Author: Marie Benz MD FAAD

MedicalResearch.com Interview with: David H. McDanielDavid H. McDaniel, MD is Board Certified by the American Board of Dermatology. He is a Co-Director of the Hampton University Skin of Color Research Institute, Adjunct Professor in the School of Science, Hampton University.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study was designed to evaluate at multiple sites the effects on submental fat of a 1060nm diode laser treatment which was already FDA cleared for non-invasive lipolysis of the abdomen, flanks, back, inner and outer thighs. A total of 19 volunteers were treated at our study site with typically two 25 minute treatments.  There was a 12 week follow-up period after treatment and photography (both 2D and 3D) was used to evaluate with expert physician grader along with other 3D analytics and a subject satisfaction questionnaire. The main findings were reduction in submental fat both from the expert grader and as well as the 3D metrics.  The 3D metrics also showed a lifting effect.  The study volunteers reported a ‘satisfied’ or ‘extremely satisfied’ score from the subject assessments.

MedicalResearch.com Interview with: “Pitching Crop” by slgckgc is licensed under CC BY 2.0Jason L. Zaremski, MD, CAQSM, FACSM, FAAPMR Assistant Professor│Divisions of PM&R, Sports Medicine, & Research Department of Orthopaedics and Rehabilitation Co-Medical Director Adolescent & High School Outreach Program University of Florida College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Throwing injuries are common in baseball and can be caused by excessive pitch counts, year-round pitching, and pitching with arm pain and fatigue. Despite the evidence, pitching injuries among high school players have not decreased. With a multitude of research in overhead throwers, yet the volume of overuse throwing injuries not decreasing, our team suspected there was a missing workload factor in baseball pitchers. Therefore, our team conducted research to determine whether an important factor was being overlooked: volume of pitches thrown during warm-up between innings and bullpen activity in high school varsity baseball pitchers. In the study, our team counted all pitches thrown off a mound during varsity high school baseball games played by 34 different high schools in North Central Florida during the 2017 season. After counting nearly 14,000 pitches in 115 pitch outings, our team found that 42% of the pitches thrown off a mound were not accounted for in the pitch counts, and that there is a large variability of bullpen pitches being thrown from pitcher to pitcher. Even with a greater focus on pitch counts as a way to prevent injuries, a substantial number of pitches are going unaccounted for in high school players as part of warm-up and bullpen activity.

MedicalResearch.com Interview with: “Soda” by Jannes Pockele is licensed under CC BY 2.0Juliana F. W. Cohen, ScM, ScD Department of Health Sciences Merrimack College North Andover MA 01845. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sugar consumption among Americans is above recommended limits and this excess intake may have important health implications. This study examined the associations of pregnancy and offspring sugar consumption, as well as sugar-sweetened beverages, other beverages (diet soda, juice), and fruit consumption with child cognition. This study found that when pregnant women or their children consumed greater quantities of sugar, as well as when women consumed diet soda during pregnancy, this was associated with poorer childhood cognition.  However, children’s fruit consumption was associated with higher cognitive scores.

MedicalResearch.com Interview with: [caption id="attachment_41398" align="alignleft" width="200"]CT scan showing a cancerous tumor in the left lung Wikipedia image CT scan showing a cancerous tumor in the left lung
Wikipedia image[/caption] Cary P. Gross, MD Department of Internal Medicine Section of General Internal Medicine Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center National Clinician Scholars Program Yale School of Medicine New Haven, CT  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In both the US and England, lung cancer is a leading cause of cancer deaths, and there is particular concern about access to high quality care among older persons in both countries. However, little is known about how the two nations compare regarding lung cancer care. We studied over 170,000 patients with lung cancer, and found that patients in the US were more likely to be diagnosed at an early stage (25% in US vs 15% of patients in England).  Our international team also found that patients in the US were more likely to receive treatment for their cancer, and were more likely to survive.

