Few Teen Moms Protect Themselves with Condoms and Long Acting Contraceptives

MedicalResearch.com Interview with:
Lee Warner, PhD

Chief of the Women’s Health and Fertility Branch
Division of Reproductive Health
CDC

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

Response: Previous research has found lower prevalence of condom use combined with the most effective reversible contraceptive methods among teens, but this is the first study to our knowledge to confirm the finding among sexually active teen mothers in the postpartum period.

Our new paper finds that only 3 in 10 postpartum teen mothers report using condoms combined with a more effective contraceptive method (either long-acting reversible contraception or LARC or a non-LARC hormonal method). Dual use was 50 percent lower among LARC users compared with users of non-LARC hormonal methods.

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T2Bacteria Panel Can Detect Blood Stream Infections in Hours, not Days

MedicalResearch.com Interview with:

Minh-Hong Nguyen, MDInfectious DiseasesProfessor of MedicineDirector, Transplant Infectious DiseasesDirector, Antimicrobial Management ProgramDepartment of Medicine University of Pittsburgh School of Medicine

Dr, Minh-Hong Nguyen

Minh-Hong Nguyen, MD
Infectious Diseases
Professor of Medicine
Director, Transplant Infectious Diseases
Director, Antimicrobial Management Program
Department of Medicine
University of Pittsburgh School of Medicine

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

Response: Blood cultures, the gold standard for diagnosing blood stream infections, are insensitive and limited by prolonged time to results. Early institution of appropriate antibiotics is a crucial determinant of improved outcomes in patients with sepsis and blood stream infections (BSI). For these reasons, development of rapid non-culture diagnostic tests for blood stream infections is a top priority.

The T2Bacteria panel is the first direct from blood, non-culture test cleared by FDA for diagnosis of blood stream infections .  It detects within 4-6 hours the 5 most common ESKAPE bacteria that are frequent causes of hospital infection, and which are often multi-drug resistant.  This study shows that the T2Bacteria panel rapidly and accurately diagnosed and identified ESKAPE bacterial BSIs, and identified probable and possible BSIs that were missed by blood cultures (in particular among patients who were already receiving antibiotics).

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HPV6 Serology Associated with Bladder Cancer

MedicalResearch.com Interview with:

Lael S. Reinstatler, MD, MPH.PGY 4 Urology ResidencyDartmouth Hitchcock

Dr. Reinstatler


Lael S
Reinstatler, MD, MPH.
PGY 4 Urology Residency
Dartmouth Hitchcock

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

Response: Human Papillomavirus is an oncogenic virus associated with other genitourinary cancers including penile cancer.

HPV is detectable in urine and in urethral swabs and it interacts with stratified squamous epithelium which lines the majority of the genitourinary tract. Prior research has identified HPV in bladder tumors but detection methods are inconsistent.

In this study, we looked for an association with HPV serology (indicating prior HPV systemic exposure) and bladder cancer.

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Novel Lantibiotic Against C. diff Infections May Improve Lipid Profile

MedicalResearch.com Interview with:

Rajesh Kumar NV, Ph.D.Affiliation during the study:Senior Manager, Human Therapeutics Division,Intrexon Corporation, Germantown, MD, USA

Dr. Rajesh Kumar NV

Rajesh Kumar NV, Ph.D.
Affiliation during the study:
Senior Manager, Human Therapeutics Division,
Intrexon Corporation, Germantown, MD, USA
Current affiliation:
Translational Research Program Manager, Oncology Drug Discovery,
Department of Radiation Oncology and Molecular Radiation Sciences,
Johns Hopkins University School of Medicine
Baltimore, MD,  


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

Response: Clostridium difficile is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Clostridium difficile infection is the most frequent form of colitis in hospitals and nursing homes and affects millions of patients in the United States and abroad. Clostridium difficile associated disease (CDAD) is a global public health challenge where even mild to moderate infections at times can quickly progress to a fatal disease if not treated promptly.

