Understanding How Energy Drinks Plus Alcohol May Increase Risky Behavior

MedicalResearch.com Interview with:
“Energy drink” by joelklal is licensed under CC BY 2.0Barbara D. Fontana

Laboratory of Experimental Neuropsychobiology,
Department of Biochemistry and Molecular Biology
Natural and Exact Sciences Center
Graduate Program in Biological Sciences
Toxicological Biochemistry, Federal University of Santa Maria,
Santa Maria, Brazil 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Our research group has been working with taurine and alcohol association for a long time. The background for this study is around increased consumption of molecules present in energy drinks frequently used as mixers for alcoholic beverages. Taurine is one of the most abundant molecules found in energetic drinks and has a neuromodulatory role in brain. In this context, we explore the effects of taurine associated to alcohol. Thus, as result we observed that this association exacerbate risky choices and reduces social cohesion in zebrafish, having a negative impact in social and fear-related behavior.

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Pregabalin Linked To Increased Risk for Opioid-Related Deaths

MedicalResearch.com Interview with:

Tara Gomes, MHSc Li Ka Shing Knowledge Institute, St Michael’s Hospital, The Institute for Clinical Evaluative Sciences Leslie Dan Faculty of Pharmacy Department of Health Policy, Management, and Evaluation University of Toronto, Toronto, Ontario, Canada

Tara Gomes

Tara Gomes, MHSc
Li Ka Shing Knowledge Institute, St Michael’s Hospital,
The Institute for Clinical Evaluative Sciences
Leslie Dan Faculty of Pharmacy
Department of Health Policy, Management, and Evaluation
University of Toronto, Toronto, Ontario, Canada 

MedicalResearch.com: What is the background for this study?

Response: Pregabalin is a medication increasingly being prescribed to manage pain, however there is emerging evidence that this drug may increase one’s risk of opioid overdose when prescribed with opioids.

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Digitization of Pathology Specimens Allows for Improved Workflow and Incorporation of Advanced Techniques

MedicalResearch.com Interview with:|
Dr. Wendy L. Frankel, MD. Kurtz Chair and Distinguished Professor and
Dr. Anil Parwani, MD, PhD, MBA, Associate Professor
Wexner Medical Center
The Ohio State University

MedicalResearch.com: What is the background for this work? How does digital pathology differ from traditional H/E specimens?  Is there is different processing method?  Difference in prep time or costs?

Response: Traditional pathology involves patient tissue coming to the lab and being processed. The end result is a glass slide with a stained tissue that pathologists use under a microscope. The process in digital pathology is the same, up until the point right after when the glass slide is made. In digital pathology, we put the glass slide under a scanner instead of under a microscope. The scanner creates a large file image that can be reviewed remotely by pathologists around the world.

The advantage of digital pathology, and the reason we are doing this at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), is because when the slide is digitized, the image can be rapidly shared with an expert for review, or another institute that the patient may be going to. In addition, I can look at the image and ask the computer to quantitate different types of features that are present in the sample. While this has historically been done manually with a microscope, it’s been a more subjective process that is open to human error.

On top of that, we now have computer programs that allow us to ask very specific questions about the sample. For example, we can ask how many nuclei are in the field, how many of the nuclei show signs of cancer, and the size and color of the nucleus. These programs make the whole diagnostic process more objective and standardized. This is something we just can’t do by looking at a glass slide under a microscope.

Finally, you can also use these images for presentations at clinical conferences or for teaching residents, fellows or other pathologists. You now have the means to create an archive of patient slides and have it instantaneously available.

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Complex Racial and Ethnic Disparities in Childhood Cancer Survival

MedicalResearch.com Interview with:
Rebecca D. Kehm, PhD
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, MN  

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer.

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Clinical Chemistry Score Helps Rule Out Diagnosis of Heart Attack

MedicalResearch.com Interview with:

Peter Kavsak, PhD, FCACB, FAACC, FCCS Professor, Pathology and Molecular Medicine McMaster University 

Prof.. Kavsak

Peter Kavsak, PhD, FCACB, FAACC, FCCS
Professor, Pathology and Molecular Medicine
McMaster University 

MedicalResearch.com: What is the background for this study?

