Author Interviews, Endocrinology, Fertility, OBGYNE / 21.10.2016

MedicalResearch.com Interview with: Kavita Vedhara FAcSS Professor of Health Psychology Division of Primary Care School of Medicine University Park,Nottingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy. This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s. However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone. In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months. We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant. If you are trying to obtain a perfect cortisol balance, I use this product that helps to do just that. (more…)
Author Interviews, Lancet, Orthopedics, Stem Cells / 21.10.2016

MedicalResearch.com Interview with: Professor Ivan Martin, PhD Department of Surgery and Department of Biomedicine University Hospital Basel University of Basel Basel, Switzerland MedicalResearch.com: What is the background for this study and new use of autologous nasal chondrocytes? Response: We previously demonstrated that nasal chondrocytes, harvested from the nasal septum, have a larger and more reproducible capacity to form new cartilage than articular chondrocytes, harvested from the knee joint. We further established that the cartilage tissue generated by nasal chondrocytes can respond to physical forces (mechanical loads) similar to articular cartilage and has the ‘plasticity’ to adapt to a joint environment, since it efficiently integrated with surrounding articular cartilage when implanted in goat joints. This was the rationale for using nasal chondrocytes for articular cartilage repair. (more…)
Author Interviews, Biomarkers, Immunotherapy, Pancreatic / 21.10.2016

MedicalResearch.com Interview with Dr. Ashton A. Connor, MD PanCuRx Translational Research Initiative, Ontario Institute for Cancer Research Dr. Steven Gallinger MD, MSC Division of General Surgery Toronto General Hospital Toronto, ON MedicalResearch.com: What is the background for this study? What are the main findings? Response: The etiology of pancreatic ductal adenocarcinoma (i.e. "pancreatic cancer") and the relationship between the tumour and its characteristic dense, encroaching stroma are still poorly understood. Using whole genome sequencing in two large cohorts, we show that there are four fundamental mutational processes that give rise to pancreatic cancer. With expression data, we also show that the interaction between the tumour and the surrounding stroma varies with the type of mutational process found in the tumour. Specifically, tumours with defective DNA repair, either homologous recombination or mismatch repair deficiency, elicited strong anti-tumour immune responses, likely due to the relatively high numbers of neoantigens in these tumours. Individually, these concepts have been studied in other cancer types, but we are first to apply either of these to pancreatic cancer, and we also the first to integrate these two aspects of cancer biology for any tumour, to our knowledge. (more…)
Author Interviews, Hearing Loss / 20.10.2016

MedicalResearch.com Interview with: Samira Anderson, AuD., Ph.D. Assistant Professor Department of Hearing and Speech Sciences Faculty, Program in Neuroscience and Cognitive Sciences Faculty, Maryland Language Science Center Director, The Hearing Brain Lab www.hearingbrainlab.umd.edu University of Maryland – College Park MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is known that older adults ability to understand speech in background noise is enhanced by factors other than hearing. Older adults draw on cognitive resources to improve their understanding of what is said more so than do younger adults. Specifically, they can use the context of the conversation to fill in the gaps of what they might have missed due to background noise. They also benefit when the distracting noise or talker is speaking in a language that is unintelligible to them. So  someone who speaks English will understand the conversation better when the distracting talker is speaking a language other than English. If the background talker is speaking a different language, then that background talker is easier to ignore. In this study we were motivated to find out what is happening in the brain when older and younger adults are listening to a story spoken in English and ignoring a background talker who is speaking either in English or in Dutch. We found that overall the neural responses of older adults were degraded by noise to a greater extent than in younger adults, despite that fact that they had normal hearing. However, the neural response in older adults improved when the background talker was speaking Dutch compared to English, and this same improvement was not seen in younger adults. The older adults also reported that it was easier for them to focus on the English talker when the background talker was speaking Dutch, but the young adults said it didn't make any difference. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Neurological Disorders / 20.10.2016

