Probiotics Found Unhelpful in Kids With Outpatient Diarrhea

Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB

Dr. Freedman

MedicalResearch.com Interview with:
Stephen Freedman MDCM, MSc
Alberta Children’s Hospital Foundation Professor in Child Health and Wellness
Sections of Pediatric Emergency Medicine and Gastroenterology
Alberta Children’s Hospital & Research Institute
University of Calgary
Calgary, AB

 MedicalResearch.com: What is the background for this study?

Response: Vomiting and diarrhea remain extremely common diseases in children and are the most common reason children are brought for emergency department care in North America.  While we have options to reduce vomiting there historically has been little physicians can offer to reduce the severity of the diarrhea.

Probiotics have recently emerged as an option with some early evidence of benefit in clinical trials but the studies performed to date have been small and few little research has been conducted in North America in outpatient or emergency department children.

The one study to date that was performed in a US emergency department did not find probiotic use to be beneficial.  Given the increasing importance of clarifying this issue we undertook this study.

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Can a Low-Gluten Diet Improve Your Health (even if you don’t have celiac disease)?

MedicalResearch.com Interview with:

Professor Oluf Pedersen Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen

Dr. Pedersen

Professor Oluf Pedersen
Novo Nordisk Foundation Center for Basic Metabolic Research
University of Copenhagen

MedicalResearch.com: What is the background for this study?

Response: We focused our study on healthy people due to the world-wide bottom-up movement among healthy adults to live gluten-free or on a low-gluten diet.

Therefore, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged healthy Danish adults with two eight week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day).

The two diets were balanced in number of calories and nutrients including the same total amount of dietary fibres. However, the composition of fibres differed markedly between the two diets.

When the low-gluten trend started years back the trend was without any scientific evidence for health benefits. Now we bring pieces of evidence that a low-gluten diet in healthy people may be related to improved intestinal wellbeing due to changes in the intestinal microbiota which to our surprise is NOT induced by gluten itself but by the concomitant change in the type of dietary fibres linked to a low-gluten intake.

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Fecal Transplantation May Stabilize Microbiome in Premature Infants

MedicalResearch.com Interview with:

Thomas Thymann PhD DVM MSc Department of Veterinary and Animal Sciences Comparative Pediatrics and Nutrition Faculty of Health and Medical Sciences University of Copenhagen Frederiksberg, Denmark

Prof. Thymann

Thomas Thymann PhD DVM MSc
Department of Veterinary and Animal Sciences
Comparative Pediatrics and Nutrition
Faculty of Health and Medical Sciences
University of Copenhagen
Frederiksberg, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infants that are born preterm are at risk of developing a severe and life threatening intestinal disease referred to as necrotizing enterocolitis (NEC). This condition is known to be under influence of several factors including the microorganisms that start to colonize the intestine immediately after birth.

We wanted to see whether fecal matter collected from healthy 10-day old piglets, would benefit the pattern of early colonization, and prevent NEC.

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CDC Identifies Most Serious Norovirus Strains

MedicalResearch.com Interview with:
"Day 19: Norovirus (stomach flu) visits our home." by Loren Kerns is licensed under CC BY 2.0Rachel M. Burke, PhD, MPH
Epidemiologist, Viral Gastroenteritis Branch
Centers for Disease Control and Prevention
Atlanta, GA 30329

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Noroviruses are the leading cause of vomiting and diarrhea from acute gastroenteritis (inflammation of the stomach or intestines) among people of all ages in the United States. Each year in the United States, norovirus illness is responsible for an estimated 19 to 21 million cases of acute gastroenteritis, and contributes to 56,000 to 71,000 hospitalizations and 570 to 800 deaths, mostly among children and the elderly.

CDC linked information from two different surveillance systems to analyze 3,747 norovirus outbreaks reported by health departments from 2009 to 2016. Our study provides a comprehensive description of norovirus outbreaks from the epidemiology and laboratory perspectives, using the National Outbreak Reporting System (NORS) and CaliciNet, respectively. 

