Author Interviews, Biomarkers, JAMA, Multiple Sclerosis / 07.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31038" align="alignleft" width="200"]Prof Rogier Q Hintzen Neurologist/immunologist Head MS Centre ErasMS Dept of Neurology Erasmus MC, PB 2040 Rotterdam Prof Rogier Q Hintzen[/caption] Prof Rogier Q Hintzen Neurologist/immunologist Head MS Centre ErasMS Dept of Neurology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Years ago, we identified soluble (s) CD27 as a biomarker for T cell activation in body fluids, as part of my PhD study. (J Immunol. 1991 Jul 1;147(1):29-35.) As we presume the neuropathology seen in MS is guided by T cells we were interested to be able to quantify the activity of such cells in a given patient. Cerebrospinal fluid (CSF) is as close as we can get to the site of the disease process in MS, therefore we focus on biomarkers in this compartment. We found clearly elevated levels of sCD27 in CSF of Multiple Sclerosis patients versus non-inflammatory controls. In this study we investigated whether at the moment of first attack of suspected Multiple Sclerosis, quantification of CSF sCD27 can predict further progression in to a diagnosis of MS and whether sCD27 levels are correlated with later attack frequency. Indeed, we found that high sCD27 measured at this early stage predicts a more rapid diagnosis of Multiple Sclerosis and a more aggressive disease course.
Author Interviews, Environmental Risks, OBGYNE, Pediatrics / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31033" align="alignleft" width="143"]Nathalie Auger MD MSc FRCPC Montréal, Québec Dr. Nathalie Auger[/caption] Nathalie Auger MD MSc FRCPC Montréal, Québec MedicalResearch.com: What is the background for this study? What are the main findings? Response: We carried out this study because congenital heart defects take a large share of birth defects, but not much is known on its risk factors. In previous research, we found that very high temperatures in the summer were associated with a greater risk of stillbirth. We sought to determine whether elevated outdoor heat could also be linked with congenital heart defects in a sample of about 700,000 pregnancies.
Author Interviews, Cancer Research / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31023" align="alignleft" width="175"]Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 Rebecca Siegel[/caption] Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the bottom line for incidence and mortality trends? Response: The bottom line for cancer mortality is that in contrast to many other major causes of death, cancer death rates continue to decline, dropping by 25% from 1991 to 2014. This translates to about 2 million fewer cancer deaths over this time period than would be expected if cancer death rates had remained at their peak. Death rates are the best measure of progress against disease. Cancer incidence rates also dropped in men over the past decade of data, whereas in women they are flat. The drop in men is because of large declines for the top 3 cancers (prostate, lung, and colorectum), which account for more than 40% of cancers diagnosed in men. The stable trend in women is largely because declines in lung and colorectal cancers are offset by a flat trend for both breast and uterine corpus (i.e., endometrial) cancers, which combined account for almost 40% of cases in women, as well as rapid increases for thyroid cancer over the past decade -- increasing by almost 5% annually. Importantly, thyroid incidence rates have stabilized in the past few data years because of modifications in diagnostic criteria.
Abuse and Neglect, Genetic Research, Schizophrenia, UCSD / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31016" align="alignleft" width="200"]Brian P. Head, MS, PhD Associate Professor, UCSD Research Scientist, VASDHS Department of Anesthesiology VA San Diego Healthcare System San Diego, CA 92161-9125 Dr. Brian Head[/caption] Brian P. Head, MS, PhD Associate Professor, UCSD Research Scientist, VASDHS Department of Anesthesiology VA San Diego Healthcare System San Diego, CA 92161-9125 MedicalResearch.com: What is the background for this study? What are the main findings? Response: DISC1 is a schizophrenia associated gene originally identified in a Scottish family. DISC1 protein is highly expressed in the developing brain and in the dentate gyrus of the adult hippocampus, and is involved in neuritogenesis and neuronal signaling. DISC1 is located in multiple intracellular locations including axons and synapses, and loss of DISC1 function causes deficits in neural development, neuronal proliferation, axonal growth, and cytoskeleton modulation, which are consistent with abnormal neural development in schizophrenia. SynCav1 means synapsin-driven caveolin construct. Synapsin promoter is neuronal specific which allows us to increase caveolin expression-specifically in neurons. We have previously shown that SynCav1 increases neuronal signaling and dendritic growth and arborization in vitro (Head BP JBC 2011), and when delivered in vivo augments functional neuroplasticity and improves learning and memory in adult and aged mice (Mandyam CD Biol Psych 2015). Since loss of DISC1 function equates to schizophrenic-like symptoms, then decreased DISC1 expression in Cav-1 KO mice agrees with this premise. Thus, loss of Cav-1 increases their likelihood of developing schizophrenia-like symptoms. Because re-espression of Cav-1 restored DISC1 expression as well as expression of key synaptic proteins, this proof-of-concept findings not only builds upon our previously results demonstrating that Cav-1 is critical for neuronal signaling and functional synaptic plasticity but also strongly links Cav-1 with maintaining normal DISC1 expression levels and potentially attenuating schizophrenia-like symptoms.
