Category Archives: Author Interviews

Medical Research Author Interviews

Dapagliflozin (Farxiga®)Added to Insulin for Type 1 Diabetes May Improve Glycemic Control

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MedicalResearch.com Interview with:

Chantal Mathieu, MD, PhD Professor of Medicine Clinical and Experimental Endocrinology Catholic University of Leuven, Belgium

Dr. Mathieu

Chantal Mathieu, MD, PhD
Professor of Medicine
Clinical and Experimental Endocrinology
Catholic University of Leuven, Belgium

MedicalResearch.com: What is the background for this study?

Response: People with type 1 diabetes (T1D) are confronted often with the inability to achieve satisfactory glycemic control, being good HbA1c, but in particular stable glycemic control, avoiding hyperglycemic events, but also hypoglycemic events, despite novel insulins and novel technologies. Moreover, intensive insulin therapy is often associated with weight gain, leading to an increase in overweight and obesity also in people with T1D. All of these issues affect quality of life.

In the DEPICT 2 study we examined the impact of adding a selective SGLT2 inhibitor, dapagliflozin (two doses tested – 5 and 10mg) in a double blinded manner versus placebo to background insulin (MDI or CSII) in people with T1D reaching insufficient glycemic control (HbA1c 7.5-10.5%). Primary endpoint was lowering in HbA1c at 24 weeks and secondary endpoints included insulin dose reduction and weight reduction as well as a composite endpoint of having a HbA1c drop of >=0.5% without severe hypoglycemia. The study ran internationally, with about 1/3 of patients coming from North America, 1/3 from Europe and 1/5 from Asia (Japan).

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Triclosan in Personal Care Products Can Induce Antibiotic Resistance

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MedicalResearch.com Interview with:

Dr Jianhua Guo PhD ARC Future Fellow, Senior Research Fellow Advanced Water Management Centre University of Queensland Brisbane Australia

Dr. Jianhua Guo

Dr Jianhua Guo PhD
ARC Future Fellow, Senior Research Fellow
Advanced Water Management Centre
University of Queensland
Brisbane Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It was found that wastewater from residential areas has similar or even higher levels of antibiotic resistant bacteria and antibiotic resistance genes compared to hospitals, where you would expect greater antibiotic concentrations. Thus, we wonder whether non-antibiotic chemicals such as triclosan can directly induce antibiotic resistance, because triclosan could be ubiquitously detected in various water environments, like wastewater.

We found triclosan found in personal care products that we use daily could directly induce multi-drug resistance through mutation. The discovery should be a wake-up call to re-evaluate the potential impact of non-antibiotic chemicals on the dissemination of antibiotic resistance.

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Accurate Measurements Suggest High Salt Intake Leads To Higher Death Rate

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MedicalResearch.com Interview with:
Salt-SodiumDr. Feng J He PhD
Wolfson Institute of Preventive Medicine,
Barts and The London School of Medicine & Dentistry,
Queen Mary University of London,
London

MedicalResearch.com: What is the background for this study?

Response: Studies have shown that there is a strong linear relationship between sodium intake and blood pressure and raised blood pressure is a leading cause of death and disability worldwide.

The current mean population sodium intake among adults in most countries is approximately 4,000 mg/d (10 g/d salt). The World Health Organisation (WHO) has recommended a 30% reduction in sodium intake by 2025 with an eventual target of less than 2,000 mg/d (5 g/d salt) for all countries. Several recent cohort studies have challenged the WHO’s recommendations, as these studies suggested that there was a J or U-shaped relationship between sodium and risk, i.e. lower and higher sodium intake both were associated with an increased risk of cardiovascular events and deaths.

However, these studies have several severe methodological problems, one of which is the use of a biased or unreliable estimate of individual’s usual sodium intake, e.g. a single spot urine with the Kawasaki formula.

Our study, for the first time, has compared the relationship of sodium intake and mortality, based on various methods to assess usual sodium intake, including estimates based on the Kawasaki formula (single and average of multiple days) and a single measured 24-hour urine, with the gold standard method, i.e. the average of multiple non-consecutive measured 24-h urines.

