Author Interviews, Social Issues / 22.12.2017

MedicalResearch.com Interview with: “Lidl Shopping Trolley” by Jeff Djevdet is licensed under CC BY 2.0Alexander P. Henkel, PhD Business Intelligence and Smart Services (BISS) Institute / Open University, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: As consumers, we are frequently bombarded with a myriad of marketing tactics. One tactic regularly employed by thrift-oriented brands is to highlight low prices, discounts, and sales promotions. When consumers encounter these low-price signals, they may adopt a price conscious mentality, that is, a singular focus on getting the cheapest deal. A price conscious mentality is likely beneficial for consumers, as it helps them save money. However, it is also possible that it has negative implications, particularly for how consumers perceive and interact with other human beings in the marketplace, such as customer service employees. We investigated this question in a collaboration project between the Business Intelligence and Smart Services (BISS) Institute (founded by the Open University and Maastricht University, both Netherlands) and the University of British Columbia in Canada. (more…)
Author Interviews, Social Issues / 22.12.2017

MedicalResearch.com Interview with: “Marriage” by sowrirajan s is licensed under CC BY 2.0Dr Akanksha Marphatia and co-authors, Dr Alice Reid and Dr Gabriel Amable Cambridge, UK MedicalResearch.com: What is the background for this study? Response: Although the total prevalence of girls marrying below the UN prescribed minimum age of 18 years has decreased over time, this is mostly due to a decrease in child marriages, <15 years. Marriages during adolescence, between 16-17 years, have increased. Women marring just after 18 years may also experience some of the consequences of those marrying under-age. These patterns are important to recognise because the predictors and consequences of marriage in these age groups are likely to differ. The aim of our review was to summarise research evidence on why women’s marriage age, independent of early child-bearing, is a major public health issue. In the four South Asian countries of our review, Bangladesh, India, Nepal and Pakistan, marriage precedes reproduction. (more…)
Author Interviews, Infections, Pfizer, Vaccine Studies / 22.12.2017

MedicalResearch.com Interview with: Judith Absalon, M.D., M.P.H Senior Director, Vaccines Clinical Research Pfizer Pharmaceuticals MedicalResearch.com: What is the background for these two studies? Response: Invasive serogroup B meningococcal disease (MenB) is uncommon, yet serious, is unpredictable and can strike at any age, including healthy teenagers and young adults, with potentially long-lasting and devastating consequences, including death. The data from these two Phase 3 studies, one in adolescents (Study 1009) and one young adults (Study 1016), highlight that Trumenba can help protect teens and young adults against meningococcal group B disease. Additionally, these two large Phase 3 studies confirmed the results of earlier studies and supported the transition from Accelerated to Traditional Approval in the US; were pivotal for approvals in Europe, Australia, and Canada earlier this year; and add to the growing portfolio of research for TRUMENBA. (more…)
Author Interviews, Education, Social Issues / 22.12.2017

MedicalResearch.com Interview with: “working class” by arileu is licensed under CC BY 2.0Igor Grossmann, Ph.D. Director, Wisdom and Culture Laboratory Associate Professor of Psychology University of Waterloo, Canada Associate Editor, Emotion MedicalResearch.com: What is the background for this study? Response: Our Wisdom & Culture laboratory studies the concepts of wisdom and cultural factors. For wisdom, we specifically focus on pragmatic reasoning that can help people to better understand and navigate uncertain contexts – strategies that philosophers for millennia discussed as “epistemic virtues.” In our prior work, my colleagues and I have observed that wisdom tends to be lower in situations when self-interests are salient, and higher when one adopted an socially-sensitive interdependent mindset. In other work by myself and several other labs, consistent finding emerged showing that lower social class tends to be more socially interdependent, whereas middle class (both in the US, Russia, and even China) tends to be more self-focused. This led to the present research, which combines prior insights to examine how wise reasoning varies across social classes. Because lower class situation involves more uncertainty and more resource-scare life circumstances, we questioned whether these situations would also evoke more wise reasoning from people who are in them. Higher class situations are assumed to provide conditions that benefit people in every way. But in so doing, they may also encourage entitlement, self-focus and thereby intellectual humility and open-mindedness – key features of a wise thought. As such, our studies show that it turns out that middle class conditions are not beneficial in at least one way – they may discourage reasoning wisely. (more…)
Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease, JAMA / 21.12.2017

