Pubic Hair Grooming Linked To Increased Risk of STDs

MedicalResearch.com Interview with:

E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital

Dr. Osterberg

E. Charles Osterberg, M.D.
Assistant Professor of Surgery
Genitourinary Reconstruction and Trauma
University of Texas- Dell Medical School
Dell-Seton Medical Center / University Hospital

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

Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.

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Handful of Nuts a Day Can Reduce Chronic Diseases

MedicalResearch.com Interview with:

Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London  UK

Dr. Dagfinn Aune

Dr. Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary’s Campus London  UK

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

Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk.

So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas).

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Starting Testosterone Associated With Increased Risk of Blood Clots

MedicalResearch.com Interview with:
Dr. Carlos Martinez

Institute for Epidemiology, Statistics and Informatics GmbH
Frankfurt, Germany,

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

Response: A 10-fold increase in testosterone prescriptions per capita in the United States and a 40-fold increase in Canada in men has occurred over the first decade of this century, mainly for sexual dysfunction and/or decreased energy. Recognised pathological disorders of the male reproductive system remain the sole unequivocal indication for testosterone treatment but there has been increasing use in men without pathological hypogonadism. A variety of studies and meta-analyses have provided conflicting evidence as to the magnitude of the risk of cardiovascular events including venous thromboembolism in men on testosterone treatment.

In June 2014, the US Food and Drug Administration and Health Canada required a warning about the risk of venous thromboembolism to be displayed on all approved testosterone products. Studies have reported contradictory results on an association between testosterone use and the risk of venous thromboembolism. The effect of timing and duration of testosterone use on the risk of venous thromboembolism was not studied and may explain some of these contradictory findings.

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Which Sports Reduce Risk of Mortality?

MedicalResearch.com Interview with:

Dr. Emmaneul Stamatakis PhD, MSc, BSc Associate Professor | NHMRC Senior Research Fellow Charles Perkins Centre, Prevention Research Collaboration School of Public Health, Sydney Medical School The University of Sydney

Dr. Emmaneul Stamatakis

Dr. Emmaneul Stamatakis PhD, MSc, BSc
Associate Professor | NHMRC Senior Research Fellow
Charles Perkins Centre, Prevention Research Collaboration
School of Public Health, Sydney Medical School
The University of Sydney

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

Response: We examined the association between participation in different sports and risk of death during subsequent decade in a large sample of >80k adults aged 30 and over who lived in Scotland and England between 2994 and 2008 .

We found the following significant reduction in risk of dying from all causes among participants compared with non-participants: cycling 15%, aerobics 27%, swimming 28%, racquet balls 47%; there was no significant reduction in mortality for running/jogging and football/rugby. We also found the following significant reduction in risk of dying from cardiovascular diseases: aerobics 36%, swimming 41%, racquet balls 56%; there were no significant reduction in mortality for running, cycling and football/rugby. Results in both cases were adjusted for the potential confounders: age, sex, chronic conditions, alcohol drinking and smoking habits, mental health, obesity, education level, doctor-diagnosed CVD, cancer, weekly volume of other physical activity besides the sport (including walking and domestic activity.

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Some Saturated Fatty Acids Linked To Risk of Coronary Artery Disease

MedicalResearch.com Interview with:

Dr. Qi Sun Sc.D, M.D., M.M.S. Assistant Professor in the Department of Nutrition Harvard T.H. Chan School of Public Heath Boston

Dr. Qi Sun

Dr. Qi Sun Sc.D, M.D., M.M.S.
Assistant Professor in the Department of Nutrition
Harvard T.H. Chan School of Public Heath
Boston

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

Response: Interpretation of existing human study data regarding saturated fat intake in relation to heart disease risk is quite confusing and distorted in certain publications. It is a fact that, depending on data analysis strategies, the effects of saturated fats may depend on which macronutrients they replace. For example, substituting saturated fats for refined carbohydrates will not lead to an elevated risk of heart disease because both nutrients are harmful whereas replacing saturated fats with good polyunsaturated fats results in risk reduction. In our current analysis, we clearly demonstrated that when total saturated fatty acids were replaced by polyunsaturated fatty acids, monounsaturated fatty acids, whole grain carbohydrates, and plant-based proteins, the diabetes risk would decrease.

Furthermore, we showed that major individual saturated fatty acids were all associated with an elevated heart disease risk.

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Inflammatory Biomarkers Found Linked to Risk of Mortality

MedicalResearch.com Interview with:
Archana Singh-Manoux, PhD

Research Professor (Directeur de Recherche)
Epidemiology of ageing & age-related diseases
INSERM,France

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

Response: A recent metabolomics study examined 106 biomarkers and found alpha-1-acid glycoprotein (AGP), an acute phase protein, to be the strongest predictor of five-year mortality. It is also unknown how well AGP compares with other sensitive, dynamic, and commonly measured markers of systemic inflammation, such as CRP and IL-6, as a predictor of mortality.

We examined the association of these three inflammatory markers with short- and long-term mortality in a large sample of middle-aged adults, followed for 17 years. Our analysis of all-cause, cancer and cardiovascular mortality suggests that for all these outcomes IL-6 may be a better prognostic marker, both in the short and the long-term.

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Involved Fathers Have Positive Impact on Pre-Adolescent Children

MedicalResearch.com Interview with:

Charles Opondo, BPharm MSc PhD. Researcher in Statistics and Epidemiology National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford

Dr. Charles Opondo

Charles Opondo, BPharm MSc PhD.
Researcher in Statistics and Epidemiology
National Perinatal Epidemiology Unit
Nuffield Department of Population Health
University of Oxford
Oxford

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

Response: Our study measured fathers’ involvement in their child’s upbringing in infancy by looking at their emotional response to their child (e.g. feeling confident with the child, making a strong bond with the child), how involved they were in childcare (e.g. changing nappies, playing, night feeding, and also general care tasks around the house such as meal preparation) and their feelings of being a secure in their role as a parent (e.g. feeling included by mother in childcare, not feeling inexperienced with children).

We found that the children of fathers who scored highly in terms of their emotional response and feeling like a secure parent were less likely to have symptoms of behavioural problems when they were 9 or 11 years.

However, fathers being more involved in direct childcare did not seem to affect the child’s risk of having later behavioural problems.

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New Online Fertility Calculators Predict Chance of IVF Success

MedicalResearch.com Interview with:

David McLernon PhD MPhil BSc Research Fellow in Medical Statistics Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen

Dr. David McLernon

David McLernon PhD MPhil BSc
Research Fellow in Medical Statistics
Medical Statistics Team
Institute of Applied Health Sciences
University of Aberdeen
Foresterhill Aberdeen

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

Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.

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Substituting Less Well Trained Assistants For Nurses Increased Hospital Mortality

MedicalResearch.com Interview with:

Dr Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing Professor of Sociology, School of Arts & Sciences Director, Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Center for Health Outcomes and Policy Research Philadelphia, PA 19104

Dr Linda H Aiken

Dr Linda H Aiken PhD, FAAN, FRCN, RN
Claire M. Fagin Leadership Professor in Nursing
Professor of Sociology, School of Arts & Sciences
Director, Center for Health Outcomes and Policy Research
University of Pennsylvania School of Nursing
Center for Health Outcomes and Policy Research
Philadelphia, PA 19104

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

Response: The idea that adding lower skilled and lower wage caregivers to hospitals instead of increasing the number of professional nurses could save money without adversely affecting care outcomes is intuitively appealing to mangers and policymakers but evidence is lacking on whether this strategy is safe or saves money.
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Cancer Drugs, Survival and Ethics

MedicalResearch.com Interview with:

Peter Wise MD Charing Cross Hospital and Imperial College School of Medicine London, UK

Dr. Peter Wise

Peter Wise MD
Charing Cross Hospital and
Imperial College School of Medicine
London, UK

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

Response: As a medical ethicist, I wished to know how much patients with advanced – metastatic – cancer knew about the drugs that were being used to treat it. What were their perceptions of likely treatment success and how did that tally with our knowledge of what drugs could actually achieve – and at what cost to the body and to the pocket. Did patients actually have a choice – and how did the drugs get approved for use in the first place?

