Author Interviews, BMJ, Diabetes, Occupational Health / 03.07.2018

MedicalResearch.com Interview with: [caption id="attachment_42837" align="alignleft" width="200"]Mahée Gilbert-Ouimet, PhD Postdoctoral fellow/Chercheure postdoctorale Institute for Work & Health Hôpital du St-Sacrement,  Québec  Dr. Gilbert-Ouimet[/caption] Mahée Gilbert-Ouimet, PhD Postdoctoral fellow/Chercheure postdoctorale Institute for Work & Health Hôpital du St-Sacrement,  Québec  MedicalResearch.com: What is the background for this study?  Response: Diabetes is one of the primary causes of death worldwide, in addition to being a major risk factor for several other chronic diseases including cardiovascular diseases. Considering the rapid and substantial increase of diabetes prevalence, identifying modifiable risk factors is of major importance. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. Our study evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada.
Author Interviews, BMJ, GSK, Smoking, Tobacco, Tobacco Research / 14.06.2018

MedicalResearch.com Interview with: “Day 1 of nicotine patch, just stuffed my face with lunch at work and do NOT even want a cigarette” by David Bruce Jr. is licensed under CC BY 2.0Paul Aveyard Professor of Behavioural Medicine Nuffield Department of Primary Care Health Sciences University of Oxford Radcliffe Primary Care Building Radcliffe Observatory Quarter Oxford MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Tobacco addiction occurs because of repeated pairings of the act and sensation of smoking with binding of nicotine in the midbrain leading to release of dopamine in the nucleus accumbens. These repeated pairings create associative learning and, when brain nicotine concentrations fall, this produces a compulsion to keep using tobacco. In theory, blocking the actions of nicotine released while smoking ought to reverse this learning. One way to do this is to use a nicotine patch which provides a steady state high concentration of nicotine that desensitises the nicotinic receptors in the midbrain, making them unresponsive to nicotine from a smoked cigarette. This is the theory behind nicotine preloading. The clinical trial evidence that preloading works is equivocal, with some trials suggesting a very large therapeutic effect and others no benefit at all. In the light of both the promise and the uncertainty, we aimed to complete the largest trial to date of nicotine preloading to examine its effectiveness, safety, and tolerability.
Author Interviews, BMJ, Depression, Weight Research / 30.05.2018

MedicalResearch.com Interview with: Dr Rafael Gafoor Research Associate Kings College London  MedicalResearch.com: What is the background for this study? Response: Obesity and weight gain are global public health problems, with approximately 60% of UK adults currently overweight or obese. Depression is common in people who are severely obese and the rate of antidepressant prescribing is increasing, which could have potential impact on public health. However, little research has been reported on the impact of widespread antidepressant treatment on weight gain. So a UK based research team, led by Rafael Gafoor at King’s College London, set out to investigate the association between the use of antidepressants and weight gain. The researchers analysed body weight and body mass measurement data from the UK Clinical Practice Research Datalink (CPRD) for over 300,000 adults with an average age of 51, whose body mass index (BMI) had been recorded three or more times during GP consultations from 2004-2014. Participants were grouped according to their BMI (from normal weight to severely obese) and whether or not they had been prescribed an antidepressant in a given year. Participants were then monitored for a total of 10 years.
Author Interviews, BMJ, Depression, Exercise - Fitness / 17.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41782" align="alignleft" width="200"]Prof. Sarah E Lamb,  MSc, MA, MCSP, Grad Dip Statistics, DPhil Centre for Rehabilitation Research and Centre for Statistics in Medicine Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences Botnar Research Centre, University of Oxford, Oxford Prof. Lamb[/caption] Prof. Sarah E Lamb,  MSc, MA, MCSP, Grad Dip Statistics, DPhil Centre for Rehabilitation Research and Centre for Statistics in Medicine Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences Botnar Research Centre, University of Oxford, Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scientists and clinicians have considered the possibility that higher intensity aerobic and muscle strength training might have a beneficial effect in preventing dementia or slowing the progression of cognitive impairment in those who have dementia. The hypothesis has come mostly from animal research. The main findings of our research which used a large sample and high quality methods was that higher intensity exercise, whilst possible, did not slow cognitive impairment. Neither did it have an impact on the functional and behavioural outcomes for people with dementia. It was a substantial commitment for people to participate in the programmes, although many enjoyed the experience and their physical fitness improved.
Author Interviews, BMJ, Cancer Research, Gender Differences / 14.05.2018

