Medical Research Journals
28 Nov Neuroimaging Detects Chemical Disturbances in Stuttering
MedicalResearch.com Interview with: Joseph O’Neill, PhD Division of Child and Adolescent Psychiatry University of California–Los Angeles Semel Institute for Neuroscience Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Stuttering seriously diminishes quality of life. While many children who stutter eventually grow out of it, stuttering does persist into adulthood in many others, despite treatment. Like earlier investigators, we are using neuroimaging to explore possible brain bases of stuttering, aiming, eventually, to improve prognosis. What's novel is that our study deploy neuroimaging modalities-- arterial spin labelling and, in this paper, magnetic resonance spectroscopy (MRS)-- not previously employed in stuttering. MRS offers prospects of detecting possible neurochemical disturbances in stuttering. The MRS results showed differences in neurometabolite-- brain chemicals-- levels between people who stutter (adults and children) and those who don't in many brain regions where other neuroimaging has also observed effects of stuttering. In particular, MRS effects were apparent in brain circuits where our recent fMRI work detected signs of stuttering, circuits subserving self-regulation of speech production, attention and emotion. This reinforces the idea that stuttering has to do with how the brain manages its own activity along multiple dimensions: motivation, allocation of resources, and behavioral output.27 Nov Estimating Survival in Patients With Lung Cancer and Brain Metastases
MedicalResearch.com Interview with: [caption id="attachment_29726" align="alignleft" width="180"]
Dr. Paul W. Sperduto[/caption]
Paul W. Sperduto, MD, MPP, FASTRO
Minneapolis Radiation Oncology
University of Minnesota Gamma Knife Center, Minneapolis, Minnesota
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Analysis of past randomized clinical trials involving patients with brain metastases, an extremely heterogeneous population, suggested that the stratification tools of the past were inadequate to ensure those trials were comparing similar patients which made the results of those trials difficult to interpret or misleading.
So, in 2008, a new prognostic index, the Graded Prognostic Assessment (GPA) was designed and published to more accurately predict survival. In 2010, the GPA was refined when we learned survival and the factors that predict survival varied by diagnosis (i.e. lung, breast, melanoma, kidney cancer patients with brain metastases had different survival). Now we have learned survival also varies by gene mutations and the diagnosis-specific GPA for lung cancer is further refined in this article with this new information, specifically EGFR and ALK gene alterations. 27 co-authors from 12 academic medical centers contributed patients to this database which represents the largest study of lung cancer patients with brain metastases ever reported.
27 Nov Association Between Statin Use and Ischemic Stroke or Hemorrhage in Patients Taking Dabigatran for A Fib
MedicalResearch.com Interview with: [caption id="attachment_29867" align="alignleft" width="200"]
Dr. Tony Antoniou[/caption]
Dr. Tony Antoniou, PhD Research Scholar
Department of Family and Community Medicine and a Scientist
Keenan Research Centre of the Li Ka Shing Knowledge Institute
St. Michael's Hospital
Assistant Professor in the Department of Family and Community Medicine and
Leslie Dan Faculty of Pharmacy
University of Toronto, Toronto, Ontario
MedicalResearch.com: What is the background for this study?
What are the main findings?
Response: Dabigatran etexilate is an anticoagulant that is commonly used for stroke prevention in patients with atrial fibrillation. Absorption of dabigatran etexilate is opposed by intestinal P-glycoprotein, an efflux transporter. Once absorbed, dabigatran etexilate is converted to its active form by carboxylesterase enzymes. Unlike other statins, simvastatin and lovastatin can inhibit P-glycoprotein and carboxylesterase. This may result in increased absorption of dabigatran etexilate, thereby increasing the risk of bleeding. Conversely, inhibition of carboxylesterase may decrease the effectiveness of dabigatran etexilate.
