HER2+ Breast Cancer: Trastuzumab Increased Survival

dr_edith_perezMedicalResearch.com Interview with:
Edith A. Perez, MD
Mayo Clinic
Jacksonville, FL 32224

Medical Research: What are the main findings of the study?

Dr. Perez: Our joint analysis of two large prospective trials showed that adding one year of Trastuzumab to otherwise standard adjuvant chemotherapy significantly improved long term survival in women with resected HER2+ breast cancer.
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Even Thin Melanomas Can Be Fatal

Prof. David Whiteman Group leader, Cancer Control Group QIMR Berghofer Herston, QueenslandMedicalResearch.com Interview with:
Prof. David Whiteman
Group leader, Cancer Control Group
QIMR Berghofer
Herston, Queensland

 

Medical Research: What are the main findings of the study?

Dr. Whiteman: Mortality from melanoma has continued to rise in Queensland, Australia, the jurisdiction with the world’s highest incidence of this disease. We analysed more than 4000 deaths from melanoma over the last 2 decades, and calculated mortality rates according the thickness of the primary lesion.
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Bipolar Disorder: Protective Genetic Discovery May Lead To New Drug Treatment

Edward I. Ginns, MD, PhD, Director Program in Medical Genetics and Lysosomal Disorders Treatment and Research Program University of Massachusetts Medical School Reed Rose Gordon Building, Room 137 Shrewsbury, MA 01545MedicalResearch.com: Interview with:
Edward I. Ginns, MD, PhD, Director
Program in Medical Genetics and
Lysosomal Disorders Treatment and Research Program
University of Massachusetts Medical School
Reed Rose Gordon Building, Room 137
Shrewsbury, MA 01545

Medical Research: What are the main findings of the study?

Dr. Ginns: Our study identified that sonic hedgehog signaling, an important brain pathway, is involved in bipolar affective disorder.

This finding shows a mechanism and provides new targets for drug development. It suggests that sonic hedgehog signaling can be modulated to help manage bipolar symptoms in adults by using drugs already being studied in clinical trials for other medical conditions.

The new findings were uncovered by decades of translational research in the Old Order Amish families of Pennsylvania, where in a few special families in the Amish Study there is a high incidence of both bipolar disorder and a rare genetic dwarfism, Ellis van‐Creveld (EvC) syndrome. No person with EvC had bipolar disorder despite forty years of documented research across multiple generations, suggesting that the genetic cause of this rare dwarfism was protective of bipolar affective disorder.
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Opioid Dependence: Buprenorphine Maintenance May Be Better Than Taper for Treatment Retention

David A. Fiellin, M.D. Professor of Medicine, Investigative Medicine and Public Health Yale University School of MedicineMedicalResearch.com Interview with
David A. Fiellin, M.D.
Professor of Medicine, Investigative Medicine and Public Health
Yale University School of Medicine

 

Medical Research: What are the main findings of the study?

Dr. Fiellin: The main finding of our randomized clinical trial, conducted in primary care, was that among prescription opioid dependent patients, ongoing buprenorphine therapy resulted in better treatment retention and reduced illicit opioid use when compared to buprenorphine taper (detoxification).

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Comorbiditites Contribute To Unplanned Hospitalizations Among GI Cancer Patients

MedicalResearch.com Interview with:
Joanna-Grace M. Manzano, MD

Assistant Professor
Department of General Internal Medicine

Maria E. Suarez-Almazor, MD, PhD
Barnts Family Distinguished Professor
Chief, Section of Rheumatology &
Deputy Chair, Dept. of General  Internal Medicine
UT MD Anderson Cancer Center Houston, TX

Medical Research: What are the main findings of the study?

Response: Our study established that unplanned hospitalization among elderly patients with GI cancer are very common – 93 events per 100-person years.

Certain characteristics were found to have an increased risk for an unplanned hospitalization in our cohort, namely: older age, black race, advanced disease, higher comorbidity score, residing in poor neighborhoods and dual eligibility for Medicare and Medicaid. Esophageal and gastric cancer had the highest risk for unplanned hospitalization among all GI cancer types.

Some of the observed reasons for unplanned hospitalization were potentially preventable and related to the patient’s comorbid illness.
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No Adverse Effects of Short-Term Daily Egg Ingestion in Coronary Artery Disease

David L. Katz, MD, MPH, FACPM, FACP Director, Yale University Prevention Research Center Griffin HospitalMedicalResearch.com Interview with:
David L. Katz, MD, MPH, FACPM, FACP
Director, Yale University Prevention Research Center
Griffin Hospital

 

Medical Research: What are the main findings of the study?

