Turn Off the Smartphone and TV at Night To Reduce Risk of Weight Gain

MedicalResearch.com Interview with:

Lead author: Yong-Moon (“Mark”) Park, MD, PhD Postdoctoral fellow Epidemiology Branch National Institute of Environmental Health Sciences

Dr. Park

Lead author: Yong-Moon (“Mark”) Park, MD, PhD
Postdoctoral fellow
Epidemiology Branch
National Institute of Environmental Health Sciences

Senior author: Dale P. Sandler, PhD Chief, Epidemiology Branch, National Institute of Environmental Health Sciences National Institutes of Health

Dr. Sandler

 

Senior author: Dale P. Sandler, PhD
Chief, Epidemiology Branch, National Institute of Environmental Health Sciences
National Institutes of Health

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

Response: A few studies had suggested that exposure to artificial light while sleeping was associated with obesity. However, the previous studies were cross-sectional, so we really do not know which came first – exposure to artificial light while sleeping or obesity. Another problem was that previous studies did not fully account for other characteristics that could affect this association, such as sleep duration and quality, calorie intake and dietary patterns, and physical activity.

We studied nearly 44,000 women ages 35-74 from across the US who are enrolled in the Sister Study cohort. Women had body weight characteristics measured at baseline and provided self-reported information on weight at baseline and follow-up – on average 5.7 years later.

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Mortality: Number of Steps Matter, Up To a Point

MedicalResearch.com Interview with:

I-Min Lee, MD, ScDProfessor of Medicine, Harvard Medical SchoolProfessor of EpidemiologyHarvard T.H. Chan School of Public Health

Prof. I-Min Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology
Harvard T.H. Chan School of Public Health 

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

Response: While we have many studies showing that physical activity is beneficial for health, there are few data on steps and health, particularly long-term health outcomes.  An expert committee – the 2018 Physical Activity Guidelines Advisory Committee, which reviewed the scientific evidence to support the recently released Physical Activity Guidelines for Americans, 2nd edition – noted this (i.e., the relation between steps and health outcomes) to be a critical gap in knowledge, since many individuals are using wearables and monitoring their step counts.

We often hear the number 10,000 steps cited as a daily goal, but the basis for this number is unclear. It likely originated as a marketing tool: in 1965, the Yamasa Clock and Instrument Company, Japan sold a pedometer called “Manpo-kei” – “ten thousand steps meter” in Japanese.

For many older people, 10,000 steps/day can be a very daunting goal; thus, we wanted to investigate whether this was necessary for lower mortality rates in older women.  Additionally, steps taken can be fast or slow, and there are no published studies on step intensity and long-term health outcomes.  Note that walking pace and step intensity are not the same concept: walking pace gauges intensity when walking purposefully (e.g., for exercise or transportation), while step intensity assesses an overall best natural effort in our daily life. Continue reading

Higher Risk of Cardiovascular Disease Linked to Long Term Antibiotic Use in Women

MedicalResearch.com Interview with:
Dr. Lu Qi MD PhD
Department of Epidemiology, School of Public Health and Tropical Medicine
Tulane University New Orleans, LA 70112
Department of Nutrition, Harvard T.H. Chan School of Public Health,
Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
Boston, MA 02115

Yoriko Heianza RD, PhD
Department of Epidemiology, School of Public Health and Tropical Medicine,
Tulane University
New Orleans, LA 

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

Response: Growing data suggest that antibiotic exposure is associated with a long-lasting alteration in gut microbiota, and may be related to subsequent cardiovascular disease (CVD). We investigated associations of duration of antibiotic use in different phases of adulthood (young, middle and late adulthood) with the CVD incidence among women at usual risk.

This new analysis from the Nurses’ Health Study shows that women who take antibiotics for long periods, especially during more recent adulthood (such as  in middle- and late adulthood) had a higher risk of CVD in later life.  Continue reading

Very Low LDL Cholesterol Associated with Hemorrhagic Stroke in Women

MedicalResearch.com Interview with:

Pamela M. Rist, ScDAssistant Professor of Medicine, Harvard Medical SchoolBrigham and Women's Hospital, Division of Preventive MedicineBoston, MA 02215 

Dr. Rist

Pamela M. Rist, ScD
Assistant Professor of Medicine, Harvard Medical School
Brigham and Women’s Hospital, Division of Preventive Medicine
Boston, MA 02215 

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

Response: Although hypercholesterolemia is a risk factor for ischemic stroke, some prior studies have observed an inverse association between total and low-density lipoprotein (LDL) cholesterol and risk of hemorrhagic stroke.  However, many studies were not able to study this association specifically among women.