27 Nov STEMI Outcomes Improve For Both Genders, But More So For Men
Posted at 01:13h
in AHA Journals, Author Interviews, Gender Differences, Heart Disease, Surgical Research
MedicalResearch.com Interview with:
Dr. Stefano Savonitto
Director, Division of Cardiology
Manzoni Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the last 15 years, there has been a shift from fibrinolytic therapy for STEMI to primary angioplasty, which required a re-organization of the whole STEMI treatment network. Besides the higher reperfusion efficiency of primary angioplasty, as compared to lytic therapy, it has been a global upgrade of the STEMI care system that has reduced the rate of no reperfusion.
Elderly patients and women (who are, on average, also older than men) had theoretically the most to gain from this shift, but little data were available to assess this benefit.
In the present paper, we have shown that “lack of reperfusion” was reduced dramatically across all age groups and in both sexes, with a progressive and uniform increase in primary angioplasty, and a significant reduction in mortality. Almost as expected, elderly women were the category with the most relevant mortality benefit.
Nevertheless, after adjustment for age and other confounders, women continue to experience a higher mortality as compared to men. In the discussion of the paper, we propose some hypotheses for this persistently higher mortality in women.
25 Nov Some Saturated Fatty Acids Linked To Risk of Coronary Artery Disease
MedicalResearch.com Interview with: [caption id="attachment_29966" align="alignleft" width="190"]
Dr. Qi Sun[/caption]
Dr. Qi Sun Sc.D, M.D., M.M.S.
Assistant Professor in the Department of Nutrition
Harvard T.H. Chan School of Public Heath
Boston
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Interpretation of existing human study data regarding saturated fat intake in relation to heart disease risk is quite confusing and distorted in certain publications. It is a fact that, depending on data analysis strategies, the effects of saturated fats may depend on which macronutrients they replace. For example, substituting saturated fats for refined carbohydrates will not lead to an elevated risk of heart disease because both nutrients are harmful whereas replacing saturated fats with good polyunsaturated fats results in risk reduction. In our current analysis, we clearly demonstrated that when total saturated fatty acids were replaced by polyunsaturated fatty acids, monounsaturated fatty acids, whole grain carbohydrates, and plant-based proteins, the diabetes risk would decrease.
Furthermore, we showed that major individual saturated fatty acids were all associated with an elevated heart disease risk.
25 Nov Inflammatory Biomarkers Found Linked to Risk of Mortality
MedicalResearch.com Interview with: Archana Singh-Manoux, PhD Research Professor (Directeur de Recherche) Epidemiology of ageing & age-related diseases INSERM,France MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent metabolomics study examined 106 biomarkers and found alpha-1-acid glycoprotein (AGP), an acute phase protein, to be the strongest predictor of five-year mortality. It is also unknown how well AGP compares with other sensitive, dynamic, and commonly measured markers of systemic inflammation, such as CRP and IL-6, as a predictor of mortality. We examined the association of these three inflammatory markers with short- and long-term mortality in a large sample of middle-aged adults, followed for 17 years. Our analysis of all-cause, cancer and cardiovascular mortality suggests that for all these outcomes IL-6 may be a better prognostic marker, both in the short and the long-term.24 Nov Penn Takes First Step in Development of Antibodies to HIV and Cure
MedicalResearch.com Interview with: [caption id="attachment_29950" align="alignleft" width="148"]
Dr. Katharine J Bar[/caption]
Katharine J Bar, MD
Assistant Professor of Medicine
Attending Physician, Infectious Diseases, Hospital of the University of Pennsylvania
Physician, International Travel Medicine, Perelman Center for Advanced Medicine
Director, Penn CFAR Viral and Molecular Core
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The passive administration of monoclonal antibodies has revolutionized many fields of medicine. Anti-HIV monoclonal antibodies are being explored as components of novel therapeutic and curative strategies, as they can both neutralize free virus and kill virus-infected cells. We sought to determine whether passive administration of an anti-HIV monoclonal antibody, VRC01, to chronically HIV-infected individuals on antiretroviral medications (ART) would be safe and well tolerated and could delay virus rebound after discontinuation of their ART.
