Author Interviews, Heart Disease, JACC / 02.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43684" align="alignleft" width="156"] Dr. Greene[/caption] Stephen J. Greene, MD Fellow, Division of Cardiology Duke University Medical Center Durham, NC, USA [caption id="attachment_43683" align="alignleft" width="200"]Stephen J. Greene, MD Fellow, Division of Cardiology Duke University Medical Center Durham, NC, USA Dr. Fonarow[/caption] Gregg C. Fonarow, MD, FACC, FAHA, FHFSA Eliot Corday Professor of Cardiovascular Medicine and Science UCLA   MedicalResearch.com: What is the background for this study? Response: Heart failure is a very common medical condition impacting roughly 6 million men and women in the United States, and associated with impaired quality of life, frequent hospitalizations, and high rates of death. There are over 300,000 deaths each year in the US among patients with heart failure. Half of heart failure patients have heart failure because of a weak heart muscle where the heart cannot eject a normal amount of blood with each heartbeat, a term called “reduced ejection fraction.” Fortunately, there are multiple medications proven in large clinical trials to make people with heart failure with reduced ejection fraction live longer and feel better. We also have target doses for these medications, which are the doses used in the trials where the medication proved its benefit. These medications and the target doses are strongly recommended in professional guidelines to improve patient outcomes. To make sure patients have the best outcomes possible, it is important that we work to get patients on these proven medications if at all possible. Unfortunately, prior research has suggested that many patients eligible for these medications in regular outpatient practice do not receive them. Most of this research is several years old, and there have been a lot of efforts to improve the quality of heart failure care in the meantime. In our study, we wanted to see if there have been improvements in the use and dosing of proven heart failure medications in modern-day practice. We also wanted to determine which patient factors were associated with not receiving a medication, or receiving the medication at a below target dose.
Author Interviews, Education, JAMA / 02.08.2018

MedicalResearch.com Interview with: “Doctors with patient, 1999” by Seattle Municipal Archives is licensed under CC BY 2.0Dr. Laura M. Mazer, MD Goodman Surgical Education Center Department of Surgery Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There are numerous articles that clearly document the high prevalence of mistreatment of medical trainees. We have all seen and experienced the results of an “I’ll do unto you like they did unto me” attitude towards medical education. Our motivation for this study was to go beyond just documenting the problem, and start looking at what people are doing to help fix it. Unfortunately, we found that there are comparatively few reports of programs dedicated to preventing or decreasing mistreatment of medical trainees. In those studies we did review, the study quality was generally poor. Most of the programs had no guiding conceptual framework, minimal literature review, and outcomes were almost exclusively learner-reported.
Author Interviews, Cost of Health Care / 02.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43659" align="alignleft" width="129"]Jodi L. Liu, PhD Associate policy researcher RAND Corporation Dr. Liu[/caption] Jodi L. Liu, PhD Associate policy researcher RAND Corporation MedicalResearch.com: What is the background for this study? What are the main findings? Response: The New York Health Act (NYHA) would create a state-based single-payer plan called New York Health. The NYHA has been proposed in the New York State Assembly for many years. New York Health would provide all residents with comprehensive health benefits with no cost sharing and create new taxes to help fund the program. In this study, we used microsimulation modeling to analyze the impact of the NYHA on outcomes such as health care utilization and costs. We estimate that total health care spending could be similar or slightly lower if administrative costs and provider payment rates are reduced. The program would require substantial new taxes and would shift the types of payments people make for health care. After the presumed redirection of federal and state health care outlays to New York Health, we estimate that the new taxes revenue needed to finance the program in 2022 would be $139 billion.
Author Interviews, Endocrinology, NEJM / 01.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43641" align="alignleft" width="196"]Prof. Dr. Mirjam Christ-Crain Professor of endocrinology, diabetes and metabolism Heads the Department of Clinical Research University and University Hospital of Basel  Prof. Christ-Crain[/caption] Prof. Dr. Mirjam Christ-Crain Professor of endocrinology, diabetes and metabolism Heads the Department of Clinical Research University and University Hospital of Basel   MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Diabetes Insipidus? Response: Drinking more than three litres per day with the equivalent increase in urination is regarded as too much. This drinking by the liter – known as “polyuria polydipsia syndrome" – usually develops over time through habit, or can be a side effect of a mental illness. In rare cases, however, it may be caused by diabetes insipidus. This is when the pituitary gland lacks the hormone vasopressin, which regulates the water and salt content in our body. Patients have a decreased ability to concentrate the urine, therefore lose a lot of fluid and have to increase their fluid intake accordingly to prevent dehydration (= Diabetes insipidus). The distinction between what is considered a "harmless" primary polydipsia and a diabetes insipidus is crucial, as their therapy is fundamentally different. Diabetes insipidus must be treated with the hormone vasopressin, while patients with primary polydipsia require behavioural therapy to reduce their habitual drinking. A wrong therapy can have life-threatening consequences as treatment with vasopressin without indication can lead to water intoxication.
