ASCO, Author Interviews, Bayer, Cancer Research / 11.02.2020

MedicalResearch.com Interview with: bayer-pharmaceuticalsDr. Kirhan Ozgurdal Global Medical Affairs Physician Oncology, Bayer MedicalResearch.com: What is the background for this study? What are the main findings?
  • Regorafenib is an oral multi-kinase inhibitor that potently blocks multiple protein kinases involved in tumor angiogenesis, oncogenesis, metastasis and tumor immunity. It is approved for the treatment of patients with hepatocellular carcinoma (HCC) who have previously been treated with sorafenib. The safety and effectiveness of regorafenib is being evaluated in patients with unresectable hepatocellular carcinoma (uHCC),a liver tumor not eligible for curative treatment approaches such as surgery, given the extent of disease.
  • Following the Phase 3 RESORCE trial, which showed that regorafenib significantly improves overall survival versus placebo in patients with uHCC who progressed on prior sorafenib therapy, we conducted an interim analysis (the first 500 of 1000 patients) of the global REFINE observational trial to evaluate the safety and effectiveness of regorafenib in uHCC in the real-world setting.
  • The REFINE study shows a more varied patient population than the Phase 3 RESORCE trial, including a higher proportion of patients with ECOG performance status ≥1, and a higher proportion with Child–Pugh B liver function.
  • The incidence of regorafenib-related grade ≥3 treatment-emergent adverse events were lower than that reported in the RESORCE trial, possibly indicating improved adverse event management with the use of regorafenib in clinical practice.
  • The median overall survival was longer than that reported in RESORCE, but the proportion of censored patients was high in this interim analysis; the median progression free survival was similar to that reported in RESORCE.
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Aging, Author Interviews, Cost of Health Care, JAMA, University of Michigan / 10.02.2020

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: While U.S. adults age 50-64 previously had more limited options for health insurance before Medicare at age 65, the Affordable Care Act expanded the number of options, including Marketplace plans (e.g., through HealthCare.gov) and Medicaid. This expanded set of options may complicate decisions about health insurance near retirement. In addition, several policy challenges to the Affordable Care Act may add uncertainty to the decision-making process. (more…)
Author Interviews, Dental Research, Opiods / 10.02.2020

MedicalResearch.com Interview with: Katie J. Suda, PharmD, MS Study Principal Investigator Professor of Medicine University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response:   Dentists are one of the top prescribers of opioids; prescribing 1 in 10 opioids in the United States. Dentists also prescribe a lot of opioids to adolescents and young adults which are a high risk population for substance misuse. This is especially true because studies have shown that non-opioid pain medications are similar or more effective for the treatment of oral pain. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Vitamin D / 10.02.2020

MedicalResearch.com Interview with: Augusto A. Litonjua, M.D., M.P.H. Professor - Department of Pediatrics, Pulmonology Interim Chief - Department of Medicine , Pulmonary Diseases and Critical Care Professor - Department of Medicine , Pulmonary Diseases and Critical Care University of Rochester MedicalResearch.com: What is the background for this study? Response: Vitamin D deficiency and insufficiency is prevalent worldwide. Prior observational studies have shown that low vitamin D levels have been associated with the development of asthma. Animal studies have reported that antenatal vitamin D is important for lung development in utero. Thus, we conducted a randomized, double-blind, controlled trial of vitamin D supplementation in pregnant women to see if we could prevent the development of asthma and wheezing illnesses in young children. The initial report of the trial results showed that children born to mothers in the vitamin D supplementation arm had lower risks for developing either asthma or recurrent wheezing episodes over the first 3 years, but this was not statistically significant (p=0.051)(Litonjua et al. JAMA 2016). (more…)
Author Interviews / 10.02.2020