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Dementia Risk Raised When Elderly Lose Home During Disaster

MedicalResearch.com Interview with:

Hiroyuki Hikichi, Ph.D. Research Fellow Harvard T.H. Chan School of Public Health Boston, MA 02215

Dr. Hiroyuki Hikichi

Hiroyuki Hikichi, Ph.D.
Research Fellow
Harvard T.H. Chan School of  Public Health
Boston, MA 02215

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

Response: Recovery after major disaster poses potential risks of dementia for the elderly population, such as resettlement in unfamiliar surroundings or psychological trauma. However, no previous studies have demonstrated that experiences of disaster are associated with the deterioration of dementia symptomatology, controlling changes of  risk factors in a natural experimental setting.

We prospectively examined whether experiences of a disaster were associated with incident dementia in the aftermath of the 2011 Great East Japan Earthquake and Tsunami.

MedicalResearch.com: What are the main findings?

Response: The main findings are that major housing damage and home destroyed were associated with cognitive decline: regression coefficient for levels of dementia symptoms = 0.12, 95% confidence interval (CI): 0.01 to 0.23 and coefficient = 0.29, 95% CI: 0.17 to 0.40, respectively.

MedicalResearch.com: What should readers take away from your report?

Response: The effect size of destroyed home is comparable to the impact of incident stroke (coefficient = 0.24, 95% CI: 0.11 to 0.36).

From these findings, cognitive decline should be added to the list of health risks of older survivors in the aftermath of disasters.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Hiroyuki Hikichi, Jun Aida, Katsunori Kondo, Toru Tsuboya, Yusuke Matsuyama, S. V. Subramanian, Ichiro Kawachi. Increased risk of dementia in the aftermath of the 2011 Great East Japan Earthquake and Tsunami. Proceedings of the National Academy of Sciences, 2016; 201607793 DOI: 10.1073/pnas.1607793113

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Men and Women Now Drink About Same Amount of Alcohol

MedicalResearch.com Interview with:

Tim Slade, PhD Associate Professor National Drug and Alcohol Research Centre University of New South Wales

Prof. Tim Slade

Tim Slade, PhD
Associate Professor
National Drug and Alcohol Research Centre
University of New South Wales

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

Response: Historically, men have been more likely to drink alcohol than women and to drink in quantities that damage their health. However, evidence points to a significant shift in the drinking landscape with rates of alcohol use converging among men and women born in more recent times. In a bid to quantify this trend over time, we pooled data from 68 published research studies in 36 countries around the world. We looked at how the ratio of men’s to women’s alcohol use differed for people born in different time periods and found that the gap between the sexes consistently narrowed over the past 100 years or so. For example, among cohorts born in the early 1900s men were just over two times more likely than women to drink alcohol. Among cohorts born in the late 1900s this ratio had decreased to almost one meaning that men’s and women’s drinking rates have reached parity.

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Cardiac CT Reduces Need for Catheterization in Atypical Chest Pain

MedicalResearch.com Interview with:

Professor Marc Dewey Heisenberg professor of radiology Vice Chairman of the Department of Radiology at Charité (Campus Mitte) Berlin Germany

Prof. Marc Dewey

Professor Marc Dewey
Heisenberg professor of radiology
Vice Chairman of the Department of Radiology at Charité (Campus Mitte)
Berlin Germany 

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

Response: Over 3.5 million cardiac catheterisations are performed in Europe each year. This study, jointly conducted by radiologists and cardiologists at Charité – Universitätsmedizin Berlin and published in today’s issue of The BMJ, compares computed tomography (CT) with cardiac catheterisation in patients with atypical chest pain and suspected coronary artery disease (CAD).

MedicalResearch.com: What are the main findings?

Response: CT reduced the need for cardiac catheterisation from 100% to 14% in the group of patients who received CT first instead of catheterisation. If catheterisation was needed in the CT group, the proportion of catheterisations showing obstructive CAD was 5 times higher than in the catheterisation group. Over a period of 3.3 years, the patients in the CT group neither had more cardiac catheterisations nor an increase in cardiovascular events. Moreover, CT shortened the length of stay by 23 hours and 79% of patients said they would prefer CT for future examinations of the heart. Overall, the results of the BMJ study show that CT is a gentle test for reliably ruling out CAD in patients with atypical chest pain who are currently being referred for cardiac catheterisation in routine clinical practice.

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Low-Intensity Ultrasound Not Effective In Accelerating Healing of Tibial Fractures

MedicalResearch.com Interview with:

Jason Busse PhD Associate Professor, Department of Anesthesia McMaster University Hamilton, ON

Jason Busse

Jason Busse PhD
Associate Professor, Department of Anesthesia
McMaster University
Hamilton, ON

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

Response: Our group previously reviewed the evidence regarding the effectiveness of low-intensity pulsed ultrasound (LIPUS) for fracture healing. We found moderate to very low quality evidence for LIPUS in accelerating functional recovery among patients with fracture, and that most trials only explored effects on surrogate outcomes (e.g. radiographic healing); only five of 13 trials directly assessed functional end points – of these, one was positive. We concluded that large trials of high methodological quality, focusing on patient important outcomes such as quality of life and return to function, were needed to establish the role of LIPUS in fracture healing.

We have now completed such a study. Our large, international trial of LIPUS for surgically managed tibial fractures found the addition of LIPUS does not improve functional recovery or accelerate radiographic healing.

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Balancing Omega 6 to Omega 3 To Prevent and Manage Obesity

MedicalResearch.com Interview with:

Artemis P. Simopoulos, M.D. FACN President, The Center for Genetics Nutrition and Health Washington, DC 20016

Dr. Artemis P. Simopoulos

Artemis P. Simopoulos, M.D. FACN
President, The Center for Genetics
Nutrition and Health
Washington, DC 20016

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

Response: I have written extensively on the evolutionary aspects of diet, the diet of Crete prior to 1960 in which I pointed to the misinterpretation of the data of the Seven Countries Study by Keys et al. A major characteristic of these diets is a balanced omega-6/omega-3 ratio.

The recommendation to substitute saturated fats with omega-6 rich oils (sunflower, corn, soybean) increases inflammation and coronary heart disease. It has been shown in a number of studies that a high omega-6/omega-3 (20/1 instead of a balanced ratio) leads to an increase in white adipose tissue and prevents the formation of brown adipose tissue leading to obesity. The changes in the diet-high in omega-6 oils depletion of omega-3 and high fructose along with highly refined carbohydrates in processed foods and a sedentary lifestyle lead to obesity, diabetes, coronary heart disease and cancer.

The scientific evidence from the FAT-1 mouse and recent cohort studies clearly show that the current dietary guidelines as the previous ones are not based on science that takes into consideration genetics, metabolism, the concept that a calorie is not a calorie. It is important to consider that nutrients influence the expression of genes, the omega-6 fatty acids are the most pro-inflammatory nutrients, and inflammation is at the base of all chronic non-communicable diseases.

