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Author Interviews, BMJ, End of Life Care, Opiods, Pain Research / 21.01.2017

MedicalResearch.com Interview with: Dr. Katherine Irene Pettus, PhD, OSB Advocacy Officer International Association for Hospice and Palliative Care Vice Chair, Vienna NGO Committee on Drugs Secretary NGO Committee on Ageing, Geneva MedicalResearch.com: What is the background for this study? Response: The background for this study is analysis of the three international drug control treaties, official attendance and participation at meetings of the Commission on Narcotic Drugs for the past four years, ongoing discussion of national opioid consumption rates with INCB, and years of home hospice visits in developing countries. (more…)
Author Interviews, Heart Disease, Lipids, Omega-3 Fatty Acids / 21.01.2017

MedicalResearch.com Interview with: Dominik D Alexander, PhD, MSPH Principal Epidemiologist EpidStat Institute Ann Arbor, MI Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, the body of scientific literature on n-3 LCPUFA (EPA/DHA) intake and coronary heart disease (CHD) risk has exploded with mixed results. It was only logical to conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) to estimate the effect of EPA+DHA on CHD, and to conduct a comprehensive meta-analysis of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk. Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event. (more…)
ASCO, Author Interviews, Brigham & Women's - Harvard, Colon Cancer, Exercise - Fitness / 21.01.2017

MedicalResearch.com Interview with: Brendan John Guercio, M.D. Clinical Fellow in Medicine (EXT) Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sedentary lifestyle is a known risk factor for the development of colon cancer and has been associated with increased disease recurrence and mortality in patients with early stage colorectal cancer. This is the first study to our knowledge to show an association between increased physical activity (i.e. non-sedentary lifestyle) and improved survival and progression-free survival in patients with metastatic colorectal cancer. (more…)
Author Interviews, Heart Disease / 21.01.2017

MedicalResearch.com Interview with: Dr. Elena Arbelo MD PhD Department of Cardiology, Cardiovascular Institute Hospital Clínic de Barcelona University of Barcelona Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Almost 20 years after its first description, catheter ablation is a widely-used treatment strategy for patients with symptomatic atrial fibrillation (AF) (AFib) resistant to antiarrhythmic drugs (AAD). If we look at the results of the ESC Pilot Atrial Fibrillation General Registry1, which included about 3000 consecutive in- and outpatients with AF presenting to cardiologists in nine participating countries in Europe, catheter ablation had previously attempted 7.6% overall, most often in those with paroxysmal AF (15.6%). A further 7.8% were prescribed an ablation as part of their management, which went up to a 19.3% in the case of paroxysmal AFib. On the other hand, several randomised clinical trials (RCTs) have shown better results of AFib ablation compared to antiarrhythmic drugs (AADs)2-6. However, these studies had a rather small sample size of selected patients, and interventions were undertaken by experienced operators with clearly pre-specified protocols. With rising prevalence of AFib and increasingly available treatment options, it was of utmost importance to have an accurate picture of contemporary AFib ablation and its outcomes which will allow the identification of practice gaps and assist evidence-based guidelines for the management of these patients. (more…)
Author Interviews, BMJ, Gender Differences, Heart Disease, Social Issues / 20.01.2017

MedicalResearch.com Interview with: Sanne Peters, PhD Research Fellow in Epidemiology The George Institute for Global Health University of Oxford Oxford United Kingdom MedicalResearch.com: What is the background for this study? Response: People from disadvantaged backgrounds are, on average, at greater risk of cardiovascular diseases than people with more affluent backgrounds. Some studies have suggested that these socioeconomic inequalities in cardiovascular disease are more consistent and stronger in women than in men. However, the literature is inconsistent. (more…)
Author Interviews, Dermatology, University of Pittsburgh / 20.01.2017