OG253 is a novel lantibiotic in development for the treatment of CDAD. Lantibiotics are antimicrobial peptides whose chemical structure includes a bridge maintained by the non-canonical amino acid lanthionine. The primary objective of our study was to evaluate the repeated dose toxicokinetics and any possible side effects of OG253 as enteric-coated capsules following daily oral administrations of three different doses (6.75, 27 and 108 mg/day) for a single day or seven consecutive days in both genders of rats.

An enteric-coated capsule of OG253 was formulated in an attempt to circumvent the proteolytic degradation of OG253 in the upper digestive tract and specifically deliver this lantibiotic to the distal portion of the small intestine. Continue reading

Bat Borne Nipah Virus Transmitted by Human Secretions

MedicalResearch.com Interview with:

Birgit Nikolay PhDMATHEMATICAL MODELLING OF INFECTIOUS DISEASESInstitut Pasteur

Dr. Nikolay

Birgit Nikolay PhD
MATHEMATICAL MODELLING OF INFECTIOUS DISEASES
Institut Pasteur 

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

Response: Nipah virus was identified by the World Health Organization as an emerging infectious disease that may cause major epidemics if the pathogen evolves to become more transmissible, leading the organization to prioritize it for research to prevent future health emergencies. In the absence of efficient treatments or vaccines, the only way to control Nipah virus outbreaks is through targeted interventions that limit opportunities of spread. Designing such interventions is challenging in a context where transmission mechanisms remain poorly understood. The study provides important insights to better understand these mechanisms.

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Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning Methods

Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning MethodsThe number of deaths caused by resistant bacteria is expected to reach 10 million by 2025, according to the Centers of Disease Control and Prevention. A highly resistant bacteria found in hospitals – Klebsiella pneumoniae – is now a big global threat, according to a recent (April, 2019) study published by researchers from University College London. Researchers have issued a warning that more stringent cleaning of infectious wards and new air disinfection protocols are key to battling the bug. This is because this bacteria possesses the ability to change genetically at an alarming rate, adapting and essentially nullifying the effect of all current antibiotics.

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West Nile Virus: Lag Time in Reporting Precludes Accurate Public Health Decisions

MedicalResearch.com Interview with:

Nicholas B. DeFelice, PhDDepartment of Environmental Medicine & Public HealthIcahn School of Medicine at Mount SinaiNew York, New York

Dr. DeFelice

Nicholas B. DeFelice, PhD
Department of Environmental Medicine & Public Health
Icahn School of Medicine at Mount Sinai
New York, New York

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

Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions.

We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported.

For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help

1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding),

2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and

3) identify when to intensify blood donor screening. Continue reading

How Long Does Protection from DTaP Vaccination Last?

MedicalResearch.com Interview with:

Dr. Matthieu Domenech de Cellès PhDBiostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines,Versailles, France

Dr. Domenech de Cellès

Dr. Matthieu Domenech de Cellès PhD
Biostatistics, Biomathematics, Pharmacoepidemiology, and
Infectious Diseases Unit, Institut Pasteur, Inserm U1181,
University of Versailles St-Quentin-en-Yvelines,
Versailles, France

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

Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination.

Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex.

In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    Continue reading

Early Childhood Infections Associated With Eating Disorders In Adolescence

MedicalResearch.com Interview with:

Lauren Breithaupt, PhDDepartment of PsychologyGeorge Mason UniversityFairfax, Virginia

Dr. Breithaupt

Lauren Breithaupt, PhD
Department of Psychology
George Mason University
Fairfax, Virginia 

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

Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders.

We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    Continue reading

Travelers Can Bring Home Drug-Resistant Bacteria as Souvenirs from Low and Middle Income Countries

MedicalResearch.com Interview with:

Lynn Meurs, PhDEPIET fellow at Robert Koch InstituteEuropean Centre for Disease Prevention and ControlGermany

Dr. Meurs

Lynn Meurs, PhD
EPIET fellow at Robert Koch Institute
European Centre for Disease Prevention and Control
Germany

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

Response: It is unknown how Enterobacteriaceae (ESBL) -producing bacteria are spread, but several studies have shown that intercontinental travellers often return home with these drug-resistant bacteria.

