Author Interviews, Cancer Research, Gastrointestinal Disease, Microbiome, Science / 27.09.2018

MedicalResearch.com Interview with: Joao Xavier PhD Associate Faculty Member | Computational & Systems Biology Memorial Sloan Kettering Cancer Center New York, NY 10065  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections. We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival. We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.  (more…)
Addiction, Author Interviews, Clots - Coagulation, NEJM / 27.09.2018

MedicalResearch.com Interview with: Dr. Amar Kelkar MD Clinical Fellow Division of Hematology & Oncology, Department of Medicine University of Florida College of Medicine, UF Health Shands Hospital MedicalResearch.com: What is the background for this study? What are synthetic cannabinoids? Response: Starting in March 2018, patients began reporting to hospitals and clinics with unexplained and prolonged bleeding symptoms, first in Chicago, Illinois, and then spreading to Peoria, Illinois and elsewhere. This gained a lot of press because the initial identifying factor was that all the patients had reported recent use of synthetic cannabinoids. As the matter was studied further, it was determined that these patients were likely exposed to an anticoagulant poison mixed in with the synthetic cannabinoids. Synthetic cannabinoids are lab-derived illicit drugs that target the cannabinoid receptors that are also targeted by marijuana. They go by many names including synthetic marijuana, K2, and Spice. (more…)
Author Interviews, Dermatology, Gender Differences, JAMA, Race/Ethnic Diversity, Social Issues / 27.09.2018

MedicalResearch.com Interview with: Raghav Tripathi, MPH Case Western Reserve University MD Candidate, Class of 2021 MedicalResearch.com: Why did you decide to perform this study? Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum. The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country.  (more…)
ALS, Author Interviews, Pharmaceutical Companies / 27.09.2018

MedicalResearch.com Interview with: RetrotopeRobert J Molinari, Ph.D. President and CEO Retrotope, Inc.   MedicalResearch.com: What is the background for this study? How does RT001 differ from other treatments for neurodegenerative diseases?  Response: Lipid peroxidation in critical cell and mitochondrial membranes represents a common pathway of cell death in many neurodegenerative diseases, regardless of the initiating trigger of original damage, e.g. aberrant gene expression, misfolded proteins such as tau and amyloid, environmental insults, etc. This hypothesis was supported by work showing that stabilizing lipids (using virtually indistinguishable isotopic variants of the original dietary molecules) was able to mitigate disease-related cell dysfunction, and reverse disease in a variety of animal models, and more recently, in human patients enrolled in clinical trials. It has been known for decades that lipid peroxidation detritus of oxidized membrane fats are present in most all diseases of degeneration and aging, including Alzheimer’s disease, Parkinson’s disease, atherosclerosis, ALS, Huntington’s, and fatal inborn genetic errors resulting in neurodegenerative diseases (among others). The hypothesis that controlling such oxidation could provide therapeutic benefit was abandoned when numerous formal trials of classical antioxidants, e.g. Co-enzyme Q, Vitamin E, and others failed to provide meaningful benefit. We believed that the antioxidant mechanism used to attempt control of the membrane oxidation was flawed, but that the target itself was correct. Indeed, by using a new class of oral drugs that are lipids fortified against damage at the key susceptible bonds, we observed reduction in lipid peroxidation damage that halted, and even reversed neurodegenerative disease progression. Dosed in amounts and forms similar to omega 3 and 6 supplements, these drugs exhibited profound disease modification across a broad range of diseases in animal models, placebo controlled- and open label- human trials. (more…)
Author Interviews, CDC, Infections / 26.09.2018

MedicalResearch.com Interview with: "Siberian Husky Puppies 2013-05-25" by Jeffrey Beall is licensed under CC BY 2.0Mark Laughlin, DVM Veterinary Medical Officer CDC MedicalResearch.com: What is the background for this study? How common are Campylobacter infections?  How does a Campylobacter infection typically present?  Response: Campylobacter is one of the most common causes of diarrheal illness in the United States, causing an estimated 1.3 million illnesses each year. Most people with Campylobacter infection usually have diarrhea (often bloody), fever, and abdominal cramps. The diarrhea may be accompanied by nausea and vomiting. These symptoms usually start within 2 to 5 days after exposure and last about a week. Most illnesses from Campylobacter likely occur due to eating raw or undercooked poultry, or from eating something that touched raw or undercooked poultry. Some illnesses can occur from contact with contaminated water, contact with animals, or from drinking raw (unpasteurized) milk. Since 2009, 13 outbreaks of human Campylobacter infections linked to contact with dogs have been reported to CDC. These outbreaks account for a reported 47 illnesses and 2 hospitalizations. (more…)
Author Interviews, Microbiome / 26.09.2018

