Author Interviews, Heart Disease, Lipids, PAD, Women's Heart Health / 27.08.2020

MedicalResearch.com Interview with: First Author: Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Dr. Virani Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX @virani_md MedicalResearch.com: What is the background for this study? What are the main findings? What do you think accounts for the gender differences? Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD. We also assessed statin adherence among men and women with PAD and ICVD. Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality. (more…)
Author Interviews, COVID -19 Coronavirus, Gastrointestinal Disease / 27.08.2020

MedicalResearch.com Interview with: Dr. Arvind J. Trindade, MD Director of Endoscopy Long Island Jewish Medical Center Associate professor at Feinstein Institutes for Medical Research Division of Gastroenterology, Zucker School of Medicine Hofstra/Northwell, Northwell Health System New Hyde Park, NY MedicalResearch.com: What is the background for this study? Response: Although most patients with COVID-19 present with respiratory symptoms, gastrointestinal (GI) symptoms have also been reported in up to 25% of patients. Some case reports have shown acute pancreatitis as the initial presentation in patients with COVID-19, however the literature supporting this is limited. Our study aimed to report the point prevalence, risk factors, and outcomes of hospitalized patients with COVID-19 presenting with acute pancreatitis in a large health system and to compare outcomes of pancreatitis in patients without COVID-19. (more…)
Author Interviews, Brigham & Women's - Harvard, Gastrointestinal Disease, Technology / 27.08.2020

MedicalResearch.com Interview with: Giovanni Traverso, MB, BChir, PhD Gastroenterologist and biomedical engineer Division of Gastroenterology at BWH Instructor of medicine at Harvard Medical School MedicalResearch.com: What is the background for this study? Response: We began working on this project with the goal to develop liquid drug formulations that could offer an easier-to-swallow alternative to capsules, especially for children. We started to think about whether we could develop liquid formulations that could form a synthetic epithelial lining that could then be used for drug delivery, making it easier for the patient to receive the medication by providing drugs in extended release formats. We discovered that an enzyme called catalase could help assemble molecules of dopamine into the polymer (poly-dopamine). These polymers have muco-adhesion properties, which means that after polymerization, the polymer can attach to the tissue very strongly. Also, catalase is found throughout the digestive tract, with especially high levels in the upper region of the small intestine. This is the first example, to the best of our knowledge, of small intestinal targeting system enabled through in-situ tissue-enzyme-catalyzed polymerization. The coating lasts up to 24 hours, after which it is shed and excreted based on experiments we conducted in pigs. (more…)
Author Interviews, Lipids, Regeneron / 26.08.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? Response: The objective of this randomized phase 3 study was to evaluate the efficacy and safety of evinacumab in adult patients with homozygous familial hypercholesterolemia (HoFH), a condition that remains very difficult to treat. The primary endpoint was reduction of low-density lipoprotein cholesterol (LDL-C) from baseline with evinacumab compared to placebo at 24 weeks. MedicalResearch.com: Would you briefly explain what is meant by homozygous familial hypercholesterolemia? How many individuals may be affected by this disorder? Response: HoFH, or homozygous familial hypercholesterolemia, is the most serious and more rare form of familial hypercholesterolemia (FH). It is estimated that as many as 1 in 300,000 people worldwide and approximately 1,300 people in the U.S. are affected by HoFH. A person who has HoFH has inherited two FH genes, one from each parent. They therefore have LDL-C levels that are elevated 4-fold or greater from birth and are at high risk for premature atherosclerotic disease and cardiac events which can occur in childhood. While current treatment guidelines recommend early and intensive LDL-C lowering, people with HoFH tend to be less responsive (or unresponsive) to standard lipid-lowering therapies, including high-intensity statins and PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors and often require lipid apheresis. (more…)
Author Interviews, COVID -19 Coronavirus, NYU, Rheumatology / 26.08.2020

