Author Interviews, Clots - Coagulation, Heart Disease, JACC, Surgical Research / 30.08.2016

MedicalResearch.com Interview with: Gennaro Giustino MD Resident Physician - Department of Medicine The Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: A period of dual antiplatelet therapy (DAPT) is required after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). The pathophysiological rationale for DAPT after DES-PCI is predicated on the need to prevent stent-related thrombotic complications while vascular healing and platform endothelialization are ongoing, a process that seems to last between 1 and 6 months with new-generation DES. Whether to extend DAPT after this mandatory period in order to provide a broader atherothrombotic risk protection (for stent-related and non-stent-related atherothrombotic events) is currently a matter of debate. Current guidelines recommend at least 6 months of DAPT after PCI in patients with stable coronary artery disease (CAD) and at least 12 months of DAPT in patients presenting with acute coronary syndrome (ACS). While, several risk scores have been developed to guide clinical decision making for DAPT intensity and duration (namely the DAPT score and the PARIS risk scores) little attention has been payed so far to PCI complexity and the extent of CAD to guide duration of DAPT. In fact irrespective of clinical presentation, patients undergoing more complex PCI procedure (likely due to greater coronary atherosclerotic burden) may remain at greater risk for ischemic events and therefore may benefit of prolonged, or more intense, DAPT. (more…)
Author Interviews, Lyme / 29.08.2016

MedicalResearch.com with Senior Author: Tara Moriarty, Ph.D. University of Toronto, Canada Faculty of Dentistry, Matrix Dynamics Group Faculty of Medicine, Department of Laboratory Medicine and Pathobiology Lead Author: Rhodaba Ebady, Ph.D. student University of Toronto, Canada Faculty of Dentistry, Matrix Dynamics Group MedicalResearch.com: What is the background for this study? What are the main findings? Response: The spread of microbes via the bloodstream (dissemination) is responsible for most of the mortality associated with bacterial infection. Even though this is a clinically important step of many infectious diseases, and likely an important target for disease treatment, we don’t know how most microbes disseminate. One of the key steps in this process is adhesion of bacteria to the inner surfaces of blood vessels. This allows bacteria to slow down enough to grab onto vessel surfaces, then escape from the blood stream into tissues where it’s easier for them to live. It’s a bit like the problem faced by a person being carried down a fast-flowing river who needs to grab onto something on the banks to get out onto dry land. A big problem for bacteria, and any other cells which must stick to blood vessel walls (like white blood cells travelling to a site of infection or inflammation), is that they have to be able to stick to vessel walls without being ripped off by the flow of blood. They have to have adhesion mechanisms strong enough to overcome forces due to flow. It’s also really helpful to be able to hang on but keep moving along walls until they reach a good spot to get out. This is important for white blood cells too, which have to “sample” their environment to get to the right place to get out of blood flow. Even though the problem of how bacteria stick to blood vessel walls is so important clinically, the mechanisms bacteria use to do this are not widely understood. Part of this gap in our knowledge arises because we haven’t had good tools to study this process as it happens, and to understand how force affects bacterial interaction with vessel walls. The process of bacteria sticking to blood vessel walls is very fast, and hard to observe. The methods to observe this have already been developed, but the major technical innovations of our paper were to figure out how to identify and track the movement of the individual bacteria which stuck to vessel walls among millions flowing past, and to figure out how to set up a flow chamber system which replicated certain conditions in human blood vessels. Figuring out how to do this allowed us to figure out a lot about how the bacteria moved, and the forces and mechanisms involved in adhesion. It took a couple of years just to figure out the common patterns in the thousands of tracks of bacteria interacting with blood vessels, after the initial technical innovation. (more…)
Author Interviews, Neurology, Stroke / 29.08.2016

