Author Interviews, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Prof. Olivier Baud MD Chef de Service, Réanimation et Pédiatrie Néonatales Team leader, INSERM U1141 Université Paris-Diderot, Sorbonne Paris Cité Département Hospitalo-Universitaire "PROTECT" Hôpital Robert Debré, Paris, France MedicalResearch.com: What is the background for this study? Response: Preterm birth is frequently associated with perinatal inflammation, a major risk factor for bronchopulmonary dysplasia (BPD). Because glucocorticoids alleviate systemic inflammation, they have been proposed as a therapeutic option in very preterm infants. Early dexamethasone therapy led to short-term benefits but was associated with cerebral palsy and other adverse neurodevelopmental events. Early treatment with low-dose hydrocortisone has been reported to improve short-term outcomes in extremely preterm infants. However, its safety remains to be assessed with regard to the long-term neurodevelopmental outcomes. (more…)
Author Interviews, Education, Electronic Records, JAMA, Johns Hopkins / 06.04.2017

MedicalResearch.com Interview with: Ge Bai, PhD, CPA Assistant Professor The Johns Hopkins Carey Business School Washington, DC 20036 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We examined the hospital data breaches between 2009 and 2016 and found that larger hospitals and hospitals that have a major teaching mission have a higher risk of data breaches. (more…)
Author Interviews, Brain Injury, Neurological Disorders, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Emily Dennis PhD Postdoctoral Scholar Imaging Genetics Center Mark and Mary Stevens Neuroimaging and Informatics Institute USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that there is heterogeneity in outcome post-traumatic brain injury (TBI), but we generally think of this as a continuous variable - with most patients falling in the middle and only a few at the extremes in terms of recovery process and outcome. Our main finding was that interhemispheric transfer time (IHTT - the time it takes for information to move from one hemisphere of the brain to the other) identified 2 subgroups of TBI patients - those with slow IHTT and those with normal IHTT. These two groups show differences in cognitive function and brain structure, with the IHTT slow group showing structural disruptions that become progressively worse while the IHTT normal group seems to be recovering from the injury. (more…)
Author Interviews, Cost of Health Care, JAMA, Surgical Research, Thyroid / 05.04.2017

MedicalResearch.com Interview with: Benjamin James, MD MS Assistant Professor of Surgery Adjunct Assistant Professor of Otolaryngology Section of Endocrine Surgery IU Division of General Surgery Indiana University Hospital Indianapolis, IN 46202 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the few decades, there has been a substantial increase in the incidence of thyroid cancer. It is the fastest growing cancer and a recent study in JAMA found that the mortality rate has been rising. In 2006, Massachusetts passed healthcare reform, which expanded Medicaid, created new subsidized insurance programs for those ineligible for Medicaid and extended young adults eligibility on parental plans until the age of 26. The aim of our study was to evaluate the impact this has had on the treatment of thyroid cancer. To address this question, we used the Hospital Cost and Utilization Project State Inpatient Databases for Massachusetts, New Jersey, New York, and Florida, which included a cohort of 56,581 inpatient admissions from 2001 to 2011. We then compared these states before and after the healthcare reform in Massachusetts to evaluate the effect the healthcare reform had on the treatment of thyroid cancer. (more…)
Author Interviews, Biomarkers, Multiple Sclerosis / 05.04.2017

MedicalResearch.com Interview with: Dr. Chase Spurlock, Ph.D. Executive Officer at IQuity, Inc Nashville, Tennessee IQuity is working to further develop RNA technologies that can be used to diagnose and treat Multiple Sclerosis. IQuity hopes to develop a ‘disease activity test’, which would help physicians determine when a patient is likely to relapse so that treatments can be timed for best effect.   MedicalResearch.com: What is the background for IQuity? What are its goals and mission? Response: IQuity, Inc. is a biotechnology company that focuses on the research and development of innovative specialty diagnostic technology, specifically for autoimmune diseases. Our research has shown that autoimmune patients have distinct RNA expression patterns in their blood, and we have figured out how to leverage machine learning methods to analyze these RNA expression patterns and test for the presence of diseases like multiple sclerosis, IBS/IBD (Crohn’s and ulcerative colitis) and fibromyalgia. We collected patient samples from around the globe to match their RNA profiles against healthy and sick patient profiles we identified through our previous research. These tests led to the development of IQIsolate, our technology that informs the suite of tests which, when used even at the earliest onset of symptoms, can give providers information to rule in or rule out a suspected autoimmune disease with more than 90% accuracy. Our mission is to relentlessly pursue innovation in specialized diagnostic and analytic technology, identifying complicated autoimmune and autoimmune-related diseases at the earliest signs of symptoms. We strive to enable providers to diagnose early and treat sooner in the disease progression to improve long-term outcomes, lower the overall cost of lifelong autoimmune diseases and minimize the uncertainty and fear patients experience during prolonged diagnosis periods. (more…)
Author Interviews, Infections, Microbiome, OBGYNE, Pediatrics / 05.04.2017

