Author Interviews, Infections, Inflammation / 07.09.2016

MedicalResearch.com Interview with: David Underhill, PhD Professor of Biomedical Sciences Research scientist, F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute Cedars-Sinai Los Angeles, CA MedicalResearch.com: What is the background for this study? Response: “Innate immunity” is the body’s natural resistance to microbial infection and stands in contrast to “adaptive immunity,” which is the body’s learned response to infection (e.g. antibodies and vaccines). In the standard model of innate immunity that has emerged over the last several decades, scientists have come to understand that the human genome encodes many “receptors” that have evolved as sensors for specific common microbial molecules, such as bacterial or viral DNA or components of bacterial or fungal cell walls. The job of these receptors is to survey the environment (skin, blood, etc.) for potentially dangerous microbes and initiate inflammatory responses if they are found. These activities are essential for defense against infection, and people and animals with defects in these sensors or the responses they trigger can be susceptible to infection. My laboratory has been interested for more than a decade in identifying these innate sensors and the microbial targets that they recognize. In this study, we were looking for the sensor that allows white blood cells (e.g. macrophages and dendritic cells) to detect Gram-positive bacterial cell walls and trigger a specific inflammatory response: secretion of the potent inflammatory mediator interleukin-1β (IL-1β). (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 07.09.2016

MedicalResearch.com Interview with: William Ryan B.V.Sc. Ryan Mitchell Associates LLC Westfield, NJ and Bernard Cohen, MD Professor Dermatology and Ellen Koch, MD Division of Pediatric Dermatology Johns Hopkins Medicine, Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a group we were concerned about the misinformation that continues to be promulgated on the internet and through other sites. Importantly, the group consisted of experts with specific experience in the management of head louse infestations, from pediatric dermatology, pediatrics, school nursing and head louse research fields. Even information sources that we would have expected to be credible are outdated, unreliable or both, often continuing myths about head louse infestations and how they can be controlled.  We wanted to provide a balanced and informed perspective that would help physicians and parents recognize that head louse infestations do not present a serious problem, and can be well managed with an informed approach to treatment. The main findings are that over the counder products (permethrin/pyrethrins) are unlikely to be effective, and that that there are safe and effective products that are available by prescription. Interestingly, head lice do affect Indian and African children in their home countries, but virtually nonexistent in African Americans in North America. There has been speculation about hair grooming regimen or structure of African American hair but the cause is unknown.  In a study we performed assessing resistance to over the counter pediculicide components over a decade ago in Baltimore, we were not able to find a single African American child with head lice. We were not able to recruit any patients from the Baltimore City Schools. (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 07.09.2016

MedicalResearch.com Interview with: Prof. Alan Irvine DSc Consultant Dermatologist Our Lady’s Children’s Hospital Associate Professor of Dermatology Trinity College Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that atopic dermatitis (AD) has a close relationship with staphylococcus aureus (SA) colonisation, and this is known to drive flares or exacerbations of AD but before our report it was not known which came first-AD colonisation or atopic dermatitis? By following a cohort pf patients very carefully over a 1 year period and regularly sampling their skin microbiome we were able to show that SA colonisation did not precede development of AD and in fact that several non SA species of staphylococcus actually appeared to be protective for developing atopic dermatitis. This is an important new finding in the complex relationship between the microbiome and skin inflammation, suggesting that some commensal bacterial are anti-inflammatory or protective. (more…)
Author Interviews, Infections, Outcomes & Safety, Pediatrics / 29.08.2016

MedicalResearch.com Interview with: Dr. Cohen Regev, M.D Head of the infectious diseases and infection control units Sanz Medical Center, Laniado hospital Netanya, Israel MedicalResearch.com: What is the background for this study? Response: During 3 months in 2012 we had a number of clinical isolates of Pseudomonas aeruginosa (PA) in our neonatal intensive care unit (NICU) and a high incidence of colonization among ventilated patients in our medical-surgical intensive care unit (MSICU). The origin of PA may be from various environmental sources (‘exogenous’), from the patients’ own microbiome (‘endogenous’), or from both. Since in NICUs the origin is usually exogenous, we investigated the sources of the bacteria, focusing on the faucets of these units, as they were previously incriminated as causes of outbreaks in ICUs. The study was conducted in Sanz medical center, a 400-bed community hospital located in central Israel. In the NICU we obtained several environmental cultures from faucets using a bacterial swab by rubbing the tip into the distal part of the faucet. Aerators were dismantled from all faucets, cultured from their inner part using a swab and were not repositioned. Contaminated faucets were occasionally replaced or treated with enzymatic fluid and sterilization by Ethylene Oxide. During the intervention and since, neonates were bathed only with warmed sterile water, and tap water was allowed only for hand hygiene practices. In the MSICU tap water was used only for bathing the patients. All other uses of tap water, such as drinking, moistening and mouth treatments, were allowed using only sterile water. The units' faucets were sampled on two different days concurrently with surveillance cultures of pharyngeal, sputum and urine from the patients. Bacteria were identified with VITEK 2 (Biomerieux®) and typing was done by Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR. (more…)
Author Interviews, Baylor College of Medicine Houston, Infections, Science / 29.08.2016

