Author Interviews, Ophthalmology, Technology / 28.03.2018

MedicalResearch.com Interview with: Dr. Caroline A. Blackie, OD PhD FAAO Medical Director, Dry Eye Johnson & Johnson Vision MedicalResearch.com: What is the background for these studies? Would you briefly explain the problem of dry eye, how common it is and why it is difficult to treat?  Response: Dry eye disease is a condition where the eyelids and/or the tear film are unable to protect the ocular surface from the negative effects of desiccating stress. If left untreated, a vicious cycle ensues resulting in a broad spectrum of sequelae, including ocular discomfort and compromised vision. The result is partial or pervasive reduced quality of life for the individual along with a significant economic burden on our society. Conversely, when the ocular surface is healthy, patients feel better, see better and live better. Meibomian gland health is essential for ocular surface health. Meibomian glands secrete the oils necessary to protect the ocular surface from the negative effects of desiccating stress. Predictably, meibomian gland dysfunction (MGD) is a leading cause of dry eye disease. MGD is almost always the result of thickened and stagnated gland secretions. These stagnated secretions obstruct and/or limit the flow of functional oil into the tear film. MGD is the most common form of dry eye disease and is also known as evaporative dry eye. While management of dry eye in general can be complex, the management of MGD affords a relatively straightforward approach, which is to improve meibomian gland function by treating obstruction. Dry eye disease is pretty common – more than 340 million people suffer from it globally. Short-term management of dry eye involves improving signs and symptoms of the condition, including the use of tear supplementation and reducing ocular surface inflammation. Long-term dry eye management requires that the cause (or causes) of the condition is also diagnosed and treated. That cause is often MGD, and MGD can be successfully managed with LipiFlow®.  (more…)
Author Interviews, Compliance, Kidney Disease, Transplantation / 27.03.2018

MedicalResearch.com Interview with: Bethany J. Foster, MD MSCE Montreal Children’s Hospital Department of Pediatrics, Department of Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, QC, Canada MedicalResearch.com: What is the background for this study? Response: Adolescent and young adult kidney transplant recipients have the highest risk of graft loss of any age group. One of the main reasons for this is not taking their anti-rejection medications as prescribed. Our study had the goal of testing an intervention to try to improve young patients' adherence to their strict medication schedule. The intervention included feedback of how well they were taking their medications (which was monitored electronically), text message reminders for medication doses, and individualized coaching to address their personal barriers to taking their medications. (more…)
Author Interviews, Global Health, Weight Research / 27.03.2018

MedicalResearch.com Interview with:

Pepita Barlow, MSc, Department of Sociology University of Oxford, Manor Road Building, Manor Road, Oxford, United Kingdom 

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: The escalating global prevalence of overweight and obesity, or “globesity,” is often described as a pandemic. Globalization via free trade agreements (FTAs) with the US has been implicated in this pandemic because of its role in spreading high-calorie diets rich in salt, sugar, and fat through the reduction of trade barriers like tariffs in the food and beverage sector.  

We used a “natural experiment” design (that mimics a randomized controlled trial as closely as possible) and data from the United Nations Food and Agricultural Office to evaluate the impact of the 1989 Canada-US Free Trade Agreement on caloric availability in Canada (CUSFTA).  

We found that CUSFTA was associated with an increase in caloric availability and likely intake of approximately 170 kilocalories per person per day in Canada. Additional models showed that this rise in caloric intake can contribute to weight gain of between 1.8-9.3 kg for men and 2.0-12.2 kg for women aged 40, depending on their physical activity levels and the extent to which availability affects caloric intake.  (more…)