MedicalResearch.com Interview with: Hans Bisgaard, MD, DMSc Professor of Pediatrics The Faculty of Health Sciences University of Copenhagen Copenhagen University Hospital, Gentofte Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: The consumption of antibiotics is increasing worldwide. Antibiotics alter the maternal bacterial colonization and by vertical transmission this can affect the offspring. An unfavorable microbiome may increase the disease propensity of the offspring. Otitis media is one of the most common infections in early childhood. We hypothesized that antibiotic consumption in pregnancy can increase the children’s risk of otitis media. (more…)
Author Interviews, Breast Cancer, Environmental Risks, Toxin Research / 05.04.2017

MedicalResearch.com Interview with: Sumi Dinda, PhD, NRP, IC. Associate Professor Biomedical Diagnostic and Therapeutic Sciences, School of Health Sciences and Adjunct Associate Professor Department of Biological Sciences School of Health Sciences Oakland University Rochester, MI 48309. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bisphenol-S (BPS), a substitute for bisphenol-A (BPA), has been suggested to be an endocrine disrupting compound interfering with normal hormonal activity. This bisphenol analogue is found in plastic substitutes, paper currency, and most products marked “BPA free.” Endocrine disrupting compounds interfere with the normal hormonal activity in the body. Bisphenols, specifically, disrupt the proper functioning of estrogen receptors, such as ERα causing interference with the normal activity of the hormone estrogen. Studies suggest BPS induces ERα pathways via its estrogen-mimicking properties in the body causing increased cell proliferation resulting in increased breast cancer risk. Despite the hope of a safer substitute, studies have shown that BPS exhibits similar estrogenic activity compared to its analogue BPA, due to their structural commonalities. BRCA1 is a commonly mutated gene in breast cancer; therefore, it is also important to study the effects of BPS on the expression of this protein. The potency of the endocrine disrupting abilities of BPS compared to BPA could show whether BPS is a suitable alternative to BPA in many everyday products. The results of this study may contribute to the understanding of the relationship between ERα, BRCA1 expression and Bisphenol-S in breast cancer treatment and prevention. (more…)
Author Interviews, Memory, Nature, PTSD / 05.04.2017

MedicalResearch.com Interview with: Dominik R Bach, PhD, MD University of Zurich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Posttraumatic stress disorder (PTSD) can occur after a psychological trauma such as physical violence, abuse, or natural disaster. It is characterised by increased arousal, flashbacks, and nightmares that reflect memories of the trauma. Current therapies include talking therapy, but it is costly and does not work in everybody. This is why we were looking for ways of reducing aversive memories with a drug. In the current study, we found that the antibiotic doxycycline impairs the formation of negative memories in healthy volunteers. To form memories, the brain needs to strengthen connections between neurons. It has recently emerged that for strengthening such connections particular proteins are required that sit between nerve cells, so-called MMPs. They are involved in many disorders outside the brain, such as certain cancers and heart disease. This is how we already know that doxycycline suppresses the activity of MMPs. Since doxycycline is relatively safe and readily accessible, our research was relatively straightforward. 76 healthy volunteers - half women, half men - came to the laboratory and received either placebo (a sugar pill) or 200 mg doxycycline. They then took part in a computer test in which one screen color was often followed by a mildly painful electric shock and another color was not. A week later, volunteers came back to the lab. They were shown the colors again , this time followed by a loud sound but never by shocks. The loud sounds made people blink their eyes - a reflexive response to sudden threat. This eye blink response was measured. Volunteers who had initially been under placebo had stronger eye blink after the color that predicted electric shock than after the other color. This "fear response" is a sensitive measure for memory of negative associations. Strikingly, the fear response was 60% lower in participants who had initially taken doxycycline. (more…)
Author Interviews, Environmental Risks, Pediatrics, Toxin Research / 05.04.2017

