E-Cigs Linked To Adverse Cardiac Effects

MedicalResearch.com Interview with:

Holly R. Middlekauff, MD Professor UCLA Division of Cardiology David Geffen School of Medicine UCLA

Dr. Holly Middlekauff

Holly R. Middlekauff, MD
Professor
UCLA Division of Cardiology
David Geffen School of Medicine
UCLA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: E-cigarettes are the fastest rising tobacco product in the US today, but almost nothing is known about their cardiovascular effects. Rather than wait decades for epidemiological data in e-cigarette users to become available, we reasoned that investigations into the known mechanisms by which tobacco cigarettes increase heart disease would provide insights into the health risks of e-cigarettes.

We focused on 2 critical mechanisms:
1) cardiac adrenaline activity, and
2) oxidative stress, measured in chronic e-cigarrete users compared to matched, healthy controls.

The major findings were that, compared to healthy controls, e-cig users had increased cardiac adrenaline activity (measured by a technique called “heart rate variability”). Furthermore, compared to healthy controls, the e-cig users had increased susceptibility to oxidative stress.

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More Than Moderate Alcohol Not Good For The Heart

MedicalResearch.com Interview with:

Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco

Dr. Gregory M Marcus

Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS
Director of Clinical Research
Division of Cardiology
Endowed Professor of Atrial Fibrillation Research
University of California, San Francisco

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Moderate alcohol consumption has previously been associated with a decreased risk of heart attack. However, as we have previously shown that individuals who believe alcohol to be good for the heart tend to drink more, there is a concern that these previous data might appear to justify excessive alcohol consumption.

In addition, previous research on the topic of alcohol consumption and heart disease has relied almost entirely on participant self-report, which is known to be particularly unreliable among heavy drinkers. Finally, previous research has sought to study relationships between alcohol and various types of heart disease, but there has not been an emphasis on individual-level characteristics that might influence these relationships.
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Patients Who Understand Their Medical Condition Less Likely To Opt For Aggressive Care

MedicalResearch.com Interview with:

Joseph A. Ladapo, MD, PhD David Geffen School of Medicine at UCLA Department of Medicine, Division of General Internal Medicine and Health Services Research Los Angeles, California

Dr. Joseph A. Ladapo

Joseph A. Ladapo, MD, PhD
David Geffen School of Medicine at UCLA
Department of Medicine, Division of General Internal Medicine and Health Services Research
Los Angeles, California

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Four million stable patients in the US undergo testing for suspected ischemic heart disease (IHD) annually. There is substantial variation in how these patients are managed by physicians, and both clinical and economic factors have been used to explain this variation. However, it is unknown whether patients’ beliefs and preferences influence management decisions, and we aimed to answer this question. Based on interviews of 351 stable patients at Geisinger Health System newly referred for cardiac stress testing/coronary computed tomographic angiography (CTA) for suspected IHD, we found that patients with an accurate understanding of their initial test result were less likely to undergo follow-up tests/procedures if the initial test was negative and more likely to undergo follow-up tests/procedures if the initial test was positive.

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Zika Virus Infection in Pregnant Women in Rio de Janeiro

MedicalResearch.com Interview with:

Karin Nielsen, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA Director, Center for Brazilian Studies

Karin Nielsen

Karin Nielsen, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA
Director, Center for Brazilian Studies

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our research was a prospective study in which pregnant women in Rio de Janeiro who developed a rash in the last 5 days between the end of 2015 to mid 2016 were screened for possible infection with Zika virus by a special molecular test (PCR) which looked for the virus in blood or urine. Women who were found to have Zika virus in either blood, urine or both were followed throughout time to look for pregnancy and infant outcomes. We also followed women who had a negative PCR test for Zika as a comparison group. By July 2016, we had outcomes known for 125 Zika affected pregnancies, of these 58 had abnormal outcomes, with 9 fetal losses and 49 babies who had abnormal findings on physical exam or brain imaging, all consistent with neurologic abnormalities. This meant 46% of the pregnant women in our study had an abnormal pregnancy outcome, and 42% of live birth infants were found to have an abnormality in the first few months of life.