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Smartphone App Can Screen For Atrial Fibrillation

MedicalResearch.com Interview with:

Dr. Ngai-yin Chan Princess Margaret Hospital Lai Chi Kok, Hong Kong

Dr. Ngai-yin Chan

Dr. Ngai-yin Chan
Princess Margaret Hospital
Lai Chi Kok, Hong Kong

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

Response: Atrial fibrillation (AF) is the most common sustained heart rhythm disorder which can cause stroke, heart failure and an increased risk of death. The risk of stroke can be reduced substantially with drug treatment. However, a quarter of patients with AF causing stroke have silent and asymptomatic AF before stroke. The current guidelines recommend opportunistic screening for AF. Whether systematic community screening for AF with a convenient smartphone ECG can reduce the burden of AF remains unknown. Continue reading

FTO Gene Make Obesity More Likely But Doesn’t Prevent Weight Loss

MedicalResearch.com Interview with:

Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne

Prof. John C. Mathers

Prof. John C. Mathers
Director, Human Nutrition Research Centre
Institute of Cellular Medicine and
Newcastle University Institute for Ageing
Newcastle University
Biomedical Research Building
Campus for Ageing and Vitality
Newcastle on Tyne

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

Response: More than 90 different genetics variants are associated with body fatness and, of these, the FTO gene has the biggest effect. People who are homozygous for the unusual variant of FTO i.e. carry two copies of the risk allele, are on average 3kg heavier than those not carrying the risk allele. In addition, they have 70% greater risk of being obese. Since the FTO gene is associated with being heavier, we wondered whether it made it more difficult for people to lose weight.

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Atrial Fibrillation Associated With Wide Range of Cardiovascular Events

MedicalResearch.com Interview with:
Ayodele Odutayo, DPhil student
Centre for Statistics in Medicine
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
University of Oxford, Oxford, UK

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

Response: Atrial fibrillation is associated with an increased risk of all cause mortality and stroke, as well as higher medical costs and a reduced quality of life. The association between atrial fibrillation and cardiovascular outcomes other than stroke is less clear.

We found that atrial fibrillation is associated with a wide range of cardiovascular events, including cardiovascular mortality, major cardiovascular events, heart failure, ischaemic heart disease, chronic kidney disease, and sudden cardiac death, as well as stroke and all cause mortality. The relative and absolute risk increase associated with many of these events is greater than that of stroke. Interventions are needed to reduce the risk of non-stroke cardiovascular outcomes in adults with atrial fibrillation.

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Poor Work/Life Balance Cited As Main Reason For Few Female Surgeons

MedicalResearch.com Interview with:
Miss Hui-Ling Kerr
SpR Trauma and Orthopaedics
Department of Trauma and Orthopaedic
Bristol Royal Infirmary, Bristol, UK

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

Response: Gender inequality at consultant level in surgery has not improved despite greater opportunities for women and only a small proportion of women apply to become surgical trainees.

We wanted to find out if the lack of female surgical role models acted as a deterrent to first year female junior doctors and final year medical students towards a career in surgery.

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Cancer Patients Have Increased Risk of Injuries Around Time of Diagnosis

MedicalResearch.com Interview with:

Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Qing Shen

Qing Shen,  PhD student
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet

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

Response: Injury, either iatrogenic (for example, complications from medical procedures and drug treatment) or non-iatrogenic (for instance, suicidal behavior and accidents), is one of the leading causes of non-cancer mortality for patients diagnosed with cancer. Iatrogenic injuries are common in those with cancer and have been shown to increase mortality in some cancer patients. Increased risks of suicide and accidental death after diagnosis have been reported, and the diagnostic process of cancer has been recognized highly stressful. It is, however, unknown whether the risk of injuries is also increased during the time period before receiving the diagnosis. Therefore, we analysed the risks of injuries during the weeks before and after diagnosis using a nationwide study sample in Sweden.

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How Does Poor Sleep Affect Risk of Suicide?

MedicalResearch.com Interview with:
Donna Littlewood PhD
School of Health Sciences
Faculty of Biology, Medicine and Health
The University of Manchester

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

Response: This was the first qualitative study to examine the role of sleep problems in relation to suicidal thoughts and behaviours. In-depth semi-structured interviews were conducted with 18 participants, who all had experienced major depressive episode(s) and suicidal thoughts and behaviours.

Data were analysed with thematic analysis which identified three interrelated pathways whereby sleep contributed to suicidal thoughts and behaviours.

The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night.

Secondly, the research found that a prolonged failure to achieve a good night’s sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity.

Finally, participants said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns – reinforcing the first two pathways.

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Volunteering in Mid and Old Age Linked To Better Mental Health

MedicalResearch.com Interview with:

Dr. Faiza Tabassum, PhD University of Southampton, Southampton

Dr. Faiza Tabassum

Dr. Faiza Tabassum, PhD
Southampton Statistical Sciences Research Institute 
University of Southampton
Southampton, UK

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

Response: Previous research has shown that volunteering in older age is associated with better mental and physical health, but it’s unclear whether this extends to other age groups. We aimed to examine the association of volunteering with mental health or well-being among the British population across all ages.

The British Household Panel Survey (BHPS) was used which has collected information from 1991 to 2008 from over 5000 households. The published study has analysed over 66,000 responses representing the whole of the UK. The BHPS included a wide range of questions on leisure time activities, which covered the frequency of formal volunteering—from at least once a week through to once a year or less, or never. The BHPS also included a validated proxy for mental health/emotional wellbeing known as the GHQ-12.

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Altruistic Men May Get More Sex

MedicalResearch.com Interview with:

Steven Arnocky, PhD Associate Professor Department of Psychology Nipissing University North Bay, ON CAN

Dr. Steven Arnocky

Steven Arnocky, PhD
Associate Professor
Department of Psychology
Nipissing University
North Bay, ON CAN 

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

Response: Our work was based on previous findings from hunter-gatherer populations showing that men who hunt and share meat often enjoy greater reproductive access to women.  Research in North America has shown that individuals prefer altruistic partners, especially for long-term mating, and that there may be a sex difference in these preferences such that women exhibit this preference more strongly than men. In line with this, some research has shown that men will sometimes compete with other men in order to make charitable donations to attractive female fundraisers (termed ‘competitive altruism’). Taken together, these findings led us to hypothesise that individuals (and perhaps particularly men) who behave altruistically might experience greater mating success.

In Study 1, undergraduate men and women completed a self-report altruism questionnaire (items such as “I have donated blood”), a personality measure, and a sexual history survey. We found that participants who scored higher on a self-report altruism measure reported they were more desirable to the opposite sex, as well as reported having more sex partners, more casual sex partners, and having sex more often within relationships. Moreover, altruism mattered more for men’s number of lifetime and casual sex partners relative to women’s.

Given the possibility that in any survey research, there is a chance individual’s may report their altruism of sexual history in what they view to be a more positive light (who doesn’t want to think of themselves as altruistic!), in Study 2, we used a behavioral measure of altruism (each participant was entered onto a draw for $100, and at the end of the survey was given the choice to keep their winnings or to donate to a charity). Participants again reported on their sexual histories, as well as completed a personality measure, a scale to capture socially-desirable responding, and a measure of narcissism. Results showed that even when controlling for these potentially confounding variables, that altruists reported having more lifetime sex partners, more casual sex partners, and more sex partners over the past year. Men who were willing to donate also reported having more lifetime dating partners.

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Air Pollution May Shorten Lung Cancer Survival

Sandrah P. Eckel PhD Assistant Professor of Preventive Medicine USC Division of Biostatistics

Dr. Sandrah Eckel

MedicalResearch.com Interview with:
Sandrah P. Eckel PhD
Assistant Professor of Preventive Medicine
USC Division of Biostatistics

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

Response: Lung cancer is the most common cancer and it is responsible for 1 in 5 cancer deaths. There is a growing body of evidence that ambient air pollution exposures are linked to lung cancer incidence and mortality, but the effect on survival of exposures after diagnosis are unclear. The International Agency for Research on Cancer recently classified ambient air pollution as carcinogenic. We reasoned that if air pollution drives lung cancer development, it could impact lung cancer progression—and shorten survival—through the same biological pathways.

