Author Interviews, Health Care Systems, JAMA / 22.01.2021

MedicalResearch.com Interview with: Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties.  MedicalResearch.com: What are the main findings? Response: We have two main findings.
  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.
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Author Interviews, Breast Cancer, Genetic Research, JAMA, Race/Ethnic Diversity / 22.01.2021

MedicalResearch.com Interview with: Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center MedicalResearch.com: What is the background for this study? Response: The racial disparity in breast cancer mortality emerged in the US in the late 1980s in the wake of widespread implementation of mammography screening and the development of successful systemic adjuvant therapies for early breast cancer. Unfortunately, more than three decades later, Black women in the US still have a 40% higher mortality rate from breast cancer compared with non-Hispanic White women despite similar disease incidence. Health disparities research has primarily focused on the fact that Black women have a higher incidence of the aggressive triple-negative subtype, and that they are more likely to present with more advanced stages of disease. As important as those factors are, in recent years our group and others reported that Black women with hormone receptor-positive breast cancer have worse survival than non-Hispanic white women even after adjustment for stage at diagnosis and treatment. Since nearly 2/3 of breast cancers in Black women are hormone receptor-positive, this is a significant contributor to the overall mortality disparity. Importantly, these studies also suggested that Black women disproportionately develop biologically aggressive forms of hormone-dependent breast cancer, which is typically considered a more favorable disease subtype. Using data on more than 70,000 patients from the SEER registry that is linked to data from Genomic Health Laboratory, which provides the Oncotype DX recurrence score (the most commonly ordered prognostic/predictive multi-gene expression assay for early breast cancer), we set out to address three questions: 1) is there evidence of disproportionately aggressive tumor biology among Black women with hormone receptor (HR)-positive breast cancer, as reflected in the Oncotype DX recurrence score? 2) Is there a racial survival disparity even among patients with early stage, axillary node-negative tumors with comparable recurrence scores on the Oncotype assay? and 3) Is there is a difference in the prognostic accuracy of the Oncotype assay between Black and non-Hispanic white patients, since there was limited representation of Black women in the development and validation of the Oncotype assay and other prognostic/predictive assays?  (more…)
Author Interviews, NYU, Race/Ethnic Diversity, Rheumatology / 21.01.2021

MedicalResearch.com Interview with: Peter Izmirly, M.D. Associate Professor of Medicine, NYU School of Medicine Director of Inpatient Rheumatology, Bellevue Hospital Center co-Director, NYU-Hospital for Joint Diseases Lupus Clinic Research Office Address: NYU School of Medicine New York, NY 10016  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Knowing how many people have systemic lupus erythematosus (SLE) is limited, particularly for racial/ethnic subgroups in the United States. Our work provides accurate estimates of who has  (SLE) among the major racial/ethnic groups in the United States and that our estimates for SLE approach the FDA’s definition or a rare disease. (more…)
Author Interviews, Infections, OBGYNE, Pharmaceutical Companies / 21.01.2021

MedicalResearch.com interview with: Dr. Stephen Brand, Chief Development Officer Mycovia Pharmaceuticals  Dr. Stephen Brand discusses the results of Mycovia’s three Phase 3 studies for recurrent vaginal yeast infections (RVVC )and what’s next for the company.  MedicalResearch.com: What is the background for these Phase 3 studies? Answer: Our Phase 3 clinical program for our oral therapy oteseconazole was comprised of three trials enrolling more than 870 patients at 176 sites across 11 different countries. Two of these trials, referred to as VIOLET were identical Phase 3 randomized, double-blind, placebo-controlled clinical trials to evaluate the safety of oteseconazole and its ability to prevent episodes of recurrent vulvovaginal candidiasis (RVVC), commonly referred to as chronic yeast infection. The trials took place over 48 weeks in subjects with an established disease history of at least three episodes of acute VVC in the past 12 months. More than 650 patients randomized at 125 sites across 11 countries. The VIOLET trials consisted of two parts: During the first part of the study which lasted two weeks after patients presented with an active VVC episode, patients were treated with three sequential 150mg doses of fluconazole. The second part consisted of 12 weeks, when the patient either took oteseconazole 150mg or a placebo once weekly (according to a random assignment), and then a 36-week follow-up period. In addition, subjects participating in the VIOLET trials in the U.S. who remained infection-free at their Week 48 visit were offered the opportunity to participate in an extension study and are being monitored for an additional 48 weeks to further define the long-term protection profile of oteseconazole. Eighty-five subjects are enrolled. The third Phase 3 study, called ultraVIOLET, was designed to complement and extend VIOLET as a 50-week randomized, double-blind, placebo-controlled clinical trial to evaluate the safety and efficacy of oteseconazole. In addition the study compared the effectiveness of oteseconazole compared to fluconazole, the current standard of care, to treat an acute VVC infection in the RVVC population. A total of 220 patients were randomized at 51 sites in the U.S. for the ultraVIOLET trial. The ultraVIOLET trial consisted of two parts: In the first part of the study RVVC subjects presenting with an active infection were randomized to receive either 2 days of dosing with oteseconazole or 3 sequential 150 mg doses of fluconazole (every 72 hours). The second part consisted of 11 weeks, when the patient took either oteseconazole or a placebo weekly (according to the random assignment from the first part of the study), and then a 37-week follow-up period. (more…)
Author Interviews, COVID -19 Coronavirus / 20.01.2021

