Author Interviews, Dermatology, Technology / 03.04.2020

MedicalResearch.com Interview with: Jung-Im Na, MD PhD Associate Professor, Department of Dermatology Seoul National University Bundang Hospital Korea  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by a convolutional neural network? Response: When a very young child looks at a picture, she can easily identify cats and dogs, however, even the most advanced computers had struggled at this task until recently. Computers began to “see” with the recent advancement of Deep Learning techniques. Deep Learning is a machine learning technique that teaches computers to learn from raw data. Most deep learning methods use artificial neural network architectures, imitating human brain, and convolutional neural networks (CNN) is a particular type of deep learning architecture, imitating the visual cortex. CNN is especially powerful for recognizing images. CNN exploit the information contained in image datasets to automatically learn features and patterns. (more…)
Author Interviews, COVID -19 Coronavirus, Pharmaceutical Companies / 02.04.2020

MedicalResearch.com Interview with: Dr. Larry Schlesinger MD Professor, President and CEO Texas Biomed MedicalResearch.com: What is the background and mission of Texas Biomed? Response: Texas Biomedical Research Institute (Texas Biomed) is a not-for-profit, independent research institute with a strong history of pioneering, biomedical breakthroughs that have contributed to the world of science and human health for nearly 80 years. The Texas Biomed mission is to pioneer and share scientific breakthroughs that protect you, your families and our global community from the threat of infectious diseases. Texas Biomed is capitalizing on its strengths – outstanding collaborative scientists and unique assets and resources. Texas Biomed is home to the nation’s only privately-owned BSL4 facility, five fully outfitted BSL3 facilities with the latest technologies and the Southwest National Primate Research Center (SNPRC). The Institute focuses on a core understanding of the basic biology of infectious diseases, animal model development, and studies to move therapies and vaccines to human clinical trials. The Institute’s independent, nonprofit business model moves science from the bench to clinical trials faster and with less bureaucracy. (more…)
Author Interviews, Columbia, COVID -19 Coronavirus, NYU, Technology / 02.04.2020

MedicalResearch.com Interview with: Professor Anasse Bari PhD Courant Institute of Mathematical Sciences, Computer Science Department, New York University, New York, and Megan Coffee MD PhD Division of Infectious Diseases and Immunology, Department of Medicine New York University, Department of Population and Family Health Mailman School of Public Health Columbia University, New York MedicalResearch.com: What is the background for this study? Coffee and Bari:  This work is led by NYU Grossman School of Medicine and NYU’s Courant Institute of Mathematical Sciences, in partnership with Wenzhou Central Hospital and Cangnan People's Hospital, both in Wenzhou, China. This is a multi-disciplinary team with backgrounds in clinical infectious disease as well as artificial intelligence (AI) and computer science. There is a critical need to better understand COVID-19. Doctors learn from collective and individual clinical experiences. Here, no clinician has years of experience. All are learning as they go, having to make important decisions about clinical management with stretched resources. The goal here is to augment clinical learning with machine learning. In particular, the goal is to allow clinicians to identify early who from the many infected will need close medical attention. Most patients will first develop mild symptoms, yet some 5-8 days later will develop critical illness. It is hard to know who these people are who will need to be admitted and may need to be intubated until they become ill. Knowing this earlier would allow more attention and resources to be spent on those patients with worse prognoses. If there were ever treatments in the future that could be used early in the course of illness, it would be important to identify who would most benefit We present in this study a first step in building an artificial intelligence (AI) framework, with predictive analytics (PA) capabilities applied to real patient data, to provide rapid clinical decision-making support. It is at this point a proof of concept that it could be possible to identify future severity based on initial presentation in COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus / 02.04.2020