MedicalResearch.com Interview with: “Faecal Coliforms analysis” by SuSanA Secretariat is licensed under CC BY 2.0Dr. Mahiben Maruthappu Public Health Registrar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender disparities in the fields of science and technology have been documented, and  it becomes increasingly apparent at higher levels of seniority. In this analysis, we found a quantifiable difference in cancer research funding awarded to female principle investigators compared to male principle investigators (PIs). Across all cancer research funding grants that we identified, male PIs received 3.6 times the total investment value, and 1.6 times the average award value compared with their female counterparts. 
Author Interviews, BMJ, Genetic Research, Pediatrics / 10.05.2018

MedicalResearch.com Interview with: “Newborn” by Brad Carroll is licensed under CC BY 2.0Dr Sian Taylor-Phillips MPhys, PhD Associate Professor Screening and Test Evaluation / NIHR Career Development Fellow Division of Health Sciences Warwick Medical School University of Warwick Coventry MedicalResearch.com: What is the background for this study? What are the main findings? Response: In newborn blood spot screening a small amount of blood is taken from newborn babies heels, and this is tested for a range of rare diseases. The idea is to detect each disease earlier when it is more treatable. However, it would be better not to test for some diseases, for example if the test is inaccurate so worries parents that their baby may have a serious illness when they do not. Some countries test for as few as 5 diseases and others as many as 50. In this study we investigated how different countries choose which diseases to test for. We found that many national recommendations on whether to screen newborn babies for rare diseases do not assess the evidence on the key benefits and harms of screening. Evidence about the accuracy of the test was not considered in 42% of recommendations, evidence about whether early detection at screening has health benefits was not consulted in 30% of recommendations, and evidence around the potential harm of overdiagnosis where babies have variants of the disease that would never have caused any symptoms or ill effects was not considered in 76% of recommendations. We also found through meta-analysis that when a systematic review was used to bring together the evidence then countries were less likely to recommend screening for the disease.
Accidents & Violence, Author Interviews, BMJ, Race/Ethnic Diversity / 08.05.2018

MedicalResearch.com Interview with: “police” by istolethetv is licensed under CC BY 2.0Anthony L. Bui, MPH M.D. Candidate, David Geffen School of Medicine at UCLA Matthew M. Coates, MPH Associate, Harvard Medical School, Department of Global Health and Social Medicine Ellicott C. Matthay, MPH Ph.D. Candidate, Division of Epidemiology, University of California, Berkeley School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Protests after recent deaths from encounters with law enforcement, the Black Lives Matter movement, and activism over social media platforms have raised the profile of the problem of police violence. Several studies have suggested that the public health community has a duty to address these deaths as a public health problem. These studies have also pointed out that although there is a lack of officially reported statistics on police violence, other journalistic and crowd-sourced efforts such as “The Counted” from The Guardian, FatalEncounters.org, U.S. Police Shootings Database, KilledbyPolice.net, and Mapping Police Violence have relatively complete documentation of deaths from police violence. To help frame the issue as a public health problem, we calculated years of life lost (YLLs) attributed to deaths from encounters with law enforcement. YLLs are, a metric that measures premature deaths, by age, gender, and race/ethnicity. To do this, we followed established methods, subtracting the age of each death from a corresponding standard life expectancy. For example, if an individual who died at age 25 had a life expectancy of 75, their YLL would be 50. 
Author Interviews, BMJ, Diabetes, Technology / 05.05.2018

MedicalResearch.com Interview with: [caption id="attachment_41250" align="alignleft" width="200"]Dr-Apostolos Tsapas Dr. Tsapas[/caption] Apostolos Tsapas, MD PhD MSc(Oxon) Associate Professor of Medicine Director of the Second Medical Department | Aristotle University Thessalonik Cruddas Link Fellow Harris Manchester College University of Oxford   MedicalResearch.com: What is the background for this study? Response: Artificial pancreas treatment, also referred to as closed loop glucose control, is an emerging treatment option combining a pump and continuous glucose monitoring with a control algorithm to deliver insulin (and potentially glucagon) in a glucose responsive manner. Compared with insulin pumps or sensor augmented pumps, artificial pancreas use can reduce the burden for patients by automatically adjusting the amount of insulin entering the body on the basis of sensor glucose levels. The US Food and Drug Administration has recently approved the first artificial pancreas system for use by people with type 1 diabetes over 14 years of age, based on a safety outpatient study.
Author Interviews, BMJ, Global Health, Pediatrics, Vitamin D, Weight Research / 04.05.2018

