Author Interviews, Breast Cancer, Cancer Research, Chemotherapy / 27.10.2014

MedicalResearch.com Interview with: Shidong Jiang Associate professor of Engineering Thayer School of Engineering at Dartmouth Medical Research: What is the background for this study? What are the main findings? Dr. Jiang: Breast cancer is the most common non-skin cancer in women worldwide, and the second leading cause of women’s cancer mortality in the United States. A common treatment strategy after diagnosis is to shrink breast cancer tumors larger than 3 centimeters with a 6 to 8 month course of Neoadjuvant Chemotherapy prior to surgery. Clinical studies have shown that patients who respond to Neoadjuvant Chemotherapy have longer disease-free survival rates, but only 20 to 30 percent of patients who receive Neoadjuvant Chemotherapy fit this profile. Our work represents the first clinical evidence that tumor total hemoglobin estimated from DOST images differentiates women with locally advanced breast cancer who have a complete pathological response with Neoadjuvant Chemotherapy from those who do not with predictive significance based on image data acquired before the initiation of therapy. The implication of this prognostic information is that certain tumors are pre-disposed to responding to Neoadjuvant Chemotherapy, and that this predisposition should be known prior to choosing the therapy.  The study also demonstrates the potential of dramatically accelerating the validation of optimal Neoadjuvant Chemotherapy regimes through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure.
Author Interviews, Heart Disease / 27.10.2014

MedicalResearch.com Interview with: Dr. David MacIver Department of Cardiology Musgrove Park Hospital, Taunton Medical Research: What is the background for this study? What are the main findings? Dr. MacIver: The study was prompted by 2 triathletes who presented to our hospital with similar symptoms suggesting they both had had fluid on the lungs whilst swimming. Both athletes were fit and active and had excellent heart function. They were diagnosed with a condition is known as swimming-induced pulmonary oedema or edema (SIPO in the UK and SIPE in the USA). A condition that has been well-documented in Navy seals during training swims in open water. A similar condition has been described in divers sometimes with fatal consequences. Fluid on the lungs or pulmonary oedema more commonly occurs in patients as a complication of severe heart disease such as heart attacks and is called acute heart failure. Pulmonary oedema has also been documented healthy race-horses during competitions. We had recently suggested that acute pulmonary edema in patients with heart disease could be explained by a transient mismatch in the right and left ventricular stroke volumes. We thought it would be interesting to see if a similar mechanism could explain swimming-induced pulmonary edema. We found that factors that might contribute included cold water and high blood pressure. We speculated that cross-training with land based activities (running, cycling) might be relevant. In this study we proposed a possible mechanism for swimming-induced pulmonary edema - fluid from the blood is force into the lung air sacs by the strong right ventricle. In effect, the individual begins drowning in their own lung fluid.
Author Interviews, Infections / 27.10.2014

Dr. Simon Corrie PhD The University of Queensland, Australian Institute for Bioengineering and Nanotechnology, Delivery of Drugs and Genes Group Australian Infectious Diseases Research Centre, St. Lucia, Queensland, AustraliaMedicalResearch.com: Interview with: Dr. Simon Corrie PhD The University of Queensland, Australian Institute for Bioengineering and Nanotechnology, Delivery of Drugs and Genes Group Australian Infectious Diseases Research Centre, St. Lucia, Queensland, Australia Medical Research: What is the background for this study? What are the main findings? Dr. Corrie: P. falciparum malaria is a major cause of morbidity and mortality around the world, particularly in developing countries. Some estimates also suggest that in developing countries, children under 5 account for ~90% mortality. As malaria is treatable, positive detection is important rule out other causes, avoid over-treatment leading to resistance, and to guide appropriate treatment. Our focus is on developing diagnostic devices for infectious diseases, which do not require needles, lancets or laboratory processing. These devices are “microprojection arrays”, silicon chips that can be applied to the skin to capture circulating protein biomarkers in the interstitial fluid of the skin. In this publication we: (a) developed methods to improve the sensitivity of the devices for capturing HRP2, (b) confirmed that HRP2 protein injected intravenously is detectable in skin fluid and (c) showed that we could capture both HRP2 and total IgG (as a positive control for penetration into skin) at the same time.
Author Interviews, Diabetes, Infections, OBGYNE / 27.10.2014

Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head of the WHO Collaborating Center for the Study of Diabetes in YouthMedicalResearch.com Interview with: Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head WHO Collaborating Center for the Study of Diabetes in Youth Medical Research: What are the main findings of the study? What was most surprising about results? Prof. Laron: The main findings were the finding of specific antibodies to the pancreatic insulin secreting beta cells together with antibodies against rota-virus in both the mother at delivery and in the newborn's cord blood. We were not surprised, but pleased to find proof to our hypothesis that part, if not the majority of childhood onset Type 1 (autoimmune diabetes) starts "in utero".
Author Interviews, Colon Cancer, Cost of Health Care / 25.10.2014

Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann ArborMedicalResearch.com Interview with: Dr. Christine Marie Veenstra MD Department of Internal Medicine, Division of Hematology/Oncology Division of Colorectal Surgery Center for Healthcare Outcomes and Policy Division of General Medicine Cancer Surveillance and Outcomes Research Team University of Michigan, Ann Arbor Medical Research: What is the background for this study? Dr. Veenstra: Nearly 50,000 patients are diagnosed with stage III colorectal cancer each year. Chemotherapy is known to increase survival by up to 20% and is the standard recommendation for these patients after surgery. However, use of chemotherapy may be associated with financial strain. In order to better understand the financial burden and worry associated with colorectal cancer treatment, we surveyed 956 patients being treated for stage III colorectal cancer. We asked patients to answer questions about financial burden such as whether they had used savings, borrowed money, skipped credit card payments, or cut back on spending for food, clothing or recreational activities because of their cancer treatment. We also asked patients how much they worry about financial problems because of their cancer or its treatment.
Author Interviews, Genetic Research, Infections / 25.10.2014

Dr R.E.W. (Bob) Hancock, OC, OBC, FRSC {Canada Research Chair and Professor, Department of Microbiology and Immunology,UBC} Director, Centre for Microbial Diseases and Immunity Research University of British Columbia, Vancouver, British Columbia, CanadaMedicalResearch.com Interview with: Dr R.E.W. (Bob) Hancock, OC, OBC, FRSC {Canada Research Chair and Professor, Department of Microbiology and Immunology,UBC} Director, Centre for Microbial Diseases and Immunity Research University of British Columbia, Vancouver, British Columbia,  Canada MedicalResearch: What is the background for this study? What are the main findings? Dr. Hancock: We wanted to understand how patients transitioned from the hyperinflammatory phase (cytokine storm) of sepsis to the hypoinflammatory (immunosuppressive) phase of sepsis (inability to respond appropriately to infections). About 15% of patients die in this first phase and 20% in the second phase, making sepsis one of the most deadly syndromes (35% overall mortality, 5 million deaths [8.3% of all deaths] annually worldwide). We hypothesized that immunosuppression was characterized by a state termed endotoxin tolerance a cellular amnesia (termed cellular reprogramming) in which cells fail to respond to microbial cues. Overall we found that an Endotoxin Tolerance gene signature is significantly associated with the subsequent development of confirmed sepsis and new organ dysfunction in patients who had suspected sepsis. All 620 sepsis patients in retrospective and new analyses presented with an expression profile strongly associated with the endotoxin tolerance signature (p<0.01; AUC 96.1%). This occurred in fact very early in sepsis and in a new clinical study we found that the signature could be detected already in the emergency ward at first clinical  presentation and 24-48 hours prior to definitive diagnosis. Importantly, this signature further differentiated between suspected sepsis patients who did, or did not, go on to develop confirmed sepsis, and predicted the development of organ dysfunction.
Author Interviews, CMAJ, Stroke / 25.10.2014