Author Interviews, Technology / 06.01.2017

MedicalResearch.com Interview with: Lukas Bereuter, PhD Candidate University of Bern ARTORG Center for Biomedical Engineering Research Bern, Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today, most electronic implants are powered by primary batteries. After battery depletion, the whole implant has to be replaced by a surgery. This causes repeated interventions in a patients’ life, which bears the risk of complications and is costly. To overcome this problem, several groups presented prototypes of implants that are powered by solar cells that are implanted under the skin. However, precise knowledge of the actual light exposure and expectable power output of such an implant in everyday life was lacking so far. With this study, we investigated the real-life feasibility of a solar-powered implant for the first time. For this, we developed portable light measurement devices that feature solar cells and continuously measure a subcutaneous solar cell’s output power when powered by AGM Solar Batteries. The measurement devices were worn by volunteers in their daily routine in summer, autumn and winter. The study showed, that subcutaneously implanted solar cells could generate enough power in everyday-life to fully power e.g. a cardiac pacemaker.
Author Interviews, Cancer Research, JAMA, Orthopedics / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31008" align="alignleft" width="130"]Charles L. Shapiro, MD Professor of Medicine Co-Director of Dubin Breast Center Director of Translational Breast Cancer Research Director of Cancer Survivorship, Tisch Cancer Institute Mount Sinai Health System Division of Hematology / Medical Oncology: Tisch Cancer Institute New York, NY 10029 Dr. Charles Shapiro[/caption] Charles L. Shapiro, MD Professor of Medicine Co-Director of Dubin Breast Center Director of Translational Breast Cancer Research Director of Cancer Survivorship, Tisch Cancer Institute Mount Sinai Health System Division of Hematology / Medical Oncology: Tisch Cancer Institute New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Metastases to bone are frequent in many cancers and cause pain, pathological fractures, necessitate surgical and/or radiation treatments, cause spinal chord compression that can lead to paralysis, and significantly increase health care costs. Zoledronic acid, a bisphosphonate that inhibits bone resorption, is used in standard practice because it reduces the risks skeletal-related events including cancer-related pathological fractures, the need for surgery and/or radiation to bone metastases, and spinal chord compression in patients with breast cancer, prostate cancer and multiple myeloma. However, the optimal dosing interval for zoledronic acid is unknown and based on prior studies and empiricism it is administered monthly along with anti-cancer treatments. In this trial, over 1800 breast cancer, prostate cancer and multiple myeloma patients with bone metastases were randomized to the standard dosing interval of monthly zoledronic acid versus every 3-months zoledronic acid for a duration of two years. The results overall, and in each specific disease site, show that giving zoledronic acid once every 3-months as opposed to monthly did not result in any increase in skeletal-related events.
Accidents & Violence, Author Interviews / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31003" align="alignleft" width="133"]Emma E. McGinty, PhD, MS Center for Injury Research and Policy and Center for Mental Health and Addiction Policy Research, Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 Dr. Emma McGinty,[/caption] Emma E. McGinty, PhD, MS Center for Injury Research and Policy and Center for Mental Health and Addiction Policy Research, Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 MedicalResearch.com: What is the background for this study? What are the main findings? Response: All states in the US have some kind of ignition interlock lock, but until this study we didn’t know whether these laws meet their intended goal – to reduce alcohol-involved fatal crashes. Specifically, we lacked evidence on the effectiveness of two different types of interlock laws – mandatory interlock laws, which require all individuals convicted of driving under the influence of alcohol to install an interlock, and partial interlock laws, which require some segments of high-risk DUI offenders – like repeat offenders or those convicted of driving with a very high blood alcohol content – to use an interlock in order to drive legally.
Author Interviews, Cost of Health Care, JAMA, Medicare, Orthopedics, University of Pennsylvania / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30994" align="alignleft" width="180"]MedicalResearch.com Interview with: Amol Navathe, MD PhD University of Pennsylvania Staff Physician, CHERP, Philadelphia VA Medical Center Assistant Professor of Medicine and Health Policy, Perelman School of Medicine Senior Fellow, Leonard Davis Institute of Health Economics, The Wharton School Co-Editor-in-Chief, HealthCare: the Journal of Delivery Science and Innovatio Dr. Amol Navathe[/caption] Amol Navathe, MD PhD University of Pennsylvania Staff Physician, CHERP, Philadelphia VA Medical Center Assistant Professor of Medicine and Health Policy, Perelman School of Medicine Senior Fellow, Leonard Davis Institute of Health Economics, The Wharton School Co-Editor-in-Chief, HealthCare: the Journal of Delivery Science and Innovation MedicalResearch.com: What is the background for this study? Response: Bundled payments pay a fixed price for an episode of services that starts at hospital admission (in this case for joint replacement surgery) and extends 30-90 days post discharge (30 days in this study). This includes physician fees, other provider services (e.g. physical therapy), and additional acute hospital care (hospital admissions) in that 30 day window.