MedicalResearch.com Interview with: Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure. (more…)
Author Interviews, Cancer Research, Hematology / 21.12.2017

MedicalResearch.com Interview with: janseen-oncologyMaria-Victoria Mateos, MD, PhD University Hospital of Salamanca/IBSAL Salamanca, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Phase 3 ALCYONE study data showed DARZALEX (daratumumab) in combination with bortezomib, melphalan, and prednisone (VMP) significantly improved clinical outcomes, including reducing the risk of disease progression or death by 50 percent, in newly diagnosed patients with multiple myeloma who are ineligible for autologous stem cell transplantation (ASCT) at a median follow-up of 16.5 months (Hazard Ratio [HR] = 0.50; 95 percent CI [0.38-0.65], p<0.0001). The median progression-free survival (PFS) for DARZALEX-VMP had not yet been reached, compared to an estimated median PFS of 18.1 months for patients who received VMP alone. In addition to reducing the risk of disease progression or death, DARZALEX significantly improved the overall response rate (ORR) as compared to VMP alone, including more than doubling rates of stringent complete response, significantly improved rates of very good partial response or better and complete response or better (CR). The most common (≥10 percent) Grade 3/4 treatment-emergent adverse events (TEAEs) for DARZALEX-VMP vs. VMP were neutropenia (40 percent vs. 39 percent), thrombocytopenia (34 percent vs. 38 percent), anemia (16 percent vs. 20 percent) and pneumonia (11 percent vs. 4 percent). One patient in each arm discontinued treatment due to pneumonia, and 0.9 percent of patients discontinued DARZALEX due to an infection. Twenty-eight percent of patients experienced infusion reactions (IRs) due to DARZALEX.. In the DARZALEX-VMP arm, 42 percent of patients experienced a serious adverse event (SAE), compared to 33 percent in the VMP arm. The study findings were as a late-breaking abstract (Abstract #LBA-4) at the 59th American Society of Hematology (ASH) Annual Meeting in Atlanta, and simultaneously published in the New England Journal of Medicine (NEJM). (more…)
Accidents & Violence, Author Interviews, Emergency Care, ENT, JAMA / 21.12.2017

“Qtip” by Rafael Castillo is licensed under CC BY 2.0MedicalResearch.com Interview with: Eric T. Carniol, MD, MBA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tympanic membrane perforations (aka "popped" or "burst" ear drum) is a common complaint of patients presenting to the emergency room, primary care offices, and otolaryngologist (ENT doctors) offices. These may be caused by trauma, infections, or other causes. As well, many patients will use qtips (cotton-tipped applicators) to clean ears and remove ear wax and are unaware of the potential harms of doing so. This study was designed to examine the cause of ear drum perforations as diagnosed in emergency departments in the United States. Foreign body instrumentation of the ear (qtips, hair combs, hair pins, needles, etc) were the cause of 61.2% of perforations. Cotton tip applicators are the single leading cause of traumatic tympanic membrane perforation in all age groups except young adults (13-18) and 19-36 year olds, in which it is the second largest cause (behind water trauma). Children less than 18 years old constitute nearly 2/3 of all ear drum perforations in the emergency department. (more…)
Author Interviews, OBGYNE, Pediatrics, Pediatrics / 21.12.2017

MedicalResearch.com Interview with: “Premature baby” by Elin B is licensed under CC BY 2.0Suvi Alenius, MD National Institute for Health and Welfare Helsinki and Oulu, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents of very or extremely low birth weight infants are less likely to have subsequent children after preterm birth. We assessed whether this phenomenon extends over the whole range of prematurity. We now show that parents of preterm-born infants (gestational age less than 37 completed weeks of gestation) have fewer subsequent children than do parents of term born infants. This is not limited to the extreme group of parents of children born very preterm, but is even seen within the large groups of parents of infants born less preterm. (more…)
Annals Internal Medicine, Author Interviews, Cognitive Issues, Lifestyle & Health / 20.12.2017

