medical research Tag
30 Nov Lumosity Study Finds Cognitive Performance Affected By Sleep, Time of Day
MedicalResearch.com Interview with:
Daniel Sternberg PhD.
Data Scientist at Lumosity
Medical Research: What is the background for this study? What are the main findings?
Dr. Sternberg: We were interested in examining how lifestyle factors such as sleep, mood and time of day impact cognitive game play performance. We analyzed game play performance data on Lumosity tasks from more than 60,000 participants and found that performance on the tasks designed to challenge memory, speed, and flexibility peaked in the morning, while performance on tasks designed to challenge aspects of crystallized knowledge such as arithmetic and verbal fluency peaked in the afternoon. Overall, game performance for most tasks was highest after seven hours of sleep and with positive moods, though performance on tasks that challenged crystallized knowledge sometimes peaked with less sleep.
28 Nov High Quality Diet Reduces Systemic Inflammation
MedicalResearch.com Interview with:
Joana Alves Dias, MPH
Department of Clinical Sciences in Malmö,
Lund University Malmö, Sweden
Medical Research: What is the background for this study? What are the main findings?
Response: The evidence that chronic inflammation may be in the genesis of diseases such as cardiovascular disease, type-II diabetes, and certain types of cancer is increasing. It is suggested that lifestyle factors such as diet, physical activity, smoking, and alcohol consumption could influence the inflammatory state. Instead of focusing on single nutrient effects, we used a hypothesis-driven approach to food pattern studies, and constructed a diet quality index based on the Swedish Nutrition Recommendations and Swedish Dietary guidelines (DQI-SNR). The DQI-SNR consisted of 6 components. Individuals were assigned 0 when not adhering to a recommendation and 1 when adhering, resulting in total scores ranging from 0 to 6. We classified individuals in low (0 or 1 points), medium (2 or 3) and high (4-6 points) diet quality. We explored the association between the index scores and low-grade inflammation.
Our study indicates that adherence to a high quality diet is associated with lower systemic inflammation, as measured by several soluble and cellular biomarkers of inflammation, in middle-aged individuals. In other words, adherence to the general nutrition recommendations could help prevent the development of diseases associated with chronic inflammation. The anti-inflammatory effects of Mediterranean-like diets have been studied extensively, but this study focused on the Swedish dietary habits and recommendations for the Swedish population, and reached similar conclusions.
28 Nov Breast Cancer: Gene Mediating Tamoxifen Resistance Identified
MedicalResearch.com Interview with:
Ben Ho Park, M.D., Ph.D.
Associate Professor of Oncology, Breast Cancer Program
Associate Director, Hematology/Oncology Fellowship Training Program The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, MD 21287
Medical Research: What is the background for this study? What are the main findings?
Dr. Park: To discover genetic mediators of tamoxifen resistance in breast cancers, we used genetic screening of breast cancer cell line models and patient data to identify a new gene that can mediate drug resistance. We found that amplification and overexpression of this gene in estrogen receptor positive breast cancers results in resistance and is associated with worse outcomes in patients whose tumors demonstrate amplification/overexpression of this gene.
28 Nov Genetics Plays Large Role in Allergic Esophagitis
MedicalResearch.com Interview with:
Dr. Hakon Hakonarson MD PhD
The Center for Applied Genomics, The Children’s Hospital of Philadelphia
Department of Pediatrics, The Perelman School of Medicine,
University of Pennsylvania Philadelphia, Philadelphia, Pennsylvania
Medical Research: What is the background for this study? What are the main findings?
Dr. Hakonarson: We have built the world’s largest pediatric biobank at the Center for Applied Genomics at CHOP. Eosinophilic esophagitis (EoE) is among the projects we have sampled in collaboration with the EoE Center in collaboration with Dr. Spergel. We have nearly 1,000 samples now of this relatively rare disorder, which is now well powered for GWAS. We previously reported association of the TSLP locus with Eosinophilic esophagitis. Here we report genome-wide significant associations at four additional loci; c11orf30 and STAT6, which have been previously associated with both atopic and autoimmune diseases, and two EoE-specific loci, ANKRD27 that regulates the trafficking of melanogenic enzymes to epidermal melanocytes and CAPN14, that encodes a calpain whose expression is highly enriched in the esophagus in EoE. This discovery not only improves our understanding of the pathobiology of EoE, but also represents novel targets for the development of new therapies to treat the disease.
