Author Interviews, Cancer Research, Gastrointestinal Disease, Genetic Research, NIH / 30.04.2015

Dr. Steven Wank MDMedicalResearch.com Interview with: Dr. Stephen Wank MD Digestive Diseases Branch, NIDDK National Institutes of Health, Bethesda, Maryland MedicalResearch: What is the background for this study? Dr. Wank: Small intestinal carcinoids are rare and difficult to diagnose because symptoms may be absent or mistaken for more common diseases. Because carcinoids usually grow slowly over several years before spreading or causing symptoms, patients often seek medical attention late with advanced, incurable disease. However, when diagnosed at an early stage, carcinoid can be surgically cured. Presently, there are no long-term effective therapies for surgically non-resectable disease. Although carcinoids occur sporadically, there have been reports of family clusters (more than one blood relative with carcinoid). Hereditary small intestinal carcinoid has not been recognized as a disease and causative genetic factors have not been identified in either sporadic cases or families with multiple affected members. If small intestinal carcinoid occurs in families on a hereditary basis, we hypothesized that asymptomatic relatives in families with carcinoid are at a high risk of harboring an undiscovered tumor. To test this, we established a clinical research protocol at the National Institutes of Health in Bethesda, Maryland to screen asymptomatic relatives in families with at least two cases of small intestinal carcinoid in the hope of detecting their tumors at an early surgically curable stage. If successful in our endeavor, we would improve the outcome of the disease in these asymptomatic relatives and position ourselves to discover the genetic basis for their disease. Understanding the gene mutations causing small intestinal carcinoid would allow us to screen for the disease with a blood test, help us understand what causes the disease, and treat the disease with specific targeted therapies. (more…)
Author Interviews, Biomarkers, BMJ, Cancer Research, Gastrointestinal Disease / 14.04.2015

MedicalResearch.com Interview with: Professor Hossam Haick Ph.D Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Haifa, Israel Medical Research: What is the background for this study? What are the main findings? Dr. Haick: Our study is based on the hypothesis that timely detection of premalignant lesions (PMLs) may provide a tool to decrease either cancer mortality or incidence, thought, currently, there is no perfect non-invasive tool to screen for gastric cancer (GC) and the related premalignant lesions. Using 1002 samples collected from 501 volunteers, we show for the first time that premalignant lesions (PMLs) relevant to (gastric) cancer result in detectable differences in Volatile Organic Compound (VOC) signatures that can be detected and classified non-invasively through exhaled breath. We show additionally that these premalignant lesions can be well-discriminated from various stages of gastric cancer as well as other background stomach diseases. (more…)
Author Interviews, Gastrointestinal Disease, PLoS / 03.04.2015

MedicalResearch.com Interview with: Ricardo Battaglino, Ph.D. Department of Mineralized Tissue Biology The Forsyth Institute, Cambridge, Massachusetts Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, Boston, Massachusetts,MedicalResearch.com Interview with: Ricardo Battaglino, Ph.D. Department of Mineralized Tissue Biology The Forsyth Institute, Cambridge, Massachusetts Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine, Boston, Massachusetts Medical Research: What is the background for this study? What are the main findings? Dr. Battaglino: Mutations in sorting nexin 10 (Snx10) have recently been found to account for roughly 4% of all human malignant osteopetrosis, some of them fatal. To study the disease pathogenesis, we investigated the expression of Snx10 and created mouse models in which Snx10 was knocked down globally or knocked out in osteoclasts. We found that Snx10, a molecule expressed in osteoclasts, was also expressed in the stomach. Studies in tissue specific or global knock-down mice showed that Snx10 deficiency resulted in a phenotype that was a consequence of deficiencies in both osteoclasts and gastric zymogenic cells. Our studies add to a growing list of genes, including atp6i (Tcirg1), whose expression is required both in bone and stomach to maintain normal gastric acidification and calcium absorption. Medical Research: What should clinicians and patients take away from your report? Dr. Battaglino: Our work provides additional insight into the mechanisms governing the regulation of bone accrual by the gastrointestinal tract. Because osteopetrorickets has not been described clinically in Snx10-related osteopetrosis, these findings highlight the importance of considering impaired acidification in both stomach and bone in osteopetrotic patients with mutations in SNX10 and other genes with similar patterns of expression and activities. Reliance solely on hematopoietic stem cell transplantation can leave hypocalcemia uncorrected with sometimes fatal consequences. Because defects in gastric differentiation and/or gastric acidification may cause or contribute to hypocalcemia, bone insufficiency, and early death, our results suggest that dietary calcium supplementation could be a life-saving intervention in these patients. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, Microbiome / 01.04.2015

