Gastrointestinal Disease

14 Mar

Posted at 23:27h in Author Interviews, C. difficile, Gastrointestinal Disease, Microbiome, Transplantation
MedicalResearch.com Interview with: [caption id="attachment_32899" align="alignleft" width="100"]Dr. H. L. DuPont MD Director, Center for Infectious Diseases, UTHealth School of Public Health Mary W. Kelsey Chair in the Medical Sciences, McGovern Medical School at UTHealth Professor, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health Houston, TX 77030 Dr. DuPont[/caption] Dr. H. L. DuPont MD Director, Center for Infectious Diseases, UTHealth School of Public Health Mary W. Kelsey Chair in the Medical Sciences, McGovern Medical School at UTHealth Professor, Department of Epidemiology, Human Genetics and Environmental Sciences UTHealth School of Public Health Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many diseases and disorders are associated with “dysbiosis,” where the intestinal microbiota diversity is reduced. This contributes to disease and to the acquisition of antibiotic resistance. Fecal microbiota transplantation (FMT) is successful in conditions with pure dysbiosis (e.g. C diff infection) and a single dose of FMT is curative in most cases.

11 Mar

Posted at 17:59h in Author Interviews, Gastrointestinal Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_32846" align="alignleft" width="142"]Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University Dr. Ronnie Fass[/caption] Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? Response: The endoscopic radiofrequency procedure (Stretta) has been used for more than a decade to treat patients with gastroesophageal reflux disease (GERD). Over time, there were several Meta-analyses with variable designs of the Stretta procedure providing conflicting results. Thus, the purpose of the current systematic review and meta-analysis was to determine the efficacy of the Stretta procedure using all currently available controlled and cohort studies.

11 Feb

Posted at 03:19h in Author Interviews, Gastrointestinal Disease, Infections, Microbiome, Rheumatology, Science
MedicalResearch.com Interview with: [caption id="attachment_31926" align="alignleft" width="150"]Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021 Dr. Randy Longman[/caption] Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inflammatory bowel disease is not limited to intestinal inflammation.  Up to 1/3 of patients with active disease suffer from extra-intestinal manifestations. The most common extra-intestinal manifestations in IBD is joint inflammation or spondyloarthritis.  Peripheral joint spondyloarthritis  carries a prevalence of 20% in Crohn’s Disease and 10% in Ulcerative Colitis, predominantly affecting joints of the lower limbs.  It has long been suggested that gut bacteria can drive this systemic joint inflammation, but microbial targets have not been characterized.

01 Feb

Posted at 16:47h in Author Interviews, Gastrointestinal Disease, Microbiome
MedicalResearch.com Interview with: [caption id="attachment_31681" align="alignleft" width="200"]Fernando Azpiroz, MD, PhD Chief of the Department of Digestive Diseases University Hospital Vall d’Hebron Autonomous University of Barcelona, Spain Dr. Fernando Azpiroz[/caption] Fernando Azpiroz, MD, PhD Chief of the Department of Digestive Diseases University Hospital Vall d’Hebron Autonomous University of Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: This open-label, single-arm study, included 26 healthy volunteers who did not have gastrointestinal (GI) symptoms or a history of GI disorders, and were not required to change their diets during treatment. Twenty participants were included in the main evaluation and six were included as control subjects. Participants in the main study were given HOST-G904 (2.8 g/day) for three weeks, during which time they followed their usual diet. In the evaluation periods (three-day periods immediately before, at the beginning and at the end of the administration), the participants followed a standardized low-fiber diet with one portion of high-fiber foods, at which time the investigators measured the following: (1) number of daytime gas evacuations for two days; (2) volume of gas evacuated; and (3) microbiome composition (as measured by fecal Illumina MiSeq sequencing).