Response: For patients who present to the hospital with symptoms suggestive of acute coronary syndrome (ACS) the preferred blood test to help physicians in making a diagnosis is cardiac troponin.

Recent studies have demonstrated that a very low or undetectable cardiac troponin level when measured with the newest generation of blood tests (i.e., the high-sensitivity cardiac troponin tests) in this population may rule-out myocardial infarction (MI or a heart attack) on the initial blood sample collected in the emergency department, thus enabling a faster decision and foregoing the need for subsequent serial measurements of cardiac troponin over several hours as recommended by the guidelines. The problem with this approach, however, is that using high-sensitivity cardiac troponin alone to do this has not reliably been demonstrated to achieve a sensitivity >99% for detecting MI, which is the estimate that most physicians in this setting consider as safe for discharge.

Our study goal was to compare the diagnostic performance of a simple laboratory algorithm using common blood tests (i.e., a clinical chemistry score (CCS) consisting of glucose, estimated glomerular filtration rate (eGFR), and either high-sensitivity cardiac troponin I or T) to high-sensitivity cardiac troponin alone for predicting MI or death within the first month following the initial blood work. Continue reading

FDA Approves Poteligeo® (mogamulizumab-kpkc) for T-Cell Lymphoma of the Skin

MedicalResearch.com Interview with:

Jeffrey S. Humphrey, MD President of Kyowa Kirin Pharmaceutical Development, Inc

Dr. Humphrey

Jeffrey S. Humphrey, MD
President of Kyowa Kirin Pharmaceutical Development, Inc

MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by Mycosis Fungoides and Sézary Syndrome?

Response: Kyowya Kirin has received FDA approval for Poteligeo (mogamulizumab), based on findings from the MAVORIC trial. Mogamulizumab is a humanized immunoglobulin G1 (IgG1) monoclonal antibody (mAb) that targets CC chemokine receptor 4 (CCR4), for the treatment of the most common subtypes of cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF) and Sézary syndrome (SS).

MF and SS may have a profound and severe impact on quality of life, including a patient’s functional, emotional and social well-being, as symptoms may include a scaly red rash or light or dark patches in areas of the body that are not usually exposed to the sun; thin, reddened, eczema-like rash; thickened scaly, red skin (or plaques) or psoriasis-like rash; more advanced disease can include tumors (with significant thickness) on the skin, which may develop ulcers and become infected. Because CTCL manifests in skin lesions, it is often mistaken for other skin conditions (early stage MF and SS can be diagnosed as other skin conditions), which can delay conclusive diagnosis and treatment options.

MF is the most common subtype of CTCL, affecting 50-70% of individuals. In most patients diagnosed with early stage MF, the skin involvement does not progress, but in some patients, it will slowly progress. SS accounts for approximately 3% of CTCL cases and is a more aggressive, leukemic form of CTCL, affecting the blood, skin, lymph nodes and visceral organs

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Kidney Cancer: Biomarker Linked to Detection and Progression

MedicalResearch.com Interview with:

Dr. David Muller, PhD  Faculty of Medicine, School of Public Health Research Fellow in Epidemiology and Biostatistics Imperial College London

Dr. Muller

Dr. David C. Muller PhD
Faculty of Medicine, School of Public Health
Research Fellow in Epidemiology and Biostatistics
Imperial College, London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our colleagues in the U.S. have been working on KIM-1 for years, particularly in the context of chronic kidney disease. Recently they found that KIM-1 is also elevated at the time of diagnosis of kidney cancer.

We wanted to see if KIM-1 concentrations could predict the chances of a future diagnosis of kidney cancer. We found that KIM-1 was a strong predictor of being diagnosis with kidney cancer in the next 5 years. We also found that higher pre-diagnostic KIM-1 was associated with worse survival after diagnosis.  Continue reading

Why Are So Many Modern Men Single?

