Medical Research Journals
14 Feb Scientists Block Cocaine Addiction in Mice by Increasing Cadherin “glue” at Synapses
MedicalResearch.com Interview with: [caption id="attachment_32039" align="alignleft" width="149"]
Andrea Globa[/caption]
Andrea K. Globa, Ph.D. Candidate
Graduate Program in Neuroscience
Life Sciences Institute
University of British Columbia
Vancouver, BC, Canada
MedicalResearch.com: What is the background for this study?
Response: Addiction is a complex disease, characterized by continued substance use despite serious negative consequences, increased drug tolerance, and withdrawal. In fact, the statistics show that over 40 million Americans abuse or are addicted to nicotine, alcohol or other drugs. This is a huge public health issue, so naturally, scientists are interested in figuring out why people get addicted, and in particular why certain people are more prone to addiction than others.
Studies examining genetic differences in addicted populations have shown that there are many mutations in genes that are important for brain function. One group of genes affected encode proteins that act as 'glue' to hold cells together. These proteins are called cadherins. In the brain, cadherins are important for holding brain cells together at spots where they communicate with one another – and these points where brain cells talk to one another are called synapses.
Many neuroscientists believe that addiction is actually a type of "pathological" learning, where there are changes at synapses in a brain circuit involved in reward and motivation. So we decided to examine the molecular mechanisms that are important for the strengthening of synapses in this brain circuit.
To put it very simply, to learn something you have to make your synapses stronger, and this involves adding more cadherin or 'glue' to the synapse. We wanted to see if these same rules held true in addiction.
14 Feb Vitamin D May Have Protective Role Against Respiratory Infections
MedicalResearch.com Interview with: Dr. Adrian R Martineau B Med Sci DTM&H MRCP PhD Clinical Professor of Respiratory Infection and Immunity Centre for Primary Care and Public Health. Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary, University of London MedicalResearch.com: What is the background for this study? Response: In addition to its well-known effects on bone, Vitamin D has also been shown to boost immune responses to viruses and bacteria that cause respiratory infections in lab experiments. In order to see whether these effects translate into a health benefit, a total of 25 clinical trials of vitamin D supplementation to prevent various respiratory infections have been carried out in around 11,000 people living in 14 different countries over the last decade. These trials have yielded conflicting results: in some, vitamin D reduced the risk of infections, but in others it did not. The reason why vitamin D ‘worked’ in some trials, but not in others, has been the subject of much debate. In order to answer this question, we assembled an international consortium of investigators and compiled the raw data from every trial into a single database containing information from 10,933 people in total. This allowed us to run sub-group analyses to determine whether particular groups of people benefit more from vitamin D supplementation than others.14 Feb Stress Reduction and Cognitive Therapy Have Long Lasting Effect on Low Back Pain
MedicalResearch.com Interview with: [caption id="attachment_31923" align="alignleft" width="142"]
Dr. Dan Cherkin[/caption]
Dan Cherkin PhD
Emeritus Senior Investigator
Group Health Research Institute
Seattle, WA 98101
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We previously reported the results of a randomized trial examining the effectiveness of Mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) for persons with chronic low back pain (Cherkin et al, JAMA, March 22, 2016).
The current report examines whether the relative effectiveness of these approaches compared with usual care that we found after one year were still evident after two years. We found that there was little decrease in the magnitude of the effects of both MBSR and CBT between one and two years, but the two-year outcomes were statistically significant only for chronic low back pain. As previously reported for outcomes up to one year, there were no significant differences in outcomes between CBT and MBSR.
