Author Interviews, Infections, Social Issues / 05.06.2018

MedicalResearch.com Interview with: rat- wikipedia imageMícheál de Barra, PhD Lecturer in Psychology Brunel University London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Disgust has been called the "intuitive microbiologist"  - it tracks the sources of infection in our environment. But so far, there has been little attempt to link the sources of disgust to the sources of infectious disease in a comprehensive way. So we developed a method for developing stimuli based on a random sample illness. We basically asked ourselves what the kinds of cues that might be associated with that kind of disease risk and asked people to rate disgust responses. The main motive for this was to contribute to a debate in the literature about if there are "kinds of disgust" and if so, how many. I results were a little ambiguous there I'm afraid. (more…)
ASCO, Author Interviews, Breast Cancer, Cancer Research / 05.06.2018

MedicalResearch.com Interview with: Dr. Giuseppe Del Priore, MD, MPH Chief Medical Officer of Tyme Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Metastatic breast cancer, sometimes also called “stage IV” or “advanced breast cancer,” is the most extensive stage of breast cancer. It is an invasive cancer that has spread to other parts of the body, most often bones, lungs, liver, and brain. The current standard of care for metastatic breast cancer is systemic drug therapies, such as hormone therapy, chemotherapy, targeted drugs or a combination of these.  Because they reach every cell in the body, they have side effects that can worsen the patient’s quality of life. Existing treatments cannot cure metastatic breast cancer and are palliative in intent. This presents a great unmet need and challenge in treating patients with metastatic breast cancer. SM-88 is a novel relatively non-toxic combination therapy that harnesses cancer’s unique cell metabolism and oxidative stress to selectively drive cancer cell death. Earlier studies with SM-88 therapy demonstrated its potential efficacy in breast and other metastatic cancers. In this current report, we assessed the efficacy of SM-88 in patients with metastatic breast cancer from the first in human “Phase 1” and compassionate use programs from 2012 to 2017. Data demonstrated the potential efficacy of SM-88 in metastatic breast cancer with favorable safety and quality of life profiles. In addition, there were no indications of cross-resistance based on hormone profile, previous treatments or metastatic site. This is an extremely important finding since most cancer deaths are due to resistance to subsequent therapies.  As predicted by the SM-88 mechanism of action, we could not detect this problem with SM-88 use. (more…)
ASCO, Author Interviews, Dermatology, Melanoma, Merck, University of Pittsburgh / 05.06.2018

MedicalResearch.com Interview with: Dr. Diwakar Davar, MD Assistant Professor of Medicine Division of Hematology/Oncology University of Pittsburgh  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal surveillance strategy to detect recurrence in cutaneous melanoma remains elusive. Risk of recurrence increases with higher stage, and is especially high for patients with stage IIIC disease. Although consensus guidelines agree on surveillance imaging for high-risk (stage IIB-IIIC) MEL, there is no consensus regarding optimal frequency/modality in these patients. NCCN guidelines suggest chest radiography (CXR) at 6- to 12-month intervals for stage IA-IIA melanoma  patients; although this is controversial. There exists a great deal of practice variation in the surveillance of these patients. (more…)
ASCO, Author Interviews, Cancer Research, Hematology / 05.06.2018

MedicalResearch.com Interview with: PharmaMarDr. Javier Gómez García Senior Manager. Biostatistics and Data Management PharmaMar Madrid Area, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multiple myeloma accounts for approximately 1 percent of all cancers and slightly more than 10 percent of all hematologic malignancies. At present, more than 80,000 new cases are reported worldwide each year, and the disease prevalence is increasing. Plitidepsin is a synthetic cyclic depsipeptide isolated from the marine tunicate Aplidium albicans targeting the proto-oncogene eEF1A2, which is over-expressed in multiple myeloma cells. In ADMYRE trial 255 relapsed and refractory multiple myeloma patients with at least three but not more than six prior regimens, including at least bortezomib and lenalidomide/thalidomide, were randomized at 2:1 ratio to receive plitidepsin 5 mg/m2 D1 and 15 plus DXM 40 mg D1, 8, 15 and 22 (P+DXM), or DXM 40 mg D1,8,15 and 22 (DXM) every four weeks. P+DXM met the primary endpoint, progression-free survival (PFS) assessed by an Independent Review Committee, showing a 35% risk reduction in the probability of progression or death. Indeed, a 20% risk reduction in the probability of death was also observed in spite of the fact that 44% of patients from control arm (DXM) switched to P+DXM arm after progression. Therefore, survival in the control arm might have been extended by the effect of plitidepsin, increasing the post progression survival and overestimating the survival observed in the control arm and consequently underestimating the actual difference between treatment arms. Several methods were used to assess the impact of crossover and the robustness of the results even when penalizations were applied; PharmaMar believes that strong evidence in terms of survival benefit in favour of P+DXM has been established.  (more…)
Author Interviews, Boehringer Ingelheim, Pulmonary Disease / 05.06.2018