MedicalResearch.com Interview with: “Exercise” by Diabetes Education Events is licensed under CC BY 2.0Michelle Brasure, MSPH, PhD, MLIS Evidence-based Practice Center School of Public Health University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We conducted a large systematic review to assess the evidence relating to interventions to prevent cognitive decline and dementia. We included experimental studies with follow up times of at least six months. This paper analyzes the physical activity interventions; other papers in this issue address other types of interventions. (more…)
Allergan, Author Interviews, Bipolar Disorder, Brigham & Women's - Harvard / 20.12.2017

MedicalResearch.com Interview with: allerganGary Sachs, MD Associate Clinical Professor of Psychiatry Harvard Medical School  MedicalResearch.com: What is the background for this data milestone? Response: Bipolar disorder affects about 5.7 million adults in the United States.  It is a common, often disabling condition in which abnormal mood states impair a person’s ability to carry out everyday tasks. Bipolar disorder touches nearly every family and community in America, because periods of illness, a patient’s symptoms often impact their family, their friends, and their community. There are a limited number of products approved to treat bipolar depression and even fewer products that have been studied and approved to treat the full spectrum of bipolar disorder, from mania through depression. Having another product proven to treat the full range of bipolar disorder would be a welcome addition to the treatment options currently available to the psychiatry community and patients. (more…)
Alzheimer's - Dementia, Author Interviews, Mineral Metabolism / 19.12.2017

MedicalResearch.com Interview with: Val Andrew Fajardo, PhD. NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health Brock University | Department of Health Sciences St. Catharines, ON, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lithium is best known for its role as a mood stabilizer, and several ecological studies across a number of different regions have shown that trace levels of lithium in tap water can exert its mood stabilizing effect and reduce rates of suicide, crime, and homicide. The results from our study show that these trace levels of lithium could also potentially protect against Alzheimer’s disease.  These findings are actually supported by several years of research using pre-clinical and clinical models to demonstrate low-dose lithium’s neuroprotective effect against Alzheimer’s disease. In addition, we also found that trace lithium in tap water may potentially protect against obesity and diabetes – an effect that is also supported with previous literature.  In fact, some of the earlier reports of lithium’s effect of increasing insulin sensitivity and improving glucose metabolism were first published in the 1920s.  Finally, we found that trace lithium’s effect on Alzheimer’s disease may be partly mediated by its effect on obesity and diabetes. My collaborator Dr. Rebecca MacPherson who is an expert on Alzheimer’s disease as a metabolic disorder explains that this effect is in support of recent research demonstrating that obesity and diabetes are important risk factors in the development of Alzheimer’s disease.  So interventions aiming to reduce obesity and diabetes such as physical activity can go a long way in lowering risk for Alzheimer’s disease, which is also something we present in our study. (more…)
Author Interviews, Heart Disease / 19.12.2017

MedicalResearch.com Interview with: David A. Bluemke, MD PhD, MsB Professor, Radiology Editor in Chief (2018), Radiology University of Wisconsin-Madison, School of Medicine and Public Health Madison WI 53792  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart failure is expected to markedly increase in the United States, because of the aging population (https://www.ncbi.nlm.nih.gov/pubmed/23616602. For patients with congestive heart failure, NT-proBNP is an excellent marker of disease severity. The presence of elevated levels of NT-proBNP also predicts future cardiac events. For individuals who do not have clinically diagnosed heart failure, the significance of small elevations in NT-proBNP is not known. We hypothesized that these small elevations were related to subclinical elevations in myocardial wall stress. However, in patients with advanced heart disease, we do know that greater myocardial wall stress is associated with histological evidence of fibrosis --- i.e., replacement of myocardial muscle by greater fibrotic tissue. New techniques using MRI can find evidence of expansion of the space between myocytes (the extracellular volume). The most common cause of this expansion is diffuse myocardial fibrosis/ collagen deposition. Using MRI to detect myocardial fibrosis is an advance because MRI is non-invasive (we would not otherwise perform myocardial biopsy for patients without clinically evident disease). Thus we can use MRI to probe the actual composition of myocardial tissue. Using MRI, we found evidence that individuals in the community (in the MESA study) who had small elevations of NT-proBNP also have evidence of myocardial fibrosis.   The mean NT-proBNP levels in the MESA study (1,334 study subjects) was 65 pg/ml. That level is considered to be normal; levels of NT-proBNP of 1200 pg/ ml or greater are found in patients with congestive heart failure. Of note, the relationship between elevations of NT-proBNP and myocardial fibrosis were independent of multiple risk factors such as age, gender, smoking status, blood pressure, cholesterol levels and diabetes. That is, if the NT-proBNP level was slightly higher (for example, due to increased wall stress), then MRI found an association with greater myocardial fibrosis. (more…)
Author Interviews, JAMA, Psychological Science / 18.12.2017