MedicalResearch.com Interview with: Dr David Lynch MB, MRCPI Leonard Wolfson Clinical Fellow UCL Institute of Neurology Queen Square, London MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2011 it was discovered that mutations in a gene called CSF1R cause a rare syndrome of early onset dementia often accompanied by movement disorders, spasticity and seizures, which is named adult onset leukoencephalopathy with axonal spheroids (ALSP). The hallmarks of ALSP are a characteristic appearance on MRI imaging and findings in brain pathological specimens - axonal swellings or 'spheroids'. We manage a multidisciplinary group with expertise in leukoencephalopathies and have previously identified patients with mutations in CSF1R. However, we also found patients with a syndrome typical of ALSP who did not carry mutations in CSF1R. In this study, we showed that some of these patients carry recessive mutations in a different gene, AARS2. This included a patient with characteristic axonal spheroids in brain tissue and typical ALSP clinical and imaging features. (more…)
AHA Journals, Author Interviews, Heart Disease / 20.10.2016

MedicalResearch.com Interview with: Joseph A. Ladapo, MD, PhD Division of General Internal Medicine and Health Services Research David Geffen School of Medicine UCLA Los Angeles, CA 90024 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Four million adults in the U.S. undergo stress testing or coronary computed tomographic angiography (CTA) each year because of suspected coronary disease. These patients are high risk for adverse cardiovascular events, but they are often not treated with the right medications after testing. Little is known about how CTA or stress testing affect physician and patient decisions about cardiovascular medications and preventive lifestyle choices like exercise and weight loss. Using data from patients in the PROMISE trial (PROspective Multicenter Imaging Study for Evaluation of chest pain), we found that patients who underwent CTA for suspected coronary artery disease were more likely to start a statin and aspirin and more likely to eat better and lose weight. (more…)
Author Interviews, Biomarkers, Infections, Technology / 19.10.2016

MedicalResearch.com Interview with: Ying Kong Ph.D. Assistant Professor University of Tennessee Health Science Center Department of Microbiology, Immunology, and Biochemistry Memphis, TN 38163 MedicalResearch.com: What is the background for this study? Response: Tuberculosis (TB) is a public health concern worldwide, with high morbidity and mortality. The causative agent of TB, M. tuberculosis, grows very slowly in culture. For research of TB, we need to quantitate bacterial numbers in order to evaluate drug and vaccine efficacy or to identify bacterial genes that are critical for survival in hosts or causing disease. M. tuberculosis divides every ~20 hours, which is much slower than other bacteria such as E. coli and Salmonella typhimurium, which divide every 20 minutes. Conventionally, quantitation of M. tuberculosis needs to spread M. tuberculosis on agar plates and wait for four weeks to obtain visible colonies, and then to count colony forming units. For the fast-growing bacteria, it takes only 18 hours to obtain visible colonies on agar plates. We and other groups have developed fluorescent protein labeled M. tuberculosis strains in order to quantitate M. tuberculosis in real time by measuring fluorescence. In this way, we are able to estimate bacterial number right after fluorescence measurement, which only takes a few minutes. However, this technology is not a diagnostic tool for clinical use, because the M. tuberculosis strains that we used were recombinant strains transformed with fluorescent protein genes. Another imaging technology that we have developed, REF, is for diagnosis purpose, which has been described in details in our other papers (Xie H, et al. Rapid point-of-care detection of the tuberculosis pathogen using a BlaC-specific fluorogenic probe. Nat Chem. 2012 Oct;4(10):802-9. Cheng Y, et al. Fluorogenic probes with substitutions at the 2 and 7 positions of cephalosporin are highly BlaC-specific for rapid Mycobacterium tuberculosis detection. Angew Chem Int Ed Engl. 2014 Aug 25;53(35):9360-4.). (more…)
Author Interviews, Endocrinology, OBGYNE, Pharmacology / 19.10.2016

