Author Interviews, Nature, Technology / 02.02.2018

MedicalResearch.com Interview with: Dr. Sarav Rajan, PhD Scientist Antibody Discovery and Protein Engineering MedImmune MedicalResearch.com: What is the background for this study? What are the main findings? Response: During an infection, B cells (a type of white blood cell) create antibodies against antigens present on a pathogen. These cells can be extremely rare, and finding them among the millions of other cells is extremely challenging. Existing methods to examine B cells require a trade-off: either capture the full sequence repertoire by next-generation sequencing but functionally screen just a subset, or culture a subset of B cells and fully screen them. Instead, our method captures the complete repertoire within a typical blood draw and screens all its members to identify the rare antigen-positive antibodies. Using a new microfluidic approach, we recovered the antibody genes from one million B cells encapsulated in picoliter-scale droplets, breaking through a widely-published view that amplifying from single cells in such small volumes is inefficient. The resulting library seamlessly integrates into our high-throughput screening infrastructure to enable rapid isolation of desired antibodies. Using this method, we were able to isolate a panel of rare cross-reactive antibodies targeting influenza. (more…)
Author Interviews, Weight Research / 02.02.2018

MedicalResearch.com Interview with: Amy Gorin, Ph.D. Professor, Psychological Sciences Associate Director Institute for Collaboration on Health, Intervention, and Policy (InCHIP) University of Connecticut Storrs, CT   06269-1248 MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This study examined whether behavioral weight management programs have a ripple effect on untreated spouses.  That is, if one member of a couple participates in a weight loss program, does the other untreated spouse benefit?  Given that many spouses are of a similar weight status, if one spouse is overweight, the other spouse tends to be overweight as well — understanding how weight management programs impact both spouses has important public health implications. To examine this question, 130 spouses were randomly assigned to Weight Watchers or a self-guided control group. Spouses assigned to Weight Watchers group had only one member enrolled in a structured 6-month weight loss program (Weight Watchers) that provided in-person counseling and online tools to assist with weight loss. In the self-guided group, one member of the couple received a four-page handout with information on healthy eating, exercise, and weight control strategies (e.g., choosing a low-fat, low-calorie diet, portion control). The results indicate that nearly one-third (32%) of untreated spouses in both groups lost ≥3% of their initial body weight (weight loss based on obesity management guidelines) at the 6-month mark, and weight losses did not differ between untreated spouses of Weight Watchers and self-guided participants. (more…)
Author Interviews, Dental Research, Technology / 02.02.2018

MedicalResearch.com Interview with: “chipped tooth” by bagaball is licensed under CC BY 2.0Dr. Ming Yang Key Laboratory of Microsystems and Microstructures Manufacturing, Harbin Institute of Technology, Harbin, China  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Self-healing materials and coatings are smart solutions to environmental and energy problems. There are heavy demands for these materials in many productions such as consumer electronics, the automotive industry and healthcare. Current coatings that can self-heal are typically soft. This means they are not as anti-scratch as rigid surfaces and the benefit of the ability to repair themselves could be overwhelmed by their limited robustness vulnerable to normal mechanical contact. It would be very useful to have a self-healing coating with a hardness that can be comparable or even outperform rigid coatings. This is normally difficult because mechanical hardness and self-healing are two conflicting properties with the opposite dependence on polymer dynamics. One good example in this context is many soft tissues can self-heal, but a notable exception is tooth enamel, which is the hardest part in our body but has no way to recover after decay. A new design will be needed to circumvent the fundamental limitation. We find that by mimicking the structure of epidermis, it is possible to combine two contradictory properties into an artificial coating, namely, self-healing ability and high hardness. The success relies on the placement of a hard layer containing graphene oxide on top of a soft sublayer with a seamless interface for interlayer diffusion. This allows a similar healing mechanism as that in skin, but the coating is not soft and has a hardness that even approaches tooth enamel.  (more…)
ASCO, Author Interviews, Biomarkers, Cancer Research, Gastrointestinal Disease / 02.02.2018