Alzheimer's - Dementia, Author Interviews, JAMA, Parkinson's / 27.03.2018

MedicalResearch.com Interview with: Benjamin Dawson, B.Sc. MD Candidate 2020 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dementia in Parkinson’s Disease is one of its most feared complications, and may happen eventually to most patients if they reached advanced age. Identifying those at especially high risk of dementia has important potential implications - it would facilitate clinical counselling, it has treatment implications (e.g. knowing a person is likely to get dementia in the near future would probably steer you away from certain medications and towards others).  Most critically, it can help select patients for trials to prevent dementia. While several factors that show high risk for dementia in Parkinson’s disease have previously been described, these have yet to shape patient-care, either because they are not very strong predictors, or they are not user-friendly.  So, we designed a very simple clinical screening tool, called the Montreal Parkinson’s Risk of Dementia Scale (MoPaRDS).  It took predictors of dementia that were established from large-scale studies and boiled them down into a simple 8-point scale that uses information that you can get in a simple office visit.  The 8 predictors were being over 70, being male, having a blood pressure drop with standing, showing early mild cognitive changes, having a symmetric bilateral disease (that is, one side not clearly worse than the other), experiencing falls or freezing, having experienced hallucinations, and having symptoms of REM sleep behavior disorder ('acting out' the dreams at night). When we tested the scale in a combined cohort of 607 patients with Parkinson’s (of whom 70 developed dementia over mean follow-up of 4.4-years) a positive MoPaRDS screen (≥4 out of 8 items) identified 14-fold increased risk of dementia compared to a negative screen. We recommend dividing the scale into three categories; low-, intermediate- and high-risk. Those in the highest score group (MoPaRDS, 6-8) had a 14.9% risk of developing dementia each year, while those with the lowest scores (MoPaRDS, 0-3) had only 0.6% annual risk.  So, these simple measures can be pretty powerful predictors of dementia. (more…)
Author Interviews, Education / 27.03.2018

MedicalResearch.com Interview with: “Classroom” by frankjuarez is licensed under CC BY 2.0Dr Anna Mazenod Institute of Education University of London UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this paper we report baseline findings from a large study of grouping practices in state-funded secondary schools in England. The study seeks to improve our understanding of how students are grouped for their English and mathematics classes, and the potential impact of different grouping practices on student outcomes and experiences of schooling. This paper draws on a survey of 597 teachers and 34 teacher interviews in schools where students are grouped by their attainment for the subject. It focuses on teacher perspectives on teaching and learning in the lower attainment groups. We found that students in the lower attainment groups were typically constructed as learners who benefit from specific approaches to learning justified through discourses of nurturing and protection. Most teachers felt that students in the lower attainment groups were not able to access learning independently from their teachers in comparison with their peers in the higher attainment groups. Some teachers for example described students in the lower attainment groups as ‘more dependent on people’ and students in the higher attainment groups as ‘independent learners.’ (more…)
Author Interviews, Breast Cancer, Chemotherapy, JAMA, Novartis / 26.03.2018

MedicalResearch.com Interview with: Melanie E. Royce, MD, PhD Division of Hematology/Oncology University of New Mexico Comprehensive Cancer Center Albuquerque MedicalResearch.com: What is the background for this study? What are the main findings? Response: BOLERO-4 is an open label, single-arm, Phase II study that evaluates the combination of everolimus plus letrozole as a first-line treatment for hormone receptor (HR)-positive/human epidermal growth factor receptor (HER2)-negative advanced breast cancer patients, as well as the use of everolimus plus exemestane beyond initial progression. Results of the BOLERO-4 trial published in JAMA Oncology showed that everolimus in combination with endocrine therapy is an effective first-line treatment option for postmenopausal women with HR+/HER2- advanced breast cancer. A total of 202 patients received everolimus in combination with letrozole as first-line treatment between March 7, 2013 and December 17, 2014. Median progression-free survival (PFS) in the first-line setting was 22.0 months (95% CI 18.1-25.1) with an overall response rate of 45% (95% CI 38.1-52.2) and clinical benefit rate of 74% (95% CI 67.7-80.1). A total of 152 (75%) discontinued treatment, primarily due to disease progression (51%) or adverse events (16%). Data from a smaller number of patients in BOLERO-4 also show limited efficacy with continued everolimus, combined with exemestane, following disease progression. Second-line treatment was ongoing in 16 (32%) patients, while 34 (68%) had discontinued. The most frequent reason for second-line treatment discontinuation was disease progression (56%). In the second-line setting, median PFS was 3.7 months (95% CI 1.9-7.4) with an overall response of 6% (95% CI 1.3-16.5) and clinical benefit rate of 28% (95% CI 16.2-42.5). Safety findings from BOLERO-4 are consistent with previous studies of Afinitor in advanced breast cancer. The most common (≥ 20% incidence) first-line all-grade adverse events were stomatitis (69%), weight loss (44%), nausea (37%) and anemia (35%). Most were ‘low grade’ in severity (grade 1 or 2) and generally well managed. Safety findings show the most common (≥ 10% incidence) second-line adverse events were stomatitis (20%) and weight loss (20%). Lower rates of stomatitis in second-line were noted.  (more…)
Author Interviews, Environmental Risks, Pediatrics, Toxin Research / 26.03.2018

