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.
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MedicalResearch.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…)
MedicalResearch.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.
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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.
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MedicalResearch.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.
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MedicalResearch.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.
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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.
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MedicalResearch.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…)
MedicalResearch.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.
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MedicalResearch.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…)
MedicalResearch.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.
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MedicalResearch.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.
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MedicalResearch.com Interview with:
Shanthi Srinivasan, M.D. Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University Atlanta, GA 30322MedicalResearch.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…)
MedicalResearch.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.
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MedicalResearch.com Interview with:Marie Lund MD, PhD student
Department of Epidemiology Research
København S | Denmark
MedicalResearch.com: What are the main findings of the study?Dr. Lund: We found macrolide use in infants to be associated with a 30-fold increased risk of infantile hypertrophic pyloric stenosis (IHPS) with use during the first two weeks after birth and a lower, but significantly increased threefold risk with use during days 14 to 120. Similarly, there was a more than three-fold increased risk of IHPS associated with maternal macrolide use during the first two weeks after birth, but no increased risk with use thereafter. Finally, we found a possible modest association between maternal macrolide use during weeks 28 to birth and infantile hypertrophic pyloric stenosis.
(more…)
MedicalResearch.com Interview with: Elizabeth C. Wick, MD
Assistant Professor,Department of Surgery
The Johns Hopkins Hospital, Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?Dr. Wick: The main finding is the high variability in physician practice for prescribing steroids and the lack of clear guidance as to best practice in the literature.
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MedicalResearch.com Interview with:Jiyoung Ahn, PhD
Assistant Professor of Epidemiology
Department of Population Health
NYU School of Medicine
New York, NY 10016
MedicalResearch.com: What are the main findings of the study?Dr. Ahn: Before we did our research, it was suspected that gut bacteria were related to colorectal cancer. We, for the first time, found colorectal cancer patients have a different gut bacteria composition than healthy subjects.
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MedicalResearch.com Interview with:Norbert Stefan, MD
Heisenberg Professorship for Clinical and Experimental Diabetology
Department of Internal Medicine IV
University Hospital Tübingen
Tübingen, Germany
MedicalResearch.com: What are the main findings of the study?Dr. Stefan: Currently there is little evidence for an effective and safe pharmacological treatment of nonalcoholic fatty liver disease (NAFLD). Based on the fact that inhibition of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), the enzyme, that converts inactive cortisone into active cortisol in metabolic tissues such as liver and adipose, was found to be effective to improve lipid metabolism in animals, we hypothesized that inhibition of 11β-HSD1 may also prove to be effective to decrease liver fat content in patients with NAFLD. In our 12 week trial in 82 patients with NAFLD, inhibition of 11β-HSD1 with RO5093151 resulted in a 14 % decrease of liver fat content and in a resolution of NAFLD in 20 % of the patients. This was accompanied by a decrease of liver enzymes. Furthermore, inhibition of 11β-HSD1 brought about a reduction of body weight and total body- and visceral adipose tissue mass, while insulin sensitivity did not change. In agreement with findings from other trials, also in our study 11β-HSD1 inhibition was well tolerated and safe.
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MedicalResearch.com Interview with: Jim Tsung, MD, MPH
Department of Emergency Medicine
Mount Sinai School of Medicine
Guggenheim Pavilion
New York, NY 10029
MedicalResearch.com: What are the main findings of the study?
Dr. Tsung:
1. Point-of-care ultrasound performed by clinicians was as accurate as ultrasound performed in the radiology department for evaluating appendicitis in children.
2. This led to significant reductions in emergency department stays when point-of-care ultrasound was able to contribute to the decision to send the patient to the operating room or to discharge home without further imaging studies. On average, a 2 hour (46%) reduction in ED LOS for patients only requiring radiology ultrasound and a 6 hour (68%) reduction in ED LOS for patients that needed CT scan.
3. Point-of-care ultrasound can also reduce the rate of CT scans obtained when used as a front-line test, 44% to 27%.
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MedicalResearch.com Interview with: Stephanie Angione
PhD Candidate
Brown University School of Engineering
Center for Biomedical Engineering
MedicalResearch.com: What are the main findings of the study?Answer: This study demonstrates the application of a novel nucleic acid detection platform to detect Clostridium difficile (C. difficile)in subjects presenting with acute diarrheal symptoms. This method amplifies three genes associated with C. difficile infection as well as genes associated with virulence attributed to the NAP1/027/BI strain. The novel PCR assay allows for simple and rapid detection of three C. difficile genes: tcdB, cdtB, and tcdC, which code for C. difficile toxin B, C. difficile binary toxin, and a protein suspected to regulate toxin production, which includes the NAP1/027/BI tcdC variant. Amplification of DNA from the tcdB, tcdC and cdtB genes can be carried out using a droplet sandwich platform that performs real-time polymerase chain reaction (PCR) in microliter droplets for the detection and identification of amplified fragments of DNA. Our technique of multiplex gene amplification provides a unique method that is both sensitive and specific to rapidly detect C. difficile in patient stool samples that can be adapted to point-of-care testing. (more…)
MedicalResearch.com Interview with: W. Katherine Yih Ph.D., M.P.H
Department of Population Medicine
Harvard Medical School and Harvard Pilgrim Health Care Institute
MedicalResearch.com: What are the main findings of the study?Dr. Yih: The main findings are that vaccination with the first dose of RotaTeq is associated with a small increase in the risk of intussusception, which is concentrated in the first week after vaccination. The estimated risk is about 1.5 excess cases per 100,000 first doses administered. This risk is fairly small, amounting to roughly 1/10 of the risk seen after the original rotavirus vaccine (called Rotashield) that was used in 1998-1999, before it was withdrawn from the market.