22 Nov Cardiac Stress Testing Increases Modestly in Commercially Insured Patients
MedicalResearch.com Interview with: [caption id="attachment_29970" align="alignleft" width="200"]
Dr. Vinay Kini[/caption]
Vinay Kini, MD, MS
Division of Cardiovascular Medicine
Hospital of the University of Pennsylvania
The Leonard Davis Institute of Health Economics
University of Pennsylvania
Philadelphia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recent studies have shown that use of cardiac stress tests has declined by about 25% among Medicare beneficiaries and by about 50% in Kaiser Permanente over the last several years. However, the reasons for these declines is not well understood. Decreases in the use of stress testing could be due to dissemination of appropriate use criteria and other clinical practice guidelines, advances in preventive care, reductions in reimbursement for testing, or other health system organizational characteristics.
Therefore, our goal was to determine whether similar declines in testing are observed among a nationally representative cohort of commercially insured patients. We identified over 2 million stress tests performed among 33 million members of the commercial insurance company, and found that there was a 3% increase in the overall use of stress testing in this cohort between 2005 and 2012. Declines in the use of nuclear SPECT tests were offset by increases in the use of stress echocardiography, exercise electrocardiography, and newer stress test modalities such as coronary computed tomography angiography.
The largest increase in use of testing was seen among younger individuals - there was a 60% increase in use of testing among patients aged 25-34, and a 30% increase among individuals aged 35-44.
22 Nov Involved Fathers Have Positive Impact on Pre-Adolescent Children
MedicalResearch.com Interview with: [caption id="attachment_29918" align="alignleft" width="200"]
Dr. Charles Opondo[/caption]
Charles Opondo, BPharm MSc PhD.
Researcher in Statistics and Epidemiology
National Perinatal Epidemiology Unit
Nuffield Department of Population Health
University of Oxford
Oxford
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study measured fathers’ involvement in their child’s upbringing in infancy by looking at their emotional response to their child (e.g. feeling confident with the child, making a strong bond with the child), how involved they were in childcare (e.g. changing nappies, playing, night feeding, and also general care tasks around the house such as meal preparation) and their feelings of being a secure in their role as a parent (e.g. feeling included by mother in childcare, not feeling inexperienced with children).
We found that the children of fathers who scored highly in terms of their emotional response and feeling like a secure parent were less likely to have symptoms of behavioural problems when they were 9 or 11 years.
However, fathers being more involved in direct childcare did not seem to affect the child’s risk of having later behavioural problems.
22 Nov Squamous Cell Carcinoma of Lip Predominantly Affects White Men in Their Mid-60s
MedicalResearch.com Interview with: [caption id="attachment_29923" align="alignleft" width="200"]
Dr. Albert Han[/caption]
Albert Yoon-Kyu Han, PhD
Class of 2017
Medical Scientist Training Program
David Geffen School of Medicine at UCLA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC.
The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.
22 Nov More Surgeries, Fewer Deaths From Abdominal Aortic Aneurysms in US than UK
MedicalResearch.com Interview with: [caption id="attachment_29912" align="alignleft" width="200"]
Dr. Alan Karthikesalingam[/caption]
Alan Karthikesalingam MD PhD, NIHR
Academic Clinical Lecturer in Vascular Surgery
St George's Vascular Institute
London, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study was that the typical diameter at abdominal aortic aneurysm (AAA) repair, and the population incidence of AAA repair, have been known to vary considerably between different countries. This study aimed to observe whether a discrepancy in the population incidence rate of AAA repair between England and the USA was seen alongside a discrepancy in population rates of AAA-related mortality or AAA rupture in those countries.
22 Nov ADHD: Heritability of Structural and Functional Brain Connectivity in Families
MedicalResearch.com Interview with: [caption id="attachment_29904" align="alignleft" width="200"]
Dr. Gustavo Sudre[/caption]
Gustavo Sudre, PhD
Section on Neurobehavioral Clinical Research, Social and Behavioral Research Branch
National Human Genome Research Institute
Bethesda, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: ADHD is the most common childhood neuropsychiatric disorder, affecting 7-9% of school age children. It is highly heritable (h2=0.7), but few risk genes have been identified. In this study, we aimed to provide quantitative brain-based phenotypes to accelerate gene discovery and understanding.
