Author Interviews, Health Care Systems / 06.06.2016

MedicalResearch.com Interview with: Myra Norton President and COO of Pegged Software MedicalResearch.com editor’s note: As part of an ongoing series on changes in the health care landscape, we interviewed Ms. Myra Norton, President and COO of Pegged Software. Pegged Software uses an advanced "analytics engine to selecting job candidates based on the actual determinants of high performance", specifically in the health care field. Ms. Norton has a special interest in gender and hospital hiring practices. MedicalResearch.com: Given that women earn 78 cents to the dollar in regards to men, can big data improve this pay inequity? If so, how does this happen? Ms. Norton: Big data and predictive analytics alone will not solve the problem of pay inequality. What these tools can do is illuminate talent in a way that removes the biases that undermine equality across gender, ethnicity, socio-economic status and other dimensions. For example, predictive analytics allows organizations to identify candidates with the highest likelihood of improving patient experience, being retained, remaining an engaged employee, lowering thirty day readmissions, and positively impacting other organizational outcomes. (more…)
ASCO, Author Interviews, Cancer Research, Chemotherapy / 06.06.2016

MedicalResearch.com Interview with: Dawn L. Hershman, MD MS Professor of Medicine and Epidemiology Leader, Breast Cancer Program Herbert Irving Comprehensive Cancer Center Columbia University NY NY MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Hershman: Chemotherapy induced peripheral neuropathy is a common side effect of anti cancer therapy and there are currently no ways to prevent it. We used a large clinical trials database, SWOG, and linked it to Medicare claims for patients over the age of 65. We found that age and type of taxane were associated with the development of CIPN. We also found a significant increase when a taxane was given along with a platinum agent. We found a doubling of risk among patients with a prior history of diabetes. No other chronic condition was associated with an increased risk of CIPN. We found a suggestion of a decreased risk among patients with a prior history of auto-immune disease. (more…)
ASCO, Author Interviews, Brigham & Women's - Harvard, Cancer Research, Pediatrics / 06.06.2016

MedicalResearch.com Interview with: Katie Greenzang, MD Dana-Farber/Boston Children’s Cancer and Blood Disorders Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Greenzang: Advances made over the last several decades mean that more than 80 percent of children diagnosed with cancer will become long-term survivors. However, many of these survivors experience physical and cognitive late effects of the treatment that cured them. We surveyed 352 parents of children recently diagnosed with cancer to assess how well they understood their children’s risk of future limitations in physical abilities, intelligence, and quality of life. We found that an overwhelming majority of parents (92 percent) are very interested in learning about possible late effects, and most (86 percent) seek detailed information. Yet, parent and physician predictions of a child’s risk of experiencing late effects of treatment often don’t match. Among children identified by their oncologists as being at high risk for such challenges, only 38 percent of parents recognized this risk in physical abilities, 21 percent in intelligence, and 5 percent in quality of life. (more…)
ASCO, Author Interviews, Cancer Research, Genetic Research / 06.06.2016

MedicalResearch.com Interview with: Gregory Idos MD Division of Gastroenterology and Hepatology Keck School of Medicine University of Southern California Los Angeles, CA 90033 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Idos: Identifying individuals at increased risk for hereditary cancer prompts enhanced cancer surveillance as early detection mitigates disease specific morbidity and mortality. This justifies germ line genetic testing for specific cancer risk alleles. In recent years, the field of cancer genetics has moved from a gene by gene sequencing approach to now having the ability to examine multiple genes concurrently. Multiplex gene panel (MGP) testing allows simultaneous analysis of multiple high- and moderate- penetrance genes. As a result, more pathogenic mutations and variants of uncertain significance (VUS) are discovered. MGP tests are increasingly being used by cancer genetic clinics, but questions remain about the clinical utility and complexities of these tests. We are conducting a multi center prospective trial to measure the added yield of detecting pathogenic mutations using the MGP approach. In our interim analysis of the first 1000 participants, we found that multiplex gene panel testing increased the yield of detection of pathogenic mutations by 26%. In some cases, we found patient’s who had a mutation in the BRCA gene, but their family history did not indicate a history of breast or ovarian cancer. (more…)
ASCO, Author Interviews, Cost of Health Care, Prostate Cancer, Surgical Research / 06.06.2016