28 Nov Cancer Survival Varies Widely By Country and Cancer Type
MedicalResearch.com Interview with:
Dr Claudia Allemani PhD FHEA MFPH
Senior Lecturer in Cancer Epidemiology
Cancer Research UK Cancer Survival Group
Department of Non-Communicable Disease Epidemiology
London School of Hygiene and Tropical Medicine, London UK
Medical Research: What is the background for this study?
Dr. Allemani: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control.
The first CONCORD study was published in 2008.1 It brought together data from 101 cancer registries in 31 countries, and included 1.9 million patients diagnosed during 1990-94 with a cancer of the colon, rectum, breast or prostate and followed up to the end of 1999. It revealed very wide international differences in five-year survival, and it confirmed the well-known racial discrepancy in cancer survival in the USA.
CONCORD-2 is the most comprehensive international comparison of trends in population-based cancer patient survival to date. It extends the first study in three ways:
- it covers 10 common cancers: collectively, these account for almost two-thirds (63%) of all cancer patients diagnosed each year in both developed and developing countries
- it includes data on more than 25 million cancer patients, provided by 279 cancer registries in 67 countries, in 40 of which the data provide complete (100%) coverage of the national population
- it examines trends in cancer survival for patients diagnosed over the 15-year period 1995-2009
28 Nov Older Brain Less Able To Filter Out Irrelevant Information
MedicalResearch.com Interview with:
Prof. Takeo Watanabe
The Fred M. Seed Professor
Cognitive, Linguistic and Psychological Sciences
Brown University
Medical Research: What is the background for this study? What are the main findings?
Prof. Watanabe: In the current study also supported by NIH, we obtained surprising results. That is, older people learn what younger people do not learn. We asked subjects to do a letter identification task at the center of a screen while another stimulus was presented in the background. This background stimulus contained a group of dots moving in one direction with noises and had nothing to do with the task. Therefore the motion was task-irrelevant. If the motion is clearly perceived, learning on the motion as task-irrelevant did not occur when subjects were college students. However, older people ended up increasing sensitivity to and, therefore learned, such task-irrelevant motion. This might sound as if the older brain worked better than the younger brain in visual perceptual learning. However, that may not be the case. Our brain capacity is limited. If our brain learned items that are not relevant to a given task and therefore are unimportant to us, there would be the risk of such unimportant items replacing important information which has already existed in the brain. Thus, learning of task-irrelevant and therefore unnecessary information could be harmful and decrease the efficiency of learning of what is important.
28 Nov AHA14: Xarelto vs Warfarin For Non-Valvular Atrial Fibrillation
Posted at 17:58h
in Heart Disease
MedicalResearch.com Interview with:
Concetta Crivera MPH, Pharm.D
Associate Director, Outcomes Research
Ortho-McNeil Janssen Scientific Affairs, LLC
Medical Research: What is the background for this study? What are the main findings?
Response: Findings from the study presented at the American Heart Association (AHA) 2014 Scientific Sessions showed once-daily XARELTO® (rivaroxaban) is associated with significantly fewer hospitalization days and outpatient visits compared to warfarin in patients with non-valvular atrial fibrillation (NVAF). Corresponding hospitalization and outpatient healthcare costs were also significantly lower for XARELTO® compared to warfarin in NVAF patients, according to longitudinal, real-world findings from this observational study.
28 Nov Congenital Heart Disease Linked To Long Term Inpatient Costs
MedicalResearch.com Interview with:
Dr. Roberta Williams MD
Professor of Pediatrics
Keck School of Medicine at the University of Southern California
MedicalResearch.com: What is the background for this study?
Dr. Williams: Although a large number of children with chronic disease are surviving into adulthood, the extent and type of health resource needs remains a mystery. Patients with congenital heart disease (CHD) require lifelong care, so it is important to understand present resource utilization both as a foundation for planning services and as a reference point to assess the changes that occur with presumed improved access to care due to health care reform.