We used 20 years of data on more than 300,000 newly diagnosed lung cancer cases from the California Cancer Registry and calculated average air pollution exposures at each patient’s residence from the date of diagnosis through the end of follow-up. We found that patients living in areas with higher pollution levels had shorter survival, particularly for patients who were diagnosed at an early stage and for those diagnosed at an early stage with adenocarcinoma histology. Interestingly, adenocarcinoma is the most common histological subtype of lung cancer in non-smokers.

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Study Calls For Curbing of Excessive Imaging after Thyroid Cancer Treatment

MedicalResearch.com Interview with:

Megan Haymart, M.D. Assistant Professor Institute for HealthCare Policy and Innovation University of Michigan

Dr. Megan Haymart

Megan Haymart, M.D.
Assistant Professor
Institute for HealthCare Policy and Innovation
University of Michigan

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

Response: Over the past three decades the incidence of thyroid cancer has risen. The majority of this rise in incidence is secondary to an increase in low-risk disease. In the setting of this rise in low-risk thyroid cancer, our team noted that over time there was a dramatic rise in imaging after initial treatment for thyroid cancer. We subsequently wanted to understand the implications of this increase in imaging. Does more imaging equal improved outcomes? In this study published in BMJ, we found that this marked rise in imaging after primary treatment of differentiated thyroid cancer was associated with increased treatment for recurrence but with the exception of radioiodine scans in presumed iodine-avid disease, no clear improvement in disease specific survival.

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Home-Cooked Baby Foods Cheaper But Not Always Better Than Commercial Products

MedicalResearch.com Interview with: Sharon Carstairs PhD Student, Public Health Research, Polwarth Building, University of Aberdeen, Aberdeen, MedicalResearch.com: What is the background for this study? Response: The introduction of solid foods is a key period when the mil diet is no longer able to meet all dietary needs, additionally it is a key time for food learning and development of eating preferences in a child’s life. It is vital that children are provided with nutritionally balanced foods as well as a variety of foods to meet dietary requirements and are exposed to different tastes and textures. Some parents provide home-cooked meals however, there is a large market of commercially available infant/toddler meals which can provide parents with a convenient alternative to home-cooking. MedicalResearch.com: What are the main findings? Response: Our main findings indicate that home-cooked recipes based from infant and toddler cookbooks are a cheaper meal option and contain greater nutrient levels, such as protein, compared to commercially available infant/toddler meals. However, when we compare nutrient levels to recommendations the majority of these home-cooked recipes (50%) exceed energy density (ED) recommendations and 37% exceed dietary fat recommendations. In comparison, the majority of commercial meals (65%) meet these ED recommendations and provide a greater vegetable variety per meal however, are below the recommendations for dietary fat. MedicalResearch.com: What should readers take away from your report? Response: Readers need to be aware that despite providing a cheaper option with greater nutrient levels to commercial meals, the majority of home-cooked recipes from targeted cookbooks exceed recommendations for energy density and dietary fats. The majority of commercial meals in contrast meet energy density recommendations and provide greater vegetable variety per meal than home-cooked recipes however, are below recommendations for dietary fat which is an essential component in the diet of young children. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: Our study did not investigate the micronutrient content of meals as this data was not available on commercial product labels. Furthermore, we did not investigate the inclusion of additives and preservatives within these meal types. Future work should therefore include these aspects to provide parents with a complete picture. MedicalResearch.com: Is there anything else you would like to add? Response: It is vital to remember that both home-cooked and commercial main meals incorporate only a part of the daily diet and these should be considered in the context of a whole daily diet. The inclusion of a variety of foods and textures is paramount to a child’s food learning experience and must be considered in the foods offered to young children. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: Bmj A comparison of preprepared commercial infant feeding meals with home-cooked recipes Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. More Medical Research Interviews on MedicalResearch.com

Sharon Carstairs

MedicalResearch.com Interview with:
Sharon Carstairs PhD Student

Public Health Research
University of Aberdeen,
Aberdeen

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

Response: The introduction of solid foods is a key period when the milk diet is no longer able to meet all dietary needs, additionally it is a key time for food learning and development of eating preferences in a child’s life. It is vital that children are provided with nutritionally balanced foods as well as a variety of foods to meet dietary requirements and are exposed to different tastes and textures. Some parents provide home-cooked meals however, there is a large market of commercially available infant/toddler meals which can provide parents with a convenient alternative to home-cooking.

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Current Complaint Investigations Contribute to Physician Burnout

MedicalResearch.com Interview with:

Professor Tom Bourne Ph.D., FRCOG, FAIUM (hon). Adjunct Professor, Imperial College, London Visiting Professor, KU Leuven, Belgium Consultant Gynaecologist Queen Charlotte's and Chelsea Hospital

Prof. Tom Bourne

Professor Tom Bourne Ph.D., FRCOG, FAIUM (hon).
Adjunct Professor, Imperial College, London
Visiting Professor, KU Leuven, Belgium
Consultant Gynaecologist
Queen Charlotte’s and Chelsea Hospital

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

Response: Previous studies had suggested that complaint investigations might be associated with psychiatric morbidity – including depression and suicide. For example in the United States, malpractice litigation has been reported to be associated with burnout, depression and suicidal ideation. We had also witnessed in our daily practice both the burden that complaints investigations have on colleagues, but also that doctors were often practicing defensive medicine to “protect themselves”. Against this background we embarked on a large survey study on doctors in the UK – with almost 8000 physicians replying to the survey. This survey contained questions relating to validated psychological instruments for depression and anxiety, new metrics for defensive practice (hedging and avoidance) as well as single item questions. We published these data in 20151. We found that recent or current complaints were associated with significant levels or anxiety, depression and suicidal ideation, this was irrespective of the complaints procedure – although this was highest when it involved the main UK regulator the general medical council (GMC). Many doctors reported practising defensive medicine due to a fear of complaints – with over 80% reporting hedging and over 40% reporting avoidance. A number of recommendations were made to improve how complaints procedures might work.

In the final part of the questionnaire we asked three open questions, how the complaints procedure made the doctor feel, what was the most stressful aspects of the procedure and what could be done to improve things. It is the analysis of this qualitative data that is presented in the current paper.

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Checkpoint Inhibitor Biologics Linked To Inflammatory Arthritis and Sicca Syndrome

MedicalResearch.com Interview with:

Laura C. Cappelli, M.D Johns Hopkins University School of Medicine

Dr. Laura Cappelli

Laura C. Cappelli, M.D
Johns Hopkins University School of Medicine

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

Response: We had been referred several patients with inflammatory arthritis or dry mouth and dry eyes after being treated with immune checkpoint inhibitors. When searching the literature for information on how to evaluate and treat these patients, we realized that there was minimal information available. We wanted to describe our experience and inform the medical community about these events so that recognition could increase.

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Alcohol: Better for Heart Attacks, Worse for Atrial Fibrillation?

MedicalResearch.com Interview with:

Dr. Gregory M. Marcus MD Associate Professor UCSF School of Medicine

Dr. Gregory 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?

Response: Multiple epidemiologic studies have demonstrated that alcohol consumption likely increases the risk for atrial fibrillation and reduces the risk for myocardial infarction. However, the results have been conflicting, they generally all rely on self-report of alcohol consumption (which is known to be unreliable, particularly in those that drink more heavily), and there is almost certainly confounding related to an individual’s choice to consume alcohol (which in most settings is ubiquitously available). In addition, the relationship between alcohol and heart failure remains poorly understood, with evidence suggesting there may be both harmful and beneficial effects. Finally, the relationship between alcohol consumption and these various cardiovascular diseases (atrial fibrillation, myocardial infarction, and heart failure) have not been examined within the same cohort of individuals in a simultaneous fashion.