MedicalResearch.com Interview with: Dr Javeria Saleem PhD Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. Around 20 million children suffer from severe acute malnutrition worldwide of whom an estimated 1.4 million live in Pakistan. The condition is a major cause of death in children under 5 in Asia and Africa. The standard treatment is to give a high-energy, micronutrient enhanced paste called ready-to-use therapeutic food (RUTF). Vitamin D deficiency has been reported to be a risk factor for severe wasting in children with severe acute malnutrition Ready-to-use therapeutic food contains relatively modest amounts of vitamin D. However, the effects of adding high-dose vitamin D to this standard treatment have not previously been evaluated. We therefore did a clinical trial to assess whether high-dose vitamin D hastened recovery in 185 children aged 6-58 months who were receiving standard treatment for severe acute malnutrition in Southern Punjab, Pakistan. The 93 children in the active arm of the study received two doses of 5 mg vitamin D by mouth, while the 92 children in the control arm received placebo (a dummy medicine containing no vitamin D). Our findings were very striking: after 2 months of treatment, the children who received high-dose vitamin D in addition to standard therapy had significantly better weight gain, and significantly better motor and language development, than those who received standard treatment alone.
Author Interviews, BMJ, Outcomes & Safety, Surgical Research, UCLA / 03.05.2018

MedicalResearch.com Interview with: “Untitled” by Marcin Wichary is licensed under CC BY 2.0Yusuke Tsugawa, MD, MPH, PhD Assistant professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCL Los Angeles, CA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We studied whether patients’ mortality rate differ based on age and sex of surgeons who performed surgical procedures. Using a nationally representative data of Medicare beneficiaries aged 65-99 years who underwent one of 20 major non-elective surgeries, we found that patients treated by older surgeons have lower mortality than those cared for by younger surgeons, whereas there was no difference in patient mortality between male and female surgeons. When we studied age and sex together, we found that female surgeons at their 50s had the lowest patient mortality across all groups.
Author Interviews, BMJ, Heart Disease, Pain Research, Stroke / 04.04.2018

MedicalResearch.com Interview with: [caption id="attachment_40974" align="alignleft" width="133"]Islam Elgendy MD Division of Cardiovascular Medicine University of Florida   Dr. Elgendy[/caption] Islam Elgendy MD Division of Cardiovascular Medicine University of Florida   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Migraine headache is a prevalent medical condition, often being chronic and debilitating to many. Previous studies have shown that migraine, particularly migraine with aura, is associated with an increased risk of cardiovascular events. Recently, a number of these studies have reported long-term follow up data. To better understand the long-term morbidity that is associated with migraines, we performed a systematic evaluation to study the link between migraine and risk of cardiovascular and cerebrovascular events. This study demonstrated that migraine is associated with an increased risk of major adverse cardiovascular and cerebrovascular events, which was driven by an increased long-term risk of myocardial infarction and stroke. This effect was predominantly observed in migraineurs who have aura. 
Author Interviews, BMJ, Pain Research, Rheumatology / 22.03.2018

MedicalResearch.com Interview with: “tai chi 11.4.09” by Luigi Scorcia is licensed under CC BY 2.0Chenchen Wang MD, MSc Professor of Medicine Tufts University School of Medicine Director, Center For Complementary And Integrative Medicine Division of Rheumatology Tufts Medical Center Boston, MA 02111  MedicalResearch.com: What is the background for this study? Response: Patients with chronic widespread pain often try many different types of pain medications, anti-depressants, physical therapy, and other approaches, and commonly find that none of these therapies work for them. Finding safe, effective approaches for pain management is an urgent priority. Previous evidence suggested that Tai Chi, a multi-dimensional mind-body practice that integrates physical, psychosocial, and behavioral elements, may be especially suited to address both chronic pain and associated psychological and somatic symptoms. In our most recent study published in the BMJ, we directly compared the effectiveness of Tai Chi versus aerobic exercise, which is a standard care non-drug treatment for fibromyalgia.
Author Interviews, BMJ, Education, Nutrition, Pediatrics, Weight Research / 13.02.2018