MedicalResearch.com Interview with: Dr. Fernandez-Ruiz Ruth Fernandez-Ruiz, MD Post-Doctoral Fellow Department of Rheumatology NYU Langone Heath MedicalResearch.com: What is the background for this study? Response: Patients with systemic lupus erythematosus (SLE) represent a unique population in considering risk for COVID-19 with biologic, genetic, demographic, clinical and treatment issues at play. By the nature of their chronic inflammatory autoimmune condition, the presence of comorbidities, and regular use of immunosuppressants, these individuals would traditionally be considered at high risk of contracting SARS-CoV-2 and possibly having worse outcomes from the viral infection. However, it might be speculated that inherently elevated type I Interferon, characteristic of the majority of patients with SLE, confers a protective effect as a first line anti-viral defense. Additionally, hydroxychloroquine, which was suggested as a potential therapeutic agent for COVID-19 early on, is used in most patients with SLE. Accordingly, we initiated this study to provide critical data needed to address the frequency and severity of COVID-19 in patients with SLE. (more…)
Author Interviews, Coffee, OBGYNE / 25.08.2020

MedicalResearch.com Interview with: Professor Jack E. James, PhD Reykjavík University Reykjavík Iceland MedicalResearch.com: What prompted this study? Response: Chronic exposure to any chemical during pregnancy is cause for concern. There should be no exception simply because that chemical, caffeine, happens to be widely consumed. Caffeine is a habit-forming substance of no nutritional value. If anything, its widespread consumption suggests that it should be given special attention. Concern is heightened by what is known about the effects of caffeine on the human body, where it affects neural processes in the brain, including networks that control respiration and heart function. When consumed during pregnancy, caffeine readily crosses the placenta, exposing the fetus to the drug. Notably, the fetus is largely physically incapable of metabolising caffeine – that ability develops during the first year of life. Pregnancy studies have shown that caffeine can interfere with fetal heart function and oxygenation. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, Heart Disease / 25.08.2020

MedicalResearch.com Interview with: Eric J. Chow, MD, MS, MPH Epidemic Intelligence Service Officer (completed in 2020); Influenza Division. Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings?
  • Both heart disease and influenza epidemics cause substantial morbidity and mortality every year. In some seasons, influenza virus infections alone contribute up to 810,000 hospitalizations and 61,000 deaths. There is increasing evidence that there is overlap between infections, specifically influenza, and heart disease. In our study, we sought to describe the frequency and risk factors for acute cardiac events in patients who are hospitalized with influenza.
  • In over 80,000 adults hospitalized with influenza over 8 seasons (2010-2018), almost 12% were diagnosed with acute cardiac events, with acute heart failure and acute ischemic heart disease being the most common.
  • Among patients hospitalized with influenza who experienced acute cardiac events, almost one-third were admitted to the intensive care unit and 7% died while hospitalized.
  • Our study also reaffirmed that people who are older, smoke tobacco or have underlying cardiovascular disease, diabetes and kidney disease are at increased risk for the most common acute cardiac events, acute heart failure and acute ischemic heart disease.
  • Although vaccinated persons had a lower risk of acute ischemic heart disease and acute heart failure, this study was not designed to specifically assess vaccine effectiveness. However, this and other studies support the importance of influenza vaccines for people with underlying heart conditions.
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Author Interviews, Environmental Risks, JAMA, Pediatrics / 24.08.2020

MedicalResearch.com Interview with: Kaleab Baye PhD Center for Food Science and Nutrition Addis Ababa University MedicalResearch.com: What is the background for this study? Response: Reducing child stunting is one of the most important objectives of the Sustainable development goals (SDGs) and the World Health Assembly (WHA). Progress is routinely measured using anthropometric indices such as height-for-age z score that compare child height to the World Health Organization (WHO) growth standards. Such comparisons rely on the assumption that children living in ideal home environment that promotes adequate growth have the same growth potential, irrespective of their genetic make-up. This assumption was confirmed by the Multicenter Growth Reference Study (MGRS), which was the origin of the development of the growth standards. However, the MGRS excluded sites above 1500 m above sea level (asl); hence, it remains unclear whether the widely adopted WHO growth standards are applicable to populations above the 1500 m asl threshold. This study investigated the association between altitude and linear growth faltering and evaluated whether the prescriptive WHO growth standards can apply to children residing at higher altitudes. (more…)
Author Interviews, COVID -19 Coronavirus, Weight Research / 24.08.2020

