Author Interviews, Breast Cancer, Chemotherapy, JAMA, Karolinski Institute / 09.11.2016

MedicalResearch.com Interview with: Jonas Bergh M.D, Ph.D. F.R.C.P. (London, UK) Professor of Oncology (Mimi Althainz´donation) Director Strategic Research Program in Cancer Karolinska Institutet Radiumhemmet, Karolinska University Hospital Stockholm, Swede MedicalResearch.com: What is the background for this study? Response: Present standard dosing of chemotherapy is aiming at a similar dose for each individual (similar effects and side-effects) , by calculating the dose per mg/m2 based on a formula originally established by du Bois (1916), based on body surface calculations by measuring height and weight. As I recall it, this was done on nine individuals… However, the body surface has very little to do with how you cytotoxic drugs are metabolized and excreted… in practice this means that chemotherapy dosing based on body surface area will result in under- or overdosing of quite a proposition of the patients… Please Google/run a PubMed research on H. Gurney in Australia, he and other have really expressed their concerns with our present chemotherapy dosing strategies. In our prospective adjuvant chemotherapy study of high risk breast cancer patients we tested a very well established standard chemotherapy regimen given every third week (FEC100 mg/m2 x 3+ docetaxel 100 mg/m2 x3) vs. our experimental arm given very second week in a dose dense fashion. We also tried to optimize the dosing, aiming at avoiding overdosing some patients at the first course and increase the dose for those without predefined toxicities. Therapy duration was similar in both groups, 15 weeks. Please see the end of the discussion in JAMA for the shortcomings with our study. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Lipids / 09.11.2016

MedicalResearch.com Interview with: Borge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry, Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acute pancreatitis is an inflammatory disorder of the pancreas with gallstones and high-alcohol consumption as leading risk factors, while mild-to-moderately increased plasma triglycerides hitherto has been overlooked. We surprisingly found that the risk of developing acute pancreatitis was increased already from triglycerides of 175 mg/dL (2 mmol/L) and above. When triglycerides were above 443mg/dL (5mmol/L) the risk was increased a massive 9-fold. Interestingly, this risk was higher than the corresponding 3.4-fold higher risk for myocardial infarction. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 09.11.2016

MedicalResearch.com Interview with: Dr. Sharon Unger BSc, MD, FRCP Staff Neonatologist at Mount Sinai Hospital Associate Staff Neonatologist at The Hospital for Sick Children (SickKids) Associate Professor in the Department of Paediatrics at the University of Toronto. Medical Director of the Rogers Hixon Ontario Human Milk Bank and Dr. Deborah L. O’Connor PhD, RD Senior Associate Scientist in Physiology & Experimental Medicine SickKids and Professor Department of Nutritional Sciences at the University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Babies who are born very early (before 32 weeks’ gestation) and/or at very low weights (less than 1,500 grams) are among the most fragile of all paediatric patients, typically facing serious medical issues and requiring care in a Neonatal Intensive Care Unit (NICU). In addition to underdeveloped organs and risk of neurodevelopmental issues, preterm and very low birth weight babies are at risk of a severe bowel emergency called necrotizing enterocolitis, which involves the damage and potential destruction of the intestinal tissue. This disease affects approximately six per cent of very low birth weight infants each year, making it one of the most common causes of death and long-term complications in this population. As a neonatologist and a PhD-trained dietitian, we have spent our careers working to improve outcomes for babies and supporting breastfeeding. While there is already strong evidence to suggest that breastfeeding is associated with a variety of benefits including reduced risk of childhood infections and may play a role in the prevention of overweight and diabetes, in healthy, full-term infants, we launched a research program a decade ago to figure out how to ensure the same advantage could be provided to vulnerable hospitalized infants, specifically very low birth weight infants. Breastfeeding initiation rates in Canada are now at all-time high for healthy newborns, but for many reasons related to preterm birth, up to two thirds of mothers of very low birth weight infants are unable to provide a sufficient volume of breast milk to their infant. A variety of factors may limit breast milk production in these cases, including immaturity of the breast cells that make milk, maternal illness, breast pump dependency, and stress. In addition to the health benefits attributed to mother’s milk for full-term, healthy infants, previous studies have shown that use of mother’s milk in very low birth weight infants is associated with a reduction in necrotizing enterocolitis. It is also associated with a reduction in severe infection, improved feeding tolerance and more rapid hospital discharge. Ten years ago, along with our inter-professional colleagues at 21 NICUs in the Greater Toronto and Hamilton areas, we began to examine whether using donor breast milk as a supplement to mother’s milk would improve health outcomes of very low birth weight infants when mother’s milk was not available. (more…)
Author Interviews, Cancer Research, Immunotherapy, Vaccine Studies / 09.11.2016