MedicalResearch.com Interview with: Mary K. Estes, Ph.D. Distinguished Service Professor Cullen Endowed Chair of Human and Molecular Virology Department of Molecular Virology and Microbiology Baylor College of Medicine Houston, TX 77030 MedicalResearch.com: What is the background for this study? Response: Noroviruses are the most common cause of acute gastroenteritis (vomiting and diarrhea) worldwide and the leading cause of food-borne gastroenteritis. They also can cause chronic (long-lasting) illness in immunocompromised patients. These viruses are highly contagious and spread rapidly among people. The first report of an outbreak caused by a norovirus was in an elementary school in Norwalk, Ohio in 1968. Since that time, it became known that the virus damaged cells in the small intestine of infected people but attempts by many research groups to grow human noroviruses in the laboratory in a variety of intestinal cancer cells lines failed. This inability to grow human norovirus has been considered the single greatest barrier to norovirus research because it limited studies to understand how the virus makes people sick and how to inactivate the virus to prevent infection. (more…)
Author Interviews, Environmental Risks, Infections / 26.08.2016

MedicalResearch.com Interview with: Lin Op De Beeck, PhD student Laboratory of Aquatic Ecology, Evolution and Conservation University of Leuven Leuven, Belgium MedicalResearch.com: What is the background for this study? Response: Mosquitoes transmit quite a few deadly diseases, including West Nile Virus. Around the world, therefore, the fight against these insects is high on the agenda. Existing strategies for mosquito control often involve the use of chemical pesticides that harm the environment. These pesticides are increasingly less effective as well, as insects can become resistant to existing products relatively quickly. Biopesticides are a possible alternative. The most commonly used biological pesticide is the Bacillus thuringiensis israelensis (Bti) bacteria. Unfortunately, mosquitoes are already developing resistance to this pesticide as well. This means we have to keep increasing the dose of Bti to kill mosquitoes, so that this biological substance, too, is beginning to harm the environment. Therefore we set out to find a new strategy in the fight against mosquitoes. We already knew that chemical substances emitted by the backswimmer – a natural enemy of mosquito larvae in the water – trigger a stress response in mosquitoes. This stress response, in turn, suppresses the mosquito’s immune system. What makes the use of these predator cues even more interesting for mosquito control is that scientists recently found a way to produce a synthetic version of these chemical substances. We discovered that this synthetic version triggers a stress response in the mosquitoes and impairs their immune system, just like the natural predator cues. This gave us the idea to combine these synthetic predator cues with the biological pesticide Bti. (more…)
Allergies, Author Interviews, Infections / 23.08.2016

MedicalResearch.com Interview with: Emily L. Heil, PharmD, BCPS-AQ ID Assistant Professor Department of Pharmacy Practice and Science University of Maryland School of Pharmacy 20 N Pine St Baltimore, Maryland 21201 MedicalResearch.com: What is the background for this study? Response: As many as nine out of ten people who think they are allergic to penicillin are, in fact, not allergic when penicillin allergy skin testing is performed. This mistaken belief, confirmed in multiple other studies and a matter of concern of the U.S. Centers for Disease Control and Prevention (CDC), has widespread implications given that patients who report penicillin allergies tend to get suboptimal antibiotic therapy compared with patients who do not. Penicillin skin testing (PST) can clarify allergy histories but is often limited by access to testing. We aimed to implement an infectious disease (ID) fellow managed PST program and to assess the need for PST via national survey. Our study found that inpatient Penicillin skin testing can be successfully managed by ID fellows, thereby promoting optimal antibiotic use. Our study showed that by testing patients for penicillin allergy via skin test, we could improve their care: 80 percent of patients were able to switch to more effective antibiotic therapy once they were tested. (more…)
Author Interviews, C. difficile, Genetic Research, Infections / 19.08.2016

