Author: Marie Benz MD FAAD
15 Aug BUZZY Reduces Pain and Fear of Needle Sticks
[caption id="attachment_26992" align="alignleft" width="200"]
Buzzy: Drug Free Pain Control[/caption]
MedicalResearch.com Interview with:
Amy Baxter MD
CEO MMJ Labs LLC
MedicalResearch.com: Would you tell us a little about your background? How did you develop an interest in pain management and prevention?
[caption id="attachment_26993" align="alignleft" width="164"]
Dr. Amy Baxter[/caption]
Response: As a pediatric emergency doctor, I found it interesting that doctors could prevent pain but sometimes couldn't be bothered to do so. The lack of empathy and impatience is built into emergency training - we learn to diagnose and fix things quickly, not comfort and support. I decided to research how pain management would make procedures more successful, or faster, to convince doctors to use pain management for THEIR benefit.
MedicalResearch.com: What is the background for the Buzzy(r) device? How does it impact pain sensation?
Response: When my 4 year old had a horrible vaccination experience, I realized that a fast effective parent-controlled option for pain relief was needed. I knew that cold running water could eliminate the pain from a burned finger using physiology called gate control. Basically, the small pain nerves run alongside big motion nerves, so if you heavily stimulate motion you scramble the pain sensation. Rubbing a bumped elbow is another good example. Vibration alone didn't work enough for needles, but when I added ice the two sensations of cold and motion eliminated pain in 84% of seniors getting a flu shot. We got a grant from the NIH to develop and study Buzzy - it's a palm sized vibration unit with a place on the back to attach ice "wings", that freeze solid. You put them both where an injection will go for a minute or less, then move them "between the brain and the pain" while doing a needle procedure. There are about 14 studies on IV access or blood draws and 6 on injections, showing between 50 and 88% pain reduction.
Several studies have demonstrated that Buzzy is truly a physiologic intervention, not a distraction: it didn't work for injections when only used for 10 seconds, too little time to block the pain nerves. But it worked really well for blood draws in severely cognitively impaired children for whom distraction wasn't an option.
15 Aug Stroke Risk Elevated in Some Patients with NAION
MedicalResearch.com Interview with: [caption id="attachment_26986" align="alignleft" width="128"]
Dr. Rong Kung-Tsai[/caption]
Rong-Kung Tsai MD, PhD
Professor and Director
Institute of Eye Research
Buddhist Tzu Chi Medical Center;
Director, Institute of Medical Sciences
Tzu Chi University, Hualien, Taiwan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Non-arteritic anterior ischemic optic neuropathy (NAION) is pathogenetically different from stroke, stroke is caused by thromboembolism. However, they share many (but not all) systemic vascular risk factors. Previous small scale studies got controversial results. Using the National Health Insurance Research Database (NHIRD) in Taiwan to conduct the cohort study, 414 patients were included in the NAION group and 789 in the control group (base one million beneficiaries). The incidence of NAION is 3.72/100,000 person-years in Taiwan, and patients with NAION have more chances to develop ischemic stroke (p=0.003), but not hemorrhage stroke.
The subgroup analyses further showed the risk of ischemic stroke among the subjects with NAION and with comorbidities was 3.35 times higher than those without NAION. However, in patients with NAION but no comorbidities, there is no increase risk of stroke development.
14 Aug Too Much ‘Good Cholesterol’ HDL Can Also Be A Bad Thing
MedicalResearch.com Interview with: [caption id="attachment_26982" align="alignleft" width="150"]
Dr. Ziyad Al-Aly[/caption]
Ziyad Al-Aly, MD, FASN
Assistant Professor of Medicine
Washington University School of Medicine
Co-Director, Clinical Epidemiology Center
Associate Chief of Staff for Research and Education
Veterans Affairs Saint Louis Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I think the most important, and novel finding is that elevated levels of HDL-cholesterol (which is thought of as the good cholesterol) are associated with increased risk of death. Previously it was thought that high HDL (increased good cholesterol) is a good thing.
We used Big Data approach (over 16 million person-years; 1.7 million people followed for over 9 years) to evaluate the relationship between HDL-Cholesterol (the good cholesterol) and risk of death. We found that low HDL is associated with increased risk of death (which is expected and consistent with prior knowledge). The novel and unexpected finding is the observation that high HDL-Cholesterol is also associated with increased risk of death. The relationship between HDL-Cholesterol levels and risk of death is a U-shaped curve where risk is increased at both ends of the HDL-C values spectrum (at both low and high end); Too low and too high is associated with higher risk of death. The findings may explain why clinical trials aimed at increasing HDL-Cholesterol levels failed to show improvement of clinical outcomes.
This finding was not expected, and has not been reported previously in large epidemiologic studies such as Framingham Heart Study and others. The Framingham Heart study and others significantly advanced our understanding of the relationship between cholesterol parameters (including HDL-Cholesterol) and clinical outcomes. However, these studies are limited in that the number of patients in these cohorts was several thousands which is relatively small compared to what a Big Data approach (millions of patients) enables us to see. Big Data approach allows a more nuanced (a more detailed) examination of the relationship between HDL and risk of death across the full spectrum of HDL levels.
