Medical Research Journals
27 Sep Ischemic Stroke Treatment Must Be Given Early To Be Effective
MedicalResearch.com Interview with: [caption id="attachment_28297" align="alignleft" width="133"]
Dr. Michael Hill[/caption]
Dr. Michael Hill, MSc, MD, FRCPC
Professor for the Departments of Clinical Neurosciences, Community Health Sciences, Medicine and Radiology University of Calgary
Director of the Stroke Unit
Calgary Stroke Program
Alberta Health Services
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The HERMES collaboration is a pooled individual patient meta-analysis of recent endovascular ischemic stroke trials. The current analysis assesses the role of time to treatment and outcome.
We show that there is a clear relationship between time from onset-to-treatment and outcome, with treatment gradually becoming less effective as time elapses from stroke onset. Treatment was still effect, on average, out to just beyond 7 hours from stroke onset.
27 Sep Isolated Cleft Palate, But Not Cleft Lip, Linked to Increased Health Risks
MedicalResearch.com Interview with: Erik Berg, MD Department of Global Public Health and Primary Care University of Bergen Bergen, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents regularly express concern about long term health outcomes for children born with oral cleft. In this study we used population-based long-term follow-up data from multiple national registries to focus on the future health outcomes of cleft cases without additional chronic medical conditions or congenital anomalies. The study cohort consisted of all individuals born in Norway between 1967 and 1992. All patients treated for clefts in Norway during the study period were invited to participate. 2 337 cases with isolated clefts and 1 413 819 unaffected individuals were followed until 2010. The main outcome variables were conditions diagnosed in childhood or early adulthood, need for social security benefits, and risk of death.27 Sep Study Supports Routine Colon Cancer Screening Through Age 75, With Individualized Decisions Afterwards
Posted at 19:48h
in Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Geriatrics
MedicalResearch.com Interview with:
[caption id="attachment_28323" align="alignleft" width="124"]
Dr. Xabier Garcia-De-Albeniz[/caption]
Xabier Garcia-De-Albeniz MD PhD
Research Associate
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Mongan Institute for Health Policy
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: Randomized controlled trials are considered the gold standard to inform health care delivery. Unfortunately, no randomized controlled trials of screening colonoscopy have been completed. Ongoing trials exclude persons aged 75 or older, and will not have mature results before 2025. However, healthy persons older than 75 may live long enough to benefit from colorectal cancer (CRC) screening. The Medicare program reimburses screening colonoscopy without an upper age limit since the year 2001. We used the extensive experience of Medicare beneficiaries to evaluate the effectiveness and safety of screening colonoscopy.
27 Sep C-section carries a 4-fold increased risk of blood clots, compared with vaginal deliveries
Posted at 11:23h
in Author Interviews, Blood Clots, CHEST, OBGYNE, Surgical Research, Thromboembolism
MedicalResearch.com Interview with:
Marc Blondon, MD
Division of Angiology and Hemostasis, Department of Specialties of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Venous thromboembolism, a condition including deep vein thrombosis (blood clots) and pulmonary embolism, is more common in older than younger patients. However, pregnancy and particularly the postpartum period are times at greater risk of blood clots in women. It is important to understand the risk and the risk factors for thrombosis in the postpartum period to guide the use of preventive measures such as heparin, an anticoagulant treatment, or leg compression devices.
Our study summarizes the evidence on the link between C-sections and blood clots from the past 35 years.
Our meta-analysis demonstrates that:
- C-section carries a 4-fold increased risk of blood clots in the postpartum period, compared with vaginal deliveries ;
- that this risk is most prominent but not restricted to emergency C-section ;
- and that women who undergo elective C-section are also at higher risk than women who have a vaginal delivery.
- Importantly, we estimated an absolute risk of blood clots after a C-section of 2-4 per 1000 pregnancies: on average, 3 out of 1000 women after C-section will develop a blood clot.
