Author Interviews, Stroke / 26.01.2018

MedicalResearch.com Interview with: Dr. J. Mocco, MD Professor Neurosurgery Mount Sinai Beth Israel Mount Sinai St. Luke's and Mount Sinai West The Mount Sinai Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous trials have demonstrated that Endovascular therapy is strongly beneficial for emergent large vessel stroke patients. The majority of patients in those trials were treated with Stent retrievers.  COMPASS was designed to evaluate a different type of Endovascular therapy called aspiration Thrombectomy.  (more…)
Author Interviews, Cognitive Issues, Geriatrics, Mayo Clinic / 25.01.2018

MedicalResearch.com Interview with: Richard J. Caselli MD Department of Neurology Mayo Clinic Arizona Scottsdale, AZ   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Personality changes are common in patients with a variety of dementing illnesses, and underlie the behavioral disturbances that complicate the course of dementia patients.  We have a been conducting a large longitudinal study of cognitive aging in individuals at genetically defined risk for Alzheimer’s disease (AD) based on their APOE genotype, and have been administering a large battery of neuropsychological tests as well as the gold standard personality questionnaire (the NEO-PI-R) in order to determine whether personality changes during the transition from normal cognition/preclinical AD to mild cognitive impairment.   (more…)
Author Interviews, BMJ, Pulmonary Disease, Surgical Research / 25.01.2018

MedicalResearch.com Interview with: Ianthe Boden Titled Cardiorespiratory APAM, PhD Candidate, MSc, BAppSc Manager Abdominal Surgery Research Group Clinical Lead – Cardiorespiratory Physiotherapy, Physiotherapy Department Allied Health Services Tasmanian Health Services – North | Launceston General Hospital Launceston TA  MedicalResearch.com: What is the background for this study? Response: Major upper abdominal surgery involves opening up the abdomen - mainly to remove cancer or damaged bowel, liver, stomach, pancreas, or kidney.  It is, by far, the most common major surgical procedure performed in developed countries with millions of procedures performed per annum. Unfortunately a respiratory complication following these operations occurs relatively frequently with between 1 in 10 to almost a half of all patients getting some type of respiratory complication after surgery. Respiratory complications included problems such as pneumonia, lung collapse, respiratory failure, and an acute asthma attack. These complications, especially pneumonia and respiratory failure, are strongly associated with significant morbidity, mortality, increased antibiotic usage and longer hospital stay. These breathing problems occur quite quickly after surgery, becoming evident usually within the first two to three days after surgery. In an effort to ameliorate these complications in developed countries it is common for physiotherapists/respiratory therapists to see a patient for the first time on the day after surgery and start patients doing breathing exercises. However as respiratory dysfunction starts occurring immediately following surgery it is debated that these breathing exercises are being provided too late. Initiating prophylactic treatment more than 24 hours after the end of surgery may not be as effective as starting prophylaxis immediately. Unfortunately, immediately after surgery patients are either very sleepy, in pain, feeling sick, or delirious. It may not be possible to effectively teach patients at this point on the importance of breathing exercises and get good performance. One method to overcome this would be to meet patients before the operation to educate them about their risk of a postoperative chest infection and to motivate and train them to perform breathing exercises to do immediately on waking from surgery. Previous trials have indicated that this may help prevent postoperative respiratory complications, although evidence is inconclusive and weak. We set out to robustly and conclusively see if respiratory complications could be prevented after major upper abdominal surgery if patients were taught breathing exercises to do as soon as they woke up after the operation. We ran this trial in two countries (Australia and New Zealand) and three different types of hospitals.  All patients were met by a physiotherapist at our hospitals’ scheduled pre-admission clinic appointment and either provided with an information booklet (control) or provided with an additional 30 minute education and training session with the physiotherapist. At this preoperative session the patient was educated about respiratory complications, their risk, and how to prevent them with breathing exercises. These exercises were then taught and practiced for just three repetitions. Patients were instructed to do these breathing exercises for 20 repetitions as soon as they woke from surgery and then 20 times every hour after surgery until they were up and out of bed frequently. Following surgery each patient had a standardised rehabilitation program and no respiratory therapy of any type was provided to the patients after surgery. For the first two weeks after surgery patients were assessed daily for a respiratory complication by research assistants unaware of what treatment the patient had received before surgery. (more…)
Artificial Sweeteners, Author Interviews, Cancer Research / 25.01.2018

