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Author Interviews, CDC, JAMA, Pediatrics / 15.05.2018

MedicalResearch.com Interview with: Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive. For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package. (more…)
Author Interviews, Infections / 15.05.2018

MedicalResearch.com Interview with: Dr. Tom Lodise PharmD, Professor Albany College of Health Sciences, NY  MedicalResearch.com: What is the background for this study? Response: P. aeruginosa (PSA) is intrinsically resistant to many commercially available antibiotics and also has a remarkable capacity to develop resistance to commonly used antibiotics like carbapenems, aminoglycosides, and fluoroquinolones. The terms ‘multidrug resistant’ (MDR) and ‘pan-drug resistant’ are often used to characterize the different patterns of multiple drug resistance exhibited by PSA. Patients with MDR-PSA infections are at an increased risk for delayed receipt of appropriate antimicrobial therapy and ample studies indicated that receipt of delayed appropriate therapy results in substantial increases in morbidity, mortality, and healthcare resource utilization. Although risk factors for these types of infections have previously been identified in the literature, this study takes identification of risk factors further, and develops two clinical risk scores to estimate the probabilities of carbapenem and extensively beta-lactam non-susceptibility among hospitalized, adult patients with PSA infections based on covariates available on clinical presentation. We focused on these two PSA non-susceptible phenotypes as they represent infections at high risk of delayed appropriate therapy due to resistance against the current commonly prescribed empiric anti-pseudomonal antibiotics. (more…)
Author Interviews, Cancer Research, JAMA, Yale / 15.05.2018

MedicalResearch.com Interview with: Jeremy O'Connor, MD Section of General Internal Medicine Department of Internal Medicine Postdoctoral Fellow, National Clinician Scholars Program Yale University MedicalResearch.com: What is the background for this study?   Response: There has been a lot of enthusiasm for the use of novel therapies in cancer care, and in particular for novel anticancer agents known as immune checkpoint inhibitors. But very little is known about how quickly providers have adopted immune checkpoint inhibitors into clinical practice. Existing studies suggest, in fact, that the process of clinical adoption is slow, with conventional wisdom holding that it takes an average of 17 years for new evidence to change practice. Our study evaluated whether the adoption of novel therapies might be much faster in certain contexts with the early use of immune checkpoint inhibitors as a notable example. (more…)
Author Interviews, Kidney Stones, Microbiome, Urology / 15.05.2018

MedicalResearch.com Interview with: Gregory Tasian MD, MSc, MSCE Assistant Professor of Urology and Epidemiology University of Pennsylvania Perelman School of Medicine Division of Urology and Center for Pediatric Clinical Effectiveness The Children’s Hospital of Philadelphia MedicalResearch.com: What is the background for this study? What are the main findings? Response:  We found that five classes of commonly prescribed antibiotics were associated with an increased risk of kidney stones. These classes were sulfa drugs (e.g. Bactrim), fluoroquinolones (e.g. Cipro), cephalosporins (e.g. cephalexin), nitrofurantoin, and broad-spectrum penicillins (e.g. augmentin).  For those five classes of antibiotics, the greatest risk was found among younger patients. However, the increased risk was still significant across all ages, including for older adults with the exception of broad-spectrum penicillins, which were not associated with an increased risk of kidney stones among patients >75 years of age. We conducted this study because: 1) Prior investigations have demonstrated that changes in the gut microbiome were associated with kidney stones, 2) Antibiotics are prescribed frequently, and 3) The number of people affected by kidney stone disease has increased 70% over the last 30 years and the greatest increases have been found among children and adolescents. Our results were consistent with these previous studies, so we were not surprised with the findings although we did not know which specific classes of antibiotics would be associated with an increased risk of stones and which ones would not. (more…)
Author Interviews, Global Health, JAMA, Pulmonary Disease, Technology / 15.05.2018