MedicalResearch.com Interview with: Dr. Hernan F. Gomez MD Department of Emergency Medicine, Hurley Medical Center Flint, MI Department of Emergency Medicine, University of Michigan Ann Arbor, MI  MedicalResearch.com: Why did you decide to do this study? Response: Although the Flint water crisis drew recent, national attention to childhood lead exposure, environmental lead exposure has been a longtime, widespread problem in the United States. I have recollections of far higher blood lead levels in children during my training as a young pediatrician in an economically challenged city with roughly the same population as Flint. As a medical toxicologist I have not seen any children with lead levels requiring medical treatment in years. The last time a child required inpatient chelation treatment for elevated lead levels in Flint was during the 1980s. (more…)
Author Interviews, CDC, Infections, JAMA / 26.03.2018

MedicalResearch.com Interview with: Dr. Katherine Fleming-Dutra, MD, senior author Deputy Director Office of Antibiotic Stewardship CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: As noted in a previous study, antibiotics are prescribed more for sinus infections than any other illness in the United States. We found that almost 70% of antibiotic prescriptions were for 10 days or longer, whereas 5-7 days is recommended for most patients when antibiotics are needed. In addition, more than 20% of antibiotic prescriptions for sinus infections were for 5 days of azithromycin, even though guidelines recommend against prescribing azithromycin for sinus infections. (more…)
Author Interviews, CMAJ, Opiods / 26.03.2018

MedicalResearch.com Interview with: Andrea Schaffer PhD Research Fellow Centre for Big Data Research in Health UNSW Sydney NSW Australia  MedicalResearch.com: What is the background for this study? Response: Use and misuse of opioids has increased dramatically in Australia over the past 20 years. In 2014, Australia introduced tamper-resistant controlled-release (CR) oxycodone, which forms a viscous gel when crushed, and is designed to deter its injection or snorting. However, this formulation does not prevent dependence, and can still be misused orally. Tamper-resistant oxycodone CR was also introduced in the US (2010) and Canada (2012), resulting in reductions in oxycodone CR use. However, no large population-level studies have looked at switching behaviour in individuals using oxycodone CR, either in Australia or abroad. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, JAMA / 26.03.2018

MedicalResearch.com Interview with: Sang Min Park MD, MPH, PhD Chief, Department of Family Medicine, Seoul National University College of Medicine Director, Health Promotion Center, Seoul National University Hospital Professor, Department of Biomedical Science & Family Medicine Seoul National University College of Medicine Seoul, Korea What is the background for this study? What are the main findings? Response: Chronic hepatitis B patients have a higher risk of hepatocellular carcinoma than the general population, which has been well-established and known to be caused by progression of hepatitis B infection into severe liver diseases. However, whether obesity-related carcinogenesis plays a central role in the development of hepatocellular carcinoma in chronic hepatitis B patients remained unclear. Therefore, we assessed the association between body mass index and risk of hepatocellular carcinoma in chronic hepatitis B patients, and stratified all analyses by sex using healthcare big data in the Republic of Korea. We found positive association of trends between body mass index and risk of hepatocellular carcinoma in both men and women with hepatitis B infection. The magnitude of the association in women was stronger than that of men. In the severely obese category, the hazard ratio for hepatocellular carcinoma was significantly higher in women compared to men. Our findings highlight that high body mass index is associated with risk of hepatocellular carcinoma in chronic hepatitis B patients, especially in women, which may be partially explained by higher fat content for the same unit of body mass index in women compared to men. (more…)
Author Interviews, Global Health, JAMA, Pediatrics / 26.03.2018