MedicalResearch.com Interview with: “Lt. Governor Brown Visits Hamilton Elem_Mid School to Highlight Summer Meals Program” by Maryland GovPics is licensed under CC BY 2.0Peymané Adab, MD University of Birmingham in England MedicalResearch.com: What is the background for this study? What are the main findings? Response: Childhood obesity is an increasing problem worldwide. In the UK, the proportion of children who are very overweight doubles during the primary school years. Furthermore during this period inequalities emerge. At school entry there is little difference in the likelihood of being overweight between groups. However on leaving primary school, children from minority ethnic groups and those from more deprived, compared to more affluent backgrounds are more likely to be overweight. Excess weight in children is linked with multiple health, emotional and social problems.  As children spend a lot of time at school, it seems intuitive that they are an ideal setting for prevention interventions. Although a number of studies have investigated the evidence for school obesity prevention programmes, the results have been mixed and methodological weaknesses have prevented recommendations being made. As a result we undertook a major high quality trial to evaluate an intervention that had been developed in consultation with parents, teachers and the relevant community. The 12 month programme  had four components. Teachers at participating schools were trained to provide opportunities for regular bursts of physical activity for children, building up to an additional 30 minutes each school day. There was also a workshop each term, where parents came in to cook a healthy meal (breakfast, lunch of dinner) with their children. In conjunction with a local football club, Aston Villa, children participated in a six-week healthy eating and physical activity programme. Finally, parents were provided with information about local family physical activity opportunities. We involved around 1500 year 1 children (aged 5-6 years) from 54 state run primary schools in the West Midlands. At the start of the study, we measured their height and weight and other measures of body fat, asked the children to complete a questionnaire about their wellbeing, to note everything they ate for 24 hours, and to wear an activity monitor that recorded how active they were. After this, the schools were randomised to either receive the programme or not. We then repeated the measures 15 and 30 months later.
Aging, Author Interviews, BMJ, Cost of Health Care, Global Health / 11.02.2018

MedicalResearch.com Interview with: [caption id="attachment_39962" align="alignleft" width="147"]Dr Grace Sum Chi-En National University of Singapore Dr Grace Sum    Chi-En[/caption] Dr Grace Sum Chi-En National University of Singapore MedicalResearch.com: What is the background for this study? Response: Chronic diseases are conditions that are not infectious and are usually long-term, such as diabetes, hypertension, cancer, chronic lung disease, asthma, arthritis, stroke, obesity, and depression. They are also known as non-communicable diseases (NCDs). Multimorbidity, is a term we use in our field, to mean the presence of two or more NCDs. Multimorbidity is a costly and complex challenge for health systems globally. With the ageing population, more people in the world will suffer from multiple chronic diseases. Patients with multimorbidity tend to need many medicines, and this incurs high levels of out-of-pocket expenditures, simply known as cost not covered by insurance. Even the United Nations and World Health organisation are recognising NCDs as being an important issue. Governments will meet in New York for the United Nations 3rd high-level meeting on chronic diseases in 2018. Global leaders need to work towards reducing the burden of having multiple chronic conditions and providing financial protection to those suffering multimorbidity. Our research aimed to conduct a high-quality systematic review on multimorbidity and out-of-pocket expenditure on medicines. 
Author Interviews, BMJ, Heart Disease, Pain Research, Stroke / 01.02.2018

MedicalResearch.com Interview with: “Headache.” by Avenue G is licensed under CC BY 2.0Kasper Adelborg, MD, PhD Postdoctoral Fellow Department of Clinical Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Around one billion people worldwide are affected by migraine. Migraine has considerable impact on quality of life and imposes a substantial burden on society. Migraine is primarily a headache disorder, but previous studies have suggested a link between migraine and stroke and myocardial infarction, particularly among women, while the link between migraine and other heart problems are less well known. In this large register-based Danish study published in the BMJ, we confirmed that migraine is associated with increased risks of stroke and myocardial infarction, but we also found that migraine was associated with increased risks of other cardiovascular diseases (specifically, venous thromboembolism and atrial fibrillation). Migraine was not associated with increased risks of heart failure or peripheral artery disease. In contrast to most previous studies, our study had a very large sample size and an age- and sex- matched comparison cohort from the general population, which allowed us to put migraine in a population context and to perform several subgroup analyses. Here, we found several interesting findings.
  • In general, the associations were strongest in the first year after diagnosis but persisted in the long term (up to 19 years after diagnosis).
  • Most associations applied to both migraine patients with aura (warning signs before a migraine, such as seeing flashing lights) and in those without aura, and in both women and in men. 
Author Interviews, BMJ, Cancer Research, MD Anderson / 01.02.2018