MedicalResearch.com Interview with: Westley Mori, fourth-year medical student (MSIV) University of Pittsburgh Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tattooed skin represents an important diagnostic challenge for the dermatologist performing a skin cancer screening. Several case reports have described melanoma being hidden in tattoos. To our knowledge, our study is the first of its kind investigating the approach of the tattoo artist to skin with melanocytic nevi (moles) or other skin lesions. We found that the approach to tattooing skin spots is highly variable, with some artists tattooing around moles and others simply tattooing over them. The final cosmetic outcome—not the potential for skin cancer—is often the paramount concern for artists. Those artists with a personal or family history of skin cancer were more likely to refuse inking over a skin spot and recommend the client see a dermatologist. (more…)
Author Interviews, Diabetes, JCEM, Microbiome / 20.01.2017

MedicalResearch.com Interview with: Prof Lorenzo Piemonti, MD Professor of Endocrinology Deputy Director, Diabetes Research Institute (SR-DRI) Head, Beta Cell Biology Unit Vita-Salute San Raffaele University, San Raffaele Scientific Institute Milano Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The potential role of gut inflammation and microbiome is becoming a hot topic in the field of diabetes. Several very recent publications report the presence of intestinal abnormalities associated with autoimmune diabetes in both experimental rodent models and patients. We have previously published that, compared to healthy subjects, patients with type 1 diabetes or at high risk of developing type 1 diabetes shows increased intestinal permeability. Among the factors that may modify the intestinal barrier and impact on its immune activation, the gut microbiota is at present the main suspect. Our study is the first in literature that had the opportunity to analyze the inflammatory profile, the microbiome and their correlation on duodenum biopsies of patients with type 1 diabetes, in comparison with patients with celiac disease and healthy controls. Previous papers pointed out a significant difference in the composition of the stool microflora in subjects with autoimmune diabetes. A major advancement of our work comes from the direct analysis of small intestine, instead of studies on stool samples. In fact, because of their close functional and spatial relationships, as well as a shared blood supply, it is logical to consider the duodenum and the pancreas correlated. We found big differences among the groups: gut mucosa in diabetes shows a peculiar signature of inflammation, a specific microbiome composition and we also discovered a strong association between some analysed inflammatory markers and specific bacteria genera. We think that our data add an important piece to disentangle the complex pathogenesis of type 1 diabetes and more generally of autoimmune diseases. (more…)
Author Interviews, Environmental Risks, Herpes Viruses, Pulmonary Disease / 20.01.2017

MedicalResearch.com Interview with: Dr. Tobias Stöger Group Leader, Dynamics of Pulmonary Inflammation Comprehensive Pneumology Center Institute of Lung Biology and Disease (iLBD) Helmholtz Zentrum München  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Particulate air pollution is common in urban areas and the inhalation of nanoparticles is known to trigger inflammatory effects in humans potentially altering the immune system. Herpes viruses are ubiquitous and well adapted pathogens hiding in host cells and persist thus continuing in a greater part of our population. Under certain stress conditions and if the immune system becomes weakened, the viruses can become active again, begin to proliferate and destroy the host cell. Thus we raised the question whether NP-exposure of persistently herpesvirus-infected cells as a second hit might provoke reactivation of latent virus and eventually lead to an inflammatory response and tissue damage. Our main finding is that NP-exposure of persistently herpesvirus-infected cells – murine or human – restores molecular signatures found in acute virus infection and boosts production of lytic viral proteins. (more…)
Author Interviews, Circadian Rhythm, Toxin Research / 20.01.2017

MedicalResearch.com Interview with: Rajendram Rajnarayanan PhD Department of Pharmacology and Toxicology Assistant Professor Jacobs School of Medicine and Biomedical Sciences University of Buffalo MedicalResearch.com: What is the background for this study? What are the main findings? Response: Human exposure to environmental chemicals i.e., insecticides and pesticides increases the risk of various diseases by directly interacting with proteins or signaling pathways in the endocrine or neuroendocrine system. In this study, our teamscience effort integrating big-data computation with receptor pharmacology, report for the first time that carbamate insecticides found in household and agricultural products interact with human melatonin receptors. At UB we have generated a database, we call it Chem2Risk, which contains about four million chemicals reported to have some level of toxicity. From those, after grouping the chemicals in clusters according to their similarity, we found several with potential to mimic melatonin. Wet-lab experiments confirmed that these chemicals indeed interact with melatonin receptors and have the potential to alter melatonin signaling. (more…)
Author Interviews, Gender Differences, Neurological Disorders, Psychological Science / 20.01.2017