14 Aug Activating Scavenger System May Treat Blocked Blood Vessels Without Surgery
MedicalResearch.com Interview with: [caption id="attachment_26978" align="alignleft" width="120"]
Dr. Qing Kenneth Wang[/caption]
Qing Kenneth Wang PhD, MBA
Huazhong University of Science and Technology
Wuhan, P. R. China and
Department of Molecular Cardiology
The Cleveland Clinic
Cleveland, Ohio
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Coronary Artery Disease (CAD) and its complication myocardial infarction (MI or so called heart attacks) are the most common causes of deaths in the US and other parts of the world. Based on the American Heart Association statistics, 620,000 Americans have a new MI each year in the United States alone, 295 000 have a recurrent MI, and nearly 400,000 of them will die from it suddenly. Moreover, an estimated 150,000 silent first MI occur each year.
CAD and MI are caused by an occlusion or blockage of a coronary artery, which disrupts blood flow to the heart region, leading to damage or death of cardiac cells, impairment of cardiac function and sudden death. Current treatment of CAD and MI relies on reperfusion therapy with reopening of the occluded coronary artery with percutaneous coronary intervention (PCA) and coronary artery bypass surgery (CABG). However, 12% of patients are not candidates for PCA or CABG due to an unfavorable occlusive pattern, diffuse coronary atherosclerosis, small distant vessels and co-morbidities. An alternative revascularization strategy has to be developed to benefit these patients.
14 Aug Lymphoma Drug Shows Promising Results in Phase 3 Trial
MedicalResearch.com Interview with: [caption id="attachment_26974" align="alignleft" width="200"]
Dr. Dirk Huebner[/caption]
Dirk Huebner, MD
Senior Medical Director
Oncology Therapeutic Area Unit
Takeda Pharmaceutical Company
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cutaneous lymphomas are a category of non-Hodgkin lymphoma that primarily involve the skin. Cutaneous T-cell lymphoma, also known as CTCL, is the most common type of cutaneous lymphoma and typically presents with red, scaly patches or thickened plaques of skin that often mimic eczema or chronic dermatitis.
ADCETRIS® (brentuximab vedotin) is an antibody-drug conjugate directed to CD30, which is expressed on skin lesions in approximately 50 percent of patients with CTCL. The Phase 3 ALCANZA trial compared the use of single-agent ADCETRIS to a control arm of investigator’s choice of standard therapies, methotrexate or bexarotene, in 131 patients with CD30-expressing CTCL who received prior systemic or radiation therapy.
The study met its primary endpoint, demonstrating a highly statistically significant improvement in the rate of objective response lasting at least four months (ORR4). The ORR4 was 56.3 percent in the ADCETRIS arm compared to 12.5 percent in the control arm.
13 Aug Increased Odds of Quitting Smoking When Distance To Store Increased
MedicalResearch.com Interview with: [caption id="attachment_26969" align="alignleft" width="200"]
Dr. Anna Pulakka[/caption]
Anna Pulakka PhD, Postdoctoral Researcher
Department of Public Health
University of Turku, Finland
MedicalResearch.com: What is the background for this study?
Response: Smoking is the one of the leading health risks globally. Finland, among some other countries, has set a target for a tobacco-free society by 2040. However, with the current rate of decline in smoking prevalence, the target will not be met. It is therefore important to explore new avenues for helping people to quit smoking.
Recently, researchers have become more interested in availability of tobacco as one determinant for smoking habit. We have learned from cross-sectional studies that people who live in neighborhoods with many stores that sell tobacco, smoke more than those who have less tobacco stores in their neighborhood. What has been lacking is more robust evidence from longitudinal studies on the association between availability of tobacco in neighborhoods and smoking behaviours. We sought to determine whether change in the location of tobacco stores nearby people’s place of residence was associated with the odds of quitting smoking or smoking relapse in a longitudinal setting.
12 Aug Phase 3 Trial of Iomab-B as an Induction and Conditioning Agent Prior to Bone Marrow or Stem Cell Transplant in Relapsed or Refractory AML
MedicalResearch.com Interview with: [caption id="attachment_26960" align="alignleft" width="200"]
Felix Garzon[/caption]
Felix Garzon, MD, PhD
Senior Vice President
Head of Clinical Development
Actinium Pharmaceuticals, Inc.
New York, NY 10016
MedicalResearch.com: What is the background for this study? What is goal of this Study?