The aim of our study was to investigate into more detail what causes colonisation with these bacteria in people travelling to low and/or middle-income countries  (LMICs) in the tropics and subtropics. We found that out of the travellers that were ESBL-negative before travelling, 23% of returned with ESBL-producing bacteria. In line with previous studies, we found that travelling to Eastern, Southern, and Western Asia is associated with ESBL colonisation.

Unexpectedly, we furthermore found that staying in a hotel as well as in private accommodation as compared to other types of commercial accommodation such as hostels, camping or guesthouses, was associated with the colonisation with these drug-resistant bacteria. Continue reading

MSM: Microbes Associated with Sexual Behavior Can Alter Immune System to Increase HIV Risk

MedicalResearch.com Interview with:

Brent E. Palmer, PhDAssociate Professor of MedicineDirector, ClinImmune and ACI/ID Flow Cytometry FacilityDivision of Allergy and Clinical ImmunologyAurora, Colorado 80045

Brent Palmer

Brent E. Palmer, PhD
Associate Professor of Medicine
Director, ClinImmune and ACI/ID Flow Cytometry Facility
Division of Allergy and Clinical Immunology
University of Colorado Anschutz Medical College
Aurora, Colorado 80045 

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

Response: Previous studies showed that in western populations, men who have sex with men (MSM) have a distinct gut microbiome composition when compared with men who have sex with women (MSW).

We wanted to understand how these microbiome differences in MSM could impact their immune system. To test this, we transferred feces from healthy MSW and MSM to gnotobiotic (germ-free) mice and examined the immune system in the mice post-transplant. In mice that received transfers from MSM, there were higher frequencies of activated T cells in gut tissues, which are the primary targets of HIV.

This result suggested that gut microbes associated with MSM sexual behavior may actually contribute to HIV transmission by driving activation of HIV target cells. In fact, when we stimulated human gut derived cells with gut microbes isolated from MSM and MSW, cells that were stimulated with microbes from MSM were infected at a higher rate.

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ASPECT-NP: Randomized, Double-Blind, Phase III Trial Comparing Efficacy & Safety of Ceftolozane/Tazobactam vs Meropenem in Ventilated Nosocomial Pneumonia

MedicalResearch.com Interview with:

Dr. Elizabeth Rhee MD Director, Infectious Disease Clinical Research at Merck

Dr. Rhee

Elizabeth Rhee, MD
Executive Director, Infectious Disease Clinical Research
Merck Research Laboratories

MedicalResearch.com: What is the background for this study? Would you briefly explain the condition of ventilated nosocomial pneumonias?

Dr. Rhee: Nosocomial pneumonia (NP) is a lung infection that occurs during a hospital stay. NP is often serious, and is associated with high mortality. It is one of the most common health-care associated infections in both the U.S. and Europe, accounting for over 20% of such cases. Gram-negative bacteria, mainly Pseudomonas aeruginosa (PSA) and Enterobacteriaceae, are frequent causes of nosocomial pneumonia. Limited options currently exist for the management of NP caused by Gram-negative pathogens. This is concerning because rates of resistance to Gram-negative bacteria are growing, and they are becoming increasingly difficult to treat.

Forms of nosocomial pneumonia include hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and ventilated HAP. High rates of death (ranging from 20% to more than 50%) are especially associated with ventilated HAP. Pseudomonas aeruginosa, a Gram-negative bacterium, is the most common cause of HAP/VAP in both the U.S. and Europe. Patients with NP are often critically ill, requiring ventilator support and time in intensive care, and it was important to look at this population as we explore new options for the treatment of NP.

Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin/beta-lactamase inhibitor combination with broad in vitro activity against Gram-negative pathogens, including multi-drug resistant (MDR) P. aeruginosa and many extended-spectrum beta-lactamase (ESBL) producers. It is FDA approved for complicated intra-abdominal and urinary tract infections in adults at 1.5g (1g ceftolozane/0.5g tazobactam) q8h. C/T is currently being studied at an investigational new dose of 3g (2g/1g) q8h, for the treatment of ventilated nosocomial pneumonia, in the ASPECT-NP Phase 3 trial.

