MedicalResearch.com Interview with: Susan Swetter, MD
Professor of Dermatology
Director, Pigmented Lesion & Melanoma Program
Stanford University Medical Center & Cancer Institute
Melanoma Survival Disadvantage in Young, Non-Hispanic White Males Compared With Females
MedicalResearch.com: What are the main findings of the study?Dr. Swetter:Women diagnosed with melanoma tend to fare better than men in terms of improved survival, and this has mostly been attributed to better screening practices and behaviors in women that result in thinner, more curable tumors, and/or more frequent physician visits in older individuals that result in earlier detection. Our study focused on survival differences between young men and women (ages 15-39 years) diagnosed with cutaneous (skin) melanoma, who constitute a generally healthy population compared to the older adults that have usually been studied. We found that young men were 55% more likely to die of melanoma than age-matched women, despite adjustment for factors that may affect prognosis, such as tumor thickness, histology and location of the melanoma, as well as presence and extent of metastasis. Our results present further evidence that a biologic mechanism may contribute to the sex disparity in melanoma survival, since adolescent and young adults see physicians less frequently and are less likely to have sex-related behavior differences in skin cancer screening practices than older individuals.
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MedicalResearch.com Interview with: Miguel Ramalho-Santos, Ph.D.
University of California - San Francisco stem-cell scientist,
VitaminC induces Tet-dependent DNA demethylation and a blastocyst-like state in ES cellsMedicalResearch.com: What are the main findings of the study?Answer: We found that Vitamin C has a profound effect in the regulation of gene activity in cultured mouse embryonic stem cells. Vitamin C specifically enhances the action of enzymes called Tet's, which remove certain chemical modifications to DNA (methylation). In this way, Vitamin C makes cultured mouse embryonic stem cells behave more like the early cells in the embryo that they represent.
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MedicalResearch.com Interview with:
Sarah H. O'Connell M.D.
PGY-4
Yale New Haven Hospital
Yale School of Medicine Department of Diagnostic Radiology
MedicalResearch.com: What are the main findings of the study?Answer: The purpose of our study was to evaluate the visibility of cancers in women at high-risk for breast cancer on 2D mammography compared to digital breast tomosynthesis.
In other words, how would the use of tomosynthesis contribute to cancer visualization in this population of patients?
We evaluated the cancers seen in both high-risk patients, those with a >20% lifetime risk of breast cancer, and intermediate risk patients, those with a 15-20% lifetime risk of breast cancer, for a total of 56 cancers.
We found that 41% (23/56) cancers were better seen on tomosynthesis and 4% (2/56) were only seen on tomosynthesis. The majority of the cancers seen better or only on tomosynthesis presented as masses rather than as calcifications alone which were better seen on 2D mammography.
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MedicalResearch.com Interview with
Dr. Karen E. Joynt, MD MPH
Cardiovascular Division
Brigham and Women's Hospital and VA Boston Healthcare System
Department of Health Policy and Management, Harvard School of Public Health
MedicalResearch.com: What are the main findings of the study?Dr. Joynt: The main findings of the study were two-fold.
First, high-cost patients in Medicare (the top decile of spenders) are responsible for about 80% of inpatient spending in the Medicare program, so understanding more about these patients' patterns of care is really important.
Second, we found that only about 10% of acute-care spending for these high-cost Medicare patients were for causes that we generally think of as preventable in the short term, like uncontrolled diabetes, COPD, or heart failure.
The rest of the spending was for acute conditions that we generally don't think of as preventable (at least in the short term), such as orthopedic procedures, sepsis, and cancer.
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MedicalResearch.com Interview with Dr. Kumar Dharmarajan MD MBA
Yale School of Medicine
Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure
MedicalResearch.com: What are the main findings of the study?
We found that among a large contemporary cohort of heart failure hospitalizations, beta blockers are frequently started in patients with markers of clinical instability such as residence in an intensive care unit (ICU), volume overload requiring intravenous diuresis, and poor cardiac output requiring intravenous inotropes. Approximately 40% of patients in whom a beta blocker is started has at least one of these three potential contraindications to treatment.
This finding is concerning, as recent performance measures for heart failure recommend that a beta blocker be started during hospitalization for heart failure among patients with left ventricular systolic dysfunction. However, these performance measures also state that persons in whom a beta blocker is started "should not be hospitalized in an ICU, should have no or minimal evidence of fluid overload or volume depletion, and should not have required recent treatment with an intravenous positive inotropic agent."
Moving forward, we are concerned that the unselective application of the new performance measure may lead to the further use of beta blocker therapy in patients at higher risk for adverse consequences of therapy.