Our main result was very low levels of low-density lipoprotein (LDL) cholesterol or low levels of triglycerides were associated with an increased risk of hemorrhagic stroke among women. Continue reading

Suboptimal Physical Activity in Women Associated With Increased Healthcare Spending

MedicalResearch.com Interview with:
Erin D. Michos, MD, MHS, FACC, FAHA, FASE
Associate Professor of Medicine and Epidemiology
Associate Director of Preventive Cardiology
Ciccarone Center for the Prevention of Heart Disease
Johns Hopkins School of Medicine

Victor Okunrintemi, MD, MPH
Department of Internal Medicine
East Carolina University
Greenville, North Carolina 

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

Response: Women are less physically active than men on average, and the lack of regular physical activity has been associated with increased risk of cardiovascular disease and poorer health outcomes. Although recommendations encouraging regular physical activity has been in place for decades, we do not know how much of these recommendations are met, particularly among high risk women with established cardiovascular disease for secondary prevention.

This study was therefore designed with the aim of describing the 10-year trends for the proportion of women with cardiovascular disease who do not meet these recommend physical activity levels, overall and by key sociodemographic groups, and the associated cost implications.

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Medication Abortion Rebounded in Texas After FDA Approved Label Change for Mifeprex®

Sarah Baum, MPHinvestigator at the Texas Policy Evaluation ProjectAssociate at Ibis Reproductive Health

Sarah Baum

MedicalResearch.com Interview with:
Sarah Baum, MPH

investigator at the Texas Policy Evaluation Project
Associate at Ibis Reproductive Health

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

Response: Before 2013, use of medication abortion in Texas mirrored national trends, which have steadily increased since the approval of mifepristone–one of the two medications used for medication abortion–in 2000. However, House Bill 2 (HB 2), which was implemented on November 1, 2013, imposed restrictions on medication abortion and required providers to follow the outdated mifepristone label. HB 2 reduced the gestational age limit to 49 days and generally required four visits.

On March 29, 2016, the US Food and Drug Administration (FDA) approved a revised label for Mifeprex® (mifepristone 200 mg) that reflected evidence-based practice, which essentially nullified the medication abortion restrictions in HB 2. The label change brought medication abortion prescribing guidelines in line with evidence-based practice, reducing the number of required in-person visits from four to two and extending the period when patients can take the pill from seven weeks of pregnancy to 10 weeks. Continue reading

Massive Reduction in Cervical Cancer Among Vaccinated Young Women

MedicalResearch.com Interview with:

Dr. Tim PalmerHonorary Senior LecturerDepartment of PathologyUniversity of EdinburghEdinburgh, UK

Dr. Palmer

Dr. Tim Palmer
Honorary Senior Lecturer
Department of Pathology
University of Edinburgh
Edinburgh, UK 

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

Response: High risk HPV infection is the obligate cause of between 70 and 90% of cervical cancers, depending upon the country. The development of vaccines against the commonest hr-HPV types has the potential to reduce the burden of cervical cancer, especially in low and middle income countries that cannot afford screening programmes. Cervical cancer affects predominantly women in their 30s and is a major public health issue even in countries with well-established screening programmes. Scotland has had a successful immunisation programme since 2008, and women immunised at age 12 to13 have been screened since 2015. We can therefore demonstrate the effect of hr-HPV immunisation on the pre-invasive stages of cervical cancer.