28 Nov Healthy Skin Guards Against Infection By Constant Immune Surveillance
MedicalResearch.com Interview with:
Univ.-Prof. Dr. med. Tilo Biedermann
Klinikdirektor
Klinik und Poliklinik für Dermatologie und Allergologie
der Technischen Universität München
Biedersteinerstr. München
Medical Research: What is the background for this study? What are the main findings?
Prof. Biedermann: The skin is constantly exposed to microbes and skin developed during evolution under the constant influence of microbes. Tightly regulated communication between microbes and the skin can be expected and levels of regulation still needed to be explored. We found that Gram-positive bacteria when sensed by one certain innate immune receptor (hetero dimer TLR 2-6 suppresses immunity both in animal models and in humans. Following the sensing of lipoproteins by toll like receptor 2-6) skin produces high levels of InterleukinL6 that induce the accumulation of so called myeloid-derived suppressor cells. These cells can be found in the blood but also migrate to the skin suppressing T-cell-immunity allowing infections to spread on the skin.
28 Nov Diabetes Risk Increased in Poor Neighborhoods
MedicalResearch.com Interview with:
Longjian Liu, MD, PhD, MSc(LSHTM), FAHA
Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics, Senior Investigator, Center for Health Equality
Drexel University School of Public Health, and
Adjunct Associate Professor of Medicine, Drexel U. College of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Liu: The prevalence of diabetes is increasing rapidly in the United States and worldwide. In 2010, 25.8 million Americans, or 8.3% of the population had diabetes in the United States. In 2012, these figures were 29.1 million, or 9.3% in the nation. Philadelphia, the largest city in PA, ranks as the 5th largest city in the nation. However, the city also had the highest prevalence of diabetes according to the national surveys in 2009. We face a great challenge to stop the epidemic of diabetes locally and nationally. It is well-known personal risk factors at individual level, including lifestyles, play a role in the prevention and control of diabetes. However very limited studies addressed the importance that physical and socioeconomic environmental factors at community level may also play a pivotal role in the prevention and control of the disease. This study aimed to quantitatively examine (1) the trend of diabetes from 2002 to 2010 in the city of Philadelphia, and (2) the impact of physical and socioeconomic environmental factors at community level (assessed using zip-codes based neighborhoods) on the risk of the prevalence of diabetes.
The main findings support our hypotheses that
- (1) the prevalence of diabetes significantly increased from 2002 to 2012.
- (2) residents who lived in neighborhoods with physical and socioeconomic disadvantage had an increased risk of the prevalence of diabetes.
28 Nov Out-of-Hospital Cardiac Arrest: Continuous vs Interrupted Chest Compressions?
MedicalResearch.com Interview with: Siobhan Brown, Ph.D. Biostatistician, ROC Clinical Trials Center University of Washington Medical Research: What is the background for this study? What are the main findings? Dr. Brown: There are several observational studies suggesting that patients with out-of-hospital cardiac arrest may be more likely to survive to hospital discharge when emergency medical service provides do not pause for ventilations while performing CPR (i.e., give continuous compressions); however, the American Heart Association recommends that rescuers pause after each 30 compression to give two ventilations (interrupted compressions). We designed and are conducting a randomized clinical trial comparing the two approaches to see which results in better survival. The trial is still ongoing, so watch for results in late 2015!28 Nov Dramatic Increase in Subthreshold Psychiatric Diagnoses In Young People
Medicalresearch.com with:
Daniel Safer MD
Department of Psychiatry
Johns Hopkins University School of Medicine
Baltimore, Maryland
Medical Research: What is the nature of this study?
Dr. Safer: A large national sample of annual physician office-based visits by youth (aged 2-19) covering 12 years (1999-2010), focusing on trends in psychiatric DSM-IV diagnoses, with psychiatric diagnostic data analyzed proportionally comparing diagnoses that were subthreshold (not otherwise specified) with those that met full diagnostic criteria.
27 Nov Yogurt May Lower Risk of Diabetes
Medicalresearch.com with:
Frank B. Hu, MD, PhD
Professor of Nutrition and Epidemiology
Harvard School of Public Health
Professor of Medicine Harvard Medical School
Boston, MA 02115
Medical Research: What is the background for this study?
Dr. Hu: Type 2 diabetes (T2D) affects approximately 26 million people in the United States and 366 million people worldwide, and thus primary prevention of T2D has become a public health imperative. The relation between consumption of different types of dairy and risk of type 2 diabetes remains uncertain.
