Author: Marie Benz MD FAAD
06 Dec Patients with Blood Cancers Especially Vulnerable to COVID-19 Infections
MedicalResearch.com Interview with:William Wood, MD
Associate Professor of Medicine, Division of Hematology
UNC School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform.
We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians
06 Dec Hand Eczema: Patch Testing Important in Diagnosis of Potential Allergens
MedicalResearch.com Interview with: [caption id="attachment_24142" align="alignleft" width="128"]
Dr. Jonathan Silverberg[/caption]
Jonathan Silverberg, MD, PHD, MPH
Associate Professor
Director of Clinical Research
Director of Patch Testing
George Washington University School of Medicine and Health Sciences
Washington, DC
MedicalResearch.com: What is the background for this study
Response: Chronic hand eczema was previously shown to be associated with higher rates of allergic contact dermatitis. Yet, little is known about recent trends in North America with respect to the clinical presentation and allergen profile in chronic hand eczema. This study sought to determine the clinical characteristics and etiologies of hand eczema in a large North American cohort of adults referred for patch testing. The patients in the study were patch tested using the North American Contact Dermatitis Group’s allergen screening series.
05 Dec LENVIMA® (lenvatinib) Based Combination Therapy in Patients With Renal Cell Carcinoma
MedicalResearch.com Interview with:Dr. Corina Dutcus MD
Vice President of Clinical Research
Oncology Business Group
Eisai
MedicalResearch.com: What is the background for this study? Would you briefly explain how lenvatinib works? Is it used for any other malignancies, ex. thyroid cancer?
Response: LENVIMA (lenvatinib), discovered and developed by Eisai, is an orally available multiple receptor tyrosine kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). LENVIMA inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1-4, the platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET.
LENVIMA is approved in combination with everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy. The approved starting dose for LENVIMA is 18 mg daily. The objective of Study 218, a randomized, open-label, Phase 2 trial, was to assess whether the lower starting dose of LENVIMA (14 mg daily) in combination with everolimus (5 mg daily) would provide similar efficacy with an improved safety profile compared to the FDA-approved starting dose of LENVIMA (18 mg daily) plus everolimus (5 mg daily) in patients with advanced renal cell carcinoma (RCC) following prior treatment with an antiangiogenic therapy.
In the US, LENVIMA is also indicated for:
- the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (RAI-refractory DTC);
- for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC);
- and in combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy, and are not candidates for curative surgery or radiation. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial.
04 Dec Study Finds Minimal Risk of Inhaled Nanoparticles from Sunscreen Application
MedicalResearch.com Interview with: [caption id="attachment_56138" align="alignleft" width="142"]
Dr. Gernand[/caption]
Jeremy M. Gernand, PhD, CSP, CRE
Associate Professor
Environmental Health and Safety Engineering
Department of Energy and Mineral Engineering
MedicalResearch.com: What is the background for this study?
Response: Given concern in the public about exposure to nanoparticles in cosmetics, we decided to investigate the exposure potential for inhaling nanoparticles during the application of aerosol mineral-based sunscreens that are typically marketed as safer for children. We choose three commercially available sunscreens to test in the lab in a manner intended to capture the amount of inhaled particles that would typically occur during application of sunscreen to the mid-point of one’s own arm.
04 Dec Peanut Oral Immunotherapy Found Safe and Effective in Real World Study of Preschoolers
MedicalResearch.com Interview with: [caption id="attachment_56134" align="alignleft" width="200"]
Dr. Soller[/caption]
Lianne Soller, PhD
Allergy Research Manager
BC Children’s Hospital Allergy Clinic
Vancouver, BC, Canada
MedicalResearch.com: What is the background for this study?
Response: Peanut oral immunotherapy (also known as OIT) has been studied for many years in clinical trials and has been found to be safe and effective in preschoolers. However, we know that clinical trials do not always reflect what happens in the real world.
