T2Bacteria Panel Can Detect Blood Stream Infections in Hours, not Days

MedicalResearch.com Interview with:

Minh-Hong Nguyen, MDInfectious DiseasesProfessor of MedicineDirector, Transplant Infectious DiseasesDirector, Antimicrobial Management ProgramDepartment of Medicine University of Pittsburgh School of Medicine

Dr, Minh-Hong Nguyen

Minh-Hong Nguyen, MD
Infectious Diseases
Professor of Medicine
Director, Transplant Infectious Diseases
Director, Antimicrobial Management Program
Department of Medicine
University of Pittsburgh School of Medicine

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

Response: Blood cultures, the gold standard for diagnosing blood stream infections, are insensitive and limited by prolonged time to results. Early institution of appropriate antibiotics is a crucial determinant of improved outcomes in patients with sepsis and blood stream infections (BSI). For these reasons, development of rapid non-culture diagnostic tests for blood stream infections is a top priority.

The T2Bacteria panel is the first direct from blood, non-culture test cleared by FDA for diagnosis of blood stream infections .  It detects within 4-6 hours the 5 most common ESKAPE bacteria that are frequent causes of hospital infection, and which are often multi-drug resistant.  This study shows that the T2Bacteria panel rapidly and accurately diagnosed and identified ESKAPE bacterial BSIs, and identified probable and possible BSIs that were missed by blood cultures (in particular among patients who were already receiving antibiotics).

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Grapefruit Juice Can Cause an EKG Change, Prolonged Q-T Interval, Aggravated by Some Medications

MedicalResearch.com Interview with:

Electrocardiogram showing QT interval calculated by tangent method Wikipedia image

Electrocardiogram showing QT interval calculated by tangent method – Wikipedia image

Sami Viskin MD
Tel-Aviv Medical Cente
Sackler School of Medicine
Tel-Aviv University, Israel.

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

Response: There are >200 medications with reported QT-prolonging risk. The majority of these medications do not even have cardiac indications, yet cause unintended QT-prolongation because they block IKr potassium channels in myocardial cells. With so many drugs, of such varied composition, blocking the IKr channel, it is reasonable to assume that food compounds also have IKr-channel-blocker properties, raising the possibility that proarrhythmic food exists.

We tested the effects of grapefruit on the QT interval with the rigorous methodology used by the pharmaceutical industry to test new medications before they are released to the market.

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Dialysis Unit Profit Primarily From Small Percentage of Privately Insured Patients

MedicalResearch.com Interview with:

Chris Childers, MD, PhDDivision of General SurgeryDavid Geffen School of Medicine at UCLA10833 Le Conte Ave., CHS 72-247Los Angeles, CA 90095

Dr. Childers

Chris Childers, MD, PhD
Division of General Surgery
David Geffen School of Medicine at UCLA
Los Angeles, CA 90095

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

Response: Patients with end-stage renal disease – poorly functioning kidneys – often have to receive dialysis. This typically requires a patient to visit an outpatient clinic several times a week to have their blood filtered by a machine. Over the past few years, two for-profit companies have increased their control over the outpatient dialysis market – DaVita and Fresenius. Combined they control approximately ¾ of the market.  A number of concerns have been raised against these for-profit companies suggesting that the quality of care they deliver may be worse than the care delivered at not-for-profit companies. But, because they control so much of the market and because patients have to receive dialysis so frequently, patients may not have much choice in the clinic they visit.

Medicare covers patients who are 65 years or older and also patients on dialysis regardless of age.  Medicare pays a fixed rate for dialysis which they believe is adequate to cover the clinics’ costs. However, if a patient also has private insurance, the insurer is required to pay for dialysis instead of Medicare. Whereas Medicare rates are fixed by the federal government, private insurers have to negotiate the price they pay, and may pay much more as a result.

