Author Interviews, Gastrointestinal Disease, Nutrition, Pediatrics, Probiotics / 05.01.2018

MedicalResearch.com Interview with: Dr Valerie Sung MBBS (Hons) FRACP MPH PhD Department of Paediatrics The University of Melbourne Murdoch Childrens Research Institute Parkville, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infant colic is excessive crying in babies less than 3 months old with no underlying medical cause. It affects 1 in 5 newborns, is very distressing, and is associated with maternal depression, Shaken Baby Syndrome, and early cessation of breastfeeding. Up to now, there has been no single effective treatment for colic. The probiotic Lactobacillus reuteri DSM 17938 has recently shown promise but results from trials have been conflicting. In particular, a previous trial from Australia, the largest in the world so far, did not find the probiotic to be effective in both breastfed and formula-fed infants with colic. This international collaborative study, which collected raw data from 345 infants from existing trials from Italy, Poland, Canada and Australia, confirms Lactobacillus reuteri to be effective in breastfed infants with colic. However, it cannot be recommended for formula-fed infants with colic. Compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed. The number needed to treat for day 21 success in breastfed infants was 2.6. In contrast, the formula fed infants in the probiotic group seemed to do worse than the placebo group, but the numbers for this group were limited. (more…)
Author Interviews, Cost of Health Care, JAMA / 05.01.2018

MedicalResearch.com Interview with: “Doctors” by Tele Jane is licensed under CC BY 2.0Kathryn R. Tringale, MAS Department of Radiation Medicine and Applied Sciences University of California San Diego, La Jolla MedicalResearch.com: What is the background for this study? What are the main findings? Response: Financial relationships between biomedical industry and physicians are common, and previous work has investigated the potential conflicts of interest that can arise from these interactions. Data show that even small payments in the form of industry sponsored lunches can influence physician prescribing patterns. Given the concern for the potential influence of biomedical industry over practice patterns and potentially patient care, the Open Payments program was implemented under the Affordable Care Act to shed light on these interactions and make reports of these financial transactions publicly available. We recently published a paper in JAMA on industry payments to physicians that found that men received a higher value and greater number of payments than women physicians and were more likely to receive royalty or licensing payments when grouped by type of specialty (surgeons, primary care, specialists, interventionalists). The purpose of the Research Letter discussed here was to further examine differences in the value of payments received by male and female physicians within each individual specialty. The main takeaway from this study is that male physicians, across almost every specialty, are receive more money from biomedical industry compared to female physicians. At first glance, this finding can be interpreted as merely another example of gender disparities in the workplace, which we have seen before with gender gaps in physician salaries and research funding. Indeed, this gender gap may be a product of industry bias leading to unequal opportunity for women to engage in these profitable relationships. Alternatively, these data may be more representative of gender differences in physician decision-making. Previous data has shown that industry engagement can lead to changes in practice patterns, so maybe female physicians acknowledge these conflicts of interest and actively choose not to engage with industry. Unfortunately, we cannot tease out these subtleties from our results, but our paper does reveal a remarkable gender difference among physician engagement with industry. With this being said, whether male or female, everyone needs a bit of help sometimes. The use of loans is a possibility for many people who need a little financial assistance. Regardless of whether men are getting paid a little more than women, they may all need help just as equally. The type of loans that would be worth looking into if this is your current situation is physician loans, which basically allows medical professionals to purchase a home with a low/little down payment while avoiding mortgage insurance. A little bit of help goes a long way, especially when it involves your future. (more…)
Author Interviews, Brigham & Women's - Harvard, Hepatitis - Liver Disease, Transplantation / 05.01.2018

