Author Interviews, Cognitive Issues, Genetic Research, Heart Disease / 23.10.2018

MedicalResearch.com Interview with: "Pregnancy 1" by operalynn is licensed under CC BY 2.0Heather Boyd, Ph.D. Senior researcher Department of Epidemiology Research Copenhagen Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart. (more…)
Author Interviews, Pediatrics, Stanford, Surgical Research, Weight Research / 22.10.2018

MedicalResearch.com Interview with: Dr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford UniversityDr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford University MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2013 obesity became recognized as a disease.  The rate of pediatric obesity continues to rise.  Severe pediatric obesity is rising at a even faster rate than obesity in pediatrics.  Despite this Metabolic and Bariatric Surgery (MBS) remains underutilized in the treatment of severe pediatric obesity.  There is a significant amount of adult data and now pediatric data about effective treatments for severe obesity.  These support the use of MBS as a primary treatment for severe obesity in children. (BMI > 120% of 95th percentile with a comorbidity or BMI > 140% of 95th percentile). (more…)
Author Interviews, Obstructive Sleep Apnea / 22.10.2018

MedicalResearch.com Interview with: "Snoring away" by Doug Ford is licensed under CC BY 2.0Matthew P Butler, PhD Assistant Professor, Oregon Institute of Occupational Health Sciences Assistant Professor, Department of Behavioral Neuroscience Oregon Health & Science University Portland, OR 97239 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive sleep apnea (OSA) is associated with heart disease and mortality, but how OSA does this is not well understood. We are therefore looking for sub-phenotypes within OSA that will help us predict who is at greatest risk. Current diagnosis of OSA is made on the basis of the apnea-hypopnea index (AHI – the number of respiratory events per hour of sleep). But the AHI is not a very good predictor of future mortality. We tested the hypothesis that the duration of events (how long the breathing interruptions are) would predict risk. We found that those with the shortest breathing interruptions had the highest risk of dying, after accounting for other conditions like age, gender, race, and smoking status.  (more…)
Author Interviews, Lung Cancer / 21.10.2018

MedicalResearch.com Interview with: Prof. Yi-Long Wu, PI of CTONG1103 Tenured Professor of Guangdong Lung Cancer Institue, South China University of Technology (SCUT) Chair of Chinese Thoracic Oncolgy Group (CTONG) MedicalResearch.com: What is the background for this study? Response: Patients with stage IIIA-N2 non-small-cell lung cancer (NSCLC) are considerable heterogeneity with variable ipsilateral mediastinal lymph node involvement. Current treatment options for this group of NSCLC patients include surgery followed by adjuvant chemotherapy, neoadjuvant therapy followed by surgical resection or definitive chemoradiation. The optimal strategy is controversial and neoadjuvant chemotherapy only give patients more 5% 5-year survival. (more…)
Author Interviews, Biomarkers, Cancer Research, FASEB / 21.10.2018

MedicalResearch.com Interview with: Prof. Diana Anderson Established Chair in Biomedical Sciences The University of Bradford Richmond Road Bradford West Yorkshire MedicalResearch.com: What is the background for this study? Response: I have worked in this field for over 40 years both as a research scientist in industry and as a university-based researcher. It has always been my ambition to develop a relatively simple and affordable test to predict if a person is sensitive to cancer. In fact, in 1974, I was appointed as Head of Mutagenesis Studies at ICI’s Central Toxicology Laboratory in Manchester, UK, and I was looking at developing a short-term test to predict cancer even back then. Our ‘universal’ cancer test is different from other ‘universal’ tests being developed, because ours is not looking for a specific biomarker or mutation. Ours is a generic test for cancer in an individual, regardless of any underlying mechanism that’s causing their cancer. It is known that levels of damage to the DNA in the cellular genome can correlate with cancer and this is what we set out to investigate with the Comet assay. Of the available tests to detect damage to the genome the Comet assay is very straightforward. This assay was primarily developed as a method to measure DNA damage. Briefly, cells are embedded in agarose on a microscope slide and lysed to remove membranes leaving supercoiled DNA loops, breaks in which after alkaline treatment and alkaline electrophoresis move towards a positive charge. The DNA is stained with a fluorescent dye and visualised by fluorescent microscopy. The image is like Haley‘s comet and the greater number of breaks the greater is the migration to the anode and the greater the damage.  (more…)
Addiction, Author Interviews, Cost of Health Care, JAMA / 20.10.2018

