Author Interviews, Hand Washing, Hospital Acquired / 12.04.2016

MedicalResearch.com Interview with: Professor Jacqui Reilly PhD Institute for Applied Health Research Glasgow Caledonian University Glasgow MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reilly: Hand hygiene is the single most important intervention to reduce avoidable illness and prevent infections. Two techniques have been reported for hand hygiene use with alcohol-based hand rub (ABHR) in international guidance:  6 step by the WHO and 3 step by the Center for Disease Control. Neither of these techniques have an evidence base to support their effectiveness. The study provides the first evidence in a RCT that the 6 step technique is superior in reducing residual bacterial load on the hands. The reduction was not related to coverage, type of organism or staff group. The 6 step technique was microbiologically more effective at reducing the median log10 bacterial count (3.28  to 2.58)than the 3 step (3.08  to 2.88), (p=0.02), but did not increase the total hand coverage area (98.8% versus 99.0%, p=0.15) and required 25% (95% CI: 6%-24%) more time (42.50 seconds  vs 35.0 seconds, p=0.002). Total hand coverage was not related to the reduction in bacterial count. (more…)
Author Interviews, Diabetes, Exercise - Fitness, UCSD / 12.04.2016

MedicalResearch.com Interview with: Britta Larsen, Ph.D. Assistant Professor Family Medicine & Public Health University of California, San Diego Medical Teaching Facility La Jolla, CA 92093-0628  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Larsen: We know that muscle is important for metabolic processes, but there has been very little research on the role muscle may play in the development of metabolic diseases like type 2 diabetes. While excess fat can increase the risk of metabolic disease, there are people who are normal weight who still develop diabetes, and it’s possible that this could be due to low muscle mass. Our main findings were that, in normal weight women, women with more abdominal, thigh, and overall muscle were less likely to develop diabetes over a 13-year period.  (more…)
Author Interviews, Hospital Acquired, JAMA, Outcomes & Safety, Surgical Research / 12.04.2016

MedicalResearch.com Interview with: Christina A. Minami, MD Surgical Outcomes and Quality Improvement Center Department of Surgery, Feinberg School of Medicine, Center for Healthcare Studies, Feinberg School of Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? Dr. Minami: An earlier study by our group demonstrated a seemingly paradoxical relationship between hospital quality and hospital penalization in the Hospital-Acquired Condition, or HAC, Reduction Program. Basically, of those hospitals that were penalized more frequently were those that were major teaching hospitals, had more quality accreditations, and had better performance on process and outcome measures. When CMS released that surgical-site infections were going to be added to the HAC scoring, we decided to see if these additional measures might exhibit the same paradoxical association between quality and penalization. MedicalResearch.com: What are the main findings? Dr. Minami: The SSI measures follow the same trend as was previously illustrated. Basically, the hospitals who were in the bottom 25% (that is, those who were the worst performers) were more often those that were major teaching hospitals, with more quality accreditations, and offered more advanced services. It’s possible that this is due in part to surveillance bias, or “the more you look, the more you find” phenomenon. Also, what do we really call an infection? The National Healthcare Safety Network has specific definitions and guidelines, but there are still different data collections used by different hospitals. (more…)
Author Interviews, Diabetes, Pharmacology / 12.04.2016

MedicalResearch.com Interview with: Christopher Sorli, MD SUSTAIN 1 investigator and Chair of the Department of Diabetes, Endocrinology and Metabolism Billings Clinic, Billings, Montana MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sorli: GLP-1 receptor agonists (GLP-1 RAs) have been found to be useful in the treatment of Type 2 diabetes with potent effects on blood glucose lowering while minimizing the risk of hypoglycemia and weight gain often seen with other classes of hypoglycemic agents. Semaglutide is a novel GLP-1RA that is currently in clinical development. The molecule shares 94% amino acid homology with native GLP-1 and has a half-life of approximately one week allowing for once weekly dosing. SUSTAIN 1 was designed to demonstrate superiority of semaglutide 0.5 mg and 1.0 mg once weekly over placebo in lowering HbA1c after 30 weeks of treatment. Additional secondary endpoints included weight loss versus placebo, percent of patients achieving HbA1c goals, percent of patients achieving 5% and 10% weight loss, and safety and tolerability. (more…)
Author Interviews, End of Life Care, JAMA / 12.04.2016