Response: Iomab-B (“Iomab”) was developed at the Fred Hutchinson Cancer Research Center (“the Hutch”) in Seattle, Washington. The Hutch is a pioneer in the field of bone marrow transplantation (BMT) having 3 Nobel Prizes and doctors there performed some of the first transplants for leukemia patients. Iomab-B is intended to be an induction and conditioning agent prior to a BMT for patients with relapsed or refractory Acute Myeloid Leukemia (AML) who are over the age of 55. BMT is the only potentially curative option for AML i.e. for this patient population that currently has a survival prognosis of 2-6 months which means that if Iomab-B is successful it would create a new market segment and offer patients a great clinical benefit and a hope for a cure. Actinium Pharmaceuticals licensed Iomab from the Hutch in 2012 and prior to us licensing Iomab, it had been studied in almost 300 patients in several phase 1 and phase 2 clinical trials in an array of blood cancers, both leukemias and lymphomas. Actinium is now the sponsor of a pivotal phase 3 trial for Iomab-B to study its use as an induction and conditioning agent prior to a bone marrow transplantation in patients with relapsed or refractory AML who are over the age of 55. This trial, which we have named the SIERRA (Study of Iomab-B in Elderly Relapsed or Refractory AML) trial, started at the end of June 2016 and we expect to enroll 150 patients by the end of 2017.
The primary endpoint of the SIERRA trial is durable complete remissions (dCR) of 6 months. The study arm will consist of Iomab-B administration followed by a bone marrow transplantation, patients will be evaluated for dCR at 6 months after engraftment, which will be assessed at day 28 or day 56. The control arm of the study will be physician’s choice of chemotherapy and if the patient is able to achieve a complete remission (CR) they may receive a BMT or some other form of treatment with curative intent. The study is designed to evaluate if the study arm of Iomab-B and a BMT can double the dCR rate of the control arm, which is designed to replicate the current treatment regimen prior to a bone marrow transplantation .
12 Aug Thymectomy A Rational Choice For Some Patients With Myasthenia Gravis
MedicalResearch.com Interview with: [caption id="attachment_26807" align="alignleft" width="133"]
Dr. Gil Wolfe[/caption]
Gil I. Wolfe, MD, FAAN
Irvin and Rosemary Smith Professor and Chair
Dept. of Neurology/Jacobs Neurological Institute
Univ. at Buffalo Jacobs School of Medicine and Biomedical Sciences/SUNY
Buffalo General Medical Center
Buffalo, NY 14203-1126
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Thymectomy has been used in myasthenia gravis (MG), in particular those patients who do not have a tumor of the thymus gland, known as a thymoma, for over 75 years without randomized data to support its use. A practice parameter in 2000 on behalf of the American Academy of Neurology stated that the benefits of thymectomy in this population of non-thymomatou smyasthenia gravis patients remained uncertain, classified thymectomy as a treatment option in this group, and called for rigorous, randomized studies.
What we found is that compared to an identical prednisone protocol alone, that extended transsternal thymectomy confers significant benefits to non-thymomatous MG patients over a period of three years after the procedure. The benefits include better disease status, reduced prednisone requirements, fewer hospitalizations to manage myasthenia gravis worsenings, and a lower symptom profile related to side effects from medications used to control the disease state.
12 Aug Insurance Status Affects Glioblastoma Survival
MedicalResearch.com Interview with: [caption id="attachment_26739" align="alignleft" width="180"]
Dr. Wuyang Yang[/caption]
Wuyang Yang, M.D., M.S.
Research Fellow
Department of Neurosurgery
Johns Hopkins Hospital
Baltimore, MD 21287
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The treatment for glioblastoma (GBM) patients involves a combined approach of surgery, radiation therapy and chemotherapy. Despite advancement in the therapeutic approaches for GBM, differing socioeconomic status result in disparities in health-care access, and may superimpose a significant impact on survival of glioblastoma patients. Insurance status is an indirect indicator of overall socioeconomic status of a patient, and has been shown to correlate with survival of patients with malignant tumor in other parts of the body. We conducted the first study to determine a relationship between different types of insurance and survival of GBM patients.
In our study of 13,665 cases of GBM patients, we found that non-Medicaid insured patients have a significant survival benefit over uninsured and even Medicaid insured patients. This is the first time a study describes this relationship in glioblastoma patients, and also the first to compare and quantify the likelihood of poor prognosis between different insurance categories. A difference in insurance coverage was also uncovered, and patients with insurance were more likely to be older, female, white, and married. In addition, we found that younger, female, married patients with smaller tumor size survive longer than other patients, which confirmed findings in existing literature.