We wanted to see study whether peanut OIT would work as well in the real world. This is a follow up of our preschool peanut OIT safety study published in April 2019 which noted only 0.4% severe reactions and 4% epinephrine use during build-up.
04 Dec COVID-19: Black and Hispanic Patients May Not Be Inherently More Susceptible to Poor COVID-19 Outcomes than Whites
Posted at 17:40h
in Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU/NYMC, Race/Ethnic Diversity
MedicalResearch.com Interview with:
[caption id="attachment_56129" align="alignleft" width="133"] Dr. Ogedegbe[/caption]
Gbenga Ogedegbe, MD, MPH
Dr. Adolph & Margaret Berger Professor of Population Health
Director, Division of Health & Behavior
Director Center for Healthful Behavior Change
Department of Population Health
NYU Langone Health
NYU School of Medicine
MedicalResearch.com: What is the background for this study?
Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)?
04 Dec Veterans Health Study Asks if Socioeconomic Status Changes Mortality Rates
MedicalResearch.com Interview with: [caption id="attachment_56079" align="alignleft" width="196"] Dr. Trivedi[/caption]
Amal Trivedi, MD, MPH
Professor of Health Services, Policy & Practice
Director of Graduate Studies, Health Services Research
Brown University School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization.
04 Dec COVID-19: IVIG Reduced Progression to Ventilator and Shortened Hospital Stays in Sicker Patients
MedicalResearch.com Interview with: [caption id="attachment_56119" align="alignleft" width="159"] Dr. Sakoulas[/caption]
George Sakoulas, MD
Sharp Memorial Hospital and
Sharp Rees-Stealy Medical Group Associate Adjunct Professor
UC San Diego School of Medicine
San Diego
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by IVIG?
Response: IVIG stands for intravenous immunoglobulin. It is a preparation from pooled blood donors isolating antibodies in their blood and highly concentrated for use. It's uses are to either replace immunoglobulins in patients who do not produce enough of them because of some underlying immunodeficiency or, as in the case of COVID, they take advantage of the immune signaling properties of the non-variable part of the antibodies. Many immune cells have receptors that bind the non-variable (also called the Fc-gamma region), and when bound, the activity of these activated immune cells is modulated. IVIG is used in many immunologic complications of infections like Guillan-Barre, Kawasaki's disease, immune mediated encephalitis from mycoplasma, just to name a few. We decided to study IVIG because:
- Our anecdotal yet successful use of IVIG in treating ARDS due to influenza and other viruses.
- Our very definitive successful use of IVIG in a very sick patient with COVID early in the pandemic.
- The weak yet positive retrospective data from China of IVIG in COVID.
- The mechanism of IVIG inhibiting neutrophil extracellular trap (or NETS) thought to play an important role in COVID severe disease.
- IVIG has been around to 4 decades and many physicians have a level of prescribing comfort.
03 Dec Hepato-Renal Syndrome Type 1: Treatment with Terlipressin Reduced Need for Renal Replacement Therapy
MedicalResearch.com Interview with: [caption id="attachment_56124" align="alignleft" width="200"] Dr. Khurram Jamil[/caption]
Khurram Jamil, MD
Vice President, Clinical Research in Hepatology
Critical Care Division, Mallinckrodt
MedicalResearch.com: What is the background for the new data of terlipressin presented during Kidney Week 2020 Reimagined? Would you briefly describe hepatorenal syndrome type 1? Whom does it affect and how frequently does it progress to ESRD?
Response: Results from two post-hoc analyses of terlipressin, an investigational agent in the U.S. for adults with hepatorenal syndrome type 1 (HRS-1), were presented at Kidney Week 2020 Reimagined, the annual meeting of the American Society of Nephrology. The first was an oral presentation titled, “Terlipressin Improves Renal Replacement Therapy–Free Survival in Hepatorenal Syndrome Type 1” and included a pooled post-hoc analysis to assess the incidence of renal replacement therapy (RRT) and its impact on survival among patients from three Phase 3 trials. The second was a poster presentation titled, “Treatment of Hepatorenal Syndrome Type 1 with Terlipressin Reduces Need for Renal Replacement Therapy After Liver Transplantation,” which focused on a post-hoc analysis of the CONFIRM study and evaluated the need for RRT among patients who had liver transplantation within 90 days of HRS treatment.