26 Sep Depressive disorders are the most frequent neuropsychiatric complication of TBI
Posted at 22:41h
in Author Interviews, Baylor College of Medicine Houston, Brain Injury, Depression, JAMA
MedicalResearch.com Interview with:
[caption id="attachment_27935" align="alignleft" width="200"]
Dr. Ricardo Jorge[/caption]
Ricardo E. Jorge MD
Professor of Psychiatry and Behavioral Sciences
Director Houston Translational Research Center for TBI and Stress Disorders
Senior Scientist Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry
Michael E DeBakey VA Medical Center
Baylor College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Depressive disorders affect between one-third and one-half of patients with traumatic brain injury. Once established, these disorders are difficult to treat and frequently follow a chronic and refractory course.
Depression has a deleterious effect on TBI outcomes, particularly affecting the community reintegration of TBI patients.
In this randomized clinical trial that included 94 adult patients with TBI, the hazards for developing depression for participants receiving placebo were about 4 times the hazards of participants receiving sertraline treatment.
26 Sep Is Muscle Memory a Myth?
MedicalResearch.com Interview with: [caption id="attachment_28165" align="alignleft" width="200"]
Dr. Maléne Lindholm[/caption]
Maléne Lindholm, PhD
Karolinska Institutet
Dept. of Physiology & Pharmacology
Stockholm Sweden
MedicalResearch.com: What is the background for this study?
Response: It is well known that exercise training provides marked health benefits and can prevent and treat a broad set of diseases. Therefore, a deeper understanding and characterization of the molecular processes behind training adaptation is essential for human health.
This study aimed at exploring the effects of endurance training on the human skeletal muscle transcriptome (activity of all genes) and investigate the possible presence of a muscle memory of training. To do this, the healthy volunteers in this study first trained only one leg, 4 times per week for 3 months. After 9 months of detraining, the subjects then came back and trained both legs in the same way as during the first training period, thus one leg was then previously well-trained and one previously untrained. This meant that each individual was their own control, as both legs have the same genome, experience the same stress, diet etc. Only the training status differed.
26 Sep Immunity to the Acellular Whooping Cough Vaccine Wanes With Time
MedicalResearch.com Interview with: Dr. Kevin Schwartz, MD MSc Infection Prevention and Control Physician Infection Prevention and Control Public Health Ontario | Santé publique Ontario MedicalResearch.com: What is the background for this study? Response: There has been a resurgence of pertussis, or ‘whooping cough’, in several countries and regions since the introduction of the new “acellular” pertussis vaccine in the 1990s to replace the older “whole cell” vaccine. In Ontario, we have not seen large increases but observed a small outbreak in 2012 that affected both unvaccinated people, as well as in those who have been vaccinated against pertussis. Our objective was to evaluate the effectiveness of the current acellular vaccine used in Ontario. We wanted to find out whether immunity wanes with time in the same way as had been previously observed during a large outbreak in California. We also wanted to study the impact of receiving the older ‘whole cell’ vaccine, which we used in Ontario until 1997.26 Sep Nausea and Vomiting During Pregnancy May Signal Less Risk of Pregnancy Loss
MedicalResearch.com Interview with: Stefanie N. Hinkle, Ph.D. Staff Scientist | Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thank you for the interest in our research. Nausea and vomiting are very common early in pregnancy and these symptoms can be difficult for women. Before we began this study there was very limited high-quality data on the implications of these difficult symptoms in pregnancy. Our study is unique because we asked women to report their symptoms continuously throughout their pregnancy before they may or may not have gone on to have a loss. We found that among women with 1 or 2 prior pregnancy losses, women who have nausea, and particularly nausea with vomiting, were less likely to have a pregnancy loss.26 Sep Parkinson’s Disease Linked To Increase in Number of Inflammatory Markers
MedicalResearch.com Interview with: [caption id="attachment_28339" align="alignleft" width="200"]
Dr. Yong Cheng[/caption]
Yong Cheng, PhD, post-doc fellow
Section on Cellular Neurobiology
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
Bethesda, Maryland
MedicalResearch.com: What is the background for this study?