AACR, Author Interviews, Breast Cancer, Cancer Research, Lung Cancer / 01.08.2018

MedicalResearch.com Interview with: “smoking” by shira gal is licensed under CC BY 2.0Dr. Jose M. Martín-Sánchez IP of this study Grupo de Evaluación de Determinantes de Salud y Políticas Sanitarias Universitat Internacional de Catalunya Sant Cugat del Vallès Spain MedicalResearch.com: What is the background for this study? Response: Breast cancer has been the first cause of death from cancer among women. However, the mortality rates of breast cancer have been decreased in the last years. This downward trend can be attributed to treatment and screening programs. On the other hand, smoking has been increased among women during the last century and the main cause of lung cancer is smoking behavior. Based on this data, we hypothesized that the lung cancer mortality could outweigh the breast cancer mortality in the next years and the main purpose of this study was to project the mortality rates of lung cancer and breast cancer in women worldwide, based in previous data and using Bayesian methods, in order to identify potential strategies of public health to reduce the impact of lung cancer. Moreover, previous works described the lung and breast cancer mortality or projected one of them in a single country. For example, we have published two articles with data of Spain one of them with the description of lung cancer mortality trend in men and women and other with the projection of lung and breast cancer among women. The information of this study provides an overall point view around the word of this problem of public health.
Author Interviews, Education, Pharmaceutical Companies / 01.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43644" align="alignleft" width="200"]Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509 Dr. Piper[/caption] Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509 MedicalResearch.com: What is the background for this study? Response: The authors of this study are biomedical scientists, health care providers and educators who teach medical and pharmacy students. It is a standard practice in reputable medical journals like the New England Journal of Medicine to disclose conflicts of interest (CoI). Reputable sources like the Cochrane Library also disclose CoIs and analyze for their potential impact on the evidence base. Unfortunately, textbooks, which can be highly influential in the training of medical professionals, usually do not disclose their conflicts of interest. A prior study in this quantitative bioethics area found that more than one-quarter of a team-authored pharmacology textbook, Goodman and Gilman’s Pharmacological Basis of Therapeutics, had an undisclosed patent (PLoS One, 2015; 10: e0133261).  The goal of this investigation was to determine whether there were undisclosed CoIs in textbooks used in the training and as a reference for allopathic physicians, osteopathic physicians, dentists, pharmacists, nurses and other allied healthcare providers. 
Author Interviews, Cost of Health Care, JAMA, Medicare, UCSF / 01.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43578" align="alignleft" width="150"]Andrew B. Bindman, MD Professor of Medicine PRL- Institute for Health Policy Studies University of California San Francisco Dr. Bindman[/caption] Andrew B. Bindman, MD Professor of Medicine PRL- Institute for Health Policy Studies University of California San Francisco MedicalResearch.com: What is the background for this study?   Response: The purpose of this study was to evaluate the use and impact of a payment code for transitional care management services which was implemented by Medicare in. The transition of patients from hospitals or skilled nursing facilities back to the community often involves a change in a patient’s health care provider and introduces risks in communication which can contribute to lapses in health care quality and safety. Transitional care management services include contacting the patient within 2 business days after discharge and seeing the patient in the office within 7-14 days. Medicare implemented payment for transitional care management services with the hope that this would increase the delivery of these services believing that they could reduce readmissions, reduce costs and improve health outcomes.
Author Interviews, Cancer Research, Cannabis, Pancreatic / 01.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43581" align="alignleft" width="200"]Prof Marco Falasca Head Metabolic Signalling Group  School of Pharmacy & Biomedical Sciences | Faculty of Health Sciences Curtin University Western University Prof. Falasca[/caption] Prof Marco Falasca Head Metabolic Signalling Group School of Pharmacy & Biomedical Sciences Faculty of Health Sciences Curtin University Western University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Each year around 9,800 people in the UK are diagnosed with pancreatic cancer. The disease is particularly aggressive and has one of the lowest survival rates of all cancers. Indeed, the life expectancy for pancreatic cancer patients has barely changed in the last 40 years because there are very few, and mostly only palliative care, treatments available. Given the five-year survival rate for people with pancreatic cancer is less than seven per cent, the discovery of new treatments and therapeutic strategies is urgently needed. In this study, we decided to concentrate on a protein, named GPR55, found in high levels in pancreatic cancer. Our results show that GPR55 promotes pancreatic cancer progression. Consequently, we decided to use its inhibitor cannabidiol, a naturally occurring constituent of medicinal cannabis, as a pharmacological strategy to block GPR55 activity. Strikingly, mice with pancreatic cancer that were treated with cannabidiol alongside chemotherapy, survived almost three times longer than those treated with chemotherapy alone, our study reports. 