14 Feb Radiation Therapy Improves Pain and Quality of Life in Bone
MedicalResearch.com Interview with: Rachel McDonald, MD(C) Department of Radiation Oncology Odette Cancer Centre Sunnybrook Health Sciences Centre Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Radiation treatment has been demonstrated in numerous studies to provide effective and timely pain relief to those suffering from painful bone metastases. However, as a palliative treatment, the goal should be not only to reduce pain but also to maintain and even improve quality of life. To date, studies have not effectively demonstrated this; most of these have included either small sample sizes or utilize questionnaires that aren’t tailored to the palliative cancer population with bone metastases. We aimed to determine how soon after radiation treatment one can expect an improvement in quality of life. Our results showed that patients who had a pain response to radiation also had significantly greater improvements in pain, pain characteristics, functional interference, and psychosocial aspects of well-being at day 10 post-treatment. Further improvements in most domains of quality of life were found for responders at day 42.14 Feb Ketamine Before Stressful Event May Reduce Risk of PTSD
MedicalResearch.com Interview with: [caption id="attachment_31986" align="alignleft" width="200"]
Dr. Christine Ann Denny[/caption]
Christine Ann Denny, Ph.D.
Assistant Professor
Department of Psychiatry
Columbia University
Division of Integrative Neuroscience
Research Foundation for Mental Hygiene, Inc.
New York, NY 10032-2695
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Post-traumatic stress disorder (PTSD) is one of the most common psychiatric illnesses, affecting about 8 million adult Americans, and an annual prevalence of about 3.5% worldwide. At-risk populations such as soldiers and veterans are at a higher risk to develop PTSD. Stress exposure is one of the major risk factors for PTSD and major depressive disorder (MDD), a disorder which is often co-morbid with PTSD.
There are currently very limited treatments for PTSD and MDD. In addition, these disorders are treated in a symptom-suppression approach, which only mitigate symptoms and work in only a small fraction of patients. Prevention is rarely an approach considered except in the form of behavioral intervention. However, pharmacological approaches to preventing psychiatric diseases has not yet been developed.
Our laboratory has previously found that ketamine, a general anesthetic and rapid-acting antidepressant, administered sub-anesthetically prior to stress can prevent against stress-induced depressive-like behaviors. We decided to delve into the literature to determine whether ketamine has any effects on PTSD in the clinic. We found numerous reports linking ketamine to PTSD, but the results were varied. We realized that the main difference in all of these studies was the timing of administration. We decided to systematically test the efficacy of ketamine in mice at various time points relative to a stressor to determine when would be the most effective window to buffer against heightened fear expression.
We found that ketamine administered 1 week, but not 1 month or 1 day, prior to a stressor was the most effective time point to administer the drug to buffer fear. This is critical, as it suggests that a pharmacological approach to enhance resilience can be more effective at protecting against PTSD symptoms than attempting to mitigate symptoms after it has already affected an individual.
13 Feb PCSK9 Inhibition with Alirocumab Increases Removal of LDL Cholesterol
MedicalResearch.com Interview with: Henry N. Ginsberg, MD Irving Institute for Clinical and Translational Research Columbia University Columbia College of Physicians and Surgeons New York, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies in mice and cells have identified increased hepatic low density lipoprotein (LDL) receptors as the basis for LDL lowering by PCSK9 inhibitors, but there have been no human studies characterizing the effects of PCSK9 inhibitors on lipoprotein metabolism, particularly effects on very low density lipoproteins (VLDL), intermediate density lipoproteins (IDL) or LDL metabolism. This study in 18 healthy subjects, found that alirocumab decreased the number of IDL and LDL particles in the circulation, and their associated cholesterol and apoB levels by increasing efficiency of the clearance of IDL and LDL. There were not effects on VLDL metabolism. The increased clearance of IDL meant that less LDL was produced from IDL, which is the precursor of LDL. Thus, the dramatic reductions in LDL cholesterol resulted from both less LDL being produced and more efficient clearance of LDL. These results are consistent with increases in LDL receptors available to clear IDL and LDL from blood during PCSK9 inhibition.13 Feb Cerebral Microinfarcts Associated With Cardiac Biomarkers and Heart Disease
MedicalResearch.com Interview with:
Christopher Chen, FRCP
Department of Pharmacology
Yong Loo Lin School of Medicine
Memory Aging and Cognition Center
National University Health System
Singapore
Saima Hilal, PhD
Department of Pharmacology, National University of Singapore
Department of Radiology, Epidemiology and Nuclear Medicine
Erasmus Medical Center, Rotterdam, the Netherlands
MedicalResearch.com: What is the background for this study?