MedicalResearch.com Interview with: Jagpreet Chhatwal, PhD Assistant Professor, Harvard Medical School MGH Institute for Technology Assessment Boston, MA and Sumeyye Samur PhD Postdoctoral Fellow MGH-Harvard Medical School MedicalResearch.com: What is the background for this study? Response: The number of patients who are in need of liver transplant continues to rise whereas the availability of organs remains limited, therefore, it becomes is important to utilize all available livers. Under the current practices, only Hep-C infected patients are eligible to receive infected livers. However, with the advent of high efficacy drugs, number of infected recipients has decreased over the last decade. On the other hand, with the rise of opioid use, number of Hep-C infected organs increased. With this contradiction, it becomes paramount of importance to utilize the infected livers which could help save more lives on the transplant waiting list. (more…)
Author Interviews, Pain Research, Surgical Research / 05.01.2018

MedicalResearch.com Interview with: “Migraine” by makelessnoise is licensed under CC BY 2.0Lisa Gfrerer, MD PhD Clinical Fellow in Surgery Brigham and Women's Hospital William Gerald Austen MD Chief, Plastic and Reconstructive Surgery Chief, Division of Burn Surgery Massachusetts General Hospital  MedicalResearch.com: What are the main findings? Response: Migraine surgery patients at our institution are chronic pain patients who have failed conservative therapy and are severely disabled by their disease. We initiated this study to understand two important points. First, it was previously unclear how to categorize these patients in terms of pain intensity and disability on the spectrum of better known pain conditions such as chronic back pain/ nerve pain/ carpal tunnel.  This is very important to appreciate the extent of this disease. Second, instead of collecting migraine characteristic such as decrease in migraine days/ duration/ pain, we wanted to understand how functionally disabled these patients are in their daily lives and how much better they get after surgery. This is ultimately what matters to patients. We therefore decided to evaluate our outcomes by using the Pain Self Efficacy Questionnaires (PSEQ). This validated pain questionnaire has been used to describe pain intensity/disability in patients with different acute and chronic pain conditions. (more…)
Allergan, Author Interviews, JAMA, Ophthalmology / 05.01.2018

MedicalResearch.com Interview with: Steven Woloshin, MD MS Professor of The Dartmouth Institute Professor of Medicine Professor of Community and Family Medicine The Center for Medicine in the Media Dartmouth Institute for Health Policy and Clinical Practice Lebanon, New Hampshire MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lot of debate about the legal maneuvers (ie, transferring patents to the Mohawk Indians) Allergan has employed to delay marketing of generic alternatives to Restasis (cyclosporine ophthalmic emulsion 0.05%).   But there is a more fundamental question that has received little attention:  Does Restasis work?  It is not approved in the European Union, Australia or New Zealand where registration applications were "withdrawn prior to approval due to insufficient evidence of efficacy" in 2001.   Although Canada approved Restasis, its national health technology assessment unit, unconvinced of meaningful benefit, recommended Canada not pay for it - according to our research, no Canadian provincial or federal drug plan currently does.   Nevertheless, Americans have spent $8.8 billion in total sales between 2009 and 2015 on Restasis, including over $2.9 billion in public monies through Medicare Part D. (more…)
Author Interviews, Autism / 04.01.2018

MedicalResearch.com Interview with: Tamara Rosen Graduate student in Clinical Psychology Stony Brook University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 40 percent of youth with autism spectrum disorder (ASD) are diagnosed with a co-occurring anxiety disorder.  Social anxiety is a common presenting problem for these youth. Youth with ASD and increased social anxiety have heightened threat sensitivity, particularly in relation to performance fears, as measured by a brain signal response called the error-related negativity (ERN), which measures response to errors. The threat sensitivity-performance fears association remained even after controlling for anxiety symptoms other than social fearfulness. (more…)
Author Interviews, Social Issues / 04.01.2018

