Author Interviews, Hepatitis - Liver Disease, Kidney Disease / 14.12.2020

MedicalResearch.com Interview with: Kevin Moore, MD UCL Institute of Liver and Digestive Health Royal Free Hospital, University College London MedicalResearch.com: What is hepatorenal syndrome – acute kidney injury (HRS-AKI) and how does terlipressin fit into the treatment landscape?  Response: HRS-AKI, also known as hepatorenal syndrome type 1 (HRS-1), is an acute and life-threatening syndrome involving acute kidney failure in people with cirrhosis.[i] HRS-1 can progress to life-threatening renal failure within daysi and has a median survival time of approximately two weeks and greater than 80 percent mortality within three months if left untreated.[ii],[iii] Terlipressin, a potent vasopressin analogue selective for V1 receptors, is an investigational agent, and its safety and effectiveness have not yet been established by the U.S. Food and Drug Administration. In the U.S., there are currently no approved pharmacologic treatments for HRS-1; however, terlipressin is approved in most other countries, where it has been a standard of care for the last 20 years in the treatment of patients with HRS-1.[iv],[v] The current standard of care for HRS-1 in the U.S. includes other vasoconstrictors such as midodrine (a drug which can increase blood pressure and potentially improve blood flow into the kidneys) along with concomitant albumin and frequent monitoring, but current data do not support good efficacy.2 Dialysis (a type of renal replacement therapy) is sometimes used in hepatorenal syndrome, but dialysis is not curative and it can be costly.  (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, End of Life Care / 14.12.2020

MedicalResearch.com Interview with: Isaac Chua, MD, MPH Division of General Internal Medicine and Primary Care Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Patient surveys have shown that most people prefer to die at home at the end-of-life. However, during the initial wave of the COVID-19 pandemic, anecdotal evidence from our colleagues and findings from a prior study published in the Journal of the American Geriatrics Society suggested that majority of COVID-19 decedents died in a medical facility. However, less is known about care intensity at the end-of-life according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.  (more…)
Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.12.2020

MedicalResearch.com Interview with: Sheela Maru, MD, MPH Department of Health System Design and Global Health and Arnhold Institute for Global Health and Department of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. (more…)
Author Interviews, COVID -19 Coronavirus, CT Scanning, Johns Hopkins, Nature / 12.12.2020

MedicalResearch.com Interview with: Nilanjan Chatterjee, PhD Bloomberg Distinguished Professor Departments of Biostatistics and Epidemiology Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? Response: Calculation of risks or severe COVID-19 disease and mortality for individuals in the general population can help to prioritize prevention efforts, such as early vaccination. We developed a model to estimate risks for COVID-19 mortality for currently uninflected individuals based on sociodemographic factors, pre-existing conditions and local pandemic intensity.  The model captures factors associated with both risk of infection and complications after infection. The model was developed using information from a large UK based cohort study called OpenSAFELY, and was adapted to the US population based on information on mortality rate associated with age and race/ethnicity available through CDC.  The model also utilizes information on state level projected death rates from pandemic forecasting models.  (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Genetic Research, Nutrition / 11.12.2020

MedicalResearch.com Interview with: Auriel Willette, PhD Assistant Professor Food Science and Human Nutrition Iowa State University MedicalResearch.com: What is the background for this study? Response: To date, pharmacology therapies done to slow down or halt Alzheimer's disease have been inconclusive. Lifestyle interventions like changes in diet and activity are also mixed but do show some promise. Dietary clinical trials or self-reported diet have tended to focus on groups of foods such as the Mediterranean or MIND diet. To build from this excellent work, we were curious if we could pinpoint specific foods that were correlated with changes in fluid intelligence over time. Fluid intelligence represents our ability to creatively use existing knowledge, working memory, and other components of "thinking flexibly." Further, we tested if these patterns of association differed based on genetic risk. In this case, genetic risk was defined as having a family history of Alzheimer's disease or having 1-2 "bad" copies of the Apolipoprotein E (APOE) gene, which is the strongest genetic risk factor for Alzheimer's disease. (more…)
Author Interviews, Circadian Rhythm, Exercise - Fitness / 11.12.2020