MedicalResearch.com Interview with: Hongcui Cao, M.D. State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious Diseases The First Affiliated Hospital College of Medicine, Zhejiang University Hangzhou, China MedicalResearch.com: What is the background for this study? Response: The proportion of severe novel coronavirus disease (COVID-19) cases has dropped significantly. Specifically, this number has decreased from 32.4% on January 28 to 21.6% in Wuhan and to 7.2% in other provinces of China on February. Measures such as strengthened medical support and centralized isolation greatly contributed to the improved circumstances, and laid a solid foundation for further enhancing the cure rate and reducing the mortality rate. However, there are still hundreds of severe patients dying every day. It is extremely important to make timely and efficient diagnosis and initiate treatment for severe patients. (more…)
Author Interviews, Heart Disease, Lipids / 02.04.2020

MedicalResearch.com Interview with: Nathan D. Wong, PhD, FACC, FAHA, FNLA Professor and Director Heart Disease Prevention Program Division of Cardiology, University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Many higher risk persons, despite guideline-recommended therapy such as statins, still suffer from cardiovascular disease events. There are few therapies available to reduce this persistent risk. The REDUCE-IT trial led by Brigham and Women’s Hospital in Boston researchers originally published in November of 2018 was landmark in showing for the first time a highly purified, stable, prescription fish oil product, icosapent ethyl (an EPA only compound marketed as Vascepa®) if given to high risk persons with either cardiovascular disease or diabetes and two or more risk factors who were on statin therapy and had elevated triglyceride levels, achieved an unprecedented 25 percent reduction in the risk of time to first cardiovascular disease events. Given that many persons often experience multiple cardiovascular events, a follow-up analysis showed that TOTAL cardiovascular events were reduced by 30 percent.  (more…)
Author Interviews, COVID -19 Coronavirus / 02.04.2020

MedicalResearch.com Interview with: Dr Zhugen Yang Lecturer in Sensor Technology NERC Fellow School of Water, Energy and Environment Cranfield University MedicalResearch.com: What is the background for this study? Response: A recent outbreak of novel coronavirus pneumonia (COVID-19) caused by SARS-CoV-2 infection has spread rapidly around the globe. Some clinical cases have found that some carriers of the virus may be asymptomatic, with no fever, and no, or only slight symptoms of infection. Currently we have a constrained diagnostic testing capacity, Therefore wastewater analysis, also namely wastewater-based epidemiology (WBE), may offer another way to track the spread of the virus that causes the disease and identify the potential infections at the community. Wastewater-based epidemiology approach could provide an effective and rapid way to predict the potential spread of novel coronavirus pneumonia (COVID-19) by picking up on biomarkers in faeces and urine from disease carriers that enter the sewer system. WBE is already recognised as an effective way to trace illicit drugs and obtain information on health, disease, and pathogens  (more…)
Author Interviews, Blood Pressure - Hypertension, COVID -19 Coronavirus / 01.04.2020

MedicalResearch.com Interview with: Fabian Sanchis-Gomar, MD, MSc, PhD Department of Medicine Stanford University Medical Center Stanford, California Department of Physiology, School of Medicine, University of Valencia INCLIVA Biomedical Research Institute Valencia, Spain MedicalResearch.com: What is the background for this study? How does the RAAS system interface with the COVID-19 virus? Response: Angiotensin-converting enzyme (ACE)2 is a functional receptor for coronaviruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The exponential growth of contagion by the SARS-CoV-2 all around the world has contributed to raising speculations and concerns about whether two commonly used anti-hypertensive drugs, i.e., ACE inhibitors and angiotensin receptor blockers (ARBs), have positive or negative effects in coronavirus disease 2019 (abbreviated “COVID-19”) patients with arterial hypertension on-going treatment with some of the former drugs. In effect, many professional health organizations have published statements claiming that there is not enough evidence to change the use of ACE-inhibitors or ARBs for the management of raised blood pressure (BP) in the context of avoiding or treating COVID-19 infection. (more…)
Author Interviews, Heart Disease, Lipids / 01.04.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? How does Evinacumab differ from the three drugs used in triple therapy for this severe form of hypercholesterolemia? Response:      Despite available lipid lowering therapies, the vast majority of patients with homozygous familial hypercholesterolemia are unable to achieve desirable LDL-cholesterol levels and remain at high risk for premature atherosclerotic cardiovascular disease. Unlike statins and PCSK9-inhibitors which act mainly by upregulating LDL receptor activity on the cell surface, evinacumab, a monoclonal antibody inhibitor of ANGPTL3, acts independent of the LDL receptor. (more…)
Author Interviews, Cost of Health Care, JAMA, Opiods / 01.04.2020