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Nuts May Improve Overall Health In Men With Prostate Cancer

MedicalResearch.com Interview with:

Dr. Ying Bao Sc.D., M.D Assistant Professor of Medicine Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School, Boston, MA

Dr. Ying Bao

Dr. Ying Bao Sc.D., M.D
Assistant Professor of Medicine
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School,
Boston, MA

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

Response: Nuts are rich in bioactive macronutrients, micronutrients, tocopherols and phytochemicals. Current epidemiological evidence has consistently linked increased nut consumption to reduced risk of several chronic conditions including cardiovascular diseases, type 2 diabetes, and inflammation. In contrast, evidence on nut consumption and cancer risk has been insufficient and equivocal.

Prostate cancer is the leading cancer among U.S. men, with approximately 220,800 new cases diagnosed in 2015. However, very few studies have investigated the association between nut intake and prostate cancer. Thus, in the current study, we followed 47,299 US men from 1986-2012, and examined
(1) whether consuming more nuts prevents getting prostate cancer, and
(2) whether consuming more nuts reduces death rates among non-metastatic prostate cancer patients.

During 26 years of follow-up, 6,810 men were diagnosed with prostate cancer, and 4,346 of these patients were without metastasis at diagnosis. We found no association between nut intake and being diagnosed with prostate cancer. However, among non-metastatic prostate cancer patients, those who consumed nuts 5 or more times per week after diagnosis had a significant 34% lower rate of overall mortality than those who consumed nuts less than once per month.

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Chronic Pain Can Affect Over Half of Adults

MedicalResearch.com Interview with:

Dr Alan Fayaz MA MBBS MRCP FRCA FFPMRCA Consultant in Anaesthesia and Pain Medicine University College London Hospital NHS Foundation Trust

Dr. Alan Fayaz

Dr Alan Fayaz
MA MBBS MRCP FRCA FFPMRCA
Consultant in Anaesthesia and Pain Medicine
University College London Hospital NHS Foundation Trust

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

Dr. Fayaz: Despite fairly well established negative consequences of chronic pain (social, psychological, biological) very little is known about the burden of chronic pain in the United Kingdom. For example healthcare costs relating to chronic pain in the USA outstrip those of Cancer and Cardiovascular disease, and yet the profile of chronic pain (as disease in its own right) is not nearly as well established as either of those conditions. Surprisingly, prior to our study, there was little consensus regarding the prevalence of chronic pain in the UK. The purpose of our review was to synthesise existing data on the prevalence of various chronic pain phenotypes, in the United Kingdom, in order to produce accurate and contemporary national estimates.

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Women With Migraine At Increased Risk of Cardiovascular Disease

MedicalResearch.com Interview with:

Prof. Dr. Dr. Tobias Kurth Professor of Public Health and Epidemiology and Director of the Institut of Public Health, Charité – Universitätsmedizin Berlin, Germany. Co-director, Centre Virchow-Villermé, for Public Health Paris – Berlin, Campus Berlin. Adjunct Associate Epidemiologist, Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.

Dr. Tobias Kurth

Prof. Dr. Dr. Tobias Kurth
Professor of Public Health and Epidemiology and Director of the Institut of Public Health, Charité – Universitätsmedizin Berlin, Germany.
Co-director, Centre Virchow-Villermé, for Public Health Paris – Berlin, Campus Berlin.
Adjunct Associate Epidemiologist, Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.

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

Dr. Kurth: Migraine has been consistently associated with increased risk of stroke. Associations with other (non-stroke) Cardiovascular Disease (CVD) was less clear.

MedicalResearch.com: What should readers take away from your report?

Dr. Kurth: Women with migraine are at increased risk of any CVD event, including Myocardial infarction, stroke and cardivoascular death.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Kurth:  We do not yet understand the mechanism of this association and strong efforts are needed to find solution to reduce the increased risk.

MedicalResearch.com: Is there anything else you would like to add?

Dr. Kurth: I am aware of the importance of the finding but we hope to not scare patients with migraine. Nevertheless, women with migraine should be evaluated for their vascular risk.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Kurth Tobias, Winter Anke C, Eliassen A Heather,Dushkes Rimma, Mukamal Kenneth J, Rimm Eric Bet al. Migraine and risk of cardiovascular disease in women: prospective cohort study

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com.

Pediatric Methylphenidate (Ritalin) May Raise Risk of Cardiac Arrhythmia

MedicalResearch.com Interview with:

Nicole Pratt PhD Senior Research Fellow Quality Use of Medicines and Pharmacy Research Centre Sansom Institute, School of Pharmacy and Medical Sciences University of South Australia GPO Box 2471, Adelaide 5001 South Australia

Dr. Nicole Pratt

Nicole Pratt PhD
Senior Research Fellow
Quality Use of Medicines and Pharmacy Research Centre
Sansom Institute, School of Pharmacy and Medical Sciences
University of South Australia
Adelaide South Australia

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

Dr. Pratt: The cardiac safety of methylphenidate has been debated. This study aimed to measure the risk of cardiac events in a large population of children treated with these medicines. We found that there was a significantly raised risk of arrhythmia in time periods when children were treated with methylphenidate compared to time periods when they were not. While the relative risk of cardiac events was significant the absolute risk is likely to be low as cardiac events are rare in children.
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Too Many Cardiovascular Disease Prediction Models Lack Clear Validation

MedicalResearch.com Interview with:

Johanna Damen, MSc Julius Center for Health Sciences and Primary Care Cochrane Netherland University Medical Center Utrecht, Netherlands

Johanna Damen

Johanna Damen, MSc
Julius Center for Health Sciences and
Primary Care Cochrane Netherlands
University Medical Center Utrecht,
Netherlands

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

Response: Prediction models for cardiovascular disease (CVD) estimate the probability that an individual will develop a certain cardiovascular condition in the future. For instance, prognostic models for CVD are typically used to decide which patients need treatment (e.g. antihypertensive or lipid lowering drugs, or life-style interventions) to reduce their 10 year risk. Previous reviews have shown there are a lot of CVD prediction models, but no systematic review has given an overview of which models exist, which predictors they use, which outcome they predict and which models have been externally validated.

MedicalResearch.com: What are the main findings?

Response: We found that there is an excess of prediction models for CVD (363 models in total) with extreme variation in predicted outcomes and included predictors. For instance, the majority of cardiovascular models predicted the risk of coronary heart disease of cardiovascular disease, although more than 70 different definitions were reported for these outcomes. Most models included predictors like age, smoking status, blood pressure, and cholesterol levels, but over 100 other predictors were identified. Remarkably, the performance of these models was almost never validated in new patients or settings, indicating that much more emphasis is placed on repeating the process of identifying new predictors rather than validating existing models. Quality of reporting was often insufficient to actually use the model for individual risk predictions, and model performance was infrequently reported.

MedicalResearch.com: What should readers take away from your report?

Response: Despite a clear excess of CVD prediction models, there is a lack of studies in which their predictive performance and usefulness in clinical practice is assessed. Furthermore, there is a lack of studies in which existing models are compared and the performance in local settings or populations is assessed. Although there are many differences between the available CVD models, most of them predict similar outcomes and use similar predictors.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should focus on validating existing prediction models, rather than developing new models. Ideally, models are compared head-to-head to identify the best model in a certain setting.

Furthermore, these models can be combined and tailored to specific settings, and other predictors can be added to improve their predictive performance.

