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MedicalResearch.com Interview with:
Ajay Goel, Ph.D. Investigator/Professor
Director, Center for Gastrointestinal Research
Director, Center for Epigenetics, Cancer Prevention and Cancer Genomics
Baylor Research Institute and Charles A. Sammons Cancer Center
Baylor University Medical Center
Dallas, TX 75246
Medical Research: What is the background for this study? What are the main findings?
Dr. Goel: Colorectal cancer (CRC) remains one of the most common and lethal malignancies worldwide, and is the second leading cause of cancer-related deaths in the United States. Although there are some improvements in cancer treatments, such as development of novel chemotherapeutic drugs and technical advances in invasive treatment for metastatic lesion, there is a clear need for prognostic biomarkers that can identify high-risk patients, who can benefit from intensive post-treatment surveillance protocols for early detection of recurrence.
Small nucleolar RNAs (snoRNAs) are one of the largest groups of single-stranded small ncRNAs, and in the past, snoRNAs were recognized for housekeeping functions due to their roles in rRNA maturation, while causing a relatively low impact on cellular homeostasis. However, recent evidence has revealed a new and previously unrecognized role of snoRNAs in the control of cell fate and oncogenesis in various cancers.
The main finding of this study is to firstly demonstrate the clinical impact of snoRNA expression as a predictive biomarker of recurrence and poor prognosis in patients with Colorectal cancer. This study for the first time showed that higher levels of SNORA42 were associated with overall and disease-free survival, and emerged as a risk factor for the return of cancer in another part of the body. It was also correlated with high risk of recurrence and shorter survival in a smaller sample of bowel cancer patients in early stages of their disease.
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MedicalResearch.com Interview with:
Katrine M. Owe PhD
Department of Psychosomatics and Health Behaviour
Norwegian Institute of Public Health
Norwegian National Advisory Unit on Women's Health
Oslo University Hospital, Rikshospitalet
OSLO, Norway
Medical Research: What is the background for this study? What are the main findings?
Dr. Owe: Pelvic girdle pain affects 20-45% of all pregnancies and may lead to functional disability, higher levels of depression, reduced quality of life and higher prevalence of sick leave during pregnancy.
Many women with pelvic girdle pain often have difficulties performing daily life activities such as walking, standing, sitting and turning over in bed.
The aetiology and pathogenesis of pelvic girdle pain are still unknown but some modifiable and non-modifiable risk factors have been identified.
Our results showed that women who exercised before they became pregnant with their first child, had the lowest risk of developing pelvic girdle pain in pregnancy. Even those women who reported low frequencies of exercise had a reduced risk of pelvic girdle pain compared with non-exercisers.
Exercising up to five times weekly before pregnancy was protective against pelvic girdle pain and no further benefits were reached with higher frequencies of exercise.
It seems that women who are running, jogging, playing ballgames/netball, doing high impact aerobics or orienteering before pregnancy, has the lowest risk of pelvic girdle pain.
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MedicalResearch.com Interview with:
Dr. Madeleine M A Tilanus-Linthorst PhD
Department of Surgery
Erasmus University Medical Centre - Cancer Institute
Rotterdam, Netherlands
Medical Research: What is the background for this study?
Medical Research: Why is this study important?
Response: This prospective nationwide study investigates whether tumor stage (size and axillary nodal involvement) still has impact on survival of breast cancer in modern times with more effective end more widely used additional systemic therapy . We take tumour biology, age and the different therapies into account and compare results with our nationwide results from 1999-2005.
MedicalResearch.com Interview with:
Dr Jonas Minet Kinge PhD
Researcher, Department of Health Statistics, Norwegian Institute of Public Health
Associate professor, Department of Health Management and Health Economics University of Oslo
Norwegian Institute of Public Health
Oslo, Norway
Medical Research: What is the background for this study? What are the main findings?
Response: Previous studies have shown that the number of people with obesity increases with the gross domestic product (GDP) of a country. Previous research has also indicated that education can be an important factor in this context. The aim of this new study was to explore the assumption from previous studies that obesity is linked to GDP and education, and to include new data from several different countries.
The results from this study confirm that there is an association between obesity, education and GDP. The prevalence of obesity increases with rising GDP, but only among individuals with lower levels of education. There is no significant increase in obesity among those with higher education.