Response: Parkinson’s disease is the second most neurodegenerative disease after Alzheimer’s disease. The symptoms of the disease are typically movement related. However, the nonmotor features in PD are increasingly recognized. Evidence suggests that inflammation may play a role in the development of AD, and a substantial number of studies have demonstrated altered levels of peripheral blood inflammatory cytokines in patients with Parkinson’s disease, but findings have been inconsistent for individual cytokines and between studies. Therefore, we undertook a systematic review of the scientific literature, using a meta-analysis to quantitatively summarize clinical data on blood cytokine levels in patients with PD, compared with healthy controls.
23 Sep Scaffold Can Potentially Deliver Therapeutic miRNA To Decrease Breast Cancer Metastases
Posted at 21:41h
in Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Nature, Technology
MedicalResearch.com Interview with:
[caption id="attachment_28309" align="alignleft" width="157"]
Dr. Natalie Artzi[/caption]
Natalie Artzi PhD
principal research scientist
MIT's Institute for Medical Engineering and Science and
Assistant professor of medicine
Brigham and Women's Hospital
With co-authors:
Avital Gilam, João Conde, Daphna Weissglas-Volkov, Nuria Oliva, Eitan Friedman, Noam Shomron
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Metastases are the primary cause for mortality in breast cancer, the most common cancer in women regardless of ethnicity. Recent studies show that germline sequence variants, such as single-nucleotide polymorphisms (SNPs) in miRNA-binding sites, can disrupt the downregulation by miRNAs, with a profound effect on gene expression levels and consequentially on the phenotype, including increased risk for cancer.
In the current study, we aimed to determine the potential effect of SNPs within miRNA-binding sites on metastatic breast cancer progression and their potential use as suppression targets to prevent metastasis.
Our collaborators at Tel-Aviv Universityin a research led by Dr. Noam Shomron found that the SNP, rs1071738, located in a target site for miR-96 and miR-182 on the 3’-UTR of the PALLD gene, encodes the Palladin actin-associated protein, which is a documented player in breast cancer motility. In vitro experiments revealed a functional downregulation of Palladin levels by miR-96 and miR-182, which subsequently reduces migration and invasion abilities of breast cancer cells.
My lab then showed in an in vivo experiment that the use of nanoparticles embedded in a hydrogel scaffold as a miRNA delivery vehicle enables an efficient and specific delivery of miR-96/miR-182 directly to breast tumours, which results in marked reduction of breast cancer metastasis. We then proceeded to study the effect of combination therapy in which we will use a chemotherapy drug to shrink the primary tumor and the miRNAs to prevent metastasis. The intercalation of a chemotherapy drug, cisplatin, to the miR-conjugated nanoparticles further improved the effect, leading to significant reduction in both primary tumour growth and metastasis.
Our study highlights the therapeutic potential of miRNAs, and specifically miR-96 and miR-182, and support the importance of Palladin regulation in breast cancer metastasis.
23 Sep Chronic Subthreshold Cortical Stimulation to Treat Resistant Focal Epilepsy.
MedicalResearch.com Interview with: [caption id="attachment_28300" align="alignleft" width="180"]
Dr. Brian Lundstrom[/caption]
Brian Nils Lundstrom, MD, PhD
Department of Neurology
Mayo Clinic
Rochester, Minnesota
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: About as many people have drug-resistant focal epilepsy as have multiple sclerosis, and treatment options are limited.
This study describes an alternative treatment option that has proven very helpful for the majority of participants. Electrical stimulation is delivered continuously via implanted electrodes to the region of brain where seizures start. The electrical stimulation decreases the seizure-related discharges from the brain, and for about 40% of patients their disabling seizures were completely stopped.
