Author Interviews, Dental Research / 07.11.2016

MedicalResearch.com Interview with: Sonia Julià-Sánchez, Ph.D. Departament de Fisiologia i Immunologia Universitat de Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Contradictory results are still reported on the influence of dental occlusion on the balance control. While most literature have evaluated this relationship in static conditions with inconclusive results, the topic is still a matter of debate. However, less research has focused on the correlation of dental occlusion and balance control in unstable surfaces, even though the higher sensitivity of the unstable platforms to examine individual responses to translational and angular perturbations. Moreover, when we talk about the influence of dental occlusion on the body balance, the study of the specific malocclusal traits influencing balance control should be of extremely importance to apply the proper treatment. Our study was focused on the influence of dental occlusion and specific malocclusal traits on the body balance control at extreme levels of stability. We found that body balance was significantly influenced by dental occlusion in unstable conditions. Moreover, specific occlusal traits significantly influencing postural control were: Angle Class, crowding, midline deviation, crossbite, anterior open bite and overjet. (more…)
Author Interviews, Weight Research / 07.11.2016

MedicalResearch.com with: Lee Kaplan, MD, PhD, Director of the Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital Weight Center and ACTION study steering committee member MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today, nearly 100 million people in the U.S. have obesity. Despite the fact that many healthcare providers and others recognize obesity as a disease that can have a significant impact on health, many people with obesity do not have access to effective care for this disorder. As a result, obesity remains substantially under-diagnosed, under-addressed and under-treated. Since multiple parties could have a role in overcoming this barrier to effective obesity care, we sought to determine and compare the perspectives and experience of three important groups – health care providers, employers, and people with obesity themselves – about obesity and its care. As the first national study looking simultaneously at these complementary perspectives, ACTION sought to help answer several important questions:
  • Given that obesity is occurring at epidemic rates, why is it not being treated? What are the barriers to effective care?
  • How could public and professional attitudes contribute?
  • To what degree do limitations of resources or knowledge about the disease contribute?
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Author Interviews, C. difficile, CDC, Infections, Outcomes & Safety / 07.11.2016

MedicalResearch.com Interview with: Dr. Shannon Novosad, MD Epidemic Intelligence Service, CDC Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium difficile can cause an infection in the colon called colitis. Symptoms include diarrhea, fever, nausea, and abdominal pain. It is an important cause of healthcare associated infections with approximately half a million C. difficile infections and 29,000 associated deaths in 2011. The Infectious Diseases Society of America and Society for Healthcare Epidemiology of America published guidelines in 2010 advising clinicians on appropriate antibiotic regimens to treat C. difficile infection.  Prior studies have found that provider adherence to these guidelines, particularly in those with severe disease, is poor.  However, these studies primarily involved patients treated at a single healthcare facility. We were interested in examining CDI treatment practices in a larger group of patients with C. difficile infection located across geographically diverse areas. Further we wanted to learn more about what patient characteristics might be associated with receiving guideline-adherent therapy for C. difficile infection. We used data from the Center for Disease Control and Prevention’s Emerging Infections Program (EIP) which performs active population and laboratory-based surveillance for C. difficile infections in 10 U.S. sites and examined how 11,717 patients including 2006 with severe disease were treated. We found that provider adherence to national treatment guidelines was low with only around 40% of those with severe disease being prescribed the appropriate antibiotic treatment. Our analysis suggests that those who were tested for C. difficile in the hospital or who were admitted to the hospital around the time of diagnosis were more likely to receive recommended antibiotic therapy. In addition, patients greater than 65 years old or with more underlying comorbidities were more likely to receive the right antibiotic treatment. We also found that after adjusting for age and underlying comorbidities, the odds of death within 30 days of diagnosis was almost 400% higher in patients who did not receive guideline-adherent therapy compared to those who did. (more…)
Anemia, Author Interviews, OBGYNE / 07.11.2016

