medicalresearch.com: medical research exclusive interviews march 12 2015

MedicalResearch.comExclusive Interviews with Medical Research and

Health Care Researchers from Major and Specialty Medical Research Journals and Meetings

Editor: Marie Benz, MD [email protected]

March 11 2015

For Informational Purposes Only: Not for Specific Medical Advice.

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Hepatocyte Growth Factor May Improve Painful Diabetic NeuropathyMedicalResearch.com Interview with:

Dr. John A Kessler MDThe Ken and Ruth Davee Professor of Stem Cell Biology Department of Neurology Professor, Department of Pharmacology

Northwestern University Feinberg School of Medicine

• Medical Research: What is the background for this study? What are the main findings?

Dr. Kessler: Painful diabetic neuropathy afflicts millions of patients. It interferes with sleep and many daily activities of living, and predisposes to depression.

• There is a loss of sensation in the legs which predisposes to foot/leg ulcers which may lead to amputation.

• The only currently available treatments, other than controlling glucose levels, are drugs including gabapentin, pregabalin, or antidepressants which have major side effects and which help only some patients.

• These are medications which must be taken daily or several times daily and are often poorly tolerated by patients.

• This study examined the effects of a nonviral gene therapy approach for using hepatocyte growth factor (HGF) to treat patients with painful diabetic neuropathy. HGF helps to support the health of neurons and it also helps to grow new blood vessels to support nerve function.

• Patients received two sets of treatments (injections) and were then followed for 9 months. The treatment was exceptionally well tolerated – literally without significant side effects.

• The patients had highly significant reductions in pain and improvement in the quality of life, and their ability to sense gentle pressure (touch) was improved. The benefits lasted months without additional treatment.

Read the rest of the interviews on MedicalResearch.comContent NOT an endorsement of efficacy and NOT intended as specific medical advice.

http://medicalresearch.com/diabetes/hepatocyte-growth-factor-may-improve-painful-diabetic-neuropathy/12410/

http://medicalresearch.com/menopause/should-the-ovaries-be-removed-at-time-of-hysterectomy-for-benign-disease/1236/





• Medical Research: What should clinicians and patients take away from your report?

• Dr. Kessler: Hepatocyte growth factor gene therapy may provide a treatment that not only reduces symptoms and improves quality of life but also may help to regenerate nerve function.

• No other such potentially regenerative treatments have ever been available.

• The percentage of patients whose symptoms improved exceeded what has generally been reported for any other treatments.

• If the findings are further substantiated in a planned large phase 3 study, this will be the first regenerative therapy for the nervous system.








• Medical Research: What recommendations do you have for future research as a result of this study?

• Dr. Kessler: A planned phase 3 study will seek to make this an approved therapy that will be widely available.

• Future studies will help to determine whether retreatments with hepatocyte growth factor will lead to actual cure of aspects of the nerve damage rather than just relief of symptoms.

• Citation:

• John A. Kessler, A. Gordon Smith, Bong-Soo Cha, Sung Hee Choi, James Wymer, Aziz Shaibani, Senda Ajroud-Driss. Double-blind, placebo-controlled study of HGF gene therapy in diabetic neuropathy. Annals of Clinical and Translational Neurology, 2015; DOI: 10.1002/acn3.186



http://dx.doi.org/10.1002/acn3.186



Nuts May Lower Odds Of Metabolic Syndrome In AdolescentsMedicalResearch.com Interview with:

Dr. Roy Kim, MDDepts. Endocrinology and Pediatrics

UT Southwestern Medical Center

• Medical Research: What was the problem you were focused on?

• Dr. Kim: We were focused on the problem of adolescent metabolic syndrome, a major public health problem. Our objective was to determine whether nut intake is linked with any difference in odds for metabolic syndrome in US adolescents.

• Medical Research: How is metabolic syndrome defined?

• Dr. Kim: In general it is diagnosed when there are 3 or more of the following things: increased belly fat, high blood pressure, high fasting glucose, elevated triglycerides, and low HDL cholesterol.

• Medical Research: How did you do your study?

• Dr. Kim: We used data from the National Health and Nutrition Examination Survey (NHANES), years 2003-2010, to examine health status and the diet history for 2,322 US adolescents age 12 to 19 years.


http://medicalresearch.com/pediatrics/nuts-may-lower-odd-of-metabolic-syndrome-in-adolescents/12419/






• Dr. Kim: Our first major finding was that adolescents who ate at least 12.9 grams of nuts per day – this is the equivalent of about 1 ounce of nuts 3 times per week – had a dramatically lower odds for metabolic syndrome compared to adolescents who ate less than that amount. The odds for nut-consumers was only about 43% of the odds for non-consumers. This remained true after controlling for age, gender, race, income, and dietary factors including sugar, fruit, and vegetable intake.

• Our second major finding was that average nut intake is very low among US adolescents –only about 5 grams per day – and more than 75% of US adolescents eat no nuts at all on a typical day.


• Dr. Kim: First, that a modest amount of daily nut consumption among adolescents is associated with a much reduced odds for metabolic syndrome. This corroborates in adolescents what has been observed in many studies of adults. Our study was cross-sectional, however, so causality cannot be determined. And the second take away point is that, in spite of what we are learning about the health benefits of nut consumption, the vast majority of US adolescents eat no nuts at all on a typical day.



http://medicalresearch.com/diabetes/diabetic_nuts_may_help_control_your_blood_sugar/6762/

http://medicalresearch.com/heart-disease/high-peanut-consumption-linked-to-reduced-cardiovascular-disease-mortality/12155/







• Dr. Kim: Further prospective research is needed to test whether prescribing nuts to adolescents will improve their cardiovascular risk profile.

• Citation:

• ENDO abstract discussing:

• Nut Intake and its Relationship to Metabolic Syndrome in Adolescents

• Authors: Roy J. Kim, MD, MPH, and David Leonard, PhD

• University of Texas Southwestern Medical Center, Department of Pediatrics,Division of Endocrinology, and Children’s Health, Dallas,

• MedicalResearch.com Interview with: Dr. Roy Kim, MD, Depts. Endocrinology and Pediatrics, UT Southwestern Medical Center (2015). Nuts May Lower Odds Of Metabolic Syndrome In Adolescents



https://www.endocrine.org/news-room/endo-annual-meeting



Genetically Modified Soybean Oil Plenish Only Slightly Healthier Than Regular Soybean OilMedicalResearch.com Interview with:

Frances M. Sladek, Ph.D. Professor of Cell Biology and ToxicologistAssociate Director, UCR Stem Cell Center

Department of Cell Biology and Neuroscience University of CaliforniaRiverside, CA 92521-0314


Dr. Sladek: In 2011 Blasbalg et al reported in the American Journal of Clinical Nutrition that the consumption of soybean oil was the component of the American diet that had changed the most since the early 1900s. It had in fact increased 1000-fold. Soybean oil is currently not only the main type of vegetable oil used in the U.S. but soybean meal is a major component of the diet of the animals such as cows and pigs, resulting in changes in the fatty acid composition of animal fat. Soybean oil is also increasingly being used worldwide: 40 million tons were produced in 2007 alone.

• In our previous study we found that a high fat diet containing comparable amounts of soybean oil to what Americans are currently consuming caused mice to become obese, diabetic and insulin resistant and to have large lipid droplets and hepatocyte ballooning in their livers.

• Others had found similar results and proposed that linoleic acid (an omega 6 polyunsaturated fat) that makes up >55% of the oil was responsible for the negative metabolic effects.


http://medicalresearch.com/weight-research/genetically-modified-soybean-oil-plenish-only-slightly-healthier/12425/






• DuPont recently generated a genetically modified soybean oil that had reduced levels of linoleic acid and hence less of a tendency to generate trans fats. This oil (called Plenish) came onto the market for the first time in 2014. The fatty acid composition of Plenish is similar to that of olive oil (low linoleic acid and high oleic acid), which is a major component of the healthy Mediterranean diet. The implication, therefore, is that Plenish is healthier than conventional soybean oil but that has not been formally proven.

• In the current study, we found that while a high fat diet containing Plenish also induced obesity, glucose intolerance and fatty liver, it did not induce insulin resistance as did the conventional soybean oil. It also induced somewhat less fat accumulation.

• Finally, we compared the diet enriched in soybean oil to an isocaloric diet that contained the same amount of total fat (40%kcal, Americans consume 34-37% fat) but with 90% of the fat from coconut oil. Those animals gained very little weight (13% versus 38% with the conventional soybean oil and 30% with the Plenish) and were not diabetic or insulin resistant. Their livers also had less fat than either of the two soybean oil diets and showed no signs of hepatocyte ballooning. Coconut oil has essentially no linoleic acid or other PUFAs.

• Our results, assuming humans respond in the same way as mice, suggest that people should avoid the consumption of too much soybean oil, either conventional or Plenish. They also show that coconut oil, which is made up of saturated fats (primarily medium chain triglycerides), is much healthier for you than soybean oil. Coconut oil has been noted previously for its beneficial health effects.









• Dr. Sladek: The clinical implications are that the ubiquitous presence of soybean oil in the American diet could be contributing to the obesity epidemic. The introduction of the GM soybean oil Plenish with low linoleic acid into the American food chain could potentially reverse that trend.

• Soybean oil is in most vegetable oils and processed foods and is widely used in restaurants, making it difficult to avoid. The best approach is to cook with olive oil at home and eat as few processed foods as possible.

• We should also note that the effects we observed are from soybean oil; there is no indication that soybean protein (i.e., tofu) or soy milk induce the same effects.









• Dr. Sladek: We need more research on the health effects of soybean oil, both in mouse models that have the advantage of being able to rigorously control for all the various parameters, as well as in humans. Since soybean oil is so ubiquitous in the U.S. and is being increasingly used worldwide at levels of consumption never seen in the past that it is vital that we know what it does to our metabolism.

• We need to determine what component(s) other than linoleic acid is driving the negative metabolic effects of soybean oil. With that knowledge it might be possible to genetically modify soybeans further so that they are truly beneficial to our health.

• Finally, we need to determine what tissues other than liver are primarily affected by soybean oil –does it act on adipose tissue? the gut? the pancreas? – as well as the molecular mechanism by which it targets those organs.

• Other components of the American diet such as saturated fats from animal products and fructose in high fructose corn syrup have received a lot of scientific as well as media attention. And yet soybean oil, which is an equally important part of our diet and arguably more difficult to avoid, is highly understudied.

• Citation:• ENDO meeting abstract discussing:

Genetically Modified Soybean Oil Only Slightly Healthier than Regular Soybean OilMedicalResearch.com Interview with: Frances M. Sladek, Ph.D. (2015). Genetically Modified Soybean Oil Plenish Only Slightly Healthier Than Regular Soybean Oil



http://medicalresearch.com/general-medicine/obesity-in-us-aggravated-by-agricultural-policy-that-encourages-high-fatsugar-foods/1382/

http://medicalresearch.com/diabetes/added-sugar-more-harmful-than-other-carbohydrates-for-promoting-diabetes/10914/




Early Onset, Frequent Hot Flashes Linked To Increased Cardiovascular Disease RiskMedicalResearch.com Interview with:

Dr. Rebecca Clark Thurston Ph.DAssociate Professor of Psychiatry, Epidemiology, Psychology, and Clinical and Translational Science

University of Pittsburgh

• MedicalResearch: What is the background for these studies? What are the main findings?

• Dr. Clark Thurston: The understanding of women’s cardiovascular disease and the role that reproductive factors play in women’s cardiovascular health is evolving. There are some studies showing links between menopausal hot flashes and cardiovascular disease risk in women. These studies help further refine this understanding. We showed in two separate studies that women who have hot flashes, particularly frequent hot flashes early in midlife, have poorer vascular health on certain indices.


http://medicalresearch.com/menopause/early-onset-frequent-hot-flashes-linked-to-increased-cardiovascular-disease-risk/12429/

http://medicalresearch.com/endocrinology/hormone-therapy/menopausal-hormone-therapy-health-outcomes/2111/






• MedicalResearch: What should clinicians and patients take away from your report?

• Dr. Clark Thurston: Women who experience hot flashes at relatively young ages – in their 40’s – particularly if the hot flashes are frequent, should be sure they are getting their regular health check ups. Stay on top of their blood pressure, lipids, glucose, and weight. If they are smoking, stop, if they are overweight, now is the time to try to lose. Start exercising. Midlife is really the time for women to set up good heart health behaviors that will serve them well as they age. Women should remember that cardiovascular disease is the leading cause of death among women.



http://medicalresearch.com/menopause/effect_of_estrogen_on_cardiovascular_events_and_hot_flashes/6796/






• MedicalResearch: What recommendations do you have for future research as a result of this study?

• Dr. Clark Thurston: We need to look at other aspects of cardiovascular health in relation to hot flashes. We need to really refine that age at which hot flashes are most predictive of adverse vascular health. We need to understand how these data might inform our approaches to treating hot flashes among younger women, and may encourage us as providers to use methods that have the lowest cardiovascular risk associated with them.