MedicalResearch.com Interview with:
“3-men-laughing” by desthal is licensed under CC BY-NC-ND 3.0Menelaos Apostolou  PhD
University of Nicosia
Cyprus

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In this study I analyzed 6794 responses from a recent Reddit thread on why men were single, and I classified them in 43 reason categories.

Among the most frequent reasons that men indicated for being single included poor flirting skills, low self-confidence, poor looks, shyness, low effort, and bad experience from previous relationships.

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Diabetes: Microvascular Complications Markedly Decreased After Bariatric Surgery

MedicalResearch.com Interview with:

David Arterburn, MD, MPH Kaiser Permanente Washington Health Research Institute Seattle, WA 

Dr. Arterburn

David Arterburn, MD, MPH
Kaiser Permanente Washington Health Research Institute
Seattle, WA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: More than 9 percent of adult Americans—about 30 million people—are estimated to have type 2 diabetes, according to the American Diabetes Association. The disease tends to worsen over time, with blood sugar levels rising along with the risks of developing large blood vessel (macrovascular) complications like heart attack and stroke, as well as small blood vessel (microvascular) complications affecting the nerves of the feet and hands (neuropathy), kidneys (nephropathy), and eyes (retinopathy).

Among more than 4000 patients who underwent bariatric surgery, the 5-year incidence of microvascular disease — including neuropathy, nephropathy, and retinopathy — was nearly 60% lower than that of 11,000 matched nonsurgical control patients receiving usual diabetes care.  Continue reading

Brain Imaging Reveals How Prolonged Intermittent Cannabis Can Induce Memory Deficits

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Ana Maria Sebastião, PhD
Professor of Pharmacology and Neurosciences
Director Institute of Pharmacology and Neurosciences, Faculty of Medicine and
Francisco Mouro, PhD
Unit of Neurosciences, Institute of Molecular Medicine
University of Lisbon, Portugal

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is pressing need to comprehend how cannabinoid exposure impacts brain functioning. While cannabinoid-related research has increased exponentially in the last decade, the mechanisms through which cannabinoids affect brain functioning are still elusive. Specifically, we need to know how prolonged cannabinoid exposure affects important cognitive processes, such as memory, and also find the roots of those effects. This is particularly relevant considering that several countries have already approved cannabis-based medicines.

In this sense, our work sheds new light into the mechanisms underlaying the memory-deficits provoked by a continuous exposure to a cannabinoid drug. More precisely, using brain imaging techniques, we found that long-term exposure to a synthetic cannabinoid drug impairs the ability of key brain regions involved in learning and memory to communicate with each other. Our data points to the necessity of considering cannabinoid actions in a broader perspective, including brain circuitry and communication.  Continue reading

Some Pulmonary Embolism Patients Can Be Treated at Home

MedicalResearch.com Interview with:

Joseph Bledsoe MD, FACEP Clinical Assistant Professor of Emergency Medicine Stanford Medicine Director of Research Department of Emergency Medicine Intermountain Medical Center Murray, UT 84157

Dr. Bledsoe

Joseph Bledsoe MD, FACEP
Clinical Assistant Professor of Emergency Medicine
Stanford Medicine
Director of Research
Department of Emergency Medicine
Intermountain Medical Center
Murray, UT 84157

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with blood clots in the lungs (pulmonary embolism) (PE) are routinely admitted to the hospital for blood thinning medications in the United States. However, evidence from other countries has shown that with appropriate risk stratification patients may be safe for outpatient treatment for their PE.

Our study is the largest prospective management study in the US to evaluate home treatment of patients with acute pulmonary embolism. We enrolled 200 patients and after risk stratification with the PE severity index score, leg ultrasounds and echocardiograms performed in the emergency department, patients were treated with blood thinning medications at home with routine outpatient follow up.

During the 90 day follow up period we found only one patient suffered a bleeding event after a traumatic injury, without any cases of recurrent symptomatic blood clots or death.  Continue reading

Single Dose of Ibalizumab Boosts Immunity in Resistant HIV

MedicalResearch.com Interview with:

Brinda Emu, MD Assistant Professor of Medicine (Infectious Diseases) Yale School of Medicine

Dr. Emu

Brinda Emu, MD
Assistant Professor of Medicine (Infectious Diseases)
Yale School of Medicine

MedicalResearch.com: What is the background for this study?