26 Jan

Posted at 16:42h in Author Interviews, Autism, Brigham & Women's - Harvard, Gastrointestinal Disease, Microbiome
MedicalResearch.com Interview with: [caption id="attachment_31521" align="alignleft" width="135"]Maria Rosaria Fiorentino, PhD Dr. Maria Rosaria Fiorentino[/caption] Maria Rosaria Fiorentino, PhD Assistant Professor at Harvard Medical School Molecular Biologist at Mucosal Immunology and Biology Research Center Massachusetts General Hospital East Charlestown, MA 02129-4404 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism Spectrum Disorders (ASD) refers to complex neurodevelopmental disorders arising from the interaction of genes and environmental factors. There are no defined mechanisms explaining how environmental triggers can lead to these conditions. One hypothesis based on the gut-brain axis connection suggests that inappropriate antigens trafficking through an impaired intestinal barrier, followed by passage of these antigens through a permissive blood-brain barrier (BBB), can be part of the chain of events leading to the disease. Many Autism Spectrum Disorders children experience co-morbid medical conditions, including gastrointestinal (GI) dysfunctions whose underlying nature is poorly understood. Several clinical observations describe increased intestinal permeability in ASD with often conflicting findings. Permeability to neuroactive food antigens derived from the partial digestion of wheat (gliadorphins) and cow’s milk (casomorphins) has been reported in ASD. However, while evidence of a permeable gut barrier in ASD is increasingly reported, no information is available concerning a similar breach for the BBB. The BBB is a critical line of defense in the Central Nervous System, limiting the access of circulating solutes, macromolecules, and cells that could negatively impact neuronal activity. Dysfunctions of the BBB have been associated with numerous inflammatory neurologic disorders, such as stroke, epilepsy, multiple sclerosis, Parkinson’s and Alzheimer’s disease.

24 Jan

Posted at 21:55h in Author Interviews, Gastrointestinal Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_31334" align="alignleft" width="126"]Dr. Mark Noar Director of The Heartburn and Reflux Study Center Towson, MD Dr. Mark Noar[/caption] Dr. Mark Noar Director of The Heartburn and Reflux Study Center Towson, MD  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was developed out of a need to know whether the Stretta procedure was effective in both the short and long-term in all forms of reflux. This included standard refluxing patients who had never had surgery but also in the subpopulation of patients who had recurring reflux after having had reflux corrective surgery. The question to be answered was whether the Stretta procedure would be less effective, more effective, or just as effective in the patient who had had prior surgery compared to patients who did not have surgery. The main findings were that independent of whether a patient had had surgery for the correction of reflux or just had standard reflux without prior surgery, the Stretta procedure was equally effective in all patient subgroups both in the short-term and the long-term.

17 Jan

Posted at 19:38h in Author Interviews, Gastrointestinal Disease, Pediatrics
MedicalResearch.com Interview with: Acupuncture Wikipedia imageDr Kajsa Landgren Faculty of Medicine, Department of Health Sciences Lund University, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infantile colic is common, affecting 10-20% of newborns. These infants have intense crying and fussing, more than 3 hours/day more than 3 days/week. There is no medical treatment, causing desperate parents to seek complementary medicine. The evidence for acupuncture is sparse. In this trial including 147 infants with colic, we tested two types of acupuncture. Both types of acupuncture were minimal, i.e needles were inserted for only a few seconds without further stimulation. Group A received only one single needle for 2-5 seconds. Group B received up to five needle insertions for maximum 30 seconds. A third group, C, received no acupuncture. All families came to four extra visits to their Child Health Center where they met a nurse who gave advice and support. During these visits the infants were separated from their parents for five minutes, being alone with an acupuncturist who gave acupuncture to the infants in group A and B, but not to infants in group C. Parents and the nurse were blinded to which group the infant was randomized to.

15 Jan

Posted at 14:44h in Author Interviews, Dermatology, Gastrointestinal Disease
MedicalResearch.com Interview with: [caption id="attachment_21019" align="alignleft" width="233"]Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital, University of Copenhagen Hellerup, Denmark Dr. Alexander Egeberg[/caption] Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Inflammatory bowel disease (IBD) has been associated with increased prevalence of HS, but data has been limited to small studies and even less is known about the concurrence and risk of new-onset IBD in patients with pre-existing HS. In our study, we found a higher prevalence of Crohn’s disease and ulcerative colitis in patients with HS. Notably, there was a more than two-fold increased risk of new-onset Crohn’s disease and a 63% increased risk of new-onset ulcerative colitis in patients with Hidradenitis suppurativa compared with the general population.

05 Jan

Posted at 23:02h in Author Interviews, Autism, Gastrointestinal Disease, Psychological Science
MedicalResearch.com Interview with: [caption id="attachment_30964" align="alignleft" width="120"]David Q. Beversdor MD Center for Translational Neuroscience University Hospital University of Missouri Health System Columbia, MO 65212 Dr. David Beversdor[/caption] David Q. Beversdor MD Center for Translational Neuroscience University Hospital University of Missouri Health System Columbia, MO 65212 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered stress reactivity, alterations in cytokines and a high incidence of gastrointestinal disturbances have all been observed in autism spectrum disorder (ASD). We wished to examine the interactions between these factors. What we found was that patients with greater stress reactivity, as indicated by cortisol response in the testing environment, had greater symptomatology involving the lower gastrointestinal tract, which was predominated by constipation.

