Blog – Medical Research News and Interviews
14 Sep Study Outlines Risk Factors for Infectious Endocarditis After TAVR
MedicalResearch.com Interview with: [caption id="attachment_21314" align="alignleft" width="120"]
Dr. Rodés-Cabau[/caption]
Josep Rodés-Cabau, MD
Director, Catheterization and Interventional Laboratories
Quebec Heart and Lung Institute
Professor, Faculty of Medicine, Laval University
Quebec City, Quebec, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Infectious endocarditis (IE) is one of the most serious complications after surgical prosthetic valve replacement. There are however scarce data regarding the incidence, predictive factors, treatment, and outcomes of IE post-TAVR. To date, the present study represents the largest series of IE post-TAVR, and the main findings can be summarized as follows: (1) the incidence of infective endocarditis (IE) post-TAVR is similar to that reported for IE after surgical prosthetic valve replacement; (2) among patients undergoing TAVR, younger age, male sex, a history of diabetes mellitus, and moderate-to-severe residual aortic regurgitation were associated with a higher risk of IE, (3) Enterococci species was the most frequently isolated pathogen, (4) IE post-TAVR was associated with a very high rate of in-hospital complications and mortality during index hospitalization and at follow-up.
14 Sep Adolescent Girls Not Adequately Screened For Pregnancy Before Chemo or CT Scans
MedicalResearch.com Interview with: [caption id="attachment_27794" align="alignleft" width="144"]
Dr. Pooja Rao[/caption]
Pooja Rao, MD, MSCE
Assistant Professor
Division of Pediatric Hematology/Oncology
Milton S. Hershey Medical Center
Penn State College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment.
Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.
14 Sep Three Criteria To Identify Out-of-Hospital Cardiac Arrest Patients With No Chance of Survival
MedicalResearch.com Interview with: [caption id="attachment_27901" align="alignleft" width="150"]
Prof. Xavier Jouven[/caption]
Prof. Xavier Jouven
Service de Cardiologie
Hôpital Européen Georges Pompidou
Paris
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are many cardiac arrests (around 300 000 per year in United States). The possibility to collect organs from a certain proportion of those cardiac arrests represents an important opportunity to fill the gap of the organ shortage.
It is absolutely mandatory to identify patients with no chance of survival. This study showed 3 criteria which allow this early identification. Several thousands of patients die every year waiting for organ transplantation.
14 Sep Playing Video Games By Children May Be Helpful In Moderation
MedicalResearch.com Interview with: [caption id="attachment_27906" align="alignleft" width="200"]
Dr. Jesus Pujol[/caption]
Jesus Pujol, MD
Director of the MRI Research Unit.
Department of Radiology. Hospital del Mar
Barcelona
MedicalResearch.com: What is the background for this study?
Response: The pros and cons of video gaming in children have been extensively debated. There are relevant amounts of data indicating both the positive and negative effects of video games. Nevertheless, a key question for many parents remains unanswered: How long should children play? To provide some clarity, we have investigated the relationship between weekly video game use and certain cognitive abilities and conduct-related problems.
13 Sep 90% of Americans Live Within Short Driving Distance To Eye Care
MedicalResearch.com Interview with: [caption id="attachment_27898" align="alignleft" width="142"]
Dr. Cecelia Lee[/caption]
Cecilia S. Lee, MD
Department of Ophthalmology
University of Washington School of Medicine
Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Access to eye care is a critical issue currently in the United States. With the expected increase in the aging US population, many eye diseases are age-related and there is an expected associated increase in demand for eye care. Prior studies have estimated access to care in many different ways including looking at providers per zipcode, utilization of billing codes, and distance to provider. We sought to estimate the access to eye care providers using a much more accurate way to estimate the driving distance to provider. Specifically, we recreated a driving route system similar to Google Maps or Apple Maps for navigation to plot direct driving routes.
13 Sep The GLORIA-AF Registry: Two Year Follow Up of Dabigatran for Non-Valvular A Fib Reported
MedicalResearch.com Interview with: [caption id="attachment_27880" align="alignleft" width="152"]
Dr. Menno Huisman[/caption]
Menno Huisman, MD, PhD
Associate professor
Department of Medicine
Leiden University Medical Center
The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: GLORIA™-AF is one of the largest ongoing global registry programs examining the use of oral antithrombotic agents in real-world clinical practice. The program is designed to characterize the population of newly diagnosed patients with non-valvular atrial fibrillation (NVAF) at risk for stroke, and to study patterns, predictors and outcomes of different regimens for stroke prevention.