MedicalResearch.com Interview with: [caption id="attachment_23591" align="alignleft" width="114"]Dr. Xifeng Wu, MD PhD Department Chair, Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences Director, Center for Translational and Public Health Genomics Professor, Department of Epidemiology Division of Cancer Prevention and Population Sciences The University of Texas MD Anderson Cancer Center, Houston, Texas Dr. Xifeng Wu[/caption] Xifeng Wu MD PhD Prevention and Population Sciences MD Anderson Center MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that certain chronic diseases may predispose to cancer. These studies generally assessed chronic diseases or disease markers individually. As chronic diseases are typically clustered, it is necessary to study them simultaneously to elucidate their independent and joint impact on cancer risk. Therefore, we investigated the independent and joint effect of several common chronic diseases or disease markers on cancer and life span in a large prospective cohort. Also, we compared the contribution of chronic diseases or disease markers to cancer risk with that of lifestyle factors. We further assessed whether physical activity could attenuate the cancer risk associated with chronic diseases or disease markers. We hope the results of this study can contribute to evidence-based recommendations for future cancer prevention strategies.
Author Interviews, Biomarkers, BMJ, Genetic Research, Prostate Cancer, UCSD / 29.01.2018

MedicalResearch.com Interview with: “DNA” by Caroline Davis2010 is licensed under CC BY 2.0Tyler Seibert, MD, PhD Radiation Oncology Center for Multimodal Imaging & Genetics UC San Diego MedicalResearch.com: What is the background for this study? Response: Prostate cancer is an extremely common condition in men. Many die from it each year, and many others live with debilitating pain caused by prostate cancer. Screening for prostate cancer with prostate-specific antigen (PSA) testing can be effective, but there are concerns with the test.
  • First, screening everyone gives a large proportion of false-positive results, and those men end up undergoing unnecessary procedures such as prostate biopsy. S
  • econd, a significant portion of men who develop prostate cancer will develop a slow-growing form of the disease that is likely not life-threatening and may not require treatment. These concerns have led to a drop in prostate cancer screening. But avoiding screening leaves a large number of men vulnerable to diagnosis of an aggressive prostate cancer at a later stage, when it is more difficult—or impossible—to be cured. Doctors are left to guess which of their patients are at risk of aggressive disease and at which age they need to start screening those patients.
Our study sought to develop a tool to provide men and their doctors with objective, personalized information about each man’s risk of prostate cancer. Based on the man’s genetics, we wanted to predict the risk of aggressive prostate cancer and at what age in his life that risk becomes elevated.
Author Interviews, BMJ, Pulmonary Disease, Surgical Research / 25.01.2018

