Author Interviews, Cancer Research, Chemotherapy, Nature, Technology / 27.07.2016

MedicalResearch.com Interview with: Natalie Artzi PhD Assistant Professor at Brigham and Women’s Hospital, Harvard Medical School Associate member of the Broad Institute of Harvard and MIT. MedicalResearch.com: What is the background for this study? Response: We have shown in the last years that dendrimer:dextran adhesive hydrogels represent a platform with ahuge potential for delivery. In 2015, we were able to report that these gels doped with smart nanoparticles could sense and differentially react with the disease microenvironment (e.g. can sense the tissue microenvironment by detecting the expression of specific genes related with multidrug resistance, Conde et al. PNAS 2015), potentiating targeted drug release and uptake in certain disease settings. Later, these hydrogels prove to be incredibly useful for miRNA delivery by using the self-assembly of a triple-helix forming miRNA structure that lead to nearly 90% levels of tumor shrinkage two weeks post-gel implantation (Conde et al. Nature Materials 2016a). Here, we took a step-forward, and used these hydrogels to develop a prophylactic patch for gene, chemo and phototherapy in a triple-combination approach to achieve complete tumor resection when applied to non-resected tumors and to the absence of tumor recurrence when applied following tumor resection (Conde et al. Nature Materials 2016b). This study also identifies the molecular and genetic pathways triggered in response to the three therapeutic modalities − photo-, gene- and chemo-therapy − by tumor gene expression profiling in treated mice. (more…)
Author Interviews, Genetic Research, Imperial College, Nutrition / 26.07.2016

MedicalResearch.com Interview with: Prof. Majid Ezzati, PhD Faculty of Medicine, School of Public Health Chair in Global Environmental Health Imperial College, London Adjunct Professor of Global Health and Department of Global Health and Population Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Human height is strongly influenced by the environment that we grow up in, from pregnancy through to late adolescence. If we have good nutrition, few illnesses and good healthcare, we are more likely to grow taller. In turn, height has a strong effect on our health in adulthood. Taller people on average live longer, have lower risk of heart disease (although they do have slightly elevated risks of some cancers). We have collated the largest-ever database of height. We analysed 1472 studies with measured height on 18.6 million individuals. We made estimates of height for 18-year-old men and women from 1914 and 2014. Height has increased in every country in the world, but this has been very uneven. The tallest men in the world are now the Dutch, and the tallest women are the Latvians. The countries that have seen the most growth are South Korea for women and Iran for men. We have seen large increases in height in East Asia, and stagnation in much of the West over the last few decades. In parts of Africa height has actually decreased by 5-10 cm over this period. (more…)
Asthma, Author Interviews / 26.07.2016

MedicalResearch.com Interview with: Hans Michael Haitchi, MD, MMed (INT) PhD, PD, FHEA, PGcert Associate Professor in Respiratory Medicine Clinical and Experimental Sciences Faculty of Medicine, University of Southampton United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is estimated that 300 million people worldwide suffer from asthma with 1 in 10/11 (USA/UK) children and 1 in 12 (USA & UK) adults suffering from the disorder. In children asthma is the most common long-term medical condition. ADAM33 is an asthma gene. Small changes in the gene have been associated with increased twitchiness of the airways (bronchial hyperresponsiveness), loss of lung function in children and decline in lung function in the general population. ADAM33 makes an enzyme, which is attached to cells in the airway muscles. When the enzyme loses its anchor to the cell surface, it is prone to going rogue around the lung causing poorer lung function in people who have asthma. Our research, published in The Journal of Clinical Investigation (JCI) Insight, analysed human tissue samples and mice. Our experiments suggest that the human rogue ADAM33 protein is increased and enzymatically active in asthma. Furthermore, ADAM33 protein initiates airway remodelling (more muscle and blood vessels around the airways) without causing any inflammation in early life. However, when we switch off ADAM33 or prevent it from going rouge, the features of asthma - airway remodelling (more muscle and blood vessels around the airways), twitchiness and inflammation - will be reversed or reduced. These findings identify ADAM33 as a novel target for disease modifying therapy in asthma. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 26.07.2016