MedicalResearch.com Interview with: Sarmad Sadeghi MD, MS, PhD Assistant Professor of Medicine Norris Comprehensive Cancer Center University of Southern California MedicalResearch.com: What is the background for this study? Dr. Sadeghi: Several years ago analyses of outcomes for radical prostatectomy highlighted the significant impact of surgical experience on the oncological outcome for the patients. In this case experience was measured by the number of radical prostatectomies performed by the surgeon, and oncological outcome was measured by treatment failure rates (rising PSA). Despite this data, the move for redirecting patients to “high volume centers” where more experienced surgeons perform the operation has been sluggish. There was insufficient data on what is involved in referring patients to high volume centers and whether or not such action is cost effective. In a previous study we demonstrated that for every referral to a high volume center, there would be an average of $1,800 over a follow-up period of 20 years in societal cost savings. The main source of these savings is fewer treatment failures. The next question was who is a good candidate for referral and whether these savings can offset the referral costs. (more…)
ASCO, Author Interviews, Cancer Research, Stem Cells / 05.06.2016

MedicalResearch.com Interview with: Philip McCarthy, BA, MD Professor of Oncology Director, Blood and Marrow Transplant Program Roswell Park Cancer Institute Associate Professor of Medicine Jacobs School of Medicine and Biomedical Sciences State University of New York at Buffalo Buffalo, NY 14263 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. McCarthy: There have been three Phase III studies that examined the role of maintenance lenalidomide after autologous stem cell transplant (ASCT) for newly diagnosed multiple myeloma patients. IFM 2005-02 (France), CALGB 100104 (Alliance, USA), GIMEMA-RVMM-PI-209 (Italy). All three studies had progression free survival (PFS) as their primary endpoint and all demonstrated a superior PFS when compared to placebo or no therapy after ASCT. However only the CALGB 100104 study demonstrated a statistically superior overall survival (OS). Thus, a meta-analysis was necessary to assess the effect of post-ASCT lenalidomide maintenance on overall survival. This study utilized a pooled analysis of updated primary-source patient data from all three studies after the primary efficacy analyses had been conducted. The meta-analysis demonstrated that there is a statistically superior OS (P value=0.001, HR=0.74 (0.62-0.89)), Median OS for no maintenance or placebo was 86 months and the median OS for lenalidomide had not been reached. The median OS for lenalidomide treatment arm was extrapolated to be 116 months based on median of the control arm and HR (median, 86 months; HR = 0.74). Thus, there is a 26% reduction in the risk of death which is an estimated 2.5 year increase in median OS. There is an increased incidence of second primary malignancies with lenalidomide maintenance when compared to placebo but this risk is less than the risk of dying when not receiving lenalidomide. (more…)
Author Interviews, OBGYNE, Pediatrics, Vaccine Studies / 05.06.2016

MedicalResearch.com Interview with: Dr Paul T Heath MB BS, FRACP, FRCPCH Reader / Honorary Consultant Paediatric Infectious Diseases St George’s, University of London and Vaccine Institute London, United KingdomDr Paul T Heath MB BS, FRACP, FRCPCH Reader / Honorary Consultant Paediatric Infectious Diseases St George’s, University of London and Vaccine Institute London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Heath: Vaccinating pregnant women is an important and proven strategy for protecting young infants against tetanus, influenza and pertussis. Among the infants at highest risk for complications of these infections are infants born prematurely but it is generally believed that because antibody transfer from mother to baby is maximal in the 3rd trimester, babies born prematurely may miss out on the benefits of maternal vaccination. (more…)
Author Interviews, Race/Ethnic Diversity, Stroke / 04.06.2016