MedicalResearch.com Interview with: Hugh S. Taylor, MD Anita O'Keeffe Young Professor of Obstetrics, Gynecology, and Reproductive Sciences and Professor of Molecular, Cellular, and Developmental Biology; Chair of Obstetrics Gynecology, and Reproductive Sciences, Yale School of Medicine Chief of Obstetrics and Gynecology Yale-New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The abstract presented at ASRM featured results from two replicate pivotal Phase 3 clinical trials evaluating the efficacy and safety of Elagolix in premenopausal women who suffer from endometriosis. Elagolix is an investigational, orally administered, gonadotropin-releasing hormone (GnRH) receptor antagonist that blocks endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. Administration results in rapid, reversible, dose-dependent inhibition of luteinizing hormone and follicle-stimulating hormone secretion, leading to reduced ovarian production of the sex hormones, estradiol and progesterone, while on therapy. The data demonstrated dose-dependent superiority in reducing daily menstrual and non-menstrual pelvic pain associated with endometriosis compared to placebo. At month three and month six, patients treated with Elagolix reported statistically significant reductions in scores for menstrual pain (dysmenorrhea) and non-menstrual pelvic pain associated with endometriosis as measured by the Daily Assessment of Endometriosis Pain scale. The safety profile of Elagolix was consistent across both Phase 3 trials and also consistent with prior Elagolix studies. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Gender Differences, Heart Disease, Social Issues / 19.10.2016

MedicalResearch.com Interview with: Adam L. Beckman Yale College, New Haven, CT (at the time this work was completed) Erica S Spatz MD MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale-New Haven Hospital Yale University School of Medicine MedicalResearch.com: What is the background for this study? Beckman: Despite the expansion of insurance coverage, young adults face major challenges to obtaining affordable healthcare. We suspected women may experience greater challenges than men — they often have lower income and less complete medical coverage than men, and care for multiple generations of family, and that this may in part explain why young women have worse outcomes following a heart attack as compared with similarly-aged men. (more…)
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, ESMO / 18.10.2016

MedicalResearch.com Interview with: Corey Pelletier PhD Director, Health Economics & Outcomes Research Celgene Corporation Summit, NJ MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a phase III clinical trial, ABRAXANE demonstrated significant improvement in ORR vs paclitaxel in patients with metastatic breast cancer. Celgene initiated this study because limited data exist on the comparative effectiveness of ABRAXANE vs paclitaxel for patients with metastatic breast cancer, including HR+/HER2- and triple negative (TN) metastatic breast cancer (MBC), in a real-world setting. This study used a U.S. based electronic medical record (EMR) dataset to evaluate the real-world comparative effectiveness of second-line ABRAXANE vs paclitaxel in patients with MBC and included patients with HR+/HER2- or TN MBC. This study also assessed adverse events and use of supportive care in this patient population. The median time to treatment discontinuation (TTD) for ABRAXANE vs paclitaxel was 4.50 vs 2.83 months (adjusted P<0.0001*) in all patients. Patients with HR+/HER2- or TN MBC had similar TTD. The median time to next treatment (TTNT) in all patients was 5.9 vs 4.2 months (adjusted P=0.2140*) for ABRAXANE vs paclitaxel, respectively. Patients receiving ABRAXANE had less fatigue, neuropathy, and anemia compared to patients receiving paclitaxel. Patients treated with ABRAXANE also used less antiemetics, and had fewer treatments for hydration or allergic reaction compared to those treated with paclitaxel. Patients treated with paclitaxel used less GCSF and had fewer treatments for bone loss compared to those treated with ABRAXANE. *TTD and TTNT were adjusted for age, number of metastases, targeted agent use, adjunctive chemotherapy, HER2 status, TN status, and CCI score without age. (more…)
Author Interviews, Biomarkers, Heart Disease / 18.10.2016