MedicalResearch.com Interview with: Leslie Chong Imugene Chief Operating Officer Armadale, Australia Leslie Chong Imugene Chief Operating Officer Armadale, Australia   MedicalResearch.com: What is the background for this study? How does HER-Vaxx work? • The technology originates from the Medical University of Vienna, one of Europe’s leading cancer institutes and was identified in 2012 by Dr Axel Hoos (Currently Sr. Vice President of Oncology R&D at GlaxoSmithKline, previous Clinical Lead on Ipilumimab at Bristol-Myers Squibb, a director at Imugene; his only Board seat worldwide) • HER-Vaxx is a peptide vaccine designed to treat tumours that over-express the HER2/neu receptor, such as gastric, breast, ovarian, lung and pancreatic cancers. The vaccine is constructed from various B Cell epitopes of HER2/neu. It has been shown in pre-clinical work and in a Phase 1 study to stimulate a potent polyclonal antibody response to HER2/neu, a commercially and clinically validated cancer target. HER-Vaxx’s successful Phase 1 study was in patients with metastatic breast cancer and the next stage of development will be a Phase 1b/2 study in patients with gastric cancer initiating in 2016. (more…)
Author Interviews, CDC, Pediatrics, Salt-Sodium / 08.11.2016

MedicalResearch.com Interview with: Zerleen S. Quader, MPH CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sodium reduction is considered a key public health strategy to reduce cardiovascular disease nationwide, and this study is the latest in ongoing CDC efforts to monitor U.S. sodium intake. Eating habits and taste for salt are established early in life by what children eat. Eating too much sodium can set them up for high blood pressure now and health problems later. Previous evidence suggests that one in nine children already has blood pressure above the normal range, and strong evidence has shown that reducing sodium intake reduces blood pressure – and lowering blood pressure lowers the risk of cardiovascular disease among adults. With voluntary efforts already underway by some manufacturers to lower the sodium and added sugar content in some of their products, these findings help provide a baseline to monitor changes in the food industry, as well as sodium intake among U.S. youth. We examined data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to determine sodium intake by major food category, place and eating occasion. We found that average sodium intake among participants was 3,256 mg, and that doesn’t include salt added at the table. On the day of assessment, nearly 90 percent exceeded the upper level of sodium recommended for a healthy diet. • There were some variations based on age and gender. For example: o Average intake was highest among high school-aged children o Girls had significantly lower daily intake than boys (for example, 2,919 mg versus 3,584 mg) • In addition, we found that ten types of food make up nearly half of youth sodium intake nationwide, including pizza, bread, lunch meats and snack foods. We also analyzed where the foods were obtained and found that approximately 58 percent of sodium comes from store foods, 16 percent from fast food and pizza restaurants and 10 percent from school cafeteria foods. And when we looked at occasion, we discovered that 39 percent of sodium intake was consumed at dinner, 31 percent at lunch, 16 percent from snacks and 14 percent from breakfast. (more…)
Author Interviews, Blood Pressure - Hypertension / 08.11.2016

MedicalResearch.com Interview with: Alejandro de la Sierra, MD, PhD, FESC, FAHA Professor of Medicine Head, Internal Medicine Department Hospital Mutua Terrassa University of Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Systolic Blood Pressure Intervention (SPRINT) trial has demonstrated that a strategy of systolic blood pressure (BP) reduction to a goal of 120 mmHg in selected hypertensive patients prevents the development of cardiovascular complications and mortality. The trial used automated office BP measurements. However, ambulatory BP monitoring (ABPM) has demonstrated to be superior to office BP in predicting cardiovascular events and mortality. We aimed to evaluate ambulatory BP values in hypertensive patients from the Spanish ABPM Registry who meet eligibility criteria for the SPRINT trial. The results indicated that one third of our hypertensive population met such eligibility criteria and that ABPM values were considerably lower than office BP, with 42% of subjects having daytime BP below 130 mmHg and 21% with 24-hour BP below 120 mmHg. (more…)
Author Interviews, Cost of Health Care, Diabetes, JAMA / 08.11.2016

