Accidents & Violence, Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Pittsburgh / 05.10.2018

MedicalResearch.com Interview with: Syed Mahmood Ali Shah, M.D. Associate Professor of Ophthalmology University of Pittsburgh School of MedicineSyed Mahmood Ali Shah, M.D. Associate Professor of Ophthalmology University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Eye trauma is a significant cause of morbidity throughout the world. In the United States, the incidence of individuals hospitalized with eye trauma from 2001 through 2014 increased. Most of these individuals were above the age of 65 and suffered a fall. This is a worrisome trend in light of an increased awareness and continued and concentrated effort to reduce falls. This is a critical point: We need to improve our existing strategies to reduce falls. The second at-risk group is children and adolescents. Previous studies have shown that effective widespread implementation of injury prevention efforts can lower trauma rates. While we did observe a small decrease in eye trauma as a primary admitting diagnosis, the fact that it was more common in children and adolescents (for whom eye trauma carries devastating consequences and can significantly reduce quality of life) highlights the significance of continued efforts to prevent eye trauma.  (more…)
Author Interviews, Cleveland Clinic, Diabetes, JAMA, Ophthalmology / 05.10.2018

MedicalResearch.com Interview with: Amy Babiuch, M.D. Medical Retina Specialist  |  Cole Eye Institute Assistant Professor Ophthalmology Case Western Reserve University WPSA Regional Focus Committee Chair Cleveland Clinic MedicalResearch.com: What is the background for this study? Response: In previous studies, the disorganization of retinal inner layers (DRIL) has demonstrated its ability to help determine visual acuity (VA) prognosis in diabetic macular edema that requires treatment. Given this association, the research group at Cole Eye Institute studied how DRIL may affect VA outcomes in patients with retinal vein occlusion (RVO) undergoing treatment for secondary macular edema. DRIL is defined as the extent to which there is a failure in the recognition of any of the demarcations between the ganglion cell-inner plexiform layer complex, inner nuclear layer, and outer plexiform layer on optical coherence tomography (OCT). (more…)
Author Interviews, CDC, JAMA, Pediatrics, Smoking / 04.10.2018

MedicalResearch.com Interview with: "Electronic Cigarette/E-Cigs/E-Cigarettes" by Chris F is licensed under CC BY 2.0Brian King, PhD Lead author and Deputy Director for Research Translation Office on Smoking and Health. CDC MedicalResearch.com: What is the background for this study? Response: Since first entering the U.S. marketplace in 2007, e-cigarettes have been a rapidly evolving product class. Typically, national surveys provide annual, self-reported estimates of e-cigarette use among adults and youth. However, given the dynamic nature of the e-cigarettes landscape, data collected at a sub-annual level can be useful for identifying rapid changes and patterns. For example, retail sales data, which is available at more frequent intervals, such as weekly, can complement annual surveys and help keep a pulse on emerging trends. This study assessed e-cigarette retail sales data in the United States from 2013 through 2017. (more…)
Author Interviews, Heart Disease, Technology / 04.10.2018

MedicalResearch.com Interview with: Waqaas Al-Siddiq Founder and CEO of Biotricity Inc MedicalResearch.com: In light of Apple's announcement that it will incorporate an EKG monitoring device into Apple watches in the near future, would you discuss your vision of the growing medical wearables market?  Response: First of all, the public is still largely confused as to what constitutes a medical wearable device. Apple’s new watch, with its EKG monitoring service, is not a medical wearable because it will not produce clinical-grade data needed for diagnosis or treatment. This is not to say that Apple’s watch isn’t helpful. Many people are not even aware that they have a heart problem, but if their Apple watch consistently tells them that they have an irregular heart rhythm, or arrhythmia, they could take that as a sign to go to a physician and get a professional diagnosis. A physician will then prescribe a medical wearable device, such as our Bioflux, to monitor the patient’s heart rhythm. Medical-grade wearable devices produce clinical-grade data that is accurate to within 90-95 percent or higher and are prescribed by physicians to make diagnoses and treatment plans. That being said, I envision that the medical wearables market will expand considerably with the advent of consumer-based wearables that facilitate health tracking. One of the biggest problems we have today is a lack of awareness. Anywhere between 2.7 and 6.1 million people in the U.S. suffer from atrial fibrillation - a condition that makes the heart beat irregularly - and many aren’t aware that they have the condition. Consumer-based health trackers like the Fitbit and the Apple Watch can help raise awareness and alert consumers to possible health issues, which will encourage them to see a physician for a thorough and professional examination and diagnosis. This, in turn, gives the medical wearable market a boost as more people will be diagnosed with the aid of a medical wearable. Another factor that is playing into this adoption trend is that next-generation medical wearables are increasingly becoming smaller and easier to use for both patients and physicians. So, I think that the future of medical wearables will see them firmly entrenched in mainstream practice and eventually become tools within the home for individuals with chronic issues.  (more…)
Author Interviews, JAMA, Neurology, Outcomes & Safety, Parkinson's, Pharmacology, University of Pennsylvania / 04.10.2018