MedicalResearch.com Interview with: Tyler Winkelman MD, MSc   Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trends in amphetamine use are mixed across data sources. We sought to identify trends in serious, problematic amphetamine use by analyzing a national sample of hospitalizations. Amphetamine-related hospitalizations increased over 270% between 2008 and 2015. By 2015, amphetamine-related hospitalizations were responsible for $2 billion in hospital costs. While opioid-related hospitalizations were more common, amphetamine-related hospitalizations increased to a much larger degree. After accounting for population growth, amphetamine hospitalizations grew 245% between 2008 and 2015, whereas opioid-related hospitalizations increased 46%. Amphetamine-related hospitalizations were more likely to be covered by Medicaid and be in the western United States compared with other hospitalizations. In-hospital mortality was 29% higher among amphetamine-related hospitalizations compared with other hospitalizations.  (more…)
Abbott, Author Interviews, Biomarkers, Heart Disease, JAMA / 20.10.2018

MedicalResearch.com Interview with: Dr John W Pickering, BSc(Hons), PhD, BA(Hons) Associate Professor , Senior Research Fellow in Acute Care Emergency Care Foundation, Canterbury Medical Research Foundation, Canterbury District Health Board |  Christchurch Hospital Research Associate Professor | Department of Medicine University of Otago Christchurch MedicalResearch.com: What is the background for this study? What are the main findings? Response: The assessment of patients with suspected myocardial infarction is one of the most common tasks in the emergency department. Most patients assessed (80 to 98% depending on the health system) are ultimate not diagnosed with an MI.   High-sensitivity troponin assays have been shown to have sufficient precision at low concentrations to allow very early rule-out of myocardial infarction. However, these are lab-based assays which typically result in a delay from blood sampling before the result is available and the physician is able to return to a patient to make a decision to release the patient or undertake further investigation. Point-of-care assays provide results much quicker, but have to-date not had the analytical characteristics that allow precise measurements at low concentrations. In this pilot study we demonstrated that a single measurement with a new point-of-care assay (TnI-Nx; Abbott Point of Care) which can measure low troponin concentrations, could safely be used to rule-out myocardial infarction a large proportion of patients (57%). The performance was at least comparable to the high-sensitivity troponin I assay, if not a little better (44%). (more…)
Author Interviews, Nutrition, OBGYNE, Pediatrics, Race/Ethnic Diversity / 19.10.2018

MedicalResearch.com Interview with: "Tortillas di una miscela di mais azzurro tostato" by fugzu is licensed under CC BY 2.0Vijaya Kancherla, PhD Research Assistant Professor, Department of Epidemiology Epidemiologist, Center for Spina Bifida Prevention Rollins School of Public Health Emory University Atlanta GA 30322 MedicalResearch.com: What is the background for this study?  Response: The scientific evidence since 1991 has shown that folic acid prevents from 35%-95% of neural tube birth defects that are caused due to low folic acid (also known as vitamin B9) in the mother’s diet prior to conception and during early pregnancy. Neural tube defects form in the embryo at 4th week of gestation when most women are unaware they are pregnant. Taking any amount of folic acid after the 4th week of pregnancy will not prevent neural tube defects. There is no cure for these birth defects. So, it matters for women to have enough folic acid prior to conception and in the first four weeks of pregnancy. If a woman is not taking prenatal vitamins that early, folic acid fortified foods come to rescue. Foods fortified with folic acid will prevent folate deficiency for everyone, and offer the benefit to mothers who were not planning their pregnancies or were not taking folic acid pills. If corn masa flour and tortillas were fortified with folic acid, that would help millions of reproductive aged women have healthy stores of folic acid in their bodies, to prepare them for their pregnancy, irrespective of their pregnancy plans. Prior to April 2016, folic acid (also known as vitamin B9) was not allowed to be added to corn masa flour (or products made from masa such as tortillas and tortilla chips) in the US. So, there was no expectation of having folic acid in these products. The March of Dimes, Spina Bifida Foundation, the American Academy of Pediatricians, Gruma Corporation and others filed a petition with the US FDA and succeeded in allowing millers to voluntarily add folic acid to corn masa flour and tortillas as a food additive. This regulation was implemented by the US FDA in April 2016.  (more…)
Author Interviews, CDC, Pediatrics, Vaccine Studies, Vanderbilt / 18.10.2018