MedicalResearch.com Interview with: Dr. Ashkan Shoamanesh MD FRCPC Assistant Professor Division of Neurology, Department of Medicine McMaster University and Dr. Jose Rafael Romero, MD Associate Professor of Neurology Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Framingham Heart Study is a population-based study of individuals residing in the community. Identifying people who are at risk for stroke can help us determine who would benefit most from existing or new therapies to prevent stroke. As inflammatory pathways are believed to contribute to vascular disease and stroke, we tested whether circulating biomarkers of inflammation and endothelial dysfunction could improve the predictive ability of the Framingham Stroke Risk Profile score, a model that contains classical vascular risk factors such as high blood pressure and diabetes. Our main observation was that inclusion of 4 biomarkers (C-reactive protein, tumor necrosis factor receptor-2, total homocysteine, and vascular endothelial growth factor) in the Framingham Stroke Risk Profile improved its ability to predict a stroke (net reclassification improvement of 0.34 [0.12–0.57]). (more…)
Author Interviews, Compliance, Cost of Health Care / 29.08.2016

MedicalResearch.com Interview with: Elizabeth Geneva Wood, MHPA Department of Health Policy and Administration College of Nursing Washington State University Spokane MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many people don’t fill prescriptions because they can’t afford them, which is risky for their health. The problem of cost-related nonadherence to prescriptions (CRN) was increasing in prevalence over time until several major policy changes in the 2000s that were intended to help prescription affordability and/or access to health insurance. We observed that each of these major policy changes corresponded with a decrease in CRN among the policy’s target population. For seniors, CRN dropped in 2006, when Medicare Part D came into effect. For younger adults (19-25), CRN dropped in 2010, when the Affordable Care Act began allowing them to stay on their parents’ insurance. Cost-related nonadherence rates also dropped for all non-elderly adults (including the younger ones) in 2014 and 2015, when the Medicaid expansion and the introduction of the health insurance marketplaces offered coverage to many previously-uninsured adults. (more…)
Addiction, Author Interviews, CDC, Opiods / 29.08.2016

MedicalResearch.com Interview with: R. Matthew Gladden, PhD Surveillance and Epidemiology Team, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured fentanyl (IMF) as a threat to public health and safety.IMF is unlawfully produced fentanyl, obtained through illicit drug markets, includes fentanyl analogs, and is commonly mixed with or sold as heroin. Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of fentanyl and fentanyl-precursor chemicals by criminal organizations. Fentanyl is a synthetic opioid 50?100 times more potent than morphine. Multiple states have reported increases in fentanyl-involved overdose (poisoning) deaths (fentanyl deaths). This report examined the number of drug products obtained by law enforcement that tested positive for fentanyl (fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). (more…)
Author Interviews, Biomarkers, Cancer Research, Genetic Research, Lancet / 29.08.2016

MedicalResearch.com Interview with: Dr. Manel Esteller Director of the Epigenetics and Cancer Biology Program (PEBC) Bellvitge Biomedical Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cancer of Unknown Primary (CUP) occurs when the patient is diagnosed with a metastasis but the primary tumor is not found. It accounts for around 5-10% of tumors around the world and the survival is very poor. Until now, only in 25% of cases the primary site was identified after diagnosis pipeline. We are showing herein that the use of epigenetic profiling, based in the determination of the chemical marks occurring in DNA that are tumor-type specific, reaches a diagnoses of 87% of cases. (more…)
Author Interviews, Infections, Outcomes & Safety, Pediatrics / 29.08.2016

MedicalResearch.com Interview with: Dr. Cohen Regev, M.D Head of the infectious diseases and infection control units Sanz Medical Center, Laniado hospital Netanya, Israel MedicalResearch.com: What is the background for this study? Response: During 3 months in 2012 we had a number of clinical isolates of Pseudomonas aeruginosa (PA) in our neonatal intensive care unit (NICU) and a high incidence of colonization among ventilated patients in our medical-surgical intensive care unit (MSICU). The origin of PA may be from various environmental sources (‘exogenous’), from the patients’ own microbiome (‘endogenous’), or from both. Since in NICUs the origin is usually exogenous, we investigated the sources of the bacteria, focusing on the faucets of these units, as they were previously incriminated as causes of outbreaks in ICUs. The study was conducted in Sanz medical center, a 400-bed community hospital located in central Israel. In the NICU we obtained several environmental cultures from faucets using a bacterial swab by rubbing the tip into the distal part of the faucet. Aerators were dismantled from all faucets, cultured from their inner part using a swab and were not repositioned. Contaminated faucets were occasionally replaced or treated with enzymatic fluid and sterilization by Ethylene Oxide. During the intervention and since, neonates were bathed only with warmed sterile water, and tap water was allowed only for hand hygiene practices. In the MSICU tap water was used only for bathing the patients. All other uses of tap water, such as drinking, moistening and mouth treatments, were allowed using only sterile water. The units' faucets were sampled on two different days concurrently with surveillance cultures of pharyngeal, sputum and urine from the patients. Bacteria were identified with VITEK 2 (Biomerieux®) and typing was done by Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR. (more…)
Author Interviews, Baylor College of Medicine Houston, Infections, Science / 29.08.2016

