Author Interviews, Cancer Research / 27.04.2016

MedicalResearch.com Interview with: E. Premkumar Reddy, Ph.D. Professor, Department of Oncological Sciences and Department of Structural and Chemical Biology Director, Experimental Cancer Therapeutics Mount Sinai School of Medicine New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reddy: It is now well established that  cancer cells harbor mutations in their genome which are responsible for uncontrolled proliferation.  Nearly 30 years ago, we as well as two other groups discovered that RAS genes are often mutated in human cancers.  Later studies showed that nearly 25-30% of human cancers contain this mutation and these mutations can be caused by chemical carcinogens such as tobacco smoke.  Since then there has been an intense effort to understand the biological functions of RAS and to develop drugs that block the activity of these mutant RAS genes.  Although molecular oncologists have made significant headway in understanding these mutations and their impact on cellular signaling, little progress has been made towards developing drugs that systematically target the RAS oncogenes.  This lack of progress has led many in the field to label RAS as “undruggable”.  However, basic research conducted by scientists in this field has revealed that RAS proteins function as ON-OFF switches to signal cells to grow or not to grow because of their ability to bind to a large number of cellular proteins and transmit this signal to their binding partners.  These findings also revealed that mutations in RAS genes leaves them in a permanent “ON” position which continues to transmit growth signals permanently.  Since most efforts to develop drugs that bind to RAS proteins and reverse their activity failed, we took a different approach to block these signals.  Since transmission of growth signals by RAS genes requires their interaction with cellular proteins, all of which contain a domain called “RAS-Binding Domain (RBD)” we created a drug named “Rigosertib” that binds to these RBDs and block their binding to RAS, thereby interrupting RAS signals.  When Rigosertib was tested in animals, it could readily inhibit the growth of human tumors that contain RAS mutations.  Our studies also show that Rigosertib is a very safe drug with minimal side-effects. (more…)
Author Interviews, Sleep Disorders, Stanford / 27.04.2016

MedicalResearch.com Interview with: Maurice M. Ohayon, MD, DSc, PhD Chief of the Division of Public Mental Health and Population Sciences Director of the Stanford Sleep Epidemiology Research Centre (SSERC) John-Arrillaga PI & Professor of Psychiatry and Behavioral Sciences School of Medicine, Stanford University Palo Alto, CA 94303  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ohayon: Artificial Lights at night are known to be powerful disruptors of the normal sleep/wake cycle. Light exposure at night acts on suppressing and delaying melatonin secretion and exciting the central nervous system. In this study we focused on the effects of the outdoor lights at night, (such as street lights and lights, outdoor light fixtures and advertising boards) as measured at nighttime by satellite observations. We analyzed the sleep habits of a representative sample of the American general population that had been interviewed with the artificial intelligence system Sleep-EVAL. We found that individuals living in areas at high level of radiance, such as can be found in the downtowns of metropolitan areas, have a delayed bedtime, delayed wake up time and, overall, shorter sleep duration, than people living in areas with low nighttime radiance. (more…)
AACR, Author Interviews, Biomarkers, Cancer Research, Colon Cancer, Technology / 27.04.2016

MedicalResearch.com Interview with: Dr. Elodie Sollier PhD Chief Scientific Officer at Vortex Biosciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vortex Biosciences has developed a fast and simple way to isolate and collect intact circulating tumor cells (CTCs) directly from whole blood in less than an hour using a process based on microfluidics. To better understand the utility of the technology for the clinical setting, PCR-based Sanger sequencing was used to profile the mutations of CTCs isolated from blood from metastatic Colorectal cancer patients. The mutations were compared to primary tumor biopsies, secondary tumor biopsies and ctDNA. There are 3 primary take-aways:
  1. The Vortex technology captures CTCs with enough purity to perform sensitive and accurate PCR-based Sanger sequencing.
  2. Mutations present in primary and secondary tumors can be identified in both CTCs and ctDNA making liquid biopsies a valuable alternative to tissue biopsies.
  3. While there is general consistency of mutations identified, some mutations are only identified in CTCs while others only in ctDNA demonstrating how these are indeed complimentary.
(more…)
Author Interviews, Genetic Research, PLoS, Vitamin D / 27.04.2016