Response: Cerebral microinfarcts (CMIs) are defined as small (usually <1 mm) regions of ischemic change found in the brain which are not readily visible on gross examination or on standard 1.5-T magnetic resonance imaging (MRI). On microscopy they appear as foci of neuronal loss, gliosis, pallor, or cysts.
Previous post mortem studies have shown that the presence of CMIs is relatively common in elderly individuals without dementia (24%) but more common in patients diagnosed with Alzheimer disease (43%) or vascular dementia (62%).
Whilst a single CMI is likely to be “silent” as the region of brain affected is probably too small to produce symptoms or neurologic deficits, however, as a large number of CMIs exist in many individuals, especially in the cerebral cortex and watershed areas, the overall effect has clinical importance – as shown by neuropathologic studies which demonstrate an important role of CMIs in cognitive dysfunction and dementia. However in vivo studies have been hampered by the inability to detect CMIs reliably on neuroimaging, leading to CMIs being termed “invisible” during life.
The advent of high spatial-definition 7-T MRI enabled the identification of cortical Cerebral microinfarcts in-vivo and importantly a study that directly compared 7-T and 3-T MRIs in the same patients reported that 3-T MRI detected about 1/3 of the lesions found on 7-T MRIs, suggesting that 3-T MRIs, which are more accessible than 7-T, may be able to detect larger cortical CMIs with a lower limit of approximately 1 mm in diameter.
Our group has made major contributions recently on the clinical associations of 3T MRI detected cortical CMIs in patients from memory clinics as well as in community based subjects. Associations were found with age, vascular risk factors, other MRI markers of cerebrovascular disease as well as cognition. However, the causes of CMIs remain unclear and may be heterogeneous with microembolism, microthrombosis, and foci of inflammation as possible causative factors.
12 Feb Brain–Computer Interface Allows Communication With Locked-In Patients
MedicalResearch.com Interview with: [caption id="attachment_31785" align="alignleft" width="180"]
Dr. Ujwal Chaudhary[/caption]
Dr. Ujwal Chaudhary, PhD
Institute of Medical Psychology and Behavioral Neurobiology
University of Tübingen
Tübingen, Germany
MedicalResearch.com: What is the background for this study?
Response: Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disorder which causes an Individual to be in Locked-in state (LIS), i.e. the patients have control of their vertical eye movement and blinking, and ultimately in Completely Locked-in state (CLIS), i.e, no control over their eye muscle. There are several assistive and augmentative (AAC) technology along with EEG based BCI which can be used be by the patients in LIS for communication but once they are in CLIS they do not have any means of communication. Hence, there was a need to find an alternative learning paradigm and probably another neuroimaging technique to design a more effective BCI to help ALS patient in CLIS with communication.
12 Feb Imatinib Revolutionizes Treatment of Unresectable/Metastatic GI Stromal Tumors
MedicalResearch.com Interview with: [caption id="attachment_31946" align="alignleft" width="96"]
Dr. Michael Heinrich[/caption]
Michael C. Heinrich, MD
Professor of Medicine and Cell and Developmental Biology
Oregon Health & Sciences University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior to 2000, there were no effective medical treatments for advanced GI stromal tumor and patients faced an average life expectancy of 18 months or less. In our study of the long-term treatment results using imatinib (Gleevec), we found that approximately 7% of patients were still on front-line therapy at 10 years without any evidence of tumor progression. More importantly, the estimated 10 year survival was 23%. Progression-free and overall survival rates were significantly higher for patients with KIT exon 11-mutant GIST when compared with patients with KIT exon 9-mutant or “wild-type” GIST (no KIT/PDGFRA mutations).