MedicalResearch.com Interview with: Ted Miller, PhD Senior Research Scientist II Pacific Institute for Research and Evaluation Calverton, Maryland MedicalResearch.com: What are the main findings? Response: Police use of undue force is an enduring tinderbox issue in America. We tried to solve it by passing the 14th Amendment after the civil war, thru the civil rights movement, the riots of the 1960s, the Rodney King riot. The discussion has focused on racial disparities in per capita rates of deaths, stops, and arrests. This article digs deeper. Its aims are to use health data sets to examine nonfatal injuries inflicted during police action and apply better denominators. Looking at nonfatal injuries is especially important as shootings with firearms or tasers account for virtually all deaths but few other injuries in police encounters. This study measures exposure as the sum of arrests plus traffic stops with search plus stops on the street. Those data come from FBI arrest reports, state arrest reports, and the 2011 Police-Public Contact Survey. Blacks have long had the highest per capita rates of stops and arrests. We believe this study is the first to assess the probability of being arrested when stopped. Those probabilities also are skewed, with police arresting 85% of Blacks and 82% of Hispanics who are stopped, well above the 71% of Whites and Native Americans and 61% of Asian-Americans. Arrest probabilities do not differ by sex or age group. The study used a newspaper census of deaths and took injury counts from the 2012 Health Care Cost and Utilization Program nationwide samples, counting people whose injuries resulted from “legal intervention.” In 2012, US police killed or injured an estimated 55, 400 people during stops and arrests. The daily toll was 3 deaths and 150 hospital-treated injuries. In 1 in 11 US homicides and legal intervention deaths, a police officer pulled the trigger. Surprisingly, the probability that a serious injury was fatal did not vary by race. Nor did the ratio of serious and fatal injuries to stops and arrests. Teenagers and to a lesser extent young adults were less likely than people age 30 and over to die or suffer a hospital-treated injury when stopped or arrested. (more…)
Author Interviews, Diabetes, PLoS, Primary Care, Telemedicine / 26.07.2016

MedicalResearch.com Interview with: Brian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre EdinburghBrian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre Edinburgh MedicalResearch.com: What is the background for this study?  Response: The prevalence of diabetes is rising as the population ages and becomes more obese. Clinical services are increasingly stretched, so much so that it will be difficult for doctors and nurses to continue to look after patients using the same service delivery they have used in the past. Increasingly patients are being asked to self-manage long-term illnesses, but particularly with type 2 diabetes they find this stressful. One solution is to encourage self-management but with monitoring at a distance through telehealth. We performed a randomised controlled trial in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) ( a measure of control over the previous three months) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycaemic or blood pressure control in the context of incentives in family practice based on a sliding scale of financial rewards for achieving glycaemic and blood pressure control targets. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed. (more…)
Author Interviews, JAMA, Schizophrenia / 26.07.2016

MedicalResearch.com Interview with: Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Director, Monash Alfred Psychiatry research centre Vic Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a complex psychiatric disorder and many patients are not able to achieve remission on the available treatments. There are clear sex differences in many aspects of the illness, which not only implicates a role for the sex hormone estrogen in schizophrenia, but also highlights the need for sex-specific treatments. Our group has conducted many clinical trials using adjunctive estradiol treatment, with excellent improvement in psychotic symptoms- however, there can be physical side effects with longer term estradiol use. Raloxifene and other selective estrogen receptor modulators ( SERMs) - the so-called "brain estrogens", with their more specific brain impacts and less body side effects - provide an option to use longer term estrogen in people with refractory schizophrenia. We conducted the first ever pilot study of raloxifene in 2010, and now present findings from a bigger study of adjunctive raloxifene treatment in schizophrenia. (more…)
Author Interviews, Genetic Research, JAMA, Pediatrics, Surgical Research / 26.07.2016