MedicalResearch.com Interview with: Haidong Zhu, MD, PhD Associate Professor of Pediatrics Georgia Prevention Institute Medical College of Georgia Augusta University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Zhu: Vitamin D plays an important role in a wide range of body functions beyond bone health. Vitamin D deficiency is associated with increased risk of cancer and cardiovascular disease. Vitamin D deficiency is common among darker skin individuals, particularly African-Americans, which could contribute to health disparity. We want to understand underlying molecular mechanism (i.e. global DNA methylation) for how vitamin D deficiency causes cancer, cardiovascular disease and impaired immune function. DNA methylation, a chemical modification to our genome, is one of the ways that our body adapts to the environment. Low rate of global DNA methylation is a common event in cancer, which may lead to disturbances in the genome, make the genome more vulnerable to environmental damage and increase disease risk. Our study shows that majority of black teens are vitamin D deficient and have a lower rate of global DNA methylation than white teens. We further demonstrate that vitamin D3 supplementation for 16 weeks increases global DNA methylation in black teens and young adults. Our study provides an important piece of evidence that vitamin D plays a role in epigenetic regulation in humans, which could be an underlying mechanism for vitamin D-deficiency related disease risk and health disparity. (more…)
Author Interviews, MRI, Prostate Cancer / 26.04.2016

MedicalResearch.com Interview with: Dr. Nelly Tan MD David Geffen School of Medicine Department of Radiology UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Tan: Standard of care for prostate cancer diagnosis has been to perform ultrasound guided random (non-targeted) prostate biopsy (TRUS) which is neither sensitive or specific. The main limitation had been our inability to detect and localize prostate cancer through imaging. Over the past 10 years, MRI has taken center stage for detection and localization of prostate cancer and has shown to improve prostate cancer diagnosis, risk stratification, and staging of the disease. Over the past few years, MRI guided biopsy techniques (in the form of Ultrasound-MRI (US-MRI) fusion and in-bore direct MRI guided biopsy) have been reported. We reported our performance of direct in-bore MRI guided biopsy at UCLA. Our study showed a prostate cancer diagnosis of 59% in all patients and 80% of patients with prostate cancer had clinically significant cancer. (more…)
Author Interviews, JAMA, Outcomes & Safety / 26.04.2016

MedicalResearch.com Interview with: Maricruz Rivera-Hernandez, PhD Investigator Department of Health Services, Policy & Practice Center for Gerontology and Health Care Research Brown University, Providence, RI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rivera-Hernandez: Over three-quarters of Medicare-eligible residents in Puerto Rico enroll in Medicare Advantage plans, making them the primary source of health care coverage for the island’s seniors. Puerto Rican Medicare Advantage plans have a long history of receiving lower payments than Medicare Advantage plans located in the United States. The study’s purpose was to compare the quality of care provided to Medicare Advantage enrollees in Puerto Rico with that delivered to Medicare Advantage enrollees in the 50 states and the District of Columbia. We found significantly worse quality for Puerto Rican Medicare Advantage enrollees compared to their US counterparts for 15 of the 17 quality indicators. These indicators measured whether patients received the recommended treatment and achieved desired outcomes in diabetes care, cardiovascular disease, and cancer screening and whether they received any inappropriate medications in 2011. (more…)
Author Interviews, Sexual Health, Social Issues / 26.04.2016

MedicalResearch.com Interview with: Lindsey Hicks Doctoral Student Social Psychology Florida State University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: My colleagues and I are very interested in the factors that differentially predict peoples’ self-reported relationship satisfaction and their gut-level feelings about their partners—the spontaneous feelings they have and may not articulate. Because explicit self-reports require conscious deliberation they are subject to the influence of biases and beliefs about relationships; gut-level, automatic attitudes do not require conscious deliberation and thus appear to better track actual experience. With that in mind, we examined whether sexual frequency influences automatic but not explicit evaluations of the partner. Previous research has yielded inconsistent results regarding the influence of sexual frequency on relationship satisfaction, and we thought such inconsistencies may stem from the influence of deliberate reasoning and biased beliefs regarding the sometimes taboo topic of sex. Thus, we tested the association between partners’ sexual frequency and their gut-level feelings about each other. Basically we found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners. This is particularly important in light of previous research done by my colleagues demonstrating that it these automatic attitudes ultimately predict whether or not they’ll end up becoming dissatisfied with their relationship. (more…)
Author Interviews, Education, Pediatrics, PNAS, Social Issues / 26.04.2016