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Lack of HPV Vaccination in Young Minority Men Is Not a Matter of Access

MedicalResearch.com Interview with:
Perry N Halkitis, PhD, MS, MPH
Dean and Professor
Department of Urban-Global Public Health
Rutgers Public Health 

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

Response: The rate of human papillomavirus (HPV) infection is high among young minority gay, bisexual, and other men who have sex with men despite the availability of a vaccine that can prevent the infection, a Rutgers School of Public Health study found.

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Massive Reduction in Cervical Cancer Among Vaccinated Young Women

MedicalResearch.com Interview with:

Dr. Tim PalmerHonorary Senior LecturerDepartment of PathologyUniversity of EdinburghEdinburgh, UK

Dr. Palmer

Dr. Tim Palmer
Honorary Senior Lecturer
Department of Pathology
University of Edinburgh
Edinburgh, UK 

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

Response: High risk HPV infection is the obligate cause of between 70 and 90% of cervical cancers, depending upon the country. The development of vaccines against the commonest hr-HPV types has the potential to reduce the burden of cervical cancer, especially in low and middle income countries that cannot afford screening programmes. Cervical cancer affects predominantly women in their 30s and is a major public health issue even in countries with well-established screening programmes. Scotland has had a successful immunisation programme since 2008, and women immunised at age 12 to13 have been screened since 2015. We can therefore demonstrate the effect of hr-HPV immunisation on the pre-invasive stages of cervical cancer.

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Therapeutic HPV Vaccine Can Trigger Resolution of Virus and Cervical Cancer in Some CIN Patients

MedicalResearch.com Interview with:

Diane Harper, M.D., M.P.H., M.S.Professor of Family Medicine and Obstetrics and GynecologySenior Associate Director, Michigan Institute for Clinical and Health ResearchPhysician Director for Community Outreach, Engagement and Health Disparities,Rogel Cancer CenterMichigan Medicine

Dr. Harper

Diane Harper, M.D., M.P.H., M.S.
Professor of Family Medicine and Obstetrics and Gynecology
Senior Associate Director, Michigan Institute for Clinical and Health Research
Physician Director for Community Outreach, Engagement and Health Disparities,
Rogel Cancer Center
Michigan Medicine 

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

Response: There is no current cure for women with HPV infection that has progressed to CIN 2/3 disease. The only treatment is for the diseased cervix, and does not eliminate the risk of another CIN 2/3 from the HPV infection 15-20 years later.

This vaccine is made from a live virus that has 3 genes inserted:  human cytokine IL-2, and modified forms of HPV 16 E6 and E7 proteins. When the vaccine is injected subcutaneously, the proteins for HPV 16/E6 and E7 and the cytokine LI-2 proteins are made. These proteins trigger the immune response.  This is very different form imiquimod which is topical and not specific for HPV.

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HPV Vaccination Rates Low Among Adults at High-Risk for HIV Infection

MedicalResearch.com Interview with:

Lisa T. Wigfall, PhD, MCHES(R)Assistant Professor, Health and KinesiologyTexas A&M

Dr. Wigfall

Lisa T. Wigfall, PhD, MCHES(R)
Assistant Professor, Health and Kinesiology
Texas A&M

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

Response: Human papilloma virus (or HPV) is a very common sexually transmitted infection that can cause some types of cancer. These include anal, cervical, oral, penile, vaginal, and vulvar cancers. Some people such as people who are HIV-positive and men who have sex with men have a greater risk for developing HPV-associated cancers. The risk of developing anal cancer is significantly higher for men who have sex with men who are also HIV-positive.

Our study included adults who were at risk for becoming HIV-positive, which included having unprotected anal sex.

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Ebola Fight Hampered by Misinformation and Mistrust

MedicalResearch.com Interview with:

Patrick Vinck, PhDResearch Director, Harvard Humanitarian InitiativeAssistant Professor, Global Health and Population T.H. Chan Harvard School of Public Health; Emergency MedicineHarvard Medical SchoolLead Investigator, Brigham & Women's Hospital 

Dr. Vinck

Patrick Vinck, PhD
Research Director, Harvard Humanitarian Initiative
Assistant Professor, Global Health and Population
T.H. Chan Harvard School of Public Health; Emergency Medicine
Harvard Medical School
Lead Investigator, Brigham & Women’s Hospital 

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

Response: The second worst epidemic of Ebola on record is currently unfolding in the eastern part of the Democratic Republic of the Congo. Whether or not safe practices are implemented to prevent the spread of the epidemic is influenced by the behavior of individuals at-risk of contracting the Ebola Virus Disease (EVD) –

Will they follow the recommendations of health professionals? Will they report suspected cases and deaths? Will they seek treatment from health professionals? Will they accept vaccines and adopt preventive behaviors?