At the ESC Congress 2016, we presented the first Phase II results of GLORIA-AF from approximately 3,000 NVAF patients, which showed that treatment with PRADAXA was associated with low incidences of stroke, major bleeding and life threatening bleeding. Less than 1% of PRADAXA-treated patients experienced a stroke over two years (0.63%). Major bleeding occurred in 1.12% of PRADAXA-treated patients and 0.54% experienced a life-threatening bleed.
13 Sep Penn Reports Successful Pilot Study of Liquid Biopsy To Monitor Advanced Lung Cancer
Posted at 19:58h
in Author Interviews, Biomarkers, Lung Cancer, Personalized Medicine, University of Pennsylvania
MedicalResearch.com Interview with:
[caption id="attachment_27877" align="alignleft" width="132"]
Dr. Erica Carpenter[/caption]
Erica L. Carpenter, MBA, PhD
Research Assistant Professor, Department of Medicine
Director, Circulating Tumor Material Laboratory
Division of Hematology/Oncology
Abramson Cancer Center
Perelman School of Medicine at the University of Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The advent of precision medicine practices for cancer patients, including the use of drugs that target specific tumor mutations, has necessitated improved diagnostics with real-time molecular monitoring of patients' tumor burden. While biopsy material, obtained surgically or through fine needle aspirate, can provide tissue for next generation sequencing (NGS) and mutation detection, this requires an invasive often painful procedure for the patient. In many cases, especially in more advanced disease when multiple metastases are present, such tissue cannot be obtained or can only be obtained from a single tumor site, thus limiting the sensitivity of tissue-based biopsy.
Here we report on a prospective cohort of 102 consecutively enrolled patients with advanced non-small lung cancer (NSCLC) for whom a non-invasive liquid biopsy was used for real-time detection of therapeutically targetable mutations. Tissue samples were only obtainable for 50 of the 102 patients, and these tissue biopsies were analyzed using a 47-gene Next Generation Sequencing (NGS) panel at Penn's Center for Personalized Diagnostics. Concordance of results for the 50 patients who received both tests was close to 100% when the samples were obtained concurrently.
13 Sep Triclosan in Household Dust Linked To Antibiotic Resistance
MedicalResearch.com Interview with: [caption id="attachment_27873" align="alignleft" width="200"]
Dr. Erica Hartmann[/caption]
Erica Marie Hartmann PhD
Assistant Professor
Dept. of Civil & Environmental Engineering
Northwestern University
Evanston, IL 60208
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The antimicrobial chemical triclosan has been found in almost every dust sample that has ever been tested worldwide, and we already know that triclosan can cause an increase in antibiotic resistance genes in wastewater. This study is the first to show a link between antibiotic resistance genes and antimicrobial chemicals in indoor dust, which people tend to come into contact with more than wastewater.
This finding is important because the World Health Organization has identified a huge information gap in community-acquired antibiotic-resistant infections; the use of antimicrobial chemicals in homes and other non-medical buildings could be contributing to the development of antibiotic resistance outside of hospital settings. This study was published in the wake of the FDA decision last week to ban the use of triclosan and several other antimicrobial chemicals in soaps. While the FDA decision is a good first step, it's not the end the problem. Antimicrobial chemicals like triclosan are in a lot of different products. Right now, we don’t know how much of the triclosan we see in dust comes from soap vs. other products (building materials, paints, plastics, etc.).
13 Sep Lung Cancer: Adjusting Afatinib Dose Reduced Side Effects With No Impact on Efficacy
MedicalResearch.com Interview with: [caption id="attachment_27869" align="alignleft" width="95"]
Dr. Chih-Hsin Yang[/caption]
Chih-Hsin Yang MD PhD
Department of Oncology
National Taiwan University Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: LUX-Lung 3 and LUX-Lung 6 are multicenter, randomized, open-label, Phase III trials of afatinib versus chemotherapy (pemetrexed / cisplatin and gemcitabine / cisplatin, respectively) as first-line treatment for patients with EGFR mutation-positive, advanced and metastatic non-small-cell lung cancer (NSCLC). Both trials met their primary endpoint of PFS with afatinib significantly delaying tumor growth when compared to standard chemotherapy.