MedicalResearch.com Interview with: Susan Stienen, MD Department of Cardiology Academic Medical Center University of Amsterdam Amsterdam, the Netherland MedicalResearch.com: What is the background for this study? Response: Prognosis of patients admitted for and discharged after acute decompensated heart failure (ADHF) is poor, with a readmission and mortality rate of up to 50% of patients at 6 months. Previous studies demonstrated that a ≤30% NT-proBNP reduction from admission to discharge for ADHF is a strong predictor of HF readmissions and mortality, while those patients with a > 30% reduction in NT-proBNP had a far better prognosis. We conducted a randomized clinical trial in ADHF patients to study the effect of NT-proBNP-guided treatment with a target of NT-proBNP reduction of >30% from admission to discharge, versus conventional treatment. The guided arm used a therapy algorithm that included HF medication, review of rhythm problems and possible ischemia, and had a reminder of a possible indication for CRT-D. A total of 405 patients were randomized after an initial period of clinical stabilization, to receive NT-proBNP-guided or conventional therapy. Intention-to-treat analyses were performed in 404 patients. (more…)
AHA Journals, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Clots - Coagulation, Heart Disease / 18.10.2016

MedicalResearch.com Interview with: Eric A. Secemsky, MD MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Fellow, Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Use of oral anticoagulant (OAC) therapy prior to coronary stenting is a significant predictor of post-procedural bleeding events. Previous studies have estimated that the frequency of chronic OAC use among patients undergoing percutaneous coronary intervention (PCI) is between 3% to 7%. Yet many of these analyses examined select patient populations, such as those admitted with acute myocardial infarction or atrial fibrillation, and preceded the market approval of non-vitamin K antagonist oral anticoagulants (NOACs). As such, the contemporary prevalence of OAC use among all-comers undergoing PCI, as well as associated risks of adverse events, are currently unknown. Therefore, we used PCI data from a large, integrated healthcare system to determine current use of  oral anticoagulant use among all-comers undergoing coronary stenting and the related short- and long-term risks of therapy. (more…)
Author Interviews, Endocrinology, Lancet, Toxin Research / 18.10.2016

MedicalResearch.com Interview with: Teresa Attina, MD, PhD Research Scientist NYU Langone School of Medicine Department of Pediatrics New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endocrine-disrupting chemicals (EDCs) have been recently documented to contribute substantially to disease and dysfunction in the European Union (EU), with an annual estimated cost of €163 billion, corresponding to 1.28% of EU Gross Domestic Product. Our current study documents even greater annual costs in the US, $340 billion, corresponding to 2.33% of US GDP. These findings speak to the large health and economic benefits to regulating EDCs, which should be weighed against the cost of safer alternatives. The different costs between the EU and the US are due to different exposure levels to EDCs, and policy predicts exposure. US costs are higher mainly because of the widespread use of brominated flame retardants in furniture, whereas Europe restricted its use in 2008. Americans have much higher levels, such that the average American has a serum level of these chemicals that would be in the top 5% of Europeans. As a result, children born to pregnant women have lower IQs, such that more children suffer from intellectual disability. On the other hand, in Americans, levels of certain pesticides in foods are much lower due to the Food Quality Protection Act, which requires additional safety thresholds to protect pregnant women and children from exposure. The costs of pesticide exposures in the US were much lower ($12.6 billion) compared to Europe ($121 billion) because fewer children suffer loss of IQ as a result. (more…)
Anesthesiology, Author Interviews, Opiods, Pain Research, Surgical Research / 18.10.2016

MedicalResearch.com Interview with: Bryan Sakamoto MD, PhD Department of Anesthesia Richard L. Roudebush, Veterans Affairs Medical Center Department of Anesthesia Indiana University School of Medicine Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Response: Liposomal bupivacaine is a novel extended-duration anesthetic that has recently become a popular option in total knee arthroplasty (TKA) for post-operative pain management. Although liposomal bupivacaine is widely used, it is unknown if the benefits justify the cost in the veteran population at our institution. The main purpose of this medication use study was to evaluate the cost verses benefit of using this agent in our veteran patient population. (more…)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Nutrition / 18.10.2016

