Author Interviews, JAMA, Pediatrics / 04.07.2016

MedicalResearch.com Interview with: Dr. Kirsten Herrick Ph.D. Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: The benefits of breastfeeding are well established: for children, it offers protection against infections and increases in intelligence; for nursing women, it protects against breast cancer and improves birth spacing. But there is no nationally representative information about whether there are differences in breastfeeding by birth weight (BW). Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014, we estimated the proportion of infants ever breastfed (initiated), and those reporting any breastfeeding at 1 month, 4 months, and 6 months by birth weight categories and birth year cohorts. Our sample size was 13,859. (more…)
Author Interviews, Heart Disease, Pharmacology / 04.07.2016

MedicalResearch.com Interview with: Robert Sheldon, MD, PhD Division of Cardiology, Department of Cardiac Sciences University of Calgary, Calgary, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vasovagal syncope is very common and more debilitating than most people appreciate. Probably up to 50% of people faint from this in their lives, making it the most common cardiovascular symptom. Around 15-20 years ago we had learned that the recurrence rates for vasovagal syncope were quite high, and that quality of life was correspondingly low. From the results of our earlier Vasovagal Pacemaker Study II and Prevention of Syncope Trial I (POST I) we knew that neither pacemakers nor beta blockers helped most patients with vasovagal syncope. However there was ample evidence that a reduction in venous return and cardiac preload were important early steps in the vasovagal cascade. Florinef is a salt-retaining mineralocorticoid that is successful in treating orthostatic hypotension with tantalizing early evidence that it might prevent vasovagal syncope induced by tilt tests. We therefore set out to test whether it prevented vasovagal syncope in a randomized placebo-controlled clinical trial. One important early part of designing a clinical trial is estimating the event rate in the untreated and treated arms. Based on our earlier work we could predict the untreated event rate but there were no data on which we could estimate the treated outcome rate. We therefore surveyed numerous colleagues for what they considered a Minimal Clinically Important Difference, and the answer was a 40% relative risk reduction. That is, to make fludrocortisone appealing to clinicians it should cause a relative risk reduction of 40%. We used this estimate to design the study. There are two main conclusions.
  • First, we studied the right population, people who would clearly be considered for active biomedical treatment. They had fainted 15-20 times in their lives and 3-4 times in the preceding year.
  • Second, we found that fludrocortisone reduced syncope by 31%, and this narrowly missed conventional statistical significance. However when we adjusted for the first two weeks that were allotted for dose adjustment we found that fludrocortisone reduced syncope by up to 50% in people who were taking 0.2 mg daily. This is quite a low dose, deliberately picked to be safe in this young and predominantly female population.
(more…)
Author Interviews, Blood Pressure - Hypertension, Mineral Metabolism, Nutrition, UT Southwestern / 04.07.2016

MedicalResearch.com Interview with: Dr. Wanpen Vongpatanasin MD The Norman and Audrey Kaplan Chair in Hypertension UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diet rich in fruits, vegetables, and dairy products, known as the DASH diet, is known to reduce blood pressure in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in people with and without high blood pressure . However, the main nutritional ingredient responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of KMg Citrate (KMgCit), K Chloride (KCl), and K Citrate (KCit) to allow dissociation of the three in hypertensive and prehypertensive individuals. This study was conducted in collaboration with Drs. Charles Pak and Orson Moe at UT Southwestern, the two leading experts in the field of Mineral Metabolism. We found that oxidative stress was markedly reduced by KMgCit powder compared to placebo, K Chloride, and K Citrate. On the hand, KMgCit has no significant effects on blood pressure . MedicalResearch.com Editor's note:  DO NOT Take Potassium supplements unless under the direction of your health care provider. (more…)
Author Interviews, Heart Disease, JAMA, Radiology / 04.07.2016

