Author Interviews, Gastrointestinal Disease, Gluten, JAMA / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27623" align="alignleft" width="125"]Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School Dr. Brandon Hyunseok Kim[/caption] Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: The background of this study was to investigate the time trends in the prevalence of celiac disease and gluten-free diet in the United States using most recent 6-year National Health And Nutrition Examination Survey. Previous studies using narrow populations or old study period mainly before mid 2000s suggested increasing prevalence of celiac disease. At the same time, there is a current popular trend of people following gluten-free diets beyond what would be expected if it were solely due to the increasing prevalence of celiac disease.
Asthma, Author Interviews, Pediatrics, Weight Research / 06.09.2016

MedicalResearch.com Interview with: Professor Charlotte Suppli Ulrik MD DMSc et al. Dept. of Respiratory Medicine Hvidovre Hospital Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Obesity is a risk factor for new-onset asthma, but the association is incompletely understood. Our aim was, therefore, to investigate the association between body mass index (BMI) BMI in childhood and asthma admissions in early adulthood (until age 45 years). We used data on BMI measured annually (age 7-13 years) in 321,830 children enrolled in the Copenhagen School Health Records Registry. During the 36-years of follow-up, a total of 2,059 first-time ever hospital admissions for asthma were observed.
Asthma, Author Interviews, OBGYNE, Pediatrics / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27674" align="alignleft" width="132"]Dr Steve Turner MD MBBS Lead investigator of the study team and Respiratory paediatrician Royal Aberdeen Children’s Hospital Dr. Stephen Turner[/caption] Dr Steve Turner MD MBBS Lead investigator of the study team and Respiratory paediatrician Royal Aberdeen Children’s Hospital MedicalResearch.com: What is the background for this study? Response: For almost thirty years there has been evidence that we are all born with a certain predisposition to what are called non communicable diseases (NCD) such as high blood pressure, type II diabetes and heart disease. The evidence comes from studies which have linked reduced birth weight with increased risk for these NCDs in later life. The question which arises, and which has been more difficult to answer, is “when during pregnancy is the predisposition to for NCDs first seen?” This is important to any attempt to reduce the unborn baby’s risk for NCD. We and other researchers have used fetal ultrasound data to link size before birth to non communicable diseases outcomes. In childhood, NCDs include asthma.
Author Interviews, OBGYNE, Pediatrics / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27700" align="alignleft" width="138"]David Osborn MB BS MM PhD FRACP Clinical Associate Professor, University of Sydney Senior Neonatologist, Royal Prince Alfred Hospital Dr. David Osborn[/caption] David Osborn MB BS MM PhD FRACP Clinical Associate Professor, University of Sydney Senior Neonatologist, Royal Prince Alfred Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an analysis of trials of placental transfusion at delivery by either delayed umbilical cord clamping or cord milking in infants born before 30 weeks gestation, placental transfusion was associated with short term benefits including increased hemoglobin, fewer blood transfusions, improved blood pressure and reduced late onset sepsis, with no significant effect on other outcomes. There were insufficient data regarding effects of placental transfusion on survival and long term disability. The Australian Placental Transfusion Study (APTS) is a randomised controlled trial that aims to determine if delayed cord clamping (≥ 60 seconds) compared to early cord clamping (≤10 seconds) in 1600 infants born before 30 weeks gestation results in improved newborn outcomes and disability free survival. In this echocardiographic sub study, the aim was to determine the effect of placental transfusion on systemic blood flow in the first day after birth in 266 infants randomly allocated to delayed versus early cord clamping (133 infants in each group). The primary outcome was superior vena cava (SVC) flow (cardiac input) which overcomes the problem of shunts across the adapting heart which affect the usefulness of measuring ventricular outputs in the first days after birth. In infants born <30 weeks gestation, delayed cord clamping had no effect on the principle measure of systemic blood flow (SVC flow) during the first 24 hours compared to immediate cord clamping. However, right ventricular output (RVO) was lower in the delayed cord clamping group. This was not predicted and may be a chance finding. Further analysis suggests the effect of cord clamping on RVO could be mediated by its effect on hemoglobin. This may be a positive or negative adaptive change. There was no evidence of an increase in right to left ductal shunting suggestive of high pulmonary blood pressure to explain the difference in RVO. Delayed cord clamping resulted in a 8.9g/L greater increase in hemoglobin to 6 hours but had no effect on ductus arteriosus size, shunt direction or treatment, no effect on blood pressure or its treatment, and no effect on blood gas parameters and other cardiovascular variables in the first 24 hours.