MedicalResearch.com Interview with:

Joan L. Luby, MD Samuel and Mae S. Ludwig Professor of Child Psychiatry Director, Early Emotional Development Program Washington University School of Medicine St. Louis, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Luby: The study was designed to investigate brain development in early onset mental disorders. The main findings validate depression in preschoolers with brain change evident this young similar to that known in adults. We also found effects of maternal support on brain development in this process which is what the current paper focuses on . (more…)
Author Interviews, Breast Cancer, JAMA / 26.04.2016

MedicalResearch.com Interview with: Ahmad Awada, MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles Bruxelles, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Awada: This Study compared, in a randomized fashion, paclitaxel + trastuzumab to paclitaxel + neratinib in the first line setting of metastatic breast cancer. All outcome endpoints (PFS, OS, ORR) were similar. In addition, paclitaxel + neratinib delayed the appearance and decreased the incidence of central nervous system (CNS) events (secondary end point) MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Awada:  Paclitaxel + neratinib is as effective as paclitaxel + trastuzumab. The data suggested that neratinib could influence the pattern of CNS events in HER2+ metastatic breast cancer. These emerging data on CNS events are under validation in the NALA trial. (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 26.04.2016

MedicalResearch.com Interview with: Jaclyn B. Caccese MS The University of Delaware PhD Candidate Biomechanics and Movement Science  MedicalResearch.com: What is the background for this study? Response: Recently, there has been increased concern regarding the adverse effects of repetitively heading soccer balls on brain function. While some studies have shown impaired balance and vision, it is unclear if these deficits are acute or chronic adaptations. Therefore, the purpose of this study was to identify changes in postural control and vestibular/ocular motor function immediately following an acute bout of 12 purposeful soccer headers. MedicalResearch.com: What are the main findings? Response: The main finding of this study was that women's soccer players showed an increase in sway velocity, but no other changes in balance or vestibular/ocular motor function were identified. (more…)
Author Interviews, C. difficile, Hospital Acquired, JAMA, McGill / 26.04.2016

MedicalResearch.com Interview with: Yves Longtin, MD, FRCPC Chair, Infection Prevention and Control Unit Montreal Jewish General Hospital - SMBD Associate professor of Medicine, McGill University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Longtin: Clostridium difficile is a major cause of infection in hospitalized patients. Current infection control measures to prevent the spread of C. difficile in hospitals focuses almost entirely on patients who present symptoms. Patients with symptoms of diarrhea due to C difficile are placed under isolation in hospitals (for example, healthcare workers will wear a gown and gloves when caring for them). However, many studies have shown that some patients may be asymptomatic carriers of C. difficile. These patients carry the C difficile bacteria in their digestive tract without being sick. It was known that these asymptomatic carriers could spread the bacteria to other patients, but it was unclear whether putting them into isolation would help prevent the spread of the microbe in hospitals. Our study tested the hypothesis that placing asymptomatic carriers under isolation could lead to a decrease in the number of infections with C  difficile. (more…)
Author Interviews, Heart Disease, Stroke / 25.04.2016

MedicalResearch.com Interview with: Professor Ralph Stewart MBChB (Otago), FRACP, FCSANZ, MD Auckland City Hospital University of Auckland, New Zealand MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Stewart: A number of studies have suggested a favorable effect of a Mediterranean dietary pattern on the risk of heart disease, but few large studies have evaluated this dietary pattern in a global population of patients with known coronary heart disease.  We assessed a Mediterranean diet score based on frequency of consumption of common foods using a very simple questionnaire.  Globally this included a very broad range of diets – showing the benefits of this dietary pattern  can be achieved with many different foods. We founds that greater adherence to this diet was associated with a lower risk of recurrent heart attacks, strokes and deaths from any cause.  In contrast a western diet score, which measured more consumption of foods thought to be unhealthy, including processed carbohydrates, sweetened foods and drinks and deep fried foods were not associated with the risk of cardiovascular events. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Toxin Research / 25.04.2016