Author Interviews, Memory, Pediatrics / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30987" align="alignleft" width="128"]Dr. Shelley Gray PhD Professor, Speech and Hearing Department of Speech and Hearing Science Arizona State University Tempe, AZ Dr. Shelley Gra[/caption] Dr. Shelley Gray PhD Professor, Speech and Hearing Department of Speech and Hearing Science Arizona State University Tempe, AZ MedicalResearch.com: What is the background for this study? Response: Working memory is the part of our human memory system that simultaneously processes and stores incoming information. It is important to understand the structure of working memory so that more tailored assessments and interventions can be developed to help children with poor working memory learn more successfully. In this study we tested four competing models of working memory in second grade students with typical development using the Comprehensive Assessment Battery for Children – Working Memory (CABC-WM; Gray, Alt, Hogan, Green, & Cowan, n.d.; Cabbage et al., in press).
Author Interviews, Nutrition, Weight Research / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30982" align="alignleft" width="82"]Dr Stacey Lockyer BSc(hons) MSc PhD RNutr Nutrition Scientist British Nutrition Foundation Imperial House 6th Floor London Dr Stacey Lockyer[/caption] Dr Stacey Lockyer BSc(hons) MSc PhD RNutr Nutrition Scientist British Nutrition Foundation Imperial House 6th Floor London MedicalResearch.com: What is the background for this study? What are the main findings? Response: This in depth review examines the potential health benefits of resistant starch, a form of starch that is not digested in the small intestine and is therefore considered a type of dietary fibre. Some forms of resistant starch occur naturally in foods such as bananas, potatoes, grains, and pulses, and some are produced or modified commercially and incorporated into food products as a functional ingredient. There has been increasing research interest in resistant starch, with a large number of human studies published over the last 10 years looking at a variety of different health outcomes such as postprandial glycaemia, satiety and gut health. The review summarises reported effects and explores the potential mechanisms of action that underpin them. There is consistent evidence that consumption of resistant starch in place of digestible carbohydrates can aid blood glucose control and this has resulted in an approved health claim in the European Union. There is also some evidence that resistant starch can support gut health and enhance satiety, though much more research is needed in these areas.
Asthma, Author Interviews, Fish, NEJM, Pediatrics / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30990" align="alignleft" width="133"]Hans Bisgaard, M.D., D.M.Sc. COPSAC, Herlev and Gentofte Hospital University of Copenhagen Copenhagen, Denmark Dr. Hans Bisgaard[/caption] Hans Bisgaard, M.D., D.M.Sc. COPSAC, Herlev and Gentofte Hospital University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Asthma and lower respiratory infections are leading causes of morbidity and mortality in pediatric populations. Thus, having low cost, effective, safe options for prevention could have important implications for both clinical practice and public health. The increased use of vegetable oils in cooking and of grain in the feeding of livestock has resulted in an increase in the intake of n−6 polyunsaturated fatty acids and a decrease in the intake of n−3 polyunsaturated fatty acids, especially the long-chain poly-unsaturated fatty acids (LCPUFAs) — eicosapentaenoic acid (20:5n–3, EPA) and docosahexaenoic acid (22:6n–3, DHA) — found in cold-water fish. N3-LCPUFAs are known to have immune-modulatory effects, and observational studies have suggested an association between a diet that is deficient in n−3 LCPUFA during pregnancy and an increased risk of asthma and wheezing disorders in offspring. Only a few randomized, controlled trials of n−3 LCPUFA supplementation during pregnancy have been performed and these have generally been underpowered and produced ambiguous results. Therefore, we conducted a double-blind, randomized, controlled trial of n−3 LCPUFA supplementation during the third trimester of pregnancy in a total of 736 Danish women to assess the effect on the risk of persistent wheeze and asthma in offspring. The clinical follow-up rate among children was 96% (N=664) by the end of the 3 years double-blind period and 93% (N=647) after an additional follow-up to age 5 years.