MedicalResearch.com Interview with: Aparna Soni PhD, Assistant Professor Department of Public Administration and Policy School of Public Affairs American University Washington, DC MedicalResearch.com: What is the background for this study? Response: The United States is in the midst of an opioid epidemic. Opioids are responsible for nearly 50,000 deaths per year and present a substantial financial burden on hospitals. The rate of opioids-related hospital events has tripled since 2005. We are particularly concerned about rising hospitalizations because they may stem from a lack of access to treatment for individuals with opioid use disorder. Medication-assisted treatment is effective in treating opioid use disorder but can be unaffordable for people without health insurance. (more…)
AstraZeneca, Author Interviews, Diabetes, Heart Disease, JAMA / 01.04.2020

MedicalResearch.com Interview with: John J. V. McMurray,  MD FRCP FESC FACC FAHA FRSE FMedSci British Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow, United Kingdom  Kieran F Docherty DAPA-HF investigator British Heart Foundation Cardiovascular Research Centre, University of Glasgow     MedicalResearch.com: What is the background for this study? Response: DAPA-HF was a double-blind randomized controlled trial comparing dapagliflozin 10 mg once daily with placebo in 4744 patients with heart failure and reduced ejection fraction (HFrEF). The primary outcome was a composite of time to occurrence of a worsening heart failure event (principally heart failure hospitalization) or cardiovascular death, whichever came first. Dapagliflozin reduced the primary outcome by 26% and reduced the risk of each of heart failure hospitalization and cardiovascular death individually, as well as overall mortality. Patient symptoms were also improved. The aim of the present report was to examine the effect of dapagliflozin separately in patients with and without type 2 diabetes at baseline (45/55% split in the trial). The reason for this was that dapagliflozin was originally introduced as a glucose-lowering medication for the treatment of type 2 diabetes. We find that dapagliflozin was equally beneficial in patients with and without diabetes and was as well tolerated in patients without diabetes as in those with diabetes. More remarkably, among the patients without diabetes, dapagliflozin was as effective in participants with a completely normal glycated haemoglobin (HbA1c) as in those with prediabetes. In patients with a normal HbA1c, dapagliflozin did not lead to any reduction in HbA1c, but did improve clinical outcomes.  (more…)
Author Interviews, COVID -19 Coronavirus / 31.03.2020