MedicalResearch.com Interview with: Christopher J. Ryerson, M.D. Assistant Professor Centre for Heart Lung Innovation University of British Columbia Vancouver, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: A new Idiopathic pulmonary fibrosis (IPF) mortality analysis presented at the American Thoracic Society’s 2018 annual conference suggests that treatment with nintedanib may be associated with reduced risk of death in patients with the rare lung disease idiopathic pulmonary fibrosis (IPF). Pooled data from the two Phase II INPULSIS trials and the Phase II TOMORROW study compared the number of deaths observed versus the number predicted based on GAP stage over one year. GAP stage is used to predict IPF prognosis and is based on gender, age and lung function (as measured by forced vital capacity [FVC] decline predicted and DLco % predicted). Higher stages of GAP are associated with an increased risk of death. Across the population in the analysis (n=1,228), there were fewer deaths observed in each treatment group than predicted based on GAP stage at baseline (nintedanib: 42 vs. 89.9; placebo: 41 vs. 64.2). In the treated group, the number of observed deaths was 46.7% of the number predicted based on GAP stage, while in the placebo group the number of observed deaths was 63.9% of the number predicted. Based on these observations, the analysis suggests that nintedanib may be associated with a 26.8% relative reduction in the risk of death compared with placebo over one year.  (more…)
Author Interviews, Breast Cancer, Chemotherapy, JAMA / 05.06.2018

MedicalResearch.com Interview with: Dr. Guy Jerusalem, MD, PhD CHU Sart Tilman Liege and Liege University Liege, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: BOLERO-6 was conducted to fulfill postapproval regulatory commitments to the FDA and EMA to estimate treatment benefit with EVE + EXE vs EVE alone or CAP for ER+, HER2− ABC that had progressed on an NSAI. Everolimus plus exemestane has not previously been compared with everolimus alone or capecitabine in a randomized setting.Data describing everolimus alone are limited to a single phase 2 study of just 19 patients. Thus, the FDA deemed it important to ascertain the efficacy of everolimus alone for ER+ breast cancer, and to determine the contribution of exemestane to combination therapy with everolimus. Capecitabine is often the first chemotherapeutic agent given for ER+ breast cancer that has progressed on anti-estrogen therapy. It has a reported PFS of 4.1–7.9 months among patients with HER2-negative advanced breast cancer. However, it has a different safety profile to everolimus or exemestane, and a comparison of endocrine-based combination therapy with single-agent chemotherapy was yet to be conducted. The median PFS with EVE + EXE (8.4 months) was consistent with BOLERO-2 (7.8 months), and compared to EVE alone here (6.8 months) corresponded to an estimated 26% reduction of risk of disease progression or death (HR 0.74). A numerical median PFS difference was observed for CAP over EVE + EXE (9.6 vs 8.4 months), which may be attributed to various baseline characteristics favoring CAP and potential informative censoring. The median PFS with capacitabine was longer than expected based on previous trials. Interpretation of the results of BOLERO-6 must consider the limited sample size and open-label design.  (more…)
Author Interviews, Pain Research, Pharmaceutical Companies / 04.06.2018