Michael J Sadowsky Ph.D Director, BioTechnology Institute University of MinnesotaMedicalResearch.com Interview with: Michael J Sadowsky Ph.D Director, BioTechnology Institute University of Minnesota MedicalResearch: What is the background for this study? What are the main findings? Dr. Sadowsky: Fecal microbiota transplantation (FMT) has become increasingly common in the treatment of patients with refractory Clostridium difficile infection (CDI). It also holds promise for the treatment of medical conditions ranging from inflammatory bowel and Crohn’s disease to diabetes and metabolic syndrome. In contrast to standard antibiotic therapies, which further disrupt intestinal microflora and may contribute to the recurrence of CDI, FMT restores intestinal microbiome and healthy gut function. Despite therapeutic successes, little is known about the stability of transplanted microbiota over time. This report contributes to our understanding of the short-and long-term composition of gut microbiota following Fecal microbiota transplantation. In this study, fecal samples collected before and after treatment were compared with data from the Human Microbiome Project (HMP). Treatment using FMT resulted in the rapid normalization of microbial composition in the patient, with the post-treatment profiles closely resembling the normal distribution of fecal microbiota from the donor. While the composition of fecal microbiota in the donor and recipient varied over time, both remained in the large band characterized as normal in hundreds of healthy individuals collected as part of the HMP. Furthermore, while the composition of the microflora in Fecal microbiota transplantation recipients and donors diverges over time, the recipient profiles stay within the same dynamic range as the original implanted donor material. (more…)
Author Interviews, Gastrointestinal Disease, Nature, Nutrition / 08.03.2015

Benoit Chassaing, Ph.D. Post-Doctoral Fellow Dr. Gewirtz's lab. Institute for Biomedical Sciences Center for Inflammation, Immunity, & Infection Georgia State University Atlanta GA 30303MedicalResearch.com Interview with: Benoit Chassaing, Ph.D. Post-Doctoral Fellow Dr.  Gewirtz's lab. Institute for Biomedical Sciences Center for Inflammation, Immunity, & Infection Georgia State University Atlanta GA 30303 Medical Research: What is the background for this study? What are the main findings? Dr. Chassaing: A key feature of inflammatory bowel diseases and metabolic syndrome is alteration of the gut microbiota in a manner that promotes inflammation. Importantly, incidence of IBD and metabolic syndrome has been markedly increasing since about the mid-20th century, and this dramatic increase has occurred amidst constant human genetics, suggesting a pivotal role for an environmental factor. We considered that any modern additions to the food supply might play an important role, and addition of emulsifiers to food seems to fit the time frame of increased incidence in these diseases. We found that emulsifiers, which are added to most processed foods to aid texture and extend shelf life, can alter the gut microbiota composition and localization to induce intestinal inflammation that promotes development of inflammatory bowel disease and metabolic syndrome. (more…)
Author Interviews, Gastrointestinal Disease, mBio, Weight Research / 06.02.2015

Senior Principal Investigator - Systems Biology Singapore Institute for Clinical Sciences Brenner Centre for Molecular Medicine SingaporeMedicalResearch.com Interview with: Joanna Holbrook PhD Senior Principal Investigator - Systems Biology Singapore Institute for Clinical Sciences Brenner Centre for Molecular Medicine Singapore Medical Research: What is the background for this study? Dr. Holbrook: Bacteria in the human gut may influence many aspects of our health; however, it is not fully known what determines the composition of the gut microbiota. Rapid bacterial colonisation of the infant gut could be influenced by the environment of the baby before birth, and microbiota content has been associated with the development of obesity and insulin resistance. Medical Research: What are the main findings? Dr. Holbrook: The rate of bacterial colonisation of the gut is influenced by external factors such as the method of delivery and duration of gestation. Also, infants with a mature gut bacteria profile at an early age gained normal levels of body fat, while infants with less mature gut bacteria profiles displayed a tendency to gain lower levels of body fat at the age of 18 months, indicating that gut bacteria could be related to normal development and healthy weight gain. (more…)
Author Interviews, CDC, Gastrointestinal Disease, Infections, Pediatrics, Vaccine Studies / 04.02.2015