MedicalResearch.com Interview with: Dr Caroline Wei Shan Hoong, MBBS, MRCP Associate Consultant Endocrinologist Department of General Medicine Woodlands Health Campus National Healthcare Group, Singapore MedicalResearch.com: What is the background for this study? Response: In the course of our clinical work, we have noticed a predominance of musculoskeletal complaints among some of COVID-19 patients who are otherwise clinically well, and a small subset of them who develop a viral arthralgia (joint pains) sometimes occurring separately from the onset of acute respiratory symptoms. Besides a few isolated case reports, there was not much described about COVID-19 associated viral arthralgia in the literature. Clinicians are well aware of the need to test for COVID-19 when patients present with cough or shortness of breath. However, when they present as joint pains without any respiratory symptoms, a diagnosis of COVID-19 could easily be missed. Due to overlapping clinical features like low platelet count and elevated liver enzymes, they could easily be misdiagnosed as having other vector-borne infections such as dengue fever, if clinicians do not have a high clinical suspicion of COVID-19. Hence we decided to describe the epidemiology and various presentations of musculoskeletal manifestations of COVID-19 in our cohort of patients.  (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes, Race/Ethnic Diversity / 16.01.2021

MedicalResearch.com Interview with: Anath Shalev, M.D. Professor of Medicine Nancy R. and Eugene C. Gwaltney Family Endowed Chair in Juvenile Diabetes Research Director, Comprehensive Diabetes Center University of Alabama at Birmingham Birmingham, AL  MedicalResearch.com: What is the background for this study?  What is metformin normally prescribed for? Response: Diabetes has been recognized as one of the major comorbidities associated with higher mortality in the context of the spreading COVID-19 pandemic, but ways to improve outcome in this at-risk population are lacking. Metformin is the most common medication used for type 2 diabetes. In addition, it is sometimes prescribed to people with prediabetes or to women with polycystic ovary syndrome (PCOS). (more…)
Author Interviews, Dermatology / 15.01.2021

MedicalResearch.com Interview with: Brian Kim, MD Associate Professor of Dermatology Co-Director, Center for the Study of Itch & Sensory Disorders John T. Milliken Department of Internal Medicine Washington University in St. Louis MedicalResearch.com: What is the background for this study? Response: Patients with eczema suffer from chronic itch due to the rashes they have on their body. However, as a physician, I have always noticed that patients with eczema will have sudden flares of their itching all over there body that is often triggered by what appear to be allergens – being around a cat, pollen, mold in a house, etc. Eczema is in the family of allergic diseases such as food allergy, asthma, and hay fever. All of these conditions are noted for patients being reactive to allergens by way of an antibody called IgE that coats a cell called the mast cell. Upon IgE binding an allergen, mast cells produce tons of histamine which can cause symptoms like itching. So we speculated that perhaps because patients with eczema have such misbehaving IgE, that exposure to allergen is what triggers this kind of severe itch flare that we see in patients. (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, Pulmonary Disease / 15.01.2021