MedicalResearch.com Interview with: Tara Gomes, MHSc Li Ka Shing Knowledge Institute, St Michael’s Hospital, The Institute for Clinical Evaluative Sciences Leslie Dan Faculty of Pharmacy Department of Health Policy, Management, and Evaluation University of Toronto, Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: In August 2013, the Ontario government introduced reimbursement limits for blood glucose test strips. Subsequent research has suggested that the provincial government saved $24 million in the first year after implementing this quantity limit policy. This study investigated whether these quantity limits led to any change in diabetes-related patient outcomes. We found that limiting the number of blood glucose test strips reimbursed by the government to levels recommended by the Canadian Diabetes Association had to no change in diabetes control (measured as rates of emergency department visits for hypoglycemia or hyperglycemia, and mean HbA1c) in the 1.5 years after implementation. Similarly, there was no worsening of patient outcomes in a subgroup of individuals who had been frequent users of test strips prior to the policy being announced. (more…)
Author Interviews, Pediatrics / 08.11.2016

MedicalResearch.com Interview with: Lisa Bailey-Davis, DEd, RD Assistant Professor, Department of Epidemiology and Health Services Research Associate Director, Obesity Institute Geisinger Health Systems Danville, PA 17822 MedicalResearch.com: What is the background for this study? What are the main findings? Response: National data from CDC suggest that 3.1% of 12-17 year olds self-reported using an antidepressant in 2005-2010, however we examined electronic health record orders at a large health system and found that antidepressants are ordered more frequently. Antidepressants were ordered for 7.2% of 13 year olds and 16.6% of 18 year olds in our population-representative data. Five or more cumulative months of antidepressant use was strongly associated with increased body mass index, particularly among older youths. At age 18 years, youth treated with 12 or more months of antidepressants were likely to be 2.1 kg heavier than youth without antidepressants. Depression diagnosis, independent, of antidepressants was also associated with higher body mass index. At age 12 years, youth with at least 1 depression diagnosis had a higher average BMI than youth without such diagnosis. (more…)
Author Interviews, Pediatrics / 08.11.2016

MedicalResearch.com Interview with: Barbara Voigtman, MSN, RN Baby and Child Care Clinical Nurse Specialist, Study Manager Kimberly-Clark Neenah, WI MedicalResearch.com: What is the background for this developmental diapering guide? Response: Changing an infant’s diaper currently is seen as a repetitive, routine task. The Huggies Nursing Advisory Council - a Kimberly Clark-sponsored consulting group made up of experts in neonatal and perinatal nursing, education, occupational therapy, as well as a NICU parent advocate - discovered an unseized opportunity for nurses to integrate, model and educate parents and other caregivers about a broad approach to diapering. This approach incorporates the developmental care model to foster infant/parent bonding as well as support psychological, neuorobiological and psychoemotional needs of the infant in addition to attending to the more commonly addressed physiological needs of the infant related to skin care. Together, the Council undertook an extensive literature review, analyzing more than 500 articles, and found that the majority of existing research focuses on prevention, diagnosis and resolution of diaper dermatitis, but there was no comprehensive resource that addresses all aspects of diapering. As a result, the Council co-authored Every Change Matters™: A Guide to Developmental Diapering Care, the first review to consider diapering care within a comprehensive approach—including skin care, physical development, sensory elements and bonding. (more…)
Author Interviews, Cost of Health Care, JAMA / 08.11.2016