05 Jan

Posted at 02:06h in Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease
MedicalResearch.com Interview with: [caption id="attachment_30939" align="alignleft" width="142"]Paul Y. Kwo, MD, FACG Stanford University School of Medicine Dr. Paul Y. Kwo[/caption] Paul Y. Kwo, MD, FACG Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: This guideline, which was jointly authored by Drs. Kwo, Cohen, and Lim provides a framework for physicians to approach the very common problem encountered of a patient whose liver chemistries are abnormal. This is particularly relevant as there remain large pools of individuals who have yet to be diagnosed with chronic hepatitis B and C, non-alcoholic fatty liver disease, advanced liver disease as well as less common conditions, all of whom will require evaluation. In particular, the rise in the prevalence of non-alcoholic fatty liver disease worldwide will be addressed in part by identifying and evaluating these individuals prior to the development of advanced fibrosis. The guideline takes clinicians through a step-wise approach to the evaluation of elevated aminotransferase (ALT and AST), alkaline phosphatase, and bilirubin levels including appropriate historical questions, important physical examination findings, laboratory , radiological evaluation and finally liver biopsy if required.

15 Dec

Posted at 13:52h in Author Interviews, Gastrointestinal Disease, HIV, Inflammation
MedicalResearch.com Interview with: Prof. Jamal Tazi Director, Institute for Molecular Genetics CNRS and University of Montpellier and Executive Committee Member ABIVAX MedicalResearch.com: What is the background for this study? Response: Its long been established that people with HIV, even those treated successfully with antiretroviral treatment, exhibit significantly higher levels of chronic inflammation than HIV-negative people. The causes of this inflammation are many – ongoing viral replication, often in the so-called viral reservoirs, leaky gut syndrome, concomitant viral infections (eg CMV, hepatitis etc).

02 Dec

Posted at 14:32h in Author Interviews, Gastrointestinal Disease, Mental Health Research, Nature, Probiotics
MedicalResearch.com Interview with: [caption id="attachment_30115" align="alignleft" width="200"]Elizabeth Bryda, PhD Professor, Director, Rat Resource and Research Center Veterinary Pathobiology University of Missouri Columbia, Missouri Dr. Elizabeth Bryda[/caption] Elizabeth Bryda, PhD Professor, Director, Rat Resource and Research Center Veterinary Pathobiology University of Missouri Columbia, Missouri MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of groups have demonstrated the ability of probiotics to benefit digestive health and there is a growing body of evidence to suggest an association between mental health and “gut health”. We were interested to see if probiotic bacteria could decrease anxiety- or stress-related behavior in a controlled setting using zebrafish as our model organism of choice for these studies. We were able to show that Lactobacillus plantarum decreased overall anxiety-related behavior and protected against stress-induced dysbiosis (microbial imbalance). The fact that administration of probiotic bacteria also protected other resident gut bacteria from the dramatic changes seen in “stressed” fish not receiving the probiotic was unexpected and suggested that these bacteria may be working at the level of the GI tract and the central nervous system.

23 Nov

Posted at 02:04h in Author Interviews, Gastrointestinal Disease, Genetic Research
MedicalResearch.com Interview with: Mauro D’Amato Ikerbasque Research Professor Head, Unit of Gastrointestinal Genetics, Department of Gastrointestinal and Liver Diseases BioDonostia Health Research Institute San Sebastian, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Irritable bowel syndrome (IBS) is a very common condition, whose underlying pathophysiology is poorly understood. People with IBS often complain certain foods trigger their symptoms and, at least in some patients, incomplete breakdown of carbohydrates may result in malabsorption with diarrhoea, bloating and abdominal pain. At the extreme of the spectrum of such clinical manifestations, this is what happens in a hereditary form of sucrose intolerance, the congenital sucrase-isomaltase deficiency (CSID) due to mutations in the Si gene that lead to defective enzymatic disaccharidase activity in the gut. Because IBS shows genetic predisposition, we tested the hypothesis that mutations and DNA variants affecting SI enzyme function may confer increased risk of IBS. We studied almost 2000 individuals from several clinics from Europe and USA, and found out that rare SI mutations and other more common defective DNA variants are indeed more frequent in patients than healthy controls.