MedicalResearch.com Interview with: Andrew Reynolds Department of Human NutritionUniversity Otago Dunedin New Zealand MedicalResearch.com: What is the background for this study? What are the main findings? Response: Current guidelines for people with type 2 diabetes are to undertake activities such as walking for at least 150 minutes a week, or 30 minutes a day. When to walk in the day is not specified. We thought it reasonable that walking after meals would improve blood sugars more so than a walk where the timing was unspecified. Our randomised controlled trial considered exactly this, a prescription to walk as per the guideline of 30 minutes a day and a prescription to walk for 10 minutes after each meal. Our participants were free-living, but wore accelerometers to record their movement, and continuous glucose monitoring systems to observe their blood glucose levels. We found that post-meal blood sugar levels dropped 12 per cent on average when the participants followed the walking after meals advice compared to walking at any time of the day. Most of this effect came from the highly significant 22 per cent reduction in blood sugar when walking after evening meals, which were the most carbohydrate heavy, and were followed by the most sedentary time. (more…)
Author Interviews, Outcomes & Safety, Surgical Research / 18.10.2016

MedicalResearch.com Interview with: Vishal Sarwahi, MD, senior author Associate Surgeon-in-Chief Chief, Spinal Deformity and Pediatric Orthopaedics Billie and George Ross center for Advanced Pediatric Orthopaedics and Minimally Invasive Spinal Surgery Cohen's Children Medical Center Northwell Hofstra School of Medicine and Stephen F. Wendolowski Research Assistant Pediatric Orthopaedics Cohen Children’s Medical Center New Hyde Park, NY, 11040 MedicalResearch.com: What is LEAN? Response: LEAN is a management principle that supports the concept of continuous improvement through small incremental changes to not only improve efficiency, but also quality. Particularly, we took interest in the 5S’s – Sort, Simplify, Sweep, Standardize, and Self-Discipline. We felt that Sort, Simplify, and Standardize were the most relevant to surgery. (more…)
Author Interviews, Dermatology, Immunotherapy / 17.10.2016

MedicalResearch.com Interview with: Dr. Alan Menter MD Texas Dermatology Associates MedicalResearch.com: What is the background for this study? Response: Psoriasis on the palms and soles of the feet—also known as palmoplantar psoriasis of which there are 2 variants, plaque type or pustular, —can significantly affect a person’s quality of life and is often difficult-to-treat with available treatments. Researchers in this study set out to determine the efficacy and safety of Taltz (ixekizumab) through 60 weeks among patients with moderate-to-severe plaque psoriasis with significant palmoplantar involvement. Plaque psoriasis is the most common form of psoriasis appearing as raised, red patches covered with a silvery white buildup of dead skin cells which are often painful or itchy. This study was an analysis of UNCOVER-3, a Phase 3, multicenter, double-blind, placebo-controlled trial. In the first 12 weeks of this study, patients were randomized to receive placebo, etanercept (50 mg, twice-weekly) or 80 mg of Taltz every two weeks or every four weeks, following an initial starting dose of 160 mg. At 12 weeks, all patients received open-label Taltz every four weeks through 60 weeks. (more…)
Author Interviews, FASEB, Weight Research / 17.10.2016

MedicalResearch.com Interview with: Ramesh Narayanan, Ph.D., MBA Associate Professor, Department of Medicine, Director, Center for Cancer Drug Discovery, University of Tennessee Health Science Center, Memphis, 38103. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity and metabolic diseases affect over a third of the global population. Obesity, unlike several diseases, is not isolated as it’s incidence is associated with other conditions such as type-2-diabetes, insulin resistance, and fatty-liver. Although calorie-restriction and exercise assist in the fight against obesity, these approaches have limitations in morbidly obese individuals and in individuals with comorbidities. The drugs that are available to treat obesity act by inducing satiety. Alternate peripheral non-CNS approaches are required to treat obesity. (more…)
Author Interviews, Breast Cancer, ESMO, Immunotherapy / 17.10.2016