MedicalResearch.com Interview with: Professor Jeffrey Braithwaite, PhD Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken. MedicalResearch.com: What is the background for this study?   Response: While seeking to improve health outcomes for patients, there has been substantial investment in developing clinical practice guidelines, to support the delivery of evidence-based healthcare. Prior to the CareTrack Kids study, little was known about the level of adherence to clinical practice guidelines for the care of Australian children. Our study examined care provided to children under 16 years of age treated for 17 important clinical conditions, such as asthma or fever, to assess adherence to these guidelines. We surveyed over 6500 medical records in four clinical settings (general practices; paediatricians offices; hospital emergency departments; and hospital inpatient wards) in South Australia, New South Wales and Queensland, and assessed visits during 2012 and 2013.  (more…)
Author Interviews, Hormone Therapy, Menopause / 25.03.2018

MedicalResearch.com Interview with: Jerilynn C. Prior, MD Professor in the Department of Medicine Division of Endocrinology and Metabolism University of British Columbia in Vancouver Dr. Prior has written the second edition of the award-winning book, Estrogen’s Storm Season—Stories of Perimenopause this year as an ebook on Google Play. MedicalResearch.com: What is the background for this study? Response: There is an urgent need for an effective therapy for perimenopausal hot flushes/flashes and night sweats (vasomotor symptoms, VMS). Although often considered “estrogen deficiency symptoms” VMS are common and very problematic for women in the menopause transition and who have not yet been one year without flow. About 23% of North American women are now in the perimenopausal age range. Surprisingly VMS are more common in perimenopause than in menopause; 9% of perimenopausal women have severe VMS as classified by the FDA, meaning more than 50 VMS per week of moderate to intense severity. The commonly used therapies for VMS in midlife women have not been proven more effective than placebo! That includes combined hormonal contraceptives (CHC) and menopausal-type hormone therapy (MHT) as well as the SSRI/SNRI anti-depressants and gabapentin.  (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease, NIH / 24.03.2018

MedicalResearch.com Interview with: Pedro F. Saint-Maurice, Ph.D. Postdoctoral Fellow Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute, NIH, HHS Rockville, MD 20850 MedicalResearch.com: What is the background for this study?  Response: The 2008 Physical Activity Guidelines for Americans recommends adults do 150 minutes/week of moderate intensity physical activity (PA) in increments of at least 10 minutes at a time. However, there is limited epidemiologic evidence supporting the use of the 10-minute increment and whether shorter increments (for instance walking up the stairs) can also be beneficial for health in adults. We looked at accelerometer-measured physical activity in roughly 5,000 adults (40 and older) representative of the US population and followed them prospectively (over 7 years) to determine whether physical activity accumulated in 10-minute increments, but also accumulated in shorter bursts, were associated with lower risk of death (mortality data came from the National Death Index). (more…)
AACR, Author Interviews, Cancer Research, Melanoma / 24.03.2018

MedicalResearch.com Interview with: Gao Zhang, Ph.D. Staff scientist in the Herlyn Lab The Wistar Institute MedicalResearch.com: What is the background for this study? Response: The past 7 years have witnessed the great success in treating patients with unresectable or metastatic melanoma. Despite the breakthrough of molecularly targeted therapies and immune checkpoint blockade therapies, a majority of patients have experienced the rapid tumor recurrence and progression, following the dramatic regression. There is an urgent and unmet need to treat therapy-resistant tumors. (more…)
Author Interviews, Lancet, Neurological Disorders, Neurology / 23.03.2018