Alzheimer's - Dementia, Author Interviews, Genetic Research, Mental Health Research / 31.07.2018

MedicalResearch.com Interview with: The Jackson LaboratoryCatherine Kaczorowski, Ph.D. Associate Professor and Evnin Family Chair in Alzheimer's Research Kristen O’Connell, Ph.D., Assistant Professor Amy Dunn, Ph.D., Postdoctoral Associate The Jackson Laboratory MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Amy Dunn: “Alzheimer's disease is complex, with both genetic and environmental factors determining symptom onset and disease progression, though our current understanding of how genetic and environmental factors interact to influence disease risk is incomplete. We recently developed a panel of genetically diverse mice carrying human familial AD mutations (AD-BXDs) that better model human AD in order to determine how genetics and diet interact to modify disease onset and severity. We fed a high fat diet to AD-BXDs and monitored metabolic and cognitive function over the duration of the HFD feeding.  We observed accelerated working memory decline in most of the AD-BXD mouse strains, however, the impact of high fat diet on memory was dependent on individual genetic differences across the panel, with some AD-BXD strains maintaining cognitive function on high fat diet (resilient strains). Our data suggest that diet and genetic background interact to mediate vulnerability to AD pathogenesis, and that metabolic factors (e.g. obesity, body composition) that may contribute to cognitive decline differentially in normal aging versus AD. “
Author Interviews, JAMA, Rheumatology, Statins / 31.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43568" align="alignleft" width="180"]Dr Gillian E. Caughey PhD Senior Research Fellow | School of Medicine | Discipline of Pharmacology THE UNIVERSITY OF ADELAIDE Australia Dr. Caughey[/caption] Dr Gillian E. Caughey PhD Senior Research Fellow | School of Medicine Discipline of Pharmacology THE UNIVERSITY OF ADELAIDE Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Statins are one of the most commonly prescribed medications worldwide.  Muscular adverse effects (myalgia and myopathy) are well recognised adverse effects and symptoms resolve with cessation of statins. Idiopathic inflammatory myositis (IIM) is a heterogeneous group of autoimmune myopathies that may also be associated with statin use. IIM does not resolve with cessation of statin therapy, requires treatment with immunosuppressive agents and is a severe, debilitating condition. To date, there have been no epidemiological studies examining exposure to statins and the association of histologically confirmed IIM. In our case control study of 221 cases o fIdiopathic inflammatory myositis, there was an almost 2-fold increased likelihood of statin exposure in patients with IIM compared with controls (adjusted odds ratio, 1.79; 95%CI, 1.23-2.60). After observing a significant association of statin exposure with IIM, we conducted a sensitivity analysis where we excluded those patients with necrotizing myositis as recent studies have reported this type of IIM to be associated with statin use and the presence of autoantibodies against HMG-CoA reductase. Exclusion of these specific cases from the analysis did not change our study findings and an increased risk of Idiopathic inflammatory myositis with statin exposure remained (adjusted OR, 1.92; 95% CI, 1.29-2.86).  This suggest the potential association of all types of Idiopathic inflammatory myositis with statin exposure.
Author Interviews, Inflammation, Kidney Disease, Personalized Medicine / 31.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43609" align="alignleft" width="125"]Michael P. Madaio, MD Sydenstricker Professor and Chairman Department of Medicine Medical College of Georgia at  Augusta University Dr. Madaio[/caption] Michael P. Madaio, MD Sydenstricker Professor and Chairman Department of Medicine Medical College of Georgia at Augusta University MedicalResearch.com: What is the background for this study? Response: Glomerulonephritis is a inflammatory disease of the kidney.  Glomeruli are the filtering units in the kidney. This is most often immunologically mediated and are autoimmune. Most therapies are directed at inhibiting the Immune/autoimmune process (immunotherapy) systemically.