12 Aug Intracoronary Antiplatelet Abciximab Bolus May Improve Outcomes of Primary PCI in STEMI patients with Diabetes
MedicalResearch.com Interview with: Raffaele Piccolo, MD Department of Cardiology Bern University Hospital University of Bern Bern, Switzerland MedicalResearch.com: What is the background for this study? Response: Over the past two decades, the prevalence of diabetes mellitus has doubled in Western countries and future projections are even worse by showing a 55% increase by 2035 when approximately 592 million of people are expected to live with diabetes all over the world. Acute myocardial infarction still represents the most common diabetes-related complication and its occurrence is associated with a higher risk of mortality. Timely recanalization of the occluded coronary vessel with primary percutaneous coronary intervention (PCI) represents the therapy of choice for acute ST-segment elevation myocardial infarction (STEMI). Our study investigated whether the direct application of an intracoronary bolus of abciximab, which is an antiplatelet drug blocking the glycoprotein IIb/III a receptor, at the time of primary PCI improves the outcomes at 1-year follow-up compared with the standard intravenous route. The study was in individual patient-level pooled analysis of 3 randomized trials including 2,470 patients, of whom 473 (19%) had diabetes.12 Aug Factors Identifying Risk of Poor Weight Loss After Bariatric Surgery Identified
MedicalResearch.com Interview with: [caption id="attachment_26834" align="alignleft" width="143"]
Dr. Michelle Lent[/caption]
Dr. Michelle R. Lent, PhD
Geisinger Obesity Institute
Geisinger Clinic
Danville, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: More than one-third of adults in the United States live with obesity. Currently, the most effective treatment for obesity is bariatric surgery. Bariatric surgery patients are expected to lose 30 to 40 percent of their body weight, but not all patients are able to lose this amount of weight and others experience weight regain. Why some patients succeed in weight loss over time, while others are less successful, remains unclear.
In this study, we evaluated over 200 patient characteristics in relation to long-term weight loss after bariatric surgery (7 years or longer), including gender, age and weight at the time of surgery, lab tests, medical conditions and medications, among others. We found that patients who used insulin, had a history of smoking, or used 12 or more medications before surgery lost the most weight, while patients with high cholesterol, older patients and patients with higher body mass indexes at the time of surgery lost the least amount of weight after surgery.
12 Aug New Onset Atrial Fibrillation Strongest Predictor of Stroke After TAVR
MedicalResearch.com Interview with: [caption id="attachment_21314" align="alignleft" width="120"]
Dr. Josep Rodés-Cabau[/caption]
Josep Rodés-Cabau, MD
Director, Catheterization and Interventional Laboratories
Quebec Heart and Lung Institute
Professor, Faculty of Medicine, Laval University
Quebec City, Quebec, Canada
MedicalResearch.com: What is the background for this study?
Response: Transcatheter aortic valve replacement (TAVR) is increasingly used in patients with severe aortic stenosis deemed at prohibitive or high surgical risk. Recently, a randomized trial demonstrated the non-inferiority of TAVR compared to surgical aortic valve replacement in intermediate risk patients for the outcome of death and disabling stroke at 2 years. Therefore, TAVR indications are likely to expand to younger and lower risk patients in the near future.
While the short-term (30-day) cerebrovascular event (CVE) rate post-TAVR has decreased over time, it remains the most dreadful complication of TAVR, and still occurs in 2% to 3% of patients. A few dedicated studies identified numerous predictors of CVE which mainly differ from one study to another. However, identifying the risk factors of CVE is of paramount relevance in clinical practice to implement preventive strategies, either instrumental (embolic protection devices) or pharmacological in high-risk patients. Thus, we performed a systematic review and meta-analysis using random-effect models to provide pooled estimates of sixteen (8 patient-related and 8 procedural-related) clinically-relevant predictors of CVE within 30 days post TAVR.
12 Aug Early Onset of Pediatric Acute Otitis Media Raises Risk of More Frequent Episodes
MedicalResearch.com Interview with: [caption id="attachment_26952" align="alignleft" width="162"]
Marieke de Hoog[/caption]
Marieke de Hoog
Assistant Professor
Julius Centrum voor Gezondheidswetenschappen en Eerstelijnsgeneeskunde
UMC Utrecht
The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Acute otitis media (AOM) is a prime reason for doctor consultations and antibiotic use in children. Although symptoms of AOM may resolve spontaneously, these infections have a significant impact on child and family life and carry a considerable health care and economic burden. Acute otitis media occurring early in life, also called early-onset AOM, has been suggested as a risk factor for subsequent Acute otitis media episodes during childhood and could therefore also impact health care resource use. Identifying the critical age-period and quantifying the long-term consequences of early-onset AOM is important to guide future management and prevention programs aiming to reduce the burden of AOM.
11 Aug Patients With Newly Diagnosed DCIS Breast Cancer May Not Need Their Core Needle Biopsy Tested for Hormone Receptors
MedicalResearch.com Interview with: [caption id="attachment_26928" align="alignleft" width="170"]
Dr. Pedram Argani[/caption]
Pedram Argani, M.D.
Professor of Pathology and
Principal consultant of the Breast Pathology Service
Johns Hopkins Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Most pathology laboratories, at the request if clinicians, automatically (reflexively) test needle core biopsies containing ductal carcinoma in situ (DCIS) for estrogen receptor (ER) and progesterone receptor (PR). The logic for testing DCIS for these hormone receptors is that, for patients who have pure DCIS that is ER positive after surgical excision, treatment with estrogen blockers like Tamoxifen can decrease the recurrence of DCIS by a small amount, though overall survival (which is excellent) is not impacted.
