Author Interviews, Diabetes, Lancet, Parkinson's / 08.08.2017

MedicalResearch.com Interview with: Dr Dilan Athauda MRCP Sobell Department of Motor Neuroscience and Movement Disorders UCL Institute of Neurology & The National Hospital for Neurology and Neurosurgery London MedicalResearch.com: What is the background for this study? Response: Exenatide is a synthetic version of a naturally occurring protein - exendin-4 - that was originally discovered by Dr John Eng in the early 1990’s in the saliva of the Gila Monster, a venomous lizard native to the Southwestern United states. He and his team were looking for bio-active peptides in insect and lizard venom that could be useful for people with Type 2 diabetes. They discovered that exendin-4 was extremely similar to a human hormone called Glucagon-like peptide-1 (GLP-1).  In humans, GLP-1 is secreted after you eat a meal to stimulate insulin secretion (and inhibit glucagon production) of which the end result is a lowering of blood sugar. Unfortunately human GLP-1 is rapidly broken down by a circulating enzyme called dipeptidyl peptidase IV (DPP-IV) and its effects only last minutes. Importantly, it was discovered that exendin-4 is naturally resistant to the actions of this enzyme, meaning it’s effects on blood sugar control lasts much longer in the body.  These properties made it very attractive to people trying to treat people with Type 2 diabetes and following many successful randomised controlled trials of patients with Type 2 diabetes in 2005, exenatide was approved for use as a treatment.  During this time, work led by Nigel Greig’s group at the NIA showed that first evidence that exendin-4 had neuroprotective properties, and could protect neurons from a variety of stresses and could also improve growth and rescue degenerating cells. Over the next few years, various groups used exendin-4 in a variety of animal toxin models of Parkinson’s disease and showed that exendin-4 could halt the progression of Parkinsonism and prevent cell death in these models through beneficial effects on inflammation, mitochondrial function and cell survival. Based on this encouraging pre-clinical data, Professor Foltynie supervised the first small, “open-label”, human trial of exenatide in patients with Parkinson’s disease.  The team found that patients treated with exenatide for 1 year (in addition to their usual medication) had less decline in their motor symptoms when assessed without their medication compared to the control group (just on their usual medication) and this advantage over the control group was still present 1 year after stopping the exenatide injections.  However, this trial was open-label – patients knew they were getting a (potentially beneficial) experimental therapy and so we couldn’t exclude the fact that placebo effects were explaining some of the results we saw. As a result of the potentially beneficial results seen in this small open label trial we carried out a double-blind, placebo controlled trial. (more…)
Author Interviews, Cancer Research, Colon Cancer, Race/Ethnic Diversity / 08.08.2017

MedicalResearch.com Interview with: Rebecca Siegel, MPH Strategic Director, Surveillance Information Services American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer (CRC) incidence rates have been increasing in people under 55 since at least the mid-1990s, despite rapid declines in older age groups. We analyzed mortality data covering over 99% of the US population and found that death rates for CRC in adults under 55 have been increasing over the past decade of data (2004-2014) by 1% per year, in contrast to rapid declines in previous years. This indicates that the increase in incidence is not solely increased detection due to more colonoscopy use, but a true increase in disease occurrence that is of sufficient magnitude to outweigh improvements in survival because of better treatment for colorectal cancer. The second major finding was that the rise in death rates was confined to whites, among whom death rates rose by 1.4% per year, for an overall increase of 14%. In blacks, the colorectal cancer death rate declined slowly during the entire study period (1970-2014). This racial disparity is consistent with incidence, but in contrast to trends for major risk factors for CRC, like obesity, which has increased across all racial and ethnic groups. This means that the obesity epidemic is probably not wholly responsible for the increase in disease. Third major finding was that CRC death rates are increasing in people in their early 50s, for whom screening has been recommended for decades. This was particularly surprising since CRC screening has a two-fold impact on death rates by both preventing cancer and detecting it early when treatment is more effective. Rising death rates in this age group likely reflects lower screening rates in ages 50-54 than 55+ -- 46% vs 67% in 2015, probably because of delayed initiation of screening. (more…)
Author Interviews, Cost of Health Care, JAMA, Social Issues / 07.08.2017