This means that:
MedicalResearch.com Interview with:
Timothy Anderson, M.D.
Chief medical resident
Department of Internal Medicine
University of Pittsburgh
Medical Research: What is the background for this study? What are the main findings?
Dr. Anderson: My coauthors and I analyzed the public disclosures of all publicly traded U.S. health care companies listed on the NASDAQ exchange and New York Stock Exchange in January 2014 that specialized in pharmaceuticals, biotechnology, medical equipment and providing health care services. Of the 442 companies with publicly accessible disclosures on boards of directors, 180 – or 41 percent – had one or more academically affiliated directors in 2013. These individuals included chief executive officers, vice presidents, presidents, provosts, chancellors, medical school deans, professors and trustees from 85 non-profit academic research and health care institutions. These individuals received compensation and stock shares from companies which far exceeds payment for other relationships such as consulting. In some cases compensation approaches or exceeds average professor and physician salaries.
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MedicalResearch.com Interview with:
Prof. Danilo Ercolini, PhD
Department of Agricultural Sciences
University of Naples Federico II
Portici - Italy
Medical Research: What is the background for this study? What are the main findings?
Prof. Ercolini: There is a thick body of literature showing that diet can significantly impact the gut microbiota and metabolome.
In a recent study, negligible differences in gut microbiota and feca lshort-chain fatty acids (SCFA) were reported between habitual omnivores and vegans in the USA.
In addition, Mediterranean diet is a recognized healthy dietary pattern but has not previously been related to the composition of the gut microbiota and related metabolome. That’s the background in short.
Here we show how habitual vegetarian and vegan diets promote enrichment of fibre-degrading bacteria in the gut.
Subjects who consume a Mediterranean diet rich in fruit, legumes and vegetables have higher levels of fecal short chain fatty acids, regardless of the diet type.
Low adherence to the Mediterranean diet corresponds to an increase in urinary trimethylamine oxide levels, a potential risk factor for cardiovascular disease.
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MedicalResearch.com Interview with:
Yi-Wen Chen PhD Candidate, and
Darlene Reid, BMR(PT), PhD
Professor and Chair
Department of Physical Therapy
University of Toronto
Toronto, Ontario
Medical Research: What is the background for this study?
Response: Tai Chi is a time-honored exercise in China, developed during the Sung Dynasty, which has gained increased popularity in Western society. Most styles of Tai Chi consist of slow rhythmic movements that often emphasize typical attributes of exercise including range of motion, strengthening, balance, and postural alignment. In addition, there are spiritual aspects of Tai Chi that focus on relaxation, breath control, and cultivating internal energy. Several studies have demonstrated its multifaceted benefits in the elderly and in people living with chronic diseases including cancer, cardiovascular diseases, respiratory disorders and arthritis. If you were interested in seeing videos of beginner practices, check out some tai chi online to better clarify the motions previously described.
Many individuals that require increased exercise and physical fitness also have one or more comorbidities; 9 out 10 Canadians live with more than one chronic condition and this proportion increases to 98% in adults over the age of 65 years. Increased fitness can increase quality of life and decrease risk of mortality and morbidity in older persons and in many chronic conditions. However, treatment, including exercise is often prescribed within a single specialty. Rarely is information provided to health professionals that integrates therapeutic approaches across several common chronic disorders. Accordingly, we performed a systematic review to determine if Tai Chi is an effective physical activity that improves symptoms, physical function, quality of life and depression in cancer, osteoarthritis (OA), heart failure (HF) and chronic obstructive pulmonary disease (COPD)? We also examined if Tai Chi had similar effects for the same outcome measures across different chronic conditions?
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MedicalResearch.com Interview with:
Wenqi Gan, MD, PhD
Assistant Professor
Department of Preventive Medicine and Environmental Health
University of Kentucky College of Public Health
Lexington, KY 40536
Medical Research: What is the background for this study?
Dr. Wenqi Gan: In epidemiologic studies on health effects of noise exposure, community noise is typically assessed using noise prediction models, occupational noise is assessed using self-reports or historical records. These methods are able to estimate community noise exposure in residential areas and occupational noise exposure in the workplace; however, these methods are not able to accurately reflect actual personal noise exposure in the home and workplace. The lack of personal noise exposure information is a major limitation of previous studies, which could cause underestimations of the true health effects of noise exposure. Bilateral high-frequency hearing loss, an objective indicator for long-term exposure to loud noise, may be used to investigate health effects of noise exposure.
