Prof. Pottel[/caption]
Prof. Dr. Hans Pottel PhD
Professeur Invité (titre honorifique)
Faculté de Médecine
Université de Liège
KULeuven-KULAK, Kortrijk, Belgium
MedicalResearch.com: What is the background for this study? Why do we need a new GFR?
Response: The currently recommended equations have flaws, mainly because there is one equation (CKiD) recommended for children, and one recommended (CKD-EPI) for adults (by KDIGO). When transitioning from pediatric nephrology care to adult nephrology care, the switch from CKiD to CKD-EPI causes implausible jumps (of more than 50%), mainly because CKD-EPI largely overestimates GFR in young adults (18-30 years). The new equation overcomes this problem as it applies for all ages (for children and adults) and overcomes the known flaws of the currently most used equations. The new equation is less biased and more precise across the full age spectrum and for the full range of serum creatinine concentrations.
The equation was developed in 11 251 participants from 7 cohorts (development and internal validation datasets) and validated in 8 378 participants from 6 cohorts (external validation dataset). Data were coming from European and American nephrology centers. No patients of African-American ancestry were included. Actually, the previously published FAS-equation served as the basic mathematical form for the equation, but we adjusted the power coefficients for serum creatinine (very much like it was done in the CKD-EPI equation). You could say that we used properties of both the FAS and CKD-EPI equation to come to an improved equation to estimate GFR.
Dr. Ganson[/caption]
Kyle T. Ganson, PhD, MSW
Assistant Professor, Factor-Inwentash Faculty of Social Work
University of Toronto
Toronto, Canada
[caption id="attachment_55902" align="alignleft" width="132"]
Dr. Nagata[/caption]
Jason Nagata, MD, MSc
Assistant Professor of Pediatrics
University of California, San Francisco
San Francisco, California, USA
MedicalResearch.com: What is the background for this study?
Response: A quarter of young adults in the US have reported being unemployed during the COVID-19 pandemic. Young adults may be especially affected by employment loss as they often work in industries most adversely affected by social distancing.
MedicalResearch.com: What are the main findings?
Response: Among a sample of nearly 5,000 young adults age 18 to 26 in the US, we found that since March 2020, young adults who lost their job or were part of a household that experienced employment loss were more likely than those with secure employment to experience four common symptoms of anxiety and depression. This was also true of young adults who expected an employment loss in the next four weeks. The study also found that symptoms of anxiety and depression were common among the sample of young adults. In the seven days prior to the survey, 75% reported being nervous, anxious or on edge, 68% reported not being able to stop or control worrying, 67% reported having little interest or pleasure in doing things, and 64% reported feeling down, depressed, or hopeless.
Dr. Al Rifai[/caption]
Mahmoud Al Rifai, MD, MPH
Cardiovascular Disease Fellow
Baylor College of Medicine Houston, TX
[caption id="attachment_55680" align="alignleft" width="150"]
Dr. Virani[/caption]
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: E-cigarettes have gained popularity since their introduction in the U.S. market nearly 20 years ago and their use has increased especially among younger adults. On the other hand, public health efforts aimed at curbing tobacco use over the past few decades have resulted in a decrease in cigarette use. However, state-specific laws and regional cultural differences with regards to perception of these products may result in variability in tobacco use patterns. We therefore evaluate temporal changes in e-cigarette and cigarette use in each U.S. state between the years 2016 to 2018.
Dr. Nordestgaard[/caption]
Børge G. Nordestgaard, MD, DMSc
Professor, University of Copenhagen
Chief Physician, Dept. Clinical Biochemistry
Herlev and Gentofte Hospital
Copenhagen University Hospital
Herlev, Denmark
MedicalResearch.com: What is the background for this study?
Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today
Dr. Nagata[/caption]
Jason M Nagata M.D., M.Sc
Assistant Professor of Pediatrics
Division of Adolescent and Young Adult Medicine
Department of Pediatrics, University of California
San Francisco, San Francisco, CA
MedicalResearch.com: What is the background for this study?
Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity.
Prof Jeffrey S Tobias, Prof Jayant S Vaidya, Prof Max Bulsara. and Prof Michael Baum[/caption]
Response: The findings of the large international randomised trial (TARGIT-A trial), published in the British Medical Journal (BMJ 2020;370:m2836), confirm the long-term effectiveness of Targeted Intraoperative Radiotherapy (TARGIT-IORT): a breast cancer treatment which is increasingly available throughout the world. For most women with early breast cancer, a single dose of targeted radiotherapy during surgery is just as effective as conventional radiotherapy, which requires several visits to hospital after surgery.