MedicalResearch.com Interview with: Robert Humble, MS, MD Candidate, 2019 President, EQUAL Med Governmental Relations Chair, CCOM Student Government University Iowa Matthew D. Krasowski, MD, PhD Department of Pathology University of Iowa Hospitals and Clinics, Iowa City MedicalResearch.com: What is the background for this study? What are the main findings? Response: Laboratory testing is a critical tool in clinical decision-making. Clinical laboratories frequently receive “extra” tubes of blood. On collection, they have no testing associated with them. They are stored in the laboratory for a period of time for add-on testing. We sought to analyze patterns of extra tube collection at an academic medical center over an extended period of time, and determine patterns of add-on testing before and after implementation of new laboratory information system (LIS) software (Epic Beaker). Until this study, extra tube collection and utilization had not been quantified at our institution to this extent. We found that most extra tubes weren’t used for laboratory testing. After collection, the vast majority of these tubes were stored until disposal. Over the period of study our institution moved from a paper ordering protocol to a ‘paperless ordering’ system that printed labels only for tubes needed for testing ordered by providers. After implementation of Epic Beaker, we saw utilization practices improve, though there is still room for improvement. Overall, we’ve seen significant decreases in extra tube collection across the institution. (more…)
Author Interviews, Geriatrics, Medical Imaging, MRI, Weight Research / 08.11.2016

MedicalResearch.com Interview with: Fatemeh Mokhtari Medical Imaging PhD Student VT-WFU SBES MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study was to use baseline anatomical brain MRI scans to prospectively predict weight loss success following an intensive lifestyle intervention. In the study, 52 participants, age 60 to 79, were recruited from the Cooperative Lifestyle Interventions Programs II (CLIP-II) project. The participants were overweight or obese (BMI greater than 28 and less than 42) and had a history of either cardiovascular disease or metabolic syndrome. All participants had a baseline MRI scan, and then were randomized to one of three groups – diet only, diet plus aerobic exercise training or diet plus resistance exercise training. The goal of the 18-month diet and exercise program was a weight loss of 7 to 10 percent of body mass. Basic brain structure information garnered from the MRIs was classified using a support vector machine, a type of computerized predictive algorithm. Specifically, we trained a computational predictive model which mapped each subject’s brain scan to weight loss performance. Predictions were based on baseline brain gray and white matter volume from the participants’ MRIs and compared to the study participants’ actual weight loss after the 18 months. The accuracy of the model was then tested, and our prediction algorithms were 78% accurate in predicting successful weight loss. Brain gray matter volume provided higher prediction accuracy compared with white matter and the combination of the two outperformed either one alone. (more…)
Author Interviews, Immunotherapy, Pulmonary Disease / 08.11.2016

MedicalResearch.com Interview with: Dr. Luca Richeldi MD PhD Professor of Respiratory Medicine Chair of Interstitial Lung Disease University of Southampton United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: The data presented at CHEST 2016 were from two post-hoc pooled analyses of the Phase III INPULSIS® trials that evaluated Ofev in idiopathic pulmonary fibrosis, or IPF. Both analyses, using different measures, demonstrate Ofev efficacy in a range of people with IPF, regardless of disease severity at the start of the trials. One analyses investigated the efficacy of Ofev on disease progression in subgroups of patients defined by their GAP (gender, age, physiology) stage. Based on the index, patients were categorized as either GAP stage I or II/III. The analysis showed a similar reduction in disease progression with Ofev versus placebo regardless of GAP stage – meaning no significant difference between GAP stage I versus GAP stage II/III. Disease progression was defined as an absolute decline in forced vital capacity (FVC) ≥5% predicted or death over 52 weeks. (more…)
Author Interviews, Cancer Research, Cost of Health Care / 08.11.2016

MedicalResearch.com Interview with: Carolyn R. Aldigé President of the Prevent Cancer Foundation MedicalResearch.com: What is the background for this tool? What types of cancers are covered under this comparison tool? Response: The coverage tool compares screening coverage by the 30 largest health insurers in the U.S. Consumers can use the tool to see their insurance plans' policies on coverage of screening tests for breast, cervical, colorectal, lung and prostate cancers. MedicalResearch.com: What are some of the differences in insurance coverage of screening tests? Response: There is a sizable variation in what insurance plans cover, partly a result of differing screening guidelines from three leading organizations. Though insurance plans are required to cover screenings recommended by the United States Preventive Services Task Force (USPSTF) without a co-pay, many will choose to cover other screening tests as well—but which guidelines do they follow? This is confusing to both patients and providers. Breast cancer screening is an area where we see big differences in insurance coverage. All 30 plans cover 2D mammography, but only 13 plans cover 3D mammography (tomosynthesis). Colorectal cancer screening coverage also differs. While almost all plans cover colonoscopy, CT colonography, flexible sigmoidoscopy, and FIT and FOBT screening tests, there are differences in coverage of stool-based DNA tests. (more…)
Author Interviews, CDC, Infections / 08.11.2016