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HPV6 Serology Associated with Bladder Cancer

MedicalResearch.com Interview with:

Lael S. Reinstatler, MD, MPH.PGY 4 Urology ResidencyDartmouth Hitchcock

Dr. Reinstatler


Lael S
Reinstatler, MD, MPH.
PGY 4 Urology Residency
Dartmouth Hitchcock

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

Response: Human Papillomavirus is an oncogenic virus associated with other genitourinary cancers including penile cancer.

HPV is detectable in urine and in urethral swabs and it interacts with stratified squamous epithelium which lines the majority of the genitourinary tract. Prior research has identified HPV in bladder tumors but detection methods are inconsistent.

In this study, we looked for an association with HPV serology (indicating prior HPV systemic exposure) and bladder cancer.

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Combat-Related Mild Traumatic Brain Injury: Magnetoencephalography Can Detect Abnormal Gamma Band

MedicalResearch.com Interview with:

Dr. Mingxiong Huang, PhDProfessor, Electrical and Computer EngineeringUniversity of California, San Diego

Dr. Huang

Dr. Mingxiong Huang, PhD
Professor, Electrical and Computer Engineering
University of California, San Diego

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

Response: Combat-related mild traumatic brain injury (mTBI) is a leading cause of sustained impairments in military service members and Veterans. Yet, conventional neuroimaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) are typically insensitive to physiological alterations caused by mild and some moderate TBIs.

With funding from the VA, we have pursued in developing sensitive imaging markers based on magnetoencephalography (MEG) for mTBI. This paper reflects the news MEG findings in this research field.  Continue reading

Excessive Supplements Linked to Increased Risk of Hip Fractures

MedicalResearch.com Interview with:

Prof. Haakon E Meyer, PhDDepartment of Public Health and Global HealthNorwegian Institute of Public HealthOslo, Norway

Prof. Meyer

Prof. Haakon E Meyer, PhD
Department of Public Health and Global Health
Norwegian Institute of Public Health
Oslo, Norway

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

Response: The use of high dose vitamin supplementation is popular in parts of the population, often without any clear indication and in the absence of clear evidence of benefit.

However, side effects can occur, and in a previous published secondary analysis of double blinded randomized controlled trials, we found to our surprise an increased risk of hip fracture in those supplemented with high doses of vitamin B6 in combination with vitamin B12.

This finding was re-assessed in the current study employing data from the large observational Nurses’ Health Study. As in the previous study, we found that a combined high intake of vitamin B6 and B12 was associated with increased risk of hip fracture. Continue reading

Circulating Tumor DNA Linked to Recurrence After Colon Cancer Surgery

MedicalResearch.com Interview with:

Louise OlssonSenior researcherDepartment of Molecular Medicine and SurgeryColorectal SurgeryKarolinski InstituteStockholm, Sweden

Dr. Olsson

Louise Olsson MD PhD
Senior researcher
Department of Molecular Medicine and Surgery
Colorectal Surgery
Karolinski Institute
Stockholm, Sweden 

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

Response: I read a very interesting paper back in 2006 “Detection and quantification of mutation in the plasma of patients with colorectal cancer”. Only some 60 % of patients with early colorectal cancer were detectable in this way whereas patients with stage IV disease all had a high concentration of APC mutations in their plasma. So the prospects of using the method for example, screening of primary colorectal cancer seemed limited but I thought wow, this is the test to detect recurrences and generalized disease during follow-up after surgery for colorectal cancer. After some discussion we started to collect plasma samples from patients at the hospital where I worked and that´s how my research began.

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Caffeine and Heart Disease: Is There a Right Amount of Daily Coffee?

MedicalResearch.com Interview with:
Professor Elina Hypponen
Professor in Nutritional and Genetic Epidemiology
Director: Australian Centre for Precision Health
 Australian Centre for Precision Health|
University of South Australia Cancer Research Institute |
South Australian Health & Medical Research Institute 

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

Response: In Randomised controlled trials caffeine, which is a key constituent of coffee, has been shown to increase blood pressure. There is also some past evidence to suggest that higher coffee consumption may increase the risk of cardiovascular disease, but only in individuals who are slow caffeine metabolisers.