Author Interviews, JAMA, Mental Health Research, Pulmonary Disease / 06.01.2017

MedicalResearch.com Interview with: Meng-Ting Wang, PhD Associate Professor School of Pharmacy National Defense Medical Center Taipei, Taiwan MedicalResearch.com: What is the background for this study? Response: During the past decades, there have been multiple case reports about acute respiratory distress or acute respiratory failure (ARF) from the use of antipsychotics. Nevertheless, no population-based studies have been conducted to examine this potential drug safety issue. We aimed to investigate the association between use of antipsychotics and risk of ARF in a population of chronic obstructive pulmonary disease (COPD), who is vulnerable to ARF and frequently prescribed with antipsychotics.
Author Interviews, Neurological Disorders, Radiology / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30973" align="alignleft" width="150"]Jay Desai, M.D. Neurologist, Children’s Hospital Los Angeles Assistant Professor, Keck School of Medicine of USC Dr. Jay Desai[/caption] Jay Desai, M.D. Neurologist, Children’s Hospital Los Angeles Assistant Professor, Keck School of Medicine of USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: We obtained measures of blood flow at rest from all regions of brain using an MRI technique called pulsed arterial spin labeling in 26 participants (children and adults) with stuttering. We compared these blood flow measures with those from 36 fluent controls. We found decreased blood flow in Broca’s region in participants with stuttering when compared to the fluent controls. The amount of blood flow correlated inversely with the severity of stuttering and these findings extended into other portions of the language loop. We also detected alterations in blood flow in other brain regions including superior frontal gyrus, cerebellar nuclei and parietal cortex.
Author Interviews, OBGYNE, Pediatrics, Pediatrics, Weight Research / 06.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30969" align="alignleft" width="133"]Edwina Yeung, Ph.D Investigator in the Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Developm Dr. Edwina Yeung[/caption] Edwina Yeung, Ph.D Investigator, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development MedicalResearch.com: What is the background for this study? Response: About 1 in 5 pregnant women in the United States is obese. Other studies have looked at mothers’ obesity in terms of children’s development, but no U.S. studies have looked at whether there might be a contribution from the father’s weight. MedicalResearch.com: What are the main findings? Response: One of the main findings of this study is that maternal obesity is associated with a delay in fine motor skill-- the ability to control movement of small muscles, such as those in the fingers and hands. Paternal obesity is associated with a delay in personal-social skills including the way the child interacts with others. Having both a mother and a father with severe obesity (BMI≥35) was associated with a delay in problem solving ability.
Author Interviews, Autism, Gastrointestinal Disease, Psychological Science / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30964" align="alignleft" width="120"]David Q. Beversdor MD Center for Translational Neuroscience University Hospital University of Missouri Health System Columbia, MO 65212 Dr. David Beversdor[/caption] David Q. Beversdor MD Center for Translational Neuroscience University Hospital University of Missouri Health System Columbia, MO 65212 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered stress reactivity, alterations in cytokines and a high incidence of gastrointestinal disturbances have all been observed in autism spectrum disorder (ASD). We wished to examine the interactions between these factors. What we found was that patients with greater stress reactivity, as indicated by cortisol response in the testing environment, had greater symptomatology involving the lower gastrointestinal tract, which was predominated by constipation.
Allergies, Author Interviews, NIH, Pediatrics / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30951" align="alignleft" width="130"]Anna Nowak-Wegrzyn, MD Associate Professor of Pediatrics Icahn School of Medicine at Mount Sinai Jaffe Food Allergy Institute New York, NY 10029 Dr. Anna Nowak-Wegrzyn[/caption] Anna Nowak-Wegrzyn, MD Associate Professor of Pediatrics Icahn School of Medicine at Mount Sinai Jaffe Food Allergy Institute New York, NY 10029 MedicalResearch.com: What is the background for this study? Response: Peanut allergy can be fatal, is usually life-long and has no cure. Considering a dramatic increase in prevalence of peanut allergy over the past decades, affecting estimated 2-3% of infants and young children in the US, there is a dire need for prevention. Prior studies determined that risk of peanut allergy is highest in the infants with severe eczema, those with mutations in filaggrin gene resulting in an impaired skin barrier function and those not eating peanut but exposed to peanut in the household dust. In addition, the prevalence of peanut allergy was 10-fold higher among Jewish children in the United Kingdom compared with Israeli children of similar ancestry. In Israel, peanut-containing foods are usually introduced in the diet when infants are approximately 7 months of age and consumed in substantial amounts, whereas in the United Kingdom children do not typically consume any peanut-containing foods during their first year of life. Based on these observations, a landmark clinical trial (Learning Early about Peanut Allergy, LEAP) has been designed to evaluate whether early introduction of peanut into the diet of infant considered at high risk for peanut allergy can reduce the risk of peanut allergy compared to avoidance of peanut. LEAP and other studies suggested that peanut allergy can be prevented by introduction of peanut-containing foods in infancy. The overall reduction in peanut allergy among the infants in the LEAP trial randomized to an early introduction group compared to those who avoided peanut until age 5 years was 81%.