HRS-1 is an acute and life-threatening syndrome involving acute kidney failure in people with cirrhosis.[i] HRS-1 can progress to life-threatening renal failure within days,i and has a median survival time of approximately two weeks and greater than 80 percent mortality within three months if left untreated.[ii],[iii] It is often a challenge to effectively diagnose in a timely manner due to its diagnosis of exclusion.iii
In general, the average patient with hepatorenal syndrome (HRS type 1 or type 2) is in their 50s,[iv] and up to 73 percent of HRS patients are men.[v] HRS-1 is estimated to affect between 30,000 and 40,000 patients in the U.S. annually.[vi],[vii]
03 Dec Surprising Impact of COVID-19 Impact on Youth E-Cigarette Use
Posted at 17:45h
in Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research
MedicalResearch.com Interview with:
[caption id="attachment_56099" align="alignleft" width="187"]
Dr. Halpern-Felsher[/caption]
Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her)
Professor of Pediatrics
Taube Endowed Research Faculty Scholar
Professor (by courtesy), Epidemiology and Population Health
Professor (by courtesy), Psychiatry and Behavioral Sciences
Director of Fellows’ Scholarship, Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Co-leader, Scholarly Concentrations, Pediatrics Residency Program
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic.
There were 4 main findings:
- About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
- Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
- Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
- Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
03 Dec Sharp Rise in Overdose Deaths During COVID-19 Pandemic
MedicalResearch.com Interview with: Joseph Friedman, MD/PhD student David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? Response: Numerous researchers, clinicians, officials, harm reduction agencies, and people who use drugs have sounded the alarm that the COVID-19 pandemic is exacerbating the United States overdose crisis. However, data sources typically used to track overdoses in the US often have long lags that impede timely monitoring and response. For example, the CDC released preliminary overdose figures for 2019 in July 2020, and even these numbers may change. As they are available in near real-time, emergency medical services (EMS) data have increasingly been used as a source of up-to-date information to monitor epidemiological shifts during the COVID-19 pandemic. In this study, we used data from the National EMS Information System (NEMSIS), a large registry of over 10,000 EMS agencies in 47 states that represented over 80% of all EMS activations nationally in 2020. We used the data to track shifts in overdose-related cardiac arrests observed by EMS.
03 Dec Algernon? Scientists Use Drug to Reverse Memory Loss in Mice
MedicalResearch.com Interview with: [caption id="attachment_56112" align="alignleft" width="150"]
Dr. Rosi[/caption]
Susanna Rosi, Ph.D.
Lewis and Ruth Cozen Chair II
Professor, Brain and Spinal Injury Center
Weill Institute for Neuroscience
Kavli Institute of Fundamental Neuroscience
Departments of Physical Therapy Rehabilitation Science,
Neurological Surgery
University of California San Francisco
MedicalResearch.com: What is the background for this study?
Response: Everybody has experienced a “senior moment” forgetting where the car keys are, or where you put your glasses. These forgetful moments are not always indicative of a disease, but rather can be a consequence of normal aging. Normal aging is associated with decline of cognitive abilities, such as memory, spatial orientation, problem solving and executive functioning. Investigating what changes happen in the brain with age, can help us to understand why these ‘senior moments’ occur. When we understand what causes these moments, we can design therapeutics with the hopes of preventing or reversing them.
With increased life expectancy age-associatedmemory decline becomes a growing concern.
We wanted to investigate
(i) What causes memory decline with age?
(ii) Are there ways to reverse it?