MedicalResearch.com Interview with: Mary K. Estes, Ph.D. Distinguished Service Professor Cullen Endowed Chair of Human and Molecular Virology Department of Molecular Virology and Microbiology Baylor College of Medicine Houston, TX 77030 MedicalResearch.com: What is the background for this study? Response: Noroviruses are the most common cause of acute gastroenteritis (vomiting and diarrhea) worldwide and the leading cause of food-borne gastroenteritis. They also can cause chronic (long-lasting) illness in immunocompromised patients. These viruses are highly contagious and spread rapidly among people. The first report of an outbreak caused by a norovirus was in an elementary school in Norwalk, Ohio in 1968. Since that time, it became known that the virus damaged cells in the small intestine of infected people but attempts by many research groups to grow human noroviruses in the laboratory in a variety of intestinal cancer cells lines failed. This inability to grow human norovirus has been considered the single greatest barrier to norovirus research because it limited studies to understand how the virus makes people sick and how to inactivate the virus to prevent infection. (more…)
Author Interviews, Exercise - Fitness, OBGYNE / 29.08.2016

MedicalResearch.com Interview with: Katrine M. Owe, PhD Domain for Mental and Physical Health Norwegian Institute of Public Health OSLO, Norway Norwegian National Advisory Unit on Women's Health Oslo University Hospital, Rikshospitalet Oso, Norway MedicalResearch.com: What is the background for this study? Response: The rising cesarean delivery rates in developed countries are of great concern. Given the many adverse consequences of repeated cesarean deliveries for both mother and child, identifying factors associated with the decision to perform the first cesarean is important. Growing evidence show that regular exercise during pregnancy is associated with a lower risk of gestational diabetes, preeclampsia and excessive birth weight, all of which are highly correlated with having a cesarean delivery. Results from previous studies examining the relationship between pregnancy exercise and mode of delivery, are inconsistent. Small sample size, not population-based, reporting crude estimates, and not powered to study cesarean delivery, are common methodological limitations in previous studies. (more…)
Alzheimer's - Dementia, Author Interviews, Nutrition / 28.08.2016

MedicalResearch.com Interview with: William B. Grant, Ph.D. Director, Sunlight, Nutrition, and Health Research Center San Francisco, CA www.sunarc.org MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is the culmination of 20 years of investigating dietary links to Alzheimer's disease (AD). I am a physicist by training and spent my salaried career as an atmospheric scientist. In the 1990s while studying the effect of acid rain and ozone on eastern hardwood forests, I became familiar with the geographical ecological study approach. In this approach, populations are defined geographically, such as by state or country, and health outcomes are compared statistically with risk-modifying factors. Ecological studies are an efficient way to analyze the results of unplanned experiments. In 1996, I read that Japanese-American men living in Hawaii had two and a half times the prevalence of  Alzheimer's disease as native Japanese. I knew that AD patients often had higher concentrations of aluminum in their brains than other people, and that acid rain increased the concentration of aluminum in trees. It quickly occurred to me that the American diet must be the cause of the increased AD rate, and that by using the ecological approach, I could prove it. My first study, published in 1997, compared AD prevalence rates for 11 countries with macro-dietary factors of national diets. Total fat was found to have the highest correlation with AD, followed by total energy (calories), with fish reducing risk slightly, while countries such as China, Japan, and India, with large amounts of rice in the diet, had very low  Alzheimer's disease rates. This study was the first major study linking diet to risk of AD and led to observational studies that confirmed the findings five years later. (more…)
Addiction, Author Interviews, CDC, Opiods, Pain Research / 27.08.2016