Author Interviews, Cost of Health Care, Diabetes, JAMA / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30753" align="alignleft" width="125"]Joseph Dieleman, PhD Institute for Health Metrics and Evaluation | University of Washington Seattle, WA 98121 Dr. Joseph Dieleman[/caption] Joseph Dieleman, PhD Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study was to provide a estimate of total health care spending in the United States for an exhaustive list of health conditions, over an extended period of time – from 1996 to 2013. The study primarily focuses on personal health spending, which includes both individual out-of-pocket costs as well as spending by private and government insurance programs on care provided in inpatient and outpatient facilities, emergency departments, nursing care facilities, dentist offices, and also on pharmaceuticals. There were 155 conditions included in the analysis, and spending was also disaggregated by type of care, and age and sex of the patient. In 2013, we accounted for $2.1 trillion in personal health spending in the U.S. It was discovered that just 20 health conditions made up more than half of all dollars spent on health care in the U.S. in 2013, and spending for each condition varied by age, sex and type of care. Diabetes was the most expensive condition, totaling $101 billion in diagnoses and treatments, growing at an alarmingly rate – a 6.5% increase per year on average. Ischemic heart disease, the number one killer in the U.S., ranked the second most expensive at $88.1 billion, followed by low back and neck pain at $87.6, treatment of hypertension at $83.9 billion, and injury from falls at $76.3. Women aged 85 and older spent the most per person in 2013, at more than $31,000 per person. More than half of this spending (58%) occurred in nursing facilities, while 20% was expended on cardiovascular diseases, 10% on Alzheimer’s disease, and 7% on falls. Men ages 85 and older spent $24,000 per person in 2013, with only 37% on nursing facilities, largely because women live longer and men more often have a partner at home to provide care.
Author Interviews, JAMA, Kidney Disease, Pediatrics / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30892" align="alignleft" width="145"]Jonathan Slaughter, MD, MPH Assistant Professor of Pediatrics Center for Perinatal Research Nationwide Children's Hospital/The Ohio State University Columbus, OH 43205 Dr. Jonathan Slaughter[/caption] Jonathan Slaughter, MD, MPH Assistant Professor of Pediatrics Center for Perinatal Research Nationwide Children's Hospital/The Ohio State University Columbus, OH 43205 MedicalResearch.com: What are the main findings? Response: The ductus arteriosus, a fetal blood vessel that limits blood flow through the lungs, normally closes shortly after birth. However, the ductus often remains open in premature infants, leading to patent ductus arteriosus (PDA). Infants with PDA are more likely to die or develop bronchopulmonary dysplasia (BPD), the major chronic lung disease of preterm infants. Nonsteroidal Anti-inflammatory Drug (NSAID) treatment has been shown to close PDAs in preterm infants and NSAID treatment of PDA is common. However, it has never been shown that PDA closure with NSAIDs leads to decreased mortality or improved long-term respiratory outcomes. NSAID closure of PDA has become increasingly controversial in recent years since NSAID treatment has been associated with acute renal injury. Also, these medications are expensive, with the usual three-dose treatment course costing well over $1000 per patient. Due to these controversies, the likelihood of a preterm infant with PDA being treated with NSAIDs varies by clinician and institution and has decreased over time. Meta-analyses of randomized trials that investigated NSAID (indomethacin and/or ibuprofen) treatment for PDA closure in preterm infants did not show a benefit. However, they were principally designed only to study whether the ductus itself closed following treatment and not to determine if there was an improvement in mortality risk or in respiratory outcomes following NSAID treatment. Given the difficulty of conducting randomized trials in preterm infants and the urgent need for practicing clinician's to know whether treatment of PDA in all preterm infants is beneficial, we used a study design that incorporated the naturally occurring practice variation in NSAID treatment for PDA as a mechanism to reduce the risk of biases that are commonly found in non-randomized investigations. This is based on the premise that if NSAID treatment for PDA in preterm infants is truly effective, we should expect to see improved mortality and respiratory outcomes in instances when clinician preference-based NSAID administration rates are higher.