MedicalResearch.com Interview with: Michael Douglas Hill, MD, MSc The Calgary Stroke Program, Department of Clinical Neurosciences Hotchkiss Brain Institute Associate Professor, University of Calgary Calgary, Alta MedicalResearch: What is the background for this study? Dr. Hill:  We conducted an audit of stroke admissions to Canadian hospitals in all provinces.  We examined key metrics of quality stroke care focusing on the acute treatment. Use of thrombolysis for stroke is a key quality metric in the Accreditation Canada standards for stroke care.  We found that the use of thrombolysis, while better than the past review (CMAJ. 2005 May 10;172(10):1307-12) remains low.  This is a marker for the overall quality of acute stroke care in Canada.  As expected, larger academic hospitals perform at a higher level than smaller community hospitals. Overall, this study serves to quantify the gaps in the delivery of acute stroke care to Canadians.
AHA Journals, Author Interviews, Cost of Health Care, Stroke / 24.10.2014

A/Prof Dominique Cadilhac, MPH PhD Head: Translational Public Health Division Stroke and Ageing Research Centre (STARC) Department of Medicine, School of Clinical Sciences at Monash Health, Monash University Melbourne, AustraliaMedicalResearch.com Interview with: A/Prof Dominique Cadilhac, MPH PhD Head: Translational Public Health Division Stroke and Ageing Research Centre (STARC) Department of Medicine, School of Clinical Sciences at Monash Health, Monash University Melbourne, Australia Medical Research: What are the main findings of the study? Dr. Cadilhac: Our results provide important information for health policy and planning, by providing a better understanding of the long-term costs of ischemic stroke (IS) and intracerebral hemorrhage stroke (ICH). 243 patients who experienced an ischemic stroke– the most common type of stroke, and 43 patients with intracerebral hemorrhage stroke who went on to survive for 10 years or more were interviewed to calculate annual costs as part of the North East Melbourne Stroke Incidence Study. Average annual healthcare costs 10 years after an ischemic stroke were $5,418 (AUD) – broadly similar to costs estimated between 3 and 5 years ($5,545). Whereas previous estimates for annual healthcare costs for intracerebral hemorrhage stroke ten years after stroke onset were $6,101, Professor Cadilhac’s team found the true cost was $9,032 far higher than costs calculated at 3 to 5 years ($6,101) because of a greater need for aged care facilities 10 years on. The high lifetime costs per stroke for both subtypes for first-ever events emphasize the significant economic implications of stroke (ischemic stroke AUD103,566 [USD 68,769] and intracerebral hemorrhage stroke AUD82,764 [USD54,956]). The study also provides evidence of the importance of updating cost estimates when population demography patterns change or if new information on incidence rates, or case-fatality rates, are available. We found a much larger number of intracerebral hemorrhage stroke would be expected than from earlier estimates because a) there are a larger number of people in the age groups 45 to 84 years living in Australia in 2010; and b) we applied new information on incidence rates from a larger geographical region than what was found from using the original NEMESIS pilot study region. In the online supplement we also provide an estimate of health loss reported as quality adjusted Life years (QALYs) lost to highlight how many years of healthy life is lost from a first-ever stroke event.
Author Interviews, Genetic Research / 24.10.2014

