Author Interviews, Diabetes, Kidney Disease, Pharmacology / 13.06.2016

MedicalResearch.com Interview with: Doctor Hiddo Lambers Heerspink Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: SGLT2 inhibitors, including canagliflozin, have beneficial effects on multiple cardiovascular and renal risk parameters. This suggests that SGLT2 inhibitors may confer cardiovascular and renal protection. A recent large clinical trial with the SGLT2 inhibitor empagliflozin demonstrated marked reductions in cardiovascular morbidity and mortality and suggested possible renoprotective effects. Whether SGLT2 inhibition slows the progression of kidney function decline independent of its glucose-lowering effect, however, is unknown. We therefore assessed whether canagliflozin slows the progression of kidney function decline by comparing the effects of canagliflozin versus glimepiride on eGFR and albuminuria. (more…)
Author Interviews, Biomarkers, Pain Research / 13.06.2016

MedicalResearch.com Interview with: Dr. Gretchen Tietjen MD Professor and Chair of Neurology Director of UTMC Headache Treatment and Research Program Director of the UTMC Stroke Program MedicalResearch.com: What is the background for this study? Dr. Tietjen : C-reactive protein (CRP) is a well-established biomarker of inflammation. Elevated levels of CRP predict future cardiovascular events, such as myocardial infarction (heart attack) and stroke. Evidence linking higher CRP levels with migraine is limited and results from large population-based studies are conflicting. The National Health and Nutrition Examination Survey (NHANES) data for children and adolescents linked elevated CRP to headache, particularly in girls, and the Women’s Health Study showed an association of CRP with migraine in women over 45 years of age. In the Reykjavik study, CRP levels in persons with migraine were similar to levels in those without migraine. The aim of our study was to examine the relationship of CRP and migraine in a large population-based sample of over 9,000 young adults (24 to 32 years old) from The National Longitudinal Study of Adolescent to Adult Health (Add Health). (more…)
Author Interviews, JAMA, Microbiome, Pediatrics, Weight Research / 13.06.2016

MedicalResearch.com Interview with: Dr. Katri Korpela, PhD University of Helsinki Helsinki MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Korpela: Previous studies have shown that breastfeeding reduces the frequency of infections in the child and is associated with lower risk of childhood overweight. Conversely, antibiotic use in early life is associated with increased BMI. Both antibiotic use and breastfeeding are known to influence the infant's microbiota. However, these two factors have not been studied together and it was not known whether antibiotic use could modify the beneficial effects of breastfeeding. We collected data on lifetime antibiotic use, breastfeeding duration, and BMI in a group of daycare-attending children aged 2-6 years. We found that the beneficial effects on long breastfeeding, particularly as regards BMI development, were evident only in the children who did not get antibiotics in early life. Antibiotic use before or soon after weaning seemed to eliminate the protection against elevated BMI in preschool age and weaken the protection against infections after weaning. (more…)
Author Interviews, Sleep Disorders, University of Pennsylvania / 12.06.2016

MedicalResearch.com Interview with: Richard J. Schwab, MD Professor, Department of Medicine Division of Sleep Medicine Pulmonary, Allergy and Critical Care Division Co-Director, Penn Sleep Center University of Pennsylvania Medical Center Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Schwab: Hypoglossal nerve stimulation is a pacemaker (a tiny generator and a sensing lead) placed in the right side of the chest, but instead of using electrical pulses to control the heart, the device stimulates the hypoglossal nerve which is the nerve that controls the motion of the tongue. Patients use a remote control to turn on the device before going to sleep and turn it off upon waking up. Stimulation of the tongue moves the tongue forward which enlarges the upper airway. (more…)
Author Interviews, Cannabis, CHEST, Pulmonary Disease / 12.06.2016