MedicalResearch.com Interview with: Lisa Pawloski PhD Associate Dean for International Programs Professor of Anthropology College of Arts and Sciences The University of Alabama Tuscaloosa, AL 35487 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This exploratory research uses the currently available data on COVID-19 cases and mortality, along with estimates of the morbidly obese populations in the United States by county to examine the association between morbid obesity and deaths from COVID-19 and to identify potential coincident spatial clusters of morbid obesity and COVID-19 deaths. Results indicate statistically significant positive correlation between population adjusted COVID-19 deaths and cases and the estimated population with a BMI>=40. Clustering analyses show there is a predominant similarity in the distribution of COVID-19 deaths and obesity. Our findings suggest it is critical to include an awareness of obesity when developing infectious disease control measures and point to a greater need to focus resources towards obesity education and policy initiatives. (more…)
Author Interviews, COVID -19 Coronavirus / 24.08.2020

MedicalResearch.com Interview with: Dr. Ajit Ahlawat (en.) Scientific staff (Post-Doc), Department Experimental Aerosol & Cloud Microphysics Leibniz Institute for Tropospheric Research (TROPOS) MedicalResearch.com: What is the background for this study? Response: World Health Organization (WHO) has recently acknowledged that novel coronavirus (COVID-19) can be transmitted via aerosols after an appeal from 239 scientists from 32 countries including the chemist Prof. Hartmut Herrmann from our institute i.e. TROPOS. In order to contain the spread via the aerosol particles floating in the air, the researchers recommend not only continuing to wear masks but also, and above all, good indoor ventilation. In aerosol research, it has been long known that air humidity plays a major role i.e. either at high humidity, more water adheres to the particles and so they can grow faster or at low humidity, evaporation occurs and particle will lose its water content. So, we were curious about what types of studies have already been conducted on this topic and how indoor relative humidity (RH) will influence SARS-CoV-2 airborne transmission in indoor environments. (more…)
Author Interviews, COVID -19 Coronavirus, Pediatrics / 22.08.2020

MedicalResearch.com Interview with: Lael Yonker, MD Pediatric Pulmonology Director, MGH Cystic Fibrosis Center Principal Investigator, Pediatric COVID biorepository Mucosal Immunology and Biology Research Center Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children were initially felt to be spared from the COVID-19 pandemic. Here, we show that children can become sick from SARS-CoV-2 infection, and even if the initial illness is mild, some go on to develop a severe inflammatory illness after the initial illness. We also show that children can carry very high levels of virus early in the course of infection, suggesting they may play a larger role in spreading the virus than previously thought. (more…)
AstraZeneca, Author Interviews, Pulmonary Disease / 22.08.2020

MedicalResearch.com Interview with: Frank Trudo, MD MBA Vice President, US Medical Affairs Respiratory & Immunology AstraZeneca MedicalResearch.com: What is the background for this study? Response: ETHOS was a randomized, double-blinded, multi-center, parallel-group, 52-week trial to assess the efficacy and safety of PT010 in symptomatic patients with moderate to very severe COPD and a history of exacerbation(s) in the previous year. A subset of patients participated in the 4-hour pulmonary function test (PFT) sub-study, with the following primary endpoints: change from baseline in morning pre-dose trough FEV1 at Week 24 at (both doses of budesonide/glycopyrrolate/formoterol fumarate MDI versus glycopyrrolate/formoterol fumarate MDI), and FEV1 area under the curve from 0-4 hours at Week 24 (both doses of budesonide/glycopyrrolate/formoterol fumarate MDI vs budesonide/formoterol fumarate MDI). (more…)
Asthma, AstraZeneca, Author Interviews / 22.08.2020