MedicalResearch.com Interview with: Zosano Pharma Dr. Peter Schmidt, MD, MSc Senior Director, medical Affairs and Clinical Development Zosano Pharma   MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a post-hoc analysis of Zosano’s pivotal efficacy trial using its adhesive dermally-applied microarray (ADAM) zolmitriptan formulation, M207. The trial found that M207 was effective versus placebo for the co-primary endpoints of pain freedom and most bothersome symptom (MBS) freedom, both at two hours. The MBS endpoint was just ratified as a new endpoint in the FDA’s February 2018 guidance for acute migraine trials. The stated aim of this new endpoint is “…to better align the study outcome with the symptom(s) of primary importance to patients…” This is logical, as a given migraine patient may not experience all four previous symptom endpoints (pain, photophobia, phonophobia, nausea). (more…)
Author Interviews, Education, JAMA / 04.06.2018

MedicalResearch.com Interview with: Kathleen M. Finn MD, MPhil Christiana Iyasere MD, MBA Division of General Internal Medicine Department of Medicine Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? Response: While the relationship between resident work hours and patient safety has been extensively studied, little research evaluates the role of attending supervision on patient safety. Beginning with the Bell Commission there have been increased calls for enhanced resident supervision due to patient safety concerns. At the same time, with the growth of the hospitalist movement more faculty physicians join daily resident work rounds under the assumption that increased supervision is better for patient safety and resident education. However, we know that supervision is a complex balancing act, so we wanted to study whether these assumptions were true. On the one hand patient safety is important, but on the other adult learning theory argues residents need to be challenged to work beyond their comfort level. Importantly, being pushed beyond your comfort level often requires appropriate space between teacher and learner. To investigate the role of attending supervision on patient safety and resident learning we studied the impact of two levels of physician supervision on an inpatient general medical team. Twenty-two teaching faculty were randomized to either direct supervision of resident teams for patients previously known to the team vs usual care where they did not join rounds but rather discussed the patients later with the team. Faculty participated in both arms of the study, after completing the first arm they then crossed over to the other arm; each faculty member participated in the study for a total of 4 weeks. (more…)
Author Interviews, Eating Disorders, Weight Research / 04.06.2018

MedicalResearch.com Interview with: Tomoko Udo, PhD Assistant Professor Department of Health Policy, Management, and Behavior School of Public Health University at Albany, State University of New York MedicalResearch.com: What is the background for this study?   Response: The National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) was the largest epidemiological study on psychiatric disorders in US non-institutionalized adults that was conducted by the National Institution on Alcohol Abuse and Alcoholism, and the first one sinceDSM-5 came out. The last population-based study with US adults that examined eating disorders was the National Comorbidity Survey-Replication Study conducted by Hudson and his colleagues and published in 2007. We felt that it was important to obtain new prevalence estimates in a larger and representative sample especially because the DSM-5 included several changes to the criteria for eating disorders from the earlier DSM-IV. Thus, we thought it was important to provide updated and new prevalence estimates for eating disorders as well as how they are distributed across sex, ethnicity/race, and age.  Many  researchers and clinicians expected higher estimates than earlier studies as a result of “loosening” of diagnostic criteria for eating disorders. (more…)
ASCO, Author Interviews, Pancreatic / 04.06.2018

MedicalResearch.com Interview with: Dr. Marcus Smith Noel, MD University of Rochester James P. Wilmot Cancer Institute Strong Memorial Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pancreatic cancer outcomes are poor even despite improvement in the overall prognosis for many cancers. Early detection of pancreatic cancer is uncommon because early stage pancreatic cancer often has few symptoms. Unfortunately, most cases are diagnosed at more advanced stages, which is in part why the disease is so lethal. Current standard of care treatments are highly toxic and not effective long-term, as about 90% of patients diagnosed with advanced or metastatic pancreatic cancer do not survive a year. SM-88 is a relatively non-toxic novel combination therapy designed to utilize cellular metabolism and oxidative stress to drive cancer cell death. This therapy has previously demonstrated activity in various metastatic cancers, such as pancreatic cancer, and is currently being evaluated in an ongoing Phase II trial for metastatic pancreatic cancer. This study is a trial in progress report of Tyme’s Phase II trial in patients with metastatic cancer. The Phase II trial is designed as an open-label, multi-center study of SM-88 in patients with metastatic pancreatic cancer who have failed at least one prior line of therapy. In the first stage of the trial, 36 patients will be randomized 1:1 to receive a dose of either a currently utilized active regimen or a double dose per day of SM-88. Primary endpoints are overall response rate (ORR) and overall survival (OS). Secondary endpoints include progression-free survival (PFS), disease control rate, duration of response and time to subsequent treatment. The purpose of the first stage of the study is to analyze the safety, efficacy and pharmacokinetics of SM-88 in patients.  The selected dose of SM-88 will be continued into the second stage of the trial for approximately 81 additional patients. (more…)
Author Interviews, Biomarkers, Prostate Cancer / 03.06.2018

