MedicalResearch.com Interview with:
Lu Qi, MD, PhD, FAHA
Assistant Professor of Medicine
Harvard Medical School
Assistant Professor of Nutrition
Harvard School of Public Health
MedicalResearch.com: What are the main findings of the study?Answer: The main findings include, we for the first time identified a genetic variant predisposing to high risk of coronary heart disease in patients with type 2 diabetes, using genome-wide association (GWA) approach. More interesting, we demonstrated that the variant may affect expression of a gene involved in metabolism of amino acid glutamic acid, which has been related to insulin secretion and heart health in previous studies.
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MedialResearch.com Interview with:Dr Catherine M. Phillips
Health Research Board Centre for Diet and Health Research
Room 4.033, Department of Epidemiology and Public Health
Western Gateway Building, University College Cork, Cork, Ireland
MedialResearch.com: What are the main findings of the study?Answer: Obesity is associated with increased risk of diabetes and heart disease leading to reduced life expectancy. However in recent years it has been recognized that not all obese individuals are at increased risk – these individuals have been described as being metabolically healthy obese (MHO) in that despite carrying excess weight they do not have the typical abnormal metabolic features associated with obesity such as hypertension, insulin resistance and alterations to their lipid profile.
It is not clear what factors determine whether an obese person becomes metabolically healthy or unhealthy. In this study conducted at the Dept. of Epidemiology and Public Health at University College Cork, Ireland, we examined levels of a range of inflammatory markers in 2047 middle-aged Irish adults to investigate to what extent differences between metabolically healthy and unhealthy obese and non-obese male and female adults are explained by inflammatory status. Participants, who were between the ages of 50 and 69, completed lifestyle questionnaires, physical and clinical assessments, and underwent blood testing so their body mass index (BMI), metabolic profiles and inflammatory markers could be determined. We found that, regardless of a person’s BMI, having a favorable inflammatory profile was associated with being metabolically healthy. Specifically metabolically healthy individuals presented with lower levels of complement component 3, C reactive protein, tumour necrosis factor alpha, interleukin 6, plasminogen activator inhibitor-1, reduced white blood cell count and higher adiponectin levels compared to their metabolically unhealthy counterparts.
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MedicalResearch.com Interview with:David A Richards, PhD
Professor of Mental Health Services Research and NIHR Senior Investigator
University of Exeter Medical School
Sir Henry Wellcome Building
University of Exeter
Washington Singer Building The Queen’s Drive
Exeter EX4 4QQ United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We found that collaborative care improves depression immediately after treatment compared to usual care, has effects that persist to 12 month follow-up and is preferred bypatients over usual care.
This difference in effect equated to a standardized effect size of 0.26 (95% CI 0.07 to 0.46). More participants receiving collaborative care than those receiving usual care met criteria for recovery (odds ratio 1.67 (95% confidence interval 1.22 to 2.29); number needed to treat=8.4) and response (1.77 (1.22 to 2.58); 7.8 at 4 months.
At 12 months follow up more participants in collaborative care than those in usual care met criteria for recovery (odds ratio 1.88 (95% confidence interval 1.28 to 2.75); number needed to treat=6.5) and response (1.73 (1.22 to 2.44); 7.3.
Collaborative care is as effective in the UK healthcare system—an example of an integrated health system with a well developed primary care sector—as in the US.
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MedicalResearch.com Interview with:Daniel Strbian, MD, PhD, MSc (Stroke Med), FESO
Associate Professor
Department of Neurology
Helsinki University Central Hospital
PL 340, 00290 HUS
MedicalResearch.com: What are the main findings of the study?Dr. Strbian: That providing early treatment is not enough, we have to be ultra-early.
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MedicalResearch.com Interview with:Dr Pamela N Peterson MD
Denver Health Medical Center, CO
MedicalResearch.com: What are the main findings of the study?Answer:We assessed the outcomes of mortality, rehospitalization, and procedural complications among 24,169 patients in the NCDR-ICD Registry with left ventricular systolic dysfunction receiving a cardiac resynchronization device in addition to an implantable defibrillator for the primary prevention of sudden cardiac death between 2006 and 2009. After stratification by the QRS complex morphology and duration on the ECG and adjustment for measured differences in other characteristics, patients with left bundle branch block (LBBB) and QRS durations of at least 150 msec had significantly lower rates of mortality and rehospitalization at 3 years compared with patients with non-LBBB QRS morphology and/or QRS duration of 120-149 msec. Rates of mortality and readmission were generally highest in patients with non-LBBB and QRS duration of 120-149 msec. Rates of procedural complications at 30- and 90-days were similar across strata of QRS morphology and duration.
