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Author Interviews, Cancer Research, JAMA, Pediatrics / 20.08.2018

MedicalResearch.com Interview with: Rebecca D. Kehm, PhD Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis, MN   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer. (more…)
Author Interviews, Biomarkers, CMAJ, Heart Disease / 20.08.2018

MedicalResearch.com Interview with: Peter Kavsak, PhD, FCACB, FAACC, FCCS Professor, Pathology and Molecular Medicine McMaster University  MedicalResearch.com: What is the background for this study? Response: For patients who present to the hospital with symptoms suggestive of acute coronary syndrome (ACS) the preferred blood test to help physicians in making a diagnosis is cardiac troponin. Recent studies have demonstrated that a very low or undetectable cardiac troponin level when measured with the newest generation of blood tests (i.e., the high-sensitivity cardiac troponin tests) in this population may rule-out myocardial infarction (MI or a heart attack) on the initial blood sample collected in the emergency department, thus enabling a faster decision and foregoing the need for subsequent serial measurements of cardiac troponin over several hours as recommended by the guidelines. The problem with this approach, however, is that using high-sensitivity cardiac troponin alone to do this has not reliably been demonstrated to achieve a sensitivity >99% for detecting MI, which is the estimate that most physicians in this setting consider as safe for discharge. Our study goal was to compare the diagnostic performance of a simple laboratory algorithm using common blood tests (i.e., a clinical chemistry score (CCS) consisting of glucose, estimated glomerular filtration rate (eGFR), and either high-sensitivity cardiac troponin I or T) to high-sensitivity cardiac troponin alone for predicting MI or death within the first month following the initial blood work. (more…)
Author Interviews, Cancer Research, Pharmaceutical Companies / 20.08.2018

MedicalResearch.com Interview with: Jeffrey S. Humphrey, MD President of Kyowa Kirin Pharmaceutical Development, Inc MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by Mycosis Fungoides and Sézary Syndrome? Response: Kyowya Kirin has received FDA approval for Poteligeo (mogamulizumab), based on findings from the MAVORIC trial. Mogamulizumab is a humanized immunoglobulin G1 (IgG1) monoclonal antibody (mAb) that targets CC chemokine receptor 4 (CCR4), for the treatment of the most common subtypes of cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF) and Sézary syndrome (SS). MF and SS may have a profound and severe impact on quality of life, including a patient’s functional, emotional and social well-being, as symptoms may include a scaly red rash or light or dark patches in areas of the body that are not usually exposed to the sun; thin, reddened, eczema-like rash; thickened scaly, red skin (or plaques) or psoriasis-like rash; more advanced disease can include tumors (with significant thickness) on the skin, which may develop ulcers and become infected. Because CTCL manifests in skin lesions, it is often mistaken for other skin conditions (early stage MF and SS can be diagnosed as other skin conditions), which can delay conclusive diagnosis and treatment options. MF is the most common subtype of CTCL, affecting 50-70% of individuals. In most patients diagnosed with early stage MF, the skin involvement does not progress, but in some patients, it will slowly progress. SS accounts for approximately 3% of CTCL cases and is a more aggressive, leukemic form of CTCL, affecting the blood, skin, lymph nodes and visceral organs (more…)
AACR, Author Interviews, Cancer Research, Imperial College, Kidney Disease / 20.08.2018

MedicalResearch.com Interview with: Dr. David C. Muller PhD Faculty of Medicine, School of Public Health Research Fellow in Epidemiology and Biostatistics Imperial College, London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our colleagues in the U.S. have been working on KIM-1 for years, particularly in the context of chronic kidney disease. Recently they found that KIM-1 is also elevated at the time of diagnosis of kidney cancer. We wanted to see if KIM-1 concentrations could predict the chances of a future diagnosis of kidney cancer. We found that KIM-1 was a strong predictor of being diagnosis with kidney cancer in the next 5 years. We also found that higher pre-diagnostic KIM-1 was associated with worse survival after diagnosis.  (more…)
Author Interviews, Medicare, Race/Ethnic Diversity / 20.08.2018