MedicalResearch.com Interview with: John Halpin, MD, MPH, Medical officer Prescription Drug Overdose Epidemiology and Surveillance Team CDC Injury Center MedicalReseach.com editor’s note: Dr. Halpern discusses the CDC alert of August 25, 2016 regarding the increase in fentanyl-related unintentional overdose fatalities in multiple states. MedicalResearch.com: What is the background for this alert? Response: The current health alert is an update to a previous alert in October, 2015 from CDC which described the geographic spread of states in which forensic labs were increasingly detecting fentanyl in the drug submissions that they receive from law enforcement, and how many of these same states were beginning to report fentanyl-related overdose deaths by their departments of public health. Further investigation by CDC and DEA have revealed that the great majority of fentanyl now present in the illicit drugs market is clandestinely-produced, and most commonly mixed with and sold as heroin, and is responsible for the great majority of fentanyl-related overdose deaths. Indications at the time of that alert pointed to a likely continuous rise in the supply of illicitly-manufactured fentanyl, and the potential for increasing numbers of fentanyl-related overdose deaths, particularly among those who use heroin. (more…)
Accidents & Violence, Author Interviews, CDC, Education, Sexual Health / 27.08.2016

MedicalResearch.com Interview with: Laura Kann, Ph.D. Chief of the School-Based Surveillance Branch Division of Adolescent and School Health CDC MedicalResearch.com: What is the background for this study? Response: CDC has been using the Youth Risk Behavior Survey (YRBS) to collect data on the sexual identity of high school students at the state and local levels and on the prevalence of health risk behaviors among gay, lesbian, and bisexual students for many years. Starting with the 2015 YRBS cycle, we had enough support to add questions to the national YRBS to provide the first ever nationally representative look at health risk behaviors among these students. (more…)
Author Interviews, Genetic Research, Neurological Disorders / 26.08.2016

MedicalResearch.com Interview with: Lee Henderson, Ph.D. CEO Vybion, Inc. Ithaca, NY 14852Lee Henderson, Ph.D. CEO, Vybion, Inc. Ithaca, NY 14852 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Huntington’s disease (HD) is a progressive and fatal neurodegenerative disease characterized by loss of both cognitive and motor function as a result of neuron loss primarily within the brain striatum. HD is directly caused by the expansion of CAG repeats in the huntingtin gene resulting in an expanded glutamine region (polyQ) near the N-terminus of the protein. Age of disease onset and the rate of progression is directly correlated to the size of the expansion with pathology observable at 35-70 repeats in adults and greater in juvenile onset. During normal turnover and degradation of the huntingtin protein, the N-terminal polyQ-containing fragments drive pathology and aggregate formation in cells. The direct link to progression has been described by several laboratories using cell-based and animal model studies and confirmed in humans as the binding of these N-terminal fragments to DNA and transcription factors that result in widespread gene dysregulation in neurons. (more…)
Author Interviews, Heart Disease / 26.08.2016

MedicalResearch.com Interview with: John A. Elefteriades, MD William W.L. Glenn Professor of Surgery Chief of Cardiothoracic Surgery Yale New-Haven Hospital Director, Aortic Institute at Yale-New Haven Yale University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the late 1990’s, Dr. Milewicz’s group in Texas and our group at Yale recognized that thoracic aortic aneurysms and aortic dissections (internal tears of the aorta) ran in families. This paper explores for the first time the ages at which aortic dissections occur among members within a family. Interestingly, we found that once one family member has suffered an aortic dissection, other family members tend to suffer dissection at about the same age (mostly within ten years of the age of the original dissector). (more…)
Author Interviews, Mental Health Research, Schizophrenia, Telemedicine / 26.08.2016