MedicalResearch.com Interview with: “Grandparents” by Tim Wilson is licensed under CC BY 2.0Allison Flamion, Doctorante Unité de Psychologie de la Sénescence Département Psychologies et cliniques des systèmes humains Université de Liège LIEGE Belgique MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ageism—stereotypes that lead to prejudice and discrimination against older people— occurs frequently in young adults and can even be seen in children as young as 3. Ageism has deleterious consequences on older people in our aging Western societies. However, the factors influencing this phenomenon in the young are not well known. To answer this question, we have asked 1151 Belgian children and adolescents to provide their views of the elderly, using especially designed questionnaires and open questions. We found four main influences on their views of the elderly: gender and age of the child, quality of contact with grandparents, and grandparents’ health. Girls had slightly more positive views than boys. Ageist stereotypes fluctuated with age, with 7- to 9-year-olds expressing the most prejudice and 10- to 12-year-olds expressing the least. This finding mirrors other forms of discrimination (e.g., those related to ethnicity or gender) and is in line with cognitive-developmental theories. For example, acquiring perspective-taking skills around age 10 reduces previous stereotypes. With regard to ageism, prejudice seemed to reappear when the participants in this study reached their teen years: 13- to 16-year-olds had higher levels of ageism compared with younger children. Moreover, youths who described their contact with grandparents as good or very good had more favorable feelings toward the elderly than those who described the contact less positively. Finally, children and adolescents with grandparents in poor health were more likely to hold ageist views than youths with grandparents in better health. (more…)
Author Interviews, JAMA, Multiple Sclerosis, Radiology / 04.01.2018

MedicalResearch.com Interview with: Netta Levin MD PhD fMRI lab Neurology Department Hadassah Hebrew University Medical Center Jerusalem  MedicalResearch.com: What is the background for this study? Response: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system, manifesting with episodes of local inflammatory processes, called relapses. The most useful surrogate laboratory test for MS is magnetic resonance imaging (MRI), in which dissemination of demyelinating lesions in space and time are the hallmark of the disease. However, there is a discrepancy between the lesion load - the number, size, and location of the lesions - and the clinical state of the patients, reflected in their disability. This discrepancy is known as the “clinico-radiological paradox” and suggests that something other than the well-known mechanisms of demyelination, remyelination, and axonal loss may tip the scale of recovery from an acute episode. Global effects of the local damage and compensatory mechanisms were suggested as an explanation to this paradox. In this study, we compared the visual system of patients with clinically isolated syndrome optic neuritis (ON) to patients with clinically isolated episodes in other functional systems, exploring changes, both anatomical and functional, caused to the system following the demyelinating episode. Optic neuritis was deemed a good in vivo model for studying the pathophysiology of tissue damage and repair in MS due to its characteristic clinical manifestation and to the visual pathways’ amenability to investigation using various techniques. To assess anatomical wiring ,i.e the white matter fibers themselves , we used diffusion tensor imaging (DTI). To assess functional networking as reflected by signal synchronization between distinct brain regions, we used resting state fMRI. (more…)
Author Interviews, Heart Disease, JACC, Pediatrics, Surgical Research, UCSD / 04.01.2018

MedicalResearch.com Interview with: Rakesh K. Singh MD, MS Department of Pediatrics, University of California–San Diego and Rady Children’s Hospital San Diego, California Steven E. Lipshultz MD Department of Pediatrics Wayne State University School of Medicine and Children’s Hospital of Michigan Detroit, Michigan  MedicalResearch.com: What is the background for this study? Response: Dilated cardiomyopathy (DCM) is a disease characterized by dilation and dysfunction of the left ventricle of the heart. While DCM is a relatively rare disease in children, nearly 40% of children with DCM require a heart transplant or die within 2 years of diagnosis. Heart transplantation has improved the outcomes of children with DCM over the last 3 decades, but is limited by donor heart availability. Newer therapies, including advanced ICU care and artificial heart machines, are now being used to treat children with DCM. This study published in the November 28, 2017 issue of the Journal of American College of Cardiology (JACC) sought to determine whether more children with DCM were surviving longer in the more recent era. Specifically, it investigated whether children with DCM were surviving longer without the need for heart transplantation. Rakesh Singh, MD is the first author and an Associate Professor of Pediatrics at UC San Diego/Rady Children’s Hospital, while the senior author is Steven Lipshultz, MD, Professor at Wayne State University School of Medicine/Detroit Medical Center’s Children’s Hospital of Michigan and Director of Children’s Research Center of Michigan. The Pediatric Cardiomyopathy Registry (PCMR) is a National Heart, Lung, and Blood Institute (NHLBI) sponsored registry from 98 pediatric centers in United States and Canada created to study the outcomes of children with various heart muscle disorders known as cardiomyopathies. For this study, outcomes of 1,199 children diagnosed with DCM from 1990-1999 were compared with 754 children diagnosed with DCM from 2000-2009. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Outcomes & Safety / 04.01.2018