21 Nov

Posted at 01:55h in Author Interviews, Gastrointestinal Disease, Microbiome, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_29871" align="alignleft" width="200"]Mahesh Desai, PhD Principal Investigator Allergology - Immunology - Inflammation Research Unit Department of Infection and Immunity Luxembourg Institute of Health Luxembourg Dr. Mahesh Desai[/caption] MedicalResearch.com: What is the background for this study? Response: Over the last few decades, our intake of dietary fiber has fallen drastically mainly due to the consumption of processed food, which has been connected to increased cases of intestinal diseases including colon cancer and inflammatory bowel disease. The gut microbiota is essential for us as it allows our body to digest dietary fiber contained in fruits and vegetables, that could otherwise not be processed. Changed physiologies and abundances of the gut microbiota following a fiber-deprived diet have been commonly linked to several intestinal diseases. However, the mechanisms behind these connections have remained poorly understood.

18 Nov

Posted at 02:39h in Author Interviews, Brigham & Women's - Harvard, Compliance, Gastrointestinal Disease, Pharmacology, Technology
MedicalResearch.com Interview with: [caption id="attachment_29758" align="alignleft" width="143"]C. Giovanni Traverso, MB, BChir, PhD Gastroenterologist and biomedical engineer Division of Gastroenterology at BWH Instructor of medicine at Harvard Medical School. Dr. Traverso[/caption] C. Giovanni Traverso, MB, BChir, PhD Gastroenterologist and biomedical engineer Division of Gastroenterology at BWH Instructor of medicine at Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: We developed a drug delivery system capable of safely residing in the stomach for 2 weeks. Furthermore we demonstrated the capacity of the novel dosage form, in the shape of a star, to protect the drug from the acidic stomach environment and also slowly release drug over the course of 14 days. We applied this new technology towards efforts targeting the elimination of malaria. Specifically, we focused on a drug called ivermectin that has been used to treat parasites but also has the benefit of being toxic to malaria-carrying mosquitos when they bite someone who has ivermectin in their system.

09 Nov

Posted at 14:18h in Author Interviews, Gastrointestinal Disease, JAMA, Lipids
MedicalResearch.com Interview with: Borge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry, Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acute pancreatitis is an inflammatory disorder of the pancreas with gallstones and high-alcohol consumption as leading risk factors, while mild-to-moderately increased plasma triglycerides hitherto has been overlooked. We surprisingly found that the risk of developing acute pancreatitis was increased already from triglycerides of 175 mg/dL (2 mmol/L) and above. When triglycerides were above 443mg/dL (5mmol/L) the risk was increased a massive 9-fold. Interestingly, this risk was higher than the corresponding 3.4-fold higher risk for myocardial infarction.

31 Oct

Posted at 13:05h in Author Interviews, Gastrointestinal Disease, Kidney Stones
MedicalResearch.com Interview with: [caption id="attachment_29289" align="alignleft" width="175"]Dr. Hatim A. Hassan Section of Nephrology, Department of Medicine The University of Chicago Chicago, IL 60637 Dr. Hatim A. Hassan[/caption] Dr. Hatim A. Hassan MD PhD Section of Nephrology, Department of Medicine The University of Chicago Chicago, IL 60637 MedicalResearch.com: What is the background for this study? Response: Nephrolithiasis is the second most prevalent kidney disease in USA after hypertension, with a rising prevalence and complications including advanced chronic kidney disease (CKD) and end stage renal disease (ESRD). It remains a major source of patient discomfort and disability, lost working days, and health-care expenditure, with an annual economic cost approaching $10 billion. Hyperoxaluria is a major risk factor for kidney stones (KS), and 70-80% of KS are composed of calcium oxalate. Urinary oxalate is an important determinant of supersaturation, and the risk for stone formation is affected by small increases in urine oxalate. Oxalate is a metabolic end product that cannot be further metabolized and is highly toxic. The mammalian intestine plays a crucial role in oxalate homeostasis, by regulating the amount of absorbed dietary oxalate and providing an avenue for enteric oxalate excretion. Anion exchanger SLC26A6 (A6)-mediated intestinal oxalate secretion plays a critical role in preventing hyperoxaluria and calcium oxalate kidney stones (COKS). Inflammatory bowel disease patients have a significantly increased risk of kidney stones due to the associated enteric hyperoxaluria. Obesity is a risk factor for KS and obese stone formers often have mild to moderate hyperoxaluria. Hyperoxaluria is also emerging as a major complication (developing in > 50% of patients) of bariatric surgery for obesity. With the rising prevalence of obesity and increased utilization of bariatric surgery, it is expected that the incidence of hyperoxaluria and related COKS (including the associated cost burden) will continue to increase at a significant rate. Primary hyperoxaluria (PH) is an inherited disease in which there is endogenous oxalate overproduction, which leads to recurrent KS and/or progressive nephrocalcinosis, ESRD, as well as significant hyperoxalemia, systemic oxalosis and premature death. Systemic deposition of calcium oxalate (oxalosis) leads to bone disease, cardiac arrhythmias, cardiomyopathy, skin ulcers, erythropoietin refractory anemia, and digital gangrene. The only treatment known to fully correct the underlying metabolic defect is liver transplantation or combined kidney-liver transplantation once ESRD develops. In addition, significant hyperoxalemia is also seen in ESRD. Cardiovascular diseases are the leading cause of morbidity and mortality in ESRD patients, and a recent report raised the possibility that the ESRD-associated hyperoxalemia might contribute to this increased risk. Lowering serum oxalate might improve cardiovascular outcomes in ESRD patients if these findings are confirmed. Unfortunately, there is currently no specific therapy that effectively lowers urine and/or plasma oxalate level(s), and the risk of recurrent COKS, nephrocalcinosis, oxalate nephropathy, ESRD, & systemic oxalosis remains substantial in the absence of treatment.