MedicalResearch.com Interview with: Alexander S. Busch, MD, PhD Department of Growth and Reproduction Rigshospitalet | Copenhagen Denmark MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Previous research has focussed a lot on menarche, i.e. the first menstrual bleeding, despite the fact that this represents a late sign of puberty. The secular trend of age at menarche is thought to have slowed down or even stopped. However, we as clinicians observed a rise in referrals with "precocious puberty" (as defined by thelarche, i.e. breast development, before the age of 8 years) over the past decades. Thus, we suspected that age at thelarche is still declining. Given the fact that there has not be any systematic review on secular trends of clinically important puberty sign, we performed this study.  (more…)
Author Interviews, C. difficile, Health Care Systems, Hospital Acquired, JAMA / 06.02.2020

MedicalResearch.com Interview with: Valerie Vaughn MD, MSc Assistant Professor of Medicine; Hospital Medicine VA Ann Arbor Healthcare System and University of Michigan Medical School @ValerieVaughnMD MedicalResearch.com: What is the background for this study? Response: Health care-associated infection are a major patient safety problem. Fortunately, they can often be prevented through key practices. The Department of Veterans Affairs has been an early adopters of these key strategies through a combination of policies, directives, and initiatives which have aimed to reduce health care-associated infection. No one had previously looked across infections to see whether key infection prevention practices are being used in the VA. (more…)
AHA Journals, Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 05.02.2020

MedicalResearch.com Interview with: Samar R. El Khoudary, M.D., M.P.H. Associate Professor of Epidemiology and Saad Samargandy, M.P.H. Ph.D. Student University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Research findings suggest that women experience adverse changes in multiple clinical measures of their cardiovascular health during the menopause transition period. We were interested in evaluating the timing of critical changes in arterial stiffness and investigating potential racial differences in how arterial stiffness progresses during the menopause transition. Arterial stiffness refers to the elasticity of arteries and it measures the rate at which blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs. We used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white. (more…)
Author Interviews, Cancer Research, CT Scanning, Lung Cancer / 04.02.2020

MedicalResearch.com Interview with: Carlijn M. van der Aalst, Ph.D. MPH Department of Public Health Erasmus MC MedicalResearch.com: What is the background for this study? Response: Lung cancer is the leading cause of cancer-related mortality among both men and women. About 70% of patients with lung cancer are diagnosed with advanced disease, which results in only 15% surviving five years. About 70% of patients with lung cancer are diagnosed with advanced disease, a stage in which cure is problematic. This results in only 15% surviving five years. Although quit smoking is most effective in preventing lung cancer, about half of all lung cancers are currently diagnosed in former smokers, who remain at high risk for decades after quitting smoking. The National Lung Screening Trial (NLST; U.S.) reported a 20% lung cancer-related mortality reduction and a 6.7% reduction in all-cause mortality for CT screening compared with chest radiography screening for lung cancer in 53,454 enrolled subjects at high risk for lung cancer.1 As a consequence, the United States Preventive Services Task Force (USPSTF) requested an independent review and a modelling study. Based on these NLST data, an efficient strategy with a reasonable harm-benefit ratio could be established, resulting in the recommendation to annually screen persons aged 55-80 with ≥30 pack-years of smoking history, who currently smoke or quit smoking <15 years ago. However, data of only one trial provides limited evidence and more trial data are needed. NELSON is the second largest lung cancer screening trial that is adequately designed to provide the evidence that is needed to conclude whether CT screening can reduce lung cancer mortality. (more…)
Author Interviews, OBGYNE, Pediatrics / 04.02.2020

MedicalResearch.com Interview with: Andrea M. Tilstra Doctoral Candidate, Department of Sociology Population Program, Institute of Behavioral Science University of Colorado Boulder MedicalResearch.com: What is the background for this study? Response: Average U.S. birth weight declined across the 1990s and 2000s, and this has puzzled most researchers. We investigate this and find that the increases in cesarean deliveries and induction of labor between 1990 and 2013 resulted in a shift in the gestational age distribution of U.S. births. We find that births are less likely to occur at gestational weeks 40+ and much more likely to occur between weeks 37-39. Additionally, results from our simulations show that if U.S. rates of cesarean deliveries and labor induction had not increased over time, then average birth weight would have increased.   (more…)
Accidents & Violence, Author Interviews, Circadian Rhythm / 03.02.2020