MedicalResearch.com Interview with: Thomas Foltynie MD PhD Senior Lecturer and Honorary Consultant Neurologist Unit of Functional Neurosurgery Institute of Neurology and National Hospital for Neurology and Neurosurgery University College London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Stimulation of the Nucleus Basalis of Meynert can enhance cholinergic innervation of the cortex in animal models and has been previously reported to have beneficial cognitive effects in a single patient with Parkinson’s Disease dementia. In this double blind crossover trial, six patients with Parkinson’s Disease underwent low frequency stimulation to the NBM bilaterally.  While there were no consistent objective improvements in cognitive performance, there was a marked reduction in visual hallucinations in two of the participants. . (more…)
Author Interviews, Geriatrics, Nutrition, Vitamin C, Vitamin D / 18.12.2017

MedicalResearch.com Interview with: “vitamins” by Colin Mutchler is licensed under CC BY 2.0Priv.-Doz. Dr. Barbara Thorand  Helmholtz Zentrum München German Research Center for Environmental Health Institute of Epidemiology II Neuherberg, Germany  MedicalResearch.com: What is the background for this study? Response: Micronutrients, which include vitamins, minerals (e.g. calcium) and trace elements (e.g. iron), are essential nutrients that are required in minute amounts by the organism for proper growth and good health. Results from the last German National Nutrition Survey (NVS II)* uncovered a high prevalence of insufficient dietary intake of micronutrients in older adults aged 65 years and over in Germany. By means of blood analyses, our study has confirmed these critical results. This is a highly relevant issue, particularly in light of our growing aging population and the high societal relevance of successful healthy aging. *Max Rubner-Institut: Nationale Verzehrsstudie II, Ergebnisbericht Teil 2 (2008). Die Bundesweite Befragung zur Ernährung von Jugendlichen und Erwachsenen. (more…)
Author Interviews, Memory, UCLA / 18.12.2017

MedicalResearch.com Interview with: “Cute babies” by daily sunny is licensed under CC BY 2.0Benjamin M. Seitz Doctoral Student Department of Psychology, Learning & Behavior University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings?   Response: The adaptive memory literature is based on two crucial theories. The first is that we process information on different ‘levels’ and these different levels of processing information strongly influence our ability to later remember that information. The second is that our evolutionary history has shaped our cognitive abilities and that these abilities therefore perform optimally when performing tasks related to evolutionary fitness. It has been established that processing words based on their relevancy to an imagined ancestral survival scenario yields incredible memory performance far superior than processing those same words based on their relevancy to similar imagined scenarios that do not involve the survival element or ancestral environment. Our study demonstrates that thinking about raising offspring in an ancestral environment while processing words leads to a similar benefit to recall of those words as when thinking about survival, suggesting the human memory system while also useful in helping our species survive may have also been particularly useful in helping us raise our offspring. (more…)
Author Interviews, Genetic Research, Pharmaceutical Companies / 17.12.2017

MedicalResearch.com Interview with: Alexander S Hauser, PhD student MRC Laboratory of Molecular Biology Cambridge UK Department of Drug Design and Pharmacology, University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence and impact of genetic variation among all human G protein coupled receptors (GPCRs) that are targeted by FDA-approved drugs remain unknown. In this study, we present a comprehensive analysis and map of the pharmacogenomics landscape of GPCR drug targets. The key highlights are: - GPCRs targeted by drugs show extensive genetic variation in the human population - Variation occurs in functional sites and may result in altered drug response - Understanding GPCR genetic variation may help reduce global healthcare expenses (more…)
Addiction, Author Interviews, Cannabis, NIH, Pediatrics, Smoking / 17.12.2017

