Author Interviews, Infections, University of Pennsylvania, Vaccine Studies / 22.08.2015

David B. Weiner, Ph.D. Professor, Department of Pathology and Laboratory Medicine Chair, Gene Therapy and Vaccine Program, CAMB Co-Leader Tumor Virology Program, Abramson Cancer Program University of Pennsylvania, Perelman School of MedicineMedicalResearch.com Interview with: David B. Weiner, Ph.D. Professor, Department of Pathology and Laboratory Medicine Chair, Gene Therapy and Vaccine Program, CAMB Co-Leader Tumor Virology Program, Abramson Cancer Program University of Pennsylvania, Perelman School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Weiner: MERS, like the Severe Acute Respiratory Syndrome (SARS), is characterized by high fever and severe cough from pneumonia. MERS is caused by an emerging human coronavirus, which is distinct from the SARS coronavirus. Since its identification in 2012, MERS has been linked to over 1,300 infections and close to 400 deaths. It has occurred in the Arabian Peninsula, Europe, and in the US and in Asia. It can be spread in a hospital setting. Scientists now report that a novel synthetic DNA vaccine can, for the first time, induce protective immunity against the Middle EastRespiratory Syndrome (MERS) coronavirus in animal species.   Researchers from the Perelman School of Medicine at the University of Pennsylvania. The NIH, the Public Health agency of Canada, and from a leading company in the development of synthetic DNA vaccine technology, Inovio described the results in a paper  published their work in Science Translational Medicine (STM) this week.  The experimental, preventive vaccine, given six weeks before exposure to the MERS virus, fully protects rhesus macaques from disease. The vaccine also generated potentially protective antibodies in blood drawn from camels, the purported source of MERS transmission in the Middle East. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 21.08.2015

Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine MedicalResearch.com Interview with: Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine     Medical Research: What is the background for this study? What are the main findings? Dr. Marshall: The infant immunization schedule has become crowded. That’s great news, in a sense, because it means that our children have become better protected against more diseases. At the same time, this has led to well child visits during which many shots are recommended, and some parents want to limit the number of injections their children receive at one time. This leads to deferrals, poor timeliness and decreased coverage rates, all of which could impair protection. This study shows that a hexavalent vaccine—one that combines diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccines in one syringe—is safe and just as immunogenic as the currently used component vaccines.  (more…)
Author Interviews, Genetic Research / 21.08.2015

Hendrik Marks Ph.D Group leader Epigenetics of Stem Cells Radboud University, Department of Molecular Biology, RIMLS, Nijmegen, The Netherlands MedicalResearch.com Interview with: Hendrik Marks Ph.D Group leader Epigenetics of Stem Cells Radboud University, Department of Molecular Biology, RIMLS Nijmegen, The Netherlands   Medical Research: What is the background for this study? What are the main findings? Dr. Marks: In mammals, sex is determined by two so-called "sex" chromosome: males have a single X chromosome as well as a Y chromosome, whereas females have two copies of the X chromosome. However, if both X chromosomes were to be active in female cells, these cells would have a double dosis of X-chromosomal gene products as compared to male cells. As this is lethal for almost all cells, female cells shut off one X chromosome in every cell in a process called X inactivation. This process occurs during early embryonic development. A lot is known about how this process is turned on, but is was unclear how such a silencing process spreads along a full chromosome. In order to further study this, we used female mouse embryonic stem cells (mESCs) as a model system and initiated X inactivation by means of differentiation. With the latest technologies, we were able to keep the two X chromosomes apart and measure one of them – with its 166 million base pairs (Mbs) – in detail. Every day we checked which parts of the chromosome had been switched off. The whole process took about eight days, and the inactivation spreads out from the centre of the X chromosome towards the ends. That doesn’t happen gradually but moves jumpwise from domain to domain. Domains are long pieces of DNA (of around 1Mb) that cluster together in knots. As it seems that X inactivation jumps from domain to domain, we now know that these domains are co-regulated. Also, we collected strong evidence that the same process is occurring in human. (more…)
Author Interviews, JAMA, Opiods, Pharmacology / 21.08.2015

Lainie Rutkow, JD, PhD, MPH Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public HealMedicalResearch.com Interview with: Lainie Rutkow, JD, PhD, MPH Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Medical Research: What is the background for this study? What are the main findings? Dr. Rutkow: Rates of prescription drug diversion and misuse, as well as overdose deaths, have increased throughout the United States. CDC estimates that each day, 44 people die from a prescription drug overdose. In the mid-2000s, Florida was viewed as the epicenter of this epidemic, with prescription drug overdose deaths increasing more than 80% from 2003 to 2009. In response, Florida enacted several laws to mitigate prescription drug abuse and diversion. Its pill mill law required pain management clinics to register with the state and prohibited physician dispensing of certain drugs. Florida’s Prescription Drug Monitoring Program (PDMP) collects data about dispensing of prescription drugs and can be accessed by physicians and pharmacists. Little is known about how these laws have affected prescribing of opioids. We applied comparative interrupted time series analyses to pharmacy claims data to examine four outcomes related to opioid prescribing in Florida, with Georgia as a comparison state. We found that in the first year of implementation, Florida’s Prescription Drug Monitoring Program and pill mill law were associated with modest reductions in prescription opioid volume, prescriptions written, and the dose per prescription. These declines were statistically significant among the highest volume prescribers and patients at baseline. (more…)
Author Interviews, Education, Genetic Research, Social Issues / 21.08.2015

Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education   MedicalResearch.com Interview with: Ben Domingue Assistant Professor (starting 9/2015) Stanford Graduate School of Education     Medical Research: What is the background for this study? What are the main findings? Response: Earlier research has started to illuminate which genetic variants are associated with educational attainment. Subsequent work has taken these variants, combined them into a "polygenic score", and studied how that polygenic score predicts educational attainment. Our research continues this line of inquiry by examining the predictive performance of that polygenic score in a representative sample of US adults who are now in their 30s. A few notable findings include that: (A) the polygenic score predicts educational attainment in the African Americans in our sample and (B) that the polygenic score is associated with neighborhood characteristics. As with earlier research, we are able to show that the higher score sibling from within a family will complete more years of schooling (on average) than their lower score co-sib. (more…)
Author Interviews, Kidney Disease, Lancet, Weight Research / 21.08.2015

Dr. Csaba P. Kovesdy MedicalResearch.com Interview with: Dr. Csaba P. Kovesdy, MD Professor of Medicine University of Tennessee Health Science Center Chief of Nephrology Memphis Veterans Affairs Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Kovesdy: Obesity has reached epidemic proportions in modern societies, and has been linked to adverse outcomes such as diabetes mellitus, hypertension, cardiovascular disease and mortality. In addition, obesity is also associated with chronic kidney disease through a variety of mechanisms. Our population is ageing, and previous studies have suggested that the effect of obesity on certain outcomes like mortality may be different in older vs. younger individuals, but this has not been previously examined for chronic kidney disease. We have this examined the association of granular BMI categories with progressive loss of kidney function in a very large cohort of patients with normal estimated GFR in patients of different ages. We found that the association of a BMI of >30 kg/m2 with progressive loss of kidney function was not present in younger individuals (< 40 years of age), and increased as people aged, with >80 years old displaying the strongest associations between obesity and loss of kidney function. In addition to this we also examined the association of BMI with mortality in different age groups, and found uniform U-shaped associations that did not vary by age. (more…)
AHA Journals, Author Interviews, Stroke / 20.08.2015

Josefine Persson Doctoral student Institute of Neuroscience and Physiology Sahlgrenska Academy University of GothenburgMedicalResearch.com Interview with: Josefine Persson Doctoral student Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Medical Research: What is the background for this study? Response: Stroke is a major global disease that requires extensive care and support from the society and the family. We know from previous research that a stroke often has a wide-spread impact on the daily life of the family. To provide support to a partner is often perceived as natural and important, but can be demanding and have an impact on the spouses own health. The situation for spouses as caregivers is well studied during the first two years after the stroke, while the long-term effects are less well known. By this, we studied the physical and mental health of 248 spouses of stroke survivors, below age 70 at stroke onset, seven years after the stroke event and compared our result with 245 spouses of non-stroke, age- and sex-matched controls. Medical Research:  What are the main findings? Response: The main finding of our study is that caregiver spouses of stroke survivors are at an increased risk of mental and physical health issues even seven years after stroke onset. This is the first study with this long period of follow up and the results show that the restriction on the spouses own activity and social relationships studied in shorter follow up is also obvious for a large proportion of the spouses in a very long perspective. Spouses’ quality of life was most adversely affected by their partners’ level of disability, cognitive difficulties and depressive symptoms. (more…)
Author Interviews, Depression, PNAS / 20.08.2015

Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of WarwickMedicalResearch.com Interview with: Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of Warwick Medical Research: What is the background for this study? Response: Depression is a major public health concern worldwide. We know social factors, such as living alone, can influence whether someone becomes depressed. We also know that social support (having people to talk to) is important for recovery from depression. Our study is slightly different as we looked at the effect of being friends with people on whether you are likely to develop depression or recover from being depressed. To do this, we looked at over 2,000 adolescents in a network of US high school students to see how their mood influenced each other. (more…)
Author Interviews, Biomarkers, Brain Cancer - Brain Tumors, Chemotherapy, Neurology, Radiation Therapy / 20.08.2015