03 Dec Could Obesity Bias Help Explain the Obesity Paradox?
MedicalResearch.com Interview with: [caption id="attachment_56108" align="alignleft" width="153"]
Dr. Singh[/caption]
Gurmukh Singh, MD, PhD, MBA
Department of Pathology, Section of Clinical Pathology
Walter Shepeard Professor of Pathology
Section Chief, Clinical Pathology.
Associate Medical Director, Clinical Laboratory GRMC and
Children's Hospital of Georgia
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by the obesity paradox?
Response: Obese people tend to get more diseases, such as hypertension, diabetes, cancer etc. However, when they get seriously ill, e.g., sick enough to require admission to intensive care treatment unit (ICU), obese people tend to have better outcomes than normal weight people.
03 Dec USPSTF: Behavioral Counseling Recommended For Patients at Risk of Cardiovascular Disease
MedicalResearch.com Interview with: [caption id="attachment_56105" align="alignleft" width="133"] Dr. Epling[/caption]
Dr. John Epling, M.D., M.S.Ed
Professor of family and community medicine
Virginia Tech Carilion School of Medicine in Roanoke, VA.
Medical director of research for family and community medicine
Medical director of employee health and wellness for the Carilion Clinic
Dr. Epling joined the U.S. Preventive Services Task Force in January 2016.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cardiovascular disease, which includes heart disease and stroke, is one of the leading causes of death in the United States. Nearly half of all adults have at least one risk factor for cardiovascular disease. Evidence shows that counseling aimed at helping people improve their diet and increase their physical activity can help prevent cardiovascular disease. This typically involves a trained counselor who provides education, helps people set goals, shares strategies, and stays in regular contact.
The Task Force recommends behavioral counseling interventions that promote a healthy diet and physical activity to help people at risk for cardiovascular disease stay healthy.
01 Dec Mental and Physical Health Suffer In Recently Divorced
MedicalResearch.com Interview with: Gert Martin Hald, PhD Head of Section (Environmental Health), Associate Professor Department of Public Health, University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Basically, much of previous research has investigated mental and physical health of divorcees only after extensive separation periods, which is mandatory in most countries before juridical divorce unless infidelity or violence is involved in the divorce. During the time of data collection (2016-2019), Denmark where data was collected did not require separation periods before granting divorce. This means that as a first, we could investigate the mental and physical health of divorcees within days of them filling for divorce and perhaps better and more accurately pick up well-known adverse effects of mental- and physical health states of divorcees at the time of their divorce.
01 Dec Gene Therapy for Mitochondrial Eye Disease Developed
Posted at 18:02h
in Author Interviews
MedicalResearch.com Interview with:
Daniel Maloney, Ph.D
Farrar Lab
Smurfit Institute of Genetics
Trinity College Dublin
MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of Dominant optic atrophy?
Response: Dominant Optic Atrophy (DOA) is a progressive blinding disorder that affects roughly 1:10,000 to 1:30,000 people. It is primarily caused by mutations in the OPA1 gene, which plays a pivotal role in the maintenance of the mitochondrial network. There is currently no way to prevent or cure DOA. We sought to build upon previous work to test if OPA1 could be delivered as a potential gene therapy intervention.
01 Dec PONENTE Study: Severe Asthma Patients Receiving Fasenra (Benralizumab) Able To Reduce or Discontinue Oral Steroids
MedicalResearch.com Interview with: [caption id="attachment_56091" align="alignleft" width="200"] Dr. Frank Trudo[/caption]
Frank Trudo, MD MBA
Vice President, US Medical, Respiratory & Immunology
AstraZeneca
MedicalResearch.com: What is the background for this study?