MedicalResearch.com Interview with: Jing Liu, Ph.D. Associate Professor College of Environmental & Resource Sciences Zhejiang University Hangzhou, China MedicalResearch.com: What is the background for this study? What are the main findings? Response: In addition to consistent observations of earlier pubertal onset in female since late 19th century, acceleration in male pubertal development also has been reported in more recent studies. Improved nutrition, health and living conditions may contribute to the secular trend towards an earlier pubertal onset. However, the potential role of environmental agents, specifically endocrine-disrupting chemicals (EDCs), also has been emphasized. Pyrethroids are among the currently used pesticide classes placed on the list of the US Environmental Protection Agency (EPA) as potential EDCs. Pyrethroids are one of the top 10 classes of pesticides and account for greater than 30% of global insecticide usage. Increased human exposure to pyrethroids is thought to occur mainly via residues in diets and indoor residential use. The metabolites of pyrethroids have been widely identified in urine samples of adults, children and adolescents worldwide and the detection rate is usually more than 60% in human populations. Here, we recognize pyrethroids as a new environmental contributor to the observed secular trend toward earlier male sexual maturity. For the first time to our knowledge, this work reveal a significant and positive association between pyrethroids exposure and gonadotropins levels in 463 Chinese boys, in which a 10% increase in 3-PBA (a common urinary metabolite of pyrethroids) is associated with more than 2% increase in both LH and FSH. Boys with increased urinary levels of 3-PBA have a significantly increased risk of earlier pubertal development, in which the odds of being in an advanced testicular volume and genitalia stage are increase by 113% and 268%, respectively. Because it is difficult to test the direct causality of environmental risk factors in humans, we further sought to identify in animals how pyrethroids alter the timing of puberty. Postnatal exposure to a widely used pyrethroid pesticide, cypermethrin, can accelerate pubertal timing and induce circulating levels of gonadotropins and testosterone in male mice. Our findings reveal the activation of voltage-gated calcium channels pathway in pituitary gonadotropes and testicular Leydig cells as a newly discovered mechanism of pyrethroid-induced early pubertal development in the male. (more…)
Author Interviews, Gender Differences, Social Issues / 05.04.2017

MedicalResearch.com Interview with: Madeleine A. Fugère, Ph.D. Professor of Psychology Eastern CT State University Willimantic, Connecticut MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that both daughters and their parents rate many traits as more important than physical attractiveness in a potential mate (for daughters), including traits such as respectfulness, honesty, and trustworthiness. Previous research also shows that women rate physical attractiveness as more important in a mate for themselves than parents do in a mate for their daughters. In our research project, we experimentally manipulated the physical attractiveness of male targets (using photographs) and we experimentally manipulated the traits associated with each male target. The trait profiles included the “respectful” trait profile which consisted of the traits respectful, honest, and trustworthy, the “friendly” trait profile which included the traits friendly, dependable, and mature, and the “pleasing” trait profile which contained the traits pleasing disposition, ambitious, and intelligent. We found that both women and their mothers were strongly influenced by the physical attractiveness of the men and preferred the attractive and moderately attractive targets. Both women and their mothers rated the attractive and moderately attractive men most favorably, especially when they were paired with the most positive trait profile (the “respectful” trait profile). However, the unattractive man was never rated more positively than his more attractive counterparts even when he possessed the most favorable trait profile. (more…)
Author Interviews, OBGYNE / 05.04.2017

MedicalResearch.com Interview with: Alain Chedotal, PhD Group Leader, Institut de la Vision (Inserm/UPMC/CNRS), Paris and Sylvain Berlemont, PhD CEO & Founder of Keen Eye Technologies, Incubateur Institut de la Vision, Paris MedicalResearch.com: What is the background for this study? What are the main findings? Response: What was known about human embryo development was based on histological techniques developed at the beginning of the twentieth century and no significant progress had been made for about fifty years. A few years ago our team found a method allowing to perform immunostaining on whole-mouse embryos and adult mouse brains. Complete 3D images of the intact samples could be obtained after they were cleared with solvents and imaged with a light sheet microscope. In this new study we have adapted this method to human embryos during the first trimester of gestation. We provide for the first time high-resolution 3D images of the developing peripheral nervous, muscular, vascular, cardiopulmonary, and urogenital systems. We found evidence for important in differences in the embryonic pattern of nerve branches between the right and left hands. We also present evidence for a differential vascularization of the male and female genital tracts concomitant with sex determination. (more…)
Author Interviews, Gastrointestinal Disease, JAMA / 04.04.2017