MedicalResearch.com Interview with: Ianthe Boden Titled Cardiorespiratory APAM, PhD Candidate, MSc, BAppSc Manager Abdominal Surgery Research Group Clinical Lead – Cardiorespiratory Physiotherapy, Physiotherapy Department Allied Health Services Tasmanian Health Services – North | Launceston General Hospital Launceston TA  MedicalResearch.com: What is the background for this study? Response: Major upper abdominal surgery involves opening up the abdomen - mainly to remove cancer or damaged bowel, liver, stomach, pancreas, or kidney.  It is, by far, the most common major surgical procedure performed in developed countries with millions of procedures performed per annum. Unfortunately a respiratory complication following these operations occurs relatively frequently with between 1 in 10 to almost a half of all patients getting some type of respiratory complication after surgery. Respiratory complications included problems such as pneumonia, lung collapse, respiratory failure, and an acute asthma attack. These complications, especially pneumonia and respiratory failure, are strongly associated with significant morbidity, mortality, increased antibiotic usage and longer hospital stay. These breathing problems occur quite quickly after surgery, becoming evident usually within the first two to three days after surgery. In an effort to ameliorate these complications in developed countries it is common for physiotherapists/respiratory therapists to see a patient for the first time on the day after surgery and start patients doing breathing exercises. However as respiratory dysfunction starts occurring immediately following surgery it is debated that these breathing exercises are being provided too late. Initiating prophylactic treatment more than 24 hours after the end of surgery may not be as effective as starting prophylaxis immediately. Unfortunately, immediately after surgery patients are either very sleepy, in pain, feeling sick, or delirious. It may not be possible to effectively teach patients at this point on the importance of breathing exercises and get good performance. One method to overcome this would be to meet patients before the operation to educate them about their risk of a postoperative chest infection and to motivate and train them to perform breathing exercises to do immediately on waking from surgery. Previous trials have indicated that this may help prevent postoperative respiratory complications, although evidence is inconclusive and weak. We set out to robustly and conclusively see if respiratory complications could be prevented after major upper abdominal surgery if patients were taught breathing exercises to do as soon as they woke up after the operation. We ran this trial in two countries (Australia and New Zealand) and three different types of hospitals.  All patients were met by a physiotherapist at our hospitals’ scheduled pre-admission clinic appointment and either provided with an information booklet (control) or provided with an additional 30 minute education and training session with the physiotherapist. At this preoperative session the patient was educated about respiratory complications, their risk, and how to prevent them with breathing exercises. These exercises were then taught and practiced for just three repetitions. Patients were instructed to do these breathing exercises for 20 repetitions as soon as they woke from surgery and then 20 times every hour after surgery until they were up and out of bed frequently. Following surgery each patient had a standardised rehabilitation program and no respiratory therapy of any type was provided to the patients after surgery. For the first two weeks after surgery patients were assessed daily for a respiratory complication by research assistants unaware of what treatment the patient had received before surgery.
Author Interviews, BMJ, OBGYNE, Probiotics / 24.01.2018

MedicalResearch.com Interview with: “My nightly probiotics to help me :) barely holding back PostOp issues! Very GRATEFUL for them!” by Ashley Steel is licensed under CC BY 2.0Mahsa Nordqvist MD Department of Obstetrics and Gynecology Sahlgrenska University Hospital Gothenburg, Sweden  MedicalResearch.com: What is the background for this study? Response: We have shown in earlier observational studies that there is an association between probiotic intake and lower risk of preterm delivery and preeclampsia. Since pregnancy is a time of rapid change and different exposures can have different effect depending on the time of exposure, we wanted to find out if there is any special time point of consumption that might be of greater importance when it comes to these associations.
Author Interviews, BMJ, Lipids, Nutrition, Pediatrics, Weight Research / 15.12.2017

MedicalResearch.com Interview with: [caption id="attachment_38942" align="alignleft" width="200"]Dr. Angela S Donin Population Health Research Institute, St George’s University of London, London, UK Dr. Donin[/caption] Dr. Angela S Donin Population Health Research InstituteSt George’s University of LondonLondon, UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are increasing numbers of takeaway outlets, particularly in deprived neighbourhoods. This is driving an increase in consumption of takeaway meals, which previous evidence has shown is linked to higher risks of heart disease, type 2 diabetes and obesity. Little is known about the dietary and health impact of high consumption of takeaway foods in children. This research found children who regularly ate takeaway meals had higher body fat and cholesterol compared to children who rarely ate take away meals, they also had overall poorer diet quality.
Alzheimer's - Dementia, Author Interviews, BMJ, Education, Karolinski Institute / 10.12.2017

MedicalResearch.com Interview with:

[caption id="attachment_38832" align="alignleft" width="161"]Susanna C. Larsson, PhD Associate Professor, Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden Dr. Larsson[/caption]

Susanna C. Larsson, PhD Associate Professor, Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden

MedicalResearch.com: What is the background for this study? Response: The causes of Alzheimer’s disease are largely unknown and there are currently no medical treatments that can halt or reverse its effects. This has led to growing interest in identifying risk factors for Alzheimer’s that are amenable to modification. Several observational studies have found that education and various lifestyle and vascular risk factors are associated with the risk of Alzheimer’s disease, but whether these factors actually cause Alzheimer’s is unclear.

We used a genetic epidemiologic method known as ‘Mendelian randomization’. This method involves the use of genes with an impact on the modifiable risk factor – for example, genes linked to education or intelligence – and assessing whether these genes are also associated with the disease. If a gene with an impact on the modifiable risk factor is also associated with the disease, then this provides strong evidence that the risk factor is a cause of the disease.