MedicalResearch.com Interview with: [caption id="attachment_13525" align="alignleft" width="112"]Edward "Ted" Weiss, Ph.D. Associate Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO 63104 Dr. Weiss[/caption] Edward "Ted" Weiss, Ph.D. Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO 63104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ketogenic diets are popular. They are very low in carbohydrate, with moderate protein and large amounts of fat. They are popular for weight loss but definitive studies of this are lacking. We tested the effects of a ketogenic diet on high-intensity exercise performance, such as sprinting. The result showed that the ketogenic diet was harmful to performance, reducing performance by 6 - 7% when compared to a high-carbohydrate diet.

MedicalResearch.com Interview with: [caption id="attachment_41387" align="alignleft" width="130"]R. Sean Morrison, MD Ellen and Howard C. Katz Professor and Chair Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York, NY 10029 Dr. Morrison[/caption] R. Sean Morrison, MD Ellen and Howard C. Katz Professor and Chair Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Palliative care is team based care that is focused on improving quality of life and reducing suffering for persons with serious illness and their families.  It can be provided at any age and in concert with all other appropriate medical treatments.  Palliative care has been shown to improve patient quality of life, patient and family satisfaction, and in diseases like cancer and heart failure, improve survival.  A number of individual studies have shown that palliative care can reduce costs by providing the right care to the right people at the right time. This study pooled data from six existing studies to quantify the magnitude of savings that high quality palliative care provides.

MedicalResearch.com Interview with: “New York at Night” by Louis Michel Eilshemius (American, Newark, New Jersey 1864–1941 New York) via The Metropolitan Museum of Art is licensed under CC0 1.0Dr Denholm Aspy PhD School of Psychology University of Adelaide MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many anecdotal reports of vitamin B6 being used to enhance dream recall, and poor dream has sometimes been considered a possible sign of vitamin B6 deficiency by some clinicians. However, until now there was only a single study that investigated this scientifically. This was a small pilot study in 2002 that included only 12 participants. My new study now provides the strongest evidence to date that vitamin B6 does in fact enhance dream recall. The double-blind placebo-controlled study included 100 participants from around Australia who took either Vitamin B6, a B vitamin complex (with a range of other B vitamins as well), or placebo directly before bed for five days. Participants recorded their dream recall using a logbook containing a range of measures each morning. Results showed the people who took B6 recalled around 64% more content from their dreams on average compared to the placebo group, and that this had no negative impact on sleep quality.

MedicalResearch.com Interview with: “Stop smoking!” by Emil_95 is licensed under CC BY 2.0Janina Markidan MS III, MD Student University of Maryland School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a study of 1,145 young men, we found a strong dose-response relationship between the number of cigarettes smoked daily and the risk of ischemic stroke. We categorized the participants as never smokers, former smokers and current smokers. Current smokers were divided into groups based on the number of cigarettes smoked daily, 1 to 10, 11 to 20, 21 to 39, or 40 or more. We found that men who smoked were 88 percent more likely to have a stroke than men who never smoked. Among current smokers, men who smoked fewer than 11 cigarettes daily were 46 percent more likely to have a stroke than those who never smoked. But the heavier smokers, smoking at least two packs a day, were nearly 5 times (466%) more likely to have a stroke than those who never smoked. 

MedicalResearch.com Interview with: Yanping Li PhD, Research Scientist Department of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that a  healthy lifestyle is associated with less chance of premature mortality; however, it is not clear how much it...

MedicalResearch.com Interview with: [caption id="attachment_41363" align="alignleft" width="135"]Morgana Mongraw-Chaffin, PhD MPH Wake Forest School of Medicine North Carolina Dr. Mongraw-Chaffin[/caption] Morgana Mongraw-Chaffin, PhD MPH Wake Forest School of Medicine North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? Response: While some large studies and meta-analyses of this topic suggest that metabolically healthy obesity (MHO) is not a benign condition, discrepancies persist in the results of individual studies. Lack of a clear explanation for these differences drives the continuing controversy over whether MHO is a useful tool for risk stratification or an intermediate condition on the pathway to cardiometabolic risk. In the Multi-Ethnic Study of Atherosclerosis (MESA), we found that 48% of those with metabolically healthy obesity transitioned to unhealthy obesity by the end of follow-up. Those who transitioned had higher odds of developing cardiovascular disease compared to those who maintained normal weight. We further found that earlier transition from MHO to unhealthy obesity was associated with higher odds.