We find that belief in misinformation about Ebola is widespread and trust in authorities is generally low, likely as a result of decades of violence and poor governance and, more recently, the politicization of the Ebola response.

Our analysis shows that trust and (mis-)information influence adherence to risk avoidance behavior and acceptance of vaccination.

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Flu Linked to Marked Increase in Heart Failure Admissions

MedicalResearch.com Interview with:

Sonja Kytomaa MAResearch AssociateBrigham and Women’s Hospital

Sonja Kytomaa

Sonja Kytomaa MA
Research Associate
Brigham and Women’s Hospital

Scott D. Solomon, MDThe Edward D. Frohlich Distinguished ChairProfessor of MedicineHarvard Medical SchoolSenior PhysicianBrigham and Women’s HospitalInternational Associate Editor, European Heart Journal

Dr. Scott Solomon

Scott D. Solomon, MD
The Edward D. Frohlich Distinguished Chair
Professor of Medicine
Harvard Medical School
Senior Physician
Brigham and Women’s Hospital
International Associate Editor, European Heart Journal

 

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

Response: Influenza is associated with an increased risk of cardiovascular events, yet few studies have explored the temporal association between influenza activity and hospitalizations, especially due to heart failure (HF).

Our aim with this study was to explore the temporal association between influenza activity and hospitalizations for HF and myocardial infarction (MI) in the general population. We related the number of MI and HF hospitalizations by month, which were sampled from 4 US communities and adjudicated in the surveillance component of the Atherosclerosis Risk in Communities (ARIC) study, to monthly influenza-like illness activity, as reported by the Centers for Disease Control and Prevention. We found that a 5% increase in influenza activity was associated with a 24% increase in HF hospitalizations rates, while overall influenza was not significantly associated with MI hospitalizations. Influenza activity in the months before hospitalization was not associated with either outcome.

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Case of Sudden Onset Schizophrenia Linked to Cat Scratch Fever Bacteria

MedicalResearch.com Interview with:

Bartonella - Wikipedia image

Bartonella – Wikipedia image

Dr. Ed Breitschwerdt, DVM, DACVIM
Melanie S. Steele Distinguished Professor of Internal Medicine
NC State

MedicalResearch.com: What is the background for this case report?  Can you briefly explain the signs/symptoms of a Bartonella infection?

Response: Bartonella henselae is a bacteria most commonly associated with cat scratch disease, which until recently was thought to be a short-lived (or self-limiting) infection. There are now at least 40 different known species of Bartonella, 13 of which have been found to infect human beings. The ability to find and diagnose Bartonella infection in animals and humans – it is notorious for “hiding” in the linings of blood vessels – has led to its identification in patients with a host of chronic illnesses ranging from migraines to seizures to rheumatoid illnesses, some of which the medical community previously hadn’t been able to attribute to a specific cause. Evolving data suggests a role for these bacteria in a spectrum of cardiovascular, neurological and rheumatological diseases. Specific symptoms or diseases that have been reported with neurobartonellosis previously include encephalitis, headaches, migraines, demyelinating polyneuropathy, neuroretinitis and transverse myelitis. Documentation of Bartonella henselae blood stream infection in a boy diagnosed with Schizophrenia and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) extends the spectrum of symptomatology associated with neurobartonellosis. Continue reading

Most Urinary Bacteria Do Not Require Antibiotics

MedicalResearch.com Interview with:

Prof. Lindsay E NicolleDepartment of Internal Medicine, School of MedicineRady Faculty of Health SciencesUniversity of Manitoba, Winnipeg, Canada 

Dr. Nicolle


Prof. Lindsay E Nicolle
Department of Internal Medicine, School of Medicine
Rady Faculty of Health Sciences
University of Manitoba, Winnipeg, Canada 

MedicalResearch.com: What is the background for these updated guidelines? What are the main recommendations?