MedicalResearch.com Interview with: Dr. Katherine Nelson MD Staff Paediatrician with the Paediatric Advanced Care Team at SickKids and PhD student University of Toronto MedicalResearch.com: What is the background for this study? Response: Trisomy 13 and 18 are rare genetic conditions that cause problems in multiple organ systems, including heart defects and severe neurologic impairment.  A majority of children with trisomy 13 and 18 die in the first days to weeks after birth, though a small number survive beyond one year.  For years, health care providers have debated the effectiveness and ethics of surgical interventions in these populations. (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 25.07.2016

MedicalResearch.com Interview with: George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Many states have allowed medical and now recreational marijuana. The impact on pediatric population has not been fully described. MedicalResearch.com: What are the main findings? Response: Unintentional exposures presenting to our children's hospital and calls to our regional poison center significantly increased after our state allowed recreational marijuana. MedicalResearch.com: What should readers take away from your report? Response: Exposures in children are increasing in our state that allows medical and recreational Marijuana, many were edible products. Marijuana products should be treated like medications and household products in home and properly and safely stored. States looking to legalize marijuana need to consider safety rules and regulations during rule making processes. (more…)
Accidents & Violence, Author Interviews, Surgical Research / 25.07.2016

MedicalResearch.com Interview with: Joshua Brown, M.D., M.S., research fellow Division of Trauma and General Surgery University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? Response: A trauma center is a hospital equipped to immediately provide specialized care to patients suffering from major traumatic injuries, such as falls, car crashes, burns or shootings. In the U.S., the American College of Surgeons sets criteria and conducts reviews for trauma center validation, and the individual states ultimately grant trauma center designation. In Pennsylvania, trauma centers are granted “Level” designations based on their capabilities, ranging from Level-I (highest) to Level-IV (lowest). We examined records of nearly 840,000 seriously injured patients seen at 287 trauma centers between 2000 and 2012. The centers averaged 247 severely injured patients per year, and 90 percent of the cases involved blunt injury. We compared the expected death rate for each center if everything involving each trauma patient’s care had gone perfectly to the center’s actual death rate. (more…)
Author Interviews, Health Care Systems, JAMA, Stroke / 25.07.2016

MedicalResearch.com Interview with: Kimon Bekelis, MD Chief Resident Department of Neurosurgery Dartmouth-Hitchcock School of Medicine MedicalResearch.com: What is the background for this study? Response: Physicians often must decide whether to treat acute stroke patients locally, or refer them to a more distant Primary Stroke Center (PSC). There is little evidence on how much the increased risk of prolonged travel time offsets benefits of specialized  Primary Stroke Center care. (more…)
Author Interviews, Cost of Health Care, JAMA / 25.07.2016

MedicalResearch.com Interview with: James C. Robinson PhD Leonard D. Schaeffer Professor of Health Economics Director, Berkeley Center for Health Technology Division Head, Health Policy and Management University of California School of Public Health Berkeley, CA MedicalResearch.com: What is the background for this study? Response: To moderate the increase in insurance premiums, employers are increasing consumer cost sharing requirements. Under reference pricing, the employer establishes a limit to what it will contribute towards each service or product, typically set at the 60th percentile or other midpoint in the distribution of prices in the market. If the patient selects a facility charging less than or equal to this contribution, he/she receives full coverage, but if a more expensive facility is chosen, the patient must pay the full difference. (more…)
Author Interviews, JAMA, Johns Hopkins, Race/Ethnic Diversity, Stroke / 25.07.2016

MedicalResearch.com Interview with: Romanus Roland Faigle, M.D., Ph.D. Assistant Professor of Neurology The Johns Hopkins Hospital MedicalResearch.com: What is the background for this study? Response: Stroke care entails a variety of procedures and interventions, which generally fall into one of the two following categories: 1) curative/preventative procedures (such as IV thrombolysis and carotid revascularization), which intent to prevent injury and restore function; and 2) life-sustaining procedures (such as gastrostomy, mechanical ventilation, tracheostomy, and hemicraniectomy), which intent to address complications from a stroke and to prevent death. The use of curative/preventative procedures is supported by excellent evidence and is guided by well-defined criteria, while those are largely lacking for life-sustaining procedures. Therefore, curative/preventative are desirable for eligible patients, while life-sustaining procedures indicate the need to address undesired complications and in itself have questionable utility. We wanted to determine whether race differences in the use of the individual stroke-related procedures exist, and whether presence and directionality of differences by race follow a pattern unique to each of the 2 procedure groups. (more…)
Author Interviews, Infections, JAMA / 25.07.2016