MedicalResearch.com Interview with: Venkatesh Locharla Murthy MD, PhD, FACC, FASNC Assistant Professor, Internal Medicine Frankel Cardiovascular Center University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Technetium-99m, which is very commonly used for cardiac stress testing, has had multiple supply disruptions due to aging nuclear reactors where it is produced coupled with changing regulations to minimize the risk of nuclear proliferation. The most severe of these disruptions occurred over six months in 2010. We asked whether this disruption lead to changes in patterns of care among Medicare beneficiaries. We found that during this time, use of technetium-99m in nuclear stress testing fell from 64% to 49%, reflecting a shift towards thallium-201, which has higher radiation exposure and lower diagnostic specificity. This was reflected in a 9% increase in the rate of cardiac catheterization after a nuclear stress test during the study period, implying nearly 6,000 additional, possibly unnecessary, catheterizations during that time. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Endocrinology, JAMA / 04.07.2016

MedicalResearch.com Interview with: Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response. (more…)
Addiction, Author Interviews, Cancer Research, Pharmacology / 04.07.2016

MedicalResearch.com Interview with: Dr Wai Liu Senior Research Fellow St George's University of London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Naltrexone is a drug commonly used to wean addicts off alcohol and heroin, but clinical evidence has shown that when the drug is used at lower doses, patients would exhibit alter immunity. The symptoms that patients with a number of autoimmune diseases and those associated with chronic pain would ease significantly. Additionally, a number of reports showed patients with some forms of cancer would experience therapeutic benefit. Interestingly, the doses of the drug was crucial, and the non-conventional effects of naltrexone was only achieved at doses that were lower that what was conventionally used. We set about to understand why a drug could have such different effects when used at differing doses. Our results show that the genetic profile of the drug is subtly different at the two different doses, which helped us identify novel ways in which the drug could be used to induce an anticancer effect. (more…)
Author Interviews, Depression, Fertility / 04.07.2016

MedicalResearch.com Interview with: Jessica Datta Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London MedicalResearch.com: What is the background for this study? Response: The paper presents an analysis of data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 is a survey of more than 15,000 women and men aged 16-74 resident in Britain, conducted in 2010-2012, which includes a wide range of questions about sexual relationships and behaviour and reproductive history. In this paper we analysed responses to the questions: ‘Have you ever had a time, lasting 12 months or longer, when you and a partner were trying for a pregnancy but it didn’t happen?’ and ‘Have you (or a partner) ever sought medical or professional help about infertility?’. As well as calculating the prevalence of experience of infertility and help seeking, we looked at associated factors e.g. education, employment, relationship status. (more…)
Author Interviews, Autism, OBGYNE / 04.07.2016

MedicalResearch.com Interview with: Dr-Claudia-Avella-GarcíaClaudia Avella-García MD, MPH, PhD ISGlobal - Institut de Salut Global Barcelona Unitat Docent de Medicina Preventiva i Salut Publica H.Mar-UPF-ASPB MedicalResearch.com: What is the background for this study? Response: Acetaminophen (paracetamol) is used by around half of all pregnant women in developed countries and is currently the recommended treatment for fever and pain during gestation. However, evidence linking exposure to this medication with negative changes in neurodevelopment has been coming to light, warranting further study. Therefore, our objective was to evaluate whether prenatal exposure to acetaminophen was adversely associated with child neurodevelopment at 1 and 5 years of age. For this reason, we evaluated 2644 mother-child pairs recruited during pregnancy as part of the INfancia y Medio Ambiente – Childhood and Environment (INMA) project, a Spanish general population-based cohort. We collected information on acetaminophen use prospectively up until week 32 of gestation. We evaluated neurodevelopment at 1 year of age using the Bayley Scales of Infant Development. At 5 years of age we applied a battery of tests evaluating different aspects of neurodevelopment including both cognitive and behavioural aspects. (more…)
Author Interviews, Brigham & Women's - Harvard, Race/Ethnic Diversity, Stroke / 04.07.2016