Dr. Toomas Kivsild PhD Department of Archaeology and Anthropology University of Cambridge, CambridgeMedicalResearch.com Interview with: Dr. Toomas Kivsild PhD Department of Archaeology and Anthropology University of Cambridge, Cambridge Medical Research: What is the background for this study? What are the main findings? Dr. Kivsild: Native populations of Siberia are known to have certain physiological characteristics such as high basal metabolic rate, and high blood pressure and low levels of serum lipids, that have been explained as traits that have evolved as a consequence of the adaptation of Siberians to their cold environment. Genetic basis of cold adaptation is still poorly understood. In our previous study using genome-wide genotyping scans we detected a 3 Mbp region of high haplotype homozygosity in chromosome 11 as a candidate of strong positive selection in Northeast Siberians. There were 79 protein coding genes mapping to this homozygosity region but we could not determine which of the genes was driving the signal we observed. In this forthcoming paper we have used high coverage whole genome sequences from 25 individuals from Northeast Siberia and we were able to determine the most likely SNP that is responsible for the high haplotype homozygosity in the chromosome 11 in Northeast Siberians maps to CPT1A gene which is a key regulator of long-chain fatty-acid oxidation in mitochondria. What makes this finding most interesting is that the same SNP had previously been found in Greenland and Canadian Inuits in association with high infant mortality and hypoketotic hypoglycemia. There are only a few other similar cases, like the sickle cell and APOL1 alleles, where disease associated genetic variants may have risen to high frequency in modern day populations due to the adaptive advantage they have presented in the past populations.
Author Interviews, Depression, Heart Disease / 24.10.2014

MedicalResearch.com Interview with: Professor Pranas Serpytis Vilnius University Hospital Santariskiu Clinic Vilnius, Lithuania Medical Research: What are the main findings of the study? Professor Serpytis: The main findings of the study were that women are more likely to develop anxiety and depression after acute myocardial infarction. In our study depression was assessed by HADS scale: no depression (0-7 score), possible depression (8-10 score), definite depression (11+ score). The mean score of assessing depression were 6.87 (± 4.6) among men and 8.66 (± 3.7) among women (p <.05). Cardiovascular disease risk factors such as smoking increases patients anxiety levels, and low physical activity is associated with an increased risk to suffer from depression. Medical Research: What was most surprising about the results? Professor Serpytis: Most surprising about the results were that for women it is indeed more difficult to cope with the disease rather than for men. Women’s anxiety and depression rates are higher. Medical Research: What should clinicians and patients take away from your report? Professor Serpytis: Clinicians and patients should look after the possible symptoms and if needed refer the patients for psychologist or psychiatrist consultation in order get proper timely treatment. This could possibly improve the long-term treatment results. Medical Research: What recommendations do you have for future research as a result of this study? Professor Serpytis: Most definitely more research is needed in this field. Most importantly it is crucial to look for the impact of depression on the long-term effects on survival and general well-being. Citation: Women more likely to develop anxiety and depression after heart attack Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC) and takes place 18-20 October in Geneva, Switzerland.MedicalResearch.com Interview with: Professor Pranas Serpytis Vilnius University Hospital Santariskiu Clinic Vilnius, Lithuania Medical Research: What are the main findings of the study? Professor Serpytis: The main findings of the study were that women are more likely to develop anxiety and depression after acute myocardial infarction. In our study depression was assessed by HADS scale: no depression (0-7 score), possible depression (8-10 score), definite depression (11+ score). The mean score of assessing depression were 6.87 (± 4.6) among men and 8.66 (± 3.7) among women (p <.05). Cardiovascular disease risk factors such as smoking increases patients anxiety levels, and low physical activity is associated with an increased risk to suffer from depression.
Author Interviews, Cancer, Pancreatic / 24.10.2014

MedicalResearch.com Interview with: Jeremy L. Humphris MBBS The Kinghorn Cancer Center, Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia and Andrew V. Biankin Regius Professor of Surgery Director, Wolfson Wohl Cancer Research Centre, University of Glasgow Garscube Estate, Switchback Road, Bearsden, Glasgow Scotland United Kingdom Medical Research: What are the main findings of the study? Response: Familial pancreatic cancer (FPC) is a family with at least 2 first degree (parent-child or siblings) with pancreatic cancer. We found these patients represent nearly 9% of our cohort. In addition we found those with familial pancreatic cancer were more likely to have other first degree relatives with a history of extra-pancreatic cancer, in particular melanoma and endometrial cancer. Patients with familial pancreatic cancer had more high grade precursor lesions in the pancreas adjacent to the tumour but the outcome was similar. Smoking was more prevalent in sporadic pancreatic cancer and active smoking was associated with significantly younger age at diagnosis in both groups. Long-standing diabetes mellitus (> 2 years duration) was associated with poorer survival in both groups.
Author Interviews, Pediatrics, Vaccine Studies / 24.10.2014