MedicalResearch.com Interview with: Dr. Igna Bonfrer PhD Post-Doctoral Research Fellow Harvard T.H. Chan School of Public Health   MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the two main elements of the Affordable Care Act, generally known as Obama Care, is the implementation of value based payments through so called “pay-for-performance” initiatives. The aim of pay-for-performance (P4P) is to reward health care providers for high-quality care and to penalize them for low-quality care. We studied the effects of the P4P program in US hospitals and found that the impact of the program as currently implemented has been limited. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 04.01.2018

MedicalResearch.com Interview with: Edward L. Hannan, PhD, MS, MS, FACC Distinguished Professor and Associate Dean Emeritus University at Albany School of Public Health Rensselaer, NY 12144     MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have done a lot of work on complete revascularization (CR) vs. incomplete revascularization (IR) already, and as a follow-up it seemed as if there may be different types of IR that are associated with even worse outcomes relative to CR and other IR. Incomplete revascularization is associated with worse outcomes if it involves multiple vessels, vessels with severe stenosis, or significant proximal left anterior descending artery vessel (PLAD) stenosis. (more…)
Author Interviews, Duke, NEJM, Rheumatology, Stem Cells, Transplantation / 04.01.2018

MedicalResearch.com Interview with: Keith M. Sullivan, M.D. James B. Wyngaarden Professor Of Medicine Division of Cellular Therapy Duke University Medical Center Durham, North Carolina 27710, USA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • Scleroderma with internal organ involvement is a devastating  autoimmune disorder with considerable morbidity and high mortality which have not changed in 40 years of reporting. Effective new therapies are needed.
  • Despite 2 prior randomized trials showing benefit for reduced-intensity stem cell transplant vs. conventional cyclophosphamide immune suppression, clinical practice in the US did not change due in part due to concern about patient safety and durability of response (attached).
  • The current randomized trial compares 12 monthly infusions of cyclophosphamide with high-dose chemotherapy plus whole-body irradiation designed to wipe-out (myeloablate) the defective, self-reactive immune system and replace with the patients own stem cells which had been treated to remove self-reacting lymphocytes. This was the first study to test if myeloablative autologous could re-establish a normal functioning immune system in patients with scleroderma.
(more…)
Author Interviews, OBGYNE, Sleep Disorders, UCSF / 03.01.2018

MedicalResearch.com Interview with: “Now I’m having contractions.” by Remus Pereni is licensed under CC BY 2.0Kathryn A. Lee, RN, CBSM, PhD Department of Family Health Care Nursing University of California at San Francisco San Francisco, California  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sleep deprivation can adversely affect health and wellbeing in any patient population. In pregnancy, adverse outcomes may include preterm birth, longer labor, cesarean birth, and depression. We found that women with high-risk pregnancies were sleep deprived even prior to hospitalization. Our sample averaged 29 weeks gestation, and half reported getting only between 5 and 6.5 hours of sleep at home before hospital admission. Our sleep hygiene intervention strategies gave them more control over the environment in their hospital room, and they self-reported significantly better sleep than controls. Interestingly, both groups increased their sleep time to almost 7 hours at night, on average, in the hospital before they were discharged home. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 03.01.2018