MedicalResearch.com Interview with: Dr. Ana Vivancos PhD, Principal Investigator Cancer Genomics Group Vall d'Hebron Institute of Oncology (VHIO Barcelona  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was designed to address a key issue in liquid biopsy testing: analytical sensitivity. We know that mutations in plasma of mCRC patients show a wide range in their allelic frequencies (0.01-90%), the biological basis for which remains unclear. We also know that around 35% of cases show very low mutant allele fractions (MAFs), < 1%, therefore highlighting the need of using high sensitivity techniques in the routine lab in order to properly detect mutations. We have compared two different testing methods that are being used in liquid biopsy: Digital PCR (OncoBEAM RAS test, BEAMing) with a limit of detection of 0.02% vs qPCR (Idylla ctKRAS test, Biocartis) with an analytical sensitivity of 1%. Our findings indicate that detection sensitivity decreases for the qPCR based method in cases with low MAF (<1%) and more so when MAF values are very low (<0.01%). (more…)
Author Interviews, Baylor College of Medicine Houston, Kidney Disease, Occupational Health / 01.02.2018

MedicalResearch.com Interview with: Dr. Kevin F. Erickson MD, MS Section of Nephrology and Selzman Institute for Kidney Health Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: An amendment to the Social Security Act passed in 1972 made it so nearly every person who develops end-stage renal disease – or ESRD – in the U.S. becomes eligible for Medicare, regardless of their age. At the time the law was passed, the bill’s supporters argued that access to life-sustaining dialysis therapy would enable patients to continue being productive members of society through work and activities at home. While the law has succeeded in providing access to dialysis therapy for many patients who would have otherwise died from kidney failure, it has been less successful at helping patients to continue working. The rate of employment among patients with ESRD who are receiving dialysis in the U.S. is low and has continued to decrease over time, despite both financial benefits from employment and evidence suggesting that patients who are employed experience improved quality of life and sense of wellbeing. We used a national ESRD registry to examine trends in employment between 1996 and 2013 among patients starting dialysis in the U.S. and in the six months before ESRD. Our goal was to determine whether difficulties that patients face when trying to work begin even before they develop ESRD. (more…)
Author Interviews, JAMA, Schizophrenia, Yale / 01.02.2018

MedicalResearch.com Interview with: Josephine Mollon PhD Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience King’s College London, London, England Currently with the Department of Psychiatry Yale University School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Psychotic disorders, such as schizophrenia, are severe mental disorders that cause a range of abnormalities in perception and thinking. Individuals with psychotic disorders also experience severe impairments in IQ and there is evidence that these impairments begin many years before hallucinations and delusions first appear. Understanding how and when individuals with psychotic disorder experience a drop in IQ scores will help us better predict and treat poor cognition in these individuals, and perhaps even the disorder itself. (more…)
Addiction, Author Interviews, JAMA, Opiods / 01.02.2018

MedicalResearch.com Interview with: “Drugs” by Ben Harvey is licensed under CC BY 2.0William G. Honer, MD, FRCPC, FCAHS Jack Bell Chair in Schizophrenia Professor and Head, Department of Psychiatry University of British Columbia Vancouver, BC MedicalResearch.com: What is the background for this study? Response: The Province of British Columbia, Canada, has experienced a tremendous increase in the number of opioid related overdoses and deaths. In 2012, there were 269 drug overdose deaths, five years later in 2017 the overdose deaths are predicted to have increased 500%. Toxicology studies of deaths, and examination of seized drugs indicate fentanyl is the major cause. These indirect measures suggest widespread exposure to fentanyl in opioid users, however direct studies of the extent of exposure of opioid users to fentanyl in the community are lacking. We carried out a community-based, longitudinal study using fentanyl testing in urine samples from volunteer participants. (It is called the “Hotel Study” since many of the participants live, or have lived in single room occupancy hotels)  (more…)
Author Interviews, Dermatology, JAMA, Sexual Health, Transplantation / 01.02.2018

MedicalResearch.com Interview with:

Dr. Christina Lee Chung, MD Associate Professor Department of Dermatology Drexel University

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

Response: In early 2016, five years after the inception of our specialty medical-surgical transplant dermatology center, we realized our nonwhite transplant patients were developing skin cancer at higher rates and found interesting trends. These data were published in a previous manuscript. One of the more striking findings was that these patients were developing a high proportion of skin cancer in non-sun-exposed areas such as the genital region. There are no standard guidelines regarding genital skin evaluation and it is unclear how often it is performed in any capacity amongst dermatologists, including practitioners in our center, quite frankly. Our group was concerned that we could be missing skin cancers in this “hidden” area in our high-risk organ transplant population so we launched a quality improvement initiative that incorporated thorough genital skin evaluation as a standard part of post-transplant skin cancer screening.   