Response: This was a Phase 3 study of a new antiretroviral agent, ibalizumab, for the treatment of HIV-1 infection.  Ibalizumab is a monoclonal antibody that targets the CD4 receptor on host cells.  CD4 is the receptor that HIV uses to infect CD4+ T cells.  By binding to the CD4 receptor, ibalizumab prevents viral entry.  This study recruited patients that harbor multi-drug resistant HIV and were failing their current regimen of antiretroviral agents, and thus had limited options for treatment of their HIV-1 infection using approved medications.

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Who Is More Likely To Be Shot by Police?

MedicalResearch.com Interview with:
“Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0Brianna Mills, PhD
Research Scientist
Harborview Injury Prevention & Research Center
University of Washington

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know that substance use, mental disorders, and arrest are markers of increased risk of firearm injury. However, many studies of firearm injury are limited in scope – looking only at one type of injury (assault-related, for example) and one type of data (often hospital records). Police shootings, although occurring with increasing frequency, have also received relatively less attention in research than other types of firearm injuries.

We combined data from a variety of sources, including both hospital and arrest records, so we could present a more complete picture of firearm injuries in Seattle, including contacts with law enforcement and healthcare in the two years prior to injury. We subdivided substance use, mental disorder, and arrests into more specific categories to present a more nuanced look at how each category may indicate increased risk of a specific type of firearm injury (assault-related, self-inflicted, unintentional, and police intervention).

We found that when you consider both arrest records and hospital records together a distinct pattern of prior contact emerges for people who were shot by police – they have arrest histories similar to people shot during an assault and hospital histories similar to people with self-inflicted firearm injuries. A majority of people shot during an assault or by police were either arrested or hospitalized in the two years prior to their injury. Compared to our control group, people shot by police were 22 times more likely to have a conduct disorder, 11 times more likely to have been diagnosed with a marijuana use disorder, and 7 times more likely to have a felony arrest, psychosis diagnosis, or depression/anxiety diagnosis.  Continue reading

Why Do Patients Seek Cosmetic Procedures?

MedicalResearch.com Interview with:
Murad Alam, MD Vice-Chair and Professor of Dermatology Chief of Cutaneous and Aesthetic Surgery Northwestern University Feinberg School of MedicineMurad Alam, MD
Vice-Chair and Professor of Dermatology
Chief of Cutaneous and Aesthetic Surgery
Northwestern University
Feinberg School of Medicine

MedicalResearch.com: What is the background for this study?

Response: For the purposes of our study, non-invasive procedures included laser and light treatments (for brown spots, blood vessels, wrinkle reduction, scar treatment, hair removal), chemical peels, and non-surgical skin tightening and fat reduction (with radiofrequency energy, cold treatment, or ultrasound).  These noninvasive treatments do not even break the skin, and are applied on top of the skin

Then we have minimally invasive procedures, which include those that just barely break the skin, but are like getting a shot, and don’t require cutting and sewing the skin as in traditional surgery.   These minimally invasive procedures include filler and neuromodulator injections to fill out the sagging aging face while reducing lines and wrinkles, as well as liposuction through tiny openings to suck out excess fat.

In the old days, cosmetic treatments meant getting traditional plastic surgery, like a face lift or tummy tuck.  These required general anesthesia, cutting and sewing the skin, significant risk of scarring, and days to weeks of recovery time.  More recently, dermatologists have pioneered noninvasive and minimally invasive procedures, such as those I just described, which provide many of the same benefits as traditional plastic surgery without the risk, scars, and downtime.   Now these minimally invasive and noninvasive treatments have become more popular than traditional cosmetic surgery.  Continue reading

Who Suffers From Phantom Smells?

