Author Interviews, Diabetes, JAMA, Mental Health Research, Pediatrics, Pharmacology / 20.01.2016

[caption id="attachment_20681" align="alignleft" width="210"]Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra Northwell School of Medicine Hempstead, New York, USA Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Manhasset, New York, USA Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital, Department of Psychiatry Dr. Christoph Correll[/caption] More on Mental Health on MedicalResearch.com MedicalResearch.com Interview with: Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra Northwell School of Medicine Hempstead, New York, USA Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Manhasset, New York, Medical Director, Recognition and Prevention The Zucker Hillside Hospital, Department of Psychiatry  Medical Research: What is the background for this study? Dr. Correll: Antipsychotics have been used increasingly for psychotic, but also for many non-psychotic conditions, including for disorders and conditions for which they have not received regulatory approval. Moreover, antipsychotics have been associated with weight gain and abnormalities in blood fat and blood glucose levels. Although data in youth have been less available than in children and adolescents, youth appear to be more sensitive to the cardiometabolic adverse effects of antipsychotics than adults in whom significant weight gain might have already occurred due to long-term prior antipsychotic treatment. Nevertheless, type 2 diabetes, which is related to weight gain, overweight and obesity, seemed to be more common in adults than youth, likely due to the fact that it takes a long time for the body to develop diabetes. Recently, several individual epidemiologic or database studies with sufficient long-term follow-up durations suggested that the type 2 diabetes risk was higher in youth exposed to antipsychotics than healthy control youth and, possibly, even compared to psychiatrically ill patients treated with non-antipsychotic medications. However, a meta-analytic pooling of all available data has not been available to estimate the absolute and relative risk of type 2 diabetes in youth receiving antipsychotic treatment.  Medical Research: What are the main findings? Dr. Correll: The main findings of the study that meta-analyzed data from 13 studies with 185,105 youth exposed to antipsychotics (average age 14.1 and 59.5 percent male) are that the absolute rates of type 2 diabetes are fortunately still relatively low, i.e. a cumulative type 2 diabetes  risk of 5.7/1,000 patients and an exposure adjusted incidence rate of 3.1/1,000 patient-years. Nevertheless, the cumulative risk of type 2 diabetes and its exposure adjusted incidence rate per patient were 2.6 times and three times higher compared with 298,803 healthy controls. Furthermore, the cumulative risk of type 2 diabetes and its exposure adjusted incidence rate per patient were 2.1 times and 1.8 times higher compared with 1,342,121 psychiatric patients not exposed to antipsychotics. Main modifiable risk factors for type 2 diabetes development in antipsychotic-treated youth were treatment with the antipsychotic olanzapine and longer antipsychotic exposure time.
Author Interviews, Brigham & Women's - Harvard, Dermatology, JAMA, Melanoma, Transplantation / 20.01.2016

More on Dermatology from MedicalResearch.com  [caption id="attachment_20781" align="alignleft" width="115"]Pritesh S. Karia, MPH Manager-Dermatologic Oncology Research Program Mohs and Dermatologic Surgery Center Brigham and Women's Hospital Boston, MA 02130 Pritesh Karia[/caption] MedicalResearch.com Interview with: Pritesh S. Karia, MPH Manager-Dermatologic Oncology Research Program Mohs and Dermatologic Surgery Center Brigham and Women's Hospital Boston, MA 02130  Medical Research: What is the background for this study? Response: Several recent studies have shown a reduced incidence of skin cancer in organ transplant recipients (OTR) treated with sirolimus as first-time therapy and those converted from calcineurin inhibitors to sirolimus. Although cancer formation is one of the main reasons for conversion to sirolimus, studies examining the effect of sirolimus on the risk of subsequent cancer formation in organ transplant recipients who have already been diagnosed with a post-transplant cancer are limited.
Author Interviews, JAMA, NYU/NYMC, Pediatrics, Weight Research / 20.01.2016

More on Obesity from MedicalResearch.com MedicalResearch.com Interview with: [caption id="attachment_20772" align="alignleft" width="178"]Brian Elbel, PhD, MPH, Associate Professor, Department of Population Health, NYU Langone Medical Center Dr. Brian Elbel[/caption] Brian Elbel, PhD, MPH, Associate Professor, Department of Population Health, NYU Langone Medical Center Amy Schwartz, PhD, Director, New York University Institute for Education and Social Policy, and the Daniel Patrick Moynihan Chair in Public Affairs, Syracuse University Michele Leardo, MA, Assistant Director New York University Institute for Education and Social Policy Medical Research: What is the background for this study? What are the main findings? Response: New York City, as well as other school districts, is making tap water available to students during lunch by placing water dispensers, called water jets, in schools. Surprisingly, drinking water was not always readily available in the lunchroom. Water jets are part of a larger effort to combat child obesity. We find small, but statistically significant, decreases in weight for students in schools with water jets compared to students in schools without water jets. We see a .025 reduction in standardized body mass index for boys and .022 for girls. We also see a .9 percentage point reduction in the likelihood of being overweight for boys and a .6 percentage point reduction for girls. In other words, the intervention is working.
Author Interviews, Heart Disease, JACC, Radiology / 20.01.2016