MedicalResearch.com Interview with: Daniel C Benyshek, PhD Professor, Department of Anthropology Adjunct Professor, UNLV School of Medicine Co-Director, Metabolism, Anthropometry and Nutrition Lab University of Nevada, Las Vegas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maternal placentophagy is ubiquitous among nearly all terrestrial mammals, but is rare to non-existent among humans in the historic and cross-cultural records. Recently, however, human maternal placentophagy has emerged as a popular trend among a small but growing number of women in many industrialized countries. Most women engaging in the practice today consume their processed placenta in capsule form, taken daily, over several weeks postpartum. While human maternal placentophagy advocates claim many maternal health benefits from the practice, including improved postpartum mood, increased breast-milk production, and improved energy, among others, no carefully designed, placebo-controlled studies have evaluated these claims. Our randomized, double-blind, placebo-controlled pilot study (N=23) investigated some of these claims. Our study found that the postpartum iron status of participants who consumed their own encapsulated placenta (based on the three week daily intake recommendation of one prominent placenta encapsulation service), was no different from those women who consumed the same amount of beef placebo. (more…)
Author Interviews, Nature, Stem Cells / 07.11.2016

MedicalResearch.com Interview with: Dr. Fred Levine MD PhD Professor & Director Sanford Children's Health Research Center Sanford Burnham Prebys Medical Discovery Institute La Jolla, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is the latest in a series that began in 2010 when we published that the combination of severe pancreatitis and ablation of preexisting pancreatic beta-cells led to the formation of new beta-cells by direct conversion of alpha-cells, which are the neighboring cells in the islets of Langerhans producing glucagon, which like insulin is also involved in glucose homeostasis. The phenomenon of generating new beta-cells by islet cell transdifferentiation went against the conventional wisdom in the field, which is that most beta-cell neogenesis in adults occurs by differentiation from cells in the pancreatic ducts, similar to what happens during embryogenesis. Since then, we have shown that beta-cell neogenesis by islet cell transdifferentiation appears to occur in murine and human type I diabetes, making it highly translationally relevant. Understanding the mechanism by which new beta-cells are formed from alpha-cells is required for eventual clinical translation. The current study describes that mechanism, which involves the activation of an atypical G protein coupled receptor called Protease Activated Receptor 2 (PAR2). Unlike most other GPCRs, it is activated by extracellular proteases such as are found in the exocrine pancreas or following tissue damage. PAR2 activation by an injectable peptide agonist was both necessary and sufficient to induce beta-cell neogenesis when preexisting beta-cells are absent, as occurs in type I diabetes. (more…)
Author Interviews, Medical Imaging / 06.11.2016

MedicalResearch.com Interview with: Devon A. Klein, MD, MPH Asst. Professor of Radiology and Orthopaedics Hofstra Northwell School of Medicine Associate Chairman, Radiology Lenox Hill Hospital New York, NY 10075 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As our Emergency Department continued to grow our Radiology Department was challenged to accommodate the resultant increased volume with fixed resources (i.e. CT Scanners) and maintain CT scan throughput. Uncoordinated insular efforts within the Department of Radiology failed to resolve the problem. A collaborative approach utilizing Six Sigma lean and involving stakeholders from the Departments of Radiology, Emergency, Medicine, and Patient Transportation was able to better illustrate the “bottlenecks” and devise solutions. (more…)
Author Interviews, Diabetes, Nutrition, PLoS, University of Michigan / 06.11.2016