MedicalResearch.com Interview with: George Howard, Dr.P.H. Professor of biostatistics Birmingham School of Public Health University of Alabama MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Howard: What has been known for many decades is that death rates from stroke are much higher in the black than white population, particularly between the ages of 45 – 65 (or maybe even a little older). These racial differences in stroke are among the greatest disparities for any disease, clearly it is a priority to reduce this disparity. However, there are two reasons more blacks could die from a disease: 1) more blacks get the disease, or 2) once you get the disease, it is more likely to kill blacks. The implications of knowing which of these is the major contributor is profound. If the driving force is more blacks are having more stroke, then we need to focus out attention on activities before stroke occur. For example, prevention of the greater prevalence of hypertension and diabetes in blacks, and also reducing the differences in the control of blood pressure and glucose. However, if the driving force is a higher chance of death in blacks once stroke occur, then we need to focus on the disparities in how black stroke patients are cared for compared to white stroke patients. That is, the former requires community-based efforts, while the latter requires hospital-based efforts. What we found was that nearly all the difference was that blacks are having more strokes ... not that they are more likely to die once stroke occurs. (more…)
Aging, Alzheimer's - Dementia, Antioxidants, Author Interviews, Nutrition, Supplements / 04.06.2016

MedicalResearch.com Interview with: Jennifer Lemon, PhD Research Associate Medical Radiation Sciences McMaster University MedicalResearch.com: What is the background for this study? Dr. Lemon: Research with the supplement began in 2000, as part of my doctoral degree; we developed the supplement to try to offset the severe cognitive deterioration and accelerated aging in a mouse model we were working with in the lab. Based on aging research, five mechanisms appeared to be key contributors to the process of aging; those include oxidative stress, inflammation, mitochondrial deterioration, membrane dysfunction and impaired glucose metabolism. The criteria we used for including components in the supplement were as follows: each one of the 30 components had scientific evidence to show they acted on one or more of the above mechanisms were able to be taken orally, and were available to humans over-the-counter. Even then the hope was that if the formulation was successful, this would make it more available to the general public. (more…)
Author Interviews, Blood Pressure - Hypertension, Compliance / 04.06.2016

MedicalResearch.com Interview with: Dr Prashanth Patel MSc, FRCP, FRCPath Consultant Metabolic Physician/ Chemical Pathologist and Head of Service Department of Chemical Pathology and Metabolic Diseases Honorary Senior Lecturer Dept of Cardiovascular Sciences University of Leicester MedicalResearch.com: What is the background for this study? Dr. Patel: Hypertension (HTN) is one of the most important and common chronic treatable condition. It affects nearly one third of the adult population. Nearly one fifth of patients treated for hypertension are thought to be resistant to treatment and these patients have a high mortality from cardiovascular diseases. Percutaneous radiofrequency catheter-based renal sympathetic denervation (renal denervation, RD) may be a potential treatment for resistant hypertension. Although RD is a safe procedure, it is irreversible and expensive. It is important that patients’ suitability for renal denervation is carefully assessed to maximise the potential benefits of the procedure. Therefore causes of pseudo-resistant hypertension namely white-coat hypertension, suboptimal pharmacological antihypertensive treatment and non-adherence to antihypertensive medications and secondary hypertension are needed to be robustly ruled out before considering a patient as suitable for renal denervation. (more…)
Author Interviews, Prostate, Prostate Cancer, Urology / 04.06.2016