MedicalResearch.com Interview with: Dr. Ane Uranga MD Department of Pneumology, Galdakao-Usansolo Hospital Galdakao, Bizkaia, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite clear benefits of shorter antibiotic treatments, reducing the duration of treatment remains challenging in daily clinical practice. Actually, IDSA/ATS recommendations for Community Acquired Pneumonia (CAP) suggested a minimum of 5 days of treatment based on clinical stability criteria. However, in our study the median of duration of antibiotic treatment in the control group was as high as 10 days. The main finding is that receiving 5 days antibiotic treatment in hospitalized patients suffering from CAP is not inferior to arbitrary treatment schedules in terms of clinical success. (more…)
Author Interviews, Diabetes, Pharmacology / 25.07.2016

MedicalResearch.com Interview with: Stig Ejdrup Andersen MD, PhD Clinical Pharmacology Unit Zealand University Hospital Roskilde Denmark MedicalResearch.com: What is the background for this study? Response: For decades, we have used sulphonylurea derivates in the medical treatment of type 2 diabetes. Although several newer drugs have become available, adding an SU is still a recommended and acceptable strategy when metformin monotherapy fails. The SUs are among the cheapest glucose lowering drugs on the marked but the risk of hypoglycaemia make clinicians prefer a newer oral drug such as a DPP-IV inhibitor or a SGLT-2 inhibitor to ansulphonylurea because even mild hypoglycaemia may affect the patients’ quality of life negatively. Several meta-analyses have examined the effectiveness and safety of noninsulin antidiabetic drug, all of which have considered the SUs a homogenous drug class. Pharmacologically, however, the SU agents are quite different. In 2004, a randomized controlled trial by Shernthaner et al. indicated that in comparison with glimepiride, gliclazide MR is equally effective and is associated with fewer hypoglycaemic episodes. Still, head-to-head comparisons of the SU-agents as add-on to metformin are few. In the absence of robust designed comparative trials, we decided to compare the relative risk of hypoglycaemia among the newer SU-agents in a network meta-analysis. (more…)
Author Interviews, Biomarkers, Diabetes, Diabetologia, OBGYNE / 25.07.2016

MedicalResearch.com Interview with: Dr. Sandra Hummel and Dr. Daniela Much Institute of Diabetes Research Helmholtz Center Munich German Research Center for Environmental Health Munich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes mellitus is associated with a seven-fold increased risk of developing type 2 diabetes postpartum. In 2012, we published that type 2 diabetes risk was markedly reduced up to 15 years after delivery in women with gestational diabetes if they breastfed for more than 3 months. However the underlying biological mechanisms are still unclear to date. Aim of this biomarker study was to identify the mechanism underlying the protective effect of prolonged lactation. At our study site in Munich, we enrolled 197 women with previous gestational diabetes participating in a postpartum assessment of glucose tolerance at a median time of 3.6 years after delivery. By using a targeted metabolomics approach (including a broad spectrum of lipids and amino acids), we identified lactation-associated biochemical changes in maternal plasma samples. Most interestingly, these metabolite signatures have been described with decreased risk for type 2 diabetes previously. Our results indicate that lactation-associated alterations persisted up to 11 years post-lactation. (more…)
Author Interviews, Gastrointestinal Disease, Mental Health Research / 24.07.2016

