MedicalResearch.com Interview with:Theodore J. Cicero, PhD
Professor, Vice Chairman for Research
Department of Psychiatry
Washington University in St Louis
St Louis, Missouri
MedicalResearch: What are the main findings of the study?Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin.
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MedicalResearch.com Interview with: Prof. Stefano Palomba
Department of Obstetrics and Gynecology
University “Magna Graecia” of Catanzaro
Catanzaro, Italy
MedicalResearch: What are the main findings of the study?Prof. Palomba: Our study demonstrates that simple markers of inflammation, commonly detectable in clinical practice with commercial kits, are significantly modified in women with PCOS during pregnancy and associated at an increased risk of complications during pregnancy in the same population with PCOS.
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MedicalResearch.com Interview with:Mark A D’Andrea, MD, FACRO
University Cancer and Diagnostic Centers
Houston, Texas
MedicalResearch: What are the main findings of the study?Dr. D’Andrea: Crude oil spills affect the human health through their exposure to the inherent hazardous chemicals such as para-phenols and volatile benzene.
Human exposure to crude oil spills is associated with multiple adverse health effects including hematopoietic, hepatic, renal, and pulmonary abnormalities. In this study, we assessed the hematological and liver function indices among the subjects participated in the Gulf oil spill clean-up operations along the coast of Louisiana. The findings were compared with the standardized normal range reference values. We found that over 77% of subjects had WBC counts in the mid range (6 - 10X 103 per mL) while none of the subjects had upper limit of the normal range (11 X 103 per mL). Similar pattern was seen in the platelet counts and BUN levels among the oil spill exposed subjects. Conversely, over 70% of the subjects had creatinine levels toward upper limit of the normal and 23% of subjects had creatinine levels above the upper limit of the normal range (> 1.3 mg per dL). Similarly, hemoglobin and hematocrit levels were toward the upper limit of the normal in more than two-third of the subjects. Aspartate amino transferase and alanine amino transferase levels above the upper limit of normal range (> 40 IU per L) were seen in 15% and 31% of subjects, respectively. Over 80% of subjects had urinary phenol levels more than detectable levels (2 mg per L).
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MedicalResearch.com Interview with: John Wilding DM FRCP
Professor of Medicine & Honorary Consultant Physician
Head of Department of Obesity and Endocrinology
Institute of Ageing & Chronic Disease
Clinical Sciences Centre
University Hospital Aintree
Liverpool United Kingdom
MedicalResearch: What are the main findings of the study?Dr. Wilding:This trial studied over 3700 obese people who were trying to lose weight. The main findings were that liraglutide (an injectable medication already approved for diabetes treatment at lower dose of 1.8mg) can help reduce body weight in people with obesity when used at a higher dose than is usually used in diabetes (3mg). Trial participants experienced a weight loss of 8 % from baseline compared to 2.6 % with placebo (diet and exercise alone).
Some risk factors for diabetes and heart disease such as blood sugar, blood pressure and cholesterol also improved with liraglutide treatment to a greater extent than with placebo. The main side effects seen were nausea which in most cases resolved after a few weeks treatment; there were also more cases of gallstones (which could be due to weight loss) and a few more cases of acute pancreatitis in people treated with liraglutide.
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MedicalResearch.com Interview with: Yael Schenker, MD, MAS
Assistant Professor
Division of General Internal Medicine
Section of Palliative Care and Medical Ethics
University of Pittsburgh
Pittsburgh, PA 15213
MedicalResearch: What are the main findings of the study? Dr. Schenker: We analyzed the content of cancer center advertisements placed in top TV and magazine media markets in 2012. Out of 1427 advertisements that met our initial search criteria, we found 409 unique advertisements that promoted clinical services at 102 cancer centers across the country. These advertisements promoted cancer treatments (88%) more often than cancer screening (18%) or supportive services (13%). Provision of information about clinical services was scant.