MedicalResearch.com Interview with: Michael Hawkes MD PhD Adjunct Professor Assistant Professor Pediatrics, Faculty of Medicine School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? What are the main findings?
  • Pneumonia is the leading cause of mortality in children globally.
  • Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
  • Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
  • We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
  • Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.
(more…)
Alzheimer's - Dementia, Author Interviews, Personalized Medicine, University of Pennsylvania / 15.05.2018

MedicalResearch.com Interview with: David A. Wolk, MD Associate Professor Department of Neurology Co-Director, Penn Memory Center Associate Director, Alzheimer’s Disease Core Center University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mild Cognitive Impairment (MCI) is a state when individuals have mild memory problems, but not enough to impact day-to-day function.  Many patients with MCI are on the trajectory to developing Alzheimer’s Disease dementia, but about half will not and remain stable.  As such, patients with MCI are often uncertain about the likelihood they should expect to decline in the future which obviously may be associated with considerable anxiety and this may delay opportunities for them to plan for the future or begin therapeutic interventions. This study examined the degree to which amyloid PET, which detects the amyloid pathology of Alzheimer’s Disease, a measure of shrinkage of the hippocampus with MRI, and cognitive measures predicted development of dementia over 3 years.  We found that each of these measures enhances prediction of whether an individual will or will not develop dementia in the future.  If all of these measures are positive, one has a very high risk of progression whereas if amyloid PET and the MRI measurement are normal, there is very little risk of progression. (more…)
Addiction, Author Interviews, JAMA, Opiods, Pharmaceutical Companies / 14.05.2018

MedicalResearch.com Interview with: “Big Lunch Extras Reading” by Big Lunch Extras is licensed under CC BY 2.0Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Boston Medical Center Director of Urban Health & Advocacy Track | Boston Combined Residency Program Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids. In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing. We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Pediatrics / 14.05.2018

MedicalResearch.com Interview with: “Crime Scene _MG_4847” by thierry ehrmann is licensed under CC BY 2.0Daniel Romer, PhD Research Director Annenberg Public Policy Center and Director of its Adolescent Communication Institute (ACI) University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been studying the steady increase in gun violence that has been occurring in popular PG-13 movies since the new rating was adopted in 1984.  It has recently even surpassed the amount of gun violence in R-rated movies.  Since these movies are open to the public at any age, we are concerned that they promote the use of guns and potentially socialize youth to believe that using guns to defend oneself is an appropriate way to handle threats and other conflicts. We knew that the rating requires the omission of graphic consequences, such as blood and suffering, that can make the violence more acceptable.  But we also wondered whether the motivation for the violence might make a difference as well.  Many of the characters in PG-13 movies are seen as heroic (e.g., Bruce Willis and Liam Neeson).  Could that also be a factor that makes such films more acceptable to parents despite their concerns about their children seeing so much violence in the movies.  So, we conducted this experiment to see if parents are less upset by justified violence in PG-13 style movies.  (more…)
Author Interviews, Hip Fractures, Orthopedics, Osteoporosis / 14.05.2018

MedicalResearch.com Interview with: “Just a hairline fracture...” by Gloria Bell is licensed under CC BY 2.0Brittany Bindon, MD Department of Internal Medicine University of Chicago Chicago, Illinois MedicalResearch.com: What is the background for this study? Response: Bisphosphonates are commonly used in the treatment of osteoporosis, however, they have been associated with rare, severe side effects such as osteonecrosis of the jaw and atypical femoral fractures. As a result, bisphosphonate drug holidays have become common in clinical practice though currently, there are minimal data on the safe duration of these drug holidays. We sought to further characterize the clinical and laboratory parameters associated with increased fracture risk in patients on bisphosphonate drug holiday. (more…)
Author Interviews, Depression, Endocrinology, JAMA, Mental Health Research, Thyroid Disease / 14.05.2018