Author Interviews, Cancer Research, Heart Disease, Pediatrics / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27606" align="alignleft" width="133"]Steven E. Lipshultz, MD, FAAP, FAHA Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology / Member, Center for Urban Responses to Environmental Stressors, Wayne State University School of Medicine / Professor in the Center for Molecular Medicine and Genetics, Wayne State University School of Medicine President, University Pediatricians & Interim Director, Children’s Research Center of Michigan Pediatrician-in-Chief, Children’s Hospital of Michigan / Specialist-in-Chief, Pediatrics, Detroit Medical Center Scientific Member, Karmanos Cancer Institute, an NCI-designated Comprehensive Cancer Center Dr. Steven Lipshultz[/caption] Steven E. Lipshultz, MD, FAAP, FAHA Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology /Professor in the Center for Molecular Medicine and Genetics Wayne State University School of Medicine President, University Pediatricians & Interim Director, Children’s Research Center of Michigan Pediatrician-in-Chief, Children’s Hospital of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Surviving childhood cancer has dramatically and increasing improved to the point where more than 80% will achieve a 5-year event free survival. Many of these survivors look forward to decades of active productive life. More than half of these survivors have been treated with therapies know to be associated with late cardiotoxicity that can be pervasive, persistent, and progressive and associated with cardiovascular morbidity and mortality. In this article we review both the course and prevention of this cardiotoxicity. We focus in part on anthracycline chemotherapy that is widely used and known to be cardiotoxicity. We further review studies we and others have conducted to examine the effectiveness of dexrazoxane, an iron chelator, that when given before each anthracycline dose results in anthracycline cardioprotection for long term survivors. In some reported studies this has allowed for higher cumulative anthracycline doses to be safely given. In other cases this has allowed for simultaneously being able to safely treat children with malignancies that would be refractory to conventional therapy more potent therapies that would normally have additive cardiotoxicity.
Author Interviews, Exercise - Fitness, Heart Disease / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_21730" align="alignleft" width="125"]Richard Moon, MD, CM, MSc, FRCP(C), FACP, FCC Medical Director, Hyperbaric Center Professor of Anesthesiology Department / Division Anesthesiology / GVTU Division Medicine / Pulmonary Duke University School of Medicine Dr. Richard Moon[/caption] Richard Moon, MD Professor of Anesthesiology Professor of Medicine Medical Director, Center for Hyperbaric Medicine & Environmental Physiology Duke University Medical Center Durham, NC 27710 MedicalResearch.com: What is the background for this study? Response: For several years we have been investigating the causes of immersion pulmonary edema (IPE, also known as swimming-induced pulmonary edema or SIPE). We determined that during exercise while immersed in cold water pulmonary artery and wedge pressures of individuals who are SIPE-susceptible are higher than normal. This demonstrated that SIPE is a form of hemodynamic pulmonary edema. It is certainly plausible that SIPE could cause death, and indeed a few fatal cases had been reported in the medical literature, mostly in scuba divers. After reading of deaths in young, apparently fit and healthy triathletes we hypothesized that some of these deaths were probably due to  swimming-induced pulmonary edema . It is easy to diagnose SIPE in a living individual, using a stethoscope or chest x-ray/CT. However, since almost anyone who dies from any cause, particularly if attempted resuscitation has occurred, will have pulmonary edema at autopsy. Before concluding that death has occurred due to SIPE, other clues are therefore necessary.