MedicalResearch.com Interview with: Josef Fritz, Ph.D. PostDoctoral Fellow Circadian and Sleep Epidemiology Laboratory Department of Integrative Physiology University of Colorado Boulder MedicalResearch.com: What is the background for this study? Response: Daylight Saving Time (DST), the practice of setting clocks forward by an hour during the summer months and an hour back again during the winter months, is currently given a lot of attention, also because of world-wide discussions whether DST should be abolished, extended, or kept year-around. Since its introduction, mainly with the intention to reduce energy consumption, the spring DST transition has been associated with various adverse outcomes within the first few days after the transition, including an increased risk of myocardial infarctions, strokes, and workplace accidents. When we reviewed the evidence linking DST to traffic accident risk, however, results were not that clear-cut. We thus decided to take a closer look, based on one of the most extensive datasets so far, with 22 years of fatal traffic accident recordings across the US. We also aimed at decomposing the potential overall effect of Daylight Saving Time on traffic accident risk, given that both environmental illumination levels, and geographical factors such as position in time zone, may play a role in modulating fatal traffic accident risk associated with DST, but explicit and concurrent examination of these factors has so far been lacking. (more…)
Author Interviews, Cancer Research, Colon Cancer, Gastrointestinal Disease, JAMA / 03.02.2020

MedicalResearch.com Interview with: Jordan J. Karlitz, MD Staff Gastroenterologist Southeast Louisiana Veterans Health Care System Associate Professor, Division of Gastroenterology Director, GI Hereditary Cancer and Genetics Program, Tulane University School of Medicine MedicalResearch.com: What is the background for this study? Response: Currently, there is debate over whether average-risk colorectal cancer screening should begin at age 45 or 50. Given this controversy, we sought to conduct a colorectal cancer incidence rate analysis by yearly-age, as opposed to age range blocks (i.e. 30-39, 40-49 etc.) as has been done in the past. We believed that this type of "high definition" analysis would allow a better understanding of incidence rates of those approaching or at screening in age.  We were particularly interested in the transition from age 49 to 50 as this is when average risk screening has historically been recommended.  (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Pediatrics / 03.02.2020

MedicalResearch.com Interview with: Dr. Jonathan R. Skirko, MD , MHPA, MPH Assistant professor Division of Pediatric Otolaryngology University of Utah Health  MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a common problem that that impacts the lives of many people. Understanding treatment effectiveness is important and Health-State Utility is a standardized way of assessing quality of life.  Before this study, we didn't have a way of measuring quality of life in this population in this important way. You have to accurately measure something before you can improve it. (more…)
Author Interviews, Diabetes, Sugar / 01.02.2020

MedicalResearch.com Interview with: Marta Yanina Pepino, PhD Assistant Professor Department of Food Science and Human Nutrition Division of Nutritional Sciences College of Agricultural, Consumer and Environmental Sciences Administration University of Illinois at Urbana-Champaign Urbana, IL 61801 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a general belief that substituting sugars with low calorie sweeteners contributes to diet healthfulness. However, accumulating data suggest that consuming a diet high in low calorie sweeteners , mainly in diet sodas, is associated with the same health issues than consuming a diet high in added sugars, including an increased risk of developing type 2 diabetes.  The potential mechanism underlying such association are varied and still unclear. Our findings contribute to the growing evidence  that despite having very little or no calories, sweeteners can affect our metabolism (i.e.  the way we handle blood sugar) and that their effects may be different in people with obesity from those of normal weight. (more…)
Author Interviews, Heart Disease, Science / 31.01.2020