MedicalResearch.com Interview with: Nancy L. Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Nancy L. Schoenborn, MD Assistant Professor Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Schoenborn: A growing body of research recommend that clinicians should consider patients’ life expectancy in a number of clinical decisions, but it is not clear how primary care clinicians approach these recommendations. We interviewed primary care clinicians to understand their perspectives on this topic. We found that clinicians describe a number of barriers and ambiguities in using long-term life expectancy to inform medical decisions; they also varied widely in their approaches to assess and to discuss life expectancy. (more…)
Author Interviews, Multiple Sclerosis, PNAS / 12.04.2016

MedicalResearch.com Interview with: Dr. Christian W. Gruber PhD Assistant Professor tenure-track and ARC Future Fellow The University of Queensland, School of Biomedical Sciences, Australia Medical University of Vienna, Center for Physiology and Pharmacology, Vienna, Austria  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Gruber: We initially discovered that particular circular peptides (called cyclotides) isolated from an African traditional herbal medicine have promising immunosuppressive properties (Gründemann et al., 2012, J Nat Prod, 75(2):167-74). Cyclotides are considered a pharmacological ‘treasure trove’ (Koehbach et al., 2013, PNAS, 110(52):21183-8). Hence we aimed at testing the efficacy of these peptides to treat and ameliorate multiple sclerosis, and found that the new plant-derived drug (‘T20K’), in an animal model, can block the progression of the disease. We demonstrated in an animal model that T20K stopped progression of the normal clinical symptoms of multiple sclerosis (Thell et al., PNAS, doi: 10.1073/pnas.1519960113). (more…)
Alzheimer's - Dementia, Author Interviews / 12.04.2016

MedicalResearch.com Interview with: Dr. Sven Joubert, PhD Département de psychologie, Université de Montréal Centre de recherche Institut universitaire de gériatrie de Montréal (CRIUGM) Montréal, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Joubert: Difficulties in recognizing familiar people in Alzheimer's disease have typically been attributed to the underlying memory impairment. There is evidence however that people with Alzheimer's disease also have difficulties in visual perception. The aim of this study was to determine if people with Alzheimer's were specifically impaired at face perception. In the current study, people with Alzheimer's along with healthy seniors were asked to process pictures of faces and cars at both upright and inverted orientation. Results showed that persons with Alzheimer's disease had a reduced face inversion effect, in other words they had a disproportionate impairment in processing upright relative to inverted faces. This reduced inversion effect in Alzheimer's disease, which was specific to faces, may reflect a reduced ability in "holistic" processing of faces, in other words the ability to form intergrated and individualized representations of faces based on their local features. (more…)
Author Interviews, OBGYNE, Weight Research / 12.04.2016

MedicalResearch.com Interview with: Laura Mullaney School of Biological Sciences Dublin Institute of Technology Dublin Ireland. MedicalResearch.com: What is the background for this study? What are the main findings? Response:  There are gaps in our knowledge regarding postpartum changes in weight. There continues to be a dramatic increase in adult obesity and the postpartum period is a vulnerable life-stage for weight gain in women. Maternal obesity matters because it is associated with an increase in both fetal and maternal complications, it is technically challenging, it is economically costly and it carries potential lifelong health consequences for the woman and her offspring. Thus, our aim was to compare trajectories in maternal weight and BMI between early pregnancy and four months postpartum and nine months postpartum, and to analyse these trajectories by BMI category. Of the 328 women who attended all appointments, mean weight at the first antenatal visit was 69.3 ±14.3 kg, mean Body Mass Index (BMI) was 25.3 ±5.0 kg/m2 and 14.4% were obese. At four months postpartum, the mean change in weight from the first antenatal visit was +1.6 ±4.2 kg, the mean change in BMI was +0.6 ±1.5 kg/m2 and 19.2% were obese. At nine months postpartum, the mean change in weight was +0.2 ±4.7 kg, the mean BMI change was -0.06 ±1.8 kg/m2 and 16.8% were obese. Of women who had an ideal BMI in early pregnancy, 16.6% and 11.1% were overweight at four and nine months postpartum respectively. Of women who were overweight in early pregnancy, 20.3%and 14.3% had become obese at four and nine months postpartum respectively. Ninety percent of women who were obese in early pregnancy remained obese at four and nine months postpartum. Women who had gained weight between early pregnancy and four months postpartum had a lower early pregnancy BMI and were less likely to be obese in early pregnancy. However women who gained weight between four and nine months postpartum were more likely to be obese in early pregnancy. (more…)
Author Interviews, Urology / 11.04.2016