Medical Research: What are the main findings?
Dr. Wenqi Gan: This study includes 5223 people aged 20-69 years who participated in the US National Health and Nutrition Examination Survey 1999-2004. Compared with people with normal high-frequency hearing, people with bilateral high-frequency hearing loss were approximately two times more likely to have coronary heart disease. This association was particularly striking for people who were chronically exposed to loud noise in the workplace or leisure time. For example, for currently employed workers with occupational noise exposure history, the possibility of having coronary heart disease increased more than four times. This study confirms that chronic exposure to loud noise is associated with increased risk of coronary heart disease.
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MedicalResearch.com Interview with:
Chiara Dall'Ora MSc
Nursing and Midwifery Sciences
University of Southampton
Medical Research: What is the background for this study? What are the main findings?
Response: There is a trend for healthcare employers to adopt longer shifts, typically 2 shifts per day each lasting 12 hours. This allows nurses to work fewer shifts each week. Changes are driven by perceived efficiencies for the employer, and anecdotal reports of improved work life balance for employees because they work fewer days per week. However, it is unclear whether these longer shits adversely affect nurses' wellbeing, in terms of burnout, job dissatisfaction, dissatisfaction with work schedule flexibility and intention to leave the job.
We found that when nurses work 12 h shifts or longer they are more likely to experience high burnout, dissatisfaction with work schedule flexibility and intention to leave their job, compared to nurses working 8 h or less. All shifts longer than 8 hours are associated with nurses' job dissatisfaction.
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MedicalResearch.com Interview with:
Dr. Mila Kingsbury PhD
Senior Research Associate at Department of Epidemiology and Community Medicine
University of Ottawa
Medical Research: What is the background for this study?
Dr. Kingsbury: Eating a healthy diet, including enough fruits and vegetables, is good for physical health, and some evidence suggests that it may be good for mental health, too. Specifically, intake of fruits and vegetables has been associated with lower risk of depression.
However, there are very few longitudinal studies on this topic. Most studies haven’t accounted for the effects of other related lifestyle factors such as smoking and exercise, nor for the fact that the links between lifestyle and mental health are bidirectional (i.e., depression can also hinder our ability to engage in healthy behaviours).
Medical Research: What are the main findings?
Dr. Kingsbury: While we found an association between fruit and vegetable consumption and psychological distress and depression two years later, depression and distress also predicted future fruit and vegetable consumption. Importantly, these associations became non-significant when we controlled for lifestyle factors like smoking and exercise.
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MedicalResearch.com Interview with:
Dr Aseem Malhotra MBChB, MRCP
Honorary Consultant Cardiologist -
Frimley Park Hospital
Consultant Clinical Associate to the Academy of Medical Royal Colleges
Science Director- Action on Sugar
Saving Londoners Lives - External Advisory Board Member
Medical Research: What is the background for this study? What are the main findings?
Dr. Malhotra: It is a review of all the research up to date on what is the impact of diet on health. What type of diet has the most robust evidence for weight and health and how this can be translated into policy to rapidly reduce the burden of chronic disease.
Medical Research: What should clinicians and patients take away from your report?
Dr. Malhotra:
MedicalResearch.com Interview with:
Alicia A. Bergman, Ph.D.
Research Health Scientist
VA Greater Los Angeles Healthcare System
Center for the Study of Healthcare Innovation, Implementation & Policy North Hills, CA 91343
Medical Research: What is the background for this study? What are the main findings?
Dr. Bergman: The impetus for this study comes from several sources but most notably the IOM report of 2002 entitled, Crossing the Quality Chasm in which the IOM estimated that between 44,000 and 98,000 lives are lost each year due to preventable medical errors in the hospital. The IOM further reported that 80% of all adverse outcomes in the hospital can be traced back to breakdowns in communication during handoffs and transfers of care. A 2005 study by our VA research team found that only 7% of medical schools in the US teach the handoff as part of the formal curriculum. As such, handoffs represent a vulnerable gap in the quality and safety of patient care.