MedicalResearch.com Interview with: Steven R. Houser, PhD, FAHA Senior Associate Dean, Research Vera J. Goodfriend Endowed Chair, Cardiovascular Research Chair and Professor, Physiology Director, Cardiovascular Research Center (CVRC) Professor, Medicine Deborah M EatonDeborah M Eaton  Doctorate Student / Research Assistant Temple University   MedicalResearch.com: What is the background for this study? Response: Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately 50% of cases of HF and to date clinical trials with HFpEF patients have failed to produce positive outcomes. Part of this is likely due to the lack of HFpEF animal models for preclinical testing. Our lab addressed this gap in knowledge by developing an animal model that mimics critical features of the human HFpEF phenotype. We performed an in-depth cardiopulmonary characterization highlighting that the model has characteristics of human disease. We then tested the effects of a pan-HDAC inhibitor, vorinostat/SAHA, in collaboration with Dr. Timothy McKinsey, who is an expert in HDAC inhibitors and recently published work1 that laid the foundation for this study.  (more…)
Author Interviews, Hip Fractures, JAMA, Orthopedics / 31.01.2020

MedicalResearch.com Interview with: Alison M. Cogan, PhD, OTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Washington DC MedicalResearch.com: What is the background for this study? Response: Medicare is shifting from a volume- to value-based payment for postacute care services, in which value is determined by patient characteristics and functional outcomes. Matching therapy time and length of stay (LOS) to patient needs is critical to optimize functional outcomes and manage costs. The objective of this study was to investigate the association among therapy time, LOS, and functional outcomes for patients following hip fracture surgery. This retrospective cohort study analyzed data on patients from 4 inpatient rehabilitation facilities and 7 skilled nursing facilities in the eastern and midwestern United States. Participants were patients aged 65 years or older who received inpatient rehabilitation services for hip fracture and had Medicare fee-for-service as their primary payer. We categorized patients into nine recovery groups based on low, medium, and high therapy minutes per day and low, medium, or high rate of functional gain per day. We measured the groups for functional mobility independence and self-care capabilities at the time each patient was discharged. (more…)
Author Interviews / 30.01.2020

MedicalResearch.com Interview with: Harri Hemilä, MD, PhD Department of Public Health University of Helsinki, Finland MedicalResearch.com: What is the background for this study? Response: Eight previous randomized trials reported that zinc lozenges can shorten and alleviate the common cold, when zinc doses were over 80 mg/day. There are also several negative findings from other trials, but those can be explained by low doses of zinc and by substances in lozenges that bind zinc so that free zinc is not released to the oro-pharyneal region. For example, citric acid binds zinc ions very strongly and has been a component of some previous lozenges. In our trial, common cold patients were instructed to use 6 commercially available zinc lozenges, 78 mg/day of zinc, for 5 days as sson as feasible after the start of the common cold. (more…)
Author Interviews, Global Health, Infections / 30.01.2020

MedicalResearch.com Interview with: Bin Cao, MD, PhD Professor, China-Japan Friendship Hospital Department of Pulmonary and Critical Care Medicine Beijing 100029, China MedicalResearch.com: What is the background for this study? Response: In December, 2019, recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of the first 41 patients with laboratory-confirmed 2019-nCoV infection by Jan 2, 2020. (more…)
Author Interviews, Health Care Systems, JAMA / 30.01.2020

MedicalResearch.com Interview with: Coleman Drake, PhD Assistant Professor, Health Policy and Management Pitt Public Health Affiliate faculty member Medicaid Research Center and Center for Pharmaceutical Policy and Prescribing MedicalResearch.com: What is the background for this study? Response: The religious directives of Catholic hospitals prohibit the provision of many forms of contraception. To examine how Catholic hospitals restrict access to reproductive health services, we examined the market share of Catholic hospitals in every county in the continental US. We found that nearly 40% of women of reproductive-aged women live in counties with high or dominant Catholic hospital market share. We also examined whether the networks of Health Insurance Marketplace (i.e., Obamacare) plans direct their enrollees toward or away from Catholic hospitals, and thus reproductive health services.  (more…)
Abuse and Neglect, Author Interviews, JAMA, Pediatrics, Tobacco / 30.01.2020