MedicalResearch.com Interview with: Prof. Robert McKenna PhD Department of Biochemistry and Molecular Biology College of Medicine, University of Florida Gainesville, Florida 32610 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Carbonic anhydrase IX (CA IX) is an enzyme that is typically only found in the GI tract, but is overexpressed in cancerous tissue. This enzyme functions to regulate the pH of tumor cells, so we hypothesize that disruption of this role will lead to tumor cell death. This study analyzes the inhibition of CA IX using an artificial sweetener, acesulfame potassium (AceK). Our research provides a structural perspective to understand the selectivity of aceK for CA IX over an off-target enzyme, CA II. We discovered that aceK binds directly to an active site zinc in CA IX whereas the sweetener anchors through a zinc-bound water in CA II. (more…)
Addiction, Alcohol, Author Interviews / 25.01.2018

MedicalResearch.com Interview with: “Alcohol Poisoning PSA Video Shoot” by Stop Alcohol Deaths, Inc. is licensed under CC BY 2.0Dr. Frank de Vocht Senior Lecturer in Epidemiology and Public Health Research Academic Lead Year 1 MBChB (MB21) ‘Foundations of Medicine’ Programme Population Health Sciences Bristol Medical School University of Bristol  MedicalResearch.com: What is the background for this study? Response: We were interested in prospectively investigating whether people who drink alcohol in the general population (so not patients), and who indicated that the were planning to reduce their consumption or complete stop drinking in the near future would, on average, succeed and have reduced consumption six months later.  (more…)
Author Interviews, Cognitive Issues, Genetic Research, JAMA, Medical Imaging, Mental Health Research / 25.01.2018

MedicalResearch.com Interview with: “The Fourth Sex: Adolescent Extremes” by Victor Soto is licensed under CC BY 2.0Dag Alnaes, PhD Norwegian Centre for Mental Disorders Research KG Jebsen Centre for Psychosis Research Division of Mental Health and Addiction, Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The transition from childhood to adulthood is characterized by swift and dramatic changes, both in our environment and in our brains. This period of life also coincides with the onset of many mental disorders. To gain a better understanding of why, the clinical neurosciences must attempt to disentangle the complex and dynamic interactions between genes and the environment and how they shape our brains. The ultimate goal is to be able to predict which individuals are at risk before clinical symptoms appear. Advanced brain imaging has been proposed to represent one promising approach for such early detection, but there is currently no robust imaging marker that allows us to identify individuals at risk with any clinically relevant degree of certainty. Our study shows that self-reported early signs of mental illness are associated with specific patterns of brain fiber pathways in young people, even if they may not fulfill criteria for a formal diagnosis or are currently in need of treatment.  (more…)
Author Interviews, Genetic Research, Neurology / 25.01.2018

MedicalResearch.com Interview with: Ona Bloom PhD “Duluth Boat Show - Sea Lamprey Booth” by USFWSmidwest is licensed under CC BY 2.0Associate Professor, Center for Autoimmune, Musculoskeletal and Hematopoietic Diseases, The Feinstein Institute for Medical Research Associate Professor, Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scientists have known for years that an ancient species of fish called the lamprey has a remarkable ability to rebuild their spinal cord after it’s been severed. After the lamprey spinal cord is cut, they recover from paralysis to fully swimming again in about twelve weeks, without taking any medicines or other treatments. We are studying the lamprey because we want to know the recipe of molecular ingredients that supports successful recovery after spinal cord injury. The genome of this animal was reported about 5 years ago, in a publication led by my colleagues Dr. Jeramiah Smith at the University of Kentucky and Dr. Weiming Li at Michigan State University.  It turns out that many aspects of the lamprey genome are similar to ours, particularly in the central nervous system. Therefore, we think it is a reasonable expectation that what we learn from lamprey could give us some relevant clues about what might be different about the responses in mammals and other animals that are not good at regenerating their spinal cord. In this study, we found that the expression of many genes in the spinal cord and brain of lampreys change during their recovery from spinal cord injury. Some of the genes that get activated are similar to what happens when our peripheral nervous system is injured, which is better at regenerating than the central nervous system. We also identified that a pathway called the Wnt pathway plays an important role in the regeneration and recovery process. This is a large, complex network of genes that are important in many biological processes, from embryological development in fruit flies to cancer in humans. (more…)
Author Interviews, Genetic Research, JAMA, Neurology, Parkinson's / 25.01.2018