MedicalResearch.com Interview with: Margaret M. Cortese MD Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Cortese: The introduction of rotavirus vaccine in the United States resulted in a dramatic reduction in hospitalizations and emergency department care for rotavirus disease among young children, as well as provided indirect protection to unvaccinated peers. However, what our study looked at was whether or not older children and adults may experience indirect protection from having children in the house who are vaccinated for rotavirus. We used 2008-2012 Marketscan claims data to compare gastroenteritis rates among households whose child had received rotavirus vaccine with households whose child did not receive vaccine. We found statistically significantly lower rates of hospitalization from rotavirus gastroenteritis or unspecified-gastroenteritis in vaccinated households among all persons 20-29 years and females 20-29 years during the 2008-2009 rotavirus season as well as males 30-39 years in the 2009-2010 season. Lower emergency department gastroenteritis rates occurred in vaccinated households among females 20-29 years during the 2009-2010 season and individuals 5-19 years during the 2010-2011 season. (more…)
Alcohol, Author Interviews, Gastrointestinal Disease / 28.01.2015

Gro Askgaard MD Department of Hepatology, Copenhagen University Hospital, Rigshospitalet National Institute of Public Health, University of Southern Denmark Copenhagen DenmarkMedicalResearch.com Interview with Gro Askgaard MD Department of Hepatology, Copenhagen University Hospital, Rigshospitalet National Institute of Public Health, University of Southern Denmark Copenhagen Denmark Medical Research: What is the background for this study? Dr. Askgaard: Alcohol is the main risk factor of cirrhosis in Europe, where 1.8% of all deaths are attributable to liver disease. Alcohol amount is known to be a significant factor of development of cirrhosis - the greater alcohol amount, the greater risk. Less is known about drinking pattern - how the way you drink alcohol affects your risk. In this study we evaluated the influence of drinking frequency (drinking days/week), of lifetime alcohol consumption versus recent alcohol consumption, and alcohol type (wine, beer, liquor). (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Pediatrics / 25.01.2015

Dr Laila J Tata PhD Associate Professor in Epidemiology Faculty of Medicine & Health Sciences University of NottinghamMedicalResearch.com Interview with: Dr Laila J Tata PhD Associate Professor in Epidemiology Faculty of Medicine & Health Sciences University of Nottingham Medical Research: What is the background for this study? What are the main findings? Response: Over the last decades there has been increased clinical awareness of coeliac disease (CD) partially because of improvements in the accuracy and availability of diagnostic tests, however, we do not have current estimates of actual celiac disease diagnoses in children and it is important to know whether diagnostic patterns vary socioeconomic group. Funded by CORE/Coeliac UK and conducted at the University of Nottingham, this study analysed 2,063,421 children aged less than 18 years who were registered with general practices (primary care doctors) across the United Kingdom contributing to their routine electronic health records to The Health Improvement Network (THIN) database  between 1993 and 2012. The study found 1,247 children were diagnosed with coeliac disease, corresponding to about 1 new case in every 10,000 children each year. Girls consistently had more diagnoses than boys and whilst the incidence of new celiac disease cases among children up to age 2 years remained stable over time, diagnoses in older children almost tripled over the past 20 years. Moreover, the study found a socioeconomic gradient in celiac disease diagnoses, such that children living in less socioeconomically deprived areas were about twice as likely to be diagnosed as those from more deprived areas. This pattern held for boys and girls and for all ages. (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics / 06.01.2015