Fifteen months after we started this modified screening process, we decided to evaluate the results. To account for any variation in examination, we looked at the findings of a single practitioner. We found that genital lesions are common in the transplant population and include high rates of genital warts and skin cancer. However, patient awareness of the presence of genital lesions was alarmingly low. Nonwhite transplant patients, Black transplant recipients in particular, were disproportionately affected by both genital warts and genital skin cancer in our cohort. Similar to cervical cancer, high-risk HPV types were closely associated with genital squamous cell carcinoma development in our transplant population. (more…)

Author Interviews, BMJ, Heart Disease, Pain Research, Stroke / 01.02.2018

MedicalResearch.com Interview with: “Headache.” by Avenue G is licensed under CC BY 2.0Kasper Adelborg, MD, PhD Postdoctoral Fellow Department of Clinical Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Around one billion people worldwide are affected by migraine. Migraine has considerable impact on quality of life and imposes a substantial burden on society. Migraine is primarily a headache disorder, but previous studies have suggested a link between migraine and stroke and myocardial infarction, particularly among women, while the link between migraine and other heart problems are less well known. In this large register-based Danish study published in the BMJ, we confirmed that migraine is associated with increased risks of stroke and myocardial infarction, but we also found that migraine was associated with increased risks of other cardiovascular diseases (specifically, venous thromboembolism and atrial fibrillation). Migraine was not associated with increased risks of heart failure or peripheral artery disease. In contrast to most previous studies, our study had a very large sample size and an age- and sex- matched comparison cohort from the general population, which allowed us to put migraine in a population context and to perform several subgroup analyses. Here, we found several interesting findings.
  • In general, the associations were strongest in the first year after diagnosis but persisted in the long term (up to 19 years after diagnosis).
  • Most associations applied to both migraine patients with aura (warning signs before a migraine, such as seeing flashing lights) and in those without aura, and in both women and in men. 
(more…)
Author Interviews, BMJ, Cancer Research, MD Anderson / 01.02.2018

MedicalResearch.com Interview with: Xifeng Wu MD PhD Prevention and Population Sciences MD Anderson Center MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that certain chronic diseases may predispose to cancer. These studies generally assessed chronic diseases or disease markers individually. As chronic diseases are typically clustered, it is necessary to study them simultaneously to elucidate their independent and joint impact on cancer risk. Therefore, we investigated the independent and joint effect of several common chronic diseases or disease markers on cancer and life span in a large prospective cohort. Also, we compared the contribution of chronic diseases or disease markers to cancer risk with that of lifestyle factors. We further assessed whether physical activity could attenuate the cancer risk associated with chronic diseases or disease markers. We hope the results of this study can contribute to evidence-based recommendations for future cancer prevention strategies. (more…)
Author Interviews, Cancer Research, CDC, Melanoma / 31.01.2018

MedicalResearch.com Interview with: Dawn Holman, MPH Behavioral Scientist Division of Cancer Prevention and Control CDC MedicalResearch.com: What is the background for this study? Response: Melanoma is the third most common type of skin cancer and the most deadly. Each year in the United States, over 70,000 people are diagnosed with melanoma, and more than 9,000 die from the disease. Melanoma is often caused by overexposure to ultraviolet (UV) rays from the sun or artificial sources like tanning beds. Previous reports have shown a steady increase in melanoma incidence rates over time, specifically among non-Hispanic whites. The purpose of this study was to determine if this trend differs across age groups.   (more…)
Author Interviews, JAMA, Surgical Research / 31.01.2018

MedicalResearch.com Interview with: Henry M. Kuerer, MD, PhD, FACS Executive Director, Breast Programs MD Anderson Cancer Network Endowed Distinguished Professor in Cancer Research Division of Surgery  MedicalResearch.com: Why did you undertake this study? Response: Many of our patients feel very overwhelmed with their new cancer diagnosis and have concern over the future need for biopsies. Many think that complete removal of the breast is a good way to prevent future cancer-related biopsies.  We did not have any good comprehensive data on the incidence of needing biopsies during follow-up for breast cancer. As a surgeon this information is something that I can use daily when discussing breast cancer treatment options regarding future expectations following breast cancer treatment. (more…)
Author Interviews, Education / 31.01.2018