MedicalResearch.com Interview with: Charles Darkoh, Ph.D., MS., MSc. Assistant Professor University of Texas Health Science Center at Houston School of Public Health Department of Epidemiology, Human Genetics & Environmental Sciences Center for Infectious Diseases Houston, Texas 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium difficile (Cdiff) is a multidrug-resistant pathogen that takes over the colon after the good bacteria in the colon have been wiped out by antibiotic therapy. As a result, antibiotic treatment is a major risk factor for C. diff infections. Because of the ability of C. diff to inactivate the majority of the antibiotics currently available, it has become necessary to urgently develop a non-antibiotic therapy for this life-threatening infection. We know that C. diff causes disease by producing toxins, designated toxin A and B. During infection, the toxins are released into the colon resulting in diarrhea and inflammation of the colon as well as other diarrhea-associated illnesses. We also know that C. diff strains that are unable to produce toxins cannot cause disease. Therefore, the toxins are promising targets for a non-antibiotic therapy. We reported last year that C. difficile regulates toxin production using quorum sensing — a system that allows bacteria to coordinate their biological activities as a group. Two sets of quorum-sensing genes (agr1 and agr2) were identified. These genes form part of a signaling communication system that makes a small peptide, which serves as a cue for the infecting bacterial population to turn on their toxin genes. In this study we used genetic analysis to identify which of these two sets of genes is responsible for regulating the toxins. Our results demonstrates that agr1 is the culprit. This is because Cdiff agr1 mutant cannot produce toxins and unable to cause disease in mice, whereas the agr2 mutant can cause disease just like the wild type C.diff. (more…)
Author Interviews, Infections, Pediatrics / 12.08.2016

MedicalResearch.com Interview with: Marieke de Hoog Assistant Professor Julius Centrum voor Gezondheidswetenschappen en Eerstelijnsgeneeskunde UMC Utrecht The Netherlands  MedicalResearch.com: What is the background for this study? Response: Acute otitis media (AOM) is a prime reason for doctor consultations and antibiotic use in children. Although symptoms of AOM may resolve spontaneously, these infections have a significant impact on child and family life and carry a considerable health care and economic burden.  Acute otitis media occurring early in life, also called early-onset AOM, has been suggested as a risk factor for subsequent  Acute otitis media episodes during childhood and could therefore also impact health care resource use. Identifying the critical age-period and quantifying the long-term consequences of early-onset AOM is important to guide future management and prevention programs aiming to reduce the burden of AOM. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Mental Health Research / 11.08.2016

MedicalResearch.com Interview with: Helene Lund-Sørensen BM Department of Biomedical Sciences Section of Cellular and Metabolic Research University of Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: Accumulating research has shown that inflammation and infections are associated with psychiatric diagnoses and interactions between infectious agents, known to affect the brain, and suicidal behavior have been reported. We find an increased risk of death by suicide among individuals hospitalized with infections. The risk of suicide increased in a dose-response relationship with the number of hospitalizations with infections and with the number of days hospitalized with infections. We also examined the risk of suicide association with the time since the last hospitalization with infection and found that infection was linked to an elevated risk with the strongest effect after 1 and 2 years compared with those without infections. (more…)
Author Interviews, Infections, PLoS / 05.08.2016

MedicalResearch.com Interview with: Dr Peter Monk BSc PhD Faculty Director of International Affairs Reader in Immunology Department of Infection, Immunity and Cardiovascular Disease Sheffield University Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: The tetraspanin proteins are found on the surface of all mammalian cells. The cell surface is the place where cells 'socialise': they talk to each other to coordinate activities, stick to each other to form tissues and sometimes crawl across each other to get to where they need to go. Tetraspanins have an important job to do in the organisation of the cell surface, amongst other things enabling the formation of 'sticky patches' (tetraspanin-enriched microdomains or TEM) that cause cells to adhere together or provide traction to allow movement. Some bacteria have evolved ways of hijacking the TEM for their own ends, adhering to tightly to these structures so that the normal things that sweep bacteria away (such as blood, sweat and tears!) are no longer effective. At this point, infection begins. We have found that the TEM can be partly disrupted, by adding small parts of tetraspanins (peptides) to cells. The peptides seem to work by weakening the tetraspanin glue that holds the TEM together and causing the other components that give the 'stickiness' to the TEM to become more spaced out. We use the analogy of Velcro(TM), where the fabric hooks and loops are held together in woven material; loosen the weave and the hooks and loops fall apart, no longer able to engage strongly with the loops in the opposing piece of fabric. Using reconstructed human skin, we were able to show that the tetraspanin peptides were both safe and effective; they did not affect wound healing in burned skin, but they could lower the bacterial load in the wound by 50%. This would allow the immune system (including the fluid that 'weeps' from wounds) to deal with the remaining bacteria more easily. Unlike conventional antibiotics that tend to kill bacteria, our peptides simply cause them to get washed away, so not invoking the evolutionary selective mechanisms that lead to resistance. (more…)
Author Interviews, Dental Research, Infections / 05.08.2016