MedicalResearch.com Interview with: Andrew W. McHill, PhD Research Assistant Professor Oregon Institute of Occupational Health Sciences Oregon Health & Science University, Portland OR Portland, OR 97239 MedicalResearch.com: What is the background for this study? Response: It has long been known that there is a home court advantage in sports, whether it be due to the home fans cheering, playing within familiar settings, or travel of the opposing team. However, the contribution of travel to home-court advantage could never be fully teased apart due to all the confounds of the other aspects of playing at home. In March, the National Basketball Association had to pause their season due to COVID-19 concerns, only to start again several months later with the top 22 teams playing in a “bubble” environment where no teams were required to travel. This created a ‘natural experiment’ wherein we could test the impact of travel on winning and performance before the COVID-19 shutdown with games played in the bubble environment with no travel. (more…)
Author Interviews, COVID -19 Coronavirus, Environmental Risks, Science / 11.12.2020

MedicalResearch.com Interview with: Asimanshu Das, Ph.D. student Brown University School of Engineering MedicalResearch.com: What is the background for this study? What are the main findings? Response: Driving in a car with  ride-share or car-pool is a widely prevalent social interaction. The study aimed to address the airflows inside cars in various window open/closed configurations using computer simulations, and also looking into the possibility of movement of aerosol-type of particles from one occupant to other. The main findings are that opening windows provides a likely benefit to reduce the potentially pathogenic aerosols inside the cabin. Generally, more windows the better, but at the least it would be advisable to have one rear side window and one frontside window open. (more…)
Author Interviews, Diabetes, Neurology, Pain Research / 10.12.2020

MedicalResearch.com Interview with: William K. Schmidt, Ph.D. Senior VP Clinical Development Helixmith Co. Ltd.  MedicalResearch.com: What is the background for this study? How common is diabetic peripheral neuropathy and how does it affect patients? Response: According to the Centers for Disease Control and Prevention (CDC), over 34 million people in the United States have diabetes (about 10% of the U.S. population) and about one in four patients do not know that they have it (https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm).  Diabetes can cause significant damage to nerves in the feet, hands, eyes, and other parts of the body. Diabetic peripheral neuropathy (DPN) is the most common form of nerve damage worldwide; it affects approximately half of the patients with diabetes (Iqbal et al., 2018).  In many individuals, severe burning, tingling, “pins and needles,” or cramping pain can occur simultaneously in both feet without external evidence of foot damage. Despite the pain, symptoms may be accompanied by numbness or loss of sensation in the feet. This is called painful diabetic peripheral neuropathy (painful DPN or P-DPN) and may affect up to one-third of the general diabetic population (Yoo et al., 2013). P-DPN may cause increased anxiety and depression, sleep impairment, and difficulties with walking.  Up to one-third of P-DPN patients may require the use of a cane, walker, or even a wheelchair due to extreme foot pain.  Once P-DPN occurs, it may result in a lifetime of pain and disability. FDA-approved daily oral medications often used to treat P-DPN include Neurontin (gabapentin), Lyrica (pregabalin), Cymbalta (duloxetine), and Nucynta ER (tapentadol).  While these “neuropathic pain” medications may dull the pain for some subjects, they produce significant side effects that may be troubling for many patients. Indeed, many patients stop using these pain killers due to lack of effectiveness at doses that they can tolerate (van Nooten et al., 2017) There is also a topical 8% capsaicin patch, but again with limited efficacy. It is well known that the most severely affected patients may require opioid analgesics to control P-DPN (Pesa et al., 2013). None of the currently used medications have disease-modifying effects. However, our new injectable medication is now in advanced clinical development that has the potential disease-modifying effects lasting months after each treatment, with limited or no side effects for most patients aside from brief injection site discomfort. (more…)
Author Interviews, Breast Cancer, Cancer Research, COVID -19 Coronavirus / 10.12.2020

MedicalResearch.com Interview with: Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center MedicalResearch.com: What is the background for this study? Would you briefly describe the POLARIS study? Response: POLARIS is an ongoing prospective, real-world, non-interventional study in patients with HR+/HER2-ABC receiving palboiclib plus endocrine therapy with a targeted enrollment of 1500 patients at 110 sites in the United States and Canada.  MedicalResearch.com: What are the main findings?
  • Because of the COVID-19 pandemic, approximately one third of the study sites experienced an impact on their responsiveness to correspondence, timely data entry, and subject management.
  • The geographic location or type (e.g., academic or community) of study site appears associated with whether the site was impacted by COVID-19.
  • Other study site characteristics were generally similar between sites that reported an impact of COVID-19 and those that were not impacted.
  • Because of inherent limitations of survey studies, these findings must be interpreted with caution.
(more…)
Author Interviews, Cancer Research, CDC, JAMA, Lung Cancer / 10.12.2020