MedicalResearch.com Interview with: Allison W. Willis, MD, MS Assistant Professor of Neurology Assistant Professor of Biostatistics and Epidemiology Senior Fellow, Leonard Davis Institute Senior Scholar, Center for Clinical Epidemiology and Biostatistics University of Pennsylvania School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was motivated by my own experiences as a neurologist-neuroscientist. I care for Parkinson disease patients, and over the year, have had numerous instances in which a person was taking a medication that could interact with their Parkinson disease medications, or could worsen their PD symptoms. (more…)
Author Interviews, NEJM, Osteoporosis / 04.10.2018

MedicalResearch.com Interview with: Prof Ian Reid Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with less marked bone loss (referred to as osteopenia) is unknown. Most fractures in postmenopausal women occur in osteopenic patients, so therapies with efficacy in osteopenia are needed. (more…)
Author Interviews, Clots - Coagulation, Critical Care - Intensive Care - ICUs, NEJM / 04.10.2018

MedicalResearch.com Interview with: Alex C Spyropoulos, MD, FACP, FCCP, FRCPC Professor of Medicine – The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Professor - The Center for Health Innovations and Outcomes Research - The Feinstein Institute for Medical Research System Director – Anticoagulation and Clinical Thrombosis Services Northwell Health at Lenox Hill Hospital New York, NY 10075 MedicalResearch.com: What is the background for this study? Response: Hospitalised medically ill patients have a significant risk of developing venous thromboembolism (VTE) within 6 weeks after discharge. The role of extended thromboprophylaxis in this population with either low molecular weight heparin or the direct oral anticoagulants remains uncertain, as it has shown either excess bleeding or beneficial effects mainly from reducing asymptomatic deep vein thrombosis (DVT). The MARINER trial was designed to compare rivaroxaban with placebo for the prevention of the composite outcome of symptomatic VTE and VTE-related death in medically ill patients at increased risk of VTE post-hospital discharge. The principal safety objective was major bleeding. The trial was a randomized, double-blind, placebo-controlled, event-driven study that included a total of 12,024 patients aged ≥40 years who had been hospitalised with an acute medical illness for 3-10 consecutive days and had additional VTE risk factors as defined by the modified IMPROVE VTE risk score of ≥4 or a score of 2 or 3 plus a plasma D-dimer level more than twice the upper limit of normal). The rivaroxaban regimen consisted of 10 mg once daily in patients with a creatinine clearance (CrCl) of >=50ml/min or 7.5 mg for patients with a CrCl of 30 to <50 ml/min. The first dose was given on the day of discharge and the last dose at Day 45. Patients were followed up for an additional 30 days. Baseline characteristics were well matched between groups and typical of a medically ill population. (more…)
Author Interviews, Rheumatology / 03.10.2018