We used information from about 350,000 individuals from the UK, to look at the association between patterns of  habitual of coffee consumption and the subsequent risk of cardiovascular disease. As we also know that people are genetically different with respect to their ability to metabolise caffeine, a further aim for our study was to look at whether those people who are able to metabolise caffeine effectively, may also be more resistant to possible cardiovascular effects of coffee, compared to those who metabolise caffeine more slowly.  Continue reading

Computerized Brain Training BrainHQ Can Reduce Neglect Symptoms of Stroke and Brain Injury

MedicalResearch.com Interview with:

Thomas M Van Vleet PhDPosit Science 

Dr. Van Vleet

Thomas M Van Vleet PhD
Posit Science 

Dr. Tom Van Vleet,  presented results on a common symptom of stroke and acquired brain injury (hemi-spatial neglect) at the American Academy of Neurology May 2019

MedicalResearch.com: What makes this study newsworthy?

Response For the first time ever a highly-scalable intervention — computerized brain training (BrainHQ made by Posit Science) —was found to improve symptoms of hemi-spatial neglect, which is a common and often intractable and debilitating problem after stroke or other acquired brain injury.

MedicalResearch.com: What can you tell us about the medical condition (hemi-spatial neglect) investigated in this study?

Response About a third of patients with a brain injury exhibit a complex and debilitating array of neurological deficits known as the “neglect syndrome” (sometimes called, “hemi-spatial neglect” or “neglect”).

The most apparent symptom of neglect is the inability of patients to efficiently process information on the side of space opposite the injury; often completely missing relevant events without awareness. As a result, patients often fail to adopt compensatory strategies or respond to other conventional rehabilitation protocols.

The cost is significant, as patients with neglect experience longer hospital stays and have higher requirements for assistance, including greater skilled nursing home placements relative to patients with similar extent of brain injury without neglect.

To date, there’s been no broadly-applicable and highly-scalable intervention for addressing neglect. An alarming reality given the increasing cost of stroke, which is currently estimated to exceed $34 billion per annum

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Over a Million Opioid Prescriptions at Risk of Diversion by Family Members

MedicalResearch.com Interview with:

Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor

Dr. Kao-Ping Chua

Kao-Ping Chua, M.D., Ph.D.
Department of Pediatrics
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan, Ann Arbor

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

Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions.

In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.

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Primary Care: Brief Training Encourages Discussions of Prescription Drug Costs

MedicalResearch.com Interview with:

Kevin Fiscella, M.D., M.P.H.Dean’s Professor, Family MedicineProfessor, Public Health Sciences and Community HealthUniversity of Rochester  Medical CenterCo-Director, Research DivisionDepartment of Family MedicineRochester, New York 14620

Dr. Fiscella

Kevin Fiscella, M.D., M.P.H.
Dean’s Professor, Family Medicine
Professor, Public Health Sciences and Community Health
University of Rochester  Medical Center
Co-Director, Research Division
Department of Family Medicine
Rochester, New York 14620 

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

Response: The study was designed to determine whether one hour of training was sufficient to promote conversations between physicians and their patients regarding patient-borne costs of prescriptions.

We found that the training, which promoted a team-based approach involving brief screening and cost-reducing strategies, nearly doubled the number of conversations.

MedicalResearch.com: What should readers take away from your report? 

Response: Brief education on brief screening and practical strategies to lower prescription costs increases office visits discussion of prescription costs and strategies to reduce them.   

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further questions are whether these effects are sustained and/or whether additional interventions are needed to produce larger and more sustained effects.