MedicalResearch.com Interview with: Dr. Snigdha Vallabhaneni Medical epidemiologist Mycotic Diseases Branch CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: This report is the first to describe U.S. cases of C. auris infection. C. auris is often resistant to antifungal drugs and tends to occur in hospitalized patients. In June 2016, CDC issued a clinical alert describing the global emergence of C. auris and requesting that laboratories report C. auris cases and send patient samples to state and local health departments and CDC. Since then, CDC has been investigating reports of C. auris with several state and local health departments. Seven of the cases occurred between May 2013 and August 2016 and are described in this report. Among the seven cases detailed in the report, patients with C. auris were reported in four states: New York, Illinois, Maryland and New Jersey. All of the patients had serious underlying medical conditions and had been hospitalized an average of 18 days when C. auris was identified. Four of the patients died; it is unclear whether the deaths were associated with C. auris infection or underlying health conditions. (more…)
Author Interviews, Autism, Gender Differences / 08.11.2016

MedicalResearch.com Interview with: Dr. John Strang, PsyD Division of Pediatric Neuropsychology Children's National Health System. MedicalResearch.com: What is the background for this study? What are the main findings Response: Gender dysphoria or transgenderism (GD) and autism spectrum disorders (ASD) often co-occur. Between 9 and 25% of youth referred for gender dysphoria concerns have co-occurring ASD. Autistic transgender youth often require significant supports; their autism symptoms alone present challenges, but when combined with gender dysphoria, the clinical needs and complexities increase significantly. For example, an autism spectrum disorder, with its resulting social and communication challenges, can make it more difficult for a transgender teen to advocate for their needs around gender. Specialists from youth gender clinics from around the world have years of experience working with autistic transgender youth. This study used an international search process to identify experts in co-occurring ASD and GD. Twenty-two experts were identified and participated in this multi-stage consensus building study. A set of initial clinical guidelines for the evaluation and care of youth with co-occurring ASD and GD were produced. (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, Neurological Disorders / 08.11.2016

MedicalResearch.com Interview with: Philip Van Damme, MD, PhD Department of Neurology and Department of Neurosciences, Experimental Neurology KU Leuven University of Leuven VIB, Vesalius Research Center, Leuven, Belgium Philip Van Damme, MD, PhD Department of Neurology and Department of Neurosciences, Experimental Neurology KU Leuven University of Leuven VIB, Vesalius Research Center, Leuven, Belgium MedicalResearch.com: What is the background for this study? Response: The hepatitis E virus (HEV) has been discovered more that 60 years ago. Its clinical manifestations are usually self-limiting and mild. More recently, several immune-mediated neurological complications of this virus have been described, such as the Guillain-Barre syndrome (GBS) and neuralgic amyotrophy. In this study, we investigated the frequency of a preceding HEV infection in patients presenting with a GBS syndrome or one of its less common disease variants. At the same time, we tested for other known pathogens known to be associated with GBS. (more…)
Author Interviews, Dental Research / 07.11.2016

MedicalResearch.com Interview with: Sonia Julià-Sánchez, Ph.D. Departament de Fisiologia i Immunologia Universitat de Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Contradictory results are still reported on the influence of dental occlusion on the balance control. While most literature have evaluated this relationship in static conditions with inconclusive results, the topic is still a matter of debate. However, less research has focused on the correlation of dental occlusion and balance control in unstable surfaces, even though the higher sensitivity of the unstable platforms to examine individual responses to translational and angular perturbations. Moreover, when we talk about the influence of dental occlusion on the body balance, the study of the specific malocclusal traits influencing balance control should be of extremely importance to apply the proper treatment. Our study was focused on the influence of dental occlusion and specific malocclusal traits on the body balance control at extreme levels of stability. We found that body balance was significantly influenced by dental occlusion in unstable conditions. Moreover, specific occlusal traits significantly influencing postural control were: Angle Class, crowding, midline deviation, crossbite, anterior open bite and overjet. (more…)
Author Interviews, Weight Research / 07.11.2016