MedicalResearch.com Interview with: David Birnkrant, MD Professor of Pediatrics, Case Western Reserve University School of Medicine Director of Pediatric Pulmonology & Student Education, MetroHealth Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study updates guidance on all aspects of the multi-disciplinary care of patients with Duchenne muscular dystrophy (DMD). The project was funded by the CDC’s National Center on Birth Defects and Developmental Disabilities and the results were recently published as three articles in The Lancet Neurology. The project was guided by a 25-member steering committee. Eleven expert committees worked over a period of three years to develop guidelines based on the RAND/UCLA appropriateness method, in which assessments and interventions were evaluated for appropriateness and necessity. The recommendations update those originally published in 2010. Duchenne muscular dystrophy is transmitted by X-linked recessive inheritance and thus affects primarily boys and men. Patients affected by DMD do not produce functional dystrophin protein, resulting in progressive weakness of skeletal, respiratory, and heart muscles, causing a shortened life span. Teens and young men may require surgery for curvature of the spine, a ventilator device to assist breathing, and a feeding tube to help ensure adequate nutrition. The approach of the various subspecialties involved in DMD management has evolved, with more anticipatory assessment and therapy, identifying and addressing predictable medical complications as early as possible for optimal patient outcomes. With this kind of multi-disciplinary care, people with DMD now live into their 30s and beyond. Along with the emergence of new genetic and molecular therapies, the recognition that people with DMD are living longer was one of the main motivations behind the need for these updated care considerations. Patients with DMD, their families and their advocacy organizations are driving a new emphasis on optimizing quality of life, not just prolongation of survival. Thus, there was a need to address issues related to transitions of care from childhood to adulthood, coordination of care across subspecialties, and other topics related to education, vocation, independence, personal relationships, emotional health, and intimacy. The updated care considerations thus include eleven topic areas, eight of which were part of the 2010 guidelines. These are: (1) diagnosis, (2) neuromuscular management, (3) rehabilitation management, (4) gastrointestinal and nutritional management, (5) respiratory management, (6) cardiac management, (7) orthopedic and surgical management, and (8) psychosocial management. Three topics are new: (9) primary care and emergency management, (10) endocrine management (including growth, puberty, adrenal insufficiency, and bone health), and (11) transitions of care across the lifespan. (more…)
Abuse and Neglect, Author Interviews, Neurology, Pharmaceutical Companies / 23.03.2018

MedicalResearch.com Interview with: Dr. Joseph Horrigan MD Pediatric neuropsychiatrist Chief medical officer   MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by myotonic dystrophy? What are the manifestations of this disease? Response: This was the first pharmaceutical intervention study conducted in adolescents and adults with congenital and juvenile onset DM1. Myotonic dystrophy type 1 (DM1) is a disorder that impacts multiple body systems following a trinucleotide expansion repeat of the DMPK gene on chromosome 19. Children with Congenital DM1 present at birth with respiratory insufficiency, talipes equinovarus (clubfoot), feeding difficulties and hypotonia. There is a risk mortality rate in the first year of life. As children grow, they are at risk for intellectual impairment, autistic features, gastrointestinal symptoms, motor delay and a variety of muscle-based symptoms. (more…)
Author Interviews, Opiods, Pharmaceutical Companies / 23.03.2018

MedicalResearch.com Interview with: Vishal Bala Senior Quantitative Data Analyst CareDash MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research into physicians and their relationships with the pharmaceutical industry has typically retained a narrow scope, focusing on how payments may be associated with prescription habits (sometimes limited to specific regions) for specific categories of drugs. For example, Modi et al. 2017 and Bandari et al. 2017 explored these connections in the context of some urologic drugs specifically. Research conducted by ProPublica in 2016 studied the connection between industry payments and physician prescriptions across some of the largest medical specialties, but was only able to look at “brand-name” vs. “generic” categories and were limited by overlapping timeframes for payments and prescriptions. CareDash took this analysis further by using Open Payments and Medicare Part D data to investigate the relationship between payments made by individual companies for specific drugs and the prescribing habits of the recipient physicians for those drugs. CareDash’s main findings are that healthcare providers who received payments for a drug from a pharmaceutical company are 5 times more likely to be high prescribers for that drug than those physicians who did not receive a payment. Physicians are 5.3 times more likely to prescribe a drug than their peers after they have received a payment for that drug from the manufacturer. When physicians already prescribe a drug significantly more often than their peers, they are 5.6 times more likely to later receive payment for that drug from the drug's manufacturer. Looking at the opioid drug class specifically, CareDash found that physicians receiving payment on behalf of an opioid were 14.5 times more likely to prescribe that opioid over alternatives. (more…)
Author Interviews, Cancer Research, Dermatology, Environmental Risks, JAMA, Melanoma / 23.03.2018