No disclosures

Citation:

Ann Intern Med. 2019 May 7;170(9_Supplement):S46-S53. doi: 10.7326/M18-2011.
Addressing Medication Costs During Primary Care Visits: A Before-After Study of Team-Based Training.
Carroll JK1, Farah S2, Fortuna RJ3, Lanigan AM4, Sanders M2, Venci JV5, Fiscella K5. 

https://www.ncbi.nlm.nih.gov/pubmed/31060055

May 11, 2019 @ 1:44 pm 

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Novel Lantibiotic Against C. diff Infections May Improve Lipid Profile

MedicalResearch.com Interview with:

Rajesh Kumar NV, Ph.D.Affiliation during the study:Senior Manager, Human Therapeutics Division,Intrexon Corporation, Germantown, MD, USA

Dr. Rajesh Kumar NV

Rajesh Kumar NV, Ph.D.
Affiliation during the study:
Senior Manager, Human Therapeutics Division,
Intrexon Corporation, Germantown, MD, USA
Current affiliation:
Translational Research Program Manager, Oncology Drug Discovery,
Department of Radiation Oncology and Molecular Radiation Sciences,
Johns Hopkins University School of Medicine
Baltimore, MD,  


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

Response: Clostridium difficile is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Clostridium difficile infection is the most frequent form of colitis in hospitals and nursing homes and affects millions of patients in the United States and abroad. Clostridium difficile associated disease (CDAD) is a global public health challenge where even mild to moderate infections at times can quickly progress to a fatal disease if not treated promptly.

OG253 is a novel lantibiotic in development for the treatment of CDAD. Lantibiotics are antimicrobial peptides whose chemical structure includes a bridge maintained by the non-canonical amino acid lanthionine. The primary objective of our study was to evaluate the repeated dose toxicokinetics and any possible side effects of OG253 as enteric-coated capsules following daily oral administrations of three different doses (6.75, 27 and 108 mg/day) for a single day or seven consecutive days in both genders of rats.

An enteric-coated capsule of OG253 was formulated in an attempt to circumvent the proteolytic degradation of OG253 in the upper digestive tract and specifically deliver this lantibiotic to the distal portion of the small intestine. Continue reading

Which Matters More? Pre-Pregnancy Obesity vs Pregnancy Weight Gain?

MedicalResearch.com Interview with:

Dr-Romy GaillardRomy Gaillard MD PhD
LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group
Erasmus MC

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

Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications.

The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known. Continue reading

Stroke: Thrombolysis Guided by Perfusion Imaging Extended Time Window up to 9 Hours after Onset

MedicalResearch.com Interview with:

Geoffrey A Donnan AOMBBS, MD, FRCP, FRACP, FAAHMSProfessor of NeurologyUniversity of Melbourne, Melbourne Brain Centre,Royal Melbourne and Austin Hospitals

Prof. Donnan

Geoffrey A Donnan AO
MBBS, MD, FRCP, FRACP, FAAHMS
Professor of Neurology
University of Melbourne, Melbourne Brain Centre
Royal Melbourne and Austin Hospital

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

Response: Currently the thrombolysis time window for acute ischemic stroke is restricted to less than 4.5 hours from stroke onset and patients with wake-up stroke are not eligible.

EXTEND is a multi-centre randomised placebo-controlled trial involving patient with acute ischemic stroke who presented between 4.5 to 9 hours of stroke onset or with wake-up-stroke and had penumbral tissue demonstrated on automated perfusion imaging.