Norovirus outbreaks caused by GII.4 strains occurred more often in healthcare settings, affected older adults, and caused more severe illness, leading to hospitalization or death.

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Crohn’s Disease: Single Capsule Antibiotic Combined Demonstrates Clinical Benefit

MedicalResearch.com Interview with:
RedHill BiopharmaDror Ben-Asher
Co-Founder, Chairman & CEO
RedHill Biopharma Ltd.

MedicalResearch.com: Your presentation at United European Gastroenterology Week (UEGW) covered top-line data from your recently completed Phase 3 study of RHB-104 in Crohn’s disease. Can you please briefly remind us of the background for this study and what results you previously announced?

Response: Crohn’s disease is a devastating gastrointestinal disorder that affects millions of people worldwide. Crohn’s is a chronic relapsing disorder that plagues people throughout their lives with a variety of symptoms including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The existing treatments for Crohn’s disease leave a lot to be desired – they are only partially effective in the long-term control of Crohn’s and are associated with serious side effects. In addition, the existing therapies only target treating the symptomatic inflammation associated with Crohn’s.

We began developing RHB-104 with the MAP hypothesis in mind, a theory that suggests Crohn’s is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP), in susceptible patients. RHB-104 is a patent-protected orally-administered combination of three antibiotics (clarithromycin, clofazimine and rifabutin) in a single oral capsule that has demonstrated its potential to benefit Crohn’s patients.

When we announced top-line results from the MAP US study, our Phase 3 trial of RHB-104 in patients with moderate to severe Crohn’s disease, we showed that RHB-104 demonstrated a significant clinical benefit to patients versus placebo control. Patients treated with RHB-104 showed significant increase in remission at 26-weeks post treatment initiation in addition to being generally safe and well tolerated. Continue reading

The Appendix May Play Role in Initiation of Parkinson’s Disease

MedicalResearch.com Interview with:

Viviane Labrie, Ph.D. Assistant Professor, Center for Neurodegenerative Science Van Andel Research Institute Grand Rapids, Michigan

Dr. Labrie

Viviane Labrie, Ph.D.
Assistant Professor
Center for Neurodegenerative Science
Van Andel Research Institute
Grand Rapids, Michigan

MedicalResearch.com: What is the background for this study?

Response: Our lab has an interest in the early events and initiation of neurodegenerative diseases. Parkinson’s disease for a long time was thought to be a movement disorder driven by the destruction of dopamine neurons in a specific area of the brain, the substantia nigra. In the last 10 years it has become evident that Parkinson’s disease is not just a movement disorder but hosts a whole range of non-motor systems. One of the most common non-motor symptoms in Parkinson’s patients is issues with the gastrointestinal (GI) tract. GI symptoms often occur early in Parkinson’s disease; for many patients, GI symptoms precede the onset of motor symptoms by as many as 2 decades. Moreover, the GI is not only involved in the early signs of Parkinson’s but has been proposed to be a place in the body where Parkinson’s disease begins.

The hallmark pathology of Parkinson’s disease in the brain is Lewy bodies, which contains a clumped form of a protein called alpha-synuclein. There is evidence that Parkinson’s disease pathology, this clumped alpha-synuclein protein, is detectable in the GI tract, even many years before the onset of Parkinson’s motor symptoms. Clumped alpha-synuclein is also capable of traveling across nerve cells. There is evidence that clumped alpha-synuclein can travel up the nerve that connects the GI tract to the brain and enter the brain. This could be disastrous because clumped alpha-synuclein can seed and spread in the brain, which has neurotoxic effects and can eventually lead to Parkinson’s disease. In fact, in the brain of Parkinson’s patients, one of the first places where alpha-synuclein clumps are detected is at the terminal where the gut nerve connects to the brain, and this pathology advances from this point to other brain areas as the disease progresses.