We were interested to know how end of shift handoffs in medicine, nursing, and surgery were enacted and audio and videotaped them in a single VA hospital. We found that there was a great deal of variation in how the handoffs were conducted and similar variations in the ways in which language was used to characterize technical and interpersonal aspects of care. We were especially interested in what we term “anticipatory management communication” and its functions during handoffs. While much technical information can easily be conveyed in the electronic medical record, some types of psychological or social information that are more informal in nature, such as “Mr. Smith’s been our problem child today,” do not lend themselves to being transmitted in the electronic medical record. However, such ‘heads up’ information and communication is often critical to understanding a patient’s context, course, and outcome of care. We also found that indirect anticipatory management communication was used among all dyads but more commonly among nurse dyads, with instructions and tasks implied and often inferential. We conclude that contextually sensitive information about anticipated events is best communicated directly (and ideally face-to-face), and that talk-backs and more explicit use of language can improve handoff quality, making them safer for patients.
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MedicalResearch.com Interview with:
Dr. Yin Cao MPH, ScD
Postdoctoral Fellow, Department of Nutrition
Harvard T. H. Chan School of Public Health
Medical Research: What is the background for this study? What are the main findings?
Dr. Cao: Light-to-moderate drinking, defined as up to 1 drink (roughly corresponds to a 355ml bottle of beer, or a small [118-148 ml] glass of wine or 44ml of liquor) for women and up to 2 drinks for men, is prevalent in many western countries. It is believed that light-to-moderate drinking may be healthy for the heart. However, the influence of light-to-moderate drinking on risk of overall cancer is less clear, although it is well known that heavy alcohol intake increases risk of several cancers, including cancers of colorectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus.
Also because drinkers are more likely to be smokers, and smoking is the major risk factor for all of the alcohol-related cancers (mentioned above) except breast cancer, it is thus difficult to tease out the influence of alcohol on cancer in studies among a mixed population of ever and never smokers. In particular, it is important to know how light and moderate drinking would affect cancer risk particularly among never smokers, who now make up the majority of the population in many western countries.
Our main findings are that, light-to-moderate drinking minimally increases risk of overall cancer. For men, the association with alcohol related cancers was primarily observed among smokers, and light to moderate drinking did not appreciably increase risk in never smokers. Among women, even consumption of up to one drink per day was associated with increased risk of alcohol-related cancers (mainly breast cancer) for both never and ever smokers.
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MedicalResearch.com Interview with:
Dr. Audrey J Gaskins
Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Gaskins: Previous studies have linked shift work, long working hours, and physical factors to an increased risk of menstrual cycle disturbances, spontaneous abortion, preterm birth, and low birth weight; however the association with fecundity is inconsistent. Several papers have also reviewed the occupational exposures of health care workers and concluded that reproductive health issues are a concern. Therefore we sought to determine the extent to which work schedules and physical factors were associated with fecundity in a large cohort of nurses. Women who work in an industry that requires them to work from a height or even lift heavy objects requires them to undertake training which guides them though the effective stages on how to work safely at heights. Without the right training, this sort of work can become very dangerous.
Our main findings were that that working >40 hours per week and moving or lifting a heavy load >15 times per day (including repositioning or transferring patients) were associated with reduced fecundity in our cohort of female nurses planning pregnancy. However, all other factors such as frequency of night work, duration of rotating and non-rotating night shifts, and time spent walking or standing at work were not significantly associated with fecundity in this cohort.
(more…)MedicalResearch.com Interview with: Lu Qi, MD,...
MedicalResearch.com Interview with:
Dr David Hupin
CHU Saint-Etienne, Hôpital Nord
Service de Physiologie Clinique et de l'Exercice, Centre VISAS Cedex 2, France
Medical Research: What is the background for this study?
Dr. Hupin: Today, over 95% of the world’s population has health problems, according to the Global Burden of Disease Study published recently in The Lancet. The proportion of healthy years lost due to disease rapidly increased with age. There is no medical treatment that can influence as many diseases in a positive manner as can physical activity. It is well established that regular physical activity is an efficient strategy for successful aging. The 2008 Physical Activity guidelines for Americans recommend a minimum of 150 min of moderate-intensity (>3 MET) or 75 min of vigorous-intensity (≥6 MET) physical activity per week or an equivalent combination of moderate and vigorous physical activity (MVPA). A Metabolic Equivalent or MET is a unit useful for describing the energy expenditure of a specific physical activity. However, less than 50% of older adults are able to achieve the current recommendations of physical activity. Thus, the prescription of physical activity for older adults needs to be clarified, i.e., what "dose" of physical activity is required.
