Dr. Torunn Yock[/caption]
Dr. Torunn Yock, MD
Director, Pediatric Radiation Oncology
Associate Professor, Harvard Medical School
Radiation Oncology Quality Assurance
Massachusetts General Hospital, Proton Center
Boston, MA
Medical Research: What is the background for this study?
Dr. Yock: Proton radiotherapy is a highly targeted form of radiation therapy that can spare normal tissues better than standard x-ray/photon based radiotherapy. Because, all side effects from radiotherapy come from radiation dose to normal healthy tissues, it is widely believed that proton radiotherapy has great potential to mitigate the side effects of treatment, both acute and long term side effects. There have been many planning studies that show that proton radiation can achieve a more highly conformal dose distribution and appear to spare 50% or more normal tissue from unnecessary irradiation. However, there have been only a handful of retrospective studies that report disease control and side effects of treatment. While the technology looked promising, the definitive clinical data has been lacking to date. Because of this lack of clinical outcome data, the role and benefit of proton radiotherapy has been a subject of great debate in the oncology community. Critics assert that proton radiotherapy is expensive and unproven and therefore a leading culprit in escalating costs of oncologic health care. Proponents assert that when used in the appropriate patient setting, the margin of benefit in terms of improved health outcomes, outweighs the increased cost of treatment.
We embarked on this study to answer help answer the call for prospectively collected clinical outcome data to better define the most appropriate role for proton radiotherapy. Importantly, this study addresses both disease control and side effects of treatment in a pediatric medulloblastoma cohort of children.
Medical Research: What are the main findings?
Dr. Yock: This study shows that disease control in the pediatric medulloblastoma population is very much the same as that which is achieved by photon based radiotherapy treatments. However, more importantly, late side effects commonly attributed to radiotherapy such as neurocognitive decline over time and hearing loss appear to be improved compared with published photon treated cohorts of pediatric medulloblastoma patients. Additionally, adverse late side effects on the cardiopulmonary, GI, and reproductive systems were essentially eliminated.
Dr. Maryam Farvid[/caption]
Dr. Maryam S. Farvid, PhD
Takemi Fellow
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Farvid: Previous studies of fiber intake and breast cancer have almost all been non-significant, but none of them examined diet during adolescence or early adulthood, a period when breast cancer risk factors appear to be particularly important. Current study supports protective role of dietary fiber intake on breast cancer. The women who reported the highest amount of fiber consumed during high school, about 28 grams daily, had a 16% lower risk of overall breast cancer compared with those who said they consumed an about 15 grams a day. Also highest verses lowest intake of fiber during early adulthood was associated with a 19% lower risk of overall breast cancer. The associations were more apparent for premenopausal breast cancer than postmenopausal breast cancer. Each 10 grams increase in adolescent fiber intake may lead to a 20% lower risk of premenopausal breast cancer, as was a 15% for overall breast cancer.
Dr. Kristi Reynolds[/caption]
KAISER PERMANENTE RESEARCH
RESEARCH & EVALUATION
PASADENA, CA 91101
Medical Research: What is the background for this study?
Dr. Reynolds: Hypertensive disorders during pregnancy are common, affecting up to 10 percent of all pregnant women, and include gestational hypertension, preeclampsia (which is a combination of high blood pressure and protein in the urine), and eclampsia, which includes seizures in women with severe preeclampsia. Research has shown that hypertensive disorders in pregnancy are associated with long-term cardiovascular disease risk, but little is known about the effect of these conditions in the early years after delivery.
As part of our study, we examined the electronic health records of 5,960 women who had prenatal care and delivered a baby at the Kaiser Permanente Southern California Bellflower Medical Center between 2005 and 2010. Women with high blood pressure before their pregnancy were excluded from the analysis.
Medical Research: What are the main findings?
Dr. Reynolds: We found that women who had a hypertensive disorder during pregnancy were 2.4 times more likely – and women with pre-eclampsia/eclampsia 2.5 times more likely – to develop pre-hypertension or hypertension in the year after delivery than those who maintained a normal blood pressure during their pregnancy, after controlling for differences between the groups.