MedicalResearch.com Interview with: Kim Lind, PhD, MPH Research Fellow Centre for Health Systems and Safety Research Australian Institute of Health Innovation Macquarie University, NSW MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Medicare Annual Wellness Visit (AWV) is a preventive care visit that was introduced in 2011 as part of the Patient Protection and Affordable Care Act. Prior to this, the only preventive care exam covered by Medicare was the Welcome to Medicare Visit, which is only available for people in their first year of Medicare enrolment. The AWV is available each year to beneficiaries without co-payment to people who are past their first year of Medicare enrolment. The AWV focuses on prevention and early detection of disease. Racial disparities in healthcare utilization and health outcomes have been well documented in the US. Prior expansions of Medicare coverage have had varied effects on reducing disparities. For example, in 2001 Medicare began to cover colorectal cancer screening which reduced racial disparities for some minority groups with respect to screening rates and improved early detection. Expanding coverage of preventive care for people on Medicare may help reduce disparities in health outcomes, but we first needed to know if people were using the Medicare Annual Wellness Visit. Our goal was to assess AWV utilization rates and determine if utilization differed by race or ethnicity. We analyzed a nationally representative database of Medicare beneficiaries (the Medicare Current Beneficiary Survey) that included self-reported race, ethnicity, income and education, linked to Medicare claims. We found that Medicare Annual Wellness Visit use was low but increased from 2011 to 2013. We also found that people on Medicare who self-identified as belonging to a racial or ethnic minority group had lower AWV utilization rates than non-Hispanic white people. People with lower income or education, and people living in rural areas had lower Medicare Annual Wellness Visit utilization.  (more…)
Author Interviews, Social Issues / 19.08.2018

MedicalResearch.com Interview with: “3-men-laughing” by desthal is licensed under CC BY-NC-ND 3.0Menelaos Apostolou  PhD University of Nicosia Cyprus MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In this study I analyzed 6794 responses from a recent Reddit thread on why men were single, and I classified them in 43 reason categories. Among the most frequent reasons that men indicated for being single included poor flirting skills, low self-confidence, poor looks, shyness, low effort, and bad experience from previous relationships. (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Kaiser Permanente, Surgical Research, Weight Research / 18.08.2018

MedicalResearch.com Interview with: David Arterburn, MD, MPH Kaiser Permanente Washington Health Research Institute Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 9 percent of adult Americans—about 30 million people—are estimated to have type 2 diabetes, according to the American Diabetes Association. The disease tends to worsen over time, with blood sugar levels rising along with the risks of developing large blood vessel (macrovascular) complications like heart attack and stroke, as well as small blood vessel (microvascular) complications affecting the nerves of the feet and hands (neuropathy), kidneys (nephropathy), and eyes (retinopathy). Among more than 4000 patients who underwent bariatric surgery, the 5-year incidence of microvascular disease — including neuropathy, nephropathy, and retinopathy — was nearly 60% lower than that of 11,000 matched nonsurgical control patients receiving usual diabetes care.  (more…)
Author Interviews, Cannabis, Cognitive Issues, Memory / 18.08.2018

MedicalResearch.com Interview with: Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Ana Maria Sebastião, PhD Professor of Pharmacology and Neurosciences Director Institute of Pharmacology and Neurosciences, Faculty of Medicine and Francisco Mouro, PhD Unit of Neurosciences, Institute of Molecular Medicine University of Lisbon, Portugal MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is pressing need to comprehend how cannabinoid exposure impacts brain functioning. While cannabinoid-related research has increased exponentially in the last decade, the mechanisms through which cannabinoids affect brain functioning are still elusive. Specifically, we need to know how prolonged cannabinoid exposure affects important cognitive processes, such as memory, and also find the roots of those effects. This is particularly relevant considering that several countries have already approved cannabis-based medicines. In this sense, our work sheds new light into the mechanisms underlaying the memory-deficits provoked by a continuous exposure to a cannabinoid drug. More precisely, using brain imaging techniques, we found that long-term exposure to a synthetic cannabinoid drug impairs the ability of key brain regions involved in learning and memory to communicate with each other. Our data points to the necessity of considering cannabinoid actions in a broader perspective, including brain circuitry and communication.  (more…)
Author Interviews, Pediatrics, Pulmonary Disease, Tobacco Research / 18.08.2018