MedicalResearch.com Interview with: Arlene S. Ash, PhD Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester  MedicalResearch.com: What is the background for this study? What are the main findings? Response: State Medicaid programs (and other health care purchasers) often contract with several managed care organizations, each of which agrees to address all health care needs for some of their beneficiaries. Suppose a Medicaid program has $5000 to spend, on average, for each of its 1 million beneficiaries. How much should they pay health plan “A” for the particular 100,000 beneficiaries it enrolls? If some group, such as those who are homeless, is much more expensive to care for than the payment, plans that try to provide good care for many such people will go broke. We describe the model now used by MassHealth to ensure that plans get more money for enrolling patients with greater medical and social needs. In this medical-social model, about 10% of total dollars is allocated by factors other than the medical-morbidity risk score. (more…)
Author Interviews, Cost of Health Care, JAMA, Lipids, University of Pittsburgh / 07.08.2017

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 1526 MedicalResearch.com: What is the background for this study? Response: A few months ago, the results of the FOURIER trial were published. This trial was the first one to evaluate the efficacy of PCSK9 inhibitors in the prevention of cardiovascular events, since the approval of these agents was based on trials that evaluated their efficacy in reducing levels of LDL-C. The results of the FOURIER trial did not meet the expectations generated by prior studies that had simulated how much the risk of cardiovascular events should decrease based on the observed reduction in LDL-C levels. A few hours after the publication of the results of the FOURIER trial, Amgen (evolocumab´s manufacturer) announced that it would be willing to engage in contracts where the cost of evolocumab would be refunded for those patients who suffer a heart attack or a stroke while using the drug. (more…)
Author Interviews, Psychological Science, Technology / 07.08.2017

MedicalResearch.com Interview with: Mag. Nicole Mirnig  Research Fellow Center for Human-Computer Interaction University of Salzburg Salzburg, Austria  MedicalResearch.com: What is the background for this study? What are the main findings? Response: From our previous research on social robots, we know that humans show observable reactions when a robot makes an error. These findings result from a video analysis we performed over a large data corpus from different human-robot interaction studies. With the study at hand, we wanted to replicate this effect in the lab in order to explore into more detail how humans react and what they think about a robot that makes a mistake. Our main findings made us quite excited. First of all, we could show that humans respond to faulty robot behavior with social signals. Second, we found that the error-prone robot was perceived as significantly more likeable than the flawless robot. One possible explanation for this finding would be the following. Research has shown that people form their opinions and expectations about robots to a substantial proportion on what they learn from the media. Those media entail movies in which robots are often portrayed as perfectly functioning entities (good or evil). Upon interacting with a social robot themselves, people adjust their opinions and expectations based on their interaction experience. We assume that interacting with a robot that makes mistakes, makes us feel closer and less inferior to technology. (more…)
Author Interviews, Kidney Disease, Transplantation / 07.08.2017

MedicalResearch.com Interview with: Dr. Anne Huml MD Center for Reducing Health Disparities Case Western Reserve University MetroHealth Medical Center Cleveland, Ohio  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Overall, about 600,000 Americans have end stage renal disease and require chronic dialysis treatment or a kidney transplant to survive. Compared to chronic dialysis, kidney transplantation results in better survival and quality of life and lower health care costs. Approximately 100,000 patients are listed for a kidney transplant. However, only 17,000 transplants occur per year with two-thirds of these coming from deceased donor organs. Annually, over 8,000 patients either die waiting for a kidney transplant or are removed from the waiting list for being too ill. Waiting times vary based on geography, but it is not unusual for patients to wait upwards of 5 years for a kidney transplant. There are sizeable race, gender, and socioeconomic disparities in access to kidney transplantation. In this study, we evaluated the outcomes of deceased donor kidney offers and their association with donor and waitlisted patient characteristics. Differences in kidney offer outcomes to patients at the top of the waiting list may contribute to disparities in transplantation. When a deceased donor organ becomes available, a match run list is created that ranks potential recipients in priority order based upon several characteristics, including waiting time and immunologic criteria. At the discretion of the transplant center, organ offers to patients on their waiting list can be accepted for transplant, or refused for a particular patient. The offers continue down the match run list in sequential order. For each potential recipient in whom the organ is not transplanted, a refusal code is generated and catalogued with the United Network of Organ Sharing, or UNOS. UNOS identifies 37 unique refusal codes and categorizes them into donor-related, transplant center bypassed for pre-specified criteria, recipient-related, histocompatibility-related, program-related, or other reasons for refusal. (more…)
Author Interviews, Kidney Stones, Nutrition / 07.08.2017