AACR, Author Interviews, Cancer Research, Prostate Cancer / 04.09.2016

MedicalResearch.com Interview with:  

Ilaria Stura PhD

Università degli Studi di Torino Turin, Piedmont, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Man has always tried to predict the future, especially to prevent catastrophes, diseases and death. In this case, we want to prevent the ‘personal catastrophe’, i.e. the spread of the disease (recurrence of prostate cancer) in the patient. Our work therefore belongs to the so-called ‘personalized medicine’, a very important and innovative clinical approach.

In particular this study may potentially improve the quality of life of the patients and help the clinicians, since it could give valuable information to the urologist, for example reporting that the growth velocity of the tumor is increasing and that a relapse is expected within few months. With this information, the clinician could chose the best therapy for the patient (e.g. hormone or radio therapy) in order to stop the spread of the disease or, conversely, the use of drugs can be delayed if not necessary. Obviously clinicians already try to do this, based on their experience, but our method provides further confidence in their 'investigation' work, since the algorithm is validated on data coming from a database much larger than his/her personal experience.
Author Interviews / 04.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27645" align="alignleft" width="125"]Alejandro Azofeifa, DDS, MSc, MPH Epidemiologist at the Substance Abuse and Mental Health Services Administration Dr. Alejandro Azofeifa[/caption] Alejandro Azofeifa, DDS, MSc, MPH Epidemiologist at the Substance Abuse and Mental Health Services Administration MedicalResearch.com: What is the background for this study? What are the main findings? Response: -In the United States, marijuana is the most commonly used illicit drug. Because of certain state-level policies that have legalized marijuana for medical or recreational use, population-based data on marijuana use and other related indicators are needed to help monitor behavioral health changes in the United States. - This SAMHSA surveillance report represents an overview of national estimates for marijuana use and other related indicators among the U.S. noninstitutionalized civilian population aged ≥12 years using 2002–2014 National Survey on Drug Use and Health data. The report includes at least seven important findings. Find more detailed information atSAMHSA surveillance report. Since 2002, marijuana use in the United States has increased among persons aged ≥18 years, but not among those aged 12–17 years. A decrease in the perception of great risk from smoking marijuana combined with increases in the perception of availability (i.e., fairly easy or very easy to obtain marijuana) and fewer punitive legal penalties (e.g., no penalty) for the possession of marijuana for personal use might play a role in increased use among adults.
Author Interviews, Heart Disease, Hospital Readmissions, Surgical Research / 04.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27659" align="alignleft" width="125"]Christian A. McNeely, M.D. Resident Physician - Internal Medicine Barnes-Jewish Hospital Washington University Medical Center Dr. Christian McNeely[/caption] Christian A. McNeely, M.D. Resident Physician - Internal Medicine Barnes-Jewish Hospital Washington University Medical Center MedicalResearch.com: What is the background for this study? Response: Prior research has demonstrated that readmission in the first 30 days after percutaneous coronary intervention (PCI) is common, reported around one in six or seven Medicare beneficiaries, and that many are potentially preventable. Since 2000, there have been significant changes in the management of coronary artery disease and the use of PCI. Additionally, in the last decade, readmission rates have become a major focus of research, quality improvement and a public health issue, with multiple resulting national initiatives/programs which may be affecting care. Therefore, in this study, we sought to examine contemporary trends in readmission characteristics and associated outcomes of patients who underwent PCI using the Medicare database from 2000-2012.