MedicalResearch.com Interview with: Lise Eliot PhD Associate Professor of Neuroscience Chicago Medical School Rosalind Franklin University North Chicago, IL 60064 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies in rats indicate that the amygdala, which is important for many social behaviors including aggression and rough-and-tumble play, is larger in male animals.  Early MRI studies also reported that the human amygdala is larger in men, even after correcting for males' larger overall brain size.  Because so many MRI studies are now imaging amygdala volume in matched groups of healthy males and females, we realized that there is a lot of published data that could settle whether the human amygdala is indeed proportionally larger in men.  Another rationale for the study is that many psychiatric disorders that involve the amygdala (e.g., depression, anxiety, substance abuse) differ in prevalence between men and women. (more…)
Addiction, Author Interviews, Mental Health Research / 20.01.2017

MedicalResearch.com Interview with: Emily Brignone, BS Informatics, Decision Enhancement, and Analytic Sciences Center VA Salt Lake City Health Care System, Salt Lake City, Department of Psychology Utah State University, Logan, Utah MedicalResearch.com: What is the background for this study? Response: Nearly 30% of active duty Veterans of post-9/11 conflicts in Iraq and Afghanistan are discharged from military service for reasons other than expired term of service or retirement. These non-routine discharges can occur for a variety of reasons, including disability, failure to meet or maintain qualifications, early release, or misconduct. Veterans discharged under non-routine conditions are at greater risk for several concerning outcomes during the reintegration period, including unemployment, incarceration, homelessness, and suicide. A better understanding of the context of the transition from military service to civilian life, including discharge type, may provide opportunities for mitigating risk for these negative outcomes. One potential indicator for the conditions surrounding this transition is the administrative code that the Department of Defense assigns to active duty military service members at the time of their separation from service. These codes describe the circumstances related to discharge, and can serve as clinically significant early markers for post-deployment mental illness, substance use disorders, and suicidality, and thereby subsequent adverse reintegration outcomes. (more…)
Author Interviews, Education, PNAS / 20.01.2017

MedicalResearch.com Interview with: Janet Shibley Hyde Evjue-Bascom Professor Helen Thompson Woolley Professor of Psychology and Gender & Women’s Studies Director, Center for Research on Gender & Women University of Wisconsin Madison, WI MedicalResearch.com: What is the background for this study? Response: The background is that, in the U.S. and many other Western nations, we don’t have enough people going into STEM fields (Science, Technology, Engineering, and Mathematics). Innovations in STEM fields are enormously important in 21st century economies. So, we need to encourage more people to go into STEM fields. To do that, they have to major in a STEM field in college, and to do that, they need to prepare in high school. (more…)
Author Interviews, Lancet, Prostate Cancer / 20.01.2017

MedicalResearch.com Interview with: Dr. Nina Klemann MD, PhD-student Copenhagen Prostate Cancer Center Copenhagen MedicalResearch.com: What is the background for this study? Response: For 30 years, ultrasound-guided biopsies of the prostate have been used in the evaluation of men suspected for prostate cancer. The biopsy needles are employed systematically into the prostate at different sites where prostate cancer is typically present. However, it has been recognized for years, that there is a risk of not hitting the cancer areas, simply by chance. Although cancer diagnosis may be missed in the initial biopsy set by sampling error, it has been a continuous debate whether lethal prostate cancer is missed. Today, we know that prostate cancer is a common finding in men age 50-80, but that the life-time risk of prostate cancer death in this age-group is low. Consequently, we know that there is a considerable risk of diagnosing, and ultimately treating, a disease that will never result in symptoms or death. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 20.01.2017