MedicalResearch.com Interview with: Dr Andrew Conway Morris Wellcome Trust Clinical Research Career Development Fellow University of Cambridge Hon Consultant in Intensive Care Medicine Addenbrookes Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Patients with COVID-19 frequently need to come to the intensive care unit (ICU), where we use mechanical ventilation to support their lungs as they get over the intense inflammation caused by the virus.  During the first wave of the virus we noted that a lot of our patients appeared to be developing secondary infections (infections they didn’t have when they came into the ICU). We therefore rolled out a rapid diagnostic test for these secondary bacterial infections that we had developed previously, and this study reports the use of this diagnostic and also describes the types of bacteria seen.  To see if the increase in secondary infections was due to COVID specifically, we compared them to patients who were managed in the same ICU but who did not have COVID. (more…)
Author Interviews, Cannabis, UCSF / 15.01.2021

MedicalResearch.com Interview with: Eric R. Pedersen, Ph.D. Adjunct Behavioral Scientist, RAND Associate Professor of Psychiatry and Behavioral Sciences Keck School of Medicine University of Southern California MedicalResearch.com: What is the background for this study? Response: In November of 2016, CA voted to legalize cannabis for sale and possession to adults 21 and older for recreational use. It wasn’t until January of 2018 that stores in most parts of LA County (we call these “outlets”) were legally able to begin selling recreational cannabis. We were collecting data from about 2,500 young adults in LA County as part of a longitudinal study (Principal Investigator Elizabeth D’Amico at RAND) and were able to look at cannabis use and intentions assessed at a period prior to the opening of the recreational cannabis outlets (pre-January 2018) to a period when those outlets were open (after January 2018). It has been suggested that once cannabis was more available for recreational purchase (and not just for medical purposes among those enrolled in CA’s medical marijuana program), use of cannabis among young adults would increase.  (more…)
Author Interviews, COVID -19 Coronavirus, Mental Health Research, Race/Ethnic Diversity, Social Issues, UCSF / 15.01.2021

MedicalResearch.com Interview with: Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California MedicalResearch.com: What is the background for this study? Response: Food insecurity is the inability to afford or access nutritionally adequate and safe foods for an active, healthy lifestyle. Rates of food insecurity were projected to rise during the COVID-19 pandemic; however, prior studies had not examined the association between food insufficiency, the most extreme form of food insecurity, and mental health. MedicalResearch.com: What are the main findings? Response: Using a large national sample of nearly 64,000 adults, we found that food insufficiency rose from 8.1% to 10.0% during the pandemic. People of color and younger adults had higher risk of food insufficiency. People living in poverty or experiencing recent job loss were at higher risk of food insufficiency. Food insufficiency was associated with symptoms of anxiety, worrying, and depression. Hunger, exhaustion, and worrying about not getting enough food to eat may worsen depression and anxiety symptoms. Receiving food assistance alleviated the relationship between food insufficiency and poor mental health.   (more…)
Allergies, Author Interviews, Dermatology / 14.01.2021

MedicalResearch.com Interview with: Karan Lal, DO, Marketing Committee Member for the Society for Pediatric Dermatology, Dermatologist at UMass Memorial Medical Center. Dr. Lal discusses the recent study of a procedure to remove black dye from henna tattoos. MedicalResearch.com: What is the background for this study? Response: Para‐phenylenediamine, a dye frequently added to henna tattoos to create the black color, is a potent contact allergen. Severe contact dermatitis may arise within days even after the first application. Our objective was to develop a method for rapid and complete removal of para‐phenylenediamine‐containing black henna tattoos from the skin, an important problem many physicians are confronted with, but for which no simple method exists.  (more…)
Author Interviews, Cost of Health Care, CT Scanning, Heart Disease, JACC, Statins / 14.01.2021

MedicalResearch.com Interview with: Prasanna Venkataraman MBBS Thomas H. Marwick MBBS, PhD Baker Heart and Diabetes Research Institute Monash University, Melbourne Melbourne, Australia   MedicalResearch.com: What is the background for this study?
  • Coronary artery calcium score (CAC) quantifies coronary calcium as determined by computed tomography and is a good surrogate marker for overall coronary plaque burden. It can help to reclassify patients at intermediate risk – many of whom are actually at low risk and can be reassured. Conversely, the finding of coronary calcium can also motivate patients (and their clinicians) to more aggressively control their cardiovascular risk factors. This is particularly problematic in those with a family history of premature coronary artery disease, where standard risk prediction tools are less accurate. However, CT CAC does not routinely attract third party payer support limiting its access and utilisation.
  • We screened 1084 participants who have a family history of premature coronary disease and a 10-year Pooled cohort Equation (PCE) cardiovascular risk >2% with CAC. We then assessed the cost-effectiveness of commencing statins in those with any coronary calcium compared to a strategy of no CAC testing and commencing statins if their PCE risk was ≥7.5% consistent with current guidelines. 
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Author Interviews, Diabetes, JAMA, Weight Research / 14.01.2021