28 Oct

Posted at 19:01h in Author Interviews, Gastrointestinal Disease
[caption id="attachment_28908" align="alignleft" width="160"]Miguel Regueiro, M.D., AGAF, FACG, FACP Professor of Medicine and Professor, Clinical and Translational Science University of Pittsburgh School of Medicine Senior Medical Lead of Specialty Medical Homes University of Pittsburgh Medical Center IBD Clinical Medical Director Division of Gastroenterology, Hepatology, and Nutrition Mezzanine Level, C Wing, 200 Lothrop Street Pittsburgh PA, 15213 Dr. Miguel Regueiro[/caption] MedicalResearch.com Interview with: Miguel Regueiro, M.D., AGAF, FACG, FACP Professor of Medicine and Professor, Clinical and Translational Science University of Pittsburgh School of Medicine Senior Medical Lead of Specialty Medical Homes University of Pittsburgh Medical Center IBD Clinical Medical Director Division of Gastroenterology, Hepatology, and Nutrition Pittsburgh PA, 15213 MedicalResearch.com: What is the background for this study? Response: The background for the study is that we created an Inflammatory Bowel Disease (IBD) patient centered medical home in conjunction with our UPMC Health Plan. The IBD medical home has been designated UPMC IBD Total Care and provides whole person care for patients with ulcerative colitis and Crohn’s disease. Unlike primary care medical homes, the gastroenterologist is the principle care provider in this specialty medical home model. We created this medical home to improve the IBD patient experience, provide high quality care, and decrease utilization and cost.

27 Oct

Posted at 12:53h in Author Interviews, Gastrointestinal Disease, Inflammation
MedicalResearch.com Interview with: Cheryl de Valliere, PhD University Hospital Zurich Division of Gastroenterology and Hepatology Zurich Switzerland and co-authors Gerhard Rogler, Jesus Cosin Roger, Pedro A. Ruiz MedicalResearch.com: What is the background for this study? Response: Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn’s disease, gives rise to chronic relapsing inflammation of the gastrointestinal (GI) tract, resulting in a disruption of the epithelial barrier function and exacerbated innate and adaptive immune responses. One of the most important features under these inflammatory conditions is the presence of hypoxic areas where oxygen levels are lower than in normal tissue. It has been widely reported that the main transcription factor regulating cellular responses to hypoxia, hypoxia inducible factor (HIF)-1, is significantly induced in patients with IBD compared with healthy subjects. Furthermore, hypoxia is not only linked to inflammation, but also influences the local tissue pH, leading to an reduction of the pH in the inflamed mucosa compared with the non-inflamed one. A family of pH-sensing G-protein coupled receptors (GPCRs), including the receptor T-cell death-associated gene 8 (TDAG8) and the ovarian cancer G-protein coupled receptor 1 (OGR1 or GPR68), play an important role in physiological pH homeostasis. At low extracellular pH, second messenger signaling pathways are activated by protons binding to the histidine residues located on the extracellular region of the receptor. Recent studies have reported a link between IBD and this family of pH-sensing receptors. Indeed, TDAG8 has been identified as an IBD risk gene and we have previously reported an increased expression of OGR1 in patients with IBD compared with healthy subjects. To better understand the basic mucosal inflammatory mechanisms, and foster the development of new treatment options (e.g. pH receptor blockers and OGR1 antagonists) for chronic mucosal inflammatory diseases, we investigated the effects of hypoxia on pH-sensing OGR1 in the intestinal mucosa and associated cells.