For example, 27% of advertisements mentioned a benefit of advertised services and 2% quantified these benefits. 2% mentioned a risk of advertised services and no advertisements quantified these risks. 5% mentioned costs or insurance coverage and no advertisements mentioned availability under specific insurance plans. In contrast, use of emotional appeals was frequent (85%). Emotional appeals commonly evoked hope for survival, focused on treatment advances, used fighting language, and/or evoked fear. Nearly half of all advertisements included patient testimonials, overwhelmingly focused on stories about survival or cure. Only 15% of testimonials included a disclaimer (for example, “most patients do not experience these results”) and none described the outcome that a typical patient may expect.
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MedicalResearch.com Interview
Anna Peeters
Associate Professor, BSc(Hons) PhD
Head Obesity & Population Health | Baker IDI Heart and Diabetes Institute
President Australian & New Zealand Obesity Society
MedicalResearch: What are the main findings of the study?Professor Peeters: The context for this study is that ‘point of sale menu labelling’ policies in fast food restaurants have some evidence of generally decreasing how many calories are consumed by people who go there. They may also lead the companies to reformulate their food to become slightly healthier. The key finding of our study is that those from more disadvantaged/ poorer backgrounds are unlikely to have a direct benefit from ‘point of sale menu labelling’ policies in fast food restaurants through a decreased number of calories consumed.
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MedicalResearch.com Interview with: Susan WuMD
Division of Hospital Medicine, Children's Hospital Los Angeles
Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California
MedicalResearch: What are the main findings of the study?Dr. Wu: We performed a randomized trial at 2 urban free-standing children's hospitals, comparing inhaled 3% hypertonic saline to 0.9% normal saline in patients under 24 months with bronchiolitis. Patients with prematurity less than 34 weeks, cyanotic heart disease, chronic pulmonary disease, and previous episodes of wheezing or bronchodilator use were excluded. Patients were 4 mL of study medication nebulized up to 3 times in the emergency department; if admitted, patients continued to receive the assigned study medication three times a day until discharge. A total of 408 patients were analyzed. We found that 28.9% of patients treated with hypertonic saline required hospital admission, compared with 42.6% of patients in the normal saline group.
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MedicalResearch.com Interview with: Kimford J. Meador, MD
Professor
Department of Neurology & Neurological Sciences
Stanford Comprehensive Epilepsy Center
Stanford University School of Medicine
Stanford, CA 94305-5235.
MedicalResearch: What are the main findings of the study?Dr. Meador:Breastfeeding while taking antiepileptic drugs does not appear to pose a risk to the child's development, and in fact the cognitive outcomes were better for those children who were breastfed vs. those were not.
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MedicalResearch Interview with:Dr. Valeria PechtnerMedical Advisor,
Lilly DiabetesMedicalResearch: What are the main findings of the study?Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint.
Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications.
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MedicalResearch Interview with: Dr Gianluca Tognon
University of Gothenburg
Gothenburg, Sweden
MedicalResearch: What are the main findings of the study?Dr. Tognon: We found that eating a pattern rich in vegetables, fruit, nuts, cereal grains and fish, that we call a Mediterranean-like diet was not only inversely associated to being overweight or obese, but also protective against an increase in body mass index and waist circumference at a 2-year follow up.
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MedicalResearch.com Interview Invitation Mary W. Carter, Ph.D.
Gerontology Program Director
Towson University
Towson, MD 21252-0001
MedicalResearch: What are the main findings of the study?Dr. Carter: Nearly 1 in 5 older adults experienced at least one severe medical injury during the five-year study period, and more than half of these occurred in an ambulatory care setting (i.e., not in the hospital). Older adults that were in poorer health and who had greater levels of disability had the greatest risk. Mortality rates were nearly twice as high among older adults experiencing a medical injury in comparison with otherwise similar older adults not experiencing a medical injury. Among survivors, the impact of medical injury was observed for extended periods of time, reflecting increased medical use and costs associated with medical injury.
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MedicalResearch.com Interview with: Ai Kubo, MPH PhD
Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612
MedicalResearch: What are the main findings of the study?Dr. Kubo:The main findings of the study are three folds:
1) The CDC guideline works for the majority of infants in preventing vertical transmission, if the immunizations are done according to the recommended schedule.