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Therapeutic HPV Vaccine Can Trigger Resolution of Virus and Cervical Cancer in Some CIN Patients

MedicalResearch.com Interview with:

Diane Harper, M.D., M.P.H., M.S.Professor of Family Medicine and Obstetrics and GynecologySenior Associate Director, Michigan Institute for Clinical and Health ResearchPhysician Director for Community Outreach, Engagement and Health Disparities,Rogel Cancer CenterMichigan Medicine

Dr. Harper

Diane Harper, M.D., M.P.H., M.S.
Professor of Family Medicine and Obstetrics and Gynecology
Senior Associate Director, Michigan Institute for Clinical and Health Research
Physician Director for Community Outreach, Engagement and Health Disparities,
Rogel Cancer Center
Michigan Medicine 

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

Response: There is no current cure for women with HPV infection that has progressed to CIN 2/3 disease. The only treatment is for the diseased cervix, and does not eliminate the risk of another CIN 2/3 from the HPV infection 15-20 years later.

This vaccine is made from a live virus that has 3 genes inserted:  human cytokine IL-2, and modified forms of HPV 16 E6 and E7 proteins. When the vaccine is injected subcutaneously, the proteins for HPV 16/E6 and E7 and the cytokine LI-2 proteins are made. These proteins trigger the immune response.  This is very different form imiquimod which is topical and not specific for HPV.

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Long Term Hormone Use May Raise Risk of Alzheimer’s Disease

MedicalResearch.com Interview with:

Tomi Mikkola MDAssociate ProfessorHelsinki University HospitalDepartment of Obstetrics and GynecologyHelsinki, Finland

Dr. Mikkola

Tomi Mikkola MD
Associate Professor
Helsinki University Hospital
Department of Obstetrics and Gynecology
Helsinki, Finland

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

Response: In Finland we have perhaps the most comprehensive and reliable medical registers in the world. Thus, with my research group I have conducted various large studies evaluating association of postmenopausal hormone therapy use and various major diseases (see e.g. the references in the B;MJ paper). There has been various smaller studies indicating that hormone therapy might be protective for all kinds of dementias, also Alzheimer’s disease.

However, we have quite recently shown that hormone therapy seems to lower the mortality risk of vascular dementia but not Alzheimer’s disease (Mikkola TS et al. J Clin Endocrinol Metab 2017;102:870-7). Now in this upcoming BMJ-paper we report in a very large case-control study (83 688 women with Alzheimer’s disease and same number of control women without the disease) that systemic hormone therapy was associated with a 9-17% increased risk of Alzheimer’s disease.

Furthermore, this risk increase is particularly in women using hormone therapy long, for more than 10 years. This was somewhat surprising finding, but it underlines the fact that mechanisms behind Alzheimer’s disease are likely quite different than in vascular dementia, where the risk factors are similar as in cardiovascular disease. We have also shown how hormone therapy protects against cardiovascular disease, particularly in women who initiate hormone therapy soon after menopause. Continue reading

Birth Control Pills May Make It Harder for Women To Identify Complex Emotions

MedicalResearch.com Interview with:

Dr. Alexander Lischke, Dipl.-Psych. Universität Greifswald Institut für Psychologie Physiologische und Klinische Psychologie/Psychotherapie University of Greifswald, Germany

Dr. Lischke

Dr. Alexander Lischke, Dipl.-Psych.
Universität Greifswald
Institut für Psychologie
Physiologische und Klinische Psychologie/Psychotherapie
University of Greifswald, Germany

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

Response: We know for a long time that cyclic variations in womens’ estrogen and progesterone levels affect their emotion recognition abilities by modulating neural activity in brain regions implicated in emotion processing. We also know that oral contraceptives suppress cyclic variations in womens’ estrogen and progesterone levels. We, thus, assumed that oral contraceptives would affect womens’ emotion recognition abilities due to the aforementioned suppression of cylic variations in estrogen and progesterone levels that modulate neural activity in brain regions during emotion processing. To test this assumption, at least with respect to the behavioral effects of oral contraceptive use on emotion recognition, we performed the current study.

We recruited regular cylcling women with and without oral contraceptive use for our study. None of the women were in psychotherapeutical or psychopharmacological treatment at the time of the study. During the study, women performed a emotion recognition task that required the recognition of complex emotional expressions like, for example, pride or contempt.
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Self-Compression During Mammography Evaluated

MedicalResearch.com Interview with:
"Kiki Gets a Mammogram" by kristiewells is licensed under CC BY-NC-SA 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by-nc-sa/2.0Philippe Henrot, MD
Radiology Department
Institut de Cancerologie de Lorraine
Vandoeuvre-les-Nancy 

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

Response: The initial observation was that daily practice of mammography shows a substantial proportion of women that report a negative experience after having a mammogram. Compression of the breast before delivering X-rays is mandatory to achieve the best image quality and to detect small cancers. Unfortunately, compression is uncomfortable, even sometimes painful.

