Artificial Sweeteners, Author Interviews, Nutrition, Sugar, Weight Research / 17.05.2018

MedicalResearch.com Interview with: “Soda” by Jannes Pockele is licensed under CC BY 2.0Kimber L. Stanhope, Ph.D., M.S., R.D. Research Nutritional Biologist Department of Molecular Biosciences: SVM University of California, Davis  MedicalResearch.com:? What are the main findings of this study? Response: Sugar-sweetened beverages increase risk factors for cardiometabolic disease compared with calorically-equal amounts of starch. We are not the first group of experts to reach this conclusion. The Nutrition and Chronic Diseases Expert Group reached a similar conclusion last year (Micha, 2017). Yet very different conclusions/opinions are being still being published by other researchers. (Latest example: Archer E., In Defense of Sugar: A Critique of Diet-Centrism. Progress in Cardiovascular Disease, May 1, 2018). These conflicting conclusions confuse the public and undermine the implementation of public health policies, such as soda taxes and warning labels, that could help to slow the epidemics of obesity and cardiometabolic disease. We hope that the careful review of the evidence and the discussion of issues that can lead to conflicting opinions in nutrition research in this paper will help to clarify this issue. Consumption of polyunsaturated (n-6) fats, such as those found in some vegetable oils, seeds, and nuts, lowers disease risk when compared with equal amounts of saturated fats. It is important to note however, that the effects of saturated fat can vary depending on the type of food. Dairy foods such as cheese and yogurts, which can be high in saturated fats, have been associated with reduced cardiometabolic risk. The non-caloric sweetener aspartame does not promote weight gain in adults. Aspartame is the most extensively studied of the non-caloric sweeteners. None of the dietary intervention studies that have investigated the effects of aspartame consumption have shown it promotes body weight gain. This includes studies in which the adult research participants consumed aspartame for 6 months, 1 year or 3 years. (more…)
Author Interviews, Epilepsy, Neurological Disorders, NYU, Pharmaceutical Companies / 17.05.2018

MedicalResearch.com Interview with: https://www.gwpharm.com/epilepsy-patients-caregivers/patientsAnup Patel, M.D. Section Chief of Neurology Interim Division Chief of Neurology Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? Response: The study evaluated kids and adults with an epilepsy syndrome (Lennox Gastaut Syndrome – LGS) that is often difficult to treat and does not respond well to current medical treatment.  The study was a double blind randomized control trial evaluating how well a plant based, liquid solution, cannabidiol (CBD) product made by Greenwich Biosciences called Epidiolex helped to treat drop seizures (the most common seizure type in LGS) and how safe it was compared to placebo.  Two doses (10 mg/kg/day and 20 mg/kg/day) were evaluated compared to placebo. (more…)
Author Interviews, Biomarkers, Breast Cancer, Technology, University of Michigan / 16.05.2018

MedicalResearch.com Interview with: Greg Thurber, PhD Assistant Professor Department of Chemical Engineering Assistant Professor Department of Biomedical Engineering University of Michigan  MedicalResearch.com: What is the background for this study? Response: Most current disease screening strategies rely on either blood tests, where the physician can obtain information on specific disease molecules but has no idea where they originated in the body, or anatomical imaging, where the physician can see changes in the structure of tissues but doesn’t have any molecular information. We wanted to develop a method that could provide both molecular information and an image of where these molecules were located. We know from decades of research in cancer that this is a molecular disease, so providing molecular information to the physician will help improve detection and diagnosis. Breast cancer screening provides an excellent opportunity to apply this approach to improve detection. Currently, estimates indicate that we are overspending $4 billion per year on the overdiagnosis and overtreatment of breast cancer because we cannot accurately determine which patients need treatment and which can be safely monitored with no intervention. Despite this problem with overdiagnosis, however, screening saves lives…we simply need a better way. Molecular imaging has the capability of providing both molecular information and the location within the body. However, most of these techniques are expensive and use ionizing radiation, meaning there is a small risk of actually causing cancer. This is not acceptable for screening large numbers of otherwise healthy patients. To avoid this risk and provide a safe, inexpensive, and relatively easy method for patients to undergo screening, we decided to develop near-infrared fluorescent imaging agents that can be taken as a pill. The goal is for the patient to simply take a pill a day or two before their visit, and then the physician shines near-infrared light on the breast tissue to detect tumors where they ‘light up’ by giving off a different color of light. (more…)
Author Interviews, Circadian Rhythm, Lancet, Mental Health Research / 16.05.2018

