Author Interviews, Dermatology, Environmental Risks / 15.10.2018

MedicalResearch.com Interview with: Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.   In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center. http://www.janetprystowskymd.com/ MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a 'safe tan'?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage?  Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight. "Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That's why you'll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, JAMA, Weight Research / 15.10.2018

MedicalResearch.com Interview with: Stuart Po-Hong Liu, MD, MPH Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50. However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence.  (more…)
Author Interviews, BMJ, Exercise - Fitness, Lifestyle & Health / 13.10.2018

MedicalResearch.com Interview with: Dr Fehmidah Munir CPsychol, AFBPsS Reader in Health Psychology Athena SWAN School Champion School of Sport, Exercise & Health Sciences National Centre for Sports and Exercise Medicine Loughborough University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Given the evidence of the harmful effects of high levels of sitting time on health and the high proportion of time the majority of adults spend in this behaviour, particularly in the workplace, methods to reduce overall and prolonged sitting were needed. Our SMArT Work (Stand More AT Work) programme was delivered to NHS office workers and involved brief education about the impact of sitting on health and benefits of reducing sitting, feedback on sitting behaviour, providing staff with a height-adjustable desk to enable them to work either standing up or sitting down, motivational posters and brief chats with a researcher to see how they were getting on. They received this programme over 12 months. We found that office workers in our study spent nearly 10 hours/day sitting down, which can be bad for health, but we’ve shown that those office workers who received our SMArT Work programme had lower sitting time by around 80mins per day after 12 months compared to those who didn’t receive our programme. Those who received SMArT Work also reported an increase in work engagement, job performance and quality of life and less musculoskeletal issues such as back and neck pain, they felt less tired after a day at work, had less feelings of anxiety and lower sickness presenteeism (working whilst sick). We didn’t find any differences in the number of days absent at work though. Whether you work remotely from home or in an office environment, it may also be good to invest in new Office Furniture. This could also help combat the issue of back and neck pains that you may be experiencing. (more…)
Author Interviews, Cancer Research, HPV, JAMA, OBGYNE / 13.10.2018

MedicalResearch.com Interview with: Megan Clarke, PhD, MHS Cancer Prevention Fellow Clinical Genetics Branch Division of Cancer Epidemiology & Genetics National Cancer Institute Rockville, MD 20892  MedicalResearch.com: What is the background for this study?
  • Infection with high-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. While hrHPV infection is common, most infections are benign and clear on their own without causing cervical cancer. However, some women develop persistent hrHPV infections and are at risk for cervical cancer and its precursors (i.e., precancer).
  • The United States Preventative Services Task Force recommends screening every 3 years with cervical cytology (i.e. Pap) alone, every 5 years with hrHPV testing alone, or with a combination of hrHPV testing and cytology (co-testing) for women aged 30 to 65 years.
  • Screening with hrHPV testing is highly sensitive for detecting cervical precancer but requires additional triage tests to identify HPV-positive women at high-risk of developing cancer who should undergo colposcopy (visualization of the cervix) and biopsy from those at low-risk who can be safely monitored.
  • Currently, Pap cytology is recommended as a triage test for women testing HPV-positive, but this approach requires frequent re-testing at short intervals because the risk of cervical precancer is not low enough in HPV-positive women who test cytology negative to provide long-term reassurance against future risk. In most settings, women who test HPV-positive, cytology-negative are referred to repeat screening within one year.
  • The p16/Ki-67 dual stain assay is a molecular test that measures two specific proteins, p16 that is strongly linked with hrHPV infection, and Ki-67, a marker of cell proliferation that is common in precancers and cancers.
  • Studies have shown that the dual stain test has greater accuracy for detecting cervical precancers in HPV-positive women compared with cytology.
  • In order to determine the optimal screening intervals for the dual stain test, long-term prospective studies are needed to determine how long HPV-positive women who test dual stain negative can be safely reassured of a low precancer risk.
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Author Interviews, Hand Washing, Hospital Acquired, Infections, JAMA / 13.10.2018