MedicalResearch.com Interview with: “Checking your phone and vaping as you do” by Alper Çu?un is licensed under CC BY 2.0Richard Allen Miech, PhD Research Professor, Survey Research Center Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Monitoring the Future conducts annual, nationally-representative surveys of ~45,000 adolescents every year to assess trends in substance use. We track which drugs are gaining traction among adolescents and which are falling out of favor. The survey draws separate, nationally-representative samples of 8th, 10th, and 12th grade students from about 400 total schools every year. Once a recruited school agrees to participate, a field interviewer travels to the school to administer the paper-and-pencil survey, typically in classrooms. The project is funded by the National Institute of Drug Abuse and is carried out by the University of Michigan. More details on the project's survey design and survey procedures can be found in chapter 3 here: http://monitoringthefutu re.org/pubs/monographs/mtf- vol1_2016.pdf (more…)
Author Interviews, Cannabis / 16.12.2017

MedicalResearch.com Interview with: Greta Hsu PhD Graduate School of Business Stanford University, Graduate School of Business MedicalResearch.com: What is the background for this study? What are the main findings? Response: My co-authors, Ozgecan Kocak at Emory University and Balazs Kovacs at Yale University, and I became interested in the cannabis industry in early 2014, when Colorado and Washington states were in the early stages of licensing recreational cannabis operations. As organizational researchers, we were interested in how the emergence of the new legalized recreational-use dispensary stores would impact existing medical cannabis dispensaries that had already been in existence for years in both states. For decades, activists and many dispensaries had framed cannabis as medicine that relieves pain for patients suffering from a wide variety of illnesses. People who use marijuana for medical purposes do not always live near a dispensary, so accessing this product may be quite difficult for some than it would be for others. In and around where you live, you may be able to look into a local dispensary who would be able to administer the products you would need. For example, living in Florida, you'd look into something like florida dispensary to help you find your nearest dispensary. As long as you find a place that works for you, then that's all that matters. As recreational-use legalization took hold, would medical dispensaries emphasize their identities as medical providers or downplay their medical orientation to compete directly for potential customers? (more…)
Author Interviews, Cancer Research, JAMA, Johns Hopkins / 16.12.2017

MedicalResearch.com Interview with: Gonzalo Torga, MD Urology Department Johns Hopkins Hospital Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liquid biopsy is a new and noninvasive alternative to tumor tissue sequencing, and it is intended to specifically detect and sequence tumor DNA circulating in patients’ blood. The results are used to help guide oncologists to tailor the best treatment for patients at each point of their disease. Our research was initially aimed at finding the best commercial lab to test samples from metastatic prostate cancer patients. We wanted to make the best choice for our patients, so we started submitting the samples to both places at the same time to compare results. However, we found significant disparities in the results from identical patient samples submitted to two different commercial liquid biopsy providers, and we believed it would be important to share them with the oncology community. The two liquid biopsy panels compared were the Guardant360, from Guardant Health, Inc., which sequenced at least part of the coding sequences of 73 genes; and the PlasmaSELECT panel from Personal Genome Diagnostics, which sequenced coding segments of 64 genes.  Both laboratories were licensed by Clinical Laboratory Improvement Amendments (CLIA) and accredited by the College of American Pathologists (CAP), and report having high sensitivity (in this case, the ability to correctly identify mutations when they occur) and high specificity (the ability to correctly report as negative when those mutations are not present). The two companies differ in which genes, and regions within each gene, are covered. Just 25 of the 40 patients in the study had at least one genetic mutation reported within the overlapping genetic sequences covered by both companies. Even when the companies were analyzing DNA from the same blood drawn, their results rarely matched each other. When comparing results within the overlapping genetic sequences, the results from both companies completely matched for all the mutations reported in only 7.5 percent (3 of 40 patients) of cases. In 15 percent of the patients (6 of 40), both companies’ results matched for at least one of the reported mutations. In 40 percent (16 of 40) of the patients, no mutations reported that were potentially covered by both panels were detected by both companies. (more…)
Author Interviews, Dermatology, Environmental Risks, Infections, Occupational Health / 16.12.2017