MedicalResearch.com Interview with: Virginia Ladd, CEO   American Autoimmune Related Disease Association (AARDA) MedicalResearch.com: Would you briefly explain what is meant by autoimmune disorders? Response: Autoimmune disease is a broad category of related diseases which share both genetic and mechanistic properties.  They occur when the person’s immune system attacks the body’s own cell, and tissue. The immune system goes awry and mistakenly attacks the tissues and organs it was designed to protect. Normally the immune system protects the It does this by body by responding to invading microorganisms, such as bacteria, and viruses. Producing antibodies which are special proteins that recognize and destroy the invaders. Autoimmune diseases occur when autoantibodies attack the body’s own cells, tissue and organs. (more…)
Author Interviews, Health Care Systems, Psychological Science / 03.10.2018

MedicalResearch.com Interview with: Professor Mary Dixon-Woods Director, The Healthcare Improvement Studies Institute (THIS Institute) University of Cambridge  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The challenges around employee voice are well documented. For various reasons, employees in all industries are often reluctant to raise concerns when they witness disruptive or unsafe behaviour from their colleagues. But it’s crucial that they speak up – especially in healthcare. Patient safety may depend on it. Our study focused on a large academic medical centre in the US that wanted to improve employee voice. Despite having reporting mechanisms in place, the organisation still had issues with disruptive behaviour from group of powerful senior individuals that went unchallenged and contributed to a culture of fear. Through confidential interviews with 67 frontline staff and leaders and the organizational actions that followed, we learned it’s important for employees to feel that their concerns will be dealt with authentically. It also helps when healthcare organisations have clear definitions of acceptable and unacceptable behaviour and well-coordinated response mechanisms. Once someone does raise a concern, organizations need good, fair and transparent systems of investigations and be prepared to implement consequences for disruptive behaviour consistently.  (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA, NIH, Nutrition, Race/Ethnic Diversity, Salt-Sodium / 03.10.2018

MedicalResearch.com Interview with: Dr. George Howard DPH, for the research team Professor and Chair of Biostatistics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Perhaps the most important distinction to draw for the readers is that this is not a paper about risk factors for hypertension, but rather a paper that looks for contributors to the black-white difference in the presence of hypertension.  This racial difference in hypertension is the single biggest contributor to the immense disparities in cardiovascular diseases (stroke, MI, etc.) that underpin the approximate 4-year difference in black-white life expectancy.  As such, this work is “going back upstream” to understand the causes that lead to blacks having a higher prevalence of hypertension than whites with hopes that changing this difference will lead to reductions in the black-white disparities in cardiovascular diseases and life expectancy.   This difference in the prevalence of hypertension is immense … in our national study of people over age 45, about 50% of whites have hypertension compared to about 70% of blacks … that is HUGE.   We think that changing this difference is (at least one of) the “holy grail” of disparities research. This study demonstrates that there are several “targets” where changes could be made to reduce the black-white difference in hypertension, and thereby the black-white difference in cardiovascular diseases and life expectancy; however, the most “potent” of these appears to be diet changes.   Even though we know what foods promote a heart healthy lifestyle, we still have major differences in terms of how that message is being adopted by various groups of Americans.  We can’t know from our data what about the Southern diet is driving these racial differences in hypertension but we can begin to design community based interventions that could possibly help to reduce these racial disparities through diet.  It is interested that diet more than being overweight was the biggest contributor to the racial disparities in hypertension.  This would suggest we might want to consider interventions to increase health foods in the diet while minimizing fried foods and processed meats. While this is not a clinical trial that “proves” that changes in diet will reduce the disparity in blood pressure, we consider the “message” of the paper to be good news, as the things that we found that contribute to this black-white difference are things that can be changed.   While it is always hard for individual people to change their diet, it can be done.   More importantly, over time we as a society have been changing what we eat … but we need to “double down” and try to change this faster.   Also, policy changes of play a role to gently make changes in these diet, where for example Great Britain has been making policy changes to slowly remove salt from the diet.   These changes are possible … and as such, we may see a day when the black-white differences in hypertension (and thereby CVD and death) may be reduced.  (more…)
Accidents & Violence, Alcohol, Author Interviews / 03.10.2018