MedicalResearch.com Interview with: “Learning a New Language” by Joel Penner is licensed under CC BY 2.0Phillip Hamrick, Ph.D. Assistant Professor || Second Language Acquisition Principal Investigator TESL Program Chair Department of English Kent State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: For a long time, language scientists (e.g., linguists, psychologists, neuroscientists) have debated the degree to which language relies on unique brain systems (those that are used for language and nothing else) or more general-purpose brain systems that we use for other things (e.g., memory, controlling attention, categorization, etc.). Our study quantitatively synthesized the results of several other studies using a technique called meta-analysis. We found that declarative and procedural memory abilities, which are fundamental for learning lots of different things (e.g., anything from facts about geography to how to play a musical instrument), are linked to language in specific ways. Importantly, these findings held up in both children learning their first language and adults learning second languages. (more…)
Author Interviews, Memory, Technology, UC Davis / 31.01.2018

MedicalResearch.com Interview with: Halle Dimsdale-Zucker University of California, Davis Center for Neuroscience | Ph.D. Candidate Dynamic Memory Lab MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to test competing models for how different types of retrieved contextual information (spatial, episodic - which is spatial AND temporal information) are supported by the hippocampus and its subfields. We only found differences between the subfields when people were spontaneously reactivating episodic, but not spatial information. This is surprising because a dominant view of the hippocampus is that it is specialized to represent spatial information. What this suggests is that when there is more than just spatial information that can be remembered that the hippocampus is able to flexibly represent whatever information is most task-relevant for remembering and distinguishing items from one another. Intriguingly, we found that different subfields represented shared episodic contextual information and item-unique contextual information. This highlights that our memories need to both link together common features of related events while retaining the event-specific details. (more…)
Author Interviews, JAMA, Outcomes & Safety / 31.01.2018

MedicalResearch.com Interview with: Lene Vestergaard Ravn-Nielsen, MSc(Pharm) Hospital Pharmacy of Funen Clinical Pharmacy Department Odense University Hospital Odense, DenmarkLene Vestergaard Ravn-Nielsen, MSc(Pharm) Hospital Pharmacy of Funen Clinical Pharmacy Department Odense University Hospital Odense, Denmark MedicalResearch.com: What is the background for this study? Response: Hospital readmissions are common among patients receiving multiple medication, with considerable costs to the patients and society. MedicalResearch.com: What are the main findings?  Response: A multifaceted clinical pharmacist intervention can reduce ED visits and hospital readmissions.  (more…)
Author Interviews, Emergency Care, JAMA, Pulmonary Disease / 31.01.2018

MedicalResearch.com Interview with: Giorgio Costantino MD Dipartimento di Medicina Interna Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico Università degli Studi di Milano Milan, Italy MedicalResearch.com: What is the background for this study? Response: Syncope is a common symptom that occurs in one in four people during their lifetime. Pulmonary embolism (PE) has long been recognized as an important and serious cause of syncope. PE has always been estimated a rare cause of syncope, present in less than 1.5% of patients. A recent study (PESIT), aiming at evaluating PE prevalence using a standardized algorithm in hospitalized patients after a first syncope episode, found a prevalence of PE as high as 17% in hospitalized patients. This means that patients with a first episode of syncope should be investigated with a standard diagnostic algorithm to exclude PE. However, many patients might go through useless and potentially harmful tests, such as computed tomography pulmonary angiogram. (more…)
Author Interviews, Environmental Risks, JAMA, MRI, Toxin Research / 31.01.2018

MedicalResearch.com Interview with: “Danger Carbon Monoxide” by SmartSign is licensed under CC BY 2.0Won Young Kim, MD PhD Department of Emergency Medicine Asan Medical Center University of Ulsan College of Medicine Seoul, Korea MedicalResearch.com: What is the background for this study? Response: Neurological symptoms of carbon monoxide (CO) poisoning can manifest not only immediately but also as late as 2 to 6 weeks after successful initial resuscitation as delayed neurological sequelae (DNS). To date, no reliable methods of assessing the probability of DNS after acute CO poisoning have been developed, which make it difficult to research the pathophysiology of DNS and targeting prevention. (more…)
Author Interviews, Infections, JAMA, Surgical Research / 30.01.2018