MedicalResearch.com Interview with: Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia President, Royal Australasian College of Physicians Chair, Committee of Presidents of Medical Colleges Hon. Treasurer, Australian Academy of Health and Medical Sciences Editor-in-Chief, Medical Journal of Australia Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia Professor of Medicine and Professor of Epidemiology, Joint Supplemental Consultant Gastroenterology and Health Sciences Research, Mayo Clinic, Rochester, MN, USA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Functional gastrointestinal diseases (FGIDs) like the irritable bowl syndrome (IBS) are very common, cause major distress including pain and psychological dysfunction, impact on quality of life and drive high health care costs. We speculated that there are two distinct types of functional gastrointestinal disease that others have not recognized. For example, IBS in a subgroup may first begin with gut symptoms (pain, diarrhea, constipation, bloating etc) in those free of psychological distress and only later does new onset anxiety or depression develop, implicating gut disease as the primary driver of the entire symptom complex (a gut-to-brain disease). On the other hand, we speculated there is another quite different subgroup where disease begins with anxiety or depression and only later do new onset gut symptoms develop, and this is likely primarily a central nervous system cause (probably through the stress system), or a brain-to-gut disease. This is exactly what we found, with gut disease occurring first followed by new onset psychological distress in about two thirds of people from the community over a one year follow-up. (more…)
Author Interviews, Endocrinology, Hematology, OBGYNE, Thyroid Disease / 24.07.2016

MedicalResearch.com Interview with: Kris Poppe, MD, PhD Co-Head Endocrine Unit CHU St-Pierre UMC Université libre de Bruxelles MedicalResearch.com: What is the background for this study?  Response: Pregnant women are often referred by gynecologists to my endocrine practice, for altered thyroid function. At that occasion, I often noticed that the women also had low iron/ferritin levels (ferritin is the iron reserve). Searching in literature did not reveal many publications on the association between iron (deficiency) and thyroid function during pregnancy and so that was the background/aim to perform this study. (more…)
AHA Journals, Author Interviews, Gender Differences, Stroke, Tobacco Research / 23.07.2016

MedicalResearch.com Interview with: Joni Valdemar Lindbohm, MD Department of Public Health University of Helsinki, Finland MedicalResearch.com: What is the background for this study? Response: Approximately 1-6% percent of people carry an unruptured intracranial aneurysm but most of these never rupture during lifetime and cause subarachnoid hemorrhage (SAH). In SAH, the rupture of an aneurysm causes bleeding into the lining between the brain’s surface and underlying tissue. Despite advances in operative techniques, SAH can lead to death in up to 45% of the cases. Because life style risk factors are critical in development of subarachnoid hemorrhage, it is important to characterize the risk factor profile of those with an elevated risk. Widely accepted risk factors for SAH are increasing age, smoking, hypertension and female sex. However, the reasons for an elevated risk in women have remained uncovered and the effect of smoking habits are not well understood. (more…)
Author Interviews, Depression, Lancet / 23.07.2016

MedicalResearch.com Interview with: Professor David A. Richards, PhD Professor of Mental Health Services Research and NIHR Senior Investigator University of Exeter Medical School University of Exeter St Luke's Campus Exeter United Kingdom MedicalResearch.com: What is the background for this study? Response: Depression is a common mental health disorder affecting around 350 million people worldwide. Untreated depression is expected to cost the global economy US$5.36 trillion between 2011 and 2030. Many patients request psychological therapy, but the best-evidenced therapy—cognitive behavioural therapy (CBT)—is complex and costly. A simpler therapy—behavioural activation (BA)—might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. (more…)
Author Interviews, HIV / 22.07.2016

MedicalResearch.com Interview with: Zhe Yuan MS. MS. PhD Candidate Nebraska Center for Virology University of Nebraska-Lincoln MedicalResearch.com: What is the background for this study? Response: AIDS causes millions of infections and deaths each year. Human immunodeficiency virus (HIV) is the cause of this detrimental disease of humans. Just like Ebola and Zika, AIDS is also a zoonotic disease at the beginning. For the origins of HIV, people believed that HIV originated from simian immunodeficiency virus from wild chimpanzees (SIVcpz). But until now, there has been no direct in vivo evidence for this assumption. Further, people cannot explain why only certain SIVcpz strains are thought to be the ancestors of already discovered HIV strains in humans. There is also a need to clarify what transmission risks might exist for those SIVcpz strains that have not already been found to infect humans. The answers to these questions are essential for a better understanding of cross-species transmission and predicting the likelihood of additional cross-species transmission events of SIV into humans. (more…)
ASCO, Author Interviews, Outcomes & Safety / 22.07.2016