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MedicalResearch.com Interview with:Thomas P. J. Solomon, Ph.D.
Associate Professor of Biomedical Sciences
Department of Biomedical Sciences | Cellular & Metabolic Research Section
Panum Institute 4.5 | University of Copenhagen | Blegdamsvej 3B | 2200 Copenhagen N | Denmark
MedicalResearch.com: What are the main findings of the study?Dr. Solomon: The main findings were that when impaired glucose tolerant and type 2 diabetic subjects underwent 3-4 months of regular aerobic exercise training, although the majority of subjects (86-90%) increased increased VO2max, lost weight, and increased insulin sensitivity, only around two-thirds of subjects improved glycemic control (HbA1c, fasting glucose, and 2-hour OGTT glucose). The novel finding was that the changes in glycemic control were congruent with changes in oral glucose-stimulated insulin secretion (GSIS). We also found that exercise training-induced changes in glycemic control were related to changes in GSIS (P0.05), but not insulin sensitivity. Furthermore, we found that training-induced improvements in glycemic control were largest in subjects with greater pre-training GSIS, i.e. in subjects with greatest beta-cell function. And, we noted that high pre-training hyperglycemia blunted exercise-induced improvements in beta-cell compensation for insulin resistance.
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MedicalResearch.com Interview with:Joyce Y Tung Ph.D.
Research Team
23andMe Inc.
Mountain View, California, USA
MedicalResearch.com: What are the main findings of the study?Dr. Tung: 23andMe researchers identified four genetic markers that were significantly associated with the development of stretch marks, including one near the elastin (ELN) gene. This finding may further explain why some individuals are more susceptible to the skin condition. Given that loose skin is a symptom of syndromes caused by deletion or loss-of-function mutations in ELN, these results also support the hypothesis that variations in the elastic fiber component of the skin extracellular matrix contribute to the development of stretch marks.
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MedicalResearch.com Interview with:Brian D. Glass
Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary, University of London, London, United Kingdom
Bradley C. Love
Department of Cognitive, Perceptual and Brain Sciences, University College London, London, United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We had 72 non-gaming participants play 40 hours of video games over 6 to 8 weeks. We tested them on psychological tests before and after. The participants either played The Sims (a life simulator game), or one of two versions of StarCraft (a real-time strategy game) -- one which had a higher level of complexity. We found that the StarCraft players (especially on the higher complexity version) performed better on specifically the psychological tasks which tested cognitive flexibility. Cognitive flexibility is the ability to adapt to a changing environment by keeping multiple things in mind and switch between tasks effectively. This sort of ability is considered a higher level psychological ability because it requires strategic thinking and creativity.
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MedicalResearch.com Interview with:Xiaohui Zhuo PhD
Health economist
Division of Diabetes Translation
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?First, someone diagnosed with type 2 diabetes may pay an average of about $85,500 treating the disease over his or her lifetime. Lifetime cost is higher for women, and for patients who developed the disease earlier in life.
Second, treating diabetic complications account for more than half of lifetime costs, and a majority of which is attributed by damage to large blood vessels, which can lead to coronary heart disease and stroke.
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MedicalResearch.com Interview with: Dr. Axel Bauer, MD, FESC, F-ISHNE
Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany.
MedicalResearch.com: What are the main findings of the study?Dr. Bauer: Catheter-based renal sympathetic denervation is a promising treatment option in patients with resistant arterial hypertension. However, it is invasive and might have presently unknown adverse side effects in the long-term. Therefore, identification of patients who benefit from RDN and, equally importantly, those who do not is of great importance. With assessment of baroreflex sensitivity (BRS) we found a way to do that. Patients with resistant hypertension and impaired BRS at baseline benefited the most from RDN in terms of reduction of mean systolic BP on (ABPM) while RDN had no effect in patients with preserved BRS.
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MedicalResearch.com Interview with: Bjarke Feenstra, Ph.D.