MedicalResearch.com Interview with: Teodor Paunescu, PhD and Sagar Nigwekar, MD Division of Nephrology Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over 25 million people in the U.S. have chronic kidney disease, and the number of deaths caused by this disease has doubled between 1990 and 2010. It is projected that by 2030 more than 1 in 3 adults over 65 years old will be diagnosed with chronic kidney disease. Many patients with kidney disease are also malnourished, which negatively impacts their quality of life, overall health, and even survival. However, no effective treatments are currently available to address malnutrition in these patients. The sense of smell plays an important role in determining food flavor. If a patient’s ability to smell is impaired, this could affect the taste of food, for example, foods that used to appeal to the patient may no longer do so. Given the relation between the sense of smell and appetite, we set out to investigate the loss of smell in patients with kidney disease, and to test an intervention aimed at alleviating their smell deficits. Our first goal was to determine if patients with various degrees of kidney disease suffer smell losses and whether smell issues might affect their nutritional status. We found that, while most kidney disease patients do not perceive a problem with their sense of smell, deficits in the ability to smell are actually common among these patients, and the severity of these deficits increases with the severity of their kidney disease. Moreover, our study found that reductions in several markers of nutrition (such as cholesterol and albumin levels) correlate with the impairment in these patients’ sense of smell. (more…)
Author Interviews, CDC, Gender Differences, HIV / 07.08.2017

MedicalResearch.com Interview with: Dr. Tiffany Aholou Behavioral Scientist Division of HIV/AIDS Prevention CDC MedicalResearch.com: What is the background for this study? Response: Women accounted for 24% of people living with HIV in the United States at the end of 2013 and 19% of HIV diagnoses in 2014. Of these diagnoses, 78% were among black women and Latinas. HIV diagnoses among women are overwhelmingly attributed to heterosexual contact with a person known to have, or to be at high risk for, HIV infection. Of note, new HIV diagnoses among US women declined 40% over a 10 year period (2005-2014), yet we continue to see significant racial/ethnic disparities due largely to a complex web of demographic, individual, social and contextual factors with the environment that enables HIV risk behaviors to occur. While the decline in new HIV diagnoses among US women is noteworthy, in our review of the literature, we found research studies that specifically focus on women and HIV from a domestic perspective were scarce. To fill this gap and sharpen our understanding about sexual behaviors that are associated with heterosexual transmission of HIV, this study used data from three cycles of the National Survey of Family Growth (2006-2008, 2008-2010, and 2011-2013) to examine HIV-related sexual risk and protective behaviors - concurrent sex partnerships, non-monogamous sex partners, and condom use at either last vaginal sex or anal sex similar to what you might of seen on websites such as fulltube xxx - among sexually active women aged 18-44 years by race/ethnicity and over time. (more…)
Author Interviews, Diabetes, Stem Cells, Weight Research / 04.08.2017

MedicalResearch.com Interview with: Dr. Xiaoyang Wu PhD Ben May Department for Cancer Research The University of Chicago, Chicago, IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been working on skin somatic stem cells for many years. As one of the most studies adult stem cell systems, skin stem cells have several unique advantages as the novel vehicle for somatic gene therapy (summarized also in the paper). The system is well established. Human skin transplantation using CEA device developed from skin stem cells have been clinically used for decades for burn wound treatment, and been proven to be safe the effective. In this study, we developed a skin 3D organoid culture model to induce stratification and maturation of mouse epidermal stem cells in vitro, which allows us to efficiently transfer engineered mouse skin to isogenic host animals. In the proof of concept study, we showed that we can achieve systematic release of GLP1 at therapeutic concentration by engineered skin grafts. (more…)
Author Interviews, Kidney Disease, NEJM, Transplantation / 04.08.2017

MedicalResearch.com Interview with: Stanley C. Jordan, M.D Director, Division of Nephrology Medical Director, Kidney Transplant Program Medical Director, Human Leukocyte Antigen and Transplant Immunology Laboratory Cedars-Sinai, Los Angeles, CA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is as follows: Patients who are highly HLA sensitized have antibodies to transplant targets create an immunologic barrier to transplant. Currently, there are no approved therapies for elimination of these antibodies. Desensitization is available but is not always successful and most desensitized patients are still transplanted with a positive crossmatch. Thus, many patients are not able to receive life-saving kidney transplants unless newer therapies to remove antibodies are found. The findings of our study published in the New England Journal of Medicine revealed that the use of the enzyme from streptococcal pyogenes called IdeS® (IgG endopeptidase) is very effective in eliminating donor specific antibodies and allowing transplantation to occur. Antibodies were eliminated from one week up to two months after one treatment with Ides® allowing a safe environment for the transplant to occur. Rejections episodes did occur in some of the patients but were generally mild and easily treatable. Only one patient of 25 lost his allograft during the study. Thus, the study shows promising results for a new approach for elimination of pathogenic antibodies that did not exist before. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Opiods, Pediatrics / 04.08.2017