• Citation:

• upcoming ACC abstracts:

• Early-Onset Menopausal Vasomotor Symptoms Are Associated with Endothelial Dysfunction: The National Heart Lung and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study and

• Physiologically-Assessed Hot Flashes Are Associated with Poorer Endothelial Function Among Early Midlife WomenMedicalResearch.com Interview with:Dr. Rebecca Clark Thurston Ph.D (2015). Early Onset, Frequent Hot Flashes Linked To Increased Cardiovascular Disease Risk



http://medicalresearch.com/menopause/hot-flashes-linked-increased-risk-hip-fracture/9884/

http://www.acc.org/latest-in-cardiology/articles/2015/03/05/17/04/studies-explore-impacts-of-hot-flashes-sedentary-behavior-and-antidepressant-use-on-cv-disease?w_nav=Tab

http://www.acc.org/latest-in-cardiology/articles/2015/03/05/17/04/studies-explore-impacts-of-hot-flashes-sedentary-behavior-and-antidepressant-use-on-cv-disease?w_nav=Tab



Sense of Purpose in Life Reduces Cardiovascular RiskMedicalResearch.com Interview with:

Randy Cohen, MD, MS, FACCDivision of Cardiology Mt. Sinai St. Luke’s Hospital

New York, NY

• MedicalResearch: What is the background for this study?

• Dr. Cohen: Psychosocial conditions such as depression, anxiety, chronic stress and social isolation have strong associations with heart disease and mortality. Recently, however, attention has focused on positive emotions, psychological health and their collective impact on overall health and well-being. Purpose in life is considered a basic psychological need, and has been defined as a sense of meaning and direction in one’s life which gives the feeling that life is worth living. We performed a meta-analysis of prospective studies evaluating the relationship between having a sense of purpose in life, mortality and cardiovascular disease.

• MedicalResearch: What are the main findings?

• Dr. Cohen: We identified 10 prospective studies involving over 137,000 subjects and found that possessing a sense of purpose in life was associated with a 23% reduced risk for all-cause mortality and a 19% reduced risk for cardiovascular disease events.


http://medicalresearch.com/heart-disease/sense-of-purpose-in-life-reduced-cardiovascular-risk/12210/



Sense of Purpose in Life Reduces Cardiovascular RiskMedicalResearch.com Interview with:

Randy Cohen, MD, MS, FACCDivision of Cardiology Mt. Sinai St. Luke’s Hospital

New York, NY


• Dr. Cohen: Future research should focus on the following:

• Develop practical screening tools for clinicians to assess for psychosocial factors (positive and negative) known to be associated with poor health outcomes.

• Develop and test practical interventions for individuals identified as having low purpose.

• Citation:

• presented on March 6 at the American Heart Association’s EPI/Lifestyle 2015 Scientific Sessions in Baltimore.

• Sense of purpose may lower risk of death, heart attack, strok





Genetic Study Confirms Most Pediatric Melanoma Linked To Sun ExposureMedicalResearch.com Interview with:

Alberto Pappo, M.D.Member, Oncology; Director, Solid Tumor Division

St. Jude Children’s Research Hospital


• Dr. Pappo: Researchers have identified three distinct subtypes of childhood and adolescent tumors of pigment-producing skin cells called melanocytes. The subtypes have different genetic alterations and often different outcomes for patients. The findings should aid efforts to improve diagnosis and treatment of melanoma, which is the most common skin cancer in children and adolescents.

• The study provides the most comprehensive analysis yet of the genetic alteration underlying pediatric melanoma, including the first genetic evidence that sun damage causes melanoma in children and adolescents as well as adults. Researchers used whole genome sequencing and other techniques to study the normal and cancer genomes of 23 young patients with a variety of melanocytic tumors, including conventional melanoma. Patients ranged in age from 9 months to 19 years old.

• The melanoma subtypes in this study included conventional melanoma, which scientists showed was the same disease in children, adolescents and adults. More than 90 percent of pediatric conventional melanoma had DNA changes linked to sun damage.


• Dr. Pappo: The findings reinforce the importance of sun protection beginning early in life. The results also underscore the need to make it easier for younger patients with conventional melanoma to access promising therapeutic agents being tried in adults. Clinicians and patients should take away that conventional melanoma in adolescents is very similar to adult melanoma and that UV plays a role in the pathogenesis of this disease.


http://medicalresearch.com/author-interviews/genetic-study-confirms-most-pediatric-melanoma-linked-to-sun-exposure/12437/

http://medicalresearch.com/author-interviews/how-much-does-sepcialized-melanoma-screening-cost/11734/

http://medicalresearch.com/author-interviews/our-skin-is-damaged-by-sunlight-even-when-we-are-out-of-the-sun/11941/

http://medicalresearch.com/author-interviews/melanoma/10616/



Genetic Study Confirms Most Pediatric Melanoma Linked To Sun ExposureMedicalResearch.com Interview with:

Alberto Pappo, M.D.Member, Oncology; Director, Solid Tumor Division

St. Jude Children’s Research Hospital


• Dr. Pappo: We would like to expand our observations by creating a registry.

• Citation:

• The Genomic Landscape of Childhood and Adolescent Melanoma

• Charles Lu1,11, Jinghui Zhang2,11, Panduka Nagahawatte2, John Easton2, Seungjae Lee3, Zhifa Liu4, Li Ding1,5,6,7, Matthew A Wyczalkowski1, Marcus Valentine8, Fariba Navid9, Heather Mulder2, Ruth G Tatevossian3, James Dalton3, James Davenport3, Zhirong Yin3, Michael Edmonson2, Michael Rusch2, Gang Wu2, Yongjin Li2, Matthew Parker2, Erin Hedlund2, Sheila Shurtleff3, Susana Raimondi3, Vadodaria Bhavin2, Yergeau Donald2, Elaine R Mardis5,6,7, Richard K Wilson5,6,7, William E Evans10, David W Ellison3, Stanley Pounds4, Michael Dyer2, James R Downing3, Alberto Pappo9 and Armita Bahrami3 for the St Jude Children’s Research Hospital–Washington University Pediatric Cancer Genome Project

• Journal of Investigative Dermatology (2015) 135, 816–823; doi:10.1038/jid.2014.425; published online 30 October 2014



http://www.nature.com/jid/journal/v135/n3/full/jid2014425a.html

http://www.nature.com/jid/journal/v135/n3/full/jid2014425a.html



More Medical Advice May Help Patients Reduce Salt IntakeMedicalResearch.com Interview with:

Dr. Sandra L. Jackson, Ph.D., M.P.HEpidemic intelligence service fellow

Centers for Disease Control and Prevention, Chamblee, GA


Dr. Jackson: With more than 90 percent of U.S. adults exceeding recommended sodium intake levels, healthcare providers can play a key role in counseling patients on the importance of limiting salt in the diet.

• To assess the impact of medical advice on an individual’s efforts to reduce sodium intake, CDC researchers examined self-reported telephone survey information from nearly 174,000 U.S. adults. Overall, more than half of the respondents reported watching or reducing their sodium intake in 2013 – but less than one quarter (23 percent) said they received advice from a doctor or healthcare professional about sodium reduction. Of those that received the medical advice, 82 percent reported taking action to limit their sodium intake. In comparison, only 44 percent of respondents who reported not receiving medical advice said they took steps to reduce sodium.

• The substantial proportion of patients who are not receiving medical advice (77%), according to these findings, reveals a missed opportunity to reduce sodium intake, particularly among groups that have a higher risk of developing cardiovascular disease. This includes African Americans, and those with high blood pressure, diabetes or chronic kidney disease.


http://medicalresearch.com/author-interviews/more-medical-advice-may-help-patients-reduce-salt-intake/12442/

http://medicalresearch.com/heart-disease/reduced_sodium_intake_may_improve_heart_failure_prognosis/9251/







• Dr. Jackson: This study is meaningful because it is one of the only ones to examine how sodium-related medical guidance relates to all patients, not just those with hypertension. With only one-quarter of respondents in this study reporting that they received medical advice about sodium, there is room for improvement.

• Heart disease, stroke and other cardiovascular diseases kill nearly 800,000 Americans each year and cost more than $320 billion dollars a year in health care and lost productivity. CDC supports reducing sodium as an effective way to lower blood pressure and improve heart health and reduce risk for stroke nationwide. We encourage doctors to discuss the importance of limiting sodium with all patients to prevent and to help reduce blood pressure.



http://medicalresearch.com/author-interviews/salt-intake-reduced-by-warnings-on-salt-containers/10502/







• Dr. Jackson: Further research could identify optimal strategies for reducing sodium in the diet. Also, while this study examined health professional advice related to sodium intake, there are other avenues of public health messaging and education. Additional research could examine the effectiveness of sodium reduction messaging delivered through other channels.

• Citation:

• Research presented at the American Heart Association EPI/Lifestyle 2015 meeting.Medical advice to limit salt intake may help adults reduce sodium



http://newsroom.heart.org/news/tuesday-news-tips-2854428



Can Phthalates Alter Sex Development During Pregnancy?MedicalResearch.com Interview with:

Dr. Jennifer Adibi, MPH ScD University of Pittsburgh, Public Health Assistant Professor, EpidemiologyAssistant Professor, Department of Obstetrics/Gynecology and Reproductive Sciences

Affiliate, Dept. of ObGYN and Reproductive Sciences University of California, San Francisco

Medical Research: What is the background for this study?

Dr. Adibi: Prenatal exposure to phthalates in rodents can cause defects in male sexual development including a shorter distance between the anus and the genitalia (anogenitaldistance or AGD). Human studies have shown a correlation between higher prenatal phthalate urinary concentrations in the mother and shorter AGD in males. AGD in males is related to fertility and reproductive health over the lifetime. In females, AGD was associated with numbers of ovarian follicles. The role of the placenta has not been considered in these studies. A placental hormone called human chorionic gonadotropin (hCG) is essential for normal male development. Our previous research has shown that hCG expression by human placental cells is disrupted by phthalate concentrations equal to what we measured in maternal urine. The placenta secretes molecules early in pregnancy that might provide an opportunity to detect these effects in humans.


http://medicalresearch.com/author-interviews/can-phthalates-alter-sex-development-during-pregnancy/12446/

http://medicalresearch.com/author-interviews/bpa_exposure_during_pregnancy_linked_with_childhood_wheezing/8147/






• Medical Research: What are the main findings?

• Dr. Adibi: In 350 pregnancies, we measured a significant association of maternal urinary concentrations of mono-n-butyl phthalate (MnBP) and monobenzyl phthalate (MBzP) with hCG in maternal blood in the first trimester. Higher phthalate concentrations were associated with higher hCG if the mother was carrying a female fetus, and lower concentrations if she was carrying a male fetus. In a high/low MnBP comparison, hCG was 15-fold higher in the higher exposed female fetuses. We also observed a relationship between maternal levels of hCG in the first trimester and anogenital distance in the newborns. The correlation was positive in female newborns, and inverse in male newborns. Similar to the parent study, we observed associations of higher first trimester MnBP and mono-2-ethyl hexyl phthalate (MEHP) with lower male anogenital distance. If we combined these findings into a mediation analysis, we estimated that approximately 20-30% of the phthalate-induced effect on anogenital distance was due to the phthalate disruption of hCG.









• Dr. Adibi: With more studies and a better understanding of these relationships and the role of the placenta in endocrine disruption, we may have the possibility to detect these types of hormonal balances earlier in pregnancy and intervene within an early time frame to protect the long-term health of the future child. A pregnant woman should do her best to reduce her exposures; however, it is difficult to do this as intervention studies have shown. Meaningful changes in this exposure can only happen at the societal level with changes in regulation, industry practices, and innovation in consumer product design









• Dr. Adibi: We are going to repeat this study with serial maternal blood and urine samples before 14 weeks in pregnancy to better understand these relationships at the population level. First trimester hCG is widely available as it is measured as part of prenatal screening for Down’s Syndrome and other defects. These results support more studies to understand the role of placental hCG in fetal origins of health and disease, and as a target of endocrine disruption.

• Citation:

• ENDO 15 abstract:Phthalates potentially alter levels of a pregnancy hormone that influences sex development



http://medicalresearch.com/author-interviews/new_blood_test_may_be_better_able_to_detect_increased_risk_of_miscarriage/6044/




Depression Remains Important Risk Factor For Cardiovascular DiseaseMedicalResearch.com Interview with:

Heidi May, Ph.D., M.S.P.H.Cardiovascular Epidemiologist

Intermountain Medical Center Heart Institute Salt Lake City

Medical Research: What is the background for this study? What are the main findings?

Dr. Heidi May: Cardiovascular disease remains the leading cause of morbidity and mortality worldwide. Statin therapy is known to reduce the risk of cardiovascular disease incidence through the reduction of blood cholesterol levels and through its pleiotropic cardioprotective properties. Depression is a risk factor for cardiovascular disease. It has been recommended that antidepressant medications should be considered first-line treatment for depression of any severity. We hypothesized that taking both statins and antidepressants would reduce cardiovascular risk more than either medication alone. However, we did not find this. Instead we found that the effectiveness of antidepressants and statin therapy to reduce death and incident cardiovascular disease at 3 years varied by the severity of depressive symptoms. Among those with none to mild depressive symptoms, statin use, with or without antidepressant therapy, was associated with a decrease in risk, but among those with moderate to severe depression, antidepressant use was associated with a decrease in risk. The combination of antidepressant and statin use did not result in a greater risk reduction in either depressive symptom category.


http://medicalresearch.com/mental-health-research/depression/depression-remains-important-risk-factor-for-cardiovascular-disease/12449/

http://medicalresearch.com/heart-disease/high-intensity-statin-therapy-underutilized-after-heart-attack/10631/







• Dr. Heidi May: This study supports the importance of depression as a risk factor for cardiovascular disease and the importance of its treatment. Assessment of depression should be made by clinicians like any other cardiovascular risk factor (high blood pressure, high cholesterol levels).









• Dr. Heidi May: I would like to see this study replicated in other populations and among different classes of antidepressants. It would also be interesting to evaluate these results among different subgroups of patients (women vs. men, older vs. younger, different levels of cholesterol, diabetics).