MedicalResearch.com Interview with: Professor Carl Coleman, JD Professor of Law Seton Hall Law School MedicalResearch.com: Do health care workers have an ethical and/or legal obligation to provide treatment during an infectious disease outbreak? Are there exceptions such as pregnancy, if the health care worker is her/himself immunocompromised or have young children at home?   Response: As a legal matter, health care workers can generally be required to fulfill pre-existing employment or contractual obligations during an infectious disease outbreak.  For example, an emergency room nurse who refuses to come to work during a pandemic can be disciplined or fired; a physician who breaches a contractual obligation to provide on-call services during an outbreak can be held liable for damages.  In addition to loss of employment and contractual damages, other potential consequences for failing to honor pre-existing commitments during a pandemic could include professional discipline for patient abandonment and, for physicians with on-call responsibilities in hospital emergency departments, civil fines under the federal Emergency Medical Treatment and Active Labor Act. This does not mean that health care workers are obligated to show up for work during a pandemic regardless of the circumstances.  For example, under the Americans with Disabilities Act, health care workers who are immunocompromised can ask for a "reasonable accommodation," such as the right to work remotely (if possible) or to take leave.  Under the Family and Medical Leave Act, employers with more than 50 employees must give workers up to 12 weeks of unpaid time off to care for a seriously ill immediate family member.  In addition, federal labor laws allow employees to refuse to work under "abnormally dangerous conditions," which might apply in situations where an employer fails to provide necessary protective equipment.  However, assuming protective equipment is available, it is not clear that an outbreak itself would be considered "abnormally dangerous," particularly in fields like emergency medicine, where exposure to contagious disease is always a foreseeable risk. In most states, health care workers without pre-existing employment or contractual obligations cannot be compelled to treat patients during a pandemic.  However, a few states have laws that authorize public health authorities to require health care professionals to work during public health emergencies.  I am not aware of any state that has invoked this authority so far. As for ethical obligations, in 2004, the American Medical Association (AMA) declared that "individual physicians have an obligation to provide urgent medical care during disasters," and that "this ethical obligation holds even in the face of greater than usual risks to their own safety, health or life."  Some academic ethicists have expressed similar views.  Common justifications for this position are that physicians "assumed the risk" of exposure to infectious diseases when they voluntarily committed themselves to the healing professions; that a "social contract" requires physicians to assume risks in exchange for their social status and privileges; and that individuals who are uniquely capable of providing life-saving care have an obligation to do so. However, I am not persuaded that all physicians -- let alone health care workers more generally -- have an ethical obligation to provide treatment when doing so involves significant risk.  A willingness to accept risk is not a condition of obtaining a medical license, nor is it part of the oaths that students commonly take at medical school graduation.  While I agree that physicians have ethical obligations to contribute to society, there are many ways they can fulfill these obligations without assuming personal health risks.  And even assuming that individuals who are in a unique position to provide life-saving care should normally do so, we generally do not expect people to rescue others from danger at significant risk to themselves.  (more…)
Author Interviews, Heart Disease, NEJM, Stanford / 31.03.2020

MedicalResearch.com Interview with: David J. Maron, MD, FACC, FAHA Clinical Professor of Medicine Chief, Stanford Prevention Research Center Director, Preventive Cardiology Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? Response: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. The goals of treating patients with stable coronary disease are to reduce their risk of death and ischemic events and to improve their quality of life. All patients with coronary disease should be treated with guideline-based medical therapy (GBMT) to achieve these objectives. Before the widespread availability of drug-eluting stents, strategy trials that tested the incremental effect of revascularization added to medical therapy did not show a reduction in the incidence of death or myocardial infarction. In one trial, fractional flow reserve–guided percutaneous coronary intervention (PCI) with drug-eluting stents, added to medical therapy, decreased the incidence of urgent revascularization but not the incidence of death from any cause or myocardial infarction at a mean of 7 months, whereas the 5-year follow-up showed marginal evidence of a decrease in the incidence of myocardial infarction. (more…)
Author Interviews, Diabetes, Kidney Disease, OBGYNE, Race/Ethnic Diversity / 30.03.2020

MedicalResearch.com Interview with: Silvi Shah, MD, MS, FACP, FNKF, FASN Assistant Professor Division of Nephrology University of Cincinnati Cincinnati, OH-45267 MedicalResearch.com: What is the background for this study? Response: The study identified 42,190,790 pregnancy related hospitalizations between Jan. 1, 2006 and Dec. 31, 2015, using data from the from the Nationwide Inpatient Sample. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues / 28.03.2020

MedicalResearch.com Interview with: Joanne Ryan, PhD Senior Research Fellow, ASPREE From the School of Public Health and Preventive Medicine Monash University Melbourne, Australia MedicalResearch.com: What is the background for this study? Response: Aspirin is a commonly used drug known to reduce inflammation, and prevent blood clotting (antiplatelet) - which is why it is commonly used in secondary prevention in individuals with established cardiovascular disease. Inflammation is thought to be a central mechanism in Alzheimer's disease, implicated in the neuropathological cascade leading to the development of dementia and other forms of dementia. Cardiovascular risk factors and stroke are both associated with cognitive decline and an increased risk of dementia. This formed the basis of the hypothesis that aspirin could be beneficial in helping to reduce cognitive decline and the occurrence of Alzheimer's Disease. (more…)
Author Interviews, Biomarkers, Gastrointestinal Disease / 28.03.2020