MedicalResearch.com Interview with: Nilay Kumar M.B.B.S. Attending physician at Cambridge Health Alliance, Cambridge, MA Instructor in Medicine at Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Racial differences in stroke mortality have major health policy implications. A large body of evidence has shown significant racial differences in the incidence of stroke and associated mortality rate (death due to stroke per unit population per year) in the United States. Few studies to date have addressed racial differences in in-hospital outcomes after acute ischemic stroke using population level datasets. Previous studies have shown inconsistent results with respect to racial differences in in-hospital case fatality rate after acute ischemic stroke. Additionally, racial minorities have been known to be less likely to receive evidence based reperfusion therapies for several cardiovascular diseases including acute myocardial infarction and ischemic stroke. Previous studies on racial differences in stroke outcomes have rarely included Asian and Pacific Islanders. Against this background, we aimed to ascertain racial differences in outcomes of acute ischemic stroke hospitalization in the US using a nationally representative sample. (more…)
Author Interviews, Diabetes, Gender Differences, JCEM, Sleep Disorders / 04.07.2016

MedicalResearch.com Interview with: Dr. Femke Rutters Department of Epidemiology and Biostatistics Vrije Universiteit Medical Centre Amsterdam, The Netherlands; EMGO+ Institute for Care Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology. (more…)
Author Interviews, Education, Medical Imaging, Radiology / 03.07.2016

MedicalResearch.com Interview with: David Leswick MD FRCPC Radiologist Saskatoon Health Region and the University of Saskatchewan MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that the use of computed tomography (CT) is increasing, and there is a significant radiation dose imparted to the population through imaging. There have been multiple prior studies showing limited knowledge of both dose levels and its associated risk from medical imaging procedures, and we wanted to evaluate local knowledge in our Health Region. We surveyed a total of 308 health care providers, including 217 referring physicians, 32 radiologists and 59 technologists. Overall, most respondents were aware of the risk of malignancy from CT, with only 23% of physicians, 3% of radiologists, and 25% of technologists believing there was no increased risk of malignancy from a single CT scan. Underestimating radiation dose levels from a procedure is more concerning than overestimating as it may lead to minimization of the perceived risk. Although relatively few respondents (20%) selected the most appropriate dose estimate for an abdominal CT scan in chest x-ray equivalents, the majority (54%) correctly or overestimated dose, with better knowledge amongst radiologists and imaging technologists than referring physicians. In general, respondents were appropriately more concerned regarding radiation dose when imaging pregnant and pediatric patients as risks from radiation are higher in those groups of patients. (more…)
Author Interviews, CDC, Exercise - Fitness, Occupational Health / 03.07.2016

MedicalResearch.com Interview with: Alberto J. Caban-Martinez, DO, PhD MPH, CPH Assistant Professor, Department of Public Health Sciences, Division of Environment & Public Health Associate Director, Miami Occupational Research Group Director, Musculoskeletal Disorders and Occupational Health Lab University of Miami MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity remains one the largest public health burdens in the United States. Strategies that support healthy nutrition, physical activity and well-being are needed to achieve our national goals of Healthy People 2020. Opportunities for physical activity in the workplace are limited. As our U.S. economy moves from a blue-collar manufacturing enterprise to an increasingly service and information producing workforce, sedentary behavior at the worksite has unfortunately increased. Long work hours seated, short paths to printing or conference room meetings can be leading to increased overweight and obesity workforce trends documented in the U.S. population. Our University of Miami, occupational health and safety research team(www.CabanMartinezLAB.com) developed and evaluated a Walking Meeting (WaM) protocol for white-collar job site using input from thought leaders, key stakeholders, and the scientific and grey literature. We pilot tested the feasibility, acceptability and implementation of the WaM protocol in small group of white collar workers at a large university center. We found that converting just one seated meeting per week at work into a walking meeting increased the work-related physical activity levels of workers by 10 minutes. This increase in physical activity also supports the American Heart Association's recommendations of 150 minutes per week of moderate-intensity physical activity for adults, or about 30 minutes each weekday. (more…)
Author Interviews, Microbiome, Multiple Sclerosis, Nutrition, Science / 02.07.2016