Response: The guideline updates the guideline previously published in 2005. There is some new information published in the interim, but the recommendations from the earlier guideline have not changed.

In addition, some populations not included in the 2005 guideline are addressed in the update. These include children, transplant recipients, and patients undergoing elective surgery with prosthesis implantation.

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Opioid Crisis Linked To Rapid Increase in Chronically Infected Heart Valves

MedicalResearch.com Interview with:

Serena Day, MDOhio State University.

Dr. Serena Day

Serena Day, MD
Ohio State University 

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

Response: The idea for this research came from my own observations of patients that I was caring for in the hospital first as an Internal Medicine Resident and now as a senior Cardiology Fellow. I did my residency here at Ohio State and noticed a marked increase in the number of patients with endocarditis that we were caring for just in my short time here as a trainee.

Over 5 years, we saw an increase of 436% in intravenous drug use related endocarditis. How this disease is treated as changed as well. It used to be that if a patient was a good surgical candidate, we would offer a replacement valve. Now, we see that these patient’s have such a high rate of recurrent intravenous drug use and reinfection of their heart valves that we now treat with antibiotics only rather than surgery. In many cases, the infection never goes away because we can’t offer definitive therapy with surgery due to their high relapse and reinfection rates of nearly 50%.
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Ultrashort TB Therapy Found Just As Effective as 6 Month Course

MedicalResearch.com Interview with:

Susan Swindells MBBSProfessor and Medical Director, HIV ClinicDepartment of Internal MedicineUniversity of Nebraska Medical CenterOmaha, NE 

Dr. Swindells

Susan Swindells MBBS
Professor and Medical Director, HIV Clinic
Department of Internal Medicine
University of Nebraska Medical Center
Omaha, NE

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

Response: More than one quarter of the world’s population is infected with tuberculosis (TB), and there is effective treatment for this but only a small fraction of those eligible actually receive it.   TB is the leading cause of death for people with HIV infection, globally.  One of the major problems with currently available treatments for TB infection is that they take too long, and people just stop taking them after a while.  We identified an ultra-short course of treatment (only one month) and tested it against the conventional 6-month course of treatment.

Our main findings were that the new short course was just as effective as the standard 6 month course, more patients taking the short course completed their treatment, and had less adverse effects.  Continue reading

Most Deaths From Sepsis Occur in Frail Older Adults and Are Not Preventable

MedicalResearch.com Interview with:

Chanu Rhee, MD,MPHAssistant Professor of Population MedicineHarvard Medical School / Harvard Pilgrim Health Care InstituteAssistant Hospital EpidemiologistBrigham and Women’s Hospital

Dr. Rhee

Chanu Rhee, MD,MPH
Assistant Professor of Population Medicine
Harvard Medical School / Harvard Pilgrim Health Care Institute
Assistant Hospital Epidemiologist
Brigham and Women’s Hospital 

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

Response: Sepsis is the body’s reaction to a serious infection that results a cascade of inflammation in the body and organ dysfunction, such as low blood pressure, confusion, or failure of the lungs, kidneys, or liver.   Sepsis is a major cause of death, disability, and cost in the U.S. and around the world.  Growing recognition of this problem has led to numerous sepsis performance improvement initiatives in hospitals around the country.  Some of these efforts have also been catalyzed by high-profile tragic cases of missed sepsis leading to death, which may have contributed to a perception that most sepsis deaths are preventable if doctors and hospitals were only better at recognizing it.

However, the extent to which sepsis-related deaths might be preventable with better hospital-based care is unknown.  In my own experience as a critical care physician, a lot of sepsis patients we treat are extremely sick and even when they receive timely and optimal medical care, many do not survive.  This led myself and my colleagues to conduct this study to better understand what types of patients are dying from sepsis and how preventable these deaths might be.  Continue reading

Bats Carry Dangerous Viruses: Why Don’t They Get Sick?

