal phototherapy and cancer in the first year after birth. (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Microbiome / 02.06.2016

MedicalResearch.com Interview with: Dr. W.H. Wilson Tang M.D. Department of Cellular and Molecular Medicine (NC10) Cleveland Clinic Lerner Research Institute Cleveland, Ohio 44195 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our group has recently described the mechanistic link between intestinal microbe-generated phosphatidylcholine metabolite, trimethylamine N-oxide (TMAO), and the pathogenesis of atherosclerotic coronary artery disease (CAD) and its adverse clinical outcomes. Here in a separate, independent, contemporary cohort of patients undergoing coronary angiography, we demonstrated the association between elevated fasting TMAO levels and quantitative atherosclerotic burden (as measured by SYNTAX and SYNTAX II scores) in stable cardiac patients and is an independent predictor for the presence of diffuse (but not focal) lesion characteristics. (more…)
Author Interviews, Baylor College of Medicine Houston, CHEST, Medical Imaging, Outcomes & Safety, Radiology / 01.06.2016

MedicalResearch.com Interview with: Daniel R. Murphy, M.D., M.B.A. Assistant Professor - Interim Director of GIM at Baylor Clinic Department of Medicine Health Svc Research & General Internal Medicine Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Murphy: Electronic health records (EHRs) have improved communication in health care, but they have not eliminated the problem of patients failing to receive appropriate and timely follow up after abnormal test results. For example, after a chest x-ray result where a radiologist identifies a potentially cancerous mass and suggests additional evaluation, about 8% of patients do not receive follow-up imaging or have a visit with an appropriate specialist within 30 days. Identifying patients experiencing a delay with traditional methods, like randomly reviewing charts, is not practical. Fortunately, EHRs collect large amounts of data each day that can be useful in automating the process of identifying such patients. We evaluated whether an electronic “trigger” algorithm designed to detect delays in follow up of abnormal lung imaging tests could help medical facilities identify patients likely to have experienced a delay. Of 40,218 imaging tests performed, the trigger found 655 with a possible delay. Reviewing a subset of these records showed that 61% were truly delays in care that required action. We also found that the trigger had a sensitivity of 99%, indicating that it missed very few actual delays. (more…)
Author Interviews, Depression, Duke, Genetic Research, Mental Health Research, Pediatrics / 27.05.2016

MedicalResearch.com Interview with: Dr. Johnna Swartz, PhD Postdoctoral researcher in the lab of Ahmad Hariri Duke postdoctoral researcher in the lab of Ahmad Hariri MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Swartz: Prior research has shown that low socioeconomic status is a risk factor for the development of depression. In this study, we examined whether this risk factor was associated with changes in an epigenetic tag near the gene coding for the serotonin transporter, which has previously been linked to depression. We found that adolescents growing up in families with lower socioeconomic status accumulated more of these tags over time, which may lead to decreased gene expression. Moreover, we found that more of these tags were associated with increased activity in the amygdala, a brain region that plays an important role in the stress response. Finally, we found that adolescents with increased activity in the amygdala were more likely to develop depression symptoms a year later, particularly if they had a close relative with a history of depression. This is some of the first research to draw a link from an environmental risk factor to changes in depression symptoms through changes in epigenetic markers and brain function. (more…)
Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Exercise - Fitness, JAMA / 26.05.2016

MedicalResearch.com Interview with: NaNa Keum, ScD| Harvard T. H. Chan School of Public Health Department of Nutrition Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? Response: While general health benefits of physical activity are well-known, evidence on its specific benefits on cancer endpoints is limited and physical activity guidelines for cancer prevention lack details in terms of the optimal dose, type and intensity of physical activity. MedicalResearch.com: What are the main findings? Response: We found that the optimal exercise regime to prevent overall digestive system cancers may be to accumulate 30 MET-hours/week of physical activity primarily through aerobic exercise and regardless of its intensity. (more…)
Author Interviews, Baylor College of Medicine Houston, Cancer Research, Gastrointestinal Disease / 24.05.2016