MedicalResearch.com Interview with: Rachel Saunders-Pullman, MD, MPH Associate Professor of Neurology Icahn School of Medicine at Mount Sinai Chief, Movement Disorders, Mount Sinai Beth Israel Co-Director Clinical/Translational Research and Research Mentoring Movement Disorders, Department of Neurology, Mount Sinai Beth Israel New York, NY 10003 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a diversity in causes of Parkinson’s Disease (PD), and this may lead to heterogeneity in drug response. While LRRK2 PD due to G2019S mutations may fully mimic idiopathic PD (IPD), cross-sectional study suggests that the course may be slightly milder than IPD. Further, the pathology is heterogeneous with a minority not demonstrating Lewy bodies, and this may also correspond to less severe non-motor features. To better understand the course of PD associated with the G2019S LRRK2 mutation (the most common LRRK2 mutation), we evaluated motor and cognitive progression in individuals enrolled in the LRRK2 Ashkenazi Jewish Consortium. Subjects were recruited from a Center in Tel Aviv, Israel, Sourasky Medical Center, and from two centers in New York, Columbia University and Mount Sinai Beth Israel. 144 participants were LRRK2 mutation carriers and 401 were not. We utilized all study visits, and constructed linear mixed-effects models to estimate the association between harboring the LRRK2 mutation and rate of change of both motor features- as assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS), and cognition, as measured by the Montreal Cognitive Assessment Scale (MoCA). Models adjusted for sex, site, age, disease duration and (for the motor models) cognitive score. We found a small but significant difference in rate of progression, with LRRK2 PD progressing at 0.69 points/year, and IPD at 1.06 points/year. While the cognitive decline was also less in the LRRK2 PD (-0.10 vs. -0.19 in the IPD, this difference was not statistically different (p=0.08). (more…)
Author Interviews, BMJ, OBGYNE, Probiotics / 24.01.2018

MedicalResearch.com Interview with: “My nightly probiotics to help me :) barely holding back PostOp issues! Very GRATEFUL for them!” by Ashley Steel is licensed under CC BY 2.0Mahsa Nordqvist MD Department of Obstetrics and Gynecology Sahlgrenska University Hospital Gothenburg, Sweden  MedicalResearch.com: What is the background for this study? Response: We have shown in earlier observational studies that there is an association between probiotic intake and lower risk of preterm delivery and preeclampsia. Since pregnancy is a time of rapid change and different exposures can have different effect depending on the time of exposure, we wanted to find out if there is any special time point of consumption that might be of greater importance when it comes to these associations. (more…)
Author Interviews, Endocrinology, JCEM, OBGYNE, Testosterone, UCSD / 24.01.2018

MedicalResearch.com Interview with: Varykina Thackray, Ph.D. Associate Professor of Reproductive Medicine University of California, San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that changes in the composition of intestinal microbes (gut microbiome) are associated with metabolic diseases. Since many women with polycystic ovary syndrome (PCOS) have metabolic dysregulation that increases the risk of developing type 2 diabetes and cardiovascular disease, we wondered whether PCOS was associated with changes in the gut microbiome and if these changes were linked to any clinical features of PCOS. We collaborated with Beata Banaszewska and her colleagues at the Poznan University of Medical Sciences in Poznan, Poland to obtain clinical data and fecal samples from 163 premenopausal women recruited for the study. In collaboration with Scott Kelley at San Diego State University, we used 16S ribosomal RNA gene sequencing and bioinformatics analyses to show that the diversity of the gut microbiome was reduced in Polish women with PCOS compared to healthy women and women with polycystic ovaries but no other symptoms of PCOS. The study confirmed findings reported in two other recent studies with smaller cohorts of Caucasian and Han Chinese women. Since many factors could affect the gut microbiome in women with PCOS, regression analysis was used to identify clinical hallmarks that correlated with changes in the gut microbiome. In contrast to body mass index or insulin resistance, hyperandrogenism was associated with changes in the gut microbiome in this cohort of women, suggesting that elevated testosterone may be an important factor in shaping the gut microbiome in women. (more…)
Author Interviews, Pediatrics, Sleep Disorders, Technology / 24.01.2018

