MedicalResearch.com - Medical Research Interviews Week in Review from Marie Benz , MD FAAD ...
MedicalResearch.com - Medical Research Interviews Week in Review from Marie Benz , MD FAAD ...
Alan S. Brown, M.D., M.P.H.
Professor of Clinical Psychiatry and Clinical Epidemiology College of Physicians and Surgeons of Columbia University Director
Unit in Birth Cohort Studies Division of Epidemiology New York State Psychiatric Institute
New York, NY
MedicalResearch.com: What are the main findings of the study?
Dr. Brown: We found that a mother's exposure to influenza during pregnancy, documented by antibodies in her serum, increased the risk of bipolar disorder with psychotic symptoms in her offspring. We did not show a relationship between influenza and bipolar disorder not accompanied by psychosis.
MedicalResearch.com Interview with:
Chunxue Bai, MD & PhD
Director, Shanghai Respiratory Research Institute
Professor of Medicine, Chairman, Shanghai Leading academic discipline
Chair, Chinese Alliance against Lung Cancer
MedicalResearch.com: What are the main findings of the study?
Dr. Bai: Recently, we found a dilemma phenomenon that the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality.
However, little information is known to the public about a regional endemic related to Chinese waterpipe smoking, which is different from the Arabic waterpipe. The Chinese waterpipe has been traditionally misconceived as less harmful for three reasons:
MedicalResearch.com Interview with:
Dr. T. M. A van Dongen, MD
Univ Med Ctr Utrecht
Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol
Utrecht, Netherlands.
MedicalResearch.com: What are the main findings of the study?
Answer: We performed a pragmatic trial, in which we randomly assigned 230 children who had acute tympanostomy-tube otorrhea to receive antibiotic-glucocorticoid eardrops, oral antibiotics or to undergo initial observation. The primary outcome of our study was the presence of ear discharge, 2 weeks after study-group assignment. We also looked at, among others, the duration of the initial otorrhea episode and the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up. We found that antibiotic–glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes.
MedicalResearch.com Interview with:
Minesh P. Mehta, M.B., Ch.B. F.A.S.T.R.O.
Professor of Radiation Oncology,
University of Maryland School of Medicine
Radiation oncologist, University of Maryland Marlene and Stewart Greenebaum Cancer Center
MedicalResearch.com: What are the main findings of the study?
Dr. Mehta: RTOG 0825 was a clinical trial evaluating whether the addition of a novel drug that inhibits tumor vascular growth, bevacizumab, to the standard of care for glioblastoma, an aggressive brain tumor, would prolong survival. Patients were allocated randomly to one of two different treatment regimens – the standard of care, which includes radiotherapy and a drug known as temozolomide, or another regimen of radiation, temozolomide and bevacizumab. The trial design was double-blinded, and therefore, on one arm patients received the bevacizumab, whereas on the other arm they received a placebo. The survival on both arms was equivalent, and therefore it was fairly concluded that bevacizumab failed to prolong survival when given initially as part of treatment for glioblastoma.
Freedom from progression, referred to as progression-free survival was also measured on this trial, and although bevacizumab appeared to lengthen progression-free survival, this level of benefit did not meet the pre-defined goals, and is therefore regarded as statistically not demonstrating an improvement.
Additional endpoints included outcomes reported by the patient, including the burden of symptoms, and the impact of these on the quality of life, as well as effects on the brain, known as neurocognitive changes. Bevacizumab did not improve these endpoints either.
MedicalResearch.com Interview with:
Bodour Salhia, PhD
Assistant Professor
Integrated Cancer Genomics Division
Translational Genomics Research Institute
Phoenix, Arizona, 85004
MedicalResearch.com: What are the main findings of the study?
Dr. Salhia: Our study identified novel rare genomic and epigenomic events underlying breast cancer metastasis to brain. We demonstrated that we could molecularly subtype breast cancer brain metastasis the same way we can subtype primary breast cancer. From this analysis we found that the Luminal B subtype was the most common subtype in our cohort, followed by Her2+/ER- enriched tumors and Basal-like tumors. Each of these subtypes displayed genetic and epigenetic features reminiscent of primary breast cancer. We demonstrated that these tumors have a strong predilection to grow by activating pathways involved in G2/M cell cycle progression, whereas, many genes involved in cell migration were epigenetically silenced. Broad amplification of chromosome 8q was common, which resulted in the upregulation of important genes.