MedicalResearch.com Interview with: Frank Trudo, MD MBA Vice President, US Medical Affairs Respiratory & Immunology AstraZeneca MedicalResearch.com: What is the background for this study?
  • Multiple pathways drive asthma. T2 inflammation-driven asthma is present in many patients with severe asthma and is typically characterized by elevated levels of T2 inflammatory biomarkers, including blood eosinophils, serum IgE and fractional exhaled nitric oxide.
    • Some patients with severe asthma do not present with increased T2 inflammation. However, currently available biologic therapies only target T2-driven inflammation.
  • The PATHWAY trial evaluated the efficacy and safety of three dose regimens of tezepelumab versus placebo as an add-on therapy in patients with a history of asthma exacerbations and uncontrolled asthma despite receiving inhaled corticosteroids/long-acting beta2-agonists with or without oral corticosteroids and additional asthma controllers. Overall, the trial showed tezepelumab significantly reduced annualized asthma exacerbation rates of 71%.
  • This post-hoc analysis presented virtually at ATS evaluated the effect of Tezepelumab treatment on asthma exacerbation rates on a seasonal and weekly basis.
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Author Interviews, Heart Disease, JAMA, Lipids / 21.08.2020

MedicalResearch.com Interview with: First Author Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX MedicalResearch.com: What is the background for this study? Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 21.08.2020

MedicalResearch.com Interview with: Ashwini Sehgal, MD Professor, Department of Medicine, School of Medicine Professor, Department of Bioethics, School of Medicine Professor, Department of Population and Quantitative Health Sciences, School of Medicine Director and Duncan Neuhauser Professor of Community Health Improvement, Center for Reducing Health Disparities, Case Western School of Medicine MedicalResearch.com: What is the background for this study? Response: News media and politicians frequently discuss the high toll of deaths from firearms and drug overdoses. They usually mention the numbers of deaths, citing figures like 40,000 firearm deaths last year, or death rates such as 20 overdose deaths per 100,000 population. But for most people, it's hard to grasp the real meaning of both the large absolute numbers and the small annual rates. So in a new study published in the American Journal of Medicine, I used official death certificate data to calculate the chance that an American child will die from a gunshot or a drug overdose over the course of a lifetime. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, JAMA, Social Issues / 21.08.2020

MedicalResearch.com Interview with: Monik Carmen Jimenez, Sc.D Assistant Professor of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: We wanted to get a comprehensive picture of the epidemiology of COVID-19 in carceral facilities that included jails and was not restricted solely to prisons. We utilized publicly available data collected in Massachusetts, pursuant to a court order. These data included prison and jail systems and were used to calculate rates of confirmed cases of COVID-19 and testing rates among incarcerated individuals. We were also able to compare those to changes in the population size within each system. (more…)
Author Interviews, Biomarkers, Cancer Research / 20.08.2020

MedicalResearch.com Interview with: Dr. Alexey Aleshin, M.D., MBA Senior Medical Director Natera MedicalResearch.com: What is the background for this study? Response: Checkpoint inhibitor-based immunotherapies (ICI) have changed the management of a range of cancers of diverse histologies. While these therapies are well tolerated and efficacious, only a minority (<20%) of patients respond to treatment or derive durable clinical benefit from them, highlighting the need for a pan-cancer biomarker that can predict response prior to, or shortly after, treatment initiation. With immune checkpoint inhibitors (ICIs) rapidly becoming a cornerstone of cancer therapy, early determination of response to ICI treatment can optimize patient benefit and minimize the risk of toxicities, while potentially reducing unnecessary treatment and costs to patients and payers. Additionally, due to the nature of immune checkpoint inhibition, atypical patterns of response have emerged. For instance, tumor pseudoprogression — a transient increase in tumor size due to the infiltration of immune cells, followed by delayed shrinkage — has been reported in as much as 10% of patients receiving ICI therapy. Distinguishing pseudoprogression from true progression is clinically important to avoid premature discontinuation of a treatment that may have future benefit, or delay the initiation of an alternative line of therapy. However, they are hard to differentiate using current imaging techniques. Our study published in Nature Cancer earlier this month, demonstrates that bespoke circulating tumor DNA (ctDNA) testing may be a valuable tool that sheds light on both of these issues. (more…)
Author Interviews, COVID -19 Coronavirus, Flu - Influenza, JAMA / 19.08.2020