Conventional external beam radiotherapy (EBRT) is delivered from outside the body via a radiotherapy machine (linear accelerator), and consists of a daily treatment session (known as fractions) to the whole breast, over a period between three to six weeks. Each of these treatments is given over a few minutes, but requires 15 to 30 hospital visits, which could be a significant distance from where the patient lives.
TARGIT-IORT is delivered immediately after lumpectomy (tumour removal), via a small ball-shaped device placed inside the breast, directly where the cancer had been. The single-dose treatment lasts for around 20 to 30 minutes and replaces the need for extra hospital visits, benefiting both patient safety and well-being. The device used is called INTRABEAM.
More details are described on the BMJ and UCL webpages:
https://www.bmj.com/company/newsroom/single-dose-radiotherapy-as-good-as-conventional-radiotherapy-for-most-women-with-early-breast-cancer/
https://www.ucl.ac.uk/news/2020/aug/single-dose-radiotherapy-effective-treating-breast-cancer
https://blogs.bmj.com/bmj/2020/08/20/targeted-intraoperative-radiotherapy-for-early-breast-cancer-new-evidence/
Dr. Uhr[/caption]
Joshua Uhr MD
Ophthalmologist
Philadelphia, PA
MedicalResearch.com: What is the background for this study?
Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology.
Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.
Our study demonstrated effective cross protection; HSV-1 R2 vaccination protected against HSV-2 challenge....
Dr. Gianfrancesco[/caption]
Milena Gianfrancesco, PhD, MPH
Assistant Professor. Education
Division of Rheumatology, Department of Medicine
University of California, San Francisco
MedicalResearch.com: What is the background for this study?
Response: This study utilized data from the COVID-19 Global Rheumatology Alliance Provider Survey, which launched on March 25th. To date, it has collected information on over 6,000 patients with rheumatic disease diagnosed with COVID-19 from over 40 countries worldwide. As COVID-19 spread across the world in the spring, and especially within the United States, it became clear that the disease was impacting certain groups more than others. Growing attention and research began to illustrate the disproportionate burden of COVID-19 among racial/ethnic minorities in the United States. We know that racial and ethnic minorities experience a higher burden of rheumatic disease risk and severity; therefore, our group was interested in examining whether the disproportionate burden of COVID-19 also affected this susceptible population.
Dr. Barrett[/caption]
Emily S. Barrett, PhD
Rutgers School of Public Health
Environmental and Occupational Health Sciences Institute
Piscataway, NJ 08854
MedicalResearch.com: What is the background for this study?
Response: As the covid-19 pandemic hit the us, it became clear that health care workers were potentially at risk and there was great concern for frontline doctors and nurses treating infected patients. With the health and safety of our hospital staff in mind, we offered covid-19 virus and antibody testing to all of the hospital employees.
Dr. Spann[/caption]
Marisa N. Spann, PhD, MPH
Columbia University Irving Medical Center
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.
MedicalResearch.com: What are the main findings?
Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.
Dr. Hussan[/caption]
Hisham Hussan, MD, FACG
The Ohio State University Wexner Medical Center
MedicalResearch.com: What is the background for this study?
Response: Early-onset colorectal cancer (i.e., CRC diagnosed before 50 years of age) is predicted to rise to 10.9% of all colon and 22.9% of all rectal cancers by 2030.
Some studies identified an association between early-onset CRC and obesity. By contrast, other studies found a similar body mass index (BMI) between adults with and without early-onset CRC. These conflicting findings are possibly due to weight loss from colorectal cancer that may obscure its relation to obesity.
Dr. Wesemann[/caption]
Duane Wesemann, MD, PhD
Div. of Rheumatology, Immunology and Allergy
Brigham and Women's Hospital
Boston, MA 02115
Wesemann Lab
MedicalResearch.com: What is the background for this study?
Response: There is a lot of variability in how long antibodies to pathogens are produced in humans. Some infections and vaccinations like measles induce high levels of antibodies that can be produced for a lifetime. Other infections or vaccinations induce only short lived antibody responses. Also, some people make longer lasting antibodies compared to others. We wanted to ask what the antibody durability dynamics looked like after COVID-19 and if we could tease out any insights—both with regard to COVID-19 as well as in general.
While CBD has a powerful effect on seizures, neuropathy, and even behavioral disorders, it is not a cure-all as some manufacturers may claim....
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many healthcare professionals throughout the world face issues surrounding medical malpractice at some point in their careers. Unfortunately, a number of these cases turn into medical malpractice lawsuits. As a specialty that treats acute pathology and refractory pain, neurosurgery is at risk for high liability. By the means of a survey among members of the Congress of Neurological Surgeons (CNS), we aimed to illustrate how malpractice lawsuits affect neurosurgeons professionally, emotionally and financially.
MedicalResearch.com: What are the main findings?