Dr. Katz: We did not see any adverse effects of short-term, daily egg ingestion in adults with established coronary artery disease.

Medical Research: What was most surprising about the results?

Dr. Katz: Eggs are routinely banned from ‘heart healthy diets.’  in particular eggs are always absent from cardiac care units, with egg beaters substituting.  However, these same units routinely serve products with refined starch and added sugar.  The scientific basis for excluding eggs from diets to improve cardiac health has long been suspect.  Here, we show that in the short term at least, there are no discernible harms of daily egg ingestion even in adults with heart disease.
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Health Insurance, Regular Healthcare Visits Linked To Hypertension Control

Dr. Brent M. Egan MD Adjunct Professor Medical University of South CarolinaMedicalResearch.com Interview with:
Dr. Brent M. Egan MD
Adjunct Professor
Medical University of South Carolina

Medical Research: What are the main findings of the study?

Dr. Egan: The study was undertaken to determine progress toward the Healthy People 2020 goals of controlling hypertension or high blood pressure in 61.2% of all adults with the condition. What we found is that hypertension control has changed very little from 2007 through 2012. In 2011-2012, an estimated 51.2% of all hypertensive adults were controlled, which is 10% below the 2020 goal.  The analysis indicated that healthcare insurance and at least two healthcare visits yearly were related to both the likelihood that hypertension would be treated and controlled.
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Alopecia Areata: Enbrel May Improve, or Worsen, Hair Loss

Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New YorkMedicalResearch.com Interview with
Marie C. Leger, MD, PhD
Ronald O. Perelman Department of Dermatology
New York University School of Medicine, New York

Medical Research: What are the main findings of the study?What was most surprising about the results?



Dr. Leger: Alopecia areata is a T-cell mediated autoimmune disease. As such, there was initially hope that inhibiting the helper T cell cytokine TNF-α could effectively treat this condition. This has not been shown to be the case—in fact, one open-label study of etanercept in 17 patients with moderate to severe alopecia showed no hair regrowth and even worsening of alopecia in several subjects. There have been many other case reports in the dermatologic literature of TNF-α inhibitors causing alopecia areata. In contrast, our case report presents a patient who very clearly grew hair on adalimumab—its strength lies in the fact that her hair loss and regrowth were replicated on withdrawal and rechallenge with the medication.

Our patient’s paradoxical response to adalimumab complements other literature suggesting that there are genetic variations in the way a patient’s immune system responds to TNF-α inhibitors. In different individuals, these medications can either treat or cause conditions such as psoriasis or lupus. It seems that this is also the case with alopecia areata.
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In Home Medication Errors Common Among Young Children

MedicalResearch.com: Interview with:

Dr.  Huiyun Xiang, MD, MPH, PhD Center for Injury Research and Policy The Ohio State University College of Medicine, Columbus, OhioDr.  Huiyun Xiang, MD, MPH, PhD
Center for Injury Research and Policy
The Ohio State University College of Medicine, Columbus, Ohio

Jeb Phillips, BA Project Specialist, Injury Research and Policy Staff Nationwide Children’s Hospital,  Columbus, OhioJeb Phillips, BA
Project Specialist, Injury Research and Policy Staff
Nationwide Children’s Hospital,  Columbus, Ohio

 

Medical Research: What are the main findings of the study?

Response: From 2002-2012, a child younger than 6 years old experienced an out-of-hospital medication error every 8 minutes. That’s a total of 696,937 during the study period, or 63,358 per year. Almost all happened at the child’s residence. The rate and number of errors decreased with increasing age.

Analgesics were the mostly commonly involved medications (25.2%), followed by cough and cold medications (24.6%). More than 1 in 4 (27%) of the errors happened when a child inadvertently took or was given medication twice. Errors also happened when children took or were given an incorrect dose, when medication measurements were confused, and when the wrong medication was taken or given.

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PCV13 Vaccine Markedly Protects Elderly Against Community Acquired Pneumonia

Dr. Susanne Huijts – Pulmonary resident UMC Utrecht | Research physician UMCU Julius Center for Health Sciences and Primary Care NetherlandsMedicalResearch.com Interview with: 
Dr. Susanne Huijts
Research Physician at UMCU Julius Center for Health Sciences Pulmonary resident, UMC Utrecht Center
Utrecht, Netherlands

 

Medical Research: What are the main findings of the study?

Dr. Huijts: The CAPiTA trial evaluated the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults of 65 years and older. In the per protocol analysis vaccine efficacy of 45.6% was demonstrated for the first episode vaccine type (VT) pneumococcal community acquired pneumonia (CAP); 45.0% for the first episode of non-bacteremic/ non-invasive (NB/NI) VT-CAP, and 75.0% for the first episode of VT-invasive pneumococcal disease.