MedicalResearch.com Interview with: Jeremy Samuel Faust, M.D., M.S., M.A., FACEP Brigham & Women's Hospital Department of Emergency Medicine Division of Health Policy and Public Health Instructor, Harvard Medical School President, Roomful of Teeth Vocal Arts Project (www.roomfulofteeth.org) MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sought to compare the initial covid-19 outbreak in NYC to the peak of the 1918 H1N1 pandemic in that same city. We found that the covid-19 pandemic was associated with more than 70% as many deaths per capita (monthly) as 1918 H1N1 was. But because baseline mortality rates are about 1/2 of what they were a century ago, death rates were over 400% of usual rates in March and April of this year compared to recent years, while 1918 was "merely" over 280% of usual death rates from prior years leading up to it. (more…)
Author Interviews, Pediatrics, Race/Ethnic Diversity / 19.08.2020

MedicalResearch.com Interview with: Anura Ratnasiri PhD Senior Research Scientist (Epidemiology and Biostatistics) Benefits Division Department of Health Care Services Sacramento, CA 95899-7417 MedicalResearch.com: What is the background for this study? Response: Infant mortality rate (IMR) is a widely-reported indicator of population health and is used as a standardized measurement of deaths in the first year of life per thousand live births. While IMR has been steadily declining in the United States, it remains relatively high compared with other developed countries. Even though significant improvements have been made in the quality and access to neonatal and infant care during the past decade, large educational, socioeconomic, racial, ethnic, geographic and behavioral disparities persist, and appear to be responsible for significant differences in IMR among different subgroups. Certain maternal and infant characteristics have important associations with IMR, and this study attempted to quantify major maternal and infant predictors, and trace associated mortality trends during the study period. There were no recent studies on infant mortality using a large data set such as California State. Moreover, gestational age based on obstetric estimates from fetal ultrasound, prepregnancy obesity, and smoking during pregnancy were not available in prior population-based studies in California. (more…)
Author Interviews, Genetic Research, Nature, NYU / 17.08.2020

MedicalResearch.com Interview with: Professor Aneel K Aggarwal, PhD Pharmacological Sciences and Oncological Sciences Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: DNA polymerase ζ (Pol ζ) is the crucial enzyme that allows cells to cope with DNA damage resulting from exposure to environmental and industrial carcinogens and to other daily genotoxic stresses. At the same time, Pol ζ has emerged as an important target for discovery of therapeutics in the treatment of chemotherapy-resistant cancers. MedicalResearch.com: What are the main findings? Response: We have succeeded in resolving the 3-D atomic structure of the complete Pol ζ enzyme using cryo-electron microscopy. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 17.08.2020

MedicalResearch.com Interview with: Pinar Karaca-Mandic, PhD Professor, Finance Department Arthur Williams Jr. Professor of Healthcare Risk Management Academic Director, Medical Industry Leadership Institute (MILI) Carlson School of Management University of Minnesota MedicalResearch.com: What is the background for this study? Response: Several studies have highlighted disparities in COVID-19 infection rates and deaths. Less is known about disparities in hospitalizations. Reports from the Centers for Disease Control showed that in the nation overall, non-Hispanic Blacks, Hispanics and American Indian Alaska Native persons have substantially higher rates of COVID-19 hospitalization. Our study extends this work by providing a state-by-state analysis of race/ethnic prevalence of cumulative COVID-19 hospitalizations and comparing this prevalence to ethnic/racial composition of each state’s population. Through our University of Minnesota Covid-19 hospitalization tracking project (https://carlsonschool.umn.edu/mili-misrc-covid19-tracking-project) we collect data every day from state department of health websites, and we started collecting information on race/ethnicity breakdown of the hospitalizations as soon as states started reporting such data. During our study period, between April 30 and June 24, 12 states reported cumulative hospitalizations by race/ethnicity. By the end of our study, our data from these 12 states represented almost 50,000 hospitalizations. (more…)
Author Interviews, Biomarkers, Lymphoma / 14.08.2020