Patients were randomised to receive either alteplase or placebo. In total there were 225 patients recruited and the patients who received alteplase had higher rate of excellent functional outcome at 3 months (35.4% vs 29.5% adjusted odd ration 1.44 with 95% confidence interval 1.01 – 2.06 p=0.04). Patients who received alteplase achieved higher rate of early neurological improvement at day 3, reperfusion and recanalization at 24 hours. There was numerically more haemorrhage in the alteplase group but this not negate the functional benefit and there was no difference in the rate of mortality between the two groups.  Continue reading

Diroximel Fumarate in Patients With Relapsing-remitting Multiple Sclerosis: Interim Efficacy and Safety Results From the Phase 3 EVOLVE-MS-1 Study

MedicalResearch.com Interview with:

Douglas Arnold, MDThe Montreal Neurological Institute & HospitalMcGill University Montreal, QC, Canada

Dr. Arnold

Douglas Arnold, MD
The Montreal Neurological Institute & Hospital
McGill University
Montreal, QC, Canada

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

Response: Diroximel fumarate (DRF) is a novel oral fumarate, with a distinct chemical structure that is being developed for relapsing forms of multiple sclerosis (MS). It is hypothesized that the distinct chemical structure of DRF may elicit less localized irritation in the gastrointestinal (GI) tract, potentially leading to improved GI tolerability. Diroximel fumarate is expected to have similar efficacy as dimethyl fumarate (marketed as TECFIDERA®), as both are converted to equivalent levels of monomethyl fumarate in the body. The EVOLVE-MS-1 study is primarily evaluating the safety of DRF and also exploring efficacy endpoints.   Continue reading

Health Professionals Concerned About Side Effects and Diversion of Medicinal Cannabis

MedicalResearch.com Interview with:
Kyle Gardiner B.Pharm(Hons)PhD candidateDiscipline of PharmacyQueensland University of Technology | QUT · Brisbane, Australia
Kyle Gardiner B.Pharm(Hons)

PhD candidate
Discipline of Pharmacy
Queensland University of Technology | QUT ·
Brisbane, Australia

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

Response: The background to this study was a personal interest in behavioural science. I am often intrigued as to why health professional behave the way they do. Studies exploring health professional behaviour are seldom complete or comprehensive, however.

Medicinal cannabis presents an interesting case point to explore health professional behaviours due to its topical nature. The socio-political discussion surrounding medicinal cannabis is often quite different from the medical discussion, yet for legal and regulated access to be achieved across most jurisdictions, a health professional is required to be involved in that process. Simply, if health professionals are not willing to behave, the delivery of medicinal cannabis does not occur. For purposes of transparency, I neither support or reject the use of medicinal cannabis and this paper has nothing to do improving or reducing access. This paper is about beginning to understand health professional behaviours within the context of medicinal cannabis. Yet, if we hope to change practice in the future, by definition, we need to change behaviour. We cannot change behaviour without first understanding the behaviour in context.

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Vaginal Progesterone May Reduce Miscarriages in Women with Bleeding in Early Pregnancy

MedicalResearch.com Interview with:

Prof. Arri Coomarasamy MBChB, MD, FRCOGInstitute of Metabolism and Systems ResearchProfessor of GynaecologyDirector of Tommy's National Centre for Miscarriage ResearchUniversity of Birmingham

Prof. Coomarasamy

Prof. Arri Coomarasamy MBChB, MD, FRCOG
Institute of Metabolism and Systems Research
Professor of Gynaecology
Director of Tommy’s National Centre for Miscarriage Research
University of Birmingham

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

Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain.

So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding.

However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages.

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Bat Borne Nipah Virus Transmitted by Human Secretions

MedicalResearch.com Interview with:

Birgit Nikolay PhDMATHEMATICAL MODELLING OF INFECTIOUS DISEASESInstitut Pasteur

Dr. Nikolay

Birgit Nikolay PhD
MATHEMATICAL MODELLING OF INFECTIOUS DISEASES
Institut Pasteur 

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

Response: Nipah virus was identified by the World Health Organization as an emerging infectious disease that may cause major epidemics if the pathogen evolves to become more transmissible, leading the organization to prioritize it for research to prevent future health emergencies. In the absence of efficient treatments or vaccines, the only way to control Nipah virus outbreaks is through targeted interventions that limit opportunities of spread. Designing such interventions is challenging in a context where transmission mechanisms remain poorly understood. The study provides important insights to better understand these mechanisms.