Finally, impact studies are urgently needed to investigate the effect of using CVD prediction models on doctor’s prescription behavior and patient outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: Damen Johanna A A G, Hooft Lotty, Schuit Ewoud,Debray Thomas P A, Collins Gary S, Tzoulaki Ioanna et al. Prediction models for cardiovascular disease risk in the general population: systematic review BMJ2016; 353 :i2416

Note: Content is Not intended as medical advice.

Please consult your health care provider regarding your specific medical condition and questions.

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Boiled, Baked, Mashed or Fried – Potatoes Increase Hypertension Risk

MedicalResearch.com Interview with:
Lea Borgi, MD, MMSc

Renal Division, Brigham and Women’s Hospital 

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

Dr. Borgi:   The association of potatoes intake with the risk of developing hypertension has not been studied. In our analyses of more than 187,000 participants without a diagnosis of high blood pressure at baseline, we observed that higher intakes of boiled, baked or mashed potatoes and French fries were associated with an increased risk of developing hypertension.

Indeed, when participants consumed 4 or more than 4 servings per week of boiled, baked or mashed potatoes as compared to 1 or less than one serving per month, the risk of hypertension increased by 11% (and 17% when French fries were consumed 4 or more than 4 times a week as compared to 1 or less than 1 serving per month). We also found that replacing one serving of boiled, baked or mashed potatoes per day with one serving of a non-starchy vegetable was associated with a lower risk of developing hypertension.

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Intentional and Alcohol Poisonings among Adolescents Increasing

MedicalResearch.com Interview with:

Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham

Dr. Edward Tyrrell

Dr Edward Tyrrell
NIHR In-Practice Research Fellow
Division of Primary Care
University Park Nottingham 

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

Dr. Tyrrell: Poisonings are among the most common causes of death amongst adolescents across the world, many of them related to self-harm. Poisonings leading to death are just the tip of the iceberg with many more resulting in invasive treatment, time off school and long term health effects. Many adolescent self-harm episodes are linked to mental health problems, which are often predictive of mental health problems in adulthood, making adolescence a key window for preventative intervention. However, up to date rates and time trends for adolescent poisonings are lacking, hindering the development of evidence-informed policy and planning of services.

To quantify this problem at a national level and provide recent time trends of poisonings, we used routinely collected primary care data from 1.3 million 10-17 year olds. We assessed how intentional, unintentional and alcohol-related poisonings for adolescent males and females vary by age, how these have changed between 1992 and 2012 and whether socioeconomic inequalities exist.

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Better Treatment Means More Patients With Type 1 Diabetes Pass on Disease Genes

MedicalResearch.com Interview with:

Wenpeng You, PhD student Biological Anthropology and Comparative Anatomy Research Unit University of Adelaide | School of Medicine Adelaide, Australia

Wenpeng You

Wenpeng You, PhD student
Biological Anthropology and Comparative Anatomy Research Unit
University of Adelaide | School of Medicine
Adelaide, Australia 

Maciej Henneberg, PhD, DSc, FAIBiol Wood Jones Professor of Anthropological and Comparative Anatomy University of Adelaide | School of Medicine Adelaide, Australia  Institute for Evolutionary Medicine, University of Zurich  Editor in Chief, Journal of Comparative Human Biology HOMO

Dr. Maciej Henneberg

Maciej Henneberg, PhD, DSc, FAIBiol
Wood Jones Professor of Anthropological and Comparative Anatomy
University of Adelaide School of Medicine;
Institute for Evolutionary Medicine, University of Zurich

Editor in Chief, Journal of Comparative Human Biology HOMO

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

Response: Type 1 diabetes disease has very strong genetic background. Prevalence of type 1 diabetes has been increasing globally. Previous studies focusing on regional genetics and environmental factors cannot fully explain this phenomenon. Due to insufficient medical knowledge up until early 20th century, people with type 1 diabetes disease would most commonly die during their teens or early 20s. Therefore, they did not have the opportunity to pass on their genes providing background for the development of type 1 diabetes to their next generations. Since discovery and introduction of insulin to modern medicine in early 1920s, more and more type 1 diabetes patients have been able to survive their reproduction cycle (up until and past 50 years of age). This has made more and more genes related to type 1 diabetes to accumulate in human populations.

We applied the Biological State Index which measures a probability to pass genes on to the next generation at population level.  We found that the rapid increase in type 1 diabetes over the last few decades was correlated with increases of the Biological State Index and its proxy, human life expectancy, especially in more developed world in which natural selection has been relaxed most. This correlation was found after statistically excluding differences in countries income, levels of urbanization, sugar consumption and obesity prevalence.

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Body weight and mortality – is overweight really beneficial?

MedicalResearch.com Interview with:

Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus Norfolk Place, Paddington, London

Dagfinn Anne

Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary’s Campus
Norfolk Place, Paddington, London

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

Response: The prevalence of overweight and obesity has increased rapidly over the past decades in all areas of the world. This has raised serious public health concerns because of the relationship between excess weight and increased risk of many chronic diseases including cardiovascular disease, several types of cancer, type 2 diabetes, gallstones, gout, osteoarthritis, and several other conditions as well as all-cause mortality.

Body mass index (BMI) is an established way of measuring adiposity and is calculated by dividing the weight in kilograms with the height in metres squared. Although overweight (BMI 25-29.9) and obesity (BMI ≥30) has been associated with increased risk of mortality in several previous studies, the largest previous study showed that when compared to normal weight, overweight was associated with reduced mortality, and only grade 2 obesity (BMI ≥35) was associated with increased risk of mortality.

However, there were several limitations in that study, for example, smoking and prevalent or prediagnostic illness were not taken into account, both of which can cause lower body weight and increased mortality and may therefore bias the optimal BMI range upwards. In addition, many large studies which did not use the standard WHO categories of normal weight, overweight and obesity, but had used smaller increments to categorize BMI to provide more detailed assessment of the dose-response relationship between BMI and mortality, had been excluded. 
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What Else Can Be Done To Reduce Medical Errors?

MedicalResearch.com Interview with:

Michael Daniel The Johns Hopkins University School of Medicine M.D. Candidate 2016

Michael Daniel

Michael Daniel
The Johns Hopkins University School of Medicine
M.D. Candidate 2016

Michael G. Daniel is a graduating medical student at the Johns Hopkins School of Medicine. He will be attending the Osler Internal Medicine Residency Training Program next year at the Johns Hopkins Hospital. His research focus is on Patient Safety, Quality, and Outcomes improvement.

Summary:

Medical error ranks as the third leading cause of death in the United States, but is not recognized in national vital statistics because of a flawed reporting process. Using recent studies on preventable medical error and extrapolating the results to the 2013 U.S. hospital admissions we calculated a mortality rate or 251,454 deaths per year.

MedicalResearch.com: What made you want to research this topic?

Response: I decided to study medicine because I wanted to improve patient health. However, I realized that improving patient health is not only about curing a disease but is sometimes about fixing the way we deliver healthcare.

MedicalResearch.com: Is this news surprising to you?

Response: Yes, because all previous estimates of medical error were much lower and when I started the research I couldn’t use the CDC statistics to get current data.

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Study Finds More Harm Than Benefit From Screening All Young Athletes To Prevent Sudden Cardiac Death

Dr-Hans-Van-Brabandt

Dr. Hans Van Brabandt

MedicalResearch.com Interview with:
Hans Van Brabandt, M.D.
Brussel, Belgium

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

Dr. Van Brabandt: We have been asked by the Belgian government to assess the benefits and harms of pre-participation screening of young athletes. A number of Belgian cardiologists and screening physicians are intensely promoting such screening through mass media and were asking governmental support.

MedicalResearch.com: What are the main findings?