MedicalResearch.com Interview with: Louise-Anne McNutt, PhD Associate Director, Institute for Health and the Environment University at Albany, State University of New YorkLouise-Anne McNutt, PhD Associate Director, Institute for Health and the Environment University at Albany, State University of New York Jessica Nadeau, PhD Epidemiologist, University at Albany, State University of New YorkJessica Nadeau, PhD Epidemiologist, University at Albany, State University of New York Medical Research: What are the main findings of the study? Response: The study found that about 25% of infants consistently deviated from the routine vaccine schedule recommended by the American Academy of Pediatrics (AAP).  Alterations included either consistently refusing a recommended vaccine or reducing the number of vaccines given at each visit. These deviations are generally associated with intent to use an alternative vaccination schedule. Infants who did not follow the AAP recommended schedule were more likely to be unprotected against vaccine preventable diseases for a longer period of time. Only 1 in10 infants vaccinated on an alternative schedule were up-to-date at 9 months of age.
Author Interviews, Health Care Systems / 23.10.2014

Dr. Steffie Woolhandler MD MPH Professor of Public Health and City University of New York, Lecturer (formerly Professor of Medicine) at Harvard Medical School Primary Care Physician Practicing in the South BronxMedicalResearch.com Interview with: Dr. Steffie Woolhandler MD MPH Professor of Public Health and City University of New York, Lecturer (formerly Professor of Medicine) at Harvard Medical School Primary Care Physician Practicing in the South Bronx Medical Research: What is the background for this study? Dr. Woolhandler: Physicians like myself are extremely frustrated by the administrative burdens of medical practice. Many hours of physicians’ time each week go to administrative work completely unrelated to good patient care, but mandated by private insurers and other payers. Colleagues often tell me that they love seeing patients but are getting burned out by the paperwork.
Author Interviews, Bipolar Disorder, JAMA, Schizophrenia / 23.10.2014

Glenn T. Konopaske, MD McLean Hospital, Belmont, Massachusetts Department of Psychiatry, Harvard Medical School Boston, MassachusettsMedicalResearch.com Interview with: Glenn T. Konopaske, MD McLean Hospital, Belmont, Massachusetts Department of Psychiatry, Harvard Medical School Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Konopaske: Using postmortem human brain tissue this study did reconstructions of basilar dendrites localized to pyramidal cells in the deep layer III of the dorsolateral prefrontal cortex. Tissue from individuals with schizophrenia, bipolar disorder or controls was examined. Dendritic spine density (number of spines per μm dendrite) was significantly reduced in bipolar disorder and also reduced in schizophrenia at a trend level. The number of dendritic spines per dendrite and dendrite length were significantly reduced in subjects with schizophrenia and bipolar disorder.
Author Interviews, Pulmonary Disease, Race/Ethnic Diversity / 23.10.2014

Nandita Bhan, ScD MSc MA Research Scientist & Adjunct Assistant Professor Public Health Foundation of India (PHFI)MedicalResearch.com Interview with: Nandita Bhan, ScD MSc MA Research Scientist & Adjunct Assistant Professor Public Health Foundation of India (PHFI) Medical Research: What are the main findings of the study? Dr. Bhan: We found that the last decade in the US has seen a rise in racial/ethnic disparities in asthma. Compared to Non-Hispanic White populations, greater rates of asthma were seen among African Americans and lower rates among Hispanic populations. But more importantly, we found that it is not just a question of who you are, but where you live. Results showed heterogeneity by region and place of origin - highlighting that it will be simplistic to assume that asthma rates for Hispanic populations are the same across all states in the US. While data is unable to explore further granularity by ethnicity, our results add to the developing evidence that state policies and politics have impacts on socioeconomic and racial/ethnic inequalities manifesting in health disparities in the US.
Author Interviews, JAMA, Pediatrics, Weight Research / 23.10.2014

Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge MedicalResearch.com Interview Invitation Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge Medical Research: What are the main findings of this report? Dr. Ong: We found that genetic factors that predict adult obesity were associated with faster weight gain and growth during infancy – the findings indicate that the biological mechanisms that predispose to later obesity are already active from birth.
Author Interviews, JAMA, Mental Health Research / 23.10.2014

Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus UniversityMedicalResearch.com Interview with: Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus University   Medical Research: What are the main findings of the study? Response:  We found that anti-inflammatory drugs and ordinary analgesics, which mainly are used against physical disorders, may have treatment effects against depression when used in combination with antidepressants. Thereby, our results furthermore support the hypothesis regarding a comorbidity between inflammatory diseases and depression, i.e. a connection between somatic and mental disorders.
AHA Journals, Author Interviews, Nutrition / 23.10.2014

Mary Ann Honors, Ph.D. Postdoctoral Research Fellow Division of Epidemiology and Community Health University of MinnesotaMedicalResearch.com Interview with: Mary Ann Honors, Ph.D. Postdoctoral Research Fellow Division of Epidemiology and Community Health University of Minnesota Medical Research: What are the main findings of the study? Dr. Honors: The American Heart Association and USDA have made recommendations on what we should and should not eat in order in reduce our cardiovascular disease risk. We wanted to know whether Americans are currently meeting these recommendations, as well as how our diets have changed over time. In particular, we were interested in several specific nutrients, including trans fats, saturated fats, and the omega-3 fatty acids, DHA and EPA. We examined trends in fatty acid intake in participants from the Minnesota Heart Survey. The Minnesota Heart Survey is a an ongoing, cross-sectional study of adults in the Minneapolis-St. Paul metro area that was designed to monitor cardiovascular disease risk factors, including diet. We found that intake of trans fats and saturated fats has declined substantially over the last 30 years. However, intake levels are still above current recommendations. With DHA and EPA, we found that levels of intake were pretty steady over time and below what is recommended. Overall, while we saw some encourage trends, there is still some room for improvement in our diets.
Author Interviews, Gastrointestinal Disease / 23.10.2014

Julian Walters Professor of Gastroenterology Section of Hepatology & Gastroenterology | Imperial College London Consultant Gastroenterologist Imperial College Healthcare Hammersmith Hospital London W12 0HS | UKMedicalResearch.com Interview Invitation Julian Walters Professor of Gastroenterology Section of Hepatology & Gastroenterology | Imperial College London Consultant Gastroenterologist Imperial College Healthcare Hammersmith Hospital London W12 0HS | UK Medical Research: What is the background for this study?  What is Bile acid diarrhoea (BAD)? Dr. Walters: Bile acid diarrhoea accounts for about a third of the patients who would otherwise be diagnosed as IBS-D (irritable bowel syndrome – diarrhoea predominant).  We estimate about 1% of the adult population have this primary disorder; others may have it secondary to previous surgery such as ileal resection in Crohn’s disease or post-cholecystectomy.  There are unmet needs to improve diagnosis rates and to improve the current treatment with bile acid sequestrants which can be poorly tolerated and do not address the primary pathology.  We have shown that primary BAD patients have reduced levels of Fibroblast Growth Factor 19 (FGF19) the ileal hormone that regulates bile acid synthesis.
Author Interviews, Psychological Science, Weight Research / 23.10.2014

Dr. Michelle Lent PhD Geisinger Health SystemMedicalResearch.com Interview with Dr. Michelle Lent PhD Geisinger Health System Medical Research: What is the background for this study? Dr. Lent: Previous study findings indicate that weight bias relates to a number of adverse outcomes in overweight and obese populations, including binge eating, psychological disorders and body image issues. In this study, we measured the degree to which people undergoing weight-loss surgery translate “anti-fat” attitudes into negative beliefs about themselves before surgery (known as “internalized weight bias”) and if this influences weight loss outcomes after surgery.
Author Interviews, Outcomes & Safety, UCSF / 23.10.2014