MedicalResearch.com Interview with: Thyroid gland Wikipedia imageTeja Grömer PD Dr. med. Habil Facharzt für Psychiatrie und Psychotherapie Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie Bamberg  MedicalResearch.com: What is the background for this study? 1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT) 2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness. 3) I thus decided to do a systematic review and meta-analysis.  (more…)
Author Interviews, BMJ, Cancer Research, Gender Differences / 14.05.2018

MedicalResearch.com Interview with: “Faecal Coliforms analysis” by SuSanA Secretariat is licensed under CC BY 2.0Dr. Mahiben Maruthappu Public Health Registrar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender disparities in the fields of science and technology have been documented, and  it becomes increasingly apparent at higher levels of seniority. In this analysis, we found a quantifiable difference in cancer research funding awarded to female principle investigators compared to male principle investigators (PIs). Across all cancer research funding grants that we identified, male PIs received 3.6 times the total investment value, and 1.6 times the average award value compared with their female counterparts.  (more…)
Author Interviews, Depression, Exercise - Fitness / 13.05.2018

MedicalResearch.com Interview with: “gym” by FooJFoo is licensed under CC BY-NC-ND 3.0Mr. Brett R. Gordon, M.Sc. Postgraduate researcher Physical Education and Sport Sciences Department University of Limerick, Ireland.  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Depression is prevalent, burdensome, and often comorbid mood disorder that is associated with other poor health outcomes. Exercise training interventions have demonstrated comparable efficacy for depressive symptoms to frontline treatments, such as antidepressant medications and behavioral therapies. However, the evidence to date has primarily focused on findings from studies of aerobic exercise training like jogging, running, and cycling. Our work is the first quantitative summary of the effects of resistance exercise training (RET), or weight lifting and strength training, on depressive symptoms, and the influence of variables like participant characteristics, features of the RET, and the methods that were used in studies on the antidepressant effects of RET. The main finding was that resistance exercise training significantly reduced depressive symptoms among adults regardless of their health status, the total prescribed volume of RET (e.g., how much the participants were supposed to exercise), or whether or not strength was significantly improved by the RET intervention.  (more…)
Author Interviews, Lifestyle & Health, Social Issues / 12.05.2018

MedicalResearch.com Interview with: “Sara Singing for the IT MS Society” by Draft is licensed under PDM 3.0Filippos Filippidis MD, MSc, MPH, PhD Lecturer in Public Health School of Public Health Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research suggests that big sports and international events are associated with happiness, productivity, suicides and homicides. Considering the popularity of the Eurovision Song Contest (ESC) in Europe, we wanted to see if there is any association between performance in the competition and life satisfaction and suicides. We used interview data from more than 160,000 people in Europe collected from 2009 to 2015 and found that better performance in the contest was associated with higher levels of life satisfaction in the country. Winning the competition did not confer any additional advantage. When comparing bad performance in the ESC with no participation at all, we found that even bad performance was associated with higher satisfaction with life compared to absence from the competition. (more…)
Author Interviews, Genetic Research, JAMA, UCSF / 12.05.2018

MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Health Research and Policy Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Changes in genetic sequencing technology and regulation have allowed much cheaper testing of many more genes in recent years. We investigated how these changes have affected hereditary cancer risk evaluation in women newly diagnosed with breast cancer. The main findings are that more comprehensive multiple-gene sequencing tests have rapidly replaced more limited tests of two genes (BRCA1 and BRCA2) only. This has helped patients by doubling the chance of finding an important gene mutation that can change their treatment options. However, there are important gaps in how this new, more comprehensive sequencing is used: more testing delays and more uncertain results, particularly among racial/ethnic minority women.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Depression, Pediatrics / 11.05.2018