MedicalResearch.com Interview with: Stefania I. Papatheodorou, MD, PhD Cyprus International Institute for Environmental and Public Health Limassol, Cyprus MedicalResearch.com: What is the background for this study? What are the main findings? Response: Marijuana is the most commonly used illicit drug in the United States. Despite increasing use and acceptance of marijuana, both medically and recreationally, gaps remain in our knowledge regarding potential health effects. In this study, we aimed to evaluate associations between recent marijuana use, exhaled Nitric Oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey (NHANES) in the years 2007 to 2012. Exhaled Nitric Oxide was lower among participants who used marijuana in the past 0 to 4 days and those who last used marijuana 5 to 30 days before the examination compared with the never users. FEV1 was higher among participants who used marijuana within 0 to 4 days before the examination compared with those who never used marijuana, while FVC was higher in both past and current marijuana users compared with never users. The FEV1/FVC ratio was significantly lower among those who used marijuana in the 0 to 4 days before the examination compared with never users. (more…)
Author Interviews, Environmental Risks, Heart Disease / 12.06.2016

MedicalResearch.com Interview with: Marko Mornar Jelavic, MD, PhD Department for Internal Medicine and Dialysis Health Center Zagreb Zagreb, Croatia MedicalResearch.com: What is the background for this study? Response: Zagreb is the capital and the largest city of the Republic of Croatia which is placed in South-Eastern Europe. The wider Zagreb metropolitan area has the total population of up to 1.2 million (20% of the total Croatia’s population). The climate of Zagreb is classified as a humid continental. The average daily mean temperature in winter is around +1 °C (from December to February) and the average temperature in summer is 22.0 °C. For the first time, we wanted to investigate whether particles of dimensions ≤10 micrometers (PM10) nitrogen dioxide (NO2) and ozone (O3), as well as certain meteorological conditions (air temperature, humidity and pressure) have any impact on appearance of myocardial infarction (MI) in the region with a humid continental climate. (more…)
Addiction, Author Interviews, Columbia, Pediatrics / 11.06.2016

MedicalResearch.com Interview with: Hannah Carliner, ScD MPH Post Doctoral Fellow in Substance Abuse Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Carliner: We know from previous research that traumatic experiences in childhood can have far-reaching effects on the mental and physical health of adults, including increasing the risk for substance use disorders. There is a particularly strong body of evidence about this concerning exposure to child abuse and various other forms of family dysfunction and violence. However, no previous studies have examined a wider range of traumatic childhood experiences and their link to experimentation with different kinds of drugs in adolescence. While some studies have interviewed adults about initiation of drug use at this age, those results are not as reliable as interviewing teens directly. Using a nationally-representative sample of almost 10,000 non-institutionalized U.S. adolescents, we therefore determined that childhood trauma was associated with lifetime drug use in teens-- not only with clinically-significant disordered drug use, but even with just trying drugs one time. (more…)
ADHD, Author Interviews, JAMA, Mental Health Research, Neurological Disorders / 11.06.2016

MedicalResearch.com Interview with: Katya Rubia, PhD Department of Child and Adolescent Psychiatry Institute of Psychiatry, Psychology, and Neuroscience King’s College London London, England MedicalResearch.com:  What are the main findings? Dr. Rubia: ADHD and OCD patients both suffer from poor inhibitory control and in both disorders this has been associated with structural and functional deficits in fronto-striatal networks. However, it is not clear to what extent the two disorders differ in their underlying neural substrates. This study therefore conducted a meta-analysis of all published whole brain structural and functional MRI studies of inhibitory control in both disorders. MedicalResearch.com: What are the main findings? Dr. Rubia: The main findings are that ADHD and OCD patients differ quite fundamentally in their structural and functional brain abnormalities. OCD patients have enlarged volume in basal ganglia and insula, while ADHD patients have reduced volumes in these regions. In fMRI, in the left hemisphere this was also observed for the left insula and putamen, which were increased in OCD and reduced in ADHD. In addition both disorders have different frontal deficits. OCD patients have deficits in rostro-dorsal medial frontal regions that are important for top-down control of affect while ADHD patients had reduced activation in lateral inferior frontal cortex, a key area of attention and cognitive control. The findings fit into the notion of fronto-striatal dysregulation in OCD where basal ganglia are overactive and poorly controlled by medial frontal regions and a delayed fronto-striatal maturation in ADHD where both lateral frontal regions and the basal ganglia/insula are smaller, and presumably less developed in structure and in function in ADHD. (more…)
Author Interviews, Infections / 10.06.2016