Jorg Dietrich, MBA MMSc MD PhD Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical SchoolMedicalResearch.com Interview with: Jorg Dietrich, MBA MMSc MD PhD  Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Dietrich: Understanding the adverse effects associated with cancer therapy is an important issue in oncology. Specifically, management of acute and delayed neurotoxicity of chemotherapy and radiation in brain cancer patients has been challenging. There is an unmet clinical need to better characterize the effects of standard cancer therapy on the normal brain and to identify patients at risk of developing neurotoxicity. In this regard, identifying novel biomarkers of neurotoxicity is essential to develop strategies to protect the brain and promote repair of treatment-induced damage. In this study, we demonstrate that standard chemotherapy and radiation in patients treated for glioblastoma is associated with progressive brain volume loss and damage to gray matter – the area of the brain that contains most neurons. A cohort of 14 patients underwent sequential magnetic resonance imaging studies prior to, during and following standard chemoradiation to characterize the pattern of structural changes that occur as a consequence of treatment. (more…)
Author Interviews, Cannabis, Smoking, University Texas / 20.08.2015

Francesca M. Filbey PhD School of Behavioral and Brain Sciences Center for Brain Health University of Texas at Dallas Dallas, TXMedicalResearch.com Interview with: Francesca M. Filbey PhD School of Behavioral and Brain Sciences Center for Brain Health University of Texas at Dallas Dallas, TX Medical Research: What is the background for this study? What are the main findings? Dr. Filbey: Most studies exclude tobacco users from participating, but 70% of marijuana users also use tobacco. We were interested in investigating the combined effects of marijuana and tobacco. Our research targeted the hippocampus because smaller hippocampal size is associated with marijuana use. We chose to study short term memory because the hippocampus is an area of the brain associated with memory and learning. The main finding was surprising. The smaller the hippocampus in the marijuana plus nicotine user, the greater the memory performance. We expected the opposite, which was true of the non-using control group. (more…)
Author Interviews, Memory / 20.08.2015

Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden UniversityMedicalResearch.com Interview with: Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden University  Medical Research: What is the background for this study? What are the main findings? Response: A recent initiative supported by several eminent research institutes and scientists calls for a more critical and active role of the scientific community in evaluating the sometimes far-reaching, sweeping claims from the brain training industry with regard to the impact of their products on cognitive performance. tDCS is a noninvasive brain stimulation technique that has developed into a promising tool to boost human cognition. Previous studies using medical tDCS devices have shown that tDCS promotes working memory (WM) updating in healthy individuals and patients. The aim of the current study was to investigate whether the commercial tDCS headset foc.us (v.1), which is easily and freely available to anyone in the world, does in fact improve cognitive performance, as advertised in the media. Results showed that active stimulation with the commercial device, compared to sham stimulation, significantly decreased working memory performance. The device we tested is just one example of a commercial device that can easily be purchased and, without any control or expert knowledge, used by anyone. The results of our study are straightforward in showing that the claims made by companies manufacturing such devices need to be validated. Even if the consequences of long-term or frequent use of the device are yet to be demonstrated, our findings provide strong support the important role of the scientific community in validating and testing far reaching claims made by the brain training industry. (more…)
AHA Journals, Author Interviews / 20.08.2015

Dr. Dominic PJ Howard BM BCh MA DPhil (Oxon) MRCS Vascular and Endovascular Fellow Flinders Medical Centre Southern Adelaide Local Health NetworkMedicalResearch.com Interview with: Dr. Dominic PJ Howard BM BCh MA DPhil (Oxon) MRCS Vascular and Endovascular Fellow Flinders Medical Centre Southern Adelaide Local Health Network Dr. Howard is I academic vascular surgeon currently based in Oxford, UK. He worked with Professor Peter Rothwell as part of the Oxford Vascular Study.   Medical Research: What is the background for this study? What are the main findings? Dr. Howard: Abdominal aortic aneurysm is a potentially lethal ballooning of the aorta, the body’s largest blood vessel, which supplies blood from the heart to the abdomen and on to the rest of the body. Smoking, high blood pressure, male gender and older age are four key risk factors for abdominal aneurysms. Currently, men 65 and older are screened in the United States and in Europe for the condition based on recommendations from European screening trials and the U.S. Preventive Services Task Force. However, deaths from abdominal aortic aneurysm are moving to older ages. Our study is the first prospective population-based study of ruptured abdominal aortic aneurysm events.  We have found high incidence and death rates for this condition, particularly in older people. Most ruptured aortic aneurysms currently happen in people aged over 75 and this is likely to shift to those aged over 85 during the next few decades. The few ruptured aortic aneurysms that do occur in younger people (aged 65-75) occur almost exclusively in male smokers. Therefore we have calculated that if the national UK screening policy was modified to screen only male current smokers aged 65 and then all men at age 75 this could result in an almost four-fold increase in the number of deaths prevented and a three-fold increase in the number of life-years saved compared to the current UK strategy, with about a 20% reduction in the number of scans required. (more…)
Author Interviews, Lancet, Stroke / 20.08.2015