Response: Some 490 members of the CNS shared their experiences with us. Among these members, 81% faced a medical malpractice lawsuit. The main concerns expressed about being sued included losing confidence and practicing defensive medicine, personal assets being at risk, and being named in the National Practitioner Data Bank. Of the respondents, 40% stated they were frequently or always concerned about being sued, and 77 % stated their fear had led to a change in how they practice medicine. For 58 %, this change led to the practice of defensive medicine, while for others it led to more extensive documentation (14%) and/or to referring or dropping complex cases (12%). Given the medical malpractice environment, 59% of respondents considered referring complex patient cases, whereas 37% considered leaving the practice of medicine.
Dr. Gade[/caption]
Kristine Gade, MD
Hematology/Oncology Fellow
UPMC Hillman Cancer Center
MedicalResearch.com: What is the background for this study? Would you briefly describe the “surprise question”?
Response: Via Oncology Pathways, a cancer care platform used by UPMC and other institutions across the country, asks physicians to answer the surprise question – “Would I be surprised if this patient died in the next 12 months?” – whenever a new treatment plan is implemented. This question has been widely adopted by many oncology and palliative care frameworks and has been shown to be modestly predictive of mortality in multiple studies. We know that advanced cancer patients have a high utilization of the emergency department, even near end of life. Our group wanted to see if we could use the results of the surprise question to easily and quickly communicate to emergency department providers the expected prognosis for our advanced cancer patients. First, we set out to assess the surprise question’s ability to predict survival among our UPMC Hillman Cancer Center patients with select stage IV cancer diagnoses.
Beth Hahn, PhD, Director
U.S. Value Evidence and Outcomes,
GlaxoSmithKline,
Research Triangle Park, NC
MedicalResearch.com: What is the background for this study?
Response: Biologic therapies are increasing as a treatment for patients with severe asthma, with multiple therapies approved by the FDA. There is also an increasing understanding of the factors influencing preference for and adherence to biologic therapies for patients with severe asthma; however, little is known about why patients discontinue biologic therapy. In patients who have access to biologic treatment, understanding the circumstances and asthma characteristics associated with discontinuation of biologic therapy may allow for the identification of barriers to treatment success . The objective of this study of cross-sectional physician and patient survey data was to assess the patient characteristics and the given reasons for treatment discontinuation in a US patient cohort with severe asthma treated with biologic therapy.
A total of 117 physicians and 285 patients completed surveys with 70% of patients continuing biologic therapy (N=200). This study included a number of different FDA approved biologics. From the perspectives of the physicians included in the current study (85 providing a rationale for discontinuation), the majority reported a lack of symptom control, particularly shortness of breath (46%), exacerbations (26%) and other chronic symptoms (29%), as a key reason for discontinuing biologic therapy in severe asthma. Symptom control was also key for patients, with these three symptom categories among their top six reasons for biologic discontinuation. The cost of biologic treatment was also an important factor, cited as the 5th most common reason for discontinuation among physicians and the 3rd among patients.
Dr. Sachdev[/caption]
Darpun D. Sachdev, M.D.
Case investigation and Contact tracing Branch Chief
SFDPH Covid Command Center
San Francisco Department of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The ultimate goal of contact tracing is to rapidly identify and isolate contacts who are COVID-19 positive before they have time to transmit to others. As mentioned in the published research letter by SFDPH, through JAMA, during early shelter-in-place (from April to June 2020), our contact tracing program successfully reached greater than 80% of cases and contacts within a median timeframe of 6 days from the onset of their case’s symptoms. Approximately 10% of named contacts were newly diagnosed with COVID-19 (compared to 2% positivity during this time period). Household contacts made up approximately 80% of all identified contacts, but 90% of contacts who tested positive lived in the same household as the case. Secondary cases (contacts who were found to be newly diagnosed with COVID-19) were traced and quarantined within 6 days of the case’s symptom onset.
With that said, the 6-day time difference between symptom onset and contact notification raises concern regarding the overall effectiveness of tracing in preventing onward transmission by infected contacts. We are working with community-based organizations to scale up access to testing and culturally competent tracing and wraparound services. Currently, we have now decreased the time difference to 5 days. Moreover, given that the majority of contacts resided in the same household, transmission could have occurred presymptomatically such that by the time infected contacts were identified, they might have already transmitted the virus. Hence, why SFDPH, on May 5, 2020, implemented the recommendation of universal testing for COVID-19 contacts, regardless of symptoms.
We recommend that testing should be offered to all contacts regardless of symptoms and encourage local health departments to adopt novel ways of increasing testing access for contacts.