MedicalResearch.com Interview with: Aaron Peter Thrift, Ph.D Assistant Professor Duncan Cancer Center Department of Medicine, Gastroenterology Section Baylor College of Medicine Houston, TX, US MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Thrift: Patients with Barrett’s esophagus are at significantly higher risk of developing esophageal adenocarcinoma. Due to the continued rise in incidence of esophageal adenocarcinoma attention has turned to chemoprevention as a method to delay or halt the progression of Barrett’s esophagus to neoplasia, including invasive cancer. Acid suppressive medications, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs), are commonly used in patients with gastroesophageal reflux disease (GERD), the primary risk factor for Barrett’s esophagus. We contacted a nested case-control study involving 311 patients with Barrett’s esophagus who developed esophageal adenocarcinoma (cases) and 856 matched controls (patients with Barrett’s esophagus but who did not develop esophageal adenocarcinoma). Compared to never users, we found that Barrett’s esophagus patients taking PPIs and H2RAs had 69% and 45% lower risk of esophageal adenocarcinoma, respectively. The associations were independent of other risk factors for progression, including concomitant use of nonsteroidal anti-inflammatory drugs and statins. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lifestyle & Health / 23.05.2016

MedicalResearch.com Interview with: Mingyang Song
Research Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although substantial data support the importance of lifestyle factors for cancer risk, a study published in Science early last year “led some to conclude that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions, while most is due to random mutations arising during stem cell divisions, so-called bad luck.” That study “has been widely covered by the press and has created confusion for the public regarding the preventability of cancer.” In response to that study, we conducted this study to estimate how many cancer cases and deaths in the US can be potentially attributed to common lifestyle factors. Our study showed that about 20-30% of cancer incidences and 40-50% of cancer deaths may be avoided if everyone in the US adopted a lifestyle pattern that is characterized by “never or past smoking (pack-years <5), no or moderate alcohol drinking ([1]1 drink/d for women,[1]2 drinks/d for men), BMI of at least 18.5 but lower than 27.5, and weekly aerobic physical activity of at least 75 vigorous-intensity or 150 moderate-intensity minutes”. (more…)
Author Interviews, Cancer Research, Dermatology, Immunotherapy, Melanoma, NYU / 21.05.2016

MedicalResearch.com Interview with: Melissa A. Wilson, MD, PhD Assistant professor of Medical Oncology NYU Langone Perlmutter Cancer Center MedicalResearch.com: What are the most common types of skin cancer? Dr. Wilson: Basal cell carcinoma, squamous cell carcinoma and melanoma. With rare exception, all are related to sun exposure. MedicalResearch.com: Are some types of skin cancer more serious than others? Dr. Wilson: Melanoma is the most serious form of skin cancer, with the highest risk of developing into metastatic disease. Most basal cell and squamous cell carcinomas are superficial and not as invasive, so removal is the treatment. Rarely, these can cause invasive and metastatic disease, but this occurs infrequently. Melanoma is much more serious. Of course, the earlier melanoma is detected and the earlier stage that it is, is more predictive of a favorable outcome. MedicalResearch.com: Who is most prone to skin cancer? Dr. Wilson: Persons with excessive sun exposure, fair skin, light hair and blue eyes - although it can certainly occur in anyone. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Columbia, Cost of Health Care / 19.05.2016

MedicalResearch.com Interview with: Nathalie Moise, MD, MS Assistant Professor Center for Behavioral Cardiovascular Health Department of Medicine Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What is the background for this study? Dr. Moise:  Our research aimed to compare the number of lives saved and changes in medical costs expected if intensive blood pressure goals of less than 120 mmHg were implemented in high cardiovascular disease risk patients. In 2014, the 8th Joint National Committee (JNC8) on Detection, Evaluation, and Treatment of High Blood Pressure issued new guidelines recommending that physicians aim for a systolic blood pressure (SBP) of 140 mmHg in adults with diabetes and/or chronic kidney disease and 150 mmHg in healthy adults over age 60. The new guidelines represented a major departure from previous JNC7 guidelines recommending SBPs of 130 mmHg and 140, mmHg for these groups, respectively. Under the 2014 guidelines, over 5 million fewer individuals annually would receive drug treatment to lower their blood pressure, compared with the prior 2003 guidelines. Recently, the Systolic Blood Pressure Intervention Trial (SPRINT) found that having a more intensive systolic blood pressure (SBP) goal of 120 mmHg in patients at high risk for cardiovascular disease reduced both cardiovascular events and mortality by about one quarter, compared with the current goal of 140 mmHg. These recent studies and guidelines have created uncertainty about the safest, most effective and high-value blood pressure goals for U.S. adults with hypertension, but no prior study has compared the cost-effectiveness of adding more intensive blood pressure goals in high cardiovascular disease risk groups to standard national primary prevention hypertension guidelines like JNC8 and JNC7. Our team at Columbia University Medical Center conducted a computer simulation study to determine the value of adding the lower, life-saving  systolic blood pressure goal identified in SPRINT to the JNC7 and JNC8 guidelines for high-risk patients between the ages of 35 and 74 years. (High risk was defined as existing cardiovascular disease, chronic kidney disease, or a 10-year cardiovascular disease risk greater than 15 percent in patients older than 50 years and with a pre-treatment SBP greater than 130 mmHg) (more…)
Author Interviews, Columbia, Pediatrics, Toxin Research, Weight Research / 18.05.2016