MedicalResearch.com Interview with: Dror Ben Zeev, PhD Associate Professor of Psychiatry Director, mHealth for Mental Health Program Dartmouth College Hanover, NH MedicalResearch.com: What is the background for this study? Response: We deployed a mobile phone intervention called FOCUS as part of a larger multi-component effort called Improving Care Reducing Costs (ICRC). ICRC was the first technology-aided relapse prevention program of its kind for people with schizophrenia; a very exciting multi-state project funded by the Center for Medicare and Medicaid Innovation (CMMI) led by Dr. John Kane at the Zucker Hillside Hospital and a team of researchers from multiple institutions. Several other technological interventions were used in concert with mHealth, including a web intervention called Coping with Voices Developed by Dr. Jen Gottlieb and a Daily Support Website developed by Dr. Armando Rotondi. A truly multi-disciplinary effort designed to help prevent re-hospitalization in people with psychosis who were recently discharged from the hospital; this is a group that is at very high risk for relapse. (more…)
Author Interviews, BMJ, Mental Health Research, Sleep Disorders / 26.08.2016

MedicalResearch.com Interview with: Donna Littlewood PhD School of Health Sciences Faculty of Biology, Medicine and Health The University of Manchester MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was the first qualitative study to examine the role of sleep problems in relation to suicidal thoughts and behaviours. In-depth semi-structured interviews were conducted with 18 participants, who all had experienced major depressive episode(s) and suicidal thoughts and behaviours. Data were analysed with thematic analysis which identified three interrelated pathways whereby sleep contributed to suicidal thoughts and behaviours. The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night. Secondly, the research found that a prolonged failure to achieve a good night's sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity. Finally, participants said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns - reinforcing the first two pathways. (more…)
Author Interviews, Environmental Risks, Infections / 26.08.2016

MedicalResearch.com Interview with: Lin Op De Beeck, PhD student Laboratory of Aquatic Ecology, Evolution and Conservation University of Leuven Leuven, Belgium MedicalResearch.com: What is the background for this study? Response: Mosquitoes transmit quite a few deadly diseases, including West Nile Virus. Around the world, therefore, the fight against these insects is high on the agenda. Existing strategies for mosquito control often involve the use of chemical pesticides that harm the environment. These pesticides are increasingly less effective as well, as insects can become resistant to existing products relatively quickly. Biopesticides are a possible alternative. The most commonly used biological pesticide is the Bacillus thuringiensis israelensis (Bti) bacteria. Unfortunately, mosquitoes are already developing resistance to this pesticide as well. This means we have to keep increasing the dose of Bti to kill mosquitoes, so that this biological substance, too, is beginning to harm the environment. Therefore we set out to find a new strategy in the fight against mosquitoes. We already knew that chemical substances emitted by the backswimmer – a natural enemy of mosquito larvae in the water – trigger a stress response in mosquitoes. This stress response, in turn, suppresses the mosquito’s immune system. What makes the use of these predator cues even more interesting for mosquito control is that scientists recently found a way to produce a synthetic version of these chemical substances. We discovered that this synthetic version triggers a stress response in the mosquitoes and impairs their immune system, just like the natural predator cues. This gave us the idea to combine these synthetic predator cues with the biological pesticide Bti. (more…)
Author Interviews, Breast Cancer, Chemotherapy, Genetic Research, JAMA, NEJM / 26.08.2016

MedicalResearch.com Interview with: Prof. Laura van ’t Veer, PhD Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center Angela and Shu Kai Chan Endowed Chair in Cancer Research UCSF Helen Diller Family Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: MINDACT was designed to involve only patients with node negative and 1 to 3 positive lymph node breast cancer. Node negative breast cancer is a cancer that has not spread to the surrounding lymph nodes and therefore has a lower risk of recurrence. Scientists have also demonstrated that breast cancer which has spread to 1 to 3 lymph nodes may behave like node negative breast cancer. Patients with either node negative cancer or with a cancer that involves 1-3 lymph nodes are often prescribed chemotherapy, although physicians believe that approximately 15% of them do not require such treatment. MINDACT provides the highest level of evidence to show that using MammaPrint® can substantially reduce the use of chemotherapy in patients with node-negative and 1-to-3 node positive breast cancer – in other words, it can identify patients with these types of breast cancer who can safely be spared a treatment that may cause significant side effects, and will offer no to very little benefit. (more…)
Author Interviews, Cancer Research, Immunotherapy / 26.08.2016