2) It takes an organized effort to case-manage each mother-infant pairs in order to achieve almost complete immunization rates and very low transmission rates.
3) Highest risk group was mothers with extremely high viral load and e-antigen positivity. This group of women may benefit from additional therapy to prevent the vertical transmission. However, for others, the risk of transmission is extremely low as long as the infants are immunized according to the guideline.
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MedicalResearch.com Interview with: Alai Tan, MD, PhD
Assistant Professor
Institute for Translational Science
Dept. of Preventive Medicine & Community Health
University of Texas Medical Branch
MedicalResearch: What are the main findings of the study?Dr. Tan: We found that substantial proportions of women with limited life expectancy receive screening mammography. The screening rates were higher among women who saw more than one generalist physician and who had more visits to generalist physicians. The screening rates were higher among U.S. hospital referral regions with more primary care physicians, mammography facilities and radiologists.
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MedicalResearch.com Interview withDr. Edythe D.London PhD
Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology
David Geffen School of Medicine, UCLA
MedicalResearch: What are the main findings of the study?Dr. London: Brain function related to risky decision-making was different in stimulant users (methamphetamine users) than in healthy control subjects. In healthy controls, activation in the prefrontal cortex (right dorsolateral prefrontal cortex) during risk-taking in the laboratory was sensitive to the level of risk. This sensitivity of cortical activation was weaker in stimulant users, who instead had a stronger sensitivity of striatum activation. The groups also differed in circuit-level activity (network activity) when they were not performing a task but were “at rest.” Stimulant users showed greater connectivity within the mesocorticolimbic system, a target of abused drugs. This connectivity was negatively related to sensitivity in the prefrontal cortex to risk during risky decision-making. In healthy control subjects, connectivity between the right dorsolateral prefrontal cortex and striatum was positively related to sensitivity of prefrontal cortical activation to risk during risky decision-making.
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MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic
MedicalResearch: What are the main findings of the study?Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.
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MedicalResearch.com Interview with:Dr. Farid Saad
Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany;
Gulf Medical University School of Medicine
Ajman, United Arab Emirates
MedicalResearch: What are the main findings of the study?Dr. Saad: There are two ongoing registry studies in men with testosterone deficiency (hypogonadism, defined by two separate measures of low serum testosterone and the presence of symptoms which are typical for testosterone deficiency). The studies are being conducted by office urologists. The total number of men who have been treated for a maximum duration of six years is 561, mean age just under 60 years. All men received three-monthly intra-muscular injections of a long-acting testosterone depot preparation.
The main findings were that at baseline only five per cent of these men had normal weight, some 25 per cent were overweight and the majority obese. Both overweight and obese men showed reductions in weight and waist circumference. The more obese men were, the more they lost. Men in the highest obesity category grade III (BMI ≥ 40 kg/m2), had a mean weight loss of 26 kg and a reduction of waist size by 12 cm.
In parallel, all components of the metabolic syndrome improved in a clinically meaningful magnitude, i.e., blood pressure, lipid profile, and glycemic control. When we analyzed a subgroup of 156 men with type 2 diabetes, we found marked improvements in their diabetes as a result of adding testosterone to the standard diabetes treatment men are receiving by their famaily physicians.
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Medicalresearch.com Interview with: Robert S. Tan MD, MBA, AGSF
Clinical Director & Chief Geriatrics, Michael DeBakey VAMC
Director, Opal Medical, LLC
Clinical Professor of Family & Community Medicine, UTHSC-Houston
Associate Professor of Medicine (Geriatrics), Baylor College Medicine
Medicalresearch: What are the main findings of the study?Dr. Tan:Our findings¹ are similar to that of an early study by Shores et al ² and other studies on endogenous testosterone that found testosterone lowered mortality. In the analysis of 39,937 patients at the Low T Centers up to 5 years, the rate ratios of new MI and strokes on testosterone as compared to general community based data sets (3,4) was 0.12 (C.I. 0.08-0.18, p<0.0001) and 0.05 (C.I 0.02-0.13, p<0.0001) respectively. Thus, there appears to be a lower risk of heart attacks and strokes with patients on testosterone. While the compared population sets are not identical or real controls; our study does suggest that rates of MI and strokes in real life practice with testosterone treated patients are even lower than the general population registries (which may include older patients).