MedicalResearch.com Interview with: Lori A. Hoepner, DrPH Department of Environmental Health Sciences Columbia University New York, NY 10032 MedicalResearch.com: What is the background for this study? Dr. Hoepner: The Columbia Center for Children’s Environmental Health was funded starting in 1998.  Pregnant African American and Dominican mothers residing in Northern Manhattan and the South Bronx were enrolled from 1998 to 2006, and mothers and their children have been followed since this time.  We collected urine samples from the pregnant mothers in their third trimester and from the children at ages 3 and 5.  At ages 5 and 7 we measured the height and weight of the children, and at age 7 we also measured body fat and waist circumference. MedicalResearch.com:  What are the main findings? Dr. Hoepner:  We found a significant association between increased prenatal exposure to Bisphenol A (BPA) and increases in childhood body fat measures of waist circumference and percent body fat at age 7.  Our research builds on earlier findings of an association between prenatal exposure to BPA and body fat in children up to age 4, and this is the first study to report an association at age 7. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Brigham & Women's - Harvard, Nutrition / 18.05.2016

MedicalResearch.com Interview with: Lea Borgi, MD, MMSc Renal Division, Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Borgi:   The association of potatoes intake with the risk of developing hypertension has not been studied. In our analyses of more than 187,000 participants without a diagnosis of high blood pressure at baseline, we observed that higher intakes of boiled, baked or mashed potatoes and French fries were associated with an increased risk of developing hypertension. Indeed, when participants consumed 4 or more than 4 servings per week of boiled, baked or mashed potatoes as compared to 1 or less than one serving per month, the risk of hypertension increased by 11% (and 17% when French fries were consumed 4 or more than 4 times a week as compared to 1 or less than 1 serving per month). We also found that replacing one serving of boiled, baked or mashed potatoes per day with one serving of a non-starchy vegetable was associated with a lower risk of developing hypertension. (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, Education, JAMA, Sexual Health, University of Michigan / 17.05.2016

MedicalResearch.com Interview with: Reshma Jagsi, MD, DPhil Department of Radiation Oncology, University of Michigan Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Jagsi: There has recently been considerable media attention to certain egregious individual cases of sexual harassment, but it has been less clear whether these cases were isolated and uncommon incidents or whether they are indicative of situations more commonly experienced by academic medical faculty.  An excellent survey study had previously documented that 52% of female faculty in 1995 had experienced harassment, but many of those women had attended medical school when women were only a small minority of the medical students (let alone faculty).  More recent estimates of faculty experiences are necessary to guide ongoing policies to promote gender equity in an era when nearly half of all medical students are women. We found that in a modern sample of academic medical faculty, 30% of women and 4% of men had experienced harassment in their careers. (more…)
Author Interviews, Brigham & Women's - Harvard, Ophthalmology, Technology / 17.05.2016

MedicalResearch.com Interview with: Sheldon J.J. Kwok MD/PhD Candidate Harvard-MIT Health Sciences and Technology | Harvard Medical School Yun Bio-Optics Lab Wellman Center for Photomedicine MGH MedicalResearch.com: What is the background for this study? Response: Corneal collagen crosslinking (CXL) using UV light and riboflavin has become a popular and effective technique for treating corneal ectatic disorders, such as keratoconus, by mechanically strengthening the corneal stroma. We were interested in enhancing the capabilities of CXL using the principle of two-photon excitation, which uses a femtosecond laser to confine crosslinking to only where the laser is focused.  By scanning the laser, this allows us to crosslink any arbitrary three-dimensional region deep inside tissue. With two-photon collagen crosslinking (2P-CXL), treatment of thin corneas is possible without affecting the underlying endothelium. Irradiation can also be patterned to improve keratocyte viability. Furthermore, selective crosslinking in three dimensions offers the possibility of modulating corneal curvature for refractive error correction. (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…)
Author Interviews, Dermatology, JAMA, Telemedicine, UCSF / 16.05.2016