MedicalResearch.com Interview with: Claire O’Hanlon, MPP Pardee RAND Graduate School and Courtney Gidengil, MD, MPH RAND Corporation MedicalResearch.com: What is the background for this study? Response: Providing high-quality health care is central to our nation’s commitment to veterans, but the quality of care provided in Veterans Affairs health care system (VA) is a longstanding area of concern. Part of the 2014 Veterans Access, Choice and Accountability Act (VACAA) mandated an independent assessment of VA’s health care capabilities and resources of the Veterans Health Administration, including a comprehensive evaluation of health care quality. As part of this evaluation we conducted this systematic review of journal articles that compare quality of care at the VA to other settings as an update to a 2009 review on this subject. (more…)
Author Interviews, Dermatology, JAMA / 22.07.2016

MedicalResearch.com Interview with: G. Thomas (Tom) Ray Division of Research, Kaiser Permanente 2000 Broadway Oakland, CA 94612-2304 MedicalResearch.com: What is the background for this study? Response: Basal cell carcinoma (BCC) is the most common cancer in the United States. BCCs tend to develop on sun-exposed areas such as the head and neck and are typically treated with various surgical techniques in an outpatient setting. Although BCCs are rarely fatal, they have been estimated to be among the most costly cancers in the Medicare population due to their high incidence. Yet because these cancers are not tracked by national registries the way, for example, melanoma is, basal cell carcinomas have been difficult to study. Incidence rates in the past have tended to rely on surveys such as those by the National Cancer Institute. And studies using disease codes have, until recently, been difficult because the codes used for basal cell carcinoma and squamous cell carcinoma were the same. Since 1997, Kaiser Permanente Northern California (KPNC) has had computerized pathology results that allowed us to develop an internal registry of BCC cancers. In addition to having detailed information about basal cell cancer patients, we also had detailed information on the underlying population - KPNC members – which allowed us to determine incidence rates of BCC by age, sex, and most importantly for this study, by geographic location. This is because we know the residential location of all KPNC members at any given time – both those that get basal cell cancer and those who do not. This combination of a validated BCC registry with a well-defined population at-risk gave us the unique ability to investigate the spatial distribution of BCC in Northern California and assess whether there existed geographic clustering of basal cell cancers. Although the investigation of spatial clustering of other cancers is fairly common, no such analyses have been performed for basal cell cancer in the United States. (more…)
Author Interviews, Dermatology / 22.07.2016

MedicalResearch.com Interview with: Charareh Pourzand, MSc, MPhil, PhD/DSc Senior lecturer and Associate Professor in Biopharmaceutics Department of Pharmcay and Pharmacology University of Bath Bath United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Exposure of skin cells to Ultraviolet A (UVA) component of sunlight provokes oxidative damage to the vital subcellular organelles, mitochondria, leading to ATP depletion and necrotic cell death. The presence of high level of potentially harmful ‘labile’ iron in mitochondria is thought to make these organelles highly susceptible to oxidative damage caused by UVA. Therefore, we designed a highly specific iron trapping compound that could directly target mitochondria and protect the organelles against UVA-induced iron damage and the ensuing cell death. The results of the study demonstrate an unprecedented level of protection afforded by these compounds against damage caused by high doses of solar UVA radiation, equivalent to up to 140 min sun exposure at sea level. (more…)
Author Interviews, BMJ, Radiology, Thyroid / 22.07.2016

MedicalResearch.com Interview with: Megan Haymart, M.D. Assistant Professor Institute for HealthCare Policy and Innovation University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past three decades the incidence of thyroid cancer has risen. The majority of this rise in incidence is secondary to an increase in low-risk disease. In the setting of this rise in low-risk thyroid cancer, our team noted that over time there was a dramatic rise in imaging after initial treatment for thyroid cancer. We subsequently wanted to understand the implications of this increase in imaging. Does more imaging equal improved outcomes? In this study published in BMJ, we found that this marked rise in imaging after primary treatment of differentiated thyroid cancer was associated with increased treatment for recurrence but with the exception of radioiodine scans in presumed iodine-avid disease, no clear improvement in disease specific survival. (more…)
Author Interviews, Environmental Risks, Hearing Loss, JAMA, Occupational Health / 22.07.2016