Professor Mika Kivimäki Chair of Social Epidemiology Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London London MedicalResearch.com Interview with: Professor Mika Kivimäki Chair of Social Epidemiology Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London Medical Research: What is the background for this study? What are the main findings? Prof Kivimäki:  Long working hours have been implicated in the cause of cardiovascular disease, but the evidence is limited. We conducted a systematic review of published studies on this topic and located additional individual-level data by searching open-access data archives and by including unpublished data from IPD-Work, a consortium of prospective cohort studies. This resulted in a pooled sample of over 600,000 men and women who were followed for cardiovascular disease 7-8 years after the assessment of working hours. During the follow-up, more than 4700 participants had a coronary event and 1700 had a stroke. Our findings show that individuals who worked 55 hours or more per week had a 1.3-times higher risk of stroke compared to those working standard 35-40 hours. This finding remained unchanged in analyses adjusted for other stroke risk factors, such as age, sex, socioeconomic position and health behaviours. (more…)
Author Interviews, Multiple Sclerosis, Salt-Sodium / 19.08.2015

Dimitry N. Krementsov PhD Research Associate University of Vermont Burlington, VT 05405MedicalResearch.com Interview with: Dimitry N. Krementsov PhD Research Associate University of Vermont Burlington, VT 05405 Medical Research: What is the background for this study? What are the main findings? Dr. Krementsov:  Multiple sclerosis (MS) is the most common disabling neurologic disorder affecting young adults. The disease is initiated by the individual’s own immune system attacking the central nervous system (brain and spinal cord).Multiple sclerosis is complex and is controlled by the interplay between sex/gender, genetics, and environmental factors. How this happens is not well understood, but an intriguing clue is that MS incidence over the last 50-100 years has been increasing in women and not men, suggesting that a recent environmental change is affecting MS preferentially in females. There are several well-documented risk factors for Multiple Scleroisis, including Epstein-Barr virus infection, low sunlight exposure, low vitamin D, and smoking. Recent studies have suggested the existence of a new risk factor – high intake of dietary salt. In our study, we sought to understand how this environmental factor may interact with genetics and sex. We used an animal model of MS, called experimental autoimmune encephalomyelitis (EAE), in laboratory mice. The advantage of this approach is the ability to precisely control both the genetics and the environment, something that cannot be done in epidemiological studies in humans. Just as in previous studies, we found that when mice were fed a high salt diet, their MS-like disease got worse. Importantly, we found that this was dependent on genetics and sex; when we varied the genetic background of the mice, we saw three different outcomes: 1) an effect of salt in both males and females, 2) an effect only in females, and 3) no effect in either sex. (more…)
Author Interviews, Cannabis, CDC / 19.08.2015

Gillian Schauer, PhD, MPH Lead author and Contractor CDC’s Office on Smoking and HealthMedicalResearch.com Interview with: Gillian Schauer, PhD, MPH Lead author and Contractor CDC’s Office on Smoking and Health Medical Research: What is the background for this study? What are the main findings? Dr. Schauer: Marijuana is the most commonly used federally illicit drug in the United States. State-level policy change legalizing marijuana or one of its constituents for recreational or medical use is increasing. Currently, 23 states and DC have legalized medical use of marijuana. Four states (Alaska, Colorado, Oregon and Washington) and the District of Columbia have legalized recreational and medical use of marijuana.
  • This paper helps fill two important knowledge gaps. It describes how US adults are using marijuana—for example, whether they smoke it, eat it, or use it in a vaporizer—and it describes whether they report using it for medical reasons or for recreational reasons, or both. Data come from the 2014 Summer Styles national consumer online panel survey (sample size of 4,269 adults), and have been published in the American Journal of Preventive Medicine.
  • Nationally, marijuana is primarily consumed in combusted (smoked) form. In 2014, among adults who used marijuana in the past 30 days, 92.1% of adults said they smoked it, 16.1% ate or drank it, and 7.6% used a vaporizer or other electronic device.
  • Among adults who used marijuana in the past 30 days, 10.5% say they used it only for medical reasons, 53.4% used it only for recreational reasons, and 36.1% used it for both.
(more…)
Alcohol, Author Interviews, BMJ, Brigham & Women's - Harvard, Cancer Research / 19.08.2015