MedicalResearch.com Interview with: “#smoke” by Seniju is licensed under CC BY 2.0Ryan Diver MSPH Director, Data Analysis American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Secondhand smoke is known to have adverse effects on the lung and vascular systems in both children and adults. But it is unknown whether childhood exposure to secondhand smoke is associated with mortality in adulthood. To explore the issue, we examined associations of childhood and adult secondhand smoke exposure with death from all causes, ischemic heart disease, stroke, and chronic obstructive pulmonary disease among 70,900 never-smoking men and women from the Cancer Prevention Study II Nutrition Cohort. Study participants, primarily ages 50 to 74 at the beginning of the study, answered questions about their secondhand smoke exposure during childhood and as adults and were followed for 22 years. Those who reported having lived with a daily smoker throughout their childhood had 31% higher mortality from chronic obstructive pulmonary disease compared to those who did not live with a smoker. Although the study counted only deaths, the increase in fatal COPD implies that living with a smoker during childhood could also increase risk of non-fatal COPD. In addition, secondhand smoke exposure (10 or more hours/week) as an adult was associated with a 9% higher risk of all-cause mortality, a 27% higher risk of death from ischemic heart disease, a 23% higher risk of death from stroke, and a 42% higher risk of death from COPD. (more…)
Author Interviews, Clots - Coagulation, Emergency Care, Pulmonary Disease, Stanford / 18.08.2018

MedicalResearch.com Interview with: Joseph Bledsoe MD, FACEP Clinical Assistant Professor of Emergency Medicine Stanford Medicine Director of Research Department of Emergency Medicine Intermountain Medical Center Murray, UT 84157 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with blood clots in the lungs (pulmonary embolism) (PE) are routinely admitted to the hospital for blood thinning medications in the United States. However, evidence from other countries has shown that with appropriate risk stratification patients may be safe for outpatient treatment for their PE. Our study is the largest prospective management study in the US to evaluate home treatment of patients with acute pulmonary embolism. We enrolled 200 patients and after risk stratification with the PE severity index score, leg ultrasounds and echocardiograms performed in the emergency department, patients were treated with blood thinning medications at home with routine outpatient follow up. During the 90 day follow up period we found only one patient suffered a bleeding event after a traumatic injury, without any cases of recurrent symptomatic blood clots or death.  (more…)
Author Interviews, HIV, NEJM, Yale / 17.08.2018

MedicalResearch.com Interview with: Brinda Emu, MD Assistant Professor of Medicine (Infectious Diseases) Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: This was a Phase 3 study of a new antiretroviral agent, ibalizumab, for the treatment of HIV-1 infection.  Ibalizumab is a monoclonal antibody that targets the CD4 receptor on host cells.  CD4 is the receptor that HIV uses to infect CD4+ T cells.  By binding to the CD4 receptor, ibalizumab prevents viral entry.  This study recruited patients that harbor multi-drug resistant HIV and were failing their current regimen of antiretroviral agents, and thus had limited options for treatment of their HIV-1 infection using approved medications. (more…)
Accidents & Violence / 17.08.2018