MedicalResearch.com Interview with: Pamela Trangenstein, PhD While  a predoctoral fellow at Johns Hopkins Bloomberg School of Public Health's Center on Alcohol Marketing and Youth (CAMY)  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Research repeatedly shows that alcohol outlet density (the number of businesses that sell alcohol in an area) is associated with violent crime, but studies disagree about whether alcohol outlets that are on premise (e.g., bars, restaurants) or off premise (e.g., liquor stores, beer and wine stores) have a stronger association with violent crime. We used advanced methods that consider both the number of alcohol outlets and their locations to better understand how the association between alcohol outlets and violent crime differs by type of outlet. We found that alcohol outlets that allow off-premise sales like liquor stores had a stronger association with homicide, aggravated assault, and robbery than on-premise outlets like bars and restaurants. We also found that disadvantaged neighborhoods had higher access to the types of alcohol outlets associated with the most harms: off-premise outlets.  (more…)
Author Interviews, JAMA, Orthopedics, Surgical Research / 03.10.2018

MedicalResearch.com Interview with: "Meniscus adalah tisu/rawan berbentuk huruf C yang berfungsi mencegah dua tulang bergesel di antara satu sama lain di bahagian lutut. Tisu meniscus yang koyak berpunca kebiasaannya daripada bersukan yang melibatkan pergerakan lutut yang banyak. Warga emas" by Rawatan Alternatif Shah Alam is licensed under CC BY 2.0 Victor A. van de Graaf, MD OLVG Ziekenhuis Amsterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although meniscal surgeries are among the most frequently performed surgical procedures in orthopedic surgery, until just recently there were hardly any randomized trials proving its superiority over conservative treatment. In this randomized clinical trial, including 321 patients with non-obstructive (e.g. no locking of the knee joint) meniscal tears, we found physical therapy non-inferior to arthroscopic partial meniscectomy.  (more…)
Author Interviews, Endocrinology, JAMA, Thyroid Disease / 02.10.2018

MedicalResearch.com Interview with: thyroid-gland-wikipediaDr. med. Martin Feller, MSc Epidemiology (LSHTM) FMH Allgemeine Innere Medizin & Prävention und Gesundheitswesen Scientific Research Coordinator INSELSPITAL, Universitätsspital Bern Universitätsklinik und Poliklinik für Allgemeine Innere Medizin (RodondiResearch) MedicalResearch.com: What is the background for this study? What are the main findings? Response: SUBCLINICAL HYPOTHYROIDISM IS VERY COMMON, WITH AN ESTIMATED 13 MILLION AMERICANS AFFECTED. SUBCLINICAL HYPOTHYROIDISM IS OFTEN TREATED WITH LEVOTHYROXINE, PARTICULARLY WHEN IT CO-OCCURS WITH SYMPTOMS POTENTIALLY ATTRIBUTABLE TO HYPOTHYROIDISM SUCH AS TIREDNESS, CONSTIPATION, AND UNEXPLAINED WEIGHT GAIN. THIS PRACTICE MAY CONTRIBUTE TO LEVOTHYROXINE BEING THE MOST PRESCRIBED DRUG FROM 2014 ONWARDS IN THE US. HOWEVER, IN OUR META-ANALYSIS OF 21 RANDOMIZED CLINICAL TRIALS, WE OBSERVED NO BENEFIT OF LEVOTHYROXINE THERAPY (COMPARED TO PLACEBO) REGARDING GENERAL QUALITY OF LIFE, THYROID-RELATED SYMPTOMS, DEPPRESSIVE SYMPTOMS, FATIGUE, COGNITIVE FUNCTION, BLOOD PRESSURE OR BODY-MASS INDEX.  (more…)
Author Interviews, Primary Care, Respiratory, Telemedicine / 02.10.2018

MedicalResearch.com Interview with: Dr. Kathryn A. Martinez PhD MPH CanSORT Cancer Surveillance and Outcomes Research Team Cleveland Clinic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most upper respiratory infections are viral and therefore should not be treated with antibiotics. Despite this, physicians commonly prescribe them for these conditions. Patients often expect antibiotics for respiratory tract infections.  As a result, physicians may find it easier to give patients what they want rather than explain to them why antibiotics aren’t needed. We hypothesized it also might be more time consuming for physicians to explain to patients why they don’t need antibiotics, which creates a further incentive to prescribe them. To explore this potential phenomenon, we used data from a large direct to consumer telemedicine system to assess differences in medical encounter length by prescription outcome for patients diagnosed with respiratory tract infections. We found that encounters resulting in antibiotics were 0.33 minutes shorter than those that resulted in no prescriptions, supporting our hypothesis that prescribing an antibiotic takes less time than prescribing nothing. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease, JACC / 02.10.2018