This intriguing connection of the GI tract to the early processes of Parkinson’s disease had us interested in trying to understand how the gut could be involved in triggering Parkinson’s. But the GI tract is a very big place, and we first asked ourselves, where should we look to better understand GI involvement in Parkinson’s disease? Continue reading

Psoriasis Patients More Likely To Have Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Psoriasis

Psoriasis

Prof Ching-Chi Chi, MD, MMS, DPhil 
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Guishan Dist, Taoyuan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies have shown common genotypes, clinical course, and immunological features shared by psoriasis and inflammatory bowel disease.

However, the relationship between psoriasis and inflammatory bowel disease was largely unclear.

In this study, we found when compared to the general population, psoriatic patients are more likely to have concomitant inflammatory bowel disease.  Continue reading

Cannabis Improved Symptoms, but Not Inflammation of Crohn’s Disease

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

Timna Naftali MD
Specialist in Gastroenterology
Meir Hospital and Kupat Holim Clinic,
Tel Aviv University, Israel

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In previous studies we could see that Crohn’s patients improve symptoms when taking cannabis but we did not have good data about actual inflammation.

So, in this study we added a colonoscopy to see if we can detect any change in inflammation. We also wanted to find a better mode of consuming cannabis, other than smoking.

MedicalResearch.com: What should readers take away from your report?

 Response: The take home massage would be that cannabis may help the patients feel better, but is not a replacement of conventional medical therapy. It should be used as an adjuvant to other treatments in appropriate cases.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Regarding future research, there are many points that should be addressed:

  • Cannabis in laboratory trials does have an anti-inflammatory effect. We have to find a way of translating this effect to clinical treatment
  • What is the best way of administering cannabis? (We certainly do not want to recommend smoking)
  • What is the best dose/combination?
  • What are the long term effects?
  • Which patients, if any, will benefit most?

Citation:

UEG 2018 abstract:
https://live.ueg.eu/week/
Cannabis induces clinical response but no endoscopic response in Crohn’s disease patients

Oct 22, 2018 @ 9:18 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Text Messages Improved Colonoscopy Adherence

MedicalResearch.com Interview with:

Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania

Dr. Mahmud

Nadim Mahmud, MD, MS, MPH
Hospital of the University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process.

We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence. 

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Education Using VR Can Encourage Patients To Get Colon Cancer Screening

MedicalResearch.com Interview with:

Nathaniel Ernstoff, MD University of Miami

Dr. Ernstoff

Nathaniel Ernstoff, MD
University of Miami

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the best efforts of all healthcare providers, colon cancer screening is underutilized with screening rates ranging anywhere from 58-76% based on the state (American Cancer Society 2017). At best we are still failing to screen 25% of the population.  Patients have serious concerns about colorectal cancer (CRC) screening with the most common barriers to screening being fear of colonoscopy and of the bowel preparation, amongst others. These barriers coupled with the lack of understanding of the risks, benefits, and the efficacy of screening contribute to our inadequate screening.

This study aims to prove that through education, and most importantly comprehension, patients will choose one of the 6 recommended colorectal cancer screening tests that best fits their preferences. In this study we had 24 patients who previously refused colonoscopy on 3 separate occasions, and had no other CRC screening, undergo a virtual reality (VR) demonstration, created by TheBodyVR, to see if education would improve the uptake of screening. Prior to the virtual reality demonstration, the patients completed a 5-item questionnaire which evaluated their baseline knowledge of CRC risk, polyps and screening as well as determining barriers to prior screening. The patient then viewed the VR demonstration which starts with an overview of colorectal cancer, followed by a tour through a virtual colon explaining and showing the viewer polyps and cancer.

Finally, the demonstration reviews and compares the strengths and weaknesses of all USPSTF-recommended CRC screening tests.  After the study, the patients complete the same questionnaire, and in this study there was a statistically significant improvement in knowledge in all questions.  Ultimately, 23 of 24 patients who previously refused colorectal cancer screening on 3 separate occasions chose to undergo screening after the VR demonstration, and about 50% have performed the screening 60 days out from the study’s completion.