MedicalResearch.com Interview with: “social media” by Jessie James is licensed under CC BY 2.0Jean-Philippe Chaput, Ph.D. Associate Professor of Pediatrics, University of Ottawa Research Scientist, Healthy Active Living and Obesity Research Group Children’s Hospital of Eastern Ontario Research Institute Ontario, Canada    MedicalResearch.com: What is the background for this study? What are the main findings? Response: No studies to date have examined the association between social media use (e.g., Facebook, Twitter, Instagram) and sleep duration in a representative sample of middle and high school students, who are a vulnerable age group that has reported high levels of social media use and insufficient sleep, writes Buzzoid. Our findings suggest an important association between the use of social media and short sleep duration among student aged 11-20 years. Using social media for at least one hour per day was associated with short sleep duration in a dose-response manner.    (more…)
Author Interviews, JAMA, MD Anderson, Outcomes & Safety, Surgical Research / 24.01.2018

MedicalResearch.com Interview with: Andrew Phillip Loehrer MD MPH Fellow in Surgical Oncology Department The University of Texas MD Anderson Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: A growing number of studies have examined the effects of the Affordable Care Act’s Medicaid expansion.  But none to date have looked at effects on surgical conditions, which are both expensive and potentially life-threatening.  We examined data for nearly 300,000 patients who presented to hospitals with common and serious surgical conditions such as appendicitis and aortic aneurysms. We found that expansion of Medicaid coverage was linked to increased insurance coverage for these patients, but even more importantly, Medicaid expansion led patients to come to the hospital earlier before complications set in, and they also received better surgical care once they got there. (more…)
Annals Internal Medicine, Author Interviews, Cannabis, Heart Disease / 24.01.2018

MedicalResearch.com Interview with: Divya Ravi, MD, MPH The Wright Center for Graduate Medical Education Scranton, PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is evidence to suggest that Marijuana can bring about changes at the tissue level and has the ability to potentiate vascular disease, in ways similar to tobacco.  With change in legalization and increase usage trends, we conducted this review to examine the known effects of marijuana on cardiovascular outcomes and risk factors, given that cardiovascular disease remains the greatest cause of morbidity and mortality worldwide. Our review found insufficient evidence to draw meaningful conclusions that marijuana use is associated with cardiovascular risk factors and outcomes. The few studies that suggested a possible benefit from marijuana use, were cross-sectional, and were contradicted by more robust longitudinal studies that reported potential harmful effects. (more…)
Author Interviews, Emory, Genetic Research, JAMA, Ophthalmology / 24.01.2018

MedicalResearch.com Interview with: Eldon E. Geisert, PhD Professor of Ophthalmology Emory School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the late 1990s a group of doctors began a study of glaucoma patients to determine if there were phenotypes that are predictive for developing glaucoma. In this Ocular Hypertension Treatment Study (OHTS) one of the highly correlated ocular traits was central corneal thickness (CCT). The early clinical studies found that people with thinner corneas were at a higher risk of developing glaucoma. In two large studies, examining thousands of people a number of genes were identified that were risk factors for glaucoma or that controlled CCT in humans. In both cases the identified genes accounted for less than 10% of the genetic risk for glaucoma and less than for 10% of the genetic control for CCT. There was little data linking the genetic control of CCT to the glaucoma risk. Our group has taken an indirect approach to the question, using well-defined mouse genetic system to identify genes modulating CCT and then interrogating human glaucoma data to determine if these genes are associated with glaucoma risk.   (more…)
Author Interviews, JAMA / 24.01.2018