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First Childhood Exposure Determines How Sick You Get From Flu As Adult

MedicalResearch.com Interview with:
Katelyn M. Gostic and
Monique Ambrose

Department of Ecology and Evolutionary Biology
University of California
Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Monique Ambrose: Influenza pandemics pose a serious, recurrent threat to human public health. One of the most probable sources of future pandemic influenza viruses is the pool of influenza A virus (IAV) subtypes that currently circulate in non-human animals. It has traditionally been thought that the human population is immunologically naïve and unprotected against these unfamiliar subtypes. However, our work suggests that an individual ‘imprints’ to the influenza A virus (IAV) encountered in early childhood in such a way that they retain protection against severe disease if they later encounter a novel IAV subtype that belongs to the same genetic group as their first exposure.

Our research looked at human cases of H5N1 and H7N9, two avian IAV subtypes of global concern, to investigate what factors most strongly predicted risk of severe disease. The most striking explanatory factor was childhood IAV imprinting: our results suggest that individuals who had childhood imprinting on an IAV in the same genetic group as the avian IAV they encountered later in life experienced 75% protection against severe disease and 80% protection against death.

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Neuroimaging Detects Chemical Disturbances in Stuttering

MedicalResearch.com Interview with:
Joseph O’Neill, PhD
Division of Child and Adolescent Psychiatry
University of California–Los Angeles Semel Institute for Neuroscience
Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Stuttering seriously diminishes quality of life. While many children who stutter eventually grow out of it, stuttering does persist into adulthood in many others, despite treatment. Like earlier investigators, we are using neuroimaging to explore possible brain bases of stuttering, aiming, eventually, to improve prognosis. What’s novel is that our study deploy neuroimaging modalities– arterial spin labelling and, in this paper, magnetic resonance spectroscopy (MRS)– not previously employed in stuttering. MRS offers prospects of detecting possible neurochemical disturbances in stuttering.

The MRS results showed differences in neurometabolite– brain chemicals– levels between people who stutter (adults and children) and those who don’t in many brain regions where other neuroimaging has also observed effects of stuttering. In particular, MRS effects were apparent in brain circuits where our recent fMRI work detected signs of stuttering, circuits subserving self-regulation of speech production, attention and emotion. This reinforces the idea that stuttering has to do with how the brain manages its own activity along multiple dimensions: motivation, allocation of resources, and behavioral output.

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Squamous Cell Carcinoma of Lip Predominantly Affects White Men in Their Mid-60s

MedicalResearch.com Interview with:

Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA

Dr. Albert Han

Albert Yoon-Kyu Han, PhD
Class of 2017
Medical Scientist Training Program
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC.

The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.

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Results of the 2-Year Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole (OASIS) Randomized Trial

MedicalResearch.com Interview with:

Pravin U. Dugel, MD Retina Consultants of Arizona Phoenix, Arizona; USC Roski Eye Institute Keck School of Medicine University of Southern California Los Angeles, California

Dr. Pravin Dugel

Pravin U. Dugel, MD
Retina Consultants of Arizona
Phoenix, Arizona; USC Roski Eye Institute
Keck School of Medicine
University of Southern California
Los Angeles, California 

MedicalResearch.com: What is the background for this study?

Response: OASIS is an acronym for “OcriplASmIn for Treatment for Symptomatic Vitreomacular Adhesion including Macular Hole”.  It was a Phase IIIB, randomized, prospective, sham-controlled, double-masked, multicenter clinical study. The goal of the study was to further evaluate the long-term (24 months) efficacy and safety of a single injection of 0.125mg of ocriplasmin in patients with symptomatic vitreomacular adhesion (VMA) and vitreomacular traction (VMT), including macular hole (MH).

OASIS evaluated 220 patients with symptomatic VMA/VMT.  One hundred forty-six patients received ocriplasmin while 74 served as a sham control group. In the latter group, no intravitreal injection was administered.  Continue reading

UV Sensitive ‘Band-aid’ Makes Monitoring Sun Exposure Easy

MedicalResearch.com Interview with:

Dr. Andrea M Armani PhD Fluor Early Career Chair and Associate Professor Mork Family Department of Chemical Engineering and Materials Science University of Southern California, Los Angeles, California credit to USC Viterbi.

Dr. Andrea M Armani

Dr. Andrea M Armani PhD
Fluor Early Career Chair and Associate Professor
Mork Family Department of Chemical Engineering and Materials Science
University of Southern California, Los Angeles, California

MedicalResearch.com: What is the background for this study?

Response: The “Internet of Things” (IoT) has seen an explosion in online sensor technologies, including UV sensors and monitors; for example, those from Apple and Samsung. However, they require connectivity and power, and they are integrated into delicate electronic systems that are not compatible with outdoor, athletic activities such as swimming, which is precisely when you should monitor UV exposure. Therefore, somewhat ironically, the technologies developed to meet the demands of the IoT are not ideal for cumulative UV exposure detection.