MedicalResearch.com Interview with: "Hand Washing" by Anthony Albright is licensed under CC BY-SA 2.0Dr. Daniel J. Livorsi, MD Assistant Professor INFECTIOUS DISEASE SPECIALIST University of Iowa MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the Joint Commission’s standards is that hospitals audit and provide feedback on hand hygiene compliance among healthcare workers. Audit-and-feedback is therefore commonly practiced in US hospitals, but the effective design and delivery of this intervention is poorly defined, particularly in relation to hand hygiene improvement. We studied how 8 hospitals had implemented audit-and-feedback for hand hygiene improvement. We found that hospitals were encountering several barriers in their implementation of audit-and-feedback. Audit data on hand hygiene compliance was challenging to collect and was frequently questioned. The feedback of audit results did not motivate positive change.  (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, Surgical Research / 12.10.2018

MedicalResearch.com Interview with: Scott A. LeMaire, MD Jimmy and Roberta Howell Professor of Cardiovascular Surgery Vice Chair for Research, Michael E. DeBakey Department of Surgery Professor of Molecular Physiology and Biophysics Director of Research, Division of Cardiothoracic Surgery Baylor College of Medicine Department of Cardiovascular Surgery Texas Heart Institute Baylor St. Luke’s Medical Center CHI St. Luke’s Health Editor-in-Chief, Journal of Surgical Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: We performed this study because of concerns about the potential association between fluoroquinolones and aortic aneurysms and dissection raised in two large clinical studies. This concern was noted by the US Food and Drug Administration in May 2016, but the evidence was not deemed sufficient to warrant a warning. Hence, there was a clear need for additional studies to evaluate the problem. Our study was designed to determine whether there is biological evidence that ciprofloxacin—the most commonly prescribed fluoroquinolone—exacerbates aortic disease in a well-established mouse model. The model uses high-fat diet and angiotensin II infusion to stress the aorta and cause aneurysm and dissection. Using this model, we compared mice that received ciprofloxacin to control mice that received only vehicle, and we found that mice that received ciprofloxacin had significant increases in the incidence of aortic dilatation, severe aortic aneurysm and dissection, and aortic rupture and premature death. Importantly, these findings were consistent in male and female mice. Further, we investigated the potential underlying mechanisms and found that the aortas from mice that received ciprofloxacin had decreased levels of lysyl oxidase, increased levels of matrix metalloproteinases, and increased levels of apoptosis and necroptosis. (more…)
Author Interviews, Infections, MRSA, NIH, Probiotics / 12.10.2018

MedicalResearch.com Interview with: "staph aureus on blood agar" by Iqbal Osman is licensed under CC BY 2.0Pipat Piewngam Postdoctorol fellow Pathogen Molecular Genetics Section, Laboratory of Bacteriology, NIAID/NIH Bethesda, MD, USA 20892  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our team at National Institutes of health, Mahidol University and Rajamangala University of Technology in Thailand has reported that the consumption of probiotic Bacillus bacteria comprehensively abolishes colonization with the dangerous pathogen, Staphylococcus aureus. We hypothesized that the composition of the human gut microbiota affects intestinal colonization with S. aureus. We collected fecal samples from 200 healthy individuals from rural populations in Thailand and analyzed the composition of the gut microbiome by 16S rRNA sequencing. Surprisingly, we did not detect significant differences in the composition of the microbiome between S. aureus carriers and non-carriers. We then sampled the same 200 people for S. aureus in the gut (25 positive) and nose (26 positive). Strikingly, we found no S. aureus in any of the samples where Bacillus were present. In mouse studies, we discovered S. aureus Agr quorum-sensing signaling system that must function for the bacteria to grow in the gut. Intriguingly, all of the more than 100 Bacillus isolates we had recovered from the human feces efficiently inhibited that system. Then, we discovered that the fengycin class of Bacillus lipopeptides achieves colonization resistance by inhibiting that system. To further validate their findings, we colonized the gut of mice with S. aureus and fed them B. subtilis spores to mimic probiotic intake. Probiotic Bacillus given every two days eliminated S. aureus in the guts of the mice. The same test using Bacillus where fengycin production had been removed had no effect, and S. aureus grew as expected. This is one of the first study that provide human evidence supporting the biological significance of probiotic bacterial interference and show that such interference can be achieved by blocking a pathogen’s signaling system. (more…)
ADHD, Author Interviews, Psychological Science, University of Michigan / 11.10.2018