MedicalResearch.com Interview with: Marc D. Basson, MD, PhD, MBA Professor of Surgery, Pathology, and Biomedical Science Senior Associate Dean for Medicine and Research University of North Dakota School of Medicine & Health Sciences Grand Forks, ND 58202    MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are now several studies that describe the use of antibiotics without surgery to manage acute uncomplicated appendicitis. This entails a prolonged treatment course and has a substantial rate of failure and recurrence, but in patients in whom it succeeds surgery can be avoided. Many surgeons resist offering this choice because they perceive it as substandard compared to surgery, which is rapid, and when it goes well (as it usually does) has no failure or recurrence rate. Instead of debating the statistics, we decided to ask people what they would prefer if they had appendicitis and why. We found that about nine tenths of people would choose surgery, but about one tenth would choose antibiotics, with some subtle distinctions depending on the characteristics of the people we asked.  (For instance, surgeons, doctors in general, and people who knew someone who had previously had appendicitis were all a bit more likely to opt for surgery.)  Furthermore, we found that the key issue for most people was not the prolonged treatment course but the rates of failure and recurrence with antibiotics. (more…)
Author Interviews, Technology / 30.01.2018

MedicalResearch.com Interview with: Lieutenant Commander Matthew Doubrava Senior Medical Officer, Naval Medical Research Unit Dayton, Ohio  MedicalResearch.com: What is the background for this research? What types of problems will be investigated using the Osprey? Response: The U.S. Marine Corps V-22 Osprey tilt-rotor aircraft will be used to conduct static aerospace medical research in an effort to provide solutions toward preventing musculoskeletal injury to tilt-rotor aircraft crew and en route care training at Wright-Patterson Air Force Base. Naval Medical Research Unit – Dayton (NAMRU-Dayton) has been tasked as the lead agency for the Navy to investigate tilt-rotor aircrafts potential effects of flight and vibration on aircrews. NAMRU-Dayton scientists will be partnering with the U.S. Air Force School of Aerospace Medicine, who will be investigating en route care training to figure out the best way for the crew to use the aircraft for that purpose. (more…)
Author Interviews, Geriatrics, Hearing Loss, JAMA / 30.01.2018

MedicalResearch.com Interview with: “Handicapped Hearing Impaired” by Mark Morgan is licensed under CC BY 2.0Madeline Sterling M.D., M.P.H. Fellow, Department of Medicine Weill Cornell Medical College - New York Presbyterian Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart Failure currently affects 5.8 million people in the United States and is becoming increasingly common as the population ages. Because it has no cure and tends to get progressively worse, physicians recommend that patients control their symptoms by taking multiple medications, maintain a diet low in salt, monitor their weight and blood pressure, and watch for changes in their symptoms. At the most basic level, in order to understand and follow these instructions, heart failure patients must be able to hear them.  Hearing loss, however, had not been studied in heart failure.  There are a lot of chronic diseases in which hearing loss is more common than in the general population, including coronary heart disease, hypertension, and diabetes. And many adults with heart failure also have these conditions. So, we thought it would be important to understand if hearing loss was prevalent among adults with heart failure, especially since so much of heart failure management revolves around effective communication between patients and their healthcare providers. (more…)
Author Interviews, Education, JAMA, Pediatrics / 30.01.2018

MedicalResearch.com Interview with: “preschool joy” by kristin :: prairie daze is licensed under CC BY 2.0Arthur J. Reynolds, PhD Institute of Child Development University of Minnesota, Minneapolis  MedicalResearch.com: What is the background for this study?   Response: Educational attainment is the leading social determinant of health. Higher attainment measured by years of education or postsecondary attainment is linked to lower cardiovascular disease risk; lower rates of smoking, diabetes, and hypertension; and higher economic well-being. Evidence on the long-term effects of early childhood programs on educational attainment is mixed. Some studies show impacts on high school graduation but not college attainment, the reverse pattern, or no measurement into adulthood. No studies of large-scale public programs have assessed impacts beyond young adulthood. Whether duration of participation over ages 3 to 9 is linked to mid 30s attainment also has not been investigated. (more…)
Alzheimer's - Dementia, Author Interviews, Circadian Rhythm, JAMA / 30.01.2018