MedicalResearch.com Interview with: Laura Lyall MA; MSc; PhD Research Associate Institute of Health and Wellbeing University of Glasgow MedicalResearch.com: What is the background for this study? Response: Previous studies have suggested a link between disturbed circadian rhythms and depression and bipolar disorder. These studies have however usually used small samples, subjective measures of circadian disruption, or have not accounted for potential confounding factors like sociodemographic and lifestyle characteristics. The UK Biobank cohort has accelerometry (activity monitor) data as well as mental health, lifestyle, BMI and sociodemographic data for over 91,000 individuals, and means we can address this question using objective measures of circadian rhythmicity on a large scale. We derived a measure of relative amplitude from the UK Biobank’s accelerometry data, which was recorded for 7 days between 2013-2014 from around 100,000 participants. Relative amplitude reflects the distinction, in terms of activity levels, between an individual’s most active 10 hours and least active 5 hours, in an average day. If an individual is inactive during the day, or has disturbed sleep at night, the will show low relative amplitude, consistent with disturbed circadian rest-activity patterns. (more…)
Author Interviews, NEJM, Stroke, University Texas / 16.05.2018

MedicalResearch.com Interview with: Dr. S. Claiborne "Clay" Johnston MD, PhD Dean Vice President for Medical Affairs Frank and Charmaine Denius Distinguished Dean’s Chair Dell Medical School The University of Texas at Austin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have shown that the risk of a stroke or other ischemic events is high in the days to weeks after a TIA or minor stroke. We sought to test whether blocking platelet aggregation more effectively with clopidogrel plus aspirin could reduce this risk compared to aspirin alone.  We found that the combination did reduce risk of major ischemic events.  It also showed a small increase in risk of major hemorrhage, but for most people the benefits would outweigh the potential risk. (more…)
Author Interviews, Cognitive Issues, Mental Health Research / 16.05.2018

MedicalResearch.com Interview with: Dr. Eero Vuoksimaa PhD Institute for Molecular Medicine University of Helsinski Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many previous reports indicating a positive association between height and cognitive ability but the underlying mechanisms behind this correlation are not well known. We used a mediation model to test if this association is explained by brain size as measured with cortical grey matter size. We found that total cortical surface mediated the relationship between height and cognitive ability. (more…)
Author Interviews, Fertility, JAMA, OBGYNE / 16.05.2018

MedicalResearch.com Interview with: “Acupuncture Needle” by Acid Pix is licensed under CC BY 2.0Caroline Smith, PhD Professor Clinical Research Western Sydney University Research Theme Champion Health and Wellbeing MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Despite technological improvements to IVF the success of IVF treatment remains low. Consequently, new drugs, laboratory techniques and other treatments need to be developed and rigorously tested to explore their effects on producing healthy babies for women undergoing IVF.  In 2002, the first randomised controlled trial of acupuncture administered a specific form of IVF acupuncture at the time of embryo transfer. The results indicated the chance of achieving a pregnancy from acupuncture was twice that to women undergoing IVF treatment alone. From mid 2000s many women have started to use adjunctive treatments such as acupuncture whilst undergoing IVF.  We conducted and reported on a  pilot study in 2006 which produced results suggesting a benefit. It is important that these findings were rigorously examined in a larger trial. Findings are presented from our trial presented in JAMA. Our study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has failed to confirm significant difference in live birth rates. (more…)
Author Interviews, JAMA, Smoking, Tobacco Research / 16.05.2018