We took into consideration a study of PJ Kornguth et al. published in 1993 reporting the self-compression technique. In this study one breast was compressed by the radiographer and the other with self-compression. The author reported a high level of patient satisfaction, and a lower discomfort, without compromising image quality. We performed a multicenter prospective randomized trial to demonstrate the feasibility of the self-compression technique in condition similar to routine screening or follow-up, compared with standard compression. The primary outcome was to demonstrate that self-compression did not lead to compress the breast less than standard compression, and that was done. The secondary outcomes were to evaluate pain, compression force and image quality.

The results indicated that compression force was higher when the women controlled themselves the compression of their breast, and the pain measured on a visual analogue scale was lower. Moreover, image quality was not compromised compared with standard compression.  Continue reading

Self Sampling for Cervical HPV: Useful Screening Tool

MedicalResearch.com Interview with:

Prof. J. (Hans) Berkhof PhD Vrije Universiteit Amsterdam 

Prof. Berkhof

Prof. J. (Hans) Berkhof PhD
Vrije Universiteit
Amsterdam 

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

Response: In most countries, the Pap test is used for cervical cancer screening but recently several countries have switched from Pap testing to HPV testing.

Like the Pap test, the HPV test requires a cervical sample to be taken by a clinician. Vaginal self-sampling is also used, but only in underscreened women. We know that self-sampling increases screening participation in underscreened women and it is likely that many women that attend screening also prefer self-sampling if it had been offered to them.

We studied whether an HPV self-sampling test is an accurate alternative to a regular HPV test in women invited for routine screening. We randomized about 14,000 women, invited for screening, to self-sampling or clinician-sampling. Women with a positive HPV test result also received the other HPV test.

We found that the HPV self-sampling test yielded similar performance as the regular HPV test for detection of cervical pre-cancerous lesions (CIN3 and CIN2).  Continue reading

Breastfeeding Linked to Less Belly Fat and Smaller Waist Size

MedicalResearch.com Interview with:
"Breast feeding... Like its her job." by Jason Lander is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Gabrielle G. Snyder, MPH
Department of Epidemiology
Graduate School of Public Health
University of Pittsburgh

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

Response: Although previous studies have investigated the association between breastfeeding duration and maternal weight change, we still do not know if there is an optimal duration of breastfeeding for mothers in order to realize potential health benefits. Furthermore, these studies were unable to determine whether health outcomes were due to breastfeeding or other health-promoting behaviors, like better diet and more physical activity.

Our study aims to address both points. To test the association between breastfeeding duration and maternal waist circumference, we used traditional regression models as well as two additional statistical methods that allowed us to control for factors that may influence if a woman would breastfeed and for how long. We found that women who breastfed more than 6 months had smaller waist circumference, as well as lower body mass index, one decade after delivery compared to women who breastfed 6 months or less. These results were consistent across all statistical methods.  Continue reading

Reclast, Zometa (zoledronate) Reduced Fractures in Osteopenic Older Women

MedicalResearch.com Interview with:

Prof Ian Reid Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand

Prof. Reid

Prof Ian Reid MD
Faculty of Medical and Health Sciences
University of Auckland
Auckland New Zealand


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

Response: Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with osteopenia is unknown. Most fractures in postmenopausal women occur in osteopenic patients, so therapies with efficacy in osteopenia are needed.

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Mediterranean Diet Linked to Lower Long-Term Cardiovascular Events in Women

MedicalResearch.com Interview with:

Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA

Dr. Mora

Samia Mora, MD, MHS
Associate Professor of Medicine
Harvard Medical School
Director, Center for Lipid Metabolomics
Brigham and Women’s Hospital
Boston, MA

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

Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit.

Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors.

Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites.  Continue reading

Hysterectomy Can Impair Short Term Memory (at least in rats)

MedicalResearch.com Interview with:

Heather A. Bimonte-Nelson, Ph.D. Professor, Barrett Honors Faculty Department of Psychology Arizona State University

Dr. Bimonte-Nelson

Heather A. Bimonte-Nelson, Ph.D.
Professor, Barrett Honors Faculty
Department of Psychology
Arizona State University

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

Response: The dogma in the field is that the nonpregnant uterus is dormant, and therefore it has not necessarily been of interest to study. Textbooks have described the nonpregnant uterus as “quiescent,” “dormant,” and “useless.” When I was in graduate school studying endocrinology, I read statements in books saying that the sole purpose of the uterus is for gestation.

However, all women aging into midlife will experience some type of menopause, and some of these women will undergo surgical menopause via removal of all, or a part of, their reproductive tracts. Research evaluating reproductive tract-brain connections has grown quite a bit in the last few decades. For example, the ovary-brain connection has been focused on quite a bit, and we now know that hormones coming from the ovaries (such as estrogens and progesterone) can affect more than reproduction, and can impact brain functioning. While the uterus-brain connection is not well understood, there is research indicating that the uterus and autonomic nervous system communicate directly.

We also know that hormones released from the ovaries impact the uterus. Therefore, there is a uterus-ovary-brain triad system. This uterus-ovary-brain triad has undergone little scientific investigation for functions outside of reproduction. Given that by age 60 one in three women experience hysterectomy, thereby interrupting this uterus-ovary-brain triad system, we believe it is important to understand the effects of variants of surgical menopause including hysterectomy.

This led to our current evaluation testing multiple variations in surgical menopause using a rat model, where we tested the effects of uterus removal alone (hysterectomy), ovarian removal alone, or uterus plus ovarian removal.

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Risk Factors for Melanoma in Women

MedicalResearch.com Interview with:

One example of malignant melanoma, courtesy of skin cancer foundation

One example of malignant melanoma, courtesy of Skin Cancer Foundation

Reza Ghiasvand, PhD
Oslo Centre for Biostatistics and Epidemiology
Faculty of Medicne
University of Oslo
Oslo, Norway 

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

Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age.

It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis.

In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years.

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Surgical Menopause Linked To More Insomnia and Sleep Difficulties

MedicalResearch.com Interview with:

Sooyeon Suh, PhD Department of Psychology Sungshin University Seoul, Republic of Korea

Dr. Suh

Sooyeon Suh, PhD
Department of Psychology
Sungshin University
Seoul, Republic of Korea

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

Response: Women who are going through menopause frequently complain of sleep complaints and depressive symptoms in addition to other typical symptoms such as hot flashes and night sweats. Two of the most common ways of becoming menopausal are through natural menopause and surgical menopause. While natural menopause is usually experienced in the course of aging, surgical menopause is usually induced by OBGYN surgery such as bilateral oopherectomy, often as a result of illnesses such as ovarian cancer.

Many studies have found that women who experience surgical menopause often experience more psychological and physical difficulties compared to women who transition through menopause naturally due to a more acute drop in estrogen following surgery, it sometimes leads to the need for practices like Advanced Gynecology to help manage the symptoms. Unfortunately, in clinical settings, women who undergo surgical menopause are not provided with additional psychoeducation or customized treatment to address these issues.

The main findings of these studies support these issues. In 526 postmenopausal women, women who went through surgical menopause reported significantly worse sleep quality an shorter sleep duration. Additionally, they had a 2.13 times higher likelihood of having insomnia that warranted treatment.

Finally, even though women who went through surgical menopause engaged in the same sleep-interfering behaviors (e.g., drinking caffeine, drinking alcohol before bed, watching TV in bed, etc) as women who went through menopause naturally, their sleep was impacted more negatively. Continue reading

Female Genital Mutilation of Young Girls Declines in Africa, Not in Western Asia

MedicalResearch.com Interview with:
Professor Ngianga-Bakwin Kandala Professor of Biostatistics Department: Mathematics, Physics and Electrical Engineering Northumbria University, UKProfessor Ngianga-Bakwin Kandala

Professor of Biostatistics
Department: Mathematics, Physics and Electrical Engineering
Northumbria University, UK

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

Response: The background “UNICEF (2014) estimates that worldwide more than two hundred million women have undergone some form of FGM/C, and approximately 3.3 million girls are cut each year. Recent estimates show that if FGM/C practices continue at current, 68 million girls will be cut between 2015 and 2030 in 25 countries where FGM is routinely practiced and more recent data are available (UNJP, 2018).”