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MedicalResearch.com Interview with:Dr. Duncan M. Chanda MD
Institute for Medical Research & Training and UNZA-UCLMS
Research and Training Project
University Teaching Hospital
Lusaka, Zambia
MedicalResearch: What are the main findings of the study?Dr. Chanda:The main findings are that in this cohort of relatively healthy patients, with a median CD4 of 367, ART can be delayed till the end of TB short course chemotherapy without deleterious effects. This differs from studies that looked at cohorts with very low median CD4 ( around 25-150 in most cases) in which early cART was found to reduce mortality and other AIDS defining events.
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MedicalResearch.com Interview with Dr. Derek Radisky PhD
Associate Professor and Consultant
Mayo Clinic Cancer Center
MedicalResearch: What are the main findings of the study? Dr. Radisky: The study used human tissue biopsies to find that production of matrix metalloproteinse-3 (MMP3) in pancreatic cancer biopsies was associated with poorer patient prognosis, and showed through transgenic animal and cell culture experiments that this was due to activation of the oncogenic protein Rac1b. The study thus identifies an MMP3-Rac1b signaling axis that drives pancreatic cancer progression.
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MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE
Chief of Staff, John D. Dingell VA Medical Center
Associate Dean for Veterans Affairs & Professor of Surgery
Wayne State University School of Medicine
John D. Dingell VA Medical Center Chief of Staff
Detroit, MI 48201
MedicalResearch: What are the main findings of the study?Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.
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MedicalResearch.com Interview with:Michael T. C. Poon, MBChB, BMedSci (Hons)
Junior Doctor, Wycombe General Hospital
Buckinghamshire Healthcare NHS Trust, UK
MedicalResearch: What are the main findings of the study?Dr. Poon: At present, we know that the incidence and one-month case fatality of intracerebral haemorrhage (ICH) have remained static for the past two decades. However, any trend in long-term survival after ICH is less clear. Survivors face the risks of recurrent ICH as well as ischaemic events in the future. The balance between these risks has particular clinical implication on the decision about restarting antiplatelet/anticoagulant therapy after ICH. To address these questions, we undertook a systematic review and meta-analysis to determine whether long-term survival after intracerebral haemorrhage has changed over time, and to re-assess the balance between the risks of recurrent ICH and ischaemic events in studies quantifying both of these risks in the same population.
The survival rates after ICH at 1 year and 5 years do not appear to have changed over time – 1 year survival was 46% and 5 year survival was 29%. The risk of recurrent ICH may be influenced by the ICH location, with lobar ICH having a higher rate of recurrence. In contrast to the previous systematic review, we found the risk of ischaemic stroke to be at least as high as the risk of recurrent ICH over 3 years after ICH. This reinforces the difficulty that clinicians and patients have in deciding about antithrombotic treatment after ICH.
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MedicalResearch.com Interview with:Seok-Yong Lee, Ph.D.
Assistant Professor of Biochemistry and
Ru-Rong Ji, Ph.D.
Distinguished Professor of Duke University
Professor of Anesthesiology and Neurobiology
Chief of Pain Research
Duke University Medical Center
Durham, NC 27710
MedicalResearch: What are the main findings of the study? Answer:We have developed an antibody that can block the pain and itching sensations in mice simultaneously with high efficacy. We would like to point out that our discovery has the potential to be applied to human once the antibody is humanized. Given the high selectivity, general safety profile, and long half-lives of monoclonal antibodies, this method we developed to raise antibodies against therapeutic targets (e.g., ion channels) can have broad applications to other diseases.
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MedicalResearch.com Interview with:Dr. Sarah Hawley PhD MPH
Associate Professor in the Division of General Medicine
University of Michigan
Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development
MedicalResearch: What are the main findings of the study?Dr. Hawley: There are a couple of main findings.