MedicalResearch.com with: Lee Kaplan, MD, PhD, Director of the Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital Weight Center and ACTION study steering committee member MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today, nearly 100 million people in the U.S. have obesity. Despite the fact that many healthcare providers and others recognize obesity as a disease that can have a significant impact on health, many people with obesity do not have access to effective care for this disorder. As a result, obesity remains substantially under-diagnosed, under-addressed and under-treated. Since multiple parties could have a role in overcoming this barrier to effective obesity care, we sought to determine and compare the perspectives and experience of three important groups – health care providers, employers, and people with obesity themselves – about obesity and its care. As the first national study looking simultaneously at these complementary perspectives, ACTION sought to help answer several important questions:
  • Given that obesity is occurring at epidemic rates, why is it not being treated? What are the barriers to effective care?
  • How could public and professional attitudes contribute?
  • To what degree do limitations of resources or knowledge about the disease contribute?
(more…)
Author Interviews, C. difficile, CDC, Infections, Outcomes & Safety / 07.11.2016

MedicalResearch.com Interview with: Dr. Shannon Novosad, MD Epidemic Intelligence Service, CDC Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium difficile can cause an infection in the colon called colitis. Symptoms include diarrhea, fever, nausea, and abdominal pain. It is an important cause of healthcare associated infections with approximately half a million C. difficile infections and 29,000 associated deaths in 2011. The Infectious Diseases Society of America and Society for Healthcare Epidemiology of America published guidelines in 2010 advising clinicians on appropriate antibiotic regimens to treat C. difficile infection.  Prior studies have found that provider adherence to these guidelines, particularly in those with severe disease, is poor.  However, these studies primarily involved patients treated at a single healthcare facility. We were interested in examining CDI treatment practices in a larger group of patients with C. difficile infection located across geographically diverse areas. Further we wanted to learn more about what patient characteristics might be associated with receiving guideline-adherent therapy for C. difficile infection. We used data from the Center for Disease Control and Prevention’s Emerging Infections Program (EIP) which performs active population and laboratory-based surveillance for C. difficile infections in 10 U.S. sites and examined how 11,717 patients including 2006 with severe disease were treated. We found that provider adherence to national treatment guidelines was low with only around 40% of those with severe disease being prescribed the appropriate antibiotic treatment. Our analysis suggests that those who were tested for C. difficile in the hospital or who were admitted to the hospital around the time of diagnosis were more likely to receive recommended antibiotic therapy. In addition, patients greater than 65 years old or with more underlying comorbidities were more likely to receive the right antibiotic treatment. We also found that after adjusting for age and underlying comorbidities, the odds of death within 30 days of diagnosis was almost 400% higher in patients who did not receive guideline-adherent therapy compared to those who did. (more…)
Anemia, Author Interviews, OBGYNE / 07.11.2016

MedicalResearch.com Interview with: Daniel C Benyshek, PhD Professor, Department of Anthropology Adjunct Professor, UNLV School of Medicine Co-Director, Metabolism, Anthropometry and Nutrition Lab University of Nevada, Las Vegas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maternal placentophagy is ubiquitous among nearly all terrestrial mammals, but is rare to non-existent among humans in the historic and cross-cultural records. Recently, however, human maternal placentophagy has emerged as a popular trend among a small but growing number of women in many industrialized countries. Most women engaging in the practice today consume their processed placenta in capsule form, taken daily, over several weeks postpartum. While human maternal placentophagy advocates claim many maternal health benefits from the practice, including improved postpartum mood, increased breast-milk production, and improved energy, among others, no carefully designed, placebo-controlled studies have evaluated these claims. Our randomized, double-blind, placebo-controlled pilot study (N=23) investigated some of these claims. Our study found that the postpartum iron status of participants who consumed their own encapsulated placenta (based on the three week daily intake recommendation of one prominent placenta encapsulation service), was no different from those women who consumed the same amount of beef placebo. (more…)
Author Interviews, Nature, Stem Cells / 07.11.2016