Medical Research: What is the design of your study?
Dr. Hupin: Within the dynamic Department of Clinical and Exercise Physiology of University Hospital of St-Etienne, we conducted a systematic review and meta-analysis. Out of at total of 835 relevant studies, nine were suitable for analysis. These involved a total of 122, 417 participants, monitored for an average of around 10 years, during which time 18,122 died.
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MedicalResearch.com Interview with: Dr. Fumiaki Imamura Ph.D.
MRC Epidemiology Unit
University of Cambridge
Medical Research: What is the background for this study? What are the main findings?
Dr. Imamura: Soft drink consumption is associated with risk of diabetes, but whether or not the association persists after controlling for obesity status is not known. Diet drinks and fruit juice may be good alternatives to soft drinks. However, while obese individuals may consume diet drinks or fruit juice instead of sugar-sweetened soft drinks, evidence was weak to determine whether or not consuming these beverages is associated with risk of diabetes.
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MedicalResearch.com Interview with:
Gijs Van Pottelbergh, MD, PhD
Department of Health and Technology
Leuven University College
Leuven, Belgium
Medical Research: What is the background for this study? What are the main findings?
Response: Earlier research identified arterial hypertension as a cause of chronic kidney disease but in older persons the relation between blood pressure and kidney function is little investigated.This study analyses the relation between dynamic blood pressure measurements and kidney function over time. A decline in blood pressure over time turned out to be a strong risk factor for kidney function decline in all age strata.
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MedicalResearch.com Interview with:
Jennita Reefhuis, PhD
Epidemiologist with CDC
National Center on Birth Defects and Developmental Disabilities
Medical Research: What is the background for this study?
Dr. Reefhuis: There are previous reports on the link between birth defects and SSRIs. However, the results across some of these studies conflicted. It is not clear whether one SSRI might be safer than other SSRIs.
Medical Research: What are the main findings?
Dr. Reefhuis: Reassuringly, we found that the five earlier reported links between specific birth defects and sertraline were not found again. We did find that some birth defects occur two to three times more frequently among babies born to mothers who took paroxetine and fluoxetine in early pregnancy. (more…)
MedicalResearch.com Interview with:
Joshua P. Cohen Ph.D
Research Associate Professor
Tufts Center for the Study of Drug Development
Boston, Massachusetts
Medical Research: What is the background for this study?
Dr. Cohen: Florbetapir 18F was the first radioactive diagnostic agent approved by the US Food and Drug Administration for positron emission tomography imaging of the brain to evaluate amyloid â neuritic plaque density.
Medical Research: What are the main findings?
Dr. Cohen: Medicare has restricted coverage of florbetapir in the US, whereas conspicuously the UK NHS decided to reimburse the radiopharmaceutical. Note, the British NHS is generally more restrictive with regard to coverage of new technologies than the Centers for Medicare and Medicaid Services. Historically Medicare has rejected coverage of 25% of diagnostics approved by the FDA, but covers all FDA approved drugs administered in the physicians office. Furthermore, Medicare has subjected labeled use of diagnostics, including a half-dozen Alzheimer's diagnostics, to its coverage with evidence development program while not subjecting any labeled uses of drugs to coverage with evidence development. In sum, diagnostics are subject to a level of scrutiny by Medicare that is rarely given Medicare Part B drugs (physician-administered).
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MedicalResearch.com Interview with:
Igho Onakpoya MD MSc
Clarendon Scholar
University of Oxford
Centre for Evidence-Based Medicine
Nuffield Department of Primary Care Health Sciences
Oxford UK
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Onakpoya: Several orphan drugs have been approved for use in Europe. However, the drugs are costly, and evidence for their clinical effectiveness are often sparse at the time of their approval.
We found inconsistencies in the quality of the evidence for approved orphan drugs. We could not identify a clear mechanism through which their prices drugs are determined. In addition, the costs of the branded drugs are much higher than their generic or unlicensed versions.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Onakpoya: Because of inconsistencies in the evidence regarding the benefit-to-harm balance of orphan medicines, coupled with their high prices, clinicians and patients should assess whether the orphan drugs provide real value for money before making a decision about their use for a medical condition.
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