More on Heart Disease on MedicalResearch.com [caption id="attachment_20766" align="alignleft" width="165"]Yitschak (Yitsik) Biton, MD Postdoctoral Research Fellow University of Rochester Medical Center Saunders Research Building Heart Research Follow-Up Program Rochester, NY Dr. Yitschak Biton[/caption] MedicalResearch.com Interview with: Yitschak (Yitsik) Biton, MD Postdoctoral Research Fellow University of Rochester Medical Center Saunders Research Building Heart Research Follow-Up Program Rochester, NY Medical Research: What is the background for this study? What are the main findings? Dr. Biton: Patients with heart failure and reduced ejection fraction have increased risk for sudden cardiac death due to ventricular arrhythmias. The causes of these arrhythmias are thought to be adverse left ventricular remodeling and scarring. Cardiac resynchronization therapy has been previously shown to reverse the adverse process of remodeling and induce reduction in cardiac chamber volumes. Relative wall thickness is a measure of the remodeling process, and it could be classified into normal, eccentric and concentric. In our study we showed that the degree relative wall thickness in patients with dilated cardiomyopathy and eccentric hypertrophy is inversely associated with the risk of ventricular arrhythmias. Furthermore we showed the CRT treated patients who had increase in relative wall thickness (became less eccentric) had lower risk for ventricular arrhythmias.
Author Interviews, Heart Disease, JAMA, Wake Forest / 20.01.2016

[caption id="attachment_20753" align="alignleft" width="200"]Ajay Dharod, M.D. Coordinator of Medical Informatics Department of Internal Medicine Wake Forest School of Medicine Dr. Ajay Dharod[/caption] More on Heart Disease on MedicalResearch.com MedicalResearch.com Interview with: Ajay Dharod, M.D. Coordinator of Medical Informatics Department of Internal Medicine Wake Forest School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Dharod: There is a relative paucity of data regarding asymptomatic bradycardia in adults free of clinical cardiovascular disease. Are individuals with low heart rates simply healthy individuals with a non-clinically significant finding or is there a subclinical disease process? That was the question that generated this study. Until now, there had not been any research to determine if a slow heart rate contributed to the development of cardiovascular disease. We found that a heart rate (HR) of less than 50 was not associated with an elevated risk of cardiovascular disease in participants regardless of whether they were taking Heart Rate-modifying drugs, such as beta blockers and calcium channel blockers. However, we did find a potential association between bradycardia and higher mortality rates in individuals taking HR-modifying drugs.
Author Interviews, CMAJ, Heart Disease / 19.01.2016

More on Heart Disease on MedicalResearch.com MedicalResearch.com Interview with: Ian R Drennan ACP PhD(c) Institute of Medical Science, University of Toronto Rescu, St. Michael's Hospital Medical Research: What is the background for this study? Dr. Drennan : Over the last number of years there has been an increase in the number of people living in high-rise buildings in many major urban centres. Research has shown that there are increased 911-response times for medical calls that occur in high-rise buildings. After a patient collapses in cardiac arrest, the chance of survival decreases by about 7-10% per minute without intervention. However, the impact living in high-rise buildings has on cardiac arrest care and survival remains unknown.  Medical Research: What are the main findings? Dr. Drennan : In this study in Toronto and neighbouring Peel Region we found that there was a significant decrease in survival between cardiac arrests that occurred in private residences on or above 3 floors compared to those that occurred below 3 floors (4.2% vs. 2.6%). Only 0.9% of cardiac arrests that occurred above the 16th floor survived and there were no survivors above the 25th floor. We also found that there was nearly a 2 minute delay in 911-response from when an emergency vehicle arrived on scene to when the 911-first responders arrived at the patient’s side when they were required to respond to the higher floors.
Author Interviews, Exercise - Fitness, Ophthalmology, PLoS / 18.01.2016

More on Ophthalmology on MedicalResearch.com MedicalResearch.com Interview with: Robert Ritch, MD, FACS Shelley and Steven Einhorn Distinguished Chair Professor of Ophthalmology Surgeon Director Emeritus and Chief, Glaucoma Services Founder, Medical Director and Chairman, Scientific Advisory Board The Glaucoma Foundation Jessica V. Jasien MEn Einhorn Clinical Research Center The New York Eye and Ear Infirmary of Mount Sinai New York, NY 10003 Medical Research: What is the background for this study? What are the main findings? Response: Glaucoma is the leading cause of irreversible blindness in the United States and elevated intraocular pressure (IOP) is the most common known risk factor for glaucomatous damage. At the current time, IOP is the only modifiable risk factor for which treatment has a proven effect on preventing or slowing the progress of the disease. The story behind this study goes back to 1980, when we saw a 45-year-old woman with severe damage from normal-tension glaucoma, which then was thought to be a disease of the elderly and also thought to be rare, which we now realize was erroneous. The causes of normal-tension glaucoma were also poorly understood. It turned out on questioning that this particular patient had been performing yoga and standing on her head for 20 minutes a day for 20 years. We measured her IOP in this position and it rose from 15 mmHg in the sitting position to 60 mmHg. When measured lying flat, it was 30 mmHg. We measured everyone working in the department standing on their heads and the IOP roughly doubled in each of them. This was our first inkling that marked changes in IOP could result from changes in body position. The background for this study came from the lack of knowledge of IOP rises during yoga inversions, other than the headstand position. We looked at four common inverted yoga positions in glaucoma patients and healthy patients who were all experienced in practicing yoga. The four positions tested were downward facing dog, plow, legs up the wall, and forward bend. Each position showed a direct increase in IOP immediately assuming the yoga position, however the IOP dropped once assuming the seated position after two minutes in the yoga position. The most significant increase in IOP was seen during the downward facing dog position. IOP of each study participant was taken seated (baseline), immediately assuming the yoga position, which was held for two minutes, again at the two minutes of the yoga position, immediately in the seated position following the yoga position, and again after 10 minutes in the seated position. Each position was tested once in this order of IOP measurements.
Author Interviews, Eating Disorders, JAMA, Karolinski Institute, Mental Health Research / 17.01.2016