MedicalResearch.com Interview with: Pushpa Pandiyan, PhD Assistant Professor, Biological Sciences School of Dental Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective was to find the role of the resident bacteria in the mouth in controlling oral immunity. We examined this in a oral fungal infection model. How resident microbiome in the mouth maintains a healthy oral immune system was unknown before. We found that antibiotics led to destruction of microbiome and some of the good fatty acids the bacteria produced. This created an immune imbalance in the local tissue, thus making the host more susceptible to the fungal infection.  (more…)
Author Interviews, Psychological Science, Weight Research / 26.09.2018

MedicalResearch.com Interview with: Dr Linda Solbrig PhD University of Plymouth MedicalResearch.com: What is the background for this study? Response: Diets are restrictive; they work in the short-term, but re-gain is common. Individuals trying to manage their weight find that motivation fades over time and that this is the hardest part about maintain a healthy weight. When given choice to self-set goals we are much more likely to stick with them; they are more sustainable and we can succeed long-term. Using multi-sensory mental imagery supports motivation to change in the long run and also the opportunity to test out in our imagination if the actions we decided will lead to personal goal success actually fit with our lives, or whether we need to tweak, or even change them. Functional Imagery Training (FIT) is based on two decades of research showing that mental imagery is more strongly emotionally charged than other types of thought and that it can directly interfere with unwanted food cravings. It uses multi-sensory mental imagery to strengthen people’s motivation and confidence to achieve their own goals, and teaches people how to do this for themselves, so they can stay motivated even when faced with challenges. It is not about creating a static picture, but encourages the use of all our senses, how a situation may feel, seeing with the mind’s eye and hearing with the mind’s ear and so on, creating a mini movie in our minds where we are the lead actors working on our personal goals, overcoming adversity and succeeding.  (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 26.09.2018

MedicalResearch.com Interview with: Thomas J Moore AB Senior Scientist Institute for Safe Medication Practices Lecturer, Department of Epidemiology and Biostatistics The George Washington University Milken Institute of Public Health Alexandria, VA 22314 MedicalResearch.com: What is the background for this study? What are the main findings?
  • The study provides realistic cost estimates of pivotal clinical trials that establish drug benefits to support FDA approval of 59 new drugs released for marketing in 2015-2016.
  • The median estimated cost was just $19 million, with half of the 138 trials studied clustered between $12 million and $33 million.
  • The highest cost trials–with estimates up to $345 million–were for new drugs that were similar to drugs already available and already proven in treating serious illnesses. 
(more…)
Author Interviews, Autism, Education, Exercise - Fitness, Pediatrics / 26.09.2018

MedicalResearch.com Interview with: Dr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming ProjectDr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming Project MedicalResearch.com: What is the background for this study? Response: The research group first started to examine rock drumming from a scientific perspective in 1999 through collaboration with Clem Burke, drummer with the iconic band ‘Blondie’. In 2008 the Clem Burke Drumming Project (CBDP) was formed (visit clemburkedrummingproject.org for further information) where academics from different disciplines came together to not only explore the physiological demands of rock drumming but also the potential use of rock drumming as an intervention in research studies. Rock drumming is attractive to the scientist in that it is a unique activity that requires the coordination of multiple limbs to produce the required drumming pattern. Inherent demands relating to timing, tempo and volume must also be met. Therefore, the ability to manipulate these facets of drumming performance in a research setting is very appealing. In relation to potential research populations drumming has a universal fascination regardless of age, gender, culture, language competency and ethnicity. Anecdotal evidence suggests that drumming is a ‘cool’ activity that has a unique ‘language currency’ in terms of stimulating communication within and between those who can and cannot play the drums. The impetus for our research study came from parents of autistic children contacting us to express their belief that drumming was having a positive effect on their child’s physical and psychological behaviour. A review of the literature showed a range of anecdotal evidence in support of such statements (Freidman 2000) and an increase in empirical drumming based research being undertaken (Bungay 2010). More recent studies have reported psychosocial benefits such as enhanced communication (Maschi et al. 2010; 2012), emotional processing and tension reduction (Flores et al. 2016; Maschi et al. 2010; 2012), group cohesion and connectedness (Blackett et al. 2005), concentration, psychomotor coordination and posture (Chen et al. 2017). The majority of this work was undertaken with adolescents with very little work focused on younger age groups. (more…)
Author Interviews, Dermatology, Eli Lilly / 25.09.2018