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH Chief Cardiovascular Medicine Fellow Stanford University MedicalResearch.com: What is the background for this study? Response: Hispanics are the largest minority group in the U.S. Although cardiovascular disease (CVD) is the leading cause of death for Hispanics, most studies exploring disparities focus on Black and White differences. Additionally, Hispanics are often aggregated into one homogenous group, which masks important differences. There is also an interesting epidemiological phenomenon known as the “Hispanic paradox” that states that although Hispanics have greater risk factors for CVD, they experience lower mortality. (more…)
Author Interviews, NIH, Nutrition, Weight Research / 20.01.2017

MedicalResearch.com Interview with: Janet M. de Jesus, M.S., R.D. Program Officer, Implementation Science Center for Translation Research and Implementation Science (CTRIS) National Heart, Lung, and Blood Institute MedicalResearch.com: What is the background for the DASH diet? What are the main components? Response: The DASH eating plan was created for a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI). DASH stands for Dietary Approaches to Stop Hypertension. The goal of the original DASH trial was to test the eating plan compared to a typical American diet (at the time in the 1990s) on the effect of blood pressure. The DASH eating plan is rich in fruits, vegetables, and whole grains. It includes low-fat dairy products, poultry, fish, legumes, vegetable oils, and nuts; and limits intake of sweets and sugar-sweetened beverages and high-fat meats. The eating plan is a good source of potassium, magnesium, and calcium. The DASH eating plan was shown to reduce blood pressure and improve lipid profiles. A second DASH trial, “DASH-sodium,” showed that adding sodium reduction to the DASH eating plan reduced blood pressure even more. (more…)
Anesthesiology, Author Interviews, JAMA, OBGYNE, Surgical Research / 20.01.2017

MedicalResearch.com Interview with: Adam Sachs MD Assistant Professor of Anesthesiology University of Connecticut School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: When women undergo appendectomy or cholecystectomy during pregnancy they are obviously concerned about the well being of their fetus. Unfortunately, the majority of the data available to council pregnant women is outdated and medical practice has significantly changed since their publication. (more…)
Author Interviews, Cancer Research, Immunotherapy, NEJM, Transplantation / 19.01.2017

MedicalResearch.com Interview with: Kenar D. Jhaveri, MD Professor of Medicine Division of Kidney Diseases and Hypertension Hofstra Northwell School of Medicine, 100 Community Drive, Great Neck, NY 11021 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The immune check point inhibitors are novel anti cancer agents being used rapidly in various cancers. Many cancers don’t allow our natural immune system to attack the cancer. These immunotherapy agents “activate” the immune system to attack the cancer. These agents have been reported to cause multiple end organ side effects as noted by this recent NYT article. We also recently reported the known renal effects of immunotherapy. In the kidney transplant patient who is on immunosuppressive agents, the physicians need to keep the immune system suppressed to preserve the kidney. When one of these agents are used for a cancer in a kidney transplant patient, prior reports have suggested severe rejection episodes and loss of the transplanted kidney. Our case in the NEJM is the first report of a preventive strategy used to allow for simultaneous treatment of cancer and preventive rejection of the kidney. We used a regimen of steroids and sirolimus( an anti-proliferative agent that is used to treat cancer and also is an immunosuppresant) along with the immunotherapy. The cancer started regressing and the kidney did not reject. (more…)
Author Interviews, Genetic Research, Infections, Pediatrics / 19.01.2017

MedicalResearch.com Interview with: Prof. Adrian Liston (VIB-KU Leuven) MedicalResearch.com: What is the background for this study? Response: With vaccinations, sanitation, antibiotics and general improvements in living standards, infectious disease is no longer a major killer of children. Death or hospitalisation of children from infection is rare in countries with modern health care systems. Those rare events were once thought to be chance outcomes on the roulette of bad luck, but increasingly we are recognising that genetic mutations underlie severe pediatric infections. In our study we are seeking to identify the mutations and immunological changes that occur in children, causing them to have severe reactions to infectious disease. (more…)
Author Interviews, CDC, Cost of Health Care, Opiods / 19.01.2017