MedicalResearch.com Interview with: “mirror clock” by tourist_on_earth is licensed under CC BY 2.0Yo-El Ju, MD Assistant Professor of Neurology Sleep Medicine Section Washington University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that prior studies have shown that people with Alzheimer's Disease have poor circadian clock function, for example sleeping during the day and being awake or agitated at night. Autopsy studies have shown that people with Alzheimer's Disease have degeneration in the "clock" part of their brains. In this study, we wanted to examine whether there were any circadian problems much earlier in Alzheimer's Disease, when people do not have any memory or thinking problems at all. We measured circadian function in 189 people with an actigraph, which is an activity monitor worn like a watch, for 1-2 weeks. Brain scans and studies of cerebrospinal fluid were used to determine who had preclinical Alzheimer's Disease, meaning they have the brain changes of Alzheimer's but do not have symptoms yet.  (more…)
Abbvie, Author Interviews, Hepatitis - Liver Disease, NEJM, Pharmaceutical Companies / 29.01.2018

MedicalResearch.com Interview with: Stefan Zeuzem, M.D. Professor of Medicine Chief Internal Medicine Goethe University Hospital Frankfurt, Germany MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Chronic hepatitis C virus (HCV) infection is a major global public health problem with more than 71 million people infected worldwide, and can result in significant morbidity and mortality, including liver cirrhosis, hepatocellular carcinoma, and death.1 This publication describes the efficacy and safety results from two Phase 3 clinical trials, ENDURANCE-1 and ENDURANCE-3, in patients with chronic HCV genotypes (GT) 1 or 3 infection who were treated with an all-oral, once-daily combination regimen of direct-acting antiviral agents (DAA) glecaprevir (GLE) at 300 mg and pibrentasvir (PIB) at 120 mg. The findings from ENDURANCE-1 trial show that the GLE/PIB combination regimen (G/P) given for 8 weeks to HCV GT1 chronically infected non-cirrhotic treatment-naïve or treatment-experienced (with sofosbuvir and/or interferon with ribavirin) patients was safe and well-tolerated, achieved high efficacy with a sustained virologic response at post-treatment week 12 (SVR12) rate >99% and was non-inferior to 12-week treatment with G/P. The trial also included subjects who were co-infected with human immunodeficiency virus (HIV), and all of these subjects achieved SVR12 while maintaining HIV suppression throughout the study. ENDURANCE-3 trial results show that the G/P regimen given for 8 weeks to HCV GT3 chronically infected non-cirrhotic treatment-naïve patients was safe and well-tolerated, achieved high efficacy in this historically difficult to cure GT with an SVR12 rate >94%, and was non-inferior to 12-week treatment with G/P, which in turn was non-inferior to the treatment with 12-week DAA regimen of sofosbivir and daclatasvir.  (more…)
Author Interviews, Biomarkers, BMJ, Genetic Research, Prostate Cancer, UCSD / 29.01.2018

MedicalResearch.com Interview with: “DNA” by Caroline Davis2010 is licensed under CC BY 2.0Tyler Seibert, MD, PhD Radiation Oncology Center for Multimodal Imaging & Genetics UC San Diego MedicalResearch.com: What is the background for this study? Response: Prostate cancer is an extremely common condition in men. Many die from it each year, and many others live with debilitating pain caused by prostate cancer. Screening for prostate cancer with prostate-specific antigen (PSA) testing can be effective, but there are concerns with the test.
  • First, screening everyone gives a large proportion of false-positive results, and those men end up undergoing unnecessary procedures such as prostate biopsy. S
  • econd, a significant portion of men who develop prostate cancer will develop a slow-growing form of the disease that is likely not life-threatening and may not require treatment. These concerns have led to a drop in prostate cancer screening. But avoiding screening leaves a large number of men vulnerable to diagnosis of an aggressive prostate cancer at a later stage, when it is more difficult—or impossible—to be cured. Doctors are left to guess which of their patients are at risk of aggressive disease and at which age they need to start screening those patients.
Our study sought to develop a tool to provide men and their doctors with objective, personalized information about each man’s risk of prostate cancer. Based on the man’s genetics, we wanted to predict the risk of aggressive prostate cancer and at what age in his life that risk becomes elevated. (more…)
Author Interviews, CMAJ, OBGYNE / 29.01.2018

MedicalResearch.com Interview with: “Don't forget the teens” by Jon Seidman is licensed under CC BY 2.0Ning Liu PhD Student Senior Research Analyst at ICES Institute of Health Policy, Management and Evaluation Institute for Clinical Evaluative Sciences University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies suggested intergenerational tendencies between a mother and her daughter in fertility patterns, such as when they give birth to a child for the first time, or the total number of children they have during their lifetime. We explored whether there is also an intergenerational tendency for induced abortion practices between a mother and her teen daughter. To do so, we used anonymized records of 431,623 daughters and their mothers, and found that a teenage daughter was twice as likely to have an induced abortion if her mother had had an induced abortion.  (more…)
Author Interviews, Dermatology, Electronic Records / 29.01.2018

