Illicitly-Manufactured Fentanyl Contributing To Increasing Numbers of Heroin Deaths

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MedicalResearch.com Interview with:
John Halpin, MD, MPH, Medical officer
Prescription Drug Overdose Epidemiology and Surveillance Team
CDC Injury Center

MedicalReseach.com editor’s note: Dr. Halpern discusses the CDC alert of August 25, 2016 regarding the increase in fentanyl-related unintentional overdose fatalities in multiple states.

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

Response: The current health alert is an update to a previous alert in October, 2015 from CDC which described the geographic spread of states in which forensic labs were increasingly detecting fentanyl in the drug submissions that they receive from law enforcement, and how many of these same states were beginning to report fentanyl-related overdose deaths by their departments of public health.

Further investigation by CDC and DEA have revealed that the great majority of fentanyl now present in the illicit drugs market is clandestinely-produced, and most commonly mixed with and sold as heroin, and is responsible for the great majority of fentanyl-related overdose deaths. Indications at the time of that alert pointed to a likely continuous rise in the supply of illicitly-manufactured fentanyl, and the potential for increasing numbers of fentanyl-related overdose deaths, particularly among those who use heroin.

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Sexual Assaults More Common Against Gay, Lesbian, and Bisexual High School Students

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MedicalResearch.com Interview with:

Laura Kann, Ph.D. Chief of the School-Based Surveillance Branch Division of Adolescent and School Health CDC

Dr. Laura Kann

Laura Kann, Ph.D.
Chief of the School-Based Surveillance Branch
Division of Adolescent and School Health
CDC

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

Response: CDC has been using the Youth Risk Behavior Survey (YRBS) to collect data on the sexual identity of high school students at the state and local levels and on the prevalence of health risk behaviors among gay, lesbian, and bisexual students for many years. Starting with the 2015 YRBS cycle, we had enough support to add questions to the national YRBS to provide the first ever nationally representative look at health risk behaviors among these students.

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Gene Therapy Delivers Intracellular Antibodies To Attack Abnormal Protein in Huntington’s Disease

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MedicalResearch.com Interview with:
Lee Henderson, Ph.D. CEO Vybion, Inc. Ithaca, NY 14852Lee Henderson, Ph.D.
CEO, Vybion, Inc.
Ithaca, NY 14852

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

Response: Huntington’s disease (HD) is a progressive and fatal neurodegenerative disease characterized by loss of both cognitive and motor function as a result of neuron loss primarily within the brain striatum. HD is directly caused by the expansion of CAG repeats in the huntingtin gene resulting in an expanded glutamine region (polyQ) near the N-terminus of the protein. Age of disease onset and the rate of progression is directly correlated to the size of the expansion with pathology observable at 35-70 repeats in adults and greater in juvenile onset. During normal turnover and degradation of the huntingtin protein, the N-terminal polyQ-containing fragments drive pathology and aggregate formation in cells. The direct link to progression has been described by several laboratories using cell-based and animal model studies and confirmed in humans as the binding of these N-terminal fragments to DNA and transcription factors that result in widespread gene dysregulation in neurons.

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Aortic Dissections Tend To Occur Around Same Age in Families

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MedicalResearch.com Interview with:

John A. Elefteriades, MD William W.L. Glenn Professor of Surgery Chief of Cardiothoracic Surgery Yale New-Haven Hospital Director, Aortic Institute at Yale-New Haven Yale University School of Medicine

Dr. John Elefteriades

John A. Elefteriades, MD
William W.L. Glenn Professor of Surgery
Chief of Cardiothoracic Surgery
Yale New-Haven Hospital
Director, Aortic Institute at Yale-New Haven
Yale University School of Medicine

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

Response: In the late 1990’s, Dr. Milewicz’s group in Texas and our group at Yale recognized that thoracic aortic aneurysms and aortic dissections (internal tears of the aorta) ran in families.

This paper explores for the first time the ages at which aortic dissections occur among members within a family. Interestingly, we found that once one family member has suffered an aortic dissection, other family members tend to suffer dissection at about the same age (mostly within ten years of the age of the original dissector).

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Study Shows Many Patients With Schizophrenia Can Use Mobile Phone Technology To Help Prevent Relapse

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MedicalResearch.com Interview with:

Dror Ben Zeev, PhD Associate Professor of Psychiatry Director, mHealth for Mental Health Program Dartmouth College Hanover, NH

Dr. Dror Ben Zeev

Dror Ben Zeev, PhD
Associate Professor of Psychiatry
Director, mHealth for Mental Health Program
Dartmouth College
Hanover, NH

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

Response: We deployed a mobile phone intervention called FOCUS as part of a larger multi-component effort called Improving Care Reducing Costs (ICRC).