MedicalResearch.com Interview with: Stelios Serghiou PhD student Epidemiology and Clinical Research and John P.A. Ioannidis, MD, DSc Meta-Research Innovation Center Stanford (METRICS), Stanford University Stanford, California MedicalResearch.com: What is the background for this study? Response: Preprints refer to versions of a manuscript prior to the one published in a peer-reviewed journal. Even though preprints have been very popular in disciplines such as physics and computer science for many years now, their use in biomedicine had been very limited. However, this seems to be changing since the establishment of bioRxiv in 2013. As such, we became interested in exploring what happens to preprints uploaded on bioRxiv and what is the impact of bioRxiv to the peer-reviewed literature in terms of attention received. (more…)
Author Interviews, Education, Gender Differences / 24.01.2018

MedicalResearch.com Interview with: Prof. Amani El-Alayli PhD Eastern Washington University MedicalResearch.com: What is the background for this study? Response: This research was conducted on the premise that people tend to view women as more nurturing, and also set higher standards for women to behave in a nurturing manner. The same pattern has been observed in past research examining how students view their female professors.  Female professors are expected to be more nurturing, such as being more available outside of the classroom, as compared to their male professors.  In the present research, we investigated whether these higher expectations of nurturing behavior would cause students to be more likely to ask things of their female professors, consequently placing higher work demands on them.  In our survey of male and female professors across the country, we indeed found that female professors received more requests for standard work demands (e.g., office hours visits or assistance with course-related matters), as well as special favor requests (e.g., requests to re-do an assignment for a better grade or asking for some form of exception, extended deadline, or alternative assignment), compared to male professors. (more…)
Author Interviews, JAMA, PTSD / 23.01.2018

MedicalResearch.com Interview with: “Man’s best friend helps NC Guardsman with PTSD [Image 1 of 8]” by DVIDSHUB is licensed under CC BY 2.0, PhD Professor of Psychiatry Director, Center for the Treatment and Study of Anxiety University of Pennsylvania Philadelphia, Pa 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As much as 10 to 20 percent of military members deployed to Iraq and Afghanistan following the September 11th attacks suffer from PTSD, which is often chronic and incapacitating. A constant increase in the number of individuals suffering from PTSD as a result of massive natural disasters, terror attacks, and the wars in Iraq and Afghanistan, has prompted an urgent need for effective and efficient evidence-based treatments for PTSD. Prolong exposure (PE) is a form of cognitive-behavioral therapy that involves exposure to trauma memories and daily life trauma reminders. Previous studies have proven PE is quite effective for treating civilians and veterans with PTSD. In this five-year study, the researchers sought to determine whether PE could have similar success with active-duty military personnel. The researchers examined the benefit of various methods for delivering PE including Massed-PE, (10 therapy sessions administered over two weeks) and Spaced-PE (10 sessions administered over 8 weeks), as well as Present Centered Therapy (PCT), a non-trauma-focused therapy that involves identifying and discussing daily stressors in 10 sessions over eight weeks, and Minimal Contact Control (MCC), which included supportive phone calls from therapists once weekly for four weeks. Patients who received Massed-PE therapy, delivered over two weeks, saw a greater reduction in PTSD symptoms than those who received MCC. Importantly, Massed-PE therapy was found to be equally effective to Spaced-PE in reducing PTSD symptom severity. The researchers also found that PCT might be an effective treatment option for PTSD in active military personnel although it was less effective than PE in veteran and civilian PTSD sufferers.  (more…)
Aging, Author Interviews, Geriatrics / 23.01.2018

MedicalResearch.com Interview with: Prof. Carol Jagger AXA Professor of Epidemiology of Ageing and Deputy Director of the Newcastle University Institute for Ageing (NUIA) Institute of Health & Society Campus for Ageing and Vitality Newcastle  MedicalResearch.com: What is the background for this study? What are the main findings? Response: As part of a larger study (MODEM – modelling outcome and cost impacts of interventions for dementia) we have developed a microsimulation model called PACSim which forecasts the number of older people aged 65 years and over along with their health and lifestyle factors as they age over the next 20 years. Crucially these are the first projections that include the health and lifestyle profiles of younger people as they age into to older population, rather than just assuming they have the same health profiles as existing young-old. Other studies have already reported that the proportion of older people with multimorbidity (two or more concurrent diseases) has increased. Our study shows that not only will this continue but that the largest increase over the next 20 years will be for complex multimorbidity (four or more diseases). Much of the gain in life expectancy over the next 20 year for a 65 year old will be years spent with complex multimorbidity. And more importantly the future cohorts of young-old entering the older population will have successively more multimorbidity. (more…)
Author Interviews, Breast Cancer, JAMA, Lymphoma / 23.01.2018