More on Eating Disorders from MedicalResearch.com MedicalResearch.com Interview with: Shuyang Yao, MSc Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm, Sweden Medical Research: What is the background for this study? Response: Suicide risk is much higher in individuals with eating disorders than individuals without the disorders. The mechanism underlying the high suicide risk in eating disorders (i.e., why?) is not clear. Large studies and genetically informative designs can help us understand the nature of the association between suicide attempts and eating disorders. Medical Research: What are the main findings? 1) Eating disorders are associated with increased risk of suicide attempts and death by suicide. 2) Increased risk of suicide attempts is also found in relatives of individuals with eating disorders. 3) Some, but not all of the increased risk for suicide in individuals with eating disorders is accounted for by the presence of comorbid major depressive, anxiety, and substance use disorders.
Alcohol, Author Interviews, BMJ, Pediatrics, Tobacco Research / 16.01.2016

[caption id="attachment_20582" align="alignleft" width="200"]Dr Joanne Cranwell PhD, CPsychol The UK Centre for Tobacco and Alcohol Studies (UKCTAS) School of Medicine Division of Epidemiology & Public Health Clinical Sciences Building University of Nottingham City Hospital Nottingham Dr. Joanne Cranwell[/caption] More on Alcohol on MedicalResearch.com MedicalResearch.com Interview with: Dr Joanne Cranwell PhD, CPsychol The UK Centre for Tobacco and Alcohol Studies  School of Medicine Division of Epidemiology & Public Health Clinical Sciences Building University of Nottingham MedicalResearch: What is the background for this study? Dr. Cranwell: We conducted this particular study because it is well established that adolescent exposure to alcohol and tobacco in the media, such as film, television, and paid for advertising are determinants of subsequent alcohol and tobacco use in young people. The extent of potential exposure has been transformed over the past decade by the emergence of social media, in which exposure to pro-tobacco content has also been linked to favourable attitudes towards tobacco, including intention to smoke, in young non-smokers. Our previous published research highlighted that popular YouTube music videos contain tobacco and substantial alcohol content, including branding. Alcohol advertising is largely self-regulated by the alcohol industry and the Portman Group who speaks on behalf of the UK drinks industry.   The Advertising Standards Authority also provides guidance on marketing of alcohol products in the UK. Broadly speaking the guidelines from these three regulators state that “Marketing communications for alcoholic drinks should not be targeted at people under 18 and should not imply, condone or encourage immoderate, irresponsible or anti-social drinking”. However the extent to which adults and adolescents are exposed to tobacco or alcohol content from YouTube at a population level has not been quantified. In this new study we have therefore estimated population exposure to tobacco and alcohol impressions, defined as appearances in 10-second intervals in a sample of popular videos, in the British adolescent and adult population.
Anesthesiology, Author Interviews, PLoS / 16.01.2016

[caption id="attachment_20539" align="alignleft" width="200"]Srivas Chennu, PhD Senior Research Associate Clinical Neurosciences, University of Cambridge Visiting Scientist, MRC Cognition and Brain Sciences Unit College Research Associate, Homerton College Dr. Srivas Chennu[/caption] More on Anesthesiology on MedicalResearch.com MedicalResearch.com Interview with: Srivas Chennu, PhD Senior Research Associate Clinical Neurosciences, University of Cambridge Visiting Scientist, MRC Cognition and Brain Sciences Unit College Research Associate, Homerton College Medical Research: What is the background for this study? Dr. Chennu:  Scientific understanding of how brain networks generate consciousness has seen rapid advances in recent years, but the application of this knowledge to accurately track transitions to unconsciousness during general anaesthesia has proven difficult. Crucially, one reason for this is the considerable individual variability in susceptibility to anaesthetic dosage.  To better understand the factors underlying this variability, we measured interconnected, oscillatory brain activity ('brain networks'), using non-invasive, high-density electroencephalography (EEG) from healthy volunteers while they were sedated with the common anaesthetic propofol. Alongside, we measured their behavioural responsiveness, and the actual concentration of the drug in their blood plasma. 
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Ophthalmology / 16.01.2016

More on Ophthalmology on MedicalResearch.com MedicalResearch.com Interview with: Jae Hee Kang, MSc, SC Associate Epidemiologist, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Channing Division of Network Medicine Boston, MA 02115 Medical Research: What is the background for this study? What are the main findings? Dr. Kang: Glaucoma is a leading cause of irreversible blindness worldwide, and primary open-angle glaucoma (POAG) is the most common form of the disease. Little is known on the causes of glaucoma but dysfunction in the regulation of blood flow to the optic nerve, which transmits visual information to the brain, may be involved. Nitric oxide is important for maintenance of blood flow and its signaling may be impaired in glaucoma. We were interested in whether dietary nitrates, an exogenous source of nitric oxide mostly found in green-leafy vegetables, may be related to lower risk of POAG. Medical Research: What is the background for this study? What are the main findings? Dr. Kang: We (Brigham and Women’s Hospital / Harvard Medical School and Massachusetts Eye and Ear researchers) used 25+ years of data from over 100,000 participants in the Nurses' Health Study (63,893 women) and the Health Professionals Follow-up Study (41,094 men). Participants were nurses or other health professionals and were aged 40 years or older and reported eye exams. We collected information on their diet and other health information every two years with questionnaires. During follow-up, 1,483 new cases of primary open-angle glaucoma with visual field loss were identified and confirmed with medical record review. Participants were divided into quintiles (one of five groups) of dietary nitrate intake (quintile 5, approximately 240 mg/day; quintile 1, approximately 80 mg/day) and of green leafy vegetables (quintile 5, approximately 1.5 servings/day; quintile 1, approximately one-third of a serving/day). We observed that greater intake of dietary nitrate and green leafy vegetables (e.g., romaine and iceberg lettuce and kale/chard/mustard greens) was associated with a 20 percent to 30 percent lower POAG risk; the association was particularly strong (40 percent-50 percent lower risk) for POAG with early paracentral visual field loss (a subtype of POAG most linked to dysfunction in blood flow autoregulation).
Author Interviews, Columbia, Cost of Health Care, JAMA, Ophthalmology / 15.01.2016