MedicalResearch.com Interview with: Dr. Ann Kurth, Task Force member Dean of the Yale School of Nursing Adjunct professor New York University College of Nursing and the College of Global Public Health. MedicalResearch.com: What is the background for this study? Response: Celiac disease, an immune disorder where people should not eat food with gluten, is fairly prevalent. When people with celiac disease eat foods containing gluten, which is found in wheat, rye and barley, their body responds by inflaming or destroying villi—the tiny, fingerlike projections on the inner lining of the small intestine–which prevents the body from absorbing the necessary nutrients from food. (more…)
Author Interviews, End of Life Care, Geriatrics, Medicare, Yale / 04.04.2017

MedicalResearch.com Interview with: Shi-Yi Wang MD, PhD. Department of Chronic Disease Epidemiology Yale School of Public Health New Haven, CT MedicalResearch.com: What is the background for this study? What are the main findings? Response: Care at the end of life is often fragmented and poorly coordinated across different health providers. Multiple transitions in care settings can be burdensome to patients and their families as well as costly to society. Despite these concerns about care transitions in the end of life, we lack contemporary data on the number, timing, and overall pattern of healthcare transitions in the last 6 months of life. This study adds to the extant literature by understanding transition trajectories, national variation of the transitions, and factors associated with transitions. We found that more than 80% of Medicare fee-for-service decedents had at least one health care transition and approximately one-third had ≥ 4 transitions in the last 6 months of life. We produced Sankey diagrams to visualize the sequences of healthcare transitions. The most frequent transition pattern involving at least four transitions: home-hospital-home (or skilled nursing facility)-hospital-healthcare setting other than hospital. There was substantial geographic variation in healthcare transitions in the United States. We found that several factors were associated with a significantly increased risk of having multiple transitions, including female gender, blacks, residence in lower income areas, presence of heart disease or kidney disease. (more…)
AHA Journals, Author Interviews, Heart Disease, Mental Health Research / 04.04.2017

MedicalResearch.com Interview with: Alessandro Paoletti Perini, MD, PhD and Valentina Kutyifa MD, PhD University of Rochester Medical Center Heart Research Follow-Up Program Rochester, New York, 14642 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality. In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being. We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP. (more…)
Author Interviews, Diabetes, Technology / 04.04.2017

MedicalResearch.com Interview with: Chandra Y. Osborn, PhD, MPH VP, Health & Behavioral Informatics One Drop Informed Data Systems, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are over 1,500 mobile apps for people with diabetes, but minimal evidence on their benefit. The One Drop | Mobile app launched in April 2015. Users manually and automatically track their blood glucose and self-care activities via One Drop's | Chrome glucose meter, other Bluetooth-enabled meters, CGMs or other health apps. Users leverage One Drop’s food library, medication scheduler, automatic activity tracking, educational content, recipes, health tips, user polls, and peer support (‘likes’, stickers, and data sharing), and can set blood glucose, medication, carbohydrate intake, and activity goals, receive data-driven insights to draw connections between their behaviors, goals, and blood glucose readings. They can also self-report and track their hemoglobin A1c (A1c) and weight. In July 2016, we queried data on ~50,000 people using One Drop | Mobile. In March 2017, we queried data on >160,000 users. Only users who had entered an A1c value when they started using the app, and entered a second A1c at least 60 days apart, but no more than 365 days apart, were included. In July 2016, people with diabetes using One Drop | Mobile reported a nearly 0.7% reduction in A1c during 2-12 months of using One Drop. In March 2017, users reported a 1.0% reduction in A1c for the same timeframe. A more recent diabetes diagnosis and using One Drop to track self-care activities was associated with more A1c improvement. (more…)
Addiction, Author Interviews, Lifestyle & Health, Occupational Health / 04.04.2017