A post-hoc analysis of the studies was conducted to look at the incidence and severity of common adverse events (AEs) before and after afatinib dose reduction and the PFS was compared between patients who dose reduced within the first 6 months of treatment and those who did not.
The results showed dose reductions were associated with decreases in the incidence and severity of treatment-related AEs, while median progression-free survival (PFS) was similar in patients who dose-reduced within the first six months of treatment versus those who did not (LUX-Lung 3, 11.3 vs 11 months; LUX-Lung 6, 12.3 vs 11 months).
13 Sep Body Mass Index Linked to LV Mass in Career Male Firefighters
MedicalResearch.com Interview with: [caption id="attachment_27860" align="alignleft" width="200"]
Maria Korre[/caption]
Maria Korre, ScD
Post-Doctoral Research Fellow
Environmental & Occupational Medicine & Epidemiology Program
Department of Environmental Health
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. It is crucial to note though, that the risk of on-duty CVD events is not evenly distributed among all firefighters, but is highly concentrated among the most susceptible individuals. Given that firefighting is an inherently dangerous occupation and many of its hazards cannot be engineered out of the job, we have concentrated our efforts on understanding what can make an individual firefighter susceptible.
As in the general population, these cardiovascular events are largely due to coronary heart disease (CHD), however, there is an increasing recognition of the role of left ventricular (LV) hypertrophy/cardiomegaly in the risk of sudden cardiac death (SCD) independent of the presence of CHD. Evidence suggests an improved prognostic value, when LV hypertrophy is based on the accurate assessment of LV mass.
LV mass is a strong predictor of CVD events and despite it’s critical prognostic significance, it’s measurement and role in clinical practice has yet to be established.
In this paper we aimed to identify the most important predictors of LV mass after indexing for height among career male firefighters as assessed by both echocardiography and cardiac magnetic resonance.
13 Sep In Utero Exposure to Ethinyl Estradiol Linked to Tamoxifen Resistance and Breast Cancer Recurrence
MedicalResearch.com Interview with: [caption id="attachment_27856" align="alignleft" width="120"]
Dr. Leena Hilakivi-Clarke[/caption]
Leena Hilakivi-Clarke, PhD
Professor of Oncology
Georgetown University
Washington, DC 20057
MedicalResearch.com: What is the background for this study?
Response: About 70% of women who develop breast cancer express estrogen receptors in their cancer. These patients are treated with endocrine therapies that target estrogen receptors. Endocrine therapies are effective in half of the patients, but the other half are resistant to the treatment and recur. Prior to the start of endocrine therapy, there is no way to predict who will respond to it and who will have recurrence of breast cancer. Therefore, it is not known which patients might benefit from an additional therapy to prevent recurrence, and what that additional therapy would entail. We wondered if resistance to endocrine therapy (we used tamoxifen) is pre-programmed by maternal exposure to the estrogenic endocrine disrupting chemical ethinyl estradiol (EE2). Previously, we and others have found that EE2 and other estrogenic compounds, when given during pregnancy, increase breast cancer risk in the female offspring in animal studies and among humans. The current study was done using a preclinical animal model that was used 50 years ago to discover that tamoxifen is an effective endocrine therapy for estrogen receptor positive breast cancer patients.
12 Sep Key Risk Factors of Non-Healing Bone Fractures Identified
MedicalResearch.com Interview with: [caption id="attachment_27845" align="alignleft" width="200"]
Dr. R. Grant Steen[/caption]
R. Grant Steen, PhD
Medical Affairs,
Bioventus LLC
Durham, North Carolina
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: When we started this research, it was really only guesswork as to how big a problem fracture nonunion really is. What we've done is to work with an enormous database of patient health claims, with two goals.
First, we wanted to characterize how common fracture nonunion is among patients across a wide age range.
Second, we wanted to identify risk factors that make a patient more likely to have problems healing.
We've now succeeded in both aims. We know that roughly 5% of fracture patients will go to nonunion, and we know a whole host of risk factors that predispose them to do so.
Most of the risk factors that we've identified—with a few exceptions—would not be a surprise to physicians who treat fracture patients. However, what we've done is to put all of these risk factors in a broader context, so that we know which risk factors are most important and which are less so.