MedicalResearch.com Interview with:
“Bad smell” by Brian Fitzgerald is licensed under CC BY 2.0Kathleen Bainbridge, PhD

Epidemiology and Biostatistics Program
NIDCD

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The causes of phantom odor perception are not understood. This study looked for the prevalence and risk factors for this disorder. We found that that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors.

This study, is the first in the U.S. to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey, a continuous survey conducted by the National Center for Health Statistics which is part of the Centers for Disease Control and Prevention. The study could inform future research aiming to unlock the mysteries of phantom odors.

We identified risk factors that may be related to the perception of phantom odors. People are more likely to experience this condition if they are female, and are relatively young—we found a higher prevalence in 40-60 year-olds compared to 60+ year-olds. Other risk factors include head injury, dry mouth, poor overall health, and low socio-economic status. People with lower socio-economic status may have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions.

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Triple Low Dose Combination Pill May Lower Blood Pressure With Fewer Side Effects

MedicalResearch.com Interview with:

Dr Ruth Webster PhD, BMedSc(hons), MBBS(hons), MIPH(hons) Head, Research Programs, Office of the Chief Scientist Senior Lecturer, Faculty of Medicine UNSW Sydney

Dr. Webster

Dr Ruth Webster PhD, BMedSc(hons), MBBS(hons), MIPH(hons)
Head, Research Programs, Office of the Chief Scientist
Senior Lecturer, Faculty of Medicine
UNSW Sydney
The George Institute for Global Health
Australia

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: We know from previous research that 80% of the blood pressure lowering efficacy of any medication occurs in the first half of the dose whilst most side effects occur at higher doses. We also know that most people will require at least 2 blood pressure lowering medications to reach their target blood pressure and that combining multiple pills into one combination medication helps patients take their medication more reliably. There was therefore good evidence to believe that using three half strength doses in one pill would be better than usual care in helping patients to achieve their blood pressure targets.

We showed that, compared with patients receiving usual care, a significantly higher proportion of patients receiving the Triple Pill achieved their target blood pressure of 140/90 or less (with lower targets of 130/80 for patients with diabetes or chronic kidney disease).

It’s estimated more than a billion people globally suffer from high blood pressure with the vast majority having poorly controlled blood pressure. Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.

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How Common is Overdiagnosis of Lung Cancer with Low Dose CT Screening?

MedicalResearch.com Interview with:
“CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD

Assistant Professor | Professor Auxiliar
NOVA Medical School | Faculdade de Ciências Médicas
Universidade Nova da Lisboa 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening.

After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers.

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For Resistant HIV: Phase III Trial of Trogarzo Demonstrates Safety and Efficacy

MedicalResearch.com Interview with:
TaiMed BiologicsStanley Lewis, M.D.

TaiMed Biologics
Irvine, CA 92614


MedicalResearch.com: What is the background for this study?

Response: The phase III clinical trial was conducted to assess the efficacy and safety of Trogarzo™ (ibalizumab-uiyk) injection in patients with multidrug resistant HIV-1. The study design was approved by the FDA. Results obtained were included in the New Drug Application submitted to the FDA which approved Trogarzo™ on March 6, 2018.

The phase III, open-label study, enrolled 40 patients with multidrug-resistant (MDR) HIV-1 in whom multiple antiretroviral therapies had failed. All patients at baseline were experiencing viral failure. After a seven-day control period, patients received an intravenous 2000 mg loading dose of Trogarzo™ which was the only change made to their antiretroviral regimen. Through the 24-week treatment period of the study, patients were given a maintenance dose of 800 mg of Trogarzo™ every two weeks along with an optimized background regimen that included at least one additional fully active agent.

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Unique Oral Microbiome Signature Detected in Children With Autism

MedicalResearch.com Interview with:
quadrant biosciencesSteven D. Hicks, MD PhD
Penn State College of Medicine
Department of Pediatrics
Division of Academic General Pediatrics
Hershey, PA, 17033‐0850

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: ​Previous studies have shown that disrupting the community of bacteria in the gut can lead to autism-like behavior in animals. In humans interventions aimed at improving the intestinal microbiome have also led to changes in autism behavior. Here, we examined whether autism-related changes in microbial activity extended to the mouth and throat. We were interested in this site because it provides the initial interface between host immunity and microbe exposure.