MedicalResearch.com Interview with> Katarina Borer, Ph.D. Professor Po-Ju Lin,PhD School of Kinesiology The University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: This study was part of the doctoral dissertation of Po-Ju Lin, who is now a post-doctoral fellow at the University of Rochester. With this study, we wanted to answer three questions: (1) Is daily carbohydrate load responsible for evening glucose intolerance and post-meal insulin resistance. (Evening glucose intolerance represents well-documented higher glucose and insulin responses in the evening than in the morning when the same quantity of glucose is eaten or infused intravenously) To answer this question we offered two daily meals containing about 800 Kcal and either 30% or 60% of carbohydrates. (2) Will exercise before the meals improve glucose tolerance (glucose clearance from the blood and insulin response) after eating? (Exercise is a well-known means of increasing glucose uptake by the muscle and of increasing muscle sensitivity to insulin action for a number of hours after exercise). To answer this question we had the subjects exercise for two hours walking on a treadmill at 45% of their maximal aerobic effort one hour before each meal. (3) Is the upper-intestinal hormone GIP involved in any effects associated with variation in dietary carbohydrate? (GIP or glucose-dependent insulinotropic peptide, stimulates insulin secretion in advance of absorbed glucose). (more…)
Author Interviews, Dermatology, Pain Research / 06.11.2016

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Hellerup Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with rosacea frequently report symptoms of migraine, and this link has been discussed for many years. However, very little research has actually been performed in this area, and the prevalence varies greatly between studies. We examined the prevalence of migraine in patients with rosacea, nationwide, as well as the risk of new-onset migraine in patients with manifest rosacea. We found a markedly increased prevalence of migraine among patients with rosacea. The risk of new-onset migraine was also higher among patients with rosacea, but only among women. Perhaps most notably was the observation that risk of new-onset migraine was highest among patients older than 50 years. This was surprising, since new-onset migraine in older individuals is often considered a "red flag". (more…)
Author Interviews, Diabetes, Weight Research / 04.11.2016

MedicalResearch.com Interview with: Patrick M. O'Neil, Ph.D. Director, Weight Management Center Professor, Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Charleston, SC 29425 MedicalResearch.com: What is already known about the subject? • Even modest weight loss (2-5%) from clinical interventions improves glycemic control in type 2 diabetes. • Commercial weight loss programs, comparatively more affordable and accessible than clinic-based modalities, can produce weight losses in this range, although they typically do not offer diabetes-specific counseling. • Data are sparse on such programs’ effects on glycemic control for adults with T2DM. (more…)
Author Interviews, CDC, OBGYNE / 04.11.2016

MedicalResearch.com Interview with: Cynthia Ferre MA PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC MedicalResearch.com: What is the background for this study? Response: Reductions in births to teens and preterm birth rates are two recent public health successes in the United States. To date, however, we haven’t had data to indicate whether these two declines are associated. So, we used age-specific data on trends in births overall and in preterm births to determine the effects of changes in maternal age on preterm birth. (more…)
Author Interviews, Dermatology, Immunotherapy / 04.11.2016

MedicalResearch.com Interview with: Brett A. King, MD, PhD Assistant Professor Department of Dermatology School of Medicine Yale University New Haven, CT 06520 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent advances in the understanding of the pathogenesis of alopecia areata (AA) have yielded Janus kinase (JAK) inhibitors as a promising therapy. Short-term treatment with the JAK inhibitor, tofacitinib, has shown efficacy for severe AA, alopecia totalis (AT), and alopecia universalis (AU), but long-term data are lacking. In this retrospective series of patients aged 18 years or older treated with tofacitinib, of 65 potential responders to therapy, defined as those with AT or AU with duration of current episode of disease of 10 years or less or AA, 77% achieved at least some hair regrowth, with 58% of patients achieving greater than 50% change in SALT score and 20% of patients achieving complete scalp hair regrowth over 4 to 18 months of treatment. Tofacitinib was well tolerated, and there were no serious adverse events. (more…)
Author Interviews, Cancer Research, JAMA / 04.11.2016

MedicalResearch.com Interview with: Ayako Okuyama, RN, PHN, MW, PhD Center for Cancer Control and Information Services National Cancer Center, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chemotherapy-induced nausea and vomiting (CINV) is a major concern for chemotherapy patients. Despite widespread concern, not all chemotherapeutic drugs cause severe CINV. Our study illustrated that the potential for overuse of prophylactic antiemetics for chemotherapy with minimal and low emetic risks according to the antiemetic guidelines. (more…)
Author Interviews, Emergency Care, Kidney Disease, Kidney Stones, UCSF / 04.11.2016