We also found evidence that Rotarix increases the risk of intussusception. However, the number of infants receiving Rotarix and the number getting intussusception after Rotarix were too small to allow us to estimate the risk after Rotarix with any precision. (more…)
MedicalResearch.com Interview with Eric S. Weintraub, M.P.H.
Epidemiologist at Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1). We examined the risk of intussusception following RV1 vaccination in a U.S. population. In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness.
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MedicalResearch.com Interview with: Flavia Indrio, MD
Department of Pediatrics
Aldo Moro University of Bari
Bari, ItalyMedicalResearch.com: What are the main findings of the study?Answer:The main finding is that for the first time the use in prevention instead of treatment with a probiotic for the colic regurgitation and constipation.
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MedicalResearch.com Interview with: Chia-Hung Kao, MD
Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taiwan.
MedicalResearch.com: What are the main findings of the study?Answer: Colonic diverticular disease and colorectal cancer shared certain characteristics. Some previous studies aimed to identify their epidemiological correlation. However, their results were discrepant and insufficiently strong to draw firm conclusion. In our nationwide population-based retrospective cohort study, we found that the previously diagnosed colonic diverticular disease is not associated with an elevated risk of colorectal cancer after the first year of a diagnosis of colonic diverticular disease (adjusted HR, 0.96). The increased risk in the first year may be due to misclassification and screening effect.
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MedicalResearch.com Interview Invitation withHenry P. Parkman, MD
Professor, Medicine
Director, GI Motility Laboratory
Temple University, Philadelphia, Pennsylvania
MedicalResearch.com: What are the main findings of the study?Dr. Parkman: Gastroparesis remains a challenging syndrome to manage with few effective treatments and a lack of rigorously controlled trials. Tricyclic
antidepressants are often used to treat refractory symptoms of nausea,
vomiting, and abdominal pain. Evidence from well-designed studies for this
is lacking.
However, in this study, among patients with idiopathic gastroparesis, the
use of nortriptyline compared with placebo for 15 weeks did not result in
improvement in overall symptoms. These findings do not support the use of
nortriptyline for idiopathic gastroparesis.
(more…)
MedicalResearch.com Interview with:Nita Ahuja, MD
Departments of Surgery and Oncology,
Johns Hopkins University School of Medicine
Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?Dr. Ahuja: Across the nation, laparoscopic colectomy is performed about as frequently as open colectomy, despite being associated with a lower complication rate and a lower overall hospital cost. On the other hand, an exponentially growing prevalence was found with robotic colectomy, a procedure that has so far demonstrated only equivalent outcomes with laparoscopic colectomy but a higher overall cost.
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MedicalResearch.com Interview with:Harrys A. Torres, MD, FACP
Assistant Professor, Director of Hepatitis C Clinic
Department of Infectious Diseases, Infection Control and Employee Health
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What are the main findings of the study?Dr. Torres:The main findings of the study were that patients with hepatitis C virus (HCV) infection who were successfully treated with antivirals and attained sustained virologic response (SVR) did not have a relapse of HCV infection after receiving immunosuppressive chemotherapy for cancer. Patients in the study received different chemotherapeutic agents, including rituximab and systemic corticosteroids. Durability of SVR was maintained up to 14 years after chemotherapy in cancer patients.
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MedicalResearch.com Interview with:Rachel Patzer, PhD, MPH
Assistant Professor
Emory University School of Medicine
Department of Surgery, Division of Transplantation
MedicalResearch.com: What are the main findings of the study?Dr. Patzer: We found significant racial/ethnic differences in important health outcomes among pediatric and adolescent patients who received a liver transplantation at a large transplant center in the Southeastern U.S., where rates of mortality and graft failure were higher among minorities compared to white patients.
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MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
Trieste, Italy
MedicalResearch.com: What are the main findings of the study?Answer: In children and adolescent with Crohn’s disease refractory to first and second line treatment, thalidomide was effective in inducing and maintaining clinical remission. About 60% of children achieved clinical remission, and clinical remission was maintained for a mean time of 180 weeks. The main reason to stop thalidomide was peripheral neuropathy.
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MedicalResearch.com Interview with:Li-Shu Wang, PhD
Department of Medicine, Medical College of Wisconsin,
Milwaukee, WisconsinMedicalResearch.com: What are the main findings of the study?Answer:Ulcerative colitis (UC) is frequently an intermediate step to colon cancer. The interleukin-10 knock-out (KO) mouse is a genetic model of this progression. We have now shown that KO mice fed 5% black raspberries (BRBs) had significantly less colonic ulceration as compared to KO mice that consumed the control diet. Dysfunction of the Wnt signaling pathway is a key event in UC-associated colon carcinogenesis. We investigated the effects of BRBs on the Wnt pathway and found that the BRB-fed KO mice exhibited significantly decreased promoter methylation of Wnt antagonists and a significantly lower level of β-catenin nuclear translocation. Our results suggest that BRBs inhibit colonic ulceration partly through inhibiting aberrant epigenetic events that dysregulate Wnt signaling.
(more…)
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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…)