MedicalResearch.com Interview with: Jaana Halonen, Docent and Senior Researcher Finnish Institute of Occupational Health MedicalResearch.com: What is the background for this study? Response: Retirement is a significant life transition when substantial changes in daily life are experienced as retirees adapt to life without work. After retirement people have more leisure time and more opportunities for different activities, and less stress. These changes are positive, but retirement can also lead to reduced social control and loss of social contacts and therefore be perceived as a stressful life transition. Both the positive and negative aspects related to changes in leisure time, stress, and social networks around retirement may affect drinking behaviours. However, little is known about how risky alcohol consumption changes around the retirement transition. Thus, in our study we wanted to examine how and for whom risky drinking changes around the time of retirement. To do that we followed up public sector workers with questionnaires before and after their old-age retirement. (more…)
Author Interviews, Cannabis, Mental Health Research, Pediatrics / 04.04.2017

MedicalResearch.com Interview with: James McIntosh PhD Economics Department Concordia University Montreal, Quebec, Canada. MedicalResearch.com: What is the background for this study Response: Marijuana is about to become legal in Canada. Consequently, an analysis of its effects on users is a high priority. This issue has been explored by Canadian researchers to some extent but there are gaps in what is known about the effects of using marijuana. Most of the Canadian studies focus on youth or adolescent use. This is clearly important but adult use is as well. Establishing the link between early usage and the effects of use over an individual’s lifetime was a major objective of the study. (more…)
Author Interviews, Depression / 04.04.2017

MedicalResearch.com Interview with: Scott T. Aaronson, M.D Psychiatrist, The Retreat at Sheppard Pratt Director of Clinical Research Sheppard Pratt Health System Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is the largest ever conducted on patients with severe, chronic depression, a group typically ignored by clinical research in psychiatry. We looked at individuals who, on average, had received 8 unsuccessful treatment interventions in the past. These individuals were split into two groups and examined over five years. One group was given proven anti-depressant treatments (medications, psychotherapy, and/or electroconvulsive therapy (ECT)), and one group was given both anti-depressant treatments and VNS Therapy—an implantable, pacemaker-like device that stimulates the vagus nerve, which regulates mood in the brain. • The study found that 67.9% of the VNS therapy group responded to treatment, compared to 40.9% of patients receiving treatment as usual. Importantly, the VNS therapy group reported responses earlier in treatment, and responses were sustained longer than those receiving treatment as usual. • VNS therapy improved treatment effect in individuals whether they had unipolar or bipolar disorder, and whether or not they had responded to ECT in the past. (more…)
Author Interviews, Prostate Cancer / 04.04.2017

MedicalResearch.com Interview with Dr. Alice Levine MD Professor, Medicine, Endocrinology, Diabetes and Bone Disease Associate Professsor ,Oncological Sciences Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Prostate cancer (PCa) bone metastases are a major cause of morbidity and mortality. This cancer is unique in its tendency to produce osteoblastic (OB) bone metastases, which affects 90% of men with PCa bone metastases, compared to others that produce osteolytic bone metastases. Currently, there are no existing therapies that specifically target the OB phase and no effective therapies for PCa bone metastases that prolong survival. We have identified a secretory protein that promotes the development PCa osteoblastic bone metastases, Prostatic acid phosphatase (PAP). Prostatic epithelial cells produce PAP. The physiologic function of PAP is unknown. It was the first human tumor marker ever described. Patients with PCa bone metastases demonstrated high levels of PAP. PAP is expressed by PCa cells in OB metastases and increases OB growth, differentiation, and bone mineralization. (more…)
Author Interviews, Kidney Disease, Transplantation / 04.04.2017