MedicalResearch.com Interview with: David A. Siegel, MD, MPH Division of Cancer Prevention and Control US Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: Why is it important to better understand the smoking histories (both current/former and never smokers) among lung cancer patients? Response: Knowledge of smoking status of patients diagnosed with lung cancer can help us understand how to best prevent, detect, and treat lung cancer in the future. More than 84% of women and 90% of men newly diagnosed with lung cancer had ever smoked cigarettes, and half of patients aged 20 to 64 years newly diagnosed with lung cancer were current cigarette smokers. These findings reinforce the importance of cigarette cessation and lung cancer screening. 1 out of every 8 people diagnosed with lung cancer had never smoked cigarettes, which reiterates the importance of learning more about their risk factors for lung cancer, which could impact prevention and treatment.  (more…)
Author Interviews, JAMA, Pulmonary Disease / 10.12.2020

MedicalResearch.com Interview with: Andrew M. Wilson, MD Clinical Senior Lecturer in Respiratory Health University of East Anglia Norwich and Honorary Consultant Physician in Respiratory Medicine Norfolk and Norwich University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Idiopathic pulmonary fibrosis has a poor prognosis and limited treatment options. Clinical trial evidence suggested a survival benefit for people taking co-trimoxazole and microbiological data suggested that infection was implicated in prognosis. However this large multicentre study did not show that co-trimoxazole had an beneficial effect in terms of time to all-cause mortality, hospitalisation or lung transplant in people with moderate and severe idiopathic pulmonary fibrosis (more…)
Author Interviews, BMC, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Diabetes, Nutrition / 10.12.2020

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer. In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis. (more…)
Author Interviews, Geriatrics, Hearing Loss, JAMA, Race/Ethnic Diversity, Social Issues / 10.12.2020

MedicalResearch.com Interview with: Nicholas S. Reed, AuD Assistant Professor | Department of Epidemiology Core Faculty  | Cochlear Center for Hearing and Public Health Johns Hopkins University Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: It is known that hearing aid ownership is relatively low in the United States at less than 20% of adults with hearing loss owning and using hearing aids. However, many national estimates of hearing aid ownership are based on data that is over 10 years old. Our team was interested in trying to understand whether ownership in hearing aids had changed over time. We used data from 2011 to 2018 in a nationally representative (United States) observational cohort (The National Health and Aging Trends Study) of Medicare Beneficiaries aged 70 years and older to estimate the change in hearing aid ownership. In our analysis, the proportion of Medicare beneficiaries 70 years and older who reported owning and using their hearing aids increased 23.3% from 2011 to 2018. However, this growth in ownership was not equal across all older adults. For example, while White males saw a 28.7% increase in hearing aid ownership, Black females saw only a 5.8% increase over the same 8-year period. Moreover, adults living at less than 100% federal poverty level actually saw an overall 13.0% decrease in hearing aid ownership while those living at more than 200% federal poverty line saw an overall 30.6% increase.   (more…)
Author Interviews, Infections / 09.12.2020

MedicalResearch.com Interview with: Ed Breitschwerdt, DVM, DACVIM The Melanie S. Steele Distinguished Professorship in Medicine Professor, Internal Medicine NC State College of Veterinary Medicine MedicalResearch.com: What is the background for this study? Response: Bartonella species represent a medically underappreciated group of vector-transmitted bacteria that are increasingly implicated in a spectrum of animal and human diseases. Most recently, our research group has focused on the potential role of these bacteria as a cause or co-factor in patients with neuropsychiatric symptoms. This focus is based upon prior case reports and case series generated by our research group and others. (more…)
Author Interviews, Genetic Research, Hematology / 08.12.2020

MedicalResearch.com Interview with: Steven Pipe, MD Professor of Pediatrics and Pathology Laurence A. Boxer Research Professor of Pediatrics and Communicable Diseases Pediatric Medical Director, Hemophilia and Coagulation Disorders Program Director, Special Coagulation Laboratory University of Michigan MedicalResearch.com: What is the background for this study? Response: Hemophilia B is an inherited bleeding disorder where patients are missing clotting factor IX (9), a critical blood clotting protein.  Patients with a severe deficiency are at risk for traumatic and spontaneous bleeds – primarily into joints.  Repeated bleeding into joints causes more than acute pain and swelling but also leads to inflammatory and degenerative changes in joints that eventually leads to severe debilitating arthritis that can be crippling.  To try to prevent this, patients as young as infants are placed on regular infusions of clotting factor IX concentrates.  The relatively short half-life of factor IX means patients must infuse on average once to twice a week.  These can only be delivered intravenously – parents and then patients themselves have to learn this.  Prophylaxis must be continued lifelong to try to prevent bleeding events and protect joint health over the lifespan.  This is a tremendous burden on the patient and their caregivers. Even with regular prophylaxis, joint bleeds may still occur and arthropathy may still ensue.  This is because the blood levels often reach critically low levels prior to the next infusion.  Gene therapy aims to deliver a functional copy of the factor IX gene such that the patient’s own liver will make a continuous supply of factor IX that is delivered to the bloodstream.  At steady state with levels close to or within the normal range, patients would no longer be subject to bleeding events and would not require prophylaxis any longer.  We hope that such a one-time treatment would produced durable, “functionally curative” levels of factor IX. (more…)
Author Interviews, Education / 08.12.2020