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Environmental Risks, Lancet / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30933" align="alignleft" width="150"]Hong Chen, PhD Scientist, Environmental Health Assessment Public Health Ontario | Santé publique Ontario Assistant Professor, Dalla Lana School of Public Health, University of Toronto Adjunct Scientist, Institute for Clinical Evaluative Sciences (ICES) Toronto, ON Dr. Hong Chen[/caption] Hong Chen, PhD Scientist, Environmental Health Assessment Public Health Ontario | Santé publique Ontario Assistant Professor, Dalla Lana School of Public Health University of Toronto Adjunct Scientist, Institute for Clinical Evaluative Sciences Toronto, ON MedicalResearch.com: What is the background for this study? Response: Over the past several decades, there is unequivocal evidence that living close to major roadways may lead to various adverse health outcomes, such as cardio-respiratory related mortality and mortality. In the past decade, concern is growing that exposures associated with traffic such as air pollution and noise may also have an adverse impact on brain health. Several experimental studies show that air pollutants and diesel exhaust induce oxidative stress and neuroinflammation, activate microglia (which act as the first and main form of immune defense in the central nervous system), and stimulate neural antibodies. There are also a small number of epidemiological studies linking traffic-related noise and air pollution to cognitive decline and increased incidence of Parkinson’s disease and Alzheimer’s disease. Studies also showed that living near roads was associated with reduced white matter hyperintensity volume and cognition, but its effect on the incidence of dementia, Parkinson’s disease, and multiple sclerosis is unknown. Given hundreds of millions of people worldwide live close to major roads, we conducted this population-based cohort study to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada.
Author Interviews, Heart Disease, HIV / 05.01.2017

MedicalResearch.com Interview with: Heidi M. Crane MD, MPH Associate Professor of Medicine Associate Director Clinical Epidemiology and Health Services Research Core Center for AIDS Research University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have suggested that rates of myocardial infarction (MI) are higher in those with HIV, likely for a variety of reasons. However, prior studies have not been able to distinguish MIs by type. The Universal Definition of MI has been recommended by cardiology societies and classifies MIs into types with Type 1 MIs resulting spontaneously from atherosclerotic plaque instability and Type 2 MIs occurring secondary to causes other than atherosclerotic plaque rupture, including hypotension, hypoxia, and stimulant induced spasm resulting in increased oxygen demand or decreased supply. Understanding MI types is likely important as they may indicate a different prognosis and need for different prevention approaches.
Author Interviews, Boehringer Ingelheim, Dermatology / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30943" align="alignleft" width="180"]Andrew Blauvelt, M.D., M.B.A. President and Investigator Oregon Medical Research Center Portland, OR 97223 Dr. Andrew Blauvelt[/caption] Andrew Blauvelt, M.D., M.B.A. President and Investigator Oregon Medical Research Center Portland, OR 97223 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Findings from the guselkumab Phase 3 VOYAGE 1 study showed that patients with moderate to severe plaque psoriasis receiving the anti-interleukin (IL)-23 monoclonal antibody (mAb) achieved significant improvements in skin clearance compared with patients receiving placebo and patients receiving Humira® (adalimumab), a TNF blocker. The Phase 3 study and head-to-head analysis of guselkumab vs. adalimumab in the treatment of moderate to severe plaque psoriasis also showed the significant efficacy of guselkumab maintained through week 48 compared with adalimumab, and the robust efficacy of guselkumab in meeting all primary and major secondary endpoints.
Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30939" align="alignleft" width="142"]Paul Y. Kwo, MD, FACG Stanford University School of Medicine Dr. Paul Y. Kwo[/caption] Paul Y. Kwo, MD, FACG Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: This guideline, which was jointly authored by Drs. Kwo, Cohen, and Lim provides a framework for physicians to approach the very common problem encountered of a patient whose liver chemistries are abnormal. This is particularly relevant as there remain large pools of individuals who have yet to be diagnosed with chronic hepatitis B and C, non-alcoholic fatty liver disease, advanced liver disease as well as less common conditions, all of whom will require evaluation. In particular, the rise in the prevalence of non-alcoholic fatty liver disease worldwide will be addressed in part by identifying and evaluating these individuals prior to the development of advanced fibrosis. The guideline takes clinicians through a step-wise approach to the evaluation of elevated aminotransferase (ALT and AST), alkaline phosphatase, and bilirubin levels including appropriate historical questions, important physical examination findings, laboratory , radiological evaluation and finally liver biopsy if required.
Author Interviews, Cancer Research, Diabetes, Pharmacology, Science / 05.01.2017

MedicalResearch.com Interview with: Dr. Don Gary Benjamin Biozentrum, University of Basel Basel, Switzerland. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We initiated the study to find a co-drug that would increase the anti-cancer effect of the commonly prescribed anti-diabetic drug metformin. Metformin is a very well tolerated medication, however the dosage required to show anti-cancer activity is higher than that usually prescribed, hence the aim of the study. We found that metformin in combination with a second drug, syrosingopine (an anti-hypertensive), potently kills cancer cells in a variety of pre-clinical models. Quite nicely, both these drugs combine to kill the cells at a concentration where they have no impact on cell growth when applied singly.