MedicalResearch.com Interview with: Kenneth A. Iczkowski, M.D. Department of Pathology Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What is the background for this study? Dr. Iczkowski: The International Society of Urological Pathology (ISUP) in 2014 proposed use of a new 5-tier grade grouping system to supplement traditional Gleason grading to facilitate prognosis stratification and treatment1. The 5 categories subsume: Gleason 3+3=6, Gleason 3+4=7, Gleason 4+3=7, Gleason 8, and Gleason 9-10. We desired to determine whether men with a highest Gleason score of 3+5=8 or 5+3=8 in their set of prostate biopsy specimens, would have differing outcomes from those with Gleason 4+4=8. Because Gleason 5 cancer has been demonstrated to have a higher biologic potential than Gleason 4, it was expected that Gleason score 8 pattern with any Gleason 5 pattern would have a worse outcome. (more…)
ASCO, Author Interviews, Brain Cancer - Brain Tumors, Cancer Research, Immunotherapy / 04.06.2016

MedicalResearch.com Interview with: Wayne L. Furman, MD Department of Oncology Jude Children's Research Hospital Memphis, TN 38105-3678 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Furman: Despite improvement in 2-yr EFS from 46% to 66% with the inclusion of dinutuximab, a monoclonal antibody that recognizes a glycoprotein on neuroblasts called ‘GD2’ (disialoganglioside), more than one-third of children with high-risk neuroblastoma still are not cured. Therefore novel therapeutic approaches are needed for this subset of patients. The clinical evaluation of various anti-GD 2 monoclonal antibodies in children with neuroblastoma has been exclusively focused on treatment of patients after recovery from consolidation, in a state of ‘minimal residual disease’. This is because traditionally chemotherapy has been thought to be too immunosuppressive to combine with monoclonal antibodies. However recent studies suggest, even in the setting of “bulky” solid tumors, the combination of chemotherapy with monoclonal antibodies can enhance the effectiveness of the antibodies. First, chemotherapy can increase the efficacy of antibodies by depleting cells of the immune system that suppress immune function. Also chemotherapy-induced tumor cell death can trigger tumor antigen release, uptake by antigen processing cells and an enhanced antitumor immune response. There is also data that anti-GD2 monoclonal antibodies can suppress tumor cell growth independent of immune system involvement. Furthermore anti-GD2 monoclonal antibodies and chemotherapy have non-overlapping toxicities. All of these reasons were good reasons to evaluate the addition of a novel anti-GD2 monoclonal antibody, called hu14.18K322A, to chemotherapy, outside the setting of minimal residual disease, in children with newly diagnosed children with high-risk neuroblastoma. (more…)
Anesthesiology, Author Interviews, Ophthalmology, Surgical Research / 04.06.2016

MedicalResearch.com Interview with: Dr Gilles Guerrier Cochin University Hospital Paris, France MedicalResearch.com: What is the background for this study? Dr. Guerrier: Awake eye surgery is particularly stressful for patients. Music has long been known to reduce anxiety, minimise the need for sedatives, and make patients feel more at ease. The purpose of this pilot study was to evaluate the effect of music on anxiety in outpatients undergoing elective eye surgery under topical (local) anaesthesia. The music played was specifically composed to ease anxiety following strict criteria, including instrumental pieces only using a decreasing tempo and a progressive decrease in the number of instruments playing. Each patient was able to choose from a panel of 16 recorded music styles according to their own preferences, and listened through high quality headphones. There were various styles available, including jazz, flamenco, Cuban, classical and piano. The music was provided by MUSIC CARE, a Paris-based company that produces music aimed at preventing and managing pain, anxiety and depression. (more…)
Author Interviews, Diabetes, Infections, Surgical Research / 04.06.2016