MedicalResearch.com Interview with: John W. Epling, Jr., M.D., M.S.Ed., Task Force Member Dr. Epling is is a professor of Family and Community Medicine at the Virginia Tech Carilion School of Medicine in Roanoke, VA. He is also the Medical Director of Research for Family and Community Medicine, Medical Director of Employee Health and Wellness for the Carilion Clinic, and maintains an active clinical primary care practice.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer is the most common type of cancer in the U.S., affecting millions of people every year. The Task Force looked at the latest research to see if clinicians can help people prevent skin cancer by providing counseling about ways to reduce risk, including using sunscreen, wearing protective clothing, and avoiding sunlight during peak hours. Based on our review of the evidence, we found that counseling younger patients with a fair skin type and their parents is effective at encouraging these sun protective behaviors. By helping reduce their patients’ exposure to harmful UV rays, clinicians can decrease their risk for skin cancer. As such, we recommend that clinicians provide counseling to people who are six months to 24 years old and have a fair skin type. For adults over 24 with a fair skin type, clinicians should consider the individual’s risks for skin cancer when deciding whether or not to provide counseling.  (more…)
Author Interviews, Genetic Research, Nature, OBGYNE, UCLA / 22.03.2018

MedicalResearch.com Interview with: Marlena Fejzo, PhD Aassociate researche David Geffen School of Medicine UCLA.  MedicalResearch.com: What is the background for this study? Response: Most women experience some nausea and vomiting of pregnancy, and the worst 2% are diagnosed with Hyperemesis Gravidarum which is associated with poor maternal and fetal outcomes. I had HG in 2 pregnancies. In my second pregnancy my HG was so severe that I could not move without vomiting and did not keep any food or water down for 10 weeks. I was put on a feeding tube, but ultimately lost the baby in the second trimester. I am a medical scientist by training so I looked into what was known about HG. At the time, very little was known, so I decided to study it. I partnered with the Hyperemesis Education and Research Foundation (HER) and we did a survey on family history of .Hyperemesis Gravidarum that provided evidence to support a role for genes. I collected saliva samples from HG patients and their unaffected acquaintances to do a DNA study. Then I partnered with the personal genetics company, 23andMe to do a genome scan and validation study, which identified 2 genes, GDF15 and IGFBP7, linked to HG. (more…)
Author Interviews, Thyroid Disease / 22.03.2018

MedicalResearch.com Interview with: Begoña Ruiz Núñez PhD (c) Laboratory Medicine UMC Groningen Co-directora de Healthy Institute President of the Asociación Española de Psico-Neuro-Inmunologí MedicalResearch.com: What is the background for this study? Response: The diagnosis of Chronic Fatigue Syndrome (​CFS)​ is based on the Fukuda criteria, i.e. symptoms, disability, and exclusion of explanatory illnesses, and not by means of physical signs or abnormalities in laboratory test results​. CFS has been described as a ´allostatic overload condition´, where the physiological mechanisms employed to deal with stress contribute to the perpetuation of the disorder. Chronic Fatigue Syndrome patients are 1.9 times more likely to have a high allostatic load index than healthy controls. Thyroid allostasis-adaptive responses, presenting as ​non-thyroidal-illness syndrome, have been found in many conditions, ranging from critical illness, uremia and starvation to tumor​s​. Taken together, it is possible that, despite TSH and T4 levels within reference ranges, Chronic Fatigue Syndrome symptoms may be attributable in part to allostatic responses, i.e. lower thyroid hormone activity, secondary to chronic (low-grade) inflammation caused by e.g. a compromised gut microbiome and gut wall integrity. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Science, Weight Research / 22.03.2018