Author Interviews, Duke, Genetic Research, Neurology, Pediatrics / 30.07.2018

MedicalResearch.com Interview with:  [caption id="attachment_43604" align="alignleft" width="128"]Paul C Marcogliese, Ph.D. Postdoctoral Associate, Laboratory of Dr. Hugo Bellen Department of Molecular and Human Genetics Baylor College of Medicine Houston, Texas 77030 Dr. Marcogliese[/caption] Paul C Marcogliese, Ph.D. Postdoctoral Associate, Laboratory of Dr. Hugo Bellen Department of Molecular and Human Genetics Baylor College of Medicine Houston, Texas 77030 [caption id="attachment_43603" align="alignleft" width="99"]Loren D. Pena, MD PhD Pediatric Medical Genetics Specialist Division of Medical Genetics, Department of Pediatrics Duke University School of Medicine, Durham, NC Dr. Peña[/caption] Loren D. Pena, MD PhD Division of Human Genetics Cincinnati Children's Hospital Medical Center Department of Pediatrics University of Cincinnati Cincinnati, OH 45229 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Undiagnosed Diseases Network (UDN) is a multi-site collaboration across the US that seeks to help diagnose patients with rare disorders that are ill-defined. Dr. Loren D.M. Pena and Dr. Vandana Shashi at the Duke-Columbia clinical site of the UDN had seen a patient with a severe neurological disorder. While the patient had no symptoms at birth, the patient began falling at about 3 years of age, eventually losing motor coordination and developing seizures. In the interim, the regression has progressed to a severely debilitating state. Re-analysis of the participant’s exome data by our site bioinformatician at Columbia (Nicholas Stong) in Dr. David Goldstein’s laboratory revealed a truncating variant in the single exon gene IRF2BPL that could be the candidate disease-causing gene. The UDN clinicians at Duke then contacted the UDN Model Organism Screening Center (MOSC) led by Dr. Hugo Bellen at Baylor College of Medicine and the Howard Hughes Medical Institute for functional analysis. In parallel, four more patients were found with truncating mutations causing a similar disorder though the UDN and GeneMatcher.org. Additionally, two patients with missense variants in IRF2BPL were identified that displayed seizures and some developmental delay or autism spectrum disorder but no motor regression. Work in MOSC by Dr. Paul Marcogliese using fruit flies revealed that the IRF2BPL truncating variants are severe loss of function mutations and one of the missense variants was a partial loss of function. Additionally, it was found that the fruit fly IRF2BPL gene, called pits, is expressed in the neurons of the adult fly brain. Lowering the levels of pits by about 50% in fly neurons leads to progressive behavioural abnormalities and neurodegeneration. By combining the human genetics, bioinformatics and model organism data, IRF2BPL was found to be a novel disease-causing gene in humans.
Author Interviews, Emergency Care / 30.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43598" align="alignleft" width="142"]Benjamin H. Schnapp, MD BerBee Walsh Department of Emergency Medicine Assistant Professor (CHS) Assistant Emergency Medicine Residency Program Director University of Wisconsin Dr. Schnapp[/caption] Benjamin H. Schnapp, MD BerBee Walsh Department of Emergency Medicine Assistant Professor (CHS) Assistant Emergency Medicine Residency Program Director University of Wisconsin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Medical errors harm thousands of patients per year.  There’s already a lot we know about systems errors - the ways that care delivery can go wrong.  We know less about cognitive errors, or the ways in which doctors think that can lead to bad outcomes.  An Emergency Department can feel particularly vulnerable to this type of errors - it’s a chaotic environment with patients in various states of illness, many unaccompanied, without records, or too ill to communicate well. An Emergency Department with trainee physicians can feel even more chaotic - even though they are supervised by staff physicians, resident physicians in their first few months to years of training have not yet accumulated the same level of knowledge and experience as longer-tenured doctors.  Errors that get made on the hospital floor are errors of information processing - physicians have the right information, they just don’t always do the right thing with it.  We wanted to know what kinds of errors get made in an Emergency Department with trainees.  Are the errors related to the chaos and an inability to obtain reliable information from patients?  Are they related to the trainees not having enough knowledge and experience?  Or are they like the errors that get made on an inpatient floor? Our study found that the most frequent type of errors were errors of information processing - just like on the hospital floors.  The most common types of errors we saw were physicians settling on a diagnosis prematurely and weighing the importance of findings incorrectly. Patients with abdominal problems had the highest number of errors in our study.  Patients with certain risk factors, such as psychiatric disease or substance abuse, seemed to be particularly prone to errors.
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Occupational Health, Sexual Health / 30.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43432" align="alignleft" width="134"]Brittany M. Charlton, ScD, Assistant Professor Harvard Medical School Harvard T.H. Chan School of Public Health Boston Children's Hospital Boston, MA Dr. Charlton[/caption] Brittany M. Charlton, ScD, Assistant Professor Harvard Medical School Harvard T.H. Chan School of Public Health Boston Children's Hospital Boston, MA MedicalResearch.com: What is the background for this study? Response: Research has shown that nearly half of all sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience employment discrimination in their lifetime, which may lead to many other disparities, including health insurance coverage, healthcare access, and ultimately health-related quality of life (e.g., pain, anxiety).