MedicalResearch.com Interview with: “E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping” by Vaping360 is licensed under CC BY 2.0Wei Bao, MD, PhD Assistant Professor Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Although the health effects of e-cigarettes remains unclear, e-cigarettes have been marketed as an approach for smoking cessation. Previous studies have reported an increase in e-cigarette use in US people since 2010. The current study showed that from 2014 to 2016, there was an increase in ever use of e-cigarettes but decline in current use of e-cigarettes.  (more…)
Author Interviews, JAMA, OBGYNE / 16.05.2018

MedicalResearch.com Interview with: Dr. Cande V. Ananth, PhD, MPH Adjunct professor Department of Health Policy and Management Mailman School of Public Health Columbia University, NY MedicalResearch.com: What is the background for this study? Response: Preterm delivery rates have declined between 2005 and 2014 in the US and in several European countries. Since reductions in preterm and early term deliveries, and perinatal mortality remain a global health priority, determining the relationship between gestational age distribution and perinatal mortality, remains a challenge. Efforts expended to a more complete understanding of the impact of new interventions, policies, and practices on reducing the burden of early deliveries, and in turn improvements in perinatal survival will be of tremendous benefit for clinical management and care of women during their pregnancy and the newborn. (more…)
Author Interviews, CDC, JAMA, Pediatrics / 15.05.2018

MedicalResearch.com Interview with: Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive. For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package. (more…)
Author Interviews, Infections / 15.05.2018

MedicalResearch.com Interview with: Dr. Tom Lodise PharmD, Professor Albany College of Health Sciences, NY  MedicalResearch.com: What is the background for this study? Response: P. aeruginosa (PSA) is intrinsically resistant to many commercially available antibiotics and also has a remarkable capacity to develop resistance to commonly used antibiotics like carbapenems, aminoglycosides, and fluoroquinolones. The terms ‘multidrug resistant’ (MDR) and ‘pan-drug resistant’ are often used to characterize the different patterns of multiple drug resistance exhibited by PSA. Patients with MDR-PSA infections are at an increased risk for delayed receipt of appropriate antimicrobial therapy and ample studies indicated that receipt of delayed appropriate therapy results in substantial increases in morbidity, mortality, and healthcare resource utilization. Although risk factors for these types of infections have previously been identified in the literature, this study takes identification of risk factors further, and develops two clinical risk scores to estimate the probabilities of carbapenem and extensively beta-lactam non-susceptibility among hospitalized, adult patients with PSA infections based on covariates available on clinical presentation. We focused on these two PSA non-susceptible phenotypes as they represent infections at high risk of delayed appropriate therapy due to resistance against the current commonly prescribed empiric anti-pseudomonal antibiotics. (more…)
Author Interviews, Cancer Research, JAMA, Yale / 15.05.2018

MedicalResearch.com Interview with: Jeremy O'Connor, MD Section of General Internal Medicine Department of Internal Medicine Postdoctoral Fellow, National Clinician Scholars Program Yale University MedicalResearch.com: What is the background for this study?   Response: There has been a lot of enthusiasm for the use of novel therapies in cancer care, and in particular for novel anticancer agents known as immune checkpoint inhibitors. But very little is known about how quickly providers have adopted immune checkpoint inhibitors into clinical practice. Existing studies suggest, in fact, that the process of clinical adoption is slow, with conventional wisdom holding that it takes an average of 17 years for new evidence to change practice. Our study evaluated whether the adoption of novel therapies might be much faster in certain contexts with the early use of immune checkpoint inhibitors as a notable example. (more…)
Author Interviews, Kidney Stones, Microbiome, Urology / 15.05.2018