MedicalResearch.com Interview with: Karen Fratantoni, M.D., M.P.H. Pediatrician and lead study author Children’s National Health System MedicalResearch.com: What is the background for this study? Response: We looked at the prevalence of depressive symptoms at NICU discharge and at six months after discharge among 125 parents randomized to the control group of a larger PCORI-funded trial of peer-to-peer support after NICU discharge. Determining factors associated with parental depressive symptoms at NICU discharge may help to identify at-risk parents who could benefit from mental health support. (more…)
Author Interviews, Biomarkers, Brigham & Women's - Harvard, Orthopedics, Pain Research / 11.05.2018

MedicalResearch.com Interview with: “osteopathic treatment for sciatica” by betterhealthosteopathy is licensed under PDM 3.0Daniel Albrecht, PhD Research Fellow in Radiology, Harvard Medical School Research Fellow, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: A great deal of preclinical work in animal models of pain has established that activation of peripheral immune cells or, in the central nervous system (brain and spinal cord), immune cells called “glia” (microglia and astrocytes) play a key role in the establishment and/or maintenance of persistent pain. For instance, if you pharmacologically block activation of these cells in the nervous system, you are able to reduce/inhibit/prevent pain behaviors, e.g. in animals who have received a nerve injury. This observation is very exciting, because it suggests that blocking neuroinflammation may be a viable way of treating pain. However, the evidence linking human chronic pain with neuroinflammation has so far been limited. In this study we show, for the first time, that patients with chronic sciatica (that is, back pain that shoots down the leg) demonstrate elevations in the levels of a protein called the translocator protein (TSPO) in the spinal cord and in the nerve roots. Because TSPO is a marker of neuroinflammation, our results suggest that sciatica is associated with neuroinflammation. While on average patients do show elevations in the levels of the TSPO, we also saw significant variability across individuals. Importantly, patients that show stronger elevations (in the nerve roots) were those who benefit the most from receiving a local anti-inflammatory treatment (epidural spinal injection). This makes sense: patients whose nerve roots are inflamed benefit from an anti-inflammatory treatment. Those whose nerve roots aren’t inflamed, don’t receive the same benefit. In the latter case, the source of the inflammation and pain may not be the nerve roots, but may be the spinal cord, or, as we showed in a previous paper (Loggia et al., Brain 2015), the brain.  (more…)
Author Interviews, JAMA, Kidney Disease / 11.05.2018

MedicalResearch.com Interview with: “Glass of Water” by Greg Riegler is licensed under CC BY 2.0Dr. William Clark Lawson Health Research Institute  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This study is about the use of increased water intake in people with chronic kidney disease (CKD). Although there are a large number of benefits claimed most are not substantiated by evidence. However there is a growing body of evidence (animal and human observational studies) that increased hydration with the suppression of antidiuretic hormone preserves kidney function in CKD. This led to our current randomised clinical trial of 631 patients with stage 3 CKD and proteinuria to determine if drinking an extra 4-6 glasses of water per day for 1 year would slow their progressive loss of kidney  function as measured by eGFR. The main findings were that those coached to increase their water intake versus those coached to sustain their normal fluid intake suffered no ill effects from the intervention and on average were able to sustain an average increase of approximately 3 glasses of water per day. At the end of 1 year the increased hydration group had suppressed their antidiuretic hormone levels (copeptin) significantly but did not demonstrate a greater preservation in their eGFR. (more…)
Author Interviews, JAMA, Prostate Cancer / 11.05.2018

MedicalResearch.com Interview with: Alex Krist, M.D., M.P.H Professor of family medicine and population health Virginia Commonwealth University and Active clinician and teacher at the Fairfax Family Practice residency MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is one of the most common cancers to affect men. However, the decision about whether to be screened is complex and personal. The U.S. Preventive Services Task Force reviewed the latest research on the benefits and harms of screening for prostate cancer using PSA-based testing, as well as evidence on treatment. We found that men who are 55 to 69 years old should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances. Men age 70 and older should not be screened, as the benefits of screening diminish as men age and the harms are greater. (more…)
Author Interviews, Exercise - Fitness, Mental Health Research / 10.05.2018