Main findings: The prevalence of FGM/C among children varied greatly between countries and regions and also within countries over the survey periods. We found evidence of significant decline in the prevalence of FGM/C in the last three decades among children aged 0–14 years in most of the countries and regions, particularly in East, North and West Africa. We show that the picture looks different in Western Asia, where the practice remains and affects the same age group.

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Is Pregnancy a “Stress Test” for Future Dementia Risk?

MedicalResearch.com Interview with:
"Pregnancy 1" by operalynn is licensed under CC BY 2.0Heather Boyd, Ph.D.
Senior researcher
Department of Epidemiology Research
Copenhagen Denmark

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

Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart.

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Nolasiban Phase 3 IMPLANT 2 Trial: IVF Live Birth Rate Increased Up to 35%

MedicalResearch.com Interview with:
Dr. Ernest Loumaye, MD, PhD
Co-Founder and CEO
ObsEva SA  

MedicalResearch.com: What is the background for this announcement? How does Nolasiban work to decrease contractions and improve uterine blood flow?

Response: The WHO has recognized infertility as a global health issue, and many couples undergo IVF treatment: there are more than 700,000 annual IVF treatment cycles in Europe and more than 200,000 in the U.S. However, more than 50% of IVF procedures do not result in pregnancy, and failure has tremendous emotional and financial costs to patients.  ObsEva is dedicated to improving fertility outcomes in IVF while also supporting the use of single embryo transfer to minimize multiple births that are associated with significant health risks to mother and baby, as well as significant health costs from premature delivery.

Nolasiban works by blocking the hormone oxytocin, which is known to induce uterine contractions.  Nolasiban reduces uterine contractions and could improve uterine blood flow, both effects being favourable for the embryo to properly implant. Continue reading

Mediterranean Diet Linked To Stroke Risk Reduction in Women

MedicalResearch.com Interview with:
“Vegetables” by Wagner T. Cassimiro "Aranha" is licensed under CC BY 2.0Professor Phyo Kyaw Myint MBBS MD FRCP(Edin) FRCP(Lond)
Clinical Chair in Medicine of Old Age
Academic Lead: Ageing Clinical & Experimental Research &
Director of Clinical Academic Training Development
The Lead Academic, Aberdeen Clinical Academic Training (ACAT) Programmes
School of Medicine, Medical Sciences & Nutrition
College of Life Sciences & Medicine, University of Aberdeen

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

Response: While Mediterranean Diet has been linked to reduced stroke risk it remains unclear
(1) its impact on populations within non-Mediterranean countries;
(2) its specific impact on different gender;
(3) the effect observed when using more robust dietary assessments; and (4) which specific components of the diet are most protective.

We therefore studied more than 23 thousand men and women (mainly British Caucasian) aged 40 years or older in Norfolk, UK as part of EPIC-Norfolk study and we found that the greater adherence to Mediterranean dietary pattern is linked to a significant reduction in stroke risk in women but not in men. This benefit was seen across the whole middle and older age population (particularly for women) regardless of their existing risk factors such as high blood pressure.

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HPV Testing or PAP Smear To Screen for Cervical Cancer?

MedicalResearch.com Interview with:

Joy Melnikow, MD, MPH Professor, Department of Family and Community Medicine Director, Center for Healthcare Policy and Research University of California, Davis Sacramento, CA 95817

Dr. Melnikow

Joy Melnikow, MD, MPH
Professor, Department of Family and Community Medicine
Director, Center for Healthcare Policy and Research
University of California, Davis
Sacramento, CA 95817

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

Response: This systematic review of the medical literature was conducted to support the update of the US Preventive Services Task Force Recommendation.  Because the effectiveness of cytology (Pap smear) screening is so well established, the review focused on the evidence on use of high risk Human Papillomavirus (hrHPV) screening, alone (primary screening) or combined with cytology (co-testing)

MedicalResearch.com: What should readers take away from your report?