• Citation:

• The Association of Antidepressant and Statin Use to Future Death and Incident Cardiovascular Disease Varies by Depression Severity,” will be presented on March 15 at 9:30 a.m. PT/12:30 p.m. ET/4:30 p.m. at the ACC15 Conference



http://accscientificsession.acc.org/ACC.aspx



Unvaccinated Children Have Higher Risk Of Developing ShinglesMedicalResearch.com Interview with:

Su-Ying Wen, MD Chief of Department of Dermatology,Taipei City Hospital, Renai Branch, Taipei City, Taiwan

Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei City, Taiwan


Dr. Su-Ying Wen: Though herpes zoster is seen as a disease of the elderly, it can affect individuals in any age group including children. There are limited population-based data regarding pediatric herpes zoster.

• We reported a higher incidence rate of pediatric herpes zoster than in previous studies. The higher incidence observed in this population-based study might be because it was measured in a cohort of children who were all infected with varicella rather than as other reports including individuals free of varicella infection in the denominator. Children younger than 2 years at the diagnosis of varicella had a significantly higher risk and shorter duration of developing herpes zoster.


• Dr. Su-Ying Wen: The children with a history of varicella had a significantly higher risk of developing pediatric herpes zoster than those who received varicella vaccine. Children contracting varicella before the age of 2 years had at least 2-fold increased the risk of developing pediatric herpes zoster than those contracting varicella after the age of 2 years.


http://medicalresearch.com/pediatrics/unvaccinated-children-have-higher-risk-of-developing-shingles/12454/

http://medicalresearch.com/author-interviews/deaths-from-skin-diseases-differ-between-developed-and-developing-countries/8053/


Unvaccinated Children Have Higher Risk Of Developing ShinglesMedicalResearch.com Interview with:

Su-Ying Wen, MD Chief of Department of Dermatology,Taipei City Hospital, Renai Branch, Taipei City, Taiwan

Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei City, Taiwan

• Medical Research: What recommendations do you have for future research as a result of this study

• Dr. Su-Ying Wen: The results of the current study may serve as baseline data for the early effects of varicella vaccinations on pediatric herpes zoster. Long term studies are required to monitor the impact of a varicella vaccination program on pediatric herpes zoster.

• Citation:

• Epidemiology of Pediatric Herpes Zoster After Varicella Infection: A Population-Based Study

• Su-Ying Wen and Wen-Liang Liu

• Pediatrics peds.2013-4037; published ahead of print February 23, 2015, doi:10.1542/peds.2013-4037


http://medicalresearch.com/pediatrics/unvaccinated-children-have-higher-risk-of-developing-shingles/12454/

http://medicalresearch.com/general-medicine/herpes-zoster-risk-slightly-increased-patients-taking-biologics/9311/

http://pediatrics.aappublications.org/citmgr?gca=pediatrics;peds.2013-4037v1




Skilled Team Work Required For Endovascular Treatment of Ischemic StrokeMedicalResearch.com Interview with:

Michael D Hill, MD MSc FRCPC Calgary Stroke ProgramProfessor, Dept Clinical Neurosciences Hotchkiss Brain Institute

University of Calgary, Cumming School of Medicine Foothills Hospital, Calgary, Canada

Medical Research: What is the background for this study? What are the main findings?Dr. Hill: Major ischemic stroke with blocked proximal arteries results in 60-80% death and disability. Recent studies of endovascular treatment were neutral. Evolution of technology has resulted in advances in the devices. Key features of past trials of endovascular therapy were, underdeveloped imaging paradigms for patient selection, slow treatment times and poor reperfusion rates.


http://medicalresearch.com/author-interviews/skilled-team-work-required-for-endovascular-treatment-of-ischemic-stroke/12456/

http://medicalresearch.com/stroke/isc-2015-analysis-mr-clean-trial-endovascular-therapy-acute-ischemic-stroke/11555/







• Dr. Hill: Simply, endovascular therapy for major ischemic stroke over and above best medical care (ie. IV tPA) is effective . It reduces disability and saves lives. The NNT is very low 4, making it one of the largest proven effect sizes in all of medicine. BUT, it applies only under selected conditions.

• First, you need a team. This means a stroke team, from pre-hospital, ED physicians and nurses, neuroradiology support, stroke neurology, stroke intervention and the stroke unit and rehabilitative support. Without the team this therapy does not work. All patients who are eligible should rapidly receive intravenous tPA.

• Second, you must image the patients to select those who will benefit from therapy. You must demonstrate a small core, a blocked intracranial large artery and evidence of good collateral flow. You must do this very fast.

• Third, you must act very quickly . This is where the team comes in. Imaging (CT) to groin puncture time should be less than 60 minutes and imaging (CT) to reperfusion time should be less than 90 minutes.

• And finally, you should use the available novel technology to get the artery completely open.

• I must emphasize that it is the triad of imaging, speed and reperfusion, performed by a team that will work. This is what we have shown in ESCAPE. It is and was a huge team effort.









• Dr. Hill: Key issues to resolve are:

• (1) What is the best imaging paradigm to select patients?

• (2) 45% of patients still did poorly. How do we improve the therapy for them?

• (3) How do we improve the procedure to get the reperfusion rates from 80% to 99%.

• (4) How do implement this therapy? What is the best way to triage stroke patients to the right centre to the right team in the right timeframe to get this therapy?

• Citation:

• Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke

• Mayank Goyal, M.D., Andrew M. Demchuk, M.D., Bijoy K. Menon, M.D., Muneer Eesa, M.D., Jeremy L. Rempel, M.D., John Thornton, M.D., Daniel Roy, M.D., Tudor G. Jovin, M.D., Robert A. Willinsky, M.D., Biggya L. Sapkota, M.B., B.S., Dar Dowlatshahi, M.D., Ph.D., Donald F. Frei, M.D., Noreen R. Kamal, M.D., Walter J. Montanera, M.D., Alexandre Y. Poppe, M.D., C.M., Karla J. Ryckborst, R.N., Frank L. Silver, M.D., Ashfaq Shuaib, M.D., Donatella Tampieri, M.D., David Williams, M.B., Ph.D., Oh Young Bang, M.D., Ph.D., Blaise W. Baxter, M.D., Paul A. Burns, M.B., Ch.B., M.D., Hana Choe, M.D., Ji-Hoe Heo, M.D., Ph.D., Christine A. Holmstedt, D.O., Brian Jankowitz, M.D., Michael Kelly, M.D., Ph.D., Guillermo Linares, M.D., Jennifer L. Mandzia, M.D., Ph.D., Jai Shankar, M.D., Sung-Il Sohn, M.D., Richard H. Swartz, Ph.D., Philip A. Barber, M.B., Ch.B., M.D., Shelagh B. Coutts, M.B., Ch.B., M.D., Eric E. Smith, M.D., M.P.H., William F. Morrish, M.D., Alain Weill, M.D., Suresh Subramaniam, M.D., Alim P. Mitha, M.D., John H. Wong, M.D., Mark W. Lowerison, M.Sc., Tolulope T. Sajobi, Ph.D., and Michael D. Hill, M.D. for the ESCAPE Trial Investigators

• N Engl J Med 2015; 372:1019-1030 March 12, 2015



http://www.nejm.org/media/doi/full/10.1056/NEJMoa1414905

http://www.nejm.org/media



Do Emulsifiers in Food Additives Play A Role In Inflammatory Bowel Diseases?MedicalResearch.com Interview with:

Benoit Chassaing, Ph.D.Post-Doctoral Fellow Dr. Gewirtz’s lab. Institute for Biomedical Sciences

Center for Inflammation, Immunity, & Infection Georgia State University Atlanta GA 30303


Dr. Chassaing: A key feature of inflammatory bowel diseases and metabolic syndrome is alteration of the gut microbiota in a manner that promotes inflammation. Importantly, incidence of IBD and metabolic syndrome has been markedly increasing since about the mid-20th century, and this dramatic increase has occurred amidst constant human genetics, suggesting a pivotal role for an environmental factor. We considered that any modern additions to the food supply might play an important role, and addition of emulsifiers to food seems to fit the time frame of increased incidence in these diseases. We found that emulsifiers, which are added to most processed foods to aid texture and extend shelf life, can alter the gut microbiota composition and localization to induce intestinal inflammation that promotes development of inflammatory bowel disease and metabolic syndrome.


• Dr. Chassaing: More work is definitively required to be able to translate these important findings to humans.

• We personally have changed our habits, trying to avoid processed food, generally loaded with emulsifiers. Food products can be found without emulsifiers, with of course a shelf life much shorten compare to emulsifiers containing foods. However, in order to more strictly regulate such emulsifiers, human trials will be needed in order to confirm that similar deleterious affects are observed on human as well.


http://medicalresearch.com/author-interviews/do-emulsifiers-in-food-additives-play-a-role-in-inflammatory-bowel-diseases/12373/

http://medicalresearch.com/heart-disease/gut-bacteria-link-between-heart-and-kidney-disease-strengthened/11304/



Do Emulsifiers in Food Additives Play A Role In Inflammatory Bowel Diseases?MedicalResearch.com Interview with:

Benoit Chassaing, Ph.D.Post-Doctoral Fellow Dr. Gewirtz’s lab. Institute for Biomedical Sciences

Center for Inflammation, Immunity, & Infection Georgia State University Atlanta GA 30303


• Dr. Chassaing: We both think that more research is needed before altering regulation of such additives. Almost all food additives are tested on animals that are relatively resistant to most disease, and those test are analyzing acute toxicity or cancer promotion. However, in order to more strictly regulate such emulsifiers, human trials will be needed in order to confirm that similar deleterious affects are observed on human as well. We are working on setting up such trial in a near future with our collaborators. Nonetheless, and as stated above, we personally already have changed our habits.

• Citation:

• Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome

• Benoit Chassaing,Omry Koren,Julia K. Goodrich,Angela C. Poole,Shanthi Srinivasan,Ruth E. Ley & Andrew T. Gewirtz

• Nature 519, 92–96 (05 March 2015) doi:10.1038/nature14232



http://www.nature.com/nature/journal/v519/n7541/full/nature14232.html





Estrogen Therapy In Young Women May Not Increase Breast Cancer RiskMedicalresearch.com Interview with:

Dr. Clarice R. Weinberg Ph.DBiostatistics and Computational Biology Branch

National Institute of Environmental Health Sciences Research Triangle Park, NC 27709


• Dr. Weinberg: Hormone therapy (HT) was commonly prescribed in the U.S. late in the 20th

century to help women through the challenges of menopause. Several decades ago, therapy with estrogen alone was shown to cause endometrial cancer, and the combined use of both estrogen and progesterone replaced treatment with estrogen alone. But research published around 2002 had far reaching effects on gynecologic practice. Both the randomized trial component of the US Women’s Health Initiative and the observational European Million Women’s Study reported that postmenopausal women who were older than 50 and were taking the combination HT had an increased risk of breast cancer. Physicians and patients responded quickly, and Hormone therapy use plummeted.

• However, it remained unclear whether there were risks of Hormone therapy use in women under age 50. Some factors, for example obesity, have opposite effects on the risk of breast cancer in pre- and post-menopausal women, so one cannot assume risk findings from older women necessarily apply to younger women. We carried out a sibling-based study of 1,419 women with breast cancer diagnosed under the age of 50 (http://sisterstudy.niehs.nih.gov/English/2sis.htm). Each case had a sister (also studied) who had never been diagnosed with breast cancer, who could serve as her control. The study was funded by Susan G. Komen for the Cure, and the National Institutes of Health.


http://medicalresearch.com/cancer-_-oncology/breast-cancer/estrogen-therapy-in-young-women-may-not-increase-breast-cancer-risk/12413/







• Dr. Weinberg: We estimated that women who had only taken estrogen (without progesterone) had a 42 percent decrease in their risk of young-onset breast cancer, compared to women of similar age who had never taken Hormone therapy. Women who had taken the combination estrogen plus progesterone showed no increase in risk, but there were few with this exposure and we cannot rule out increased risk for the combination therapy. Interestingly, participants in the Women’s Health Initiative who were randomized to estrogen alone had reduced risk of fractures and reduced risk of breast cancer. However, that study had to be discontinued because those women showed increased risk of stroke.


• Dr. Weinberg: In women under age 50, estrogen therapy does not appear to increase the risk of breast cancer. We did not study whether use of estrogen before 50 might affect risk at later ages.









• Dr. Weinberg: Our data suggest that estrogen use before age 50 is less harmful than commonly assumed, and might actually confer some protection against breast cancer. However, these findings require replication through additional research. Since a randomized trial would probably not be feasible, we would like to see an observational study that carefully ascertains the indications for use when a young woman reports taking estrogen alone. Such data will be helpful in ruling out the possibility that it is the underlying indications and not the estrogen that confers protection against breast cancer. Prospective follow up beyond age 50 would also be valuable.