ICRC was the first technology-aided relapse prevention program of its kind for people with schizophrenia; a very exciting multi-state project funded by the Center for Medicare and Medicaid Innovation (CMMI) led by Dr. John Kane at the Zucker Hillside Hospital and a team of researchers from multiple institutions. Several other technological interventions were used in concert with mHealth, including a web intervention called Coping with Voices Developed by Dr. Jen Gottlieb and a Daily Support Website developed by Dr. Armando Rotondi. A truly multi-disciplinary effort designed to help prevent re-hospitalization in people with psychosis who were recently discharged from the hospital; this is a group that is at very high risk for relapse.

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How Does Poor Sleep Affect Risk of Suicide?

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MedicalResearch.com Interview with:
Donna Littlewood PhD
School of Health Sciences
Faculty of Biology, Medicine and Health
The University of Manchester

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

Response: This was the first qualitative study to examine the role of sleep problems in relation to suicidal thoughts and behaviours. In-depth semi-structured interviews were conducted with 18 participants, who all had experienced major depressive episode(s) and suicidal thoughts and behaviours.

Data were analysed with thematic analysis which identified three interrelated pathways whereby sleep contributed to suicidal thoughts and behaviours.

The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night.

Secondly, the research found that a prolonged failure to achieve a good night’s sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity.

Finally, participants said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns – reinforcing the first two pathways.

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Adding Predator Cues To Biopesticides Increases Mosquito Mortality

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MedicalResearch.com Interview with:

Lin Op De Beeck, PhD Laboratory of Aquatic Ecology, Evolution and Conservation University of Leuven Leuven, Belgium

Lin Op De Beeck

Lin Op De Beeck, PhD student
Laboratory of Aquatic Ecology, Evolution and Conservation
University of Leuven
Leuven, Belgium

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

Response: Mosquitoes transmit quite a few deadly diseases, including West Nile Virus. Around the world, therefore, the fight against these insects is high on the agenda. Existing strategies for mosquito control often involve the use of chemical pesticides that harm the environment. These pesticides are increasingly less effective as well, as insects can become resistant to existing products relatively quickly. Biopesticides are a possible alternative. The most commonly used biological pesticide is the Bacillus thuringiensis israelensis (Bti) bacteria. Unfortunately, mosquitoes are already developing resistance to this pesticide as well. This means we have to keep increasing the dose of Bti to kill mosquitoes, so that this biological substance, too, is beginning to harm the environment.

Therefore we set out to find a new strategy in the fight against mosquitoes. We already knew that chemical substances emitted by the backswimmer – a natural enemy of mosquito larvae in the water – trigger a stress response in mosquitoes. This stress response, in turn, suppresses the mosquito’s immune system. What makes the use of these predator cues even more interesting for mosquito control is that scientists recently found a way to produce a synthetic version of these chemical substances. We discovered that this synthetic version triggers a stress response in the mosquitoes and impairs their immune system, just like the natural predator cues. This gave us the idea to combine these synthetic predator cues with the biological pesticide Bti.

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70-Gene Signature Can Help Identify Early-Stage Breast Cancer Patients Who Do Not Need Chemotherapy

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MedicalResearch.com Interview with:

Prof. Laura van ’t Veer, PhD Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center Angela and Shu Kai Chan Endowed Chair in Cancer Research UCSF Helen Diller Family Comprehensive Cancer Center

Dr. Laura Van’t Leer

Prof. Laura van ’t Veer, PhD
Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center
Angela and Shu Kai Chan Endowed Chair in Cancer Research
UCSF Helen Diller Family Comprehensive Cancer Center

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

Response: MINDACT was designed to involve only patients with node negative and 1 to 3 positive lymph node breast cancer. Node negative breast cancer is a cancer that has not spread to the surrounding lymph nodes and therefore has a lower risk of recurrence. Scientists have also demonstrated that breast cancer which has spread to 1 to 3 lymph nodes may behave like node negative breast cancer. Patients with either node negative cancer or with a cancer that involves 1-3 lymph nodes are often prescribed chemotherapy, although physicians believe that approximately 15% of them do not require such treatment.

MINDACT provides the highest level of evidence to show that using MammaPrint® can substantially reduce the use of chemotherapy in patients with node-negative and 1-to-3 node positive breast cancer – in other words, it can identify patients with these types of breast cancer who can safely be spared a treatment that may cause significant side effects, and will offer no to very little benefit.