MedicalResearch.com Interview with: Hongying (Daisy) Dai, PhD Associate Professor Department of Biostatistics | College of Public Health University of Nebraska Medical Center Omaha, NE MedicalResearch.com: What is the background for this study? Response: E-cigarette use increased dramatically from 11.7% to 27.5% for high school students and from 3.3% to 10.5% for middle school students during the periods of 2017 - 2019. In September 2018, the Food and Drug Administration (FDA) warned that youth e-cigarette use is reaching an epidemic proportion. Exposure to secondhand aerosol (SHA) from e-cigarettes is not harmless as e-cigarettes aerosol contains nicotine and potentially harmful substances, including carbonyl compounds, TSNAs, heavy metals, and glycols. This study analyzed the 2015-2018 National Youth Tobacco Survey (NYTS) and the main findings are:
  • The prevalence of secondhand aerosol exposure significantly increased from 25.6% in 2017 to 33.2% in 2018 (p<.001) after being stable during 2015 and 2017 (25.2% vs. 25.6%, p>0.05). The increase of SHA exposure from 2017 to 2018 was observed across socio-demographic groups.
  • Among never tobacco users in 2018 NYTS, students who reported secondhand aerosol exposure (vs. no) had higher odds of susceptibility to use e-cigarettes (38.8% vs. 21.0%) and cigarettes (30.7% vs. 21.2%) and higher odds of reporting exposure to e-cigarette marketing.
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Addiction, Author Interviews, Technology / 29.01.2020

MedicalResearch.com Interview with: John W. Ayers, PhD MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study? Response: Already half of US adults use smart device enabled intelligent virtual assistants, like Amazon Alexa. Moreover, many of the makers of intelligent virtual assistants are poised to roll out health care advice, including personalized wellness strategies. We take a step back and ask do intelligent virtual assistants provide actionable health support now? To do so we focus on a specific case study. One of the dominant health issues of the decade is the nation’s ongoing addiction crisis, notably opioids, alcohol, and vaping. As a result, it is an ideal case to begin exploring the ability of intelligent virtual assistants to provide actionable answers for obvious health questions. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 29.01.2020

MedicalResearch.com Interview with: Dr. Carol Chelimo PhD Research Fellow Dept. of Paediatrics, School of Medicine University of Auckland MedicalResearch.com: What is the background for this study? Response: New Zealand has the third highest prevalence of obesity among Organisation for Economic Co-operation and Development countries. Pediatric obesity is associated with development of cardiovascular risk factors in later life, such as type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome. Antibiotic exposures in early life may affect weight by altering the gut microbiota, potentially increasing the risk of childhood obesity. The overall aim of this research was to examine whether repeated antibiotic exposure by age 48 months is associated with higher body mass index (BMI) at age 54 months. Specifically, it evaluates whether the number, timing (age), and type of antibiotic exposures are associated with a higher body mass and an increased likelihood of overweight and obesity. This work incorporates antibiotic exposure during pregnancy (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, McGill, Neurology, Technology / 28.01.2020

MedicalResearch.com Interview with: Yasser Iturria-Medina PhD Assistant Professor, Department of Neurology and Neurosurgery Associate member of the Ludmer Centre for Neuroinformatics and Mental Health McConnell Brain Imaging Centre McGill University MedicalResearch.com: What is the background for this study? Response: As background, two main points:
  • Almost all molecular (gene expression) analyses performed in neurodegeneration are based on snapshots data, taking at one or a few time points covering the disease's large evolution. Because neurodegenerative diseases take decades to develop, until now we didn't have a dynamical characterization of these diseases. Our study tries to overcome such limitation, proposing a data-driven methodology to study long term dynamical changes associated to disease.
Also, we still lacked robust minimally invasive and low-cost biomarkers of individual neuropathological progression. Our method is able to offer both in-vivo and post-mortem disease staging highly predictive of neuropathological and clinical alterations. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout / 28.01.2020