More on Health Care Costs on MedicalResearch.com MedicalResearch.com Interview with: Alisa Prager BS Bernard and Shirlee Brown Glaucoma Research Laboratory Department of Ophthalmology Edward S. Harkness Eye Institute Columbia University Medical Center, New York, New York MedicalResearch: What is the background for this study?  Response: The goal of this research was to better understand the impact of glaucoma on non-ophthalmic healthcare use and costs. While there have been other studies assessing costs associated with glaucoma, these studies were primarily derived from either claims data or chart review. Our study used the Medicare Current Beneficiary Survey, which is a dataset that links claims data with survey results. The advantage of this is that the survey data allowed us to assess patient reported outcomes that did not necessarily prompt an encounter with the health care system, such as recent falls or feelings of sadness. The MCBS also provides complete expenditure and source of payment data on health services, including those not covered by Medicare, which allowed us to look at a more full spectrum of both private and public healthcare use and costs among Medicare beneficiaries. MedicalResearch: What are the main findings? Response: We found that Medicare beneficiaries with glaucoma have 27% higher likelihood of inpatient hospitalizations and home health aide visits compared to those without glaucoma, even after adjusting for covariates and excluding individuals who were admitted to the hospital with a diagnosis of glaucoma. When we stratified glaucoma patients based on self-reported visual disability, we found that those with self-reported visual disability were more likely to complain of depression, falls and difficulty walking compared to those without. We also found that glaucoma patients incurred a predicted $2,903 higher mean annual total healthcare costs from all sources compared to those without glaucoma after adjusting for socioeconomic factors and comorbidities. Costs were higher among those who reported visual disability, and remained higher after excluding outpatient payments.
Author Interviews, BMJ, NYU/NYMC, Pain Research / 15.01.2016

[caption id="attachment_15303" align="alignleft" width="159"]Dr. Mia T. Minen, MD, MPH Director, Headache Services at NYU Langone Medical Center Assistant professor, Department of Neurology Dr. Mia T. Minen[/caption] More on Mental Health Research on MedicalResearch.com MedicalResearch.com Interview with: Dr Mia Tova Minen Department of Neurology NYU Langone Medical Center New York, NY 10016 Medical Research: What is the background for this study? What are the main findings? Dr. Minen: Migraine affects 12% of adults in the United States, and is thus a very common condition. There are effective treatments for migraine patients, but we also know that if patients and their doctors do not consider the psychiatric disorders that can co-occur with migraine, migraines can worsen, a term called migraine chronification. Thus, we felt that it was important to discuss the various psychiatric disorders associated with migraine, the screening tools available to assess for them, and various treatment considerations for patients with migraine and psychiatric conditions. We also discussed potential explanations for the relationship between migraine and these psychiatric conditions.
Author Interviews, Brigham & Women's - Harvard, Pancreatic, Pharmacology, PLoS / 15.01.2016

More on Pancreatic Cancer on MedicalResearch.com [caption id="attachment_20661" align="alignleft" width="200"]Dai Fukumura, M.D., Ph.D. Edwin L. Steele Laboratory Department of Radiation Oncology Massachusetts General Hospital Harvard Medical School Dr. Dai Fukumura[/caption] MedicalResearch.com Interview with: Dai Fukumura, M.D., Ph.D. Joao Incio, M.D. and Rakesh K. Jain, Ph.D Edwin L. Steele Laboratory Department of Radiation Oncology Massachusetts General Hospital Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Fukumura: This study focused on pancreatic ductal adenocarcinoma, the most common form of pancreatic cancer, which accounts for almost 40,000 cancer death in the U.S. ever year. Half of those diagnosed with this form of pancreatic cancer are overweight or obese, and up to 80 percent have type 2 diabetes or are insulin resistant. Diabetic patients taking metformin – a commonly used generic medication for type 2 diabetes – are known to have a reduced risk of developing pancreatic cancer; and among patients who develop the tumor, those taking the drug may have a reduced risk of death. But prior to the current study the mechanism of metformin’s action against pancreatic cancer was unclear, and no potential biomarkers of response to metformin had been reported. We have uncovered a novel mechanism behind the ability of the diabetes drug metformin to inhibit the progression of pancreatic cancer. Metformin decreases the inflammation and fibrosis characteristic of the most common form of pancreatic cancer. We found that metformin alleviates desmoplasia – an accumulation of dense connective tissue and tumor-associated immune cells that is a hallmark of pancreatic cancer – by inhibiting the activation of the pancreatic stellate cells that produce the extracellular matrix and by reprogramming immune cells to reduce inflammation. Our findings in cellular and animal models and in patient tumor samples also indicate that this beneficial effect may be most prevalent in overweight and obese patients, who appear to have tumors with increased fibrosis.
Author Interviews, Geriatrics, Heart Disease, Lancet / 15.01.2016