23 Sep Non–TNF-Targeted Biologic Found Superior to Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug
MedicalResearch.com Interview with:
Jacques-Eric Gottenberg, MD, PhD
Department of Rheumatology
National Reference Center for Systemic Autoimmune Diseases
Strasbourg University Hospital, Université de Strasbourg
Strasbourg, France
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is no recommendation for the choice of the second biologic in patients with rheumatoid arthritis and insufficient response to a first anti-TNF, which is a common situation in our daily practice (approximately one third of patients treated with anti-TNF). We therefore conducted the first randomized trial to date to investigate the best strategy in such a setting.
23 Sep Genetic Ancestry using Mitochondrial DNA in patients with Triple-Negative Breast Cancer
MedicalResearch.com Interview with: [caption id="attachment_28272" align="alignleft" width="96"]
Dr. Roshni Rao[/caption]
Roshni Rao, M.D
Breast Surgery
University of Texas Southwestern
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Triple negative breast cancer (TNBC) is characterized by not having estrogen, progesterone, or Her2Neu receptors. Although a less common type, it is aggressive, and leads to a disproportionate number of deaths from breast cancer.
TNBC is more common in young, African American women, but can be found in other ethnic groups as well.
This study performed mitochondrial DNA (mtDNA) analysis, to evaluate for patient genetic ancestry, in 92 patients with TNBC. In regards to self-identified ethnicity, there were 31 African-Americans, 31 Whites, and 30 Hispanics. Utilizing mtDNA, 13% of patients had discordance between self identified ethnicity and mtDNA analysis. Discordance was highest in the Hispanic group. The Hispanic patients were also much younger at initial age of diagnosis, and less likely to have a family history of breast cancer. Ancestry from Nigeria, Cameroon, or Sierre Leone were most common in the African-Americans with triple negative breast cancer.
22 Sep Genetic Determinants of Cisplatin Resistance in Patients With Advanced Germ Cell Tumors
MedicalResearch.com Interview with: [caption id="attachment_28253" align="alignleft" width="200"]
Dr. Darren Feldman[/caption]
Darren R. Feldman, MD
Medical Oncologist
Memorial Sloan Kettering Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is limited knowledge as to why a minority of patients with advanced germ cell tumors are resistant to chemotherapy while the majority achieve complete responses. Patients with cisplatin-resistant disease require intensive salvage treatment and are at high risk of dying from their disease. We sought to determine whether certain genomic alterations within tumors might be associated with cisplatin-resistance in GCT. We also wanted to identify the spectrum of genomic alterations in this population which might represent novel targets for existing or new drug development in this disease.
22 Sep Chronic Kidney Disease in Primary Care: Outcomes after Five Years in a Prospective Cohort Study
MedicalResearch.com Interview with: Dr. Adam Shardlow Derby Teaching Hospitals NHS Foundation Trust UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chronic Kidney Disease (CKD) is common in the general population, and many people are managed in primary care rather than by specialist nephrologists. This study was designed to investigate 5 year outcomes in people with mild to moderate CKD (CKD stage 3). The main findings were that the majority of participants were stable, and progression to end stage renal disease was a rarity. Interestingly, and contrary to common thinking about CKD, we found that a significant minority no longer had evidence of CKD stage 3 at 5 years, which we have termed ‘CKD remission’.21 Sep Bidirectional Link Between Depression and Risk of Gestational Diabetes
MedicalResearch.com Interview with: [caption id="attachment_28228" align="alignleft" width="158"]
Dr. Cuilin Zhang[/caption]
Cuilin Zhang MD, PhD
Senior Investigator
NICHD, National Institutes of Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pregnant women are at high risk of developing depressive symptoms; at least 10% US women suffering from depression during pregnancy. Gestational diabetes is a common pregnancy complication, affecting 4-7% of pregnancies in the U.S.. Gestational diabetes has adverse health implications on both women and their children. Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes and depression during pregnancy and the postpartum period is less understood.