• Citation:

• Hormone Therapy and Young-Onset Breast Cancer

• Katie M. O’Brien, Chunyuan Fei, Dale P. Sandler, Hazel B. Nichols, Lisa A. DeRoo, and Clarice R. WeinbergAm. J. Epidemiol. first published online February 18, 2015 doi:10.1093/aje/kwu347



http://aje.oxfordjournals.org/content/early/2015/02/18/aje.kwu347.abstract

http://aje.oxfordjournals.org/content/early/2015/02/18/aje.kwu347.abstract



Tooth Enamel Defects May Reflect Perinatal Exposure to Bisphenol AMedicalResearch.com Interview with:

Sylvie Babajko, PhDCentre de Recherche des Cordelier Inserm UMR_S 1138

Laboratoire de Physiopathologie Orale Moléculaire 75006 Paris cedex 06

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

• Dr. Babajko: The environment has become increasingly contaminated by various pollutants. This has led to an increase in the incidence and gravity of known pathologies and/or the emergence of new pathologies. In 2001, a distinct enamel pathology called molar incisor hypomineralization (MIH) was described. It is diagnosed by white to brown creamy lesions affecting permanent first molars and frequently permanent incisors too. These teeth are sensitive and susceptible to caries. MIH prevalence turns around 15-18 % of 6 to 9 years-old children in studied populations all over the world. To date, MIH etiology remains unclear. However, given that MIH affects those teeth that are undergoing mineralization around the time of birth, MIH is indicative of some adverse event(s) occurring during early childhood that impact on enamel development. Interestingly, susceptibility to BPA in human is the highest during the same period of time.

• Our experimental data (1, 2) showed that BPA may be a causal agent of MIH and that BPA irreversibly impacts amelogenesis via steroid hormone pathway.


http://medicalresearch.com/author-interviews/tooth-enamel-defects-reflect-perinatal-exposure-to-bisphenol-a/12473/

http://medicalresearch.com/author-interviews/bpa_exposure_during_pregnancy_linked_with_childhood_wheezing/8147/







• Dr. Babajko: We propose that affected teeth could be used as early marker of exposure to EDCs acting as BPA.

• The EDCs (especially BPA) are suspected of being involved in a variety of pathologies such as obesity, infertility, behavioral disorders or even hormone-dependent cancers. Therefore, clinicians should examine the teeth of their patients affected by one of these pathologies. And in particular, they should take into account MIH (if any) as an easy marker of exposure to these agents.

• Similarly, parents of children affected by MIH should be particularly vigilant to limit exposure to EDCs (eg avoiding industrial food packed in plastic containers that is probably the main source of contamination). Patients should request information to their dentist on the materials used for restoration or to protect from caries to be sure they’re BPA free.



http://medicalresearch.com/author-interviews/bpa-canned-soda-linked-increased-blood-pressure/9525/







• Dr. Babajko: Epidemiological data would help to identify the potential correlation between MIH and other endocrine pathologies (to be precisely characterized). Such data are expected to argue the use of affected teeth as easy (and cheap) marker of exposure to EDCs.

• (1): Jedeon et al., Am J Pathol, 2013, 183(1):108-18

• (2): Jedeon et al., Endocrinology, 2014, 155(9):3365-75

• ENDO15 March 2015

• Enamel Defects Reflect Perinatal Exposure to Bisphenol A

• Sylvie Babajko, Katia Jedeon, et al.

• -Research Centre of Cordeliers, INSERM UMRS 1138, Laboratory of Molecular Oral Pathophysiology, Paris, France

• -Paris-Diderot University, UFR Odontology, Paris, France





Why Is It So Hard To Reach Our Behavior Goals?MedicalResearch.com Interview with:

Margaret C. Campbell, Phd | Professor | MarketingChair, Doctoral Curriculum Program Committee437 Leeds School of Business

University of Colorado at BoulderBoulder, CO 80309-0419


Dr. Campbell: People try to maintain healthy body weights, attain academic and career success, save money for a car, a house, or retirement, and achieve a host of other goals that require repeated, goal-consistent behaviors. Unfortunately, consumers’ efforts often fall short. For example, 68% of Americans are overweight (Weight Control Information Network 2010), 46% who begin college do not graduate within six years (Associated Press 2006), and although 93% say that saving for retirement is important, only about 60% are actually saving (TIAA-CREF 2010) and approximately 50% have accumulated less than $25,000 (Helman, VanDehrei and Copeland 2007). Understanding goal pursuit and consumers’ choices to continue effort toward a goal that requires repeated goal-consistent behaviors is thus important. People need to be able to make progress on important goals that substantially impact their quality of life.

• Monitoring the influence of behavior on distance from a focal goal has been identified as important for successful goal pursuit – such as weight loss. In seven experiments, we find that people tend to have a “progress bias” such that they perceive that goal-consistent behaviors (such as avoiding eating a piece of cake) help progress more than equivalent-sized goal-inconsistent behaviors (such as eating a piece of cake) hurt progress. An experiment on exercise and eating shows that the progress bias can lead to poor understanding of progress and thus, premature release of the goal. In this study, the progress bias resulted in people with a goal of expending more calories than they consumed ended up consuming more than they expended.


http://medicalresearch.com/weight-research/why-is-it-so-hard-to-reach-our-behavior-goals/12483/







• Dr. Campbell: This research is meaningful because it provides evidence of a persistent tendency for people to mis-estimate the effects of their consistent versus inconsistent behaviors. We think that understanding this bias can help people to avoid it. Clinicians and patients can focus on more careful monitoring of patients’ behaviors so that they have better insight into their actual goal progress. For example, knowing that there is a tendency to think that “good” behaviors are great and “bad” behaviors are not so bad, patients can be encouraged to carefully record both types of behaviors to assess their actual progress.









• Dr. Campbell: Further research could identify interventions to help patients better understand the effects of their behaviors on their goal progress and to study the extent to which this can help with goal achievement. For example, research on more careful consideration of both “energy in” and “energy out” on weight goals would be useful.

• Citation:

• The Progress Bias in Goal Pursuit: When One Step Forward Seems Larger than One Step Back

• Margaret C. CampbellUniversity of Colorado at BoulderCaleb WarrenTexas A&M University – Department of MarketingJanuary 30, 2015Journal of Consumer Research, Vol. 41, February 2015Mays Business School Research Paper No. 2015-15



http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2558106









Gene Signature May Predict Risk of Metastases and Death From MelanomaMedicalResearch.com Interview with:

Pedram Gerami MDAssociate Professor of Dermatology and Pathology

Northwestern University

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

• Dr. Gerami: The outcomes for patients with cutaneous melanoma are highly variable and there are limitations to the conventional staging system for melanoma. For example while the status of the sentinel lymph node biopsy is considered the strongest prognosticator, approximately 2/3 of cutaneous melanoma patients that ultimately die from their melanoma will have a negative sentinel lymph node biopsy result. In this study we showed that using a technique known as mRNA expression profiling to determine which genes are highly active and which are not that a molecular prognostic assay with accuracy could be developed. This assay can accurately classify patients based on their gene signature as having a high or low risk for metastasis and death from their melanoma. In an independent validation cohort, patients with a class I or low risk signature had a 5 year disease free survival rate of 97% while those with a class II or high risk signature had a 5 year disease free survival rate of only 31%.


• Dr. Gerami: This assay maybe used to better predict prognosis and to better guide follow up and management. For example one may choose to have a patient with a class II signature to have more frequent imaging studies and closer clinical follow up.


http://medicalresearch.com/genetic-research/gene-signature-may-predict-risk-of-metastases-and-death-from-melanoma/12488/

http://medicalresearch.com/genetic-research/melanoma-assaying-multiple-proteins-helps-identify-braf-inhibitor-resistance/12331/



Gene Signature May Predict Risk of Metastases and Death From MelanomaMedicalResearch.com Interview with:

Pedram Gerami MDAssociate Professor of Dermatology and Pathology

Northwestern University


• Dr. Gerami: In the future it would be beneficial to determine whether patients with no evidence of active disease but with a class II signature would have any survival benefit from adjuvant therapy.

• Citation:

• Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy

• Gerami, Pedram et al.

• Journal of the American Academy of Dermatology

• DOI: http://dx.doi.org/10.1016/j.jaad.2015.01.009

• Accepted: January 5, 2015; Published Online: March 04, 2015



http://medicalresearch.com/genetic-research/gene-signature-may-predict-risk-of-metastases-and-death-from-melanoma/12488/www.jaad.org/article/S0190-9622(15)00040-7/abstract







Curvy Bottoms Linked To Pregnancy AdvantageMedicalResearch.com Interview with:

Dr. David M.G. Lewis, PhDAssistant Professor Department of Psychology Bilkent Üniversitesi Ankara, Turkey Research Affiliate,

Individual Differences and Evolutionary Psychology Area Department of Psychology The University of Texas at Austin


• Dr. Lewis: My motivations to conduct this study were a combination of several things. Men would often mention to me the features that they found attractive in women. They would often mention the butt, but not the *size* of the butt…it was something else, but they couldn’t seem to put their finger on exactly what…

• I then began reading more deeply into the different muscular, ligamentous, skeletal, etc. structures that could influence the appearance of the buttocks. I moved beyond just buttock tissue and buttock size. What I began to discover is that while the size of the buttocks does indeed influence the buttocks’ appearance, so too does other morphology that is not part of the buttocks themselves. These readings indicated that certain spinal structures can help women shift their center of mass back over the hips during pregnancy and reduce hip torque by roughly 700%. To the extent that women who possess these spinal structures would thereby be better able to carry a pregnancy (or multiple pregnancies) to term without suffering spinal injuries, selection would have favored the evolution of psychological mechanisms in men to prefer women exhibiting cues to these spinal structures. Men could not directly observed women’s vertebrae, but lumbar curvature is an externally visible cue to the relevant spinal structures.

• At this point, we had a hypothesis that was both anchored in evolutionary theory and grounded in medical orthopedic literature. It was time we tested our idea that men possess a previously undiscovered, evolved preference for a beneficial intermediate angles of lumbar curvature in women.


http://medicalresearch.com/genetic-research/curvy-bottoms-linked-to-pregnancy-advantage/12493/







• Dr. Lewis: The key findings are that men possess a previously undiscovered preference in women — one that is rooted in spinal structures that influence a woman’s lumbar curvature but also the protrusion of her buttocks. We know that this preference is *not* merely a by-product of a preference for large buttocks. In our critical test, we showed men multiple women whose buttocks stuck out the exact same amount, but for different morphological reasons (e.g., large buttocks vs. spinal curvature). The men showed a strong tendency to prefer women whose buttock protrusion resulted from these spinal structures, not the women with larger buttocks.









• Dr. Lewis: I hope that readers take away a new piece of knowledge, one that is distinct from what many people thought they knew (i.e., a male preference for big buttocks as opposed to a male preference for spinal curvature). I also hope they see that an evolutionary approach is one that can inform our understanding of the world around us in new ways. Lastly, I hope that all women who read this study recognize that in no way does this mean that a woman must have a particular angle of lumbar curvature in order to be beautiful. Our research shows that lumbar curvature has an influence on women’s attractiveness, but a closer examination of the data also shows that many women who do not have an ideal angle of lumbar curvature can still seen as very beautiful.









• Dr. Lewis: Our research establishes a previously undiscovered standard of attractiveness based on spinal structures, but it does not eliminate the possibility of a true male preference for female buttock size. There are many cultural anecdotes tied to buttock size, and some recent research suggests that fat deposition in this region of the body would have been associated with reproductive benefits. However, there is a relative absence of rigorous scientific investigation of men’s psychology regarding this region of the female body. I hope that we see an increase in good science that provides true tests of what we believe to be true. We may find out that we were right, or wrong — or we may discover something new altogether. Good science can offer all three.

• Citation:

• Lewis DMG, Russell EM, Al-Shawaf L, Buss DM. Lumbar curvature: a previously undiscovered standard of attractiveness. Evolution and Human Behavior. 2015.

• MedicalResearch.com Interview with: Dr. David M.G. Lewis, PhD (2015). Curvy Bottoms Linked To Pregnancy Advantage





Nanobody May Make Noroviruses Self DestructMedicalResearch.com Interview with:

Dr. Grant HansmanCHS Research Group at CellNetworks Heidelberg University and DKFZ

Deutsches Krebsforschungszentrum Heidelberg Germany


Dr. Hansman: Human noroviruses are the major cause of outbreaks of acute gastroenteritis. There are several promising vaccine candidates. Vaccines may offer some protection, but the fact that the virus changes every other year produces a challenge. Therefore, my research group investigates the possibility to produce universal antivirals targeting conserved regions on the virus capsid.

• We found that a Nanobody was able to bind with a high affinity, and broad reactivity to diverse norovirus types. The Nanobody binding on the virus capsid caused the virus particles to disassemble. The disassembly of the particles may render the virus non-infectious and block viral infections.


• Dr. Hansman: At the moment, we are not ready to test in humans, but with further development and testing, we hope to provide a proof-of-concept in surrogate norovirussystems, since human norovirus cannot be grown in cell culture. A lot of work will be required before any clinical trials, but for now, we have the potential to modify the Nanobodyfor preclinical testing.


http://medicalresearch.com/infections/nanobody-may-make-noroviruses-self-destruct/12501/



Nanobody May Make Noroviruses Self DestructMedicalResearch.com Interview with:

Dr. Grant HansmanCHS Research Group at CellNetworks Heidelberg University and DKFZ

Deutsches Krebsforschungszentrum Heidelberg Germany


• Dr. Hansman: We need optimize the binding to animal models and determine the effects in these systems. We have to work out ways to deliver the Nanobody in order to give the most effective treatment

• Citation:

• Nanobody Binding to a Conserved Epitope Promotes Norovirus Particle DisassemblyJ Virol. 2015 Mar 1;89(5):2718-30. doi: 10.1128/JVI.03176-14. Epub 2014 Dec 17.Koromyslova AD1, Hansman GS2.



http://www.ncbi.nlm.nih.gov/pubmed/25520510





Law Brings More Student Athletes To ER For Sports-Related ConcussionsMedicalResearch.com Interview with:

Dr. Pina Violano, RN, PhDTrauma Department, Yale-New Haven Hospital, Injury Free Coalition for Kids of New Haven

Yale-New Haven Children’s Hospital New Haven 06510, CT


• Dr. Violano: In July of 2012, Connecticut became one of the first states to enact legislation to ensure the safety and appropriate evaluation and management of sports-related concussions (SRC) among High School students. SRCs are a common occurrence in high school sports with their diagnosis increasing over the last decade. While the exact reasons are not known, public health campaign efforts and education may have facilitated improvement in the evaluation and detection of sports-related concussions and may have contributed to increase awareness and treatment.