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MedicalResearch.com Interview with: Dr. Susan Redline M.D.,M.P.H.
Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School
Brigham and Women's Hospital
221 Longwood Ave., Boston, MA 02115
MedicalResearch.com: What are the main findings of the study?Dr. Redline: Among children with sleep apnea, early adenotonsillectomy resulted in significant improvements in breathing during sleep, daytime behavior, sleep related symptoms, sleepiness and quality of life when we valuated 6 months after surgery.
MedicalResearch.com: Were any of the findings unexpected?
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MedicalResearch.com Interview with:
Dr. Mitchell Jones, MD, PhD
Faculty of Medicine at McGill University in Montreal
MedicalResearch.com: What are the main findings of the study?Dr. Jones: We had previously reported on the cholesterol lowering efficacy of bile salt hydrolase active L. reuteri NCIMB 30242 due to reduced intestinal sterol absorption.
However, the effects of bile salt hydrolase active L. reuteri NCIMB 30242 on fat soluble vitamins was previously unknown and was the focus of the study.
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MedicalResearch.com Interview with Yanping Li, PhD
Brigham and Women's Hospital and Harvard Medical School
Department of Medicine
Channing Division of Network Medicine
Boston, MA
MedicalResearch.com: What are the main findings of the study?Answer: During 8 years of follow-up, we observed that men with RLS had a 30% increased risk of death.
MedicalResearch.com: Were any of the findings unexpected?Answer:Based on our hypothesis, we would like to observed a higher risk of death from cardiovascular diseases, but we do not.
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Hemodialysis.com Interview with: Christopher Kaufmann, MHS
Department of Mental Health,
Johns Hopkins Bloomberg School of Public Health
Hampton House, Room 800
624 North Broadway
Baltimore, MD 21205
email: [email protected]MedicalResearch.com: What are the main findings of the study?Mr. Kaufmann: The purpose of our study was to examine the association between insomnia and the use of a number of costly health services. We used data from the Health and Retirement Study, a large nationally representative longitudinal population-based study of US middle-aged and older adults. We found that individuals who reported a greater number of insomnia symptoms were more likely to report being hospitalized, using home healthcare services, and using nursing homes two years later. After we accounted for a number of demographic and clinical characteristics, the association between number of reported insomnia symptoms and hospitalization remained statistically significant.
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Department of Psychology & Neuroscience,
Institute for Genome Sciences & Policy
2020 West Main Street, Suite 201
Box 104410
Durham, North Carolina 27708
TITLE:Retinal Vessel Caliber and Lifelong Neuropsychological Functioning
An international research team from the USA, UK, Singapore and New Zealand reports that the size of the blood vessels in the back of the eye can indicate the health of the brain of people approaching midlife (age 38 years), years before age-related declines in brain functioning.
PUBLICATION SOURCE: Psychological Science, advance online publication date, May 2013. BACKGROUND:
Young people who score low on IQ tests, tend to be at higher risk for diseases in later life, and even tend to die younger.
One plausible explanation for this link is that intelligence tests assess brain health.
Digital retinal imaging is a relatively new and non-invasive method to visualize the small blood vessels in the retina, at the back of the eye. The small vessels in the eye may reflect the conditions of the vessels inside the brain because both eye and brain vessels share similar size, structure and function. Thus, retinal imaging can provide a window to study the health of the brain in living humans.
We studied the link between retinal vessel width and intelligence tests scores in the representative Dunedin birth cohort of 1000 New Zealanders born in 1972-73, and followed for 38 years with repeated assessments.
Using a digital fundus camera, which can photograph the interior surface of the eye, we were able to assess the size of the small blood-vessels in the retina, namely, the arterioles and venules (the small branches of the arteries and veins). We also administered intelligence tests in childhood and adulthood.
THE FINDING:
We found that study members who presented with wider venules had poorer intelligence tests scores at midlife (age 38 years). This finding held up independently of potential factors that may explain this link, such as low socio-economic status, smoking, or diabetes.
Moreover, wider venules in the eye were linked with lower childhood IQ that had been tested 25 years earlier.
MedicalResearch.com Interview with: Frederick M. Brown, Ph.D.