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Recreational Cannabis Linked to Acute Pancreatitis

MedicalResearch.com Interview with:
Tarek Alansari, MD Metropolitan HospitalTarek Alansari, MD
Metropolitan Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cannabis is the most frequently consumed recreational drug in the world. The use of cannabis is becoming increasingly accepted by the general public in the United States. The estimates of the prevalence of cannabis use in the United States is about 9.5% in the adult population and the prevalence of dependence or abuse approaches 2.9%. Those under the age of 35 years are the most frequent consumers. According to Business Insider as of June 2018, recreational cannabis is legal in 9 states and medical cannabis is legal in 30 states. Recent surveys show that about 35 million Americans are frequent cannabis users.

Aiming for symptomatic relief, some patients with different gastrointestinal disorders have turned to cannabis without fully understanding the effect of its use for their individual condition.
Biliary tract disease, ethanol abuse, infections, autoimmunity, and genetics are well known causes of acute pancreatitis. However, medication-induced pancreatitis remains a less common etiology. In about 20% of cases of acute pancreatitis despite of the great improvement in genetic testing and imaging modalities, the workup still fails to reveal an etiology. These cases are labeled idiopathic.

Cannabis use is emerging as a rare, possibly overlooked cause of acute pancreatitis with few cases reported in the literature. In the United States, only 5 cases of cannabis – induced acute pancreatitis (AP) have been reported till September 2017. The review of literature revealed that only 26 cases of cannabis-induced AP have been reported worldwide. Continue reading

More Patients With Bariatric Surgery Admitted for Gallstone-Related Biliary Disease

MedicalResearch.com Interview with:

Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center 

Dr. Popov

Violeta Popov, MD PhD FACG
Assistant Professor of Medicine
Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan)
Division of Gastroenterology
NYU Langone Medical Center 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions.

We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  Continue reading

Obesity Linked to Alarming Risk in Gastric and Colon Cancers in Young Adults

MedicalResearch.com Interview with:

Hisham Hussan, M.D. Assistant Professor of Clinical Medicine Director, Obesity and Bariatric Endoscopy Section Division of Gastroenterology, Hepatology, and Nutrition Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus, OH 43210

Dr. Hussan

Hisham Hussan, M.D.
Assistant Professor of Clinical Medicine
Director, Obesity and Bariatric Endoscopy Section
Division of Gastroenterology, Hepatology, and Nutrition
Department of Internal Medicine
The Ohio State University Wexner Medical Center
Columbus, OH 43210

MedicalResearch.com: What is the background for this study?

Response: Obesity, a major healthcare burden, is an established risk factor for many gastrointestinal cancers. With obesity being on the rise, we inspected whether obesity related gastrointestinal cancers are increasing in different age groups, and relation to obesity.

MedicalResearch.com: What are the main findings? 

Response: We identify an alarming increase in incidence of gastric and colorectal cancers in young adults (less than 50 years of age) between 2002-2013.

This was paralleled by an uptrend in obese patients undergoing surgeries for these cancers during the same period. 

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest, for the first time, a contributing role of obesity in the etiology as well as the increasing incidence of gastric and colorectal cancers in young adults. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: More studies are needed to investigate the interplay of epigenetics factors such as young-onset obesity and western diet in relation to risk of adults developing colorectal and gastric cancers at an earlier age. Also public policies are needed to counter obesity and the rising incidence of gastric and colorectal cancer in this young high risk group.

MedicalResearch.com: Is there anything else you would like to add?

Response: My main career focus is translational and clinical research at the interface of energy balance, the microbiome and gastrointestinal cancer.

We have no financial disclosers or conflict of interest.