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215 MedicalResearch.com: What is the background for this study? Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown.  (more…)
Author Interviews, OBGYNE, Opiods, Pain Research / 28.01.2020

MedicalResearch.com Interview with: Dave Stack Chief Executive Officer and Chairman Pacira BioSciences  MedicalResearch.com: What is the background for this study? Response: Cesarean sections (C-sections) are one of the most common surgeries in the United States, and research shows many women experience moderate to severe pain after this procedure. When postsurgical pain is inadequately managed for new mothers, it can interfere with recovery, maternal-infant bonding and may even lead to postpartum depression. Additionally, prescribing data reveals that postsurgical opioid consumption poses a great risk to women. We recently completed a Phase 4 study of EXPAREL in C-section patients, and results revealed adding EXPAREL to bupivacaine transversus abdominis plane (TAP) blocks for C-section delivery provided significant reductions in opioids and pain scores. Results of that study provided the basis for the design of this next-generation study, which was created to be completely opioid-free in the EXPAREL arm. The study was a Phase 4 multicenter, active-controlled study conducted in 18 clinical sites in the United States, with 169 enrolled patients undergoing elective C-section. The enrolled C-section patients were randomized to receive either 150 mcg morphine spinal anesthesia plus a standard of care postoperative pain regimen, 50 mcg morphine spinal anesthesia plus EXPAREL TAP field block, or opioid-free spinal anesthesia plus EXPAREL TAP block. Patients in the EXPAREL arms received a protocol-defined non-opioid postsurgical pain management regimen including ketorolac, acetaminophen, and ibuprofen.  (more…)
Author Interviews, Dartmouth, JAMA, Pharmaceutical Companies, Primary Care / 27.01.2020

MedicalResearch.com Interview with: Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Industry spends more on detailing visits and free samples than any other form of prescription drug marketing.  There is good evidence that these activities can lead to more use of expensive new drugs over equally effective cheaper options.  Given these concerns there have been efforts by some hospitalls and practices to restrict these forms of marketing. We asked physicians in group practices delivering primary care about how often pharmaceutical reps visit their practice and whether they have a free sample closet.  (more…)
Author Interviews, Education, Gender Differences, Neurology, UC Davis / 27.01.2020

MedicalResearch.com Interview with: Allison Brashear, M.D., M.B.A. Dean, UC Davis School of Medicine MedicalResearch.com: What is the background for this study? Why is the demand for neurology services and neurologists increasing?  Response: The American Academy of Neurology estimates that by 2025 the number of neurologists in practice will increase to 18,060 but some 3,400 more will be needed to meet the demand for their services. The 58% increase in the number of residency positions in the National Resident Matching Program since 2008 also reflects the growing demand. The higher prevalence of neurologic conditions, aging U.S. population and more patients having access to the health care coverage are the major driving forces. (Note: source of NRMP neurology trend data comes from a physician/resident forum posted May 2019 https://forums.studentdoctor.net/threads/growth-trends-in-neurology-residency-positions.1375918/) MedicalResearch.com: Why is neurology included among the less desirable fields of medicine (similar to nephrology, infectious disease, endocrinology etc.) for medical students and residents to pursue?  Why is burnout and dissatisfaction so high? Response: According to the American Academy of Neurology, a minority of medical students choose to train in neurology each year, with approximately 3.1% matching into a neurology residency in 2018. The newer generations of neurologists value lifestyle and time off work more than their predecessors. According to a recent American Medical Association survey, neurology tied with critical care as the medical specialty with the highest stress levels and burnout. Too many administrative tasks, too many hours at work, increased computerization of practice and insufficient compensation were among the top causes of burnout. (more…)
Author Interviews, Kidney Disease, Stem Cells / 27.01.2020