MedicalResearch.com Interview with: Dr. Gary Smith, MD PhD Director, Center for Injury Research and Policy Nationwide Children's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Smith: Laundry detergent packets are relatively new to the U.S. market (introduced in 2012). As their popularity has increased, so have calls to poison centers for detergent packet exposures. The study analyzed calls to poison centers and compared exposures to young children from dishwasher and laundry detergent packets as well as traditional (liquid and powder) dishwasher and laundry detergents. Incidents related to laundry detergent packets saw the biggest rise - increasing 17% over the two-year study period. Poison control centers received more than 30 calls a day on average about a child who had been exposed to a laundry detergent packet, which is about one call about every 45 minutes. Claims made by others that the rate of exposures is decreasing are misleading – these claims are based on an inappropriate use of numbers. Children exposed to laundry detergent packets were significantly more likely to be admitted to a healthcare facility or have a serious medical outcome than those exposed to other types of detergent. They were also more likely to have serious clinical effects. Coma, pulmonary edema, respiratory arrest, and death were only observed among children exposed to laundry detergent packets. (more…)
AACR, Author Interviews, Breast Cancer, Cancer Research, Pediatrics, Radiation Therapy / 25.04.2016

MedicalResearch.com Interview with: Lindsay M. Morton, PhD Senior investigator in the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetic National Cancer Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? Dr. Morton: We know that childhood cancer survivors, particularly those who received radiotherapy to the chest, have strongly increased risk of developing breast cancer. We studied about 3,000 female survivors of childhood cancer to identify whether inherited genetic susceptibility may influence which survivors go on to develop breast cancer. MedicalResearch.com: What are the main findings? Dr. Morton: In this discovery study, we found that specific variants in two regions of the genome were associated with increased risk of breast cancer after childhood cancer among survivors who received 10 or more gray of chest radiotherapy. A variant at position q41 on chromosome 1 was associated with nearly two-fold increased risk and one at position q23 on chromosome 11 was associated with a more than three-fold increased risk for each copy of the risk alleles. However, the variant alleles didn’t appear to have an effect among survivors who did not receive chest radiotherapy. (more…)
Author Interviews, Biomarkers, Lancet, Pulmonary Disease / 25.04.2016

MedicalResearch.com Interview with: Danny McBryan, MD Vice president, Clinical Development & Medical Affairs, Respiratory Boehringer Ingelheim Pharmaceuticals, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Dr. MvBryan: The new post-hoc analysis from the WISDOM study shows a routine blood test could help identify the small minority of patients with severe or very severe COPD who may benefit from the addition of inhaled corticosteroids (ICS). This post-hoc analysis was recently published online in The Lancet Respiratory Medicine. For 80 percent of patients in the WISDOM study, the use of ICS on top of SPIRIVA HANDIHALER (a long-acting muscarinic antagonist – LAMA) and salmeterol (a long-acting beta-agonist – LABA) had no additional benefit in reducing the risk of exacerbations, compared to SPIRIVA HANDIHALER and the LABA without ICS. The post-hoc analysis shows that these patients can be easily identified by measuring the level of white blood cells, called eosinophils. Patients with levels lower than 4 percent (300 cells/µL) were associated with a lack of response to ICS. The WISDOM study evaluated stepwise withdrawal of inhaled corticosteroids (ICS) in severe to very severe COPD patients with a history of exacerbation. WISDOM was a 12-month, double-blind, parallel-group, active-controlled study in which all patients received triple therapy (tiotropium 18 μg once daily, salmeterol 50 μg twice daily and fluticasone 500 μg twice daily) for a six-week run-in period. Patients were randomized 1:1 to continue triple therapy or stepwise withdrawal of ICS over 12 weeks (dose reduction every six weeks). The WISDOM data show that in patients with severe to very severe COPD, the risk of moderate/severe exacerbations during one year of follow-up was non-inferior between those patients who continued on inhaled corticosteroids and those where ICS therapy was withdrawn in a stepwise manner. (more…)
Addiction, Author Interviews, Cocaine, Methamphetamine, Opiods, University of Pittsburgh / 25.04.2016