MedicalResearch.com Interview with: “Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0Brianna Mills, PhD Research Scientist Harborview Injury Prevention & Research Center University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that substance use, mental disorders, and arrest are markers of increased risk of firearm injury. However, many studies of firearm injury are limited in scope – looking only at one type of injury (assault-related, for example) and one type of data (often hospital records). Police shootings, although occurring with increasing frequency, have also received relatively less attention in research than other types of firearm injuries. We combined data from a variety of sources, including both hospital and arrest records, so we could present a more complete picture of firearm injuries in Seattle, including contacts with law enforcement and healthcare in the two years prior to injury. We subdivided substance use, mental disorder, and arrests into more specific categories to present a more nuanced look at how each category may indicate increased risk of a specific type of firearm injury (assault-related, self-inflicted, unintentional, and police intervention). We found that when you consider both arrest records and hospital records together a distinct pattern of prior contact emerges for people who were shot by police – they have arrest histories similar to people shot during an assault and hospital histories similar to people with self-inflicted firearm injuries. A majority of people shot during an assault or by police were either arrested or hospitalized in the two years prior to their injury. Compared to our control group, people shot by police were 22 times more likely to have a conduct disorder, 11 times more likely to have been diagnosed with a marijuana use disorder, and 7 times more likely to have a felony arrest, psychosis diagnosis, or depression/anxiety diagnosis.  (more…)
Author Interviews, JAMA, Surgical Research / 17.08.2018

MedicalResearch.com Interview with: Murad Alam, MD Vice-Chair and Professor of Dermatology Chief of Cutaneous and Aesthetic Surgery Northwestern University Feinberg School of MedicineMurad Alam, MD Vice-Chair and Professor of Dermatology Chief of Cutaneous and Aesthetic Surgery Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? Response: For the purposes of our study, non-invasive procedures included laser and light treatments (for brown spots, blood vessels, wrinkle reduction, scar treatment, hair removal ie laser hair removal or Hair Removal Service - sponsored), chemical peels, and non-surgical skin tightening and fat reduction (with radiofrequency energy, cold treatment, or ultrasound). These noninvasive treatments do not even break the skin, and are applied on top of the skin Then we have minimally invasive procedures, which include those that just barely break the skin, but are like getting a shot, and don’t require cutting and sewing the skin as in traditional surgery. These minimally invasive procedures include filler and neuromodulator injections to fill out the sagging aging face while reducing lines and wrinkles, as well as liposuction through tiny openings to suck out excess fat. All of these procedures and many more are available but if you do want to have a cosmetic procedure then make sure you seek out a reputable cosmetic surgeon such as Lisa Rush. In the old days, cosmetic treatments meant getting traditional plastic surgery, like a face lift or tummy tuck. These required general anesthesia, cutting and sewing the skin, significant risk of scarring, and days to weeks of recovery time. More recently, dermatologists have pioneered noninvasive and minimally invasive procedures, such as those I just described, which provide many of the same benefits as traditional plastic surgery without the risk, scars, and downtime, for example, somewhere like Rhinoplasty NYC talk about Rhinoplasties with noninvasive methods. Now these minimally invasive and noninvasive treatments have become more popular than traditional cosmetic surgery. (more…)
Author Interviews, ENT, JAMA, NIH / 17.08.2018

MedicalResearch.com Interview with: “Bad smell” by Brian Fitzgerald is licensed under CC BY 2.0Kathleen Bainbridge, PhD Epidemiology and Biostatistics Program NIDCD MedicalResearch.com: What is the background for this study? What are the main findings? Response: The causes of phantom odor perception are not understood. This study looked for the prevalence and risk factors for this disorder. We found that that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors. This study, is the first in the U.S. to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey, a continuous survey conducted by the National Center for Health Statistics which is part of the Centers for Disease Control and Prevention. The study could inform future research aiming to unlock the mysteries of phantom odors. We identified risk factors that may be related to the perception of phantom odors. People are more likely to experience this condition if they are female, and are relatively young—we found a higher prevalence in 40-60 year-olds compared to 60+ year-olds. Other risk factors include head injury, dry mouth, poor overall health, and low socio-economic status. People with lower socio-economic status may have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, Pharmacology / 17.08.2018