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Assistant Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Neonatal drug withdrawal is common; in the U.S. about 1 infant is born every 25 minutes with signs of drug withdrawal. Neonatal drug withdrawal is a well-recognized complication of intrauterine exposure to illicit or prescription opioids, but other psychotropic medications can also cause signs of withdrawal. Psychotropic medications are frequently co-prescribed with opioids in pregnancy, and the use of both has increased significantly, raising concerns about an increase in the incidence and severity of neonatal drug withdrawal due to potential drug-drug interactions, but these risks are not well understood. In this study, we found a 30-60% increase in the risk of neonatal drug withdrawal associated with co-exposure to antidepressants, benzodiazepines and gabapentin, compared to opioids alone; no significant increase in risk was observed for atypical antipsychotics and Z-drugs. Exposure to psychotropic polypharmacy along with opioids was associated with a two-fold increased risk of withdrawal. (more…)
Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 03.08.2017

MedicalResearch.com Interview with: Samar R. El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor, Epidemiology PITT Public Health Epidemiology Data Center University of Pittsburgh Pittsburgh, PA 15260   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart fat is associated with greater coronary heart disease risk. Postmenopausal women have greater heart fat volumes than premenopausal women, and the association between specific heart fat depots and calcification in the coronary arteries is more pronounced after menopause. Race, central adiposity, and visceral adiposity are important factors that could impact heart fat volumes. We evaluated whether racial differences in heart fat volumes and in their associations with central (abdominal visceral fat) and general adiposity (as measured by body mass index [BMI]) exist in midlife women. Our study included 524 women from the Study of Women's Health Across the Nation (SWAN) (mean age: 51 years; 62% White and 38% Black) who had data on heart fat volumes, abdominal visceral fat and BMI. After accounting for the potential health effects of lifestyle and socioeconomic factors we found that midlife Black women had less heart fat volumes than white women and not surprisingly, the more fat a women carries overall, the higher her risk for a fatty heart. However, white women with higher BMI had significantly more heart fat, as measured by a CT scan, than black women with the same BMI. For black women, the levels of heart fat were greater if they carried more fat in their midsection, as measured by a cross-sectional CT scan, compared with white women with the same volume of fat in their midsection. The results echo the findings we have reported previously in midlife men and published at the International Journal of Obesity (2015) 39, 488–494. (more…)
Author Interviews, Education, Weight Research / 02.08.2017

MedicalResearch.com Interview with: Gregory Gayer, PhD Associate Professor Chair of Basic Science Department TUCOM California  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of obesity in the United States continues to be a growing and remains a major health concern.  Closely associated with obesity is an extensive list of chronic diseases, including hypertension, dyslipidemia, and type 2 diabetes.  Unfortunately, physician bias against obese people may create a self-defeating environment that can produce less effective communication in a manner that could reduce the patient’s willingness to participate in their own health. Our overall goal is to prepare future physicians to appropriately engage the obese patient in order to optimize health care delivery. This study was initiated in response to the ever increasing demand on the medical profession to properly care for the obese patient. We demonstrated that medical students have the same inherent bias as other health care providers and this bias can be sustainably reduced by education. We hope that this reduction in bias shown in medical school will enable students to be better prepared to address the concerns of their obese patients and ultimately translate into better clinical outcomes for them. (more…)
Author Interviews, BMC, Breast Cancer, Radiation Therapy / 02.08.2017

MedicalResearch.com Interview with: Heiko Enderling, Ph.D. Associate Member & Director for Education and Outreach Dept. of Integrated Mathematical Oncology Dept. of Radiation Oncology H. Lee Moffitt Cancer Center & Research Institute Tampa, FL 33612 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although radiation therapy after breast-conserving surgery for early-stage breast cancer has significantly improved patient prognosis, many patients will face a second cancer diagnosis within 20 years of primary treatment. Experimental and clinical studies have shown that local radiation therapy can activate an immune response that can propagate systemically to attack distant untreated metastases. However, current radiotherapy practice has not specifically focused on enhancing immune responses. We asked the question if pre-operative irradiation, when applied to the bulk of disease, could have potentially higher immune stimulatory effects. To study this, we analyzed historic outcomes of breast cancer patients treated with either adjuvant (radiation after surgery) or neoadjuvant (radiation before surgery) radiotherapies. Our analysis showed that the risk of developing a second tumor after neoadjuvant compared with adjuvant RT was significantly lower, especially for estrogen receptor-positive women who underwent breast conserving surgery or mastectomy. Historic data revealed an increase in disease-free survival of 12% over 20 years after treatment of the original tumor. (more…)
Author Interviews / 02.08.2017