MedicalResearch.com Interview with: Melanie Royce, MD, PhD Professor of Medicine University of New Mexico School of Medicine Director of the Breast Multidisciplinary Clinic and Program UNM Cancer Center. Albuquerque, NM MedicalResearch.com: What is the background for this study? What are the main findings? Response: BOLERO-4 is an open label, single-arm, Phase II study that evaluates the combination of everolimus plus letrozole as a first-line treatment for hormone receptor (HR)-positive/HER2-negative advanced breast cancer patients, as well as the use of everolimus plus exemestane beyond initial progression. Results of the Phase II BOLERO-4 clinical trial, presented as an oral presentation at the 2016 European Society for Medical Oncology (ESMO) annual meeting, show preliminary evidence that everolimus in combination with letrozole is effective in treating women with HR-positive/HER2-negative advanced breast cancer in the first-line setting. With follow up of 17.5 months, the median progression-free survival (PFS) is not yet reached. At six months, 83.6% (95% CI: 77.3-88.2%) of women taking everolimus plus letrozole in the first-line setting were without disease progression, and 71.4% (95% CI: 64.0%-77.5%) did not have disease progression at twelve months. Safety findings from BOLERO-4 are consistent with previous studies of everolimus in advanced breast cancer, with the most common adverse events being stomatitis (67.8%), weight loss (42.6%) and diarrhea (36.1%). These adverse events were mostly grade 1 or 2 in severity1. (more…)
Author Interviews, FASEB, Heart Disease, Imperial College, Pain Research, Pharmacology / 17.10.2016

MedicalResearch.com Interview with: Dr Nicholas Kirkby BHF Intermediate Fellow | Vascular Biology National Heart & Lung Institute | Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know drugs like ibuprofen, called ‘non-steroidal anti-inflammatory drugs’ cause an increase in the risk of heart attacks. These side effects cause very real concerns for the many millions of people who rely on them. They are also the reason why there are no new drugs in this class and why they have been withdrawn (2011) for use as a preventative treatment for colon cancer. Previous research from our group suggests that L-arginine supplements may prevent the cardiovascular side effects caused by these drugs. Our findings here suggest that a particular formulations of ibuprofen, called ibuprofen arginate, which is already available in many parts of the world, can act like an L-arginine supplement and that this could potentially protect the cardiovascular system. (more…)
Author Interviews, Coffee, Heart Disease, JAMA / 17.10.2016

MedicalResearch.com Interview with: Luis E. Rohde, MD, ScD Postgraduate Program in Health Science: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Cardiovascular Division, Hospital de Clínicas de Porto Alegre MedicalResearch.com: What is the background for this study? Response: Caffeine-rich beverages have been implicated as a common cause of several cardiac-related symptoms, such as palpitations, tachycardia, or irregular heartbeats. Because of this “intuitive” assumption, counseling to reduce or avoid caffeine consumption is still widely recommended in clinical practice by most physicians for patients with any heart disease. (more…)
Author Interviews, JAMA, Outcomes & Safety / 17.10.2016

MedicalResearch.com Interview with: David Michael Levine M.D.,M.A. Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: About a decade ago, researchers showed that Americans only received half of recommended health care. Since then, national, regional, and local initiatives have attempted to improve quality and patient experience, but there is incomplete information about whether such efforts have been successful. We found that over the past decade the quality of outpatient care has not consistently improved, while patient experience has improved. (more…)
Author Interviews, Cancer Research, Pharmacology / 17.10.2016

MedicalResearch.com Interview with: Dr Pan Pantziarka, PhD Scientist: Anticancer Fund (www.anticancerfund.org) Coordinator: Repurposing Drugs in Oncology (www.redo-project.org) MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is part of the Repurposing Drugs in Oncology (ReDO) project to look at a series of non-cancer drugs which have strong evidence of anti-cancer effects. Other drugs have included the antacid cimetidine, the antibiotic clarithromycin and the NSAID diclofenac. The data for propranolol comes from multiple sources: epidemiological data and retrospective data from cancer patients who have also been treated concurrently with propranolol, pre-clinical work in vitro and in animal models and from case series reports in which cancer patients have had propranolol added to their existing treatments. The main findings are that propranolol has multiple mechanisms of action, including anti-proliferative and immunomodulation. There is particularly strong evidence that shows that propranolol has potent effects in the treatment of the rare soft-tissue sarcoma angiosarcoma. It is also suggested that when used at the time of surgery, propranolol in combination with a COX-2 inhibitor, can reduce the risk of metastatic spread. (more…)
Author Interviews, Infections, Lancet / 17.10.2016