MedicalResearch.com Interview with: Jesper Smit, MD Department of Clinical Microbiology Aalborg University Hospital Aalborg, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Smit: Use of glucocorticoids have been suggested to be associated with increased risk of blood infections by Staphylococcus aureus, but the existing evidence is sparse. Therefore, we conducted a large case-control study to investigate this topic in detail. We found that the risk of staphylococcal blood infections was more than doubled in users of systemic glucocorticoids compared with non-users and that the risk of infection escalated with increasing dose. (more…)
Artificial Sweeteners, Author Interviews, Nutrition, Sugar / 10.06.2016

MedicalResearch.com Interview with: Margaret A. Brennan Department of Wine, Food and Molecular Biosciences Lincoln University Lincoln, Canterbury, New Zealand MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been immense consumer attention recently in terms of the reduction of sugar levels in food products. Most of this attention has stemmed from a nutritional understanding that foods high in sugar and easily digested carbohydrates can increase blood glucose levels and hence potentially lead to weight gain, obesity issues, metabolic diseases (diabetes related illnesses) and even Alzheimer’s disease due to up regulation of genes responsible for amyloid like complexation. Our research over the last 10-15 years has tried to investigate the relationship between food composition – food structure / processing – human nutrition. We have developed a deep understanding of how we can regulate the potential glycaemic index of foods by selective use of non-starch polysaccharides, natural sweeteners and texturizing agents to manipulate the rate of starch and carbohydrate digestion. This study clearly illustrates the great potential of the use of certain natural sweeteners in producing reduced sugar consumer products which have the benefit of reducing glycaemic response in individuals. The utilisation of plant based ingredients to manipulate such a a response offers not only the industry but consumers a powerful opportunity to regulate glycaemia and hence associated metabolic orders. The study also illustrates that sugar is important in modern foods in providing the structure and hence textural characteristics we have grown accustomed to as consumers. Again careful selection of ingredients can minimise any potential negative effects on food structure and texture that sugar reduction may have. (more…)
Author Interviews, Diabetologia, Heart Disease, Johns Hopkins, Lifestyle & Health, Race/Ethnic Diversity / 10.06.2016

MedicalResearch.com Interview with: Joshua J. Joseph, MD Christopher D. Saudek M.D. Fellow in Diabetes Research Division of Endocrinology, Diabetes and Metabolism Johns Hopkins University School of Medicine MedicalResearch.com: What does your study explore? Response: Our study explores two basic questions: (a) Are multi-ethnic people with higher levels of cardiovascular health less likely to develop diabetes based on the AHA ideal cardiovascular health metric? (b) Do these associations vary by race/ethnicity (non-Hispanic white, Chinese American, African American, and Hispanic American)? MedicalResearch.com: Why did you choose this topic to explore? Response: The literature has shown a strong association between lifestyle factors and elevated risk of diabetes in majority non-Hispanic white studies. One study of American Indians showed that meeting a greater number of ideal cardiovascular health goals was associated with a reduced risk of diabetes. We aimed to assess the association of baseline ideal cardiovascular health with incident diabetes within a multi-ethnic population, due to variation of ideal cardiovascular health by race/ethnicity. (more…)
Author Interviews, Depression, Lancet, Pediatrics / 10.06.2016