MedicalResearch.com Interview with: Gregory Tasian MD, MSc, MSCE Assistant Professor of Urology and Epidemiology University of Pennsylvania Perelman School of Medicine Division of Urology and Center for Pediatric Clinical Effectiveness The Children’s Hospital of Philadelphia MedicalResearch.com: What is the background for this study? What are the main findings? Response:  We found that five classes of commonly prescribed antibiotics were associated with an increased risk of kidney stones. These classes were sulfa drugs (e.g. Bactrim), fluoroquinolones (e.g. Cipro), cephalosporins (e.g. cephalexin), nitrofurantoin, and broad-spectrum penicillins (e.g. augmentin).  For those five classes of antibiotics, the greatest risk was found among younger patients. However, the increased risk was still significant across all ages, including for older adults with the exception of broad-spectrum penicillins, which were not associated with an increased risk of kidney stones among patients >75 years of age. We conducted this study because: 1) Prior investigations have demonstrated that changes in the gut microbiome were associated with kidney stones, 2) Antibiotics are prescribed frequently, and 3) The number of people affected by kidney stone disease has increased 70% over the last 30 years and the greatest increases have been found among children and adolescents. Our results were consistent with these previous studies, so we were not surprised with the findings although we did not know which specific classes of antibiotics would be associated with an increased risk of stones and which ones would not. (more…)
Author Interviews, Global Health, JAMA, Pulmonary Disease, Technology / 15.05.2018

MedicalResearch.com Interview with: Michael Hawkes MD PhD Adjunct Professor Assistant Professor Pediatrics, Faculty of Medicine School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? What are the main findings?
  • Pneumonia is the leading cause of mortality in children globally.
  • Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
  • Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
  • We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
  • Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.
(more…)
Alzheimer's - Dementia, Author Interviews, Personalized Medicine, University of Pennsylvania / 15.05.2018

MedicalResearch.com Interview with: David A. Wolk, MD Associate Professor Department of Neurology Co-Director, Penn Memory Center Associate Director, Alzheimer’s Disease Core Center University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mild Cognitive Impairment (MCI) is a state when individuals have mild memory problems, but not enough to impact day-to-day function.  Many patients with MCI are on the trajectory to developing Alzheimer’s Disease dementia, but about half will not and remain stable.  As such, patients with MCI are often uncertain about the likelihood they should expect to decline in the future which obviously may be associated with considerable anxiety and this may delay opportunities for them to plan for the future or begin therapeutic interventions. This study examined the degree to which amyloid PET, which detects the amyloid pathology of Alzheimer’s Disease, a measure of shrinkage of the hippocampus with MRI, and cognitive measures predicted development of dementia over 3 years.  We found that each of these measures enhances prediction of whether an individual will or will not develop dementia in the future.  If all of these measures are positive, one has a very high risk of progression whereas if amyloid PET and the MRI measurement are normal, there is very little risk of progression. (more…)
Addiction, Author Interviews, JAMA, Opiods, Pharmaceutical Companies / 14.05.2018

MedicalResearch.com Interview with: “Big Lunch Extras Reading” by Big Lunch Extras is licensed under CC BY 2.0Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Boston Medical Center Director of Urban Health & Advocacy Track | Boston Combined Residency Program Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids. In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing. We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Pediatrics / 14.05.2018

MedicalResearch.com Interview with: “Crime Scene _MG_4847” by thierry ehrmann is licensed under CC BY 2.0Daniel Romer, PhD Research Director Annenberg Public Policy Center and Director of its Adolescent Communication Institute (ACI) University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been studying the steady increase in gun violence that has been occurring in popular PG-13 movies since the new rating was adopted in 1984.  It has recently even surpassed the amount of gun violence in R-rated movies.  Since these movies are open to the public at any age, we are concerned that they promote the use of guns and potentially socialize youth to believe that using guns to defend oneself is an appropriate way to handle threats and other conflicts. We knew that the rating requires the omission of graphic consequences, such as blood and suffering, that can make the violence more acceptable.  But we also wondered whether the motivation for the violence might make a difference as well.  Many of the characters in PG-13 movies are seen as heroic (e.g., Bruce Willis and Liam Neeson).  Could that also be a factor that makes such films more acceptable to parents despite their concerns about their children seeing so much violence in the movies.  So, we conducted this experiment to see if parents are less upset by justified violence in PG-13 style movies.  (more…)
Author Interviews, Hip Fractures, Orthopedics, Osteoporosis / 14.05.2018