MedicalResearch.com Interview with: Jeanine Buchanich, Ph.D. Deputy director of the Graduate School of Public Health’s Center for Occupational Biostatistics and Epidemiology Research assistant professor in Pitt Public Health’s Department of Biostatistics University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buchanich: Using the Mortality and Population Data System, a unique repository and retrieval system for detailed death data from the National Center for Health Statistics, housed at the University of Pittsburgh Graduate School of Public Health, my team examined overdose deaths in the U.S. from 1979 to 2014. We started with 1979 because changes in reporting cause of death make it impossible to make comparisons with previous years. 2014 is the most recent year for which data are available. The counties with the largest increases in overdose death rates were clustered in southern Michigan; eastern Ohio and western Pennsylvania; eastern Pennsylvania, New Jersey and much of southeastern New York; and coastal New England. Counties in the Midwest, California and Texas have seen little to no increase in overdose death rates. We cross-referenced the mortality data with counties in the High Intensity Drug Trafficking Areas program, which was created by Congress in 1988 to provide 31 high drug-trafficking areas of the U.S. with coordinated law enforcement resources dedicated to reducing trafficking and production. High Intensity Drug Trafficking Areas with high overdose death rates were mostly concentrated in Appalachia and the Southwest U.S., whereas such areas with lower death rates were near the borders in California, Texas and southern Florida. (more…)
Aging, Author Interviews, Mental Health Research / 25.04.2016

MedicalResearch.com Interview with: Dr. Jesus Bertran-Gonzalez, Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute University of Queensland Brisbane Australia MedicalResearch.com: What is the background for this study? Response: It has long been recognized that elderly people often show behavioural inflexibility, for example they may have difficulties in finding alternative routes to reach a previously known place in neighbourhoods that have changed, or they may find it difficult to remember new episodes in their life, as opposed to very old ones. The question that we wanted to address in this study is how this memory rigidity in old individuals affects their goal-directed performance, as this can directly impair their capacity to adjust their behaviour to new demands in the environment. Specifically, we wanted to investigate the changes in the brain that occur with normal ageing that have these negative effects on adaptation, and that can potentially keep old people from achieving their needs. (more…)
Author Interviews, Breast Cancer, JAMA / 25.04.2016

MedicalResearch.com Interview with: Sherene Loi, MBBS(Hons), FRACP, PhD Associate Professor, University of Melbourne Consultant Medical Oncologist, Breast Unit Head, Translatonal Breast Cancer Genomics and Therapeutics Lab Cancer Council Victoria John Colebatch Fellow Peter MacCallum Cancer Centre, East Melbourne Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Loi: Even though HER2 amplification/overexpression is such a strong oncogenic driver in breast cancer, clinical and biological heterogeneity is still evident. Our study was performed to investigate the hypothesis that a subgroup of patients with ER-positive, HER2-positive primary breast cancers seem to have lower responses to anti-HER2 therapy, in this case trastuzumab (trade name Herceptin), and we could better identify this group using both ER and HER2 levels. Our study was designed to try to better define this group so we could potentially evaluate the efficacy of future treatment strategies in this group, particularly as combination anti-HER2 therapy (i.e. trastuzumab and pertuzumab) is currently being investigated in the adjuvant setting. (more…)
Author Interviews, BMJ, Heart Disease, Pediatrics / 25.04.2016

MedicalResearch.com Interview with: Hans Van Brabandt, M.D. Brussel, Belgium MedicalResearch.com: What is the background for this study? Dr. Van Brabandt: We have been asked by the Belgian government to assess the benefits and harms of pre-participation screening of young athletes. A number of Belgian cardiologists and screening physicians are intensely promoting such screening through mass media and were asking governmental support. MedicalResearch.com: What are the main findings? Dr. Van Brabandt:  There is no solid evidence on the benefit of cardiovascular pre-participation screening, and certainty of harms it induces through numerous false-positives, making that such screening in young athletes cannot be defended. -          Italian investigators assert they have provided evidence for the benefit of screening. The single study on which they base their claim however is far from convincing. Unfortunately, more than 10 years after their first paper, they still did not make the majority of their data publicly available. (more…)
Author Interviews, Heart Disease, JAMA / 25.04.2016