MedicalResearch.com Interview with: Dr Ruth Webster PhD, BMedSc(hons), MBBS(hons), MIPH(hons) Head, Research Programs, Office of the Chief Scientist Senior Lecturer, Faculty of Medicine UNSW Sydney The George Institute for Global Health Australia MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know from previous research that 80% of the blood pressure lowering efficacy of any medication occurs in the first half of the dose whilst most side effects occur at higher doses. We also know that most people will require at least 2 blood pressure lowering medications to reach their target blood pressure and that combining multiple pills into one combination medication helps patients take their medication more reliably. There was therefore good evidence to believe that using three half strength doses in one pill would be better than usual care in helping patients to achieve their blood pressure targets. We showed that, compared with patients receiving usual care, a significantly higher proportion of patients receiving the Triple Pill achieved their target blood pressure of 140/90 or less (with lower targets of 130/80 for patients with diabetes or chronic kidney disease). It's estimated more than a billion people globally suffer from high blood pressure with the vast majority having poorly controlled blood pressure. Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke. (more…)
Author Interviews, Cancer Research, CT Scanning, JAMA, Lung Cancer / 16.08.2018

MedicalResearch.com Interview with: “CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD Assistant Professor | Professor Auxiliar NOVA Medical School | Faculdade de Ciências Médicas Universidade Nova da Lisboa  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening. After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers. (more…)
Author Interviews, HIV, Pharmaceutical Companies / 16.08.2018

MedicalResearch.com Interview with: TaiMed BiologicsStanley Lewis, M.D. TaiMed Biologics Irvine, CA 92614 MedicalResearch.com: What is the background for this study? Response: The phase III clinical trial was conducted to assess the efficacy and safety of Trogarzo™ (ibalizumab-uiyk) injection in patients with multidrug resistant HIV-1. The study design was approved by the FDA. Results obtained were included in the New Drug Application submitted to the FDA which approved Trogarzo™ on March 6, 2018. The phase III, open-label study, enrolled 40 patients with multidrug-resistant (MDR) HIV-1 in whom multiple antiretroviral therapies had failed. All patients at baseline were experiencing viral failure. After a seven-day control period, patients received an intravenous 2000 mg loading dose of Trogarzo™ which was the only change made to their antiretroviral regimen. Through the 24-week treatment period of the study, patients were given a maintenance dose of 800 mg of Trogarzo™ every two weeks along with an optimized background regimen that included at least one additional fully active agent. (more…)
Author Interviews, Autism, Microbiome / 16.08.2018

MedicalResearch.com Interview with: quadrant biosciencesSteven D. Hicks, MD PhD Penn State College of Medicine Department of Pediatrics Division of Academic General Pediatrics Hershey, PA, 17033‐0850 MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​Previous studies have shown that disrupting the community of bacteria in the gut can lead to autism-like behavior in animals. In humans interventions aimed at improving the intestinal microbiome have also led to changes in autism behavior. Here, we examined whether autism-related changes in microbial activity extended to the mouth and throat. We were interested in this site because it provides the initial interface between host immunity and microbe exposure. By examining nearly 350 children with autism, typical development, or developmental delay (without autism) we identified 12 groups of oral bacteria with unique activity patterns in children with autism. Interestingly, microbial activity (measured by RNA sequencing) also differed between children with autism and gastrointestinal (GI) disturbances and peers with autism but no GI disturbance. Levels of several microbes also displayed correlations with measures of autism behaviors. We utilized microbial activity patterns to create diagnostic panels that displayed accuracy for distinguishing children with autism from peers with typical development (79.5% accuracy) or developmental delay (76.5% accuracy).  (more…)
Alzheimer's - Dementia, Author Interviews, Pharmacology / 16.08.2018

MedicalResearch.com Interview with: MedicalResearch.comVesa Tapiainen, MD School of Pharmacy, University of Eastern Finland Research Centre for Comparative Effectiveness and Patient Safety University of Eastern Finland Kuopio, Finland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alzheimer’s disease is a non-curable dementing disease and a major health concern and thus, identification of potential modifiable risk factors, such as benzodiazepines, is important. Benzodiazepines and related drugs are commonly used among older people as every fourth older people use them. Benzodiazepines and related drugs were associated with modestly increased risk of Alzheimer’s disease. A dose-response relationship was observed with higher cumulative dose and longer use periods being associated with higher risk of Alzheimer’s disease. The risk associated with larger cumulative doses was partly explained by more common use of other psychotropics among these persons.  (more…)
Author Interviews, Neurology / 15.08.2018