Dr. Adnan[/caption]
Darbaz Adnan, MBChB
Lab Research Assistant
Department of Internal Medicine - Section of Gastroenterology
Rush University Medical Center
Chicago, Illinois 60612
MedicalResearch.com: What is the background for this study?
Response: - We have conducted a large study of over 1000 patients at a major COVID-19 response center in Chicago at Rush University Medical Center, to assess for the frequency of initial GI symptoms (diarrhea, vomiting, abdominal pain) and evaluate whether these symptoms in adult COVID-19 positive could predict the disease course. Overall, 22.4% of our patients reported at least one GI symptom at the onset of their infection, with nausea/vomiting being the most common complaint. GI symptoms in COVID-19 patients were associated with worse outcomes.
Dr. Curtis J. Donskey[/caption]
Curtis J. Donskey, MD
Professor of Medicine
Case Western Reserve University
Staff Physician, Infectious Diseases Section,
Louis Stokes Cleveland VA Medical Center
MedicalResearch.com: What is the background for this study?
Response: The goal of the study was to obtain a better understanding of how healthcare-associated pathogens are transmitted. Infection control efforts tend to emphasize hand hygiene and cleaning of high-touch surfaces in patient rooms. However, there is evidence that portable equipment and floors could be underappreciated sources of transmission.
We previously found that a nonpathogenic virus inoculated onto floors in patient rooms spread rapidly to the hands of patients and to surfaces in the room and throughout the ward. This raised concern that pathogens could spread by the same route.
Example of one type of squamous cell skin cancer: DermNetNZ image[/caption]Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time.
MedicalResearch.com: What are the main findings?
Response: In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade.
Dr. Drakos[/caption]
Stavros G. Drakos, MD, PhD, FACC
Professor of Cardiology
Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center.
Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program
Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology
MedicalResearch.com: What is the background for this study?
Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed.
The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center.
Dr. Maslin[/caption]
Dr. Douglas Maslin, MPhil, MB BCHir
Dermatologist and Pharmacologist
Addenbrooke's Hospital
Cambridge, UK
MedicalResearch.com: What is the background for this study?
Response: I’d like to answer this question in three parts:
Firstly, the background to Evelo and the therapeutic EDP1815: Evelo is developing orally administered biologic medicines based on a new understanding of how systemic inflammation is controlled. Evelo’s medicines are selected for their ability to modulate the small intestinal axis, or SINTAX, a network of anatomical and functional connections that has evolved to connect the small intestine with the rest of the body. SINTAX links small intestinal mucosal immunology with systemic inflammation and is now accessible with oral medicines. This inflammatory control pathway may enable a new class of products which are effective, safe, and can be manufactured affordably at large scale.
EDP1815 is a non-live pharmaceutical preparation of a strain of the bacterium Prevotella histicola isolated from the duodenum of a human donor. Its pharmacodynamic effect is through interactions with the immune cells within the small intestine and it has no systemic absorption. These local interactions in the small intestine then downregulate systemic inflammation. In fact, the inflammatory control afforded by targeting the small intestinal axis appears to result in the coordinated downregulation of multiple inflammatory pathways without immunosuppression, mimicking the body’s normal physiological processes of inflammation resolution.
Secondly, there is the key and exciting background pre-clinical data on EDP1815 – the details of which have been published today at the EADV conference. For example, oral administration of EDP1815 to mice has been shown to lead to striking therapeutic effects in in vivo models of delayed-type hypersensitivity, imiquimod-induced skin inflammation, fluorescein isothiocyanate cutaneous hypersensitivity, collagen-induced arthritis, and experimental acute encephalomyelitis (EAE).
The consistency of effect and dose shows that EDP1815 can coordinately resolve systemic inflammation across TH1, TH2 and TH17 pathways. This suggests the potential for clinical benefit across multiple diseases.
And, thirdly, there is the clinical unmet need for an oral, safe, effective treatment specifically for mild and moderate psoriasis patients, who have very limited treatment options outside of the poorly tolerated topical therapies, and these patients are reported to be dissatisfied with treatment options and therefore are often under-treated.
These three points explain the background to EDP1815 and the reason for progressing forward into the phase 1b in psoriasis.
Dr. Batool-Anwar[/caption]
Salma Batool-Anwar, MBBS, MPH
Instructor, Harvard Medical School
Pulmonary and Critical Care, Sleep Medicine
Brigham and Women's Faulkner Hospital
MedicalResearch.com: What is the background for this study?
Response: A well functioning sleep-wake cycle is vital to our health and prevention of chronic diseases.
During previous disaters sleep disturbances have been reported.
When Massachusetts governor declared a state of emergency in March’20, we hypothesized that sleep duration would be adversely affected by covid-19 related lockdown and stress.
The study was approved by the institutional review board and information was collected retrospectively using the electronic medical records.