MedicalResearch.com Interview with: Dora Lin, MHS Sr. Research Assistant Johns Hopkins Bloomberg School of Public Health Center for Drug Safety and Effectiveness Baltimore, MD 21205  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In response to the opioid epidemic and growing number of overdose deaths each year, the CDC released draft guidelines to improve the safe use of opioids in primary care. The draft guidelines were open to public comment, and many organizations, ranging from professional societies to consumer advocates to local governmental organizations, submitted comments regarding the guidelines. We examined the levels of support or non-support for the draft guidelines among the 158 organizations who submitted comments.   We also examined each organization’s relationship to opioid manufacturers. Most organizations supported the guidelines, regardless of whether or not they had a financial relationship to a drug company. However, organizations receiving funding from opioid manufacturers were significantly more likely to be opposed to the guidelines than those who did not receive such funding. (more…)
Author Interviews, BMJ / 19.01.2017

MedicalResearch.com Interview with: Salomeh Keyhani MD Associate professor of general internal medicine San Francisco VA Medical Center and University of California San Francisco, CA 94121, USA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Randomized controlled trials are the foundation of the evidence base. We examined the prevalence of financial ties in randomized controlled trials and also examined the relationship of financial ties of principal investigators (PI) with trial outcome. We defined a financial tie as the direct compensation (e.g., consulting fees) of a PI by the drug manufacturer of interest. Although there have been past studies that have examined this relationship, many did not separate financial ties from funding source for the trial and many were focused on one specialty, journal, or type of drug. This study identified a random sample of RCTs published in 2013 that were focused on assessing drug efficacy. Both the disclosure section of the paper and several online databases (Medline, Google, Propublica’s Dollars for Doctors, and the US Patent Office) were searched for evidence of financial ties. Principal investigators financial ties with industry were independently associated with positive study outcomes. (more…)
Author Interviews, CDC, Lyme / 17.01.2017

MedicalResearch.com Interview with: Tammi L. Johnson PhD, Microbiologist Division of Vector-Borne Diseases CDC MedicalResearch.com: What is the background for this study? Response: Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks, also called deer ticks. Lyme disease is the most commonly reported vectorborne illness in the United States, with approximately 300,000 humans becoming infected each year. While Lyme disease infections are highly concentrated in the northeast and upper Midwest, the number of counties in which the blacklegged tick has become “established” has more than doubled in the past two decades. Established populations of these ticks are found in 35 states. Knowing that Lyme disease is increasing both in numbers of infections and in geographic range in the United States, we did this study to determine if people are at risk of encountering infected ticks while recreating in eastern national parks. This is the first large-scale survey in multiple national parks, and though suspected, it had not been confirmed that ticks in many of these parks were infected. So the purpose of the study was to survey national park units across six Northeastern and Mid-Atlantic States and the District of Columbia, ranging from Maine in the north to Virginia in the south and characterize the risk of human exposure to ticks-borne bacteria. Researchers from the Centers for Disease Control and Prevention and the National Park Service evaluated frequently used trails in Acadia National Park, Catoctin Mountain Park, Fire Island National Seashore, Gettysburg National Military Park, Manassas National Battlefield Park, Monocacy National Battlefield, Prince William Forest Park, Rock Creek Park, and Shenandoah National Park. (more…)
Author Interviews, Technology, Vitamin C, Vitamin D, Vitamin K / 17.01.2017