27 Nov Minimally Invasive Surgery May Not Be Best For Disc Removal
MedicalResearch.com Interview with: Nat
han Evaniew MD
Division of Orthopaedics
McMaster University
Medical Research: What is the background for this study?
Dr. Evaniew: Symptomatic cervical and lumbar spinal disc diseases affect at least 5% of the population and they cause a great deal of pain, disability, social burden, and economic impact. For carefully selected patients that fail to improve with nonsurgical management, conventional open discectomy surgery often provides good or excellent results.
Minimally invasive techniques for discectomy surgery were introduced as alternatives that are potentially less destructive, but they require specialized equipment and expertise, and they may involve increased risks for technical complications.
26 Nov Powerpoint of This Week’s Medical Research Exclusive Interviews
Posted at 21:20h
in Author Interviews
26 Nov Most US Patients With HIV Do Not Have Virus Under Control
MedicalResearch.com Interview with: Heather Bradley, PhD Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC Medical Research: What is the background for this study? What are the main findings? Dr. Bradley: The key to controlling the HIV epidemic is controlling the virus. When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Yet, only one-third of the 1.2 million people with HIV in the U.S. have the virus under control. Among those who did not have the virus under control, approximately two-thirds had been diagnosed but were not in medical care. Young people were least likely to have the virus under control. Only 13 percent of 18 – 24 year olds were virally suppressed, primarily because half don’t know they are infected. To close this gap among young people, increased HIV testing is critical. The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group.26 Nov Inflammatory Gut Microbes May Drive Metabolic Syndrome
MedicalResearch.com Interview with:
Dr. Andrew Gewirtz PhD
Professor & Associate Chair
Department of Biology
Georgia State University
Medical Research: What is the background for this study?
Dr. Gewirtz: 2010 science paper that discovered that loss of toll-like receptor 5 altered gut microbiota to drive metabolic syndrome
Medical Research: What are the main findings?
Dr. Gewirtz: It is loss of tlr5 on epithelial cells that alters the microbiota to make it more pro-inflammatory that drives metabolic syndrome.
26 Nov CPAP May Improve Depression In Patients With Sleep Apnea
MedicalResearch.com Interview with:
Dr. Marcus Povitz MD
Department of Community Health Sciences
University of Calgary, Calgary, Alberta, Canada
Adjunct Professor and Clinical Fellow
Western University Department of Medicine,
Western University, London, Ontario, Canada
Medical Research: What is the background for this study? What are the main findings?
Dr. Povitz: Both depression and obstructive sleep apnea are important causes of illness and have overlapping symptoms. Both feature poor quality sleep, difficulty with concentration and memory as well as daytime sleepiness or fatigue. Previous research showed that depression is common in individuals with sleep apnea, but studies investigating the effect of treating sleep apnea on depressive symptoms have had conflicting results. Our study combined the results of all randomized controlled trials of participants who were treated for sleep apnea with CPAP or mandibular advancement devices where symptoms of depression were measured both before and after treatment. We found that in studies of individuals without a lot of symptoms of depression there was still a small improvement in these symptoms after treatment with CPAP or mandibular advancement device. In 2 studies of individuals with more symptoms of depression there was a large improvement in symptoms of depression.
26 Nov COPD: Nutritional Supplements Improved Outcomes and Reduced Costs
MedicalResearch.com Interview with:
Refaat Hegazi, MD, PhD, MS, MPH
Medical Director, Abbott Nutrition
Affiliate Research Associate Professor,
The Brody School of Medicine at East Carolina University
Medical Research: What is the background for this study? What are the main findings?
Dr. Hegazi: This study stems from the need to address the financial and health burdens that Chronic Obstructive Pulmonary Disease (COPD) places on the United States. It is the third leading cause of death in the U.S. and costs us about $50 billion a year. It’s a devastating and chronic condition that plagues patients on a daily basis, and previous studies have shown that proper nutrition is essential for proper pulmonary function and rehabilitation.
In a retrospective study of inpatient medical records, we found that by ensuring the nutritional needs of COPD patients were met with oral nutritional supplements (ONS), we were able to tackle the issue of cost, as well as better health outcomes. Specifically, the COPD patients that received oral nutritional supplements, experienced reduced length of hospitalization, lower average hospital costs, and lower readmission rates within 30 days, compared to those that did not.