However, there are several factors which suggest that this reflex testing unnecessarily increases costs.
• First, the ER/PR results on core needle biopsy do not impact the next step in therapy; namely, surgical excision.
• Second, a subset of excisions performed for DCIS diagnosed on core needle biopsy will harbor invasive breast carcinoma, which would than need to be retested for ER/PR.
• Third, because ER and PR labeling is often variable in DCIS, negative results for ER/PR in a small core biopsy specimen should logically be repeated in a surgical excision specimen with larger amounts of DICS to be sure that the result is truly negative.
• Fourth, many patients with pure DCIS which is ER/PR positive after surgical excision will decline hormone therapy, so any ER/PR testing of their DCIS is unnecessary.
• Fifth, PR status in DCIS has no independent value.
We reviewed the Johns Hopkins experience with reflex ER/PR testing of DCIS on core needle biopsies over 2 years. We found that reflex core needle biopsy specimen testing unnecessarily increased costs by approximately $140.00 per patient. We found that ER/PR testing in the excision impacted management in only approximately one third of cases, creating an unnecessary increased cost of approximately $440.00 per patient. Extrapolating the increased cost of reflex ER/PR testing of DCIS to the 60,000 new cases of DCIS in the United States each year, reflex core needle biopsy ER/PR testing unnecessarily increased costs by approximately 35 million dollars.
11 Aug Study Raises Concerns About Sales of Secondhand CPAP Devices
Posted at 22:06h
in Author Interviews, JAMA, Obstructive Sleep Apnea, Pulmonary Disease, Sleep Disorders
MedicalResearch.com Interview with:
[caption id="attachment_26802" align="alignleft" width="150"]
Dr. Kunisaki[/caption]
Ken Kunisaki, MD, MS
Associate Professor of Medicine
Minneapolis Veterans Affairs Health Care System and University of Minnesota and
[caption id="attachment_26803" align="alignleft" width="98"]
Dr. Prichard[/caption]
Roxanne Prichard, PhD
Associate Professor of Psychology and Neuroscience
University of St. Thomas
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: CPAP devices, or continuous positive airway pressure devices, are used to treat obstructive sleep apnea, a common condition that causes people to intermittently stop breathing during their sleep. This leads to poor sleep quality and often results in symptoms like excessive sleepiness in the daytime. In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription. We were aware of online advertisements for secondhand, used CPAP machines, but we have not seen publications that have analyzed this practice.
Once a week, our research team monitored online advertisements for secondhand CPAP devices on Craigslist.org in 18 U.S. cities and areas over a one-month period. During that time, we found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only 5 of the advertisements mentioned anything about the legal requirements of a prescription and 61 percent of the devices included a used mask without information about its age or how it was cleaned.
CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory. Our study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners.
The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device.
11 Aug Serious Infections Associated With Increased Risk of Suicide
Posted at 22:01h
in Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Mental Health Research
MedicalResearch.com Interview with:
Helene Lund-Sørensen BM
Department of Biomedical Sciences
Section of Cellular and Metabolic Research
University of Copenhagen
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Accumulating research has shown that inflammation and infections are associated with psychiatric diagnoses and interactions between infectious agents, known to affect the brain, and suicidal behavior have been reported.
We find an increased risk of death by suicide among individuals hospitalized with infections. The risk of suicide increased in a dose-response relationship with the number of hospitalizations with infections and with the number of days hospitalized with infections. We also examined the risk of suicide association with the time since the last hospitalization with infection and found that infection was linked to an elevated risk with the strongest effect after 1 and 2 years compared with those without infections.
11 Aug Concomitant Use of Clopidogrel and PPIs Still Prescribed Despite Safety Warnings
MedicalResearch.com Interview with: Willemien J. Kruik-Kollöffel, PharmD Medisch Spectrum Twente in Enschede Netherlands, MedicalResearch.com: What is the background for this study? Response: Safety concerns of the concomitant use of clopidogrel and proton pump inhibitors (PPIs) were published in 2009 and 2010 by the medicines regulatory agencies, including a direct healthcare professional communication. Those publications caused a lot of turmoil. We examined the association between various safety statements and prescription behavior for gastroprotective drugs in naïve patients in the Netherlands during the years 2008–2011.11 Aug Pancreatic Cancer Study Finds Abraxane Superior to Paclitaxel
MedicalResearch.com Interview with: [caption id="attachment_26931" align="alignleft" width="200"]
Dr. Rajesh Kumar NV[/caption]
Rajesh Kumar NV, Ph.D.
Instructor of Oncology and Pathology
Johns Hopkins University School of Medicine
Baltimore, MD, USA
Current Affiliation: Senior Manager, Human Therapeutics Division, Intrexon Corporation, 20358 Seneca Meadows Parkway, Germantown, MD, USA
MedicalResearch.com: What is the background for this study?