MedicalResearch.com Interview with: Holly White, PhD Research Scientist Basic and Applied Cognition Laboratory Department of Psychology University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was inspired by my previous findings of higher originality and creative achievement among adults with ADHD, as well as my personal observations of individuals with ADHD choosing non-traditional approaches to problem solving. College students with ADHD sometimes ignore task instructions and examples, and while this may lead to errors, it may also lead to extraordinarily unique answers and solutions. I was curious as to whether this tendency of ADHD individuals to think in an unconventional and expansive manner might lead to resistance to conformity during creative tasks. In the present study, college students with ADHD were less likely to copy experimenter-provided task examples, compared to non-ADHD peers, on a product label invention task. ADHD participants were also less likely to create imaginary fruits that resembled typical Earth fruit, compared to non-ADHD participants. Students with ADHD were less likely to conform to pre-existing prototypes of fruit and therefore invented more original creations. Individuals with ADHD may be more flexible in tasks which require creating something new, and less likely to rely on examples and previous knowledge. As a result, the creative products of individuals with ADHD may be more innovative, relative to creations of non-ADHD peers.  (more…)
Author Interviews, Flu - Influenza, Roche / 11.10.2018

MedicalResearch.com Interview with: Mark D. Eisner, MD, MPH Vice President, Product Development Immunology Infectious Disease and Ophthalmology Genentech  MedicalResearch.com: What is the background for this study? Response: CAPSTONE-2 is a Phase III multicenter, randomized, double-blind study that evaluated the efficacy and safety of a single dose of baloxavir marboxil compared with placebo and oseltamivir in people 12 years and older who are at a high risk of complications from the flu. The Centers for Disease Control and Prevention (CDC) defines people at high risk for serious flu complications to include adults 65 years of age or older, or those who have conditions such as asthma, chronic lung disease, morbid obesity or heart disease. A total of 2,184 participants enrolled in the study and were randomly assigned to receive a single, oral dose of 40 mg or 80 mg of baloxavir marboxil (according to body weight), placebo or 75 mg of oseltamivir twice daily for five days. The primary objective of the study evaluated the efficacy of a single dose of baloxavir marboxil compared with placebo by measuring the time to improvement of influenza symptoms. Key secondary endpoints compared outcomes in baloxavir marboxil versus placebo or oseltamivir – these included time to resolution of fever, time to cessation of viral shedding, infectious virus detection in swabs of the nose and throat, prescription of antibiotics and influenza-related complications. Genentech announced initial results from the study on July 16, 2018 but the full data was presented for the first time during a late-breaking oral presentation at the annual IDWeek meeting in San Francisco, CA on October 6, 2018. Baloxavir marboxil is a first-in-class, single-dose investigational oral medicine with a novel proposed mechanism of action designed to target the influenza A and B viruses, including oseltamivir-resistant strains and avian strains (e.g. H7N9, H5N1). Baloxavir marboxil is the first potential influenza treatment to demonstrate a clinically meaningful benefit for people highly vulnerable to serious influenza complications in clinical trials. The FDA accepted a New Drug Application (NDA) and granted Priority Review to baloxavir marboxil as a single-dose, oral treatment for acute, uncomplicated influenza in people 12 years and older. The NDA was based on results from the Phase III CAPSTONE-1 study of a single dose of baloxavir marboxil compared with placebo or oseltamivir 75 mg, twice daily for five days, in otherwise healthy people with the flu. Results from a placebo-controlled Phase II study in otherwise healthy people with the flu were included as supporting data in the NDA. The FDA is expected to make a decision on approval by December 24, 2018. (more…)
Author Interviews, MRI, Pain Research, Rheumatology / 11.10.2018