MedicalResearch.com Interview with: [caption id="attachment_41358" align="alignleft" width="200"]Dr. Maria Sullivan MD PhD Senior Medical Director of Clinical Research and Development Alkermes Dr. Sullivan[/caption] Maria Sullivan, M.D., Ph.D Senior Medical Director of Clinical Research and Development Alkermes MedicalResearch.com: What is the background for this study? Response: Extended release injectable naltrexone is approved for the prevention of relapse to opioid dependence after detoxification and when used with counseling. It is recommended that patients abstain from opioids for a minimum of seven to 10 days prior to induction onto XR-naltrexone to avoid precipitating opioid withdrawal. This requirement of detoxification represents a substantial clinical challenge, particularly in the outpatient setting. There is currently no single recognized best method for opioid detoxification prior to first dose of extended-release naltrexone (XR-naltrexone). A number of induction regimens have been explored, including the use of low doses of oral naltrexone to shorten the transition period from dependence on opioids to XR-naltrexone treatment. The goal of the study was to help establish an outpatient regimen to transition subjects from physiological opioid dependence to XR-naltrexone treatment and mitigate the severity of opioid withdrawal symptoms. We hypothesized that low-dose oral naltrexone, combined with buprenorphine and psychoeducational counseling, would assist with the transition of patients with opioid use disorder onto XR-naltrexone. In this 3-arm trial, we examined the utility of oral naltrexone, buprenorphine, and a fixed regimen of ancillary medications (oral naltrexone + buprenorphine vs. oral naltrexone + placebo buprenorphine vs. placebo +placebo), to determine whether any of these regimens was associated with higher rates of induction onto XR-naltrexone.

MedicalResearch.com Interview with: [caption id="attachment_41321" align="alignleft" width="200"]A/Prof Bruce Campbell MBBS(Hons), BMedSc, PhD, FRACP Dr. Campbell[/caption] A/Prof Bruce Campbell MBBS(Hons), BMedSc, PhD, FRACP Consultant Neurologist, Head of Stroke Department of Neurology, Royal Melbourne Hospital Principal Research Fellow,Melbourne Brain Centre @ RMH Department of Medicine University of Melbourne Australia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with stroke due to a large blood vessel in the brain receive a clot-dissolving medication followed by clot retrieval surgery performed via an angiogram. The standard clot dissolving medication "alteplase" rarely opens the artery prior to clot retrieval surgery. Tenecteplase is genetically modified form of alteplase that may be more effective and is widely available (it is the standard clot dissolving medication used for heart attacks). It can be given over 10 seconds instead of the 1 hour required to infuse alteplase, meaning that patients can be transferred between hospitals to receive treatment more easily. Tenecteplase is also less expensive than alteplase. In EXTEND-IA TNK we found that tenecteplase doubles the number of patients who have blood flow restored to the brain earlier than is possible with clot retrieval surgery (22% vs 10%) and improves patient outcomes compared to the current standard medication called alteplase. 1 in 5 tenecteplase treated patients have blood flow rapidly restored and do not require clot retrieval surgery compared to 1 in 10 with alteplase.

MedicalResearch.com Interview with: Dr. med. Carsten Lennerz, M.Sc. Deutsches Herzzentrum München München  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Knowing that strong electric motors cause electromagnetic fields (EM) and  that CIED (Cardiac implanted electronic devices) may malfunction due to electromagnetic fields raises serious concerns when electric cars are considered. Moreover the use of electric cars for private and public transport is increasing and thus the question of safety is becoming more and more important. 108 CIED patients drove and charged 4 commercially available e-cars on a roller bench test (simulating road driving in a safe environment). There were no adverse events and no electromagnetic interference was detected during driving or charging of the cars.