MedicalResearch.com Interview with: Dr. Fred Levine MD PhD Professor & Director Sanford Children's Health Research Center Sanford Burnham Prebys Medical Discovery Institute La Jolla, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is the latest in a series that began in 2010 when we published that the combination of severe pancreatitis and ablation of preexisting pancreatic beta-cells led to the formation of new beta-cells by direct conversion of alpha-cells, which are the neighboring cells in the islets of Langerhans producing glucagon, which like insulin is also involved in glucose homeostasis. The phenomenon of generating new beta-cells by islet cell transdifferentiation went against the conventional wisdom in the field, which is that most beta-cell neogenesis in adults occurs by differentiation from cells in the pancreatic ducts, similar to what happens during embryogenesis. Since then, we have shown that beta-cell neogenesis by islet cell transdifferentiation appears to occur in murine and human type I diabetes, making it highly translationally relevant. Understanding the mechanism by which new beta-cells are formed from alpha-cells is required for eventual clinical translation. The current study describes that mechanism, which involves the activation of an atypical G protein coupled receptor called Protease Activated Receptor 2 (PAR2). Unlike most other GPCRs, it is activated by extracellular proteases such as are found in the exocrine pancreas or following tissue damage. PAR2 activation by an injectable peptide agonist was both necessary and sufficient to induce beta-cell neogenesis when preexisting beta-cells are absent, as occurs in type I diabetes. (more…)
Author Interviews, Medical Imaging / 06.11.2016

MedicalResearch.com Interview with: Devon A. Klein, MD, MPH Asst. Professor of Radiology and Orthopaedics Hofstra Northwell School of Medicine Associate Chairman, Radiology Lenox Hill Hospital New York, NY 10075 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As our Emergency Department continued to grow our Radiology Department was challenged to accommodate the resultant increased volume with fixed resources (i.e. CT Scanners) and maintain CT scan throughput. Uncoordinated insular efforts within the Department of Radiology failed to resolve the problem. A collaborative approach utilizing Six Sigma lean and involving stakeholders from the Departments of Radiology, Emergency, Medicine, and Patient Transportation was able to better illustrate the “bottlenecks” and devise solutions. (more…)
Author Interviews, Diabetes, Nutrition, PLoS, University of Michigan / 06.11.2016

MedicalResearch.com Interview with> Katarina Borer, Ph.D. Professor Po-Ju Lin,PhD School of Kinesiology The University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: This study was part of the doctoral dissertation of Po-Ju Lin, who is now a post-doctoral fellow at the University of Rochester. With this study, we wanted to answer three questions: (1) Is daily carbohydrate load responsible for evening glucose intolerance and post-meal insulin resistance. (Evening glucose intolerance represents well-documented higher glucose and insulin responses in the evening than in the morning when the same quantity of glucose is eaten or infused intravenously) To answer this question we offered two daily meals containing about 800 Kcal and either 30% or 60% of carbohydrates. (2) Will exercise before the meals improve glucose tolerance (glucose clearance from the blood and insulin response) after eating? (Exercise is a well-known means of increasing glucose uptake by the muscle and of increasing muscle sensitivity to insulin action for a number of hours after exercise). To answer this question we had the subjects exercise for two hours walking on a treadmill at 45% of their maximal aerobic effort one hour before each meal. (3) Is the upper-intestinal hormone GIP involved in any effects associated with variation in dietary carbohydrate? (GIP or glucose-dependent insulinotropic peptide, stimulates insulin secretion in advance of absorbed glucose). (more…)
Author Interviews, Dermatology, Pain Research / 06.11.2016

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Hellerup Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with rosacea frequently report symptoms of migraine, and this link has been discussed for many years. However, very little research has actually been performed in this area, and the prevalence varies greatly between studies. We examined the prevalence of migraine in patients with rosacea, nationwide, as well as the risk of new-onset migraine in patients with manifest rosacea. We found a markedly increased prevalence of migraine among patients with rosacea. The risk of new-onset migraine was also higher among patients with rosacea, but only among women. Perhaps most notably was the observation that risk of new-onset migraine was highest among patients older than 50 years. This was surprising, since new-onset migraine in older individuals is often considered a "red flag". (more…)
Author Interviews, Diabetes, Weight Research / 04.11.2016

MedicalResearch.com Interview with: Patrick M. O'Neil, Ph.D. Director, Weight Management Center Professor, Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston, SC 29425 MedicalResearch.com: What is already known about the subject? • Even modest weight loss (2-5%) from clinical interventions improves glycemic control in type 2 diabetes. • Commercial weight loss programs, comparatively more affordable and accessible than clinic-based modalities, can produce weight losses in this range, although they typically do not offer diabetes-specific counseling. • Data are sparse on such programs’ effects on glycemic control for adults with T2DM. (more…)
Author Interviews, CDC, OBGYNE / 04.11.2016