12 Feb Bisphosphonates Can Be Reduced In Second Year of Breast Cancer Metastases
MedicalResearch.com Interview with: [caption id="attachment_31942" align="alignleft" width="114"]
Dr. Gabriel Hortobagyi[/caption]
Gabriel N. Hortobagyi, MD, FACP, FASCO
Professor, Department of Breast Medical Oncology
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, TX 77230-1439
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Bisphosphonates have been commercially available for several decades as supportive care for patients with bone metastases. They reduce the frequency and severity of bone-related complications. While the optimal dose and short-term scheduling of zoledronic acid (and previously, pamidronate) have been determined, there has been no research to determine how long these drugs need to be maintained nor the optimal dose and schedule beyond the first year of therapy. These questions are particularly important for this family of drugs, since they are incorporated into bone and not excreted from the body for many years.
We set out to determine whether a reduction in the frequency of administration of zoledronic acid (every 12 weeks) was able to maintain the therapeutic efficacy of this intervention when compared to the “standard” schedule of administration (every 4 weeks). It was a prospective, randomized, non-inferiority trial that recruited patients with metastatic breast cancer with bone metastases and who had previously received 9 or more doses of zoledronic acid or pamidronate. The primary endpoint was the proportion of patients with one or more skeletal-related events. Four hundred and sixteen patients were randomized in a 1:1 ratio. The two groups were comparable at baseline. After the first year of follow-up, there was no statistically significant difference in SRE rate between the two arms, confirming the non-inferiority fo the every-12-week schedule of zoledronic acid.
12 Feb Multiple Treatment Options Now Available for Multiple Sclerosis
Posted at 18:12h
in Author Interviews, Lancet, Multiple Sclerosis, Neurological Disorders, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_31938" align="alignleft" width="147"]
Dr. Tomas Kalincik[/caption]
Tomas Kalincik, MD, PhD, PGCertBiostat
Neurologist and Senior Research Fellow
Melbourne Brain Centre | Department of Medicine | University of Melbourne
Department of Neurology | Royal Melbourne Hospital
Melbourne | Victoria | Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Multiple sclerosis is a disease predominantly of young adults, with the peak of incidence in the 3rd and 4th decades. It is the most common cause of neurological disability in young adults. Only in Australia, 23,000 people are living with MS, with MS representing an annual cost of almost 1 billion $AU to the Australian society. It is a disease that presents with broad range of neurological symptoms and signs, which are typically temporary (these are called relapses) that with time can lead to permanent neurological disability. While there is currently no cure for MS, with appropriate therapy, its symptoms can be controlled and the disability progression slowed down.
12 Feb New Blood Test May Screen For ATTR Cardiac Amyloidosis
MedicalResearch.com Interview with: [caption id="attachment_31832" align="alignleft" width="169"]
Dr. Frederick Ruberg[/caption]
Frederick L. Ruberg, MD
Director, Cardiovascular Medicine Fellowship Training Program
Director, Pilot Grants Program, Boston University Clinical and Translational Science Institute
Director, Advanced Cardiac Imaging Program
Section of Cardiovascular Medicine
Department of Medicine
Department of Radiology
Boston Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: ATTR cardiac amyloidosis is an under-recognized cause of congestive heart failure in older adults that results from the deposition of misfolded TTR protein in the heart. One cause of ATTR cardiac amyloidosis is a genetic abnormality, inherited from an affected patient’s parent, that causes the protein TTR to misfold. The most common genetically inherited cause of ATTR amyloidosis in the US is called Val122Ile (V122I), named for the specific mutation in the TTR gene, that is seen in approximately 3.5% of US African Americans. ATTR cardiac amyloidosis was once an untreatable disease, but now new drugs are in different stages of clinical trial testing. Thus, recognition is important to get patients on the right treatments.
One of the principal reasons why the disease is under-recognized is that doctors don’t have proven and available diagnostic tests that can be applied in the outpatient clinic. This study demonstrated that a new point-of-care diagnostic test, using measurement of a blood protein called retinol binding protein 4 (RBP4) and other standard of care test information, can accurately diagnose ATTR cardiac amyloidosis. We demonstrated the validity of this test in two separate cohorts of patients with proven ATTR cardiac amyloidosis due to the Val122Ile mutation and control patients with heart failure but without amyloidosis.