26 Nov Proton Pump Inhibitors May Decrease Gut Diversity, Increase C. diff Risk
MedicalResearch.com Interview with:
Dr. John K. DiBaise MD
Gastroenterology and Hepatology
Mayo Clinic, Scottsdale Arizona
Medical Research: What is the background for this study? What are the main findings?
Dr. DiBaise: Despite nearly 25 years of safe and effective use of proton pump inhibitors (PPI), in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use. One such association with PPI use has been Clostridium difficile infection (CDI) which can cause severe and recurrent episodes of diarrhea. Previous reports evaluating the microbes present within the gastrointestinal tract (ie, gut microbiome) of individuals with CDI have shown a reduction in overall microbial community diversity. We studied the gut microbiome in healthy individuals both before and after using a proton pump inhibitors for one month and found a similar reduction in microbial diversity while taking the PPI that did not entirely revert back to the ‘normal’ baseline after being off the medication for a month. While this does not demonstrate a causal association between proton pump inhibitors use and CDI, it demonstrates that PPI use creates a situation in the gut microbial environment that may increase the individual’s susceptibility to CDI.
26 Nov Full Day Preschool Increased School Readiness
MedicalResearch.com Interview with:
Dr. Arthur Reynolds PhD, Professor
Institute of Child Development
Humphrey School of Public Affairs
University of Minnesota
Medical Research: What is the background for this study? What are the main findings?
Dr. Reynolds: Given the high national priority on enhancing early childhood development, evidence about the relationship between full-day preschool participation and school readiness is meager.
The study found that among about 1000 children attending 11 schools in low-income neighborhood. participation in full-day preschool at ages 3 or 4 for 7 hours per day was associated with significantly higher school readiness skills at the end of preschool in language and literacy, socio-emotional development, math, and physical health than part-day participation for 3 hours per day. This translate to about a half of a year of growth in learning. Full-day preschool was also associated with significantly higher attendance and lower rates of chronic absences. No differences were found in parent involvement in school.
26 Nov Guidelines For Surgery After Cardiac Stents Have Improved Adverse Postoperative Outcomes
MedicalResearch.com Interview with
Dr. Mary T. Hawn MD
Center for Surgical, Medical Acute Care Research, and Transitions,
Birmingham Veterans Affairs Medical Center
University of Alabama at Birmingham, Birmingham
Medical Research: What are the main findings?
Dr. Hawn: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1 These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent. In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations.
26 Nov First Episode of Psychosis: Stopping Drug Use Improves Prognosis
MedicalResearch.com Interview with: Melissa Anne Elin Authen Weibell Consultant Psychiatrist Helse Stavanger HF Medical Research: What is the background for this study? Dr. Weibell: Little is known about the effect of different patterns of substance use on outcomes in first-episode psychosis and the few studies that exist are often cross-sectional and heterogeneous. This new study investigated different patterns of substance use in an epidemiological first-episode psychosis (FEP) sample longitudinally, with the hypothesis that continuous use would predict poorer outcomes compared to never users or stop users. The study included 301 patients aged 16-65 with first episode non-affective included (1997-2001) from three separate catchment areas in Norway and Denmark. Four patterns of substance use were defined; never used (153 patients), persistent use(43), completely stopped use having previously used (36), and on-off use (48) during the first 2-years of follow-up. 184 patients were followed up at 10 years and compared on symptom levels and remission status.26 Nov Obesity in Midlife Increases Risk of Dementia and Alzheimer’s Disease
MedicalResearch.com Interview with:
Nicolas Cherbuin PhD
ARC Future Fellow - Director of the NeuroImaging and Brain Lab
Centre for Research on Ageing, Health and Wellbeing
Research School of Population Health - College of Medicine Biology and Environment
Australian National University
Medical Research: What is the background for this study? What are the main findings?