Click Here for More on Heart Disease on MedicalResearch.com MedicalResearch.com Interview with: Bjørn Bendz MD PhD and Nicolai K. Tegn, MD Department of Cardiology, Oslo University Hospital, Rikshospitalet Oslo, Norway  Medical Research: What is the background for this study? What are the main findings? Response: According to life expectancy statistics, a person who reaches age 80 can expect to live an average of 8 years (in men) and 9 years (in women). People over 80 yrs are underrepresented in clinical trials, they are less likely to receive treatment according to guidelines. Our study, which directly targets the over-80 population, is the first to demonstrate that a more invasive strategy results in better outcomes in these patients. We believe our study provides a sufficient basis to recommend an invasive approach.”
Allergies, Author Interviews, Science / 15.01.2016

More on Allergies on MedicalResearch.com [caption id="attachment_20683" align="alignleft" width="200"]Yuxia Zhang PhD Population Healthy and Immunity Division Walter + Eliza Hall Institute Parkville VIC 3052 Australia Dr. Yuxia Zhang[/caption] MedicalResearch.com Interview with: Yuxia Zhang PhD Population Healthy and Immunity Division Walter + Eliza Hall Institute Parkville VIC 3052 Australia  Medical Research: What is the background for this study? Dr. Zhang: There has been a dramatic increase in hospital presentations due to food allergy over recent decades, most among children under five years of age. In Melbourne Australia, up to one in every 10 babies develop food allergy during the first year of life. To understand the mechanisms underlying the increased incidences of allergy and other diseases in children, Associate Professor Peter Vuillermin and colleagues established the Barwon Infant Studies (BIS), following and collecting bio-speciments  from pregnant mothers and their babies. Together with my colleagues Prof. Leonard  Harrison and Mr. Gaetano Naselli from the Walter and Eliza Hall Institute of Medical Research, we examined the immune cell composition and function in cord blood in babies who developed food allergy compared to allergy-free babies at one year of age.    Medical Research: What are the main findings? Dr. Zhang: Our initial observation was that in cord blood the proportions of CD14+ monocytes and CD4+T cells were inversely associated. In infants who developed food allergy, there was a higher ratio of CD14+monoctypes/CD4+T cells and a lower ratio of naive natural regulatory T cells (nTreg).  The reduced nTreg frequency was also independently discovered by Dr. Fiona Collier in the BIS fresh blood cohort. CD14+ monocytes are the foot-solders of the immune system, which immediately release inflammatory cytokines upon infection. These inflammatory cytokines then guide the unexperienced CD4+T cells down to different paths to control infection. nTreg cells police the immune system to prevent unwanted damages during the elimination of the infections. Despite this widely accepted view of how our immune system are activated,  we do not know if and how these interactions may cause an allergic reaction in babies. Through a series of in vitro experiments, we found that the inflammatory cytokines- most likely in the mucosal sites where food allergy was initiated-could lead the development of both CD4+T cells and nTregs towards a Th2-type immune phenotype. These Th2-type immune cells secrete large amount of IL-4, a cytokine through which may cause allergic reactions to some foods.
Author Interviews, Dermatology, JAMA / 15.01.2016

More interviews with researchers from JAMA on MedicalResearch.com MedicalResearch.com Interview with: Daniela Kroshinsky, MD, MPH Department of Dermatology Massachusetts General Hospital, Boston  and Suchismita Paul, MD Medical student at Harvard Medical School, Boston, Massachusetts, at the time of the study now with Department of Medicine and Department of Dermatology and Cutaneous Surgery Jackson Memorial Medical Research: What is the background for this study? Response: Calciphylaxis is a life-threatening disease and the diagnosis is challenging with clinicians mostly relying on the clinical findings along with an assessment of risk factors. Tissue biopsy is often falsely negative, requiring multiple tissue biopsies, possibly propagating new lesion formation, and delaying treatment initiation. Therefore, a non-invasive tool would be of significant value for the diagnosis of calciphylaxis. The use of bone scans for the diagnosis of calciphylaxis has been reported in several case reports, yet its use remains controversial because of the reported low sensitivity and specificity. Only one previous study from 2002 reported that in fact the sensitivity is very high (97%), however, only 4 of 36 calciphylaxis patients were biopsy-confirmed and the specificity was not addressed. We investigated the potential role of bone scintigraphy for the early diagnosis and treatment monitoring of calciphylaxis. We performed a retrospective case-control study involving 49 patients, 18 calciphylaxis cases (biopsy-confirmed in 14) and 31 controls with end-stage renal disease without calciphylaxis.
Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Dermatology, Nature, Testosterone / 14.01.2016

[caption id="attachment_20631" align="alignleft" width="160"]Dr. Nana Keum, PhD Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA Dr. NaNa Keum[/caption] More on Colon Cancer on MedicalResearch.com MedicalResearch.com Interview with: Dr. Nana Keum, PhD 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. Keum: Male pattern baldness, the most common type of hair loss in men, is positively associated with androgens as well as IGF-1 and insulin, all of which are implicated in pathogenesis of colorectal neoplasia.  Therefore, it is biologically plausible that male pattern baldness, as a marker of underlying aberration in the regulation of the aforementioned hormones, may be associated with colorectal neoplasia.  In our study that examined the relationship between five male hair pattern at age 45 years (no-baldness, frontal-only-baldness, frontal-plus-mild-vertex-baldness, frontal-plus-moderate-vertex-baldness, and frontal-plus-severe-vertex-baldness) and the risk of colorectal adenoma and cancer, we found that frontal-only-baldness and frontal-plus-mild-vertex-baldness were associated with approximately 30% increased risk of colon cancer relative to no-baldness.  Frontal-only-baldness was also positively associated with colorectal adenoma.
Author Interviews, NEJM, NIH, Opiods / 14.01.2016