Miranda van Tilburg, PhD Associate Professor of Medicine University of North CarolinaMedicalResearch.com Interview with: Miranda van Tilburg, PhD Associate Professor of Medicine University of North Carolina Medical Research: What is the background for this study? What are the main findings? Dr. van Tilburg: Functional gastrointestinal disorders are common in children, adolescents and adults but little is known about the prevalence in infants and toddlers.  Functional gastrointestinal disorders in infancy include disorders such as regurgitation, colic, and dyschezia, while functional gastrointestinal disorders in toddlers include functional constipation, functional diarrhea, functional dyspepsia, cyclic vomiting, and rumination. Of these disorders only colic and regurgitation have received much research attention. Prevalence, cause and consequences of most functional gastrointestinal disorders in infants and toddlers are largely unknown. We set out to determine the prevalence in the US by asking a representative sample of mothers to report on their child’s symptoms. Our study found that 27% of infants and toddlers may suffer from a functional gastrointestinal disorder. Among infants, regurgitation was the most common disorder and among toddlers constipation. Despite functional gastrointestinal disorders generally being more prevalent in older girls and adult women, no sex differences were found in this age group. Toddlers who suffer from a functional gastrointestinal disorders had lower quality of life and made more health care visits. (more…)
Author Interviews, Gastrointestinal Disease, Inflammation, Metabolic Syndrome / 26.11.2014

Dr. Andrew Gewirtz PhD Professor & Associate Chair Department of Biology Georgia State UniversityMedicalResearch.com Interview with: Dr. Andrew Gewirtz PhD Professor & Associate Chair Department of Biology Georgia State University Medical Research: What is the background for this study? Dr. Gewirtz: 2010 science paper that discovered that loss of toll-like receptor 5 altered gut microbiota to drive metabolic syndrome Medical Research: What are the main findings? Dr. Gewirtz: It is loss of tlr5 on epithelial cells that alters the microbiota to make it more pro-inflammatory that drives metabolic syndrome. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, Mayo Clinic / 26.11.2014

Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale ArizonaMedicalResearch.com Interview with: Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale Arizona Medical Research: What is the background for this study? What are the main findings? Dr. DiBaise: Despite nearly 25 years of safe and effective use of proton pump inhibitors (PPI), in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use.  One such association with PPI use has been Clostridium difficile infection (CDI) which can cause severe and recurrent episodes of diarrhea.  Previous reports evaluating the microbes present within the gastrointestinal tract (ie, gut microbiome) of individuals with CDI have shown a reduction in overall microbial community diversity.  We studied the gut microbiome in healthy individuals both before and after using a proton pump inhibitors for one month and found a similar reduction in microbial diversity while taking the PPI that did not entirely revert back to the ‘normal’ baseline after being off the medication for a month.  While this does not demonstrate a causal association between proton pump inhibitors use and CDI, it demonstrates that PPI use creates a situation in the gut microbial environment that may increase the individual’s susceptibility to CDI. (more…)
Author Interviews, Erasmus, Gastrointestinal Disease, Pediatrics / 05.11.2014

MedicalResearch.com Interview with: Anne Tharner, PhD and Jessica C. Kiefte-de Jong, PhD Department of Epidemiology Erasmus Medical Center, Rotterdam The Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Constipation is one of the most common health problems in children, and occurs in most cases without organic reason. In our study, we examined if fussy eating behavior might be related to constipation in children. “Fussy eaters” are children who reject specific foods – often (green and bitter) vegetables – and often compensate this with the intake of less healthy but highly palatable foods (such as fast food or sweets). This kind of diet might be one of the reasons for constipation in children, but at the same time, children might develop difficult eating patterns due to digestive problems such as constipation. Therefore, we examined whether fussy eating and functional constipation mutually affect each other, which might point to the development of a vicious cycle. We examined this in a large study including almost 5000 children aged 2-6 years who participated in a longitudinal study in Rotterdam, the Netherlands. Families were regularly followed up starting in pregnancy. Our main finding was that fussy eating co-exists with functional constipation and also predicts subsequent development of functional constipation. In addition, we also found evidence for the reverse, as functional constipation predicted subsequent fussy eating behavior. Together with previous studies, our findings suggest that indeed a vicious cycle may develop throughout childhood in which children’s constipation problems and problematic eating behavior mutually affect each other. On the one hand, fussy eating might affect the development of functional constipation via poor dietary quality which is a characteristic for the diet of fussy eaters. On the other hand, our findings show that functional constipation in also predicts future fussy eating. This pathway is less well studied, but it is conceivable that children with constipation and the accompanying abdominal pain and painful defecation may develop problematic eating behavior. (more…)
Author Interviews, Gastrointestinal Disease / 23.10.2014