Senior Research Scientist
Statens Serum Institut
Artillerivej 5, 2300 Copenhagen S
Denmark
MedicalResearch.com: What are the main findings of the study?Dr. Feenstra: We discovered a new genome-wide significant locus for infantile hypertrophic pyloric stenosis (IHPS) in a region on chromosome 11 harboring the apolipoprotein (APOA1/C3/A4/A5) gene cluster and also confirmed three previously reported loci. Characteristics of the new locus led us to propose the hypothesis that low levels of circulating lipids in infants are associated with increased risk of IHPS. We addressed this hypothesis by measuring plasma lipid levels in prospectively collected umbilical cord blood from a set of 46 IHPS cases and 189 matched controls. We found that levels were on average somewhat lower in the children who went on to develop the condition.
(more…)
MedicalResearch.com Interview with: Matthew Parkes
Research Statistician
Research in Osteoarthritis Manchester (ROAM)
Arthritis Research UK Epidemiology Unit
Centre for Musculoskeletal Research
Institute of Inflammation and Repair
The University of Manchester
Manchester Academic Health Science Centre
Manchester M13 9PT
MedicalResearch.com: What are the main findings of the study?Answer: Looking at all trials of lateral wedge insoles, they seem to reduce pain slightly.
However, looking at trials which compare lateral wedges to flat wedges, they don’t appear to differ in terms of pain reduction.
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MedicalResearch.com: Interview with Sirimon Reutrakul MD
Section of Endocrinology Department of Medicine
Rush University Medical Center
Chicago, Illinois 60612
MedicalResearch.com: What are the main findings of the study?Answer: We found a strong association between obstructive sleep apnea and gestational diabetes mellitus. In pregnant women diagnosed with gestational diabetes, the risk of obstructive sleep apnea is increased nearly 7-fold compared to those without gestational diabetes. In addition, we found that in non-diabetic women, pregnancy is associated with more disrupted sleep.
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MedicalResearch.com: Interview with: Therese Koops Grønborg PhD student/ph.d.-studerende, MSc
Section of Biostatistics/Sektion for Biostatistisk
Department of Public Health/Institut for Folkesundhed
Aarhus University
Bartholins Allé 2, DK-8000 Aarhus C, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: There are three important findings in our study.
We estimated a population-based Autism Spectrum Disorder (ASD) sibling recurrence risk relative to the background population and found an almost seven-fold increase. While this indeed is an increased risk, it is also lower than what other recent studies have suggested.
We also compared the relative recurrence risk for full and maternal/paternal half siblings and found a lower relative recurrence risk in half siblings than in full siblings, which supports the genetic pathway to ASD. The recurrence risk for maternal half siblings is still higher than for the background population suggesting that factors unique to the mother, such as the intrauterine environment and perinatal history, may contribute to ASD.
Last, but not least, we estimated the time trends in the relative recurrence risk. While the ASD prevalence has been increasing for several years, we found no time trends in the relative recurrence risk, suggesting that the factors contributing to the risk for ASDs recurrence in siblings (perhaps a combination of genes and environment) have not changed over time.
(more…)
MedicalResearch.com Interview with:
Dr.Csaba P. Kovesdy MD FASN.
The Fred Hatch Professor of Medicine
Director, Clinical Outcomes and Clinical Trials Program in Nephrology
University of Tennessee Health Science Center
Chief of Nephrology
Division of Nephrology, Memphis VA Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kovesdy: In this study of >650,000 US veterans with CKD we found that categories of lower SBP/DBP combinations are associated with lower mortality only as long as the DBP component remains above a threshold of approximately 70 mmHg, and that patients with BP values in the range of 130-159/70-89 mmHg had the lowest mortality. Patients who might be considered to have “ideal” blood pressure (<130/80) actually had increased mortality due to the inclusion of individuals with low systolic and diastolic blood pressures.
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MedicalResearch.com Interview with:Leora I. Horwitz, MD, MHSSection of General Internal Medicine, Department of Medicine,
Yale School of Medicine,
Center for Outcomes Research and Evaluation,
Yale–New Haven Hospital, New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?Answer: We interviewed nearly 400 older patients who had been admitted with heart failure, pneumonia or heart attack within one week of going home from the hospital. We also reviewed the medical records of 377 of the patients. We found, for example, that:
40% of patients could not understand or explain the reason they were in the hospital in the first place;
A fourth of discharge instructions were written in medical jargon that a patient was not likely to understand;
Only a third of patients were discharged with scheduled follow-up with a primary care physician or cardiology specialist;
Only 44% accurately recalled details of their appointments.