[caption id="attachment_20558" align="alignleft" width="200"]Dr. Wilson Compton Dr. Wilson Compton[/caption] For more on Opioids on MedicalResearch.com please click here. MedicalResearch.com Interview with: Wilson M. Compton, M.D., M.P.E. Deputy Director National Institute on Drug Abuse Medical Research: What is the background for this study? What are the main findings? Dr. Compton: Deaths related to opioids (from both prescription pain killers and street drugs, like heroin) have dramatically increased in the past 15 years.  How these different types of opioids are related to each other is important because the pain killers ultimately are derived from prescriptions written by health care providers and street drugs, like heroin, are from illegal sources.  The different types of opioids vary in there source but are quite similar in their effects in the brain.  Given the different sources, interventions to reduce availability vary across the two categories. There is also a concern that interventions to reduce the availability of prescription opioids may be encouraging people to switch to heroin.  That’s the main question addressed in this review.
Author Interviews, NEJM, Surgical Research / 14.01.2016

[caption id="attachment_20542" align="alignleft" width="169"]Dr. Jenny Löfgren Surgery and Perioperative Sciences, Faculty of Medicine, University Hospital of Umeå Umeå Sweden Dr. Jenny Löfgren[/caption] MedicalResearch.com Interview with: Dr. Jenny Löfgren Surgery and Perioperative Sciences Faculty of Medicine, University Hospital of Umeå Umeå Sweden  Medical Research: What is the background for this study? What are the main findings? Response: There are an estimated 220 million groin hernia patients in the World. 20 million are operated on annually making it one of the worlds most commonly performed surgeries. The surgical repair rate in low income settings is very low. Also, the quality of the surgery is lower than in high income settings. The superior technique that uses a synthetic mesh to reinforce the abdominal wall at the site of the hernia is not affordable due to the high cost of that mesh. Mosquito mesh, which is very similar to the expensive mesh, is already used in several settings but its safety and effectiveness had not previously been investigated in a randomized trial of sufficient size with follow up for as long as one year.   Medical Research: What are the main findings? Response: The most important finding of the study is that it was not able to detect any differences in terms of safety, effectiveness and patient satisfaction when outcomes in the group receiving the low-cost (mosquito) mesh with the group receiving a commonly used commercial mesh. The study also shows that high quality surgery, on par with standards in high income settings, can be provided for an underserved population in rural Uganda, at an affordable cost. Finally, the study shows that it is possible to conduct high quality surgical (clinical) research with high follow up rates also in settings such as rural Uganda. This should encourage us and others to conduct other trials in the future. 
Annals Thoracic Surgery, Author Interviews, Heart Disease / 14.01.2016

[caption id="attachment_20613" align="alignleft" width="180"]Islam Elgendy, MD Clinical Pharmacology, Cardiology University of Florida Dr. Islam Elgendy[/caption] MedicalResearch.com Interview with: Islam Elgendy, MD Clinical Pharmacology, Cardiology University of Florida Medical Research: What is the background for this study? What are the main findings? Dr. Elgendy: This study aimed to review the current evidence for the effect of statin therapy before and after bypass surgery on different outcomes. The evidence suggests that statins can help reduce cardiac complications, such as atrial fibrillation, following the surgery. Statin use also seemed to be associated with a reduced risk of death during and immediately after bypass surgery.
Author Interviews, Breast Cancer, Nature, University Texas / 13.01.2016

Click Here for More Articles Related To Breast Cancer on MedicalResearch.com. MedicalResearch.com Interview with: Dr. Chunru Lin PhD Assistant Professor, Department of Molecular and Cellular Oncology, Division of Basic Science Research and Graduate School of Biomedical Sciences The University of Texas MD Anderson Cancer Center, Houston, TX MedicalResearch: What is the background for this study? What are the main findings? Dr. Lin: Triple-Negative Breast Cancer (TNBC) continues to be a serious healthcare problem despite improvements in early detection and treatment; lncRNAs are one of the emerging elements that make the process of understanding breast cancer development and progression so complex yet thorough. Thus, it is imperative to include an examination of lncRNAs when studying breast cancer, especially when researching challenging questions related to relapses and recurrences of breast cancer that occur after targeted therapeutic treatments. A perspective that incorporates lncRNAs into the discussion of breast cancer biology could be the conceptual advance that is necessary to encourage further breakthroughs. Our research reveals the biological functional roles of cytoplasmic lncRNAs as signaling pathway mediators and catalysts that serve as indispensable components of signal transduction cascades and gene networks. This understanding could transform the prevailing dogma of the field of signal transduction. This study has identified a previously unknown mechanism for HIF stabilization and signal transduction, which is triggered by the HB-EGF bound EGFR/GPNMB heterodimer and is mediated by LINK-A-dependent recruitment of two kinases, BRK and LRRK2, to phosphorylate HIF1α at two new sites, leading to HIF1α stabilization and interaction with p300 for transcriptional activation; this further results in cancer glycolytic reprogramming under normoxic conditions. LINK-A is the first demonstrated lncRNA that acts as a key mediator of biological signaling pathways, which suggests the potential for the involvement of other lncRNAs as mediators of numerous signaling pathways. Importantly, expression of LINK-A and activation of the LINK-A mediated signaling pathway are both correlated with TNBC. Targeting LINK-A with LNAs (Locked Nucleic Acids) serves as an encouraging strategy to block reprogramming of glucose metabolism in TNBC with therapeutic potential. 
Author Interviews, Heart Disease, JACC / 13.01.2016