MedicalResearch.com Interview with: Ashutosh K Mangalam PhD Assistant Professor Department of Pathology University of Iowa Iowa City, IA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every human carries trillions of bacteria in their gut (gut microbiome) and recent advances in research indicate that these tiny passengers play an important role in our overall health maintenance. Having evolved over the time span of millions of years with the gut microbiome, they keep us healthy in multiple ways such as fermentation and absorption of undigested carbohydrates, synthesis of some vitamins, metabolism of bile acids etc. However, new research suggests that gut microbiome, also regulating our body’s defense system. It is hypothesized that a diverse gut microbiome is good for our health and perturbations in this might predispose us to disease development. Therefore, we asked whether multiple sclerosis (MS) patients have a gut microbiome which is distinct from healthy individuals. We collected fecal samples from MS patients and healthy controls and performed microbiome analysis. I have recently moved to UI but the entire study was completed at Mayo Clinic Rochester. This study involved a big team comprised of neurologist, gastroenterologist, bioinformatician, system biologist and study coordinators. We found that  multiple sclerosis patients indeed have a gut microbiome which is different from what is observed in healthy people. We identified certain bacteria which are increased or decreased in the gut of patients with multiple sclerosis compared to healthy controls. (more…)
Author Interviews, Heart Disease / 01.07.2016

MedicalResearch.com Interview with: Dr. Mieke Louwe (1) and Prof. dr. Miranda van Eck (2) 1Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands 2Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands MedicalResearch.com: What is the background for this study? Response: ATP-binding cassette transporter A1 (Abca1) is a key protein facilitating the production of high-density lipoprotein (HDL) and the maintenance of macrophage cholesterol homeostasis. Patients and mice with mutations in the Abca1 gene have virtually no HDL in their circulation. Since HDL plays a key protective role in atherosclerosis, by exerting several cardioprotective functions, up regulation of Abca1 is considered as an important novel therapeutic strategy to prevent atherosclerotic cardiovascular disease. Although the role of Abca1 in atherosclerosis is extensively studied, the interplay between Abca1 and myocardial infarction, an acute cardiovascular event often resulting from rupture of advanced atherosclerotic plaques, has not yet been investigated. (more…)
Author Interviews, JAMA / 01.07.2016

MedicalResearch.com Interview with: Christopher Badger, MS3 PRIME-LC UC Irvine School of Medicine MedicalResearch.com: Which over-the-counter mechanical nasal dilators are effective at relieving nasal valve obstruction? Response: In this systemic review, 33 over-the-counter mechanical nasal dilators were identified and classified by mechanism. Ten peer reviewed articles identified six effective devices. MedicalResearch.com: What should readers take away from your report? Response: External nasal dilators and nasal clips may be an effective treatment for the relief of nasal valve obstruction. (more…)
Author Interviews, Depression, JAMA, PTSD / 01.07.2016

MedicalResearch.com Interview with: Bradley E. Belsher, Ph.D. Chief of Research Translation and Integration, Deployment Health Clinical Center, Defense Center of Excellence for PH and TBI Research Assistant Professor, Department of Psychiatry Uniformed Services University of the Health Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: One out of five U.S. military service members returning from overseas military conflicts meets screening criteria for at least one mental health condition, yet fewer than half of service members will receive help from a mental health professional. The consequences of inadequate mental health treatment are considerable and can lead to significant social and functional problems for service members and their families. In response to these mounting concerns, the Military Health System (MHS) has increased efforts to expand and improve the identification and treatment of mental health disorders. Given that the average service member visits primary care three times each year, the MHS has invested considerable resources into the integration of mental health services into the primary care setting. Collaborative care is an effective model for integrating mental health services into primary care and has demonstrated effectiveness in treating different mental health conditions to include depression and anxiety disorders. However, no previous studies have examined whether the concept can work in the MHS. Recently, the first large-scale, randomized effectiveness trial evaluating an integrated health care model in primary care for PTSD and depression in the DoD was conducted. This trial randomized 666 military members treated across six large Army bases to a centrally-assisted collaborative telecare (CACT) approach for PTSD and depression or to the existing standard of care (usual collaborative care). This effectiveness trial targeted a large population of service members as they came into primary care and minimized exclusion criteria to improve the generalizability of the findings and broaden the applicable reach of the intervention. (more…)
Author Interviews, Baylor College of Medicine Houston, Endocrinology, Sexual Health, Testosterone / 01.07.2016