Julian Walters Professor of Gastroenterology Section of Hepatology & Gastroenterology | Imperial College London Consultant Gastroenterologist Imperial College Healthcare Hammersmith Hospital London W12 0HS | UKMedicalResearch.com Interview Invitation Julian Walters Professor of Gastroenterology Section of Hepatology & Gastroenterology | Imperial College London Consultant Gastroenterologist Imperial College Healthcare Hammersmith Hospital London W12 0HS | UK Medical Research: What is the background for this study?  What is Bile acid diarrhoea (BAD)? Dr. Walters: Bile acid diarrhoea accounts for about a third of the patients who would otherwise be diagnosed as IBS-D (irritable bowel syndrome – diarrhoea predominant).  We estimate about 1% of the adult population have this primary disorder; others may have it secondary to previous surgery such as ileal resection in Crohn’s disease or post-cholecystectomy.  There are unmet needs to improve diagnosis rates and to improve the current treatment with bile acid sequestrants which can be poorly tolerated and do not address the primary pathology.  We have shown that primary BAD patients have reduced levels of Fibroblast Growth Factor 19 (FGF19) the ileal hormone that regulates bile acid synthesis. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, JAMA / 13.10.2014

Dr. Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, MassachusettMedicalResearch.com Interview with: Dr.  Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Youngster: The main finding is that oral administration seems to be as safe and effective as more traditional routes of delivery like colonoscopy or nasogastric tube. This is important as it allows Fecal microbiota transplantation (FMT) to be performed without the need of invasive procedures, making it safer, cheaper and more accessible to patients. (more…)
Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease / 28.09.2014

Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA.MedicalResearch.com: Interview with: Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA. Medical Research: What are the main findings of the study? Dr. Thrift: We conclude that height is inversely associated with risk of esophageal adenocarcinoma, both in men and women. The association is not due to confounding from known risk factors or bias. (more…)
Author Interviews, Gastrointestinal Disease, General Medicine, Surgical Research / 13.09.2014

Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of MichiganMedicalResearch.com Interview with: Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of Michigan MedicalResearch.com Editor’s note: American Medical Systems Inc. (AMS), a subsidiary of Endo International plc (Nasdaq: ENDP) (TSX: ENL), released top-line results from its TRANSFORM study that show the investigational TOPAS™ System improves fecal incontinence in women. The results show that over a 12 month period, 69% of women suffering from fecal incontinence who were implanted with the TOPAS™ System experienced at least a 50% reduction in weekly incontinence episodes and experienced a durable, consistent effect across the study period. The results were presented in Cape Town, South Africa at the International Society of University Colon & Rectal Surgeon (ISUCRS) Congress. Dr. Fenner, a primary investigator of the study, kindly answered the questions below: Medical Research: How common/prevalent is the problem of fecal incontinence in women? Dr. Fenner: Fecal incontinence, also known as accidental bowel leakage (ABL), is estimated to affect nearly 11 million women and 10% of women over the age of 20 in the United States.1,2 Additionally, nearly one in five women over the age of 45 experience ABL at least once a year.3 (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA, Mayo Clinic / 11.09.2014

Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, MinnesotaMedicalResearch.com Interview with: Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, Minnesota Medical Research:  What are the main findings of the study? Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD. (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics / 03.09.2014

MedicalResearch.com Interview with: Cade M. Nylund, MD, MS, FAAP Major, United States Air Force, Medical Corps Assistant Professor of Pediatrics F. Edward Hébert School of Medicine Uniformed Services University Bethesda, Maryland
Medical Research: What are the main findings of the study? Dr. Nylund: The main findings of our study were that among children who were identified as having a diagnosis of Clostridium difficile infection (CDI), CDI was about twice as likely to occur during periods when the child was taking either a proton pump inhibitor or histamine-2 receptor antagonist. In brief, we performed a type of observational study called a self-controlled case series. Our data source was the military health system database which contains billing records for patients seen in military and civilian facilities. We identified all cases of Clostridium difficile infections in children ages 2-18 over the period of October 2001 to July 2013. We also identified periods when children were prescribed both proton pump inhibitors and histamine-2 receptor antagonists over the same time period. We compared the incidence of CDI during periods prescribed acid suppression medications to periods not prescribed these medications. (more…)
Author Interviews, Gastrointestinal Disease, mBio / 04.08.2014