MedicalResearch.com Interview with: John Penders PhD Assistant professor Dept. of Medical Microbiology Maastricht University, Maastricht MedicalResearch.com: What is the background for this study? Response: Antimicrobial resistance (AMR) constitutes an increasingly important human health hazard worldwide. Especially, the rapid emergence and global spread of multidrug resistant Enterobacteriaceae is worrisome. These bacteria often produce enzymes like extended-spectrum beta-lactamases (ESBLs) and carbapenemases, which inactivate most beta-lactam antibiotics, and are often co-resistant to multiple other antibiotic classes. Consequently, treatment options for infections with multidrug resistant Enterobacteriaceae are limited. The prevalence of antimicrobial-resistant bacteria is generally higher in low and middle income countries as a result of inappropriate use of antimicrobial agents, overcrowding and lack of hygiene and infection control measures. The exponential increase of international travel to such endemic areas may substantially contribute to the emergence and spread of AMR as it allows resistant bacteria to be rapidly transported between regions. Indeed several previous studies had already indicated that international travel is a major risk factor for colonisation with ESBL-producing Enterobacteriaceae. However, many questions remained unanswered, such as the travel destinations and potential risk-behaviour that provide the highest risk for colonisation, how long travellers remain colonised after they return and whether they can transmit these resistant bacteria to other people within their household once they returned from their travel. That is why we initiated the largest prospective study on the acquisition and spread of multidrug resistant bacteria in returning travellers. This multicenter study, conducted by Maastricht University Medical Center, Erasmus University Medical Center, Academic Medical Center Amsterdam, Havenziekenhuis and Utrecht University, included 2,001 travellers and 215 household members. Fecal samples of these participants were collected before and immediately after travel as well as 1, 3, 6 and 12 months after travel return and screened for the prescence of multidrug resistant Enterobacteriaceae. Moreover, extensive information on demographics, travel details, illnesses and behaviour were collected at all follow-up moments by repeated questionnaires. (more…)
Author Interviews, Cancer Research, ESMO, Immunotherapy, NYU / 16.10.2016

MedicalResearch.com Interview with: Arjun Balar, M.D. Assistant Professor of Medicine Director - Genitourinary Medical Oncology Program NYU Perlmutter Cancer Center New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Standard treatment for advanced urothelial cancer includes cisplatin-based chemotherapy which has been shown to improve survival. But more than half of patients are not expected tolerate it well and alternative treatment is inferior to cisplatin. The average survival for these patients is in the range of 9-10 months with carboplatin-based treatment, which is the most commonly used alternative to cisplatin. Pembrolizumab is a PD-1 blocking antibody that reactivates the body’s cancer-fighting T-cells (part of the immune system) to fight urothelial cancer. The trial overall enrolled 374 patients who had not yet received any treatment for advanced urothelial cancer, but were considered ineligible for cisplatin chemotherapy. (more…)
Author Interviews, Dental Research / 15.10.2016