MedicalResearch.com Interview with: Scott David Solomon, MD Director, Noninvasive Cardiology Professor, Harvard Medical School Brigham and Women's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The sodium glucose transport proteins are known to be important in regulating uptake of glucose. SGLT-1 is predominantly located in the gut and is responsible for uptake of glucose and galactose in the small intestine. Individuals born with severe mutations of this gene have severe malabsorption syndrome. We looked at genetic variants that lead to reduced function of the protein, but not complete loss of function, in a large cohort of individuals in the NIH funded Atherosclerosis Risk in Communities Study. We found that those with mutations in the gene had reduced glucose uptake, as measured by an oral glucose tolerance test, as well as less obesity, diabetes, heart failure and death. (more…)
Author Interviews, Pediatrics, Sexual Health / 02.10.2018

MedicalResearch.com Interview with: Laura M. Padilla-Walker, PhD Professor, School of Family Life Associate Dean, College of Family, Home, and Social Sciences Brigham Young University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The current study included approximately 500 teens that we followed for 8 years starting at approximately age 14. In this particular study, we explored how parent-child sex communication regarding sexual safety changed from ages 14-18, and then how this change was associated with children’s sexual outcomes at age 21. Though we would hope and expect that parents would discuss sexual safety with their children at increasing levels as children age, findings from this study suggested low and unchanging levels of parent-child sex communication over time. In other words, parents are talking very little to their children about sexual safety, and how much they talk to children isn’t changing from age 14 to 18. In addition, mothers reported significantly higher levels of sex communication than did children and fathers, suggesting that mothers think they talk about sexuality more than children think they do. Though this is an issue of perception, what the child perceives is generally a more important predictor of positive outcomes. Mothers also reported talking with their sons less than their daughters, though sex communication with sons increased over time and by age 18 mothers reported the same (relatively low) levels of sex communication with both daughters and sons. That being said, initial levels and positive change in parent-child sex communication was associated with safer sex at age 21, suggesting that parents SHOULD talk with their children more and at increasing levels over time, because these factors are associated with positive child outcomes. (more…)
Author Interviews, JAMA, Urinary Tract Infections, Urology, UT Southwestern / 02.10.2018

MedicalResearch.com Interview with: "Glass of Water" by Iwan Gabovitch is licensed under CC BY 2.0Professor Yair Lotan MD Chief of Urologic Oncology Holder of the Helen J. and Robert S. Strauss Professorship in Urology UT Southwestern Medical Center at Dallas Department of Urology Dallas, Texas 75390-9110  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Urinary tract infections are extremely common in women and many women experience recurrent episodes which impact their quality of life.  There are also many women who do not drink as much water as is recommended. This study found that in healthy women with recurrent UTIs who drink less than 1.5 liters per day, the additional intake of 1.5 liters of water daily reduced the risk of recurrent infections by nearly 50%.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics / 01.10.2018

MedicalResearch.com Interview with: Matthew D. Weaver, PhD Instructor in Medicine · Harvard Medical School Associate Epidemiologist · Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response: We were interested whether high school students who tended to sleep less than 8 hours per night reported more risk-taking behaviors compared to high school students who slept at least 8 hours per night on a school night. We utilized a nationally representative dataset from the CDC of surveys that were completed by high school students between 2007 and 2015. Over that time, approximately 67,000 students were surveyed. Students were asked about the hours of sleep that they obtained on an average school night. They were also asked how often, in the month prior to the survey, they engaged in a number of risk-taking behaviors. Some behaviors were related to driving, like driving without a seatbelt or driving drunk, while others were related to using alcohol, doing drugs, or being involved in a fight. They were also asked about their mood, including whether they felt sad or hopeless, considered suicide, and whether they had attempted suicide.  (more…)
AACR, Author Interviews, Cancer Research, MD Anderson, University Texas / 01.10.2018