11 Feb Executive Brain Function Predictive of Success on the Soccer Pitch
Posted at 20:57h
in Author Interviews, Exercise - Fitness, Karolinski Institute, Mental Health Research, PLoS
MedicalResearch.com Interview with:
Torbjörn Vestberg
Licensed Psychologist & Researcher
Department of Clinical Neuroscience, Karolinska Institutet
Stockholm, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The aim of our research is to study the importance of executive functions for successful behaviour. In our first study published in 2012 (Executive Functions Predict the Success of Top-Soccer Players) we showed that the level of elite soccer players’ higher executive functions was in general 2 standard deviations above the normal population. It was the same for both men and women.
Moreover, we also found a strong correlation between the capacities of higher executive functions and the number of goals and assists the player made after two and a half year.
In our new study we were interested in how the situation is at a younger age, from twelve to nineteen years of age. Because of the maturation of the brain, higher executive functions do not reach their full capacity before nineteen years of age.
On basis of this, our question was whether there were other parts of the executive functions that correlated with success in soccer. In this new study, we focused on core executive functions like the working memory, as it reaches its full capacity in the early teens. We found that there was a moderate correlation with the accuracy of the working memory and the number of goals the junior elite players made during a period of two years. When we made a composite measurement of both the demanding working memory and the test for the capacity of the higher executive functions, we found a strong correlation between these results and the number of goals that the players made during the two years of time. When we measured IQ and physical features, like length, we found out that those did not influence the results.
11 Feb Intestinal E. coli Linked to Arthritis in Inflammatory Bowel Disease
Posted at 03:19h
in Author Interviews, Gastrointestinal Disease, Infections, Microbiome, Rheumatology, Science
MedicalResearch.com Interview with:
[caption id="attachment_31926" align="alignleft" width="150"]
Dr. Randy Longman[/caption]
Randy Longman, M.D. / Ph.D.
Assistant Professor of Medicine
Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease
Weill Cornell Medicine
Division of Gastroenterology and Hepatology
Joan and Sanford I. Weill Department of Medicine
Department of Microbiology and Immunology
New York, NY 10021
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Inflammatory bowel disease is not limited to intestinal inflammation. Up to 1/3 of patients with active disease suffer from extra-intestinal manifestations.
The most common extra-intestinal manifestations in IBD is joint inflammation or spondyloarthritis. Peripheral joint spondyloarthritis carries a prevalence of 20% in Crohn’s Disease and 10% in Ulcerative Colitis, predominantly affecting joints of the lower limbs. It has long been suggested that gut bacteria can drive this systemic joint inflammation, but microbial targets have not been characterized.
09 Feb Gene Therapy Restores Hearing Down To A Whisper, in Mice
Posted at 18:35h
in Author Interviews, Brigham & Women's - Harvard, Genetic Research, Hearing Loss, Nature
MedicalResearch.com Interview with:
[caption id="attachment_31894" align="alignleft" width="100"]
Dr. Gwenaelle Geleoc[/caption]
Gwenaelle Geleoc, PhD
Assistant Professor
Department of Otolaryngology
F.M. Kirby Neurobiology Center
Children's Hospital and Harvard Medical School
Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We seek to develop gene therapy to restore auditory and balance function in a mouse model of Usher syndrome. Usher syndrome is a rare genetic disorder which causes deafness, progressive blindness and in some cases balance deficits. We used a novel viral vector developed by Luk Vandenberghe and package gene sequences encoding for Ush1c and applied it to young mice suffering from Usher syndrome. These mice mimic a mutation found in patients of Acadian descent. We assessed recovery of hearing and balance function in young adult mice which had received the treatment. Otherwise deaf and dizzy, we found that the treated mice had recovered hearing down to soft sounds equivalent to a whisper and normal balance function.