ADHD is increasingly viewed as resulting from anomalies of the brain’s connectome. The connectome is comprised of the structural connectome (white matter tracts joining different brain regions) and the functional connectome (networks of synchronized functional activity supporting cognition). Here, we identified features of the connectome that are both heritable and associated with ADHD symptoms.
22 Nov Compared To Other Blood Pressure Medications Diuretics Have Bone Protective Effect
Posted at 12:00h
in Author Interviews, Blood Pressure - Hypertension, Bone Density, JAMA, Kaiser Permanente, Osteoporosis, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_29895" align="alignleft" width="200"]
Dr. Joshua I. Barzilay[/caption]
Joshua I. Barzilay, MD
Kaiser Permanente of Georgia
Duluth, GA 30096
MedicalResearch.com: What is the background for this study?
Response: Hypertension (HTN) and osteoporosis (OP) are age-related disorders. Both increase rapidly in prevalence after age 65 years. Prior retrospective, post hoc studies have suggested that thiazide diuretics may decrease the risk of osteoporosis. These studies, by their nature, are open to bias. Moreover, these studies have not examined the effects of other anti HTN medications on osteoporosis.
Here we used a prospective blood pressure study of ~5 years duration to examine the effects of a thiazide diuretic, a calcium channel blocker and an ACE inhibitor on hip and pelvic fractures. We chose these fractures since they are almost always associated with hospitalization and thus their occurrence can be verified.
After the conclusion of the study we added another several years of follow up by querying medicare data sets for hip and pelvic fractures in those participants with medicare coverage after the study conclusion.
21 Nov Deep Brain Stimulation Improves Parkinson’s Symptoms In Some Patients With SPG 11 Mutations
MedicalResearch.com Interview with: [caption id="attachment_29406" align="alignleft" width="120"]
Dr. Adolfo Ramirez Zamora[/caption]
Adolfo Ramirez Zamora, MD
Associate Professor of Neurology and
Phyllis E. Dake Endowed Chair in Movement Disorders
Department of Neurology
Albany Medical College
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Patients with SPG 11 mutations can present with motor symptoms characterized by juvenile onset dystonia, Parkinsonism and lower extremity spasticity. Parkinsonism appears to be responsive to levodopa therapy early in the disease but treatment is complicated by the occurrence of motor fluctuations resembling parkinson disease. Patients have short duration of medication effects, unpredictable response to medications along with generalized, excessive involuntary movements known as dyskinesias.
Deep Brain stimulation is a well-established treatment for movement disorders but it has never been used in this disease. We first report the clinical outcome obtained with globus pallidus internal deep brain stimulation in a patient with parkinsonism, dystonia, dyskinesias related to SPG 11. Additionally, we report for the first time the basal ganglia changes observed in the disease using intraoperative neuronal recordings. Patient had a sustained and remarkable response to stimulation over the next two years without side effects. Neurophysiologic changes revealed a unique pattern of neuronal firing despite of the resemblance to advance Parkinsons disease.
21 Nov New Online Fertility Calculators Predict Chance of IVF Success
MedicalResearch.com Interview with: [caption id="attachment_29707" align="alignleft" width="144"]
Dr. David McLernon[/caption]
David McLernon PhD MPhil BSc
Research Fellow in Medical Statistics
Medical Statistics Team
Institute of Applied Health Sciences
University of Aberdeen
Foresterhill Aberdeen
MedicalResearch.com: What is the background for this study?
Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.
21 Nov USPSTF Updates Recommendation of Statins for Prevention of Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_29860" align="alignleft" width="200"]
Dr. Doug Owens[/caption]
Dr. Doug Owens MD
former USPSTF Task Force member
Professor at Stanford University
Henry J. Kaiser, Jr. Professor
Director of the Center for Health Policy
Freeman Spogli Institute for International Studies
Center for Primary Care and Outcomes Research
Department of Medicine and School of Medicine
Stanford
MedicalResearch.com: What is the background for review and statement?