Dr. Yin Cao MPH, ScD Postdoctoral Fellow, Department of Nutrition Harvard T. H. Chan School of Public HealthMedicalResearch.com Interview with: Dr. Yin Cao MPH, ScD Postdoctoral Fellow, Department of Nutrition Harvard T. H. Chan School of Public Health Medical Research: What is the background for this study? What are the main findings? Dr. Cao: Light-to-moderate drinking, defined as up to 1 drink (roughly corresponds to a 355ml bottle of beer, or a small [118-148 ml] glass of wine or 44ml of liquor) for women and up to 2 drinks for men, is prevalent in many western countries. It is believed that light-to-moderate drinking may be healthy for the heart. However, the influence of light-to-moderate drinking on risk of overall cancer is less clear, although it is well known that heavy alcohol intake increases risk of several cancers, including cancers of colorectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus. Also because drinkers are more likely to be smokers, and smoking is the major risk factor for all of the alcohol-related cancers (mentioned above) except breast cancer, it is thus difficult to tease out the influence of alcohol on cancer in studies among a mixed population of ever and never smokers. In particular, it is important to know how light and moderate drinking would affect cancer risk particularly among never smokers, who now make up the majority of the population in many western countries. Our main findings are that, light-to-moderate drinking minimally increases risk of overall cancer. For men, the association with alcohol related cancers was primarily observed among smokers, and light to moderate drinking did not appreciably increase risk in never smokers. Among women, even consumption of up to one drink per day was associated with increased risk of alcohol-related cancers (mainly breast cancer) for both never and ever smokers. (more…)
Author Interviews, Diabetes, JAMA, Weight Research / 19.08.2015

Melanie J Davies MB ChB MD FRCP FRCGP Professor of Diabetes Medicine 
NIHR Senior Investigator Leicester Diabetes Unit
Leicester Diabetes Centre Bloom
University of Leicester MedicalResearch.com Interview Invitation Melanie J Davies MB ChB MD FRCP FRCGP Professor of Diabetes Medicine 
NIHR Senior Investigator Leicester Diabetes Unit
Leicester Diabetes Centre Bloom
 University of Leicester   MedicalResearch: What is the background for this study? What are the main findings?
 Dr. Davies: This study was designed to test the efficacy and safety of Liraglutide using a dose of 3mg for weight loss among patients with type 2 diabetes.  It was a large international study in which we compared once daily subcutaneous Liraglutide at a dose of 3mg to Liraglutide 1.8mg which is the current maximum dose licenced in patients with diabetes and placebo.  In all patients we offered a calorie deficit diet and lifestyle advice to increase physical activity.  Our main findings were that the dose of 3mg of Liraglutide resulted in greater weight loss than both other arms of the study indeed 54% of patients at 56 weeks achieved more than 5% weight loss and a further 25% were able to achieve more than 10% weight loss.  The 3mg of Liraglutide compared to the placebo, there were also significant impacts on HbA1c and other cardiovascular risk factors such as systolic blood pressure and lipids as well as improving patient quality of life particularly physical functioning and patient treatment satisfaction.  (more…)
AHA Journals, Author Interviews, Heart Disease, Hospital Readmissions / 19.08.2015

Jason H. Wasfy, MD Assistant Medical Director Massachusetts General Physicians Organization Massachusetts General Hospital MedicalResearch.com Interview with: Jason H. Wasfy, MD Assistant Medical Director Massachusetts General Physicians Organization Massachusetts General Hospital   Medical Research: What is the background for this study? What are the main findings? Dr. Wasfy: Hospital readmission after angioplasty (heart stents) is very common in the United States and is associated with poorer patient outcomes and substantial health care costs.  We can predict which patients will get readmitted, but only with moderate accuracy.  Analyzing the electronic medical records of large health care systems may provide clues about how to predict readmissions more accurately. Medical Research: What should clinicians and patients take away from your report? Dr. Wasfy: Patients who are anxious or have visited the emergency department frequently before the procedure may be at higher risk of readmission.  For those patients, reassurance and support may help them stay out of the hospital.  This has the potential to improve health outcomes after angioplasty and improve value in cardiology care generally.  High quality care for patients with coronary artery disease involves not only procedures and medicines, but also creating a support system for patients to cope with their disease. (more…)
Author Interviews, Cost of Health Care, Infections, JAMA, Pharmacology / 19.08.2015

Jerome A. Leis, MD MSc FRCPC Division of Infectious Diseases, Sunnybrook Health Sciences Centre Physician Lead, Antimicrobial Stewardship Team Faculty Quality Improvement Advisor, Centre for QuIPS Assistant Professor, Department of Medicine, University of Toronto Sunnybrook Health Sciences Centre Toronto, OntarioMedicalResearch.com Interview with: Jerome A. Leis, MD MSc FRCPC Division of Infectious Diseases Sunnybrook Health Sciences Centre Physician Lead, Antimicrobial Stewardship Team Faculty Quality Improvement Advisor, Centre for QuIPS Assistant Professor, Department of Medicine University of Toronto Sunnybrook Health Sciences Centre Toronto, Ontario Medical Research: What is the background for this study? What are the main findings? Dr. Leis: We know that urinary tract infections are frequently diagnosed among general medicine patients who lack symptoms of this infection.  We wondered whether urinalysis ordering practices in the Emergency Department influence diagnosis and treatment for urinary tract infection among these asymptomatic patients.  We found that over half of patients admitted to the general medicine service underwent a urinalysis in the Emergency Department of which over 80% lacked a clinical indication for this test.  Urinalysis results among these asymptomatic patients did influence diagnosis as patients with incidental positive results were more likely to undergo urine cultures and treatment with antibiotics for urinary tract infection.  The study suggests that unnecessary urinalysis ordering contributes to over-diagnosis and treatment of urinary tract infection among patients admitted to general medicine service. (more…)
Author Interviews, Social Issues / 19.08.2015

Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews MedicalResearch.com Interview with: Carlota Batres PhD Candidate at the Perception Lab School of Psychology and Neuroscience University of St Andrews   Medical Research: What is the background for this study? What are the main findings? Response:  Dominance in men is associated with a variety of social outcomes, ranging from high rank attainment of cadets in the military to high levels of sexual activity in teenage boys. Dominant men are also favored as leaders during times of intergroup conflict and are more successful leaders in the business world. Therefore, we wanted to investigate what exactly it is that makes a face look dominant. Our main finding was that maximum dominance was achieved by increasing perceived height and masculinity while maintaining a man's age at around 35 years. (more…)
Author Interviews, Compliance, Race/Ethnic Diversity / 19.08.2015

Louanne Bakk, Ph.D. Assistant Professor Director, Institute on Innovative Aging Policy and Practice School of Social Work The University at Buffalo Buffalo, NY 14260 MedicalResearch.com Interview with: Louanne Bakk, Ph.D Assistant Professor Director, Institute on Innovative Aging Policy and Practice School of Social Work The University at Buffalo Buffalo, NY  14260 Medical Research: What is the background for this study? What are the main findings? Dr. Bakk: Medicare Part D reduces out-of-pocket health care costs and increases access to medications.  While overall the benefit has facilitated the purchase of medications, cost sharing exists and be particularly difficult for more vulnerable populations.  Racial and gender disparities in cost-related nonadherence (CRN)  exist under Medicare Part D plans.  However, it was unknown whether the impact of the coverage gap on older Blacks and females.  This study examined whether the Medicare Part D coverage gap directly and indirectly affects the relationship between race, gender, and CRN. Racial differences in cost-related nonadherence were largely driven by reaching the coverage gap.  In other words, the gap appears to be more difficult for older Blacks than Whites.  Additionally, both reaching and not reaching the coverage gap, poorer health and having a lower income were associated with cost-related nonadherence . (more…)
Author Interviews, OBGYNE, Pediatrics / 19.08.2015

Jennifer B. Kane PhD Assistant professor of Sociology University of California, Irvine MedicalResearch.com Interview with: Jennifer B. Kane PhD Assistant professor of Sociology University of California, Irvine Medical Research: What is the background for this study? Dr. Kane: We know that low-birth-weight babies are more susceptible to later physical and cognitive difficulties and that these difficulties can sharpen the social divide in the U.S. But knowing more about what causes low birth weight can help alleviate this intergenerational perpetuation of social inequality through poor infant health. This study was designed to expand our knowledge of these causes. Medical Research: What are the main findings? Dr. Kane: This study found that risk factors for low birth weight extend far beyond pregnancy—dating all the way back to women’s early life environment as well as to conditions dating back three generations. For example, a woman’s own weight at birth, as well as her education level and marital status pre-pregnancy can have repercussions for two generations, putting her children and grandchildren at higher risk of low birth weight. This study also discovered new pathways of risk that contribute to poor infant health. For example, intergenerational transmissions of maternal education, potentially reflecting parent-child socialization or role modeling, appear to have a long-term influence on birth outcomes of future generations. In addition, this study showed that intra-generational and inter-generational processes work in conjunction with one another to place some infants at higher risk of low birth weight. (more…)
Anesthesiology, Author Interviews, Breast Cancer, Journal Clinical Oncology, Surgical Research / 19.08.2015

Jaclyn Bradley Palmer, MM, MT-BC University Hospitals Of Cleveland Cleveland, OHMedicalResearch.com Interview with: Jaclyn Bradley Palmer, MM, MT-BC University Hospitals Of Cleveland Cleveland, OH  Medical Research: What is the background for this study? What are the main findings? Response: Patients awaiting breast cancer surgery may be understandably anxious. While pharmacologic intervention may reduce anxiety, higher doses of preoperative drugs can depress circulation and respiration, making alternative measures a particular interest. Music therapy is the clinical use of music interventions to accomplish individualized goals within a therapeutic relationship by a board-certified music therapist. While music in surgery has been researched under the label of "music therapy", many of the studied investigations illicit recorded music provided by non-music therapy staff, making it truly "music medicine" practices instead. In this investigation, the effect of both live and recorded music therapy on anxiety, anesthesia requirements, recovery time and patient satisfaction were studied perioperatively. Breast cancer surgery patients were engaged in a brief music therapy session which consisted of one live or recorded preferred song choice, followed by discussion and processing of emotions. Compared to usual care, both live and recorded music therapy groups experienced significantly greater reductions in anxiety (p<.001) with point reductions of 27.5 (42.5%) and 26.7 (41.2%), respectively. During surgery, both music groups listened to music-therapist selected recorded, instrumental harp music, chosen for it's evidence-based therapeutic value of smooth lines, consistent volumes and stable melodies. In measuring the amount of interoperative drug (propofol) needed to reach moderate sedation, the intraoperative music was not found to have an effect in this trial. Patient satisfaction was universally high in all three study groups. Those who received live music preoperatively were discharged an average of 12.5 minutes sooner than those who received recorded music preoperatively, although neither music group was dischanged significantly sooner than the control group. Subjective reactions to the music interventions relayed that music therapy in surgery was an enjoyable addition. (more…)
Author Interviews, Ovarian Cancer / 18.08.2015