21 Sep Fewer Physicians Than Anticipated Treat Opioid Use Disorder With Buprenorphine
MedicalResearch.com Interview with: [caption id="attachment_28220" align="alignleft" width="130"]
Dr. Bradley Stein[/caption]
Bradley D. Stein, MD, MPH, PhD
RAND Corporation
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The United States is in the midst of a serious opioid abuse epidemic and we know that medically assisted treatment is one of the best ways to help people with addiction to opioids. The drug buprenorphine has advantages over methadone, the historic medical treatment, because it can be prescribed by physicians in the community who receive a waiver allowing them to prescribe it after undergoing eight hours of training.. Methadone is dispensed at special clinics that many people with opioid addition may be unable to get to with the frequency required by effective treatment.
To better understand patterns of the use of buprenorphine, we examined treatment patterns in the states with the most buprenorphine-waivered physicians (California, Florida, Massachusetts, Michigan, New York, Pennsylvania and Texas). Our data came from a prescription records that account for over 80 percent of the retail pharmacies in the nation. We examined use patterns among 3,200 physicians who treated 250,000 patients.
We had two surprising findings:
First, the median length of treatment with buprenorphine was 53 days, which is much shorter than the duration that most individuals are likely to need for optimal results. Second, despite concerns that federal limits on the number of patients and waivered physician can treat being a significant barrier for many individuals obtaining treatment, we found that most physicians were treating far fewer patients than would be allowed by the patient limits. In fact, 22 percent of the physicians treated an average of 3 patients per month and just 9 percent treated 75 or more patients per month.
21 Sep Romosozumab Has Potential To Reduce New Vertebral Fractures at 12 Months
MedicalResearch.com Interview with: [caption id="attachment_28216" align="alignleft" width="118"]
Dr. Felicia Cosman[/caption]
Felicia Cosman, M.D.
Medical Director of the Clinical Research Center
Helen Hayes Hospital
Professor of Medicine
Columbia University College of Physician and Surgeons
New York
Editor-in-Chief, Osteoporosis International
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Amgen and UCB presented detailed data from the Phase 3 FRAME study in an oral session at ASBMR 2016, and the data were also published in the New England Journal of Medicine. Additionally, the FRAME abstract has been awarded the 2016 ASBMR Most Outstanding Clinical Abstract Award. The FRAME data show significant reductions in both new vertebral and clinical fractures in postmenopausal women with osteoporosis.
Patients receiving a monthly subcutaneous 210 mg dose of romosozumab experienced a statistically significant 73 percent reduction in the relative risk of a vertebral (spine) fracture through 12 months, the co-primary endpoint, compared to those receiving placebo (fracture incidence 0.5 percent vs. 1.8 percent, respectively [p<0.001]). By six months, new vertebral fractures occurred in 14 romosozumab and 26 placebo patients; between six to 12 months, fractures occurred in two versus 33 additional patients in each group, respectively.
Patients receiving romosozumab experienced a statistically significant 36 percent reduction in the relative risk of a clinical fracture, a secondary endpoint, through 12 months compared to those receiving placebo (fracture incidence 1.6 percent vs. 2.5 percent, respectively [p=0.008]).
In patients who received romosozumab in year one, fracture risk reduction continued through month 24 after both groups transitioned to denosumab treatment through the second year of the study: there was a statistically significant 75 percent reduction in the risk of vertebral fracture at month 24 (the other co-primary endpoint) in patients who received romosozumab followed by denosumab vs. placebo followed by denosumab (fracture incidence 0.6 percent vs. 2.5 percent, respectively [p<0.001]).
Clinical fractures encompass all symptomatic fractures (both non-vertebral and painful vertebral fractures; all clinical fractures assessed in the FRAME study were symptomatic fragility fractures. A 33 percent reduction in relative risk of clinical fracture was observed through 24 months after patients transitioned from romosozumab to denosumab compared to patients transitioning from placebo to denosumab (nominal p=0.002, adjusted p=0.096).