Response: Cardiovascular disease is serious—it can lead to heart attacks and strokes, and is responsible for one in every three adult deaths in the U.S. People with no signs or symptoms and no past history of cardiovascular disease can still be at risk. Fortunately, some people can benefit from taking a medication called statins to reduce that risk.
20 Nov Autism: Timely Access to Behavioral Intervention Decreases Overall Costs
MedicalResearch.com Interview with: [caption id="attachment_29602" align="alignleft" width="193"]
Dr. Melanie Penner[/caption]
Dr. Melanie Penner, MD FRCP (C)
Clinician investigator and developmental pediatrician
Holland Bloorview Kids Rehabilitation Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Studies have shown that accessing intensive behavioral intervention (IBI) services at younger ages is associated with improved outcomes for children with autism spectrum disorder (ASD). In Ontario, Canada, children wait years to access publicly-funded IBI. This analysis estimated costs and projected adult independence for three IBI wait time scenarios: the current wait time, a wait time reduced by half, and an eliminated wait time. The model inputs came from published literature.
The main findings showed that eliminating the wait time generated the most independence and cost the least amount of money to both the government and society. With no wait time for intensive behavioral intervention, the government would save $53,000 (2015 Canadian dollars per person) with autism spectrum disorder over their lifetime, and society would save $267,000 (2015 Canadian dollars).
20 Nov Menopausal Hormone Therapy Benefits Bone Health For Several Years After Discontinuation
Posted at 13:03h
in Author Interviews, Endocrinology, Hormone Therapy, JCEM, Menopause, Osteoporosis
MedicalResearch.com Interview with:
[caption id="attachment_29927" align="alignleft" width="131"]
Dr Georgios Papadakis[/caption]
Dr Georgios Papadakis
FMH, Médecin InternenMédecin assistant
Service d'endocrinologie, diabétologie et métabolisme
Lausanne
MedicalResearch.com: What is the background for this study?
Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal.
We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture.
20 Nov Breast Cancer Cells Become Chemotherapy Resistant By Eating Surrounding Stem Cells
MedicalResearch.com Interview with: [caption id="attachment_29824" align="alignleft" width="144"]
Dr. Thomas Bartosh Jr,[/caption]
Thomas Bartosh Jr, Ph.D.
Assistant Professor Medical Physiology
Texas A&M Health Science Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One mysterious and devastating aspect of breast cancer is that it can reemerge abruptly, often as metastatic disease, in patients many years after an apparent eradication of the primary tumor. The sudden reappearance of cancer has been termed relapse and is thought to occur because a minimal number of resilient tumor cells are able to evade frontline therapies and linger in an undetectable/dormant state somewhere in the body for an unpredictable amount of time. Then, for reasons that remain unclear, these same dormant cells awaken and rapidly grow, and produce almost invariably fatal cancerous lesions. The therapeutic challenges of tumor dormancy and need to decode the underlying mechanisms involved are apparent.
Cancer cell behavior is strongly influenced by various non-malignant cell types that are found within the tumor mass itself and that help make up the tumor microenvironment (TME). In particular, bone marrow-derived mesenchymal stem/stromal cells (MSCs), which are actively recruited into the tumor stroma, directly interact with carcinoma cells and significantly impact cancer progression, although the role of MSCs in tumor dormancy remains ill-defined.