Barbara J. Drew, RN, PhD, FAAN, FAHA David Mortara Distinguished Professor in Physiological Nursing Research Clinical Professor of Medicine, Cardiology University of California, San Francisco (UCSF) Department of Physiological Nursing San Francisco, CA 94143-0610 MedicalResearch.com: Interview Barbara J. Drew, RN, PhD, FAAN, FAHA David Mortara Distinguished Professor in Physiological Nursing Research, Clinical Professor of Medicine, Cardiology University of California, San Francisco (UCSF) Department of Physiological Nursing San Francisco, CA 94143-0610 Medical Research: What is the background for this study? Dr. Drew: Physiologic monitors used in hospital intensive care units (ICUs) are plagued with alarms that create a cacophony of sounds and visual alerts causing “alarm fatigue.” Alarm fatigue occurs when clinicians are desensitized by numerous alarms, many of which are false or clinically irrelevant. As a result, the cacophony of alarm sounds becomes “background noise” that is perceived as the normal working environment in the ICU. Importantly, alarms may be silenced at the central station without checking the patient or permanently disabled by clinicians who find the constant audible or textual messages bothersome. Disabling alarms creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. To date, there has not been a comprehensive investigation of the frequency, types, and accuracy of physiologic monitor alarms collected in a “real-world” ICU setting. For this reason, nurse and engineer scientists in the ECG Monitoring Research Laboratory at the University of California, San Francisco (UCSF) designed a study to provide complete data on monitor alarms.
Author Interviews, Pulmonary Disease / 23.10.2014

MedicalResearch.com Interview with: Jared Radbel MD Staten Island, New York Medical Research: What are the main findings of the study? Dr. Radbel: Using ICD 9 coding from the largest all-payer inpatient health care database in the United States, the National Inpatient Sample (NIS) database we identified 174,180 patients with Acute Respiratory Distress Syndrome (ARDS) from 1996-2011.  When expanded to estimate country-wide discharges, our data represents 856,293 patients.  We found a decrease in case fatality rate from 46.8% in 1996 to 32.2% in 2011. This corresponds to an absolute mortality reduction of 14.6% and relative reduction of 31%.
Author Interviews, Colon Cancer, NEJM / 22.10.2014

Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana ItalyMedicalResearch.com Interview with: Alfredo Falcone MD Chiara Cremolini Fotios Loupakis University of Pisa and Azienda-Ospedaliero Universitaria Pisana Italy Medical Research: What are the main findings of the study? Dr. Falcone: In the TRIBE study the main findings are that the use of an initial more intensive therapy with a triplet of cytotoxics (FOLFOXIRI) plus bevacizumab vs a doublet (FOLFIRI) + bevacizumab improves the outcome of metastatic colorectal cancer patients with unresectable metastases. In particular FOLFOXIRI + bevacizumab vs FOLFIRI+bevacizumab improved RECIST response-rate (65% vs 53%, p=0.006), progression-free survival which was the primary endpoint (median 12,1 vs 9,7 months, HR=0,75, p=0.003) and overall survival (median 31,0 vs 25,8 months, HR=0.79, p=0.054). These results, also compared to those reported in previous phase III studies in molecularly unselected patients, represent an important advance in the treatment of this disease.
Heart Disease / 22.10.2014