MedicalResearch.com Interview with: Dr. Bojana Kuzmanovic PhD Max Planck Institute for Metabolism Research Translational Neurocircuitry Group Cologne, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Do our beliefs depend on what we want to believe? Until now, researchers failed to show how interactions between brain regions mediate the influence of motivation to adopt desirable notions on ongoing reasoning. Our study used optimized design and analyses to rule out alternative explanations and to identify underlying neurocircuitry mechanisms. MedicalResearch.com: What are the main findings? Response: First, we demonstrated that people’s belief formation behavior depends on their preferences. When people were asked to reconsider their beliefs about their future outcomes, they tended to rely more strongly on good news and to disregard bad news. Second, we showed that favorable belief updating activated the brain valuation system known to be responsive to rewards such as food or money (ventromedial prefrontal cortex, vmPFC). That is, the valuation system was activated when participants incorporated good news to improve their risk estimates, and when they disregarded bad news to avoid a worsening of their risk estimates. And third, the valuation system influenced other brain regions that are involved in deriving conclusions about oneself (dorsomedial prefrontal cortex, dmPFC). Importantly, the more participants were biased in their belief formation behavior, the stronger was the engagement and the influence of the valuation system. The influence of the valuation system on the reasoning system helps to understand how motivation can affect reasoning. It supports the idea that memories and knowledge we recall to form our beliefs are selected in such a way as to yield the desired conclusions. For example, when we wish to convince ourselves that our risk of having a heart attack is low although federal statistics indicate a higher risk, we might recall our healthy life style but not our family history of heart-related diseases, or neglect the fact that the federal population may have a comparable life style. (more…)
Aging, Author Interviews, Genetic Research / 15.08.2018

MedicalResearch.com Interview with: Aladdin H. Shadyab, PhD  MS, MPH, CPH Department of Family Medicine and Public Health University of California, San Diego twitter.com/TheDrAladdin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that offspring of long-lived parents are not only likely to live longer but to also avoid major chronic diseases (e.g., coronary heart disease), have fewer chronic disease risk factors, and to have better cognitive and physical function in late life. However, few studies have examined parental longevity in relation to an overall measure of successful aging that included reaching old age free of both major diseases and disabilities. The objective of our study was to determine if parental longevity predicted healthy aging, defined as survival to age 90 without any major age-related diseases (coronary heart disease, stroke, diabetes, cancer, or hip fracture) or physical limitations. The participants of our study were from the Women's Health Initiative, a large, longitudinal study among postmenopausal women from the United States. We observed that women whose mothers survived to at least age 90 years were 25% more likely to achieve healthy aging. We also observed that women whose fathers only lived to age 90 did not have increased likelihood of healthy aging. However, women whose mother and father both lived to age 90 were the most likely to achieve healthy aging. (more…)
Abuse and Neglect, Author Interviews, Geriatrics / 15.08.2018

MedicalResearch.com Interview with: “Hospital” by Avinash Bhat is licensed under CC BY 2.0Eilon Caspi PhD Research Associate School of Nursing University of Minnesota MedicalResearch.com: What is the background for this study? Response: The phenomenon of distressing and harmful resident-to-resident incidents in long-term care homes (such as nursing homes and assisted living residences) is prevalent, concerning but underrecognized. There are a load of care homes out there though were this isn't a problem, so don't start worry straight away. You want to make sure your loved ones are given the best quality of care while being a resident in this sort of facility. Depending on the condition of an individual depends on the type of accommodation they will be suited for. It can be a tough decision to make but these choices need to be made. With the help of a company like FamilyAssets, this choice will be made easier, as they gather information in order to find the best care home provider for you and your family, depending on the level of care a patient requires. However, these incidents are currently not being tracked by The Centers for Medicare and Medicaid Services (CMS), the Federal agency that oversees nursing homes compliance with the Federal Nursing Home Regulations (there is no unique state survey deficiency citation -- also called F-Tag or "Regulatory Grouping" that is specific to these incidents; beyond the classification under the broad categories of "Abuse," Neglect," and "Accident" where these incidents for all practical purposes are currently buried forever). In addition, the Minimum Data Set 3.0 (MDS), the largest clinical data set in nursing homes in the U.S., does not track this phenomenon in its Behavior E Section. Despite rapid growth in the number of research studies on various aspects of this phenomenon in recent years, no study in the U.S. and Canada examined fatal resident-to-resident incidents in the context of dementia in long-term care homes. In light of lack of centralized data sets on resident-to-resident incidents resulting in injuries and deaths, the study had to overcome this formidable barrier by using non traditional data collection strategy and analytic methods. A comprehensive internet search conducted over several years identified reports on the death of 105 elders as a result of resident-to-resident incidents in dementia in long-term care homes (over 150 newspaper articles and dozens of death review records were identified; all publicly available information). A qualitative review and abstraction of narratives of the text-based reports revealed important patterns for prevention. (more…)
Abuse and Neglect, Dermatology, Leukemia, Lymphoma, Melanoma / 15.08.2018