MedicalResearch.com Interview with: Dr Charles Akle, Chairman and Linda Summerton, CEO Immodulon Therapeutics Short Hills, NJ 07078 and London, UKDr Charles Akle, Chairman and Dr. Linda Summerton, CEO Immodulon Therapeutics Short Hills, NJ 07078 and London, UK MedicalResearch.com: What is the background for Immodulon? Would you tell us a little about Dr. Charles Akle? Response: Immodulon was established in November 2007. The founder and Chairman, Dr Charles Akle, was a Harley Street surgeon and pioneer of keyhole surgery who established Immodulon with the financial support of a former patient. His interest in immunology led him to the potential of cancer immunotherapy long before the term “immuno-oncology” was coined and when skepticism, rather than optimism was the norm. His ambition from the start was to develop an affordable immunotherapy treatment that would transform the way that cancer is treated in the world today. Since then, Immodulon has become a leading, independent biopharmaceutical company with one of the longest running research projects into how to harness the power of the immune system in treating cancer. It also has its own R&D and manufacturing capability in Lyon, France. The wider Immodulon senior team has extensive experience of bringing drugs to market and includes Dr James Shannon and Dr Jean Pierre Bizzari. (more…)
Author Interviews, Orthopedics / 26.08.2016

MedicalResearch.com Interview with: Brandon J. Erickson, MD Midwest Orthopaedics Rush, Rush University Medical Center Chicago, IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ulnar collateral ligament reconstruction (UCLR), also known as Tommy John surgery has become a common procedure amongst major league baseball (MLB) pitchers. It is unclear if a limit on innings pitched following Tommy John surgery should be instituted to prevent revision Tommy John surgery. The purpose of this study was to determine if innings pitched following Tommy John surgery is associated with an increased risk of revision Tommy John surgery amongst MLB pitchers. To answer this question we located all MLB pitchers between 1974-2015 who pitched at least one full season following their Tommy John surgery and included them in our analysis. Pitch counts and innings pitched for the first full season following Tommy John surgery as well as total pitch count and total innings pitched over the course of the player’s career were recorded. Pitch counts and innings pitched were compared amongst players who required revision Tommy John surgery and those who did not. We were able to include 154 pitchers. Of these, 135 pitchers did not require revision Tommy John surgery while 19 underwent revision Tommy John surgery.  No significant difference existed between pitchers who underwent revision Tommy John surgery and those who did not when comparing number of innings pitched in the season following Tommy John surgery,  number of pitches thrown in the season following Tommy John surgery,  number of innings pitched in the pitcher’s career following Tommy John surgery and number of pitches thrown in the pitcher’s career following Tommy John surgery.  Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season following Tommy John surgery. (more…)
Author Interviews, Primary Care / 25.08.2016

MedicalResearch.com interview with: Diane Hayes, Ph.D., President and co-founder, InCrowd Areal time market intelligence service to the life sciences MedicalResearch.com: What is the background for this survey? Response: Physician burnout is a significant concern across the healthcare continuum, as Affordable Care Act (ACA) measures change the nature of doctoring, and as at least 30 major teaching hospitals at least 30 major teaching hospitals undertake initiatives aimed at reducing burnout ahead of its potential impact on patient safety and quality outcomes. Numerous studies have documented the issue. We thought it would be instructive to use InCrowd’s mobile microsurvey platform for a mid-year snapshot of burnout sentiment. The microsurvey used the Maslach Burnout Inventory of symptoms to determine respondents who could be considered to be experiencing burnout—the same index as used by the widely cited Mayo Clinic and MedScape studies. We also asked if facilities are addressing the issue, a topic not always covered. (more…)
Author Interviews, Cancer Research, Chemotherapy, JAMA / 25.08.2016

MedicalResearch.com Interview with: Leni van Doorn, MSc Department of Medical Oncology Erasmus MC Cancer Institute Rotterdam, the Netherlands MedicalResearch.com: What is the background for this study? Response: The common cancer treatment capecitabine, a regular treatment for patients mostly diagnosed with breast-, colon- or gastic cancer, induces hand foot syndrome (HFS). HFS is a cutaneous condition that may lead to red palms and blisters in approximately 50% to 60% of the patients and is believed to result in the loss of fingerprints. This fingerprint loss has been described sporadically in the literature. The main aim of our prospective study was to have a closer look of the association between  hand foot syndrome and the loss of fingerprints. (more…)
AHA Journals, Author Interviews, Emory, Heart Disease / 25.08.2016