21 Sep Cures of Multidrug Resistant Tuberculosis Probably Underestimated Under Current WHO Guidelines
MedicalResearch.com Interview with: Dr. Heinke Kunst, M.D. Queen Mary University Hospital, London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multidrug resistant tuberculosis (MDR-TB) has been on the increase worldwide over the past decade. Many patients who have been identified with MDR-TB live in the European region. Despite treatment with expensive second-line drug regimens, curing MDR TB remains a challenge and cure rates were thought to be very low. As part of the EU Commission funded TB-PANNET project 380 patients with MDR-TB were observed at 23 TB centers in countries of high, intermediate and low TB burden in Europe over a period of 5 years. Observation started from the time of diagnosis and lasted until one year after the end of the treatment. The TBNET proposed new definitions for “cure” and “failure” of MDR-TB treatment based on the sputum culture status at 6 month after the initiation of therapy and whether patients were free from disease recurrence one year after the end of therapy. The researchers found that the WHO criterion for “cure” could not be applied in the majority of patients, simply because most patients who were being treated successfully were not able to produce sputum after 8 months of therapy. The TB-PANNET study showed much higher cure rates using a new definition of cure and failure of treatment for MDR TB in the European region. (61% cure rates compared to only 31% when using WHO criteria.) The study also demonstrates that the results for “cure” from MDR-TB correlate very well with the level of drug resistance and the time to culture conversion that means the time when TB bacilli are no longer detectable in sputum. The new definitions are also independent of the total duration of treatment and can be applied to the standard 20 months MDR-TB regimen as well as to the 9-12 months shorter course MDR-TB treatment that was recently proposed by the WHO.21 Sep Sertraline May Prevent Depression Following Traumatic Brain Injury
Posted at 20:42h
in Author Interviews, Baylor College of Medicine Houston, Brain Injury, Depression, JAMA
MedicalResearch.com Interview with:
[caption id="attachment_28208" align="alignleft" width="200"]
Dr. Ricardo Jorge[/caption]
Ricardo E. Jorge MD
Professor of Psychiatry and Behavioral Sciences
Director Houston Translational Research Center for TBI and Stress Disorders
Senior Scientist Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry
Michael E DeBakey VA Medical Center
Baylor College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Depressive disorders affect between one-third and one-half of patients with traumatic brain injury (TBI). Once established, these disorders are difficult to treat and frequently follow a chronic and refractory course.
Depression has a deleterious effect on TBI outcomes, particularly affecting the community reintegration of TBI patients. In this randomized clinical trial that included 94 adult patients with TBI, the hazards for developing depression for participants receiving placebo were about 4 times the hazards of participants receiving sertraline treatment.
21 Sep Collaborative Care is Effective and Cost-Effective For Adolescent Depression
MedicalResearch.com Interview with: [caption id="attachment_28010" align="alignleft" width="173"]
Dr. Laura Richardson[/caption]
Laura P. Richardson, MD, MPH
Interim Chief | Division of Adolescent Medicine
Director | UW Leadership Education in Adolescent Health (LEAH) Program
Professor | UW Department of Pediatrics
Seattle Children's | University of Washington
MedicalResearch.com: What is the background for this study?
Response: Adolescent depression is one of the most common mental health conditions during adolescence. Up to one in five adolescents experience an episode of major depression by age 18. Depressed youth are at greater risk of suicide, dropping out of school and poor long-term health. Treatments, including medications and psychotherapy, have been proven to be effective but most depressed teens don’t receive any treatment.
Two years ago, we showed that the Reaching Out to Adolescents in Distress (ROAD) collaborative care model (a.k.a. Reach Out 4 Teens) designed to increase support and the delivery of evidence-based treatments in primary care was effective in treating depression in teens, significantly improving outcomes. We ran a randomized clinical trial at nine of Group Health’s primary care clinics and reported effectiveness results in JAMA.
The current paper represents the next step in this work, examining the cost-effectiveness of collaborative care for adolescent depression in our intervention sample of 101 adolescents with depression, ages 13-17 years.