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Open Communication Linked to Lower Hospital Mortality

MedicalResearch.com Interview with:
Veronica Toffolutti PhD

Postdoctoral researcher working with Professor David Stuckler
Department of Sociology
Bocconi University

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

Response: Openness has been linked with better patient safety and better understanding of patients’ care goals. In addition, more open environments appear to be linked with positively ranked quality of teamwork, which in turns lead to better health care.

Yet if the expected benefits are to be achieved, it is necessary to show that greater openness actually corresponds to improvements in performance or lower mortality rates. To the best of our knowledge our is the first study to show an association between hospital mortality and openness and more precisely one point increase in the standardized openness score leads to a decrease of 6.48% in the hospital mortality rates. With the term openness we refer to an environment in which communication among patients, staff members and managers is open and transparent.  Continue reading

Amyloid and Tau Biomarkers Help Distinguish Alzheimer’s from Other Forms of Mild Cognitive Impairment

MedicalResearch.com Interview with:
Lauren McCollum, MDCognitive and Behavioral Neurology FellowPenn Memory Center / Cognitive Neurology DivisionLauren McCollum, MD

Cognitive and Behavioral Neurology Fellow
Penn Memory Center / Cognitive Neurology Division

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

Response: Alzheimer’s Disease (AD) is a heterogenous condition, with considerable variability in cognitive symptoms and progression rates.

One major reason for this heterogeneity is “mixed pathology,” – i.e., both AD- and non-AD pathology. Examples of non-AD pathology include cerebrovascular disease (CVD), Lewy Bodies, and TDP-43. Pathologically, Alzheimer’s Disease is defined by characteristic amyloid plaques and neurofibrillary tangles, which can be assessed for in living patients with CSF- or PET-based biomarkers for amyloid and tau, respectively. Classically, amyloid deposition begins years or even decades before pathologic tau accumulation, which is in turn associated with brain atrophy and cognitive decline.

The recently developed NIA-AA “ATN” research framework allows for the classification of individuals with regard to 3 binary biomarkers: Amyloid (A), Tau (T), and Neurodegeneration (N). An individual’s ATN biomarker status indicates where along the “Alzheimer’s Disease continuum” they lie. Additionally, some ATN statuses are on the “typical AD” continuum, while others are not. Research has shown that 15-30% of cognitively normal older adults have elevated amyloid. It stands to reason that some portion of cognitively impaired individuals with elevated amyloid and neurodegeneration have something other than AD driving their neuronal injury. Within the context of the ATN research framework, this subset of people is the A+T-N+ group (i.e., people who have elevated amyloid and neurodegeneration, but are tau-negative), as amyloid alone (that is, amyloid without tau) is not thought to cause significant cognitive impairment or brain atrophy. Our hypothesis was that, compared to A+T+N+ (a set of typical-AD biomarkers), A+T-N+ have cognitive and neuroimaging profiles that deviate from a typical Alzheimer’s Disease pattern – i.e., with less memory loss and less atrophy in AD-signature regions – and may have biomarkers suggestive of alternate non-AD pathologies [e.g., white matter hyperintensities (WMHs), a marker of CVD].

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Proximity to Oil Refineries and Risk of Bladder Cancer

MedicalResearch.com Interview with:

Stephen B. Williams, MD, FACSChief, Division of UrologyAssociate Professor, Urology and RadiologyRobert Earl Cone ProfessorshipDirector of Urologic OncologyDirector of Urologic ResearchCo-Director Department of Surgery Clinical Outcomes Research ProgramUniversity of Texas Medical Branch at Galveston

Dr. Williams

Stephen B. Williams, MD, FACS
Chief, Division of Urology
Associate Professor, Urology and Radiology
Robert Earl Cone Professorship
Director of Urologic Oncology
Director of Urologic Research
Co-Director Department of Surgery Clinical Outcomes Research Program
University of Texas Medical Branch at Galveston

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

Response: Despite prior studies evaluating cancer in those living near and working in oil refineries, there remains a gap in knowledge regarding proximity to oil refineries and risk of bladder cancer.