MedicalResearch.com Interview with: “Just a hairline fracture...” by Gloria Bell is licensed under CC BY 2.0Brittany Bindon, MD Department of Internal Medicine University of Chicago Chicago, Illinois MedicalResearch.com: What is the background for this study? Response: Bisphosphonates are commonly used in the treatment of osteoporosis, however, they have been associated with rare, severe side effects such as osteonecrosis of the jaw and atypical femoral fractures. As a result, bisphosphonate drug holidays have become common in clinical practice though currently, there are minimal data on the safe duration of these drug holidays. We sought to further characterize the clinical and laboratory parameters associated with increased fracture risk in patients on bisphosphonate drug holiday. (more…)
Author Interviews, Depression, Endocrinology, JAMA, Mental Health Research, Thyroid Disease / 14.05.2018

MedicalResearch.com Interview with: Thyroid gland Wikipedia imageTeja Grömer PD Dr. med. Habil Facharzt für Psychiatrie und Psychotherapie Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie Bamberg  MedicalResearch.com: What is the background for this study? 1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT) 2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness. 3) I thus decided to do a systematic review and meta-analysis.  (more…)
Author Interviews, BMJ, Cancer Research, Gender Differences / 14.05.2018

MedicalResearch.com Interview with: “Faecal Coliforms analysis” by SuSanA Secretariat is licensed under CC BY 2.0Dr. Mahiben Maruthappu Public Health Registrar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender disparities in the fields of science and technology have been documented, and  it becomes increasingly apparent at higher levels of seniority. In this analysis, we found a quantifiable difference in cancer research funding awarded to female principle investigators compared to male principle investigators (PIs). Across all cancer research funding grants that we identified, male PIs received 3.6 times the total investment value, and 1.6 times the average award value compared with their female counterparts.  (more…)
Author Interviews, Depression, Exercise - Fitness / 13.05.2018

MedicalResearch.com Interview with: “gym” by FooJFoo is licensed under CC BY-NC-ND 3.0Mr. Brett R. Gordon, M.Sc. Postgraduate researcher Physical Education and Sport Sciences Department University of Limerick, Ireland.  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Depression is prevalent, burdensome, and often comorbid mood disorder that is associated with other poor health outcomes. Exercise training interventions have demonstrated comparable efficacy for depressive symptoms to frontline treatments, such as antidepressant medications and behavioral therapies. However, the evidence to date has primarily focused on findings from studies of aerobic exercise training like jogging, running, and cycling. Our work is the first quantitative summary of the effects of resistance exercise training (RET), or weight lifting and strength training, on depressive symptoms, and the influence of variables like participant characteristics, features of the RET, and the methods that were used in studies on the antidepressant effects of RET. The main finding was that resistance exercise training significantly reduced depressive symptoms among adults regardless of their health status, the total prescribed volume of RET (e.g., how much the participants were supposed to exercise), or whether or not strength was significantly improved by the RET intervention.  (more…)
Author Interviews, Lifestyle & Health, Social Issues / 12.05.2018

MedicalResearch.com Interview with: “Sara Singing for the IT MS Society” by Draft is licensed under PDM 3.0Filippos Filippidis MD, MSc, MPH, PhD Lecturer in Public Health School of Public Health Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research suggests that big sports and international events are associated with happiness, productivity, suicides and homicides. Considering the popularity of the Eurovision Song Contest (ESC) in Europe, we wanted to see if there is any association between performance in the competition and life satisfaction and suicides. We used interview data from more than 160,000 people in Europe collected from 2009 to 2015 and found that better performance in the contest was associated with higher levels of life satisfaction in the country. Winning the competition did not confer any additional advantage. When comparing bad performance in the ESC with no participation at all, we found that even bad performance was associated with higher satisfaction with life compared to absence from the competition. (more…)
Author Interviews, Genetic Research, JAMA, UCSF / 12.05.2018

MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Health Research and Policy Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Changes in genetic sequencing technology and regulation have allowed much cheaper testing of many more genes in recent years. We investigated how these changes have affected hereditary cancer risk evaluation in women newly diagnosed with breast cancer. The main findings are that more comprehensive multiple-gene sequencing tests have rapidly replaced more limited tests of two genes (BRCA1 and BRCA2) only. This has helped patients by doubling the chance of finding an important gene mutation that can change their treatment options. However, there are important gaps in how this new, more comprehensive sequencing is used: more testing delays and more uncertain results, particularly among racial/ethnic minority women.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Depression, Pediatrics / 11.05.2018