For example, it has been known for a long time that smoking is a risk factor for nonunion. What we've shown is that, in the scheme of things, it's not all that important. Let me be more precise here, because this is an important point. If all you know about a patient is that they smoke, we've shown that smoking is associated with a 62% increase in risk of nonunion. That's a lot. But, as you learn more about that patient and can factor that new knowledge into a risk prediction, it turns out that smoking, all by itself, increases the risk of nonunion by only about 20%. However, smoking is a surrogate marker for a range of other risk factors that also increase risk, including male gender, cardiovascular disease, obesity, vitamin D deficiency, alcoholism, and so on. Once you factor these separate risk factors into your new nonunion prediction, you have a much more nuanced—and probably much more accurate—prediction of nonunion risk.
12 Sep Low-Intensity Interventions Addressing Social Needs In Pediatric Settings Can Improve Child Health
MedicalResearch.com Interview with: Laura M. Gottlieb, MD, MPH Department of Family and Community Medicine, 2Center for Health and Community University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks. In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation. To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health. The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13).12 Sep Stem Cells Drive Vascular Calcification in Arteriosclerosis
MedicalResearch.com Interview with: Rafael Kramann, MD, FASN RWTH Aachen University Division of Nephrology and Clinical Immunology Pauwelsstr 30 52074 Aachen, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vascular calcification contributes centrally to the increased cardiovascular morbidity and mortality in patients with diabetes or chronic kidney disease. Vascular calcification is of major clinical importance as it predicts cardiovascular events, affects plaque stability contributing to stroke and myocardial infarction and also contributes to chronic heart failure by stiffening of the arterial wall. However, the cellular origin of vascular calcification is incompletely understood. While it is known that resident vascular smooth muscle cells and circulating macrophages are involved the contribution of adventitial cells is controversial and partly unknown. Our data indicates that adventitial progenitor cells marked by expression of Gli1 are key drivers of vascular calcification in athero- and arteriosclerosis. Genetic ablation of this cell population completely abolished vascular calcification in a mouse model of high lipid load and chronic kidney disease. Identification of this progenitor population might be the first step towards a cell-specific targeted therapy of vascular calcification.12 Sep Roundworm Infection Transmitted By Raccoons Has Serious Neurologic Complications
MedicalResearch.com Interview with: [caption id="attachment_27834" align="alignleft" width="193"]
Dr. Anita Sircar[/caption]
Anita D. Sircar, MD
Epidemic Intelligence Service
Division of Parasitic Diseases and Malaria
Center for Global Health
CDC
MedicalResearch.com: What is the background for this study?
Response: Baylisascaris procyonis is a roundworm commonly found in raccoons. It can be found anywhere in the United States where raccoons live. People, especially children, can be infected by this roundworm when they accidentally ingest contaminated raccoon feces. Infection with Baylisascaris procyonis can have severe outcomes in people such as blindness and even death if not treated promptly.
Despite expansion of the geographic distribution of Baylisascaris procyonis in the last 14 years and probable increasing human exposure, baylisascariasis is likely an underreported disease: only 22 documented cases were reported in the United States during 1973–2010.
During May 2013–December 2015, seven additional cases of baylisascariasis were identified among patients in the United States through testing at CDC, including six cases of central nervous system disease and one of ocular disease. Laboratory and clinical information for each patient was gathered and reviewed in a case series to contribute to knowledge about Baylisascaris procyonis infection. All seven patients survived, although approximately half had residual neurologic sequelae.
12 Sep Atrial Fibrillation Associated With Wide Range of Cardiovascular Events
MedicalResearch.com Interview with: Ayodele Odutayo, DPhil student Centre for Statistics in Medicine Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation is associated with an increased risk of all cause mortality and stroke, as well as higher medical costs and a reduced quality of life. The association between atrial fibrillation and cardiovascular outcomes other than stroke is less clear. We found that atrial fibrillation is associated with a wide range of cardiovascular events, including cardiovascular mortality, major cardiovascular events, heart failure, ischaemic heart disease, chronic kidney disease, and sudden cardiac death, as well as stroke and all cause mortality. The relative and absolute risk increase associated with many of these events is greater than that of stroke. Interventions are needed to reduce the risk of non-stroke cardiovascular outcomes in adults with atrial fibrillation.11 Sep Earned Income Tax Credits Linked To Improved Health Parameters
MedicalResearch.com Interview with: [caption id="attachment_27824" align="alignleft" width="165"]
Dr. Peter Muennig[/caption]
Peter Muennig, MD, MPH
Associate Professor
Mailman School of Public Health
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We looked that the supplemental Earned Income Tax Credit
( EITC ) programs offered by states to determine whether they have health impacts or not.