Author Interviews, Cancer Research, Technology / 04.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27640" align="alignleft" width="125"]Adam G Alani, PhD Associate Professor of Pharmaceutical Sciences Department of Pharmaceutical Sciences College of Pharmacy Oregon State University-Oregon Health & Science University Affiliate Assistant Professor Department of Biomedical Engineering School of Medicine at Oregon Health & Science University Oregon State University-Portland Campus at OHSU Portland Oregon Dr. Adam Alani[/caption] Adam G Alani, PhD Associate Professor of Pharmaceutical Sciences Department of Pharmaceutical Sciences College of Pharmacy Oregon State University-Oregon Health & Science University Affiliate Assistant Professor Department of Biomedical Engineering School of Medicine at Oregon Health & Science University Oregon State University-Portland Campus at OHSU Portland Oregon MedicalResearch.com: What is the background for this study? Response: Current chemotherapeutic regimens while effective are difficult for patients and affect their quality of life. Our research tackles this issue by designing a nanotherapy that can deliver multiple chemotherapeutic agents by targeting the entire tumor microenvironment and not just the cancer cells and by reducing drug resistance. This, then is intended to simplify the treatment regimen, reduce drug related side effects and extends the life of the drugs by preventing resistance should the patient need it in the future. Thus, the ultimate underlying goal is to improve the patient’s quality of life by not just maximizing the drug’s efficacy but also trying to decrease its impact on the overall lifestyle of the individual.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Outcomes & Safety, Surgical Research / 04.09.2016

MedicalResearch.com Interview with: Senthil Selvaraj, MD, MA and Deepak L. Bhatt, MD, MPH Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been significant controversy in the effect of off-hours presentation in ST-elevation myocardial infarction (STEMI). Off-hours presentation has been associated with longer treatment time, an independent predictor of worse outcomes in STEMI, though a number of other studies have shown no difference as well. Moreover, little data has been generated from clinical trials, which has the advantage of comprehensive and adjudicated outcomes. In our analysis of nearly 2,000 STEMI patients from the CHAMPION PHOENIX study (a randomized, controlled trial of cangrelor in percutaneous coronary intervention), we found that off-hours presentation was not associated with worse efficacy or safety outcomes at 48 hours or 30 days. More specifically, outcomes not typically reported in registry data, such as ischemia-driven revascularization and stent thrombosis, were not significantly different between the groups. Interestingly, treatment times were actually faster in the “off-hours” group as well.
Author Interviews, Dermatology, Endocrinology, Fertility / 03.09.2016

MedicalResearch.com Interview with: Anders Rehfeld MD, PhD Student Faculty of Health and Medical Sciences Department of Cellular and Molecular Medicine University of Copenhagen Copenhagen Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Human fertility is declining in many areas of the world and the reason is largely unknown. Our study shows that 44% of the tested chemical UV filters can induce calcium signals in human sperm cells, thereby mimicking the effect of progesterone. Progesterone-induced calcium signals, and the sperm functions it triggers, is absolutely essential for the human sperm cell to normally fertilise the human egg.
Author Interviews, BMJ, Education, Surgical Research / 03.09.2016

MedicalResearch.com Interview with: Miss Hui-Ling Kerr SpR Trauma and Orthopaedics Department of Trauma and Orthopaedic Bristol Royal Infirmary, Bristol, UK MedicalResearch.com: What is the background for this study? Response: Gender inequality at consultant level in surgery has not improved despite greater opportunities for women and only a small proportion of women apply to become surgical trainees. We wanted to find out if the lack of female surgical role models acted as a deterrent to first year female junior doctors and final year medical students towards a career in surgery.
Author Interviews, Diabetes, Diabetologia / 02.09.2016

MedicalResearch.com Interview with: Oluf Pedersen, MD Specialist in Internal Medicine and Endocrinology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Peter Gæde and Jens Oellgaard Department of Cardiology and Endocrinology Slagelse Hospital Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Steno-2 study was the attempt to investigate the effect of an intensified, multifactorial intervention in type 2 diabetes simultaneously targeting risk factors such as hyperglycaemia, hypertension, dyslipidaemia, blood platelet aggregation, and elevated urinary albumin excretion rate as well as life style factors such as smoking, diet and a sedentary lifestyle. On top of that patients were by a dedicated team of care givers offered continued education and motivation. A total of 160 Danish type 2 diabetes patients with microalbumuria (a biomarker of generalized vascular damage) were originally randomized either to intensified multifactorial treatment at Steno Diabetes Center, Copenhagen or to conventional multifactorial treatment at their general practitioners. The trial ended after 8 years, and patients in both of the original treatment arms were for the following 13 years given intensified multifactorial treatment as the one originally given to the intensified intervention group only. Three previous milestone reports from the Steno-2 trial published in Lancet and New England Journal of Medicine have provided unprecedented evidence that this targeted and multifaceted approach reduces the risk of diabetic late complications such as kidney, eye or nerve disease as well as cardiovascular disease and total mortality with around fifty percent.