MedicalResearch.com Interview with: Dr. Mintsje de Boer, MD Resident plastic surgery Department of Plastic, Reconstructive and Hand-Surgery Maastricht University Medical Centre+, Maastricht the Netherland On behalf of the Netherlands BIA-ALCL Consortium: Daphne de Jong (Hematopathologist, VU university medical Center, Amsterdam, the Netherlands), Hinne Rakhorst (Plastic Surgeon, MST/ZGT, Enschede, the Netherlands) René van der Hulst (Plastic surgeon, MUMC+ Maastricht, the Netherlands) Flora van Leeuwen (Epidemiologist, Netherlands Cancer Institute, Amsterdam, the Netherlands), Jan Paul de Boer (Hemato-oncologist, Netherlands Cancer Institute, Amsterdam, the Netherlands) Lucy Overbeek (Database expert PALGA, Houten, the Netherlands),  MedicalResearch.com: What is the background for this study? Response: Breast implants are one of the most commonly used medical devices worldwide. Associations with breast cancer, connective tissue diseases and auto-immune diseases have never been unequivocally supported. For lymphoma risk, this is different and several reports have suggested an association between breast implants and risk of anaplastic large cell lymphoma in the breast (breast-ALCL). Over the past few years, the number of women with breast implants reported with breast-ALCL has strongly increased. This has resulted in significant attention amongst medical professionals and women alike with publications in medical journals and lay press. In part due to the rarity of the disease and due to the lack of breast implant prevalence data in the population, the absolute risks of breast-ALCL are largely unknown, precluding evidence-based counseling about implants. In the Netherlands, we are in the unique position to be able to retrieve all diagnosed breastALCL since 1990 as well as appropriate population-based control groups from the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA). This has allowed a formal epidemiological risk assessment study based on sufficient numbers. Moreover, using combined and complementary sources of information, we have been able to determine age- and calendar year-specific implant prevalence rates to determine reliable absolute risks. This study could be successfully performed thanks to a multidisciplinary taskforce consisting of plastic surgeons, hematopathologists, epidemiologists, hemato-oncologists and radiologists from the several large institutions in the Netherlands  (more…)
ASCO, Author Interviews, Colon Cancer, MD Anderson / 23.01.2018

MedicalResearch.com Interview with: Scott Kopetz, M.D., Ph.D., FACP Associate Professor Department of Gastrointestinal Medical Oncology Division of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: The BRAF mutation carries a very poor prognosis for patients with advanced colo-rectal cancer (CRC), and is particularly unresponsive after first-line therapy, so additional treatment options for these patients are needed. While treatment with a BRAF inhibitor alone has not been effective in treating this disease, combination therapies have shown promise and lead to the initiation of the BEACON study. The safety lead-in phase of the BEACON CRC trial was designed to assess the safety and tolerability of encorafenib, binimetinib  and cetuximab triplet combination prior to the Phase 3 randomized portion of the study. Thirty patients were treated in the safety lead-in and received the triplet combination (encorafenib 300 mg daily, binimetinib 45 mg twice daily, and cetuximab per label). Out of the 30 patients, 29 had a BRAFV600E mutation. Microsatellite instability-high (MSI-H) (resulting from defective DNA mismatch repair) was detected in only 1 patient. The triplet demonstrated good tolerability, supporting initiation of the randomized portion of the study. In addition, promising initial clinical activity was observed. In patients with the BRAFV600E mutation, the estimated median progression-free survival (mPFS) at the time of analysis was 8 months. The confirmed overall response rate (ORR) in patients with the BRAFV600E mutation was 48%, and 3 patients achieved complete responses (CR). Further, the ORR was 62% in the 16 patients (10/16) who received only one prior line of therapy. Additionally, the triplet combination was generally well-tolerated. Two patients discontinued treatment due to AEs with only one of these considered related to treatment. The most common grade 3 or 4 AEs seen in at least 10% of patients were fatigue (4/30), urinary tract infection (3/30), increased aspartate aminotransferase (AST; 3/30) and increased blood creatine kinase (CK; 3/30). (more…)
Author Interviews, Stroke, Technology / 23.01.2018