Associate Professor
The Pennsylvania State University
Department of Psychology, Cognitive and Wellness
Director, Human Performance Rhythms Laboratory
MedicalResearch.com: What was the primary finding of your study?Dr. Brown:Time of day of an occupation, as well as a regular versus irregular
routine, may influence whether a person wants to go into it or not. Most
educational research has focused on academic major selection motivated
by job aptitude, personality, and sociocultural factors. Our findings
suggest that a person’s genetically determined built-in morning versus
evening (M/E) preference for best time of day to work or sleep may
influence career choice in two important ways: This M/E preference for
work and sleep is related to 1) personality and to 2) the time of day
the job is executed. These may interact with how much sleep a person
thinks they need. In addition to the personality traits associated with
M/E, such as morning people being more introverted and evening people
more extroverted, an individual’s choice of major may be influenced by
their preference for the typical work hours of a profession, such as a
routine 9-to-5 schedule versus irregular evening and weekend work.
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MedicalResearch.com eInterview with:John Hart, M.D.
Medical Science Director at the Center for BrainHealth
Jane and Bud Smith Distinguished Chair
Cecil Green Distinguished Chair
The University of Texas at Dallas
MedicalResearch.com: What are the main findings of the study?Dr. Hart: Football players often sustain numerous concussive and subconcussive impacts—head impacts that do not elicit neurologic symptoms that may lead to white matter damage. We evaluated a population of retired NFL players in order to study the relationship between white matter integrity and the manifestation of depressive symptoms. We identified, for the first time, a correlation between depression and white matter abnormalities in former players with a remote history of concussion using diffusion tensor imaging (DTI).
Our data demonstrated a significant association between white matter integrity, as measured by DTI Fractional Anisotropy (FA), and the presence as well as severity of depressive symptoms in retired NFL athletes with a history of concussive or subconcussive impacts. We also found that dysfunction of the anterior aspect of the corpus callosum (forceps minor) and its projections to the frontal lobe can identify those with depression with 100% sensitivity and 95% specificity.
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MedicalResearch.com eInterview with Ronald Levy, M.D.
Professor and Chief Division of Oncology
Stanford University, 269 Campus Drive
Stanford, California 94305, USA
MedicalResearch.com: What are the main findings of the study?
Dr. Levy: Injection of antibodies that deplete Treg cells directly into a tumor can evoke an immune response that cures the animal of distant, untreated tumors.
This effect eliminates cancer even in the brain.
The dose of antibodies locally injected can be as low as 1/100 the dose used for systemic injection and therefore should avoid the usual autoimmune side effects of these antibodies.
The antibodies used are directed against CTLA4 and OX40 antigens.
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MedicalResearch.com eInterview with Timothy J. Daskivich, MD
Robert Wood Johnson Foundation Clinical Scholars®
University of California Los Angeles
Division of General Internal Medicine and Health Services Research
10940 Wilshire Blvd, 7th Floor Suite 710, Room 721
Los Angeles, California 90024
MedicalResearch.com: What are the main findings of the study? Were any of the findings unexpected?Dr. Daskivich: We found that age and a simple count of comorbidities were strongly predictive of likelihood of dying of causes other than prostate cancer. When we put numbers to it, it was surprising how often older men with multiple comorbidities were dying of something else than their prostate cancer within 14 years of diagnosis. For example, a 75-year old man with 3 or more comorbidities—diabetes, high blood pressure, and history of heart attack—had a probability of death from something other than CaP of 71% at 10 years. For a 71-year old man with 3 or more comorbidities, the probability was 60%. We compared that to the amount of time they were dying of prostate cancer, which was 3% for low-risk disease and 7% for intermediate-risk disease.
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MedicalResearch.com eInterview with Iris Shai, RD, PhD
PI of the DIRECT trial
Ben Gurion University of the Negev,
Israel
MedicalResearch.com: What are the main findings of the study?Dr. Shai: Low-carbohydrate is as effective as Mediterranean or low-fat diets in improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine<176µmol/L (not sever renal stage). The effect is likely to be mediated by weight-loss induced improvements in insulin sensitivity and blood pressure.
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John D. Mathews, MBBS, MD, PhD, DSc Hon, DMedSc Hon,
Professor of epidemiology at the School of Population and Global Health,
University of Melbourne,
Carlton, Victoria, AustraliaCancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million AustraliansMedicalResearch.com: What are the main findings of the study?Prof Mathews:We found that for persons having at least one CT scan before the age of 20 years, and followed for an average period of 10 years, the average risk of cancer was increased by 24% compared with unexposed persons matched for age, sex and year of birth. The cancer risk increased by 16% for each CT scan that preceded the cancer by more than one year. The proportional increase in risk was greater for persons exposed at younger ages.
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MedicalResearch.com eInterview with Dr. Giuseppe Orlando, M.D., Ph.D.