Response: Pancreatic cancer remains as one of the most deadly malignancies in the world. Recently, a cremophor-free and albumin-bound formulation of paclitaxel (nab-PTX, Abraxane) in combination with gemcitabine (GEM, Gemzar) is recently approved as a standard of care treatment option for patients with metastatic pancreatic cancer. Majority of the newly diagnosed pancreatic cancer patients use the nab-PTX plus GEM regimen. Currently there are over 100 clinical trials at various stages with this regimen as a backbone to approved medicines or investigational agents. Since widely available cremophor-based paclitaxel (PTX, Taxol) is a key chemotherapy component for the treatment of several human malignancies and the treatment cost of nab-PTX is relatively higher than PTX, patients, clinicians, third party payers and regulatory agencies have a substantial interest in understanding whether these two drugs provide a similar level of therapeutic efficacy in pancreatic cancer.
We utilized orthotopic models of human pancreatic cancer, which were shown to better recapitulate the histologic and metastatic characteristics of disease, and compared the anticancer efficacy, effect on tumor stroma modulation, metastatic spreading to distant organs and survival following GEM, PTX, nab-PTX and combinations of GEM plus PTX or nab-PTX. The preclinical trial used a total of 300 mice with established orthotopic pancreatic tumors. The tumors used for implantation were originally resected from the primary tumors of patients with moderately differentiated and poorly differentiated pancreatic cancer.
11 Aug Pulsed Electric Field Therapy May Reduce Unwanted Scar Formation
MedicalResearch.com Interview with: Alexander Golberg, PhD Senior Lecturer Head of Environmental Bioengineering Laboratory Porter School of Environmental Studies Tel Aviv University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wound care costs the U.S. healthcare system more than $20 billion each year, and care required to combat skin scarring represents an additional $12 billion burden. Hypertrophic scarring after trauma and burn injury remains a major clinical challenge that leads to physical, aesthetic, functional, psychological, and social stresses in thousands of patients. This is a stubborn clinical problem very difficult to solve. Inspired by previous works that pulsed electric fields kill cells precisely in tissue (procedure called irreversible electroporaiton, developed by UC Berkeley group of Boris Rubinsky and Rafael Davalo) and these ablated tissues regenerate with minimal scarring, we decided to test whether pulsed electric fields can reduce the scar formation if we treat the wound during healing. We found that partial irreversible electroporation using 200 pulses of 250 V and 70 µs duration, delivered at 3 Hz every 20 days during a total of five therapy sessions after the initial burn injury resulted in a 57.9% reduction of the scar area in comparison with untreated scars and structural features approaching those of normal skin. Noteworthy, unlike humans, rats do not develop hypertrophic scars. Therefore, the use of a rat animal model is the limiting factor of this work.11 Aug Inflammation is An Important Feature of Uveal Melanoma
MedicalResearch.com Interview with: [caption id="attachment_26912" align="alignleft" width="150"]
Dr. Ulrich Pfeffer[/caption]
Ulrich Pfeffer, PhD
Laboratory of Molecular Pathology
Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino–IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The melanoma of the eye or uveal melanoma is well controlled by radiotherapy or surgery but very aggressively growing metastases often develop and therapy has only marginally improved in decades. On the other hand, uveal melanoma is probably the best studied cancer in absolute: we know its development in great detail and we can make very precise prognosis. An important piece of information that is lacking is the effect of a chromosomal alteration, amplification of a part of chromosome 6, that is often encountered in a subset of uveal melanomas that show features of bad prognosis but actually perform better. Many have guessed that the immune system or more generally, inflammation might protect uveal melanomas with this alteration from progression to metastasis. Therefore we have set out to analyze a candidate gene, the putative immunomodulatory BTNL2, that is located on chromosome 6. We found highly variable expression of this gene in uveal melanoma samples where it is expressed by tumor cells and by infiltrating immune cells. The type of infiltrate is strongly associated with the risk to develop metastases. We also analyzed genetic variants of BTNL2 in 209 patients but we could not find a significant association with uveal melanoma risk.
10 Aug Unsafe levels of toxic chemicals found in drinking water for six million Americans
Posted at 12:51h
in Author Interviews, Brigham & Women's - Harvard, Environmental Risks, Toxin Research
MedicalResearch.com Interview with:
[caption id="attachment_26899" align="alignleft" width="133"]
Dr. Courtney Carignan[/caption]
Courtney C. Carignan PhD
Research Fellow
Department of Environmental Health
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We used mapping technology coupled with drinking water data from EPA to identify military bases, airports, industrial sites, and wastewater treatment plants as major sources of PFOS and PFOA contamination in drinking water. These measurements suggest that at least six million people have drinking water that exceeds the recent EPA health advisorylevels for PFOA and PFOS.
These are chemicals that have been historically manufactured in the US and used widely in consumer products such as stain-proof carpeting, non-stick pans and aqueous firefighting foam. They have been replaced with new generation of shorter-chain fluorinated chemicals, which also do not break down in the environment and may be similarly toxic.