In comparison to women with normal blood pressure during pregnancy, women with pregnancy-related hypertension tended to be slightly younger and overweight or obese before pregnancy. In addition, they were more likely to have had one or more children previously and to gain excess weight and develop gestational diabetes during their pregnancy.
Dr. Briannon O'Connor[/caption]
MedicalResearch.com Interview with:
Briannon O'Connor PhD
New York University Child Study Center
Department of Child and Adolescent Psychiatry
New York University School of Medicine
New York
Medical Research: What is the background for this study? What are the main findings?
Dr. O'Connor: a. As the health care system continues to emphasize accountability for providing high quality care, the development of meaningful quality standards is critical. This study came from NCQA’s work to develop these quality measures for adolescent depression care. Prior to this study, little was known about what routine care looked like for adolescents who showed up at their primary care visits with significant symptoms of depression.
This study looked at follow up care documented in an electronic health record in the three months after an adolescent was first identified with significant symptoms of depression.
Medical Research: What is the background for this study? What are the main findings?
Dr. O'Connor: Key findings from this study include:
Dr. Rosebud Roberts[/caption]
MedicalResearch.com Interview with:
Rosebud O. Roberts, M.B., Ch.B.
Mayo Clinic
Rochester, Minn.
Medical Research: What is the background for this study?
Dr. Roberts: Decline in weight has been observed 10-20 years prior to onset of dementia. We wanted to study whether this decline also occurs for mild cognitive impairment (an intermediate stage in the progression from normal cognition to dementia).
Medical Research: What are the main findings?
Dr. Roberts: The main finding was that there was indeed a decline in weight (from the maximum weight in midlife to weight assessed in late life) was associated with a increased risk of mild cognitive impairment.
Dr. Dominguez-Bello[/caption]
Maria Dominguez-Bello, PhD
Associate Professor, Department of Medicine, Division of Translational Medicine
NYU Langone Medical Center and
[caption id="attachment_21188" align="alignleft" width="150"]
Dr. Jose Clemente[/caption]
Jose Clemente, PhD
Assistant Professor, Departments of Genetics and Genomic Sciences, and Medicine
Icahn School of Medicine at Mount Sinai
Medical Research: What is the background for this study? What are the main findings?
Response: Humans and animals are a composite of their own cells and microbes.
But where they get their microbes from? For mammals, labor and birth are major exposures to maternal vaginal bacteria, and infants are born already with a microbiota acquired from the mother.
Mom’s birth canal is heavily colonized by bacteria that are highly related to milk: some will use milk components and become dominant during early development, an important window for maturation of the immune system, the intestine and the brain. Thus, the maternal vaginal microbiota is thought to be of high adaptive value for newborn mammals. Indeed, studies in mice confirm that microbes acquired at birth are important to develop adequate immune and metabolic responses, and the mature adult microbiome will continue to modulate host metabolism and immunity.
Humans are the only mammals that interrupt the exposure to maternal vaginal microbiota, by delivering babies by Cesarean section. C-sections save lives of babies and moms, and they are estimated necessary in 10-15% of the cases. But most Western countries have rates above 30%, with the notable exception of the Scandinavian countries, Holland and Japan, which have excellent health systems and low maternal-infant mortality rates.
Previous work by us an others has shown that infants born by C-section acquire different microbiota at birth, and those differences are sustained over time, altering the normal age-dependent maturation of the microbiome. The fundamental questions are then, can we restore the microbiota of Cesarean delivered babies? And if we can, does that reduce the associated disease risks? In relation to the first question, we present here the results of a pilot study in which infants born by Cesarean delivery were exposed to maternal vaginal fluids at birth.
A total of 18 infants were recruited for the study. Seven of them were vaginally delivered, the remaining 11 were born by scheduled C-section. Among the C-section infants, 4 were exposed to maternal vaginal fluids at birth and 7 were not. We sampled all infants and their mothers for the first month of life across different body sites (oral, skin, anal, maternal vagina) and determined the microbiome composition on a total of over 1,500 samples.
Dr. Victor Neel[/caption]
Victor Allen Neel, MD, PhD
Director, Dermatologic Surgery
Massachusetts General Hospital
Medical Research: What is the background for this study?