MedicalResearch.com Interview with: Ralph Wang, MD, MAS Associate Clinical Professor, Department of Emergency Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical expulsive therapy, most notably tamsulosin, has been studied extensively to improve stone passage in patients diagnosed with ureteral stone. Prior trials and meta-analyses have identified a benefit. In fact, tamsulosin is recommended by the American Urologic Association for patients diagnosed with ureteral stones < 10mm that do not require intervention. However, recent well-conducted multi-center randomized trials have not found any improvement in stone passage. Thus we conducted a systematic review and meta-analysis of all double blinded, placebo controlled randomized trials of tamsulosin to determine whether it improves stone passage. (more…)
Author Interviews, Neurological Disorders / 04.11.2016

MedicalResearch.com Interview with: Nir Lahav Physics Department Bar-Ilan University in Israel MedicalResearch.com: What is the background for this study? Response: Our brain is a very complex network, with approximately 100 billion neurons and 100 trillion synapses between the neurons. The question is how can we cope with this enormous complexity? Ultimately, scientists seek to understand how a global phenomenon such as consciousness can emerge from our neuronal network. We used network theory in order to cope with this complexity and to determine how the structure of the human cortical network can support complex data integration and conscious activity. Previous studies have shown that the human cortex is a network with small world properties, which means that it has many local structures and some shortcuts from global structures which connect faraway areas (similar to the difference between local buses and cross-country trains). The cortex also has many hubs, which are nodes that have a high number of links (like central stations), that are also strongly interconnected between themselves, making it easy to travel between the brain's information highways.But in order to examine how the structure of the network can support global emerging phenomena, like consciousness, we need to look not only in the different nodes. We need to check global areas with lots of nodes. That's why we applied a network analysis called k-shell decomposition. This analysis takes into account the connectivity profile of each node making it easy to uncover different neighborhoods of connections in the cortical network, we called shells. The most connected neighborhood in the network is termed the network's nucleus. until today scientists were only interested in the network's nucleus, but we found that these different shells can hold important information about how the brain integrates information from the local levels of each node to the entire global network. For the first time we can build a comprehensive topological model of our cortex. (more…)
Author Interviews, Diabetes, Electronic Records / 04.11.2016

MedicalResearch.com Interview with: Lee Kallenbach, PhD, MPH Principal Investigator Practice Fusion MedicalResearch.com: What is the background for this study? Response: Clinical inertia, or the tendency for patients and providers to continue using the same course of treatment even when clinical markers may suggest that treatment intensification is necessary, is an ongoing factor that can contribute to inadequate diabetes care. This is especially true when the treatment intensification may involve a switch from an oral medication to an injectable medication. It is less challenging for a patient to take a pill than it is to give themselves a shot. Even with all the new diabetes treatments available, clinical inertia is still common among patients with uncontrolled type 2 diabetes (T2D). To further understand the extent of clinical inertia among patients with T2D, the study assessed treatment intensification patterns and associated demographic and clinical characteristics for patients with uncontrolled T2D who were already taking two or more oral anti-diabetes medications. The study consisted of a retrospective observational analysis leveraging data from Practice Fusion’s de-identified clinical database, which includes more than 38 million records, representing 6.7 percent of all practices across the United States.1 Using a cohort of 25,365 de-identified records, we studied the care given by providers in independent practices to patients in need of intensifying their antidiabetic therapy for managing T2D. To our knowledge, this is one of the largest real world evidence (RWE) studies of T2D that has leveraged a de-identified clinical database from an electronic health record (EHR) platform. (more…)
Addiction, Author Interviews, Occupational Health / 04.11.2016