MedicalResearch.com Interview with: James T. Kearns, MD Clinical Fellow, Department of Urology University of Washington School of Medicine Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The effects of the USPSTF recommendation against prostate cancer screening had not been fully characterized among a younger population, particularly with respect to downstream effects such as prostate biopsy, prostate cancer diagnosis, and treatment for prostate cancer. We found that PSA testing decreased in the years surrounding the USPSTF recommendation, but we also found a larger proportionate decrease in prostate biopsy, prostate cancer diagnosis, and use of surgery or radiation for the treatment of prostate cancer. (more…)
Anesthesiology, Author Interviews, Pulmonary Disease / 03.06.2018

MedicalResearch.com Interview with: Dr James Purcell University College Cork and South Infirmary Victoria University Hospital Cork, Ireland MedicalResearch.com: What is the background for this study? Response: Nail varnish and acrylic nails are common accessories and as such are commonly encountered by an array of healthcare professionals in various scenarios when SpO2 readings may be part of patient care.. Colloquially there was a wide variety of approaches and beliefs as to whether or not these treatments impacted on SpO2 readings. This is due to the fact that the Digital Pulse oximetry relies on the passing of a wavelength of light through a pulsatile nailbed to a sensor on the opposite side of the finger tip in order to read SpO2 levels. Any potential interference to this process by polish of certain hues, or acrylic was therefor believed to impact on the resultant readings As such it was decided to analyse the actual level of knowledge and variety of approaches to the issue by means of a multisite study involving Consultants, NCHDs, and nursing staff in areas where this issue may arise. A second, experimental part of the study was set up using healthy volunteers and venous congestion and hypoxia modelling. Nail varnish of differing hues and acrylic nails were applied and results of SpO2 readout in healthy and pathological models with and without nail treatments applies were analysed. (more…)
Abbvie, ASCO, Author Interviews, Cancer Research, Leukemia / 03.06.2018

MedicalResearch.com Interview with: Dr. Danelle James, M.D., M.A.S. Head of Clinical Science Pharmacyclics, an AbbVie Company MedicalResearch.com: What is the background for this study? What are the main findings? Response: CAPTIVATE is a Phase 2 study investigating IMBRUVICA (ibrutinib) plus VENCLEXTA (venetoclax) for the treatment of Chronic Lymphocytic Leukemia (CLL) in the first-line setting. It was designed to evaluate if remission with undetectable minimal residual disease (MRD) can provide treatment-naïve CLL/SLL patients with treatment holidays (a period of time when a patient is able to stop therapy). The study enrolled 164 patients with previously untreated CLL or SLL. In preclinical and ongoing clinical studies, we’ve seen complementary activities with this combination. The combination has also previously shown potential for deeper remissions, as well as potential for lower risk of tumor lysis syndrome with ibrutinib as the lead-in therapy. Early data from CAPTIVATE show promising activity for the combination in this patient population, with 77 percent of the first 30 patients achieving responses with no detectable MRD in the blood after only six cycles of the combination therapy. Approximately nine out of 10 of the first patients achieved undetectable MRD after 12 cycles of combination therapy (which were preceded by three cycles of single agent ibrutinib, for a total of 15 cycles of therapy). Specifically, 86 percent of the first 14 patients achieved undetectable MRD in the marrow and 93 percent in the peripheral blood. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 02.06.2018