Dr. Neel: Seborrheic keratoses (SKs) are the very common, warty brown skin lesions that are found on the face, chest and back of most people over forty. They affect every race and they increase in size and frequency with age. Although they are not dangerous, they can mimic dangerous conditions and are cosmetically unappealing. There is a high demand in the field of dermatology by both patients and physicians for a topical treatment. Currently there no FDA-approved drugs that have been shown to be effective at removing them.
Medical Research: What are the main findings?
Dr. Neel: Although seborrheic keratoses are the most common benign tumors in humans, very little was known about what causes them. Our paper was the first to study the biology of SKs in the laboratory, identify the key proteins controlling their abnormal growth and to pinpoint a potential treatment for commercial development.
We found that the enzyme called Akt was activated in seborrheic keratoses. Inhibiting this enzyme with a compound called A44 caused the SK cells to undergo "apoptosis," or programmed cell death. Normal skin cells were unaffected by A44.
Dr. Mary Wilson[/caption]
Mary E. Wilson, MD
Visiting Professor of Epidemiology and Biostatistics
School of Medicine, University of California
San Francisco
Adjunct Professor of Global Health and Population
Harvard T.H. Chan School of Public Health
Boston, Massachusetts
Medical Research: What is the background for this study?
Response: Zika virus infections are spreading explosively in the Americas. This flavivirus infection, spread by Aedes mosquitoes, is new to the Americas, so the majority clinicians have little knowledge of the infection and its potential complications. The country most affected so far is Brazil, where more than a million infections have been reported in less than a year. Infection has also spread to at least 20 other countries in the Americas (the Caribbean, Mexico, Central and South America). Prior to 2007 Zika virus was known to cause infections only in Africa and Asia. Since then, it has spread and caused epidemics in Micronesia, French Polynesia, Easter Island, and since 2015 in Brazil. Most of the movement of the virus from one region to another is via travelers who are infected and then are bitten by mosquitoes in a new region.
In Brazil an increase in cases of infants born with microcephaly (small head) has been noted coincident with the Zika epidemic, and the virus has been recovered from amniotic fluid and from fetal tissue, suggesting that Zika infection during pregnancy may cause microcephaly in the developing fetus. An increase in cases of Guillain-Barre syndrome has also been observed during this and previous outbreaks. Studies are underway to determine if Zika virus is the cause of microcephaly and Guillain-Barre syndrome.
Most countries in the Americas, including the United States, are infested with types of mosquitoes that are competent to transmit the virus, but weather conditions also have to be warm enough to permit the virus to disseminate in the mosquito so that it can be transmitted to another person.
The symptoms of Zika virus infection are typically mild and self-limited – fever, aches, rash, and conjunctivitis. In fact, the majority of those infected have no symptoms. Because the virus can enter the bloodstream even in asymptomatic infected persons, there is concern that the virus could be spread by blood transfusion, if a person donates blood during the short period (probably a few days at most) when virus is in the blood.
Other reasons for the paper are to highlight what is known about some of the insect repellents and to point out important gaps in our knowledge of their use and urgent research needs.
Mariah L. White[/caption]
MedicalResearch.com Interview with:
Mariah L. White, MD
Department of Radiology
Mayo Clinic
Rochester, MN 55905
Medical Research: What is the background for this study?
Dr. White: Stage IV (metastatic) melanoma carries a poor prognosis with median survival of 6 to 10 months, claiming over 9000 lives per year in the United States. There is evidence that aggressive focal treatment in patients with oligometastatic disease with complete eradication of all clinical disease can result in durable remissions and potentially improve overall survival. Oligometastatic disease is typically defined as metastatic disease limited to 5 or fewer lesions. Thermal ablation is an alternative local management strategy to resection of limited sites of distant spread. Similar to surgical management of oligometastatic disease it can be used in conjunction with systemic medical therapy or as an alternative in those patients where SMT is not well tolerated or unable to achieve complete remission.
Adil H. Haider, MD, MPH
Kessler Director for the Center for Surgery and Public Health
Brigham and Women's Hospital Harvard Medical School,
and the Harvard T.H. Chan School of Public Health
Deputy Editor of JAMA Surgery
Medical Research: What is the background for this study?