Instructor, General Surgery
Specialty Areas: Transplant Urology, Kidney Transplantation, Pancreas Transplantation, Transplant Immunology, Transplant Immunosuppression, Transplant Surgery
Wake Forest Baptist Medical Center
Medical Center Boulevard, Winston-Salem, NC 27157.
MedicalResearch.com: What are the main findings of the study?Dr. Orlando: Our study shows that we can use discarded kidneys from deceased human donors as platform for kidney regeneration investigations. As of now, we are using porcine models, after having developed smaller scale models (mainly in rodents, as it normally occurs in health science ie we need to provide the proof of concept in small animals before scaling up to larger animals which, for obvious reasons, are clinically more relevant). In regenerative medicine we know that cells do not survive if they are not seeded on supporting platforms which we call "scaffolds". There are several types of scaffolds, but probably the most effective are the ones that we can produce from animal/human organs. Basically, every organ consists of a cellular component which is endowed within the framework of the so-called extracellular matrix. When we strip cells out of an organ, what remains is the acellular extracellular matrix. Quite strikingly, the acellular organ in question maintains the same shape and volume that it had before stripping. What counts is that the so-obtained scaffold contains most information that cells require to grow, be viable and exert their function. It looks like this happens also for discarded human kidneys which may represent the most promising platform for our research
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MedicalResearch.com eInterview with:Linden Oliver, MA, Clinical Research Coordinator
University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa
MedicalResearch.com: What are the main findings of the study?Answer:We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night.
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MedicalResearch.com eInterview with
Satya Krishna Ramachandran MD FRCA
Director, Quality Assurance
Department of Anesthesiology
University of Michigan
MedicalResearch.com: What are the main findings of the...
MedicalResearch.com eInterview with: M. Kit Degado, MD, MS
Instructor, Emergency Medicine
Affiliated Faculty, Centers for Health Policy/Primary Care and Outcomes Research
Stanford University School of Medicine
[email protected]MedicalResearch.com: What are the main findings of the study?Dr. Degado:
We found that if an additional 1.6% of patients flown by helicopter survive or if there is any improvement in disability outcomes, then helicopter EMS should be considered cost-effective over transporting patients by ground EMS.
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MedicalResearch.com eInterview with Dr. David Perry
UCSF School of Medicine
Clinical Fellow in Neurology
675 Nelson Rising Lane
San Francisco CA 94158
MedicalResearch.com: What are the main findings of the study?
Dr. Perry: We described two patients with clinical syndromes and brain imaging patterns that are consistent with Alzheimer’s disease. Both were found to have mutations in GRN, which are typically associated with inherited frontotemporal dementia. They both showed evidence of underlying Alzheimer’s pathology, in one case through autopsy confirmation (demonstrating Alzheimer’s disease in addition to TDP-43 pathology), and in the other case from a positive amyloid PET scan.
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MedicalResearch.com: eInterview with Siran M. Koroukian, Ph.D.
Population Health and Outcomes Research Core,
Clinical & Translational Science Collaborative
Associate Professor Department of Epidemiology and Biostatistics
School of Medicine Case Western Reserve University
Cleveland, OH 44106-7281
MedicalResearch.com: What are the main findings of the study?Dr. Koroukian: Among individuals who died of cancer, those with mental illness (MI) died an average of 10 years earlier than those without MI.
Overall, there was excess mortality from cancer associated with having mental illness in all the race/sex strata: SMR, 2.16 (95% CI, 1.85-2.50) for black men; 2.63 (2.31-2.98) for black women; 3.89 (3.61-4.19) for nonblack men; and 3.34 (3.13-3.57) for nonblack women.
We note statistically significant higher SMRs for every anatomic cancer site in nonblack men and women and for most cancer sites in black men and women.
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MedicalResearch.com:Katrina N. Glazebrook, MB, ChB
Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905
MedicalResearch.com: Why did you do the study?Dr. Glazebrook: We felt CT was being underutilized for evaluation of knee injuries. The utility of CT has been well documented in the assessment of fractures, but little attention has been made on soft tissue evaluation.
CT now has high spatial resolution with very thin reconstructions in any desirable plane, and we have previously noted that this allowed injured soft tissue structures such as cruciate ligaments to be well visualized [presented at Society of Skeletal Radiology meeting March 2013]. We had determined in that prior study that the best reconstruction plane to evaluate both normal and torn anterior cruciate ligaments was the oblique sagittal plane parallel to the lateral femoral condyle as routinely used in MRI imaging of the knee The soft tissue window, single energy bone removal and Dual energy bone removal were the best reconstructions to determine the presence or absence of ACL disruption The bone removal techniques removed the distracting bone so the soft tissue structures were more apparent.