MedicalResearch.com Interview with: "Vacuna influenza / Flu vaccine" by El Alvi is licensed under CC BY 2.0Kathryn M. Edwards, M.D. Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics Professor of Pediatrics Vanderbilt University School of Medicine Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States. MedicalResearch.com: What is the background for this study? What are the main findings? Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year.  This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age.  The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received.  The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted.  Overall 15, 333 children had their immunization records reviewed. When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered. First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage.  Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%). There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates.  In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine. (more…)
Alzheimer's - Dementia, Author Interviews, University of Pittsburgh / 18.10.2018

MedicalResearch.com Interview with: Rachel H. Mackey, PhD, MPH, FAHA Assistant Professor of Epidemiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: “Hardening,” or stiffening, of the arteries is a risk factor for heart attacks and other cardiovascular disease. Arterial stiffness can be measured by pulse wave velocity (PWV), because the pulse pressure wave travels faster in stiffer arteries. Stiffer arteries transmit increased pulsatile blood flow to the brain and are linked with markers of silent, or subclinical, brain disease, which are related to increased risk of dementia. However, it was not clear whether arterial stiffening would predict risk of dementia, especially in older adults, who often have existing subclinical brain disease. Therefore, a University of Pittsburgh team, led by Chendi Cui, M.S, doctoral student, and Rachel Mackey, PhD, MPH, FAHA, assistant professor of epidemiology at Pitt Public Health, analyzed the association between arterial stiffness and 15-year risk of dementia among 356 older adults, with an average age of 78. Study participants were part of the Cardiovascular Health Study Cognition Study (CHS‐CS), a long‐term study to identify dementia risk factors, led by coauthors Oscar Lopez MD and Lewis Kuller, MD, DrPH. In 1996-2000, study participants had had arterial stiffness measured by pulse wave velocity (PWV), brain imaging by MRI, and had annual follow-up visits for cognitive status. (more…)
Author Interviews, Brain Injury, Pediatrics, Pediatrics, University Texas / 18.10.2018

MedicalResearch.com Interview with: Dr. Linda Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children may have long-lasting psychological and physical symptoms after an injury. Post-concussive symptoms (PCS) are nonspecific cognitive, physical, and mood symptoms such as difficulty concentrating, headache, and irritability. These symptoms occur in approximately 15 to 30% children after mild traumatic brain injury (TBI). Although PCS often resolve within one month, some children experience symptoms for longer periods of time. (more…)
Author Interviews, Cognitive Issues, Geriatrics, JAMA, Surgical Research / 17.10.2018

MedicalResearch.com Interview with Mark Oldham, M.D. Assistant Professor of Psychiatry Medical Director, PRIME Medicine Proactive Integration of Mental Health Care in Medicine University of Rochester Medical Center MedicalResearch.com: What is the background for this study? Response: Patients who have undergone coronary artery bypass graft (CABG) surgery and, specifically, those who have been placed on cardiopulmonary bypass (CPB) have received attention for the potential effects of such procedures on brain health. Heart valve surgery patients have received far less attention, which often leaves clinicians to extrapolate the data from CABG cohorts to their patients preparing to undergo valve surgery. However, there are many reasons why this is far less than ideal, especially as the CABG literature increasingly points to person- and procedure-specific factors as the determinants of postoperative cognitive outcomes. (more…)
Author Interviews / 17.10.2018