MedicalResearch.com Interview with: Dr. Fredrik Björck, MD Umea University Umea, Sweden MedicalResearch.com: What is the background for this study? Dr. Björck: Vitamin K antagonist (eg, warfarin) use is nowadays challenged by the non–vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in non-valvular atrial fibrillation (AF). NOAC studies were however based on comparisons with warfarin arms with times in therapeutic range (TTRs) of 55.2% to 64.9%, making the results less credible in health care systems with higher TTRs. Historically Sweden has had the best international normalized ratio (INR) control in the world. By this study we wanted to evaluate the efficacy and safety of real life well-managed warfarin therapy in patients with non-valvular AF, the risk of complications, especially intracranial bleeding, in patients with concomitant use of aspirin, and the impact of INR control. We therefore performed a retrospective, multicenter cohort study based on Swedish registries, especially AuriculA, a quality register for AF and oral anticoagulation. A total of 40 449 patients starting warfarin therapy owing to non-valvular AF during the study period were monitored until treatment cessation, death, or the end of the study. The study was conducted from January 1, 2006, to December 31, 2011.  By associating complications with risk factors and individual INR control, we evaluated the efficacy and safety of warfarin treatment in patients with concomitant aspirin therapy and those with no additional antiplatelet medications. (more…)
Author Interviews, Outcomes & Safety, Stroke / 25.04.2016

MedicalResearch.com Interview with: Mathew J. Reeves, PhD Department of Epidemiology and Biostatistics Michigan State University East Lansing, MI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reeves:   The transfer of stroke patients with ischemic stroke to primary and comprehensive stroke centers so they can receive specialized care including tPA (thrombolysis) and endovascular (catheter based) care is becoming increasingly important with the release or trial data showing substantial benefit for endovascular treatment in eligible patients.   A major goal of integrated stroke systems of care is to ensure that stroke patients requiring specialized care beyond the capability of the initial hospital are identified and transferred to a specialist center as quickly as possible.   Surprisingly, there is relatively little written about the frequency and outcomes of stroke patients who are transferred between hospitals, especially in the context of large quality improvement registries such as the Coverdell Stroke Registry or Get-With-The- Guidelines- Stroke (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Nature / 24.04.2016

MedicalResearch.com Interview with: Zhimin (James) Lu, M. D., Ph. D Ruby E. Rutherford Distinguished Professor Department of Neuro-Oncology MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What is the background for this study? Dr. Lu: Among primary liver cancers, hepatocellular carcinoma (HCC) is the most common histological subtype, accounting for 70-85% of all cases. HCC incidence is increasing in many parts of the world, including developing countries and developed countries such as the United States. HCC has a very poor prognosis, and the overall 3-year survival rate for patients with HCC is approximately 5%. The potentially curative treatments of HCC are resection and liver transplantation. However, most patients with hepatocellular carcinoma present with advanced disease and underlying liver dysfunction and are not suitable candidates for these treatments. Thus, they generally have a poor prognosis, with a median survival time of less than 1 year. The increasing incidence and mortality rates of hepatocellular carcinoma, along with a lack of effective curative treatment options for advanced HCC, have rendered this disease a major health problem worldwide. Thus, a better understanding of HCC tumorigenesis and the development of better diagnostic and therapeutic approaches based on an understanding of the molecular mechanisms that drive hepatocellular carcinoma progression are greatly needed. The liver, as a major metabolic organ, catalyzes dietary sugar. Dietary sugar encompasses several carbohydrates, including starch, sucrose, and high-fructose corn syrup, each of which is composed of glucose with or without fructose. Starch, which is found in bread and rice, is a glucose polymer. Sucrose is a disaccharide made up of 50% glucose and 50% fructose. High-fructose corn syrup, a common constituent of soft drinks, is a mixture of approximately 40% glucose and 60% fructose. Dietary fructose is also derived from fruits and vegetables. A molecule of glucose has the same caloric value as a molecule of fructose. However, the human body treats these carbohydrates quite differently. Glucose is used directly by tissues such as the muscles and brain as an energy source. Excess glucose is stored in the liver as glycogen. In contrast, dietary fructose, which is epidemiologically linked with obesity and metabolic syndrome, is almost exclusively metabolized by the liver. Hepatocellular carcinoma cells enhance glucose uptake and lactate production regardless of the oxygen supply, a phenomenon known as the Warburg effect. However, whether fructose metabolism is differentially regulated in hepatocellular carcinoma and normal liver tissue and, if so, the extent to which this altered carbohydrate metabolism contributes to hepatocellular carcinoma development is unknown. (more…)
Author Interviews, Global Health, Pediatrics / 23.04.2016