MedicalResearch.com Interview with: Jiang He, MD, PhD Joseph S. Copes Chair of Epidemiology, Professor School of Public Health and Tropical Medicine Tulane University MedicalResearch.com: What is the background for this study? What are the main findings?   Response: The 2017 American College of Cardiology and American Heart Association hypertension guideline recommended lower blood pressure cut points for initiating antihypertensive medication and treatment goals than the previous hypertension guideline. We estimated the prevalence of hypertension and the proportion of the US adult population recommended for antihypertensive treatment according to the 2017 hypertension guideline. More importantly, we estimated the risk reductions of cardiovascular disease and all-cause mortality, as well as increases in adverse events, assuming the entire US adult population achieved the 2017 guideline-recommended systolic blood pressure treatment goals of less than 130 mmHg. Our study indicated the prevalence of hypertension was 45.4%, representing 105 million US adults with hypertension, according to the 2017 hypertension guideline. In addition, the proportion of individuals recommended for antihypertensive treatment was 35.9% or 83 million US adults. Based on data from the National Health and Nutrition Examination Survey, antihypertensive clinical trials, and US population-based cohort studies, we estimated 610 thousand cardiovascular disease events and 334 thousand total deaths could be prevented annually in the US population if the 2017 hypertension guideline systolic blood pressure treatment goals were achieved in the entire US population. Compared to full implementation of the previous hypertension guideline, we estimated the 2017 hypertension guideline recommendations would reduce an additional 340 thousand cardiovascular disease events and 156 thousand deaths per year in the US. Implementing the 2017 hypertension guideline was estimated to increase 62 thousand hypotension, 32 thousand syncope, 31 thousand electrolyte abnormality, and 79 thousand acute kidney injury or kidney failure events. These analyses indicated implementing the 2017 hypertension guideline would significantly increase the proportion of US adults recommended for antihypertensive treatment and further reduce cardiovascular disease events and all-cause mortality, but might increase the number of adverse events in the US population. (more…)
Author Interviews, Endocrinology, Social Issues, University of Pennsylvania / 01.06.2018

MedicalResearch.com Interview with: “Monkeys” by Dmitry Baranovskiy is licensed under CC BY 2.0Yaoguang Jiang PhD Postdoctoral Researcher PLATT Lab University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Oxytocin (OT) and arginine vasopressin (AVP) are important neuropeptides known to influence social behaviors in a wide array of mammals. In humans, OT is widely referred to as the ‘prosocial’ hormone and is thought to promote social functions in neurotypical individuals as well as those diagnosed with autism spectrum disorder (ASD). Currently, dozens of ongoing clinical trials in the US are trying to evaluate the therapeutic potential of these neuropeptides in remedying social deficits associated with disorders such as ASD. Yet there are significant gaps in our knowledge especially regarding the neurobiological basis of OT and AVP function. Most importantly, we are unclear which brain areas and pathways these neuropeptides act on to influence social behavior. Additionally, due to strong similarity in molecular structure, OT can bind to AVP receptors with high affinity and vice versa, making it difficult to rule out the possibility that, for example, the behavioral effect of exogenous oxytocin is mediated through the AVP system. Both of these questions have been thoroughly investigated in rodents, but unfortunately the same thing cannot be said for humans. Our study aims to bridge the gap between rodent and human literature on neuropeptide function by studying rhesus macaque monkeys. These monkeys resemble human beings not only in their social behaviors, but also in the neural network that is supporting those behaviors. In this study we show that treating one male macaque monkey intranasally with aerosolized OT relaxes his spontaneous social interactions with another monkey. Oxytocin reduces differences in social behavior between dominant and subordinate monkeys, thereby flattening the status hierarchy.Oxytocin also increases behavioral synchrony within a pair, perhaps through increased attention and improved communication. Intranasal delivery of aerosolized AVP reproduces the effects of OT with greater efficacy. Remarkably, all behavioral effects are replicated when either OT or AVP is injected focally into the anterior cingulate gyrus (ACCg), a brain area linked to empathy, vicarious reward, and other-regarding behavior. ACCg lacks post-synaptic OT receptors but is rich in post-synaptic AVP receptors, suggesting exogenous OT may shape social behavior, in part, via nonspecific binding, particularly when available at supra-physiological concentrations.  (more…)
Author Interviews, Cancer Research, Leukemia, Nature, University of Pennsylvania / 01.06.2018