MedicalResearch.com Interview with: Dr. H. Bob Smouse MD Interventional Radiology, Radiology OSF Saint Francis Medical Center Peoria, IL MedicalResearch.com: What is the background for this study? Dr. Smouse: For more than twenty years I've seen my patients with severe blockages of the ureter undergo two separate invasive procedures to implant one ureteral stent. Even though these procedures are done with interventional techniques, they require sedation, radiation, time off work, and occasionally have some level of pain and discomfort. Being able to potentially eliminate an entire invasive procedure for these patients has been a goal of mine for years. MedicalResearch.com: What are the main findings? Dr. Smouse: All devices tested showed 100% success in implantation and 100% success in converting from an internal-external nephroureteral catheter into an internal nephroureteral stent without the need for a second invasive procedure. (more…)
Author Interviews, Autism, Brigham & Women's - Harvard, PLoS / 09.04.2016

MedicalResearch.com Interview with: Ya Wen PhD TRANSCEND Research, Neurology Department Massachusetts General Hospital, Charlestown, Massachusetts, Harvard Medical School, Harvard University, Boston, Massachusetts Higher Synthesis Foundation, Cambridge, Massachusetts MedicalResearch.com: What is the background for this study? Dr. Ya Wen: At the time of this study (December 2014), the SFARI (Simons Foundation Autism Research Initiative) Gene-Human Gene Module recorded 667 human genes implicated as relevant to Autism spectrum disorders (ASDs). Now the number is close to 800. We sought to address the challenge of making sense of this large list of genes by identifying coherent underlying biological mechanisms that link groups of these genes together. To do this, we used information from several existing and well established databases and created a “demographics” of autism genes and pathways. MedicalResearch.com: What are the main findings? Dr. Ya Wen: From these hundreds of autism genes, we first found the relatively most important pathways, and then we generated a pathway network by mapping the pathway-pathway interactions into an Autism Pathway Network. Our systems analyses of this network converged upon an important role in autism pathophysiology for two pathways: MAPK signaling and calcium signaling, and specifically the process where they overlap, “calcium-protein kinase C-Ras-Raf-MAPK/ERK”. Our study also illuminated genetic relationships between autism and several other kinds of illness, including cancer, metabolic and heart diseases. Many of the significant genes and pathways were associated with vulnerability in the processing of challenging environmental influences. (more…)
Author Interviews, NYU, Radiology, Surgical Research / 09.04.2016

MedicalResearch.com Interview with: Eric T. Aaltonen MD, MPH Interventional Radiologist Assistant Professor, Department of Radiology Radiology  NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Aaltonen: A few years ago we started placing Denali  inferior vena cava (IVC) filters and noticed that these filters tended to not tilt and were subsequently more straight forward to remove when patients returned for filter retrieval.  Subsequently, a retrospective study was performed comparing these Denali filters with ALN and Option filters that have also been placed and removed at our hospitals.  The results demonstrate that Option filters have an increased rate of tilt at retrieval and increased retrieval time compared to Denali filters.  No significant difference in tilt or retrieval time was found with ALN filters.  Additionally, the presence of tilt correlates with more equipment use and increased fluoroscopy time during retrieval. (more…)
Author Interviews, Infections / 09.04.2016