09 Feb Cost Effectiveness of Lung Cancer Screening Requires Careful Patient Selection
MedicalResearch.com Interview with: Kevin ten Haaf MSc Scientific researcher, Public Health Erasmus Medical Center Rotterdam MedicalResearch.com: What is the background for this study? Response: Lung cancer screening is currently recommended in the United States, for persons aged 55 through 80 who smoked at least 30 pack-years (the average number of cigarettes smoked per day multiplied by the number of years the person has smoked) and who currently smoke or have quit within the last 15 years. Other countries, such as Canada, are investigating the feasibility of implementing lung cancer screening policies. However, the cost-effectiveness of lung cancer screening in a population-based setting is uncertain. Concerns have been raised on the feasibility of implementing lung cancer screening policies, especially with regards to the potential costs. In this study, the benefits, harms and costs of implementing lung cancer screening in the province of Ontario, Canada were assessed.09 Feb Anti-Cancer Agent May Have Simultaneous Regenerative Properties
MedicalResearch.com Interview with: [caption id="attachment_31860" align="alignleft" width="70"]
Dr. Lum[/caption]
Lawrence Lum, Ph.D.
Associate Professor
Virginia Murchison Linthicum Scholar in Medical Research
UT Southwestern Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Scarring of the adult heart due to excessive fibrotic responses is common after a heart attack, or following radiation therapy for the treatment of certain cancers. We have identified an anti-cancer agent currently in clinical development called WNT-974 that decreases fibrotic responses and improves heart function following myocardial infarction in mice. This unexpected observation was the outcome of a study focused on identifying unwanted adult tissue toxicities associated with this class of chemicals.
08 Feb Is the Benefit of Arthroscopic Meniscus Surgery a Placebo Effect?
MedicalResearch.com Interview with: [caption id="attachment_31841" align="alignleft" width="109"]
Dr. Jonas Thorlund[/caption]
Jonas Bloch Thorlund
Associate Professor (MSc, PhD)
Department of Sports Science and Clinical Biomechanics
Research Unit for Musculoskeletal Function and Physiotherapy
University of Southern Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Arthroscopic partial meniscectomy is a very common knee surgery. Research evidence has seriously questioned the effect of this type of surgery for degenerative meniscal tears in middle-aged and older patients. Most young patients with traumatic meniscal injury (from sports or similar) also undergo this type of surgery. There is a general understanding that young patients with traumatic tears experience larger improvements in patient reported pain, function and quality of life. However, evidence for this presumption is sparse.
08 Feb Bisphenol A May Promote Obesity By Interfering with Leptin Early in Life
MedicalResearch.com Interview with: Alfonso Abizaid PhD Department of Neuroscience Carleton University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bisphenol A (BPA) is a compound considered to be a potential environmental hazard and an endocrine disruptor. We have found an association between exposure to BPA at levels that are considered safe by Health Canada and the EPA early in life, and the development of obesity. In addition, we found that this propensity to develop obesity is due to under development of the hypothalamic projection field of POMC neurons, a set of neurons that regulate satiety and stimulate metabolic rate. In this paper we replicate those findings and also show that this abnormal development is due to BPA altering the secretion of the hormone leptin at critical times where this hormone is important for the post-natal development of these POMC neurons.08 Feb Smokers Who Switch Completely To E-Cigs Reduce Their Exposure to Toxins
Posted at 01:41h
in Annals Internal Medicine, Author Interviews, Smoking, Tobacco, Tobacco Research, Toxin Research
MedicalResearch.com Interview with: Dr Lion Shahab MA (Oxon) MSc MSc PhD CPsychol AFBPsS PGCLTHE Senior Lecturer in Health Psychology Department of Behavioural Science and Health University College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: To date most studies on e-cigs have either looked at the product itself, i.e. analysed...
08 Feb Hospice Services May Be Difficult To Find For Undocumented Immigrants
MedicalResearch.com Interview with: [caption id="attachment_31813" align="alignleft" width="156"]
Dr. Nathan Gray[/caption]
Nathan A. Gray, M.D.
Duke Palliative Care
Durham, NC 27710
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The estimated number of undocumented immigrants living in the United States has been stable in recent years, but lengths of residence in the country are rising. This aging population of undocumented immigrants can expect to face an increasing burden of chronic disease and end-of-life needs, but may experience challenges in obtaining hospice care in the last months of life as many are uninsured and none are eligible for the Medicare Hospice Benefit. While hospice agencies do provide charity care, little is known about hospice agency approaches to caring for undocumented immigrants.