MedicalResearch.com Interview with: “Open Space Yoga Hawaii” by Open Space Yoga Hawaii is licensed under CC BY 2.0Michael Christopher Melnychuk PhD candidate Trinity College Institute of Neuroscience Trinity, Dublin  MedicalResearch.com: What is the background for this study? Response: Practitioners of yoga have claimed for some 2,500 years, that respiration influences the mind. In our study we looked for a neurophysiological link that could help explain these claims by measuring breathing, reaction time, and brain activity in a small area in the brainstem called the locus coeruleus. We chose to focus on the locus coeruleus because this area and the chemical it produces play intimate roles in both attention and respiration. The locus coeruleus produces noradrenaline and releases it to the entire brain. This neurotransmitter functions as an all-purpose action system. When we are stressed we produce too much noradrenaline and we can’t focus. When we feel sluggish, we produce too little and again, we can't focus. There is a sweet spot of noradrenaline in which our emotions, thinking and memory are much clearer.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Merck / 10.05.2018

MedicalResearch.com Interview with: Dr. Elizabeth Rhee MD Director, Infectious Disease Clinical Research Merck MedicalResearch.com: What is the background for this study? What are the main findings? Response: High-risk patients, such as the critically ill, with suspected bacterial infections require prompt treatment with appropriate empiric therapy to improve survival. Given the high prevalence of multidrug-resistant (MDR) Pseudomonas aeruginosa in the ICU setting, new safe and broadly effective treatment options are needed for critically ill patients requiring antipseudomonal agents. Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin/beta-lactamase inhibitor combination with broad in vitro activity against Gram-negative pathogens, including MDR P. aeruginosa and many extended-spectrum beta-lactamase (ESBL) producers. It is FDA approved for complicated intra-abdominal and urinary tract infections in adults at 1.5g (1g/0.5g) q8h. C/T is currently being studied at 3g (2g/1g) q8h, for the treatment of ventilated nosocomial pneumonia, in the ASPECT-NP Phase 3 trial. This Phase 1 pharmacokinetic (PK) study investigated the penetration of a 3g dose of C/T in the epithelial lining fluid (ELF) of ventilated patients with proven or suspected pneumonia. This is the dose and patient population being evaluated in ASPECT-NP. ELF lines the alveoli, and investigators took samples in a group of 26 patients to see what amount of C/T was in the lung and what was circulating in the plasma during the dosing intervals. In mechanically ventilated critically ill patients, the 3g dose of C/T achieved ≥50% lung penetration (relative to free plasma) and sustained levels in ELF above the target concentrations for the entire dosing interval. These findings support the 3g dose that is included in the ASPECT-NP Phase 3 trial.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Merck / 10.05.2018

MedicalResearch.com Interview with: Becky Jayakumar, PharmD College of Pharmacy Assistant Professor of Pharmacy Practice Roseman University of Health Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bacteremia (bloodstream infections) due to Gram-negative (GN) bacteria are a frequent cause of severe sepsis and pose serious therapeutic challenges due to multidrug-resistance (MDR). Ceftolozane/tazobactam (C/T) is a novel antipseudomonal cephalosporin combined with an established β-lactamase inhibitor. This retrospective, observational study evaluated the clinical outcomes of C/T real-world use in severely ill patients. Twenty-two patients with sepsis and/or bacteremia were included; 95% of whom had Pseudomonas aeruginosa that was resistant to almost all antibacterials with the exception of colistin. C/T successfully treated the majority of these complicated patients. In this real-world study, 77% of patients had a clinical response with C/T and 75% had a microbiological response. Clinical success rates were high and mortality rates were similar to other studies in this severely ill population. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Merck / 10.05.2018