Author Interviews, Cancer Research, JAMA, Leukemia, Transplantation / 30.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43481" align="alignleft" width="156"]Smita Bhatia, MD, MPH Gay and Bew White Endowed Chair in Pediatric Oncology Professor, Pediatric Oncology Vice Chair for Outcomes Research, Dept of Pediatrics Director, Institute for Cancer Outcomes and Survivorship School of Medicine University of Alabama at Birmingham Associate Director for Outcomes Research UAB Comprehensive Cancer Center  Dr. Bhatia[/caption] Smita Bhatia, MD, MPH Gay and Bew White Endowed Chair in Pediatric Oncology Professor, Pediatric Oncology Vice Chair for Outcomes Research, Dept of Pediatrics Director, Institute for Cancer Outcomes and Survivorship School of Medicine University of Alabama at Birmingham Associate Director for Outcomes Research UAB Comprehensive Cancer Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Allogeneic bone marrow transplantation BMT is used with a curative intent for life-threatening malignant and non-malignant diseases of childhood. In this observational study, we describe the late mortality experienced by children undergoing BMT over the past 3 decades. Our cohort included 1388 BMT recipients who had undergone allogeneic BMT between 1974 and 2010 and survived 2 or more years. We found that, conditional on surviving the first 2 years after bone marrow transplantation, the probability of surviving an additional 20 years approached 80%. Risk of dying from non-relapse-related causes exceeded the risk of dying from relapse-related causes. The leading non-relapse-related causes of death were infection (with or without graft vs. host disease) and new cancers. Overall, the cohort was at a 14-fold greater risk of dying as compared with the general population (of similar age and sex). Further, this excess risk remained elevated even among those who had survived 25 years. On a positive note, the risk of late mortality has continued to decline over the past 3 decades. 
Accidents & Violence, Author Interviews, JAMA / 30.07.2018

MedicalResearch.com Interview with: “GUNS” by Jessica Spengler is licensed under CC BY 2.0Kendrin R. Sonneville, ScD, RD Assistant Professor Department of Nutritional Sciences University of Michigan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The results from this come out of MyVoice, a text message cohort of youth ages 14-24 representing every state in the country (http://hearmyvoicenow.org/). Each week we ask the youth in our cohort a series of open-ended to questions, with the goal of gathering the real-time opinions and experiences of youth across the U.S. This study reports the results of questions we asked MyVoice paritpatns between 07/2017 and 01/2018 about guns and gun control.  (1) What are your thoughts about having guns in your home? (2) Do you think gun control laws would affect mass shootings? Why? (3) Who, if anyone, should NOT be allowed to own guns? We found that about one-third of youth in our diverse sample were “against” guns in the home, and the remaining two-thirds were either “pro” or “conditionally pro” guns in the home, stating that gun ownership is acceptable under certain conditions, such as proper storage, or kept away from children. Youth in our sample largely believed that gun control laws could decrease mass shootings, but one-third felt that gun control laws would not be enough to impact mass shootings.
Author Interviews, JAMA, Neurology, Surgical Research / 30.07.2018

MedicalResearch.com Interview with: Jianning Zhang MD, Ph.D Chairman, II, VII Chinese Medical Association of Neurosurgery President, Tianjin Medical University General Hospital, China  Jianning Zhang MD, Ph.D Chairman, II, VII Chinese Medical Association of Neurosurgery President, Tianjin Medical University General Hospital, China   MedicalResearch.com: What is the background for this study? Response: The elderly population is growing dramatically world widely, especially in China. The incidence of chronic subdural hematoma has been rising over the past years. Although the surgery is not a difficult process, the risk of death and recurrence persist, and the affliction and economic expenditure of the patients are relatively higher in the elderly. For these reasons, it is urgent to develop novel pharmacological therapies with sufficient safety and efficacy.  It has been known that the high expression of VEGF and inflammatory factors in chronic subdural hematoma can lead to abundant angiogenesis of immature vessels on the wall of hematoma. In our previous study, patients with chronic subdural hematoma have impaired ability to promote vascular maturation. For example, the number of endothelial progenitor cells in circulating blood is about 67% of the healthy individuals with similar age.  Atorvastatin can mobilize endothelial progenitor cells to reduce inflammation. It increases the number of circulating endothelial cells that are inversely correlated with the volume of hematoma. We have demonstrated that atorvastatin can promote endothelial cell formation and reduce the leakage of endothelial cell barrier in vitro. Results from in vivo experiments in animal models of subdural hematoma suggest that atorvastatin can promote the maturation of blood vessels and reduce inflammation on the margin of hematoma, and thus improve the neurological outcome.
Author Interviews, Cannabis, McGill, Pulmonary Disease / 30.07.2018

MedicalResearch.com Interview with: [caption id="attachment_40908" align="alignleft" width="200"]“Cannabis sativa” by Manuel is licensed under CC BY 2.0 cannabis[/caption] Sara Abdallah, PhD Student, first author and Dennis Jensen, PhD Associate Professor, Department of Kinesiology and Physical Education Associate Dean – Infrastructure, Faculty of Education Director, McGill Research Center for Physical Activity and Health Canada Research Chair in Clinical Exercise & Respiratory Physiology Associate Member, Translational Research in Respiratory Diseases Program Research Institute of the McGill University Health Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many patients with chronic obstructive pulmonary disease (COPD) suffer from severe breathlessness at rest and on minimal exertion despite receiving optimal drug therapy for their underlying disease (e.g., bronchodilators). In these patients, breathlessness significantly diminishes exercise capacity and quality of life. Thus, research focused on identifying adjunct therapies for management of breathlessness in patients with advanced COPD is clinically relevant. A series of studies conducted in the 1970’s found that smoked cannabis caused bronchodilation (i.e., improved airway function) in healthy individuals and in patients with asthma. More recently, it has been demonstrated that delta-9 (∆9)-tetrahydrocannabinol (THC, the major cannabinoid constituent of cannabis) inhibits cholinergic contractions in isolated human bronchi and that a positive association exists between measure of lung function (e.g., forced expiratory volume in 1-sec) and cannabis use in patients with COPD. These studies lead us to hypothesize that inhalation of vaporized cannabis may alleviate exertional breathlessness and improve exercise tolerance in patients with advanced COPD by improving airway function at rest and during exercise.