MedicalResearch.com Interview with: Lindsey Milich Rutgers School of Public Health studiesLindsey Milich Rutgers School of Public Health studies   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Much of the spotlight has been focused on hair and nail technicians, with the focus now shifting towards the health and safety of hair and nail salon clients. We wanted to assess perceived safety and health risks and prevalence of respiratory and dermal symptoms among hair and nail salon clients in New Jersey. Main findings include dermal/fungal symptoms being more prevalent among clients who visited salons three or more times within the past year, compared with those with fewer reported visits. Respiratory symptom prevalence was higher among clients with fewer salon visits, indicating a “healthy client effect”; clients with these symptoms may be less likely to return. (more…)
Author Interviews, Hematology / 16.12.2017

MedicalResearch.com Interview with: Dr. Charles T. Nakar, MD Indiana Hemophilia and Thrombosis Center Pediatrics Indianapolis, IN   MedicalResearch.com: What is the background for this study? Response: Congenital plasminogen deficiency is a rare genetic disorder that is caused by mutations in the PLG gene. Mutations in this gene lead to clinical manifestations such as fibrinous deposits on mucous membranes leading to disruption of tissue or organ function. These symptoms, when untreated, lead to significant morbidity and decreased quality of life. Life-threatening episodes may occur especially when the respiratory system is affected. There is currently no established approach to treatment of type 1 plasminogen deficiency and the available topical and systemic therapies (e.g. FFP, corticosteroids, immunomodulatory drugs, anticoagulants, amongst others) lack consistent efficacy. Patients may undergo multiple surgeries to remove lesions, but this approach typically leads to regrowth of lesions. Prometic’s intravenous plasminogen replacement therapy represents the first direct treatment for this serious disorder. (more…)
Author Interviews, Cancer Research, Hematology, NEJM / 15.12.2017

MedicalResearch.com Interview with: Dr. Meletios A. Dimopoulos MD Professor and Chairman Department of Clinical Therapeutics University Athens School of Medicine Athens, Greece MedicalResearch.com: What is the background for this study? What are the main findings? Response: Updated data from the Phase 3 POLLUX trials showed DARZALEX, in combination with lenalidomide and dexamethasone, reduced the risk of disease progression or death by 56 percent, compared to lenalidomide and dexamethasone alone (Hazard Ratio [HR]=0.44; 95 percent CI [0.34-0.55], p<0.0001). After a median follow-up of 32.9 months, the median progression-free survival (PFS) in the DARZALEX arm has not been reached, compared with a median PFS of 17.5 months for patients who received lenalidomide and dexamethasone alone. DARZALEX in combination with lenalidomide and dexamethasone also significantly increased the overall response rate (ORR) compared to lenalidomide and dexamethasone alone (93 percent vs. 76 percent, p<0.0001), including rates of complete response (CR) or better (55 percent vs. 23 percent, p<0.0001). DARZALEX also showed significantly higher (>3-fold) MRD-negative rates compared to lenalidomide and dexamethasone alone. These data were featured as an oral presentation (Abstract #739) at the 59th American Society of Hematology (ASH) Annual Meeting in early December. (more…)
Author Interviews, Primary Care, Pulmonary Disease / 15.12.2017

MedicalResearch.com Interview with: Dr Jennifer K Quint MSc PhD FHEA FRCP Clinical Senior Lecturer Respiratory Epidemiology Respiratory Epidemiology, Occupational Medicine and Public Health National Heart and Lung Institute Imperial College London  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were commissioned by the Chartered Society of Physiotherapy in the UK to undertake a piece of work to show the value of pulmonary rehabilitation in reducing exacerbations in COPD patients so that they could create a web based tool that would show cost savings if GPs actually referred people for pulmonary rehabilitation. Previous systematic reviews have found that pulmonary rehab can reduce hospital admissions but those groups are often small and not very generalizable so we decided to look at what happens in a primary care COPD population. Our main finding is that people who are eligible for referral are not being referred  - less than 10% eligible were actually referred. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, JAMA / 15.12.2017