Citation:

 ACG18 abstract:

Rising, Age‐Specific, Trends of Obesity‐Related Gastrointestinal Cancers Correspond With Increasing Cancer Resections in Obese Patients: A 2002‐2013 National Analysis Using the SEER and NIS Databases

Oct 9, 2018 @ 11:58 am

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Gut Microbiome Can Be Restored in Cancer Patients with Fecal Transplantation

MedicalResearch.com Interview with:

Joao Xavier PhD Associate Faculty Member | Computational & Systems Biology Memorial Sloan Kettering Cancer Center New York, NY 10065

Dr. Joao Xavier

Joao Xavier PhD
Associate Faculty Member | Computational & Systems Biology
Memorial Sloan Kettering Cancer Center
New York, NY 10065 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our team at Memorial Sloan Kettering has been investigating the intestinal microbiota of patients receiving bone marrow transplantations for more than eight years now. We have found through several studies that these patients lose important healthy bacteria from their microbiota, and that these losses are mostly caused by the antibiotics given as prophylaxis or to treat infections.

We also found that the drastic changes in the microbiota composition, especially the intestinal dominations by bacteria such as Enterococcus, increase the risk of transplant-related complications and lowered patient survival.

We aimed to determine the feasibility of autologous microbiota transplant (auto-FMT) as a way to reconstitute lost bacteria. This randomized study found that indeed auto-FMT could reconstitute important microbial groups to patients.  Continue reading

H. pylori Link to Stomach Cancer Strengthened

MedicalResearch.com Interview with:

Nina R. Salama. PhD Member Human Biology Division Member Public Health Sciences Division Affiliate Member Basic Sciences Division Dr. Penny E. Petersen Memorial Chair for Lymphoma Research  Director of Molecular and Cellular Biology (MCB) Graduate Program Fred Hutchinson Cancer Research Center

Dr. Salama

Nina R. Salama. PhD
Member Human Biology Division
Member Public Health Sciences Division
Affiliate Member Basic Sciences Division
Dr. Penny E. Petersen Memorial Chair for Lymphoma Research
Director of Molecular and Cellular Biology (MCB) Graduate Program
Fred Hutchinson Cancer Research Center 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We wanted to better understand why certain patients infected with H. pylori developed stomach cancer and how we could better identify them. H. pylori is one of the strongest risk factors for stomach cancer, but how much it predisposes individuals to gastric cancer varies around the world.

Working closely with colleagues from Zhengzhou University, we ran tests on 49 samples from China and found that 91 percent of patients infected with the EPIYA D gene variant of H. pylori also had stomach cancer. Continue reading

Vaccines Against Rotavirus Gastroenteritis Decreased Infections Even in Unvaccinated Kids

MedicalResearch.com Interview with:

Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics

Dr. Chuanxi Fu

Chuanxi Fu, MD.PhD.
Professor of Epidemiology, School of Public Health
Zhejiang Chinese Medical University
Associate editor, Human Vaccines & Immunotherapeutics 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated.

In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  Continue reading

Crohn’s Disease: Positive Findings from Phase III Study of Antibiotic Combination

MedicalResearch.com Interview with:
RedHill Biopharma LtdMr. Gilead Raday, MPhil, MSc
Chief Operating Officer
RedHill Biopharma Ltd

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Crohn’s disease?  How common is it and whom does it affect? 

Response: Crohn’s disease (CD) is a chronic, relapsing inflammatory gastrointestinal disorder characterized by a variety of symptoms, including severe abdominal pain, diarrhea, bleeding, bowel obstruction, fever and weight loss. The underlying cause of Crohn’s is unknown; however, CD is believed to arise secondary to genetic and environmental stimuli. More than 1.5 million people suffer from CD globally and it is prevalent in the U.S., affecting more than 200 people per 100,000.

The current standard of care for Crohn’s disease is limited to anti-inflammatories, immuno-suppressants and biologics that treat auto-immune disorders. These therapies target symptomatic improvement in the inflammation associated with CD, are widely considered to be of limited efficacy in the long term, and are associated with numerous side effects. This speaks to the great unmet need for an effective therapy for this debilitating disease.