MedicalResearch.com Interview with:
bats-mattaeMatae Ahn,MD-PhD candidate
Emerging Infectious Diseases (EID) Programme
Duke-NUS Medical School

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

Response: Bats, as the only flying mammals, are ‘special’ in their ability to host many highprofile viruses without suffering from disease. Such viruses including Ebola virus, Nipah virus and SARS or MERS coronaviruses, are highly pathogenic and often lethal to humans or animals, but yet cause no or minimal disease in bats. In addition, they also live very long relative to their small body size, despite elevated metabolic rates. However, what makes them special is still unclear.

In this study, we discovered dampened NLRP3-mediated inflammation in bats in response to both ‘sterile’ stressors and infection with three different types of zoonotic RNA viruses. We identified multiple molecular mechanisms of altered bat NLRP3, a critical regulator of virus-induced and age-related inflammation, as the cause. Importantly, the reduced inflammation had no effect on the viral loads, which suggests enhanced immune tolerance to infection in bats. Bats’ natural ability to dampen stress-related and virusinduced inflammation may be a key mechanism underlying their long lifespans and unique viral reservoir status.  Continue reading

HPV Testing for Primary Cervical Cancer Screening

MedicalResearch.com Interview with:

Matejka Rebolj, PhD King’s College London, London, UK

Dr. Rebolj

Matejka Rebolj, PhD
King’s College London, London, UK

Henry Kitchener, MD FRCOG FRCS University of Manchester, Manchester, UK

Dr. Kitchener

 

Professor Henry Kitchener, MD FRCOG FRCS
University of Manchester, Manchester, UK

 

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

Response: We now have reliable and affordable technologies to detect human papillomavirus (HPV), a virus which is universally accepted as the cause of cervical cancer. Various large trials confirmed that cervical screening could be improved by replacing the smear (cytology) test that has been in use for decades, with HPV testing. Many countries are now making the switch. In England, this is planned for the end of 2019. To test how to run HPV testing within the English National Health Service, a pilot was initiated in 2013 in six screening laboratories. We also wanted to determine whether the encouraging findings from the trials could be translated to everyday practice. This is important not only because we will be using different HPV tests, but also because women undergoing screening in trials are much more selected than those who are invited to population-based screening.  Continue reading

Vitamin D May Speed Recovery From Resistant Tuberculosis

MedicalResearch.com Interview with:

Professor Adrian Martineau, B Med Sci DTM&H MRCP PhD FRSB Clinical Professor of Respiratory Infection and Immunity Queen Mary University of London

Prof. Martineau

Professor Adrian Martineau, B Med Sci DTM&H MRCP PhD FRSB
Clinical Professor of Respiratory Infection and Immunity
Queen Mary
University of London

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

Response: The World Health Organisation estimates that 10.0 million people developed active tuberculosis in 2017, and that 1.6 million people died of this disease. Multi-drug resistant (MDR) TB is caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB drugs, causing around 500,000 cases and 150,000 deaths per year worldwide. Existing antibiotic treatments for MDR TB are lengthy, costly and often toxic due to their serious side effects.

One novel approach to treating MDR TB is to complement antibiotic treatment by using therapies that boost the immune system’s ability to kill TB bacteria. Vitamin D – the sunshine vitamin – is known to help white blood cells to make natural antibiotic substances (antimicrobial peptides) that can punch holes in the cell membranes of TB bacteria. Several clinical trials have investigated the effects of adding vitamin D to antibiotic treatment for TB.

In this study we pooled data from 8 of these studies (1850 participants) and analysed them to see if some TB patients benefited more from adding vitamin D to their treatment regimen than others. We found that vitamin D accelerated clearance of TB bacteria from the lungs of patients who had MDR TB; this benefit was not seen in patients who had ‘standard’ drug-sensitive TB. Continue reading

Adverse Outcomes More Likely in Infants Born to Mothers Who Get the Flu

MedicalResearch.com Interview with:

Kim NewsomeCDC

Kim Newsome

Kim Newsome, MPH
National Center on Birth Defects and Developmental Disabilities
CDC 

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

Response: This study supports data from previous studies that have shown increased risks for infants born to pregnant women who are severely ill with flu.

MedicalResearch.com: What are the main findings?