MedicalResearch.com Interview with: Amanda Miller, MD, FRCPC Dalhousie University Transplant Nephrology MedicalResearch.com: What is the background for this study? What are the main findings? Response: Earlier studies have shown that there may be a higher risk of kidney transplant failure if a kidney donor is smaller than their recipient. This may be due to increased strain on the relatively smaller transplanted kidney. Very few studies have investigated outcomes associated with donor and recipient weight mismatch measured directly by differences in body weight however. There is also a suggestion that sex mismatch between kidney donor and recipient may lead to worse outcomes post-transplant, however results from earlier studies have been controversial and conflicting. The combined effect of weight and sex matching/mismatching between kidney donor and recipient (two very important and physiologically relevant factors) has not been rigorously studied previously. Thus, the aim of this study was to determine if receiving a kidney transplant from a smaller donor of the opposite sex would impact transplant outcomes. Accounting for other transplant variables, we demonstrated that if a kidney transplant recipient is more than 30 kg (66 pounds) heavier than the donor there is a 28% increased risk of the transplant failing compared to equally weighted donors and recipients. If the kidney is from a smaller donor of the opposite sex, the risk of transplant failure is further increased to 35% for a male receiving a kidney from a female donor, and 50% for a female receiving a kidney from a male donor. This risk is high and is similar to that when a recipient receives a kidney transplant from a donor who has diabetes; a known risk factor for kidney failure in the non-transplant population. (more…)
Author Interviews, Fertility, OBGYNE, Omega-3 Fatty Acids, Weight Research / 04.04.2017

MedicalResearch.com Interview with: Alex J. Polotsky, MD Associate Professor of Obstetrics and Gynecology University of Colorado Denver Practice homepage MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been well established that profound dietary changes occurred over the past 100 years. The type and amount of fat consumed has changed quite a bit over the course of 20th century. Intake of omega-3 polyunsaturated fatty acids (PUFAs), previously consumed in large quantities by humans from vegetable and fish sources, has dropped significantly. The typical Western diet (sometimes also called the typical American diet) provides an omega-6 to omega-3 fatty acid ratio of as high as 25:1, which is quite different from what it used to up until about the 19th century (believed to be about 1:1 ratio). In animal studies, diets enriched with omega-3 PUFA enhance early embryonic development and boost progesterone secretion. Obesity is well known to be associated with decreased progesterone production in women (even if a obese woman ovulates). The reasons for this are not clear. Obesity is also a state of low-grade chronic inflammation. Omega-3 fatty acids are well known to have anti-inflammatory properties. We sought to test whether dietary supplementation with omega-3 PUFA favorably affects reproductive hormones in women and whether this effect includes normalization of progesterone production in obesity. All women in the study tolerated supplementation well, and had significantly decreased their omega-6 to omega-3 ratios (they were normalized much closer to a 1:1 ratio). Omega-3 supplementation resulted in a trend for increased progesterone in obese women, thus enhancing ovulatory function. A 16 to 22 percent increase was observed. Additionally, the supplementation resulted in reduced systemic inflammation. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity / 04.04.2017

MedicalResearch.com Interview with: Amanda Leiter, MD MSCR Medical Resident, Internal Medicine Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Black women are more likely than White women to have breast cancer with poor prognostic features, which cannot be completely explained by differences in screening, treatment and established risk factors for breast cancer mortality. Black women have higher rates of obesity, insulin resistance and dyslipidemia when compared to White women. Prior studies have shown a decreased risk of breast cancer recurrence and improved survival with statin use. As statins have an association with decreased breast cancer recurrence and potentially improved survival, disparities in statin use between Black and White women with breast cancer are important to investigate. We aimed to elucidate whether or not statin use differs between Black and White women with breast cancer and if racial disparities in breast cancer can be partially explained by differences in statin use. (more…)
Author Interviews, Cancer Research, Mental Health Research / 03.04.2017

MedicalResearch.com Interview with: Raffaella Calati, Psy.D., Ph.D. University of Montpellier INSERM U 1061: Neuropsychiatry: Epidemiological and Clinical Research Department of Emergency Psychiatry and Post Acute Care Lapeyronie Hospital, Centre Hospitalier Universitaire Montpellier, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of previous original studies investigated suicidal thoughts and behaviours in cancer patients, finding them to be higher than those in the general population. However, to our knowledge, we performed the first meta-analysis on this link, pooling all the published data to calculate the size of this increased risk. Our main finding is an increased suicide risk in patients with cancer compared to individuals without it. It should be underlined that the analyses presented are the first stage in our work, since at the moment we are analyzing a higher number of studies and we are planning to control for confounders, not considered in our first analyses. This means that the exact strength of this association will be more precisely known. (more…)
Author Interviews, Cost of Health Care, JAMA, Macular Degeneration, Ophthalmology, Telemedicine / 02.04.2017