Response: Current evidence supports the use of cytology, hrHPV testing alone, or co-testing as effective approaches to screening for cervical cancer.  hrHPV testing, alone or as co-testing, can be done at five year intervals, longer than the recommended 3 year interval for cytology. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Additional research is needed to identify effective strategies for outreach and screening women who are not regularly screened.  Because most women in the US are not part of an organized screening program, effective outreach is especially important in the US. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Since the prior review, more evidence has emerged to support the use of hrHPV testing as primary screening.

I have no financial conflicts of interest. 

Citation:

US Preventive Services Task Force. Screening for Cervical CancerUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674–686. doi:10.1001/jama.2018.10897

Aug 22, 2018 @ 12:01 pm 

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Patients With Type II Diabetes Have Greatest Risk of Heart Failure

MedicalResearch.com Interview with:

Dr Araz Rawshani, PhD Department of Molecular and Clinical Medicine Institute of Medicine University of Gothenburg Gothenburg, Sweden

Dr. Rawshani

Dr Araz Rawshani, PhD
Department of Molecular and Clinical Medicine
Institute of Medicine
University of Gothenburg
Gothenburg, Sweden

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

 Response: Patients with type 2 diabetes have 2 to 4 times greater risk for death and cardiovascular events compared to the general population. There are several randomized trails that encourage a range of interventions that target traditional and modifiable risk factors, such as elevated levels for glycated hemoglobin, blood pressure and low-density lipoprotein cholesterol to reduce the risk for complications of type 2 diabetes. However, there are few randomized trails that have investigated the effects of multifactorial risk factor intervention in reducing the risk for death and cardiovascular events, as compared to patients that are treated with usual care.

We set out to investigate the extent to which the excess risk associated with type 2 diabetes may be mitigated or potentially eliminated by means of evidence-based treatment and multifactorial risk factor modification. In addition, we estimated the relative importance between various risk factors and the incremental risk of death and cardiovascular events associated with diabetes. Furthermore, we investigated the association between glycated hemoglobin, systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) within evidence based target ranges and the abovementioned outcomes.

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HPV Testing Detects Cervical Pre-Cancer Earlier Than PAP Tests

MedicalResearch.com Interview with:

Gina Ogilvie | MD MSc FCFP DrPH Professor | Faculty of Medicine | University of British Columbia Canada Research Chair | Global control of HPV related disease and cancer Senior Public Health Scientist | BC Centre for Disease Control Senior Research Advisor | BC Women's Hospital and Health Centre BC Women's Hospital and Health Centre Vancouver, BC

Dr. Gina Ogilvie

Dr. Gina Ogilvie | MD MSc FCFP DrPH
Professor | Faculty of Medicine | University of British Columbia
Canada Research Chair | Global control of HPV related disease and cancer
Senior Public Health Scientist | BC Centre for Disease Control
Senior Research Advisor | BC Women’s Hospital and Health Centre
BC Women’s Hospital and Health Centre
Vancouver, BC

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

Response: HPV is known to be the cause of 99% of cervcial cancers.

In this study, we compared the routine screening test for cervical cancer, Pap test, to HPV testing.

We found that by using HPV testing, women were significantly more likely to have cervical pre-cancers detected earlier. In addition, women with negative HPV tests were significantly less likely to have pre-cancers 48 months later.

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Greater Risk of Diabetes in Women With Longer Work Week

MedicalResearch.com Interview with:

Mahée Gilbert-Ouimet, PhD Postdoctoral fellow/Chercheure postdoctorale Institute for Work & Health Hôpital du St-Sacrement,  Québec 

Dr. Gilbert-Ouimet

Mahée Gilbert-Ouimet, PhD
Postdoctoral fellow/Chercheure postdoctorale
Institute for Work & Health
Hôpital du St-Sacrement,  Québec 

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

Response: Diabetes is one of the primary causes of death worldwide, in addition to being a major risk factor for several other chronic diseases including cardiovascular diseases. Considering the rapid and substantial increase of diabetes prevalence, identifying modifiable risk factors is of major importance. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. Our study evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada.

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USPSTF: Women 65 and Older Should Be Screened for Osteoporosis to Prevent Fractures

MedicalResearch.com Interview with:

Chien-Wen Tseng, M.D., M.P.H., M.S.E.E. Hawaii Medical Service Association Endowed Chair in health services and quality research Associate professor, and the Associate research director Department of Family Medicine and Community Health University of Hawaii John A. Burns School of Medicine

Dr. Chien-Wen Tseng

Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
Hawaii Medical Service Association Endowed Chair in health services and quality research
Associate professor, and the Associate research director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine 

MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?