MedicalResearch.com Interview with: Andrea Cipriani, MD PhD Associate Professor Department of Psychiatry University of Oxford Warneford Hospital Oxford UK MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Cipriani: Major depressive disorder is common in young people, with a prevalence of about 3% in school-age children (aged 6–12 years) and 6% in adolescents (aged 13–18 years). Compared with adults, children and adolescents with major depressive disorder are still underdiagnosed and undertreated, possibly because they tend to present with rather undifferentiated depressive symptoms—eg, irritability, aggressive behaviours, and school refusal. Consequences of depressive episodes in these patients include serious impairments in social functioning, and suicidal ideation and attempts. Our analysis represents the most comprehensive synthesis of data for currently available pharmacological treatments for children and adolescents with acute major depressive disorder (5620 participants, recruited in 34 trials). Among all antidepressants, we found that only fluoxetine was significantly better than placebo. According to our results, fluoxetine should be considered the best evidence-based option among antidepressants when a pharmacological treatment is indicated for children and adolescents with moderate to severe depression. Other antidepressants do not seem to be suitable as routine treatment options. (more…)
Accidents & Violence, Author Interviews, CDC, Pediatrics / 09.06.2016

MedicalResearch.com Interview with: Laura Kann, PhD Chief, School-Based Surveillance Branch Division of Adolescent and School Health National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Centers for Disease Control and Prevention (CDC) MedicalResearch.com: What is YRBSS? Dr. Kann: The Youth Risk Behavior Surveillance System (YRBSS) is the only surveillance system designed to measure the major health risk behaviors among our nation's high school students and to track those behaviors over time at the national, state, and local levels. Reports from this surveillance system have been released every two years since 1991. More information is available at: www.cdc.gov/yrbs. (more…)
Author Interviews, Cost of Health Care, JAMA, Macular Degeneration, Ophthalmology / 09.06.2016

MedicalResearch.com Interview with: Adam Glassman, M.S. Director, DRCRnet Coordinating Center Jaeb Center for Health Research Tampa, FL 33647 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetic macular edema (DME) is the most common cause of vision loss in patients with diabetes, impairing the vision of approximately 750,000 people in the United States. The most common treatment involves the injection into the eye of one of 3 drugs that inhibit vascular endothelial growth factor (VEGF). The Diabetic Retinopathy Clinical Research Network, funded by the National Institutes of Health, conducted a randomized clinical trial on the comparative effectiveness of the 3 anti-VEGF drugs EYLEA®, Avastin®, or Lucentis® for eyes with decreased vision from diabetic macular edema. There are substantial cost differences between the three drugs. In the United States, EYLEA® costs approximately $1850, repackaged (compounded) Avastin® $60, and Lucentis® $1170 per injection. In eyes with relatively good starting vision, there were no differences in vision outcomes; all three groups, on average, had improved vision. In eyes with starting vision of 20/50 or worse, EYLEA® had better vision outcomes at 1 year than either Avastin® or Lucentis®, and better vision outcomes at 2 years than Avastin®. However, given that, on average, eyes will receive 9 to 10 injections within the first year of treatment and 5 injections in the second year, neither EYLEA® nor Lucentis® would be considered cost effective by standard benchmarks compared with Avastin® unless their prices decrease substantially. (more…)
Author Interviews, Dermatology, Heart Disease / 09.06.2016

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Egeberg: While psoriasis has been associated with an increased risk of cardiovascular disease (CVD), studies have generally neglected to adjust for family history of CVD which is a well-established cardiovascular risk factor. In a population-based study of young patients with psoriasis, we found an increased risk of CVD only in patients with a positive family history of CVD but not in those patients that did not have a positive family history. (more…)
Author Interviews, Blood Pressure - Hypertension, NEJM, Stroke / 09.06.2016