• Dr. Violano: Evaluation of two emergency department records revealed a marked increase in the frequency of high school student athletes being treated for sports-related concussions after the implementation of Connecticut’s SRC law. This suggests that Connecticut’s legislation is effective in improving the evaluation and detection of sports-related concussions in high school students.


http://medicalresearch.com/author-interviews/law-brings-more-student-athletes-to-er-for-sports-related-concussions/12504/

http://medicalresearch.com/general-medicine/sports-related-concussions-gender-related-differences/3615/







• Dr. Violano: State concussion laws are a safety net to ensure that student athletes are protected from further harm after sports-related concussions and require that they get the appropriate evaluation and treatment. While the current law pertains only to student athletes participating in Connecticut Interscholastic Athletic Conference (CIAC) sponsored athletics, ALL athletes with a sports-related concussion who participate in organized sports at all levels could benefit from the same standard of care by healthcare professionals trained in the evaluation and management of concussions.



http://medicalresearch.com/general-medicine/lacrosse/6812/







• Dr. Violano: Recommendations to expand the law to include youth level sports should be perused.

• The numbers of youth athletes with sports-related concussions are presenting to the ED are increasing, but further expansion of the state laws to youth sports should be considered for future research. Our study showed that this legislation does not cause a residual increase in presentation of sports-related concussions to the ED in other age groups. We have identified that the law is not affecting summer sports-related concussion visits.

• Changes to state concussion laws could include summer camps, travel teams and all-star teams to ensure that all children with sports-related concussions are getting appropriate care and education. Concussion laws mandating the removal of athletes with a head injury from play might be expanded to include all organized sports at all levels.

• Citation:

• The Effects of a State Concussion Law on the Frequency of Sport-Related Concussions as Seen in Two Emergency Departments

• Thomas Trojian1*, Pina Violano23, Matthew Hall4 and Charles Duncan5

• Injury Epidemiology 2015, 2:2 doi:10.1186/s40621-015-0034-7 Published February 2015



http://medicalresearch.com/author-interviews/sports-related_concussion_diagnosis_using_blood_biomarker_tau/4143/

http://www.injepijournal.com/content/2/1/2





Study Suggests Need For Long Term Follow Up Of Monoclonal GammopathyMedicalResearch.com Interview with:

Prof. Sigurdur Y KristinssonProfessor of Hematology

University of Iceland

• MedicalResearch: What is the background for this study? What are the main findings?• Prof. Kristinsson: Multiple myeloma is always preceded by a precursor condition called monoclonal

gammopathy of undetermined significance (MGUS). MGUS is characterized by a detectable monoclonal protein in persons without evidence for end-organ damage or other related plasma cell or lymphoproliferative disorders. MGUS is very common and is detected in approximately 5 percent of persons 70 years or older. However, only a small proportion of MGUS progresses to a malignant disorder, in fact the annual risk of progression to multiple myeloma or other related disorders is on average 1 percent, with varying risks according to risk groups. Current guidelines suggest, depending on the individual patient’s clinical risk score, life-long monitoring of MGUS individuals to detect progression to multiple myeloma or related disorders. At this time, the impact of annual monitoring on the outcome of patients who eventually develop multiple myeloma is unclear.

• Using high-quality population-based data from Sweden, we estimated the impact of prior knowledge of MGUS diagnosis and comorbidities on multiple myeloma survival, by performing a large population-based study using data on more than 14,000 multiple myeloma patients diagnosed in Sweden 1976-2005, with follow-up through 2007. The hypothesis that detection and follow-up of MGUS may influence survival in multiple myeloma is unlikely to ever be tested in a prospective clinical study due to the large sample size required with long follow-up time, and consequent extreme costs.

• We found that multiple myeloma patients with prior knowledge of MGUS had significantly 15% better survival, despite having significantly more comorbidities. Interestingly, low-risk MGUS (with very low M-protein) had highest risk of death. The observation that low M-protein concentration at MGUS diagnosis was associated with poorer multiple myeloma survival may reflect less frequent clinical follow-up. Our observations stress the importance of clinical follow-up in MGUS, regardless of risk stratification.


http://medicalresearch.com/cancer-_-oncology/study-suggests-need-for-long-term-follow-up-of-monoclonal-gammopathy/12510/







• Prof. Kristinsson: Our results reflect the importance of life-long follow-up for individuals diagnosed with MGUS, independent of risk score and highlight the need for better risk models based on the biology of the disease. Patients should receive balanced information stressing both the overall very low risk of progression to malignant disease but also what symptoms could signal such development and the need of consulting their physician. The higher prevalence of comorbid conditions in multiple myeloma patients with prior MGUS knowledge supports that MGUS most often is diagnosed during follow-up for unrelated conditions. Our findings raise the question whether screening for MGUS in the general population could translate into earlier detection and treatment of multiple myeloma and lead to better multiple myeloma survival.









• Prof. Kristinsson: Our results highlight the need for better risk models based on the biology of multiple myeloma and MGUS. Also the impact of screening needs to be studied and discussed and importantly, the impact of comorbidity on outcome in multiple myeloma should be studied.

• Citation:

• Sigurdardottir E, Turesson I, Lund S, et al. The Role of Diagnosis and Clinical Follow-up of Monoclonal Gammopathy of Undetermined Significance on Survival in Multiple Myeloma. JAMA Oncol. Published online March 05, 2015. doi:10.1001/jamaoncol.2015.23.



http://oncology.jamanetwork.com/article.aspx?articleid=2174766



Healthy Vegetarian Diet May Reduce Risk of Colon CancerMedicalResearch.com Interview with:

Michael J. Orlich, MD, PhDProgram Director, Preventive Medicine Residency Loma Linda University

Co-Investigator, Adventist Health Studies


• Dr. Orlich: Colorectal cancer is the second leading cause of death from cancer in the United States. Screening efforts such as colonoscopies have helped save many lives by detecting pre-cancerous polyps and removing them. However, it is even better to prevent cancers from forming in the first place. We call this primary prevention. Diet is a potentially important approach to reduce the risk of developing colorectal cancer. In this analysis, we compared those eating different categories of vegetarian dietary patterns to those eating a non-vegetarian diet. About half of our study population was classified as non-vegetarian, which we defined as eating meat at least weekly. The other half of our population we called vegetarian and further divided them into four different vegetarian groups: semi-vegetarians ate meat but less than once per week; pesco-vegetarians ate fish but avoided other meats; lacto-ovo-vegetarians avoided meat but ate eggs and/or dairy products; and vegans avoided all meats, eggs, and dairy. All vegetarians together had on average a 22% relative reduction in the risk of developing colorectal cancer, compared to non-vegetarians, after carefully adjusting for many other factors. Pesco-vegetarians in particular had a much lower risk compared to non-vegetarians.


http://medicalresearch.com/cancer-_-oncology/colon-cancer/healthy-vegetarian-diet-may-reduce-risk-of-colon-cancer/12464/

http://medicalresearch.com/cancer-_-oncology/colon-cancer/colorectal-cancer-incidence-rising-in-young-adults/10904/







• Dr. Orlich: People consuming healthy vegetarian diets may have a lower risk of colorectal cancer than non-vegetarians. Our vegetarians not only ate less meat than the non-vegetarians, but also less sweets, snack foods, refined grains, and caloric beverages and more fruits, vegetables, avocados, whole grains, beans, and nuts. Prior evidence strongly links eating red and processed meat to a higher risk of colorectal cancer and fiber-rich foods to a lower risk.









• Dr. Orlich: We plan to examine the relationship of several specific foods to colorectal cancer risk in our population. Further research into mechanisms linking diet to colorectal cancer is important. Interesting possibilities could include how dietary factors may alter the expression of certain genes or how they may affect the many microbes that inhabit the large intestine and the effects that such changes may have on cancer development. There is also a need for improved methods for accurately measuring long-term diet in large numbers of people.

• Citation:

• Orlich MJ, Singh PN, Sabaté J, et al. Vegetarian Dietary Patterns and the Risk of Colorectal Cancers. JAMA Intern Med. Published online March 09, 2015. doi:10.1001/jamainternmed.2015.59.





Male Occupation and Health Can Affect FertilityMedicalResearch.com Interview with: Michael L. Eisenberg, M.D.

Director, Male Reproductive Medicine and SurgeryAssistant Professor Department of Urology

Stanford University School of Medicine


Dr. Eisenberg: There has been growing data that a man’s overall health may impact his fertility. As such, we wanted to explore this link using the NICHD LIFE Study which has the unique ability to account for both health and work exposure in men with both normal and abnormal fertility. We found that certain aspects of a man’s work and health can impact his semen parameters.


• Dr. Eisenberg: We have identified potentially modifiable factors which can provide future targets for studies to improve a man’s fertility.


• Dr. Eisenberg: These associations should be explored in other populations. In addition, further work is necessary to be able to understand how a health ailment can impact fertility.

• Citation:

• Michael L. Eisenberg, Zhen Chen, Aijun Ye, Germaine M. Buck Louis. Relationship between physical occupational exposures and health on semen quality: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertility and Sterility, 2015; DOI: 10.1016/j.fertnstert.2015.02.010


http://medicalresearch.com/author-interviews/male-occupation-and-health-can-affect-fertility/12517/

http://medicalresearch.com/author-interviews/link-between-stress-and-fertility-examined/10841/

http://medicalresearch.com/author-interviews/infertility-men-linked-mortality/5349/

http://dx.doi.org/10.1016/j.fertnstert.2015.02.010


http://medicalresearch.com/author-interviews/male-occupation-and-health-can-affect-fertility/12517/

New Mechanism Driving Lung Cancer ElucidatedMedicalResearch.com Interview with:

Jean-Bosco Tagne Ph.D.Assistant Professor of Medicine

Boston University School of Medicine; Pulmonary Center Boston, MA


Response: The lung transcription factor Nkx2-1 is an important gene regulating lung formation, and normal respiratory functions after birth. Alteration in the expression of this transcription factor can lead to lung interstitial disease, postnatal respiratory distress and lung cancer. MicroRNAs repress gene expression, also controlling lung cell differentiation. In this study, we characterized miRNAs regulated by Nkx2-1 in lung cells by genome-wide analysis and confirm the expression patterns of highly regulated miRNAs in normal lung and in lungs lacking functional Nkx2-1. By in vitro studies in lung cell lines we found that down-regulation of Nkx2-1 de-represses miR-200c. Increased miR-200c, in turn, reduces the expression of its predicted targets Nfib and Myb. These findings add new components to the gene regulatory network controlled by Nkx2-1 in lung epithelial cells that may have implications in the various roles of Nkx2-1 in development and disease particularly in this case lung cancer where the levels are seriously altered.


http://medicalresearch.com/cancer-_-oncology/lung-cancer/we-are-now-using-the-results-from-this-study-to-evaluate-mechanisms-of-prevention-and-treatment-in-a-lung-cancer-model-with-the-hope-of-improving-disease-outcomes/12522/

http://medicalresearch.com/cancer-_-oncology/lung-cancer/enzyme-critical-to-non-small-cell-lung-cancer-growth-identified/11404/



New Mechanism Driving Lung Cancer ElucidatedMedicalResearch.com Interview with:

Jean-Bosco Tagne Ph.D.Assistant Professor of Medicine

Boston University School of Medicine; Pulmonary Center Boston, MA


• Response: As the regulatory mechanisms studied in this project are linked to tumor suppression our findings have the potential to contribute to the control of lung tumor formation. We are now using the results from this study to evaluate mechanisms of prevention and treatment in a lung cancer model with the hope of improving disease outcomes. We are testing a novel drug delivery system developed in our laboratory using a Nano Emulsion Technology to target-deliver miRNAs such as miR-200c into cancer cells to inhibit its predicted targets Nfib and Myb, two strong oncogenes.

• Citation:

• Transcription factor and microRNA interactions in lung cells: an inhibitory link between NK2 homeobox 1, miR-200c and the developmental and oncogenic factors Nfib and Myb

• Respir Res. 2015; 16(1): 22.

• Published online 2015 Feb 13. doi: 10.1186/s12931-015-0186-6

• Jean-Bosco Tagne, Omar R Mohtar, Joshua D Campbell, Meenakshi Lakshminarayanan, Jingshu Huang, Anne C Hinds, Jining Lu, and Maria I Ramirez



http://medicalresearch.com/cancer-_-oncology/lung-cancer/enzyme-critical-to-non-small-cell-lung-cancer-growth-identified/11404/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335692/






High Testosterone Low Estrogen Linked To Men’s Cardiovascular HealthMedicalResearch.com Interview with:

Elaine W. Yu, MD, MMSc Assistant Professor of MedicineHarvard Medical School Massachusetts General Hospital

MGH Endocrine Unit


Dr. Yu: It is well known that cardiovascular disease is more common in men than in women. The exact reasons for this are unknown, but may be related to gender differences in levels of sex hormones such as testosterone and estrogen. As compared to premenopausal women, men have higher testosterone and lower estrogen levels. It is currently unclear whether the actions of testosterone and/or estrogen affect cardiovascular risk factors.