Response: PONENTE is a multicenter, open-label, single-arm, Phase IIIb trial to evaluate the efficacy and safety of reducing daily oral corticosteroids (OCS) use after initiation of 30 mg dose of FASENRA (benralizumab) administered subcutaneously in adult patients with severe eosinophilic asthma on high-dose inhaled corticosteroids plus long-acting beta2-agonist and long-term use of OCS therapy with or without additional asthma controller(s). The trial expands on OCS-sparing data previously seen in the ZONDA Phase III trial by using a faster steroid tapering schedule in patients who did not experience adrenal insufficiency to reduce OCS use from higher doses.
Compared to published trials of other biologics, PONENTE has a personalized OCS tapering schedule that allows for more rapid OCS tapering from higher OCS doses, followed by an assessment of the adrenal function as part of decision-making to manage the risk of adrenal insufficiency. PONENTE also has a longer maintenance phase (approximately 24-32 weeks), allowing assessment of the durability of OCS reduction.
FASENRA is a monoclonal antibody that binds directly to IL-5 receptor alpha on eosinophils and attracts natural killer cells to induce rapid and near-complete depletion of eosinophils via apoptosis (programmed cell death).
MedicalResearch.com: How is it administered?
Response: FASENRA is injected under your skin (subcutaneously) one time every 4 weeks for the first 3 doses, and then every 8 weeks. In 2019, FASENRA was approved in the US for self-administration in a single dose prefilled autoinjector, the FASENRA pen.
01 Dec Anxiety Linked to Increased Cognitive Decline in Alzheimer’s Disease
Posted at 12:34h
in Alzheimer's - Dementia, Author Interviews, Medical Imaging, Mental Health Research
MedicalResearch.com Interview with:
[caption id="attachment_56055" align="alignleft" width="142"]
Dr. Spampinato[/caption]
Maria Vittoria Spampinato, MD
Neuroradiology Division Director
Department of Radiology and Radiological Science
Medical University of South Carolina
Charleston, SC 29425-3230
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Alzheimer’s disease (AD) represents a major public health crisis worldwide. More than 5 million people currently have AD in the United States. AD is a slowly progressing neurodegenerative brain disorder with a long preclinical phase. Many people with AD first suffer from mild cognitive impairment (MCI), a decline in cognitive abilities like memory and thinking skills that is greater than that associated with normal aging. A person with MCI is at an increased risk of developing AD or another dementia, although some individuals with MCI remain cognitively stable or improve.
Anxiety is frequently observed in individuals with MCI. The reported prevalence of anxiety in MCI patients varies between 10 and 50%. In this study we evaluated a cohort of 339 individuals with MCI participating in the Alzheimer’s Disease Neuroimaging Initiative study (ADNI2). During the five years of study participation, 72 patients experienced cognitive decline and were diagnosed with AD. We did not find difference in age, gender and education among patients with and without AD conversion. Patients who progressed had greater atrophy of the hippocampi and entorhinal cortex on their MRI scan, as expected (hippocampal atrophy is often used as a marker of neurodegeneration in AD), as well as greater prevalence of APOE4 is the strongest known genetic risk factor for AD. Patients who progressed to Alzheimer’s disease also had greater severity of anxiety during the study, as measured using the Neuropsychiatric Inventory-Questionnaire. Next we determined the effect of the MRI findings (hippocampal and entorhinal cortex atrophy), of the genetic risk factor (APOE4) and of the severity of anxiety on the time to progression to AD. We found that higher levels of anxiety were associated with faster progression from MCI to AD, independently of whether they had a genetic risk factor for Alzheimer’s disease or brain volume loss. We still need to understand better the association between anxiety disorders and cognitive decline. We do not know whether increased levels of anxiety are a consequence of cognitive decline or if anxiety exacerbates to cognitive decline. If we were able to find in the future that anxiety is actually contributing to cognitive decline, then we should more aggressively screen for anxiety disorders in the elderly population.