MedicalResearch.com Interview with: Jean-Frederic Colombel MD The Henry D Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sina New York, NY 10029, USA MedicalResearch.com: What is the background for this study? Response: The goals of therapy in Crohn’s disease have shifted from mere control of symptoms also called clinical remission towards combination of clinical and endoscopic remission also called deep remission which is now considered as the new therapeutic “target”. However it has yet to be proven that targeting deep remission instead of clinical remission is able to stop the progression of Crohn’s disease towards bowel damage, complications and hospitalizations. This study is a post-hoc analysis of the CALM trial that was published in The Lancet in 2018 where newly diagnosed patients were randomized to escalate therapy based on symptoms only (control arm) or based on a combination of symptoms and two biomarkers namely C-reactive protein in blood and calprotectin in stools (tight control arm). (more…)
Author Interviews, COVID -19 Coronavirus, NEJM / 28.03.2020

MedicalResearch.com Interview with: Bin Cao, Yeming Wang, Guohui Fan, Lianghan Shang, Jiuyang Xu, DingyuZhang, Chen Wang on behalf of LOTUS-China Study Group China-Japan Friendship Hospital; Wuhan Jintinyan Hospital; Institute of Respiratory Medicine, Chinese Academy of Medical Science  MedicalResearch.com: What is the background for this study? Response: In the past two months, the outbreak of Coronavirus Disease 2019 (COVID-19) has been spreading rapidly across the world. Science and technology is the most powerful weapon for human to fight against diseases, especially in such a pandemic setting. Seeking for effective antiviral medication is the most critical and urgent among the many scientific tasks in the pandemic. At the most critical moment in the fight against COVID-19, Chinese clinical scientists have stepped forward under extremely difficult research conditions to carry out clinical trials in antiviral treatment including lopinavir–ritonavir and remdesivir, in a swift, decisive and effective manner. These trials have attracted worldwide attention. Recently, the Lopinavir–ritonavir Trial for suppression of SARS-CoV-2 in China (LOTUS-China) has been completed, which, with great clinical significance, can provide strong evidence for the treatment of COVID-19 both in China and around the world. (more…)
Author Interviews, COVID -19 Coronavirus, Lung Cancer / 27.03.2020

MedicalResearch.com Interview with: Dr. Amy C. Moore PhD Director of Science and Research GO2 Foundation for Lung Cancer MedicalResearch.com: What is the mission of the GO2 Foundation for Lung Cancer? Response: GO2 Foundation for Lung Cancer’s mission is to transform survivorship by  saving, extending, and improving the lives of those vulnerable, at risk, and diagnosed with lung cancer. (more…)
Author Interviews, COVID -19 Coronavirus, Duke / 27.03.2020

MedicalResearch.com Interview with: Dr. Rupesh Agrawal, MD Associate Professor Senior Consultant Ophthalmologist Duke-NUS Medical School, Singapore MedicalResearch.com: What is the background for this study? Wasn't Dr Li Wenliang, the Chinese physician who first alerted his community of coronavirus an opthalmologist, with possible exposure to tears from this surgical work with glaucoma patients? Response: Since the start of the pandemic, there have been multiple reports which suggested the transmission of SARS-CoV-2 via ocular fluids. As ophthalmologists, we come into close contact with tears on a daily basis during our clinical examination. Furthermore, many equipment in the clinic like the Goldman tonometer come into direct contact with such ocular fluids, providing a channel for viral transmission. The evidence, as of date, were mainly anecdotal reports included in newspaper articles and media interviews. We wanted to know if the virus can truly be found in tears, so we decided to embark on this study. (more…)
Author Interviews, Mental Health Research, Pediatrics / 26.03.2020