MedicalResearch.com Interview with: Cynthia Ferre MA PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC MedicalResearch.com: What is the background for this study? Response: Reductions in births to teens and preterm birth rates are two recent public health successes in the United States. To date, however, we haven’t had data to indicate whether these two declines are associated. So, we used age-specific data on trends in births overall and in preterm births to determine the effects of changes in maternal age on preterm birth. (more…)
Author Interviews, Dermatology, Immunotherapy / 04.11.2016

MedicalResearch.com Interview with: Brett A. King, MD, PhD Assistant Professor Department of Dermatology School of Medicine Yale University New Haven, CT 06520 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent advances in the understanding of the pathogenesis of alopecia areata (AA) have yielded Janus kinase (JAK) inhibitors as a promising therapy. Short-term treatment with the JAK inhibitor, tofacitinib, has shown efficacy for severe AA, alopecia totalis (AT), and alopecia universalis (AU), but long-term data are lacking. In this retrospective series of patients aged 18 years or older treated with tofacitinib, of 65 potential responders to therapy, defined as those with AT or AU with duration of current episode of disease of 10 years or less or AA, 77% achieved at least some hair regrowth, with 58% of patients achieving greater than 50% change in SALT score and 20% of patients achieving complete scalp hair regrowth over 4 to 18 months of treatment. Tofacitinib was well tolerated, and there were no serious adverse events. (more…)
Author Interviews, Cancer Research, JAMA / 04.11.2016

MedicalResearch.com Interview with: Ayako Okuyama, RN, PHN, MW, PhD Center for Cancer Control and Information Services National Cancer Center, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chemotherapy-induced nausea and vomiting (CINV) is a major concern for chemotherapy patients. Despite widespread concern, not all chemotherapeutic drugs cause severe CINV. Our study illustrated that the potential for overuse of prophylactic antiemetics for chemotherapy with minimal and low emetic risks according to the antiemetic guidelines. (more…)
Author Interviews, Emergency Care, Kidney Disease, Kidney Stones, UCSF / 04.11.2016

MedicalResearch.com Interview with: Ralph Wang, MD, MAS Associate Clinical Professor, Department of Emergency Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical expulsive therapy, most notably tamsulosin, has been studied extensively to improve stone passage in patients diagnosed with ureteral stone. Prior trials and meta-analyses have identified a benefit. In fact, tamsulosin is recommended by the American Urologic Association for patients diagnosed with ureteral stones < 10mm that do not require intervention. However, recent well-conducted multi-center randomized trials have not found any improvement in stone passage. Thus we conducted a systematic review and meta-analysis of all double blinded, placebo controlled randomized trials of tamsulosin to determine whether it improves stone passage. (more…)
Author Interviews, Neurological Disorders / 04.11.2016

MedicalResearch.com Interview with: Nir Lahav Physics Department Bar-Ilan University in Israel MedicalResearch.com: What is the background for this study? Response: Our brain is a very complex network, with approximately 100 billion neurons and 100 trillion synapses between the neurons. The question is how can we cope with this enormous complexity? Ultimately, scientists seek to understand how a global phenomenon such as consciousness can emerge from our neuronal network. We used network theory in order to cope with this complexity and to determine how the structure of the human cortical network can support complex data integration and conscious activity. Previous studies have shown that the human cortex is a network with small world properties, which means that it has many local structures and some shortcuts from global structures which connect faraway areas (similar to the difference between local buses and cross-country trains). The cortex also has many hubs, which are nodes that have a high number of links (like central stations), that are also strongly interconnected between themselves, making it easy to travel between the brain's information highways.But in order to examine how the structure of the network can support global emerging phenomena, like consciousness, we need to look not only in the different nodes. We need to check global areas with lots of nodes. That's why we applied a network analysis called k-shell decomposition. This analysis takes into account the connectivity profile of each node making it easy to uncover different neighborhoods of connections in the cortical network, we called shells. The most connected neighborhood in the network is termed the network's nucleus. until today scientists were only interested in the network's nucleus, but we found that these different shells can hold important information about how the brain integrates information from the local levels of each node to the entire global network. For the first time we can build a comprehensive topological model of our cortex. (more…)