MedicalResearch.com Interview with: Annette S. Kim, MD, PhD Associate Professor, Harvard Medical School Brigham & Women's Hospital Boston MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The recent debate on laboratory developed tests (LDTs) and FDA-approved companion diagnostics (FDA-CDs) has centered upon both the regulatory and performance aspects of LDTs and we, at the College of American Pathologists (CAP), had the data through our proficiency testing (PT) programs to address the latter point, performance that we wanted to share with the community.  We analyzed almost 7000 PT responses on three molecular oncology tests, those for BRAF, EGFR, and KRAS mutations, and found that both LDTs and FDA-CDs demonstrated excellent performance, with both test types exceeding 97% accuracy overall. The second key finding of the study was that more than 60% of all laboratories in our study that were using an FDA-CD kit report using it with modifications from the FDA-approved protocol.  These modifications in fact render these test LDTs.  These modifications appear to be driven by the exigencies of real day-to-day clinical practice that requires adapting the assays to meet the needs of a variety of clinical situations that may not be accommodated by the FDA-approved protocol.  These modifications include, for example, the testing of other tumor types that may carry targetable variants, different types of input specimen preparations available in pathology such as cytology smears or other fresh specimens rather than paraffin blocks, and availability of different methods of DNA quantification that those mandated by the FDA approval based upon pre-existing technologies in the laboratories.  In the clinical laboratory, we are always acutely aware that there is a patient awaiting this result. Therefore, we validate our assays to ensure that we can provide reliable and accurate results from our laboratory under as many varied clinical situations as possible. These data support that practice. (more…)
Author Interviews, Microbiome, OBGYNE, Pediatrics / 15.12.2017

MedicalResearch.com Interview with: Anita Kozyrskyj, PhD, Professor Dept Pediatrics Faculty of Medicine & Dentistry, University of Alberta Edmonton, AB    MedicalResearch.com: What is the background for this study? What are the main findings? Response: The first year of an infant’s life is a critical time for the development of his or her gut microbiome. Gut microbes not only help infants digest food, but they also “train” their developing immune system. An infant’s environment, from the type of birth and infant diet to use of antibiotics, has a large impact in determining which microbes are present. Frequently these early life exposures occur together. Using data from AllerGen’s CHILD birth cohort and a new analytical approach —called Significance Analysis of Microarrays—we quantified changes to gut microbiota throughout the first year of life according to common combinations of early life exposures. We found that, compared to vaginally-born and breastfed infants, formula-fed or cesarean-delivered infants had different trajectories of microbial colonization in later infancy, which could have implications for their future health. (more…)
Asthma, Author Interviews, Microbiome, Pediatrics / 15.12.2017

MedicalResearch.com Interview with: Anita Kozyrskyj, PhD, Professor, Dept Pediatrics Faculty of Medicine & Dentistry, University of Alberta Edmonton, AB   MedicalResearch.com: What is the background for this study? What are the main findings? Response: I was motivated to study the maternal asthma-infant microbiome link by the well-established fact that maternal asthma affects infant birth weight in a sex-specific manner. Based on data from AllerGen’s CHILD birth cohort, Caucasian baby boys born to pregnant moms with asthma—putting them at the highest risk for developing asthma in early childhood—were one-third as likely to have high levels of the microbe, Lactobacillus, in their gut microbiome at 3-4 months after birth. (more…)
Author Interviews, BMJ, Lipids, Nutrition, Pediatrics, Weight Research / 15.12.2017

MedicalResearch.com Interview with: Dr. Angela S Donin Population Health Research Institute, St George’s University of London, London, UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are increasing numbers of takeaway outlets, particularly in deprived neighbourhoods. This is driving an increase in consumption of takeaway meals, which previous evidence has shown is linked to higher risks of heart disease, type 2 diabetes and obesity. Little is known about the dietary and health impact of high consumption of takeaway foods in children. This research found children who regularly ate takeaway meals had higher body fat and cholesterol compared to children who rarely ate take away meals, they also had overall poorer diet quality. (more…)
Author Interviews, Genetic Research, Melanoma / 14.12.2017