MedicalResearch.com Interview with: Jack Resneck, Jr, MD Professor and Vice-Chair of Dermatology Core Faculty, Philip R. Lee Institute for Health Policy Studies UCSF School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Resneck: Telemedicine, when done right, can improve access and offer convenience to patients.  We have seen proven high-quality care in telemedicine services where patients are using digital platforms to communicate with their existing doctors who know them, and where doctors are getting teleconsultations from other specialists about their patients.  But our study shows major quality problems with the rapidly growing corporate direct-to-consumer services where patients send consults via the web or phone apps to clinicians they don’t know. Most of these sites aren’t giving patients a choice of the clinician who will care for them or disclosing the credentials of those clinicians – patients should know whether their rash is being cared for by a board-certified dermatologist, a pain management specialist, or a nurse practitioner who usually works in an emergency department.  Some of these sites are even using doctors who aren’t licensed in the US.   We also found that these sites were regularly missing important diagnoses, and prescribing medications without discussing risks and side-effects, putting patients at risk.  We observed that if you upload photos of a highly contagious syphilis rash but state that you think you have psoriasis, most clinicians working for these direct-to-consumer sites will just agree with your self-diagnosis and prescribe psoriasis medications, leaving you with a contagious STD. Perhaps the biggest problem with many of these sites is the lack of coordinating care for patients – most of them didn’t offer to send records to a patient’s existing local doctors.  And when patients end up needing in-person care if their condition worsens, or they have a medication side-effect, those distant clinicians often don’t have local contacts, and are unable to facilitate needed appointments. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Race/Ethnic Diversity / 16.05.2016

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard T. H. Chan School of Public Health / Brigham & Women's Hospital Boston, MA 02115  Molly E. Frean Data Analyst Department of Health Policy and Management Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? Dr. Sommers: We conducted this study in an effort to see how Native Americans have fared under the Affordable Care Act. In addition to the law's expansion of coverage via Medicaid and tax credits for the health insurance marketplaces, the law also provided support for Native Americans’ health care specifically through continued funding of the Indian Health Service (IHS). We sought to see how both health insurance coverage patterns and IHS use changed in the first year of the law's implementation. (more…)
Author Interviews, Emory, PAD, Pharmacology / 15.05.2016

MedicalResearch.com Interview with: Shipra Arya MD, SM Assistant Professor, Division of Vascular Surgery Emory University School of Medicine Assistant Professor of Epidemiology (Adjunct) Rollins School of Public Health Staff Physician, Atlanta VA Medical Center Director, AVAMC Vascular Lab and Endovascular Therapy  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Arya: Peripheral Arterial Disease is the next cardiovascular epidemic. It is poorly recognized and not adequately treated compared to heart disease – and research is lacking on the optimal use of statins for PAD patients. Very few randomized clinical trials have been done specifically in PAD patients to assess the impact of statins on cardiovascular outcomes and none on limb related outcomes. The 2013 ACC/AHA guidelines for cholesterol lowering medications recommends high intensity statins for PAD patients extrapolated from the level 2 and 3 evidence and empirically based on CAD and stroke data. In this study we looked at the amputation and mortality risk based on statin dosage in a large cohort of patients from the VA population and found that high intensity statins are associated with a significant reduction in limb loss (~30%) and mortality (~25%) in PAD patients followed by a smaller risk reduction [~23% for amputation risk reduction and 20% reduction in mortality risk] by low-moderate intensity statins as compared to no statin therapy. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Pulmonary Disease / 15.05.2016