MedicalResearch.com Interview with: Glenn Cunningham, MD Departments of Medicine and Molecular and Cellular Biology Division of Diabetes, Endocrinology and Metabolism Baylor College of Medicine and Baylor St. Luke's Medical Center Houston, Texas 77030 MedicalResearch.com: What is the background for this study? Response: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of testosterone in symptomatic men ≥65 years with unequivocally low testosterone levels. Previous studies in older men have been limited and the results have been conflicting. Initial results of the Sexual Function Trial showed that testosterone improved sexual activity, sexual desire and erectile function. (more…)
Author Interviews, Ovarian Cancer / 01.07.2016

MedicalResearch.com Interview with: Professor Richard Morgan Director, The Institute of Cancer Therapeutics University of Bradford Richmond Road Bradford UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ovarian cancer is the 5th most common cause of cancer-related death in woman and the most deadly gynaecological cancer. One of the reasons for this is its resistance to conventional chemotherapy. Although tumours often respond well at first, showing dramatic shrinkage in the first few months of treatment, they usually grow again and at this point they are no longer sensitive to the drugs. We studied the role of HOX genes in ovarian cancer. The HOX genes play an important role in the early development of the embryo but are usually switched off in adult cells. However, many cancers, including ovarian cancer, turn them back on. Previous work suggested that they might have an important role in promoting the rapid proliferation of cancer cells. (more…)
Author Interviews, Depression, Heart Disease, JAMA / 01.07.2016

MedicalResearch.com Interview with: Prof. Dr. med. Christiane E. Angermann, FESC, HFA Deutsches Zentrum für Herzinsuffizienz Würzburg Comprehensive Heart Failure Center (CHFC) Universitätsklinikum Würzburg Würzburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous meta-analysis indicates that depression prevalence in patients with heart failure is much higher than in the general population, 10 percent to 40 percent, depending on disease severity. Depression has been shown to be an independent predictor of mortality and rehospitalization in patients with heart failure, with incidence rates increasing in parallel with depression severity. Furthermore, it is associated with poor quality of life and increased healthcare costs. It would, against this background, seem desirable to treat the depression, and when planning the study we hypothesized that by doing so we might be able to improve depression and thus reduce mortality and morbidity of this population. Long-term efficacy and safety of selective serotonin reuptake inhibitors (SSRIs), which are widely used to treat depression and have proven efficacious in individuals with primary depression, is unknown for patients with heart failure and (comorbid) depression. (more…)
Author Interviews, Breast Cancer, Mammograms / 01.07.2016

MedicalResearch.com Interview with: Rachel Brem, MD Professor of Radiology and Director of Breast Imaging and Intervention George Washington University School of Medicine. MedicalResearch.com Editor’s note: Many states now have laws regarding patient notification of breast density after mammography screening. Dr. Brem discusses the background and implications of the new mandatory notification laws. MedicalResearch.com: What is meant by 'breast density?’ Is breast density a risk factor for breast cancer? Is breast cancer more difficult to detect in dense breasts? Dr. Brem: Breast density is a measure used to describe the proportion of fat versus breast tissue, which includes fibrous and glandular tissue. Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This is important because on a mammogram dense breast tissue is white and breast cancer is white. The lack of contrast can make detecting cancer more difficult. You can only tell if your breasts are dense from the mammogram. You can’t feel dense breast tissue or see it. An estimated 40 percent of women have dense breast tissue that may mask the presence of cancerous tissue in standard mammography. Dense breast tissue decreases with age, but remains important throughout life. Over 75 percent of women in their 40s have dense breast tissue but over a third of women in their 70s have dense breast tissue. As breast density increases, mammography sensitivity decreases. This is significant, but we must consider the increased risk of breast cancer in women with dense breast tissue. Women with dense breast tissue have up to a four-fold increased risk of developing breast cancer. So, breast density is essentially the “perfect storm” where the ability to detect cancer decreases while the risk for breast cancer increases. Therefore, optimal approaches to individualized breast cancer screening are needed. (more…)
Anemia, Author Interviews, Heart Disease, Hematology / 01.07.2016