Accidents & Violence, Author Interviews, BMJ, Cancer Research, Karolinski Institute / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27551" align="alignleft" width="125"]Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet Qing Shen[/caption] Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Injury, either iatrogenic (for example, complications from medical procedures and drug treatment) or non-iatrogenic (for instance, suicidal behavior and accidents), is one of the leading causes of non-cancer mortality for patients diagnosed with cancer. Iatrogenic injuries are common in those with cancer and have been shown to increase mortality in some cancer patients. Increased risks of suicide and accidental death after diagnosis have been reported, and the diagnostic process of cancer has been recognized highly stressful. It is, however, unknown whether the risk of injuries is also increased during the time period before receiving the diagnosis. Actually confirming a diagnosis can often be difficult due to patients sometimes concealing information. This is why Motivational Interviewing is important. Anyway, we analysed the risks of injuries during the weeks before and after diagnosis using a nationwide study sample in Sweden.
Author Interviews, Duke, JAMA, Surgical Research, Weight Research / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27481" align="alignleft" width="156"]Matthew Leonard Maciejewski, PhD Professor in the Division of General Internal Medicine Department of Medicine Duke University School of Medicine Research Career Scientist and Director of the Health Economics and Policy Unit in the Center for Health Services Research in Primary Care Durham VA Medical Center Dr. Matt Maciejewski[/caption] Matthew Leonard Maciejewski, PhD Professor in the Division of General Internal Medicine Department of Medicine Duke University School of Medicine Research Career Scientist and Director of the Health Economics and Policy Unit in the Center for Health Services Research in Primary Care Durham VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: No study based on a US cohort undergoing current procedures has examined weight change comparing surgical patients and nonsurgical patients for as long as we have. This is the first study to report 10-year outcomes on gastric bypass patients and compare them to matched patients who did not get surgery. At 1 year, gastric bypass patients lost 31% of their baseline weight compared controls who only lost 1.1% of their baseline weight. At 10 years, gastric bypass had lost 28% of their baseline weight. We also compared weight loss at 4 years for Veterans who received the 3 most common procedures (gastric bypass, sleeve gastrectomy, and adjustable gastric banding). At 4 years, patients undergoing gastric bypass lost more weight than patients undergoing sleeve gastrectomy or gastric banding. Given that few high quality studies have examined sleeve gastrectomy to 4 years, the 4-year sleeve outcomes contribute to filling this important evidence gap as the sleeve gastrectomy is now the most commonly performed bariatric procedure worldwide.
Author Interviews, Heart Disease, JAMA, Surgical Research / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27459" align="alignleft" width="163"]Dr Marlous Hall PhD Senior Epidemiologist Leeds Institute of Cardiovascular and Metabolic Medicine Dr. Marlous Hall[/caption] Dr Marlous Hall PhD Senior Epidemiologist Leeds Institute of Cardiovascular and Metabolic Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that death rates following heart attacks have fallen considerably over recent decades. Many studies have looked at the effect of medications and invasive strategies, and their association with better clinical outcomes is clear. However, a big question remains: why have heart attack deaths fallen? Is it due to increased use of medications and treatment, is the risk of patients simply lower over time due to things like earlier diagnosis or are patients generally healthier with fewer comorbidities such as diabetes? Answering this is not straightforward - as “gold standard” studies like clinical trials on historic data cannot be done. An alternative approach is to look for patterns in data observed from routine care to look at all these factors together. This study used a large and rich dataset covering heart attack care in the UK (Myocardial Ischaemia National Audit Project (MINAP)). This dataset was linked to outcome data from the Office for National Statistics to allow us to look at all the different factors that could influence the change in mortality over time.