MedicalResearch.com Interview with: H. Eric Xu, Ph.D. Professor, Center for Cancer and Cell Biology Van Andel Research Institute  MedicalResearch.com: What is the background for this study? What are the main findings? Response: G protein–coupled receptors (GPCRs) comprise the largest family of cell surface signaling receptors and drug targets, with about 30 percent of drugs currently on the market interacting with these receptors. GPCR signaling is primarily mediated through two pathways: G proteins or arrestins, each of which drives distinct physiologic and therapeutic effects on GPCR ligands. Current GPCR drugs often activate or block both pathways, leading to therapeutic effects as well as unwanted side effects. An ideal GPCR drug will have a therapeutic effect but block the side-effects by selectively modulating either the G protein or arrestin pathway. The switch between the G protein and arrestin pathways is determined by the phosphorylation of the GPCR, the underlying mechanism of which has been a long sought-after question in the field. Our study uncovered and validated the phosphorylation pattern, which serves as the instructional code to switch on the arrestin pathway. Furthermore, the code appears to be universally applicable to the proteome of GPCRs and could serve as a guiding light for understanding other GPCR-arrestin interactions and arrestin-biased signaling. (more…)
Author Interviews, JAMA, Schizophrenia / 02.08.2017

MedicalResearch.com Interview with: Peter Kochunov PhD Professor Maryland Psychiatric Research Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a debilitating disorder that strikes young people at the point of entering adulthood. In the past, we and others demonstrated that patients with schizophrenia are characterized by deficits in the white matter of the brain. White matter is the part of the brain that serves the backbone of cerebral networks transmitting information and interconnecting brain regions. In this report, we link the impaired white matter of the brain in schizophrenia patients with the disorder-related deficits in the processing speed. We also showed that mental processing speed is a fundamental cognitive construct that partially supports other functions like working memory in patients, where processing speed acting as the intermediate between white matter deficits and reduced working memory. This interesting relationship between processing speed, working memory, and white matter is most obvious in white matter regions most vulnerable to schizophrenia. That was the main finding of the study. (more…)
Author Interviews, Breast Cancer, JAMA, Surgical Research / 02.08.2017

MedicalResearch.com Interview with: Dr. Lisa K. Jacobs MD Johns Hopkins School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast preservation is the preferred treatment for many women diagnosed with breast cancer.  The most common question that a patient will ask after the surgery is, “Did you get it all?” In the ideal case, this is accomplished in a single outpatient surgery with very good cosmetic results.  In our study, Beyond the Margins-Economic Costs and Complications Associated with Repeated Breast-Conserving Surgeries we evaluated the detrimental effects of an unsuccessful initial surgery due to positive surgical margins. Using private insurance claims data, we found that 16% of patients planning breast preservation required a second breast-conserving surgery and an additional 7% converted to mastectomy.  Of those patients that required additional surgery there was a 56% ($16,072) increase in cost and a 48% increase in complications.  Those complications include infection, hematoma, seroma, and fat necrosis.  This study demonstrates that repeated surgery has not only cosmetic consequences, but also has financial implications and increased risk. (more…)
Author Interviews, Cancer Research, JAMA / 02.08.2017

MedicalResearch.com Interview with: Benjamin Weixler, MD Department of Surgery University Hospital Basel, Basel, Switzerland and Leiden University Medical Center, Leiden, the Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: For most patients with lymph node negative colon cancer (stage I and II) surgery is regarded to be the curative treatment. Despite the curative attempt up to thirty percent of these patients will develop disease recurrence, most likely due to missed micro-metastatic disease at initial tumor staging. Pathological standard processing with hematoxylin and eosin (H&E) entails a considerable risk of missing micro-metastatic deposits in the lymph nodes. Mounting evidence indicates that micro-metastatic tumor deposits in the lymph nodes as well as in the bone marrow might be associated with an increased risk of disease recurrence and death in node negative patients. With our study we wanted to examine the correlation between the occurrence of micro-metastatic deposits in the lymph nodes and the bone marrow as well as their prognostic significance. As a main finding, the study provides compelling evidence that tumor cell dissemination to the lymph nodes and to the bone marrow are independent events in patients with colon cancer. Most importantly did the study demonstrate that micro-metastatic deposits in the lymph nodes as well as in the bone marrow are independent negative prognostic factors regarding  disease-free and overall survival. The combined occurrence is associated with significantly worse prognosis compared to either one of them. (more…)
AACR, Author Interviews, Cancer Research, Dental Research, Menopause / 02.08.2017