22 Oct

Posted at 22:31h in Author Interviews, Gastrointestinal Disease
MedicalResearch.com Interview with: [caption id="attachment_29078" align="alignleft" width="142"]Christopher V. Almario, MD, MSHPM</strong> Assistant Professor of Medicine Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center Cedars-Sinai Center for Outcomes Research and Education Los Angeles, CA Dr. Christopher V. Almario[/caption] Christopher V. Almario, MD, MSHPM Assistant Professor of Medicine Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center Cedars-Sinai Center for Outcomes Research and Education Los Angeles, CA MedicalResearch.com: What is the background for this study? Response: Recent drug approvals have increased the availability of biologic therapies for inflammatory bowel disease (IBD). However, the growing number of biologics has also made it more difficult for both patients and healthcare providers to navigate treatment options and to ultimately choose the most appropriate therapy. In this study, we wanted to examine patient decision-making surrounding IBD biologic therapies using conjoint analysis, which is a form of tradeoff analysis that determines how respondents make complex decisions by presenting them with competing product profiles. Here, we quantified the relative importance of 9 biologic therapy attributes (e.g., how the medicine works, how the medicine is received, long-term effectiveness, side-effect profile, etc.) in the decision-making process.

15 Oct

Posted at 12:37h in Author Interviews, Gastrointestinal Disease, Genetic Research, Hepatitis - Liver Disease, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_28898" align="alignleft" width="180"]Annette Schürmann PhD Department of Experimental Diabetology German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) Nuthetal Germany German Center for Diabetes Research (DZD München-Neuherberg Germany Dr. Annette Schürmann[/caption] Annette Schürmann PhD Department of Experimental Diabetology German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) Nuthetal Germany German Center for Diabetes Research (DZD München-Neuherberg Germany MedicalResearch.com: What is the background for this study? Response: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern of liver at two time points, at the age of 6 weeks, (the earlierst time point to distiguish between those that respond to the diet (responder mice) and those that did not (non-responders)), and at the age of 20 weeks. One transcript that was significantly reduced in the liver of responder mice at both time points was Igfbp2. The reason for the reduced expression was an elevated DNA-methylation at a position that is conserved in the mouse and human sequence. The elevated DNA-methylation of this specifc site in human was recently described to associate with elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old mice did not show differences in liver fat content between responder and non-responder mice we conclude that the alteration of Igfbp2 expression and DNA metyhlation occurs before the development of fatty liver. Our data furthermore showed that the epigenetic inhibition of Igfbp2 expression was associated with elevated blood glucose and insulin resistance but not with fatty liver.

10 Oct

Posted at 16:14h in Author Interviews, Gastrointestinal Disease, Infections, PLoS
MedicalResearch.com Interview with: [caption id="attachment_28701" align="alignleft" width="133"]Brian K. Coombes, PhD Professor & University Scholar Associate Chair, Graduate Education Department of Biochemistry & Biomedical Sciences Assistant Dean, Biochemistry Graduate Program Canada Research Chair in Infectious Disease Pathogenesis Dr. Brian Coombes[/caption] Brian K. Coombes, PhD Professor & University Scholar Associate Chair, Graduate Education Department of Biochemistry & Biomedical Sciences Assistant Dean, Biochemistry Graduate Program Canada Research Chair in Infectious Disease Pathogenesis MedicalResearch.com: What is the background for this study? Response: North Americans have among the highest reported prevalence and incidence of inflammatory bowel disease (IBD) in the world. This is a lifelong disease that often strikes people in their early years, leading to decades of suffering, increased risk of colorectal cancer, and 50% increased risk of premature death. Compared to the general population, quality of life for those with Crohn’s disease is low across all dimensions of health. The need to understand the root origins of this disease and to use this information to invigorate a new pipeline of treatments and preventions has never been more pressing.