Our goal was to develop a single use patch – like a smart “band-aid” – for the beach to alert users when they had been in the sun for an hour and needed to re-apply sunscreen or get out of the sun altogether. This application required a rugged system that was waterproof, bendable, and compatible with sunscreen. Additionally, the sensor readout needed to be easy to interpret. These requirements influenced our design and material selection.

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U.S. Hispanics Age More Slowly Than Caucasians and African-Americans

MedicalResearch.com Interview with:

Michael Gurven, Professor Department of Anthropology University of California Santa Barbara, CA 93106

Dr. Michael Gurven

Michael Gurven, Professor
Department of Anthropology
University of California
Santa Barbara, CA 93106

MedicalResearch.com: What is the background for this study?

Response: Understanding the sources of ethnic and sex disparities in health and longevity is critical in order to insure the health and well-being of everyone. We often hear about disparities due to differences in health care access, education, income, and sometimes genetic differences. But what we’ve done here is to employ a new biomarker developed by Steve Horvath, called the “epigenetic clock”, which measures the cumulative changes to the epigenome, i.e. alterations to DNA that affects gene activity and
expression but do not alter the DNA itself. This new measure is arguably
one of the best biomarkers of aging out there today – so it’s indeed a
biological measure, but tells a different story than conventional genetic
differences. Instead epigenetic age is influenced by the lived experience,
physical and social environment, and genetic make-up of individuals.

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ACEI and ARBs Had Similar Outcomes in Study of PD Dialysis Patients

MedicalResearch.com Interview with:

Jenny Shen, MD, MS Assistant Professor of Medicine David Geffen School of Medicine at UCLA Los Angeles Biomedical Institute at Harbor-UCLA Medical Center

Dr. Jenny Shen

Jenny Shen, MD, MS
Assistant Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles Biomedical Institute at Harbor-UCLA Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: With cardiovascular disease being the No. 1 cause of death in end-stage kidney disease patients on peritoneal dialysis, we examined two classes of medications commonly prescribed to prevent cardiovascular events in these patients and found no significant difference in outcomes.

The two classes of medications, angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB), have slightly different mechanisms and could theoretically have differing outcomes. Previous studies had suggested that ACEI may lead to a kinin-mediated increase in insulin sensitivity not seen with ARB. This could potentially lower the cardiovascular risk in patients on peritoneal dialysis because they are exposed to high glucose loads in their dialysate that may lead to insulin resistance and its associated cardiovascular risk.

Using a national database, the U.S. Renal Data System, we surveyed records for all patients enrolled in Medicare Part D who initiated maintenance peritoneal dialysis from 2007 to 2011. Of those, we found 1,892 patients using either drug class. Surveying their medical records, we found no difference in cardiovascular events or deaths between the users for each class of medication.

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Menopause Speeds Up the Aging Process in Women

MedicalResearch.com Interview with:

Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles

Dr. Levine

Morgan Elyse Levine, PhD
Postdoctoral Fellow
Department of Human Genetics
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: From an evolutionary perspective, aging and reproduction are two processes that are linked. For instance, in order to maximize fitness, an individual has to survive and remain healthy enough to:

1) reproduce and

2) insure offspring survive to reproductive age.

Thus, the rate of aging is tied to a species’ timing of reproductive senescence and necessary length of parental involvement. There is also evidence that among humans, women with longer reproductive stages (later age at menopause, ability to conceive at older ages) are more likely to live to age 100, which we hypothesize is because they age slower.

Using an epigenetic biomarker believed to capture biological aging (previously developed by the Principle Investigator of this study, Steve Horvath), we tested whether age at menopause, surgical menopause, and use of menopausal hormone therapies were associated with a woman’s aging rate.

We found that the blood of women who experienced menopause at earlier ages (especially those who underwent surgical menopause) was “older” than expected, suggesting they were aging faster on a biological level than women who experienced menopause at later ages. We also found that buccal epithelium samples (cells that line the inside of the cheek) were epigenetically younger than expected (signifying slower aging) for post-menopausal women who had taken menopausal hormone therapy, compared to post-menopausal women who had never taken any form of menopausal hormone therapy.

Finally, we had a number of results that suggested that the previously mentioned findings were a result of the process of menopause directly speeding up the aging process—rather than the alternative explanation, which would have been that women who aged faster experience menopause earlier.

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