We found that, on average, folks who live in states that offer supplemental EITC showed improvements in health after EITC was implemented.
11 Sep Pemphigus Incidence Much Higher Among Jews Than Arabs in Northern Israel
MedicalResearch.com Interview with: [caption id="attachment_27818" align="alignleft" width="200"]
Dr. Khalaf Kridin[/caption]
Khalaf Kridin, MD
Department of Dermatology
Rambam Health Care Campus
Haifa Israel
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pemphigus shows an uneven geographic and ethnic distribution. A high incidence of pemphigus was observed in some ethnic groups, namely Ashkenazi Jews and those of Mediterranean origin. This observation has been shown to be strongly related to several HLA-class II genes; HLA-DRB1*04 and HLA-A*10 which have been more frequently found among Ashkenazi Jewish pemphigus patients. We sought to estimate trends in the incidence of pemphigus in northern Israel in the years 2000-2015, in relation to the major ethnic groups who inhabit the same geographic area and exposed to the same environmental elements.
The overall estimated incidence of pemphigus in northern Israel was 7.2 per million inhabitants per year (95% CI, 6.2-8.3). The incidence in the Jewish population was 3-fold higher than that in Arabs; 9.6 vs. 3.2 cases per million per year, respectively, p<0.0001), and higher among women than men; 9 vs. 5.3 cases per million per year, respectively, p<0.0001). Patients of Arab ancestry tend to present with the disease at earlier age, in line with observations from Arab and Mediterranean countries.
A declining trend in the incidence of pemphigus throughout the last 16 years in northern Israel was observed.
11 Sep TAVR: Women Have More Short Term Complications But Better One-Year Survival
MedicalResearch.com Interview with: [caption id="attachment_27680" align="alignleft" width="152"]
Dr. Michael Gaglia[/caption]
Michael A. Gaglia Jr., MD, MSc, FACC, FSCAI
Scientific Lead, Population Research
Medstar Cardiovascular Research Network
Interventional Cardiology
Medstar Heart and Vascular Institute
Washington, DC 20010
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular outcomes vary according to gender in a variety of disease states. For example, short-term mortality is higher among women presenting with an acute coronary syndrome in comparison to men. There is a similar trend for higher short-term mortality of women undergoing coronary artery bypass grafting, although this is in part due to a relatively higher burden of comorbidities. Female gender is also a well-established risk factor for bleeding complications after percutaneous coronary intervention.
In regards to women undergoing surgical aortic valve replacement for severe aortic stenosis (AS), however, the data is equivocal; some studies suggest higher mortality for women, whereas others suggest improved survival for women.
The emergence of transcatheter aortic valve replacement (TAVR) as the preferred therapeutic option for patients with severe AS at high or extreme risk for surgery offered another opportunity to examine gender disparities in outcomes. The evidence base for the impact of gender upon TAVR, however, is still evolving. A recent meta-analysis suggested improved long-term survival among women after TAVR. And in general, previous studies also suggest more vascular and bleeding complications in women when compared to men. The goal of this study was relatively simple: to compare outcomes between women and men undergoing TAVR at a single center.
11 Sep Liquid Biopsies Hold Promise of Diagnosing Response to Chemotherapy
MedicalResearch.com Interview with: [caption id="attachment_27803" align="alignleft" width="200"]
Dr. Karen Reckamp[/caption]
Karen L. Reckamp, M.D.
Associate Professor
City of Hope Comprehensive Cancer Center
Duarte, CA 91010
MedicalResearch.com: What is the background for this study? What are the main findings?
Response:
• Approximately 60% of patients with non-small cell lung cancer (NSCLC) receiving EGFR tyrosine kinase inhibitors (TKIs) will develop TKI resistance through the acquisition of the EGFR T790M mutation.
• A major challenge for assessing EGFR mutation status in advanced NSCLC is the availability of suitable biopsy tissue for molecular testing, specifically for determination of the emergence of T790M following progression on initial EGFR TKI therapy.
• The objective of this study was to demonstrate that a highly sensitive and quantitative next-generation sequencing analysis of EGFR mutations is feasible from urine and plasma, providing comparable clinical information while potentially mitigating the issues associated with tissue biopsies.