MedicalResearch.com Interview with: Dr. Mary Forhan OT Reg (Alberta), PhD, Assistant Professor ad Dr. Tasuku Terada, post-doctoral research fellow Faculty of Rehabilitation Medicine University of Alberta MedicalResearch.com: What is the background for this study? Response: The prevalence of obesity has increased. Notably, a proportion of severe obesity (body mass index: body weight [kg] divided by height squared [m2]: >40kg/m2) has shown the most significant increase. Greater body mass increases the risk of cardiovascular disease and referrals for coronary artery graft surgery (CABG) have increased in patients with severe obesity. Interestingly, while obesity is often considered to increase the risk of complications and associated health care costs, many studies have reported better prognosis in patients with obesity compared to patients with normal weight, a phenomenon referred to as the obesity paradox. Therefore, it was not clear if patients with severe obesity were at higher risk of complications and contributed to greater resource use. A better understanding of the relationship between obesity and post-surgical adverse outcomes was needed to provide quality and efficient care. (more…)
Anesthesiology, Author Interviews, Breast Cancer, Opiods, Pain Research / 04.06.2016

MedicalResearch.com Interview with: Dr. Sarah Saxena Université Libre de Bruxelles MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Saxena: Opioids are well known analgesics, but like every drug, they do not come without side-effects. Recently, certain studies have been published about an opioid-free approach in bariatric patients. An opioid free approach is possible combining ketamine, lidocaine and clonidine. We studied this type of approach in breast cancer patients and looked at several factors such as patient comfort pain quality after an opioid free approach vs after an opioid approach. The study showed patients requiring less analgesics after an opioid free approach. (more…)
Author Interviews, Pediatrics, Weight Research / 04.06.2016

MedicalResearch.com Interview with: Jimmy Celind Postgraduate student The Sahlgrenska Academy University of Gothenburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that there is a widespread belief that birth weights are increasing, and that this at least partly is a product of the obesity epidemic (together with decreased smoking prevalence and higher maternal age). Several studies from countries such as Sweden, Norway, Denmark, USA, Scotland, Israel and Australia have shown a slight increase during the last decades of the 20th century. Our aim was to see when the increase started and how much it had increased. Our main findings are that the trends of birth weight are stable during the study period of 65 years (1946-2011), regarding mean, distribution, and odds ratios for being born with a high birth weight (>4,5 kg) per birth year increment. (more…)
Author Interviews, Endocrinology, Social Issues / 03.06.2016

MedicalResearch.com Interview with: Dr Robb Rutledge UCL Institute of Neurology and Max Planck UCL Centre for Computational Psychiatry and Ageing Research University College London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rutledge: As we get older, dopamine levels in the brain gradually decline. Dopamine has long been associated with risk taking and we have recently found that it is related specifically to how willing people are to take risks for potential rewards. It is widely believed that older people are risk averse, but this is controversial, and it is unknown whether age-related changes in dopamine are responsible for changes in risk taking. In this study, we tested over 25,000 people using a smartphone app called The Great Brain Experiment where players tried to win as many points as they could by choosing between safe and risky options. We found that older people were less willing to takes risks for potential rewards than young people, the same situations dopamine is known to be involved in. (more…)
Author Interviews, Opiods / 03.06.2016

MedicalResearch.com Interview with: Hsien-Yen Chang PhD Assistant Scientist Johns Hopkins Bloomberg School of Public Health Department of Health Policy & Management Center for Drug Safety & Effectiveness MedicalResearch.com: What is the background for this study? Dr. Chang: Prescription opioid addiction and non-medical use are significant public health problems, responsible for about 44 daily overdose deaths in the United States. Although there are no magic bullets to address these issues, policy makers play an important role in shaping regulatory, payment and public health policies to reduce opioid-related injuries and deaths. For example, state policy-makers in the United States have used prescription drug monitoring programs (PDMPs) and “pill mill” laws to address the prescription opioid epidemic. While there is growing evidence regarding the effect of these approaches on opioid sales, little is known about how they affect specific groups of prescribers. This is important, as approximately 20% of U.S. physicians are responsible for prescribing 80% of all opioid analgesics. Therefore, in this study we evaluated the impact of PDMPs and pill mill laws on the clinical practices of high-risk prescribers in Florida, such as their total number of prescription-filling patients with an opioid prescription. Furthermore, we also characterized the concentration of opioid volume and prescriptions among this group of prescribers as well as how the policies of interest impacted these measures. (more…)
Alzheimer's - Dementia, Author Interviews, Geriatrics, Johns Hopkins / 03.06.2016