In other words, we didn't do a very good job of preparing patients for discharge, and perhaps as a result, patients were pretty confused about important things they needed to know after they were home.
We just published a companion paper in the Journal of Hospital Medicine last week in which we looked at the discharge summaries for the same patients - that is, the summary of the hospitalization that is meant to help the outpatient doctor understand what happened in the hospital. Turns out we were just as bad at communicating with doctors as with patients - we focused on details of the hospitalization rather than what needed to happen next or what needed to be followed up, and in a third of cases, we didn't even send the summary to the outpatient doctor. In fact out of 377 discharge summaries, we didn't find a single one that was done on the day of discharge, sent to the outpatient doctor, and included all key content recommended by major specialty societies.
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MedicalResearch.com Interview with: Michiyo Yamakawa MHSc
Department of Epidemiology
Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences,
Okayama, Japan
MedicalResearch.com: What are the main findings of the study?Answer: We found that breastfeeding was associated with decreased risk of overweight and obesity at the age of 7 and 8 years compared with formula feeding. Moreover, the protective associations for obesity were greater than those for overweight.
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MedicalResearch.com Interview with: Steve Estus PhD
Dept. of Physiology University of Kentucky
Office: Room 332 Sanders-Brown Building
800 S. Limestone Street
Lexington, KY 40536-0230
MedicalResearch.com: What are the main findings of the study?Answer: We report evidence for the function of a Alzheimer's genetic risk factor. This protective allele of the polymorphism decreases the splicing efficiency of exon 2 in CD33, a receptor protein that regulates microglial activation. Loss of exon 2 appears to produce a dormant CD33 protein, resulting in increased microglial phagocytosis activity. Overall, these findings confirm and extend recent papers in Neuron and Nature Neuroscience (discussed further in our report) that described decreased CD33 activity with the protective SNP allele.
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Prof. Steve Allen
Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow
Room 314, The College of Medicine, Swansea University,
Swansea, SA2 8PP, UK.
MedicalResearch.com: What are the main findings of the study?Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo.
Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit.
In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm.
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MedicalResearch.com Interview with: Rebecca M Reynolds, Professor of Metabolic Medicine
Endocrinology Unit, BHF/University Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh EH14 6TJ, UK
MedicalResearch.com: What are the main findings of the study?Answer: We found that the adult offspring of women who were obese at the start
of pregnancy were 35% more likely to die prematurely than offspring of
normal-weight women. We also found that children born to mothers who
were overweight when they became pregnant had an 11% increased risk of
premature death. Adult offspring of mothers who were obese were also
at increase risk of hospital admissions for cardiovascular events.
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MedicalResearch.com Interview with: Miles D. Witham, PhD
Aging and Health, University of Dundee, Dundee, United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We gave high dose vitamin D3 (100,000 units) or placebo every 3 months to people aged 70 or over, who all had isolated systolic hypertension (ISH). The main focus of the trial was to test whether vitamin D supplementation could reduce blood pressure in this group of patients – this pattern of blood pressure, whether the systolic (top number) is high, and the diastolic (bottom number) is normal, is very common in older people. Previous studies have suggested a link between low vitamin D levels and higher blood pressure, but no trial has yet tested this idea in older patients with ISH.
Despite the treatment causing a significant increase in circulating vitamin D levels, we saw no significant reduction in blood pressure with vitamin D supplementation, despite the trial running for a year. We tested whether certain groups might still benefit – e.g. those with very high blood pressure or very low vitamin D levels, but even these groups did not show a reduction in blood pressure.
We also tested whether vitamin D supplementation reduced the health and stiffness of arteries – both important predictors of future heart attack or stroke. Unfortunately, vitamin D did not affect these measures either, and didn’t reduce cholesterol or glucose levels.
On the more positive side, vitamin D supplements did appear safe, and the number of falls in the vitamin D group was slightly lower than in those people who received placebo. This is reassuring, as an earlier study (Sanders et al) had suggested that very high doses of vitamin D might make falls more likely, in contrast to previous low dose studies that show a protective effect of vitamin D against falls.