MedicalResearch.com Interview with: Adnan I. Qureshi, M.D Zeenat Qureshi Stroke Research Center University of Minnesota Minneapolis, MN MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Qureshi: An acute hypertensive response in patients with intracerebral hemorrhage is common and may be associated with hematoma expansion and increased mortality. The Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-2) trial was designed to determine the efficacy of rapidly lowering systolic blood pressure in patients in an earlier time window after symptom onset than evaluated in previous trials. The trial was based on evidence that hematoma expansion and subsequent death or disability might be reduced with very early and more aggressive reduction in systolic blood pressure in those at higher risk due to presence of high systolic blood pressure at presentation. The trial randomized eligible subjects with intracerebral hemorrhage to test the superiority of intensive (goal 110-140 mmHg) over standard (goal 140-180 mmHg) systolic blood pressure reduction using intravenous nicardipine within 4.5 hours of symptom onset. Of a total of 1000 subjects that were recruited with a mean (standard deviation) baseline systolic blood pressure of 200.6 (27.0) mmHg, 500 were assigned to intensive-treatment and 500 to standard-treatment. Enrollment was stopped following a pre-specified interim analysis because of futility. The primary endpoint of death or disability at 3 months post-randomization was observed in 38.7% (186/481) of subjects receiving intensive treatment and 37.7% (181/480) subjects receiving standard treatment (relative risk: 1.03; 95% confidence interval: 0.85 to 1.27), adjusted for age, initial Glasgow Coma scale, and presence or absence of intraventricular hemorrhage. The rate of renal adverse events within 7 days of randomization was significantly higher among subjects randomized to intensive treatment. Compared to a target systolic blood pressure of 140-180 mmHg, treating subjects with intracerebral hemorrhage to a target systolic blood pressure of 110-140 mmHg did not lower the rate of death or disability. (more…)
Author Interviews, Biomarkers, JAMA / 09.06.2016

MedicalResearch.com Interview with: Matthew D. Jankowich, MD Assistant Professor of Medicine Alpert Medical School of Brown University Staff physician at the Providence VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Jankowich: For some time, endothelin-1 has been known to cause vasoconstriction in the pulmonary circulation, and elevated endothelin-1 levels have been noted in patients with pulmonary arterial hypertension and decompensated congestive heart failure, as well as other advanced disease states. However, endothelin-1 has not been well studied in members of the general population. In our study, we examined plasma endothelin-1 levels in participants in the Jackson Heart Study and the relationship of plasma endothelin-1 levels to pulmonary hypertension, mortality and heart failure. We found increased odds of having pulmonary hypertension, defined as an echocardiography estimation of the pulmonary artery systolic pressure>40mmHg, in those participants with higher plasma endothelin-1 levels. Having higher endothelin-1 levels was also associated with an increased risk of both mortality and heart failure. Those participant with both high endothelin-1 levels (a level in the top 25%) and pulmonary hypertension were at the highest risk of mortality. (more…)
Author Interviews, Autism, Genetic Research / 09.06.2016

MedicalResearch.com Interview with: David Beversdorf, M.D. Associate professor in the departments of radiology, neurology and psychological sciences University of Missouri and Missouri University Thompson Center for Autism and Neurodevelopmental DisordersDavid Beversdorf, M.D. Associate professor in the departments of radiology, neurology and psychological sciences University of Missouri and Missouri University Thompson Center for Autism and Neurodevelopmental Disorders MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Beversdorf: Our previous work had demonstrated in retrospective surveys a higher incidence of prenatal psychosocial stress exposure during the late 2nd and early 3rd trimester in pregnancies where the offspring had developed autism spectrum disorder (ASD). This had been confirmed in other studies, including a study examining the timing of exposure to tropical storms during pregnancy. However, not everyone exposed to stress during pregnancy has a child with ASD, so we began to look at genetic risk for augmented stress reactivity. This initial exploration involved examination of the interaction between stress exposure during ASD-associated pregnancies and the maternal presence of variations in one gene well known to affect stress reactivity. Variations in this gene were also targeted as they have been associated with ASD in some studies. We found in two independent groups of patients (one in Missouri, one in Ontario, Canada) that maternal presence of at least one copy of the stress-susceptible variant of this gene is associated with the link between maternal stress exposure during this time window of pregnancy and subsequent development of ASD in the offspring. (more…)
Author Interviews, Breast Cancer, Lipids, MRI, NYU / 09.06.2016