19 Nov Auditory Perceptual Abnormalities As High Risk Indictor of Progression to Psychosis
MedicalResearch.com Interview with: Guillermo Horga, MD, PhD Assistant Professor of Clinical Psychiatry Columbia University Medical Center MedicalResearch.com: What is the background for this study? Response: Some people who eventually develop schizophrenia or other psychotic disorders have early “prodromal” symptoms such as subtle perceptual abnormalities and unusual thoughts that precede the onset of these disorders by months or even years. These subtle symptoms are typically not fully formed or met with full conviction, which distinguishes them from full-blown symptoms of psychosis. The “prodromal” phase has been the subject of intense study as researchers believe it can provide an invaluable window into the neurobiological processes that cause psychotic disorders as well as an opportunity to develop early preventive interventions. Persons who experience “prodromal” symptoms (known as “clinical high-risk” individuals) tend to report a variety of relatively subtle perceptual abnormalities (e.g., heightened sensitivity to sounds, distortions in how objects are perceived, momentarily hearing voices of speakers who are not present), unusual thoughts, and disorganized speech, some of which have been shown to be particularly informative in distinguishing who among these persons will eventually develop a full-blown psychotic disorder, a prediction that is clinically important as it may indicate the need for close monitoring of individuals who are at the greatest risk. Even though subtle perceptual abnormalities are common in this population, the available research indicates that they are as a whole uninformative for clinical prediction purposes. However, previous research in this area had never examined in detail whether assessing perceptual abnormalities in different sensory domains (such as visual versus auditory abnormalities) separately could be more informative than assessing them as a whole.19 Nov Hypoglycemia Linked To Increased Mortality in Hospitalized Patients
Posted at 20:30h
in Author Interviews, Critical Care - Intensive Care - ICUs, Diabetes, JCEM, Outcomes & Safety
MedicalResearch.com Interview with:
Amit Akirov, MD
Institute of Endocrinology
Rabin Medical Center- Beilinson Hospital
Petach Tikva, Israel
MedicalResearch.com: What is the background for this study?
Response: As hypoglycemia is common among hospitalized patients with and without diabetes mellitus, we aimed to investigate the association between spontaneous and insulin-related hypoglycemia including severe hypoglycemia and all-cause mortality among a large cohort of hospitalized patients.
19 Nov Brain-Computer Interface Allows Locked-in ALS Patient To Communicate
MedicalResearch.com Interview with: Mariska Van Steensel PhD Nick F. Ramsey, Ph.D. Department of Neurology and Neurosurgery Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients who are severely paralyzed due to for example ALS or brain stem stroke are often unable to speak (also called ‘ Locked-in State'), and therefore need assistive devices, such as an eye tracker, for their communication. When these devices fail (e.g. due to environmental lighting or eye movement problems), people may indicate yes or no with eye blinks in response to closed questions. This leaves patients in a highly dependent position, since questions asked may or may not represent their actual wish or comment. In the current study, we used a technology called brain-computer interfacing (BCI), to allow a patient with late-stage amyotrophic lateral sclerosis (ALS) to control a communication device using her brain signals. The patient was implanted with subdural electrodes that covered the brain area that is normally responsible for hand movement. The electrodes were connected with wires, subcutaneously, to an amplifier/transmitter device that was placed subcutaneously under the clavicle. The patient was able to generate a signal equivalent to a mouse-click with this brain-computer interface by attempting to move her hand, and used it to make selections of letters or words on her communication device, with high accuracy and a speed of 2 letters per minute. She used the brain-computer interface system to communicate whenever she was outside, as her eye-tracker device does not function well in that situation.19 Nov Benefits and Harms of Duloxetine For Treatment of Stress Urinary Incontinence
MedicalResearch.com Interview with: Emma Maund, MSc PhD Nordic Cochrane Centre MedicalResearch.com: What is the background for this study? Response: Duloxetine has been approved in Europe for the treatment of stress urinary incontinence in women. It is not approved for this indication in the US and Canada. Currently, reasons why marketing authorization applications are withdrawn or denied are not published by either the Canadian or the US drug agency. However, the FDA has said that a higher-than-expected rate of suicide attempts - 2.6 timer higher - was observed in the open-label extensions of controlled trials of duloxetine for stress urinary incontinence. Given the FDA’s statement about the rate of suicide attempts, we wanted to determine whether duloxetine increased the risk of suicidality, violence or their possible precursors (drug induced akathisia, an extreme type of restlessness; activation, which consists of stimulating effects such as insomnia, anxiety and agitation; emotional disturbance, such as depersonalization and derealization; or psychotic events, such as delusions and hallucinations) in the randomized phases of the trials. We therefore assessed the benefits and harms of duloxetine in stress urinary incontinence using clinical study reports, including individual patient data, of the 4 main trials submitted by Eli Lilly to the European Medicines Agency.19 Nov Precise Structure of Cannabis Brain Receptor Defined
MedicalResearch.com Interview with: [caption id="attachment_29787" align="alignleft" width="300"]
(l-r) Dr. Zhenhua Shao and Dr. Daniel Rosenbaum UT Southwestern[/caption]
Dan Rosenbaum, Ph.D.