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MedicalResearch.com: Interview with Peter Nordström Ph.D
Umeå University in Sweden
MedicalResearch.com: What are the main findings of the study?Answer: I would say that the main finding of our study is the nine independent risk factors identified for Young-Onset Dementia.
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MedicalResearch.com Interview with: Tina Costacou, Ph.D.
Assistant Professor of Epidemiology
University of Pittsburgh
MedicalResearch.com: What are the main findings of the study?Answer: The generation of reactive oxygen species is a natural and essential feature of human physiology, although excess production of free radicals has been related to the development and progression of diabetes complications. Simply put, a “balance” is required between the pro- and the anti-oxidant forces to maintain good health. Our aim in this study of people with type 1 diabetes was to evaluate whether an individual’s antioxidant vitamin levels in blood can modify the heart disease risk conferred by increased oxidative stress.
Indeed, we observed that higher concentrations of α-tocopherol (a form of vitamin E) in blood overtime were related to lower risk of developing coronary heart disease, whereas greater oxidative stress (as measured by urinary 15-isoprostane F2t) was related to greater risk of disease. Interestingly, the ratio of α-tocopherol to urinary 15-isoprostane F2t, which we used as a measure of an individual’s ability to respond to / counteract oxidative stress, also was a strong predictor of subsequent coronary heart disease development.
Our findings thus point to a different way of assessing a person’s risk for developing disease. Currently in clinical practice, physicians assess an individual’s risk factors (e.g. oxidative stress) for a pathologic condition (e.g. heart disease) to make inferences about the person’s risk to develop this condition and take preventive measures if needed (e.g. assign a treatment regimen). Our findings, however, suggest that an individual’s risk for disease may be better evaluated by simultaneously assessing factors representing the risk and those representing protection from or resistance to the risk. Thus, though two individuals may have similarly high levels of oxidative stress, there may be differences in the concentration of antioxidant vitamins between the two (and vice versa), which may put them at different risk categories, with one person potentially requiring vitamin supplementation while the second not needing to use supplements.
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MedicalResearch.com Interview with:
Dr. Wen-Ya Ko, Ph.D.Postdoctoral Fellow, First author of the paper
Department of Genetics
School of Medicine
University of Pennsylvania
426 Clinical Research Building
415 Curie Boulevard
Philadelphia, PA 19104-6145
Dr. Sarah Tishkoff, Ph.D., Senior author of the paper
David and Lyn Silfen University Professor
Departments of Genetics and Biology
School of Medicine
School of Arts and Sciences
University of Pennsylvania
MedicalResearch.com: What are the main findings of the study? Answer: In humans the APOL1 gene codes for Apolipoprotein L1, a major component of the trypanolytic factor in serum. The APOL1 gene harbors two risk alleles (G1 and G2) associated with chronic kidney disease (CKD) among individuals of recent African ancestry. We studied APOL1 across genetically and geographically diverse ethnic groups in Africa. We have discovered a number of novel variants at the APOL1 functional domains that are required to lyse trypanosome parasites inside human blood vessels.
We further identified signatures of natural selection influencing the pattern of variation on chromosomes carrying some of these variants. In particular, we have identified a haplotype (a cluster of genetic variants linked along a short region of a chromosome), termed G3, that has evolved adaptively in the Fulani population who have been practicing cattle herding which has been historically documented as early as in the medieval ages (but which could have begun thousands of years earlier). Many of the novel variants discovered in this study are candidates to play a role conferring protection against trypanosomiasis and/or to play a role in susceptibility of CKD in humans.
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MedicalResearch.com Interview with: Simon Maltais MD PhD
Vanderbilt University Medical Center
Division of Cardiovascular Surgery
1215 21st Ave S, MCE 5th Flr
Nashville, TN 37232-8808.
MedicalResearch.com: What did your study evaluate and why is this important?Answer: We performed a rigorous, retrospective review of the Scientific Registry of Transplant Recipients (SRTR) data base to evaluate donor, recipient, and technical characteristics associated with graft survival in patients undergoing mechanical circulatory support (MCS) device explantation at the time of heart transplantation surgery.
Donor and recipient characteristics has been well described in the medical literature for routine heart transplantation, however these characteristics in patients who were supported with a long term MCS device at the time of heart transplant was not known. Additionally, due to chronic donor heart shortages, an increasing number of patients with advanced heart failure are being bridged with MSC devices until a suitable donor heart can be obtained.