We surveyed a national sample of hospice agencies and found that many hospice agencies do not enroll undocumented immigrants or place restrictions on the number enrolled. More than half of agencies sampled had received requests for enrollment of undocumented immigrants in the past year. Offering unrestricted enrollment was more common among larger, not-for-profit hospices in our sample.
07 Feb A1C May Be Less Accurate Measure of Diabetes in African Americans with Common Sickle Cell Trait
MedicalResearch.com Interview with: Mary E. Lacy, MPH Department of Epidemiology Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hemoglobin A1c (A1C) is a blood test that is used to screen for and monitor diabetes. It measures average blood sugar control over the past 2-3 months. A person with sickle cell trait is a carrier for sickle cell disease but often doesn’t have any clinical symptoms. African Americans are more likely than Whites to have diabetes and are more likely to have sickle cell trait. In this article we examined if A1C can be interpreted in the same way in people with and without sickle cell trait. We found that, despite similar results on other measures of blood sugar control, people with sickle cell trait had lower A1C results than people without sickle cell trait. This means that A1C may underestimate diabetes risk in people with sickle cell trait. We also found that, when using standard A1C cutoffs to screen for disease prevalence, we identified 40% fewer cases of prediabetes and 48% fewer cases of diabetes in individuals with sickle cell trait than in those without sickle cell trait. To me, this finding really underscores the potential clinical impact that the observed underestimation of A1C in those with sickle cell trait could have.07 Feb NSAIDS Have Minimal Effect On Back Pain and Risk GI Side Effects
MedicalResearch.com Interview with: [caption id="attachment_31800" align="alignleft" width="180"]
Dr. Gustavo Machado[/caption]
Dr. Gustavo Machado BPhty (Hons) Cert.MDT
The George Institute for Global Health
Sydney Medical School, University of Sydney
Sydney, New South Wales, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: People with back pain are usually told by their health care practitioners to take analgesic medications to relieve their pain. But our previous research published in the BMJ showed that paracetamol does not have a measurable impact on patient’s symptoms. This resulted in recent changes in guidelines' recommendations. The 2017 National Institute for Health and Care Excellence (NICE) guidelines/UK no longer recommend paracetamol as a stand-alone intervention for back pain.
So now non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as the analgesic of first choice. However, our results show that compared to placebo, commonly used NSAIDs, such as Ibuprofen (e.g. Nurofen) and Diclofenac (e.g. Voltaren), provide only small benefits for people with back pain while increasing the risk of gastrointestinal adverse effects by 2.5 times.
07 Feb Losing Some Weight May Reduce Risk of Endometrial Cancer
MedicalResearch.com Interview with: [caption id="attachment_31782" align="alignleft" width="133"] Dr. Juhua Luo[/caption] Juhua Luo, PhD Associate professor of epidemiology and biostatistics Indiana University School of Public Health MedicalResearch.com: What is the background for this study? Response: We already know obesity increases risk of endometrial cancer. However, information on whether weight loss reduces risk of endometrial cancer is limited. MedicalResearch.com:...
07 Feb Disorder-Specific vs Nonspecific Psychotherapy for Chronic Depression
MedicalResearch.com Interview with: [caption id="attachment_31668" align="alignleft" width="100"]
Dr. Elisabeth Schramm[/caption]
Prof. Dr. phil. Elisabeth Schramm
Klinik für Psychiatrie und Psychotherapie
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Chronic depression is a highly prevalent and disabling disorder. As compared to acute episodically depressed patients, chronic depressives benefit less from psychological and pharmaceutical treatment.
Prior investigations suggest that these patients need longer treatment duration for symptom improvement.
In this randomized clinical trial including 268 adults with early onset chronic depression not taking antidepressant medication, patients treated with a disorder-specific psychological treatment (Cognitive Behavioral Analysis System of Psychotherapy; CBASP) reported significantly less severe depressive symptoms after 20 and 48 weeks as compared to a nonspecific supportive therapy. CBASP patients were also more likely to reach remission and showed significant advantages in global functioning and quality of life.