MedicalResearch.com Interview with: Alvaro Alonso, MD, PhD Associate Professor Department of Epidemiology Rollins School of Public Health Emory University Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sudden cardiac death (SCD) is a major public health problem. Each year, 300,000-400,000 Americans experience SCD and, in more than half of these cases, sudden cardiac death is the first manifestation of heart disease. To date, however, we lack effective strategies to identify those at higher risk of developing sudden cardiac death so targeted preventive strategies can be applied. In this study, we develop and validate the first model for the prediction of SCD in ~18,000 adults without a prior history of cardiovascular disease. We show that information on demographic variables (age, sex, race), some traditional cardiovascular risk factors (smoking, elevated blood pressure, diabetes, HDL cholesterol) as well as some factors more specifically related to SCD causes (electrocardiogram QT interval) and novel biomarkers (albumin, potassium in blood, kidney function) can be leveraged to predict risk of SCD and identify individuals more likely to suffer this event. (more…)
Author Interviews, Radiology, Zika / 25.08.2016

MedicalResearch.com Interview with: Fernanda Tovar Moll, MD, PhD Vice president of the D'Or Institute for Research and Education Professor,Federal University of Rio de Janeiro Rio de Janeiro, Brazil MedicalResearch.com: What is the background for this study? Response: The consequences of congenital zika virus infection are still under investigation. Recent studies suggest microcephaly as one of the consequences, but we wanted to go deeper in investigating what other kinds of neurological changes could happen in the developing central nervous system. Based on that, we performed a cohort study with multimodal images exams and longitudinal follow up (pre and post natal analyses) of some cases. (more…)
Author Interviews, Cancer Research, Weight Research / 25.08.2016

MedicalResearch.com Interview with: Beatrice Lauby-Secretan, PhD IARC – Section IMO (International Agency for Research on Cancer) Lyon, France MedicalResearch.com: What is the background for this study? Response: The IARC Handbook of Cancer Prevention Series perform systematic reviews and evaluations of the cancer-preventive effects of interventions and strategies. The summary article published today presents the conclusions of a Working Group of experts who examined and assessed the currently available literature on the link between overweight/obesity and cancer. Thus this is not a single study, but the report on more than 1000 individual studies. (more…)
Allergies, Asthma, Author Interviews, Pediatrics / 25.08.2016

MedicalResearch.com Interview with: David A. Hill, M.D., Ph.D. Fellow Physician Division of Allergy and Immunology The Children's Hospital of Philadelphia Philadelphia, PA 19104-3375 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Eczema, asthma, allergic rhinitis, and food allergies are among the most common childhood medical conditions in the United States. Importantly, disease rates for these conditions are thought to be changing, prompting the need for continued surveillance. In our study, we examined electronic medical record data of over 1 million children to measure incidence and prevalence rates of these conditions in our community. We found that 1 in 5 children seen in our network are diagnosed with asthma, a rate that is among the highest in the nation. Additionally, the large size of our study allowed us to measure the extent to which food allergies are associated with asthma or allergic rhinitis. In this analysis, we found that children with food allergies are 2 to 3 times more likely to develop asthma or allergic rhinitis, as compared with children without food allergy. (more…)
Author Interviews, Depression, Heart Disease, HIV, Vanderbilt / 25.08.2016

MedicalResearch.com Interview with: Matthew S Freiberg, MD, MSc Cardiovascular Medicine Division, Vanderbilt University School of Medicine Tennessee Valley Geriatric Research Education and Clinical Center, Nashville  TN Tasneem Khambaty, PhD Department of Psychology, University of Miami, Coral Gables, Florida Jesse C. Stewart, PhD Department of Psychology, Indiana University–Purdue University , Indianapolis, Indianapolis MedicalResearch.com: What is the background for this study? Response: Due to highly effective antiretroviral therapy, people with HIV are living longer. Unfortunately, these HIV-infected individuals remain at a higher risk for other chronic diseases, with cardiovascular disease (CVD) being one of the leading cause of death in this population. In the general population, depressive disorders, such as major depressive disorder (MDD) and dysthymic disorder, are associated with increased risk of new-onset CVD. Given that roughly 24-40% of HIV-infected individuals have a depressive disorder, we examined whether MDD and dysthymic disorder are also associated with an increased risk of new-onset CVD in people with HIV. (more…)
Author Interviews, Mental Health Research / 25.08.2016