MedicalResearch.com Interview with: Adrienne R. Minerick, Ph.D. Associate Dean for Research & Innovation, College of Engineering Assistant to the Provost for Faculty Development Professor, Chemical Engineering Michigan Technological University Houghton, MI 49931 MedicalResearch.com: What is the background for this study? What are the main findings? Response: With seed funding from the Gerber Foundation, we asked two scientific questions. 1. Are vitamins present in tears and could we reliably detect them? 2. Do the vitamin levels in tears correlate with the vitamin levels in blood? This research, conducted by recent PhD graduate Maryam Khaksari, illustrated that vitamins are present in tears. The majority of the essential vitamins are water soluble, which were present in tears in higher concentration than fat soluble vitamins. Given that tears are 98% water, this result wasn’t surprising. This study developed up protocols to reliably detect both water and fat soluble vitamins. The limits of detection and limits of quantification did vary by vitamin, so there is ample room to improve this technique. The second question was answered by a small clinical trial with UP Health: Portage Hospital’s Pediatric Clinic. During the 4-month well-baby check-up, willing parents and their infant each donated both a blood sample and a tear sample. Vitamin concentrations were determined in the samples and correlations quantified. Fat soluble vitamin K showed the strongest concentration correlation between blood and tears. The strength of additional vitamin correlations were noted. These early-stage results demonstrate that vitamin screening from a single drop of tears (35uL or microliters) is feasible – with additional refinement. (more…)
Author Interviews, Cost of Health Care, JAMA, Johns Hopkins, Medicare / 17.01.2017

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: The average anesthesiologist, emergency physician, pathologist and radiologist charge more than four times what Medicare pays for similar services, often leaving privately-insured out-of-network patients stuck with surprise medical bills that are much higher than they anticipated. The average physician charged roughly 2.5 times what Medicare pays for the same service. There are also regional differences in excess charges. Doctors in Wisconsin, for example, have almost twice the markups of doctors in Michigan (3.8 vs. two). (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics / 17.01.2017

MedicalResearch.com Interview with: Acupuncture Wikipedia imageDr Kajsa Landgren Faculty of Medicine, Department of Health Sciences Lund University, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infantile colic is common, affecting 10-20% of newborns. These infants have intense crying and fussing, more than 3 hours/day more than 3 days/week. There is no medical treatment, causing desperate parents to seek complementary medicine. The evidence for acupuncture is sparse. In this trial including 147 infants with colic, we tested two types of acupuncture. Both types of acupuncture were minimal, i.e needles were inserted for only a few seconds without further stimulation. Group A received only one single needle for 2-5 seconds. Group B received up to five needle insertions for maximum 30 seconds. A third group, C, received no acupuncture. All families came to four extra visits to their Child Health Center where they met a nurse who gave advice and support. During these visits the infants were separated from their parents for five minutes, being alone with an acupuncturist who gave acupuncture to the infants in group A and B, but not to infants in group C. Parents and the nurse were blinded to which group the infant was randomized to. (more…)
Anemia, Author Interviews, Global Health, JAMA, OBGYNE / 17.01.2017

Ola Andersson, MD, PhD Department of Women’s and Children’s Health Uppsala University, Uppsala, Sweden MedicalResearch.com Interview with: Dr. Ola Andersson MD, PhD Uppsala University, Uppsala, Sweden MedicalResearch.com: What is the background for this study? Response: Anemia affects over 40% of all children under 5 years of age in the world. Anemia can impinge mental and physical performance, and is associated with long-term deterioration in growth and development. Iron deficiency is the reason for anemia in approximately 50% of the children.is. When clamping of the umbilical cord is delayed, ie after 3 minutes, iron deficiency up to 6 months of age can be prevented, but it has not been shown to prevent iron deficiency or anemia in older infants. At birth, approximately 1/3 of the child's blood is in the placenta. If clamping of the umbilical cord is done immediately (early cord clamping), the blood will remain in the placenta and go to waste (or can be stored in stem cell banks). If instead clamping is postponed for 3 minutes, most of the blood can flow back to the child as an extra blood transfusion, consisting of about one deciliter (1/2 cup) of blood, equivalent to about 2 liters (half a US gallon) of an adult. A blood donor leaves 0.4-0.5 liters of blood. Blood contains red blood cells that contain hemoglobin. Hemoglobin carries oxygen to the tissues of the body. Hemoglobin contains a lot of iron, and the extra deciliter of blood may contain iron that corresponds to 3-4 months of the need for an infant. The World Health Organization (WHO) recommends umbilical cord clamping at 1 minute or later, American College of Obstetricians and Gynecologists (ACOG) recommends umbilical cord clamping at 30-60 seconds or later. (more…)
Author Interviews, BMJ, HIV, STD / 17.01.2017