MedicalResearch.com Interview with: Dr. J Joseph Melenhorst, PhD Director, Product Development & Correlative Sciences laboratories (PDCS) Adjunct Associate Professor Penn Medicine Center for Cellular Immunotherapies University of Pennsylvania MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by CLL and CAR T cells?  Response: We started treating patients with a form of blood cancer called CLL (chronic lymphocytic leukemia) using a form of gene therapy wherein we engineer the patient’s own immune cells – T cells – with a tumor targeting molecule: The CAR, which stands for chimeric antigen receptor. When we engineer the patient’s immune cells we use a vehicle, in this case virus, that inserts the payload – the CAR – into the patient’s DNA. The virus disappears, and the CAR stays. Where this CAR inserts itself is unpredictable, but we always get stably engineered cells.  (more…)
Author Interviews / 01.06.2018

MedicalResearch.com Interview with: Dr. Christina Fitzmaurice M.D., M.P.H. UW Medicine MedicalResearch.com: What is the background for this study? What are the main findings? o   We analyzed cancer incidence (i.e. how many people develop a new cancer), cancer mortality (i.e. how many people die of a cancer), and disability associated with cancer for 29 cancer subgroups and for all cancers combined. The findings cover 1990-2016 for 195 countries and territories. o   In 2016, there were 17.2 million cancer cases worldwide, an increase of 28% over the past decade. There were 8.9 million cancer deaths the same year. o   While cancer death rates decreased in a majority of countries from 2006 to 2016, incidence rates conversely increased. o   Breast cancer was the leading cause of cancer death in women. o   Lung cancer was the leading cause of cancer death in men; it was also the leading cause of cancer mortality globally, accounting for nearly 20 percent of all cancer deaths in 2016. o   Prostate cancer is one of the most common causes of cancer incidence and death in men, in both high- and low-SDI countries, but especially in sub-Saharan Africa.  (more…)
Author Interviews, Duke, Education, Heart Disease, JAMA / 01.06.2018

MedicalResearch.com Interview with: Pamela S. Douglas, MD, MACC, FASE, FAHA Ursula Geller Professor of Research in Cardiovascular Disease Duke University School of Medicine Durham, NC 27715     MedicalResearch.com: What is the background for this study? What are the main findings? Response: For any profession to succeed, it needs to attract top talent. We surveyed internal medicine residents to find out what they valued most in their professional development, how they perceived cardiology as field and how these two areas are associated with  their choosing a career in cardiology or another specialty. We found that trainees were seeking careers that had stable hours, were family friendly and female friendly, while they perceived cardiology to  have adverse work conditions, interfere with family life and to not be diverse. We were able to predict career choice with 89-97% accuracy from these responses; the predictors are mix of things that attract to cardiology and those that are deterrents. For men, the attractors outnumber the deterrents, for women its just the opposite. (more…)
Author Interviews, Diabetes, Heart Disease, Lancet, Metabolic Syndrome, Weight Research / 01.06.2018

MedicalResearch.com Interview with: Nathalie Eckel, MSc German Diabetes Center Düsseldorf, Germany  MedicalResearch.com: What is the background for this study?  Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called "metabolically healthy obesity" and "metabolically unhealthy normal-weight". So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 01.06.2018

MedicalResearch.com Interview with: Harindra C. Wijeysundera MD PhD FRCPC FCCS FAHA Director of Research, Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre Senior Scientist, Sunnybrook Research Institute (SRI) Associate Professor, Dept. of Medicine & Institute of Health Policy, Management and Evaluation, University of Toronto Adjunct Senior Scientist, Institute for Clinical Evaluative Sciences (ICES) Toronto, ON, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the most common complications post TAVR is the need for a permanent pacemaker.  It is unclear if the need for a pacemaker is associated with long term adverse outcomes. Using a population level registry of all TAVR procedures in ontario, canada, we found that pacemakers were required in ~15% of cases.  Requiring a pacemaker was associated with worse long term outcomes, including death, readmission to hospital and emergency room visits.  (more…)
Author Interviews, Autism, Dental Research, Mineral Metabolism, Pediatrics / 31.05.2018