Jiyoung Ahn, PhD
Assistant Professor of Epidemiology
Department of Population Health
NYU School of Medicine
New York, NY 10016
MedicalResearch.com: What are the main findings of the study?
Dr. Ahn: Before we did our research, it was suspected that gut bacteria were related to colorectal cancer. We, for the first time, found colorectal cancer patients have a different gut bacteria composition than healthy subjects.
MedicalResearch.com Interview with:
Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
Professor Department of Medicine, Cardiology Division
Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship
,Hamilton, ON, Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Morillo: The main findings were that Ablation of atrial fibrillation was superior to conventional antiarrythmic drug therapy in patients with Paroxysmal atrial fibrillation that had not been treated with Antiarrhythmic medications. Ablation extended the time to first recurrence of atrial fibrillation within the 2 year follow-up of the study and significantly reduced the recurrence of repeated episodes of AF.
MedicalResearch.com Interview with:
Norbert Stefan, MD
Heisenberg Professorship for Clinical and Experimental Diabetology
Department of Internal Medicine IV
University Hospital Tübingen
Tübingen, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Stefan: Currently there is little evidence for an effective and safe pharmacological treatment of nonalcoholic fatty liver disease (NAFLD). Based on the fact that inhibition of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), the enzyme, that converts inactive cortisone into active cortisol in metabolic tissues such as liver and adipose, was found to be effective to improve lipid metabolism in animals, we hypothesized that inhibition of 11β-HSD1 may also prove to be effective to decrease liver fat content in patients with NAFLD. In our 12 week trial in 82 patients with NAFLD, inhibition of 11β-HSD1 with RO5093151 resulted in a 14 % decrease of liver fat content and in a resolution of NAFLD in 20 % of the patients. This was accompanied by a decrease of liver enzymes. Furthermore, inhibition of 11β-HSD1 brought about a reduction of body weight and total body- and visceral adipose tissue mass, while insulin sensitivity did not change. In agreement with findings from other trials, also in our study 11β-HSD1 inhibition was well tolerated and safe.
MedicalResearch.com Interview with:
Prof. Nicholas J. Wald
Wolfson Institute of Preventive Medicine
Barts and the London School of Medicine and Dentistry
Queen Mary University of London
London, United Kingdom
MedicalResearch.com: What are the main findings of the study?
Prof Wald: The percentage of women who become pregnant without having taken folic acid supplements to reduce the risk of a neural tube defect declined from a relatively low proportion (35%) to an even lower one (31%) between 1999 and 2012.
Moreover such use of folic acid in some groups of the population is much lower for example 17% in Afro-Caribbean women and 6% in women aged under 20.
Dorothy D Dunlop, PhD
Professor, Medicine-Rheumatology
Center for Healthcare Studies - Institute for Public Health and Medicine and Preventive Medicine
Northwestern University Feinberg School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Dunlop: We know being active, especially doing moderate activity like taking a brisk walk, is good for health. We know a sedentary lifestyle leads to health problems. What we do not know is whether or not those are two ways of looking at the same question. Does being sedentary like sitting just reflect insufficient activity OR is sedentary time is a separate and distinct risk factor for health problems. Our physical activity research group looked at national US data from the National Health and Nutrition Examination Survey. This is an important study because they monitored physical activity using an accelerometer. We found sedentary behavior such as sitting was its own separate risk factor for disability.
MedicalResearch.com Interview with:
Dr.Hooman Kamel MD
Department of Neurology and the Brain and Mind Research Institute
Weill Cornell Medical College in New York City.
MedicalResearch.com: What are the main findings of the study?
Dr. Kamel: The risk of thrombotic events remains higher than normal for twice as long after childbirth as previously thought. However, the absolute risk in any given patient is low, especially after the first 6 weeks.
MedicalResearch.com Interview with:
Krishnansu S. Tewari, MD, FACOG, FACS| Professor & Director of Research
Principal Investigator - The Gynecologic Oncology Group at UC Irvine, Division of Gynecologic Oncology
University of California, Irvine Medical Center
Orange, CA 92868
MedicalResearch.com: What are the main findings of the study?