MedicalResearch.com Interview with: John Wittenborn Senior research scientist NORC's Public Health Analytics University of Chicago MedicalResearch.com: What is the background for this study? What are the main findings? Response:The emergence of anti-VEGF treatment for wet-form AMD (choroidal neovascularization) has had a dramatic impact on preserving vision for many Americans. However, community-based studies show that most patients are not diagnosed with wet-form AMD until they have already lost a significant, and largely unrecoverable amount of their vision.  Early detection of wet-form AMD is key to effective treatment and the preservation of vision. The ForeseeHome telemonitoring technology provides patients with a means to check their own eyes on a daily basis to detect the earliest signs of vision loss from wet-form AMD. This is a novel technology that has the potential to improve visual health outcomes for AMD patients.  A prior clinical trial (the AREDS-2 HOME study) demonstrated that this technology can detect wet-form AMD earlier, and with less vision loss than standard care alone. However, that is exactly where that study ended as it reported no cost information nor follow-up. Since the end of this study, the device has been cleared by the FDA and approved for reimbursement by Medicare for certain higher risk patients, but no study has yet considered the long-term implications of adoption of this technology. In our analysis, we use a computer simulation model to essentially estimate what will come next, after patients realize earlier detection of wet-form AMD by utilizing home monitoring. Basically, we follow simulated patients from the time they begin monitoring for the rest of their lives, recording the likely impacts of home monitoring on patients’ long term outcomes including visual status, costs and quality of life. We find that home telemonitoring among the population indicated for reimbursement by Medicare would cost $35,663 per quality adjusted life year (QALY) gained.  Medicare would expect to incur $1,312 in net budgetary costs over 10 years for each patient who initiates monitoring.  However, Medicare patients may expect to achieve lifetime net savings when accounting for the chance of avoided vision loss and its associated costs later in life. (more…)
Author Interviews, Global Health, Infections / 02.04.2017

MedicalResearch.com Interview with: Dr Mihály Sulyok MD Eberhard Karls University Institute of Tropical Medicine, Tübingen, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: New antimalarials are desperately needed, not just for treatment, but also for prophylaxis. DSM265, a novel antimalarial compound that selectively inhibits the plasmodial dihydroorotate dehydrogenase has a promising pharmacokinetic profile characterized by a long elimination half-life. We performed a study at the Institute of Tropical Medicine, Eberhard Karls University (Tübingen, Germany) to investigate safety, tolerability and efficacy of DSM265 using controlled human malaria infection. In the first cohort, 400mg of DSM265 was administered orally to five healthy, malaria naive individuals one day before direct venous inoculation of an established infective dose of P. falciparum sporozoites (PfSPZ Challenge). Placebo was administered to two volunteers. The study was randomized and double blinded. In this cohort all placebo participants developed malaria, whereas all DSM265 participants were protected. In a second cohort, 400mg DSM265 was administered 7 days before the sporozoite inoculation for six participants, two participants recieved placebo. In this cohort, the two placebo and three of six DSM265 volunteers developed thick blood smear positive malaria. The remaining three DSM265 volunteers developed transient submicroscopic parasitemia without symptoms or thick blood smear positivity. The only possible DSM265-related adverse event was a slight transient elevation in serum bilirubin in one volunteer. The study was funded by the Global Health Innovative Technology Fund, Wellcome Trust, Bill & Melinda Gates Foundation through Medicines for Malaria Venture, and the German Center for Infection Research. (more…)
Author Interviews, Environmental Risks, Thyroid, Thyroid Disease / 02.04.2017