By examining nearly 350 children with autism, typical development, or developmental delay (without autism) we identified 12 groups of oral bacteria with unique activity patterns in children with autism. Interestingly, microbial activity (measured by RNA sequencing) also differed between children with autism and gastrointestinal (GI) disturbances and peers with autism but no GI disturbance. Levels of several microbes also displayed correlations with measures of autism behaviors. We utilized microbial activity patterns to create diagnostic panels that displayed accuracy for distinguishing children with autism from peers with typical development (79.5% accuracy) or developmental delay (76.5% accuracy). 

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Benzodiazepines Linked to Modest Increased Risk of Alzheimer’s

MedicalResearch.com Interview with:
MedicalResearch.comVesa Tapiainen, MD
School of Pharmacy, University of Eastern Finland
Research Centre for Comparative Effectiveness and Patient Safety
University of Eastern Finland Kuopio, Finland

 MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Alzheimer’s disease is a non-curable dementing disease and a major health concern and thus, identification of potential modifiable risk factors, such as benzodiazepines, is important. Benzodiazepines and related drugs are commonly used among older people as every fourth older people use them.

Benzodiazepines and related drugs were associated with modestly increased risk of Alzheimer’s disease. A dose-response relationship was observed with higher cumulative dose and longer use periods being associated with higher risk of Alzheimer’s disease. The risk associated with larger cumulative doses was partly explained by more common use of other psychotropics among these persons.  Continue reading

How Our Brain Lets Us Believe What We Want To Believe

MedicalResearch.com Interview with:

People demonstrate biased belief updating: They tend to regard good news indicating that personal risks are lower than expected, and to disregard bad news indicating that personal risks are higher than expected. Kuzmanovic and colleagues show that this optimism bias depends on the update valuation by the ventromedial prefrontal cortex (vmPFC) and its influence on the dorsomedial prefrontal cortex (dmPFC) associated with self-referential reasoning. Credit: Bojana Kuzmanovic

People demonstrate biased belief updating: They tend to regard good news indicating that personal risks are lower than expected, and to disregard bad news indicating that personal risks are higher than expected. Kuzmanovic and colleagues show that this optimism bias depends on the update valuation by the ventromedial prefrontal cortex (vmPFC) and its influence on the dorsomedial prefrontal cortex (dmPFC) associated with self-referential reasoning.
Credit: Bojana Kuzmanovic

Dr. Bojana Kuzmanovic PhD
Max Planck Institute for Metabolism Research
Translational Neurocircuitry Group
Cologne, Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Do our beliefs depend on what we want to believe? Until now, researchers failed to show how interactions between brain regions mediate the influence of motivation to adopt desirable notions on ongoing reasoning. Our study used optimized design and analyses to rule out alternative explanations and to identify underlying neurocircuitry mechanisms.

MedicalResearch.com: What are the main findings?

Response: First, we demonstrated that people’s belief formation behavior depends on their preferences. When people were asked to reconsider their beliefs about their future outcomes, they tended to rely more strongly on good news and to disregard bad news.

Second, we showed that favorable belief updating activated the brain valuation system known to be responsive to rewards such as food or money (ventromedial prefrontal cortex, vmPFC). That is, the valuation system was activated when participants incorporated good news to improve their risk estimates, and when they disregarded bad news to avoid a worsening of their risk estimates.

And third, the valuation system influenced other brain regions that are involved in deriving conclusions about oneself (dorsomedial prefrontal cortex, dmPFC). Importantly, the more participants were biased in their belief formation behavior, the stronger was the engagement and the influence of the valuation system.