Tanush Gupta, MD MedicalResearch.com Interview with: Tanush Gupta, MD Chief Resident & Instructor of Medicine and Prakash Harikrishnan, MD Prakash Harikrishnan, MD Fellow in Cardiology New York Medical College at Westchester Medical Center Valhalla, NY   Medical Research: What is the background for this study? Response: Complete heart block (CHB) is a relatively frequent complication in patients hospitalized with ST-elevation myocardial infarction (STEMI). Patients who develop complete heart block in the setting of STEMI have a 3- to 5-fold increase in in-hospital mortality compared to those without CHB. However, most of the existing reports on CHB complicating STEMI are from the pre-thrombolytic and thrombolytic era in the 1980s and 1990s, before the widespread use of percutaneous coronary intervention (PCI) and advent of modern adjunctive medical therapies. Hence, the purpose of this investigation was to examine the association of complete heart block with in-hospital outcomes in patients hospitalized with STEMI and to examine the temporal trends in the incidence and outcomes of CHB complicating STEMI using the National Inpatient Sample (NIS) databases from 2003 to 2012.
Author Interviews, BMJ, Diabetes, NIH, OBGYNE / 13.01.2016

[caption id="attachment_20536" align="alignleft" width="158"]Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 Dr. Cuilin Zhang[/caption] MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852  Medical Research: What is the background for this study? What are the main findings? Dr. Zhang: Potatoes are the third most commonly consumed food crop in the world. In the United States, about 35% of women of reproductive age consume potatoes daily, accounting for 8% of daily total energy intake.  Gestational diabetes mellitus (GDM) is a common complication of pregnancy characterized by glucose intolerance with onset or first recognition during pregnancy. GDM is at the center of a vicious circle of 'diabetes begets diabetes' across generations. Potato foods are typically higher in glycemic index and glycemic load, but data are lacking regarding whether potato consumption is associated with the risk of Gestational diabetes mellitus. Medical Research: What is the background for this study? What are the main findings? Dr. Zhang: Women who eat more potatoes before pregnancy may have higher risk of gestational diabetes—the form of diabetes that occurs or first diagnosed during pregnancy—compared to women who consume fewer potatoes. Substituting potatoes with other vegetables, legumes or whole grains may help lower gestational diabetes risk.
ALS, Alzheimer's - Dementia, Author Interviews, JAMA, Multiple Sclerosis, Neurological Disorders, Stem Cells / 12.01.2016

[caption id="attachment_20586" align="alignleft" width="200"]Prof. Dimitrios Karussis M.D., Ph.D. Professor of Neurology Head, Multiple Sclerosis Center Hadassah BrainLabs Prof. Dimitrios Karussis[/caption] MedicalResearch.com Interview with: Prof. Dimitrios Karussis M.D., Ph.D. Professor of Neurology Head, Multiple Sclerosis Center Hadassah BrainLabs Medical Research: What is the background for this study? What are the main findings? Prof. Karussis: BrainStorm Cell Therapeutics is developing innovative, autologous stem cell therapies for highly debilitating neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), and Parkinson’s Disease (PD).  Our technology, NurOwn™ is a first-of-its-kind approach that induces autologous bone marrow-derived Mesenchymal Stem Cells (MSCs) to secrete Neurotrophic Growth Factors (NTFs).  These MSC-NTF cells have been shown to be protective in several animal models of neurodegenerative diseases. Data from the clinical trials described in the recent issue of the Journal of American Medicine – Neurology (JAMA Neurology), suggest that NurOwn can help patients with ALS.  The two trials featured in the article, a phase 1/2 and a phase 2a, studied the transplantation NurOwn cells in ALS patients.  These trials confirmed the excellent safety profile of NurOwn and suggest a clinically meaningful effect. The investigators used two well established clinical endpoints that measure disease activity in ALS, the Revised ALS Functional Rating Scale and Forced Vital Capacity, and were able demonstrate a slowing of disease activity in the period following treatment.
AHA Journals, Author Interviews, Brigham & Women's - Harvard, NIH, Nutrition, Sugar, Weight Research / 12.01.2016

[caption id="attachment_20483" align="alignleft" width="70"]Dr. Caroline Fox, MD MPH National Heart, Lung, and Blood Institute Assistant Clinical Professor of Medicine Harvard Medical School Dr. Fox[/caption] MedicalResearch.com Interview with: Dr. Caroline Fox, MD MPH National Heart, Lung, and Blood Institute Assistant Clinical Professor of Medicine Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Fox: There is evidence linking sugar sweetened beverages with obesity and type 2 diabetes. There is also evidence suggesting that specific adipose tissue depots may play a role in the pathogenesis of these diseases. We found that higher levels of sugar sweetened beverage (SSB) intake was associated with more visceral fat (fat in the stomach cavity) over 6 years.
Author Interviews, Depression, JAMA, Surgical Research, UCLA, Weight Research / 12.01.2016

[caption id="attachment_16030" align="alignleft" width="165"]Aaron J. Dawes, MD Fellow, VA/RWJF Clinical Scholars Program Division of Health Services Research, University of California Los Angeles Los Angeles, CA 90024 Dr. Aaron Dawes[/caption] MedicalResearch.com Interview with: Aaron J. Dawes, MD Fellow, VA/RWJF Clinical Scholars Program Division of Health Services Research University of California Los Angeles Los Angeles, CA 90024 Medical Research: What is the background for this study? What are the main findings? Dr. Dawes: We reviewed the published literature to answer three basic questions about bariatric surgery and mental health conditions. First, how common are mental health conditions among patients being referred for or undergoing bariatric surgery?
  • Second, do patients who carry a diagnosis of one of these conditions lose less weight after surgery than patients without these conditions?
  • And, third, what happens to the clinical course of mental health conditions after patients undergo surgery? Do they get better, worse, or stay the same?
We found that mental health conditions are surprisingly common among bariatric patients, especially depression and binge eating disorder, which occur at almost twice the rate among bariatric patients than in the general U.S. population. We also found no strong evidence to suggest that patients with depression lose less weight after surgery and some evidence that the condition may actually improve after surgery. Eleven of the twelve studies on the topic found either lower rates or fewer symptoms of depression, at least during the first 3 years post-operatively.
Accidents & Violence, Author Interviews, Autism, JAMA / 12.01.2016