MedicalResearch.com Interview with: Amanda Paschke, MD, MSCE Senior principal scientist Infectious disease clinical research Merck Research Laboratories MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to evaluate a new beta-lactam/beta-lactamase inhibitor antibacterial combination, imipenem/relebactam (IMI/REL), compared with colistin plus imipenem for the treatment of infections caused by resistant Gram-negative bacteria. Patients enrolled in the trial had hospital-acquired or ventilator-associated bacterial pneumonia (HABP/VABP), complicated intra-abdominal infections (cIAI), or complicated urinary tract infections (cUTI) caused by pathogens that were non susceptible to imipenem, a carbapenem antibacterial. In this study, the primary outcome was a favorable overall response to treatment, which was comparable between the IMI/REL vs colistin + IMI arms. Colistin (often combined with a carbapenem) is currently among the standard of care treatment regimens for MDR infections.  A key secondary endpoint of the study was safety.  IMI/REL was well tolerated; among all treated patients, drug-related adverse events (AEs) occurred in 16.1% of IMI/REL and 31.3% of colistin + IMI patients with treatment-emergent nephrotoxicity observed in 10% (3/29 patients) and 56% (9/16 patients), respectively (p=0.002). Results of the trial support the use of imipenem-relebactam (IMI/REL) as an efficacious and well-tolerated treatment option for carbapenem-resistant infections.  (more…)
Author Interviews, BMJ, Genetic Research, Pediatrics / 10.05.2018

MedicalResearch.com Interview with: “Newborn” by Brad Carroll is licensed under CC BY 2.0Dr Sian Taylor-Phillips MPhys, PhD Associate Professor Screening and Test Evaluation / NIHR Career Development Fellow Division of Health Sciences Warwick Medical School University of Warwick Coventry MedicalResearch.com: What is the background for this study? What are the main findings? Response: In newborn blood spot screening a small amount of blood is taken from newborn babies heels, and this is tested for a range of rare diseases. The idea is to detect each disease earlier when it is more treatable. However, it would be better not to test for some diseases, for example if the test is inaccurate so worries parents that their baby may have a serious illness when they do not. Some countries test for as few as 5 diseases and others as many as 50. In this study we investigated how different countries choose which diseases to test for. We found that many national recommendations on whether to screen newborn babies for rare diseases do not assess the evidence on the key benefits and harms of screening. Evidence about the accuracy of the test was not considered in 42% of recommendations, evidence about whether early detection at screening has health benefits was not consulted in 30% of recommendations, and evidence around the potential harm of overdiagnosis where babies have variants of the disease that would never have caused any symptoms or ill effects was not considered in 76% of recommendations. We also found through meta-analysis that when a systematic review was used to bring together the evidence then countries were less likely to recommend screening for the disease. (more…)
Author Interviews / 09.05.2018

MedicalResearch.com Interview with: Ryo Nagashio, Ph.D. Department of Molecular Diagnostics School of Allied Health Sciences, Kitasato University Japan. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Lung cancer is the leading cause of cancer deaths in both men and women in the United States and worldwide. The disease is associated with a poor prognosis because most lung cancers are only diagnosed at an advanced stage. The identification of patients at an early stage of cancer when it can be treated surgically is extremely important to improve prognosis. Current biomarkers for lung cancer include carcinoma embryonic antigen (CEA), sialyl Lewis X antigen (SLX), SCC antigen, and cytokeratin fragment (CYFRA) 21-1, but these are not sensitive enough to detect tumors early. The results of our study provide evidence that the CKAP4 protein may be a novel early sero-diagnostic marker for lung cancer. Across disease stages I-IV, the sensitivities of serum CEA, CYFRA, and SCCa are reported with 30-52, 17-82, and 24-39 percent, respectively. In this study, the sensitivity of serum CKAP4 was 81 percent in the training set and 69 percent in the validation set. These rates are higher than those of the current sero-diagnostic markers. Furthermore, the sensitivity of serum CKAP4 was also high even in stage I non-small cell lung cancer. (more…)
Author Interviews, Social Issues / 09.05.2018