10 Aug Volunteering in Mid and Old Age Linked To Better Mental Health
MedicalResearch.com Interview with: [caption id="attachment_26773" align="alignleft" width="180"]
Dr. Faiza Tabassum[/caption]
Dr. Faiza Tabassum, PhD
Southampton Statistical Sciences Research Institute
University of Southampton
Southampton, UK
MedicalResearch.com: What is the background for this study?
Response: Previous research has shown that volunteering in older age is associated with better mental and physical health, but it’s unclear whether this extends to other age groups. We aimed to examine the association of volunteering with mental health or well-being among the British population across all ages.
The British Household Panel Survey (BHPS) was used which has collected information from 1991 to 2008 from over 5000 households. The published study has analysed over 66,000 responses representing the whole of the UK. The BHPS included a wide range of questions on leisure time activities, which covered the frequency of formal volunteering—from at least once a week through to once a year or less, or never. The BHPS also included a validated proxy for mental health/emotional wellbeing known as the GHQ-12.
10 Aug US Task Force Reviews Lipid Screening For Children and Adolscents
MedicalResearch.com Interview with: [caption id="attachment_26893" align="alignleft" width="142"]
Dr. Paula Lozano[/caption]
Paula Lozano, MD MPH
Associate Medical Director, Research and Translation
Group Health Physicians
Senior Investigator
Group Health Research Institute
Metropolitan Park East
Seattle, WA 98101
MedicalResearch.com: What is the background for this study?
Response: This wasn’t a study, but rather a study of studies, to support the US Preventive Services Task Force in updating its previous recommendation of
I: insufficient to assess the balance of benefits and harms. We conducted two systematic evidence reviews of screening children and adolescents:
1. for familial hypercholesterolemia (FH, a genetic disorder that interferes with the body’s ability to metabolize cholesterol and can result in early coronary heart disease); and
2. for multifactorial dyslipidemia—which we defined as elevated LDL cholesterol or total cholesterol, not caused by familial hypercholesterolemia. LDL and total cholesterol were of interest because they are considered atherogenic.
One of the challenges of lipid screening in youth is that blood levels of these atherogenic lipids are known to fluctuate during the course of childhood and adolescence. It’s sort of a W-shaped curve, with a peak at age 9-11 years. So for a given child, the definition of what’s an elevated LDL or total cholesterol level will change with age. Also, two-thirds of kids identified as having high cholesterol through universal screening would not go on to have high cholesterol as adults.
10 Aug Clinical Course of Diabetic Kidney Disease Has Changed Over Past 30 Years
MedicalResearch.com Interview with: [caption id="attachment_26816" align="alignleft" width="133"]
Dr. Ian de Boer[/caption]
Ian de Boer, MD, MS
Associate Professor of Medicine
Adjunct Associate Professor of Epidemiology
Division of Nephrology and Kidney Research Institute
University of Washington, Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: From the perspective of patients with diabetes, kidney disease can be a devastating complication, leading to end stage renal disease requiring dialysis or kidney transplantation and markedly increasing the risks heart disease, stroke, peripheral vascular disease, and amputation. From a public health perspective, diabetes is the most common cause of end stage renal disease in the US, so understanding, preventing, and treating diabetic kidney disease is critical to reduce the numbers of people needing dialysis and kidney transplants. There have been major changes in the treatment of patients with diabetes over the last 30 years, so we were interested in evaluating how diabetic kidney disease was changing in this context.
We observed that the clinical manifestations of kidney disease have indeed changed among US adults with diabetes over the last 30 years. Albuminuria, or elevated levels of albumin in the urine, has traditionally been thought of as the first evidence of kidney damage for people with diabetes. Reduced GFR, or a reduced ability of the kidneys to filter out waster products, has typically been thought of as a late stage of diabetic kidney disease. But from 1988 to 2014, we saw a significant decrease in the prevalence of albuminuria accompanied by a significant increase in reduced GFR.
10 Aug Counterfeit Xanax Contained Toxic Amounts of Opioid Fentanyl
MedicalResearch.com Interview with: Ann M. Arens, MD California Poison Control Center San Francisco, CA 94110 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prescription opioid abuse is a significant public health threat that has garnered the attention of health care providers throughout medicine. With efforts to curb the number of prescriptions for opioid pain medications, users may begin to purchase prescription medications from illegal sources. Our study reports a series of patients in the San Francisco Bay Area who were exposed to counterfeit alprazolam (Xanax®) tablets found to contain large amounts of fentanyl, an opioid 100 times more potent than morphine, and in some cases etizolam, a benzodiazepine. The California Poison Control System – San Francisco division identified eight patients with unexpected serious health effects after exposure to the tablets including respiratory depression requiring mechanical ventilation, pulmonary edema, cardiac arrest, and one fatality. Patients reportedly purchased the tablets from drug dealers, and were unaware of their true contents. In one case, a 7 month-old infant accidentally ingested a counterfeit tablet dropped on the floor by a family member.10 Aug Apical Periodontitis Significantly Associated With Cardiovascular Diseases
MedicalResearch.com Interview with: [caption id="attachment_26880" align="alignleft" width="100"]
Dr. John Liljestrand[/caption]
John Liljestrand, DDS
Department of Oral and Maxillofacial Diseases
University of Helsinki
MedicalResearch.com: What is the background for this study?