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Enterovirus infection Linked to Increased Risk of Childhood Diabetes

MedicalResearch.com Interview with:
Dr Tsai Chung-Li
Graduate Institute of Biostatistics, College of Management, China
Medical University,Taichung, Taiwan and
Dr. Hsiao-Chuan Lin
Department of Public Health, College of Public Health, and
Department of Pediatrics,
China Medical University, Taichung, Taiwan

Medical Research: What are the main findings of the study?

Response: We conducted a nationwide population-based cohort study that included two groups. Children with enterovirus infection (aged < 18 years) during 2000-2007 were identified and followed up until December 31, 2008 or until first occurrence of type 1 diabetes. The group without enterovirus infection comprised half of all insured children of the same age and without a diagnosis of enterovirus infection. By use of frequency-matching with sex and birth year, children in the group with enterovirus were selected from those eligible. This nationwide retrospective cohort study found:

  • type 1 diabetes is positively correlated with enterovirus infection in patients younger than 18 years.
  • the incidence rate of type 1 diabetes was lower in the non-enterovirus than the enterovirus group (4 vs 6 per 100,000 person-years; incidence rate ratio 1.48 [95% CI 1.19, 1.83]).
  • children that have been infected with enterovirus are 48% more likely to have developed type 1 diabetes.
  • the risk of developing type 1 diabetes is 2.18 times greater among children aged 10 years and older than among those aged younger than 1 year.

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Sleep Apnea Increases Risk of Atrial Fibrillation After Bypass Surgery

Adrian Baranchuk MD FACC FRCPC Associate Professor of Medicine Director, EP Training Program Queen's University Kingston, Ontario, CanadaMedicalResearch.com Interview with:
Adrian Baranchuk MD FACC FRCPC
Associate Professor of Medicine
Director, EP Training Program Queen’s University
Kingston, Ontario, Canada

Medical Research: What are the main findings of the study?

Dr. Baranchuk: In this study, we investigated whether obstructive sleep apnea increases the risk of atrial fibrillation after coronary artery bypass surgery. We found the risk to increase by approximately two-fold for patients with obstructive sleep apnea, suggesting that this disease is a strong predictor of atrial fibrillation after coronary artery bypass surgery.

We also found that the risk increases in patients with more severe obstructive sleep apnea.

This is an important association to explore since atrial fibrillation after coronary artery bypass surgery increases patient mortality, the risk of stroke, hospital stay, healthcare costs, and has substantial burden on patients and their families. It is also a common complication of the surgery, occurring in up to half of the patients. Knowing which factors increase its risk gives us a better understanding of how to manage it and mitigate its negative consequences.
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Canadian Universal Health Insurance Reduces Racial Disparities in Primary Care Access

Arjumand Siddiqi, Sc.D., Assistant Professor Departments of Epidemiology and Social and Behavioral Sciences Dalla Lana School of Public Health University of Toronto Toronto, Ontario CanadaMedicalResearch.com Interview with:
Arjumand Siddiqi, Sc.D., Assistant Professor
Departments of Epidemiology and Social and Behavioral Sciences
Dalla Lana School of Public Health
University of Toronto
Toronto, Ontario Canada

MedicalResearch: What are the main findings of the study?

Dr. Siddiqi: The main finding of the study is that, in a society with universal health insurance (Canada), racial disparities in access to primary care are drastically reduced, with some important exceptions.

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Patients With Severe Mental Illness Find Supportive Community On YouTube

MedicalResearch.com Interview with:

John A. Naslund, MPH – PhD Student at The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH

Stuart W. Grande, PhD, MPA – Post–doctoral fellow at The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH

Medical Research: What are the main findings of the study?

Naslund: In this study we explored whether people with severe mental illness such as schizophrenia, schizoaffective disorder, or bipolar disorder, use a popular social media website like YouTube to naturally provide and receive peer support. We found that people with severe mental illness use YouTube to feel less alone and to find hope, to support and to defend each other, and to share personal stories and strategies for coping with day-to-day challenges.  

Dr. Grande: They also sought to learn from the experiences of others about using medications and seeking mental health care.  YouTube appears to serve as a platform that helps these individuals to overcome fears associated with living with mental illness, and it also creates a sense of community among them.
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Calorie Posting Reduced Adolescent Sugary Drink Purchases

Sara N. Bleich, Ph.D. Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205  MedicalResearch.com Interview with:
Sara N. Bleich, Ph.D.
Associate Professor Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205

Medical Research: What are the main findings of the study?