Additionally, there is no current therapy that treats the suspected underlying cause of Crohn’s disease. We have developed RHB-104 with the MAP hypothesis in mind, which posits that Crohn’s disease is caused by infection by a bacteria, Mycobacterium avium subspecies paratuberculosis (MAP). This is similar to peptic ulcer disease, a condition that was initially associated with stress, smoking, NSAIDs and other behavioral factors, yet was found to be caused by H. pylori bacterial infection in the 1980s, revolutionizing the field of ulcer treatment. Validation of this theory would revolutionize how Crohn’s disease is viewed and treated by the medical community and RHB-104 is the only therapy in development targeting MAP infection.  Continue reading

Study Identifies How Medical Marijuana May Ease IBD Symptoms

MedicalResearch.com Interview with:

Beth A. McCormick, Ph.D. Professor and Vice Chair | Department of Microbiology & Physiological Systems Founding Executive Director | University of Massachusetts Center for Microbiome Research Board of Editors | Gastroenterology University of Massachusetts Medical School Worcester, MA 01655

Dr. McCormick

Beth A. McCormick, Ph.D.
Professor and Vice Chair | Department of Microbiology & Physiological Systems
Founding Executive Director | University of Massachusetts Center for Microbiome Research
Board of Editors | Gastroenterology
University of Massachusetts Medical School
Worcester, MA 01655

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been extensive, but to date mostly anecdotal, support for a beneficial role for cannabinoids and cannabis-derived agents to provide benefit for symptoms in individuals suffering from intestinal inflammatory disease (IBD).

Our studies have provided one possible rationale for these previous findings: that there is a constitutively active efflux system at the luminal surface of cells that line the intestine that pumps out one class of lipids of the family known as endocannabinoids. In doing so, the intestine floods this surface with these endocannabinoids in a manner that counteracts the actions of a particular potent stimulators of intestinal inflammation that appears to be over-active in certain forms of IBD. This is most significant because a number of cannabinoids and cannabis-derived agents can mimic the actions of this class of endocannabinoids. Moreover, while cannabinoids and endocannabinoids have been shown to provide anti-inflammatory actions, these studies have identified one mechanism used by the body to localize and focus this protective function at a critical site where pro-inflammatory and anti-inflammatory events intersect, providing new insights into how to treat that imbalance in these process that occurs in certain forms of IBD.

Therefore, there is the immediate opportunity to use this research to identify new therapeutic strategies to treat individuals suffering from IBD that could include either agents extracted from marijuana plants or novel molecules selected based upon superior properties made obvious by this newly defined mechanism.

Continue reading

Gastric Cancer: Gene Mutation Predictive of Response to Immunotherapy

MedicalResearch.com Interview with:

Wei Zhang, Ph.D. Hanes and Willis Family Professor in Cancer Director Cancer Genomics and Precision Oncology Wake Forest Baptist Comprehensive Cancer Center Winston-Salem, NC  27157-1082

Prof. Zhang

Wei Zhang, Ph.D.
Hanes and Willis Family Professor in Cancer
Director
Cancer Genomics and Precision Oncology
Wake Forest Baptist Comprehensive Cancer Center
Winston-Salem, NC  27157-1082

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gastric cancer is a leading cause of cancer-related death worldwide. Infection by the Helicobacter pylori is the major cause of gastric cancer, which accounts for more than 60% of cases. Despite progress in helicobacter pylori eradication and early cancer diagnosis, the five-year survival rate of gastric cancer remains less than 30%. Gastric cancer is one of the most common cancer types in Asia but the incidence for gastric cancer has seen a steadily increase in the United States in recent years.

Immunotherapy treatment has shown remarkable benefit for some cancer patients whereas others experience toxicities. It is important to identify markers that help oncologists decide which patient would benefit from this promising new treatment strategy. It has been suggested that gastric cancer that is positive for Epstein-Barr Virus is likely more responsive to immunotherapy but only about 10% of gastric cancer patients belong to this category. More potential markers are urgently needed for clinical practice.

There is accumulating evidence that high tumor mutation load, which means there are high numbers of gene mutations in the tumor, can provide a signal to activate immune response systems thus rendering tumors more sensitive to immunotherapy.