• In this study, we explored the regulation of cardiovascular risk factors by testosterone and estrogen in men. We found that higher levels of testosterone led to lower HDL levels (“good” cholesterol), whereas estrogen did not regulate HDL. In contrast, low levels of estrogen led to worsening insulin resistance and increased muscle fat, markers for developing diabetes. Importantly, LDL cholesterol (“bad” cholesterol”) was not affected by either testosterone or estrogen in men.


• Dr. Yu: This study of adult men revealed that HDL levels are regulated by testosterone and unaffected by estrogen, whereas insulin resistance and muscle fat are regulated by estrogen but not testosterone. These observations may help explain why men have a higher risk of cardiovascular disease than women.


http://medicalresearch.com/heart-disease/high-testosterone-low-estrogen-linked-to-mens-cardiovascular-health/12528/

http://medicalresearch.com/heart-disease/low-levels-of-testosterone-may-raise-risk-of-heart-disease/11035/

http://medicalresearch.com/exercise-fitness/hdl-function-improved-strength-training-even-overweight/2245/

http://medicalresearch.com/author-interviews/test_helps_determines_which_patients_may_not_benefit_from_elevated_hdl/9404/



High Testosterone Low Estrogen Linked To Men’s Cardiovascular HealthMedicalResearch.com Interview with:

Elaine W. Yu, MD, MMSc Assistant Professor of MedicineHarvard Medical School Massachusetts General Hospital

MGH Endocrine Unit


• Dr. Yu: It will be important to evaluate whether other cardiovascular risk factors are similarly regulated by gonadal steroids in men. For example, we plan to study effects of testosterone and estrogen on inflammatory markers as well as hormones related to fat metabolism and cardiovascular function. An improved understanding of these effects may help to explain sex differences in cardiovascular disease.

• Citation:

• ENDO15 Abstract discussing:

• Men’s heart disease risk linked to high testosterone and low estrogen

• MedicalResearch.com Interview with:Elaine W. Yu, MD, MMSc Assistant Professor of Medicine Harvard Medical School (2015). High Testosterone Low Estrogen Linked To Men’s Cardiovascular Health



http://medicalresearch.com/heart-disease/cardiovascular_disease_risk_varies_by_demographics_and_geography/9100/




Clinical Breast Exams May Be Improved By Integrating SensorsMedicalResearch.com Interview with:

Carla M. Pugh, M.D., Ph.D. FACSAssociate Professor, Vice Chair, Education and Patient Safety Clinical Director, UW Health Clinical Simulation Program

Section of Trauma, Acute Care Surgery, Burn and Surgical Critical Care Division of General Surgery University of Wisconsin, School of Medicine and Public Health, Madison, W


Dr. Pugh: The clinical breast examination is routinely performed on millions of women each year. It is used for screening breast cancer and is also routinely performed on women presenting with symptomatic breast conditions.

• In this study we assessed the performance of the clinical breast examination among a large sample of practicing physicians. There were two main goals to the study. The first goal was to identify current recommendations for performing the clinical breast examination and investigating how this relates to examination sensitivity or finding a mass. The second and more general goal was to develop a method for objective assessment of clinical skills.

• Novel clinical breast examination simulators were used in this study; in addition to their ability to present different pathologies and multiple clinical scenarios, they were all integrated with advanced force sensors. These sensors include approximately 2000 discrete sensing elements, measuring force level and distribution thought the breast examination. These sensors provide information at a level of detail that is not possible with observation alone.

• Four models were used in this study; two models presenting superficial soft masses and two models representing hard chest wall masses. The study was performed from 2013 to 2014 with 553 physicians performing the clinical breast examination on our models. The participants were recruited at three annual clinical meetings: 136 at the American Society of Breast Surgeons, 236 at the American Academy of Family Physicians, and 181 at the American College of Obstetricians and Gynecologists.

• The study found a significant relationship between the force used during palpation and the accuracy of the assessment of the deep-tissue lesions. More specifically, the study found that some physicians don’t apply enough force during the examination putting them at high risk of missing deep-tissue lesions. Since force can’t be measured by human observation this underscores the added value of integrating sensors into clinical simulators.


http://medicalresearch.com/cancer-_-oncology/breast-cancer/clinical-breast-exams-may-be-improved-by-integrating-sensors/12550/







• Dr. Pugh: Clinicians and patients should be aware that while gentle patting of the breast might find superficial masses, more force is typically needed for finding deep-tissue lesions. The amount of force will depend on factors such as breast density and size and should be adjusted as such. This high risk practice of light patting was found at all levels of experience. Some physicians will need to change and improve the clinical breast examination techniques they have been using for many years.









• Dr. Pugh: Assessment of clinical skill has been part of the medical licensing examination since 2004. Yet this assessment includes only patient actor based assessment with no objective measurements of hands-on performance. Adding sensor enabled simulators to this process can reveal and assess aspects of clinical skill performance that were not evaluated before. Furthermore, this approach provides a method for collecting data from a large sample of experts. This data can then be analyzed and can be used for finding risky behavior and for setting standards of clinical skill performance. Integrating sensors into simulators adds a level of information and detail that was not present before.

• Citation:

• Sensor Technology in Assessments of Clinical Skill

• N Engl J Med 2015; 372:784-786February 19, 2015DOI: 10.1056/NEJMc1414210



http://www.nejm.org/doi/full/10.1056/NEJMc1414210





Chinese Licorice May Enhance Skin Protection From Sun ExposureMedicalResearch.com interview with:J. Kühnl, D. Roggenkamp, G. Neufang.

Research & Development, Beiersdorf AG, Hamburg

• MedicalResearch:What is the background for this study? What are the main findings?• Response: The skin is constantly challenged by environmental stressors that induce inflammatory

processes, resulting in skin damage and –in the long term- consequently aging processes. UV-irradiation is an important exogeneous stressor. Even the best filter systems do not completely abolish the impact of UV radiation. For example, after application of a SPF50+ sun lotion, about 2% of UV-rays still reach the skin. However, the skin developed strategies to cope with exogenous stressors: Intracellular thiols quench harmful UV-derived free radicals and a multitude of detoxifying enzymes convert noxious compounds and metabolites into harmless species.

• We strived to specifically stimulate these cytoprotective cellular systems in order to tip the balance in favor of more robust skin cells.

• Previous studies showed that the root extract of the plant Glycyrrhiza inflata (Chinese Licorice) exhibits anti-inflammatory and anti-microbial effects. The major phenolic constituent of the licorice extract is Licochalcone A (LicA) and this compound is largely responsible for the beneficial effects. This was explained by LicA´s inhibitory effect on the pro-inflammatory transcription factor NFkB and its antioxidant properties.

• However, in this study, we could add another facet of LicA´s efficacy: by activating the transcription factor Nrf2, LicA stimulates the expression of cytoprotective enzymes such as heme oxygenase I and the key enzyme of glutathione synthesis, resulting in increased intracellular thiols concentrations. Consequently, when pre-incubated with LicA, isolated human skin cells were more robust against solar simulated light-induced cellular damage, indicated by a significantly decrease in the generation of free radicals in vitro. In a translational approach, we conducted a study with healthy volunteers demonstrating that the application of a lotion containing LicA-rich root extract on the inner forearms for two weeks protected the skin from UV-provoked oxidative stress.

• Thus the cellular effects of licorice are able to provide a protective shield from sun exposure, supporting and going beyond the action of sunscreens regarding sun protection.


http://medicalresearch.com/author-interviews/chinese-licorice-may-enhance-skin-protection-from-sun-exposure/12553/






• Response: Our findings clearly indicate that skin´s own protection systems can be enhanced by the application of licorice extract. In combination with UV filters, this approach might provide superior sun protection by not only mediating physical but also biological sun protection. Specific activation of cellular antioxidant-generating enzymes may be superior to topical application of “passive” antioxidants (i.e. radical scavenger) because the latter are rapidly depleted while the cellular-derived are constantly regenerated.

• We think that the concept of stimulation of cellular defense systems against inflammatory stimuli and oxidative stress could also be relevant for other dermatological issues. For instance, the skin of patients suffering from atopic dermatitis or acne displays enhanced oxidative stress due to inflammatory processes. Also polymorphic light eruption (PLE, also known as sun allergy or Mallorca acne) is related to an increased oxidative burden. Fortifying skin cells against the detrimental effects of reactive oxygen species may therefore alleviate several skin conditions.



http://medicalresearch.com/ophthalmology/young_eyes_should_be_protected_from_uv_light/7415/






• Response: We think that the outcome of our study helps to further improve the effectiveness of sunscreens by combining UV-filters with the favorable activation of cell´s own defense systems, protecting from harmful aspects of sun exposure. Furthermore, our study indicates that licorice extract improves inflammatory skin diseases and therefore might enable a better quality of life for patients with atopic dermatitis and acne. Future research should compare the profiles of plant extracts with regard to their ability to strengthen skin´s own defense in order to provide tailor-made solutions for different dermatological indications.

• Citation:

• Licochalcone A activates Nrf2 in vitro and contributes to licorice extract-induced lowered cutaneous oxidative stress in vivo

• Kühnl J1, Roggenkamp D, Gehrke SA, Stäb F, Wenck H, Kolbe L, Neufang G.

• Exp Dermatol. 2015 Jan;24(1):42-7. doi: 10.1111/exd.12588. Epub 2014 Dec 8



http://medicalresearch.com/cancer-_-oncology/animal_model_demonstrates_pediatric_use_of_sunscreen_prevents_melanoma/5973/






Should Hospitalized Patients Have Access To Their Electronic Medical Record?MedicalResearch.com Interview with: Jonathan Pell, MD

Assistant Professor Hospital MedicineUniversity of Denver

Medical Research: What is the background for this study? Dr. Pell: Back in 2001, the Institute of Medicine’s charter document Crossing the Quality Chasm proposed that the health care system needs to do a better job of patient centered care. In order to provide true patient centered care, we must provide patients and their families with the knowledge and tools they need to make autonomous and informed decisions about their healthcare. A patient cannot make informed decisions about their healthcare without having easy access to their own health information. Almost 15 years later, we are still discussing whether or not patients should have immediate electronic access to information in their electronic health record. Studies have shown that giving outpatients direct electronic access to their test results and even doctors notes does not cause patients worry or confusion, and there is no undue burden on care providers explaining this newly accessible information to their patients. Despite this, many institutions still have a moratorium on release of patients’ test results, and the duration of this moratorium is variable from institution to institution. The technology to deliver this type of information real-time to patients is readily available. We decided to explore the effect of giving hospitalized patients real-time access to their test results and hospital medication list/schedule.


http://medicalresearch.com/author-interviews/should-hospitalized-patients-have-access-to-their-electronic-medical-record/12405/

http://medicalresearch.com/author-interviews/ehr-electronic-health-records-cost-challenges-implementation/3651/






• Dr. Pell: 60% of patients in the study brought their own laptop or smartphone to the hospital, but we also provided patients with electronic tablets for the purposes of the study. The majority(≥65%) of providers and nurses were concerned that giving patients real-time access to their test results would increase their workload, but this sentiment decreased in both groups post-intervention. Concerns that seeing test results would cause patient worry were high(>85%) among providers and nurses and greater than among patients pre-intervention, but these concerns decreased in all groups post-intervention. Endorsement of patient empowerment items decreased in all groups, but overall, a majority of patients(50-86%) responded positively to these items post-intervention. Providers(96%) and nurses(93%) were more optimistic than patients(44%) that patient access to their medication lists would help them find errors, but this decreased significantly across all groups post-intervention(patients, -38%, providers, -31%, nurses,-43%).








• Dr. Pell: Clinicians should be reassured that giving inpatients direct access to their test results will not increase provider workload. Based on our study, nurses and providers were more concerned about patient confusion and worry over patients seeing these test results real-time than the patients actually were. Patients should continue to lobby for transparency of the medical record.








• Dr. Pell: Giving hospitalized patients real-time electronic access to their test results is not the silver bullet to engage them in their inpatient care, but giving them this tool is a step in the right direction. Future work should focus on improving the usability and display of patient information in electronic portals to better educate and engage inpatients and their families during a hospitalization. Evaluating the real-time release of provider and nursing notes to inpatients is the next frontier of true transparency of the medical record.