MedicalResearch.com Interview with: Dr. Doug Nemecek, MD MPH Co-chair National Quality Improvement Committee Senior medical director for CIGNA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that approximately 1 in 6 adults in the U.S. suffer from a mental health condition, and research has noted that mental health issues are one of the most rapidly increasing causes of long-term sick leave. But when looking closer, we found that most people with mental health or chronic conditions have a similar pathology: they also suffer from loneliness. It’s clear that loneliness has a tremendous impact on health – it actually has the same impact on mortality as smoking 15 cigarettes a day. We decided we needed to learn more. The key takeaway from our research is that most Americans are considered lonely, as measured by a score of 43 or higher on the UCLA Loneliness Scale. Specifically, we found that nearly half of Americans report sometimes or always feeling alone or left out, and one in four Americans rarely or never feel as though there are people who really understand them. We also discovered that younger adults are lonelier and claim to be in worse health than older generations. However, our survey revealed several bright spots that reinforce the social nature of humans and the importance of community. Our results showed that people who report being less lonely are more likely to have regular, meaningful, in-person interactions; be in good overall physical and mental health; and have found a balance in their daily activities, including getting the right amount of sleep, socialization and work/life balance. We also hypothesized that the workplace played a role in this. It turns out that we were right – being employed and having good relationships with your co-workers is correlated with being less lonely and being more healthy.  (more…)
Author Interviews, Genetic Research, Weight Research / 09.05.2018

MedicalResearch.com Interview with: “Mmm...hamburgers” by jeffreyw is licensed under CC BY 2.0Dr. Peter Kühnen Institute for Experimental Pediatric Endocrinology Charité Universitätsmedizin Berlin Berlin Germany  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We are focusing our interest on rare monogenic forms of obesity. The hormones leptin and MSH are playing a pivotal role for the regulation of satiety and body weight. Mutations within this pathway, e.g. in the leptin receptor gene, are leading to severe hyperphagia and early onset obesity.  Although tremendous effort it is extremely difficult for the affected patients to stabilize their body weight for a longer period of time. For this reason it has been analyzed within this investigated initiated trial whether patients with a leptin receptor mutation benefit from a treatment with the MC4R agonist setmelanotide. The treatment led to a reduction of the initially increased hunger feeling and to a reduction of body weight. Additionally, we identified molecular evidences that a specific signaling cascade of the MSH receptor (MC4R) is of importance for the regulation of body weight. (more…)
Author Interviews, Nutrition / 09.05.2018

MedicalResearch.com Interview with: “Eggs” by John Morgan is licensed under CC BY 2.0Nick Fuller PhD Charles Perkins Centre Research Program Director University of Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a disparity in research findings between epidemiological studies and randomised controlled trials in those with type 2 diabetes mellitus. A lot of the research showing that a high egg consumption (6 or more eggs per week) is detrimental to a person’s health was conducted at a time when we were told to avoid eggs. People that were eating a high egg diet during that time were also likely to have other poor eating habits, such as one high in saturated fat and low in wholegrain carbohydrates. These studies did not control for such confounding factors. As a result of this disparity in findings between epidemiological and controlled studies this has resulted in differing guidelines for recommended egg intake between countries. To address a lack of randomised controlled trials in this field we conducted a large study over 12-months to assess the effect of a high egg consumption (12 eggs per week) on heart disease and diabetes risk factors in a group of people at high risk of cardiovascular heart disease – diagnosed with pre-diabetes or type 2 diabetes mellitus. 140 people were randomised to a high egg diet (12 eggs per week) or a low egg diet (less than 2 eggs per week) and advised on the principles of a healthy diet. For example, including plenty of wholegrain and low glycemic index carbohydrate sources and swapping sources of saturated fat (e.g. butter) for sources of poly and mono-unsaturated fat (e.g. avocado or olive oil). They followed their respective high or low egg diet for 12 months and over the time we measured a comprehensive list of risk factors for heart disease and type 2 diabetes. Both the low and high egg groups had the same improvements in the health at the end of the 12 months and the high egg diet did not result in an increased risk of cardiovascular disease. (more…)
Author Interviews, JAMA, Schizophrenia / 08.05.2018