The influence of the valuation system on the reasoning system helps to understand how motivation can affect reasoning. It supports the idea that memories and knowledge we recall to form our beliefs are selected in such a way as to yield the desired conclusions. For example, when we wish to convince ourselves that our risk of having a heart attack is low although federal statistics indicate a higher risk, we might recall our healthy life style but not our family history of heart-related diseases, or neglect the fact that the federal population may have a comparable life style. Continue reading

Women Whose Mothers Lived to 90, Likely To Have Health Old Age

MedicalResearch.com Interview with:

Aladdin H. Shadyab, PhD  MS, MPH, CPH Department of Family and Preventive Medicine UCSD twitter.com/TheDrAladdin

Dr. Aladdin Shadyab

Aladdin H. Shadyab, PhD  MS, MPH, CPH
Department of Family Medicine and Public Health
University of California, San Diego
twitter.com/TheDrAladdin

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies have shown that offspring of long-lived parents are not only likely to live longer but to also avoid major chronic diseases (e.g., coronary heart disease), have fewer chronic disease risk factors, and to have better cognitive and physical function in late life. However, few studies have examined parental longevity in relation to an overall measure of successful aging that included reaching old age free of both major diseases and disabilities.

The objective of our study was to determine if parental longevity predicted healthy aging, defined as survival to age 90 without any major age-related diseases (coronary heart disease, stroke, diabetes, cancer, or hip fracture) or physical limitations. The participants of our study were from the Women’s Health Initiative, a large, longitudinal study among postmenopausal women from the United States.

We observed that women whose mothers survived to at least age 90 years were 25% more likely to achieve healthy aging. We also observed that women whose fathers only lived to age 90 did not have increased likelihood of healthy aging. However, women whose mother and father both lived to age 90 were the most likely to achieve healthy aging.

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Patients with CLL Should Be Monitored for Skin Cancer, Including Melanoma

MedicalResearch.com Interview with:

Clive S. Zent MD Professor of Medicine Director of Lymphoma/CLL Program Wilmot Cancer Institute University of Rochester Medical Center Rochester NY

Dr. Zent


Clive S. Zent MD

Professor of Medicine
Director of Lymphoma/CLL Program
Wilmot Cancer Institute
University of Rochester Medical Center
Rochester NY

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have an increased risk of all skin cancers including malignant melanoma.

This study in a stable population of CLL patients managed by a regional referral center confirmed that melanoma was over 6 times more common in than in an age and sexed matched general population. Because of the proactive skin screening program at the University of Rochester Medical Center’s Wilmot Cancer Center, most melanomas (77%) were detected at earlier stages and were treated surgically with curative intent. One patient with CLL and metastatic melanoma had a sustained remission of both diseases on treatment with ibrutinib and pembrolizumab. Continue reading

Daily Chest X-Rays Still Overused in Mechanically Ventilated Patients

MedicalResearch.com Interview with:

Hayley B. Gershengorn, MD Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York

Dr. Gershengorn

Hayley B. Gershengorn, MD
Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Beginning in December, 2011, professional guidelines have recommended against the practice of daily chest radiography (CXRs) for mechanically ventilated patients.  However, we hypothesized that this practice was still commonplace in the US and varied from hospital to hospital.

To address this question, we performed a retrospective cohort study of >500,000 mechanically ventilated adults across 416 US hospitals. We found that 63% of these patients received daily CXRs and that, while use has been decreasing, this decrease is small (a 3% relative reduction in the odds of daily CXR receipt per discharge quarter starting in 2012).

Moreover, the hospital at which a patient received care greatly impacted the likelihood of daily CXR receipt.

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DCIS is a Bona Fide Breast Cancer, Not a Cancer Precursor

MedicalResearch.com Interview with:

Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto

Dr. Narod

Steven Narod, MD, FRCPC, FRSC
Senior Scientist, Women’s College Research Institute
Director, Familial Breast Cancer Research Unit, Women’s College Research Institute
Professor, Dalla Lana School of Public Health, University of Toronto
Professor, Department of Medicine
Tier 1 Canada Research Chair in Breast Cancer
University of Toronto

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer.

Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.

  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.

So, if the goal is to prevent new cancers in the breast –   then mastectomy is the best treatment

If the goal is to prevent the woman from dying of breast cancer – then radiotherapy is the best treatment.  Continue reading