MedicalResearch.com Interview with: Daniel S. Albrecht, Ph.D. Research Fellow, Department of Radiology Harvard Medical School MedicalResearch.com: What is the background for this study? Can you briefly describe what is meant by fibromyalgia? Response: Fibromyalgia (FM) is a poorly understood chronic condition characterized by widespread musculoskeletal pain, fatigue, unrefreshing sleep, memory deficits and attention difficulties, among other symptoms. FM affects an estimated 4 million adults in the U.S., but despite this prevalence, effective therapies for treating FM are lacking. Part of the reason for the paucity of effective therapeutics is insufficient knowledge of the underlying mechanisms contributing to FM. Previous work from co-senior author of the current manuscript, Eva Kosek, MD, PhD, and collaborators at the Karolinska Institute in Sweden found elevated inflammatory molecules in the cerebrospinal fluid of FM patients, which could be reflective of brain neuroinflammation in these patients. However, no study had directly assessed the presence of neuroinflammation in the brain of FM patients. Co-senior author of the study, Marco Loggia, PhD, and collaborators showed in a 2015 Brain publication that individuals with chronic low back pain (cLBP) exhibit evidence of brain neuroinflammation, specifically activation of glial cells. Our team utilized simultaneous MR/PET imaging to image brain levels of the 18 kDa translocator protein (TSPO), which is widely used as a marker of glial activation due to vast upregulation of TSPO in glial cells, e.g. microglia and astrocytes, in preclinical models of inflammation and neurological disease. Dr. Loggia sought to extend these finding in cLBP to FM, hypothesizing that activation of glial cells may also be associated with FM pathology. To this end, we used the same TSPO PET tracer to image 20 FM patients and 16 healthy controls. During a conference where I was presenting preliminary results of the fibromyalgia study, Dr. Loggia met with Dr. Kosek and discovered that, across the Atlantic, her group was performing a very similar study, imaging 11 FM patients and 11 controls with the same TSPO PET compound. They decided to form a collaboration, and logistic talks began to determine the best strategy to combine and analyze the separate datasets. In addition to PET imaging with the TSPO tracer, which is suggested to reflect activated microglia and astrocytes, Dr. Kosek’s group also collected PET scans using a tracer thought to bind specifically to astrocytes rather than microglia. This tracer was used in order to discern the relative contributions of microglia and astrocytes to any observed differences in TSPO PET signal. (more…)
Author Interviews, Bipolar Disorder, JAMA, Schizophrenia / 11.10.2018

MedicalResearch.com Interview with: Thomas Wolfers PhD Donders Center for Cognitive Neuroimaging Kapittelweg 29 6525EN Nijmegen The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia and bipolar disorder are severe and complex mental disorders. Currently, the most common approach in characterizing disorders biologically is by comparing patient groups with groups of healthy individuals. We employed a fundamentally different approach and investigated how much the brains of individual patients diagnosed with schizophrenia and bipolar disorder differ from one another. For this purpose, we selected brain scans from healthy individuals to model a norm reflecting the healthy range, subsequently we compared the brain scans of patients with schizophrenia and bipolar disorder to this norm on the level of the individual. The main outcome was that individuals with schizophrenia and bipolar disorder differ substantially from one another, thus, considering only the ‘average patient’ has little to say about what might be occurring in the brain of an individual patient. (more…)
Author Interviews, Johns Hopkins, Smoking, Tobacco, Tobacco Research / 11.10.2018