MedicalResearch.com Interview with: Jonathon P. Leider, PhD Department of Health Policy and Management Johns Hopkins University Baltimore, MD MedicalResearch.com: What is the background for this study? Response: The increasing utilization of Emergency Departments (ED) for the treatment of non-urgent and non-traumatic dental conditions among adults in the United States is an increasing policy issue. Research shows that seeking dental care in an ED is often more expensive and less effective when compared to a traditional dental office. Seeking care in the ED for non-traumatic dental conditions is more frequent among low income individuals and people in rural areas, who must often overcome insufficient dental coverage and access to receive office-based care. Under the Affordable Care Act, there has been considerable expansion in state Medicaid dental coverage for adults. However, not all states are participating in the expansion or extension of dental benefits and dental professional shortage areas are fairly common– over 4,900 exist in the United States. Innovative programs are needed to effectively address the challenges low income individuals in rural areas encounter accessing care. Our study examined the expansion of a Community Dental Program (CDP) in rural Western Maryland and its impact on dental-related visits at a regional ED. (more…)
Alzheimer's - Dementia, Author Interviews, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.10.2016

MedicalResearch.com Interview with: Kevin T. Nead, MD, MPhil Resident, Radiation Oncology Perelman School of Medicine Hospital of the University of Pennsylvania. MedicalResearch.com: What is the background for this study? Response: Androgen deprivation therapy is a primary treatment for prostate cancer and works by lowering testosterone levels. There is a strong body of research suggesting that low testosterone can negatively impact neurovascular health and function. We were therefore interested in whether androgen deprivation therapy is associated with dementia through an adverse impact on underlying neurovascular function. (more…)
Author Interviews, BMJ, Heart Disease, Technology / 15.10.2016

MedicalResearch.com Interview with: Dr. Ngai-yin Chan Princess Margaret Hospital Lai Chi Kok, Hong Kong MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common sustained heart rhythm disorder which can cause stroke, heart failure and an increased risk of death. The risk of stroke can be reduced substantially with drug treatment. However, a quarter of patients with AF causing stroke have silent and asymptomatic AF before stroke. The current guidelines recommend opportunistic screening for AF. Whether systematic community screening for AF with a convenient smartphone ECG can reduce the burden of AF remains unknown. (more…)
Author Interviews, Gastrointestinal Disease, Genetic Research, Hepatitis - Liver Disease, Weight Research / 15.10.2016

MedicalResearch.com Interview with: Annette Schürmann PhD Department of Experimental Diabetology German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) Nuthetal Germany German Center for Diabetes Research (DZD München-Neuherberg Germany MedicalResearch.com: What is the background for this study? Response: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern of liver at two time points, at the age of 6 weeks, (the earlierst time point to distiguish between those that respond to the diet (responder mice) and those that did not (non-responders)), and at the age of 20 weeks. One transcript that was significantly reduced in the liver of responder mice at both time points was Igfbp2. The reason for the reduced expression was an elevated DNA-methylation at a position that is conserved in the mouse and human sequence. The elevated DNA-methylation of this specifc site in human was recently described to associate with elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old mice did not show differences in liver fat content between responder and non-responder mice we conclude that the alteration of Igfbp2 expression and DNA metyhlation occurs before the development of fatty liver. Our data furthermore showed that the epigenetic inhibition of Igfbp2 expression was associated with elevated blood glucose and insulin resistance but not with fatty liver. (more…)
Author Interviews, ESMO, Immunotherapy, Ovarian Cancer / 14.10.2016

MedicalResearch.com Interview with: Dr. Mansoor Raza Mirza, MD Medical Director: Nordic Society of Gynecologic Oncology Board of Directors: Gynecologic Cancer Inter-Group (GCIG) Faculty: European Society of Medical Oncology (ESMO) Faculty: International Gynecologic Cancer Society (IGCS) Chief Oncologist, Rigshospitalet Copenhagen University Hospital Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Recurrent ovarian cancer is an area of significant unmet medical need, and there have been few therapeutic advances for these patients in the past few decades. Niraparib was studied to provide patients with recurrent ovarian cancer an option other than “watchful waiting,” potentially redefining the standard of care for the disease. The ENGOT-OV16/NOVA trial was a Phase 3 double-blind, randomized, placebo-controlled international study of maintenance treatment with niraparib compared with placebo. Niraparib successfully achieved the primary endpoint of prolonging progression-free survival versus placebo in all three prospectively defined primary efficacy populations: (more…)