MedicalResearch.com Interview with: "Herpes" by LEONARDO DASILVA is licensed under CC BY 2.0Prof Ruth Itzhaki PhD Emeritus Professor Division of Neuroscience & Experimental Psychology The University of Manchester MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Over 30 million people worldwide suffer from Alzheimer’s disease and unfortunately, this figure will rise as longevity increases, so the need for effective treatments is extremely urgent. Current treatments, at best, alleviate symptoms but do not prevent further deterioration. Our research has strongly implicated a common virus in the development of the disease, indicating a direct route to treatment: very effective and safe antiviral agents are available to combat the virus and thus to treat AD patients. They indicate also the future possibility of preventing the disease by vaccination against the virus in infancy. The virus implicated in Alzheimer's disease, herpes simplex virus type 1 (HSV1), is the one that causes cold sores. It infects most humans in infancy and thereafter remains lifelong in the body in latent (i.e., dormant) form within the peripheral nervous system (PNS - the part other than the brain and the spinal cord). Occasionally, if the person is stressed, the virus becomes activated and in some people it then causes cold sores.  (more…)
Abuse and Neglect / 17.10.2018

MedicalResearch.com Interview with: Patrick Weber  Doctorate Student / Research Assistant University of Regensburg Regensburg, GermanyPatrick Weber Doctorate Student / Research Assistant University of Regensburg Regensburg, Germany MedicalResearch.com: What is the background for this study? What are the main findings? 
  • More than 20 years ago, Gigerenzer and Hoffrage (1995) were able to show the advantages of so-called natural frequencies (e.g., 8 out 10 women) compared to probabilities expressed with percentages (e.g. 80% of the women) when it comes to solving Bayesian reasoning problems. Only last year, a meta-analysis (McDowell & Jacobs, 2017) revealed that while only 4% of all people are able to solve such a task in probability format, tasks that are presented in natural frequencies have solution rates of 24%. Even though this improvement is remarkable, still more than three quarters of participants fail with the intuitive natural frequencies. We wanted to know what exactly these people did wrong.In a first step, we checked the questionnaires from previous studies (e.g. Binder, Krauss, & Bruckmaier, 2015) and found out that many participants had translated given frequencies into probabilities. In a second step, we wanted to examine this systematically.
  • With our study, we were able to show that many people actually do not actively make use of the intuitive natural frequencies when presented with a task in frequency format. Instead, they rely on the more complex probabilities, with which they are more familiar from their mathematics education. As a consequence, the majority of these people who translate the intuitive frequencies into more complex probabilities cannot solve the task any more.
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Author Interviews, Geriatrics, JAMA, Pharmacology / 17.10.2018

MedicalResearch.com Interview with: Dr. Emily Reeve BPharm(Hons) PhD NHMRC-ARC Dementia Research Fellow Northern Clinical School University of Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older adults commonly take multiple medications. All medications carry the potential for both benefit and harm. When a medication is started a decision has been made between the healthcare professional and the patient that the likely benefits outweigh the potential risks. But over time the potential benefits and harms can change. So, part of good clinical care is discontinuation of medications when the benefit no longer outweighs the risks – for example when it is no longer needed or high risk. This is called “deprescribing”. Previously we knew that older adults could have mixed feelings about their medications, that is, they believe that all their medications are necessary but also feel that they are a burden to them. Qualitative research has explored this further, finding that there are a number of barriers and enablers to deprescribing from the patient perspective. For example, someone might have fear of deprescribing because they are worried that their symptoms may come back. But if they know that deprescribing is a trial and they will be monitored and supported by their physician or other healthcare professional they might be more open to deprescribing. From the physician perspective, there were concerns that older adults and their families were resistant to deprescribing and so there was fear that discussing possible medication discontinuation could damage the doctor-patient relationship. In this study of almost 2000 older adults in the United States, we found that over 90% were willing to stop one of more of their medications if their doctor said it was possible. Additionally, one third of participants wanted to reduce the number of medications that they were taking.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Emergency Care / 17.10.2018

MedicalResearch.com Interview with: Dr Anne Kristine Servais Iversen, Anne Kristine Servais Iversen Department of Obstetrics and Gynecology Rigshospitalet Copenhagen, Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systematic triage has been implemented worldwide with different triage scales in use all over the world. Prior to the introduction of formalised triage, patients were prioritised based on clinical assumption. After the introduction of formalised triage only a few studies have assessed agreement between formal and informal triage. Additionally, the majority of formalised triage scales are supported by limited and often insufficient evidence. This is troublesome since formalised triage forces clinicians to follow an algorithm rather than use their experience and clinical judgement. During my own residency at a Danish Emergency ward I was often contacted by the nurse performing formalised triage telling me that a patient she was assessing scored to be very acute (high triage level), but that she didn’t believe that to be the case. In order for her to prioritise the patient to a lower (less acute) triage level the patient had to be assessed by a doctor. Very often my colleagues and I would agree with the nurse in that the scoring was to high, and we therefore had to overrule the formalised triage decision. In cases like these you ask yourself whether or not we are using the most effective and best form of triage for initial patient sorting. Our study found that agreement between formalised triage and a quick clinical assessment in the form of Eyeball triage is poor. It also suggest that eyeball triage better predicts those at highest risk of death within 48-hours and 30 days after assessment. (more…)
Author Interviews, BMJ, Genetic Research, Pain Research, Pediatrics / 17.10.2018