MedicalResearch.com Interview with: Clive S. Zent MD Professor of Medicine Director of Lymphoma/CLL Program Wilmot Cancer Institute University of Rochester Medical Center Rochester NY MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) have an increased risk of all skin cancers including malignant melanoma. This study in a stable population of CLL patients managed by a regional referral center confirmed that melanoma was over 6 times more common in than in an age and sexed matched general population. Because of the proactive skin screening program at the University of Rochester Medical Center’s Wilmot Cancer Center, most melanomas (77%) were detected at earlier stages and were treated surgically with curative intent. One patient with CLL and metastatic melanoma had a sustained remission of both diseases on treatment with ibrutinib and pembrolizumab. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pulmonary Disease / 15.08.2018

MedicalResearch.com Interview with: Hayley B. Gershengorn, MD Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida Division of Critical Care Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Beginning in December, 2011, professional guidelines have recommended against the practice of daily chest radiography (CXRs) for mechanically ventilated patients.  However, we hypothesized that this practice was still commonplace in the US and varied from hospital to hospital. To address this question, we performed a retrospective cohort study of >500,000 mechanically ventilated adults across 416 US hospitals. We found that 63% of these patients received daily CXRs and that, while use has been decreasing, this decrease is small (a 3% relative reduction in the odds of daily CXR receipt per discharge quarter starting in 2012). Moreover, the hospital at which a patient received care greatly impacted the likelihood of daily CXR receipt. (more…)
Author Interviews, Gastrointestinal Disease, Pharmaceutical Companies / 15.08.2018

MedicalResearch.com Interview with: RedHill Biopharma LtdMr. Gilead Raday, MPhil, MSc Chief Operating Officer RedHill Biopharma Ltd MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Crohn's disease?  How common is it and whom does it affect?  Response: Crohn's disease (CD) is a chronic, relapsing inflammatory gastrointestinal disorder characterized by a variety of symptoms, including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The underlying cause of Crohn's is unknown; however, CD is believed to arise secondary to genetic and environmental stimuli. More than 1.5 million people suffer from CD globally and it is prevalent in the U.S., affecting more than 200 people per 100,000. The current standard of care for Crohn's disease is limited to anti-inflammatories, immuno-suppressants and biologics that treat auto-immune disorders. These therapies target symptomatic improvement in the inflammation associated with CD, are widely considered to be of limited efficacy in the long term, and are associated with numerous side effects. This speaks to the great unmet need for an effective therapy for this debilitating disease. Additionally, there is no current therapy that treats the suspected underlying cause of Crohn’s disease. We have developed RHB-104 with the MAP hypothesis in mind, which posits that Crohn's disease is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP). This is similar to peptic ulcer disease, a condition that was initially associated with stress, smoking, NSAIDs and other behavioral factors, yet was found to be caused by H. pylori bacterial infection in the 1980s, revolutionizing the field of ulcer treatment. Validation of this theory would revolutionize how Crohn's disease is viewed and treated by the medical community and RHB-104 is the only therapy in development targeting MAP infection.  (more…)
Author Interviews, Breast Cancer, JAMA, Radiation Therapy / 14.08.2018