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Immaturity Plays Leading Role in Late Preterm Complications

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MedicalResearch.com Interview with:

Melissa Lorenzo MD Pediatric medical resident

Dr. Lorenzo

Melissa Lorenzo MD
Pediatric medical resident
Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University

MedicalResearch.com: What is the background for this study?

Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States.

Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear.

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Sibling Closeness in Middle School Predicts Differences in College Graduation

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MedicalResearch.com Interview with:
“siblings” by Britt Reints is licensed under CC BY 2.0Xiaoran Sun
Department of Human Development and Family Studies
The Pennsylvania State University
University Park, PA 16802.  

MedicalResearch.com: What is the background for this study?

Response: College graduation has significant implications for adult life outcomes including for employment, family formation, and health (IOM & NRC, 2015).

Investigating how sibling differences in college graduation emerge sheds light on why children growing up in the same family sometimes follow diverging paths in adulthood. Our study also responds to the call by researchers interested in policy and practice to conduct longitudinal research investigating the role of early family socialization processes in educational attainment (Pettit, Davis-Kean, & Magnuson, 2009). Despite siblings’ important role in child and adolescent development, previous research has focused on parenting and on the academic outcomes of individual children in the family.

Further, although sibling experiences, including their relationship characteristics and parental differential treatment, have been linked to sibling similarities and differences in domains such as risky behaviors (Slomkowski, Rende, Novak, Lloyd-Richardson, & Raymond, 2005), to date, there has been very little research on the role of sibling experiences in positive development, such as academic achievement.   Continue reading →

Enabling Angioplasty-Ready “Smart” Stents to Detect In-Stent Restenosis and Occlusion

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MedicalResearch.com Interview with:

Kenichi Takahata, Ph.D., P.Eng. Associate Professor Department of Electrical & Computer Engineering Faculty of Applied Science University of British Columbia Vancouver, B.C., Canada

Dr. Takahata

Kenichi Takahata, Ph.D., P.Eng.
Associate Professor
Department of Electrical & Computer Engineering
Faculty of Applied Science
University of British Columbia
Vancouver, B.C., Canada

MedicalResearch.com: What is the background for this technology and study? 

Response: Cardiovascular disease (CVD) is the number one cause of mortality globally. One of the most common and proven treatments for CVD is stenting. Millions of stents are implanted annually worldwide. However, the most common complication called in-stent restenosis, re-narrowing of stented arteries, still poses a significant risk to patients.

To address the current lack of diagnostic technology to detect restenosis at its early stage, we are developing “smart” stents equipped with microscale sensors and wireless interface to enable continuous monitoring of restenosis through the implanted stent. This electrically active stent functions as a radio-frequency wireless pressure transducer to track local hemodynamic changes upon a re-narrowing condition. We have reported a new smart stent that has been engineered to fulfill clinical needs for the implant, including its applicability to current stenting procedure and tools, while offering self-sensing and wireless communication functions upon implantation.

The stent here has been designed to function not only as a typical mechanical scaffold but also as an electrical inductor or antenna. To construct the device, the custom-designed implantable capacitive pressure sensor chip, which we developed using medical-grade stainless steel, are laser-microwelded on the inductive antenna stent, or “stentenna”, made of the same alloy. This forms a resonant circuit with the stentenna, whose resonant frequency represents the local blood pressure applied to the device and can be wirelessly interrogated using an external antenna placed on the skin.

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Watson for Clinical Trial Matching Increases Enrollment in Breast Cancer Trials

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MedicalResearch.com Interview with:

Alexandra Urman, MPH Clinical Research Manager Clinical Development IBM Watson Health 

Alexandra Urman

Alexandra Urman, MPH
Clinical Research Manager
Clinical Development
IBM Watson Health 

MedicalResearch.com: What is the background for this study? 

Response: Cancer statistics show only 3-5% of cancer patients participate in clinical trials although up to 20% may be eligible.

Dr. Tufia Hadad, a medical Oncologist at the Mayo Clinic in Rochester, Minnesota sought to address this issue and spearheaded a project conducted at the Rochester facility in collaboration with IBM Watson Health. The objective was to determine if the use of cognitive computing increased clinical trial enrollment and screening efficiency in the breast cancer clinic.