Oleh Taratula,PhD Assistant Professor Oregon State University/Oregon Health & Science University College of PharmacyMedicalResearch.com Interview with: Oleh Taratula, PhD Assistant Professor Oregon State University/Oregon Health & Science University College of Pharmacy MedicalResearch: What is the background for this study? Dr. Taratula: The background for the study consists of previous work we had published in the lab using photodynamic therapy (PDT) as the stand alone treatment modality. We were successful in synthesizing and incorporating the photodynamic nanoplatform in the treatment for ovarian cancer, but our current graduate student, Canan Schumann said he could make the therapy more efficient using his current research on gene therapy. The gene therapy he is currently working on is the delivery of siRNA targeted to the multifaceted oncogenic protein DJ-1 which has been implicated in antioxidative stress defense as well as the overall survival of ovarian cancer. Cancer is highly intelligent able to adapt quickly to new insults that it comes across, even ROS formed inside the cell. Cancer cells can even upregulate a whole host of antioxidant stress response proteins to combat the formation of or scavenge already created ROS. The idea was can we combine our currently used PDT, which uses the generation of reactive oxygen species (ROS) as its cytotoxic mechanism of action, coupled with gene therapy targeted to DJ-1, in hope to drastically increase ROS inside the cell leading to a more pronounced cell death. (more…)
Author Interviews / 18.08.2015

MedicalResearch.com Interview with: Jessica Leung, MPH and Rafael Harpaz, MD, MPH Division of Viral Diseases, National Center for Immunization and Respiratory Diseases (NCIRD) Centers for Disease Control and Prevention (CDC) MedicalResearch: What is the background for this study? Authors’ Response: Prior to the introduction of varicella (chickenpox) vaccination in the U.S., there were millions of cases, tens of thousands of hospitalizations, and hundreds of deaths due to varicella. One-dose of varicella vaccination was recommended in 1995, and two-doses in 2006. Since 1995, there have been substantial declines in varicella disease. In a previously published paper by authors Zhou et al (JAMA. 2005 Aug 17;294(7):797-802), they found an 88% decrease in varicella-related hospitalizations and a 59% decrease in outpatient visits during 1994-2002, a period after the one-dose program began in the U.S. but before the two-dose program started. We wanted to update the prior analyses with an additional 10 years of data to describe the impact of the varicella vaccination program during a period of high 1-dose coverage and increasing levels of 2-dose coverage. We looked at claims data during the 1994-2012 period using the Truven Health MarketScan® databases. (more…)
Author Interviews, Brigham & Women's - Harvard, Genetic Research, Heart Disease, Nature / 18.08.2015

Susan A. Slaugenhaupt PhD Professor of Neurology, Harvard Medical School Associate Geneticist, Department of Neurology, Molecular Neurogenetics Unit Center for Human Genetic Research Massachusetts General HospitalMedicalResearch.com Interview with: Susan A. Slaugenhaupt PhD Professor of Neurology, Harvard Medical School Associate Geneticist, Department of Neurology, Molecular Neurogenetics Unit Center for Human Genetic Research Massachusetts General Hospital   Medical Research: What is the background for this study? What are the main findings? Dr. Slaugenhaupt: Mitral valve prolapse (MVP) is one of the most common human diseases affecting 1 out of every 40 people worldwide.  The mitral valve is found between two chambers of the heart, and mitral valve prolapse results when the valve does not close properly.  By studying families in which multiple members have mitral valve prolapse, we have identified a biological explanation for the disease.  Mutations in the DCHS1 gene cause mitral valve prolapse in three families, and suggest that early defects in heart valve formation during development contribute to the progressive deterioration of the valve. (more…)
Addiction, Author Interviews, Mental Health Research, Psychological Science / 18.08.2015