Dr. Van Brabandt:  There is no solid evidence on the benefit of cardiovascular pre-participation screening, and certainty of harms it induces through numerous false-positives, making that such screening in young athletes cannot be defended.

–          Italian investigators assert they have provided evidence for the benefit of screening. The single study on which they base their claim however is far from convincing. Unfortunately, more than 10 years after their first paper, they still did not make the majority of their data publicly available.

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Early Pregnancy Risk Factors for Pre-Eclampsia Identified

MedicalResearch.com Interview with:

Joel Ray, MD MSc FRCPC Clinician-Scientist St. Michael’s Hospital Toronto, ON

Dr. Joel Ray

Joel Ray, MD MSc FRCPC
Clinician-Scientist
St. Michael’s Hospital
Toronto, ON

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

Dr. Ray:

  • Clinical practice guidelines strongly recommend that physicians and midwives start aspirin before 20 weeks gestation in a woman at high risk of preeclampsia (PE).
  • However, these guidelines do not provide a systematic approach for identifying a woman at high risk of pre-eclampsia (PE), using readily available clinical risk factors (RFs) known before 20 weeks gestation.
  • Thus, there is a need for a clear, concise and evidence-based list of risk factors that clinicians can use, before 20 weeks gestation, to estimate a woman’s risk of pre-eclampsia.
  • We systemically analyzed large cohort studies and estimates of the absolute pooled risk of developing pre-eclampsia in the presence vs. absence of one of 14 common risk factors.

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Social Isolation and Loneliness Raise Risk of Heart Disease and Stroke

MedicalResearch.com Interview with:

Nicole Valtorta NIHR Doctoral Research Fellow Department of Health Sciences University of York, UK

Nicole Valtorta

Nicole Valtorta
NIHR Doctoral Research Fellow
Department of Health Sciences
University of York, UK

Medical Research: What is the background for this study? What are the main findings?

Response: Lonely and socially isolated adults are at increased risk of mortality. The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. We systematically reviewed the evidence from prospective cohort studies to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke. We identified 23 papers reporting data from 16 longitudinal datasets, for a total of 4,628 CHD and 3,002 stroke events. Reports of eleven studies (CHD) and eight studies (stroke) provided data suitable for meta-analyses, the results of which indicated that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. People who were lonely or isolated had, on average, a 29% greater risk of incident CHD; similarly, the risk of developing stroke was 32% greater among isolated individuals.

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Clinical Findings and Brain Calcifications of Zika Babies Described

MedicalResearch.com Interview with:

Team of Doctors Brazil - Article BJM - Zika -  Ana van Der Linden, Alessandra Brainer, Maria de Fatima Aragao, Vanessa va Der Linden e Arthur Cesário.jpg

Team of Doctors:  Ana van Der Linden, Alessandra Brainer, Maria de Fatima Aragao, Vanessa va Der Linden e Arthur Cesário

Maria de Fatima Vasco Aragao MD, PhD
Radiologist and Neuroradiologist
Professor of Radiology, Mauricio de Nassau University, Recife, Brazil
Scientific Director of Multimagem Radiology Clinic, Recife – PE, Brazil
President of Pernambuco Radiology Society

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

Response: The new Zika virus epidemic in Brazil was recognized as starting in the first half of 2015 and the microcephaly epidemic was detected in the second half of that same year.

This is a transmission electron micrograph (TEM) of Zika virus, which is a member of the family Flaviviridae. Virus particles are 40 nm in diameter, with an outer envelope, and an inner dense core.

This is a transmission electron micrograph (TEM) of Zika virus, which is a member of the family Flaviviridae. Virus particles are 40 nm in diameter, with an outer envelope, and an inner dense core.

MedicalResearch.com: What are the main findings?

  • Response:  In our study of the 23 mothers, only one did not report rash during pregnancy (rash is a sign that can happen in Zika virus infection). However, Zika virus infection can be asymptomatic in three of every four infected patients. All of the 23 babies had the same clinical and epidemiological characteristics and other congenital infection diseases had been excluded. Of these 23 babies, six were tested for IgM antibodies, specific to Zika virus and all six proved positive. So, by deduction, the other 17 babies on whom it was not possible to make the IgM test, were considered as also having presumed congenital infection related to the Zika virus, after other congenital infections being excluded.
  • All the babies showed malformations of cortical development and sulcation.  The most frequent cortical malformation were: Microcephaly with a simplified cortical gyral pattern and areas of thick cortex of polymicrogyria or pachygyria which were located predominantly in the frontal lobes.
  • Abnormalities of the corpus callósum (hypogenesis and hypoplasia) were common.
  • Decreased brain volume was a common finding. Ventriculomegaly was present in all the babies, with a predominant enlargement of the posterior portions of the lateral ventricles,
  • Delayed myelination were also common. The cisterna magna was enlarged in most of the cases, with or without cerebellar hypoplasia.
  • Some of the babies showed a symmetrical enlargement of the anterior subarachnoid space of the supratentorial compartment, associated with severe ventriculomegaly.

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Public Largely Unaware of the Potential Negative Effects of Cancer Overdiagnosis

MedicalResearch.com Interview with:
Dr Alex Ghanouni
Research Associate
UCL Research Department of Epidemiology and Public Health
Health Behaviour Research Centre
London

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

Dr. Ghanouni: This study comes out of growing concern among academics, doctors, and policymakers about the unintended harms of healthcare interventions. One prominent issue in the ongoing debate is ‘overdiagnosis’, that is detection of disease that would not have caused symptoms or death if it had remained undetected. There are many contexts in which overdiagnosis can occur but one of the most prominent is cancer screening, in which asymptomatic individuals undergoing testing may have slow-growing cancers detected that would never have otherwise come to light. However, because it is impossible to be sure which cancers are slow-growing and which are aggressive, most are treated. This means that overdiagnosis can lead to harm through the anxiety caused by a disease label and the negative effects of treatment (e.g. surgery) that is actually unnecessary.

Despite professional concern about overdiagnosis, previous research has found that the public is mostly unaware that it exists. One study that was particularly relevant to our research was an Australian survey in which members of the public were asked whether they had encountered the term before and what they thought it meant. Although around half the sample stated that they had heard or seen the term before, only 41% were able to provide a definition that was approximately correct. We tested the extent to which this was true as part of an online survey of adults aged 50-70 years in the UK. We found that recognition of the term was very low (only 30%) and almost no-one (3%) gave an answer that was strictly accurate. Responses often indicated misconceptions (e.g. “misdiagnosis”, “false positive diagnosis”, or being “overly health conscious”).

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Unexpected Loss of Life Partner Raises Risk of Atrial Fibrillation in Bereaved Spouse

MedicalResearch.com Interview with:
Dr. Simon Graff

Department of Public Health
Aarhus University

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

Dr. Graff: We knew that a substantial amount of evidence have accumulated, linking our mental wellbeing to our body. With that in mind we wanted to examine one of the (if not the most) most stressful life event; the loss of a partner! Former studies have ranked bereavement of a life partner as the most stressful life event we humans can experience.

Our study reports that spousal bereavement is followed by a transiently increased risk of new onset of atrial fibrillation (AF). The risk was highest 8-14 days after the loss and remains elevated for one year.

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Cannabis During Pregnancy Can Lead To Low Birth Weight Infants

MedicalResearch.com Interview with:

Cara Christ, M.D., M.S. Director of the Arizona Department of Health Services

Dr. Cara Christ

Cara Christ, M.D., M.S.
Director of the Arizona Department of Health Services

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

Dr. Christ: This study was a systematic review. The purpose of a systematic review is to critically assess and summarize the best available research evidence on a specific issue. This usually involves a critical synthesis of the results of several high quality studies on the issue under review. Overall, this review found that infants exposed to cannabis during pregnancy had a 77% higher likelihood of being underweight (<2500grams) at birth, compared to infants whose mothers did not use cannabis. Also, if the mother used cannabis during pregnancy, the likelihood of her infant needing to be placed in a neonatal intensive care unit was two times higher compared to those infants whose mothers did not use cannabis during pregnancy.