Dr. Tewari: The main findings of this study were that the addition of bevacizumab to chemotherapy resulted in a significantly improved survival of 3.7 months in a population of patients that have very limited options. This improvement in overall survival was not accompanied by any significant deterioration in quality of life and serious side effects were limited to 3% to 8% of the study population.
MedicalResearch.com: Interview with:
Dr Heike Daldrup-Link
Associate Professor of Radiology
Stanford University School of Medicine, Palo Alto
MedicalResearch.com: What are the main findings of the study?
Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT): We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans.
MedicalResearch.com Interview with:
Dr. Jane Muncke PhD
Managing Director
Food Packaging Forum Foundation
Zurich, Switzerland
MedicalResearch.com: What are the main conclusions from your work?
Answer: Food packaging is a relevant, but still under-recognized source of chemical contamination in foods. Everybody is exposed to these chemicals on a daily basis, but we have very little understanding of the actual health effects caused by this chronic exposure source. We propose that epidemiological research tackles chemical exposures from food packaging as a new and highly relevant exposure source. Epidemiologist have played crucial roles in advancing understanding of health issues, for example cardiovascular disease caused by fine particulate air pollution. Through their work they have encouraged toxicologists to ask different questions, thereby supporting the generation of critical knowledge and, essentially, enabling prevention.
MedicalResearch.com Interview with:
Dr. David Hanauer, MD
Associate Professor, University of Michigan Medical School
1500 East Medical Center Drive
Ann Arbor, MI 48109-5940
MedicalResearch.com: What are the main findings of the study
Dr. Hanauer: From my perspective, the primary findings were that 65% of the general public is now aware of physician rating web sites and among those who are aware, about 36% had used them in the prior year. Awareness and usage seems to be rapidly increasing compared to what has been reported in prior studies from just a few years ago. We also found that patients consider word of mouth recommendations (from family/friends) to be almost twice as important as ratings sites are.
MedicalResearch.com Interview with:
Ganesh Raghu, M.D.,FCCP, FACP
Professor of Medicine & Lab Medicine (Adjunct)
Division of Pulmonary & Critical Care Medicine
University of Washington(UW)
Director,CENTER for Interstitial Lung Disease (ILD),UW Medicine,
ILD, Sarcoid and Pulmonary Fibrosis Program
Co-Director, Scleroderma Clinic, UW Medical center(UWMC)
Seattle, WA 98195
MedicalResearch.com: What are the main findings of the study?
Dr. Raghu: In a subgroup of patients with typical clinical features of Idiopathic pulmonary fibrosis ( IPF) , further evaluation by a thorough evlauation by regional experts experienced in management of idiopathic pulmonary fibrosis and related diseases may lead to a diagnosis of idiopathic pulmonary fibrosis without the need for surgical lung biopsy if the HRCT features have a Possible-UIP pattern AND if there are no suspicion for environmental factors or collagen vascular diseases to explain the pulmonary fibrosis .
MedicalResearch.com Interview with:
Sammy Elmariah, MD, MPH
Massachusetts General Hospital
Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. Elmariah: Within the randomized PARTNER I trial, we evaluated the effect of left ventricular (LV) dysfunction on clinical outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively) and the impact of valve replacement technique on recovery of LV function. We found that LV dysfunction, defined as an LV ejection fraction < 50%, had no impact on 30-day and 1-year mortality after either TAVR or SAVR. In those with baseline LV dysfunction, marked improvement in LV ejection fraction was observed within 30-days of valve replacement in approximately half of patients, with an equivalent degree of improvement observed after TAVR and SAVR. Permanent pacemaker at study entry, low mean aortic valve gradient, and high LV ejection fraction were associated with reduced odds of LV functional recovery after valve replacement.
MedicalResearch.com Interview with:
Sadeq A. Quraishi, MD, MHA
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Quraishi: Our retrospective study suggests that there is an association between pre-operative 25-hydroxyvitamin D [25(OH)D] levels and the risk of hospital-acquired infections after gastric bypass surgery. In particular, patients with 25(OH)D levels <30 ng/ml before surgery were almost 4 times more likely to develop a surgical site infection within 30 days of surgery than patients with pre-operative 25(OH)D levels at 30 ng/ml or higher.
MedicalResearch.com Interview with:
Anton P. Porsteinsson M.D.