MedicalResearch.com Interview with: "Electronic Cigarette/E-Cigs/E-Cigarettes" by Chris F is licensed under CC BY 2.0Mohammadhassan (Hassan) Mirbolouk, MD American Heart Association Tobacco Regulation Center (A-TRAC) Johns Hopkins Hospital Baltimore, MD 21224. MedicalResearch.com: What is the background for this study? Response: E-cigarettes were introduced first in US market as a less harmful method of nicotine delivery which potentially would help smokers to have a less harmful option. However, overtime e-cigarette found its niche of consumers in the younger/tobacco naïve population. Our study is amongst the first studies that describes those who use e-cigarette without any history of combustible-cigarette smoking.  (more…)
Alzheimer's - Dementia, Author Interviews, Critical Care - Intensive Care - ICUs, Geriatrics, Inflammation, Johns Hopkins / 11.10.2018

MedicalResearch.com Interview with: Keenan Walker, PhD Johns Hopkins University School of Medicine Baltimore MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was conducted in response to anecdotal accounts and scientific evidence which suggests that major medical conditions, such as critical illness and severe infections, can have a long-term neurological effect on some individuals. There are quite a few studies to date which have found that critical illnesses, such as severe sepsis, are associated with long-term cognitive impairment. Based on this evidence, we wanted to figure out to what degree critical illness and major infection may affect later brain structure and to determine whether the structural changes associated with these events were similar to those observed in Alzheimer’s disease. Our main finding was that individuals who had one or more critical illness or major infection major infection during the decades leading up to older adulthood were more likely to have smaller brain volumes in brain regions most vulnerable to Alzheimer's disease. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 11.10.2018

MedicalResearch.com Interview with: Nathaniel Ernstoff, MD University of Miami MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening. This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer. Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study's completion. (more…)
Author Interviews, Cancer Research, Colon Cancer, Genetic Research, University Texas / 10.10.2018

MedicalResearch.com Interview with: Mohammad Bilal, MD University of Texas Medical Branch MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC. The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population. These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy.  (more…)
Author Interviews, Cannabis, Gastrointestinal Disease / 10.10.2018

MedicalResearch.com Interview with: Tarek Alansari, MD Metropolitan HospitalTarek Alansari, MD Metropolitan Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cannabis is the most frequently consumed recreational drug in the world. The use of cannabis is becoming increasingly accepted by the general public in the United States. The estimates of the prevalence of cannabis use in the United States is about 9.5% in the adult population and the prevalence of dependence or abuse approaches 2.9%. Those under the age of 35 years are the most frequent consumers. According to Business Insider as of June 2018, recreational cannabis is legal in 9 states and medical cannabis is legal in 30 states. Recent surveys show that about 35 million Americans are frequent cannabis users. Aiming for symptomatic relief, some patients with different gastrointestinal disorders have turned to cannabis without fully understanding the effect of its use for their individual condition. Biliary tract disease, ethanol abuse, infections, autoimmunity, and genetics are well known causes of acute pancreatitis. However, medication-induced pancreatitis remains a less common etiology. In about 20% of cases of acute pancreatitis despite of the great improvement in genetic testing and imaging modalities, the workup still fails to reveal an etiology. These cases are labeled idiopathic. Cannabis use is emerging as a rare, possibly overlooked cause of acute pancreatitis with few cases reported in the literature. In the United States, only 5 cases of cannabis - induced acute pancreatitis (AP) have been reported till September 2017. The review of literature revealed that only 26 cases of cannabis-induced AP have been reported worldwide. (more…)
Author Interviews, Breast Cancer, Genetic Research / 10.10.2018

MedicalResearch.com Interview with: "JFK Plaza/ Breast Cancer Awareness" by nakashi is licensed under CC BY 2.0Univ.- Prof. Dr. Wolfgang Schreiner Section Biosimulation and Bioinformatics Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna General Hospital WIEN / AUSTRIA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The choice of correct individualized therapy for breast cancer depends on correct diagnosis: receptors for estrogen, progesterone and HER2 are determined routinely. However 5-10% of these routine diagnostics are inaccurate and may entail suboptimal therapy. We have paved the way for additional diagnostics from gene expression data so as to increase precision of diagnostics. (more…)
Author Interviews, Cancer Research, Exercise - Fitness / 10.10.2018