MedicalResearch.com Interview with: Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer. Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.
  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.
So, if the goal is to prevent new cancers in the breast -   then mastectomy is the best treatment If the goal is to prevent the woman from dying of breast cancer - then radiotherapy is the best treatment.  (more…)
Author Interviews, Cannabis, Gastrointestinal Disease / 14.08.2018

MedicalResearch.com Interview with: Beth A. McCormick, Ph.D. Professor and Vice Chair | Department of Microbiology & Physiological Systems Founding Executive Director | University of Massachusetts Center for Microbiome Research Board of Editors | Gastroenterology University of Massachusetts Medical School Worcester, MA 01655 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been extensive, but to date mostly anecdotal, support for a beneficial role for cannabinoids and cannabis-derived agents to provide benefit for symptoms in individuals suffering from intestinal inflammatory disease (IBD). Our studies have provided one possible rationale for these previous findings: that there is a constitutively active efflux system at the luminal surface of cells that line the intestine that pumps out one class of lipids of the family known as endocannabinoids. In doing so, the intestine floods this surface with these endocannabinoids in a manner that counteracts the actions of a particular potent stimulators of intestinal inflammation that appears to be over-active in certain forms of IBD. This is most significant because a number of cannabinoids and cannabis-derived agents can mimic the actions of this class of endocannabinoids. Moreover, while cannabinoids and endocannabinoids have been shown to provide anti-inflammatory actions, these studies have identified one mechanism used by the body to localize and focus this protective function at a critical site where pro-inflammatory and anti-inflammatory events intersect, providing new insights into how to treat that imbalance in these process that occurs in certain forms of IBD. Therefore, there is the immediate opportunity to use this research to identify new therapeutic strategies to treat individuals suffering from IBD that could include either agents extracted from marijuana plants or novel molecules selected based upon superior properties made obvious by this newly defined mechanism. (more…)
Author Interviews, Genetic Research, Mental Health Research / 14.08.2018

MedicalResearch.com Interview with: Prof. Carmen Sandi Director, Brain Mind Institute Laboratory of Behavioral Genetics Brain Mind Institute Ecole Polytechnique Federale de Lausanne Lausanne, Switzerland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We are interested in understanding how the brain regulates social behaviors and aggression, both in healthy individuals and individuals with psychiatric disorders. In our recent publication in Molecular Psychiatry, we investigated the impact of an alteration in a gene, St8sia2, that plays important roles during early brain development. Alterations in this gene have been linked with schizophrenia, autism and bipolar disorder, and individuals with these disorders frequently present high aggressiveness. In addition, expression of this gene in the brain can be altered by stressful insults during very early life and development. Our study shows that genetic and environmental conditions linked to a reduction in the expression of this neuroplasticity gene during early life can lead to impaired fear learning and associated pathological aggression. We could further reveal that deficits in St8sia2 expression lead to a dysfunction in a receptor in the amygdala (a brain region critically involved in emotionality and fear learning), the GluN2B subunit of NMDA Receptors. This allowed us to target this receptor with D-cycloserine, a drug that facilitates NMDA receptor function. This treatment, when given acutely, ameliorated the capacity to learn from adversity and reduced individuals’ aggressiveness.  (more…)
Author Interviews / 14.08.2018

MedicalResearch.com Interview with: “Pets” by GRANT DAWSON is licensed under CC BY 2.0Derek S. Mason, MPH Colorado University School of Medicine MD Candidate, Class of 2022 Anschutz Medical Campus, Aurora, CO MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this report stems from a focus group of veterinarians that was held and identified that opioid diversion could be occurring within clinics. After this, we became concerned that human patients were indeed diverting opioids for abuse and misuse and we wanted to get a broader sense from the veterinary medical community if they had been aware of opioid diversion happening within their clinics. Additionally, we noticed that there was a gap in the scientific literature on how the veterinary medical community feels about the opioid epidemic. As prescribers of opioids, we felt that their input was highly valuable and should be included in the discussion on how to prevent opioid abuse and misuse.  (more…)