MedicalResearch.com Interview with: Karen Fratantoni, M.D., M.P.H. Pediatrician and lead study author Children’s National Health System MedicalResearch.com: What is the background for this study? Response: We looked at the prevalence of depressive symptoms at NICU discharge and at six months after discharge among 125 parents randomized to the control group of a larger PCORI-funded trial of peer-to-peer support after NICU discharge. Determining factors associated with parental depressive symptoms at NICU discharge may help to identify at-risk parents who could benefit from mental health support. (more…)
Author Interviews, Biomarkers, Brigham & Women's - Harvard, Orthopedics, Pain Research / 11.05.2018

MedicalResearch.com Interview with: “osteopathic treatment for sciatica” by betterhealthosteopathy is licensed under PDM 3.0Daniel Albrecht, PhD Research Fellow in Radiology, Harvard Medical School Research Fellow, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: A great deal of preclinical work in animal models of pain has established that activation of peripheral immune cells or, in the central nervous system (brain and spinal cord), immune cells called “glia” (microglia and astrocytes) play a key role in the establishment and/or maintenance of persistent pain. For instance, if you pharmacologically block activation of these cells in the nervous system, you are able to reduce/inhibit/prevent pain behaviors, e.g. in animals who have received a nerve injury. This observation is very exciting, because it suggests that blocking neuroinflammation may be a viable way of treating pain. However, the evidence linking human chronic pain with neuroinflammation has so far been limited. In this study we show, for the first time, that patients with chronic sciatica (that is, back pain that shoots down the leg) demonstrate elevations in the levels of a protein called the translocator protein (TSPO) in the spinal cord and in the nerve roots. Because TSPO is a marker of neuroinflammation, our results suggest that sciatica is associated with neuroinflammation. While on average patients do show elevations in the levels of the TSPO, we also saw significant variability across individuals. Importantly, patients that show stronger elevations (in the nerve roots) were those who benefit the most from receiving a local anti-inflammatory treatment (epidural spinal injection). This makes sense: patients whose nerve roots are inflamed benefit from an anti-inflammatory treatment. Those whose nerve roots aren’t inflamed, don’t receive the same benefit. In the latter case, the source of the inflammation and pain may not be the nerve roots, but may be the spinal cord, or, as we showed in a previous paper (Loggia et al., Brain 2015), the brain.  (more…)
Author Interviews, JAMA, Kidney Disease / 11.05.2018

MedicalResearch.com Interview with: “Glass of Water” by Greg Riegler is licensed under CC BY 2.0Dr. William Clark Lawson Health Research Institute  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This study is about the use of increased water intake in people with chronic kidney disease (CKD). Although there are a large number of benefits claimed most are not substantiated by evidence. However there is a growing body of evidence (animal and human observational studies) that increased hydration with the suppression of antidiuretic hormone preserves kidney function in CKD. This led to our current randomised clinical trial of 631 patients with stage 3 CKD and proteinuria to determine if drinking an extra 4-6 glasses of water per day for 1 year would slow their progressive loss of kidney  function as measured by eGFR. The main findings were that those coached to increase their water intake versus those coached to sustain their normal fluid intake suffered no ill effects from the intervention and on average were able to sustain an average increase of approximately 3 glasses of water per day. At the end of 1 year the increased hydration group had suppressed their antidiuretic hormone levels (copeptin) significantly but did not demonstrate a greater preservation in their eGFR. (more…)
Author Interviews, JAMA, Prostate Cancer / 11.05.2018