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HPV Status Influences Survival in Esophageal Cancer

MedicalResearch.com Interview with:

Barrett's Esophagus -wikipedia

Barrett’s Esophagus -wikipedia

Shan Rajendra MBBCh, MSc , MD, FRCP, FRACP
Professor of Medicine
University of New South Wales
Director of Medicine & Clinical Executive Director
Bankstown-Lidcombe Hospital
Director Gastro-Intestinal Viral Oncology Group
Ingham Institute for Applied Medical Research
Sydney 

MedicalResearch.com: What is the background for this study?  

Response: High-risk human papillomavirus(HPV)  infection has been strongly associated with a subset of Barrett’s dysplasia and oesophageal adenocarcinoma.

The research question was; Does HPV status of Barrett’s high-grade dysplasia and esophageal adenocarcinoma influence survival as in viral positive head and neck cancers?

We therefore sought to determine the prognostic significance of esophageal tumor HPV status and associated viral transcriptional markers (E6/E7 mRNA and p16INK4A) and TP53.

Continue reading

Bariatric Surgical Approach To Increase Bile Acids May Reduce Cocaine Reward

MedicalResearch.com Interview with:

Aurelio Galli, Ph.D. Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science Associate Director for Research Strategy Vanderbilt Brain Institute

Dr. Galli

Aurelio Galli, Ph.D.
Professor of Molecular Physiology & Biophysics and Psychiatry & Behavioral Science
Associate Director for Research Strategy
Vanderbilt Brain Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study builds on evidence that bile acids influence the brain’s reward system. Bile acids are normally released from the gall bladder into the upper part of the small intestine, where they emulsify fats for absorption, before being recycled further down the small intestine. In bile diversion surgery, an experimental treatment for weight loss, bile is released at the end of the small intestine, increasing the amount of bile acids that enter the general circulation.

Mice treated with this surgery have less appetite for high-fat foods, which suggests that bile acids affect brain reward pathways.

We demonstrated that mice receiving the surgery also showed less preference for the cocaine-associated chamber, indicating that cocaine was probably less rewarding. Continue reading

Both Honey and Carafate® May Slow Damage to Esophagus from Button Battery Ingestion

MedicalResearch.com Interview with:

“button battery of Apple Remote” by tsurutakoji is licensed under CC BY 2.0

Example of Button Battery

Kris R. Jatana, MD, FAAP, FACS
Associate Professor
Director, Pediatric Otolaryngology Quality Improvement
Department of Otolaryngology-Head & Neck Surgery
Nationwide Children’s Hospital & Wexner Medical Center
at Ohio State University

MedicalResearch.com: What is the background for this study?  

Response: More than 2,500 pediatric button battery ingestions occur annually in the United States. When lodged in the esophagus, rapid injury can occur from the tissue and saliva connecting the circuit of the battery. Serious injury can occur in a matter of hours. This results in a highly alkaline caustic injury that dissolves tissue, a process called liquefactive necrosis. There was a need for novel mitigation strategies to slow the progression of esophageal injury caused by presence of a button battery. This study aimed at identifying a palatable liquid that can be given at home or hospital setting to reduce esophageal injury until the battery can be removed. Continue reading

Developing a Pill That Mimics Effects of Gastric Bypass Surgery

MedicalResearch.com Interview with:

Jeff Karp B.Eng. PhD. Professor of Medicine Center for Nanomedicine and Division of Engineering in Medicine Brigham and Women’s Hospital, Harvard Medical School Boston MA

Prof. Karp

Jeff Karp B.Eng. PhD.
Professor of Medicine
Center for Nanomedicine and Division of Engineering in Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston MA

MedicalResearch.com: How would you briefly explain the most important findings and conclusions of this study to a non-expert?