MedicalResearch.com Interview with: Halima Amjad, MD, MPH Post-doctoral Fellow Johns Hopkins University School of Medicine Division of Geriatric Medicine and Gerontology MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Amjad: Safety is an important aspect of dementia care. Dementia is underdiagnosed, however, and there is limited understanding of safety issues in people with undiagnosed dementia. We wanted to better understand potentially unsafe activities and living conditions in all older adults with dementia and specifically examine these activities in undiagnosed dementia. We found that in all study participants with probable dementia, the prevalence of driving, cooking, managing finances, managing medications, or going to physician visits alone was over 20%. The prevalence was higher in older adults with probable dementia without a diagnosis, and even after accounting for sociodemographic, medical, and physical impairment factors, the odds of engaging in these activities was over 2.0 in undiagnosed versus diagnosed probable dementia. Potentially unsafe living conditions including unmet needs and performance on cognitive tests were similar between these groups. (more…)
Author Interviews, Cognitive Issues, Race/Ethnic Diversity, Social Issues / 03.06.2016

MedicalResearch.com Interview with: Zhenmei Zhang, Ph.D. Associate Professor Department of Sociology Michigan State University East Lansing, MI48824 MedicalResearch.com: What is the background for this study? Dr. Zhang: Blacks are especially hard hit by cognitive impairment and dementia. Recent estimates of dementia prevalence and incidence were substantially higher for blacks than whites. Reducing racial/ethnic disparities in dementia has been identified as a national priority by the National Alzheimer’s Project Act, which was signed into law by President Obama in 2011. So I really want to contribute to the ongoing discussion of the origins and pathways through which racial disparities in cognitive impairment is produced. If we have a better understanding of the factors contributing to racial disparities in cognitive impairment in later life, more effective interventions can be conducted to reduce the racial disparities. (more…)
Author Interviews, Cancer Research, Kaiser Permanente, Pediatrics / 03.06.2016

MedicalResearch.com Interview with: Andrea C. Wickremasinghe, MD Neonatologist Kaiser Santa Clara California MedicalResearch.com: What is the background for this study? Response: Neonatal jaundice is common and is often treated with phototherapy. Phototherapy is typically considered to be benign. In the past decade, phototherapy use has increased and it is sometimes started at bilirubin levels below recommended treatment thresholds. Beginning in the 1970’s, in-vitro and in-vivo studies have shown phototherapy to be associated with cellular changes implicated in the pathogenesis of cancer. Epidemiologic studies have yielded mixed results, with some studies showing associations between phototherapy and leukemia and other studies failing to show this association. In this study, we used a large statewide administrative dataset to investigate the relationship between neonatal phototherapy and cancer in the first year after birth. (more…)
Author Interviews, Diabetes, FASEB / 03.06.2016

MedicalResearch.com Interview with: Dr. Soo Jung Park, Ph.D. Senior Scientist Division of Bioconvergence Korea Basic Science Institute in Seoul, South Korea MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetes is a leading cause of morbidity and mortality worldwide. The elevated level of blood glucose (hyperglycemia) can induce the cell death of the pancreatic beta cells which are responsible for the production of insulin. Loss of β-cell number and function underlies much of the pathology of diabetes. However, the mechanism is not fully understood, and we found the novel regulator for hyperglycemia induced beta cell death. MedicalResearch.com: What should readers take away from your report? Response: TSPAN2 protein levels dramatically increased in response to high glucose. High TSPAN2 levels upregulated phosphorylated-JNK (p-JNK) and induced apoptosis. p-JNK enhanced the phosphorylation of β-catenin (p-β-catenin) and Dickkopf-1 (Dkk1). Dkk1 knockdown by siRNA upregulated nuclear β-catenin, suggesting that it is a JNK/β-catenin-dependent pathway. siRNA-mediated TSPAN2 depletion in RNAKT-15 cells increased nuclear β-catenin. This decreased Bax activation, leading to marked protection against high glucose-induced apoptosis. Bax subfamily proteins induced apoptosis through caspase-3. Thus, TSPAN2 might have induced Bax translocation and caspase-3 activation in pancreatic β cells, thereby promoting the apoptosis of RNAKT 15 cells by regulating the JNK/β-catenin pathway in response to high glucose concentrations. (more…)
Anesthesiology, Author Interviews, Critical Care - Intensive Care - ICUs, Environmental Risks / 02.06.2016