MedicalResearch.com Interview with: “Breastfeeding welcome here” by Newtown grafitti is licensed under CC BY 2.0Clare Relton, PhD School of Health and Related Research University of Sheffield, Sheffield, England MedicalResearch.com: What are the key findings of your report? Response: Our five year research project explored whether offering financial incentives (shopping vouchers) for breastfeeding increased breastfeeding. We studied what happened to breastfeeding rates at 6 to 8 weeks post-partum in areas in England with low (<40%) breastfeeding prevalence. Our cluster randomized clinical trial (which included 10 010 mother-infant dyads) showed that areas with the financial incentive had significantly higher rates of breastfeeding at 6 to 8 weeks (37.9% vs 31.7%) compared to usual care. The financial incentive scheme was widely acceptable to healthcare providers (midwives, health visitors, doctors) and mothers. The financial incentives made it easier for everyone to discuss breastfeeding and mothers reported feeling valued (supported and rewarded) for breastfeeding. (more…)
Author Interviews, Mayo Clinic, OBGYNE, Surgical Research / 03.01.2018

MedicalResearch.com Interview with: Dr. Shannon Laughlin-Tommaso MD Associate Professor of Obstetrics and Gynecology Consultant, Division of Gynecology, Department of Obstetrics & Gynecology Mayo Clinic, Rochester New York  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy. We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, Weight Research / 02.01.2018

MedicalResearch.com Interview with: Michael P. Bancks, PhD Northwestern University Chicago, Illinois  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the disparity in diabetes between black and white youth and young adults is growing, but the reasons why are unclear. We also know that traditional risk factors for diabetes, such as obesity and low socioeconomic status, are more common among blacks as compared with whites. Our study describes how the unequal rates of these traditional diabetes risk factors explain or account for the higher rates of diabetes among blacks. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Pediatrics / 02.01.2018

MedicalResearch.com Interview with: “Baby Bottle” by brokinhrt2 is licensed under CC BY 2.0Mikael Knip, MD, PhD Professor of Pediatrics TRIGR PI  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Experimental studies have indicated that the avoidance of early exposure to cow's milk proteins reduces the cumulative incidence of autoimmune diabetes in animal models of human type 1 diabetes, e.g. BB rats and NOD mice. Epidemiological studies in humans have suggested that there may be a link between type 1 diabetes and short breastfeeding or early introduction of infant formulas. All regular infant formulas contain intact cow's milk proteins. The main finding was that weaning to an extensively hydrolyzed formula did not reduce the cumulative incidence of Type 1 diabetes in at-risk children by the mean age of 11 years. The extensively hydrolyzed formula did not contain any intact cow's milk proteins but only small peptides (maximal size 2000 daltons). (more…)
Author Interviews, Education, NYU, Pediatrics, Pediatrics / 02.01.2018

MedicalResearch.com Interview with: Adriana Weisleder, PhD Research scientist, Department of Pediatrics NYU Langone Medical Center New York  MedicalResearch.com: What is the background for this study? What are the main findings? Response: An estimated 250 million children in low- and middle-income countries do not reach their developmental potential due to poverty. Many programs in the US, such as Reach Out and Read and Video Interaction Project, have shown success in reducing poverty-related disparities in early child development by promoting parent-child interactions in cognitively stimulating activities such as shared bookreading. This randomized study sought to determine whether a program focused on supporting parent-child shared bookreading would result in enhanced child development among 2- to 4-year-old children in a low-resource region in northern Brazil. Families in the program could borrow children’s books on a weekly basis and could participate in monthly parent workshops focused on reading aloud. Findings showed that participating families exhibited higher quantity and quality of shared reading interactions than families in a control group, and children showed higher vocabularies, working memory, and IQ. (more…)
ASCO, Author Interviews, Cancer Research, Journal Clinical Oncology, Kidney Disease, UT Southwestern / 01.01.2018