MedicalResearch.com Interview with: Dr. Orit Harari-Steinberg Dr. Dorit Omer Dr. Oren Pleniceanu Prof. Benjamin Dekel The Pediatric Stem Cell Research Institute Sheba Medical Center Tel Hashomer, Israel MedicalResearch.com: What is the background for this study? Response: The motivation behind this study is the rising epidemic of chronic kidney disease (CKD). With a prevalence in some reports of up to 17.3%  and very expensive treatments, especially in its advanced stages, CKD is more common than most people think, and it keeps growing at a very fast rate, due to the increasing number of patients suffering from diabetes and hypertension. At the same time, medicine doesn’t offer good solutions to these patients, with dialysis creating high morbidity and mortality. From the fact that 70,000 cells are shed in the urine each hour, we deduce that the kidney has the ability to form new cells to make up for this loss. In a previous work, we used a mouse model to show that cell clones form and proliferate in the adult kidney, so we know that cells of the adult kidney, or at least a portion thereof, have the ability to multiply in-vivo. It has been possible for quite a while to isolate proliferating cells from human kidneys and grow them in a dish. The problem, however, is that in order to achieve a large enough number of cells capable of regenerating the kidneys, massive expansion is needed ex-vivo, and that's the real obstacle. The reason is that following several passages, the cells lose their phenotype and become senescent, and therefore useless for regenerative purposes. In this study, we developed a unique 3D culturing method, growing the kidney cells in structures which we termed 'nephrospheres'. This culturing method rejuvenated the cells and allowed massive expansion for long periods of time. The positive effect on the cells was evident when we analyzed their transcriptome and found activation of molecular pathways associated with renal epithelial identity and renal tissue-forming capacity. What's even more striking, is that the same effect was seen when we used cells from the kidneys of CKD patients. We were then interested in determining whether these cells might also have a therapeutic effect. Indeed, when we injected these cells into mice with CKD (which was generated by resecting 5/6 of their kidneys), we saw a functional improvement in GFR. When we analyzed the treated kidneys, we found that the injected cell both formed renal tubule-like structures and integrated into existing host tubules, which resulted in a therapeutic effect. So, altogether, this study showed that our culturing method can serve as an effective means of establishing large numbers of autologous cells with regenerative capacity. (more…)
Author Interviews / 23.01.2020

MedicalResearch.com Interview with: Dr. Lindsay Sabik, Ph.D. Associate Professor Graduate School of Public Health Department of Health Policy and Management University of Pittsburgh  MedicalResearch.com: What is the background for this study? Response: In 2006, Massachusetts passed a health insurance reform law with the aim of providing health care access to nearly all of its residents. My colleagues and I pulled data from the Massachusetts Cancer Registry on all colorectal and breast cancer cases in people ages 50- to 64-years-old from 2001 through 2013. We selected those two cancers for our study because both are common, have routine screening guidelines and have high survival rates when caught early. The age range captured people covered by the recommended screening guidelines but not old enough to qualify for Medicare. We also pulled similar data from several other states for comparison. (more…)
Author Interviews, Education / 23.01.2020

MedicalResearch.com Interview with: Brian Piper PhD Department of Medical Education Geisinger Commonwealth School of Medicine Center for Pharmacy Innovation & Outcomes Geisinger Precision Health Center MedicalResearch.com: What is the background for this study? Response: Disclosure of funding sources is standard practice for journal articles and clinical practice guidelines in order to alert readers to potential conflicts of interest (CoI). However, CoI disclosure is uncommon for textbooks. A new edition of Goodman and Gilman’s Pharmacological Basis of Therapeutics (GG-PBT) was recently published. This is affectionately known as “the blue bible of pharmacology” because it is widely used in the training of doctors, pharmacists, dentists, scientists, and nurses. This provided an opportunity to extend upon past research2,3 and determine whether the authors and editors had undisclosed CoIs. (more…)