Principal Investigator
Department of Biophysics
The University of Texas Southwestern Medical Center
Dallas, Texas
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study focuses on the structure of the human CB1 cannabinoid receptor.
The CB1 protein is a membrane-embedded G protein-coupled receptor (GPCR) in the brain and peripheral tissues that responds to a variety of different compounds, including endogenous lipid messengers (‘endocannabinoids’), plant natural products (such as THC from the Cannabis sativa plant i.e. marijuana), and synthetic antagonists (such as the taranabant ligand used for this study). The CB1 receptor is involved in regulating neurotransmission in vertebrates, and is a potential therapeutic target for numerous conditions including obesity, pain, and epilepsy.
The main findings of this study entailed the solution of the high-resolution crystal structure of human CB1 receptor bound to the inhibitor taranabant. This structure revealed the precise shape of the inhibitor binding pocket, which is also responsible for binding THC and endocannabinoids. In addition to helping explain the mechanism of inhibitor and THC binding, our structure provides a framework for computational studies of binding to a large diversity of cannabinoid modulators of therapeutic importance.
19 Nov Gender-Specific Risk Factors for Stroke Outlined
MedicalResearch.com Interview with: [caption id="attachment_29782" align="alignleft" width="180"]
Dr. Catharina J. M. Klijn[/caption]
Catharina J. M. Klijn, MD
Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery
University Medical Center Utrecht, Utrecht
Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience
Department of Neurology
Radboud University Nijmegen Medical Centre
Nijmegen, the Netherlands
MedicalResearch.com: What is the background for this study?
Response: The incidence of stroke is higher in men than in women. This difference attenuates with increasing age. Established risk factors for stroke, such as hypertension, cigarette smoking and ischemic heart disease are more prevalent in men but only partly explain the difference in stroke incidence. The contribution of oral contraceptive use and hormone therapy to stroke risk has been previously reviewed. We aimed to evaluate what is known on other female- and male specific risk factors for ischemic and hemorrhagic stroke incidence and stroke mortality through a systematic review and meta-analysis of 78 studies including over 10 million participants.
18 Nov Acute Kidney Injury Linked To Increased Mortality in Critically Ill Children and Young Adults
Posted at 22:36h
in Author Interviews, Critical Care - Intensive Care - ICUs, Kidney Disease, NEJM, Pediatrics
MedicalResearch.com Interview with:
[caption id="attachment_29776" align="alignleft" width="133"]
Dr. Stuart L. Goldstein[/caption]
Stuart L. Goldstein, MD, FAAP, FNKF
Clark D. West Endowed Chair
Professor of Pediatrics
University of Cincinnati College of Medicine
Director, Center for Acute Care Nephrology | Associate Director, Division of Nephrology
Medical Director, Pheresis Service | Co-Medical Director, Heart Institute Research Core
Division of Nephrology and Hypertension | The Heart Institute
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH 45229
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This was a prospective international multi-center assessment of the epidemiology of acute kidney injury in children in young adults. Over 5,000 children were enrolled from 32 pediatric ICUs in 9 countries on 4 continents.
The main findings are:
1) Severe AKI, defined by either Stage 2 or 3 KDIGO serum creatinine and urine output criteria carried an incremental risk of death after adjusting for 16 co-variates.