MedicalResearch.com Interview with: Filip Janku, MD, PhD Associate Professor, Investigational Cancer Therapeutics (Phase I Clinical Trials Program) Center Medical Director, Clinical and Translational Research Center The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium novyi-NT is an attenuated strain of bacteria Clostridium, which induced a microscopically precise, tumor-localized response in a rat brain tumor model and in companion dogs bearing spontaneous cancers. Clostridium novyi-NT can only grow in hypoxic (low-oxygen) tumor environment and destroys cancer cells by secreting lipases, proteases, and other hydrolytic enzymes; recruiting inflammatory cells to tumors eliciting anti-tumor immune responses in animals. Furthermore, intratumoral injection can plausibly induce an immune mediated abscopal effect in non-injected tumor sites. Therefore, we designed a phase I dose-finding study to test for safety and tolerability of the single intratumoral injection of Clostridium novyi-NT in 24 patients with advanced cancers with no available standard therapies. We also designed experiments to study activation of antitumor immune response in blood and tumor samples from patients undergoing the therapy. We demonstrated that single dose of intratumoral injection of Clostridium novyi-NT is feasible and has led to significant destruction of injected tumor masses. Adverse events, which were often related to the tumor destruction at the infected site, could have been significant but mostly manageable. Correlative studies of pre-treatment and post-treatment tumor and blood samples suggested immune response to therapy. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Social Issues / 30.09.2018

MedicalResearch.com Interview with: Sage J. Kim, PhD Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers. Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes. (more…)
Author Interviews, Cancer Research, HPV, UCLA / 28.09.2018

MedicalResearch.com Interview with: Manon Eckhardt, PhD Gladstone Institutes The Quantitative Biosciences Institute University of California San Francisco  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infection with Human Papillomavirus (HPV) causes 5% of all cancers worldwide, including cervical cancer and an increasing number of head and neck cancers. Most cancers are caused by mutations in genes, leading to the production of malfunctioning proteins that result in unconstrained cell division. However, certain viruses like HPV can cause cancer without introducing mutations. In this study, we compared cancers of the same type (i.e. head and neck) that are caused by either mutation or virus infection to identify important processes that are dysregulated in both subsets. We hypothesized that identifying which proteins the virus binds can lead the way to prioritize which of the proteins and cellular processes (pathways) that are affected in cancer cells are most important. To do this, we identified the complete set of human proteins that interact with HPV. We next determined genes that were more frequently mutated in non-viral cancers, and combined both data sets. The proteins we find to be both binding to HPV and mutated in non-viral cancers will be potential targets for new, more specific drug development, and help better understand the development of head and neck cancer. From the many pathways we identified in this study, we highlighted two pathways with further mechanistic studies: the oxidative stress response, which helps cancer cells survive, as well as a pathway that allows the cancer to spread to other parts of the body. (more…)
Author Interviews, Genetic Research, Pediatrics / 28.09.2018

MedicalResearch.com Interview with: Barry M. Lester, PhD Center for the Study of Children at Risk Warren Alpert Medical School, Brown University Women and Infants Hospital of Rhode Island Providence, Rhode Island;  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from rodent studies that maternal care or nurturing behavior can change the rat pups physiologic response to stress. More nurturing behavior makes it easier for rat pups to relax after stress. Not only that, these changes are permanent, they last into adulthood and there is evidence that these changes can be passed on to the next generation. With animal studies you can unlock the mechanism for this in ways that you can’t do with humans and we know from the rodent studies that the mechanism for these changes has to do with changes in gene activity. Nurturing behavior controls a specific gene that regulates the infant’s physiological response to stress. In other words, we are looking at maternal behavioral programming of a gene that can make, in our case, a human infant less physiologically reactive to stress. The physiological reactivity to stress that we studied was the production of the stress hormone cortisol. Cortisol is part of the body’s flight or fight reaction, the body’s major response to stress and too much or too little cortisol can be harmful and is related to a wide range of mental and physical health disorders in children and adults. The concerns about separating immigrant children from their parents that we read about every day in the paper are based on this same physiological system, where brain structures that control cortisol production are damaged by the stress of separation.  (more…)
Author Interviews, End of Life Care, Hearing Loss, JAMA / 28.09.2018