MedicalResearch.com Interview with: Lotus Mallbris, M.D., Ph.D., Vice president, Immunology Development Lilly Bio-Medicines  MedicalResearch.com: What is the background for this study? What are the main findings? Response: By exploring creative clinical approaches and patient-centric pathways to more thoroughly address the key aspects of treating these complex conditions, Lilly is bringing innovation forward in hopes of reducing the burden of dermatologic disease for people around the world. The results of the IXORA-S study suggest that Taltz may provide significantly greater clearance of nail psoriasis than ustekinumab. This is significant because nail lesions are a common feature of psoriasis. It’s often associated with discomfort, which can lead to functional impairment and distress, further supporting the importance of complete clearance.   (more…)
Author Interviews, Neurology, Pain Research / 25.09.2018

MedicalResearch.com Interview with: John Douglas Markman, M.D. Director, Translational Pain Research Program Department of Neurosurgery Professor University of Rochester School of Medicine and Dentistry  MedicalResearch.com: What is the background for this study? Response: Peripheral nerve injury after trauma and surgery is a leading cause of chronic pain and disability. These pain syndromes are often considered to have an underlying neuropathic mechanism because there is altered sensory processing (e.g., numbness, allodynia) at the site of trauma or surgical incision that localizes to the anatomic distribution of a peripheral nerve. A previous eight-week randomized clinical trial demonstrated efficacy for pregabalin in patients with chronic post-traumatic or -surgical pain.(10) The longer duration of treatment of this study was designed to meet the regulatory standard for a chronic pain indication in the US, 12 weeks of treatment at maintenance or fixed dosing. (more…)
Antibiotic Resistance, Author Interviews, Infections / 25.09.2018

MedicalResearch.com Interview with: "pseudomonas first bacteria to be patented. professor Chakrabarty" by adrigu is licensed under CC BY 2.0Dr Dorival Martins Department of Microbiology and Immunology Meakins-Christie Laboratories, Research Institute McGill University Health Centre Montreal Canada.  MedicalResearch.com: What is the background for this study? Response: Antibiotic tolerance, together with drug resistance, makes bacteria refractory to antibiotics and can cause treatment failure in subacute and chronic bacterial infections. Pseudomonas aeruginosa, a major health concern worldwide, can cause severe chronic infections that are refractory to antibiotic treatments due to tolerance. Since the discovery of new antibiotics has been drastically diminished over the last decades, overcoming tolerance could be a strategy to enhance the efficacy of currently available antibiotic treatments. However, very little is known about the mechanism of tolerance, even though this phenomenon has been observed over 60 years ago. (more…)
Author Interviews, Nutrition, Weight Research / 25.09.2018

MedicalResearch.com Interview with: Hana Kahleova, MD, PhD, MBA Director of Clinical Research Physicians Committee for Responsible Medicine Washington, DC 20016  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The effects of carbohydrates on body weight and insulin sensitivity are controversial. In this 16-week randomized clinical trial, we tested the role of carbohydrate quantity and quality, as part of a plant-based diet, on body weight, body composition, and insulin resistance. We have demonstrated that carbohydrates and dietary fiber play important roles in the regulation of body weight, body composition, and insulin resistance in overweight individuals. Increased consumption of total carbohydrate was associated with a decrease in BMI and volume of visceral fat, even after adjustment for energy intake. Increased consumption of total and particularly insoluble fiber was associated with a decrease in BMI, fat mass, and volume of visceral fat. (more…)
Author Interviews, Emory, JAMA, Orthopedics / 25.09.2018