Dr. Bleich: Providing easily understandable calorie information — particularly in the form of miles of walking — makes adolescents more likely to buy a beverage with fewer calories, a healthier beverage or a smaller size beverage. Adolescents were also more likely to not buy any drink at all after seeing the signs with calorie information.
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Dendritic Cell Vaccination May Help Uveal Melanoma

MedicalResearch.com Interview with:
Prof I. Jolanda M. de Vries
Professor, Dept of Tumor Immunology
Radboud University Nijmegen

Medical Research: What are the main findings of the study?

Prof. de Vries: Dendritic cells are antigen-presenting cells with the unique capacity to activate naive antigen-specific T cells, and by this means are very suitable to induce immunologic antitumor responses. Dendritic cells cultured from monocytes can be matured and loaded with tumor antigen ex vivo and administered back into the patient. Within the lymph node, dendritic cells present antigens to T cells to initiate an immune response.

Metastatic uveal melanoma patients were vaccinated with autologous DCs loaded with tumor antigens (gp100 and tyrosinase), obtained by leukapheresis, according to a schedule of 3 biweekly vaccinations. One to 2 weeks after the last vaccination, a skin test was performed to analyse the induction of immunologic responses.

We can conclude that dendritic cell vaccination is feasible and safe in metastatic uveal melanoma. Dendritic cell-based immunotherapy is potent to enhance the host’s antitumor immunity against uveal melanoma in approximately one third of patients.
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Proton Therapy May Decrease Overall Costs While Improving Quality of Cancer Care

Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with:
Steven J. Frank, M.D.
Associate Professor of Radiation Oncology
Medical Director of the Proton Therapy Center
The University of Texas MD Anderson Cancer Center

MedicalResearch.com Editor’s Note:

A recent research published in Oncology Payers, discusses the quality of life benefits and cost-savings of intensity modulated proton therapy (IMPT or proton therapy) with traditional x-ray therapy for advanced stage head and neck cancer. The senior author of the paper, Dr. Steven Frank, highlights two oropharyngeal cancer patients, one of whom received proton therapy and the other x-ray treatments. Both patients received chemotherapy.

The study showed that although the upfront costs of proton therapy were three times that of standard x-ray treatments, the proton therapy patient was spared the necessity of a feeding tube, nutritional and supportive care and weight loss that accompanied the x-ray treatments. By the end of the treatment period, the total care costs for the proton therapy patient were 20% lower than the x-ray treatment plan.

To evaluate the costs, Dr. Frank has been employing a costing tool used elsewhere at MD Anderson called Time-driven Activity-based Costing that places the emphasis on the value of medical care, both monetary and in terms of quality of life. Dr. Frank plans to enroll 360 patients over the next five years as well as to open the study to other cancer centers. He notes that the results will be especially valuable as health insurance companies look to further bundled insurance payments.

Dr. Frank was kind enough to answer several questions regarding his work for the MedicalResearch.com audience.

Medical Research: From a patient’s perspective, what are the main differences between traditional x-ray therapy and proton therapy for cancer treatment?

Dr. Frank: In proton therapy, the radiation hits the cancer, while with traditional x-ray the radiation hits the cancer and the normal tissues in the head and neck, causing more side effects during and after treatment. The main advantage is that proton therapy eliminates unnecessary radiation. As radiation oncologists, our primary goal is to effectively kill cancer while sparing the patient the side effects of excessive radiation. Proton therapy achieves this for many patients with a variety of cancers, including lymphoma, lung, head and neck, prostate, esophageal and pediatric cancers.
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High Fat Diets Worse for Male Brains

Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048MedicalResearch.com Interview with:
Deborah Clegg, PhD
Research Scientist, Diabetes and Obesity Research Institute
Associate Professor, Department of Biomedical Science
Cedars-Sinai Medical Center
Los Angeles, CA 90048

Medical Research: What are the main findings of the study?

Dr. Clegg: The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!!  Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not.  With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!!
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Melanoma: Combination BRAF and MEK Inhibitors Has Better Safety Profile

Martina Sanlorenzo, MD Department of Dermatology Mt. Zion Cancer Research Bldg. San Francisco, CA 94143-0808MedicalResearch.com Interview with:
Martina Sanlorenzo, MD
Department of Dermatology
Mt. Zion Cancer Research Bldg.
San Francisco, CA 94143-0808


Medical Research:
What are the main findings of the study?

Dr. Sanlorenzo: In the treatment of BRAF mutant melanoma, the combination of BRAF inhibitor and MEK inhibitor has a better cutaneous safety profile compared with BRAF inhibitor monotherapy. Combination regimen shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval. In particular, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent.
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