[caption id="attachment_20512" align="alignleft" width="150"]Diana Schendel, Professor MSO Department of Public Health Institute of Epidemiology and Social Medicine and Department of Economics and Business National Centre for Register-based Research Aarhus University Denmark Dr. Diana Schendel[/caption] MedicalResearch.com Interview with: Diana Schendel, Professor MSO Department of Public Health Institute of Epidemiology and Social Medicine and Department of Economics and Business                             National Centre for Register-based Research Aarhus University Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Schende: Elevated mortality has been reported in persons with autism spectrum disorder (ASD), especially with comorbid epilepsy and intellectual disability. The effect of comorbidity on the risk for mortality in ASD, however, has not been rigorously examined in large, population-based studies. Our study aim was to investigate ASD mortality patterns overall and to assess the specific effects of comorbid mental, behavioral, and neurologic disorders on ASD mortality into young adulthood. Our study comprised a nation-wide Danish cohort of 1.9 million children of whom 20,492 were diagnosed with ASD. We observed 68 deaths in persons with ASD; 83% of the persons with ASD who died had comorbid mental/behavioral or neurologic disorders. The risk for mortality was two-fold higher in persons with autism spectrum disorder overall. An elevated risk for mortality was also seen in persons who had ASD only, or had both ASD and other neurologic or mental/behavioral disorders, compared to persons without these other morbidities and no ASD. However, the co-occurrence of ASD in persons with neurologic, or with mental/behavioral disorders, added no additional mortality risk compared to persons with these disorders and no autism spectrum disorder. These results suggest that the mechanisms underlying mortality risk in ASD in part may be shared with these other disorders, although what might be the specific shared mechanisms cannot be determined with these data.
Annals Internal Medicine, Author Interviews, Breast Cancer, Mammograms / 12.01.2016

[caption id="attachment_20523" align="alignleft" width="120"]Susan K. Boolbol, MD, FACS Chief, Division of Breast Surgery Chief, Appel-Venet Comprehensive Breast Service Co-Director, Breast Surgery Fellowship Mount Sinai Beth Israel Associate Professor of Surgery Icahn School of Medicine at Mount Sinai New York, NY 10003 Dr. Boolbol[/caption] MedicalResearch.com Interview with: Susan K. Boolbol, MD, FACS Chief, Division of Breast Surgery Chief, Appel-Venet Comprehensive Breast Service Co-Director, Breast Surgery Fellowship Mount Sinai Beth Israel Associate Professor of Surgery Icahn School of Medicine at Mount Sinai New York, NY 10003 Medical Research: What is the background for these new recommendations? Dr. Boolbol: To make this final recommendation, the Task Force conducted a comprehensive review of the science since its 2009 recommendation and considered the public comments it received on its 2015 draft recommendation statement. Based on all of this, the task force issued their recommendations. Medical Research: What are the main changes from current guidelines? Dr. Boolbol: Presently, there are several different guidelines and recommendations regarding screening mammography. Depending on the group issuing the guidelines, the recommendations vary from annual mammography beginning at 40 years old to biennial mammograms from 50 to 74 years old. The Task Force continues to find that the benefit of mammography increases with age, and recommends biennial screening in women ages 50 to 74.
Author Interviews, Clots - Coagulation, FDA, Heart Disease, JAMA, Johns Hopkins / 12.01.2016

[caption id="attachment_20566" align="alignleft" width="200"]Victor Serebruany, MD, PhD HeartDrug Research, Towson, Maryland Department of Neurology Johns Hopkins University Baltimore, Maryland Dr. Victor Serebruany[/caption] MedicalResearch.com Interview with:
Victor Serebruany, MD, PhD
HeartDrug Research, Towson, Maryland
Department of Neurology Johns Hopkins University Baltimore, Maryland Medical Research: What is the background for this study? What are the main findings?

Dr. Serebruany: Missing data are common challenges to the validity of trial results, yet it is unclear how to characterize the extent of missing data.  We compared the published lost-to-follow-up rates to incomplete follow-up rates determined from subject records submitted to the FDA for major oral antithrombotic trials.  The 21 trials having both sets of rates included 270,089 patients followed for a median duration of 20 months.  The mean published lost-to-follow-up rates is 0.4% (median 0.3%, range 0.005% to 2%), consistently much lower than the FDA incomplete follow-up rates: mean 12% (median 13%, range 2% to 23%).  There is no correlation between the publication and FDA-calculated  rates (R 0.07, p = 0.76).   The FDA rates exceed greatly the endpoint rate differences: mean 1.3% (median 1,0%, range 0.2% to 3.0%). Medical Research: What should clinicians and patients take away from your report? Dr. Serebruany: That the FDA incomplete follow-up rates greatly exceed the endpoint rate differences raises questions of whether the endpoint differences may be due to differential follow-up rather than drug effect.  That they greatly exceed the measures routinely reported for trials, i.e., lost-to-follow-up rates, suggests that current trial reporting is inadequate.  Completeness of follow-up and other indicators of trial data quality should be considered when interpreting trial results.