Author Interviews, Breast Cancer, Cost of Health Care, Mammograms, Medical Imaging / 29.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43571" align="alignleft" width="133"]Michal Horný PhD Assistant Professor Emory University School of Medicine, Department of Radiology and Imaging Sciences Emory University Rollins School of Public Health Department of Health Policy and Management Atlanta, GA 30322 Dr. Horný[/caption] Michal Horný PhD Assistant Professor Emory University School of Medicine, Department of Radiology and Imaging Sciences Emory University Rollins School of Public Health Department of Health Policy and Management Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Response: Increased breast tissue density is a common finding at screening mammography. Approximately 30-50% of women have so-called “dense breasts” but many of them are not aware of it. The problem is that the increased tissue density can potentially mask early cancers. In other words, if there is cancer hiding in dense breast tissue, it could be difficult to spot it. To improve the awareness of breast tissue density, a patient group called Are You Dense Advocacy, Inc., started lobbying state and federal policymakers to pass laws mandating health care providers to notify women about their breast density assessments. As a result, 31 states have already enacted some form of legislation regarding dense breast tissue.
Author Interviews, Biomarkers, NYU/NYMC, Pediatrics, Pulmonary Disease / 29.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43557" align="alignleft" width="200"]Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center Dr. Kazachkov[/caption] Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? How common is the problem of chronic cough in children?  Is it more common in children with allergies, asthma or reflux? Response: Chronic cough is one of the leading causes of pediatric referrals to subspecialty physicians.  Its prevalence in the general pediatric population may approach 3% (Galassi et al, Epidemiol. Prev. 2005;29,Suppl.:9–13). It is important to recognize that the main causes of chronic cough in children are completely different for those in adults.  Specifically, gastroesophageal reflux and postnasal drip are not considered to be important causes of cough in children.  Cough variant asthma, although is a common cause of cough in adults, does not seem to be frequently diagnosed and a cause of chronic cough in children. The main cause of chronic wet cough in children is protracted bacterial bronchitis (Chang et al, Chest. 2017 Apr;151:884-890).  It is important to recognize that neurologically impaired children have completely different pathogenesis of chronic cough, which is mostly related to aspiration into the lower airway and development of aspiration-related lung disease.
Author Interviews, Genetic Research, Osteoporosis, PLoS, Stanford / 29.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43561" align="alignleft" width="150"]Stuart Kim - PhD Professor of Developmental Biology, Emeritus Bio-X Affiliated Faculty James H. Clark Center Stanford University Dr. Kim[/caption] Stuart Kim PhD Professor of Developmental Biology, Emeritus Bio-X Affiliated Faculty James H. Clark Center Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Osteoporosis is caused by a reduction in bone mass, and leads to a high incidence of bone fracture because the weakened bone is less able to withstand the stress of slips and falls. Osteoporosis affects millions of elderly, is responsible for as many as 50% of fractures in women and 25% of fractures in men over the age of 50, and accounts for $19 billion in annual health care costs in the US. Identification of people with an increased genetic risk for osteoporosis could reduce the incidence of bone fracture. Low BMD is also a risk factor for stress fractures. For athletes and military personnel undergoing harsh rigors of training, stress fractures are common injuries that limit playing time, military effectiveness and competitive success. Using data from UK Biobank, a genome-wide association study identified 1,362 independent SNPs that clustered into 899 loci of which 613 are new. These data were used to train a genetic algorithm using 22,886 SNPs as well as height, age, weight and sex as predictors. Individuals with low genetic scores (about 2% of those tested) showed a 17-fold increase in risk for osteoporosis and about a 2-fold increase in risk of fractures.
Aging, Alzheimer's - Dementia, Author Interviews / 27.07.2018

MedicalResearch.com Interview with: alkahestIan Gallager, MS Scientist at Alkahest Inc. San Francisco Bay Area  MedicalResearch.com: What is the background for this study? Response: Our research is aimed to develop novel therapeutics for age-related disorders from fundamental understandings of blood plasma. This expands upon work initially performed in the Wyss-Coray lab at Stanford utilizing a model of parabiosis. By surgically conjoining the blood supplies between a young and aged mouse, they established that beneficial effects were observed in the aged mouse brain, suggesting that there are proteins in young blood which have enhancing properties. The research presented at AAIC was the culmination of several years of model and dosing paradigm development utilizing both human plasma and a proprietary fractionated plasma product leading to advances for clinical application.