MedicalResearch.com Interview with: Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, NY Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital, Department of Psychiatry   MedicalResearch.com: What is the background for this study? Response: Schizophrenia and other psychotic disorders are still all to often chronic and recurring mental health conditions that not uncommonly take a course during which individuals have varying degrees of significantly impaired personal, social and educational/vocational functioning. Prior individual studies examining early specialty intervention services, which integrate multiple different and complementary treatment components, had shown that this treatment approach can yield superior outcomes for people with early-phase schizophrenia and other psychotic disorders compared to usual care given to all people with psychotic disorders. However, we were lacking a broad overview of the type and results of treatment programs that had been conducted across different countries, continents and mental health service delivery systems. Moreover, we did not yet have a synthesis across all important outcomes that had been examined across these individual studies. This first comprehensive meta-analysis on this topic provides previously missing information on the different early intervention programs and their components as well as on all relevant outcomes for people who did or did not receiving early integrated care, also recently called ‘coordinated specialty care.’ (more…)
FDA, Infections, Vaccine Studies / 08.05.2018

MedicalResearch.com Interview with: Lisa Danzig, MD Chief Medical Office PaxVax MedicalResearch.com: Would you briefly explain what is meant by Chikungunya infection?  Whom does it primarily affect?  How is it transmitted and what the  complications? Response: Chikungunya is caused by the chikungunya virus (CHIKV), an arthropod-borne virus (arbovirus) spread by infected mosquitos. Infection with chikungunya virus results in severe, often debilitating joint pain in infected patients, known as arthralgia. Symptoms can include intense discomfort in joints, such as the wrists, fingers, ankles, and feet, in the knees and in the hips or shoulders. Those affected can also frequently suffer from headaches, fever, and severe muscle pain, rashes on the torso and limbs and swelling in one or more cervical lymph nodes. Individuals who are at a higher risk for contracting chikungunya include infants, elderly and those with chronic conditions. The virus is a small, spherical, enveloped, positive-strand RNA virus. The virus is transmitted by the Aedes aegypti and Aedes albopictus mosquito, which originated in Africa, first spreading to Asia and recently expanding to the western hemisphere.  Outbreaks are rapid and widespread.  In February 2005 a major outbreak of chikungunya occurred in the islands of the Indian Ocean after which over 1.9 million cases have been reported in India, Indonesia, Maldives, Myanmar and Thailand. Chikungunya spread has been identified in 45 countries in the Americas alone with more than 1.7 million suspected cases reported to the Pan American Health Organization since 2015, increasing the incidence of the disease and risk to U.S. travelers. In 2016 there were approximately 60,000 cases of chikungunya across India. Beyond the Indian subcontinent, the Caribbean, Central America and South America, inhabitants and travelers visiting sub-Saharan Africa and Southeast Asia are also at risk. (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, JAMA / 08.05.2018

MedicalResearch.com Interview with: Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist, San Francisco VA Medical Center Senior Investigator, Tideswell at UCSF: http://www.tideswellucsf.org/ Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have found a link between moderate to severe head injuries and increased dementia risk.
  • The association between mild head injuries and dementia – especially mild head injury that doesn’t result in loss of consciousness – is less well established
  • We examined the association between mild head injuries with and without loss of consciousness and dementia diagnoses in nearly 360,000 Veterans receiving care in the VA health care system.
  • We found that Veterans with a head injury diagnoses were two to four times more likely to be diagnosed with dementia than those without head injury diagnoses.
  • The risk of dementia diagnosis was doubled in Veterans who experienced head injury without loss of consciousness compared to those with no head injury. 
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