01 Dec Similar Frameshift Mutations Identified in Variety of Tumors
MedicalResearch.com Interview with: [caption id="attachment_56006" align="alignleft" width="130"] Dr. Bhardwaj[/caption]
Nina Bhardwaj MD PhD
Director of Immunotherapy
Tisch Cancer Institute
Icahn School of Medicine at Mt Sinai
Ward-Coleman Chair in Cancer Research
Professor of Hematology and Oncology
MedicalResearch.com: What is the background for this study?
Response: Neoantigens are novel antigens expressed by tumors as a result of somatic mutations or frame shift mutations. They can be very immunogenic and consequently they are being incorporated into cancer vaccine platforms. In most cases it is necessary to determine each patient’s individual mutations and customize their vaccine antigens accordingly. We sought to identify shared mutations in cancer antigens which are deficient in DNA repair mechanisms namely microsatellite unstable tumors. These tumors have mutations in genes that normally are responsible for ensuring that DNA is properly replicated. Because these genes encode proteins that ensure proper repair around micro-satellite areas (which contain short repeated sequences of DNA and are present in similar regions from one person’s genome to the next), when they are mutated, these regions may not be repaired. Consequently due to nucleotide deletions and insertions one gets frame shift mutations which result in new protein expression which can be shared across tumors, as has been observed for a few regions. We therefore did a comprehensive study of a subset of tumors to determine the breadth of shared frame shift mutations.
30 Nov COVID-19: Disproportionate Burden of Multisystem Inflammatory Disorder Among Black and Hispanic New York Children
Posted at 16:36h
in Author Interviews, COVID -19 Coronavirus, Inflammation, JAMA, Pediatrics, Race/Ethnic Diversity
MedicalResearch.com Interview with:
Ellen H. Lee, MD
Incident Command System Surveillance and Epidemiology Section
New York City Department of Health and Mental Hygiene
Long Island City, New York
MedicalResearch.com: What is the background for this study?
Response: Published reports of the COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) have described higher proportions of cases among Black and Hispanic children. However, case series are limited by the lack of population-level data, which could help provide context for the racial/ethnic distribution of cases described in these reports.
The New York City (NYC) Department of Health and Mental Hygiene required reporting of all possible cases of MIS-C among NYC residents, and for cases meeting MIS-C criteria, applied population denominators to calculate MIS-C incidence rates stratified by race/ethnicity. To help characterize the burden of severe COVID-19 disease in NYC, we also calculated COVID-19 hospitalization rates stratified by race/ethnicity.
30 Nov Women Older, With More Medical Conditions When First Heart Attack Diagnosed
MedicalResearch.com Interview with: [caption id="attachment_56073" align="alignleft" width="200"] Dr. Ezekowitz[/caption]
Justin A. Ezekowitz, MBBCh, MSc
Professor, Department of Medicine
Co-Director, Canadian VIGOUR Centre
Director, Cardiovascular Research, University of Alberta
Cardiologist, Mazankowski Alberta Heart Institute
MedicalResearch.com: What is the background for this study? What are the main findings? Are women older, sicker when they experience heart disease?
Response: Previous research looking at sex-differences in heart health has often focused on recurrent heart attack or death, however, the vulnerability to heart failure between men and women after heart attack remains unclear.
Our study includes all patients from an entire health system of over 4 million people and includes information not usually available in other analyses. Women were nearly a decade older and more often had a greater number of other medical conditions when they presented to hospital for their first heart attack, and were at greater risk for heart failure after the more severe type of heart attack (also known as a ST-elevation MI). This gap between men and women has started to narrow over time.
26 Nov Greater Rate of Infection-Related Hospitalizations in Cesarean Section-Born Children
MedicalResearch.com Interview with: [caption id="attachment_55957" align="alignleft" width="200"] Dr. Miller[/caption]
Jessica Miller PhD
Postdoc Fellow
Murdoch Childrens Research Institute
MedicalResearch.com: What is the background for this study?