Aromatic amines have been associated with increased risk of various cancers including bladder cancer. Texas is a home to the largest numbers of oil refineries in the US. Our goal was to evaluate if there was a link between bladder cancer and living in close proximity to an oil refinery in Texas.

Our data did suggest that living within 10 miles of an oil refinery was associated with a small increase in risk of bladder cancer. These data support further research to validate these findings.

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Pre-Visit Electronic Screening Helps Doctors Counsel Their Adolescent Patients

MedicalResearch.com Interview with:

Cari McCarty, PhDResearch Professor, UWInvestigator, Seattle Children’s Research Institute

Dr. McCarty

Cari McCarty, PhD
Research Professor, UW
Investigator, Seattle Children’s Research Institute 

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

Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care.

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COPD: Aclidinium Bromide (Tudorza Pressair) Has Favorable Safety Profile in Patients with CVD

MedicalResearch.com Interview with:

Robert A. Wise, M.D.Professor of MedicinePulmonary and Critical CareJohns Hopkins University School of MedicineBaltimore, MD 

Dr. Wise

Robert A. Wise, M.D.
Professor of Medicine
Pulmonary and Critical Care
Johns Hopkins University School of Medicine
Baltimore, MD

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

Response: There has been a lingering controversy about the safety of long-acting anti-muscarinic agents (LAMA) as maintenance treatment for COPD in patients who have increased cardiovascular risk.  This study enrolled participants with COPD who also had increased cardiovascular risk or known cardiovascular disease.  Participants were randomly treated with either aclidinium bromide (Tudorza Pressair) or placebo.

Over 3 years of follow up there was no increased risk of adverse cardiovascular events.  Moreover, the medication had a significant benefit in terms of reducing exacerbations and COPD hospitalizations. Continue reading

Over 11 Million US Adults Have Alcoholic Liver Disease

MedicalResearch.com Interview with:

Robert Wong, MD, MS, FACGAssistant Clinical Professor of MedicineDirector, GI Education & ResearchHighland Hospital   I A member of Alameda Health SystemOakland, CA 94602

Dr. Wong

Robert Wong, MD, MS, FACG
Assistant Clinical Professor of Medicine
Director, GI Education & Research
Highland Hospital   I A member of Alameda Health System
Oakland, CA 94602 

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

Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S.  However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder.  Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S

We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease.  Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease.  Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression.

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Could Aspirin Improve Stool Testing for Colon Cancer Screening?

MedicalResearch.com Interview with:
Prof. Dr. med. Hermann Brenner
Clinical Epidemiology and Aging Research
Division Head
German Cancer Research Center
Foundation under Public Law
Germany 

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

Response: Colorectal cancer is the third most common cancer globally, accounting for almost 900.000 deaths every year. Most of these deaths could be prevented by screening colonoscopy with early detection and removal of precursors of the cancer. However, capacities and use of screening colonoscopy are limited in most parts of the world, and low-cost but reliable noninvasive screening tests are important alternative primary screening tests.

The currently best established noninvasive tests are fecal immunochemical tests for hemoglobin (FITs) which are offered for colorectal cancer screening in an increasing number of countries. Although FITs detect the majority of colorectal cancers they detect approximately one out of four advanced adenomas only, the precursors of most colorectal cancers.

We hypothesized that this proportion could be increased by taking a single pill of aspirin two days prior to collecting the stool sample for FIT, because the well-established antithrombotic effects of aspirin might favor detecting occult bleeding from colorectal cancer or its precursors.