Dr. Haider: Racial/Ethnic disparities have been identified in multiple surgical fields. They are thought to be caused by a complex interplay of patient-, provider-, and systems-level factors. As healthcare professionals, providers play a key role in the care and outcomes that patients experience. However, despite published research about the existence of disparities, it remains unknown the extent to which surgeons perceive that racial/ethnic disparities exist.
Medical Research: What are the main findings?
Dr. Haider: In a pilot study designed to assess the extent to which US surgeons report awareness of racial/ethnic disparities, only 36.6% agreed that racial/ethnic disparities exist in healthcare. Even fewer, 11.6% acknowledged that disparities were present in their hospital or clinic, and a mere 4.7% reported disparities in their personal practice.
Dr. Flavio Vincenti[/caption]
Dr. Flavio Vincenti, M.D
Clinical Professor of Medicine and Surgery
Departments of Medicine and Surgery
Endowed Chair in Kidney Transplantation
University of California, San Francisco
San Francisco, CA 94143
Medical Research: What is the background for this study? What are the main findings?
Dr. Vincenti: This is a phase 3 study of belacept immunosuppression as compared to cyclosporine based immunosuppression in renal transplant recipients randomly assigned to 2 treatments arms of belatacept and a controlled arm consisting of cyclosporine. The main finding of this study is that Belatacept, a fusion receptor protein that blocks co-stimulation and is administered intravenously on the maintenance of a 4 weekly maintenance therapy, had superior outcomes at 5 and 7 years as compared to patients on a CsA-based regimen. The 7 year data show that patients on either arm of belatacept had a 43 percent risk reduction of deaths or grafts loss as compared to patients treated with cyclosporine. In addition, belatcept patients had significantly better preservation of renal function throughout the 7 years of follow up and had lower incidence of donor specific antibodies. Nephrotoxicity from cyclosporine and donor specific antibodies are important causes of late graft loss.
Stanford Chihuri[/caption]
Stanford Chihuri MPH
Center for Injury Epidemiology and Prevention
Department of Anesthesiology
Columbia University Medical Center
New York City, New York
Medical Research: What is the background for this study? What are the main findings?
Response: For many older adults, driving is instrumental to their daily living and is a strong indicator of self-control, personal freedom and independence. This study assesses and synthesizes evidence in the research literature on the impact of driving cessation on subsequent health and well-being of older adults. The main findings are that driving cessation in older adults appears to contribute to a variety of health problems, particularly depression.
Dr. Douglas Corley[/caption]
MedicalResearch.com Interview with:
Douglas A. Corley, MD, PhD
Gastroenterologist and Research Scientist III
Division of Research
Kaiser Permanente
Oakland, CA
Medical Research: What is the background for this study? What are the main findings?
Dr. Corley: Colorectal cancer is a leading cause of cancer death in the United States, so understanding how cancer screening tests for this cancer are used and if they are effective is extremely important.
There are two commonly used tests for colorectal cancer screening in the United States: colonoscopy and fecal immunochemical tests (also known as "FIT"). Colonoscopy requires a bowel preparation to clean you out and is invasive but, if normal, it is done infrequently (every ten years).
FIT is simple to do at home but, to be most effective, needs to be done every year. This has the advantage of potentially picking up cancers that grow between tests. There are few studies that have looked at how well FIT picks up cancers when used year after year. If a test picks up most cancers, it is said to be very "sensitive" for picking up cancer. Most studies only looked at 1 or 2 years of use for how well FITdetected cancers. It is possible that the first year of use may "clear out" most of the easily detectable cancers and that FIT might not work as well in subsequent years.
This very large study over several years at Kaisier Permanente, where we use both colonoscopy and FIT for colorectal cancer screening, looked at whether FIT worked as well at detecting cancer in years 3 and 4 as it did the first time someone used it.
We found that the sensitivity was highest in the first year, likely from clearing out cancers that were there for a while and easily detected, but that in subsequent years the sensitivity, though 5-10% lower, remained high. Also, most people who started with FIT continued doing it, suggesting that it is both feasible and effective for colorectal cancer screening.