MedicalResearch.com Interview with: John G. F. Cleland, MD, FRCP, FESC Department of Cardiology Hull York Medical School, University of Hull, Castle Hill Hospital, Kingston-Upon-Hull National Heart and Lung Institute Royal Brompton and Harefield Hospitals Imperial College London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: This analysis shows that iron deficiency is very common in patients with heart failure and often leads to anaemia and that the prevalence of both iron deficiency and anaemia are highly sensitivity to the criteria used to define them. The World Health Organization defines anaemia as a haemoglobin concentration of <13g/dL in men and <12g/dL in women but doctors should realise this is the lower limit of normal and haemoglobin concentrations should ideally be about 2g/dL higher than this. A man with a haemoglobin of 12g/dL is quite severely anaemic. This study suggest that iron deficiency is common when haemoglobin drops below 14g/dL for men and 13g/dL for women. (more…)
Author Interviews, Ophthalmology / 30.06.2016

MedicalResearch.com Interview with: Marianne Price, Ph.D. Executive Director Cornea Research Foundation of America Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Dr. Price: Over 40% of Americans are near-sighted and the rate of near-sightedness continues to increase. The most common treatments are glasses, contact lenses, or laser refractive surgery (LASIK). The purpose of this study was to find how patient satisfaction compares with contact lenses and with LASIK. We enrolled 1800 participants at 20 sites across the USA; 694 participants (39%) continued wearing contact lenses and 1106 (61%) had LASIK. Participants were surveyed at baseline, 1, 2 and 3 years. (more…)
Author Interviews, Heart Disease, Nature, Stanford / 30.06.2016

MedicalResearch.com Interview with: Mark Mercola, Ph.D. Professor, Development, Aging and Regeneration Program, Sanford-Burnham-Prebys Medical Discovery Institute La Jolla, California 92037 Professor, Stanford Cardiovascular Institute and Stanford University School of Medicine Stanford, CA, 94305, MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease, especially after heart attack (myocardial infarction) is a major cause of death worldwide, accounting for over 13% of all human mortality. There is a major search for ways to treat the immediate cause or lessen the effect of a heart attack. One way researchers have considered is to boost the blood vessels that nourish the heart muscle. The heart muscle is nourished by many small blood vessels. We found a normal protein that acts as a high level regulator of blood vessel formation in the heart. This protein, known as RBPJ, suppresses the factors that make vessels grow. Therefore, we found that inhibiting this protein made more vessels, and consequently protected the hearts from the damage of a heart attack. (more…)
Author Interviews, Emergency Care, Neurological Disorders, NYU, Pain Research / 30.06.2016

MedicalResearch.com Interview with: Mia Minen, MD, MPH Assistant Professor of Neurology NYU Langone Medical Center MedicalResearch.com Editor’s note: The American Headache Society has issued new guidelines on “The Management of Adults With Acute Migraine in the Emergency Department” (1,2) Dr. Minen, Director of Headache Services at NYU Langone Medical Center, discusses these new guidelines below. MedicalResearch.com: What is the background for these new guidelines? How common/severe is the issue of migraine or headache presentation to the ER? Dr. Minen: These guidelines were needed because previous research shows that there are about 1.2. million visits to the emergency department (ED) each year for migraine, and over 25 different medications are sometimes used for treatment. Many of these medications don’t have evidence-based data to back their usage, and opioids are especially likely to be prescribed in between 60 and 70 percent of these cases, despite their lack of efficacy and risks. The American Headache Society convened an expert panel to review the existing evidence on all the medications used to treat migraines in the ED, and we developed these new treatment guidelines. (more…)
Author Interviews, Cancer Research, Leukemia, NEJM, Stanford / 29.06.2016