06 Oct

Posted at 21:14h in Author Interviews, Gastrointestinal Disease, Pancreatic
MedicalResearch.com Interview with: Dr. Pouria Jandaghi Functional Genome Analysis, Deutsches Krebsforschungszentrum Heidelberg, Germany Department of Human Genetics, McGill University University and Genome Quebec Innovation Centre Montreal, Canada MedicalResearch.com: What is the background for this study? Response: Although the overall five-year survival of all patients with cancer stands at 63%, for pancreatic cancer patients, it is a disheartening 8% - a number that remains largely unchanged for three decades. Of the patients diagnosed with pancreatic cancer, about 85% exhibit pancreatic ductal adenocarcinoma (PDAC). Most of these patients die within 4 to 6 months after diagnosis. The poor prognosis is caused by the its detection at only late stages, and lack of effective options for chemotherapy. The widely used chemotherapeutic agent gemcitabine, confers a median survival advantage of only 6 months, and resistance to therapy develops in the vast majority of patients. Given this poor prognosis of patients with PDAC, there is an urgent need to find more effective therapies. In this study, we set out to investigate potential therapeutic targets by dissecting gene expression profiles of tumors and control samples. Candidate targets were validated with respect to their suitability and analyzed functionally.

29 Sep

Posted at 00:43h in Author Interviews, Gastrointestinal Disease, Nutrition, Science
MedicalResearch.com Interview with: [caption id="attachment_28438" align="alignleft" width="180"]Distinguished Professor Kourosh Kalantar-zadeh RMIT's School of Engineering Australia Prof. Kourosh Kalantar-Zadeh[/caption] Distinguished Professor Kourosh Kalantar-Zadeh RMIT's School of Engineering Australia MedicalResearch.com: What is the background for this study? What are the main findings? 1- The development of "swallow-able gas sensor capsules". This was the final test on animals and focused on the measurement of a food supplement (cinnamon) to show the extraordinary capability of this noninvasive tool that will revolutionise the future of Gastroenterology and Food Sciences 2- That cinnamon can improve the health of the stomach, and hence our overall health, by adjusting the acidity and enzymatic secretion in the stomach. So the good effect of cinnamon is not just a grandparent old advice - It is real.

11 Sep

Posted at 15:00h in Author Interviews, CDC, Gastrointestinal Disease, Global Health
MedicalResearch.com Interview with: Dr. Matt Goers Internal Medicine Resident at UMN MedicalResearch.com: What is the background for this report? What are the main findings of the evaluations of refugee populations in western Uganda? Response: In 2014, International Organization of Migration (IOM) reported an unusually high number of Congolese refugees in western Uganda had palpable, enlarged spleens detected during their routine refugee pre-departure medical examinations. Due to this trend, the IOM, with the assistance of the Centers for Disease Control and Prevention (CDC), implemented a diagnostic and treatment protocol to further evaluate and assist with management of refugees with splenomegaly during their pre-departure medical examinations. In March and June 2015, a total of 987 U.S.-bound refugees underwent medical examinations performed as part of their routine resettlement process. Of those evaluated, 145 (14.7%) had a detectable spleen on physical examination. In fact, 84.7% (122 people) were found to have marked or massive splenomegaly during their evaluation (classified based on a prior World Health Organization ultrasonography protocol). During the work-up for this condition, less than 33% were found to have an infectious cause of their condition including 26.9% (39 people) who had malaria.

06 Sep

Posted at 18:02h in Author Interviews, Gastrointestinal Disease, Gluten, JAMA
MedicalResearch.com Interview with: [caption id="attachment_27623" align="alignleft" width="125"]Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School Dr. Brandon Hyunseok Kim[/caption] Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: The background of this study was to investigate the time trends in the prevalence of celiac disease and gluten-free diet in the United States using most recent 6-year National Health And Nutrition Examination Survey. Previous studies using narrow populations or old study period mainly before mid 2000s suggested increasing prevalence of celiac disease. At the same time, there is a current popular trend of people following gluten-free diets beyond what would be expected if it were solely due to the increasing prevalence of celiac disease.

29 Jul

Posted at 22:09h in Author Interviews, Gastrointestinal Disease, Genetic Research, JAMA
MedicalResearch.com Interview with: [caption id="attachment_26492" align="alignleft" width="133"]Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 Dr-Amitabh-Chak[/caption] Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 20 years ago we discovered that Barrett's esophagus and esophageal cancer aggregate in a small proportion of families suggesting there might be a genetic basis to these complex diseases. As we started looking at these families, we identified a rare family with multiple members who had Barrett's esophagus and multiple members who had passed away from esophageal cancer at a young age. Advances in exome sequencing have now allowed us to identify a mutation in a gene whose function is not known that predisposes this family to develop Barrett's esophagus. Functional studies suggest that this gene, VSIG10L, is involved in maturation of normal squamous esophagus.