William B. and Sheila Konar Professor of Psychiatry
Director, Alzheimer's Disease Care, Research and Education Program (AD-CARE)
University of Rochester School of Medicine and Dentistry
Rochester, N.Y. 14620
MedicalResearch.com: What are the main findings of the study?
Dr. Porsteinsson: Identifying drugs outside the antipsychotic class with targeted anti-agitation effects that provide greater benefit or lower risk among patients with Alzheimer’s disease is a research priority. Citalopram, a selective serotonin reuptake inhibitor (SSRI), is frequently used in older individualsand has been suggested as an alternative to antipsychotic drugs for agitation and aggression in dementia. Among 186 patients with probable Alzheimer’s disease and agitation receiving psychosocial intervention, the addition of citalopram compared with placebo robustly and significantly reduced agitation and caregiver distress, but modest cognitive and cardiac adverse effects of citalopram may limit its practical application at the 30 mg/d dose studied in this trial. There are insufficient data on efficacy for agitation at lower doses of citalopram.
Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College
MedicalResearch.com: What are the main findings of this study?
Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.
MedicalResearch.com Interview with:
Gregg C Fonarow, UCLA Medical Ctr, Los Angeles, CA;
Director, Ahmanson-UCLA Cardiomyopathy Center
Professor, Department of Medicine
Associate Chief, Cardiology
David Geffen School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Fonarow: The study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke. The primary aim of Target: Stroke is to increase the number of stroke patients treated with tPA for acute ischemic stroke within 60 minutes or less after hospital arrival. The study demonstrated that patients received stroke therapy significantly faster in hospitals that participated in Target: Stroke. Between 2010 and 2013, the time between hospital arrival and use of tPA (door-to-needle time) dropped by 15 minutes, from 74 to 59 minutes, in hospitals that participated in Target: Stroke. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. Faster treatment was associated with improved patient outcomes and fewer complications, including death.
MedicalResearch.com Interview with:
M. Arfan Ikram, MD, PhD
Departments of Radiology, Epidemiology, and Neurology
Erasmus Medical Center,
Rotterdam, the Netherlands
MedicalResearch.com: What are the main findings of the study?
Dr. Ikram: The main finding of the study, carried out within the Rotterdam Study and led by drs. Daniel Bos and Arfan Ikram (both from the Erasmus Medical Center Rotterdam, the Netherlands), was that intracranial atherosclerosis is a major risk factor for stroke in the Western (white) population. Traditionally, intracranial atherosclerosis has not been considered of major importance to stroke risk in Western populations. In contrast, most research on intracranial atherosclerosis originates from Asian and African populations, where is was actually recognized as the most important risk factor of stroke. Our study demonstrates that also in the Western population intracranial atherosclerosis is a major risk factor for stroke and should get more focus in clinical practice. Moreover, our findings indicate that its contribution to the proportion of all strokes is greater than that of atherosclerosis in other vessel beds that are further away from the brain.
MedicalResearch.com Interview with:
Dr Clare Llewellyn PhD Cpsychol
Lecturer in Behavioural Obesity Research
Health Behaviour Research Centre
Department of Epidemiology and Public Health
University College London, London
MedicalResearch.com: What are the main findings of the study?
Dr. Llewellyn:This study indicated that appetite – and, in particular, satiety sensitivity (how quickly you feel full during eating, or how long you remain full after eating) – could be one of the mechanisms through which ‘obesity genes’ influence body weight.
We know that body weight has a strong genetic basis, but the mechanisms through which ‘obesity genes’ influence weight are largely unknown.
We showed that children with a higher genetic predisposition to obesity (estimated from a score comprising 28 known obesity-related genes) not only had more body fat (a larger BMI and waist circumference), but importantly they were also less sensitive to satiety.
Prof. Nanshan Zhong[/caption]
--Jinping Zheng, MD, FCCP
Guangzhou Institute of Respiratory Disease
First Affiliated Hospital of Guangzhou Medical University
151 Yanjiang Rd. Guangzhou 510120, China
MedicalResearch.com: What are the main findings of the study?
Answer: PANTHEON is the largest, evidence-based study of long-term treatment with N-acetylcysteine (NAC) in COPD patients conducted to date. The main finding of this study is that 1-year of treatment with high dose NAC (600mg twice daily) was effective at reducing exacerbations in patients with COPD, especially in the earlier stage [GOLD II (moderate) of disease. NAC was well tolerated.