Continue reading

Multiple Sclerosis: Extended Dosing of Natalizumab Reduces Risk of PML

MedicalResearch.com Interview with:

Lana Zhovtis Ryserson, MDAssistant Professor, Department of NeurologyNYU Langone Health

Dr. Zhovtis Ryserson

Lana Zhovtis Ryserson, MD
Assistant Professor, Department of Neurology
NYU Langone Health

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

Response: Natalizumab is an effective therapy of relapsing remitting multiple sclerosis dosed at 300mg every 4 weeks. However it is associated with a potentially deadly infection – progressive multifocal leukoencephalopathy. In order to mitigate this risk, clinicians have adopted an approach of infusing the medication less frequently, a strategy which has become known as Extended Interval Dosing (EID).

The TOUCH database is US mandatated risk evaluation and mitigation program which is the largest database available to assess PML risk for patients on EID schedule. Previous analysis of this database in 2017, showed a significant risk reduction of PML in patients utilizing extended interval dosing schedule. The aim of the current study was to update on this analysis with another year of data.

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Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning Methods

Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning MethodsThe number of deaths caused by resistant bacteria is expected to reach 10 million by 2025, according to the Centers of Disease Control and Prevention. A highly resistant bacteria found in hospitals – Klebsiella pneumoniae – is now a big global threat, according to a recent (April, 2019) study published by researchers from University College London. Researchers have issued a warning that more stringent cleaning of infectious wards and new air disinfection protocols are key to battling the bug. This is because this bacteria possesses the ability to change genetically at an alarming rate, adapting and essentially nullifying the effect of all current antibiotics.

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Collaboration and Teamwork Allowed Reduction in Unintended Extubations in Neonatal ICU

MedicalResearch.com Interview with:

John P. Galiote, M.D.Neonatologist at Children’s National-Virginia Hospital Center NICU

Dr. Galiote

John P. Galiote, M.D.
Neonatologist at Children’s National-Virginia Hospital Center NICU

Michelande Ridoré, MS, NICUQuality improvement lead at Children’s National 

Ms. Ridoré

Michelande Ridoré, MS, NICU
Quality improvement lead at Children’s National

Lamia Soghier, M.D., MEd, Children’s National NICU medical director

Dr. Soghier

 

Lamia Soghier, M.D., MEd, Children’s National NICU Medical Director

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

Response: Our study emphasizes the importance of team work and real-time communication in a quality-improvement project within the neonatal intensive care unit (NICU) setting.

Through bedside huddles, weekly reviews of apparent cause analysis reports reducing the frequency of X-rays and the creation of an Airway Safety Protection Team, we were able to focus not only on  reducing unintended extubations, but also on the quality-improvement project’s effect on our staff. Adhering to simple quality principles enabled us to ensure that all members of our staff were heard and had a positive effect on the progress of our project. This allowed us to implement and sustain a series of simple changes that standardized steps associated with securing and maintaining an endotracheal tube (ET). Unintended extubations are the fourth-most common adverse event in the nation’s NICUs. Continual monitoring via this quality-improvement project allowed us to intervene when our rates increased and further pushed our unintended extubation rate downward. Continue reading

How Much of Your Sunscreen is Absorbed?

MedicalResearch.com Interview with:

David Strauss, MD, PhDDirector, Division of Applied Regulatory ScienceU.S. Food and Drug AdministrationCenter for Drug Evaluation and Research

Dr. Strauss

David Strauss, MD, PhD
Director, Division of Applied Regulatory Science
U.S. Food and Drug Administration
Center for Drug Evaluation and Research

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

Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies.

This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling.

All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL.  Continue reading

Are Commercial Peanut Immunotherapy Products Cost-Effective?

MedicalResearch.com Interview with:

Dr. Marcus Shaker

Dr. Shaker

Marcus S. Shaker, MD
Associate Professor of Pediatrics
Associate Professor of Community and Family Medicine
Dartmouth-Hitchcock Medical Center

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

Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment.  Both have tremendous potential benefit.  The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective.

We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present.  That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing.  Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective.

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