MedicalResearch.com Interview with: [caption id="attachment_41288" align="alignleft" width="150"]Dr-W-Robert-Taylor Dr. Taylor[/caption] Robert Taylor, MD, PhD Marcus Chair in Vascular Medicine Executive Vice Chair, Medicine Director, Division of Cardiology Professor of Medicine and Biomedical Engineering Emory University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The early identification and localization of bacterial infections is a critical step for initiating effective treatment.   This is particularly challenging in the setting of infections associated with implanted medical devices.  We have developed a highly specific probe for bacteria that is based on the fact that bacteria have a specific system for taking up maltodextrins which are polysaccharides that mammalian cells cannot take up directly.  We can label this probe with either a fluorescent of radioactive tag that allows visualization of the bacteria. In the current article, we have used an animal model of implantable cardiac devices to demonstrate that our probe is very specific and sensitive for detecting bacterial infections.  It is worth noting that these are subclinical infections that could not be detected by any other means except for surgical removal.

MedicalResearch.com Interview with: [caption id="attachment_41344" align="alignleft" width="143"]Dr. Alex Krist Dr. Krist[/caption] Dr. Alex Krist, M.D., M.P.H. Dr. Krist is is a professor of family medicine and population health at Virginia Commonwealth University and active clinician and teacher at the Fairfax Family Practice residency. What is the background for these recommendation statements? What are the main findings? Response: Falls are the leading cause of injuries in adults age 65 and older and can lead to serious disability and even death. Bone fractures—which may result from a fall—can also cause serious disability and death in older adults. The U.S. Preventive Services Task Force looked into the most recent evidence on the best ways to prevent falls and fractures in older adults. We found that clinicians should recommend exercise or physical therapy to help prevent falls by older adults who live at home and are at higher risk for falling. Additionally, we concluded that taking a low dose of vitamin D and calcium does not help prevent fractures due to osteoporosis, but we don’t know if taking a higher dose is effective or not, so we are calling for more research.

MedicalResearch.com Interview with: Peter Grace PhD Professor in the Department of Critical Care Research University of Texas MD Anderson Cancer Center. He was a NHMRC Postdoctoral Fellow University of Colorado Boulder in the lab of Prof Linda Watkins MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Opioids are effective for managing pain after surgery. However, we previously showed that opioids like morphine can have unexpected long-term effect when used to treat nerve pain in rats: just 5 days of morphine treatment shortly after nerve injury doubled the duration of pain (Grace et al., 2016; PNAS). Our current study shows that something similar happens in post-operative pain. When we gave daily morphine for a week after exploratory abdominal surgery (laparotomy), the postoperative pain lasted more than twice as long compared to rats that didn’t receive morphine at all. We also showed that the prolonged pain was correlated with immune signaling in the spinal cord, similar to what we showed in our previous study (Grace et al., 2016; PNAS). Importantly, this suggests that the long-term pain caused by morphine could be blocked while retaining short-term analgesia by inhibiting immune activation. 

MedicalResearch.com Interview with: Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine  MedicalResearch.com: What is the background for this study Response: Most Americans know that the United States faces an epidemic of deaths due to drug overdose.  And many are also aware that there is a critical shortage of organs available for transplant.  Perhaps less widely known is that today, more than 1 in every 8 deceased organ donors died from a drug overdose.  The objective of our study was to look at the outcomes of patients who received transplants with organs donated after an overdose.

MedicalResearch.com Interview with : [caption id="attachment_41371" align="alignleft" width="200"]Dr. Hyacinth I Hyacinth MD Aflac Cancer and Blood Disorder Center, Emory Children’s Center, Department of Pediatrics, Emory University School of Medicine Atlanta, GA 30322 Dr. Hyacinth[/caption] Dr. Hyacinth I Hyacinth MD Aflac Cancer and Blood Disorder Center, Emory Children’s Center, Department of Pediatrics, Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? This study was conducted against the backdrop of a significantly higher risk for stroke among African Americans compared to non-Hispanic Whites, despite adjusting for traditional risk factors. Also, sickle cell disease is a well-known genetic risk factor for stroke and recent studies show that sickle cell trait is a risk factor for chronic kidney disease, venous thromboembolism and pulmonary embolism, all of which are potential risk factors for stroke.

