Author Interviews, Clots - Coagulation, NEJM / 12.08.2020
NEJM: Compression Therapy Prevention of Recurrent Cellulitis Without Antibiotics
MedicalResearch.com Interview with:
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Elizabeth Webb[/caption]
Elizabeth Webb, M.P.H
Physiotherapy Department
Calvary Public Hospital Bruce
Bruce, Australia
MedicalResearch.com: What is the background for this study?
Response: Our study showed that in patients with a history of leg swelling (chronic edema), compression therapy by a skilled lymphedema therapist reduced the risk of infection in the leg (cellulitis) by a huge 77%. With up to 47% of patients experiencing recurrence of cellulitis in their legs within 3 years, this result is a game-changer in terms of our approach to managing patients with leg swelling and recurrent cellulitis.
Until now, the use of prophylactic antibiotics to prevent cellulitis has been the only evidence-based practice. We know however, there are many reasons why avoidance of antibiotics is important within our community.
Elizabeth Webb[/caption]
Elizabeth Webb, M.P.H
Physiotherapy Department
Calvary Public Hospital Bruce
Bruce, Australia
MedicalResearch.com: What is the background for this study?
Response: Our study showed that in patients with a history of leg swelling (chronic edema), compression therapy by a skilled lymphedema therapist reduced the risk of infection in the leg (cellulitis) by a huge 77%. With up to 47% of patients experiencing recurrence of cellulitis in their legs within 3 years, this result is a game-changer in terms of our approach to managing patients with leg swelling and recurrent cellulitis.
Until now, the use of prophylactic antibiotics to prevent cellulitis has been the only evidence-based practice. We know however, there are many reasons why avoidance of antibiotics is important within our community.
Dr. Walline[/caption]
Jeffrey J. Walline, OD PhD
Associate Dean for Research
The Ohio State University
Columbus, OH 43210-1240
MedicalResearch.com: What is the background for this study?
Response: Greater amounts of nearsightedness are related to higher risks of sight-threatening complications in adulthood, so anything we can do to slow the progression of nearsightedness in childhood can have meaningful benefits in the future.
As the prevalence of nearsightedness increases worldwide and affects approximately 1/3 of the people in the United States, a treatment that provides clear vision AND slows the progression of nearsightedness can have a profound effect.
Dr. Amy Kennedy, M.D., M.S
Clinician-Researcher Fellow, General Internal Medicine
University of Pittsburgh
MedicalResearch.com: What is the background for this study?
Response: UPMC uses a nucleic acid polymerase chain reaction (PCR) test for SARS-CoV-2 and specimen collection is done with a nasopharyngeal swab by trained clinicians. The health system developed its COVID-19 test in early March 2020 in anticipation of the tremendous need for diagnostic capabilities.
My colleagues and I worked with the Wolff Center at UPMC — the health system’s quality care and improvement center — to review the results of more than 30,000 COVID-19 tests performed on adult patients who received care through one of UPMC’s 40 academic, community and specialty hospitals, or 700 doctors’ offices and outpatient sites in Pennsylvania, New York and Maryland. The tests were performed between March 3 and May 3, 2020. Of those tests, 485 were repeated at least once.
Dr. Schreiber[/caption]
Darren Schreiber JD PhD
Senior Lecturer
Exeter
MedicalResearch.com: What is the background for this study?
Response: My co-authors and I saw an opportunity to match existing functional brain imaging data with publicly available voter registration data so that we could look for patterns that distinguish brain activity in nonpartisans from partisans. While a number of studies have found differences in both brain structure and function between partisans on the left and right and there is a massive amount of scholarship in political science on partisans and polarization, no brain imaging work had focused on nonpartisans. Around 40% of Americans do not affiliate with a political party and one important campaign strategy has been to persuade these voters to support party candidates. However many political scientists are skeptical about voters claims to be nonpartisans and will instead treat them as if they were merely covert partisans.
Dr. Batres[/caption]
Carlota Batres, PhD
Assistant Professor of Psychology
Franklin & Marshall College
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many studies have examined how defendant characteristics influence jury decisions, but none have investigated the effect of makeup. We therefore examined how cosmetics influence jury decisions for young and middle-aged female defendants. We found that participants were more likely to assign guilty verdicts to middle-aged defendants than young defendants and when presented with makeup, male participants gave young defendants longer sentences and middle-aged defendants shorter sentences.
Dr. Gerstung[/caption]
Moritz Gerstung PhD
Group Leader: Computational cancer biology
EMBL-European Bioinformatics Institute
MedicalResearch.com: What is the background for this study?
Response: We have learned a lot in the last ten years about the molecular nature about various cancers thanks to the resources created by TCGA, ICGC and many other initiatives. Similarly, digital pathology has progressed hugely due to new AI algorithms. Yet it hasn’t been explored deeply how a cancer’s genetic makeup and its histopathological appearance are related. Here computers can be very helpful as they can process large amounts of digital microscopy slide images and test whether there are any recurrent histopathological patterns in relation to hundreds or thousands of genetic and other molecular abnormalities.
Dr. Heald-Sargent[/caption]
Taylor Heald-Sargent, M.D., Ph.D.
Ann & Robert H. Lurie Children’s Hospital
Chicago
MedicalResearch.com: What is the background for this study?
Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions. Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily.
Dr. Sinha[/caption]
Pranay Sinha, MD
Research Fellow
Section of Infectious Diseases
Boston University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: In the early days of the COVID-19 pandemic there were no evidence-based treatments for severely ill patients infected with this virus. We formed an interdisciplinary group of physicians from departments of adult and pediatric infectious diseases, rheumatology, and pulmonary/critical care as well as clinical pharmacy specialists. Given some promising data from China, we instituted treatment with off-label IL-6 receptor inhibitors (tocilizumab and sarilumab). The rationale was to mitigate the exuberant immune response observed in some patients infected with SARS-CoV-2 (also called cytokine storm or cytokine release syndrome).
Quite quickly, we started noticing that giving the drug to our sickest patients wasn’t eliciting dramatic improvement. We reasoned that by the time patients were severely ill and requiring ventilators, the damage to their lungs from the cytokine storm had already taken place. It was like closing the barn door after the horse had already bolted.
Dr. Hervé Perron[/caption]
Hervé Perron PhD
Chief Scientific Officer at GeNeuro
MedicalResearch.com: What is the background for this study?
Response: Human endogenous retroviruses (HERVs), remnants of ancestral viral genomic insertions, are known to represent 8% of the human genome and are associated with several pathologies. Certain proteins produced by HERVs have previously been found to be involved in pathogenic mechanisms linked to, e.g., multiple sclerosis (MS) or amyotrophic lateral sclerosis. However, despite previous results having shown an abnormal expression of HERV-W in patients with schizophrenia or bipolar disorder, the mechanisms involved in these psychiatric disorders are poorly understood.
Dr. Weisskopf[/caption]
Marc Weisskopf, PhD, ScD
Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology
Departments of Environmental Health and Epidemiology
Harvard T.H. Chan School of Public Health
Boston, MA 02115
MedicalResearch.com: What is the background for this study?
Response: There is a long history of health disparities by race. We were interested to see whether these also show up in professional football players, with the thought that perhaps the advantages that come with being an elite athlete in a sport (e.g. related to income, potential access to carte, prestige) might minimize health disparities.