MedicalResearch.com Interview with: Prof. David H. Howard PhD Department of Health Policy and Management Emory University Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a lot of skepticism that physicians respond to evidence, especially when trials report that widely-used, separately-reimbursed procedures are not effective. Physicians are reluctant to abandon treatments. This study shows that in the case of knee arthroscopy, evidence has made a difference. The use of knee arthroscopy declined by 23% in Florida between 2002 and 2015. This change occurred despite increases in the prevalence of osteoarthritis.  (more…)
Author Interviews, CMAJ, Cost of Health Care / 25.09.2018

MedicalResearch.com Interview with: "patient in hospital bed with nursing staff gathered around" by Penn State is licensed under CC BY-NC-ND 2.0Andrea Gruneir, PhD Department of Family Medicine University of Alberta Edmonton, AB Canada MedicalResearch.com: What is the background for this study? Response: Hospital readmissions – when a patient is discharged from hospital but then returns to hospital in a short period of time – are known to be a problem, both for the patients and for the larger health system. Hospital readmissions have received considerable attention and there have been a number of initiatives to try to reduce them, but with mixed success. Older adults are among the most vulnerable group for hospital readmission. Older adults are also the largest users of continuing care services, such as home care and long-term care homes (also known as nursing homes). Yet, few large studies have really considered how older adults with different pathways through hospital compare on the risk of hospital readmission. In our study, we take a population-level approach and use health administrative data to create a large cohort of older adults who were hospitalized in Ontario between 2008 and 2015. For each of the 701,527 patients in our study, we identified where they received care before the hospitalization (in the community or in long-term care) and where they received care after discharge (in the community, in the community with home care, or in long-term care).  (more…)
Author Interviews, Biomarkers, Ovarian Cancer / 25.09.2018

MedicalResearch.com Interview with: Fabian Coscia PhD Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, German and Ernst Lengyel MD PhD Department of Obstetrics and Gynecology Section of Gynecologic Oncology University of Chicago, Chicago, IL  MedicalResearch.com: What is the background for this study? Response: Ovarian cancer is a very aggressive disease. Only one in six patients survives more than 10 years after the first diagnosis. This high mortality is primarily because the disease is usually detected late in its course, when the tumor has already spread from the ovaries to the surrounding organs in the abdomen. In an interdisciplinary collaboration between the Max Planck Institute of Biochemistry in Martinsried, Munich, the University of Chicago and the University of Copenhagen, we performed deep tissue proteomics on archived biobank material to identify drivers of long-term patient survival.  (more…)
Author Interviews, Infections, Technology, Urinary Tract Infections / 24.09.2018

MedicalResearch.com Interview with: SMARTPHONE, M.D. A NEW APP TO DIAGNOSE URINARY TRACT INFECTIONS Michael J. Mahan PhD Professor, Microbiology and Molecular Genetics Dept of Molecular, Cellular, and Developmental Biology University of California, Santa Barbara, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Urinary tract infections (UTIs) cause nearly 10 million doctor visits each year in the United States. Women are much more likely to have a UTI than men, and are particularly harmful to pregnant women and can cause miscarriage. Thus, there is a medical need for rapid, low-cost, on-site testing — particularly in resource-limited settings. We developed a new app that enables a smartphone to identify (ID) bacteria causing UTIs in just one hour — a fraction of the time and cost of clinical diagnostics. (more…)
Author Interviews, Surgical Research / 24.09.2018