07 Feb Physically Active Children May Have Reduced Symptoms of Depression
MedicalResearch.com Interview with: Lars Wichstrøm, PhD NTNU Social Reseach, Trondheim, Norway; and Department of Psychology Norwegian University of Science and Technology Trondheim, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has linked physical activity, and particularly moderate to vigorous physical activity to less depression in adolescents and adults, but the potential prospective relationship between physical activity and depression in middle childhood has not yet been identified. The main findings in this study support existing research by showing that physically active children have fewer symptoms of depression two years later compared to less physically active children, but there is no relationship between sedentary behavior and depressive symptoms in middle childhood.07 Feb Can Propranolol Reduce Nicotine Cravings?
MedicalResearch.com Interview with: [caption id="attachment_31790" align="alignleft" width="133"]
Dr. Lin Lu[/caption]
Lin Lu, M.D. Ph.D.
Director/Professor, Institute of Mental Health and Peking University Sixth Hospital
Director/Professor, National Institute on Drug Dependence, Peking University
Beijing China
MedicalResearch.com: What is the background for this study?
Response: Nicotine addiction is the leading preventable cause of mortality, and causes over 6 million deaths each year. One fundamental mechanism that maintain smoking relapse in smokers is the persistence of memories of both nicotine reward and nicotine-associated conditioned stimulus (CS, e.g. ashtray,cigarette lighters, etc.).Preclinical studies suggest that the drug reward memories can be reactivated by nicotine-associated CS undergo an unstable stage, named memory reconsolidation, and that pharmacological or behavioral manipulations that interfere with reconsolidation inhibit subsequent drug relapse.
However, most of the translational studies targeting reconsolidation stages of the drug reward memory have not been successful.One important reason is that when participants were exposed to nicotine-associated CS to induce memory reconsolidation, the pharmacological or behavioral manipulations only interfere with the reconsolidation of memories selectively associated with the reactivated CS, without affecting other CSs.
However, in real life, smoking is associated with multiple CSs that vary across individuals. Thus, a key question is how to interfere with reconsolidation of multiple nicotine-associated memories . In the present study, we introduce a novel memory reconsolidation interference procedure in which we reactivated multiple nicotine reward memories in rats and human smokers by acute exposure to nicotine (the UCS) and then interfered with memory reconsolidation using the noradrenergic blocker propranolol, an FDA-approved drug.
06 Feb Better Means to Reduce Breast Density Needed To Decrease Breast Cancer Risk
MedicalResearch.com Interview with: [caption id="attachment_31761" align="alignleft" width="133"]
Natalie Engmann[/caption]
Natalie Engmann, MSc
PhD Candidate, Epidemiology and Translational Science
Department of Epidemiology & Biostatistics
University of California, San Francisco
MedicalResearch.com: What is the background for this study?
Response: Breast density is well-established as a strong risk factor for breast cancer. Our study looked at what proportion of breast cancer cases in the entire population can be attributed to risk factors routinely collected in clinical practice, including breast density, measured using the clinical Breast Imaging and Reporting Scale (BI-RADS) categories.
06 Feb Severe Clostridium difficile Infections May Be Better Treated With Vancomycin
MedicalResearch.com Interview with: [caption id="attachment_31754" align="alignleft" width="200"]
Dr. Vanessa Stevens[/caption]
Vanessa W. Stevens, PhD
IDEAS 2.0 Center, Veterans Affairs (VA) Salt Lake City Health Care System
Division of Epidemiology, Department of Internal Medicine
University of Utah School of Medicine
Salt Lake City, Utah
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Although metronidazole remains the most commonly used drug to treat Clostridium difficile infection (CDI), there is mounting evidence that vancomycin is a better choice for some patients. Most previous studies have focused on primary clinical cure, but we were interested in downstream outcomes such as disease recurrence and mortality. We found that patients receiving metronidazole and vancomycin had similar rates of recurrence, but patients who were treated with vancomycin had lower risks of all-cause mortality. This was especially true among patients with severe Clostridium difficile.