MedicalResearch.com Interview with: Sungheon G. Kim, PhD Associate Professor Department of Radiology NYU Langone and Researcher at the Center for Advanced Imaging, Innovation, and Research MedicalResearch.com: What is the background for this study? Dr. Kim: The role of fat in breast cancer development and growth has been studied extensively using body mass index (BMI), a measure of whole body fatness, and dietary fat intake in a number of epidemiological studies. However, there is a paucity of studies to assess the role of breast fat itself in breast cancer due to lack of a non-invasive and fast measurement method. Since breast fibroglandular cells are surrounded by breast fat cells, the characteristics of breast fat may have a stronger relationship with breast cancer development and growth than BMI and/or dietary fat. However, it is not trivial to study the role of breast fat, mainly due to the lack of a non-invasive and fast measurement method sensitive enough to important features of breast fat, such as types of fat. (more…)
Author Interviews, Outcomes & Safety / 09.06.2016

MedicalResearch.com Interview with: Stryker Nate Miersma Director of Surgical Safety Editor’s note: As part of an ongoing series on health care safety, Nate Miersma discusses the use of Stryker’s SurgiCount system to reduce he incidence of retained surgical sponges. MedicalResearch.com: What is the background of the Stryker Surgicount Safety-Sponge System?  Mr. Miersma: Retained surgical sponges are the number one reported surgical never event, occurring roughly a dozen times per day in the United States. SurgiCount helps hospitals eliminate retained sponges by supplementing and verifying the manual count of sponges using a unique bar code for each sponge. • The traditional manual sponge-counting method expects nurses and surgical technicians to track sponges with extreme precision using only a whiteboard and dry-erase marker. Though the majority of nurses and surgical technicians are experienced and thorough, the fast-paced, high-pressure environment of an operating room creates the risk for false-correct counts caused by distraction, exhaustion or personnel changes. At a rate of 11 times per day, the ‘white board while multi-tasking’ method clearly isn’t sufficient. • When using SurgiCount, a nurse or surgical technician scans the barcodes to enter them into the computer’s backup count. During the closing count at the end of the procedure, a nurse or surgical technician scans each bar code again, while the computer tracks which sponges have been counted out and which remain. If the counts do not match, the SurgiCount scanner identifies which sponge or sponges are still unaccounted for, and directs staff to resolve the count by locating the outstanding sponge or sponges. Numerous clinical studies indicate that the primary cause of retained surgical sponges is false-correct counts. SurgiCount ensures that these false-correct counts no longer occur during the busy closing process. • The scanner never gets tired or distracted, and can’t accidentally count the same sponge out twice, or count out a sponge which was accidentally introduced to the case possibly from another room, or from a sponge which was hidden and left over from a previous case. (more…)
ASCO, Author Interviews, Cancer Research, Immunotherapy / 08.06.2016

MedicalResearch.com Interview with: Dr. Arjun Balar MD Assistant Professor, Department of Medicine Co-Leader Genitourinary Cancers Program NYU Langone Medical Center Laura and Isaac Perlmutter Cancer Center MedicalResearch.com: What is the background for this study? Dr. Balar: Standard treatment for advanced urothelial cancer includes cisplatin chemotherapy. But more than half of patients are not expected to tolerate it well and alternative treatment is inferior to cisplatin. The average survival for these patients is in the range of 9-10 months with carboplatin-based treatment, which is the most commonly used alternative to cisplatin. Atezolizumab is a PD-L1 blocking antibody that reactivates the body¹s immune system to fight bladder cancer and has been recently FDA approved in the management of advanced urothelial cancer in the second-line setting after failure of platinum-based chemotherapy. (more…)
Author Interviews, Genetic Research / 08.06.2016