Dr. Cherbuin: A number of modifiable risk factors for cognitive aging dementia and Alzheimer’s disease have been identified with a high level of confidence by combining evidence from animal research and systematic reviews of the literature in humans that summarise the available findings without focusing on extreme findings that come about from time to time in research. One such risk factor is obesity for which we have previously conducted a systematic review (Anstey et al. 2011). This showed that obesity is associated with a two-fold increased risk of dementia and a 60% increased risk of Alzheimer’s disease. What was surprising is that this effect was only detectable for obesity in middle age but not old age. This might suggest that the obesity only has an adverse effects on brain health earlier in life and that this effect fades at older ages. This is unlikely because a number of animal studies have shown that the biological mechanisms linking obesity with brain pathology do not disappear with older age but in fact appear to increase. Moreover, human studies show that thinking abilities decline faster in obese individuals. An alternative explanation is that human epidemiological studies investigating this question in older individuals include participants who do not have clinical dementia but in whom the disease is developing. Since dementia and Alzheimer’s disease pathology is associated with weight loss it is possible that estimated effects in humans have been confounded by this issue. Another possible confounder is that older people tend to lose muscle mass (sarcopenia) this may lead to the paradoxical condition in aging where a person has a normal weight but has excessive fat mass. Since it is fat tissue that is linked to risk to cerebral health it may have led to the apparently contradictory findings that obesity may not be a risk in older age. It is therefore of great interest to clarify whether obesity in early old age in individuals free of dementia is associated with poorer cerebral health. The hippocampus is one of the structures most sensitive stressors. Because obesity is known to lead to a state of chronic inflammation which is deleterious to the hippocampus, it was a logical structure to investigate. Moreover, the hippocampus is needed for memory function and mood regulation and is directly implicated in the dementia disease process.
This study investigated 420 participants in their early 60s taking part in a larger longitudinal study of aging taking place in Canberra, Australia and who underwent up to three brain scans over an 8-year follow-up. These individuals were free of dementia and other neurological disorders. Associations between obesity and shrinkage of the hippocampus were investigated with longitudinal analyses which controlled for major confounders.
The main findings were that overweight and obese participants had smaller volume of the hippocampus at the start of the study. In addition, the hippocampus shrunk more in these individuals over the follow-up period.
26 Nov Fitness An Important Predictor of Heart Failure
MedicalResearch.com Interview with:
Carl "Chip" Lavie MD, FACC
Medical Director, Cardiac Rehabilitation and Prevention
Director, Exercise Laboratories
John Ochsner Heart and Vascular Institute
Professor of Medicine
Ochsner Clinical School-UQ School of Medicine
Editor-in-Chief, Progress in Cardiovascular Diseases
Medical Research: What are the key points of your editorial?
Dr. Lavie:
1) The importance of higher fitness to predict a lower rate of developing Heart Failure;
2) improvements in fitness over time predict a lower rate of developing Heart Failure, and
3) Once Heart Failure develops, higher fitness predicts a more favorable prognosis.
26 Nov Drop in Cardiac Mortality Varies by Subtype and Ethnicity
MedicalResearch.com Interview with: Matthew D. Ritchey, DPT Division for Heart Disease and Stroke Prevention US Centers for Disease Control and Prevention, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Ritchey: This study analyzes the contribution of heart disease subtypes – such as coronary heart disease, heart failure, hypertensive heart disease and arrhythmia – to overall trends in heart disease death rates between 2000 and 2010. Our research revealed that overall heart disease-related deaths declined during that time frame at a rate of almost four percent annually. Most of this decline appears to be driven by decreases in coronary heart disease mortality, which includes deaths due to heart attacks. However, not all heart disease subtypes saw similar decreases. Arrhythmia and hypertensive heart disease death rates increased annually during this period. In addition, there were differences depending on age group, subtype, gender and race/ethnicity. For example, hypertensive heart disease rates were much higher (more than double) among non-Hispanic blacks in 2010 than among non-Hispanic whites. That could be due to factors including uncontrolled blood pressure and obesity among younger adults. Also, the increase in arrhythmia mortality was highest among non-Hispanic whites, women and adults age 75 and over. That increase might be linked to the growing aging population, the result of individuals living longer with heart failure, increases in chronic kidney disease and hypertensive heart disease prevalence and changes in how the condition is reported. To determine these findings, we examined de-identified death certificates of U.S. residents ages 35 and up who died from 2000 to 2010. The data was pulled from the CDC WONDER database, which contains death certificate information from every U.S. state and the District of Columbia.26 Nov Study Addresses Nutritional Support Of Critically Ill Patients