Author Interviews, Cancer Research, Cost of Health Care, JAMA / 27.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43498" align="alignleft" width="200"]Manali Patel MD MPH Assistant Professor of Medicine, Oncology Stanford Palo Alto Veterans Affairs Health Care System  Dr. Patel[/caption] Manali Patel MD MPH Assistant Professor of Medicine, Oncology Stanford Palo Alto Veterans Affairs Health Care System   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In prior work, many patients with advanced stages of cancer report a lack of understanding of their prognosis and receipt of care that differs from their preferences. These gaps in care delivery along with the unsustainable rise in healthcare spending at the end-of-life and professional healthcare provider shortages led our team to consider new ways to deliver cancer care for patients.  Based on input from focus groups with patients, caregivers, oncology care providers and healthcare payers, we designed a novel model of cancer care to address these gaps in care delivery.  The intervention consisted of a well-trained lay health worker to assist patients with understanding and communicating their goals of care with their oncology providers and caregivers. We found that patients who received the six-month intervention reported greater satisfaction with the care they received and their decision-making, had higher rates of hospice use, lower acute care use, and 95% lower total healthcare expenditures in the last month of life.  The intervention resulted in nearly $3 million dollars in healthcare savings.
Alzheimer's - Dementia, Author Interviews, Genetic Research / 27.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43446" align="alignleft" width="151"]Gregory Carter Dr. Carter[/caption] Gregory Carter, PhD Associate Professor at The Jackson Laboratory MedicalResearch.com: What is the background for this study? What are the main findings? Response: Animal models for late-onset Alzheimer’s disease (LOAD) will be of significant benefit for the discovery and characterization of links between specific genetic factors and the molecular pathways associated with the disease. To date, most animal models have been based on rare, early-onset Alzheimer’s disease genes that incompletely capture the complexity of LOAD and have not translated well to therapies. Therefore, developing and utilizing animal models based on genes hypothesized to play a role in LOAD will provide new insights into its basic biological mechanisms. 
Author Interviews, Cocaine, Gastrointestinal Disease, PLoS, Surgical Research, Vanderbilt, Weight Research / 27.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43239" align="alignleft" width="169"]Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute Dr. Galli[/caption] Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation. Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways. We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding.
Author Interviews, BMJ / 27.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43533" align="alignleft" width="166"]Trudo Lemmens (LicJur, LLM bioethics, DCL) Professor and Scholl Chair in Health Law and Policy Faculty of Law, University of Toronto Toronto Ontario, Canada Prof. Lemmens[/caption] Trudo Lemmens (LicJur, LLM bioethics, DCL) Professor and Scholl Chair in Health Law and Policy Faculty of Law, University of Toronto Toronto Ontario, Canada  MedicalResearch.com: What is the background for this study? Response: The study is part of a series of articles organized in collaboration between the BMJ and the Pan American Health Organization, with particular involvement of members of PAHO’s Advisory Committee on Health Research. The goal of the series is to highlight some of the key accomplishments in the PAHO region in the last decades following PAHO’s 2009 regional policy on research for health, the first WHO regional policy that aimed at contributing to WHOs Stragegy on Research for Health. One of the issues that have been identified in the last decades as an important challenge, particularly for research related to pharmaceutical product and medical device development, is the lack of transparency of clinical trials data. This has been associated with problems of hiding and misrepresentation of research results, duplication of research, and misleading or even outright fraudulent presentations of findings in medical publications. Various remedies have been proposed to address these problems, from trial registration, to results reporting, to broader data sharing that enables independent researchers to verify and challenge research results. I have been involved through PAHO and in my own research in the promotion of transparency measures at the national and international level. PAHO has been playing a leading role in this in the region, so it seemed more than fitting to have an article in the series on what has been accomplished and what challenges remain.
Author Interviews, CDC, Infections / 26.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43528" align="alignleft" width="200"]https://www.cdc.gov/salmonella/backyard-flocks-06-18/index.html Dr. Megin Nichols[/caption] Dr. Megin Nichols DVM, MPH, DACVPM Lead , Enteric Zoonoses Activity Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases CDC Veterinarian MedicalResearch.com: What is the background for this announcement? Response: Each year, CDC and multiple states investigate several multistate outbreaks of Salmonella infections linked to contact with live poultry in backyard flocks. Seventy outbreaks of Salmonella infections have been linked to contact with poultry in backyard flocks since 2000.