MedicalResearch.com Interview with: Dr Addolorata Pisconti Ph.D. Department of Biochemistry Institute of Integrative Biology University of Liverpool Liverpool United Kingdom MedicalResearch.com: What is the background for this study? Dr. Pisconti: Duchenne muscular dystrophy (DMD) is a genetic disorder caused by lack of the cytoskeletal protein dystrophin which, under normal conditions, protects the muscle fibres during the stress of contraction. In the absence of dystrophin, muscle fibres are more fragile and are easily damaged leading to progressive loss of muscle mass and strength, loss of ambulation, difficulties breathing, cardiomyopathy and eventually premature death. There is no cure for DMD. In Duchenne muscular dystrophy the resident muscle stem cells are impaired and therefore regeneration of damaged muscle fibres is also impaired. Some of the mechanisms leading to impaired muscle stem cell function have been hypothesised, however this remains to date an elusive topic. Chronic inflammation and fibrosis are a hallmark of dystrophic muscle but how they affect muscle stem cells and their regenerative potential remains largely unknown. (more…)
Author Interviews, CDC, Zika / 08.06.2016

MedicalResearch.com Interview with: Andrea M. Bingham, PhD Vector-Borne Disease Surveillance Coordinator Florida Department of Health MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bingham: Since its introduction to Brazil in 2015, Zika virus has spread throughout the Caribbean and South and Central America. We are constantly learning new things about Zika virus, including its potential for sexual transmission and its ability to cause certain birth defects such as microcephaly. Because many states, including Florida, have mosquito vectors that can potentially be infected with Zika virus, being able to identify infected people is important to ensure proper response and control measures are put in place to prevent local introductions. Improving testing capacity helps ensure that we have the ability to rapidly detect local Zika virus introductions if they occur. On the basis of previous small Zika fever case studies that reported positive testing of patient urine and/or saliva samples, the Florida Department of Health made the decision to collect multiple specimen types from persons with suspected acute travel-related Zika fever in order to determine the most sensitive and efficient testing algorithm. Testing performed at our state public health laboratories in Tampa and Jacksonville suggested that urine was the most useful specimen for identifying acute Zika fever infections. Zika virus real time reverse-transcriptase polymerase chain reaction (RT-PCR) testing conducted on urine and serum samples collected the same day from 66 travel-associated Zika fever patients, detected Zika virus in nearly twice as many urine samples (61) as serum samples (31). Viral RNA was also detectable in urine longer than in serum. Although a high percentage of saliva samples also tested positive, no additional cases were identified through saliva testing alone. Based on these results and those of the small case studies, CDC updated their guidance to include urine as a recommended specimen type for testing of patients with suspected acute Zika fever. (more…)
Author Interviews, CDC, JAMA, Pediatrics, Weight Research / 08.06.2016

MedicalResearch.com Interview with: Cynthia L Ogden PhD, MRP Public Health, Nutrition and Dietetics CDC Atlanta MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ogden: Monitoring trends in obesity prevalence is important because of the health risks associated with obesity and because obesity often tracks from childhood to adulthood. The most recent data before this point showed no increases overall in youth, men or women over the previous decade. We used the most recent nationally representative data with measured weights and heights from the National Health and Nutrition Examination Survey to look at trends in obesity prevalence. (more…)
Anesthesiology, Author Interviews, Cognitive Issues, Columbia, JAMA, Pediatrics / 08.06.2016

MedicalResearch.com Interview with: Lena S. Sun, MD E. M. Papper Professor of Pediatric Anesthesiology Professor of Anesthesiology and Pediatrics Executive Vice Chairman, Department of Anesthesiology Chief, Division of Pediatric Anesthesiology Columbia University Medical Center New York, New York 10032 MedicalResearch.com: What is the background for this study? Dr. Sun: The background for the study is as follow: There is robust evidence in both rodent and non-human primate studies that exposure of the developing brain leads to impairment in cognitive function and behavior later in life. The evidence from human studies derives mostly from retrospective studies and the results have been mixed. Some have demonstrated anesthesia in early childhood was associated with impaired neurocognitive function, while others have found no such association. Our study is the first to specifically designed to address the question of effects of general anesthesia exposure on cognitive function, comparing exposure with no exposure. (more…)
ASCO, Author Interviews, Cancer Research, Immunotherapy, University of Pittsburgh / 07.06.2016