MedicalResearch.com Interview with: Ian Rockett, PhD, MPH, FACE Professor, Department of Epidemiology School of Public Health West Virginia University Morgantown, WV MedicalResearch.com: What is the background for this study? Response: Self-injury deaths in the United States are seriously underestimated because they are officially limited to registered suicides, and exclude non-suicide deaths from drug self-intoxication. Suicides themselves are undercounted due primarily to under-resourcing of medical examiner and coroner offices and associated challenges in detecting drug suicides. Although most drug-intoxication deaths involve deliberate behaviors that markedly elevate risk of premature death, they are formally classified, but mischaracterized, as “accidents” on death certificates. Representing self-injury mortality (SIM) as a combination of registered suicides and estimated deaths from drug self-intoxication (DDSI), this study compared its national trends and patterns with those of 3 proximally ranked top 10 causes of death. (more…)
Author Interviews, Autism, Diabetes, Mental Health Research / 25.08.2016

MedicalResearch.com Interview with: Evdokia Anagnostou MD Canada Research Chair (Tier II) in Translational Therapeutics in Autism Senior Clinician Scientist and co-lead of the Autism Research Centre Holland Bloorview Kids Rehabilitation Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Researchers from Holland Bloorview Kids Rehabilitation Hospital / University of Toronto (Canada), Ohio State University, University of Pittsburgh, Columbia University, and Vanderbilt University, led a double-blind, placebo-controlled randomized clinical trial to examine whether metformin, a common type-2 diabetes drug, may be effective in counteracting weight gain commonly seen with the use of atypical antipsychotic medications, indicated by the FDA for the treatment of irritability in children and youth with autism spectrum disorder (ASD). Results showed that metformin was effective in helping overweight children and adolescents with autism spectrum disorder (ASD) who take antipsychotic medications lower their body mass index (BMI). Both FDA-approved antipsychotic medications for treating irritability and agitation symptoms in children and adolescents with ASD can cause a significant increase in weight gain, which in addition to increasing BMI, enhances long-term risk of diabetes. This complicates an already challenging issue as adolescents with autism spectrum disorder are ~ two times more likely to be obese than adolescents without developmental disabilities. Findings of this research are important, especially for families of children with ASD, as managing long-term physical health while also treating irritability/agitation symptoms, can help ensure that their child can participate fully in life (school, etc.). (more…)
Author Interviews, Columbia, Heart Disease, JAMA, Medical Imaging / 25.08.2016

MedicalResearch.com Interview with: Adam Castano, M.D., M.S. Division of Cardiology Columbia University Medical Center New York Presbyterian Hospital MedicalResearch.com: What is the background for this study? Response: Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF). Traditionally, the gold standard for diagnosis has required an endomyocardial biopsy coupled with either immunohistochemistry or mass spectroscopy. These specialized tests are only performed at centers with experienced satff, do not yield prognostically useful information, may be inadvisable for frail older adults, and often present logistical challenges that lead to delayed care. Fortunately, single center studies have demonstrated excellent diagnostic accuracy using technetium 99m pyrophosphate (Tc99mPYP) cardiac imaging for noninvasively detecting ATTR-CA and differentiating it from another major type of cardiac amyloidosis called light chain (AL). But the diagnostic accuracy of this technique in a multicenter study and the association of Tc99mPYP myocardial uptake with survival were not known prior to this study. Therefore, we assessed in a multicenter study Tc99mPYP cardiac imaging as a diagnostic tool and its association with survival. We conducted a retrospective cohort study of 229 patients evaluated at 3 academic specialty centers for cardiac amyloidosis and also underwent Tc99mPYP cardiac imaging. We measured retention of Tc99mPYP in the heart using a semiquantitative visual score (range 0-3) and a more quantitative heart-to-contralateral (H/CL) ratio calculated as total counts in a region of interest over the heart divided by background counts in an identical size region of interest over the contralateral chest. The outcome measured was time to death after Tc99mPYP imaging. (more…)