MedicalResearch.com Interview with: Janet Currie Henry Putnam Professor of Economics and Policy Affairs Chair, Department of Economics Director, Center for Health and Wellbeing Princeton University Princeton NJ 08544 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many recent studies point to increasing inequality in mortality in the United States over the past 20 years. These studies often use mortality rates in middle and old age. This is the first study to examine mortality trends for younger ages.  We find that for infants, children and young adults below age 20, however, there have been strong mortality improvements that were most pronounced in poorer counties, implying a strong decrease in mortality inequality. There is a great deal of evidence from past studies that healthier children grow up to be healthier adults.  These current young people will form the future adult U.S. population, so this research suggests that inequality in middle and old-age mortality may have peaked and is likely to decline as these cohorts become older. (more…)
Author Interviews, Infections, Lancet / 23.04.2016

MedicalResearch.com Interview with: Prof Jean-Pierre Allain Principal Investigator, Department of Haematology University of Cambridge, Cambridge Blood Centre Cambridge UK MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Allain: In sub-Saharan Africa (SSA), 70% of the transfusions are in the form of  whole blood units (generally 1 or 2). Lack of resources limit the safety measures to donor questionnaire, viral/bacterial testing (HIV, HCV, HBV and Syphilis). Other measures used in rich countries i.e. nucleic acid testing, filtration, bacterial culture etc. are not done because of cost. Pathogen reduction would be an effective way to overcome these issues as it is able to inactivate viruses, bacteria, parasites and nucleated cells in one go, provided it is applied to whole blood and affordable. The study consisted in assessing the efficacy of such a method (Mirasol using riboflavin and UV illumination) taking inactivation of plasmodium as major endpoint of a randomised controlled clinical trial called AIMS (African Investigation of Mirasol System). (more…)
Author Interviews, Heart Disease, Rheumatology / 22.04.2016

MedicalResearch.com Interview with: Nicola Veronese, MD University of Padova Department of Medicine (DIMED)-Geriatrics Section Padova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Veronese: Osteoarthritis (OA) is the most common rheumatic disease. Although an increasing research is showing that OA, particularly of lower limbs, is associated with an increased risk of cardiovascular diseases (CVD) the association with overall mortality seems to be less clear. (more…)
Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 22.04.2016

MedicalResearch.com Interview with: Csaba P Kovesdy MD Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? Dr. Kovesdy: Older patients experience several physiologic changes which could modify their response to blood-pressure lowering. In fact, hypertension treatment guidelines such as JNC8 recommend slightly higher blood pressure targets when treating elderly patients. Patients with chronic kidney disease (CKD) have been excluded from most hypertension treatment trials, hence the blood pressure treatment goals in this group are mainly derived based on extrapolations. Even less is known about the effects of age on the association of blood pressure with mortality and various other clinical outcomes in patients with CKD. (more…)
Author Interviews, Nature, NYU, Pancreatic / 22.04.2016