MedicalResearch.com Interview with: Jason R. Gotlib, MD The Clinical Investigator Pathway Hematology Division Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that advanced forms of systemic mastocytosis, which are blood cancers characterized by accumulation of abnormal mast cells in the bone marrow and additional organs, represent a group of orphan diseases with a large unmet need. Approximately 90% of patients harbor the acquired KIT D816V mutation, a mutated receptor tyrosine kinase on the surface of mast cells which a primary driver of disease pathogenesis. Only 1 drug is approved for patients with one form of advanced systemic mastocytosis, termed ‘aggressive systemic mastocytosis, or ‘ASM’. This therapy is imatinib (Gleevec), but it is only approved for patients without the KIT D816V mutation, or with KIT mutation status unknown because the KIT D816V mutation is resistant to imatinib. Therefore, this drug may only be useful for approximately 10% of patients. Other drugs that have been used off-label for systemic mastocytosis (but are not approved for this indication) include interferon-alpha or cladribine, which show some activity, but their evaluation to date has been primarily limited to small case series which are usually retrospective in nature, and include mixed populations of systemic mastocytosis patients who have both early stage disease without organ damage (e.g. indolent systemic mastocytosis) and and advanced stage patients, as included in this trial, who have one or more findings of organ damage. Also, those trials employed differing response criteria and no central adjudication of eligibility and response assessments was undertaken. Midostaurin is a multikinase inhibitor with activity against both wild-type KIT, but most importantly, KIT D816V (in contrast to imatinib). Prior work demonstrated that cell lines transformed with the KIT D816V mutation can be inhibited at relatively low concentrations of midostaurin. These concentrations could also be achieved in vivo (e.g. at concentrations achievable in the blood of patients). Cell lines transformed by KIT D816V could not be inhibited by imatinib. (more…)
Author Interviews, Infections, NEJM, Vaccine Studies / 29.06.2016

MedicalResearch.com Interview with: Philip Bejon, Ph.D. Professor of Tropical Medicine, Director of the Wellcome-KEMRI-Oxford Collaborative Research Programme, Group Head / PI, Consultant Physician and Unit Director Kilifi, Kenya MedicalResearch.com: What is the background for this study? Response: According to the latest World Health Organisation (WHO) estimates more than 400,000 people died from malaria in 2015, with over 90% of these deaths occurring in sub-Saharan Africa. The vast majority who die are children under 5, and almost all cases are caused by the P. falciparum strain of malaria transmitted by female Anopheles mosquitoes. RTS,S, which protects only against P. falciparum, was developed by GlaxoSmithKline with support from the PATH Malaria Vaccine Initiative (MVI) and with grant funds from the Bill & Melinda Gates Foundation to MVI. In July 2015, it received a positive opinion from the European Medicines Agency. Earlier this year, the WHO recommended further evaluation of the four-dose regimen of RTS,S in a pilot implementation programme in sub-Saharan Africa, to address several knowledge gaps before the vaccine might be rolled out more widely. (more…)
Author Interviews, Dermatology, JAMA, OBGYNE, Sexual Health, Social Issues, UCSF / 29.06.2016

MedicalResearch.com Interview with: Tami Rowen MD MS Obstetrics, Gynecology and Reproductive Sciences UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to answer the question of which women are engaging in genital grooming and understand their motivations. Prior studies have been limited by geography and age thus our goal was to provide a nationally representative sample of women. (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Heart Disease, University of Michigan / 29.06.2016

MedicalResearch.com Interview with: Thomas Valley, MD, MSc Fellow, Pulmonary and Critical Care University of Michigan Ann Arbor, MI 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hospitalizations for cardiovascular condition such as acute myocardial infarction (AMI) and heart failure (HF) are incredibly common and costly. Yet, about 20% of hospitalized patients with these conditions receive substandard care. We assessed whether there was an association between the quality of care a hospital provided for AMI or heart failure and how frequently a hospital used the ICU. We found that hospitals with the highest rates of ICU use for AMI or HF delivered worse quality of care and had higher 30-day mortality for these conditions. (more…)