MedicalResearch.com Interview with: Dr Ramiz Boulos PhD School of Chemical and Physical Sciences Flinders University, Bedford Park Chief Executive Officer Boulos & Cooper Pharmaceuticals Pty Ltd Port Adelaide, SA, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Boulos: Zolav® is a first generation antibiotic belonging to a novel class of small molecule synthetic antibiotics that was developed using in-silico modelling. It targets the mechanosensitive ion channel of large conductance, a highly conserved ion channel in bacteria not found in the human genome, making it a well sought after target. The channels have evolved to rescue bacteria from a high osmotic environment by acting as an emergency valve, opening up, and preventing bacteria from lysis. Our antibiotics reduce the threshold at which the channels open and elongate their opening times, in essence causing bacteria to "vomit". Acne affects about 650 million people worldwide making it one of the top ten most common diseases.  Isotretinoin, a vitamin A derivative, is currently the standard of care for treatment. However, it has a number of side effects among which a well-established teratogenic activity is the most serious, a reason for the development of novel and low-risk treatment options for acne. Zolav®,like other antibiotics in this new class, have low cytotoxicity, antioxidant properties and high chemical stability. The very low concentrations needed to yield a therapeutic effect and reduce inflammation in the mouse intradermal acne infection model, and the low risk nature of a topical administration of the drug, makes Zolav® a potentially very attractive option for the treatment of acne. (more…)
AHA Journals, Author Interviews, Heart Disease / 08.04.2016

MedicalResearch.com Interview with: Luigi Di Biase, MD, PhD, FACC, FHRS Section Head Electrophysiology Director of Arrhythmia Services Associate Professor of Medicine, Department of Medicine (Cardiology) Albert Einstein College of Medicine at Montefiore Hospital Moses and Weiler Campuses Montefiore-Einstein Center for Heart & Vascular Care Bronx, NY 10467 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Di Biase: The superiority of catheter ablation of atrial fibrillation (AF) over antiarrhythmic drugs (AADS) has been tested and demonstrated in several randomized clinical trial in patients with normal ejection fraction and paroxysmal AF. Only a few studies are available for patients with heart failure and persistent AF. In this multicenter randomized trial we compared the most utilized AAD for heart failure patients to achieve a rhythm control strategy (Amiodarone) vs ablation of atrial fibrillation in patients with heart failure, persistent AF and ICD. Catheter ablation was superior to Amiodarone to achieve long term freedom from AF. In addition patients undergoing ablation had a lower re-hospitalization rate and importantly a lower mortality. (more…)
Aging, Author Interviews, Melanoma, Nature, Wistar / 08.04.2016

MedicalResearch.com Interview with: Ashani T. Weeraratna, Ph.D. Associate Professor Melanoma Research Center The Wistar Institute Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Weeraratna: The background for this study is the fact that advancing age remains the greatest risk factor for the development of many cancers, and melanoma is no exception. We found that age-related changes in normal skin, specifically dermal fibroblasts, increase both the metastatic potential and therapeutic resistance of melanoma cells. The most fascinating thing is that even targeted therapy, which should depend solely on the interaction between the drug and the target within the tumor cell is affected by the age of the microenvironment. (more…)
Author Interviews, BMJ, Cancer Research, Education / 08.04.2016

MedicalResearch.com Interview with: Dr Alex Ghanouni Research Associate UCL Research Department of Epidemiology and Public Health Health Behaviour Research Centre London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ghanouni: This study comes out of growing concern among academics, doctors, and policymakers about the unintended harms of healthcare interventions. One prominent issue in the ongoing debate is ‘overdiagnosis’, that is detection of disease that would not have caused symptoms or death if it had remained undetected. There are many contexts in which overdiagnosis can occur but one of the most prominent is cancer screening, in which asymptomatic individuals undergoing testing may have slow-growing cancers detected that would never have otherwise come to light. However, because it is impossible to be sure which cancers are slow-growing and which are aggressive, most are treated. This means that overdiagnosis can lead to harm through the anxiety caused by a disease label and the negative effects of treatment (e.g. surgery) that is actually unnecessary. Despite professional concern about overdiagnosis, previous research has found that the public is mostly unaware that it exists. One study that was particularly relevant to our research was an Australian survey in which members of the public were asked whether they had encountered the term before and what they thought it meant. Although around half the sample stated that they had heard or seen the term before, only 41% were able to provide a definition that was approximately correct. We tested the extent to which this was true as part of an online survey of adults aged 50-70 years in the UK. We found that recognition of the term was very low (only 30%) and almost no-one (3%) gave an answer that was strictly accurate. Responses often indicated misconceptions (e.g. “misdiagnosis”, “false positive diagnosis”, or being “overly health conscious”). (more…)
Allergies, Author Interviews, JAMA, Pediatrics / 08.04.2016