MedicalResearch.com Interview with: "DNA model" by Caroline Davis2010 is licensed under CC BY 2.0Hakon Hakonarson, MD, PhD Corresponding Author Xiao Chang, PhD Lead Author The Center for Applied Genomics Children’s Hospital Philadelphia Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Migraine is a genetic disorder characterized by recurrent and intense headaches often accompanied by visual disturbances. Genome-wide association studies (GWASs) are a powerful hypothesis-free tool for investigating the genetic architecture of human disease. Currently, multiple GWASs have been conducted on European adults with migraine that have successfully identified several migraine susceptibility genes involved in neuronal and vascular functions. Considering the prevalence of migraines varies across ethnicities, the genetic risk factors may be different in patients of African ancestries and European ancestries. In addition, if migraine presents at an early age (childhood), it may reflect elevated biological predisposition from genetic factors or increased susceptibility to environmental risk factors. We performed the first GWAS to investigate the susceptibility genes associated with migraine in African-American children. The main out come was that common variants at the 5q33.1 locus in the human genome are associated with migraine risk in African-American children. The genetic underpinnings at this locus responsible for this finding are less relevant in patients of European ancestry.  (more…)
Author Interviews, Cannabis, Genetic Research, JAMA, Mental Health Research / 17.10.2018

MedicalResearch.com Interview with: Dr. Nicole Karcher, PhD Post-doctoral scholar with the NIMH Training in Clinical Sciences fellowship Department of Psychiatry Washington University School of Medicine   MedicalResearch.com: What is the background for this study? What are the main findings? Response: For over fifteen years, researchers have debated the role that cannabis use plays in the development of both psychotic disorders as well as subthreshold psychotic symptoms, such as psychotic-like experiences (PLEs). There is still a lack of consensus regarding the nature of the association between cannabis use and psychosis risk, with some research finding evidence for genetic overlap, while other research finds evidence for potentially causal pathways. The current study examined data from twins and siblings from two different samples, the U.S.-based Human Connectome Project and the Australian Twin Registry, with a total of 4,674 participants. Overall, psychotic-like experiences were associated with three separate cannabis use variables [frequent (≥100 times) use, a Cannabis Use Disorder diagnosis, and current cannabis use]. Furthermore, the current research found evidence for both shared genetic and individual-specific contributions to the association between PLEs and these three cannabis use variables. More specifically, while the association between cannabis use and psychotic-like experiences was largely attributable to shared genetic factors, cannabis users were more likely to endorse PLEs in comparison to the relative who used cannabis less.  (more…)
Author Interviews, Genetic Research, PLoS, Smoking, Tobacco Research / 17.10.2018

MedicalResearch.com Interview with: "Photo booth: The Smoking Man" by simpleinsomnia is licensed under CC BY 2.0Pradeep G. Bhide, Ph.D. Professor | Jim and Betty Ann Rodgers Eminent Scholar Chair of Developmental Neuroscience Director, Center for Brain Repair Department of Biomedical Sciences Florida State University College of Medicine Tallahassee, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Until now, much attention had been focused on the adverse effects of cigarette smoking by pregnant women on their children’s cognitive development. Some reports suggested that cigarette smoking during pregnancy can produce harmful effects in multiple generations of descendants (transgenerational effects). Not much had been known about the effects of paternal smoking, although more men smoke cigarettes than women. Our study shows that paternal nicotine exposure can be deleterious to the offspring in multiple generations. That is, cognitive function may be compromised in children and grandchildren of a nicotine-exposed male. Of course, our study was done in mice and not men.  However, since studies done in mice on maternal nicotine exposure produced results consistent with studies done in women and children, we believe that he findings from our present study likely can be extrapolated to humans.  (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, Lancet, Technology / 16.10.2018