MedicalResearch.com Interview with: Dr. Barry Sample PhD Senior director, science and technology Quest Diagnostics Employer Solutions A business of Quest Diagnostics MedicalResearch.com: What is the background for this study of drug testing of the U.S. workforce? Response: As a leader in the drug testing industry, our primary goal at Quest Diagnostics Employer Solutions is to help employers maintain drug-free workplaces and combat the impacts of substance abuse such as higher absenteeism, increased risk of injury and lower productivity and performance. One way we support these efforts is to offer analysis and information from resources like the Quest Diagnostics Drug Testing Index™, which we publish as a public service for government, media, and industry. We’ve published the Drug Testing Index since 1988, which is also the year that Congress passed the Drug-Free Workplace Act. The Drug Testing Index examines positivity rates – the proportion of positive drug test results – among three major testing populations: federally-mandated, safety-sensitive workers; the general (private sector) U.S. workforce; and the combined U.S. workforce. Thresholds for positivity are determined by cutoff levels as established by the administrating authority; these cutoff levels determine the threshold for positivity for a specific substance. Should a metabolite appear at or above the level of the cutoff, a test is determined to be positive. Over the last few decades, testing policies have evolved to serve a dual purpose of protecting the health, safety, and welfare of both employees and the general public. That’s especially important in certain industries, such as transportation, where an impaired driver, pilot, or operator can create substantial public risk. The positivity rate in 1998, the year of the first Drug Testing Index, was 13.6 percent. Over the last 25 years, as we have tracked the overall positivity rate, we have noted other significant trends in the American workforce based on workplace drug tests. For example, our 2003 analysis revealed that amphetamine positivity had grown by 70 percent over the previous five years. The 2011 Drug Testing Index found that hydrocodone and oxycodone led U.S. general workforce positives. In both 2010 and 2011, the overall drug positivity rate was 3.5 percent, the lowest rate since we began publishing the Drug Testing Index. This year, we found positivity is at a ten-year high. What that tells us is that trends come and go, and that we cannot rely on assumptions about drug use. (more…)
Author Interviews, Exercise - Fitness, Psychological Science / 04.11.2016

MedicalResearch.com Interview with: Colin Zestcott PhD Graduate Student University of Arizona MedicalResearch.com: What is the background for this study? What are the main findings? Response: We are very interested in terror management theory, which was developed by Jeff Greenberg (one of the co-Authors of the paper) and his colleagues in the late 80's. The theory is a very broad motivational theory that may help explain why people do the things they do in many different contexts. The theory explains why people need self esteem and why they care so much about their cultural worldviews. Athletes use many different motivational techniques to improve their performance in sport. Our idea was to apply an experimental social psychology theory--Terror Management Theory (TMT)--as one novel way to improve performance in basketball. According to Terror Management Theory (TMT; Greenberg, Pyszczynski & Solomon, 1986) self-esteem and cultural worldviews help human beings avoid worrying about their inevitable mortality, by convincing them that they are more than just material creatures that are destined to die and decay; that they have meaning, purpose and value, and that they may somehow continue to exist after they die, either literally, as in religious beliefs in the afterlife, or symbolically, through their achievements, relationship and identification with groups. According to TMT self-esteem is defined as the feeling that one is a valuable member of a meaningful universe. (more…)
Author Interviews, Columbia, Genetic Research, OBGYNE / 03.11.2016

MedicalResearch.com Interview with: Sarah Horvath, MD Paula M. Castaño, MD, MPH Anne R. Davis, MD, MPH Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 3% of pregnant women in the United States will receive a prenatal diagnosis of fetal aneuploidy (such as trisomy 21) or fetal structural abnormality (such as cardiac or CNS malformations). Many of these women will undergo abortion. Advances in screening over the past few decades have allowed earlier diagnosis of aneuploidy, but most structural abnormalities cannot be diagnosed until the anatomy ultrasound at 18-20 weeks gestational age because of fixed patterns of fetal development. Our analysis examines gestational age at time of abortion for these two types of fetal diagnosis from 2004-2014. Our main finding was that median gestational age at time of abortion for fetal aneuploidy decreased from 19 weeks to 14 weeks. However, over the same 11 year period, median gestational age at time of abortion for fetal structural abnormalities remained unchanged and at or above 20 weeks gestation. (more…)
Author Interviews, Kaiser Permanente, Mayo Clinic, Prostate Cancer / 03.11.2016