  • The type-2 diabetes (T2D) epidemic will affect over 642 million people worldwide by 2040. As a result, diabetes costs the US healthcare over $174 billion dollars annually and is the leading cause of blindness, amputations, renal failure, and poor cardiovascular outcomes. Recently, bariatric surgery, bypassing stomach and intestine from the food stream, has shown promising results and shown to be superior to pharmaceuticals in managing T2D. However, the risks of surgery along with permanent changes to gastrointestinal anatomy deters many suitable patients from surgery, with less than 1-2% of Americans who qualify for weight loss surgery actually undergoing the procedure. Therefore, there is an urgent need for a safe, non-invasive and effective treatment for wider diabetic patient population.
  • We envisioned a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery. During the past 8 years, we’ve been working on this idea and have developed a safe gut-coating material that can potentially mimic the beneficial effects of gastric bypass procedures in the form a pill.
  • LuCI can be activated in any part of gastrointestinal tract (e.g. stomach, duodenum, intestine, colon) to form a temporary physical barrier that isolates that part of gastrointestinal tract. In our pre-clinical models, LuCI coated the duodenum to modulate glucose responses in oral glucose tolerance tests.
  • These beneficial effect are observed without any evidence of systemic absorption of the drug.
  • We believe that LuCI could be a new therapeutic approach for T2D that is based on Roux-en-Y gastric bypass surgery, but is safer, associated with significantly less complications, and thus can potentially help a wide T2D patient population.
  • In a separate set of studies, we also showed that luCi allows delivery of certain proteins and drugs, which would normally be degraded by the gastric acid, to the GI tract, protecting it from gastric acid digestion and prolonging their luminal exposure.

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Amgen Tests IL-Blocker To Treat Symptoms of Hidden Gluten Consumption in Celiac Disease

MedicalResearch.com Interview with:

Markku Mäki, MD, PhD Professor (emeritus) at the University of Tampere and Presently research director at the Tampere University Hospital Tampere, Finland

Prof. Mäki

Markku Mäki, MD, PhD
Professor (emeritus) at the University of Tampere and
Presently research director at the
Tampere University Hospital
Tampere, Finland

MedicalResearch.com: What is the background for this study?

Response: The only treatment for this life-long gluten-induced autoimmune systemic disease is a strict avoidance of wheat, rye and barley, the food cereals which contain gluten, the environmental trigger and driving force in celiac disease.  Gluten causes intestinal
inflammation, usually with (but sometimes without) gastrointestinal or
nutritional symptoms or signs, and with frequent extra-intestinal
diseases. However, it is impossible for celiac disease patients to
avoid gluten entirely and indefinitely and a third of patients report
symptoms on a strict gluten-free diet. Gut mucosal healing is not
optimal in half of the patients, and inflammation and injury is
detected for years after starting the diet, presumably due to
contamination with gluten in the diet. This is why patients are
requesting, and academia and industry are looking for novel adjunct
therapies for celiac disease. Initially, these therapies are tested to
prevent the consequences of hidden gluten; the ultimate goal being
that also celiacs could one day eat safely wheat, barley and rye
products. Some 20 novel experimental therapies are at present actively
being investigated (modifying wheat or different drugs, devices and
vaccines/immunotherapy).

The present study investigated whether blocking interleukin 15, an
important mediator of celiac disease, reduces or prevents
gluten-driven ill health, both the inflammation and injury at the
small intestinal mucosal level and gluten-induced symptoms. The
experimental drug used was Amgen’s AMG 714, a human monoclonal
antibody, used at a low and high dose, in the presence or absence of a
high-dose gluten challenge. Continue reading

Marked Increase in Colorectal Cancer in Teenagers and Younger Adults

MedicalResearch.com Interview with:

Anas Raed,MD Section of General Internal Medicine Augusta University

Dr. Raed

Anas Raed, MD
Section of General Internal Medicine
Augusta University

MedicalResearch.com: What is the background for this study?

Response: Colorectal cancer (CRC) incidence and mortality rates have been decreasing in the US since mid 1980s, however, recent evidence shows that incidence and mortality rates of CRC in patients younger than 50 years have been increasing significantly.

In spite of the increasing trend of colorectal cancer, routine screening of this population has not been addressed due to lack of evidence and cost-effectiveness. Administering screening colonoscopy for all individuals younger than 50 years might not be feasible and, therefore routine screening colonoscopy for specific age groups might reduce the disparity of the incidence in this disease.

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