MedicalResearch.com Interview with: Martin J. Bergee Professor and Associate Dean for Academic Affairs School of Music University of Kansas MedicalResearch.com: What is the background for this study? What are the main findings? Response: The idea that listening, participating, or achieving in music makes you better at another subject, say, math, science, or reading, has been around for a while.  Indeed, there’s a relationship between achievement in music and achievement in other content areas.  But I’ve always assumed that the relationship was spurious, that is, driven my any number of such background influences as urbanicity, ethnicity, SES, level of parent education, the type of school one attends, and so forth.  Essentially, I set out to demonstrate once and for all that with these background influences accounted for statistically, the relationship is considerably attenuated.  Much to my surprise, however, music achievement’s relationships with reading and math achievement remained quite strong. (more…)
Alcohol, Author Interviews, COVID -19 Coronavirus / 07.12.2020

MedicalResearch.com Interview with: Sitara Weerakoon, MPH (she/her) PhD Candidate | Epidemiology & Biostatistics Graduate Research Assistant Center for Pediatric Population Health UTHealth MedicalResearch.com: What is the background for this study? What are the main findings? Response: Measures to control the spread of COVID-19 included stay-at-home mandates and business lockdown policies which resulted in many facing a loss of income or employment and more time spent isolated at home. Life stressors (like job loss and social isolation) have been shown to be associated with increased drinking at unhealthy levels. Those with a history of mental health problems may be even more at risk. We aimed to see if binge drinking (5 or more drinks [male] or 4 or more drinks [female] in one session) and levels of alcohol consumption among binge drinkers were impacted by these pandemic-related factors. We found that increased time spent at home (in weeks) was associated with a 19% increase in the odds of binge drinking and binge drinkers with a previous diagnosis of depression and current depression symptoms (during the early months of the pandemic) had a 237% greater odds of drinking more alcohol (vs drinking the same amount) compared to those with no history and current symptoms of depression. (more…)
Author Interviews, COVID -19 Coronavirus / 07.12.2020

MedicalResearch.com Interview with: Prof. Martin Scholz Heinrich-Heine-University Düsseldorf, Germany MedicalResearch.com: What is the background for this study? Response: Primary care physicians should have options available to effectively treat newly diagnosed COVID-19 patients in the outpatient setting to avoid severe COVID-19 progression, hospitalizations, and mortality. Already since the beginning of the pandemic different early treatment options were evaluated. My co-authors, Dr. Zelenko, Dr. Derwand, and myself were keen to confirm retrospectively the observed evidence for beneficial early treatment effects of an already applied  triple therapy in combination with a risk stratification approach. The defined risk stratification allowed to differentiate between patients at low and high risk for disease progression and guided treatment decisions. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Leukemia / 06.12.2020

MedicalResearch.com Interview with: William Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of MedicineWilliam Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform. We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians (more…)
Allergies, Author Interviews, Dermatology / 06.12.2020

MedicalResearch.com Interview with: Jonathan Silverberg, MD, PHD, MPH Associate Professor Director of Clinical Research Director of Patch Testing George Washington University School of Medicine and Health Sciences Washington, DC MedicalResearch.com: What is the background for this study Response: Chronic hand eczema was previously shown to be associated with higher rates of allergic contact dermatitis. Yet, little is known about recent trends in North America with respect to the clinical presentation and allergen profile in chronic hand eczema. This study sought to determine the clinical characteristics and etiologies of hand eczema in a large North American cohort of adults referred for patch testing. The patients in the study were patch tested using the North American Contact Dermatitis Group’s allergen screening series. (more…)
Author Interviews, Cancer Research, Immunotherapy / 05.12.2020