MedicalResearch.com Interview with: Kevin D. Courtney, M.D., Ph.D.  Assistant Professor UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clear cell renal cell carcinoma (ccRCC) is the most common form of kidney cancer. Metastatic ccRCC does not respond to traditional chemotherapy. Current standard treatments for metastatic ccRCC include drugs called vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) that block the growth of new blood vessels that feed the cancer, as well as drugs that inhibit an enzyme called mTOR that is involved in ccRCC growth and immune therapies that rev up the body’s immune response to try to fight the cancer. Each of these treatments can have significant side effects for patients that can make them difficult to tolerate. Metastatic ccRCC is largely incurable, and we need novel and better-tolerated treatments. A central driver of ccRCC is a protein called hypoxia inducible factor 2alpha (HIF-2alpha). This protein has been very difficult to try to target with a drug. This study is the first to test a drug that targets HIF-2alpha in patients with metastatic ccRCC. The study results showed that the HIF-2alpha inhibitor, PT2385 (Peloton Therapeutics) was active in fighting metastatic ccRCC and was well-tolerated. (more…)
Author Interviews, Bipolar Disorder, Depression, JAMA / 01.01.2018

MedicalResearch.com Interview with: Andre Russowsky Brunoni, MD, PhD Coordinator, Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences  Department and Institute of Psychiatry Coordinator, Interdisciplinary Center for Applied Neuromodulation, University Hospital University of São Paulo São Paulo, Brasil  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study, our aim was to evaluate the safety and efficacy of transcranial direct current stimulation (tDCS) as an add-on treatment for patients with bipolar depression. There are a only few treatment alternatives for bipolar depression, which often have important side effects. Thus, we wanted to evaluate the efficacy of this non-pharmacological treatment. We found that active vs. sham tDCS effected greater response and remission for patients with bipolar depression. The frequency of adverse effects was similar, including treatment-emergent affective switches. However, higher rates of skin redness were observed in the active group. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, End of Life Care, JAMA / 01.01.2018

MedicalResearch.com Interview with: Dr. Laura A. Petrillo MD Instructor in Medicine Harvard Medical School, and Palliative Care Physician Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hospice is end-of-life care focused on maximizing quality of life. Hospice often involves reducing or stopping treatments that are unlikely to have short-term benefit in order to avoid uncomfortable side effects. About a quarter of Americans die in nursing homes, and some of them receive hospice care in their final days. We looked at whether adults with type 2 diabetes experience low blood sugar while on hospice in veterans’ nursing homes, since low blood sugar signals inappropriately aggressive diabetes treatment in patients close to death and contributes to unnecessary discomfort. We found that one in nine people experienced low blood sugar at least once while receiving hospice care. Among people who were on insulin, the number was one in three. (more…)
Allergies, Author Interviews / 29.12.2017

MedicalResearch.com Interview with: Sandra Andorf PhD Kim and Ping Li Director of Computational Biology Sean N. Parker Center for Allergy and Asthma Research at Stanford University Instructor, Nadeau Lab Department of Medicine, Division of Pulmonary & Critical Care Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Food allergies are on the rise in the world. Approximately 15 million Americans have food allergies, which includes around 6 million children. Of people with food allergies, 30-40% are allergic to more than one food and therefore these people have a greater risk for an accidental ingestion resulting in an allergic reaction or anaphylaxis. Currently there is no FDA approved treatment for food allergies but oral immunotherapy, a treatment in which the patient eats small but slowly increasing doses of their allergen until they can tolerate a specified dose, was shown in research settings to be safe in children and adults for up to 5 foods in parallel. In this trial, we studied the efficacy and safety of Omalizmuab (an anti-IgE drug) treatment with oral immunotherapy in multifood allergic participants versus placebo with oral immunotherapy for a total of 9 months. We found that 83% of the participants who received Omalizumab could tolerate at least 2 g of at least two different food allergens at the end of the trial compared to 33% of those who received placebo. The participants that received Omalizumab were also desensitized faster, meaning they were on average able to eat 2 g of each of their allergic foods earlier in the treatment. Furthermore, we could show that the use of Omalizumab and the fast updosing is safe. (more…)
Author Interviews, Cost of Health Care, OBGYNE / 29.12.2017