Addiction, Anesthesiology, Author Interviews, Opiods / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27601" align="alignleft" width="125"]N. Nick Knezevic, MD, PhD Vice Chair for Research and Education Associate Professor of Anesthesiology and Surgery at University of Illinois Advocate Illinois Masonic Medical Center Department of Anesthesiology Chicago, IL 60657 Dr. N. Nick Knezevic[/caption] N. Nick Knezevic, MD, PhD Vice Chair for Research and Education Associate Professor of Anesthesiology and Surgery at University of Illinois Advocate Illinois Masonic Medical Center Department of Anesthesiology Chicago, IL 60657 MedicalResearch.com: What is the background for this study? Response: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic non-cancer pain, still many Americans seek pain relief through opioid consumption. The purpose of this study was to accurately assess compliance of chronic opioid consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing could improve compliance.
Author Interviews, Emergency Care, Nursing / 02.09.2016

MedicalResearch.com Interview with Mathew Douma, RN BSN ENC(C) CNCC(C) Emergency Department, Royal Alexandra Hospital Edmonton, Alberta, Canada; Masters of Nursing Student University of Toronto, Toronto MedicalResearch.com: What is the background for this study? Response: Many emergency departments experience crowding, which is typically defined as a situation where demands for service exceed the ability of the emergency department to provide quality care in a timely fashion. Typically when patients are waiting in a waiting room they do not undergo diagnostics or treatments. In an effort to speed the process up and reduce the amount of time the patient spends in the emergency department, some facilities have created protocols for diagnostics or treatments typically outside the traditional scope of practice of nursing staff. Our emergency department had protocols like this for almost 15 years, though we had never evaluated their effectiveness. So an interdisciplinary group in our emergency department updated them and then we set out to evaluate them.
Author Interviews, Baylor College of Medicine Houston, Diabetes, Health Care Systems, Heart Disease / 02.09.2016

MedicalResearch.com Interview with: Salim S. Virani, MD, PhD and Julia Akeroyd MPH Health Services Research and Development Michael E. DeBakey Veterans Affairs Medical Center Houston MedicalResearch.com: What is the background for this study? Response: Given the increase in the number of Americans seeking primary health care due to the Affordable Care Act, combined with current and anticipated physician shortages in the US, there is a growing need to identify other models of primary care delivery to address chronic diseases.
Anemia, Author Interviews, Hematology, Lancet, Surgical Research / 02.09.2016

MedicalResearch.com Interview with: Alhossain A. Khalafallah, Clinical Professor Menzies Institute for Medical Research, University of Tasmania, Australia Consultant Haematologist Launceston General Hospital Australia MedicalResearch.com: What is the background for this study? Response: There are limited data regarding the effect of postoperative anemia on patient’s outcomes. The issue of postoperative anemia was noticeably to affect a large cohort of patients world-wide. This study was aiming at comparing the new approach with a single ferric carboxymaltose infusion versus standard or routine usual care for management of postoperative anemia.
Author Interviews, Cost of Health Care, Weight Research / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27587" align="alignleft" width="125"]John A. Batsis, MD, FACP, AGSF Associate Professor of Medicine and The Dartmouth Institute Geisel School of Medicine at Dartmouth Section of General Internal Medicine - 3M Dartmouth-Hitchcock Medical Center Lebanon, NH Dr. John Batsis[/caption] John A. Batsis, MD, FACP, AGSF Associate Professor of Medicine and The Dartmouth Institute Geisel School of Medicine at Dartmouth Section of General Internal Medicine - 3M Dartmouth-Hitchcock Medical Center Lebanon, NH MedicalResearch.com: What is the background for this study? Response: In 2011, the Centers for Medicare and Medicaid implemented a regulatory coverage benefit to cover 22 brief, targeted 15-minute counseling visits by clinicians over the course of a 12-month period for Medicare beneficiaries with a body mass index exceeding 30kg/m2. This was an important policy determination in tackling the obesity epidemic in the United States. An emphasis on the importance of counseling, or intensive behavioral therapy, in a primary care setting set the foundation for this benefit. Yet, it was unclear how and if this benefit (which would be free of charge without a copay or deductible for beneficiaries) was being implemented in clinical care. We therefore identified fee-for-service Medicare claims for the years 2012 and 2013 to determine whether the G0477 code (Medicare Obesity benefit code) was billed. We additionally explored the rate of uptake of the Medicare benefit in relation to the prevalence of obesity using the 2012 Behavior Risk Factor Surveillance System data.