MedicalResearch.com Interview with: Jillian Hardin, Ph.D. Developmental Psychophysiology Lab Florida Atlantic University MedicalResearch.com: What is the background for this study? Response: Most Kangaroo Care (KC) research examines the procedure’s positive physiological and psychological developmental effects on preterm infants as these infants are separated from their mothers before the end of gestation. However, the aim of our study was to determine whether kangaroo care parent-training and implementation with non-vulnerable, full-term infants provided developmental neurophysiological benefits.  (more…)
Author Interviews, Biomarkers, Diabetes, Diabetes Care, Johns Hopkins / 26.03.2020

MedicalResearch.com Interview with: Olive Tang, MD/PhD Student Johns Hopkins School of Medicine   Elizabeth Selvin, PhD, MPH Professor of Epidemiology & Medicine Director, Cardiovascular and Clinical Epidemiology Department of Epidemiology Welch Center for Prevention, Epidemiology and Clinical Research and the Johns Hopkins Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: The best approach to diabetes management in older adults is unclear. A new blood test called high-sensitivity troponin can detect damage to the heart, even in people without any signs or symptoms of heart disease. (more…)
Author Interviews, Melanoma, NYU / 25.03.2020

MedicalResearch.com Interview with: David Polsky, MD, PhD Professor of Dermatology and Pathology Alfred W. Kopf MD, Professor of Dermatologic Oncology Director, Pigmented Lesion Section The Ronald O. Perelman Department of Dermatology New York University Grossman School of Medicine Perlmutter Cancer Center Joan and Joel Smilow Research Center New York, NY 10016 MedicalResearch.com: What is the background for this study? Response: The background for the study was to determine the extent to which new treatments for metastatic melanoma were impacting melanoma mortality rates for the United States population. Multiple clinical trials have demonstrated that several new agents were highly effective at prolonging survival. These treatments belong to two different groups of medications: those targeting the biological pathway activated by mutation in the BRAF oncogene, which occurs in just under 50% of metastatic melanomas; and those targeting the immune system, called checkpoint inhibitors. These drugs prevent melanomas from suppressing the immune response to the tumors. Ten treatments were approved beginning in 2011, including six treatments between 2011 and 2014. We examined mortality rates between 1986 and 2016, prior to and after FDA approval of these agents. (more…)
Addiction, Author Interviews, Cannabis / 25.03.2020

MedicalResearch.com Interview with: Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University, Pullman, WA Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University, Pullman, WA MedicalResearch.com: What is the background for this study? Response: The evolving legal landscape concerning the use of cannabis has increased urgency to better understand its effects on the brain and behavior. Animal models are advantageous in this respect; however, researchers traditionally use forced injections of synthetic cannabinoids which fails to capture the complex effects of volitional cannabis consumption. In our study, we developed a novel model of cannabis self-administration using response-contingent delivery of vaporized cannabis extracts containing high concentrations of Δ9 tetrahydrocannabinol (THC) or cannabidiol (CBD). (more…)
Author Interviews, Genetic Research, Nature, Prostate Cancer, Vanderbilt / 24.03.2020

MedicalResearch.com Interview with: Jeffrey R. Smith, MD PhD Department of Medicine, Division of Genetic Medicine Vanderbilt-Ingram Cancer Center, and Vanderbilt Genetics Institute Vanderbilt University Medical Center Medical Research Service Tennessee Valley Healthcare System, Veterans Administration Nashville, TN MedicalResearch.com: What is the background for this study?   Response: Roughly 20% of men with prostate cancer have a family history of the disease, and 5% meet criteria for hereditary prostate cancer. Although prostate cancer has the greatest heritability of all common cancers (twice that of breast cancer), extensive heterogeneity of its inherited causes has presented a considerable obstacle for traditional pedigree-based genetic investigative approaches. Inherited causes across, as well as within families are diverse. This study introduced a new familial case-control study design that uses extent of family history as a proxy for genetic burden. It compared a large number of men with prostate cancer, each from a separate family with a strong history of the disease, to screened men with no personal or family history. The study comprehensively deconstructs how the 8q24 chromosomal region impacts risk of hereditary prostate cancer, introducing several new analytical approaches. The locus had been known to alter risk of prostate, breast, colon, ovarian, and numerous additional cancers. (more…)
Author Interviews, Erectile Dysfunction, JAMA, Karolinski Institute / 23.03.2020