MedicalResearch.com Interview with: Professor Alireza Gharabaghi Univ.-Prof. Dr. med. Alireza Gharabaghi Ärztlicher Leiter Sektion Funktionelle und Restaurative Neurochirurgie Neurochirurgische Universitätsklinik Eberhard Karls Universität Tübingen  MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to the World Health Organization, 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled. Stroke is the leading cause of serious, long-term disability. About half of all stroke survivors will never be able to use their affected hand for activities of daily living again. The current study investigates a novel technology which may lead to new therapeutic options for these patients.  (more…)
Author Interviews, Cost of Health Care, JAMA, Ophthalmology, Surgical Research, UCSF / 23.01.2018

MedicalResearch.com Interview with: Catherine L. Chen, MD, MPH Assistant Professor UCSF Department of Anesthesia & Perioperative Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: Routine preoperative medical testing (such as common laboratory tests looking at a patient's blood cell counts and kidney function, or cardiac tests like an EKG) are not recommended in patients undergoing cataract surgery, but these tests still occur quite frequently among Medicare cataract surgery patients because these patients tend to be older and sicker than the general population. In the past, researchers have used a 30-day window counting backwards from the date of surgery to determine whether a given test should be categorized as a routine preoperative test. However, we know that testing often takes place outside this window and therefore, the frequency and cost of routine preoperative medical testing has generally been underreported. In our study, we used a new method to figure out how to determine the start of the routine preoperative testing period. In cataract patients, ocular biometry is a diagnostic test that is performed in anticipation of cataract surgery, and this test is only performed in cataract patients who will be having cataract surgery in the near future. For each patient, we calculated the elapsed time between the ocular biometry and cataract surgery dates to get a better idea of when to start looking for unnecessary routine preoperative testing. Our goal was to identify all the routine preoperative medical testing that occurs once the decision has been made to operate and better estimate the cost to Medicare of this unnecessary testing. In a previous study that we published in the New England Journal of Medicine, we reported a significant spike in the rate of routine preoperative medical testing that occurs in the 30 days before surgery compared to the baseline rate of testing. In our current study, we discovered that there is a second spike in testing that occurs in the 30 days after ocular biometry. In fact, even if you exclude the testing that takes place during the 30 days before surgery, there is still a 41% increase in testing rates during the interval between ocular biometry and cataract surgery over the baseline rate of testing. In addition, we found that the cost of routine preoperative testing was 47% higher when looking at the entire biometry to surgery timeframe compared to testing that occurs just in the 30 days before surgery. We estimate that the cost to Medicare of all of this unnecessary testing approaches $45.4 million annually. (more…)
Author Interviews, CT Scanning, Heart Disease, Technology / 23.01.2018

MedicalResearch.com Interview with: Cardiologist Mark Rabbat, MD, FSCCT Who pioneered the use of FFRct at Loyola Medicine and was first author of an international expert panel of leading cardiologists and radiologists from centers in the United States, Canada, Denmark, Italy, Belgium and the Netherlands on how to interpret and report the tests published in the Journal of Cardiovascular Computed Tomography.   MedicalResearch.com: What is the scope of the problem? Response: Coronary artery disease is a very large healthcare burden. Over sixteen million individuals in the United States have coronary artery disease.  Coronary artery disease may result in your heart not getting enough blood and increases your risk of a heart attack. Historically, we have been faced with either using tests we knew were not always accurate or putting a patient through an invasive angiogram just to determine whether they would need another invasive procedure to restore blood flow.  The CT-derived fractional flow reserve (FFRct) analysis is the first technology that bridges the gap between the non-invasive and invasive tests within one platform.  Any patient with symptoms such as chest pain, chest tightness, fatigue, or shortness of breath without known coronary artery disease may be a candidate for the FFRct study.  (more…)
Author Interviews, JAMA, Johns Hopkins, Kidney Disease, Transplantation / 23.01.2018