MedicalResearch.com Interview with: Maarten Persenaire, MD Co-founder, Chief Medical Officer TELA Bio MedicalResearch.com: What is the background for this study? What are the main findings? Response: OviTex Reinforced BioScaffolds (RBSs) are a novel distinct class of surgical implants that combine biologic and synthetic materials in a unique embroidered construction and design for hernia repair and soft tissue reconstruction. The two recent publications reported clinical results of OviTex RBS performance in inguinal and hiatal hernia repair. Case series published in the International Journal of Surgery Open evaluated the role of OviTex RBSs in inguinal hernia repair to reduce the incidence of chronic postoperative pain. Thirty-one consecutive patients who had inguinal hernia repaired with OviTex RBSs were followed for an average of 12.6 months, during which time there were no reported recurrences, complications requiring surgical intervention or infections. None of the patients reported postoperative inguinal pain beyond the first days after surgery and none required a narcotic pain medication refill. The second study published in the Journal of the Society of Laparoendoscopic Surgeons is the first reported series describing the use of OviTex RBSs in hiatal hernia repair. A retrospective chart review of 25 consecutive patients undergoing laparoscopic or open hiatal hernia repairs with mean follow-up of 14.2 months showed no recurrences. The hiatal hernia repairs with OviTex RBSs resulted in good to excellent control and resolution of symptoms, including heartburn, dysphagia, regurgitation, nausea and vomiting, dyspnea, and chest pain or discomfort.  (more…)
Author Interviews, Brain Injury, CDC, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: Juliet Haarbauer-Krupa, PhD Senior Health Scientist Division of Unintentional Injury Prevention CDC MedicalResearch.com: What is the background for this study?
  • Traumatic brain injury in children results in a large number of emergency department visits each year and can result in long term difficulties
  • The purpose of this study was to estimate lifetime prevalence of TBI in children based on a nationally representative sample of U.S. parents/adults and to describe the association between TBI and other childhood health conditions.
  • CDC researchers examined the National Survey of Children’s Health, a cross-sectional telephone survey of U.S. households, to provide a national estimate of TBI in children.
(more…)
Abuse and Neglect, Addiction, Author Interviews, CDC, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: Michelle M Johns, MPH, PhD Health Scientist Division of Adolescent and School Health CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender nonconformity is an under-researched area of adolescent health that is often linked to negative health outcomes. To address this gap, we analyzed Youth Risk Behavior Survey data to describe the associations between gender nonconformity and risk behaviors, including mental distress, and substance use. Gender nonconformity was associated with feeling sad and hopeless, as well as suicidal thoughts and/or behaviors among female and male students. In addition, gender nonconformity was strongly associated with substance use among male students. (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, JAMA, Pediatrics / 24.09.2018

MedicalResearch.com Interview with: Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine he University of Alabama at Birmingham Birmingham Alabama 35249 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma.  Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment. In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination.  If none of these risk factors are present, a CT scan is not indicated. If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated. If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression. In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain.  The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation. In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician.  Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit. (more…)
Author Interviews, Exercise - Fitness, JAMA, Neurology, Parkinson's / 23.09.2018

MedicalResearch.com Interview with: Fudi Wang, M.D., Ph.D. Qiushi Chair Professor Nutrition Discovery Innovation Center School of Public Health/School of Medicine Zhejiang University Hangzhou 310058, ChinaFudi Wang, M.D., Ph.D. Qiushi Chair Professor Nutrition Discovery Innovation Center School of Public Health/School of Medicine Zhejiang University Hangzhou  China MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parkinson disease (PD) is the second most common neurodegenerative disease affecting approximately 10 million people around the world. To date, the cause of PD remains poorly understood. It is reported that 90% PD cases have no identifiable genetic cause. What’s worse, few therapeutic advances for the treatment of PD have been made in the past decades. Nevertheless, growing prospective longitudinal studies shed lights on the potential beneficial effect of lifestyle factors on reducing the risk of developing Parkinson disease. In this study, we performed a a dose-response meta-analysis of more than half a million participants. We found that physical activity, particularly moderate to vigorous physical activity, could significantly reduce PD risk. (more…)
Author Interviews, Endocrinology, Pediatrics, Race/Ethnic Diversity / 23.09.2018

MedicalResearch.com Interview with: Julie Flom, MD MPH Clinical Fellow Division of Allergy & Immunology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study?   Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants.  Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted. Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant. (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA, Yale / 22.09.2018

MedicalResearch.com Interview with: Michael F. Murray, MD, FACMG, FACP Director for Clinical Operations in the Center for Genomic Health Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: Population screening for the cancer risk associated with the BRCA1 and BRCA2 genes has been suggested by some.  We screened a cohort of about 50,000 adult patient volunteers at Geisinger Health System in Pennsylvania for this risk.  (more…)
Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 22.09.2018