• This blinded, retrospective study was conducted on matched tissue, urine and plasma specimens collected from 63 patients with Stage IIIB-IV NSCLC enrolled in the TIGER-X trial of rociletinib, an investigational 3rd generation tyrosine kinase inhibitor (TKI), targeting T790M.
11 Sep Many Congolese Refugees Applying for Resettlement to the US Have Marked Splenomegaly
MedicalResearch.com Interview with: Dr. Matt Goers Internal Medicine Resident at UMN MedicalResearch.com: What is the background for this report? What are the main findings of the evaluations of refugee populations in western Uganda? Response: In 2014, International Organization of Migration (IOM) reported an unusually high number of Congolese refugees in western Uganda had palpable, enlarged spleens detected during their routine refugee pre-departure medical examinations. Due to this trend, the IOM, with the assistance of the Centers for Disease Control and Prevention (CDC), implemented a diagnostic and treatment protocol to further evaluate and assist with management of refugees with splenomegaly during their pre-departure medical examinations. In March and June 2015, a total of 987 U.S.-bound refugees underwent medical examinations performed as part of their routine resettlement process. Of those evaluated, 145 (14.7%) had a detectable spleen on physical examination. In fact, 84.7% (122 people) were found to have marked or massive splenomegaly during their evaluation (classified based on a prior World Health Organization ultrasonography protocol). During the work-up for this condition, less than 33% were found to have an infectious cause of their condition including 26.9% (39 people) who had malaria.09 Sep Vitamin A May Inhibit Pancreatic Cancer by Preventing Desmoplasia That Surrounds Tumor
MedicalResearch.com Interview with: [caption id="attachment_27789" align="alignleft" width="200"]
Dr. del Río Hernández[/caption]
Armando E. del Río Hernández, PhD
European Research Council Fellow
Head, Cellular and Molecular Biomechanics Laboratory
http://biomechanicalregulation-lab.org/
Senior Lecturer, Department of Bioengineering
Imperial College London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pancreatic cancer is an extremely aggressive disease with an unacceptably low survival rate that has not changed during the last 40 years despite significant efforts aimed at developing therapies against cancer cells.
Pancreatic cancer is characterised by an extensive desmoplasia, which forms the majority of the tissue around the tumour. This desmoplastic tissue is known to help the tumour to grow and metastasize, and hinders drug delivery.
We have focused our efforts on understanding how pancreatic stellate cells (PSCs), which are the key effectors that orchestrate the desmoplastic reaction in pancreatic cancer, can promote tumour progression. PSCs in healthy pancreas have abundant vitamin A storage in their cytoplasm and exist in a quiescent state that guarantees a balanced tissue homeostasis. In pancreatic cancer, loss of this balance activates PSCs, which lose the vitamin A content and remodel the surrounding tissue to make it favourable for cancer cell invasion.
We found that treating PSCs which ATRA (All trans-retinoic acid), the active metabolite of vitamin A mechanically reprograms PSCs to promote quiescence in vitro. Quiescent PSCs are unable to remodel the microenvironment to allow pancreatic cancer cell invasion.
To get more information about our findings please find the article in the open access journal Nature Communications:http://www.nature.com/articles/ncomms12630
09 Sep Early Palliative Care Improved Patients’ Symptoms and Coping Skills
Posted at 03:14h
in Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, End of Life Care, Lung Cancer
MedicalResearch.com Interview with:
[caption id="attachment_27780" align="alignleft" width="253"]
Dr. Joseph Greer[/caption]
Joseph A. Greer, Ph.D.
Program Director, Center for Psychiatric Oncology & Behavioral Sciences
Associate Director, Cancer Outcomes Research Program,
Massachusetts General Hospital Cancer Center
Yawkey Center, Boston, MA 02114
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many patients with advanced cancer have a high symptom burden, increased depression symptoms, misperceptions about their prognosis, and difficulties in making decisions about care at the end of life.
To address these challenges and improve care for this vulnerable population, our research team initially conducted a small, single-group pilot study of early palliative care integrated with standard oncology care for patients with advanced lung cancer.