MedicalResearch.com Interview with: “Computer” by FullCodePress is licensed under CC BY 2.0Matilda W. Nicholas, MD, PhD Duke Dermatology Durham, North Carolina MedicalResearch.com: What is the background for this study? Response: I have found many physicians overwhelmed by the electronic messaging feature in Electronic Health Record systems (EHRs). I found there was very little published about this phenomenon, particularly for specialists. So, we set out to take a look at the volume and effect these systems have.  MedicalResearch.com: What are the main findings?  Response: We found that, on average, clinicians receive 3.24 messages per patient visit, for an average of about 50 messages per full day of clinic. The number of messages also correlated with poor reported work life balance for dermatologists. (more…)
Author Interviews, Breast Cancer, Cancer Research, Yale / 28.01.2018

MedicalResearch.com Interview with: Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director of Breast Cancer Translational Research Co-Director of the Yale Cancer Center Genetics, Genomics and Epigenetics Program Yale School of Medicine New Haven, CT  06511 MedicalResearch.com: What is the background for this study? Response: Overall, about 85% of newly diagnosed stage I-III breast cancer patients will not die of their disease, and this roughly equates to an 85% cure rate. Of course cure rates are higher for stage I cancers and lower for stage III cancers. An 85% overall cure rate is good but not good enough, we continuously try to develop new therapies hoping to push these rates to 90%...,95%...etc. However, it is not possible to cure a patient twice over. For example, if surgery plus endocrine therapy cures all patients, the addition of chemotherapy cannot improve on it no matter how effective it is. If surgery plus endocrine therapy cures 95%, adding the perfect chemo to this treatment can only bring about a 5% improvement, and very good chemo that would push cure from 95% to 97%, would require a very large trial including many thousands of patients. This is an increasingly common scenario in modern breast cancer adjuvant trials (where the goal is to improve survival and cure); the control arm that receives the current standard of care invariably does better than expected and the experimental arm only improves outcome by 1-3% that does not reach statistical significance.  The painful conclusion from these trials is that we do not know if the new drug actually works or not because there were not enough events to demonstrate an effect. Of course, a lot of patients in the study were also exposed to a new drug with all of its associated toxicities who could not possibly benefit from it. (more…)
Author Interviews, JAMA, Prostate Cancer, Radiation Therapy / 27.01.2018

MedicalResearch.com Interview with: Jason Alexander Efstathiou, D., PH.D Director, Genitourinary Division Department of Radiation Oncology Clinical Co-Director, The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: When surgery has probably failed to cure a patient, the best prospective data supports the use of postoperative radiation therapy. The debate now centers on the optimal timing of such post-prostatectomy radiation therapy; is it adjuvant (ART) for all (with adverse pathologic features) or early salvage (ESRT) for some (who experience biochemical failure)? (more…)
ALS, Author Interviews, Neurological Disorders, Technology / 26.01.2018

MedicalResearch.com Interview with: David Brandman, MD, PhD Postdoctoral research associate (neuroengineering), Brown University Senior neurosurgical resident Dalhousie University BrainGate Website MedicalResearch.com: What is the background for this study? Response: People with cervical spinal cord injuries, ALS, or brainstem stroke, may lose some or all of their ability to use their arms or hands. In some cases, they may even lose the ability to speak. One approach to restoring neurologic function is by using a brain computer interface (BCI). BCIs record information from the brain, and then translate the recorded brain signals into commands used to control external devices. Our research group and others have shown that intracortical BCIs can provide people with tetraplegia the ability to communicate via a typing interface, to control a robotic limb for self-feeding, and to move their own muscles using functional electrical stimulation. Use of a BCI generally requires the oversight of a trained technician, both for system setup and calibration, before users can begin using the system independently. An open question with intracortical BCIs is how long it takes people to get up and running before they can communicate independently with 2 dimensional cursor control. The goal of this study was to systematically examine this question in three people with paralysis. As part of the ongoing BrainGate2 clinical trial, each study participant (T5, T8, and T10) had tiny (4x4 mm) arrays of electrodes implanted into a part of their brain that coordinates arm control. Each participant used motor imagery – that is, attempted or imagined moving their body – to control a computer cursor in real time. (more…)