MedicalResearch.com Interview with: Moshe Ben-Shoshan, MD, M.Sc. Assistant Professor Division of Pediatric Allergy and Clinical Immunology Department of Pediatrics McGill University Health Center Montreal, Quebec, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ben-Shoshan: Given that up to 10% of children treated with amoxicillin are tagged as allergic usually with no confirmatory tests (given high waiting times to see an allergist and controversy regarding confirmatory tests) we aimed to assess the accuracy of the graded provocation challenge (PC) . Unlike previous studies we challenged ALL 818 children presenting with rashes on amoxicillin treatment . We were able to show that almost 95% tolerated the challenge while 17 had immediate reactions (within 1 hour ) and 31 had non immediate reactions . We found that although it is suggested to do skin tests ( with PrePen and pen G ) to diagnose immediate amoxicillin allergy only 1 of 17 had a positive skin test indicating poor sensitivity of this test. In addition among all those with negative challenge that we followed over 3 years 10% had mild skin reactions when they received subsequent full treatment . (more…)
Author Interviews, Biomarkers, Columbia, JAMA, Lung Cancer / 08.04.2016

MedicalResearch.com Interview with: Adrian G. Sacher, M.D. Assistant Professor of Medicine Thoracic Oncology & Phase I Drug Development Columbia University/New York-Presbyterian Hospital  MedicalResearch.com: What is the background for this study? Dr. Sacher: The aim of this prospective study was to determine the accuracy, turnaround time and robustness of ddPCR-based liquid biopsy for the detection of EGFR and KRAS mutations in patients with advanced non-small cell lung cancer (NSCLC). The detection of these mutations is key to selecting optimal therapy for patients with this disease. Currently, the standard of care is to perform tissue biopsies on patients in order to obtain material to detect these mutations and make decisions about treatment. Frequently, patients undergo multiple tissue biopsies during the course of their treatment. We sought to determine if liquid biopsy could quickly and accurately detect these mutations with the ultimate goal of understanding how to use these tests to select treatment for patients. (more…)
Author Interviews, Breast Cancer, Endocrinology, Journal Clinical Oncology, Menopause / 08.04.2016

MedicalResearch.com Interview with: Karin Ribi, PhD, MPH Head of Quality of Life Office IBCSG International Breast Cancer Study Group Bern Switzerland  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ribi: This study investigated the quality of life (QoL) outcomes for women in the Suppression of Ovarian Function (SOFT) trial. SOFT investigated the value of adding ovarian suppression (OFS) to tamoxifen and to determine the role of the aromatase inhibitor exemestane+OFS as adjuvant (post-surgery) therapies for hormone-sensitive early breast cancer. SOFT was conducted by the International Breast Cancer Study Group (IBCSG) in over 3000 premenopausal women from more than 500 centers worldwide. The primary analysis of SOFT compared tamoxifen alone with tamoxifen+OFS in over 2000 women, and showed that adding OFS to tamoxifen did not provide a significant benefit in the overall population of premenopausal women. However, for women who were at sufficient risk for recurrence to warrant adjuvant chemotherapy and who remained premenopausal, the addition of OFS improved disease outcomes.[1] With regard to the QoL main findings, patients on tamoxifen+OFS were more affected than patients on tamoxifen alone by hot flushes at 6 and 24 months, by loss of sexual interest and sleep disturbance at 6 months, and by vaginal dryness up to 60 months. Without prior chemotherapy, patients on tamoxifen alone reported more vaginal discharge over the 5 years than patients on tamoxifen+OFS. Symptom-specific treatment differences at 6 months were less pronounced in patients with prior chemotherapy. Changes in global QoL indicators from baseline were small and similar between treatments over the whole treatment period. (more…)
Author Interviews, Bone Density, Endocrinology, Hip Fractures, Pharmacology / 08.04.2016