MedicalResearch.com Interview with: Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology, University of Michigan Adjunct Investigator Kaiser Permanente Southern California North Campus Research Complex Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: 5 alpha-reductase inhibitors (5ARIs) are often used for the management of lower urinary tract symptoms in men. Two prior clinical trials found 5ARIs also reduced the risk of prostate cancer, but there was an increase in more aggressive (Gleason 7-10) cancers among the men who were diagnosed. Thus, concerns over whether 5ARIs may increase the risk of prostate cancer death have limited their use in the prevention of prostate cancer, which remains controversial. To address the safety of 5ARIs for the primary prevention of prostate cancer, we conducted a large population-based study of over 200,000 men in community practice settings of over a 19 year observation period to assess whether 5ARI use (as compared to alpha-blocker use) was associated with prostate cancer mortality. Our results suggest that 5ARI use was not associated with an increased risk of prostate cancer mortality when compared to alpha-blocker use. (more…)
Author Interviews, Pharmacology, Weight Research / 03.11.2016

MedicalResearch.com Interview with: Dr Todd Hobbs MD Chief medical officer (CMO) Novo Nordisk in North America MedicalResearch.com: What is the background for this study? Response: There is little data that describes weight loss and other outcomes separately in early weight loss responders and early weight loss non-responders. Early weight loss, whether through lifestyle or pharmacotherapy, can be a good predictor of long-term weight loss. Consequently, all recently-approved weight loss medication labels include ‘stopping rules’ for discontinuing medication if a threshold weight loss is not achieved by a specified milestone. Bottom line, it’s important patients don’t continue on a therapy that isn’t working for them. This makes this form of research important from a clinical standpoint but also in the larger obesity treatment paradigm - including payers and how pharmaceutical treatments are labeled. (more…)
Author Interviews, End of Life Care, HIV, Pediatrics, Pediatrics / 03.11.2016

MedicalResearch.com Interview with: Maureen E. Lyon PhD Division of Adolescent and Young Adult Medicine, Center for Translational Science/Children’s Research Institute, Children’s National The George Washington University School of Medicine and Health Sciences Washington, District of Columbia MedicalResearch.com: What is the background for this study? Response: Despite policy recommendations to include adolescents with chronic and life-limiting conditions in decision-making about their own end-of-life care, barriers continue in clinical practice, including fear of distressing vulnerable adolescents and providers’ beliefs that these conversations are potentially harmful. (more…)
Allergies, Author Interviews, Pediatrics / 03.11.2016

MedicalResearch.com Interview with: Dr. Daniela Posa, MD Department of Paediatric Pneumology & Immunology Charité–Universitätsmedizin Berlin Berlin, Germany MedicalResearch.com: What is the background for this study? Response: Allergy to house dust mites contributes to chronic rhinitis and asthma in hundreds million children and adults worldwide, causing tremendous health and economic burden in high- and middle-income countries. The disease is caused by antibodies called immunoglobulin E (IgE), it starts in childhood and can be controlled with drugs and allergen avoidance. However, there is no cure, hence primary and secondary prevention of mite allergy is a global research priority. We wanted to discover how allergy to mites starts and evolves and why some children develop more severe sensitization and symptoms than others. (more…)
Author Interviews, End of Life Care, JAMA, Race/Ethnic Diversity, UCSF / 02.11.2016