MedicalResearch.com Interview with: Harrison W. Lin, M.D. Assistant Professor Department of Otolaryngology-Head & Neck Surgery UC Irvine Medical Center Orange, CA 92868 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We reviewed the data from the Integrated Health Interview Series, which is a project funded by the National Institutes of Health to supplement the National Health Interview Survey (NHIS), a household-based, personal interview survey administered by the US Census Bureau and Centers for Disease Control and Prevention since 1957. The NHIS serves as the largest source of health information in the civilian population of the United States. Analyzing the available data on tinnitus symptoms from this survey, we found that approximately 1 in 10 Americans have chronic tinnitus. Moreover, durations of occupational and leisure time noise exposures correlated with rates of tinnitus – people who reported higher rates of loud noise exposures at work and recreationally more frequently reported chronic tinnitus. Finally, health care providers provided advice and treatment plans to patients with chronic tinnitus that were infrequently in line with the clinical practice guidelines published by the American Academy of Otolaryngology-Head & Neck Surgery Foundation. (more…)
Author Interviews, Beth Israel Deaconess, Biomarkers, Cost of Health Care, Medical Imaging, Ovarian Cancer / 22.07.2016

MedicalResearch.com Interview with: Katharine Mckinley Esselen, M.D. Instructor in Obstetrics, Gynecology and Reproductive Biology Beth Israel Deaconess Medical Center Brigham and Womens Hospital MedicalResearch.com: What is the background for this study? Response: There is no consensus on how to follow a patient in remission from ovarian cancer in order to detect recurrent disease. However, a 2009 randomized clinical trial demonstrated that using CA-125 blood tests for routine surveillance in ovarian cancer increases the use of chemotherapy and decreases patient’s quality of life without improving survival compared with clinical observation. Published guidelines categorize CA-125 tests as optional and discourage the use of radiographic imaging for routine surveillance. Thus, this study aims to examine the use of CA-125 tests and CT scans at 6 Cancer Centers and to estimate the economic impact of this surveillance testing for ovarian cancer. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease / 22.07.2016

MedicalResearch.com Interview with: Jari Laukkanen MD, PhD Cardiologist Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this population-based study we found a strong inverse association between long-term change in directly measured cardio-respiratory fitness (CRF), using maximal oxygen uptake (VO2peak) and all-cause mortality. A small decrease in CRF over 11-years was associated with a lower risk of all-cause death in a graded fashion. The observed association was independent of risk factors. This population-based study with repeated and direct assessment of CRF using a very similar time-interval for all participants, whereas some previous studies showing the value of CRF were constructed on participants referred to exercise testing at varying time-intervals between two repeated tests using only indirect cardio-respiratory fitness assessment or other exercise scores. Cardiorespiratory fitness was assessed at baseline and follow-up using respiratory gas analyzer which is a golden standard for assessing aerobic fitness level. A single assessment of CRF predicts outcomes, however, no previous studies using directly measured VO2max have shown the association between long term changes in VO2max (i.e. 10 years) and its association with mortality. In the recent study VO2max defined from respirator gases with similar time-interval between two separate assessments of VO2max (=directly measured). This is a very novel finding in the field of exercise sciences, as well as in cardiovascular prevention and rehabilitation. Although cardio-respiratory fitness is recognized as an important marker of functional ability and cardiovascular health, it is currently the major risk factor that is not routinely and regularly assessed in either the general or specialized clinical setting, although it is suggested that an individual’s CRF level has been even a stronger or similar predictor of mortality than the traditional risk factors, including smoking, hypertension, high cholesterol, and type 2 diabetes mellitus. (more…)
Author Interviews, Biomarkers, Cancer Research / 22.07.2016