MedicalResearch.com Interview with:
Dr Waridibo Allison MD PhD
Department of Medicine, Division of Infectious Diseases and Immunology
New York Langone University School of Medicine
New York, NY 10016
Medical Research: What is the background for this study? What are the main findings?
Dr. Allison: It was found that among 383 baby boomers presenting to a large urban emergency department in New York City the prevalence of HCV antibody reactivity was 7.3%. Only four patients were successfully linked to care and only one patient was started on HCV treatment. The study highlights the possibility that there may be problems in linking patients to care from the ED compared to other clinical settings such as primary care and inpatient settings. It was concluded that only with strategies to improve linkage to care could a screening program for baby boomers be recommended in the ED where the study was carried out.
The study additionally had a qualitative component and, via structured interviews, evaluated knowledge about HCV infection amongst baby boomers presenting to the ED. Overall knowledge was good but some misconceptions about transmission persisted and many patients mistakenly believed that there is a vaccine for hepatitis C.
Dr. Augusto Litonjua[/caption]
MedicalResearch.com Interview with:
Augusto A. Litonjua, MD, MPH
Associate Professor
Channing Division of Network Medicine
and Division of Pulmonary and Critical Care Medicine
Department of Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, MA 02115 USA
Medical Research: What is the background for this study? What are the main findings?
Response: Vitamin D deficiency has been hypothesized to contribute to the asthma and allergy epidemic. Vitamin D has been shown to affect lung development in utero. However, observational studies have shown mixed results when studying asthma development in young children. Since most asthma cases start out as wheezing illnesses in very young children, we hypothesized that vitamin D supplementation in pregnant mothers might prevent the development of asthma and wheezing illnesses in their offspring. We randomly assigned 881 pregnant women at 10 to 18 weeks' gestation and at high risk of having children with asthma to receive daily 4,000 IU vitamin D plus a prenatal vitamin containing 400 IU vitamin D (n = 440), or a placebo plus a prenatal vitamin containing 400 IU vitamin D (n = 436). Eight hundred ten infants were born during the study period, and 806 were included in the analyses for the 3-year outcomes. The children born to mothers in the 4,400 IU group had a 20% reduction in the development of asthma or recurrent wheeze compared to the children born to mothers in the 400 IU group (24% vs 30%, respectively; an absolute reduction of 6%). However, this reduction did not reach statistical significance (p=0.051).
Dr. Thomas Kirchhoff[/caption]
MedicalResearch.com Interview with:
Tomas Kirchhoff, PhD
Assistant Professor, Departments of Population Health and Environmental Medicine
NYU Langone Medical Center
Member, Laura and Isaac Perlmutter Cancer Center
NYU Langone
Medical Research: What is the background for this study?
Dr. Kirchhoff: Melanoma is the deadliest form of skin cancer, and the cause of approximately 80% of all skin cancer patients annually. One factor that can help reverse this negative trend is efficient prediction of which patients at early melanoma stage will likely progress to more advanced metastatic disease. Current clinical predictors of patient survival, based on tumor characteristics, are important, but are relatively non-specific to inform melanoma prognosis to an individual patient level. It is critical to identify other factors that can serve as more personalized markers of predicting the course of melanoma.
Medical Research: What are the main findings?
Dr. Kirchhoff: In our study, we found that inherited genetic markers that impact activity of certain immune genes correlate with melanoma survival. More specifically, our findings show that patients with more frequent forms of these genetic markers (genotypes) have, on average, a five-year shorter survival than patients with less common genotypes. We suggest that these genetic markers are independent of the current tumor surrogates and, as such, can serve as novel personalized markers of melanoma prognosis.
Dr. Ephraim Tsalik
Dr. Chirag Patil[/caption]
MedicalResearch.com Interview with:
Dr. Chirag Patil, MD
American Board Certified Neurosurgeon
Brain & Spine Tumor Program
Lead Investigator, Precision Medicine Initiative Against Brain Cancer
Program Director, Neurosurgical Residence training program
Director, Center for Neurosurgical Outcomes Research Cedars-Sinai Medical Center, Los Angeles, California
MedicalResearch.com Editor’s note: Dr. Patil’s research is focused on developing a method of personalized cancer treatment through the harnessing of genome wide mutational analysis of a specific patient’s cancer.