Dr. Sridhar Mani MD Departments of Genetics and Medicine Albert Einstein College of Medicine, Bronx, NY 10461MedicalResearch.com Interview with: Dr. Sridhar Mani MD Departments of Genetics and Medicine Albert Einstein College of Medicine Bronx, NY 10461

  Medical Research: What are the main findings of the study? Dr. Mani: In a series of studies using cells grown in the lab and mouse studies, the researchers found that a metabolite called indole 3-propionic acid (IPA)—produced exclusively by so-called commensal bacteria —both strengthens the intestinal epithelium’s barrier function and prevents its inflammation by activating an orphan nuclear receptor, Pregnane X Receptor (PXR). Specifically, PXR activation suppresses production of an inflammatory protein called tumor necrosis factor alpha (TNF-á) while increasing levels of a protein that strengthens the junctions between intestinal epithelial cells (makes the intestines less permeable to noxious substances). Loss of PXR protein and/or IPA results in a disrupted intestinal barrier and increased propensity towards intestinal inflammation and/or toxin induced injury to the intestines. (more…)
Author Interviews, Gastrointestinal Disease, Genetic Research, NEJM, Pediatrics / 03.07.2014

Dr. Daniel AgardhMedicalResearch.com Interview with: Dr. Daniel Agardh M.D., Ph.D Department of Pediatrics Diabetes and Celiac Disease Unit Skåne University Hospital Malmo, Sweden, MedicalResearch: What are the main findings of the study? Dr. Agardh: In this study, we stratify the risk of celiac disease among children according to their HLA genotype and country of residence. We confirm that HLA-DQ2/2 genotype is the major risk factor for early celiac disease, but also show how the risk differs between the participating countries despite of sharing similar HLA risk. This points to the direction of an interaction between HLA and the environment that eventually lead to an autoimmune response in genetic susceptible children. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease / 18.06.2014

Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch.com Interview with: Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch: What are the main findings of the study? Dr. Andersen: Previous studies evaluating the risk of cancer associated with the use of TNF-α antagonists are mainly based on data from randomized clinical trials with a short follow up time. Consequently, we used the national Danish registries to conduct a nationwide population-based cohort study assessing the risk of cancer in patients with inflammatory bowel disease (IBD) exposed to these drugs from their introduction in 1999 until 2012. We included more than 56.000 patients with IBD and among those 4500 were exposed to TNF-α antagonists, contributing with almost 20.000 person-years of follow-up. Our main results revealed that the risk of overall cancer was significantly increased in the analysis adjusted for propensity score and potential confounders except for azathioprine, however, when we additionally adjusted for azathioprine use the relative risk decreased markedly leaving no significant increased risk of cancer. Given the upper limit of the confidence intervals, this study could rule out a more than 36% relative increase in the risk of overall cancer over a median follow-up of 3.7 years among TNF-α antagonist-exposed patients with 25% of these followed for 6 years or longer. We also did some stratified analyses according to cumulative number of TNF-α inhibitor doses, and time since first TNF-α inhibitor dose, but these results did not reveal any significantly increased risk of cancer nor did the analyses on site-specific cancers. (more…)
Author Interviews, Gastrointestinal Disease, NEJM, Pain Research, University of Michigan / 11.06.2014

William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health SystemMedicalResearch.com Interview with: William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health System MedicalResearch: What are the main findings of the study? Dr. Chey: Opiate analgesics are the most commonly prescribed medications in the US. GI side effects are common in patients who opiates. Constipation is the most common and most bothersome GI side effect of opiates. Peripherally acting mu opioid antagonists have been shown to benefit a subset of patients with opiate induced constipation. In 2 large, randomized, placebo controlled phase III trials, the peripherally acting, mu-opioid antagonist naloxegol was found to improve constipation in patients taking opioid analgesics for noncancer pain. Response rates were significantly higher with 25 mg of naloxegol than with placebo (intention-to-treat population: study 04, 44.4% vs. 29.4%, P = 0.001; study 05, 39.7% vs. 29.3%, P = 0.02) in both studies. Benefits were seen with the lower 12.5 mg dose in one of the studies (intention-to-treat population, 40.8% vs. 29.4%, P = 0.02). An interesting aspect of this study was the a priori inclusion of patients who had tried and failed to respond to other laxatives prior to enrollment. Response rates in this population were similar to the overall population (patients with an inadequate response to laxatives: study 04, 48.7% vs. 28.8%, P = 0.002; study 05, 46.8% vs. 31.4%, P = 0.01). Pain scores and daily opioid dosing were similar among the three groups before and after treatment. (more…)
Author Interviews, Circadian Rhythm, Gastrointestinal Disease, Sugar / 23.05.2014

Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, IllinoisMedicalResearch.com Interview with: Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, Illinois MedicalResearch: What are the main findings of the study?  Dr. Voigt: We found that chronic circadian rhythm disruption has no effect on the intestinal microbiota when mice are fed a standard chow diet but when combined with a high-fat, high-sugar diet circadian rhythm disruption results in intestinal dysbiosis and an increase in pro-inflammatory bacteria. (more…)
Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease, NEJM / 05.05.2014

Stefan Zeuzem, M.D. Professor of Medicine, Chief Department of Medicine JW Goethe University Hospital Frankfurt GermanyMedicalResearch.com Interview with: Stefan Zeuzem, M.D. Professor of Medicine, Chief Department of Medicine JW Goethe University Hospital Frankfurt Germany   MedicalResearch.com: What are the main findings of the study? Dr. Zeuzem: Main finding is that also patients infected with HCV 3 can be cured with an IFN-free regimen. However, duration of therapy must be prolonged to 24 weeks. (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Transplantation / 29.04.2014

Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UKMedicalResearch.com Interview with: Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we compared the basic energy metabolism of liver grafts obtained from conventional and widely practiced form of organ donation, the donation after brain death (DBD) donors, and recently revived form of organ donation called donation after circulatory death (DCD) donors. To introduce a background to this study - DCD liver grafts are perceived as marginal liver grafts, owing to the basic differences surrounding the organ donation. DCD organs suffer a period of warm ischemia from the time of treatment withdrawal in a potential donor up until the organs are actually recovered and preservation is initiated. Although the DCD liver grafts have supplemented the donor organ pool, the initial and short-term results following liver transplantation are comparatively poor and these differences are attributable to the donor warm ischemia. However there were no studies in the literature examining the energy status of DCD liver grafts and our study is the first such study. (more…)
Author Interviews, Coffee, Gastrointestinal Disease, Hepatitis - Liver Disease / 03.04.2014

Woon-Puay Koh (Associate Professor) Office of Clinical Sciences Duke-NUS Graduate Medical School Singapore 8 College Road Level 4 | Singapore 169857MedicalResearch.com Interview with: Woon-Puay Koh (Associate Professor) Office of Clinical Sciences Duke-NUS Graduate Medical School Singapore 8 College Road Level 4 | Singapore 169857   MedicalResearch.com:  What are the main findings of the study? Answer: The main finding is that coffee intake was associated with a lower risk of death from cirrhosis, specifically for non-viral hepatitis related cirrhosis. Subjects who drank two or more cups per day had a 66% reduction in mortality risk, compared to non-daily coffee drinkers. However, coffee intake was not associated with viral hepatitis B related cirrhosis mortality. (more…)
Author Interviews, Gastrointestinal Disease, General Medicine, Weight Research / 02.04.2014

Shanthi Srinivasan, M.D. Associate Professor of Medicine Division of Digestive Diseases Department of Medicine Emory University Atlanta, GA 30322MedicalResearch.com Interview with: Shanthi Srinivasan, M.D. Associate Professor of Medicine Division of Digestive Diseases Department of Medicine Emory University Atlanta, GA 30322   MedicalResearch.com: What are the main findings of the study? Dr. Srinivasan: The main findings of this study are that the neurotrophic factor GDNF is was able to protect against the weight gain induced by mice on a high fat diet. The mice that had overexpression of GDNF showed less weight gain while eating the same high fat diet as the control mice. GDNF seems to have effects on the genes regulating fat metabolism and energy expenditure and this could be the mechanism of prevention of weight gain. (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Pediatrics, Probiotics / 02.04.2014

Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health, The Royal Children’s HospitalMedicalResearch.com Invitation with: Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health The Royal Children’s Hospital MedicalResearch.com: What are the main findings of the study? Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this. (more…)