MedicalResearch.com Interview with: Dr. Steven Heymsfield, MD Professor, Pennington Biomedical Research Center Baton Rouge, LA MedicalResearch.com: What is the background for this study? Response: Bimagurmab is a monoclonal antibody that blocks the activin type 2 receptor. This receptor is found mainly on skeletal muscles and when blocked acts to stimulate muscle growth. Bimagrumab was developed as a potential treatment for skeletal muscle disorders. However, the first-in-man studies revealed an unexpected response to the drug: not only did skeletal muscle mass increase, but marked lowering in body fat and improved insulin sensitivity were observed. The current study was launched to follow up on these initial observations.  (more…)
Author Interviews, Autism, Fertility, Genetic Research / 12.01.2021

MedicalResearch.com Interview with: Michael Skinner,  PhD Eastlick Distinguished Professor Founding Director, Center for Reproductive Biology School of Biological Sciences Washington State University Pullman WA MedicalResearch.com: What is the background for this study? Response: Over twenty years ago we identified the existence of a non-genetic form of inheritance through analysis of environmentally induced epigenetic transgenerational inheritance of disease, now well established in a number of species including humans.  I was giving a talk on this topic at a meeting in Spain.   This study was initiated following the scientific meeting in Spain with an in vitro fertilization clinical group that said they had access to sperm from males with and without autistic children.  It took several years to collect and characterize the samples, and find financial support for the study.  Once this was done then we did the molecular analysis to see if the sperm from fathers with autistic children had epigenetic, DNA methylation alterations, that associated with them having offspring with autism. (more…)
Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: Dr. Liam Townsend, PhD Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland  MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease. (more…)
Aging, Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: Dr. Maria A. Blasco, PhD Director of the Spanish National Cancer Research Centre Head of the Telomeres and Telomerase Group – CNIO  MedicalResearch.com: What is the background for this study? Response: In my group we have previously described that telomere dysfunction in alveolar type II (ATII) cells in the lung is sufficient to induce pulmonary fibrosis in mice, thus demonstrating that these cells, which have a role in lung regeneration, are at the origin of the disease (Povedano et al., Cell Reports, 2015). Indeed, we further demonstrated that telomere elongation in these cells by using a gene therapy strategy based on telomerase activation, was sufficient to stop the progression of pulmonary fibrosis induced by short telomeres in mice (Povedano, eLife, 2018). (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Heart Disease, JACC / 11.01.2021

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center Associate Program Director, Cardiovascular Medicine Fellowship Assistant Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: The direct toll of the novel coronavirus disease 2019 (COVID-19) in the U.S. has been substantial, but concerns have also arisen about the indirect effects of the pandemic on higher-risk patients with chronic medical conditions, such as cardiovascular disease. Hospitalizations for acute cardiovascular conditions, including myocardial infarction, heart failure, and stroke precipitously declined during the early phase of the pandemic. These patterns have raised concern that patients may be avoiding hospitals due to fear of contracting SARS-CoV-2, and that some have died from cardiovascular conditions without seeking medical care. In addition, there has been growing concern about the the effects of health-care system strain and the deferral of semi-elective procedures on patients with cardiovascular conditions. (more…)
Author Interviews, Environmental Risks, Exercise - Fitness / 09.01.2021

MedicalResearch.com Interview with: Zach Finewax, PhD Research Scientist I Cooperative Institute for Research in Environmental Sciences (CIRES) National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL) Chemical Processes and Instrument Development (CPID) University of Colorado, Boulder, CO  MedicalResearch.com: What is the background for this study? gym-exercise-sweat.jpegResponse: Humans on average spend 90% of their time indoors. As a result, they are exposed to indoor air far more often than outdoor air (the atmosphere). Yet, the chemistry (and air quality) of the atmosphere has been studied far more often than indoor air. Air quality is linked to direct health impacts, and the emissions indoors can be ventilated outdoors where they can undergo chemical transformations that have climate and health impacts. Beyond exposure to indoor air, humans contribute significantly to overall indoor air quality by breathing, sweating, and applying personal care or hygiene products. Previous studies have investigated these emissions at a high level of chemical detail for seated or standing individuals indoors, but limited chemical and time-resolution studies have been conducted while people are exercising indoors. (more…)
Author Interviews, Opiods, Pancreatic, PLoS / 08.01.2021