Professor Jackie Andrade PhD School of Psychology Cognition Institute Plymouth University Plymouth Australia MedicalResearch.com Interview with: Professor Jackie Andrade PhD School of Psychology Cognition Institute Plymouth University Plymouth Australia   Medical Research: What is the background for this study? What are the main findings? Dr. Andrade: We want to understand the mental processes that are going on during episodes of craving for drugs or food. We know that cravings are largely mental events because people rarely experience them when in the middle of a mentally-engaging task - giving a presentation or finishing an exciting novel, for example. By understanding the mental processes underpinning cravings, we can improve treatments for addiction and eating problems, and also find ways of strengthening desires for healthy activities. Visual mental imagery is a key component of craving, with people picturing themselves indulging their desires. Laboratory research has shown that blocking this craving imagery can reduce the strength of cravings for food and cigarettes. Tetris is a good task for doing this because it involves a lot of visual processing to keep track of the different coloured shapes and mentally rotate them to fit the spaces. For our latest study, we wanted to find out if Tetris helped block cravings in ‘real life’ rather than in the laboratory, and whether it worked for a range of common cravings. We asked 31 participants to carry iPods with them for a week. They received text messages 7 times a day prompting them to use the iPod to report whether they were craving something and, if so, what it was and how strong the craving was. A random 15 participants assigned to the Tetris condition were also asked to play Tetris for 3 minutes and answer the craving questions again. For this group, we compared the before-Tetris and after-Tetris craving scores on each occasion and found that cravings were 20% weaker after playing Tetris. People played Tetris 40 times on average, but the craving-reducing effect did not wear off as they got used to the game. The control group who reported cravings without playing Tetris allowed us to see how cravings varied naturally across the week. Tetris reduced craving strength across the range of cravings reported, which included cravings for drugs (alcohol, nicotine, caffeine), food, and ‘other activities’ including sleep, videogaming, sex and social interaction. (more…)
Author Interviews, Depression, JAMA, Pediatrics / 18.08.2015

Edward D. Barker, PhD Developmental Psychopathology Group Department of Psychology, King’s College London Institute of Psychiatry LondonMedicalResearch.com Interview with: Edward D. Barker, PhD Developmental Psychopathology Group Department of Psychology, King’s College London Institute of Psychiatry London Medical Research: What is the background for this study? Dr. Barker: The study looks at how the brain may be affected by experiences that happen early in life and adolescence. It has been known for a long time now that people who experience intense adversity are at increased risk of developing depression and other psychiatric problems. Previous research has also shown that both adversity and depression can affect the development of the brain and lead to altered brain structure. In this study, we wanted to examine how early adversity and depression relate to altered brain structure when you examined each within a specific temporal order (i.e., adversity, then depression/anxiety, then brain structure). This study design allowed us to examine not only the effects of adversity and depression, but also if some of the variation in brain structure associated with depression may also be explained by early adversity. Other researchers have previously suggested that some of the variation in brain structure observed in depressed patients may relate to early adversity, but no previous study has examined this prospectively like we did, using the Avon Longitudinal Study of Parents and Children. (more…)
Author Interviews, Osteoporosis / 17.08.2015

MedicalResearch.com Interview with: Prof. Jonathan M. Hodgson School of Medicine and Pharmacology Royal Perth Hospital University of Western Australia Perth, Australia MedicalResearch What is the background for this study? What are the main findings? Prof. Hodgson: Flavonoids are a class of phytochemicals present at high levels in tea. Observational studies have found that higher tea and flavonoid intakes are associated with higher bone mineral density. However, the relationships of tea and flavonoid intakes with fracture risk are not clear. We therefore examined the relationship of black tea drinking and flavonoid intake with fracture risk in a population of women aged over 75 years followed for 10 years. We found that a higher intake of black tea and particular classes of flavonoids, some of which are derived primarily from tea, were associated with lower risk of fracture-related hospitalizations in these elderly women. (more…)
Author Interviews, Chemotherapy, Lancet / 17.08.2015

Bernardo L. Rapoport M. D. The Medical Oncology Centre of Rosebank Johannesburg, South AfricaMedicalResearch.com Interview with: Bernardo L. Rapoport M. D. The Medical Oncology Centre of Rosebank Johannesburg, South Africa Medical Research: What is the background for this study? What are the main findings? Dr. Rapoport: Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects of chemotherapy, and can lead to dose reductions or discontinuations of life-extending anti-cancer therapy. In the past, the serotonin (5-HT3) receptor antagonists, such as granisetron, palonosetron , and ondansetron, have shown effectiveness in preventing acute CINV (0-24 hours after chemotherapy administration), but many chemotherapies, such as cisplatin, carboplatin, and anthracycline/cyclophosphamide combinations, can cause delayed chemotherapy-induced nausea and vomiting that occurs from >24 hours to 5 days or more after chemotherapy. Neurokinin-1 receptor antagonists (NK-1 RAs) work though the substance P signaling pathway and are effective at preventing the delayed phase of chemotherapy-induced nausea and vomiting. Aprepitant was the first NK-1 RA to come to market in 2003, followed by a fixed dose of netupitant plus palonosetron late last year. (more…)