MedicalResearch.com Interview with: Jean Wactawski-Wende, PhD Dean, SUNY Distinguished Professor Professor, Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a growing interest in the role of periodontal disease in system chronic diseases, including cancer. We explored the association of periodontal disease history and incident cancer in the women's health initiative study of postmenopausal women. We found that women reporting periodontal disease history were at increased risk of developing cancer overall. In addition they were found to have significant increased risk of specific cancers including cancers of the lung, breast, esophagus, gallbladder and melanoma. The risk persisted after control for many other factors. In addition, the risk was seen in women regardless of their smoking history. Both ever smokers and never smokers were found to have increased risk of cancer associated with periodontal disease history. (more…)
Author Interviews, Biomarkers, Brain Injury, JAMA / 01.08.2017

MedicalResearch.com Interview with: Dr. Adrian Harel, PhD Chief Executive Officer Medicortex Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every 15 seconds, someone in the United States suffers a new head injury. Of the 2.5M people treated in hospital emergency rooms each year, 80,000 become permanently disabled because of TBI. Currently, there are no reliable diagnostic tests to assess the presence or severity of an injury on-site, nor are there any pharmaceutical therapies that could stop the secondary injury from spreading. Accurate diagnostics would benefit especially mild cases of TBI (concussions), which, if occurring repeatedly, may cause neurodegenerative conditions such as Chronic Traumatic Encephalopathy (which is typical for athletes in NFL and Ice-hockey). We have performed extensive preclinical research comparing fluid biopsies from normal and injured lab animals. The results showed some unique biomarkers released as a biodegradation products after head injury. The data served as the basis and confirmation for our patent applications to protect the biomarker concept. Medicortex has completed a clinical proof-of-concept trial in collaboration with Turku University Hospital (Tyks). Samples from 12 TBI patients and 12 healthy volunteers were collected and analyzed for the presence and for the level of the biomarker in state-of-the-art laboratories. The study demonstrated the diagnostic potential of the new biomarker in humans and it confirmed the prior preclinical findings. This was a significant milestone for Medicortex. (more…)
Author Interviews, Stroke, Technology / 01.08.2017

MedicalResearch.com Interview with: Bertrand LAPERGUE, MD, PhD Hôpital Foch, University Versailles Saint Quentin en Yvelynes Department of Stroke Center, Diagnostic and Interventional Neuroradiology Suresnes, France. Michel PIOTIN, MD Department of Diagnostic and Interventional Neuroradiology Fondation Rothschild, Paris, France. on behalf of the ASTER Trial Investigators. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO). Favorable outcome is strongly associated with the successful reperfusion status (TICI 2b/3= 71% with SR, Hermes Study group). New techniques for MT such as ADAPT (A Direct first pass Aspiration Technique) seem promising to increase reperfusion status and clinical outcome in retrospective studies. (more…)
Author Interviews, Cleveland Clinic, Orthopedics, Pain Research, Surgical Research / 01.08.2017

MedicalResearch.com Interview with: Michael A. Mont, MD Department of Orthopaedic Surgery Cleveland Clinic Cleveland, OH  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Postoperative pain after total knee arthroplasty (TKA) is a major hurdle for both the patients and the orthopaedists. Many analgesic modalities are currently in use, and can be used alone or in combination in order to augment their effect. Addition of local anesthetic analgesia has been shown to improve pain control and reduce opioid consumption during postoperative period. However, the effects of this analgesia tend to dissipate with time, with the longest duration of action (bupivacaine) of approximately 12 hours. Therefore, long acting local anesthetic (liposomal bupivacaine) has been developed in order to expand the duration of effectiveness of pain relief for up to 96 hours. Many studies evaluated the effectiveness of this anesthetic and demonstrated contradictory results, however, they did not use the same methods and infiltration technique. Therefore, we conducted a prospective, randomized, double-blind, controlled study at 16 hospitals using optimal infiltration techniques. Our study demonstrated significant improvement in pain, decreased opioid consumption, increased time to first opioid rescue, more opioid free patients in liposomal bupivacaine cohort. In addition, there were no unexpected safety concerns. (more…)
Author Interviews, Psychological Science / 31.07.2017