MedicalResearch.com Interview with: Krista Lyn Harrison, PhD Division of Geriatrics School of Medicine University of California San Francisco VA Medical Center San Francisco, CA 94121 MedicalResearch.com: What is the background for this study? Response: Advance care planning (ACP) is the process of discussing plans and preferences for end-of-life care. It may include completion of advanced directives or a living will and designation of a surrogate decision-maker in a durable power of attorney for health care. There is a growing awareness of the benefits of such discussions for both elders and their families. In absence of these discussions, loved ones are left to guess what the affected individual wanted or may even get mired in unexpected legal issues. But until recently, it was unknown if all races/ethnicities, education levels, and incomes have benefited from efforts to improve engagement in advance care planning, and if these discussions are greater among those in worse health and with a poorer prognosis. (more…)
Author Interviews, HIV, Immunotherapy / 02.11.2016

MedicalResearch.com Interview with: Jacob Lalezari, MD Quest Clinical Research San Francisco, CA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • Tremendous strides have been made since HIV-1 was first discovered 35 years ago. However, while many HIV patients can control the infection with currently-approved therapies, there is an urgent need for new treatments that can address viruses that are resistant to multiple antiretroviral treatment classes. With people starting treatments earlier and staying on them longer, some patients also face long-term safety and tolerability issues associated with current therapies.
  • Thousands of people are infected with HIV-1 with resistance to three classes of antiretroviral therapy (ART), and are in dire need of treatment. There are limited or no treatment options available for these patients.
  • As multi-drug resistant (MDR) HIV can be transmitted, it is imperative that it be controlled in order to prevent it from becoming a larger problem. It is important to not only focus on the patient being treated but also consider those they could infect.
  • Ibalizumab is the first biologic long-acting investigational ART to show efficacy in patients in just seven days. The Phase III TMB-301 results showed that patients with MDR HIV-1 and with limited treatment options experienced a significant decrease in viral load after receiving a loading dose of ibalizumab (2,000 mg intravenously) in addition to their failing ART therapies.
    •  A total of 40 patients were enrolled in the study.
    • Seven days after the loading dose, 83% of patients achieved a ≥ 0.5 log10 decrease from baseline compared with 3% during the seven-day control period.
    • These results were statistically significant (p<0.0001). Moreover, during that same period, 60% achieved a decrease of ≥1.0 log10.
    • The average viral load decrease for the total population was 1.1 log10
    • There were no treatment-related serious adverse events or discontinuations reported during the initial seven-day treatment period. 
(more…)
Author Interviews, JAMA, OBGYNE, Pediatrics, Vaccine Studies / 02.11.2016

MedicalResearch.com Interview with: Malini B. DeSilva, MD, MPH Clinician Investigator HealthPartners Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is a retrospective study of more than 324,000 live births at seven Vaccine Safety Datalink sites between 2007 and 2013 which showed that the Tdap vaccine in pregnant mothers was not associated with increased risk for microcephaly or other major birth defects in their offspring. (more…)
Author Interviews, CHEST, Clots - Coagulation, Surgical Research / 02.11.2016

MedicalResearch.com Interview with: William T. Kuo, MD, FSIR, FCCP, FSVM Director, Stanford IVC Filter Clinic Director, IR Fellowship Program Founding Director, IR-DR Residency Program Associate Professor, Interventional Radiology Stanford University Medical Center Stanford, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the USA, over 250,000 IVC filters are now implanted each year, and rising filter use has led to an increase in filter-related morbidity and recognition of the potential complications from indwelling IVC filters. Consequently, the FDA has issued two safety communications alerting all physicians caring for patients with IVC filters to consider removing the filter as soon as protection from pulmonary embolism is no longer needed: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm221676.htm http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm396377.htm?so urce=govdelivery&utm_medium=email&utm_source=govdelivery Despite heightened awareness, up to 40-60% of IVC filters cannot be easily removed using standard methods alone, after the filter becomes firmly embedded. Additionally, many patients have undergone prior placement of a permanent-type filter not even designed for retrieval, leaving them with few options for safe device removal. Although all of these patients can develop filter-related morbidity especially after chronic implantation, there is currently no routine option for removing embedded IVC filters refractory to standard retrieval methods. Our 5-year first-in-human study of a novel procedure—laser-assisted filter removal— demonstrates the safety and efficacy of this technique to treat such patients. In a cohort refractory to standard retrieval methods and high force, endovascular laser-assisted retrieval was overall safe and successful in removing a variety of filter types including permanent filters, regardless of dwell time and without the need for open surgery. (more…)
Author Interviews, Pediatrics, Race/Ethnic Diversity / 01.11.2016