Response: Osteoporosis is a condition where bones become weak and can break or fracture more easily. These fractures can happen at the spine, hip, and other locations, and can have serious health consequences such as pain, limited mobility, or even death. By 2020, more than 12 million Americans over the age of 50 are expected to have osteoporosis and two million fractures occur yearly.

Since people often may not know they have osteoporosis until they have a fracture, the U.S. Preventive Services Task Force looked at the evidence to see if screening for osteoporosis can help to prevent fractures. We found that screening for and treating osteoporosis can prevent fractures in women ages 65 and older and in younger women who have been through menopause and have additional factors that put them at increased risk for osteoporosis.

In men, more research is needed to know if routine screening and treatment for osteoporosis can prevent fractures. Continue reading

Unique Vaginal Cells Facilitate HIV Infection and Persistence

MedicalResearch.com Interview with:

Manish Sagar, MD Assistant Professor of Medicine, Boston University School of Medicine Boston MA 

Dr. Sagar

Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA 

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

Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure.  The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.

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Obese Women Remain at Risk For Heart Disease, Even When Metabolically Healthy

MedicalResearch.com Interview with:
Nathalie Eckel, MSc

German Diabetes Center
Düsseldorf, Germany 

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

 Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called “metabolically healthy obesity” and “metabolically unhealthy normal-weight”. So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

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CPAP Improved Sexual Quality of Life for Women

MedicalResearch.com Interview with:

“The new CPAP machine” by Bryan Alexander is licensed under CC BY 2.0

One CPAP model
Image by Bryan Alexander

Sebastian M. Jara, MD
Resident Physician & Research Fellow
Department of Otolaryngology – Head & Neck Surgery
University of Washington Affiliated Hospitals 

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

Response: Sleep apnea is a common disorder associated with numerous health consequences and reduced quality of life. There is growing evidence that sleep apnea also affects sexual quality of life and that treatment for sleep apnea, with CPAP (continuous positive airway pressure), may improve sexual quality of life. The goal of this study was to evaluate the impact of long-term CPAP therapy on sexual quality of life in a group of men and women with sleep apnea.

Our study included 182 men and women with newly diagnosed obstructive sleep apnea, each of whom were prescribed a CPAP. Subjects completed a quality of life survey, which included questions on sexual quality of life, at their initial clinic visits and again one year later. Changes in sexual quality of scores over time were then compared between CPAP users and non-users.

Among the subjects, 72 used a CPAP nightly and 110 did not. When looking at all subjects, an overall improvement in sexual quality of life was observed in subjects that used their CPAP compared to subjects that did not, after accounting for several factors that can also affect sexual quality of life. When subgroup analysis was performed, a large improvement in sexual quality of life was noticed for women in the study. In contrast, men in the study experienced little-to-no improvement in sexual quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: These findings add to a large body of evidence that CPAP improves overall health and quality of life, in both men and women with sleep apnea. Because sleep apnea is more common men, there are fewer studies, especially those assessing sexual dysfunction, in women. However, there’s growing recognition that women, too, are affected and can benefit from CPAP use. Our findings demonstrate that improved sexual quality of life is one of the many health benefits that comes with CPAP treatment for women.While this study showed no improvements in sexual quality of life for men, CPAP has been shown to have numerous other health benefits in men and use should still be encouraged. Our hope is that the findings of this study will help motivate patients of both sexes who sleep poorly to seek evaluation for sleep apnea as treatment can have a wide-range of health benefits, including improved sexual quality of life. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, it will be important to study more comprehensive measures of sexual quality of life in sleep apnea patients. This will include both a more extensive assessment of sexual quality of life in patients themselves and effects on their bed partners. Additionally, it will be important to test the effects of other sleep apnea treatments, such as surgery. Although CPAP is the first-line treatment for sleep apnea, it can be cumbersome to wear and might adversely affect intimacy and sexual quality of life compared to other treatments. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study was funded by the National Institutes of Health. The authors of this study otherwise have no other funding, financial relationships, or conflicts of interest to disclose. 

Citation:

Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485

 

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