MedicalResearch.com Interview with: Laura R. Wherry, Ph.D. Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA Los Angeles, CA 90024  MedicalResearch.com: What is the background for this study? Response: All states provide Medicaid coverage to pregnant women, but many low-income women do not qualify for the program when they are not pregnant. However, state decisions to expand Medicaid coverage to low-income parents and adults allow low-income women to have Medicaid coverage prior to, and between, their pregnancies. Increased health insurance coverage for low-income women during these non-pregnancy periods may help improve their preconception health and their planning of pregnancies, ultimately leading to healthier pregnancies and infants. This study examines how state expansions in Medicaid coverage for low-income parents before the Affordable Care Act affected the health insurance status of mothers prior to additional pregnancies (i.e. their pre-pregnancy health insurance status). I also examine whether there are changes in pregnancy intention (i.e. whether the pregnancy was mistimed or unwanted), as better access to pre-pregnancy insurance coverage could increase contraception utilization and improve the planning of pregnancies. Finally, I examine whether there were changes in insurance coverage during pregnancy and in the utilization of prenatal care, since women who have pre-pregnancy insurance coverage may experience fewer barriers to establishing care during their pregnancies. (more…)
Author Interviews, Parkinson's / 28.12.2017

MedicalResearch.com Interview with: Dr. Frances M. Weaver PhD Hines VA Hospital Center of Innovation for Complex Chronic Healthcare Hines, IL 60141 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Research has shown that deep brain stimulation (DBS) for Parkinson’s disease (PD) improves motor function and this improvement is sustained. There is also improvement in quality of life after DBS. However, it is not known whether DBS also effects survival. A few studies that have examined survival have had mixed results. In the current study we compared survival for a large cohort of persons with Parkinson’s disease who underwent DBS to a match group of persons with PD who were managed medically. We found a modest improvement in survival for persons with Parkinson’s disease who underwent DBS compared to individuals who did not. (more…)
Author Interviews, Cocaine / 27.12.2017

“cocaine photo” by Imagens Evangélicas is licensed under CC BY 2.0MedicalResearch.com Interview with: Mary Kay Lobo, PhD Associate Professor University of Maryland School of Medicine Department of Anatomy and Neurobiology Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered energy balance has been studied in drug abuse but the fundamental source of energy, mitochondria, has not been well examined.  In this study we found that a molecular regulator of mitochondrial fission (division) is increased in the nucleus accumbens, a major brain reward region, of rodents exposed to repeated cocaine and postmortem samples of cocaine dependent individuals.  We further found that mitochondrial fission is increased in a nucleus accumbens neuron subtype in rodents that self-administer cocaine. Pharmacological blockade of mitochondrial fission can prevent physiological responses to cocaine in this neuron subtype while reducing cocaine-mediated behaviors.  Finally, genetic reduction of mitochondrial fission in this neuron subtype in the nucleus accumbens can reduce drug (cocaine) seeking in rodents previously exposed to cocaine. In contrast, increasing mitochondrial fission, in this neuron subtype, enhances cocaine seeking behavior. (more…)
Aging, Author Interviews, Blood Pressure - Hypertension, Nature, UT Southwestern / 27.12.2017

MedicalResearch.com Interview with: Hamid Mirzaei, Ph.D. Assistant Professor of Biochemistry University of Texas Southwestern Department of Biochemistry Dallas, TX 75390 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aging is a complex process at the cellular level with distinct organismal phenotypes. Despite millennia-old obsession with aging and relentless pursuits for ways to stop and reverse it, such elixir has not been found due to the complexity of the involved mechanisms and our limited understanding of the processes that lead to aging. Although progress has been made in recent years in slowing down the aging process in model organisms and human cells. In this study, we report that and FDA approved antihypertensive drug, hydralazine, decelerates aging in C. elegans by mechanisms that seem to resemble dietary restriction. We show that hydralazine increases the median lifespan of the C. elegans by 25% which is comparable to or better than other known antiaging compounds. We demonstrate that not only hydralazine-treated worms live longer, they appear to be healthier in general. Because aging is directly linked to neurodegenerative diseases, we tested our drug on both in vitro and in vivo models of neurodegenerative diseases using chemical and biological stressors (rotenone and tau fibrils) and show that hydralazine has neuroprotective properties as well. (more…)
Author Interviews, Autism, JAMA, Nutrition, OBGYNE / 27.12.2017