MedicalResearch.com:  What are the main findings?

Response: Our results, based on aggregated genetic data from 17 000 Alzheimer’s disease patients and 37 000 healthy controls, revealed that genetic variants that predict higher education were clearly associated with a reduced risk of Alzheimer’s disease. A possible explanation for this link is ‘cognitive reserve’, which refers to the ability to recruit and use alternative brain networks or structures not normally used to compensate for brain ageing. Previous research has shown that high education increases this reserve.

We found suggestive evidence for possible associations of intelligence, circulating vitamin D, coffee consumption, and smoking with risk of Alzheimer’s disease. There was no evidence for a causal link with other modifiable factors, such as vascular risk factors.

Author Interviews, BMJ, Nutrition / 26.11.2017

MedicalResearch.com Interview with: “Coffee” by Treacle Tart is licensed under CC BY 2.0Robin Poole Specialty registrar in public health Academic Unit of Primary Care and Population Sciences Faculty of Medicine University of Southampton MedicalResearch.com: What is the background for this study? Response: Worldwide, over two billion cups of coffee are consumed every day. Since such a lot of coffee is consumed it is important to understand whether this is beneficial or harmful to our health. Evidence to date has been mixed and this tends to vary between different outcomes. Coffee is a complex mixture of many bioactive compounds including caffeine, chlorogenic acids, and diterpenes. Laboratory experiments have previously highlighted the potential for coffee to have anti-oxidant, anti-inflammatory, anti-fibrotic and anti-cancer effects. Our research group is interested in liver conditions and we were aware of studies suggesting beneficial associations between drinking coffee and liver disease. We went on to conduct two meta-analyses and concluded that coffee drinking was beneficially associated with both liver cirrhosis and liver cancer.
Author Interviews, BMJ, Imperial College, Surgical Research / 15.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38303" align="alignleft" width="400"]ruptured Abdominal Aortic Aneurysm as seen on CT- Wikipedia James Heilman, MD A ruptured abdominal aortic aneurysm  as seen on CT[/caption]     Professor JT Powell PhD, MD, FRCPath Faculty of Medicine, Department of Surgery & CancerImperial College London       MedicalResearch.com: What is the background for this study? Response: The mortality from ruptured abdominal aortic aneurysm (AAA) remains very high causing about 6000 deaths each year in the UK.  The only hope for survival is an emergency operation to repair the burst aorta.  Even so the mortality may be as high as 45% within a month of repair using open surgery. It has been suggested that minimally invasive repair using keyhole or endovascular techniques would lower the mortality to about 25% within a month of repair.  However not all shapes of aorta are suitable for endovascular repair (also called EVAR).
Author Interviews, BMJ, Cancer Research / 07.11.2017

MedicalResearch.com Interview with: Dr. Wai Keung Leung Professor, Division of Gastroenterology & Hepatology Department of Medicine Assistant Dean, LKS Faculty of Medicine University of Hong Kong Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: It remains controversial whether proton pump inhibitors will increase the risk of gastric cancer. Although previous studies have shown a possible increase in risk in patients taking long-term proton pump inhibitors (PPI), these studies are confounded by the presence of H. pylori infection. In this population-based study from Hong Kong, we have determined the risk of gastric cancer development in more than 63,000 H. pylori-infected subjects who had the bacterium eradicated by a course of  clarithromycin-based triple therapy and continued to take PPI or H2-receptor antagonist (H2RA). After adjusting for various baseline differences among those PPI and non-PPI users, we found that the risk of gastric cancer was increased by 2.4-fold in those who used long-term PPI. The risk was in tandem with the frequency and duration of PPIs treatment. The risk increased from 5-fold to 8-fold for more than 1-year and 3-year use of PPI, respectively. Similar increase in risk was not observed among those who took H2RA, a weaker acid suppressive agent.
Aging, Author Interviews, BMJ, Cost of Health Care, Exercise - Fitness, Social Issues / 27.10.2017