MedicalResearch.com: Would you tell us a little about yourself and your research interests?
Dr. Patil: I am a Stanford-trained, Board Certified Neurosurgeon and cancer researcher at Cedars-Sinai Medical Center in Los Angeles, California. I primarily focus on the care of patients with malignant brain tumors, particularly glioblastomas. I received my undergraduate degree from Cornell, followed by a medical degree from the University of California, San Francisco (UCSF), where I was a Regent’s scholar. I completed a residency in neurosurgery and a fellowship in stereotactic radiology at Stanford University. I also have a master’s degree in epidemiology with a focus on clinical trial design and mathematical modeling from Stanford.
MedicalResearch.com: Can you tell us about some of your research interests?
Dr. Patil: I am keenly interested in and focused on developing precision science-powered novel brain tumor therapies, immuno-therapies, and patient-centered “big data” outcomes research. I lead the recently-funded Cedars-Sinai Precision Medicine Initiative Against Brain Cancer, which utilizes tumor genomics to build a mathematical computer model, i.e., a virtual cancer cell of each patient’s unique tumor. The White House and several other stakeholders have taken keep interest in this research initiative as an example of a leading precision medicine program.
Dr. Rachael Callcut[/caption]
MedicalResearch.com Interview with:
Dr. Rachael Callcut M.D., M.S.P.H
Assistant Professor of Surgery
Division of General Surgery
UCSF
Medical Research: What is the background for this study? What are the main findings?
Dr. Callcut: San Francisco General Hospital (SFGH) responded on July 6, 2013 to one of the larger multiple casualty events in the history of our institution. Asiana Airlines flight 214 crashed on approach to San Francisco International Airport with 307 people on board. 192 patients were injured and SFGH received the highest total of number of patients of area hospitals. The majority of data that is available on disaster response focuses on initial scene triage or initial hospital resources required to respond to these types of major events. Our paper focuses on some additional considerations for optimizing disaster response not typically included in literature on these events including nursing resources, blood bank needs, and radiology studies. As an example, over 370 hours of nursing overtime were needed just in the first 18 hours following the disaster to care for patients. This type of information in traditionally not been included in disaster planning, but clearly was a critical element of providing optimum care to our patients.
Dr. Jerry Park[/caption]
MedicalResearch.com Interview with:
Jerry Park, Ph.D.
Associate professor of sociology
Affiliate Fellow, Institute for Studies on Religion
Baylor's College of Arts & Sciences
Medical Research: What is the background for this study? What are the main findings?
Dr. Park: Research has shown that media representations of Asian Americans tend stereotype them as a “model minority.” The implied message in those media-based stereotypes is that non-Asian American minorities must not be working hard enough to achieve the same upward mobility levels of Asian Americans.
So we wanted to know
1) whether these stereotypes inhabit the minds of college students and
2) whether those stereotypes are associated with beliefs about racial inequality.
Using data on a sample of white college students at very selective universities (e.g. Columbia, Northwestern, Rice, Stanford) we found that these students tended to rate Asian Americans (as a group) as more competent than Blacks or Latinos. Then we analyzed whether there was a relationship between this stereotype and attitudes that read: “Many [Blacks/ Latinos] have only themselves to blame for not doing better in life. If they tried harder they would do better.” We found that most students disagree with this statement moderately; however when we account for their beliefs about Asian American competence, their responses shift more toward agreement. This confirmed for us that this model minority stereotype is not just in the media but in the thinking of college students as well. And it’s associated with beliefs about other minority groups who are perceived as not working hard enough (as opposed to recognizing the realities of systemic discrimination).
Dr. Jeffrey Silber[/caption]
Jeffrey H. Silber, M.D., Ph.D.
The Nancy Abramson Wolfson Professor of Health Services Research
Professor of Pediatrics and Anesthesiology & Critical Care, The University of Pennsylvania Perelman School of Medicine
Professor of Health Care Management
The Wharton School
Director, Center for Outcomes Research
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
Medical Research: What is the background for this study?