Alzheimer's - Dementia, Author Interviews, Biomarkers / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27583" align="alignleft" width="125"]Inflammatory Biomarkers May Presage Development of Alzheimer's Prof. Paul Morgan[/caption] Professor B. Paul Morgan Director, Systems Immunity Research Institute Institute of Infection and Immunity School of Medicine Cardiff University MedicalResearch.com: What is the background for this study? Response: Inflammation is a normal response of the body to infection or injury; however, it is well known that inflammation also has a dark side and when it escapes normal controls can cause disease. Some illnesses, like rheumatoid arthritis, have been known for many years to be caused by rogue inflammation and most of the drugs used to treat work by suppressing the inflammation (anti-inflammatories). More recently, it has become clear that inflammation is behind many other diseases that were previously thought of as diseases of ageing caused by wear and tear and lifestyle - these include heart disease and some brain diseases, notably Alzheimer's disease the commonest cause of dementia. Evidence that inflammation is one of the drivers of disease has come from many sources, including some where it was noticed that people on long-term anti-inflammatory drugs for other reasons appeared to be protected from developing Alzheimer's disease. A problem is that Alzheimer's disease, despite the name, is not a single disease but rather a group of conditions with similar symptoms, and inflammation is likely to be a cause in only some of the patients; further, most of the inflammation might be occurring very early in the disease, even before symptoms are obvious. So, there is an urgent need for a simple test or set of tests that can be used in individuals with the very earliest hints of Alzheimer's disease - mild memory loss - that will pick out those who have brain inflammation and are most likely to develop Alzheimer's disease. It might then be possible to treat this select group with anti-inflammatory drugs that will reduce brain inflammation and slow or stop progression of the disease.
Alzheimer's - Dementia, Author Interviews, Immunotherapy, Nature / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27578" align="alignleft" width="100"]Roger M. Nitsch, MD Professor and Director Institute for Regenerative Medicine · IREM University of Zurich Campus Schlieren Switzerland Prof. Roger Nitsch[/caption] Roger M. Nitsch, MD Professor and Director Institute for Regenerative Medicine · IREM University of Zurich Campus Schlieren Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main finding is that treatment with aducanumab resulted in an unprecedented reduction of brain amyloid plaques in patients with Alzheimer's disease.  The removal of amyloid from patients brains were both dose- and time-dependent.  We also observed initial hints for stabilized brain functions in patients receiving aducanumab.  In contrast, patients in the placebo group continued to declined as usual in this stage of Alzheimer's disease. The main safety finding in 22% of all treated patients was ARIA - an Amyloid-Related Imaging Abnormality - suggestive of fluid shifts in the brains. In most cases, ARIA occurred in the absence of clinical signs and resolved spontaneously.  In one third of the ARIA cases, patients experienced transient headaches.  None of the patients had to hospitalized because of ARIA.
Author Interviews, Cocaine / 01.09.2016

MedicalResearch.com Interview with: Dr Stefania Fasano Cardiff University MedicalResearch.com: What is the background for this study? Response: Exposure to drugs of abuse such as cocaine produces intense and long-lasting memories that are critical in the transition from recreational drug-taking to uncontrolled drug use. In the brain, addictive drugs usurp cellular circuits and signalling molecules involved in normal memory processes; hence, these drug-related memories resist extinction and contribute to high rates of relapse. Despite almost five decades of experimental research, there are currently no approved medications for cocaine dependence.