MedicalResearch.com Interview with: Michael McGeachie, PhD Instructor in Medicine Harvard Medical School Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Dr. McGeachie: In asthma, and in general but particularly in asthma, a person’s level of lung function has a big impact on his or her quality of life, level of respiratory symptoms and complications, and general morbidity. In asthma, low lung function leads to greater severity and frequency of asthma symptoms. Asthma is a common childhood illness, affecting 9-10% of children. Many children grow out of asthma as they become adults, but other asthmatics remain effected through adulthood, which can lead to a lifetime of respiratory symptoms and chronic airway obstruction, including chronic obstructive pulmonary disease (COPD). If you consider lung function longitudinally, throughout development, plateau, and decline, different people and different asthmatics tend to exhibit different patterns of lung function. Healthy, non-asthmatic people tend to have a period of rapid lung function increase in adolescence, a plateau of lung function level in their late teens and early 20s, and starting around 25 or so a slow, gradual decline of lung function that continues throughout old age. We call this Normal Growth of lung function. However, some people exhibit Reduced Growth, where they don’t reach their expected maximum lung function for a person of the same age, sex, height, and race. Others can show Early Decline, who might reach a normal maximum but then begin to decline immediately without a plateau or with a truncated plateau. We hypothesized that these patterns, Reduced Growth and Early Decline, might have different baseline indicators, precursors, outcomes, and risk of developing COPD. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Nutrition, Pediatrics / 13.05.2016

MedicalResearch.com Interview with: Maryam Farvid, Ph.D. Visiting Scientist Department of Global Health and Population Harvard T.H. Chan School of Public Health MedicalResearch: What is the background for this study? What are the main findings? Dr. Farvid: Breast cancer is one of the most frequently diagnosed cancers and is the second leading cause of cancer deaths among women in the United States. While we know many breast cancer risk factors, few of them are easily modified. Further, evidence suggests that exposure to carcinogens and anti-carcinogens in early life may play an important role. According to this study, what women eat as teens or young adults could affect their breast cancer risk in the future. Teenage girls who eat a lot of fruits may have a lower risk of breast cancer later in life. The risk of breast cancer among women who reported the highest amount of dietary fruits during high school, about 2.9 servings of fruit a day, was 25 percent lower, compared with those who had eaten the lowest amount, about 0.5 serving of fruit a day. We also analyzed individual fruit and vegetable intake and risk of breast cancer: greater consumption of apple, banana, and grapes during adolescence, as well as oranges and kale for young adult was significantly associated with a reduced risk. (more…)
Author Interviews, Kaiser Permanente, OBGYNE, Pediatrics, Weight Research / 12.05.2016

MedicalResearch.com Interview with: Anny H. Xiang, PhD Kaiser Permanente Southern California Department of Research & Evaluation MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Xiang: Previous studies have identified a link between maternal obesity, diabetes and/or excessive gestational weight gain and long-term obesity risk in children. Our study examined the interplay among all four factors associated with childhood obesity: pre-pregnancy obesity, gestational weight gain, gestational diabetes and breastfeeding. To our knowledge, the interplay among these factors and their independent contributions to childhood obesity with data from a large and multi-ethnic cohort under current standard clinical care had not been previously studied. The study included 15,710 women who delivered babies at Kaiser Permanente medical facilities in Southern California in 2011. The key findings were:
  • A woman being obese (BMI of 30.0 or higher) prior to getting pregnant increased the odds of her child being overweight at age 2 by more than two-fold compared to women who had a normal pre-pregnancy weight (BMI between 18.5 and 25), after adjusting for weight gain during pregnancy, gestational diabetes and breastfeeding.
  • A woman being overweight (BMI between 25.0 and 29.9) prior to pregnancy was associated with 50 percent increased odds of her child being overweight at age 2.
  • Excessive weight gain during pregnancy was associated with 23 percent increased odds of a child being overweight at age 2 compared to women who had healthy weight gain during pregnancy after adjusting for pre-pregnancy weight, gestational diabetes and breastfeeding.
  • Breastfeeding for at least six months was associated with a 24 percent reduction for the odds of a child being overweight at age 2 regardless of a mother’s pre-pregnancy weight, gestational diabetes or excessive weight gain during pregnancy.
  • Gestational diabetes was not associated with the risk of a child being overweight at age 2. Women with gestational diabetes in this cohort were treated following standard clinical practice and had 40-49 percent lower rate of excessive weight gain during pregnancy and similar breastfeeding rates compared to women without gestational diabetes.
Excessive weight gain was defined according to Institute of Medicine guidelines, with normal-weight women gaining more than 35 pounds, overweight women gaining more than 25 pounds and obese women gaining more than 20 pounds during their pregnancy. Children were considered overweight at age 2 if their BMI was greater than the 85th percentile for their age and sex, based on growth charts from the Centers for Disease Control and Prevention. (more…)
Author Interviews, Heart Disease, Johns Hopkins, Nature, Technology / 11.05.2016