Asthma, Author Interviews, Genetic Research, Pediatrics / 04.01.2017

MedicalResearch.com Interview with: [caption id="attachment_26649" align="alignleft" width="100"]Donata Vercelli, MD Professor of Cellular and Molecular Medicine, University of Arizona Director, Arizona Center for the Biology of Complex Diseases Associate Director, Asthma and Airway Disease Research Center The BIO5 Institute, Rm. 339 Tucson, AZ 85721 Dr. Donata Vercelli[/caption] Donata Vercelli, MD Professor of Cellular and Molecular Medicine Director, Arizona Center for the Biology of Complex Diseases Director, Molecular Genomics, Asthma and Airway Disease Research Center The University of Arizona The BIO5 Institute Tucson, AZ 85721 MedicalResearch.com: What is the background for this study? Response: Asthma is the most prevalent chronic disease of childhood. Epidemiological evidence suggests that the disease often begins during the pre-school years even when chronic symptoms appear much later in life. However, firm criteria to pinpoint how early a child’s trajectory to asthma truly begins are currently lacking. The mechanisms underlying asthma inception also remain largely unknown. Although epigenetic mechanisms likely contribute to asthma pathogenesis, little is known about their role in asthma inception.
Annals Thoracic Surgery, Author Interviews, Diabetes, Duke, Heart Disease, Hepatitis - Liver Disease, Pharmacology / 04.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30926" align="alignleft" width="156"]Matthew J. Crowley, MD, MHS Assistant Professor of Medicine Member in the Duke Clinical Research Institute Duke University Medical Center Dr. Matthew Crowley[/caption] Matthew J. Crowley, MD, MHS Assistant Professor of Medicine Member in the Duke Clinical Research Institute Duke University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although metformin is widely considered to be the first-line drug for type 2 diabetes, concerns about lactic acidosis have traditionally limited its use in some populations. However, FDA now indicates that metformin may be used safely for patients with mild-moderate chronic kidney disease and other historical contraindications like congestive heart failure. With the lactic acidosis question addressed for these groups, this review asked “what do we know about how metformin affects mortality and other outcomes for patients with historical contraindications and precautions?” The main take-home message is that metformin appears associated with lower mortality in patients with mild-moderate chronic kidney disease, congestive heart failure, and chronic liver disease.
Author Interviews, Autism, Genetic Research, Nature, Pediatrics, Schizophrenia / 04.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30921" align="alignleft" width="150"]Dr. Beate St Pourcain MSc, PhD(Cardiff) Genetic Epidemiology School of Oral and Dental Sciences MRC Integrative Epidemiology Unit University of Bristol Dr. Beate St Pourcain[/caption] Dr. Beate St Pourcain MSc, PhD(Cardiff) Genetic Epidemiology School of Oral and Dental Sciences MRC Integrative Epidemiology Unit University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: People with autism and with schizophrenia both have problems interacting and communicating with other people, because they cannot easily initiate social interactions or give appropriate responses in return. On the other hand, the disorders of autism and schizophrenia develop in very different ways. The first signs of Autism Spectrum Disorder (ASD) typically occur during infancy or early childhood, whereas the symptoms of schizophrenia usually do not appear until early adulthood. The researchers asked whether it is possible to disentangle the apparent symptom overlap in ASD and schizophrenia through genetic analyses. As clinical diagnoses relate to the age of onset of a disorder and do not capture multiple developmental stages, the researchers used a trick. They assumed that there is a continuum between normal and abnormal behaviour and captured social communicative competence - the ability to socially engage with other people successfully - in participants of a population-based birth cohort during development. Specifically, the researchers studied the genetic overlap between the risk of having these psychiatric disorders and these measures of social communicative competence. Investigating thousands of genetic variants with small effects across the genome, they showed that genes influencing social communication problems during childhood overlap with genes conferring risk for autism, but that this relationship wanes during adolescence. In contrast, genes influencing risk for schizophrenia were most strongly interrelated with genes affecting social competence during later adolescence, in line with the natural history of the disorder. "The findings suggest that the risk of developing these contrasting psychiatric conditions is strongly related to distinct sets of genes, both of which influence social communication skills, but exert their maximum influence during different periods of development", explained Beate St Pourcain, senior investigator at the Max Planck Institute and lead author of the study. This is consistent with studies showing that genetic factors underlying social communication behaviour also change to some degree during childhood and adolescence.