MedicalResearch.com Interview with: Dr. Scarlett McNally Consultant Orthopaedic Surgeo Eastbourne D.G.H. MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are vast differences between older people in their abilities and their number of medical conditions. Many people confuse ageing with loss of fitness. Ageing has specific effects (reduction in hearing and skin elasticity for example) but the loss of fitness is not inevitable. Genetics contributes only 20% to diseases. There is abundant evidence that adults who take up physical activity improve their fitness up to the level of someone a decade younger, with improvements in ‘up and go’ times. Physical activity can reduce the severity of most conditions, such as heart disease or the risk of onset or recurrence of many cancers. Inactivity is one of the top four risk factors for most long-term conditions. There is a dose-effect curve. Dementia, disability and frailty can be prevented, reduced or delayed. The need for social care is based on an individual’s abilities; for example, being unable to get to the toilet in time may increase the need for care from twice daily care givers to needing residential care or live-in care, which increases costs five-fold. Hospitals contribute to people reducing their mobility, with the ‘deconditioning syndrome’ of bed rest, with 60% of in-patients reducing their mobility. The total cost of social care in the UK is up to £100 billion, so even modest changes would reduce the cost of social care by several billion pounds a year.
Author Interviews, Autism, BMJ, Nutrition / 14.10.2017

MedicalResearch.com Interview with: Elizabeth DeVilbiss, PhD MPH Dornsife School of Public Health Drexel University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unfortunately, not much is known about how diet during pregnancy affects autism risk.  There have been studies in recent years about varied aspects of diet during pregnancy and autism risk involving multivitamins, iron, folic acid, vitamin D, and more, but the evidence is still inconclusive. After adjusting for several potentially influencing factors in both mothers and children, we found that multivitamin use, with or without additional iron and/or folic acid, was associated with a lower likelihood of child autism spectrum disorder with intellectual disability relative to mothers who did not use folic acid, iron, and multivitamins.
Author Interviews, BMJ / 07.10.2017

MedicalResearch.com Interview with: Dr Mark A Green BA (Hons), MSc, PhD, AFHEA Lecturer in Health Geography University of Liverpool MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between Dec 2013 and Dec 2015 there was an increase of 41% in the number of acute patients delayed being discharged from hospital. If we compare the previous year of data –Dec 2012- Dec 2014 – there was only a 10% increase. 2015 saw one of the largest annual spikes in mortality rates for almost 50 years – we wanted to explore if there was any correlation between these two trends.
Asthma, Author Interviews, BMJ, Vitamin D / 04.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37294" align="alignleft" width="125"]David Jolliffe, PhD Centre for Primary Care and Public Health Blizard Institute Barts and the London School of Medicine and Dentistry London Dr. Jolliffe[/caption] David Jolliffe, PhD Centre for Primary Care and Public Health Blizard Institute Barts and the London School of Medicine and Dentistry London MedicalResearch.com: What is the background for this study? Response: Asthma affects more than 300 million people worldwide and is estimated to cause almost 400,000 deaths annually. Asthma deaths arise primarily during episodes of acute worsening of symptoms, known as attacks or ‘exacerbations’, which are commonly triggered by viral upper respiratory infections. Vitamin D is thought to protect against such attacks by boosting immune responses to respiratory viruses and dampening down harmful airway inflammation. Several clinical trials have tested whether vitamin D supplementation might protect against asthma attacks, but individually their results are inconclusive. In the current study, we pooled raw data from 955 asthma patients who took part in 7 separate trials, which allowed us to answer two questions: 1, Does vitamin D protects against asthma attacks overall, when data from all trials are pooled? 2, Do people who have lower vitamin D levels to start with particularly benefit from supplementation?
Author Interviews, BMJ, Gender Differences, Heart Disease / 02.10.2017

MedicalResearch.com Interview with: Min Zhao PhD student Julius Center for Health Sciences and Primary Care, Clinical Epidemiology University Medical Center Utrech MedicalResearch.com: What is the background for this study? Response: Heart disease is still one of leading causes of deaths and disability worldwide. Management of modifiable risk factors, including both medical treatment target and healthy lifestyle, reduce the chance of new heart attack among those who survived a previous heart attack (so-called secondary prevention). Previous studies have demonstrated that the secondary prevention of heart disease is poorer among women than men. However, most studies were performed in Western populations. We aimed to assess whether sex differences exist on risk factor management and to investigate geographic variations of any such sex differences. Our study is a large-scale international clinical audit performed during routine clinic visit. We recruited over 10,000 patients who had survived a previous heart attack from 11 countries in Europe, Asia, and the Middle East.