MedicalResearch.com Interview with: Dr. Hunter R. Underhill MD, PhD Department of Pediatrics, Division of Medical Genetics, Department of Radiology, University of Utah, Salt Lake City, Utah Department of Radiology and Department of Neurological Surgery University of Washington Seattle, Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: When cells undergo cell death (i.e., apoptosis) the DNA has the potential to enter the circulation. This DNA is not contained within a cellular membrane and is known as "cell-free DNA." This is a naturally occurring process. The same process also occurs when malignant tumors grow and evolve. The deposition of cell-free DNA derived from tumors is known as "circulating tumor DNA." Analysis of circulating tumor DNA holds the promise of detecting, diagnosing, and monitoring response to therapy of cancers through a simple blood draw - the "liquid biopsy." The challenge has been isolation of circulating tumor DNA from the background of the naturally occurring cell-free DNA. This has been particularly difficult in non-metastatic solid tumors as circulating tumor DNA has been heretofore indistinguishable from normal cell-free DNA except for the occurrence of mutant alleles that commonly occur at a frequency below detection limits - the proverbial needle in a haystack. Our study found a distinct size difference in DNA fragment length between circulating tumor DNA and cell-free DNA. Specifically, circulating tumor DNA is about 20-50 base pairs shorter than cell-free DNA originating from healthy cells. We were subsequently able to exploit this difference in size to enrich for circulating tumor DNA - essentially removing a large portion of the haystack that does not contain the needle to simplify the search. (more…)
Author Interviews, Neurological Disorders, PLoS / 21.07.2016

MedicalResearch.com Interview with: Zoltan Toroczkai, PhD, Professor of Physics Concurrent Professor of Computer Science and Engineering Physics Department University of Notre Dame, Notre Dame, IN, 46556 MedicalResearch.com: What is the background for this study? Response: The mammalian brain is arguably the most complex information processing network and with billions of neurons and trillions of connections it presents formidable challenges to deciphering its fundamental mechanisms for information processing. In the brain, information is encoded into the spatio-temporal firing patterns of groups of neurons (population coding), making the connectivity structure of the network crucial for brain function. Damages to this network have been associated with diseases such as Alzheimer’s, autism and schizophrenia, and thus understanding the cortical network would also help better understand certain diseases of the brain. An experimentally and computationally more feasible approach is to study the anatomical (physical connectivity) network between the functional areas of the cortex, a mosaic of brain patches, each associated with a specific function (e.g., visual, auditory, somatosensory). Based on phylogenic considerations one expects the existence of common fundamental network architectural (and implicitly, processing) principles to be present in all mammalian brains. However, the mammalian brain spans over five orders of variation in size and thus it is not clear at all what are this common architectural features and how would we find them. The challenge here is to compare networks of the same nature (information processing type) but of different orders, with different nodal identities, and of very different spatial embedding (geometrical size) properties. (more…)
Author Interviews, Cost of Health Care, Health Care Systems / 21.07.2016

Medicalresearch.com Interview with: Alex Mainor, JD, MPH Research Project Coordinator The Dartmouth Institute for Health Policy and Clinical Practice Lebanon, NH 03756 Carrie H. Colla, Alexander J. Mainor, Courtney Hargreaves, Thomas Sequist, Nancy Morden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Waste in the healthcare system is an important concern to healthcare providers, patients, policymakers, and taxpayers, and is estimated to account for 30% of all healthcare costs. Low-value care can expose patients to unnecessary costs for little or no medical benefit, or to potential harm from unnecessary tests and procedures. In recent years, the concept of low-value care has gained wider acknowledgement and acceptance as a pressing concern for the healthcare system, and many interventions have been studied to reduce the use of this wasteful care. However, the landscape of these interventions has not been studied in a systematic and comprehensive way. In this review, we found that interventions to reduce the use of wasteful medical care are often studied and published selectively. Findings suggest that interventions using clinical decision support, clinician education, patient education, and interventions combining elements from each have strong potential to reduce low-value care. (more…)