MedicalResearch.com Interview with: Bente Langdahl Professor, Consultant, PhD, DMSc Department of Endocrinology and Internal Medicine THG Aarhus University Hospital Aarhus Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Romosozumab is a humanised antibody against sclerostin currently in development for the treatment of osteoporosis. Romosozumab has a dual effect on bone; it stimulates bone formation and inhibits bone resorption. If this new treatment obtains regulatory approval and becomes available for the treatment of osteoporosis, some of the patients who will be candidates for this new treatment will already have been treated with other available treatments, for example, bisphosphonates. This study compared the effects of romosozumab and teriparatide, a currently available bone forming treatment, on bone mass, bone structure and bone strength. The results showed that the percent change from baseline in BMD at the total hip through month 12 (the primary endpoint) was significantly greater with romosozumab compared with teriparatide: 2.6 percent versus –0.6 percent, respectively (p<0.0001). For the secondary endpoints; lumbar spine BMD by DXA, total hip and femoral neck BMD by DXA and QCT and bone strength estimated by finite element analysis patients treated with romosozumab had significantly larger increases from baseline compared with those taking teriparatide, with mean differences ranging from 3.1 percent to 4.6 percent (all p-values <0.0001). (more…)
Accidents & Violence, Author Interviews, CDC, Pediatrics, Sleep Disorders / 07.04.2016

MedicalResearch.com Interview with: Anne G. Wheaton, Ph.D. Epidemiologist Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Population Health Epidemiology and Surveillance Branch Atlanta, GA  30341-3717  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Wheaton: Unintentional injury, mostly from motor vehicle crashes, is the leading cause of death for adolescents. Adolescents who do not get enough sleep are at an increased risk for motor vehicle crashes and other unintentional injury, such as sports injuries and occupational injuries. We evaluated the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among more than 50 thousand US high school students. The likelihood of each of five injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) was significantly higher for students sleeping ≤7 hours on an average school night compared with 9 hours. Infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students sleeping ≥10 hours compared to 9 hours on an average school night. Although short and long sleep may simply be associated with other adolescent risk behaviors, insufficient sleep may cause individuals to take more risks and disregard the possibility of negative consequences. However, the study was cross-sectional, meaning the students were asked questions at one time point, so it is not possible to determine if there is a cause and effect association between sleep and these risk behaviors. Insufficient sleep may contribute to injury risk directly by slowing reaction time, impairing ability to pay attention, or causing a driver to fall asleep, but these results provide evidence that some of the increased risk associated with insufficient sleep might be due to engaging in injury-related risk behaviors. (more…)
Author Interviews, CDC, HPV, Pediatrics, Vaccine Studies / 07.04.2016

MedicalResearch.com Interview with: Natalie L. McCarthy, MPH Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recently, deaths immediately following 4vHPV vaccination have garnered intense media attention.  Often, these media stories do not take into account the background rates of death in older children and young adults or disclose the potential for non-vaccine related causes of death.  The publicity surrounding deaths temporally associated with HPV and the paucity of studies examining deaths in adolescents following vaccination, was the basis for our evaluation of deaths following vaccines administered to individuals 9 through 26 years of age in the Vaccine Safety Datalink (VSD). The VSD is a collaborative project between the Centers for Disease Control and Prevention and several integrated healthcare systems, which monitors the safety of vaccines in the U.S. This study assessed the risk of death in the first 30 days following vaccination, described the causes of death, and included an evaluation of the potential association of vaccination and death among older children and young adults. The risk of death was not increased during the 30 days following vaccination, and no deaths were found to be causally associated with vaccination. The causes of death were consistent with what would be expected for this age group. (more…)
Author Interviews, Hearing Loss, JAMA / 07.04.2016