MedicalResearch.com Interview with: Laurien Buffart, PhD Chair Amsterdam eXercise in Oncology (AXiON) research Departments of Epidemiology & Biostatistics and Medical Oncology VUmc  Amsterdam | The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is evidence from randomized controlled trials that exercise has beneficial effects on physical fitness, fatigue, quality of life and self-reported physical function during and following cancer treatment. The magnitude of the effects, however, often appear modest, possibly because interventions rarely target patients with worse symptoms and quality of life. Based on individual patient data from 34 randomized controlled trials, we found that exercise interventions during cancer treatment are effective in maintaining muscle strength and quality of life, regardless of their baseline values. Offering exercise interventions post cancer treatment to patients with a relatively high muscle strength and quality of life does not appear to further improve these outcomes. For aerobic fitness, exercise interventions during treatment had larger effects in patients with higher baseline aerobic fitness, whereas all patients were able to improve aerobic fitness post treatment. Greater effects on fatigue and self-reported physical function were found for patients with worse baseline fatigue and physical function, both during and post-treatment.  (more…)
Author Interviews, Gastrointestinal Disease, NYU, Surgical Research, Weight Research / 10.10.2018

MedicalResearch.com Interview with: Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions. We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  (more…)
AHRQ, Author Interviews, Cost of Health Care, JAMA / 09.10.2018

MedicalResearch.com Interview with: Salam Abdus, PhD Division of Research and Modeling, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality Department of Health and Human Services Rockville, Maryland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: High deductible health plans are more prevalent than ever. Previous research showed that adults in low-income families or with chronic conditions are more likely to face high financial burdens when they are enrolled in high-deductible health plans, compared to adults in higher income families or healthier adults. In this study we examined the financial burden of high-deductible health plans among adults who are both low income and chronically ill. We used AHRQ’s Medical Expenditure Panel Survey Household Component (MEPS-HC) data from 2011 to 2015 to study the prevalence of high out-of-pocket health care spending burden of high deductible health plans among adults enrolled in employer-sponsored insurance. We included family out-of-pocket spending on premiums and health care services. We found that among adults who had family income below 250% of Federal Poverty Level (FPL), had multiple chronic conditions, and were enrolled in high-deductible health plans, almost half (46.9%) had financial family out-of-pocket health care burden exceeding 20 percent of family disposable income. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Urinary Tract Infections / 09.10.2018

MedicalResearch.com Interview with: Thomas P. Lodise Jr., PharmD, PhD Clinical Pharmacist at the Stratton VA Medical Center in Albany, NY Albany College of Pharmacy and Health Sciences Albany, NY MedicalResearch.com: What is the background for this study? How does Ceftolozane/Tazobactam differ from other antibiotics for serious Gram-negative infections including Pseudomonas aeruginosa? Response: Treatment of patients with Gram-negative infections is increasingly difficult due to rising resistance to commonly used agents. Ceftolozane/tazobactam (C/T) is a potent anti-pseudomonal agent with broad Gram-negative coverage that is indicated for complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI) and is currently being studied for ventilated nosocomial pneumonia. C/T differs from other antibiotics in terms of its potency against multi-drug resistant Pseudomonas aeruginosa, one of the most concerning and difficult-to-treat Gram-negative pathogens. This study evaluates C/T in a large database of US hospitals to better understand treatment patterns and associated outcomes. (more…)
Author Interviews, Columbia, Environmental Risks, Genetic Research, Ophthalmology, PLoS / 09.10.2018