MedicalResearch.com Interview with: [caption id="attachment_41220" align="alignleft" width="200"] Dr. Geronemus[/caption] Roy G. Geronemus, M.D Director of the Laser & Skin Surgery Center of New York® MedicalResearch.com: What is the background for this study? What are the main findings? Response: The incidence of tattoos in types V and VI skin is increasing and the number of patients...

MedicalResearch.com Interview with: [caption id="attachment_41306" align="alignleft" width="150"]Dr-Michael O'Rand Dr. O'Rand[/caption] Michael O'Rand, PhD Retired professor of cell biology and physiology in the University of North Carolina at Chapel Hill School of Medicine, and president/CEO of Eppin Pharma, Inc MedicalResearch.com: What is the background for this study? What are the main findings? Response: My lab at the UNC School of Medicine discovered the protein Eppin in 2004. It coats the sperm cell. Through our subsequent research, we learned it is essential for sperm protection in the female. We thought it could make an excellent target for a male contraceptive. Subsequently we developed a compound called EP055 that would bind to Eppin and as a result stop sperm from swimming. In our latest study published in PLOS One, we show that EP055 substantially limits sperm motility in non-human primates. And we showed the effect of EP055 is temporary, which would make it a good contraceptive.

MedicalResearch.com Interview with: “Children Playing at Swyalana Lagoon” by Doug Hay is licensed under CC BY 2.0Dr Anuja Pandey Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health London UK  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence from longitudinal studies suggests that self-regulation skills can be a powerful predictor of positive health, educational, financial and social outcomes. Hence, self-regulation has received interest as an intervention target and a number of interventions have been evaluated in children and adolescents. Our study summarised the evidence from 50 rigorously evaluated self-regulation interventions in children and adolescents including 23098 participants. We found that while most interventions were successful in improving self-regulation (66%), some of them did not produce a noticeable change (34%).Curriculum based approach was most commonly used to deliver interventions, and this involved training teachers, who implemented these interventions. 

MedicalResearch.com Interview with: [caption id="attachment_41185" align="alignleft" width="128"]Sean Lee Zheng BM BCh MA MRCP Cardiovascular Division King's College Hospital London British Heart Foundation Centre of Research Excellence London, UK Dr. Zheng[/caption] Sean Lee Zheng BM BCh MA MRCP Cardiovascular Division King's College Hospital London British Heart Foundation Centre of Research Excellence London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The growing prevalence of type 2 diabetes and its associated burden on cardiovascular disease is a global problem. A number of drug treatments effective in lowering blood glucose are now available, with the three latest drug classes developed being the DPP-4 inhibitors, GLP-1 agonists and SGLT-2 inhibitors. While the use of medications from these three classes are increasing, it remains unknown how they compare in lowering the risk of death or cardiovascular disease. This leads to clinical uncertainty when it comes to introducing new medicines for our patients. Our study aimed to use data from randomized clinical trials in a network meta-analysis, allowing these three drug classes to be compared with one another. Our study, which included 236 studies enrolling 176310 participants, showed that the use of SGLT-2 inhibitors or GLP-1 agonists were associated with a lower risk of death than with DPP-4 inhibitors. SGLT-2 inhibitors had additional beneficial effects on heart failure events compared with the other two drug classes.

MedicalResearch.com Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0José R. Banegas, M.D. Department of Preventive Medicine and Public Health Universidad Autónoma de Madrid Madrid, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-based studies and a few relatively small clinical investigations have defined the prognostic role of ambulatory blood pressure monitoring (ABPM) in hypertensive patients. However, previous studies were mostly limited by relatively small number of outcomes. Our study is the largest worldwide and provides unequivocal evidence that ABPM is superior to clinic pressure at predicting total and cardiovascular mortality across a wide range of clinical scenarios – the differences are striking. Also, whether white-coat hypertension is a benign phenotype is still debated. Our study demonstrates that white-coat hypertension was not benign. Lastly, masked hypertension patients (clinic BP normal but ABPM elevated) experienced the greatest risk of death.  

Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine MedicalResearch.com Interview with: Dr. Véronique J. C. Kraaijenga MD Department of Otorhinolaryngology–Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? Response: During the past two decades, the frequency of hearing loss among young people has increased and going to music concerts, clubs and festivals may part of the reason. Noise-induced hearing loss because of recreational noise exposure is reduced by using earplugs. Our study evaluated 51 adults who attended an outdoor music festival in Amsterdam, the Netherlands, in September 2015. The study measured music festival visit for 4.5 hours (intervention); temporary hearing loss (outcome).

MedicalResearch.com Interview with: [caption id="attachment_41271" align="alignleft" width="150"]Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892 Dr. Nora Volkow[/caption] Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Findings from animal studies had shown that sleep deprivation increased the content of beta-amyloid in brain, which is a risk factor for Alzheimer’s disease.  We wanted to test whether this also happened in the human brain after one night of sleep deprivation. We found that indeed one night of sleep deprivation led to an accumulation of beta amyloid in the human brain, which suggest that one of the reasons why we sleep is to help clean our brain of degradation products that if not removed are toxic to brain cells. 

MedicalResearch.com Interview with: “Diabetes Mellitus” by Steve Davis is licensed under CC BY 2.0Matthew James O'Brien MD Assistant Professor, Medicine General Medicine Division Assistant Professor, Preventive Medicine Northwestern University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The USPSTF is an expert group that makes recommendations for screening and other preventive services. In December 2015, they recommend that providers screen for diabetes in patients who are 40-70 years old and also overweight/obese. The same recommendation stated that clinicians “should consider screening earlier” in patients who have any of the following risk factors: non-white race/ethnicity, family history of diabetes, or personal history of gestational diabetes or polycystic ovarian syndrome. Using nationally representative data, we studied the performance of the “limited” criteria based on age and weight alone vs. the “expanded criteria” mentioned above. The main findings were that following the “limited” screening criteria of age and weight would result in missing over 50% of adults with prediabetes and diabetes. In other words, if providers followed the “limited” criteria, over 50% of adults with prediabetes and diabetes would not get screened. The “expanded” criteria exhibited much better performance, resulting in 76.8% of adults with prediabetes and diabetes who would be screened. 

MedicalResearch.com Interview with: [caption id="attachment_34201" align="alignleft" width="200"]Laura Korb Ferris, MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, Department of Dermatology University of Pittsburgh Medical Center Dr. Laura K. Ferris[/caption] Laura K. Ferris MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, UPMC Department of Dermatology University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dermatology is one of the greatest utilizers of physician extenders, including physician assistants (PAs) in medicine. The scope of practice of PAs has also expanded over time from a role in assisting the dermatologist to taking a more independent role and many PAs now do skin cancer screening examinations and make independent decisions about which lesions are suspicious for skin cancer and need to be biopsied. Our main findings were that, overall, in comparison to board-certified dermatologists, PAs were more likely to perform biopsies of benign lesions. For every melanoma that they found, PAs biopsied 39 benign lesions whereas dermatologists biopsied 25. In addition, PAs were less likely than dermatologists to diagnose melanoma in situ, the earliest and most curable, but also hardest to identify and diagnose, form of melanoma. However, PAs had a similar rate of diagnosing the more clinically-obvious forms of skin cancer, including invasive melanoma, basal cell carcinoma, and squamous cell carcinoma.