MedicalResearch.com Interview with: Dai Fukumura, M.D., Ph.D Associate Professor, Radiation Oncology Harvard Medical School Deputy Director, Edwin L. Steele Laboratory, Radiation Oncology, Massachusetts General Hospital Boston, MA      Dr. Joao Incio PhD Post-Doc, Edwin L. Steele Laboratory           Dr. Rakesh K. Jain PhD Andrew Werk Cook Professor of Tumor Biology and director of the Edwin L. Steele Laboratories for Tumor Biology Rradiation oncology department Massachusetts General Hospital and Harvard Medical School.   MedicalResearch.com: What is the background for this study?   Response: Based on promising data from preclinical studies and subsequent increase in progression-free survival in patients, anti-vascular endothelial growth factor (VEGF) therapy received accelerated approval for metastatic breast cancer. However, this approval was withdrawn in the United States based on the lack of overall survival benefit in several subsequent phase III studies in metastatic and adjuvant settings. Potential mechanisms of resistance to anti-VEGF therapy include the upregulation of alternative angiogenic and pro-inflammatory factors. Production of some of these factors has been shown to increase in obesity specifically in hypoxic adipose tissues including the breast. Given that up to 70% of breast cancer (BC) patients in the United States are overweight or obese, we addressed one simple but important question in this study: Is obesity contributing to anti-VEGF treatment resistance in breast cancer? (more…)
Author Interviews, Diabetes, Gastrointestinal Disease, Pharmacology / 22.03.2018

MedicalResearch.com Interview with: Devin Abrahami, graduate student Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal Department of Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal, QC, Canada MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The goal of our study was to assess whether a class of antidiabetic drugs, the dipeptidyl peptidase-4 (DPP-4) inhibitors, is associated with the risk of inflammatory bowel disease (IBD). While these drugs control blood sugar levels in patients with type 2 diabetes, there is some evidence that they may also be involved in immune function, and possibly in conditions such as IBD. In our study, we found that the use of DPP-4 inhibitors was associated with a 75% increased risk of IBD, with the highest risk observed after three to four years of use. (more…)
Author Interviews, BMJ, Pain Research, Rheumatology / 22.03.2018

MedicalResearch.com Interview with: “tai chi 11.4.09” by Luigi Scorcia is licensed under CC BY 2.0Chenchen Wang MD, MSc Professor of Medicine Tufts University School of Medicine Director, Center For Complementary And Integrative Medicine Division of Rheumatology Tufts Medical Center Boston, MA 02111  MedicalResearch.com: What is the background for this study? Response: Patients with chronic widespread pain often try many different types of pain medications, anti-depressants, physical therapy, and other approaches, and commonly find that none of these therapies work for them. Finding safe, effective approaches for pain management is an urgent priority. Previous evidence suggested that Tai Chi, a multi-dimensional mind-body practice that integrates physical, psychosocial, and behavioral elements, may be especially suited to address both chronic pain and associated psychological and somatic symptoms. In our most recent study published in the BMJ, we directly compared the effectiveness of Tai Chi versus aerobic exercise, which is a standard care non-drug treatment for fibromyalgia. (more…)
Author Interviews, Dermatology / 21.03.2018

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: Would you describe what dandruff looks like on most people?  Dr. Prystowsky: Normal dandruff looks like tiny white flakes or dust in your hair. These flakes are a buildup of dead skin cells mixed with skin oils. MedicalResearch.com: Is dandruff the same as seborrheic dermatitis? How does it differ from psoriasis or eczema? Do scientists understand what causes dandruff? Is it caused by stress, diet or fatigue?  Dr. Prystowsky: Normal dandruff is caused by the accumulation of dead skin cells and skin oils (sebum) that are a part of normal scalp function. Sebum is produced in hair follicle oil glands, and skin cells slough from the scalp surface just as they do from the rest of your body. It is a part of normal skin cell turnover. However, you may also get excessive dandruff if you have scalp skin diseases such as psoriasis, eczema, and seborrheic dermatitis.  Skin infections with fungus (tinea capitus), head lice, or Staph. Aureus may also trigger excessive flaking.  (more…)
Abuse and Neglect, Accidents & Violence, Brigham & Women's - Harvard, Pediatrics, PLoS / 21.03.2018

MedicalResearch.com Interview with: Neha Bairoliya, Ph.D. Harvard Center for Population and Development Studies Cambridge, MA 02138 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. We show that infants born full-term in the US face 50%-200% higher risks of infant mortality compared to leading European countries. The two main drivers of these high relative risks are increased risk of mortality due to congenital malformations, which patients cannot really do much about other than ensuring adequate screening during pregnancy, and high risk of sudden unexpected deaths in infancy, which should largely be preventable through appropriate sleeping arrangements. While we do not have data on actual sleeping arrangements from our study, other data sources suggest that a substantial number of babies continue to sleep on their tummy; we also found a shockingly large number of babies dying from suffocation, which suggests that parents either use covers that are not safe, or let children sleep in their own beds. (more…)
Author Interviews, Bone Density, Heart Disease / 21.03.2018