MedicalResearch.com Interview with: Dr. Corina Dutcus MD Vice President of Clinical Research Oncology Business Group Eisai MedicalResearch.com: What is the background for this study? Would you briefly explain how lenvatinib works? Is it used for any other malignancies, ex. thyroid cancer? Dr. Corina Dutcus Response: LENVIMA (lenvatinib), discovered and developed by Eisai, is an orally available multiple receptor tyrosine kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). LENVIMA inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1-4, the platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET. LENVIMA is approved in combination with everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy. The approved starting dose for LENVIMA is 18 mg daily. The objective of Study 218, a randomized, open-label, Phase 2 trial, was to assess whether the lower starting dose of LENVIMA (14 mg daily) in combination with everolimus (5 mg daily) would provide similar efficacy with an improved safety profile compared to the FDA-approved starting dose of LENVIMA (18 mg daily) plus everolimus (5 mg daily) in patients with advanced renal cell carcinoma (RCC) following prior treatment with an antiangiogenic therapy. In the US, LENVIMA is also indicated for:
  • the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (RAI-refractory DTC);
  • for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC);
  • and in combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy, and are not candidates for curative surgery or radiation. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trial.
Please see Prescribing Information for LENVIMA (lenvatinib) at http://www.lenvima.com/pdfs/prescribing-information.pdf. (more…)
Author Interviews, Dermatology, Environmental Risks / 04.12.2020

MedicalResearch.com Interview with: Jeremy M. Gernand, PhD, CSP, CRE Associate Professor Environmental Health and Safety Engineering Department of Energy and Mineral Engineering MedicalResearch.com: What is the background for this study? Response: Given concern in the public about exposure to nanoparticles in cosmetics, we decided to investigate the exposure potential for inhaling nanoparticles during the application of aerosol mineral-based sunscreens that are typically marketed as safer for children. We choose three commercially available sunscreens to test in the lab in a manner intended to capture the amount of inhaled particles that would typically occur during application of sunscreen to the mid-point of one’s own arm.  (more…)
Allergies, Author Interviews, Immunotherapy, Pediatrics / 04.12.2020

MedicalResearch.com Interview with: Lianne Soller, PhD Allergy Research Manager BC Children’s Hospital Allergy Clinic Vancouver, BC, Canada MedicalResearch.com: What is the background for this study? Response: Peanut oral immunotherapy (also known as OIT) has been studied for many years in clinical trials and has been found to be safe and effective in preschoolers. However, we know that clinical trials do not always reflect what happens in the real world. We wanted to see study whether peanut OIT would work as well in the real world. This is a follow up of our preschool peanut OIT safety study published in April 2019 which noted only 0.4% severe reactions and 4% epinephrine use during build-up. (more…)
Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU, Race/Ethnic Diversity / 04.12.2020

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine MedicalResearch.com: What is the background for this study? Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)? (more…)
Author Interviews, JAMA, Social Issues / 04.12.2020

MedicalResearch.com Interview with: Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization. (more…)
Author Interviews, COVID -19 Coronavirus, Hematology / 04.12.2020

MedicalResearch.com Interview with: George Sakoulas, MD Sharp Memorial Hospital and Sharp Rees-Stealy Medical Group Associate Adjunct Professor UC San Diego School of Medicine San Diego MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by IVIG?   Response: IVIG stands for intravenous immunoglobulin. It is a preparation from pooled blood donors isolating antibodies in their blood and highly concentrated for use. It's uses are to either replace immunoglobulins in patients who do not produce enough of them because of some underlying immunodeficiency or, as in the case of COVID, they take advantage of the immune signaling properties of the non-variable part of the antibodies. Many immune cells have receptors that bind the non-variable (also called the Fc-gamma region), and when bound, the activity of these activated immune cells is modulated. IVIG is used in many immunologic complications of infections like Guillan-Barre, Kawasaki's disease, immune mediated encephalitis from mycoplasma, just to name a few. We decided to study IVIG because:
  1. Our anecdotal yet successful use of IVIG in treating ARDS due to influenza and other viruses.
  2. Our very definitive successful use of IVIG in a very sick patient with COVID early in the pandemic.
  3. The weak yet positive retrospective data from China of IVIG in COVID.
  4. The mechanism of IVIG inhibiting neutrophil extracellular trap (or NETS) thought to play an important role in COVID severe disease.
  5. IVIG has been around to 4 decades and many physicians have a level of prescribing comfort.
It is worth clarifying that the benefit here is NOT from neutralizing antibodies against SARS-CoV-2 virus but rather the immunomodulatory effect. It will be very interesting to see if the effect/benefit changes over time as pooled blood donors feeding the IVIG supply do develop more antibodies against SARS-CoV-2, but this is not yet known.  (more…)
Author Interviews, Kidney Disease / 03.12.2020