MedicalResearch.com Interview with: Tanjala S. Purnell, PhD MPH Assistant Professor of Surgery, Epidemiology, and Health Behavior and Society Core Faculty, Epidemiology Research Group in Organ Transplantation Johns Hopkins University Associate Director for Education and Training, Johns Hopkins Center for Health Equity Member, OPTN/UNOS Minority Affairs Committee  MedicalResearch.com: What is the background for this study?
  • Our study was motivated by the fact that we know live donor kidney transplants are associated with longer life expectancy and higher quality of life than deceased donor kidney transplants or long-term dialysis treatment. We also know that Black and Hispanic adults are more likely than White adults to have end-stage kidney disease but are less likely than White patients to receive live donor kidney transplants.
  • Over the last 2 decades, there have been several transplant education programs implemented within transplant centers and dialysis centers, and legislative policies enacted to improve overall access to live donor kidney transplants for patients. We wanted to see whether these programs and policies resulted in narrowed racial and ethnic disparities in access to live donor kidney transplants in the United States. 
(more…)
Author Interviews, Cancer Research, Ovarian Cancer / 22.01.2018

MedicalResearch.com Interview with: Dr. W.J. van Driel Gynaecologic Oncologist Antoni van Leeuwenhoek Amsterdam  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study reports on the results of a randomized phase 3 study in patients with FIGO stage III ovarian cancer who were ineligible for primary cytoreductive surgery and therefore treated with neo-adjuvant chemotherapy and interval cytoreductive surgery. Following optimal or complete cytoreductive surgery another 3 cycles of chemotherapy were given. During the interval cytoreductive surgery patients were randomized between surgery alone or surgery + HIPEC. During hyperthermic intraperitoneal administration of chemotherapy (HIPEC) the abdomen is perfused with cisplatin to expose any remaining minimal or microscopic disease to a high dose of heated chemotherapy. The main findings are that the addition of HIPEC to interval cytoreductive surgery resulted in longer recurrence-free survival and overall survival than surgery alone and the addition of HIPEC did not result in higher rates of side effects.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Chemotherapy / 22.01.2018

MedicalResearch.com Interview with: Bakhos Tannous, PhD Neuro-Oncology Division Department of Neurology MGH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Glioblastoma (GBM) is the most common and most aggressive type of brain tumors in adults. Over the last two decades, the major improvement in the treatment for GBM has been the addition of the chemotherapeutic temozolomide (TMZ) to the standard of care (surgery and radiation), however, despite this aggressive therapy, over 90% of patients die within five years after diagnosis. Further, only about half of GBM patients really benefit from TMZ treatment, while the other half are somewhat resistant to TMZ since their tumor endogenously carry a DNA repair mechanism that removes DNA adducts caused by TMZ. We therefore wanted to find a combination therapy that overcomes TMZ resistance and works in all GBM patient populations, with a fast transition to the clinic. Through a repurposing drug screening aiming at recycling of old known drugs for new therapies, we found that the FDA-approved drug hydroxyurea to synergizes with temozolomide in patient-derived GBM cells from newly diagnosed and recurrent tumors, irrespective of their DNA repair mechanism. The combination of hydroxyurea and TMZ worked very well in all different patient cell population tested, and was not specific to one subtype, and lead to a significant increase in survival rate in different mouse models. (more…)
Author Interviews, Infections / 22.01.2018

MedicalResearch.com Interview with: Bala Venkatesh, MBBS, MD(Int.Med), FRCA, FFARCSI, MD(UK), FCICM Director of Intensive Care, Wesley Hospital Pre-eminent specialist, Princess Alexandra Hospital Professor of Intensive Care,University of QLD Honorary Professor, University of New South WalesProfessorial Fellow, The George Institute for Global Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Whether hydrocortisone reduces mortality in patients with septic shock is unclear. The uncertainty about the efficacy of glucocorticoids in reducing mortality in patients with septic shock has resulted in widespread variation in clinical practice In the results published in the New England Journal of Medicine the investigators found steroids not only reduced the duration of septic shock, they also led to less blood transfusions, and the time spent on life support therapy in intensive care. However, the use of steroids did not lead to fewer deaths overall compared to placebo. Some of the findings are consistent with previous research whilst other results add new information that will inform clinicians. Our results show there is still a lot to learn about septic shock which kills up to half of those affected in some parts of the world. There are undoubtedly many other contributors to survival which we don’t yet understand.  (more…)