MedicalResearch.com Interview with: Qure-ai.jpgSasank Chilamkurthy AI Scientist, Qure.ai MedicalResearch.com: What is the background for this study? Response: Head CT scan is one of the most commonly used imaging protocols besides chest x-ray. They are used for patients with symptoms suggesting stroke, rise in intracranial pressure or head trauma. These manifest in findings like intracranial haemorrhage, midline shift or fracture. Scans with these critical findings need to be read immediately. But radiologists evaluate the scans on first-come-first-serve basis or based on stat/routine markers set by clinicians. If the scans with critical findings are somehow pushed to the top of radiologists’ work list, it could substantially decrease time to diagnosis and therefore decrease mortality and morbidity associated with stroke/head trauma. (more…)
Author Interviews, Hand Washing, Infections, Pulmonary Disease, Respiratory / 16.10.2018

MedicalResearch.com Interview with: "still picking her nose" by quinn norton is licensed under CC BY 2.0Dr Victoria Connor  Clinical Research Fellow Liverpool School of Tropical Medicine and Royal Liverpool Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pneumococcus is a bacteria which is very common and causes lots of different infections (pneumococcal disease). Infections can be non-invasive or invasive. Non-invasive diseases include middle ear infections, sinusitis and bronchitis. Invasive infections including chest infection (pneumonia), infections of brain and spinal cord (meningitis) and blood infections (sepsis). Invasive pneumococcal infections is a major cause of death around the world and in the UK, is estimated that is responsible for 1.3 million deaths in children under 5 annually. Pneumococcal disease causes more deaths in low and middle income countries where approximately 90% of pneumonia deaths occur. Pneumococcus also is commonly carried (colonises) the nose/throat of children and adults. This colonisation is important to understand as it is the main source of the bacterial transmission and is also the first step in pneumococcal infections. The understanding of transmission of pneumococcus is currently poor. It is generally thought that transmission occurs through breathing in the respiratory sections of someone carrying pneumococcus in their nose which are infected with pneumococcus. However more recently studies especially in mice have shown that there may be a role of hands or other objects as vehicles for the transmission of pneumococcus. (more…)
Author Interviews, Dermatology, Environmental Risks / 15.10.2018

MedicalResearch.com Interview with: Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.   In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center. http://www.janetprystowskymd.com/ MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a 'safe tan'?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage?  Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight. "Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That's why you'll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, JAMA, Weight Research / 15.10.2018

MedicalResearch.com Interview with: Stuart Po-Hong Liu, MD, MPH Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50. However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence.  (more…)
Author Interviews, BMJ, Exercise - Fitness, Lifestyle & Health / 13.10.2018

MedicalResearch.com Interview with: Dr Fehmidah Munir CPsychol, AFBPsS Reader in Health Psychology Athena SWAN School Champion School of Sport, Exercise & Health Sciences National Centre for Sports and Exercise Medicine Loughborough University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Given the evidence of the harmful effects of high levels of sitting time on health and the high proportion of time the majority of adults spend in this behaviour, particularly in the workplace, methods to reduce overall and prolonged sitting were needed. Our SMArT Work (Stand More AT Work) programme was delivered to NHS office workers and involved brief education about the impact of sitting on health and benefits of reducing sitting, feedback on sitting behaviour, providing staff with a height-adjustable desk to enable them to work either standing up or sitting down, motivational posters and brief chats with a researcher to see how they were getting on. They received this programme over 12 months. We found that office workers in our study spent nearly 10 hours/day sitting down, which can be bad for health, but we’ve shown that those office workers who received our SMArT Work programme had lower sitting time by around 80mins per day after 12 months compared to those who didn’t receive our programme. Those who received SMArT Work also reported an increase in work engagement, job performance and quality of life and less musculoskeletal issues such as back and neck pain, they felt less tired after a day at work, had less feelings of anxiety and lower sickness presenteeism (working whilst sick). We didn’t find any differences in the number of days absent at work though. Whether you work remotely from home or in an office environment, it may also be good to invest in new Office Furniture. This could also help combat the issue of back and neck pains that you may be experiencing. (more…)