MedicalResearch.com Interview with: Natalia Trayanova PhD, FHRS, FAHA Murray B. Sachs Endowed Chair Professor of Biomedical Engineering Joint Appointment, Medicine Johns Hopkins University Institute for Computational Medicine Johns Hopkins University Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Trayanova: The methodology for modeling cardiac electrical function has matured sufficiently that we can now create computational models of the electrical functioning of the entire heart. My research is focused on translating this methodology into the clinic. The goal is to create, if you will, "a virtual heart for every patient", that will enable the physician to play our scenarios that manifest the heart dysfunction in the given patient, and to enable physicians to make personalized decisions about patient treatment. The present paper is the first application of this overall vision. The motivation for this particular paper was that determining which patients are at risk for sudden cardiac death represents a major unmet clinical need. Patients at risk receive life-saving implantable defibrillators (ICDs), but because of the low sensitivity and specificity of current approach (based on low ejection fraction), risk assessment is inaccurate. Thus, many patients receive ICDs without needing them, while others die of sudden cardiac death because they are not targeted for ICD therapy under the current clinical recommendations. Our goal was to develop a non-invasive personalized virtual-heart risk assessment tool that has the potential to ultimately prevent sudden cardiac death and avoid unnecessary ICD implantations. (more…)
Author Interviews, Biomarkers, Cancer Research, Genetic Research, MD Anderson / 11.05.2016

MedicalResearch.com Interview with: Dr. Han Liang PhD Associate Professor and Deputy Department Chair, Department of Bioinformatics and Computational Biology The University of Texas MD Anderson Cancer Center Faculty Member, Baylor College of Medicine Houston, TX MedicalResearch: What is the background for this study? What are the main findings? Dr. Liang: An individual’s sex has been long recognized as a key factor affecting the risk of cancer development and management. However, previous studies on the sex effect have been limited to individual genes, single molecular data types, and single cancer lineages. We performed a comprehensive analysis of molecular differences between male and female patients in a diversity of cancer types and revealed two sex-effect groups. One group contains a small number of sex-affected genes, whereas the other shows much more extensive sex-biased molecular signatures. More than half of clinically actionable genes (e.g., therapeutic targets or biomarkers) show sex-biased signatures. (more…)
Abuse and Neglect, Author Interviews, NYU, Pharmacology, Urology / 11.05.2016

MedicalResearch.com Interview with: Dr. Jed Kaminetsky MD Clinical Assistant Professor Department of Urology NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kaminetsky: Nocturia is a voiding disorder not well treated by available drugs for overactive bladder and benign prostatic hypertrophy. Desmopressin stimulates the kidneys to concentrate the urine which results in a greatly reduced volume of urine formation for a period of time. Serenity Pharmaceuticals has spent many years developing a low dose nasal spray version of desmopressin called Noctiva specifically for nocturia. The study reported now is a large, placebo controlled phase 3 trial to confirm the statistical efficacy and clinical benefit of this treatment for nocturia. (more…)
Author Interviews, Heart Disease, University Texas, Weight Research / 11.05.2016

MedicalResearch.com Interview with: Sanghamitra Mohanty, MD MS FHRS Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School What is the background for this study? What are the main findings? Dr. Mohanty:  In the last few years, several trials from a research group in Australia have generated tremendous interest in life-style modifications to manage AF more effectively. These studies reported significant decrease in arrhythmia burden and symptom severity and improvement in ablation outcome in patients with paroxysmal and persistent atrial fibrillation. We investigated the impact of weight-loss on procedure outcome in terms of arrhythmia burden, quality of life and arrhythmia-free survival in long-standing persistent (LSPAF) patients undergoing catheter ablation. Our main findings were the following;
  1. In patients with long-standing persistent atrial fibrillation, weight loss improved quality of life but had no impact on symptom burden and long-term ablation outcome
  2. No change in AF type or status was detected after the weight loss
  3. Extensive ablation including pulmonary vein (PV) isolation plus ablation of posterior wall and non-PV triggers resulted in comparable outcome in both groups at 1-year follow-up, irrespective of weight-loss interventions (63.8% vs 59.3%, p=0.68).
(more…)