Author Interviews, Cancer Research, JAMA, Prostate Cancer / 26.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43522" align="alignleft" width="168"]Alison L. Allan, PhD Department of Oncology, Western University London Regional Cancer Program, London Health Sciences Centre London, Ontario, Canada  Dr. Allan[/caption] Alison L. Allan, PhD Department of Oncology, Western University London Regional Cancer Program, London Health Sciences Centre London, Ontario, Canada  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This was an international collaborative study between Lawson Health Research Institute (London, ON), Memorial Sloan Kettering Cancer Center (New York), the Royal Marsden (London, UK) and molecular diagnostics company Epic Sciences (San Diego, CA). The study used a liquid biopsy test developed by Epic Sciences that examines circulating tumour cells (CTCs) in blood samples from patients with advanced prostate cancer who are deciding whether to switch from hormone-targeting therapy to chemotherapy. CTCs are cancer cells that leave a tumour, enter the blood stream and invade other parts of the body, causing the spread of cancer. The test identifies whether or not a patient’s CTCs contain a protein in the nucleus called AR-V7. The research team set out to determine whether the presence of this protein predicted which treatment would best prolong a patient’s life. They found that patients who tested positive for the protein responded best to taxane-based chemotherapy while those who tested negative for the protein responded best to hormone-targeting therapy with drugs called androgen-receptor signaling (ARS) inhibitors. These are the two most widely used drug classes to treat advanced prostate cancer.
Abbvie, Author Interviews, OBGYNE, Pain Research / 26.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43518" align="alignleft" width="200"]Dr. Dawn Carlson MD MPH Vice President, General Medicine Development AbbVie  Dr. Carlson[/caption] Dr. Dawn Carlson MD MPH Vice President, General Medicine Development AbbVie  MedicalResearch.com: Please provide some background on this announcement. Would you briefly explain what endometriosis is? Whom does it affect and how does it interfere with quality of life? Response: Endometriosis is one of the most common gynecologic disorders in the U.S that affects an estimated one in 10 women of reproductive age. It occurs when tissue similar to the lining of the uterus starts growing outside of the uterus, where it doesn’t belong. The symptoms of endometriosis, including pain with menstrual periods and between periods, and with sexual intercourse, can be debilitating and significantly impact day-to-day activities of women’s lives, personally and professionally. Unfortunately, women with endometriosis can suffer for up to 10 years and visit multiple physicians before receiving a proper diagnosis. Unresolved endometriosis pain results in higher healthcare costs from emergency department visits and repeat surgeries. 
Author Interviews, Flu - Influenza, Genentech / 26.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43512" align="alignleft" width="200"]Mark Eisner MD MPH Vice President and Global Head of Respiratory Actemra, ID, and Metabolism Clinical Development at Genentech Professor of Clinical Medicine University of California, San Francisco Dr. Mark Eisner[/caption] Mark Eisner MD MPH Mark D. Eisner, MD, MPH Vice President, Product Development Immunology, Infectious Disease, and Ophthalmology Genentech   MedicalResearch.com: What is the background for this study? Would you briefly explain how baloxavir marboxil differs from other flu treatments?  Response: CAPSTONE-2 is a Phase III multicenter, randomized, double-blind study that evaluated a single dose of baloxavir marboxil compared with placebo and oseltamivir in people 12 years and older who are at a high risk of complications from the flu. The high risk inclusion criteria in CAPSTONE-2 were aligned with the Centers for Disease Control and Prevention (CDC), which defines people at high risk for serious flu complications to include adults 65 years of age or older, or those who have conditions such as asthma, chronic lung disease, diabetes or heart disease. For these people, flu can lead to hospitalization or even death. Participants enrolled in the study were randomly assigned to receive a single dose of 40 mg or 80 mg of baloxavir marboxil (according to body weight), placebo or 75 mg of oseltamivir twice a day for five days. The FDA recently accepted a New Drug Application (NDA) and granted Priority Review to baloxavir marboxil as a single-dose, oral treatment for acute, uncomplicated influenza in people 12 years and older. The NDA was based on results from the Phase III CAPSTONE-1 study of a single dose of baloxavir marboxil compared with placebo or oseltamivir 75 mg, twice daily for five days, in otherwise healthy people with the flu. Results from a placebo-controlled Phase II study in otherwise healthy people with the flu were included as supporting data in the NDA. The FDA is expected to make a decision on approval by December 24, 2018. Baloxavir marboxil is a first-in-class, single-dose investigational oral medicine with a novel proposed mechanism of action designed to target the influenza A and B viruses, including oseltamivir-resistant strains and avian strains (H7N9, H5N1). Unlike other currently available antiviral treatments, baloxavir marboxil is the first in a new class of antivirals designed to inhibit the cap-dependent endonuclease protein within the flu virus, which is essential for viral replication. By inhibiting this protein, baloxavir marboxil prevents viral replication earlier in the flu virus life cycle.