MedicalResearch.com Interview with: Andrei V. Tkatchenko, M.D., Ph.D. Associate Professor Columbia University Medical Center Edward S. Harkness Eye Institute New York, NY 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clear distance vision is rapidly becoming a rare privilege around the world, especially in Asia, due to increasing prevalence of myopia. Although much effort has been directed towards elucidating the mechanisms underlying refractive eye development and myopia, treatment options for myopia are mostly limited to optical correction, which does not prevent progression of myopia or pathological blinding complications often associated with the disease. During early childhood development, the axial length of the eye normally grows to match its optical power in a process called emmetropization, producing focused images on the retina. However, very often environmental and genetic factors lead to a mismatch between the optical power of the eye and its axial length resulting in the development of myopia if eyes grow too long for their optical power. Experimental studies in many animal species suggest that emmetropization is regulated by optical defocus. The eye can compensate for imposed negative and positive optical defocus by increasing or decreasing its growth rate, respectively. However, the molecular mechanisms underlying emmetropization are poorly understood which prevents development of anti-myopia drugs. (more…)
Author Interviews, Dermatology, Pharmaceutical Companies / 09.10.2018

MedicalResearch.com Interview with: foamixDavid Domzalski CEO Foamix Pharmaceuticals MedicalResearch.com: What is the background for this study?  How does FMX101 differ from other treatment for acne, ie benzoyl peroxide, topical clindamycin etc?  Response: This study measures the safety and efficacy of a topical foam formulation of the antibiotic minocycline, for the treatment of moderate-to-severe acne. Minocycline is one of the most commonly used products for the treatment of acne, but is currently only available in an oral dosage form. Significant side effects are associated with oral minocycline, including GI upset, photosensitivity, headaches, dizziness, and other potential effects on the CNS.  In addition to the side effects associated with oral minocycline, many currently available topical acne medications contain ingredients which can be drying and irritating to the skin.  These side effects can be frustrating to patients and potentially impact overall compliance to their treatment regimen.  The study addresses important unmet needs in dermatology to determine whether providing patients with a topical dosage form of minocycline may have potential advantages over existing products. In our first two Phase 3 clinical studies, >95% of facial local tolerability signs and symptoms were classified as “none” or “mild,” including dryness, erythema and itching.  Also, our topical minocycline foam, FMX101, is a natural triglyceride-based vehicle that does not contain ingredients that serve as  primary irritants or surfactants.  We believe that FMX101, if approved, would be the first topical minocycline available for the treatment of acne and provide a novel and much needed treatment option for patients who suffer from the physical and psycho-social effects of acne. (more…)
Author Interviews, Mineral Metabolism, Vitamin D / 09.10.2018

MedicalResearch.com Interview with: "MaxMedica D-vitamin" by Midsona Sverige AB is licensed under CC BY 2.0Dr Mark J Bolland PhD Bone and Joint Research Group Department of Medicine University of Auckland New Zealand MedicalResearch.com: What is the background for this study? Response: Vitamin D supplements have long been recommended for older people to treat or prevent osteoporosis. Early evidence suggested vitamin D supplements might have benefits for musculoskeletal health, but more recent systematic reviews have reported no effect of vitamin D supplementation on fractures, falls or bone mineral density. Some authors have suggested that inadequate vitamin D doses might explain these null results. (more…)
Author Interviews, HIV, HPV, PLoS, Sexual Health / 09.10.2018

MedicalResearch.com Interview with: Brandon Brown, MPH, PhD Associate Professor Center for Healthy Communities Department of Social Medicine, Population and Public Health UCR School of Medicine Riverside, CA MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The authors have been working in Lima, Peru on HIV-related projects for over 17 years. This particular study arose out of interest from our main community collaborator and the only gay men’s health NGO in Lima, Epicentro Salud (http://epicentro.org.pe/index.php/en/). The NGO noticed that one of the main health issues among their clients was genital warts. When we learned this, we applied for funding through the Merck Investigator Initiated Studies Program to conduct a study examining the link between genital warts and incident HIV infection. Although most studies have shown a general link between HPV and HIV co-infection, our findings illustrate the strong relationship between individual HPV types and HIV infection. Specifically, individuals in our study with any HPV type, more than one HPV type, or high-risk HPV were more likely to acquire HIV. (more…)