MedicalResearch.com Interview with: Robert L. Ferris, M.D., Ph.D. Robert L. Ferris, M.D., Ph.D. UPMC Endowed Professor and Vice-Chair Associate Director for Translational Research Co-Leader, Cancer Immunology Program MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ferris: Investigators at the University of Pittsburgh Cancer Institute<http://upci.upmc.edu/> (UPCI) co-led CheckMate-141<https://clinicaltrials.gov/ct2/show/NCT02105636> a large, randomized international phase III clinical trial that enrolled 361 patients with recurrent or metastatic head and neck squamous cell carcinoma who had not responded to platinum-based chemotherapy, a rapidly progressing form of the disease with an especially poor prognosis. Patients were randomized to receive either nivolumab or a single type of standard chemotherapy until tumor progression was observed. Nivolumab, which belongs to a class of drugs known as immunotherapeutics, enables the body’s immune system to destroy cancer cells. It currently is approved to treat certain types of cancers, including melanoma and lung cancer. The nivolumab group achieved better outcomes than the standard chemotherapy group by all accounts. After 12 months, 36 percent of the nivolumab group was alive, compared to just 17 percent of the standard chemotherapy group. Nivolumab treatment also doubled the number of patients whose tumors shrunk, and the number whose disease had not progressed after six months of treatment. Importantly, these benefits were achieved with just one-third the rate of serious adverse events reported in the standard chemotherapy group. In addition, on average, patients receiving nivolumab reported that their quality of life remained stable or improved throughout the study, while those in the chemotherapy group reported a decline. The new trial was considered so successful that it was stopped early to allow patients in the comparison group to receive the new drug. (more…)
ASCO, Author Interviews, Dermatology, Journal Clinical Oncology, Melanoma, Primary Care, University of Pittsburgh / 07.06.2016

MedicalResearch.com Interview with: Laura Ferris, M.D., Ph.D. Associate professor, Department of Dermatology University of Pittsburgh School of Medicine and Member of the Melanoma Program University of Pittsburgh Cancer Institute MedicalResearch.com: What is the background for this study? Dr. Ferris: Rates of melanoma, the most dangerous form of skin cancer, are on the rise, and skin cancer screenings are one of the most important steps for early detection and treatment. Typically, patients receive skin checks by setting up an appointment with a dermatologist. UPMC instituted a new screening initiative, which was modeled after a promising German program, the goal being to improve the detection of melanomas by making it easier for patients to get screened during routine office visits with their primary care physicians (PCPs). PCPs completed training on how to recognize melanomas and were asked to offer annual screening during office visits to all patients aged 35 and older. In 2014, during the first year of the program, 15 percent of the 333,788 eligible UPMC patients were screened in this fashion. (more…)
Author Interviews, FDA, JAMA, Smoking / 07.06.2016

MedicalResearch.com Interview with: Marissa G. Hall, MSPH Doctoral Candidate, Department of Health Behavior Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? What are the main findings? Response: The US Food and Drug Administration (FDA) requires pictorial warnings on cigarette packs, but implementation was stalled by a 2012 lawsuit by the tobacco industry. The US Court of Appeals for the DC Circuit ruled against pictorial warnings, saying that FDA had “not provided a shred of evidence” that the pictorial warnings reduce smoking. To address this critique, our randomized trial examined the impact on smoking behavior of adding pictorial warnings to the front and back of cigarette packs. We found that smokers with pictorial warnings on their packs were more likely to attempt to quit and to successfully quit than those whose packs had text-only warnings. (more…)