MedicalResearch.com Interview with: Hildur Helgadottir, M.D., Ph.D. Department of Oncology Karolinska University Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Malignant melanoma of the skin is one of the fastest increasing cancer types in the West. The main risk factors for melanoma are UV light exposure and hereditary factors. It is therefore relatively common for the afflicted to have family members with the disease. Inherited mutations of the tumour suppressor gene CDKN2A are the strongest known risk factors for familial melanoma and mutations in this gene also increase the risk of other cancers. Children, siblings or parents of mutation carriers have a 50-50 chance of also having the mutation, which can be identified with a gene test. The present study included Swedish and American families with inherited CDKN2A mutations. The researchers studied whether family members who have not inherited the mutation have any higher than normal risk of developing melanoma or other cancers. Melanoma, but no other cancers, was more common in the non-carriers in these families compared to the normal population. The phenomenon whereby non-carriers of a specific mutation copy the phenotype (in this case melanoma) from their mutation-carrying relatives is known as phenocopy. Phenocopy can be caused by other risk-modifying genes or exposure patterns that increase the probability of the specific phenotype manifesting itself. Previous studies have shown that people with the mutation who also have certain pigmentation variants run an even higher risk of melanoma. Even though the CDKN2A mutation should be present in all populations, it has almost exclusively been identified in families with a Caucasian heritage.This suggests that dark-skinned people with this mutation probably don’t develop melanoma as often and are therefore not tested for this specific mutation, presumably because they lack the risk-modifying pigmentation variants that increase the risk of melanoma. The researchers believe that such pigmentation variants also contribute to a higher melanoma risk in the family members who do not carry the mutation. (more…)
Author Interviews, Infections, Ophthalmology, Surgical Research / 14.12.2017

MedicalResearch.com Interview with: Penny Asbell, MD Icahn School of Medicine Mt. Sinai, New York City. MedicalResearch.com: What is the background for this study? ─     Bacterial endophthalmitis is a serious, although infrequent, complication of ocular surgery, typically caused by perioperative introduction of bacterial flora from the patient’s own conjunctiva and skin. ─     Prophylactic measures such as perioperative antibiotic treatment may minimize the risk for endophthalmitis, but can be complicated by antibiotic resistant bacteria. ─     The ongoing Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study is the only nationwide antibiotic resistance surveillance program specific to ocular pathogens. ─     The purpose of this presentation is to report on the antibiotic susceptibility profiles of bacterial isolates from the vitreous and aqueous humor collected in the ARMOR study expanding upon earlier findings. (more…)
Author Interviews, Stem Cells, Technology / 14.12.2017

MedicalResearch.com Interview with: http://www.insilico.com/Andreyan Osipov PhD Insilico Medicine and Dmitry Klokov PhD Canadian Nuclear Laboratories, Chalk River, Ontario, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cells and tissues can be damaged when exposed to ionizing radiation. In case of radiotherapy, it is a desirable effect in tumor cells. In case of occupational, medical and accidental exposures, typically to low-dose radiation, this may pose health risk to normal cells and tissues. In both cases, short-term assays that quantify damage to DNA and help evaluate long-term outcome are key to treatment/risk management. One such short-term assay is based on quantification of a modified histone protein called gH2AX in exposed cells up to 24 hrs after exposure. This protein marks sites in DNA that have both strands of the DNA helix broken or damaged. This assay is also widely used for various applications, including determination of individual radiosensitivity, tumor response to radiotherapy and biological dosimetry. With the advent of regenerative medicine that is based on stem cell transplantation, the medical and research communities realized that there is a need to understand how stem cells respond to low-dose diagnostic radiation exposures, such as CT scans. Stem cell therapies may have to be combined with diagnostic imaging in recipient patients. The gH2AX assay comes in very handy here, or at least it seemed this way. We exposed mesenchymal stem cells isolated from human patients to low or intermediate doses of X-rays (80 and 1000 mGy) and followed formation of gH2AX in their nuclei. First we found that residual gH2AX signal in cells exposed to a low dose was higher than in control non-irradiated cells. If the conventional assumptions about this assay that it is a surrogate for long-term detrimental effects was followed it would mean that the low-dose exposed cells were at a high risk of losing their functional properties. So we continued growing these cells for several weeks and assayed gH2AX levels, ability to proliferate and the level of cellular aging. Surprisingly, we found that low-dose irradiated cells did not differ from non-irradiated cells in any of the measured functional end-points. This was in contrast to 1000 mGy irradiated cells that did much worse at those long-term end points. (more…)