MedicalResearch.com Interview with: Jared Friedman Doctoral Student, Organizational Behavior Research Assistant II, Brain Mind and Consciousness Lab Case Western Reserve University MedicalResearch.com: What is the background for this study? What are the main findings? Response: These studies were motivated by our prior work in neuroscience and psychology.  Neuroscience research from our lab has shown that brain areas associated with empathy seem to share a ‘see-saw’ relationship with brain areas associated with analytic reasoning.  As activity in one set of brain areas goes up, activity in the other set of brain areas tends to go down.  This suggests there is a sort of neural antagonism between warm, empathic sorts of thinking on the one hand, and cold, analytic sorts of thinking on the other. In prior psychological work, we tested the hypothesis that these two different sorts of thinking might share opposing relationships to religious belief.  Over a series of 8 studies, we showed that although religious belief is negatively related to analytic reasoning skills (which many other labs had shown), it shares a much stronger positive relationship to measures of empathy and moral concern.  This suggests that religious belief, measured on a continuum, might emerge from the tension between empathic and analytic forms of thinking. The current studies expanded on this prior work by examining how dogmatism – strongly holding onto one’s beliefs, even in the face of contradictory evidence – relates to measures of moral concern and analytic reasoning among individuals identifying as religious and non-religious.  The measure of dogmatism we used is neutral with respect to any particular belief system, which means that it measures dogmatism in general (rather than dogmatism towards, for instance, religious beliefs).  We found that analytic reasoning negatively relates to dogmatic tendencies in both groups.  However, the interesting part is that higher levels of dogmatism among the religious were related to higher levels of moral concern, whereas higher levels of dogmatism among the nonreligious relate to lower levels moral concern.  This is very intriguing because it suggests that religious and nonreligious individuals rely differently on these two types of cognition when forming beliefs about the world, in general.  We also found that perspective taking, which is an emotionally detached form of understanding other people’s minds, had a particularly strong negative relationship among the nonreligious. (more…)
Author Interviews, Cannabis, Social Issues / 31.07.2017

MedicalResearch.com Interview with: Carrie Cuttler, Ph.D. Clinical Assistant Professor Washington State University Department of Psychology Pullman, WA, 99164-4820 MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the most common reasons cannabis users report using cannabis is to cope with stress. In support of this, previous research has shown that acute administration of THC or cannabis dampens affective responses and subjective stress ratings. This has made strains of cannabis popular for use for stress and other ailments with some online outlets, like high thc having reviews such as the og kush strain review to perpective users. However, our study is the first to compare the stress response of sober cannabis users to non-users. More specifically, we randomly assigned 42 non-cannabis users and 40 cannabis users (who abstained from using cannabis for at least 12 hours prior to the study) to either a stress or no stress condition. Participants in the stress condition were required to perform multiple trials of placing their hand in ice water and counting backwards from 2043 by 17s. Each time they made an error they were given negative feedback and told to start again. Further, they were being video recorded and their image was displayed in front of them. Participants who were assigned to the no stress condition were simply required to perform multiple trials of placing their hand in lukewarm water and counting from 1 to 25. They were not given feedback or recorded. Participants were asked to rate their level of stress and to provide a saliva sample, from which the stress hormone cortisol was measured. The results showed that, as expected, non-users in the stress condition had higher cortisol levels and higher self-reported stress than non-users in the no stress condition. In contrast, cannabis users in the stress condition demonstrated the same levels of cortisol as cannabis users in the no stress condition and their increase in self-reported stress was smaller than that of the non-users. (more…)
Author Interviews, Cost of Health Care, Emory / 31.07.2017

MedicalResearch.com Interview with: Xu Ji PhD Candidate Emory University Department of Health Policy and Management Rollins School of Public Health Emory University Atlanta, GA What is the background for this study? What are the main findings? Response: Gaps in Medicaid coverage (sometimes called “churning”) can disrupt ongoing outpatient care needed to manage chronic conditions, such as depression, and trigger use of emergency care. This study examined how disruptions in Medicaid coverage impacted acute care use—specifically emergency department visits and hospital stays—in nearly 140,000 adults treated for major depression. We found that those with disruptions in Medicaid coverage were more likely to have emergency department visits and longer hospital stays when they went back on Medicaid compared to those with continuous coverage. We also found that disruptions in Medicaid coverage occurred less frequently for Medicaid enrollees with depression in states requiring only yearly recertification (i.e., more streamlined re-enrollment procedures) than those in states that required recertification every six months or more frequently (i.e., more stringent procedures). Eligibility recertification usually requires enrollees to visit the social welfare office to provide income or other documentation to prove eligibility. Failure to complete the recertification process would drop enrollees out of Medicaid. (more…)
Author Interviews / 30.07.2017