MedicalResearch.com Interview with: “baby teeth” by Thomas Ricker is licensed under CC BY 2.0Christine Austin PhD Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that some metals (nutrients and toxicants) are absorbed and metabolized differently in children with autism spectrum disorder compared to neuro-typical children. However, it is not known when this dysregulation occurs and it is incredibly difficult to study prenatal metal metabolism. Teeth, which begin forming prenatally, grow by adding a new layer every day, much like the yearly growth rings in trees. Each layer formed captures many of the chemicals circulating in the body at the time. We have developed a method to measure metals in these layers to build a timeline of metal exposure during the prenatal and early childhood period. We found that the cycles of copper and zinc metabolism were disrupted in children with ASD and used this feature to develop a method to predict the emergence of autism spectrum disorder with 90% accuracy. (more…)
Author Interviews, Heart Disease, JACC, Supplements / 31.05.2018

MedicalResearch.com Interview with: “Pills Vitamins Macro April 22, 2012 4” by Steven Depolo is licensed under CC BY 2.0David J.A. Jenkins, MD, PhD, DSc Professor and Canada Research Chair in Nutrition and Metabolism Department of Nutritional Sciences University of Toronto  MedicalResearch.com: What is the background for this study? Response: The study was requested by the editor of JACC (Dr. Valentin Fuster) due to the widespread use of vitamin and mineral supplementation by the public and the requirement to know if there were any benefits or harms for cardiovascular disease. Our study was a follow-up to the US Preventive Services Task Force 2013 recommendations. (more…)
Author Interviews, Pharmaceutical Companies / 31.05.2018

MedicalResearch.com Interview with: “pills” by Dominique Godbout is licensed under CC BY 2.0George P. Ball PhD Operations and Decision Technologies Department Kelley School of Business, Indiana University Bloomington, IN 47405, MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sought to examine how the intense pressure on firms to produce generic drugs more cheaply might influence product quality. We find that the greater proportion of generic drugs a firm manufactures, the more severe product recalls they experience, because of an apparent relaxation of manufacturing quality standards. Additionally, they experience fewer less severe recalls, which may also result from forces of competition. When the opportunity exists to not announce a recall that has high discretion, competition may lead firms to forgo the recall to avoid negative ramifications associated with recalls. (more…)
AHA Journals, Author Interviews, Heart Disease, Red Meat / 31.05.2018

MedicalResearch.com Interview with: “mmmm Meat” by Glen MacLarty is licensed under CC BY 2.0 Jyrki Virtanen, PhD Adjunct professor of nutritional epidemiology Heli Virtanen, MSc University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have found that animal sources of protein may have an adverse impact on the risk of cardiovascular diseases, like myocardial infarct, whereas plant sources of protein have had an opposite impact. In this study we investigated that how protein intake from different dietary sources is associated with developing heart failure in men during the study’s follow-up. During the mean follow-up time of about 22 years, 334 men developed heart failure. The main finding of the study was that higher protein intake was associated with a moderately higher risk of heart failure and the findings were similar with protein from most dietary sources, although the association was stronger with protein from animal sources. Only protein from fish and eggs were not associated with the risk in our study. (more…)
Author Interviews, JAMA, Thromboembolism, University of Michigan / 31.05.2018