MedicalResearch.com Interview with: Faraz Bishehsari, MD, PhD Associate Professor of Medicine and Graduate College Director of the Translational Gastroenterology Unit Division of Digestive Diseases Rush University Medical Center MedicalResearch.com: What is the background for this study? Response: This study builds on recent population based studies where opium use was found to be possible risk factor for pancreatic cancer. Although opium use is not a common recreational habit in the United States, opioid use has been rising remarkably over the past decade. In fact, opioid misuse and overdose have evolved into a public health crisis here with increasing opioid prescription use and abuse over the past decade. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, JAMA / 08.01.2021

MedicalResearch.com Interview with: Jay C. Butler, MD, FAAP, MACP, FIDSA Deputy Director for Infectious Diseases Centers for Disease Control and Prevention Atlanta, GA  30333 MedicalResearch.com: What is the background for this study? Response: There are still disagreements about the significance of transmission of SARS-CoV-2 from asymptomatic persons.  It has been known since at least March 2020 that, unlike the closely related coronavirus that causes SARS, transmission of COVID-19 from asymptomatic and presymptomatic persons occurs and that at least 30% of infected persons do not develop symptoms.  Estimating the proportion of transmissions from persons without symptoms informs the decision analysis for prioritization of community mitigations opportunities:  wearing of masks, social distancing, and hand hygiene. If only a low proportion of transmission occurs from people without symptoms, these interventions would be less likely to control transmission when broadly applied in the community.  On the other hand, if a significant proportion of spread is from infected persons without symptoms, the value of these measures is enhanced. Additionally, obtaining strategic and systematic screening tests for SARS-CoV-2 to identify and isolate persons without symptoms in selected settings, such as congregational housing settings, will have greater potential impact if spread from persons without symptoms is common.  (more…)
Author Interviews, JAMA, Surgical Research / 08.01.2021

MedicalResearch.com Interview with: Melina R. Kibbe, MD, FACS, FAHA Colin G. Thomas Jr. Distinguished Professor and Chair Department of Surgery Professor, Department of Biomedical Engineering The University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7050 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fluoroquinolones are a commonly prescribed antibiotic.  Recent data from Taiwan, Sweden, and Canada suggests that the use of fluoroquinolones increase the short-term risk of aneurysm formation in certain older patient  populations.  As such, the FDA issued a warning in 2018 regarding the use of fluoroquinolone antibiotics suggesting that this class of antibiotics should not be used in patients at increased risk. The FDA defined the high risk population as those with a history of aneurysms or blockages, high blood pressure, certain genetic disorders related to blood vessels, and the elderly.  However, we hypothesized that this risk of taking fluoroquinolones extends to all patient populations and not just high risk patient populations.  (more…)
Author Interviews, Cancer Research, Microbiome / 04.01.2021

MedicalResearch.com Interview with: Ben Boursi MD Senior Physician in the Gastrointestinal Cancer Department at Sheba Medical Center School of Medicine, Sackler Faculty of Medicine Tel Aviv University Tel Aviv, Israel MedicalResearch.com:  What is the background for this study? What conditions have fecal matter transplants been previously studied in (ie c. diff)? Response: “Many melanoma patients do not respond to immunotherapy and even among responders, many eventually progress. Extensive research has been conducted in order to overcome resistance to immunotherapy and modulation of the gut microbiota, is one of the promising leads. The gut microbiome has been shown to influence response to immunotherapy in preclinical mouse models and observational patient cohorts. Currently FMT is being used for the treatment of C. Difficile that is resistant to antibiotics, but it is also being evaluated as a treatment option for other disease states such as inflammatory bowel disease and obesity.” (more…)
Author Interviews, Brain Injury, Brigham & Women's - Harvard / 03.01.2021