MedicalResearch.com Interview with: Dr. Eveline Claes Jessa Ziekenhuis Hospital Hasselt, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background of this study was the presence of noise in our ICU, and patients complaining about it. We wanted to look into the problem. The main findings were that there is indeed too much noise in our ICU compared to the WHO recommendations, but the measured sound levels were comparable with other ICU's. (more…)
Author Interviews, Circadian Rhythm, Endocrinology, Lifestyle & Health, Occupational Health, Sleep Disorders, Stroke / 02.06.2016

MedicalResearch.com Interview with: David Earnest, Ph.D. Professor in the Department of Neuroscience and Experimental Therapeutics Texas A&M Health Science Center College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Earnest: When body clocks are disrupted, as they are when people engage in shift work or go to bed and get up at radically different times every few days, more severe ischemic strokes can result. MedicalResearch.com: What should readers take away from your report? Dr. Earnest:  Whenever possible, go to bed and get up at the same time each day and keep regular mealtimes. If you do need to keep an irregular schedule, it is especially important to be mindful of stroke risk and try especially hard to eliminate other risk factors, such as hypertension and obesity. (more…)
Author Interviews, NEJM, Rheumatology / 02.06.2016

MedicalResearch.com Interview with: Chih-Hung Kuo, M.B., B.S. Peter McCluskey, M.D. Clare L. Fraser, M.B., B.S. University of Sydney Sydney, NSW, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Giant cell arteritis is a life and sight threatening systemic inflammatory condition, which remains difficult to diagnose. Jaw claudication (cramping of muscle from ischemia) is a highly specific symptom with significant diagnostic and prognostic (risk of permanent blindness) values. The reporting of jaw symptoms may be affected by many factors, such as diet. There remains no standardized clinical test available for clinicians. We study the use of chewing gum as a standardized test (like a stress test for angina pain) to better characterize this critical symptom. The pilot study of two cases with abnormal results were published in the New England Journal of Medicine. Chewing gum at a rate of 1 chew/second can reproduce the jaw claudication symptom around 2-3 minutes. In one case, the jaw claudication was unmasked by the test with a subsequent positive biopsy result. The test result became negative after corticosteroid treatment. (more…)
Author Interviews, Genetic Research, Weight Research / 02.06.2016

MedicalResearch.com Interview with: Dr. Yann C. Klimentidis PhD Assistant Professor Epidemiology and Biostatistics Department The University of Arizona Tucson, AZ 85724 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Klimentidis: There is a large gender disparity in obesity rates among African-Americans. African-American women have much higher rates of overweight and obesity as compared to African-American men. We hypothesized that genetic factors may partly explain this difference. So we tested whether the influence of West-African genetic ancestry on obesity differed among men and women. We found that greater West-African genetic ancestry was associated with protection against central obesity in men, but no such effect was observed in women. (more…)
Author Interviews, Hospital Acquired, NEJM, Urinary Tract Infections / 02.06.2016