21 Sep Reporting of Adverse Events in Published and Unpublished Studies of Health Care Interventions May Differ
MedicalResearch.com Interview with: [caption id="attachment_28026" align="alignleft" width="107"]
Dr. Su Golder[/caption]
Dr Su Golder PhD
Research Fellow
Department of Health Sciences
University of York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Serious concerns have emerged regarding publication bias or selective omission of outcomes data, whereby negative results are less likely to be published than positive results. There remains considerable uncertainty about the extent of unpublished data on adverse events beyond that reported in the published literature. We aimed to estimate the potential impact of additional data sources and the extent of unpublished information when conducting syntheses of adverse events.
We found that less published papers contain adverse events information. The median percentage of published documents with adverse events information was 46% compared to 95% in the corresponding unpublished documents. There was a similar pattern with unmatched studies, for which 43% of published studies contained adverse events information compared to 83% of unpublished studies.
We also found even when adverse events are reported in the published and unpublished versions of the same study that the numbers of adverse events do not always match The percentage of adverse events that would have been missed had each analysis relied only on the published versions varied between 43% and 100%, with a median of 64%.
Lastly we found that inclusion of unpublished data increased the precision of the pooled estimates (narrower 95% confidence intervals) in three-quarters of pooled analyses, but did not markedly change the direction or statistical significance of the risk in most cases.
21 Sep Quality Performance Measures Should Include Hypoglycemia Assessments
MedicalResearch.com Interview with: [caption id="attachment_28018" align="alignleft" width="166"]
Dr. Victor Montori[/caption]
Victor M. Montori, MD MSc
Knowledge and Evaluation Research Unit in Endocrinology
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What is the background for this study?
Response: Hypoglycemia can acutely disrupt patients’ lives through symptoms ranging from bothersome to life-threatening; worsen quality of life; and hinder medication adherence and glycemic control. Hypoglycemia is now known to increase risk of mortality, cognitive impairment, and cardiovascular events. In order to improve the quality of diabetes care, healthcare organizations use publicly reported performance measures for quality measurement and improvement, and pay-for-performance initiatives. The degree to which existing performance measures are aligned with guidelines, particularly in regard to hypoglycemia avoidance, is uncertain.
21 Sep Early Introduction May Reduce Peanut and Egg, But Not Gluten, Allergies in Children
MedicalResearch.com Interview with: [caption id="attachment_28127" align="alignleft" width="200"]
Dr. Robert Boyle[/caption]
Dr Robert Boyle
Senior lecturer in paediatric allergy
honorary consultant, Paediatric allergist
Imperial College Healthcare NHS Trust
MedicalResearch.com: What is the background for this study? What are the main findings?
Editors' note: Please discuss food introduction with your child's pediatrician before embarking on any new foods.
Response: Food allergy is a common problem which may be getting more common.
We have known for over 100 years that feeding egg to animals such as guinea pigs can prevent egg allergy. However randomised trials of allergenic food introduction for preventing food allergy in human infants have not been done until the past 5 years, and have so far yielded mixed results. One trial for peanut allergy was positive, with less peanut allergy in infants who were fed the food from early in life compared with infants who avoided it for 5 years. Other trials have yielded null findings, but may have been too small to yield a conclusive result. We used a technique called meta-analysis to combine the results of all previous trials of timing of allergenic food introduction and risk of food allergy. We also evaluated other allergic and autoimmune diseases.
Our analysis yielded conclusive results for both egg and peanut – that early introduction of these foods into an infant’s diet might reduce their risk of egg and peanut allergy by around 40-70%. We were surprised to see null findings in our meta-analysis of timing of gluten or wheat introduction and risk of coeliac disease (gluten intolerance) which is a different type of allergy to egg and peanut allergy. This suggests that early introduction of allergenic foods does not reduce risk of all types of food allergy.