MedicalResearch.com Interview with: Nitin Joshi, Ph.D. Engineering in Medicine/Department of Medicine Brigham and Women's Hospital   Dr. Jeffrey M Karp Ph.D Principal Investigator Professor of Medicine at Brigham and Women’s Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Would you explain what is meant by the blood brain barrier? How will nanoparticles facilitate transport of drugs into the brain? Response: Over the past few decades, researchers have identified promising therapeutic agents that can target the biological pathways involved in brain diseases. Unfortunately, clinical translation of these therapeutics is limited by their inability to cross the blood brain barrier (BBB) and enter the brain at therapeutically effective levels. The BBB is a highly selective semipermeable border of cells that prevents molecules in the circulating blood from non-selectively crossing into the brain tissue. We have developed a simple targeted nanoparticle platform that can stably encapsulate therapeutic agents and enable their therapeutically effective delivery into the brain. In this work, we have demonstrated the utility of this platform for the treatment of traumatic brain injury (TBI), which is a leading cause of death and disability in children and young adults, with millions of people suffering TBI each year in accidents, sports, and military conflicts. Following primary injury, which is a result of the mechanical impact to the brain, secondary injury gradually occurs over months to years and can lead to neurological dysfunctions, including Alzheimer’s and Parkinson’s diseases. After TBI, the BBB is physically breached for a short time and previous approaches to achieve therapeutically effective transport of drugs across the BBB have been severely limited to utilizing this very short window. However, the extent to which the BBB is physically breached in TBI varies greatly across the patient population. Therefore, current approaches are applicable to only a subset of injuries with substantially breached BBB. Moreover, BBB can self-repair within a few hours to weeks post-injury to restore its integrity. Hence, physical breaching of BBB offers a limited window for therapeutic interventions, which is not ideal as the secondary injury can last months to years and may require repeated dosing over long term. The nanoparticle platform developed in this work can enable therapeutically effective delivery of drugs into the brain, irrespective of the state of the BBB. We achieved this by precise engineering of the surface properties of nanoparticles, which maximized their transport across the BBB. The therapeutic used in this study was a small interfering RNA (siRNA) molecule designed to inhibit the expression of the tau protein, which is believed to play a key role in neurodegeneration. Poly(lactic-co-glycolic acid), or PLGA, a biodegradable and biocompatible polymer used in several existing products approved by the U.S. Food and Drug Administration was used as the base material for nanoparticles. We systematically engineered and studied the surface properties of the nanoparticles to maximize their penetration across the intact, undamaged BBB in healthy mice. This led to the identification of a unique nanoparticle design that maximized the transport of the encapsulated siRNA across the intact BBB and also significantly improved the uptake by the brain cells.  (more…)
Author Interviews, Cancer Research, JAMA / 31.12.2020

MedicalResearch.com Interview with: Deborah C. Marshall, MD New York University School of Medicine New York, New York  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Tarras ES, Marshall DC, Rosenzweig K, Korenstein D, Chimonas S. Trends in Industry Payments to Medical Oncologists in the United States Since the Inception of the Open Payments Program, 2014 to 2019. JAMA Oncol. Published online December 30, 2020. doi:10.1001/jamaoncol.2020.6591  MedicalResearch.com: What should readers take away from your report? Response: Overall, though, there has not been a dramatic shift in these interactions after the inception of Open Payments. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues, Technology, University of Pennsylvania / 30.12.2020

MedicalResearch.com Interview with: Srinath Adusumalli, MD, MSc, FACC Assistant Professor of Clinical Medicine Division of Cardiovascular Medicine| Penn Medicine Lauren A. Eberly, MD, MPH Division of Cardiovascular Medicine, Department of Medicine Hospital of the University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study?   Response: The coronavirus disease 2019 (COVID-19) pandemic has uprooted conventional health care delivery for routine ambulatory care, requiring health systems to rapidly adopt telemedicine capabilities. At Penn Medicine, we wanted to ensure that as we developed a new system of telemedical care, we were reaching all of the patients we serve and access to care was maintained. As such, we undertook this study to examine utilization of care as we continued to iterate on and develop our telemedical system of care. (more…)
Author Interviews, COVID -19 Coronavirus / 30.12.2020

MedicalResearch.com Interview with: Anita M. McGahan PhD, MBA University Professor Professor of Strategic Management Professor, Munk School of Global Affairs & Public Policy George E. Connell Chair in Organizations & Society Rotman School of Management University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response:    The article by Phebo Wibbens, Wesley Wu-Yi Koo, and me that came out today in PLOS ONE at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244177 investigates how effective different policies are in accomplishing COVID control across 40 different countries and U.S. states.   The policies that we consider are standardized in the Oxford COVID policy database, and include, for example, school closings, workplace closings, international travel controls, restrictions on gatherings, etc.  Each of these policies can be implemented at different levels of intensity.   The analysis looks at the marginal impact of each of these policies in the presence of the others.  We find that, in 90% of jurisdictions, compliance is not high enough to make a core group of socially tolerable policies sufficient to drive COVID growth below zero.   In these places, one or more tougher-to-tolerate policies must be implemented on top of the core group to get COVID growth to stop. (more…)
Author Interviews, Clots - Coagulation, COVID -19 Coronavirus, Heart Disease, JAMA / 30.12.2020