MedicalResearch.com Interview with: Sanjay Saint, MD, MPH Chief of Medicine VA Ann Arbor Healthcare System George Dock Professor of Internal Medicine & Senior Associate Chair - Department of Internal Medicine University of Michigan Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Saint: Catheter-associated urinary tract infection (CAUTI) is a common, costly, and morbid complication of hospitalization. Urinary tract infection (UTI) is one of the most common device-related infections in the United States. CAUTI rates rose nationally between 2009 and 2013. We put in place a national program to reduce CAUTI. Specifically, we enrolled 926 intensive care unit (ICU) and non-ICU hospital units in 603 hospitals spread over 32 states, the District of Columbia and Puerto Rico between March 2011 and November 2013. By the end of the 18-month program, UTI rates among hospital patients in general wards had dropped by a third. Specifically: • The rate of CAUTIs dropped from 2.40 per 1000 days of catheter use to 2.05 (a ~14 percent overall drop). • Nearly all of the decrease in CAUTI rates was due to changes in infection rates in non-ICUs, which went from 2.28 to 1.54 infections per 1,000 catheter-days – a drop of 32 percent. In non-ICUs, the overall use of catheters decreased by 7%. • ICUs didn’t see a substantial change in either CAUTI or catheter use, likely because the nature of patients treated in ICUs means more frequent urine output monitoring and culturing of urine, so UTIs are more likely to be spotted. (more…)
Author Interviews, Pharmacology / 02.06.2016

MedicalResearch.com Interview with: Professor Neil Carragher Principal Investigator Drug Discovery Institute of Genetics and Molecular Medicine University of Edinburgh MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Carragher: The aim of the study was to generate novel small molecule inhibitors that target breast cancers using a strategy which we named: "dual ligand based phenotypic screening". From initial derivation of a small chemical library based on a promiscuous kinase inhibitor PP1, iterative screening across a suite of breast cancer phenotypic assays guided chemical design towards the novel compound eCF506. eCF506 is a highly potent, orally bioavailable and specific inhibitor of Src Kinase. (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Microbiome / 02.06.2016

MedicalResearch.com Interview with: Dr. W.H. Wilson Tang M.D. Department of Cellular and Molecular Medicine (NC10) Cleveland Clinic Lerner Research Institute Cleveland, Ohio 44195 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our group has recently described the mechanistic link between intestinal microbe-generated phosphatidylcholine metabolite, trimethylamine N-oxide (TMAO), and the pathogenesis of atherosclerotic coronary artery disease (CAD) and its adverse clinical outcomes. Here in a separate, independent, contemporary cohort of patients undergoing coronary angiography, we demonstrated the association between elevated fasting TMAO levels and quantitative atherosclerotic burden (as measured by SYNTAX and SYNTAX II scores) in stable cardiac patients and is an independent predictor for the presence of diffuse (but not focal) lesion characteristics. (more…)
Author Interviews, Gastrointestinal Disease, Gluten, Microbiome / 02.06.2016

MedicalResearch.com Interview with: Ettje Tigchelaar MSc PhD student from department of Genetics University of Groningen, Groningen MedicalResearch.com: What is the background for this study? What are the main findings? Response: A gluten-free diet is used by celiac disease patients to alleviate their symptoms. Previous research in these patients has shown differences in gut microbiota composition when on habitual gluten containing diet (HD) compared to a gluten-free diet (GFD). Recently more and more individuals without celiac disease also started to adopt a gluten-free diet to improve their health and/or control weight. We studied changes in gut microbiota composition in these healthy individuals on a gluten-free diet. We observed changes in the abundance of specific bacteria, for example the abundance of the bacterium family Veillonellaceae was much lower on a gluten-free diet versus HD, whereas it was higher for the family Clostridiaceae. We also looked at the function of the bacteria in the gut and found that many of those bacteria that changed because of the gluten-free diet played a role in metabolism of starch. This makes sense since starch is like gluten highly present in wheat containing products, thus when eliminating gluten from the diet, the intake of starch also changes and the gut bacteria processing this dietary starch change accordingly. (more…)