MedicalResearch.com Interview with: Alex Krist, M.D., M.P.H Professor of family medicine and population health Virginia Commonwealth University and Active clinician and teacher at the Fairfax Family Practice residency MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is one of the most common cancers to affect men. However, the decision about whether to be screened is complex and personal. The U.S. Preventive Services Task Force reviewed the latest research on the benefits and harms of screening for prostate cancer using PSA-based testing, as well as evidence on treatment. We found that men who are 55 to 69 years old should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances. Men age 70 and older should not be screened, as the benefits of screening diminish as men age and the harms are greater. (more…)
Author Interviews, Exercise - Fitness, Mental Health Research / 10.05.2018

MedicalResearch.com Interview with: “Open Space Yoga Hawaii” by Open Space Yoga Hawaii is licensed under CC BY 2.0Michael Christopher Melnychuk PhD candidate Trinity College Institute of Neuroscience Trinity, Dublin  MedicalResearch.com: What is the background for this study? Response: Practitioners of yoga have claimed for some 2,500 years, that respiration influences the mind. In our study we looked for a neurophysiological link that could help explain these claims by measuring breathing, reaction time, and brain activity in a small area in the brainstem called the locus coeruleus. We chose to focus on the locus coeruleus because this area and the chemical it produces play intimate roles in both attention and respiration. The locus coeruleus produces noradrenaline and releases it to the entire brain. This neurotransmitter functions as an all-purpose action system. When we are stressed we produce too much noradrenaline and we can’t focus. When we feel sluggish, we produce too little and again, we can't focus. There is a sweet spot of noradrenaline in which our emotions, thinking and memory are much clearer.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Merck / 10.05.2018

MedicalResearch.com Interview with: Dr. Elizabeth Rhee MD Director, Infectious Disease Clinical Research Merck MedicalResearch.com: What is the background for this study? What are the main findings? Response: High-risk patients, such as the critically ill, with suspected bacterial infections require prompt treatment with appropriate empiric therapy to improve survival. Given the high prevalence of multidrug-resistant (MDR) Pseudomonas aeruginosa in the ICU setting, new safe and broadly effective treatment options are needed for critically ill patients requiring antipseudomonal agents. Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin/beta-lactamase inhibitor combination with broad in vitro activity against Gram-negative pathogens, including MDR P. aeruginosa and many extended-spectrum beta-lactamase (ESBL) producers. It is FDA approved for complicated intra-abdominal and urinary tract infections in adults at 1.5g (1g/0.5g) q8h. C/T is currently being studied at 3g (2g/1g) q8h, for the treatment of ventilated nosocomial pneumonia, in the ASPECT-NP Phase 3 trial. This Phase 1 pharmacokinetic (PK) study investigated the penetration of a 3g dose of C/T in the epithelial lining fluid (ELF) of ventilated patients with proven or suspected pneumonia. This is the dose and patient population being evaluated in ASPECT-NP. ELF lines the alveoli, and investigators took samples in a group of 26 patients to see what amount of C/T was in the lung and what was circulating in the plasma during the dosing intervals. In mechanically ventilated critically ill patients, the 3g dose of C/T achieved ≥50% lung penetration (relative to free plasma) and sustained levels in ELF above the target concentrations for the entire dosing interval. These findings support the 3g dose that is included in the ASPECT-NP Phase 3 trial.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Merck / 10.05.2018

MedicalResearch.com Interview with: Becky Jayakumar, PharmD College of Pharmacy Assistant Professor of Pharmacy Practice Roseman University of Health Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bacteremia (bloodstream infections) due to Gram-negative (GN) bacteria are a frequent cause of severe sepsis and pose serious therapeutic challenges due to multidrug-resistance (MDR). Ceftolozane/tazobactam (C/T) is a novel antipseudomonal cephalosporin combined with an established β-lactamase inhibitor. This retrospective, observational study evaluated the clinical outcomes of C/T real-world use in severely ill patients. Twenty-two patients with sepsis and/or bacteremia were included; 95% of whom had Pseudomonas aeruginosa that was resistant to almost all antibacterials with the exception of colistin. C/T successfully treated the majority of these complicated patients. In this real-world study, 77% of patients had a clinical response with C/T and 75% had a microbiological response. Clinical success rates were high and mortality rates were similar to other studies in this severely ill population. (more…)