Author Interviews, Breast Cancer / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27570" align="alignleft" width="147"]James R. Lambert, PhD. Department of Pathology University of Colorado Anschutz Medical Campus Aurora, CO Dr. Jim Lambert[/caption] James R. Lambert, PhD. Department of Pathology University of Colorado Anschutz Medical Campus Aurora, CO MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our laboratory has been investigating a novel small molecule drug, AMPI-109, as a targeted therapeutic agent for triple-negative breast cancer (TNBC). We demonstrated that AMPI-109 is a potent inducer of apoptosis in TNBC cells and that its cell killing activities are largely specific for the TNBC subtype of breast cancer. Through our efforts to identify the molecular mechanism of AMPI-109 action in TNBC cells we identified the oncogenic phosphatase, PRL-3 as a mediator of AMPI-109 action and as a potential direct target of the drug in TNBC cells. Our studies have defined PRL-3 as an oncogenic driver of  triple-negative breast cancer as exemplified by knocking down PRL-3 using shRNAs, or treating TNBC cells with AMPI-109, ultimately results in TNBC cell apoptosis. We thus became interested in elucidating the mechanisms whereby loss of PRL-3 expression, or function, results in cell death. During the course of these investigations we noted that at early times following PRL-3 knock down TNBC cells undergo a period of cell senescence followed by induction of apoptosis. This dynamic reprogramming of  triple-negative breast cancer cell fate was determined to be mediated through signaling events mediated by an autocrine tumor necrosis factor receptor 1 (TNF-R1) feedback loop. TNF-R1, which binds the pro-inflammatory cytokine TNFα, is a widely studied mediator of both cell survival and cell death yet the precise molecular mechanism controlling this toggling effect of TNF-R1 on TNBC cells remained largely unknown. In this report, we demonstrate that PRL-3 is transcriptionally regulated by the pro-inflammatory NF-ĸB pathway in  triple-negative breast cancer cells, and that PRL-3 knock down elicits an autocrine TNF-R1 feedback loop that results in cell cycle arrest and senescence as a pre-determinant to engaging apoptosis of TNBC cells. These studies reveal a previously undescribed mechanism for how PRL-3 influences TNBC cell growth and further increase our understanding of the role of TNFα signaling in the disease.
Author Interviews, Prostate, Prostate Cancer, Urology / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27566" align="alignleft" width="160"]Jim C. Hu, MD Ronald Lynch Professor of Urologic Oncology Weill Cornell Medicine New York, NY 10065 Dr. Jim Hu[/caption] Jim C. Hu, MD Ronald Lynch Professor of Urologic Oncology Weill Cornell Medicine New York, NY 10065 MedicalResearch.com: What is the background for this study? Response: Initial results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a large-scale randomized controlled trial of prostate cancer screening in the United States, radically changed the landscape of prostate cancer screening insofar as it led the United States Preventative Services Task Force (USPSTF) to recommend against routine screening with prostate-specific antigen (PSA). Though many subsequent studies have continued to investigate the role of PSA in screening, there is a paucity of data examining the use of digital rectal examination (DRE) for screening in the PSA era. Indeed, the USPSTF recommendation did not explicitly address DRE, calling for further research to evaluate the role of periodic DRE in prostate cancer screening. Likewise, while recent guidelines from the National Comprehensive Cancer Network (NCCN) recommend use of PSA in all men who elect screening, the role of digital rectal examination is equivocal. We sought to evaluate the value of  digital rectal examination and PSA for detection of clinically significant prostate cancer and prostate cancer-specific (PCSM) and overall mortality in a secondary analysis of the PLCO.
Asthma, Author Interviews, Lancet, Pediatrics / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27559" align="alignleft" width="125"]Francine M. Ducharme, MD, FRCPC Professor, Departments of Paediatrics and Social and Preventive Medicine University of Montreal Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine Prof. Francine Ducharme[/caption] Francine M. Ducharme, MD, FRCPC Professor, Departments of Paediatrics and Social and Preventive Medicine University of Montreal Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children. We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma. Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).
Asthma, Author Interviews, NEJM, Pediatrics, Pharmacology / 01.09.2016

MedicalResearch.com Interview with: David A Stempel, MD Medical Affairs Lead US Medical Affairs GlaxoSmithKline MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.