MedicalResearch.com Interview with: Michael Rekart, MD, DTM&H Clinical Professor, Medicine and Global Health The University of British Columbia .... On behalf of my co-authors MedicalResearch.com: What is the background for this study? Response: The background for this study is the observation that new syphilis cases over the last decade in British Columbia, Canada, have been escalating more rapidly than anyone could have predicted and that syphilis incidence has outpaced the incidence of other sexually transmitted diseases (STDs), including gonorrhea and chlamydia. This unexpected increase in syphilis has been almost wholly concentrated in men who have sex with men (MSM). Most of these MSM are HIV-1 infected and many are taking highly active antiretroviral therapy (HAART). In fact, the expansion in HAART coverage in MSM parallels the growth in syphilis in the same population. In addition, my co-authors and I had serious doubts as to whether 'treatment optimism', the generally accepted explanation for this phenomenon, was robust enough to account for such a dramatic increase in new syphilis cases. Treatment optimism posits that HAART availability and effectiveness have led to the perception in both HIV-1-infected and HIV-1-uninfected individuals that HIV-1 transmission has become much less likely, and the effects of HIV-1 infection less deadly. This is expected to result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 STDs, including gonorrhea, chlamydia and syphilis. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Emory, Neurological Disorders / 17.01.2017

MedicalResearch.com Interview with: Andres Rodriguez Ruiz, MD Clinical Neurophysiology and Neurology Emory School of Medicine MedicalResearch.com: What is the background for this study? Response: The Critical Care EEG monitoring research consortium (CCEMRC) was established with the goal of promoting collaboration and research among healthcare institutions highly involved in continuous EEG monitoring of critically ill patients. This group together with the American Clinical Neurophysiology Society (ACNS) established the standardized critical care EEG terminology that allowed uniform reporting of EEG findings in critically ill patients. As part of this effort, a database was developed for collection and clinical reporting of such EEG findings and was adopted for daily clinical use by Yale University, Emory University and Brigham and Women's Hospital. Prior retrospective reports have acknowledged an association between periodic discharges and seizures. However, many of these reports were small series and did not include specific characteristics of these patterns. Our goal was to ascertain whether features of periodic and rhythmic patterns such as location (generalized vs. lateralized), frequency and prevalence influenced seizure risk in a large cohort of critically ill adults. (more…)
Author Interviews, Genetic Research, Nature / 17.01.2017

MedicalResearch.com Interview with: Natalie Shaw, MD, MMSc National Institute of Environmental Health Sciences Research Triangle Park, North Carolina and Harrison Brand, PhD Molecular Neurogenetics Unit and Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research Massachusetts General Hospital, Boston Massachusetts, USA. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Congenital arhinia, or absence of the nose and olfactory system, is an extremely rare malformation, often accompanied by defects in the eyes and reproductive system. Arhinia has been reported in only 80 patients in the past century and though a genetic cause had been suspected, no previous study had identified a plausible genetic candidate. Through an international collaboration among clinicians and investigators spanning 10 different countries, we were able to assemble a cohort of 40 arhinia patients. Using whole-exome sequencing, we found that 84% of the patients had rare mutations in the same gene – SMCHD1. Further, modeling studies based on patient cells and SMCHD1 knockdown in zebrafish strongly support a role for the gene in arhinia. We were surprised by this discovery because mutations that impair SMCHD1 function are known to interact with other regions of the genome to cause a type of muscular dystrophy (FSHD2) that does not affect the bones or cartilage of the face. Deep phenotyping of our cohort revealed that individuals with arhinia can in fact develop FSHD2, but it is still unclear why individuals with FSHD2 do not have arhinia. (more…)