MedicalResearch.com Interview with: Jennifer Howse, Ph.D. President of the March of Dimes Foundation MedicalResearch.com: What is the background for this study? What are the main findings? Response: The March of Dimes Premature Birth Report Card was created in 2007 to raise awareness of the unfair burden of preterm birth in certain communities and geographic areas in the United States. We also want to monitor progress, or lack of it, towards our goal to lower the national preterm birth rate to 8.1 percent by 2020 and to 5.5 percent by 2030. This year’s Report Card finds that, for the first time in eight years, the nation’s preterm birth rate did not decline – it worsened from 9.57 percent of all live births in 2014 to 9.63 percent in 2015, earning the nation a “C” grade. Seven states -- Arkansas, Connecticut, Idaho, Nebraska, New Mexico, Utah, and Wisconsin – received worse grades this year than last year on the Report Card. The March of Dimes strives for a world where every baby has a fair chance for a full-term pregnancy and a healthy birth, yet this is not the reality for many mothers and babies. The 2016 Report Card shows that babies in this country have different chances of surviving and thriving simply based on the circumstances of their birth. (more…)
ADHD, Author Interviews, Genetic Research, Pediatrics / 01.11.2016

MedicalResearch.com Interview with: Dr. Josephine Elia, M.D. Neuroscience Center Department of Child and Adolescent Psychiatry Nemours/Alfred I. DuPont Hospital for Children MedicalResearch.com: What is the background for this study? What are the main findings? Response: Glutamate neurotransmission may play an important role in ADHD and other neuropsychiatric disorders. The purpose of this study is to determine the frequency of genetic mutations involving specific genes (GRM network genes) which influence glutamatergic neurotransmission. A total of 23 study sites across the USA enrolled 1,013 children, aged 6-17 years who had been previously diagnosed with ADHD. Saliva samples were submitted to The Center for Applied Genomics (CAG) at CHOP for analysis of mutations of interest. Information on medical history, including other neuropsychiatric diagnoses and family history as well as areas of academic and social concern were also collected. Overall, the mutation frequency was 22%, with a higher prevalence of 25% observed in patients aged 6-12. When compared to mutation negative ADHD patients, the patients with the mutations of interest were more likely to have concerns about anger control and disruptive behaviors. (more…)
Accidents & Violence, Author Interviews, JAMA, Karolinski Institute, Mental Health Research / 01.11.2016

MedicalResearch.com Interview with: Zheng Chang PhD Dept. of Medical Epidemiology and Biostatistics Karolinska Institutet and Seena Fazel MD Department of Psychiatry Warneford Hospital University of Oxford, Oxford, England MedicalResearch.com: What is the background for this study? What are the main findings? Response: There were more than 10 million prisoners worldwide in 2015, with approximately 2.2 million in the United States alone. Despite reported decreases in violence in many countries, reoffending rates remain high. From 2005 through 2010, more than one-third of released prisoners in the United States and the United Kingdom were reconvicted of a new crime within 2 years. Most programs to reduce reoffending focus on psychosocial interventions, but their effect sizes are weak to moderate. As psychiatric and substance use disorders, which increase reoffending rates, are overrepresented among jail and prison populations. This study investigated the main psychotropic medication classes prescribed to prisoners using longitudinal Swedish population registers and examined the association between prescription of psychotropic medication and risk of violent reoffending. We found that three classes of psychotropic medications were associated with substantial reductions in violent reoffending: antipsychotics, a 42% reduction; psychostimulants, 38%; and drugs used in addictive disorders, a 52% reduction. The magnitudes of these associations were as strong as and possibly stronger than those for widely disseminated psychological programs in prison. (more…)