MedicalResearch.com Interview with: Dr. Joshua Lewis, PhD National Health and Medical Research Council Career Development Fellow, Edith Cowan University, School of Medical and Health Sciences / Centre for Kidney Research Children’s Hospital Westmead Honorary Senior Research Fellow, Sydney Medical School, School of Public Health University of Sydney  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Bone scans from bone density machines are widely used to predict future fracture risk. These scans can also be used to detect the presence and severity of abdominal aortic calcification (AAC), which is a marker of advanced atherosclerosis. We examined bone scans of over one thousand Australian women that were taken in the late 1990s using a method developed many years ago by one of the authors Dr. Kiel from the Institute for Aging Research at Hebrew SeniorLife and Harvard Medical School, and validated on scans from bone density machines by the joint first author Dr. Schousboe from the University of Minnesota. More than 2/3rd of these women had detectable AAC and women with more advanced calcification had increased likelihood of long-term cardiovascular hospitalizations and deaths as well as deaths from any cause. These finding remained significant even after adjusting for conventional cardiovascular risk factors. (more…)
Author Interviews, Cancer Research, MRI, Prostate Cancer / 21.03.2018

MedicalResearch.com Interview with: Veeru Kasivisvanathan MBBS BSc MRCS MSc PGCert Lead for CPD, Division of Surgery and Interventional Science, UCL Academic Section Committee, British Association of Urological Surgeons Twitter: @veerukasi PRECISION Study Coordinator https://clinicaltrials.gov/ct2/show/NCT02380027   MedicalResearch.com: What is the background for this study? What are the main findings? 
  • We knew that there were limitations in the standard of care pathway for the diagnosis of prostate cancer, TRUS biopsy which missed harmful cancers and over diagnosed harmless cancers.
  • Emerging reports in the literature showed that using an alternative diagnostic pathway, MRI and MRI-targeted biopsy, showed promising prostate cancer detection rates
  • In 2012 we set out in an international working group to design a study that could change clinical practice and replace the standard of care with a pathway involving MRI 
(more…)
AHA Journals, Author Interviews, Hospital Readmissions, JAMA / 21.03.2018

MedicalResearch.com Interview with: Dr. Sahil Agrawal, MBBS MD Division of Cardiology, St. Luke’s University Health Network, Bethlehem, PA Dr Lohit Garg MD Division of Cardiology Lehigh Valley Health Network, Allentown  MedicalResearch.com: What is the background for this study? Response: Readmissions among advanced heart failure patients are common and contribute significantly to heath care related costs. Rates and causes of readmissions, and their associated costs among patients after durable left ventricular assist device (LVAD) implantation have not been studied in a contemporary multi-institutional setting. We studied the incidence, predictors, causes, and costs of 30-day readmissions after LVAD implantation using Nationwide Readmissions Database (NRD) in our recently published study. (more…)
Author Interviews, PLoS, Weight Research / 21.03.2018

MedicalResearch.com Interview with: Robin Dando, PhD Assistant Professor Director, Cornell Sensory Evaluation Facility Department of Food Science Cornell University Ithaca, NY 14853 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: For many years, people have been interested in if gaining weight can change how we perceive foods, thus maybe encouraging less healthy food choices.  There is some evidence in previous work that if we become obese, we seem to perceive things as tasting less intense.  Now if this were the case, to make up for this we might eat more of whatever food it was we were eating, or conversely we might choose something that tasted more intense, to make up this difference.  More intense usually means higher calories, so if we took either of these approaches, we’re at risk for weight gain. In our study, we examined the taste buds of mice who were fed an unhealthy diet that induces obesity, versus sibling mice fed a more healthy diet that keeps them lean.  The mice gaining weight ended up after only 8 weeks with a lot fewer taste buds than the lean mice.  This loss of taste buds represents one explanation for foods tasting less intense to the obese. (more…)