Watson for Clinical Trial Matching (CTM) is a cognitive system which utilizes natural language processing to derive patient and tumor attributes from unstructured text in the electronic health record that can be further used to match a patient to complex eligibility criteria in trial protocols.

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Higher Vitamin D Levels Linked to Lower Breast Cancer Incidence

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MedicalResearch.com Interview with:

Cedric F. Garland, Dr.P.H., F.A.C.E. Adjunct Professor Division of Epidemiology Department of Family Medicine and Public Health University of California San Diego La Jolla, California 92093-0620

Dr. Garland

Cedric F. Garland, Dr.P.H., F.A.C.E.
Adjunct Professor
Division of Epidemiology
Department of Family Medicine and Public Health
University of California San Diego
La Jolla, California 92093-0620

MedicalResearch.com: What is the background for this study?

Response: Studies mapping death rates from female breast cancer in the US, the former USSR and Canada by Drs. Edward Gorham, and Frank and Cedric Garland revealed for the first time in history that death rates from breast cancer tracked latitude where people lived.

The rates were highest in the least sunny northern tier of states, lowest in the sunny southwest. This led these scientists to be the first to theorize that vitamin D prevents breast cancer” said study first author Sharon McDonnell. Continue reading →

Bisexual Men Face Greater Risk of Heart Disease

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MedicalResearch.com Interview with:

Billy A. Caceres, PhD, RN, AGPCNP-BC NYU Rory Meyers College of Nursing New York, NY 10010

Dr. Caceres

Billy A. Caceres, PhD, RN, AGPCNP-BC
NYU Rory Meyers College of Nursing
New York, NY 10010

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although current evidence, primarily based on self-reported data, suggests gay and bisexual men report higher rates of cardiovascular risk factors (such as poor mental health and tobacco use) than heterosexual men, few studies have examined heart disease risk in this population. This study is one of the few studies to examine heart disease risk in gay and bisexual men using biological measures.

Using data from a nationally representative sample we identified higher rates of mental distress, obesity, hypertension, and diabetes among bisexual men compared to exclusively heterosexual men after adjusting for traditional risk factors (demographic characteristics, mental distress, and health behaviors). We also included men who identified as heterosexual but report a history of same-sex sexual behavior. Gay and heterosexual-identified men who have sex with men displayed similar risk profiles to exclusively heterosexual men.

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Unrelated Bacterial Strains Can Transfer Antibiotic Resistance Genes To Each Other

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MedicalResearch.com Interview with:

CRE bacteria - CDC image

CRE bacteria – CDC image

Richard Stanton, PhD
Health Scientist, Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: We used whole genome sequencing (WGS) to investigate an outbreak of carbapenem-resistant Enterobacteriaceae (CRE) that occurred in an acute care hospital in Kentucky over a six month period in late 2016. The outbreak included 18 cases of CRE.

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No Evidence Probiotics Will Reduce Your Anxiety

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MedicalResearch.com Interview with:

Daniel Reis MA Graduate Student Clinical Psychology University of Kansas

Daniel Reis

Daniel Reis MA
Graduate Student
Clinical Psychology
University of Kansas

MedicalResearch.com: What is the background for this study? What are the main findings?

Probiotics have generated considerable interest as a possible treatment for numerous forms of physical and mental illness. Preliminary evidence from both preclinical and clinical studies suggest that probiotics may be able to reduce anxiety. Our goal was to comprehensively review and summarize existing preclinical and clinical studies.

Overall, probiotic administration reduced anxiety-like behaviors in rodents, but only in those with some form of experimentally-induced disease (such as early-life stress or socieal defeat). Probiotics did not reduce anxiety in humans.

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Anti-PD1 Immunotherapy May Work Better in Older Melanoma Patients

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MedicalResearch.com Interview with:

Ashani Weeraratna, Ph.D. The Ira Brind professor and Co-program leader of the Immunology, Microenvironment and Metastasis Program The Wistar Institute Member of Wistar’s Melanoma Research Center Philadelphia 

Dr. Weeraratna

Ashani Weeraratna, Ph.D.
The Ira Brind professor and
Co-program leader of the Immunology, Microenvironment and Metastasis Program
The Wistar Institute
Member of Wistar’s Melanoma Research Center
Philadelphia 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response:  This study shows for the first time that older patients, especially those who have had prior MAPKi therapy fare better than younger patients when treated with anti-PD1. We found that tumors in younger patients and younger mice have higher levels of Tregulatory cells, the cells that regulate other immune cells. This is not true systemically, only within the tumor microenvironment.