MedicalResearch.com Interview with: Dr. Marte Bjørk, MD PhD Department of Clinical Medicine University of Bergen, Department of Neurology Haukeland University Hospital Bergen, Norway MedicalResearch.com: What is the background for this study? Response: In utero antiepileptic drug exposure are associated with neurodevelopmental problems in the child. We looked into if maternal folate during pregnancy could reduce the risk of autistic traits in children of women in need of antiepileptic drugs in pregnancy. The rationale for the hypothesis that folate could be beneficial, was that many antiepileptic drugs interact with folate metabolism. Folic acid supplement use is also associated with slightly reduced risk of autism in children of women from the general population. (more…)
Author Interviews, Cost of Health Care, Pediatrics / 27.12.2017

MedicalResearch.com Interview with: “Babies at Brunch!” by TJ DeGroat is licensed under CC BY 2.0Kandice A. Kapinos, Ph.D. Economist Professor RAND Corporation Pardee RAND Graduate School MedicalResearch.com: What is the background for this study? Response: In the U.S., we have relatively high rates of breastfeeding initiation – about 80% of mothers will attempt breastfeeding, but rates drop off precipitously in the first few months of an infant’s life. There are tremendous health benefits for both the mother and child from breastfeeding and estimates of significant cost savings from diseases prevented from breastfeeding. However, breastfeeding can be difficult, especially when you need to return to work or school. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, but only 22% of mothers breastfeed exclusively for 6 months. My coauthors, Tami Gurley-Calvez and Lindsey Bullinger, and I were interested in evaluating provisions in recent healthcare legislation (the Affordable Care Act) that required private insurers to cover lactation support services, including breast pumps and visits with lactation consultants, without cost-sharing. (more…)
Author Interviews, Chemotherapy, JAMA, Ovarian Cancer / 26.12.2017

MedicalResearch.com Interview with: Debra Richardson, MD, FACOG, FACS Associate Professor, Section of Gynecologic Oncology, Oklahoma TSET Phase I Program Stephensen Cancer Center The University of Oklahoma MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ovarian cancer is the leading cause of gynecologic cancer deaths. Pazopanib is an oral multitarget tyrosine kinase inhibitor of VEGF receptors 1, 2, and 3; platelet-derived growth factor (PDGF) receptors α and β and c-KIT. Weekly paclitaxel is an active agent for recurrent ovarian cancer. This was a national, randomized, double-blind, placebo controlled phase 2b trial of weekly paclitaxel with or without pazopanib for the treatment of recurrent ovarian cancer. The primary objective was to estimate the progression-free survival (PFS) hazard ratio (HR) of the combination of weekly paclitaxel (80mg/m2 D1, 8, 15 every 28 days) and pazopanib (800mg PO daily) compared with weekly paclitaxel and placebo in women with persistent or recurrent ovarian cancer. 106 women were enrolled. There was no difference in median PFS, overall survival (OS), or proportion responding. Severe hypertension was more common on the pazopanib plus paclitaxel arm. More patients discontinued treatment on the paclitaxel arm for disease progression, and more on the pazopanib plus paclitaxel arm for adverse events. Patients with VEGFA CC genotype may be more resistant to weekly paclitaxel than those with the AC or AA genotype. (more…)
Author Interviews, JAMA, OBGYNE / 26.12.2017

MedicalResearch.com Interview with: Gabriele Saccone, MD Department of Neuroscience Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples, Italy MedicalResearch.com: What is the background for this study? Response: Preterm birth is a major cause of perinatal morbidity and mortality. About 15 million infants were born too soon every year, causing 1.1 million deaths. The cervical pessary is a silicone device that has been studied to prevent preterm birth. However, the efficacy of this device in preventing preterm birth is still subject of debate. (more…)