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MedicalResearch.com Interview with: Prasad Adusumilli MD, FACS
Associate Member, Thoracic Surgery
Memorial Sloan-Kettering Cancer Center
New York
MedicalResearch.com: What are the main findings of the study?Answer: The current standard of care of for early-stage lung adenocarcinoma, the common form of lung cancer is curative-intent surgery either by limited resection, LR (removal of tumor with clear margins) or lobectomy, LO (removal of one-third to one-half of the lung harboring the tumor). Although lung-sparing LR is preferable, there is a reported incidence of 30-40% of recurrences within the same lung. The causative factor/s for these local recurrences is not known.
In our study, we analyzed recurrence patterns and pathological features in patients who underwent 476 LO and 258 LR performed at the Memorial Sloan-Kettering Cancer Center, New York. We investigated the morphological patterns in pathology specimens utilizing the recently proposed International Association for the Study of Lung Cancer / European Respiratory Society / American Thoracic Society (IASLC/ERS/ATS) classification. We noticed that presence of micropapillary morphology was associated with three times higher recurrences in patients undergoing LR compared to LO, these recurrences were lower when there is an adequate margin (2 cm) resected beyond the tumor. In patients undergoing LO, the recurrences were 75% less.
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MedicalResearch.com Interview with Frederic D. Bushman, Ph.D.
Professor, Department of Microbiology
Department of Microbiology
Perelman School of Medicine
University of Pennsylvania
426A Johnson Pavilion 3610 Hamilton Walk
Philadelphia, PA 19104
MedicalResearch.com: What are the main findings of the study?Dr. Bushman: Viral populations in the human gut are huge, and some of the viruses change rapidly over time.
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MedicalResearch.com Interview with: Satish Gopal, MD, MPH
Program in Global Oncology, Lineberger Comprehensive Cancer Center
UNC Project-Malawi, Tidziwe Center, Private Bag A-104, Lilongwe, Malawi
MedicalResearch.com: What is the primary message our physician readers should take away from the piece?”Answer: Lymphoma is one of the leading causes of HIV-associated death in the modern ART era. In our analyses of a large multicenter US cohort, survival for HIV-associated lymphoma patients receiving routine care has not clearly improved since the modern ART era began, and remains significantly worse than SEER outcomes for the same lymphoma subtypes in the general population. This was somewhat surprising in an era of normalizing life expectancy for HIV-infected patients on ART, and quite different from the outstanding results achieved for this population in recent clinical trials conducted by AMC and NCI.
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MedicalResearch.com Interview with Edna B. Foa, PhDDepartment of Psychiatry, University of Pennsylvania, Philadelphia
MedicalResearch.com: What are the main findings of the study?Dr. Foa:Naltrexone was effective in decreasing the percentage of days drinking in people with alcohol dependence and posttraumatic stress disorder during active treatment. Six months after treatment discontinuation, participants who received prolonged exposure therapy for PTSD drank less than those who did not receive prolonged exposure. Participants who received a combined treatment of prolonged exposure and naltrexone had the lowest drinking level after six-month treatment discontinuation. The main message of the study is that simultaneous treatment of alcohol dependence and PTSD yield superior outcome than each treatment alone. Importantly, the findings indicated that prolonged exposure therapy was not associated with increased drinking or alcohol craving, a concern that has been voiced by some investigators. In fact, reduction in PTSD severity and drinking was evident for all four treatment groups. This finding contradicts that common view that trauma-focuses therapy is contraindicated for individuals with alcohol dependence and PTSD, because it may exacerbate PTSD symptoms and thereby lead to increased alcohol use. (more…)
MedicalResearch.com: Interview with: Samir Gupta, MD, MSCS
San Diego Veterans Affairs Healthcare System
Associate Professor of Clinical Medicine
Division of Gastroenterology, Department of Internal Medicine
Moores Cancer Center
University of California San Diego
MedicalResearch.com: What are the main findings?Dr. Gupta: In a randomized, comparative effectiveness study among uninsured individuals not up to date with screening, we found that mailed outreach invitations to complete colonoscopy outreach, and mailed outreach to complete a non-invasive fecal immunochemical test (FIT) tripled screening rates compared to usual care. Additionally, we found that outreach was almost twice as effective with offers for FIT versus colonoscopy screening.
(more…)
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