MedicalResearch.com Interview with: Eyal Cohen, MD, MSc, FRCP(C) Associate Scientist and Program Head (interim), Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children Professor, Paediatrics and Health Policy Management & Evaluation The University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Having a child with a major birth defect can be a life-changing and stressful event for the child's mother.  This stress may be associated with higher risk of premature cardiovascular disease. We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers.  The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child. (more…)
Author Interviews, Endocrinology, JAMA, Prostate Cancer, UCLA / 22.09.2018

MedicalResearch.com Interview with: Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Three large randomized trials demonstrated an overall survival (OS) benefit when androgen deprivation therapy (ADT) is combined with radiotherapy (RT) for high-risk prostate cancer (PCa). The duration of ADT in these seminal studies ranged from six months to lifelong. Because ADT has multiple attendant adverse effects--including bone loss, altered metabolism, diminished muscle mass, gynecomastia, hot flashes, and possibly increased cardiovascular events--shortening the duration of ADT without compromising oncologic effectiveness has been an area of active study. Five trials have compared various durations of ADT, reaching conflicting conclusions with respect to overall survival outcomes, with some suggesting an improvement with longer durations of ADT and others failing to show a uniform survival benefit. Most of these trials have amalgamated Gleason grade group 4 (Gleason score 8) PCa with Gleason grade group (GG) 5 (Gleason score 9-10) PCa. Emerging data indicate that GS 9-10 PCa constitutes a distinct subset of high-risk PCa with inferior outcomes and earlier progression than GS 8 disease. With the knowledge that GS 9-10 PCas constitute a distinct, more aggressive form of PCa, one might hypothesize that longer durations of ADT may be more advantageous in both augmenting local control and controlling potential micrometastatic disease. Alternatively, as GS 9-10 lesions by definition contain highly de-differentiated Gleason pattern 5 disease foci and may proceed to a castrate-resistant state more rapidly, one may also hypothesize that GS 9-10 lesions are less responsive to ADT, and longer durations may be counter-productive. In order to identify differences in the impact of ADT duration on clinical outcomes of patients with GG 4 and GG 5 PCa, we performed an individual patient-level meta-analysis of six randomized trials. Our working hypothesis was that longer durations of ADT would offer significant survival benefits in both groups. (more…)
Accidents & Violence, Author Interviews, CDC, Race/Ethnic Diversity / 21.09.2018

MedicalResearch.com Interview with: Dr. Kameron Sheats PhD Licensed Psychologist; Behavioral Scientist Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: This study updates literature on racial disparities in violence between black and white youth using data capturing different severity levels in violent outcomes such as homicide versus assault. This study also seeks to increase the understanding of the impact of these disparities by examining associations between disparities in childhood adversity (e.g., child abuse and neglect, exposure to violence, household challenges) and adult health conditions. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Dermatology, Emory, JAMA, Medicare / 21.09.2018

MedicalResearch.com Interview with: “Actinic Keratosis” by Ed Uthman is licensed under CC BY 2.0Howa Yeung, MD Assistant Professor of Dermatology Emory University School of Medicine Atlanta, GA 30322  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses? Response: Actinic keratoses are common precancerous skin lesions caused by sun exposure. Because actinic keratoses may develop into skin cancers such as squamous cell carcinoma and basal cell carcinoma, they are often treated by various destructive methods. We used Medicare Part B billing claims to estimate the number and cost of treated actinic keratoses from 2007 to 2015. MedicalResearch.com: What are the main findings?  Response: While the number of Medicare Part B beneficiaries increased only moderately, the number of actinic keratoses treated by destruction rose from 29.7 million in 2007 to 35.6 million in 2015. Medicare paid an average annual amount of $413.1 million for actinic keratosis destruction from 2007 to 2015. Independently billing non-physician clinicians, including advanced practice registered nurses and physician assistants, are treating an increasing proportion of actinic keratosis, peaking at 13.5% in 2015. MedicalResearch.com: What should readers take away from your report? Response: Readers should understand that the burden of actinic keratosis treatment is increasing in the Medicare population. There is also an increasing proportion of actinic keratoses being treated by advanced practice registered nurses and physician assistants.  (more…)