First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
MedicalResearch.com Interview with:Bríain ó Hartaigh, Ph.D.
Assistant Research Professor of Epidemiology
Dalio Institute of Cardiovascular Imaging
NewYork-Presbyterian Hospital and the Weill Cornell Medical College
Belfer Research Building New York, NY 10021
MedicalResearch: What are the main findings of the studyDr. Hartaigh: Elevated resting heart rate (RHR) during childhood and midlife are associated with an increased risk of all-cause mortality.
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MedicalResearch.com Interview with:
Katharine N. Sourbeer, BS
Institute for Medical Research
Durham, N.C.
MedicalResearch: What are the main findings of the study?Answer: In a study where biopsies were conducted independent from PSA, more metabolic syndrome components were found to be associated with more high-grade prostate cancers. (more…)
MedicalResearch.com Interview with:Edward Giovannucci, MD, ScD
Department of Nutrition
Harvard School of Public Health
Boston, MA
MedicalResearch: What are the main findings of the study?Dr. Giovannucci: In 50,000 men followed over 24 years, we found that those regularly consuming tomato products, which are high in lycopene, had a 30% lower risk of developing lethal prostate cancer. Among men being screened regularly with PSA, the risk reduction from high tomato consumption was 50%. We also examined the prostate cancer tissue and found that higher dietary lycopene intake was associated with less new blood vessel formation, which may help explain why the cancers were less likely to progress.
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MedicalResearch.com Interview with:Neel M. Butala, AB
Medical student at Yale School of Medicine
New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?
Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010.
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MedicalResearch.com Interview with:
Unab I. Khan, M.B.,B.S., M.S.
Assistant Professor of Pediatrics and Family & Social Medicine
Division of Adolescent Medicine
The Children’s Hospital at Montefiore
The Pediatric Hospital for Albert Einstein College of Medicine
Bronx, NY 10467
MedicalResearch: What are the main findings of the study?Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly.
On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions.(more…)
MedicalResearch.com Interview with: Nitesh D. Kuhadiya MD, MPH
Assistant Professor of Medicine
Section of Endocrinology,Diabetes and Metabolism
University of Buffalo, New York
MedicalResearch: What are the main findings of the study?
Dr. Kuhadiya: This is the first randomized clinical trial to show that the addition of liraglutide 1.2 and 1.8mg to insulin significantly reduces HbA1c, mean blood glucose, total insulin doses, body weight, carbohydrate intake, C-Reactive protein (a marker of cardiovascular risk), significantly improves quality of life and reduces systolic blood pressure(top number in a blood pressure reading) in 1.8mg group in patients with type 1 diabetes over a period of 12 weeks.
In 1.2mg, HbA1c fell by 0.78% from 7.84 to 7.06% and in 1.8mg group fell by 0.42% from 7.41 to 6.99% which means that more number of patients will be able to achieve HbA1c levels close to 7% and lower which is recommended by most diabetes organizations. Also the total daily dose of insulin fell by about 10-12 units in both groups. The total daily carbohydrate intake in both the groups fell by an average of 40 grams. There was a 5 kg weight loss in both 1.2 mg and 1.8 mg groups and both these groups on an average lowered their Body Mass Index from 29 to 28 kg/m2 . In 1.8 mg group there was fall in systolic blood pressure by 9 mm from 120 to 111 mm Hg.
The improvements seen are important because 40 to 50 percent of people with Type 1 diabetes have the metabolic syndrome(Cluster of risk factors, including high blood pressure, large waistline, high blood sugar, low HDL ("good") cholesterol and high triglycerides (fats in the blood) which increases the chances of later developing Type 2 diabetes and heart disease.
Our findings have significant implications for the future treatment of patients with Type 1 Diabetes.
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MedicalResearch.com Interview with:Scott Stroup, MD, MPH
Professor of Psychiatry
Director, Program for Intervention Effectiveness Research,
Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric InstituteDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
MedicalResearch: What are the main findings of the study?Dr. Stroup:We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.
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