27 Jul

Posted at 23:34h in Author Interviews, Gastrointestinal Disease, Gluten, Immunotherapy
MedicalResearch.com Interview with: [caption id="attachment_26555" align="alignleft" width="173"]Armin Alaedini, PhD Assistant Professor Department of Medicine & Institute of Human Nutrition Columbia University Medical Center New York, NY 10032 Dr. Armin Alaedini[/caption] Armin Alaedini, PhD Assistant Professor Department of Medicine & Institute of Human Nutrition Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What is the background for this study? Response: It has been a mystery why some people experience a range of symptoms in response to the ingestion of wheat and related cereals, even though they do not have celiac disease (an autoimmune disorder) or wheat allergy. Both gastrointestinal (GI) symptoms, most commonly abdominal pain, diarrhea, and bloating, as well as extra-intestinal symptoms, such as fatigue, anxiety, depressed mood, and cognitive difficulties are reported by patients. The identity of the component(s) of wheat responsible for triggering the symptoms remains uncertain and it is not clear if gluten or non-gluten molecules are involved. There is evidence to indicate that wheat sensitivity also affects a subset of patients with irritable bowel syndrome (IBS), a common disorder. Despite the interest from the medical community and the general public, the causes and mechanism of the associated symptoms have remained unknown and no biomarkers are available to aid in the diagnosis of patients.

27 Jul

Posted at 18:15h in Author Interviews, Gastrointestinal Disease, Lancet, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_26515" align="alignleft" width="200"]Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK Mr. Steven Brown[/caption] Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK MedicalResearch.com: What is the background for this study? Response: Haemorrhoids are common. One in 4 of us will at some time have symptoms that can be directly attributed to piles. Whilst most symptoms will settle spontaneously or with improvement to our lifestyle, there remains a large group of patients who require intervention to reduce symptomatology. Numerous interventions exist ranging from relatively minor office therapy to procedures that may take several weeks to recover from. Haemorrhoidal artery ligation (HAL) is one of the more recent surgical operations for haemorrhoidal therapy. It has been introduced certainly into the UK associated with a significant element of media hype purporting ‘painless surgery for piles’. Substantial subsequent medical literature has also suggested an efficacy rivaling other more invasive procedures. Too good to be true? Perhaps. Several systematic reviews have highlighted the lack of good quality data as evidence for the advantages of the technique. A well designed randomized controlled trial was required. The existing literature on  haemorrhoidal artery ligation at the time of the trial suggested the procedure was most effective for less symptomatic haemorrhoids (those that are associated with bleeding and/or minor prolapse; grade II or mild III piles). These type of haemorrhoids also tend to be the most common requiring intervention. The most frequently used alternative procedure for these grade of haemorrhoids in the UK is rubber band ligation (RBL), a simple office therapy not requiring anaesthetic. Hence participants with this grade of haemorrhoids were chosen as the participants with RBL as the comparator. Multiple outcomes were investigated but a patient reported outcome measure of recurrence was chosen as the primary outcome.

24 Jul

Posted at 11:45h in Author Interviews, Gastrointestinal Disease, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26433" align="alignleft" width="150"]Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia Prof. Nicholas Talley[/caption] Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia President, Royal Australasian College of Physicians Chair, Committee of Presidents of Medical Colleges Hon. Treasurer, Australian Academy of Health and Medical Sciences Editor-in-Chief, Medical Journal of Australia Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia Professor of Medicine and Professor of Epidemiology, Joint Supplemental Consultant Gastroenterology and Health Sciences Research, Mayo Clinic, Rochester, MN, USA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Functional gastrointestinal diseases (FGIDs) like the irritable bowl syndrome (IBS) are very common, cause major distress including pain and psychological dysfunction, impact on quality of life and drive high health care costs. We speculated that there are two distinct types of functional gastrointestinal disease that others have not recognized. For example, IBS in a subgroup may first begin with gut symptoms (pain, diarrhea, constipation, bloating etc) in those free of psychological distress and only later does new onset anxiety or depression develop, implicating gut disease as the primary driver of the entire symptom complex (a gut-to-brain disease). On the other hand, we speculated there is another quite different subgroup where disease begins with anxiety or depression and only later do new onset gut symptoms develop, and this is likely primarily a central nervous system cause (probably through the stress system), or a brain-to-gut disease. This is exactly what we found, with gut disease occurring first followed by new onset psychological distress in about two thirds of people from the community over a one year follow-up.