MedicalResearch.com Interview with: Paul Grant, MD Associate Professor of Medicine Associate Chief Medical Information Officer Director, Perioperative and Consultative Medicine Division of Hospital Medicine Department of Internal Medicine Michigan Medicine University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that hospitalized medical patients are at risk for venous thromboembolism VTE, but the severity of patient risk can vary significantly. National guidelines have consistently stated that low-risk patients should not receive VTE prophylaxis beyond early ambulation. In this retrospective cohort study, we analyzed data from 52 hospitals participating in the Michigan Hospital Medicine Safety consortium. Trained medical record abstractors at each hospital collected data from 44,775 medical patients including VTE risk factors, type of VTE prophylaxis administered, and contraindications to pharmacologic prophylaxis. Individual patient risk of VTE was determined using the Padua risk assessment model. Of the 32,549 low-risk patients, 77.9% received excess venous thromboembolism prophylaxis as either pharmacologic prophylaxis (30.6%), mechanical prophylaxis (20.8%), or both (26.5%). In the 12,226 high-risk patients, VTE prophylaxis was underused in 22% of patients. The rates of inappropriate prophylaxis varied considerably by hospital.  (more…)
Author Interviews, CDC, JAMA, Neurological Disorders, Zika / 31.05.2018

MedicalResearch.com Interview with: Dr. Emilio Dirlikov, PhD Office of Epidemiology and Research, Puerto Rico Department of Health Epidemic Intelligence Service Division of Scientific Education and Professional Development CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: After reporting local Zika transmission in December 2015, the Puerto Rico Department of Health (PRDH), US Centers for Disease Control and Prevention (CDC), and University of Puerto Rico began identifying cases of Guillain-Barré syndrome (GBS), testing specimens, and conducting follow-up telephone interviews after patients left the hospital. Through these efforts, we were able to characterize acute clinical features and long-term disability of GBS associated with Zika infection by analyzing data from GBS patients with and without evidence of Zika infection. This investigation increases scientific and medical understanding of Guillain-Barré syndrome following Zika infection, provides insight into the disease processes involved in GBS following Zika infection, and adds to growing evidence of a causal association between Zika and GBS.  (more…)
Author Interviews, Prostate, Prostate Cancer, Urology / 31.05.2018

MedicalResearch.com Interview with: Dr. Fred Saad, MD FRCS Professor and Chief of Urology Director of GU Oncology Raymond Garneau Chair in Prostate Cancer University of Montreal Hospital Center (CHUM) Director, Prostate Cancer Research , Montreal Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patient Reported Outcomes (PRO) data from the Phase 3 SPARTAN study showed adding ERLEADA (apalutamide) to androgen deprivation therapy (ADT) for patients with nmCRPC who were asymptomatic and well, did not worsen or cause detriment to HRQoL when compared to the placebo.The percent of patients who felt “quite a bit” or “very much” bothered was low (<2–6 percent of patients in the apalutamide group and 0–6 percent of those in the placebo group), suggesting that ERLEADA treatment was generally well-tolerated. This outcome, coupled with the efficacy results seen in SPARTAN, suggest that apalutamide can be given to patients at risk of metastasis without worry about compounded side effects or negative HRQoL.. (more…)
Author Interviews, Geriatrics / 30.05.2018

MedicalResearch.com Interview with: “Pills” by Victor is licensed under CC BY 2.0Khalid Ali, MBBS, FRCP, MD Senior lecturer in Geriatrics Brighton and Sussex Medical School, UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older people are more like to have more than one chronic condition (multi-morbidity), and as such as are more likely to be prescribed several medications (poly pharmacy) to treat those conditions. At the point of hospital discharge, older people are given different / new medications in addition to their old ones, and this puts them at higher risk of harm related to medicines. Our study led by  Brighton and Sussex Medical School (BSMS) and King’s College London involved five hospitals and 1,280 patients (average age 82 years) in South England. Senior pharmacists interviewed patients and carers, reviewed GP records and analysed hospital readmission to determine medication-related harm. The study found that more than one in three patients (37%) experienced harm from their medicines within two months of hospital discharge, and that this was potentially preventable in half of the cases. Medication-related harm was most commonly found to occur from the toxicity of the medicine itself and in a quarter of cases from poor adherence.  The medicines found to pose the highest risk were opiates, antibiotics and benzodiazepines. Patients suffered a range of side effects including serious kidney injury, psychological disturbance, irregular heart rhythms, confusion, dizziness, falls, diarrhoea, constipation and bleeding. (more…)