• Citation:

• Pell J, Mancuso M, Limon S, Oman K, Lin C. Patient Access to Electronic Health Records During Hospitalization. JAMA Intern Med. Published online March 09, 2015. doi:10.1001/jamainternmed.2015.121.



http://medicalresearch.com/author-interviews/electronic_records_and_withholding_information_from_doctors/6768/

http://archinte.jamanetwork.com/article.aspx?articleid=2174938



Study Raised Concerns About Ability of Appropriate Use Criteria To Guide Decision MakingMedicalResearch.com Interview with:

Harindra C. Wijeysundera MD PhD FRCPCInterventional Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre

Scientist, Sunnybrook Research Institute (SRI)Assistant Professor, Dept. of Medicine & Institute of Health Policy, Management and Evaluation


Dr. Wijeysundera: Given the rapid increase in health care costs, there has been growing emphasis on the more rational use of resources. One such effort is the development of appropriate use criteria. Such criteria have been developed in many areas of medicine, including in cardiology for diagnostic angiography. The underlying rationale for a test to be appropriate is that its anticipated benefit outweighs its anticipated harms. However, there is a paucity of empirical evidence validating this conceptual framework. Our goal was to validate the 2012 appropriate use criteria for diagnostic coronary angiography, by examining the relationship between the appropriateness of a coronary angiography in patients with suspected stable ischemic heart disease and the proportion of patients who were found to have obstructive coronary artery disease. We used data obtained from the Cardiac Care Network registry of Ontario, Canada. This is a population based registry of all cardiac procedures in the province of Ontario. We examined 48,336 patients and found that 58.2% of angiographic studies were classified as appropriate, 10.8% were classified as inappropriate, and 31.0% were classified as uncertain. Overall, 45.5% of patients had obstructive CAD. In patients with appropriate indications for angiography, 52.9% had obstructive CAD, with 40.0% undergoing revascularization. In those with inappropriate indications, 30.9% had obstructive CAD and 18.9% underwent revascularization; in those with uncertain indications, 36.7% had obstructive CAD and 25.9% had revascularization. Although more patients with appropriate indications had obstructive CAD and underwent revascularization (P < 0.001), a substantial proportion of those with inappropriate or uncertain indications had important coronary disease. Our conclusion was that despite the association between appropriateness category and obstructive CAD, this study raises concerns about the ability of the appropriate use criteria to guide clinical decision making.


http://medicalresearch.com/heart-disease/study-raised-concerns-about-ability-of-appropriate-use-criteria-to-guide-decision-making/12452/

http://medicalresearch.com/heart-disease/women-veterans-undergoing-cardiac-catheterization-highight-link-between-stress-and-cad/11998/



Study Raised Concerns About Ability of Appropriate Use Criteria To Guide Decision MakingMedicalResearch.com Interview with:

Harindra C. Wijeysundera MD PhD FRCPCInterventional Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre

Scientist, Sunnybrook Research Institute (SRI)Assistant Professor, Dept. of Medicine & Institute of Health Policy, Management and Evaluation


• Dr. Wijeysundera: Based on our study, it is clear that the appropriateness use criteria is an important tool but it is insufficient in isolation to determine where a diagnostic angiogram was warranted.


• Dr. Wijeysundera: We believe that this study reinforces the need to further refine the appropriateness use criteria such that they can have greater utility in everyday practice to guide patient selection for this test.

• Citation:

• Validation of the Appropriate Use Criteria for Coronary Angiography

• Michael M. Mohareb, MD; Feng Qiu, MSc; Warren J. Cantor, MD; Kori J. Kingsbury, MSN, MPA; Dennis T. Ko, MD, MSc; and Harindra C. Wijeysundera, MD, PhD

• Ann Intern Med. Published online 10 March 2015 doi:10.7326/M14-1889



http://annals.org/article.aspx?articleid=2194947





Test Can Help Predict Toxic Reactions To New MedicationsMedicalResearch.com Interview with: Professor Jane A. Mitchell

Head of Vascular Biology Section Head of Cardiothoracic Pharmacology National Heart and Lung Institute,Institute of Cardiovascular Medicine & Science,

Imperial College, London


• Response: In 2006 a drug called TGN1412 was given to 6 healthy male volunteers as a final test for safety. The drug had passed all of the preclinical tests and showed no problem when it was given to laboratory animals. However when it was given to people it caused a catastrophic side effect known as a ‘cytokine storm response’. All 6 volunteers became sick very quickly and needed immediate hospital treatment, they nearly died and remain at risk of immune problems still. We found a way to mimic the effects of TGN1412 in the laboratory using stem cell technology to engineer two different types of cells from the same donor to be grown and mixed together in a dish. Our test is better than the current tests used because it mimics better the human body and uses cells from one individual donor.


• Response: This test can now be used to identify side effects of new drugs and can be used with cells from patient groups, allowing for personalised medicine.


http://medicalresearch.com/medication-research/heart-diseasestudy-raised-concerns-about-ability-of-appropriate-use-criteria-to-guide-decision-making12452/12543/



Test Can Help Predict Toxic Reactions To New MedicationsMedicalResearch.com Interview with: Professor Jane A. Mitchell

Head of Vascular Biology Section Head of Cardiothoracic Pharmacology National Heart and Lung Institute,Institute of Cardiovascular Medicine & Science,

Imperial College, London


• Response: This test should be implemented for assessing the potential side effects of drugs like TGN1412, drugs that are so human specific that they might not not show side effects in animal models.

• Citation:

• An autologous endothelial cell:PBMC assay that detects cytokine storm responses to biologics

• FASEB J fj.14-268144; published ahead of print March 6, 2015, doi:10.1096/fj.14-268144



http://www.fasebj.org/content/early/2015/03/06/fj.14-268144.abstract

http://www.fasebj.org/content/early/2015/03/06/fj.14-268144.abstract



‘Traffic Light’ Nutrition Labels Help Consumers Make Healthier ChoicesMedicalResearch.com Interview with:

Professor Dr. Bernd WeberHeisenberg Professor Department of Epileptology

Head – NeuroCognition | Imaging Life&Brain Center Board of DirectorsCenter for Economics and Neuroscience Bonn


Prof. Weber: Obesity is a growing problem in most industrialized nations. One way to fight the problem is by helping consumers in their food choices, by providing them with nutritional information on the packaged products. The background for this study was to identify the effect of different ways to present the nutritional content of the food products to the subjects, i.e. with purely numerical information or with additional signals by means of a traffic light label. We find that the traffic light label influences the willingness-to-pay of subjects in that a red signal decreases the prices subjects are willing to pay, while a green signal increases it in contrast to a purely numerical information. The brain imaging data shows that the traffic light signal influences the brains valuation region of the ventromedial prefontal cortex by the dorsolateral prefrontal cortex, which has been shown to be necessary to apply self-control in value-based choices. Hence, traffic light signals seem to implicitely make consumers focus more on the health aspect of the immediate choices.


http://medicalresearch.com/weight-research/traffic-light-nutrition-labels-help-consumers-make-healthier-choices/12534/



‘Traffic Light’ Nutrition Labels Help Consumers Make Healthier ChoicesMedicalResearch.com Interview with:

Professor Dr. Bernd WeberHeisenberg Professor Department of Epileptology

Head – NeuroCognition | Imaging Life&Brain Center Board of DirectorsCenter for Economics and Neuroscience Bonn


• Prof. Weber: That the context of choices plays an important role in the kind of decisions consumers make. Easy and salient signals on the food packages may make it easier for consumers to go for a healthier – less calorie dense – option.


• Prof. Weber: Future research will have to address several important questions: do some people profit more from nutrition-labels than others, e.g. obese vs. non-obese, or higher-educated vs. lower educated people, what about children? How long-lasting are the effects of food labels on behavior? Do consumers habituate, i.e. do they get less effective with time?

• Citation:

• Enax, L., Hu, Y., Trautner, P. and Weber, B. (2015), Nutrition labels influence value computation of food products in the ventromedial prefrontal cortex. Obesity. doi: 10.1002/oby.21027



http://onlinelibrary.wiley.com/doi/10.1002/oby.21027/abstract



Personalized Risk Calculations May Reduce Readmissions Of Sepsis SurvivorsMedicalResearch.com Interview with:

Hallie Prescott, MD, MSc Clinical Lecturer, Internal MedicineDivision of Pulmonary & Critical Care Medicine

University of Michigan Health System Ann Arbor, MI 48109-2800


Dr. Prescott: The post-hospital period has been widely recognized as a vulnerable time for patients. In particular, patients who survive sepsis are frequently readmitted to the hospital in the following three months.

• In this study, we examined data from 2,600 survivors of sepsis, a severe infection that leads to organ failure. About 42% of the sepsis patients were readmitted in the next 90 days, similar to the rate seen for patients hospitalized for other acute conditions.

• However, the reasons for hospital readmission after sepsis are different. A greater number of patients are re-hospitalized for “ambulatory-care sensitive conditions”, which are conditions that could potentially be prevented or treated early in the outpatient setting to avoid a hospital stay.


http://medicalresearch.com/infections/personalized-risk-calculations-may-reduce-readmissions-of-sepsis-survivors/12531/

http://medicalresearch.com/infections/sepsis_sniffer_tool_better_identifies_patients_requiring_advanced_care/8300/







• Dr. Prescott: Patients surviving sepsis frequently end up back in the hospital, and many of these repeat hospitalizations may be preventable. Because hospitals currently face financial penalties from Medicare for high rates of readmission after certain conditions, much of the debate focuses on readmissions as measures of the quality of inpatient care.

• However, this report suggests that we should focus on building better systems to ensure that patients get timely outpatient care during the critical weeks to months after a sepsis hospitalization.



http://medicalresearch.com/diabetes/elderly-with-co-morbidities-account-for-most-readmissions-for-diabetics/11645/







• Dr. Prescott: A small number of potentially preventable conditions accounts for many of the re-hospitalizations after sepsis. Therefore, it may be possible to develop tools that give personalized risk calculations for a handful of common conditions experienced by sepsis survivors. This would allow primary care physicians to focus their limited time towards patients’ most immediate health threats. Better risk prediction tools and good primary care could go a long way towards improving the recovery after sepsis.

• Citation:

• Prescott HC, Langa KM, Iwashyna TJ. Readmission Diagnoses After Hospitalization for Severe Sepsis and Other Acute Medical Conditions. JAMA. 2015;313(10):1055-1057. doi:10.1001/jama.2015.1410.



http://medicalresearch.com/infections/genetic_signature_provides_early_prediction_of_sepsis_and_organ_failure/8555/

http://jama.jamanetwork.com/article.aspx?articleid=2190975



Inhaled Nitric Oxide Still Used Off-Label In Preterm InfantsMedicalResearch.com Interview with:

Marc Ellsworth, M.DNeonatology fellow at the

Mayo Clinic Children’s Center


• Dr. Ellsworth: Inhaled Nitric Oxide (iNO) is a drug that has FDA approval for use in neonates >34 weeks gestational age. It is used for severe respiratory failure secondary to pulmonary hypertension. However, it has been previously shown that neonatologists have been using this medication off-label and especially in the most premature neonates. Over the last 10 years there have been multiple large studies trying to determine a clinical use (ie long term benefit) for iNO in preterm neonates (patients where there is no FDA approval for iNO use currently). Despite evidence of short term benefit (improved clinical stability) use of this drug has not been shown to improve long-term outcomes (death and chronic lung disease) in premature neonates. As a result of these findings the National Institute of Child Health and Human Development (NICHD) released a consensus guideline in 2011 indicated that available evidence did not support the routine use of iNO in preterm neonates and discouraged this use of this expensive therapy in preterm neonates. Similarly, in 2014 the American Academy of Pediatrics issued a similar statement with similar recommendations.


http://medicalresearch.com/pediatrics/inhaled-nitric-oxide-still-used-off-label-in-preterm-infants/12540/






• In 2014 a group of NICUs (collectively called the Neonatal Research Network) associated with the NICHD published a report showing that the use of Inhaled Nitric Oxide in preterm infants (ie off-label) decreased following the report in 2011.

• However, I did not feel that these NICUs were representative of the United States alone as the Neonatal Research Network consists of only a handful of NICUs (~15) and is directly associated with the NICHD. As a result I wanted to get a better idea of Inhaled Nitric Oxide use in a population based study to see if the trends were similar (ie use of iNO has been decreasing) on a much larger, more representative scale. (Editorial comment: My anecdotal experience was that rates of iNO use off-label have not decreased in preterm neonates since the 2011 report).









• Dr. Ellsworth: Between 2009 and 2013, the rate of iNO utilization in 23 – 29 week neonates increased from 5.03% to 6.19%, a relative increase of 23% (CI 8-40%; p = 0.003). Of all neonates who received iNO therapy in 2013, nearly half were <34 weeks’ gestation (off label) with these infants accounting for more than half of all first exposure iNO days each year of the study period.

• Of note, this data was also validated with data from the Vermont Oxford Network (VON) during the same years. Between 2009 and 2013, for the 79,434 infants 23 to 29 weeks cared for at the 703 hospitals in the United States participating in the Vermont Oxford Network, the rate of iNO utilization increased from 6.7 to 6.9 percent. (This data was added into the discussion of our paper).

• We estimated that off-label use in the United States generated a cost of $19.6 million in 2013 alone.









• Dr. Ellsworth: Despite professional guidance from the NICHD to discourage off-label Inhaled Nitric Oxide use, neonatologists in many NICUs throughout the United States continue to use this medication in the most premature of neonates.

• I think it is important for neonatologists to be aware that our data of increasing off label iNOuse is, independent of any clinical consequences, potentially placing a significant economic burden on the care of the critically ill neonate in the United States. The uncertainty in future pricing models and insurance reimbursement practices of this costly, and in a majority of cases, off label therapy is something every neonatologist should be aware of and should guide discussions among clinicians on how iNO use should best be managed in their individual NICU settings.









• Dr. Ellsworth: Over the last few years there has been an uptick in published case series and small trials of alternative therapies for respiratory failure, often due to pulmonary hypertension, in preterm neonates. These therapies (milrinone , vasopressin, sildenafil, prostacyclins) are being shown to provide short term clinical benefits to a similar degree and in the same clinical situations where Inhaled Nitric Oxide is currently being used off label as first-line therapy. Hopefully the findings of our study will encourage investigators to dedicate research efforts and resources to further studying these alternative, and in most cases much more economical, therapies to determine their safety and long term consequences. An approach similar to what was undertaken to study iNO in preterm neonates may enable us to find more suitable alternatives to the vexing clinical situations that often prompt off label prescription of Inhaled Nitric Oxide in NICUs today.