MedicalResearch.com Interview with: Ana Blasco, MD, PhD Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Our group has been investigating issues related to coronary thrombosis in patients with acute myocardial infarction for years. Recently, we developed a standardized technique for the detection and quantification of extracellular neutrophil networks (NETs) in coronary thrombi. During the first wave of the COVID-19 pandemic in Madrid, Spain, we had some cases of myocardial infarctions with ST elevation and a large thrombotic component among patients with severe SARS-CoV-2 infection. Given the important participation of NETs in severe COVID-19 disease, causing occlusion of microvessels as shown in pulmonary samples, we decided to analyze their role in coronary thrombi. Thanks to similar previous analyzes in patients without COVID-19, we have been able to compare our results with a historical series. (more…)
Author Interviews, Pediatrics, PLoS, Smoking, Tobacco Research / 29.12.2020

MedicalResearch.com Interview with: Dongmei Li, Ph.D., Associate Professor Clinical and Translational Science Institute University of Rochester Medical Center MedicalResearch.com: What is the background for this study? Response: Previous animal and human studies have found that nicotine exposure could harm adolescents’ brain development and impact their cognitive functions. Electronic cigarettes, which have become very popular among youth in the US in recent years, usually contain nicotine at equivalent or possibly higher levels than traditional tobacco cigarettes. Thus, it is reasonable to assume that vaping might be associated with self-reported cognitive complaints. MedicalResearch.com: What are the main findings?  Response: Main findings from our study are:
  1. Our cross-sectional youth and adult studies are the first to associate vaping with self-reported complaints of serious difficulty concentrating, remembering, or making decisions.
  2. Our youth study also found that students who reported starting to vape early – between eight and 13 years of age – had higher odds of reporting difficulty concentrating, remembering, or making decisions than those who started vaping at 14 or older.
  3. These studies add to a growing list of conditions and diseases (wheezing, COPD, cardiovascular disease, cancer) that have been associated with vaping/electronic cigarette use. 
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Accidents & Violence, Author Interviews, Cannabis, JAMA / 24.12.2020

MedicalResearch.com Interview with: Li Li, MS, PhD Candidate Division of Epidemiology, College of Public Health, Ohio State University Graduate Research Associate, Center for Injury Research and Policy The Abigail Wexner Research Institute at Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? Response: Marijuana use impairs cognitive abilities necessary for safe driving, including reaction time, road lane-tracking ability, and attention maintenance. Given increasing legalization of marijuana use in the US, our study aimed to estimate marijuana-impaired driving among teens at a national level and help to identify the current prevalence to guide future intervention programs. (more…)
Author Interviews, JAMA, Neurology / 24.12.2020

MedicalResearch.com Interview with: Dr. Roopa Rajan MD, DM Post Doctoral Fellowship (Movement Disorders) Assistant Professor Department of Neurology AIl India Institute of Medical Sciences New Delhi  MedicalResearch.com: What is the background for this study? Response: This study was inspired by the need for more effective treatments for patients with disabling hand tremor, particularly dystonic tremor. Dystonic tremor is a movement disorder in which both dystonia (abnormal posturing) and tremor co-exist in the same body part. In general, this common and often disabling disease responds only modestly to oral medications. Surgical treatments such as deep brain stimulation may be offered to persons with severe tremor, however the outcomes are not as robust as seen in other tremor conditions,  for instance, essential tremor. Therefore, there is a critical need for more effective treatments for people living with this disease. Botulinum toxin injections are known to be effective for dystonic tremor affecting the head and voice, although these remain off-label indications. Previous studies using botulinum toxin injections for other hand tremors like essential tremor led to limited clinical application, in part due to transient hand weakness that may be a side effect of botulinum toxin injections. Recently, advances in injection delivery such as electromyographically guided botulinum toxin injections with individualized muscle and dose selections were reported to be beneficial in essential tremor. We built upon this existing data to explore the effects of such a treatment in patients with dystonic hand tremor.   (more…)