Response: Our study found that severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes (such as their baby being born preterm or of low birth weight) than women without influenza. 

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Federal Incentives Did Not Reduce Catheter Infections in Hospitals

MedicalResearch.com Interview with:

Heather Hsu, MD MPH Assistant Professor of Pediatrics Boston University School of Medicine Boston Medical Center Boston, MA 02118

Dr. Hsu

Heather Hsu, MD MPH
Assistant Professor of Pediatrics
Boston University School of Medicine
Boston Medical Center
Boston, MA 02118

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

Response: In October 2013, the Centers for Medicare and Medicaid Services (CMS) implemented value-based incentive programs to financially reward or penalize hospitals based on quality metrics. Two of these programs – Hospital Value Based Purchasing and the Hospital Acquired Condition Reduction Program – began targeting hospitals’ rates of certain healthcare-associated infections deemed to be preventable in October 2015.

Previous studies demonstrated minimal impact of these value-based payment programs on other measures of hospital processes, patient experience, and mortality. However, their impact on healthcare-associated infections was unknown.

Our goal was to study the association of value-based incentive program implementation with healthcare-associated infection rates, using catheter-associated urinary tract infection in intensive care units (one of the targeted outcomes) as an example.

We found no evidence that federal value-based incentive programs had any measurable association with changes in catheter-associated urinary tract infection rates in the critical care units of US hospitals.

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USPSTF Recommends Antibiotic Prophylaxis to Prevent Gonorrheal Eye Disease in Newborns

MedicalResearch.com Interview with:

Michael Silverstein, M.D., M.P.H. Professor of pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine

Dr. Silverstein

Michael Silverstein, M.D., M.P.H.
Professor of Pediatrics
Director of the Division of General Academic Pediatrics
Vice chair of research for the Department of Pediatrics
Boston University School of Medicine

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

Response: Gonococcal ophthalmia neonatorum, or GON, is a severe infection of the eye that can occur in babies born to women who have gonorrhea. If left untreated, GON can cause serious problems, including blindness, that can appear as soon as 24 hours after delivery.

Fortunately, there are effective treatments available that can prevent GON in newborns. The U.S. Preventive Services Task Force reviewed the most current research on the benefits and harms of ocular prophylaxis—which is applying antibiotic ointment to the babies’ eyes at birth—to prevent GON.

We found that, if applied within 24 hours after birth, the ointment is very effective at preventing gonococcal ophthalmia neonatorum and the problems it causes. Therefore, we are recommending that clinicians provide this preventive service for all newborns.  Continue reading

Prions from Brain Detectable in Skin Earlier Than Brain Damage

MedicalResearch.com Interview with:

Wenquan Zou, MD, PhD Associate Professor Departments of Pathology and Neurology Director of CJD Skin Project Associate Director National Prion Disease Pathology Surveillance Center Institute of Pathology Case Western Reserve University School of Medicine Cleveland, Ohio 44106

Dr. Wen Quan Zou

Wenquan Zou, MD, PhD
Associate Professor
Departments of Pathology and Neurology
Director of CJD Skin Project
Associate Director
National Prion Disease Pathology Surveillance Center
Institute of Pathology
Case Western Reserve University School of Medicine
Cleveland, Ohio 44106

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

Would you briefly explain the significance of prion-induced diseases and why they have been difficult to diagnosis?

Response: Our previous study has demonstrated that infectious prions are detectable in the skin samples of patients with sporadic Creutzfeldt-Jakob disease (sCJD), the most common form of human prion disease, at the terminal stage by the highly sensitive real-time quaking-induced conversion (RT-QuIC) assay and animal-based bioassay.

The prion-induced diseases are significant because they are infectious diseases that can be transmitted inter-species and intra-species. For instance, mad cow disease, a prion disease in cattle, has been documented to transmit to humans. Currently, there are no cures for these fatal diseases.

The definite diagnosis of prion diseases is difficult because it mainly depends on the availability of brain tissues obtained either by biopsy or autopsy for detection of prions. Brain biopsy is highly invasive and it is difficult to be accepted by patients and their families. Even for brain autopsy, it is not always feasible because of religious and cultural limitations in some regions or countries.  Continue reading