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Refugees Granted Asylum More Likely to Have Schizophrenia and Psychotic Disorders

MedicalResearch.com Interview with:

Dr. Anna-Clara Hollander

Dr. Anna Clara Hollander

Anna-Clara Hollander PhD
Division of Social Medicine, Department of Public Health Sciences
Karolinska Institutet, Stockholm, Sweden.

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

Response: The humanitarian crises in Europe, the Middle East, north Africa, and central Asia have led to more displaced people, asylum seekers, and refugees worldwide than at any time since the second world war. Refugees are known to be at an increased risk of mental health problems, such as post-traumatic stress disorder and other common mental disorders, compared to non-refugee migrants, but little is known about their risk of psychosis.

The aim of the study was to determine the risk of schizophrenia and other non-affective psychotic disorders among refugees, compared to non-refugee migrants, and the general Swedish population. We used a linked national register data to examine more than 1.3 million people in Sweden, and tracked diagnoses of non-affective psychotic disorders among the population. The cohort included people born to two Swedish-born parents, refugees, and non-refugee migrants from the four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, Eastern Europe and Russia.

Results showed 3,704 cases of non-affective psychotic disorders during the 8.9 million person years of follow up. Refugees granted asylum were on average 66% more likely to develop schizophrenia or another non-affective psychotic disorder than non-refugee migrants. In addition, they were up to 3.6 times more likely to do so than the Swedish-born population. Incidence rates for non-affective psychosis were 385 per million in those born in Sweden, 804 per million in non-refugee migrants, and 1264 per million in refugees.

The increased rate in refugees was significant for all areas of origin except sub-Saharan Africa, for whom rates in both groups were similarly high relative to the Swedish-born population. One possible explanation is that a larger proportion of sub-Saharan Africa immigrants will have been exposed to deleterious psychosocial adversities before emigration, irrespective of refugee status. Alternatively post-migratory factors, such as discrimination, racism, and social exclusion may explain these high rates.
Overall, our findings are consistent with the hypothesis that increased risk of non-affective psychotic disorders among immigrants is due to a higher frequency of exposure to social adversity before migration, including the effects of war, violence, or persecution.

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Doctors Make More Mistakes When Patients Are Difficult or Disruptive

MedicalResearch.com Interview with:

Sílvia Mamede, MD, PhD Associate professor Institute of Medical Education Research Rotterdam Erasmus MC Rotterdam, The Netherlands

Dr. Silvia Mamede

Sílvia Mamede, MD, PhD
Associate professor
Institute of Medical Education Research Rotterdam
Erasmus MC
Rotterdam, The Netherlands

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

Dr. Mamede: Doctors are often engaged in clinical encounters that are emotionally charged. Patients who feel anxious about their problems often respond emotionally in their interaction with their doctors. Most of these encounters fall within the limits of what is to be expected in clinical practice, but some patients behave in ways that make the doctor-patient interaction particularly distressing. Aggressive or disrespectful patients, frequent demanders, patients who don’t trust their doctors’ competence or ever-helpless patients are known, in the medical literature, as “difficult patients”. Doctors have reported to encounter these so-called “difficult patients” in around 15% of the outpatient consultations. As it might be expected, these patients’ behaviors provoke emotional reactions in doctors. The potential negative effect of these reactions on the doctor’s diagnostic accuracy has long been discussed in the medical literature. However, there was no empirical evidence that this happened. We conducted two studies to fill this gap.

In the two studies, doctors diagnosed clinical cases that were exactly the same except for the patient’s behaviors. In the first study, we used complex and simple cases. Even though the cases were the same, doctors made 42% more mistakes in disruptive than in non-disruptive patients when the cases were complex, and 6% more mistakes when the cases were simple. In the second study, we used cases deemed to be at an intermediate level of complexity. Doctors made 20% more mistakes in difficult compared to neutral patients. These findings show that disruptive behaviors displayed by patients seem to affect doctors’ reasoning and induce them to make diagnostic errors. The findings of our second study suggest that disruptive behaviors “capture” the doctor’s attention at the expense of attention for the clinically relevant information. We came to this conclusion because when asked to recall the information from a case afterwards, doctors who were confronted with a difficult patient remember more information about the patient’s behaviors and less information of the clinically relevant symptoms than doctors confronted with the natural version of the same patient. Recall of information is considered a measure of the amount of attention given to such information.

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Women Are First Authors in About 1/3 Major Medical Journals

MedicalResearch.com Interview with:

Giovanni Filardo, PhD, MPH Director of Epidemiology, Office of the CQO, Baylor Scott & White Health Briget da Graca, JD, MSSenior Medical Writer, Center for Clinical Effectiveness, Office of the CQO, Baylor Scott & White Health Dallas, Texas

Dr. Giovanni Filardo

Giovanni Filardo, PhD, MPH
Director of Epidemiology, Office of the CQO, Baylor Scott & White Health Briget da Graca, JD, MSSenior Medical Writer
Center for Clinical Effectiveness
Office of the CQO
Baylor Scott & White Health Dallas, Texas

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

Dr. Filardo: While there are readily available, up-to-date data on the proportion of medical school applicants, graduates, and member of faculty women constitute, no similar information is routinely collected and shared about women’s participation in and leadership of medical research studies. The previous studies looking at this issue were conducted in 2004, and were limited to investigating the proportion of women among the first authors with MD degrees and with institutional affiliations in the United States or United Kingdom. The time was therefore ripe for an updated, rigorous, and comprehensive examination of first authorship in high impact medical journals.

We examined female first authorship of original research articles published over the past 20 years in the 6 general medical journals with the highest impact factors: Annals of Internal Medicine (Annals), Archives of Internal Medicine (Archives), The BMJ (formerly the British Medical Journal), Journal of the American Medical Association, The Lancet, and New England Journal of Medicine (NEJM). After adjusting for differences over time and between journals related to different prioritisation of studies according to type, topic/specialty, country in which the research was conducted, or number of listed authors, we found that female first authorship increased overall from 27% in 1994 to 37% in 2014, but had plateaued – and in the cases of The BMJ and NEJM – declined in the last 5 years. Our results also revealed significant differences in female first authorship between journals.

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Children Receive a Disproportionate Share of Antibiotic Treatment

MedicalResearch.com Interview with:
Ashley Bryce, NIHR PhD student
Centre for Academic Primary Care, University of Bristol (first author)
Dr Céire Costelloe
NIHR Health Protection Research Unit in Healthcare associated infections and AMR, Imperial College London (senior author)

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

Response: Antimicrobial resistance is an internationally recognised threat to health. Previous antibiotic use has been shown to be a risk factor for antimicrobial resistance in adults.

The contribution of primary healthcare is particularly important as this is where almost 80% of all antibiotics used within the health service are prescribed. Children receive a lot of primary healthcare services and, as such, receive a disproportionately high number of antibiotics compared with middle aged populations.

Despite this, little research has been published describing the prevalence of bacterial resistance in children or the risk factors of importance in this group.

MedicalResearch.com: What are the main findings?

Response: Prevalence of resistance to commonly prescribed antibiotics in primary care in children with urinary tract infections caused by E coli is high, particularly in countries outside the OECD, where one possible explanation is the availability of antibiotics over the counter. This could render some antibiotics ineffective as first line treatments for urinary tract infection. Routine use of antibiotics in primary care contributes to antimicrobial resistance in children, which can persist for up to six months after treatment.

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