We were surprised because we expected that, as with targeted therapy, older patients would have a poorer response to immunotherapy, given what we perceive as a poorer immune system in older patients.  Continue reading →

Atopic Dermatitis (Eczema) Patients Have Higher Likelihood of Osteoporosis

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MedicalResearch.com Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois

MedicalResearch.com: What is the background for this study?

Response: Persons with atopic dermatitis have a number of risk factors for osteopenia and osteoporosis, including systemic atopy and inflammation, being less physically active and using a lot of topical and/or systemic corticosteroids. We aimed to determine whether adults with atopic dermatitis in fact have higher rates of physician-diagnosed osteopenia and osteoporosis.

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Individuals With Very High Levels of Lipoprotein(a) May Benefit Most From LDL(a)-Lowering Drugs

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MedicalResearch.com Interview with:

Dr. Stephen Burgess PhD Programme Leader at the Medical Research Council Biostatistics Unit University of Cambridge

Dr. Burgess

Dr. Stephen Burgess PhD
Programme Leader at the Medical Research Council Biostatistics Unit
University of Cambridge

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lipoprotein(a) is a lipoprotein subclass, and an important biomarker for coronary heart disease. As a clinical biomarker, it has a similar story to LDL-cholesterol (“bad” cholesterol), in that it is thought to be a causal risk factor for coronary heart disease, and so is a potential target for drug development. However, while drugs that lower LDL-cholesterol, such as statins, have been successful in reducing coronary heart disease risk, drugs that lower lipoprotein(a) have not as yet been successful. New drugs are currently in development that specifically target lipoprotein(a) and can lower lipoprotein(a) concentrations by 80-90%. We performed this study to investigate whether these drugs are likely to be successful in reducing coronary heart disease risk.

We compared individuals with naturally-occurring genetic variants that predispose them to a higher or lower lifetime concentration of lipoprotein(a) as a way of mimicking a randomized controlled trial. This approach has previously been undertaken for other biomarkers, including LDL-cholesterol. We found that having 10mg/dL lower genetically-predicted concentration of lipoprotein(a) was associated with a 5.8% reduction in coronary heart disease risk.

However, associations between genetically-predicted LDL-cholesterol and coronary heart disease risk are quantitatively much stronger than the proportional effect of LDL-cholesterol lowering on coronary heart disease risk as estimated by statin trials. This is because differences in genetic variants reflect lifelong changes in LDL-cholesterol, whereas statin trials only lower LDL-cholesterol for a few years. Hence, using the ratio between the genetic and trial estimates for LDL-cholesterol, we estimate that lowering lipoprotein(a) by 10mg/dL in a short-term clinical trial would only reduce coronary heart disease risk by 2.7%. To obtain the same reduction in coronary heart disease risk of around 20% as observed in statin trials, lipoprotein(a) would have to be lowered by around 100mg/dL. This explains why previous trials of less specific and less potent lipoprotein(a)-lowering drugs have failed to demonstrate benefit.

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Stress Disorders Linked to Increase Risk of Autoimmune Disease

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MedicalResearch.com Interview with:

Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Huan Song

Huan Song
Associated
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet

MedicalResearch.com: What is the background for this study?

Response: Earlier findings from our group (e.g. Fang et al., NEJM 2012; Arnberg et al., Lancet Psychiatry 2015; Lu et al., JAMA Oncol 2016; Shen et al., BMJ 2016; Zhu et al., Ann Oncol 2017) have identified pathways through which stressful events contribute to deterioration in human health. With strong animal models and human data supporting a role of stress in immune dysregulation, the hypothesis linking mental distress with autoimmune is indeed plausible. However, the evidence is as yet limited to clinical observations and a few larger observational studies on US veterans, most of them on men only, and some of which have cross-sectional designs and various other methodological shortcomings.

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