MedicalResearch.com Interview with: Dr. Ivana Špaková Pavol Jozef Šafárik University Košice, Slovakia MedicalResearch.com: What is the background for this study? Response: The background is the plenty of space for studying "waste metabolites" which tell us more about the metabolism of the whole body as well as about the metabolism of the smallest compartment - cell. So we decided to study what is the difference in urine spectra (absorbance, excitation, and emission spectra) in patients with malignant melanoma and healthy subjects without positive cancer history. MedicalResearch.com: What are the main findings? Response: The main findings are "discovery" (it is not true discovery because the target molecules or metabolites are known for decades) of molecules{metabolites which together describe the stage of malignant melanoma. These findings could be used for future tracking the patient's response for treatment or for tracking the previously treated patients for malignant melanoma and are healthy at the moment of sampling. (more…)
Author Interviews, HIV, University of Pittsburgh / 14.08.2020

MedicalResearch.com Interview with: James Egan, Ph.D., M.P.H. Assistant Professor Behavioral and Community Health Sciences Pitt Public Health MedicalResearch.com: What is the background for this study? Response: When taken as a daily pill, pre-exposure prophylaxis (PrEP) reduces the risk of getting HIV from sex by about 99%, according to the Centers for Disease Control and Prevention. However, adhering to a daily medication regimen doesn’t work for everyone for reasons that include cost and individual concerns about the biological consequences of long-term medication. Previous studies have shown that there are certain periods when some men who have sex with men may be more vulnerable to contracting HIV, including when traveling, on vacation, moving to a new city or after a break-up. Our team set out to explore whether these men might be more receptive to adhering to PrEP treatment during these times. We followed 48 adult men from Pittsburgh or Boston who have sex with men in a pilot program to test the daily use of PrEP for 30 days that included an out-of-town vacation, with the men starting the medication seven days before the trip and continuing for at least seven days after vacation. The men were also given a brief session introducing them to the use of PrEP and discussion adherence. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology, JAMA / 14.08.2020

MedicalResearch.com Interview with: Maryam M. Asgari, MD MPH Professor Department of Dermatology, Massachusetts General Hospital Department of Population Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? What are Topical Calcineurin Inhibitors used for? Response: Topical calcineurin inhibitors (TCIs) are FDA approved for the treatment of atopic dermatitis (though they are used off-label to treat a wide range of inflammatory conditions of the skin, including psoriasis, seborrheic dermatitis, and contact dermatitis). There are currently two drugs available – tacrolimus and pimecrolimus – both of which carry a black box label warning users about the potential for increased skin cancer risk. The risk associated with keratinocyte carcinoma, the most common cancer (defined as basal cell carcinoma and squamous cell carcinoma), remains poorly defined because findings from large-scale post-marketing surveillance studies are lacking. (more…)
Author Interviews, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 12.08.2020

MedicalResearch.com Interview with: Morayma Reyes Gil M.D., Ph.D. Director of hematology and Coagulation Labs Associate Professor, Pathology Montefiore Medical Center and Albert Einstein School of Medicine Bronx, NY 10467 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antiphospholipid Syndrome is an entity caused by autoantibodies that cause arterial and venous thrombosis as well as miscarriages. During the COVID-19 pandemic, we tested 187 patients for Lupus anticoagulant (LA); 68 turned out to be COVID positive. 30 of the 68 COVID-positive patients were found to be positive for LA by the DRVVT test, and 17 of them were also determined to be positive by the hexagonal phospholipid neutralization STACLOT-LA test. Importantly, of the 30 patients who were LA positive, 19 had documented thrombosis (arterial and venous), an event rate of 63%, as compared with a rate of 34% (p = .03) for LA-negative patients. We also checked CRP, an inflammatory marker known to affect the hexagonal phospholipid neutralization STACLOT-LA test. Although the mean CRP level was higher in patients testing positive for LA by DRVVT (14.4 vs 7.5 mg/dL; P < .01), patients with thrombosis did not have significantly higher CRP levels than those with no thrombosis. Hence, we adjusted for CRP, and LA was found to be independently associated with thrombosis (odds ratio, 4.39; 95% CI, 1.45-14.57; p= .01). No statistically significant difference was found by anticoagulation at the time of thrombosis, gender, race, ethnicity, ventilation, and mortality between patients who tested LA positive vs. negative. (more…)
Author Interviews, Clots - Coagulation, NEJM / 12.08.2020