Author Interviews, Biomarkers, Heart Disease, JACC / 04.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30915" align="alignleft" width="188"]Prof. Michele Emdin, MD, PhD, FESC Associate Professor of Cardiovascular Medicine Institute of Life Sciences Scuola Superiore Sant'Anna - Sant'Anna School of Advanced Studies Director, Cardiology & Cardiovascular Medicine Division Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica Prof. Michele Emdin[/caption] Prof. Michele Emdin, MD, PhD, FESC Associate Professor of Cardiovascular Medicine Director, Cardiology & Cardiovascular Medicine Division Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica CNR-Regione Toscana with the collaboration of Dr. Alberto Aimo, MD Institute of Life Sciences Scuola Superiore Sant'Anna - Sant'Anna School of Advanced Studies Pisa, Italy MedicalResearch.com: What is the background for these meta-analyses? Response: Soluble suppression of tumorigenicity 2 (sST2) is a novel and promising biomarker of heart failure (HF). It has been extensively studied in both stable chronic (CHF) and acute HF (AHF), demonstrating substantial potential as a predictor of prognosis in both settings (Dieplinger et al., 2015). An International Consensus Panel (Januzzi et al., 2015) and latest American College of Cardiology Foundation/American Heart Association (ACCF/AHA) guidelines (Yancy et al., 2013) support the use of sST2 assay for risk stratification in both CHF and AHF patients. By contrast, European Society of Cardiology guidelines do not provide specific recommendations on sST2 (Ponikowski et al., 2016). Because of ambiguity due to discordant conclusions and to the absence of a thorough revision of the literature and of rigorous meta-analyses of published studies up-to-date, we felt it worthwhile to carefully examine and meta-analyze evidence supporting measurement of sST2, in order to assess the prognostic role of this biomarker in CHF and AHF. Most of the groups originally publishing on the topic all over the world and representing the Gotha of clinical research on cardiovascular biomarker, accepted to directly contribute allowing the main Authors to achieve novel information by a guided statistical reappraisal, The final results furnish clinically significant support to the use of sST2 as a risk stratification tool either in the acute or in the chronic heart failure setting.
Author Interviews, Cancer Research, JAMA, Prostate Cancer / 03.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30832" align="alignleft" width="131"]Dr. Jim C. Hu MD MPH Professor of Urology Weill Cornell Medicine Dr. Jim Hu[/caption] Dr. Jim C. Hu MD MPH Professor of Urology Weill Cornell Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The most significant finding from our population based study is that after years of decline following the introduction of PSA screening, we see a rise in the incidence of metastatic prostate cancer at diagnosis among men aged 75 years and older. This is concerning in light of recent criticisms and guidelines against PSA testing. For instance, in 2008, the US Preventative Services Task Force recommended against PSA testing in this age group, and in our study, we see the incidence of metastasis at diagnosis rising in 2012 and 2013. This is significant because there is no cure for men with metastatic prostate cancer of their disease. The traditional argument against PSA screening is that it leads to over-diagnosis and over-treatment of prostate cancer. However, we currently do not have a better test for diagnosing prostate cancers before it has spread beyond the prostate and metastasized. Remarkably, when Ben Stiller shared his personal use of PSA testing in his mid to late 40's and how this led to a detection of intermediate risk prostate cancer that led him to surgery and cure, others criticized him for sharing his story.
Author Interviews, Dermatology, JAMA, Melanoma / 02.01.2017

MedicalResearch.com Interview with: Jessica S. Mounessa, BS Robert P. Dellavalle, MD, PhD, MSPH Dermatology Service, Denver Veterans Affairs Medical Center, Denver, Colorado Department of Dermatology, University of Colorado School of Medicine, Aurora MedicalResearch.com: What is the background for this study? What are the main findings? Response: Skin cancer remains the most common cancer in the U.S., despite ongoing efforts to address this major public health problem. Over 9,000 deaths occur annually, and mortality rates continue to increase faster than those associated with any other preventable cancer. Malignant melanoma, the deadliest type of skin cancer, accounts for the overwhelming majority of these deaths. Our study identified regional and state differences in the incidence and mortality rates of melanoma in the United States. We found that the Northeast, specifically New England, represents the only U.S. region in which the majority of states experienced a reduction in both incidence and death rates over the ten-year period between 2003 and 2013.
Alcohol, Author Interviews, Heart Disease, JACC, UCLA / 02.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30841" align="alignleft" width="166"]Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco Dr. Gregory M Marcus[/caption] Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Moderate alcohol consumption has previously been associated with a decreased risk of heart attack. However, as we have previously shown that individuals who believe alcohol to be good for the heart tend to drink more, there is a concern that these previous data might appear to justify excessive alcohol consumption. In addition, previous research on the topic of alcohol consumption and heart disease has relied almost entirely on participant self-report, which is known to be particularly unreliable among heavy drinkers. Finally, previous research has sought to study relationships between alcohol and various types of heart disease, but there has not been an emphasis on individual-level characteristics that might influence these relationships.