MedicalResearch.com Interview with: [caption id="attachment_41214" align="alignleft" width="143"]Dr Pan Pantziarka Dr Pan Pantziarka[/caption] Dr Pan Pantziarka, PhD Program Director, Drug Repurposing: Anticancer Fund Coordinator: Repurposing Drugs in Oncology (www.redo-project.org)  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Repurposing Drugs in Oncology (ReDO) project is an on-going collaboration assessing the evidence of anticancer activity in a wide range of already licensed non-cancer drugs. A subset of these drugs have a sufficient level of evidence to support clinical investigation and these are profiled in detail in order to synthesise the existing evidence and to bring it to the attention of clinical researchers. In the case of the PDE5 inhibitors sildenafil, tadalafil and vardenafil the evidence is clear that these drugs have multiple anticancer mechanisms of action at clinically relevant dosing. In particular there is evidence that these drugs target anti-tumour immune responses, as shown from a small number of early stage clinical trials. This opens up the prospect of using these cheap and widely available drugs in combination with existing therapies to improve the number and duration of responses. The chance to increase the therapeutic effectiveness of immune checkpoint inhibitors is especially compelling and definitely warrants clinical research.

MedicalResearch.com Interview with: [caption id="attachment_41267" align="alignleft" width="200"]Ed Liu, M.D President and CEO The Jackson Laboratory (JAX) Dr. Ed Liu[/caption] Ed Liu, M.D President and CEO The Jackson Laboratory (JAX) MedicalResearch.com: What is the background for this study? What are the main findings? Response: A few years ago we and others identified a complex genomic instability profile commonly found in the genomes of breast, ovarian and endometrial carcinomas, which is characterized by hundreds of isolated head-to-tail duplications of DNA segments, called tandem duplications. We refer to this configuration as the tandem duplicator phenotype, or TDP. In this study, we perform a meta-analysis of over 2,700 cancer genomes from over 30 different tumor types and provide a detailed description of six different types of TDP, distinguished by the presence of tandem duplications of different sizes. Collectively, these profiles are found in ~50% of breast, ovarian and endometrial carcinomas as well as 10-30% of adrenocortical, esophageal, stomach and lung adeno-carcinomas. We show that distinct genetic abnormalities associate with the distinct TDPs, clearly suggesting that distinct molecular mechanisms are driving TDP formation. In particular, we provide strong evidence of a casual relationship between joint abrogation of the BRCA1 and TP53 tumor suppressor genes and the emergence of a short-span (~11 Kb) TDP profile. We also observe a significant association between hyper-activation of the CCNE1 pathway and TDP with medium-span (~230 Kb) tandem duplications, and between mutation of the CDK12 gene and medium- and large-span TDP (coexisting 230 Kb and 1.7 Kb tandem duplications). Importantly, we find that different forms of TDP result in the perturbation of alternative sets of cancer genes, with short-span TDP profiles leading to the loss of tumor suppressor genes via double transections, and larger-span TDP profiles resulting in the duplication (i.e. copy number gain) of oncogenes and gene regulatory elements, such as super-enhancers and disease-associated SNPs. 

MedicalResearch.com Interview with: [caption id="attachment_41246" align="alignleft" width="200"]Benjamin D. Horne, PhD Director of Cardiovascular and Genetic Epidemiology Intermountain Heart Institute Intermountain Medical Center Salt Lake City, Utah  Dr. Horne[/caption] Benjamin D. Horne, PhD Director of Cardiovascular and Genetic Epidemiology Intermountain Heart Institute Intermountain Medical Center Salt Lake City, Utah  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that short-term elevations (even for just a few days) of fine particulate matter air pollution (PM2.5, which is particulate matter less than 2.5 um or about one-thirtieth the diameter of a human hair) is associated with various poor health outcomes among adults, including myocardial infarction, heart failure exacerbation, and worsening of chronic obstructive pulmonary disease symptoms. Studies of long-term exposure to moderately elevated levels of PM2.5 indicate that chronic daily air pollution exposure may contribute to death due to pneumonia and influenza. Research regarding the association of short-term elevations in PM2.5 has provided some limited evidence of a possible association between short-term PM2.5 increases and infection with respiratory syncytial virus (RSV) or bronchiolitis in children, but scientifically these reports have been weak and unreliable, probably because they have only looked at a period of a few days to a week after short-term PM2.5 elevations. An evaluation of a very large population in a geographic location that provides a wide variation in PM2.5 levels from lowest to highest levels and that examines longer periods of time after the PM2.5 elevations is needed to determine whether a PM2.5 association with lower respiratory infection exists.