MedicalResearch.com Interview with: Tae-Min Rhee, M.D. Chief of Undersea and Diving Medicine, Underwater Medical Institute, National Maritime Medical Center, Republic of Korea Navy, Changwon Republic of Korea MedicalResearch.com: What is the background for this study? Response: The sudden sensorineural hearing loss (SSNHL) has an incidence of 5 to 20 per 100,000 person-years in the general population and sometimes results in permanent deafness followed by considerable socio-economic costs. The causes of SSNHL are often unclear, and in these cases there are no treatment of choice that is proven to be effective. In addition, spontaneous recovery is not uncommon in SSNHL, making it difficult to predict the natural course of the disease, and thus a well-controlled clinical trial is rare in spite of its clinical significance. Many treatment options (systemic or intratympanic steroids, antiviral agents, vasodilators, and hyperbaric oxygen therapy) have been suggested and tried to date, but only systemic steroid therapy has been the most effective among them. However, for the cases with contraindications to steroids, or steroid-refractory SSNHL, there is paucity of information on the second line treatment option. Hyperbaric oxygen therapy (HBOT), i.e., high-pressurized oxygen therapy, is a method of treating patients within a chamber saturated with 100% oxygen maintained at a high pressure of 2.0 to 2.5 atm. Cochlea is an organ that relies more on the diffusion of oxygen than the direct vascular supply, and thus it is known to be vulnerable to ischemia. Since this is suggested as one of the main pathophysiology of SSNHL, we wanted to prove the hypothesis that, by providing high-pressure oxygen, the partial pressure of oxygen delivered to the inner ear is maximized, and the additional or complementary therapeutic effects can be observed. A number of reports have been published for 20 years, but there is no systematically organized evidence except a Cochrane Review in 2012. Therefore, our research team tried to integrate the evidence through a comprehensive meta-analysis and to provide important clues for further research.  (more…)
Author Interviews, Heart Disease, JAMA, University of Pittsburgh / 27.09.2018

MedicalResearch.com Interview with: Masashi Okubo, MD. Clinical Instructor of Emergency Medicine Research Fellow Department of Emergency Medicine University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Out-of-hospital cardiac arrest (OHCA) is a major public health problem, annually affecting over 350,000 individuals in the US with low survival rate, 11.4% among those who were treated by emergency medical services (EMS). Prior studies showed a 5-fold difference (3.0% to 16.3%)  in survival to hospital discharge between 10 study sites in North America (US and Canada) and 6.5-fold difference (3.4% to 22.0%) between 132 US counties after OHCA. However, it was unclear how much patient outcome after OHCA differ between EMS agencies which play a critical role in OHCA care. Among 43,656 adults treated for Out-of-hospital cardiac arrest by 112 EMS agencies in North America, we found that survival to hospital discharge differed from 0% to 28.9% between EMS agencies. There was a median difference of 56% in the odds of survival to hospital discharge for patients with similar characteristics between any 2 randomly selected EMS agencies, after adjusting for known measured sources of variability. (more…)
Author Interviews, BMJ, Heart Disease / 27.09.2018

MedicalResearch.com Interview with: Professor Prash Sanders Director, Centre for Heart Rhythm Disorders NHMRC Practitioner Fellow, Knapman-NHF Chair of Cardiology Research, University of Adelaide | SAHMRI Director, Cardiac Electrophysiology & Pacing, Royal Adelaide Hospital MedicalResearch.com: What is the background for this study? Response: CLINICALLY WE HAVE HAD SOME PATIENTS WHO HAVE SURVIVED SUDDEN DEATH EPISODES AND HAVE NOTED THAT THEY HAD MITRAL VALVE PROLAPSE. THIS STIMULATED US TO UNDERTAKE A REVIEW OF THE LITERATURE. (more…)