This study showed that the model of integrated care was feasible and acceptable to patients and their families. Specifically, the majority of patients in the study were able to meet with a palliative care clinician at least monthly from the time of diagnosis of metastatic lung cancer, in order to receive help with managing symptoms as well as support for coping with the disease and making decisions about treatment. We then conducted a follow-up randomized controlled trial of early, integrated palliative care in a sample of approximately 150 patients with metastatic non-small cell lung cancer. This study was published in the New England Journal of Medicine in 2010 and showed that those patients who received early palliative care reported significantly improved quality of life, mood, prognostic awareness, and end-of-life care compared to those who received standard oncology care alone.
To confirm the findings of our prior research and to determine whether the benefits of early integrated palliative care would apply to a larger sample of patients with diverse malignancies, we recently completed another randomized trial of this same model of care in a sample of 350 patients with incurable lung and gastrointestinal cancers. In this trial, we observed that patients who received the early palliative care intervention reported higher quality of life and improved mood by 24 weeks but not at the primary end-point of 12 weeks. Our team was surprised to find that the trajectory of quality of life and depression symptoms over time was different for individuals with incurable lung versus gastrointestinal cancers in this study. As expected, the palliative care intervention positively buffered the decline in quality of life by 12 weeks for patients with incurable lung cancer, as we had seen in our prior trial. However, the group of patients with gastrointestinal cancers reported an improvement in their quality of life by the 12-week time point regardless of whether they received the palliative care intervention.
We are still exploring possible reasons for this difference, such as whether changes in cancer therapy may have reduced symptoms and improved quality of life in the group of patients with gastrointestinal cancer.
In addition, we were pleased to learn that the early integrated palliative care intervention led to improvements in how patients cope with their illness. For example, compared to patients in the usual oncology care group, those who received early, integrated palliative care were more likely to learn ways to accept their diagnosis and to take positive actions to make their lives better. So, in addition to treating patients’ symptoms, the palliative care clinicians in this study were bolstering people’s adaptive coping skills.
09 Sep Storage Time Can Effect Plasma Biomarker Results
MedicalResearch.com Interview with: Stefan Enroth, Associate Professor, PhD Dept. of Immunology, Genetics & Pathology Uppsala University MedicalResearch.com: What is the background for this study? Response: One basic requirement of life science research is the quality of samples. Proper handling and rigorous biobanking of clinical samples is very important when for instance collecting samples for rare diseases, for monitoring individual variation in longitudinal studies and when conducting prospective studies of biomarkers and risk of developing for instance cardiovascular disease. In epidemiological studies using case and control cohorts, great care is taken to ensure that the cases and controls are matched in terms of for instance age, anthropometrics and lifestyle exposures such as smoking or alcohol consumption. Technical factors and sampling handling history are not as commonly used. There has been a lack of studies that systematically investigated the effects of for instance storage-time on a larger set of plasma proteins. With emerging high-throughput technologies enabling measurements of a high number of proteins simultaneously on a population level, biomarker research will enter a new era and the more knowledge we have on what factors that influence circulating biomarker levels - such as plasma proteins, the higher the chances are of finding new clinically important biomarkers for disease.09 Sep Long-Term Bone Loss Linked to Antidepressants May Be Ameliorated By Beta Blockers
MedicalResearch.com Interview with: [caption id="attachment_27772" align="alignleft" width="157"]
Dr. Patricia Ducy[/caption]
Patricia Ducy, PhD
Associate Professor
Department of Pathology & Cell Biology
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Response: In the past few years, several large clinical studies have reported an association between the use of selective serotonin reuptake inhibitors (SSRIs) and an increased risk of bone fractures. Yet, a few studies conducted on small cohorts using these drugs for a short time showed a decrease in bone resorption parameters and thus minor bone gain.
To understand this paradox and to define how the deleterious effect of SSRIs could be prevented we conducted a series of studies in mice treated with fluoxetine, the active molecule of the widely prescribed SSRI Prozac.
09 Sep Severe Periodontitis Associated with Insulin Resistance
MedicalResearch.com Interview with: [caption id="attachment_27775" align="alignleft" width="159"]
In-Seok-Song[/caption]
In-Seok Song, DDS, PhD
Clinical Assistant Professor
Oral and Maxillofacial Surgeon
Department of Dentistry, Korea University Anam Hospital,
Seoul, Republic of Korea
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Periodontitis is a well-known cause of various systemic diseases including cardiovascular disease, type 2 diabetes. As for type 2 diabetes, insulin resistance is responsible for the low-grade systemic inflammation, which can deteriorate body function throughout pancreatic β-cell dysfunction and impaired fasting glucose. There are emerging evidences that insulin resistance is a cause of periodontal disease progression among Korean adults as well as other citizens including American, French, Finnish, and the British.