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Immodulon Aims to Activate Both Arms of Immune System To Fight Broad Range of Cancers

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MedicalResearch.com Interview with:
Dr Charles Akle, Chairman and Linda Summerton, CEO Immodulon Therapeutics Short Hills, NJ 07078 and London, UKDr Charles Akle,
 Chairman and
Linda Summerton, CEO
Immodulon Therapeutics
Short Hills, NJ 07078 and
London, UK

MedicalResearch.com: What is the background for Immodulon? Would you tell us a little about Dr. Charles Akle?

Response: Immodulon was established in November 2007. The founder and Chairman, Dr Charles Akle, was a Harley Street surgeon and pioneer of keyhole surgery who established Immodulon with the financial support of a former patient. His interest in immunology led him to the potential of cancer immunotherapy long before the term “immuno-oncology” was coined and when skepticism, rather than optimism was the norm.

His ambition from the start was to develop an affordable immunotherapy treatment that would transform the way that cancer is treated in the world today. Since then, Immodulon has become a leading, independent biopharmaceutical company with one of the longest running research projects into how to harness the power of the immune system in treating cancer. It also has its own R&D and manufacturing capability in Lyon, France.

The wider Immodulon senior team has extensive experience of bringing drugs to market and includes Dr James Shannon and Dr Jean Pierre Bizzari.

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May Be No Need For A Pitch Restriction After Tommy John Surgery

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MedicalResearch.com Interview with:

Brandon J. Erickson, MD Midwest Orthopaedics Rush, Rush University Medical Center Chicago, IL

Dr. Brandon Erickson

Brandon J. Erickson, MD
Midwest Orthopaedics
Rush, Rush University Medical Center
Chicago, IL

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

Response: Ulnar collateral ligament reconstruction (UCLR), also known as Tommy John surgery has become a common procedure amongst major league baseball (MLB) pitchers. It is unclear if a limit on innings pitched following Tommy John surgery should be instituted to prevent revision Tommy John surgery.

The purpose of this study was to determine if innings pitched following Tommy John surgery is associated with an increased risk of revision Tommy John surgery amongst MLB pitchers. To answer this question we located all MLB pitchers between 1974-2015 who pitched at least one full season following their Tommy John surgery and included them in our analysis. Pitch counts and innings pitched for the first full season following Tommy John surgery as well as total pitch count and total innings pitched over the course of the player’s career were recorded.

Pitch counts and innings pitched were compared amongst players who required revision Tommy John surgery and those who did not. We were able to include 154 pitchers. Of these, 135 pitchers did not require revision Tommy John surgery while 19 underwent revision Tommy John surgery.  No significant difference existed between pitchers who underwent revision Tommy John surgery and those who did not when comparing number of innings pitched in the season following Tommy John surgery,  number of pitches thrown in the season following Tommy John surgery,  number of innings pitched in the pitcher’s career following Tommy John surgery and number of pitches thrown in the pitcher’s career following Tommy John surgery.  Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season following Tommy John surgery.

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Physician Burnout Continues Unabated, With Clinicians Saying Facilities Aren’t Doing Enough to Address It

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MedicalResearch.com interview with:

Diane Hayes, Ph.D., President and co-founder, InCrowd Areal time market intelligence service to the life sciences

Diane Hayes Ph.D.

Diane Hayes, Ph.D.,
President and co-founder, InCrowd
Areal time market intelligence service to the life sciences

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

Response: Physician burnout is a significant concern across the healthcare continuum, as Affordable Care Act (ACA) measures change the nature of doctoring, and as at least 30 major teaching hospitals at least 30 major teaching hospitals undertake initiatives aimed at reducing burnout ahead of its potential impact on patient safety and quality outcomes. Numerous studies have documented the issue.

We thought it would be instructive to use InCrowd’s mobile microsurvey platform for a mid-year snapshot of burnout sentiment. The microsurvey used the Maslach Burnout Inventory of symptoms to determine respondents who could be considered to be experiencing burnout—the same index as used by the widely cited Mayo Clinic and MedScape studies. We also asked if facilities are addressing the issue, a topic not always covered.

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Capecitabine Cancer Treatment Can Result in Loss of Fingerprints

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MedicalResearch.com Interview with:

Leni van Doorn, MSc Department of Medical Oncology Erasmus MC Cancer Institute Rotterdam, the Netherlands

Leni van Doorn

Leni van Doorn, MSc
Department of Medical Oncology
Erasmus MC Cancer Institute
Rotterdam, the Netherlands

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

Response: The common cancer treatment capecitabine, a regular treatment for patients mostly diagnosed with breast-, colon- or gastic cancer, induces hand foot syndrome (HFS). HFS is a cutaneous condition that may lead to red palms and blisters in approximately 50% to 60% of the patients and is believed to result in the loss of fingerprints. This fingerprint loss has been described sporadically in the literature.

The main aim of our prospective study was to have a closer look of the association between  hand foot syndrome and the loss of fingerprints.

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