MedicalResearch.com Interview with: Sheila E. Harvey, Ph.D. CTU Manager/Senior Research Fellow ICNARC Napier House London Medical Research: What is the background for this study? Dr. Harvey: The CALORIES trial was set-up in the context of concerns about malnutrition in critically ill patients in NHS hospitals and conflicting evidence as to the optimal route for delivery of early nutritional support to critically ill patients. The enteral route is the mainstay of nutritional support in the critically ill but it is frequently associated with gastrointestinal intolerance and underfeeding. In contrast, the parenteral route, though more invasive and expensive, is more likely to secure delivery of the intended nutrition but has been associated with more risks and complications (e.g. infectious complications) compared with the enteral route. In light of the uncertainty surrounding the most effective route for delivery of early nutritional support and, given recent improvements in the delivery, formulation and monitoring of parenteral nutrition, the UK National Institute of Health Research (NIHR) Health Technology Assessment (HTA) Programme put out a “call” for a large pragmatic randomised controlled trial to be conducted in critically ill patients to determine the optimal route of delivery of early nutritional support. CALORIES was set up to test the hypothesis that early nutritional support delivered via the parenteral route is superior to early nutritional support delivered via the enteral route in adults who had an unplanned admission to an intensive care unit and who could be fed via either route. The primary outcome was all-cause mortality at 30 days. The secondary outcomes included infectious and non-infectious complications (hypoglycaemia, elevated liver enzymes, nausea requiring treatment, abdominal distension, vomiting, new or substantially worsened pressure ulcers).25 Nov Reduced Sodium Intake May Improve Heart Failure Prognosis
MedicalResearch.com Interview with: Dr. Eloisa Colin-Ramirez, BSc, PhD and Justin A. Ezekowitz, MBBCh MSc Associate Professor, University of Alberta Co-Director, Canadian VIGOUR Centre Director, Heart Function Clinic Cardiologist, Mazankowski Alberta Heart Institute Medical Research: What is the background for this study? What are the main findings? Response: The SODIUM-HF study is a randomized control trial on sodium restriction in patients with chronic heart failure (HF). Sodium restriction has been broadly recommended as part of the self-care strategies in heart failure yet is based on little high-quality evidence. This study reports the results of the pilot SODIUM-HF trial in 38 patients with chronic HF. Nineteen patients were prescribed a low sodium containing diet (1500 mg/day) and 19 a moderate sodium containing diet (2300 mg/day). Both interventions were based on a structured and individualized meal plan to achieve the targeted sodium intake, and all patients were followed for 6 months with monthly phone call to reinforce adherence to the diet. We found a meaningful reduction in sodium intake to less than 1500 mg/day at 6 months in both groups. Additionally, we observed that patients that achieved a sodium intake less than 1500 mg/day at 6 months of follow-up had reduced BNP levels, a biomarker of volume overload and surrogate prognostic marker in heart failure, and increased overall and clinical scores of the Kansas City Cardiomyopathy Questionnaire, compared to those with a sodium intake greater than 1500 mg/day.25 Nov Some Diabetics Do Not Benefit From Exercise
MedicalResearch.com Interview with:
Lauren Marie Sparks, PhD
Faculty Scientist at the Translational Research Institute for Metabolism and Diabetes
Florida Hospital and the Sanford-Burnham Medical Research Institute Orlando, FL
Medical Research: What is the background for this study? What are the main findings?
Dr. Sparks: As a clinical scientist focused on exercise effects on muscle metabolism in diabetes, I have seen first-hand a significant minority of individuals with diabetes not improve their glucose control (HbA1c) after 9 months of supervised exercise. They poured their hearts out on those treadmills 3-4 days a week for 9 months and still ended up no better than when they started. I have also seen similar data from some of my colleagues’ studies. So I really want diabetes research to invest the intellect and dollars into discovering what these roadblocks are—I happen to believe it is in the DNA (genetics) and the way that DNA is “read” or expressed (epigenetics). So it’s a bit of a ‘call to action’ for researchers to start looking into some of their data to find these people and better understand this phenomenon and for hopefully the funding sources to recognize this as a viable area of research.