MedicalResearch.com Interview with: Khurram Jamil, MD Vice President, Clinical Research in Hepatology Critical Care Division, Mallinckrodt MedicalResearch.com: What is the background for the new data of terlipressin presented during Kidney Week 2020 Reimagined? Would you briefly describe hepatorenal syndrome type 1? Whom does it affect and how frequently does it progress to ESRD? Response:  Results from two post-hoc analyses of terlipressin, an investigational agent in the U.S. for adults with hepatorenal syndrome type 1 (HRS-1), were presented at Kidney Week 2020 Reimagined, the annual meeting of the American Society of Nephrology. The first was an oral presentation titled, “Terlipressin Improves Renal Replacement Therapy–Free Survival in Hepatorenal Syndrome Type 1” and included a pooled post-hoc analysis to assess the incidence of renal replacement therapy (RRT) and its impact on survival among patients from three Phase 3 trials. The second was a poster presentation titled, “Treatment of Hepatorenal Syndrome Type 1 with Terlipressin Reduces Need for Renal Replacement Therapy After Liver Transplantation,” which focused on a post-hoc analysis of the CONFIRM study and evaluated the need for RRT among patients who had liver transplantation within 90 days of HRS treatment. HRS-1 is an acute and life-threatening syndrome involving acute kidney failure in people with cirrhosis.[i] HRS-1 can progress to life-threatening renal failure within days,i and has a median survival time of approximately two weeks and greater than 80 percent mortality within three months if left untreated.[ii],[iii] It is often a challenge to effectively diagnose in a timely manner due to its diagnosis of exclusion.iii In general, the average patient with hepatorenal syndrome (HRS type 1 or type 2) is in their 50s,[iv] and up to 73 percent of HRS patients are men.[v]  HRS-1 is estimated to affect between 30,000 and 40,000 patients in the U.S. annually.[vi],[vii] (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research / 03.12.2020

MedicalResearch.com Interview with: Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics Director of Research, Division of Adolescent Medicine Co-leader, Scholarly Concentrations, Pediatrics Residency Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic. There were 4 main findings:
  • About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
  • Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
  • Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
  • Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
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Addiction, Author Interviews, COVID -19 Coronavirus, JAMA, Opiods, UCLA / 03.12.2020

MedicalResearch.com Interview with: Joseph Friedman, MD/PhD student David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? Response: Numerous researchers, clinicians, officials, harm reduction agencies, and people who use drugs have sounded the alarm that the COVID-19 pandemic is exacerbating the United States overdose crisis. However, data sources typically used to track overdoses in the US often have long lags that impede timely monitoring and response. For example, the CDC released preliminary overdose figures for 2019 in July 2020, and even these numbers may change. As they are available in near real-time, emergency medical services (EMS) data have increasingly been used as a source of up-to-date information to monitor epidemiological shifts during the COVID-19 pandemic. In this study, we used data from the National EMS Information System (NEMSIS), a large registry of over 10,000 EMS agencies in 47 states that represented over 80% of all EMS activations nationally in 2020. We used the data to track shifts in overdose-related cardiac arrests observed by EMS.   (more…)
Aging, Author Interviews, Cognitive Issues / 03.12.2020

MedicalResearch.com Interview with: Susanna Rosi, Ph.D.  Lewis and Ruth Cozen Chair II Professor, Brain and Spinal Injury Center Weill Institute for Neuroscience Kavli Institute of Fundamental Neuroscience Departments of Physical Therapy Rehabilitation Science, Neurological Surgery University of California San Francisco MedicalResearch.com: What is the background for this study? Response: Everybody has experienced a “senior moment” forgetting where the car keys are, or where you put your glasses. These forgetful moments are not always indicative of a disease, but rather can be a consequence of normal aging. Normal aging is associated with decline of cognitive abilities, such as memory, spatial orientation, problem solving and executive functioning. Investigating what changes happen in the brain with age, can help us to understand why these ‘senior moments’ occur. When we understand what causes these moments, we can design therapeutics with the hopes of preventing or reversing them.  With increased life expectancy age-associatedmemory decline becomes a growing concern. We wanted to investigate (i) What causes memory decline with age? (ii) Are there ways to reverse it?  (more…)