In this study, we hypothesized that insulin resistance aggravates the severity of periodontitis. We investigated the associations between type 2 diabetes, insulin resistance, and severe periodontitis. The associations between severe periodontitis and insulin resistance in non-obese adults with normal body mass index (BMI) or waist circumference (WC) were also evaluated.
We found that non-abdominal obese adults with insulin resistance were more likely to have severe periodontitis compared to metabolically healthy adults with normal waist circumference. Insulin resistance without abdominal obesity can be considered an independent risk factor of severe periodontitis.
09 Sep Chinese Medicine Compound Investigated For Anti-Cancer Properties
MedicalResearch.com Interview with: [caption id="attachment_27765" align="alignleft" width="150"]
Dr. David Adelson[/caption]
Professor David Adelson PhD
Chair of Bioinformatics
The University of Adelaide
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Chinese Medicine has been used for thousands of years to treat a number of diseases, but with few exceptions, has not been linked to specific molecular mechanisms that might explain its mode of action. This is because the Chinese Medicine formulations are often combinations of multiple plant extracts and are thus complex molecular mixtures. Fractionation of these extracts to test individual components often demonstrates low or no activity for individual components of these mixtures.
We decided to use a Systems Biology approach to investigate a well characterized, injectable extract from two plants that has been commonly used in conjunction with Western chemotherapy to treat cancer patients in China. We do not fractionate the mixture, but test it “as is” in order to determine the molecular consequences of the complex mixture. We limited this study to a specific breast cancer cell line (MCF-7) in order to determine if this preparation, Compound Kushen Injection (CKI), can directly affect cancer cells.
We found that CKI can kill MCF-7 cells and can also alter gene expression patterns associated with cell cycle control and cell death. The gene expression networks/pathways altered by CKI are similar to those altered by the Western chemotherapeutic drug 5-Fluorouracil (5FU), but the specific genes in those pathways with expression altered by CKI are often different to those affected by 5FU.
09 Sep Better Patient Safety Linked to Lower Hospital Readmission Rates
Posted at 01:13h
in AHA Journals, Author Interviews, Heart Disease, Hospital Readmissions, Outcomes & Safety
MedicalResearch.com Interview with:
Sheila Eckenrode, RN, CPHQ
Project Manager
Medicare Patient Safety Monitoring System (MPSMS)
Qualidigm
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We sought to investigate the association at the hospital-level between 21 in-hospital adverse event rates and both mortality and readmission rates for Medicare Fee-For-Service patients with AMI. We used data from the Medicare Patient Safety Monitoring System (MPSMS), the nation's largest randomly selected hospital medical record-abstracted patient safety database, and data from the Centers for Medicare & Medicaid Services, which includes hospital performance on mortality and readmissions for over 4,000 Medicare-certified hospitals, to assess the association between hospital performance on patient safety and hospital performance on 30-day all-cause mortality and readmissions for Medicare fee-for-service patients discharged with AMI.
We found that hospital performance on patient safety is associated with hospital performance on mortality and readmission rates for AMI. Hospitals with poorer patient safety performance are likely to have higher 30-day all-cause mortality and readmission rates for these patients.
09 Sep Cancer Caregivers Report More Stress Than For Non-Cancer Conditions
MedicalResearch.com Interview with: [caption id="attachment_27738" align="alignleft" width="133"]
Dr. Erin Kent[/caption]
Erin Kent, PhD, MS
Program Director
Outcomes Research Branch of the Healthcare Delivery Research Program
National Cancer Institute
MedicalResearch.com: What is the background for this study?
Response: Informal or family caregivers assist loved ones by providing care which is typically uncompensated, takes place typically at home, and often involves significant efforts for an extended period of time. Caregiving can require the performance of demanding tasks, which include managing symptom burden, monitoring for side effects from treatment, coordinating care, administering medication, and managing a care recipient’s financial and social obligations. In addition, there are many unique aspects of cancer that can place unique demands on caregivers, including sometimes a rapid deterioration of health, the receipt of multi-modal therapy (eg. surgery, chemotherapy, and radiation), and the possibility of cancer recurrence.