MedicalResearch.com Interview with: Stanford Chihuri, MPH Staff Associate/Data Analyst Department of Anesthesiology, College of Physicians and Surgeons Columbia University Medical Center NY, NY 10032  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the past 2 decades, consumption of prescription opioids has substantially increased in the U.S. Prescription drugs may cause drowsiness and impaired cognition which may interfere with psychomotor functioning necessary during the operation of a motor vehicle. The current study assessed time trends in prescription opioids detected in drivers killed in motor vehicle crashes from 1995 to 2015 in 6 states in the U.S. Results of the study showed that the prevalence of prescription opioids detected in fatally injured drivers has increased 700% in the past 2 decades. (more…)
Author Interviews, Diabetes, JAMA, Ophthalmology, UC Davis / 30.07.2017

MedicalResearch.com Interview with: Jeffrey R. Willis MD, PhD UC Davis Eye Center University of California, Davis Sacramento California MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetic retinopathy is one of the leading causes of blindness in the United States.  Yet there is limited national level data on the impact of worsening DR on quality of life and visual function. Our study aimed to address this knowledge gap by evaluating the functional burden of DR across severity levels, utilizing data from the National Health and Nutrition Examination Survey (NHANES). We found that one-half of US adults with severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) had difficulty with ≥ 1 visual function task, possibly impacting their daily work/activities.  These patients reported a significantly greater vision-related functional burden relative to those with less severe forms of DR. (more…)
Author Interviews, Hearing Loss, JAMA, Pediatrics / 30.07.2017

MedicalResearch.com Interview with: Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC , Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been increasing interest for acquired hearing loss among children, and concerns about its prevalence possibly rising over time. One of the questions that come up, is whether there is an association with the growing use of portable music players with headphones, including smartphones and tablets. There have been few longitudinal studies to explore this relation. In order to examine this relation, among other factors, we have conducted a formal hearing screening among more than 5000 9- to 11-year-old children from a population-based birth cohort in the Netherlands. Our study showed that nearly one in five children did not have normal hearing. Of the cohort, 7.8% of the children showed signs of permanent hearing loss. (more…)
Author Interviews, Brain Injury, Cleveland Clinic, Cognitive Issues, MRI, Occupational Health / 29.07.2017

MedicalResearch.com Interview with: Virendra Mishra, Ph.D. Department of Imaging Research Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Repetitive head trauma has been shown to be a risk factor for various neurodegenerative disorders, mood swings, depression and chronic traumatic encephalopathy. There has been a significant amount of research into identifying an imaging biomarker of mild traumatic brain injury (mTBI) due to repetitive head trauma. Unfortunately, most of the biomarkers have not been able to find a successful translation to clinics. Additionally, the quest for the mTBI imaging biomarker especially using Magnetic Resonance Imaging (MRI) techniques has been done by looking at either the gray matter (T1-weighted) or the white matter (Diffusion Tensor Imaging) independently; and both have shown changes that are associated with repetitive head trauma. Hence in this study, we wanted to investigate if combining gray matter and white matter information enables us to better predict the fighters who are more vulnerable to cognitive decline due to repetitive head trauma. Our method found seven imaging biomarkers that when combined together in a multivariate sense were able to predict with greater than 73% accuracy those fighters who are vulnerable to cognitive decline both at baseline and follow-up. The imaging biomarkers were indeed a combination of gray and white matter measures of regions reported previously in the literature. A key point in our study was we found the regions predicting cognitive decline without enforcing any assumptions on the regions previously reported. (more…)
Author Interviews, Genetic Research, Nature / 29.07.2017

MedicalResearch.com Interview with: Dr. Zoltán Kutalik, PhD Group Leader Swiss Institute of Bioinformatics Assistant professor at the Institute of Social and Preventive Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Why do some of us live longer than others? While the environment in which we live – including our socio-economic status or the food we eat – plays the biggest part, about 20 to 30% of the variation in human lifespan comes down to our genome. Changes in particular locations in our DNA sequence, such as single-nucleotide polymorphisms (SNPs), could therefore hold some of the keys to our longevity. Until now, the most comprehensive studies had found only two hits in the genome. (more…)