MedicalResearch.com Interview with: Julie Sosa, MD MA FACS Professor of Surgery and Medicine Chief, Section of Endocrine Surgery Director, Surgical Center for Outcomes Research Leader, Endocrine Neoplasia Diseases Group Duke Cancer Institute and Duke Clinical Research Institute Durham, NC 2771 MedicalResearch.com: What is the background for this study? Response: The incidence of thyroid cancer has dramatically increased world-wide over the last several decades. In the United States, thyroid cancer is the fastest increasing cancer among women and men. This observation has been almost exclusively the result of an epidemic of papillary thyroid cancer, or PTC, which now comprises approximately 90% of new cases. The use of flame retardant chemicals, or Flame Retardant Chemicals, also increased over the last several decades due to the implementation of mandatory and voluntary flammability standards for furniture, electronics, and construction materials. Over time, FRs come out of these products and accumulate in indoor environments where humans are exposed. Animal studies suggest that FRs can disrupt thyroid function, and many contribute to cancer risk. But many human health endpoints have not been investigated. Our work was aimed at investigating whether exposure to Flame Retardant Chemicals could be associated with PTC. To address our research question, we recruited 140 adults, 70 with PTC and 70 who were healthy volunteers without evidence for thyroid cancer or thyroid disease. Then we visited participants’ homes and collected dust samples, a metric that we have previously shown is an indicator of long-term exposure to Flame Retardant Chemicals in the home. (more…)
Author Interviews, Breast Cancer, Surgical Research / 02.04.2017

MedicalResearch.com Interview with: Ahmedin Jemal, DVM, PHD Vice President, Surveillance and Health Services Research American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? Response: Previous studies reported that Contralateral Prophylactic Mastectomy (CPM) increased in the United States among women diagnosed with unilateral early-stage breast cancer with surgery without evidence for survival benefit. Previous studies also reported that receipt of this procedure is more common in younger than older patients, in white than in black patients, and in privately insured than uninsured patients. However, the extent of variation in receipt of CPM by state of residence was unknown. (more…)
Abuse and Neglect, Author Interviews, BMJ, Exercise - Fitness, Mental Health Research / 02.04.2017

MedicalResearch.com Interview with: Tine Vertommen, Criminologist Faculty of Medicine and Health Sciences Universiteitsplein 1 Antwerp, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent prevalence study into interpersonal violence against child athletes in the Netherlands and Belgium showed that 6% experienced severe sexual violence, 8% experienced severe physical violence, and 9% of respondents experienced severe psychological violence in sport (Vertommen et al., 2016). While general literature has repeatedly shown that exposure to interpersonal violence during childhood is associated with mental health problems in adulthood, this relationship has not yet been demonstrated in (former) athletes. Thus, the objective of the current study is to assess the long-term consequences of these experiences on adult mental health and quality of life. (more…)
Author Interviews, Biomarkers, Heart Disease / 31.03.2017

MedicalResearch.com Interview with: Szilard Voros, MD, FACC, FSCCT, FAHA CEO of Global Genomics Group  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atherosclerotic coronary artery disease (ASCAD) is the leading cause of death and morbidity in the United States and worldwide, despite relatively successful medical therapies such as statins, like Zocor or Lipitor. A significant majority of patients with ASCAD present with sudden cardiac arrest, and the clinical evaluation of those patients who present with chest pain to their physicians is very inefficient. Based on current clinical guidelines, patients who present to their physician with complaints of new onset chest pain or its equivalent, such as exertional dyspnea should be assessed for the probability of the presence of significant ASCAD based on simple clinical predictors. Approximately 60% of such patients have an intermediate probability, and they are typically referred for initial non-invasive evaluation, such as a stress test with cardiac imaging, or for some other type of non-invasive test. Strikingly, no more that 5% of such stress tests performed in the United States are actually positive, and even when patients with positive stress test are taken for invasive coronary angiography, no more than 40% have significant ASCAD. A blood test that could serve as first step, as a “gatekeeper”, to non-invasive evaluation, would be highly desirable. Global Genomics Group, or G3, has performed one of the largest, unbiased, mass-spectrometry-based discovery studies in over 1,000 patients who underwent detailed cardiac CT to assess the presence or absence of ASCAD, by measuring over 1,000 metabolites from the blood. Using sophisticated bioinformatics tools, the researchers identified 8 important metabolites that were significantly abnormal in patients with ASCAD, and generated a biomarker signature for the detection of ASCAD based on those analytes, called “knowPLAQUETM”. The biomarker signature was generated in approximately 800 subjects, and was validated in an independent set of approximately 400 subjects, showing an area under the curve (“AUC”) of 0.82 for the diagnosis of Atherosclerotic coronary artery disease. This biomarker signature can be adapted relatively easily on commercial mass spectrometry platforms, and the researchers anticipate that this signature may be available for physicians to use by 2018. In addition to its diagnostic power, this biomarker signature also has uncovered important biological insights for the development of ASCAD, which can be leveraged for therapeutic purposes. (more…)