MedicalResearch.com Interview with: Elizabeth Webb, M.P.H Physiotherapy Department Calvary Public Hospital Bruce Bruce, Australia MedicalResearch.com: What is the background for this study? Response: Our study showed that in patients with a history of leg swelling (chronic edema), compression therapy by a skilled lymphedema therapist reduced the risk of infection in the leg (cellulitis) by a huge 77%. With up to 47% of patients experiencing recurrence of cellulitis in their legs within 3 years, this result is a game-changer in terms of our approach to managing patients with leg swelling and recurrent cellulitis. Until now, the use of prophylactic antibiotics to prevent cellulitis has been the only evidence-based practice. We know however, there are many reasons why avoidance of antibiotics is important within our community. (more…)
Author Interviews, Heart Disease, JAMA, Lipids, Metabolic Syndrome, UCSF / 12.08.2020

MedicalResearch.com Interview with: Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins. In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin. Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs. (more…)
Author Interviews, Genetic Research, Neurology / 11.08.2020

MedicalResearch.com Interview with:
BrainHQ Henry Mahncke, PhD
Chief Executive Officer BrainHQ
Dr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO.
MedicalResearch.com Tell us what’s important about this new study in people with Down Syndrome? Response: Often, we believe that genetic conditions are predetermined and completely inalterable, but this new study underscores that, when it comes to the brain, positive change is almost always possible – regardless of age or health condition. That’s consistent with the science of brain plasticity, and it’s a very different and hopeful way to think about the potential of people with Down Syndrome – and people, generally.   MedicalResearch.com: Can you briefly describe Down Syndrome and findings in this study? Response: Down Syndrome is one of the most common genetic abnormalities in humans, found in about 1 in 1,000 births each year, and caused by the presence of all or part of a third copy . of chromosome 21.It’s usually associated with physical growth delays and characteristic facial features. While cognitive abilities vary enormously, one study estimates the average IQ of a young adults is about 50 (comparable to average 8 or 9 year olds). In a pilot study among 12 people with Down Syndrome involving physical, cognitive and EEG measurements, researchers at Aristotle University of Thessaloniki, Greece, found a 10-week combined protocol of physical exercises and computerized brain training led to a reorganization of the brain and to improved performance on both cognitive and physical measures. The physical training consisted of aerobic, flexibility, strength, and balance exercises. The cognitive training used in the study was the Greek version of the commercially-available BrainHQ brain app, consisting of 29 visual and auditory exercises targeting memory, attention, processing speed, problem-solving, navigation, and social skills. The researchers had hypothesized that the training would trigger the brain’s neuroplasticity – its ability to change chemically, structurally and functionally. Their results showed increased connectivity within the left hemisphere and from left to right hemisphere, as well as improved performance on physical and cognitive assessments. (more…)
Author Interviews, COVID -19 Coronavirus, Genetic Research, JAMA / 11.08.2020

MedicalResearch.com Interview with: Caspar van der Made, MD Resident in Internal Medicine, PhD-student Alexander Hoischen, PhD Geneticist, Assistant professor, Departments of Human Genetics and Internal Medicine Radboud University Medical enter Nijmegen, The Netherlands First author Caspar van der Made is a resident in Internal Medicine and PhD-student on the topic of immunogenomics. Alexander Hoischen is geneticist with a special focus on the application of genomic technologies in primary immunodeficiencies and last author of this study. MedicalResearch.com: What is the background for this study? Response: This study was initiated to investigate the presence of monogenic factors that predispose young individuals to develop a severe form of COVID-19. It has become clear that several general risk factors such as obesity, hypertension and diabetes mellitus increase the risk of developing severe coronavirus disease. However, even though differences in interindividual genetic make-up are thought to influence the immune response to SARS-CoV-2, such specific genetic risk factors had not yet been identified. We therefore chose to study young brother pairs (sharing half of their genomes) without any general risk factors that nevertheless contracted severe COVID-19. We hypothesized these highly selected case series may offer the most optimal chance of identifying a (possible X-linked) primary immunodeficiency specific to COVID-19. (more…)