Response: There is an increased amount of evidence supporting the hypothesis that oral inflammations increase the risk for cardiovascular diseases (CVDs). The association between marginal periodontitis, a common inflammatory disease in the tooth supporting tissues, and CVDs is well established. The link is thought to depend on transient but repeated bacteremia, endotoxemia and an increased systemic inflammatory burden.
Apical periodontitis is a common manifestation of an endodontic infection, most often caused by dental caries. It is an inflammatory reaction surrounding the root tip of a tooth and it restrains the dental infection from spreading into the bone. Apical periodontitis is similar to marginal periodontitis regarding its microbial profile and ability to increase systemic inflammatory markers. Therefore, it is justified to suggest that apical periodontitis might also increase the risk for CVDs. There is only a minor amount of publications on this topic and further research is still needed.
10 Aug Altruistic Men May Get More Sex
MedicalResearch.com Interview with: [caption id="attachment_26876" align="alignleft" width="205"]
Dr. Steven Arnocky[/caption]
Steven Arnocky, PhD
Associate Professor
Department of Psychology
Nipissing University
North Bay, ON CAN
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our work was based on previous findings from hunter-gatherer populations showing that men who hunt and share meat often enjoy greater reproductive access to women. Research in North America has shown that individuals prefer altruistic partners, especially for long-term mating, and that there may be a sex difference in these preferences such that women exhibit this preference more strongly than men. In line with this, some research has shown that men will sometimes compete with other men in order to make charitable donations to attractive female fundraisers (termed 'competitive altruism'). Taken together, these findings led us to hypothesise that individuals (and perhaps particularly men) who behave altruistically might experience greater mating success.
In Study 1, undergraduate men and women completed a self-report altruism questionnaire (items such as “I have donated blood”), a personality measure, and a sexual history survey. We found that participants who scored higher on a self-report altruism measure reported they were more desirable to the opposite sex, as well as reported having more sex partners, more casual sex partners, and having sex more often within relationships. Moreover, altruism mattered more for men’s number of lifetime and casual sex partners relative to women’s.
Given the possibility that in any survey research, there is a chance individual’s may report their altruism of sexual history in what they view to be a more positive light (who doesn’t want to think of themselves as altruistic!), in Study 2, we used a behavioral measure of altruism (each participant was entered onto a draw for $100, and at the end of the survey was given the choice to keep their winnings or to donate to a charity). Participants again reported on their sexual histories, as well as completed a personality measure, a scale to capture socially-desirable responding, and a measure of narcissism. Results showed that even when controlling for these potentially confounding variables, that altruists reported having more lifetime sex partners, more casual sex partners, and more sex partners over the past year. Men who were willing to donate also reported having more lifetime dating partners.
10 Aug Abnormal Microbiome Found in Preterm Infants Who Develop Chronic Lung Disease
[caption id="attachment_26871" align="alignleft" width="139"] Dr. Lal[/caption] MedicalResearch.com Interview with: Charitharth ‘Vivek' Lal, MD Assistant Professor, Division of Neonatal-Perinatal Medicine, Departments of Pediatrics University of Alabama at Birmingham Birmingham, AL 35249-7335 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Airway microbiome of neonates, at birth, has not been studied. Also, association of airway...
09 Aug Preconception Counselling Resource Improves Pregnancy Care in Women With Diabetes
MedicalResearch.com Interview with: [caption id="attachment_26855" align="alignleft" width="174"]
Dr. Valerie Holmes[/caption]
Dr Valerie Holmes
Senior Lecturer
Centre for Public Health
School of Medicine, Dentistry and Biomedical Science
Queen's University Belfast
Belfast
MedicalResearch.com: What is the background for this study?
Response: Women with diabetes, type 1 diabetes and type 2 diabetes, are advised to plan for pregnancy as there are higher risks of complications for both the mother and baby when compared to the general maternity population. Careful planning in partnership with diabetes care teams, especially in relation to achieving optimum blood glucose control and taking folic acid can significantly reduce the risks. However, while most women know that they should plan for pregnancy, they are unaware as to why this is important or how to engage with the process, and thus the majority of women (up to two thirds of women) enter pregnancy unprepared. This study describes the implementation of a regional preconception counsellng resource, in the format of a DVD, into routine care in Northern Ireland to raise awareness of pregnancy planning. The authors assessed if the introduction of this resource improved pregnancy planning among women with diabetes in the region.