• Citation:

• Off-Label Use of Inhaled Nitric Oxide After Release of NIH Consensus Statement Pediatrics peds.2014-3290d; Published online March 9, 2015 (10.1542/peds.2014-3290d)



http://pediatrics.aappublications.org/content/early/2015/03/04/peds.2014-3290d.abstract



Breath Test for Drug Testing In the PipelineMedicalResearch.com Interview with:

Niclas Stephanson, PhDLeg. Apotekare, Analytisk kemist

Karolinska Universitetssjukhuset Stockholm


• Dr. Stephanson: Drug testing is most commonly performed using urine samples, which is based on a long and comprehensive experience. The methodology and regulations for reliable urine testing are well developed and can be considered the current gold standard for drug testing. However, one problem with urine testing is related to the sample collection, often perceived as inconvenient and privacy-overriding by those undergoing the test. To overcome this problem a group of researchers from the Department of Laboratory Medicine at the Karolinska Institute in Sweden have worked on developing a more donor-friendly alternative to urine testing for drugs by focusing on exhaled breath.

• Doctor Niclas Stephanson in the research group led by Professor Olof Beck, has developed the first fully validated and robust screening method for the routine measurement of drugs of abuse in exhaled breath. The procedure involves a simple method of sample collection and preparation, which is followed by a highly sensitive analytical technique known as LC-MS (Liquid chromatography–mass spectrometry). The drug groups which are identified: amphetamine, methamphetamine, cannabis, cocaine and heroin.

• The underlying mechanism in exhaled breath drug testing is believed to be the formation of aerosol particles from the airway lining fluid by the breathing process. These aerosol particles may contain drugs present in the body, which enables drugs to be analyzed. A simple collection device is currently available which selectively collects the micrometer aerosol particles on a filter and enables further laboratory investigation of possible drug content.


http://medicalresearch.com/addiction/breath-test-for-drug-testing-in-the-pipeline/12536/



Breath Test for Drug Testing In the PipelineMedicalResearch.com Interview with:

Niclas Stephanson, PhDLeg. Apotekare, Analytisk kemist

Karolinska Universitetssjukhuset Stockholm


• Dr. Stephanson: This results in many possible applications of breath drug testing for workplace, criminal justice, accidents and compliance monitoring of patients, roadside tests relating to DUID (Driving Under the Influence of Drugs) where the short detection time window is relevant since the state of influence is in focus, and this combined with the convenient sampling procedure makes it an attractive solution for roadside testing.


• Dr. Stephanson: My recommendations for future research will be conducting controlled pharmacokinetic studies related to dose dependent excretion of drugs in breath.

• Citation:

• Method validation and application of a liquid chromatography–tandem mass spectrometry method for drugs of abuse testing in exhaled breath

• Niclas Stephanson, ,

• Sören Sandqvist,

• Marjan Shafaati Lambert,

• Olof Beck

• Journal of Chromatography B

• Volume 985, 15 March 2015, Pages 189–196



http://www.sciencedirect.com/science/article/pii/S1570023215000720









Nearly All Babies Born With Neonatal Abstinence Syndromes Were Exposed To OpioidsMedicalResearch.com Interview with:

Dr. Jennifer Lind PharmD, MPHDivision of Birth Defects and Developmental Disabilities,

CDC

• Medical Research: What is the background for this study? Dr. Lind: CDC and Florida investigators published a new report describing the characteristics of infants with neonatal abstinence syndrome (NAS) and their mothers. NAS is a group of signs exhibited by newborns exposed to addictive drugs taken by a mother during pregnancy. Infants with neonatal abstinence syndrome have prolonged hospital stays, experience serious medical complications, and are very costly to treat.


Dr. Lind: In this investigation, 242 infants with neonatal abstinence syndrome were identified in three Florida hospitals during a 2-year period (2010–2011). Nearly all of the infants with NAS were exposed to opioid painkillers during pregnancy (99.6%) and experienced serious medical complications, with more than 97% being admitted to an intensive care unit, where the average length of stay was 26 days. Despite a high prevalence of positive urine toxicology tests during the birth hospitalization, only a small proportion of mothers had documentation of referrals for drug counseling or rehabilitation.


http://medicalresearch.com/addiction/nearly-all-babies-born-with-neonatal-abstinence-syndromes-were-exposed-to-opioids/12597/

http://medicalresearch.com/pain-research/misuse-of-pain-medication-may-be-pathway-to-high-risk-drug-behaviors/17/



Nearly All Babies Born With Neonatal Abstinence Syndromes Were Exposed To OpioidsMedicalResearch.com Interview with:

Dr. Jennifer Lind PharmD, MPHDivision of Birth Defects and Developmental Disabilities,

CDC


• Dr. Lind: The findings of this report underscore the important public health problem of neonatal abstinence syndrome and add to current knowledge on the characteristics of these mothers and infants. Improvements are needed in drug addiction counseling/rehabilitation referral and documentation policies. Women who are pregnant or thinking about becoming pregnant should discuss all medications and any addictive drugs that they are currently taking with a healthcare provider.


• Dr. Lind: Other analyses from this investigation will evaluate the use of Florida’s linked administrative data (linked hospital inpatient discharge, birth certificate, and infant death certificate data) for neonatal abstinence syndrome surveillance.

• Citation:

• Infant and Maternal Characteristics in Neonatal Abstinence Syndrome — Selected Hospitals in Florida, 2010–2011

• Jennifer N. Lind, PharmD1,2,3, Emily E. Petersen, MD1,3,4, Philip A. Lederer, MD1,3,5, Ghasi S. Phillips-Bell, ScD4,6, Cria G. Perrine, PhD2,3, Ruowei Li, MD2, Mark Hudak, MD7, Jane A. Correia6, Andreea A. Creanga, MD4, William M. Sappenfield, MD8, John Curran, MD9, Carina Blackmore, PhD6, Sharon M. Watkins, PhD6, Suzanne Anjohrin, MPH6

• MMWR Weekly

• March 6, 2015 / 64(08);213-216



http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6408a3.htm






Interarm Blood Pressure Variability Linked To Greater Cardiovascular Risk in CKDMedicalResearch.com Interview with:

Dr. Borja Quiroga MD Ph.D.Nephrology Unit, Hospital General Universitario Gregorio Marañón

Madrid, Spain


Dr. Quiroga: Chronic kidney disease patients are at high-risk for the development of cardiovascular events. Although several strategies have been tried for identifying those patients with poorer prognosis, no one has demonstrated by itself being the best one. This could be explained by the fact that several factors are implied in the cardiovascular profile of chronic kidney disease patients.

• With this background, in our study we hypothesized if differences in the interarm systolic blood pressure could detect patients with enhanced cardiovascular risk early, and, consequently therapies could be initiated.

• Our results provide interesting data on this regard, as we have concluded that an interarm systolic blood pressure difference higher that 10 mmHg is an independent prognosis factor for cardiovascular events.


• Dr. Quiroga: The first thing clinicians and patients must have in their mind is that chronic kidney disease in a cardiovascular risk factor per se, so they should be controlled more frequently. A multifactorial approach for stratifying the risk of the patients can promote the development of new strategies for improving the poor cardiovascular profile. We propose an easy, cheap and feasible method, measuring blood pressure in both arms. If a difference higher than 10 mmHg is found, the clinician must deeply study the cardiovascular profile of these patients, as, for example, controlling the classical cardiovascular risk factors. In addition, those chronic kidney disease patients with diabetes or history of cardiovascular disease that show an interarm systolic blood pressure difference > 10 mmHg, are even at higher risk.


http://medicalresearch.com/heart-disease/interarm-blood-pressure-variability-linked-to-greater-cardiovascular-risk-in-ckd/12580/



Interarm Blood Pressure Variability Linked To Greater Cardiovascular Risk in CKDMedicalResearch.com Interview with:

Dr. Borja Quiroga MD Ph.D.Nephrology Unit, Hospital General Universitario Gregorio Marañón

Madrid, Spain


• Dr. Quiroga: The next step is checking if interventional treatments for improving the enhanced cardiovascular risk in chronic kidney disease patients decreases their interarmsystolic blood pressure difference, and establish this marker in clinical practice.

• Citation:

• Interarm systolic blood pressure as a predictor of cardiovascular events in patients with chronic kidney disease

• Quiroga, B., Galan, I., Garcia de Vinuesa, S., Goicoechea, M., Verdalles, U., Luno, J.Nephrol Dial Transplant. 2015 Mar 9. pii: gfv059. [Epub ahead of print]MedicalResearch.com Interview with: Dr. Borja Quiroga MD Ph.D. (2015). Interarm Blood Pressure Variability Linked To Greater Cardiovascular Risk in CKD



http://www.ncbi.nlm.nih.gov/pubmed/25753805?dopt=Abstract





MedicalResearch.com Interview with:Elizabeth A. Lawson, M.D., M.M.Sc.

Assistant Professor of Medicine Harvard Medical School Director, Interdisciplinary Oxytocin Research ProgramNeuroendocrine Unit Massachusetts General Hospital

Boston, MA 02114


Response: Oxytocin is a hormone produced in the brain that has been shown to reduce food intake in animal studies. The role of oxytocin on appetite and food consumption in humans is not well understood. We therefore performed a randomized, placebo controlled cross-over study of single dose administration of intranasal oxytocin (Syntocinon, Novartis) in healthy men. Subjects presented fasting in the early morning and were randomized to receive 24 IU intranasal oxytocin or placebo. They selected breakfast from a menu and were offered double portions. The caloric content of the food they ate was calculated. They returned for a second visit, which was the same except for this time, they received the other treatment (placebo or oxytocin). There was no difference in how much food the men reported eating in the three days leading up to each of the study visits. On average, the men ate 122 fewer calories and about 9 grams less fat after receiving oxytocin compared to placebo. There was also evidence that oxytocin resulted in greater use of fat as a fuel for the body, and improved insulin sensitivity.


• Response: This study is exciting because it translates findings in animal research to humans. Whether oxytocin could be used to treat obesity and its metabolic complications is unknown at this point and needs to be studied.


http://medicalresearch.com/weight-research/intranasal-oxytocin-before-meal-reduced-calorie-consumption-in-men/12602/

http://medicalresearch.com/weight-research/endocrine-society-guidelines-for-weight-loss-medications-in-obesity/10709/



MedicalResearch.com Interview with:Elizabeth A. Lawson, M.D., M.M.Sc.

Assistant Professor of Medicine Harvard Medical School Director, Interdisciplinary Oxytocin Research ProgramNeuroendocrine Unit Massachusetts General Hospital

Boston, MA 02114


• Response: To better understand how oxytocin works, we are currently using functional MRI to investigate the effects of intranasal oxytocin on brain pathways involved in regulating food intake. Next we plan to study oxytocin effects in women, who may not respond in the same way as men. Studies examining the efficacy and safety of daily intransal oxytocin (for example, 24 IU before meals) in the treatment of obesity will be important.

• Citation:

• ENDO 2015 Abstract March 201

• Synthetic nasal formulation of the hormone oxytocin reduced caloric intake in healthy men



https://www.endocrine.org/news-room/current-press-releases/oxytocin-nasal-spray-causes-men-to-eat-fewer-calories



Familial Hypercholesterolemia Linked To Lower Type2 Diabetes RiskMedicalResearch.com Interview with:

Joost Besseling PhD-studentAcademic Medical Center

Dept. of Vascular MedicineAmsterdam


Response: Statins are associated with an increased risk for type 2 diabetes mellitus (DM). The exact mechanism for this adverse event is largely unknown, although the upregulation of the low-density lipoprotein receptor (LDLR) has been suggested to play a role. In familial hypercholesterolemia (FH) the uptake of LDL-cholesterol via the LDLR is decreased due to a genetic defect. We found that the prevalence of type 2 DM is 50% lower in relative terms in patients with familial hypercholesterolemia. Moreover, there was a dose-response relationship: the more severe the genetic defect that causes familial hypercholesterolemia, the lower the prevalence of type 2 DM.

Medical Research: What should clinicians and patients take away from your report?

• Response: Although the high relative reduction of type 2 diabetes mellitus prevalence in familial hypercholesterolemia patients, this probably has no consequences for patients and clinicians. Since the prevalence of type 2 DM is quite low (3% in unaffected persons in our study), the absolute difference in prevalence is modest. Our findings primarily contribute to our understanding of the pathogenesis of type 2 diabetes mellitus and suggest a role for cellular cholesterol metabolism in the pathogenesis of type 2 diabetes mellitus.


http://medicalresearch.com/diabetes/familial-hypercholesterolemia-linked-to-lower-type2-diabetes-risk/12583/

http://medicalresearch.com/diabetes/diabetes_and_cardiovascular_disease_share_several_key_driver_genes/9545/

http://medicalresearch.com/diabetes/type-2-diabetes-u-shaped-association-bmi-cause-mortality/8922/



Familial Hypercholesterolemia Linked To Lower Type2 Diabetes RiskMedicalResearch.com Interview with:

Joost Besseling PhD-studentAcademic Medical Center

Dept. of Vascular MedicineAmsterdam


• Response: Our study was cross-sectional and our results should be confirmed using a longitudinal study design. Furthermore, the role of cellular cholesterol metabolism in the pathogenesis of type 2 diabetes mellitus can be explored more in depth, so that we might eventually be able to target it in order to prevent and treat type 2 diabetes mellitus.

• Citation:

• Besseling J, Kastelein JP, Defesche JC, Hutten BA, Hovingh G. Association Between Familial Hypercholesterolemia and Prevalence of Type 2 Diabetes Mellitus. JAMA. 2015;313(10):1029-1036. doi:10.1001/jama.2015.1206.



http://jama.jamanetwork.com/article.aspx?articleid=2190985



medicalresearch.com: medical research exclusive interviews march 12 2015

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