MedicalResearch.com Interview with: Ilina and Medha KrishenMedicalResearch.com Interview with: Ilina and Medha Krishen Michigan high school students and sisters Ilina and Medha Krishen, have developed screening tools using electronic stethoscopes to detect lung and heart disease. Their research was presented at the 2014 CHEST national meeting. Ilina and Medha have kindly agreed to discuss their work for the MedicalResearch.com audience. Medical Research: Ilina, please tell us a little about you and the background for your study. Ilina: I am a senior at Port Huron Northern High School in Fort Gratiot, Michigan. I was exploring the effects of air pollutants on lungs using frequency analysis of lung recordings.  My goal was to see if I could pick up early changes in healthy smokers and firefighters. Dr. Sridhar Reddy, a local pulmonologist and occupational medicine expert mentored me.  He lent me his electronic stethoscope.  I am a violinist and a clarinet player, so initially had a lot of fun analyzing music frequencies. Later, I moved to lung sounds (a little more difficult!). I used a Thinklabs Electronic Stethoscope for recording lung sounds. The inventor, Mr. Clive Smith, helped me understand the stethoscope. I used the MATLAB program for analyzing frequencies.  Mr. Charles Munson, a graduate student at the University of Michigan, helped me write the software program for it.
Allergies, Author Interviews, Infections, Nutrition, Pediatrics / 22.10.2014

Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, GermanyMedicalResearch.com Interview with: Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, Germany Medical Research: What are the main findings of the study? Dr. Loss: In this large population based cohort study we observed that consumption of fresh unprocessed cow’s milk protected from respiratory infections, febrile illness and inflammation of the middle ear during the first year of life. The risk of developing these conditions was reduced by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT (Ultra-heat-treatment) processing eliminated the effect altogether. Importantly, the positive impact of fresh milk could be clearly separated from the confounding effects of other elements of the children’s nutrition. Furthermore, infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status.
Author Interviews, Heart Disease, UCLA / 22.10.2014

Dr. Matthew Budoff, M.D. Los Angeles Biomedical Research Institute Torrance CaliforniaMedicalResearch.com Interview with: Dr. Matthew Budoff, M.D. Los Angeles Biomedical Research Institute Torrance California Medical Research: What are the main findings of the study? Dr. Budoff: We evaluated whether patients undergoing coronary CT angiography (non-invasive angiography) had better outcomes than those treated without the test.  We found survival was better with CT angiography.    Finding atherosclerosis allows cardiologists and primary care doctors to treat the patient better, including more statin therapy, more anti-platelet therapy, more lifestyle modifications.  Several small studies showed similar results, but this was by far the most significant and largest study of it’s kind.
Author Interviews, BMJ, Environmental Risks, OBGYNE, Pulmonary Disease / 22.10.2014

Medical Research Interview with: Eva Morales, MD, PhD, MPH Centre for Research in Environmental Epidemiology (CREAL) Barcelona Biomedical Research Park Barcelona, Spain Medical Research: What are the main findings of the study? Dr. Morales: We aimed to assess the consequences of exposure to outdoor air pollution during specific trimesters of pregnancy and postnatal lifetime periods on lung function in preschool children. We conducted a longitudinal study by using data from 620 mother-child pairs participating in the INfancia y Medio Ambiente (INMA) Project – a population-based cohort study set up in several geographic areas in Spain. We found that exposure to outdoor air pollution during the second trimester of pregnancy in particular raises the risk of harm to a child’s lung function at preschool age.
Author Interviews, CMAJ, Pediatrics, Vitamin D / 22.10.2014

Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of TorontoMedicalResearch.com: Interview with: Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist  Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of Toronto   Medical Research: What is the background for this study? What are the main findings? Dr. Maguire: One of the main health benefits of cow’s milk is vitamin D.  We were interested to know if non-cow’s milk supports children’s vitamin D blood levels as well as cow’s milk.
Author Interviews, BMJ, Occupational Health, Tobacco / 22.10.2014

Dr. John Cherrie PhD Honorary Professor in Occupational Hygiene Institute of Applied Health Sciences Aberdeen, UKMedicalResearch.com Interview with: Dr. John Cherrie PhD Honorary Professor in Occupational Hygiene Institute of Applied Health Sciences Aberdeen, UK Medical Research: What are the main findings of the study? Dr. Cherrie: We set out to bring together measurements of fine particle levels in homes where smoking takes place, to compare these with smoke-free homes and then to estimate how much of these fine particles are inhaled by people at different stages in their life. We also wanted to look at the exposure to particles of non-smokers living with smokers and compare this with the exposure of people living in heavily polluted major cities around the world.