MedicalResearch.com Interview with: Prof. dr. Wilko Grolman MD, PhD Department of Otolaryngology Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands. Linkedin: https://www.linkedin.com/in/wilko-grolman-73a4927   MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Grolman: The importance of healthy hearing is extremely important for us humans. Decline in hearing will potentially affect not only our functional status but also our emotional and social health but also our economic status. It is impossible to imagine what the impact of losing one’s hearing ability is while still having a healthy hearing. Although many of us will eventually suffer from reduced hearing as part of the physiological effect of getting older, scientists are alarmed by the fact that hearing loss is on the rise and especially the number of youngsters that are affected is increasing. The WHO in their report of March 2015 reveal some alarming statistics; 360 million people have disabling hearing loss. In the acquired hearing loss group, excessive noise from personal audio devices and concert and festival visits has gained importance. Occupational noise has long been recognized as a source of acquired hearing loss. The WHO recognizes that half of the hearing loss cases can be prevented by primary prevention. For the noise induced hearing loss category, it is important to reduce exposure to loud sounds by raising awareness about the risks, implement relevant legislation and to encourage the use of personal protective devices such as earplugs, noise-canceling earphones and headphones. Our previous systematic review of the effectiveness of wearing earplugs to music venues showed that there were only two studies on this subject of which only one was a randomized clinical trial but had a major different set-up. (more…)
Author Interviews, Baylor College of Medicine Houston, Heart Disease, JACC / 07.04.2016

MedicalResearch.com Interview with: Dr. William Frank Peacock MD, FACEP Baylor College of Medicine, Houston MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Peacock: ​Patients with atrial fibrillation get strokes but can take anticoagulation which is very effective at preventing strokes. Patients on anticoagulation bleed, to the point that a very few die. The higher the CHADSVASC score, the more likely you are to have a stroke.​ ​Also the more likely ​you are to bleed. But the risk of stroke ALWAYS exceeds the risk of bleeding. We studied diabetics with atrial fibrillation as a subset, because diabetes is significant predictor for both stroke and bleeding and we wanted to determine if our understanding of the risks and benefits were maintained in real world trial. What we found was the risk of a fatal major bleed for a diabetic with atrial fibrillation who was taking rivaroxaban was 0.09/100 patient years of treatment. We know that the risk of having a stroke in a patient with a CHADS score of 2 is about 3% per year (that is 3/100 patients will stroke). Put in a similar denominator as our study, failing to treat an Afib diabetic will results 300 strokes for every 100 patient years, which compares to the effect of treatment, which will significantly prevent stroke, at the cost of 0.1 major bleed fatality per 100 patient years. Even if the effect of treatment was as low as 50% (which it is not), that is still preventing 150 strokes. 0.1 dead, to prevent 150 strokes seems like easy math to me.  ​ (more…)
Author Interviews, Heart Disease, JACC / 07.04.2016

MedicalResearch.com Interview with: Laura Mauri, MD,MSc Professor, Harvard Medical School Brigham and Women Hospital MedicalResearch.com: What is the background for this study? Dr. Mauri: The Dual Antiplatelet Therapy (DAPT) Study, the largest randomized controlled trial to date comparing different durations of dual antiplatelet therapy (thienopyridine plus aspirin) after coronary stenting, found that patients who were free from major ischemic or bleeding events at 1 year after coronary stenting with either drug-eluting or bare metal stents, and who were compliant with their antiplatelet therapy, experienced significant reductions in stent thrombosis and myocardial infarction (MI) but increases in moderate or severe bleeding when treated with 30 months of thienopyridine plus aspirin, as compared with 12 months.  In this analysis of the DAPT Study, we wanted to determine whether the subset of patients who had a MI before the study or at the time of the index stenting procedure had different risks or benefits with long-term dual antiplatelet therapy compared to patients with no history of MI prior to or at the time of the index stenting procedure.  We also wanted to evaluate whether the use of a clinical decision tool to identify patients expected to derive benefit vs. harm from continuing thienopyridine beyond one year after coronary stenting (the DAPT Score), would aid in the individualized prescription of dual antiplatelet therapy duration among these populations. (more…)
Author Interviews, JAMA, Pulmonary Disease, Smoking / 07.04.2016