MedicalResearch.com Interview with: Alexander Stridh, MSc Department of Clinical Neuroscience Karolinska Institute Solna, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​We wanted to investigate how large the effect size is in the placebo arm of clinical trials with PDE5Is for erectile dysfunction. The major findings in this study is that there is a placebo response in general in ED, though it is hard to tell if this is a genuine placebo effect rather than normal fluctuations in symptom severity among patients. Another interesting finding was that the placebo response seems largely more important when the cause of ED is mainly due to psychogenic factors, as in post traumatic stress disorder. Lastly there was an important finding that there was no difference between placebo and active drug with daily treatment of PDE5Is  for long term recovery of erectile function after prostate cancer treatment, a practice which is common in some places and seems to be questionable.  (more…)
Allergies, Asthma, Author Interviews, ENT / 23.03.2020

MedicalResearch.com Interview with: Joseph Han, MD FARS, FAAOA FAAAAI Medical Director for the Division of Allergy Eastern Virginia Medical School  MedicalResearch.com: What is the background for this study? Response: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease of the nasal passages and sinuses associated with a high symptom burden due to the chronic, relapsing nature of the disease. If you ask CRSwNP patients about the most important disease symptoms, they would say nasal congestion and decrease in smell. However, many CRSwNP patients would say that losing their sense of smell is particularly troublesome. This study was conducted to better understand the effect of dupilumab, which is approved in the U.S. for adults with uncontrolled CRSwNP, on sense of smell.   (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 23.03.2020

MedicalResearch.com Interview with: Leah Nelson, MD MS Addiction Medicine Fellow University of New Mexico MedicalResearch.com: What is the background for this study? Response: With the progression of the opioid epidemic over the past decade, more women of reproductive age are seeking treatment for addiction. Many more pregnant women are prescribed methadone and buprenorphine, two opioid medications that prevent relapse and overdose. Maternal use of mediations for opioid use disorder is recommended because it lowers the risk to the fetus from uncontrolled drug use and also allows the mother to engage with prenatal care and social work. Subsequently, the number of infants born after prenatal exposure to opioids is increasing. Several previous studies have shown measurable differences in the cognitive scores of children after prenatal opioid exposure. However, much of the previous work was done on convenience samples (easy to recruit rather than rigorously matched for comparability) and the demographic characteristics of both mothers and children in the exposed and unexposed groups varied widely on important factors such as maternal education, socioeconomics, employment, tobacco use, and infant gender. Each of these factors has been demonstrated to impact early childhood development in the absence of opioid exposure. (more…)
Author Interviews, Orthopedics, Surgical Research / 23.03.2020

MedicalResearch.com Interview with: Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery ICES, Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Controversy exists among arthroplasty surgeons and patients about the best surgical approach for total hip arthroplasty (THA) - one of the most common operations performed worldwide. In the last few years, the direct anterior approach has become increasingly popular compared to posterior and lateral approaches, partially as a result of advertising to patients.  We sought to determine whether a direct anterior surgical approach was associated with lower surgical complications compared to lateral and posterior approaches. (more…)
Author Interviews, HIV, NEJM / 20.03.2020

MedicalResearch.com Interview with: Susan Swindells MBBS Professor, Infectious Diseases Department of Internal Medicine University of Nebraska Medical Center Omaha, NE MedicalResearch.com: What is the background for this study? Response: The background for this study is the development of long-acting injectable formulations of two antiretroviral agents: cabotegravir and rilpivirine.  These were previously tested in a Phase 2 study, and the current study (called ATLAS) reports findings from Phase 3 in which HIV-infected patients on antiretroviral therapy were switched to monthly injections. The partner study, (FLAIR), is published in the same addition of the journal, and reports results from patients that were new to antiretroviral therapy, and took oral medications as a lead-in to achieve viral suppression before switching to similar monthly injections.  Both studies included randomization to continuing oral antiretroviral therapy. (more…)