MedicalResearch.com Interview with: Dr. George Miller, MD Vice Chair for research, Department of Surgery Associate Professor, Department of Surgery Associate Professor, Department of Cell Biology NYU Langone’s Perlmutter Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Miller: Cancer cell death is the goal of most therapeutic programs. Indeed, chemotherapy induces cancer cell death. We show that a novel form of cancer cell death entailing organized necrosis is a prominent way by which cancer cells die. However, paradoxically this form of cell death termed "necroptosis" actually accelerates pancreatic cancer growth in animals by inducing immune suppressive inflammation. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Miller: Novel agents are needed to block necroptosis in pancreatic cancer. This can potentially enhance the immune system's ability to fight the cancer. (more…)
Author Interviews, Blood Pressure - Hypertension, Brain Cancer - Brain Tumors / 22.04.2016

MedicalResearch.com Interview with: Hervé Chneiweiss MD PhD Bâtiment A3 pièce 336 Case courrier 2 Plasticité Gliale et Tumeurs cérébrales Neuroscience Paris Seine (directeur) Inserm/Université Pierre et Marie Curie MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chneiweiss: Treatments available for glioblastoma -- malignant brain tumors -- have little effect. An international collaboration[1] led by the Laboratoire Neurosciences Paris-Seine (CNRS/ INSERM/UPMC)[2] tested active ingredients from existing medications and eventually identified one compound of interest, prazosin, on these tumors. We chose to study the most common malignant tumors that develop from brain cells, glioblastomas, which represent the fourth most frequent cause of cancer deaths among adults and the second in children. This is due to the inefficacy of current treatments. Indeed, a glioblastoma can resist treatment and reawaken from a very small number of tumor cells called glioblastoma-initiating cells (GIC). It is these cells -- whose characteristics and properties resemble those of stem cells -- that were targeted in the study. Rather than trying to discover new compounds, the team opted for repositioning existing drugs. In other words, we tested a collection of substances used for so long to treat other conditions that their patents have now fallen into the public domain[3]. This method makes it possible to develop new active ingredients cheaply and very rapidly. Twelve hundred compounds were thus tested on normal human neural stem cells and on glioblastoma-initiating cells from different aggressive tumors. Twelve of these compounds showed a toxic effect on GIC -- and none on the normal neural stem cells. The most effective was prazosin. Tested in mice carrying glioblastoma-initiating cells, prazosin significantly reduced the size of tumors and prolonged survival of the mice by more than 50%. [1] Including scientists from the Laboratoire d'Innovation Thérapeutique (CNRS/Université de Strasbourg), the Stanford University Institute for Stem Cell Biology and Regenerative Medicine (USA) and the Instituto Estadual do Cérebro Paulo Niemeyer in Rio de Janeiro (Brazil). [2] This laboratory forms part of the Institut de Biologie Paris-Seine. [3] Pharmaceutical compounds are protected by a patent for 20 years after their discovery. Because of the length of the clinical trials that are necessary before a drug can be put on the market, the duration of their patent protection does not normally exceed 10-15 years after a Marketing Authorization (MA) is granted. (more…)
Author Interviews, Gender Differences, Kidney Disease, Transplantation, University of Pennsylvania / 22.04.2016

MedicalResearch.com Interview with: Matthew Levine, MD, PhD Assistant Professor of Transplant Surgery Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Levine: This work stemmed from a known finding that female mice tolerate kidney injury better than males and this is true of mice that share exactly the same genes.  Therefore, the gender difference was the driving factor.  My basic science laboratory works at the intersection between scientific discovery and clinical application and this led us to question whether the same phenomenon was true in humans and whether we could identify a way in which this could be used to improve injury tolerance above what is seen in untreated subjects.  What we found was that the hormonal environment seems to impact ischemia tolerance, with female environment being protective and the male environment worsening injury tolerance in ischemia models where blood flow is interrupted and then restored.  The kidneys seemed to adapt to take on the injury response of the host after transplantation, indicating that the differences were not forged into the kidney itself and therefore could be altered.  We then found that estrogen therapy improved kidney injury tolerance when given to female mice in advance of injury, but no effect was seen in male mice.  And most importantly, we found that in a large cohort of transplant recipients that female recipients had better injury tolerance after transplant than male recipients, as shown by ability to avoid dialysis in the first week after transplant, otherwise known as delayed graft function (DGF). This is a fairly major finding since it has not been observed in the literature despite several decades of transplant data being carefully studied. (more…)