MedicalResearch.com Interview with: Dr. William Phillips MD MPH USPSTF  Task Force member and Theodore J. Phillips Endowed Professor in Family Medicine University of Washington, Seattle. Dr. Phillips is also a founder and senior associate editor of the Annals of Family Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Phillips: Chronic obstructive respiratory disease, or COPD, is a serious, chronic condition that affects a person’s ability to breathe. It is the third leading cause of death in the United States. When the Task Force reviewed the research on screening adults for COPD in a primary care setting, we concluded with moderate certainty that screening has no net benefit, which is why we do not recommend screening for COPD in people who do not have symptoms. (more…)
Author Interviews, BMJ, Heart Disease, Social Issues / 07.04.2016

MedicalResearch.com Interview with: Dr. Simon Graff Department of Public Health Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Graff: We knew that a substantial amount of evidence have accumulated, linking our mental wellbeing to our body. With that in mind we wanted to examine one of the (if not the most) most stressful life event; the loss of a partner! Former studies have ranked bereavement of a life partner as the most stressful life event we humans can experience. Our study reports that spousal bereavement is followed by a transiently increased risk of new onset of atrial fibrillation (AF). The risk was highest 8-14 days after the loss and remains elevated for one year. (more…)
Author Interviews, Nature, Transplantation / 07.04.2016

MedicalResearch.com Interview with: Muhammad M. Mohiuddin, MD Cardiothoracic Surgery Research Program National Heart, Lung, and Blood Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Mohiuddin: There are around 150,000 patients waiting for organ transplants. Unfortunately, the supply of human donor organs will never be able to meet this demand. We are trying to explore if animal (pig) organs can be used for these patients. Pig organs are rejected within a few minutes by humans or baboons. Therefore, we along with our industrial partner Revivicor Inc. have modified the pig genetics to knock out molecules harmful to humans and have also expressed some human genes in these pigs. Through these modifications, along with the use of novel target-specific immunosuppressive drugs, we have extended pig heart survival in the abdomen for almost 3 years. In this experimental model, the heart is transplanted in the abdomen while the original heart stays in the chest cavity. The major advantage of this model is that the baboon is kept alive, despite the rejection of the transplanted organ in the abdomen. (more…)
Author Interviews, Cancer, Cancer Research, End of Life Care / 06.04.2016

MedicalResearch.com Interview with: Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Director, Center for Research on End of Life Care Weill Cornell Medicine New York Presbyterian Hospital New York City, New York 10065  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Prigerson: Patients need to know their prognosis to be informed consumers of end-stage cancer care. We found that most patients have an overly optimistic view of their life-expectancy and that few patients base their life expectancy estimate on communications with their healthcare providers. It was striking that 0% of black patients said their prognostic estimate was based on a medical professional. (more…)
Addiction, Author Interviews, JAMA, Opiods / 06.04.2016

MedicalResearch.com Interview with: Dr. Eugenia Oviedo-Joekes PhD Assistant Professor, School of Population and Public Health University British Columbia Centre for Health Evaluation and Outcome Sciences Providence Health Care, St Paul’s Hospital, Vancouver British Columbia, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Oviedo-Joekes: Diacetylmorphine is the active ingredient in heroin. Medically prescribed diacetylmorphine has shown greater effectiveness than methadone alone for the treatment of patients with long term opioid dependence who are not benefitting from available treatments (i.e., they continue injecting in the street daily for many years).  Medically prescribed diacetylmorphine is being used in a small number of countries in Europe but is unlikely to be accepted in many countries around the world, including Canada and the US.  SALOME is the world’s first study to examine the effectiveness of hydromorphone, a licensed, legal pain medication, as an alternative treatment to diacetylmorphine for chronic heroin addiction. Participants were randomly assigned to receive injectable diacetylmorphine or hydromorphone, double-blinded (up to three times daily) for six months under supervision. Injectable hydromorphone was as effective as injectable diacetylmorphine for long-term street opioid users not currently benefitting from available treatments (about 10 per cent of the heroin-dependent population).Study participants on both medications reported far fewer days of street-heroin and other opioid use at six months compared to almost daily illicit opioid use before taking part in the study. They also reported a reduction in days of illegal activities, from an average of 14.1 days per month to fewer than four. (more…)