21 Sep Combination of Restrictions and Incentives May Lead To Better Food Choices By SNAP Beneficiaries
MedicalResearch.com Interview with: [caption id="attachment_28068" align="alignleft" width="133"]
Dr. Lisa Harnack[/caption]
Lisa Harnack, DrPH, RD | Professor and Director
Nutrition Coordinating Center
Division of Epidemiology and Community Health
School of Public Health, University of Minnesota
Minneapolis, MN 55454-1087
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is interest in considering ways to reshape SNAP so that it better meets meet its objective to help families buy the food they need for good health. Prohibiting the purchase of foods such as soft drinks with SNAP benefits is one of the proposed program changes. Offering an incentive for the purchase of fruits and vegetables is another program change that is being discussed.
Little is known about the effects of prohibitions and restrictions on food purchasing and consumption. Consequently, we carried out an experimental trial to evaluate effects.
In our study we found that a food benefit program that includes both prohibitions on the purchase of less nutritious foods and incentives for purchasing nutritious foods may lead to a number of favorable changes in diet.
To elaborate, we found those enrolled in a food benefit program that prohibited the purchase of sugar sweetened beverages, sweet bakes goods, and candies with food program benefits and provided a 30% financial incentive for fruit and vegetable purchases had a number of favorable dietary changes that were significantly different from changes among those enrolled in a food benefit program that had neither prohibitions or incentives. These favorable changes included reduced consumption of calories, sugar sweetened beverages, sweet baked goods, and candies; and increased consumption of fruit. The overall nutritional quality of the diet also improved.
Fewer nutritional improvements were observed among those enrolled in food benefit programs that included prohibitions or incentives only.
21 Sep BDNF Is Potential Biomarker For Autism Spectrum Disorder
MedicalResearch.com Interview with: [caption id="attachment_28240" align="alignleft" width="150"]
Dr. Yong Cheng[/caption]
Dr. Yong Cheng, PhD
Postdoctoral Fellow
NIH
MedicalResearch.com: What is the background for this study?
Response: Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which affect about 1 in 68 children in the United States, according to data from the Centers for Disease Control and Prevention. Brain-derived neurotrophic factor (BDNF) is an important moderator in neurodevelopment and neuroplasticity, and studies have suggested the involvement of BDNF in ASD. Although some clinical studies show abnormal expression of BDNF in children with ASD, findings have been inconsistent. Therefore, we undertook a systematic review of the scientific literature, using a meta-analysis to quantitatively summarize clinical data on blood BDNF levels in children with ASD, compared with healthy peers.
21 Sep Intestinal Microbiome Linked to Obesity and Fat Storage in Children
MedicalResearch.com Interview with: [caption id="attachment_28185" align="alignleft" width="133"]
Dr. Nicola Santoro[/caption]
Nicola Santoro, MD, PhD
Associate Research Scientist in Pediatrics (Endocrinology)
Yale University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The study start from previous observations showing an association between the gut microbiota and obesity.
Similarly to what previously described in adults and in children, we found an association between the gut microbiota and obesity. We took a step further and also observed that the gut flora is associated to body fat partitioning (amount of fat in the abdomen). Moreover, we observed that the effect of microbiota could be mediated by the short chain fatty acids a product of gut flora.
21 Sep High SPF Sunscreen Use Linked To Lower Risk of Melanoma
MedicalResearch.com Interview with: [caption id="attachment_28154" align="alignleft" width="150"]
Dr. Reza Ghiasvand[/caption]
Reza Ghiasvand, PhD
Postdoctoral fellow,
Department of Biostatistics,
Faculty of Medicine,
University of Oslo.
Oslo, Norway
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To date, findings from studies have been inconsistent. Some studies found a decreased risk of melanoma among sunscreen users, while others found no association or a higher risk of melanoma among sunscreen users. Several studies found that many sunscreen users do not apply sunscreens properly and do not reapply as recommended and stay longer in the sun after using sunscreen and as a result get sunburn and increase their risk of skin cancer.
Our findings suggest higher UV exposure among sunscreen users compared to nonusers. However, those who used sunscreen with high SPF had 33% lower risk of melanoma compared to users of low SPF sunscreens.