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MedicalResearch.com Interview with Dr. Ciaran McMullan MD
from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston Mass
MedicalResearch.com: What are the main findings of the study?Dr. McMullan: In this observational study performed in non-diabetic women we found that lower nocturnal melatonin secretion predicted future risk of developing type 2 diabetes. When we categorized the individuals by category of nocturnal melatonin secretion we found that those in the lowest category had twice the risk as those in the highest category of nocturnal melatonin secretion. This association remained even after adjusting for other well established risk factors for development of diabetes including body mass index, physical activity, dietary factors, family history of diabetes, smoking and hypertension. This increased risk translates into the lower melatonin secretion group having an additional 5 cases of incident diabetes per 1000 person years than the high melatonin secretion group.
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MedicalResearch.com Author Interview: Ildiko Lingvay, MD, MPH, MSCS
Departments of Internal Medicine–Endocrinology and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
MedicalResearch.com: What are the main findings of the study?Dr. Lingvay:We found that the restrictive diet imposed after a bariatric procedure like RYGB is the key element to the rapid improvement in the diabetes seen immediately after surgery.
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MedicalResearch.com Interview Dr. Alexander Turchin M.D.,M.S.
Director of Informatics Research
Assistant Professor, Harvard Medical School
Endocrinology, Diabetes and Hypertension
Brigham and Women's Hospital Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Turchi: A large number of patients – 17% of individuals included in our study – report side effects to statins in routine care settings. Nearly 60% of these patients stopped the statin at least temporarily. However, overwhelming majority of patients who stopped taking a statin after experiencing a possible side effect, could tolerate a statin long-term if they tried taking one again. In other words, it appears that many statin-related events are tolerable, specific to individual statins or have other causes. These findings are consistent with the current guidelines that urge a conservative approach to statin discontinuation. They are particularly important because statins have been convincingly shown to save lives – they decrease all-cause mortality, and also cardiovascular mortality and incidence of cardiovascular events in patients with ischemic heart disease and / or elevated cholesterol levels.
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MedicalResearch.com Author Interview:Dr. Steven A. Branstetter, PhD
The Pennsylvania State University, 315 E. HHD, University Park, PA 16810.
MedicalResearch.com: What are the main findings of the study?Dr. Branstetter:This study demonstrated that the time to the first cigarette of the day after waking is associated with increased levels of a NNAL, a metabolite of a powerful tobacco-specific carcinogen, NNK -- even after controlling for the total number of cigarettes smoked per day.
For years, the time to the first cigarette of the day after waking was one of several questions assessing nicotine dependence on the Fagerstrom Test for Nicotine Dependence (FTND), the gold standard questionnaire int he field. Over time, it was found that much of the predictive validity of the FTND was due to the time to first cigarette item. Researchers have found that single time to first cigarette item was highly correlated with other measures of nicotine dependence, and was predictive of more difficulty quitting smoking and increased intake of nicotine. Our current study demonstrates that this behavioral measure, is predictive of exposure to the cancer-causing components of cigarettes, regardless of the total number of cigarettes smoked per day. The results suggest that researchers, clinicians and smokers can assess the level of nicotine dependence and potential cancer risk by looking at the time to the first cigarette of the day after waking.
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MEDICALRESEARCH.COM INTERVIEW WITH Charnita Zeigler-Johnson, Ph.D., M.P.H.
Research Assistant Professor CCEB
University of Pennsylvania
MEDICALRESEARCH.COM: What are the main findings of the study?Dr. Zeigler-Johnson: The main findings of the study are:
Younger African-American men diagnosed with advanced prostate cancer at an early age (under the age of 60) are more likely to have had a personal history of early-onset baldness (baldness by age 30.)
For older patients, this is not necessarily the case, and future studies will need to focus on which factors place men in this age group at risk for prostate cancer.
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MedicalResearch.com Author Interview: Jun J. Yang, Ph.D.
Assistant Member Dept. of Pharm. Sci.
St. Jude Children's Research Hospital
262 Danny Thomas Pl., MS313 Memphis, TN 38105
MedicalResearch.com: What are the main findings of the study?Dr. Yang: We performed a comprehensive survey of inherited genetic variations for their contribution to the susceptibility of acute lymphoblastic leukemia (ALL), the most common cancer in children. This is by far the largest study of its kind (in terms of the number of subjects involved), and also the first one to include multi-ethnic populations. We identified 4 genomic loci related to the predisposition to ALL, 2 of which contributed to racial differences in the incidence of ALL. This study provided unequivocal evidence for inherited susceptibility of childhood ALL and pointed to novel biology of the pathogenesis of this disease.
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