Response: We wanted to test whether hospitals with better nursing work environments displayed better outcomes and value than those with worse nursing environments, and to determine whether these results depended on how sick patients were when first admitted to the hospital.
Medical Research: What are the main findings?
Response: Hospitals with better nursing work environments (defined by Magnet status), and staffing that was above average (a nurse-to-bed ratio greater than or equal to 1), had lower mortality than those hospitals with worse nursing environments and below average staffing levels. The mortality rate in Medicare patients undergoing general surgery was 4.8% in the hospitals with the better nursing environments versus 5.8% in those hospitals with worse nursing environments. Furthermore, cost per patient was similar. We found that better nursing environments were also associated with lower need to use the Intensive Care Unit. The greatest mortality benefit occurred in patients in the highest risk groups.
Pritesh Karia[/caption]
MedicalResearch.com Interview with:
Pritesh S. Karia, MPH
Manager-Dermatologic Oncology Research Program
Mohs and Dermatologic Surgery Center
Brigham and Women's Hospital
Boston, MA 02130
Medical Research: What is the background for this study?
Response: Several recent studies have shown a reduced incidence of skin cancer in organ transplant recipients (OTR) treated with sirolimus as first-time therapy and those converted from calcineurin inhibitors to sirolimus. Although cancer formation is one of the main reasons for conversion to sirolimus, studies examining the effect of sirolimus on the risk of subsequent cancer formation in organ transplant recipients who have already been diagnosed with a post-transplant cancer are limited.
Dr. Brian Elbel[/caption]
Brian Elbel, PhD, MPH, Associate Professor, Department of Population Health, NYU Langone Medical Center
Amy Schwartz, PhD, Director, New York University Institute for Education and Social Policy, and the Daniel Patrick Moynihan Chair in Public Affairs, Syracuse University
Michele Leardo, MA, Assistant Director
New York University Institute for Education and Social Policy
Medical Research: What is the background for this study? What are the main findings?
Response: New York City, as well as other school districts, is making tap water available to students during lunch by placing water dispensers, called water jets, in schools. Surprisingly, drinking water was not always readily available in the lunchroom. Water jets are part of a larger effort to combat child obesity.
We find small, but statistically significant, decreases in weight for students in schools with water jets compared to students in schools without water jets. We see a .025 reduction in standardized body mass index for boys and .022 for girls. We also see a .9 percentage point reduction in the likelihood of being overweight for boys and a .6 percentage point reduction for girls. In other words, the intervention is working.
Dr. Ajay Dharod[/caption]
More on Heart Disease on MedicalResearch.com
MedicalResearch.com Interview with:
Ajay Dharod, M.D.
Coordinator of Medical Informatics
Department of Internal Medicine
Wake Forest School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Dharod: There is a relative paucity of data regarding asymptomatic bradycardia in adults free of clinical cardiovascular disease. Are individuals with low heart rates simply healthy individuals with a non-clinically significant finding or is there a subclinical disease process? That was the question that generated this study. Until now, there had not been any research to determine if a slow heart rate contributed to the development of cardiovascular disease. We found that a heart rate (HR) of less than 50 was not associated with an elevated risk of cardiovascular disease in participants regardless of whether they were taking Heart Rate-modifying drugs, such as beta blockers and calcium channel blockers. However, we did find a potential association between bradycardia and higher mortality rates in individuals taking HR-modifying drugs.
Dr. Marie St-Onge[/caption]
Marie-Pierre St-Onge, Ph.D, FAHA
Assistant Professor, Department of Medicine
New York Obesity Nutrition Research Center
Institute of Human Nutrition
College of Physicians & Surgeons, Columbia University
New York, NY 10032
Medical Research: What is the background for this study? What are the main findings?
Dr. St-Onge: We have shown that sleep affects food intake: restricting sleep increases energy intake, particularly from fat (others also find increased sugar intake). We wanted to know if the reverse was also true: does diet affect sleep at night?
Medical Research: What should clinicians and patients take away from your report?
Dr. St-Onge: Diet quality can play an important role in sleep quality. Sleep can be affect after only a single day of poor dietary intakes (high saturated fat and low fiber intakes). It is possible that improving one’s diet can also improve their sleep.