2) Patients with AKI by low urine output would have been misclassified as not having AKI by serum creatinine criteria and patients with AKI by urine output criteria have worse outcomes than patients with AKI by creatinine crtieria.
3) Severe AKI was also associated with increased and prolonged mechanical ventilation use, increased receipt of dialysis or ECMO
17 Nov Fully Magnetized HeartMate 3 LVAD Eliminates Pump Clots
Posted at 21:28h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, NEJM, Surgical Research
MedicalResearch.com Interview with:
Mandeep R. Mehra, MD, FACC, FESC, FHFSA, FRCP
Medical Director, Brigham and Women’s Hospital Heart and Vascular Center
Executive Director, Center for Advanced Heart Disease
Professor of Medicine, Harvard Medical School
Editor in Chief, The Journal of Heart and Lung Transplantation
Brigham and Women's Hospital
Boston, MA
MedicalResearch.com: What is the background for this study?
Response: 10% of patients with heart failure and a reduced ejection fraction transition into Advanced Stages of disease where they become unresponsive to life prolonging traditional medications. Such patients typically require intravenous inotropic therapy to preserve cardiac function but most remain profoundly limited in their quality of life. In such cases a heart transplant is desirable but this is an option for only a few patients.
Left Ventricular Assist Devices (LVADs) have become the mainstay for treating such patients either while they await a transplant or as a permanent option. However, there are challenges leading to infections, strokes, bleeding and most importantly pump malfunction due to thrombosis of the LVAD itself. The HeartMate 3 LVAD is a centrifugal pump that is designed to overcome the problem of pump thrombosis by virtue of 3 engineering attributes:
(a) A frictionless rotor that is based on a fully magnetically levitated platform
(b) wide blood flow passages that reduce red cell destruction and
(c) an artificial intrinsic pulse that prevents stasis of blood within the pump.
16 Nov Coronary Artery Calcium Found in 1/3 Women Designated “Low-Risk’
MedicalResearch.com Interview with: [caption id="attachment_29717" align="alignleft" width="180"]
Dr. Maryam Kavousi[/caption]
Maryam Kavousi MD, PhD, FESC
Assistant Professor
Department of Epidemiology
Erasmus University Medical Center
Rotterdam The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The most recent American College of Cardiology/American Heart Association (ACC/AHA) cardiovascular disease (CVD) prevention guidelines recommend statins for a larger proportion of populations.
Notably, a large group of women are categorized as low CVD risk by the guidelines and would therefore not typically qualify for intensive management of their standard risk factors. Coronary artery calcium (CAC) scanning allows for the detection of subclinical coronary atherosclerosis and is viewed as the vessel’s memory of lifetime exposure to risk factors. We therefore aimed to address the utility of CAC as a potential tool for refining CVD risk assessment in asymptomatic women at low CVD risk based on the new guidelines.
This study involved data on 6,739 low-risk women from 5 population-based cohort studies across the United States and Europe. We found that CAC was present in 36% of low-risk women and was associated with increased risk of CVD.
16 Nov Substituting Less Well Trained Assistants For Nurses Increased Hospital Mortality
Posted at 20:41h
in Author Interviews, BMJ, Cost of Health Care, Nursing, Outcomes & Safety, University of Pennsylvania
MedicalResearch.com Interview with:
[caption id="attachment_29710" align="alignleft" width="200"]
Dr Linda H Aiken[/caption]
Dr Linda H Aiken PhD, FAAN, FRCN, RN
Claire M. Fagin Leadership Professor in Nursing
Professor of Sociology, School of Arts & Sciences
Director, Center for Health Outcomes and Policy Research
University of Pennsylvania School of Nursing
Center for Health Outcomes and Policy Research
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study?
Response: The idea that adding lower skilled and lower wage caregivers to hospitals instead of increasing the number of professional nurses could save money without adversely affecting care outcomes is intuitively appealing to mangers and policymakers but evidence is lacking on whether this strategy is safe or saves money.