Response: Cesarean section (CS) may be a lifesaving intervention for women and babies. However, the global proportion of CS births is rapidly increasing and may not be medically justified. As CS has implications for both mother and child, the increasing rates warrant population-level analyses of potential risks. Many suggested long-term outcomes in CS-born children relate to altered immune development. It is possible that differences in the newborn microbiome by mode of birth contribute to the development of early immune responses which may influence the risk of immune-related outcomes, including infection. CS has been associated with an increased risk for specific infection-related hospitalisations, mainly lower respiratory tract and gastrointestinal infections, but it remains unclear whether CS is associated with increased risk of overall infection-related hospitalisation or only certain infection types, and whether risk differs for emergency versus elective/pre-labour CS.
26 Nov Breast Cancer: Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies
MedicalResearch.com Interview with: [caption id="attachment_56014" align="alignleft" width="191"] Dr. Pusztai[/caption]
Lajos Pusztai, M.D, D.Phil.
Professor of Medicine
Director, Breast Cancer Translational Research
Co-Director, Yale Cancer Center Genetics and Genomics Program
Yale Cancer Center
Yale School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive. We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy.
These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy.
In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective.
26 Nov Higher Risk of Death From Police Shootings Among Black and Hispanic Youth
MedicalResearch.com Interview with: [caption id="attachment_56050" align="alignleft" width="200"]
Dr. Goyal[/caption]
Dr. Monika K. Goyal, MD
Associate Division Chief, Emergency Medicine
Children’s National Hospital
Department of Pediatrics, School of Medicine and Health Sciences
The George Washington University
Washington, District of Columbia
MedicalResearch.com: What is the background for this study?
Response: There has been growing attention to the disproportionate use of police force in communities of color. Therefore, we sought to investigate whether Black and Hispanic teenagers have higher rates of death due to police shootings when compared to white youth.
26 Nov Caregiver’s Response to Baby Babbling Can Improve Infant’s Vocabulary
MedicalResearch.com Interview with: Lukas D. Lopez Doctoral Candidate Psychological Sciences, Developmental Psychology University of California, Merced MedicalResearch.com: What is the background for this study? What are the main findings? Response: "This study is unique because it uses LENA recording devices which are small recording devices that infants wear in the pocket of a vest that record all infant babbles and caregiver responses in the home. We then had trained listeners annotate infant-adult vocal exchanges within sections of those recordings focusing on the specific types of sounds infants made and specific types of adult responses to those sounds. Using this combination of methods is distinctive because it allowed us to capture a more natural picture of a family's language environment in the home context, whereas most research on this topic is conducted in the laboratory. We then related this information to caregivers' reports of their infant's vocabulary. Our study finds that the caregivers who scaffold and elaborate on their infant’s babbling report that their infants can say more words."
25 Nov Magnet Sets Continue to Pose Serious Ingestion Hazard for Children
MedicalResearch.com Interview with: [caption id="attachment_56023" align="alignleft" width="200"]
Dr. Flaherty[/caption]
Michael R. Flaherty, DO
Attending, Pediatric Critical Care Medicine
Co-Director, Trauma and Injury Prevention Outreach Program, MGH
Instructor in Pediatrics,
Harvard Medical School
Boston, MA 02114
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was a joint collaboration between Massachusetts General Hospital and Boston Children’s Hospital. The Consumer Product Safety Commission (CPSC) found an increasing incidence of rare earth magnet ingestions by children causing serious injury; Injuries are particularly serious when a child ingests two of these small magnets, or a magnet with another metal object – this can lead to bowel walls becoming attached and kinked, leading to catastrophic bowel injury and/or death.
The Consumer Product Safety Commission initiated campaigns to limit sales in 2012 with voluntary recalls and safety standards, as well as public awareness campaigns, legislative advocacy, and lawsuits. In October 2014, the CPSC published their final rule, “Safety Standard for Magnet Sets,” which prohibited the sale of magnets based on a pre-specified size and power scale, essentially eliminating the ability to sell SREMs. This rule was appealed by largest manufacturer of these magnets, Zen Magnets, LLC., and in November 2016 this rule was legally reversed by the U.S. Court of Appeals Tenth Circuit resulting in a resurgence of these magnets on the market.
24 Nov NEJM Study: Plasma Must Not be Used in Patients with Severe COVID 19 Pneumonia
Posted at 16:24h
in Author Interviews
MedicalResearch.com Interview with:
Ventura Simonovich
Jefe. Sección Farmacología Clínica. Servicio de Clínica Médica
Coordinador Operativo. Investigación Patrocinada. Departamento de Investigación
Hospital Italiano de Buenos Aires
Vicepresidente. Asociación Argentina de Farmacología Experimental (AAFE)
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The convalescent plasma is something that was used almost since the beginning of this pandemic, but all the information came at the beginning from cohort studies. We decided to run this trial to evaluate the efficacy of the convalescent plasma in patients with severe Covid 19 pneumonia, which was the main indication in our country.
Our findings show that convalescent plasma is equal to placebo except in patients younger than 65, in that population placebo is better than plasma.
23 Nov Deep Learning of Germline Mutations Enables Identification of More Patients at Risk of Cancer
Posted at 15:07h
in Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer
MedicalResearch.com Interview with:
[caption id="attachment_56034" align="alignleft" width="97"] Dr. AlDubayan[/caption]
Saud H AlDubayan, M.D.
Instructor in Medicine, Harvard Medical School
Attending Physician, Division of Genetics,
Brigham and Women's Hospital
Computational Biologist, Department of Medical Oncology,
Dana-Farber Cancer Institute
Associate Scientist, The Broad Institute of MIT and Harvard
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations.
To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.
22 Nov Rare Mutation in the PCSK9 Gene Confers Long Healthy Life
MedicalResearch.com Interview with: [caption id="attachment_56017" align="alignleft" width="111"] Dr. Austin[/caption]
Richard C. Austin, PhD
Professor and Career Investigator of the Heart and Stroke Foundation of Ontario
Amgen Canada Research Chair in Nephrology
McMaster University and St. Joseph’s Healthcare
Hamilton, Ontario, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A previous study published in 2011 by my collaborator, Dr. Michel Chretien at the IRCM, identified a rare mutation in the PCSK9, termed Q152H. Individuals harboring this mutation demonstrated dramatic reductions in their LDL cholesterol levels and had a significantly lower risk of CVD. Furthermore, individuals harboring the Q152H mutation showed increases in longevity with no evidence of other diseases such as liver disease, cancer and chronic kidney disease. This Q152H mutation was unique with only 4 families in Quebec shown to harbor this genetic variant.
In terms of its effect on PCSK9 expression/activity, the mutation at Q152H was precisely at the cleavage site in PCSK9 necessary for its activation. As a result, the Q152H mutation fails to be cleaved and activated, thereby blocking its secretion into the circulation. This is why the Q152H mutation is considered a loss-of-function PCSK9 mutant. Given our lab's interest in endoplasmic reticulum (ER) stress and ER storage diseases, we began to collaborate with Drs. Chretien and Seidah at the IRCM to investigate whether this Q152H mutant, when overexpressed in liver cells, would cause ER stress and liver cell injury. This was based on the findings that the Q152H mutant does not undergo autocatalytic cleavage and its subsequent secretion from liver cells.
It is well known in the literature that the accumulation of misfolded or inactive proteins in the ER gives rise to ER stress and cell injury/dysfunction. As a result, we initially showed to our surprise that overexpression of the Q152H mutant in liver cells failed to cause ER stress BUT increased the protein levels of several important ER chaperones, GRP78 and GRP94, known to PROTECT against liver cell injury/dysfunction. As part of our JCI study, we furthered these studies to examine the effect of the Q152H mutant when overexpressed in the livers of mice. This is where we demonstrated that the Q152H mutation showed protection against ER stress-induced liver injury/dysfunction.