MedicalResearch.com Interview with: Stephanie S. Momeni, MS, MBA Doctoral Candidate, Department of Biology DART Trainee, Department of Pediatric Dentistry & IOHR UAB School of Dentistry Birmingham, Alabama 35294-0007 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was a small part of a large scale of S. mutans in a group of high-caries risk children and their household family members in Perry County, Alabama, USA. Overall dental caries is a dietary and infectious disease that we seek to understand better. We found only 34 rep-PCR genotypes for over 13,000 bacterial isolates from over 594 individual subjects. With so much commonality we wanted to determine if any conclusions could be made about transmission. The key findings are: • Children having multiple S. mutans genotypes were 2.3 times more likely to have dental caries. • Analysis for transmission performed from two perspectives (by child and by genotype) indicating 63% of children shared at least 1 genotype with their mother, but 72% of children had at least 1 genotype not shared with any household family members. • Child-to-child transmission of some genotypes is highly probable. • About 1/3 of isolates observed were transient, and may confound the search for strains associated with tooth decay. (more…)
Author Interviews, Infections, PNAS / 27.07.2016

MedicalResearch.com Interview with: Adam Hayward PhD Impact Research Fellow University of Stirling MedicalResearch.com: What is the background for this study? Response: Adult life expectancies in industrialized countries have increased dramatically in the last 150 years, even once we’ve accounted for the fact that previously common deaths in childhood and now very rare. One hypothesis seeking to explain this increase is that childhood infections cause chronic inflammation, which are then linked with heart disease and stroke in later life, reducing lifespan. Since such childhood infections were previously common but are now, thanks to vaccine and sanitation, much rarer, chronic inflammation should be lower and people should live longer and be less likely to die from early-onset heart disease. If this hypothesis is correct, we should see that higher exposure to infections in early life leads to increased adult mortality and deaths from heart disease and stroke. (more…)
Author Interviews, Infections, JAMA / 25.07.2016

MedicalResearch.com Interview with: Dr. Ane Uranga MD Department of Pneumology, Galdakao-Usansolo Hospital Galdakao, Bizkaia, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite clear benefits of shorter antibiotic treatments, reducing the duration of treatment remains challenging in daily clinical practice. Actually, IDSA/ATS recommendations for Community Acquired Pneumonia (CAP) suggested a minimum of 5 days of treatment based on clinical stability criteria. However, in our study the median of duration of antibiotic treatment in the control group was as high as 10 days. The main finding is that receiving 5 days antibiotic treatment in hospitalized patients suffering from CAP is not inferior to arbitrary treatment schedules in terms of clinical success. (more…)
Author Interviews, Infections / 20.07.2016

MedicalResearch.com Interview with: Prof. Andrea Endimiani, MD, PhD Institute for Infectious Diseases University of Bern MedicalResearch.com: What is the background for this study? Response: The spread of multidrug-resistant Gram-negative bacteria represents a serious issue for the healthcare system worldwide because our antibiotic armamentarium is becoming too limited. These «superbugs» may cause serious infections with high morbidity and mortality rates – there are already 700,000 estimated deaths per year worldwide because common antimicrobial therapies have become ineffective. In this scenario, colistin has represented the last active antibiotic option able to cure many infected people. Unfortunately, in November 2015 a new mechanism of resistance against colistin was found with a high prevalence in Escherichia coli and Klebsiella pneumoniae strains detected in China among humans, food animals, and chicken meat; more recently, it has also been found in other countries. This mechanism is encoded by a gene (named mcr-1) that is plasmid-mediated, thus assuring its great ability to mobilize and spread between different enterobacteria, including those normally present in the human and animal intestinal tracts. (more…)
Author Interviews, Infections, NEJM, Vaccine Studies / 20.07.2016

MedicalResearch.com Interview with: Nicole E. Basta, PhD MPhil Assistant Professor Division of Epidemiology and Community Health School of Public Health University of Minnesota MedicalResearch.com: What is the background for this study? Response: Meningococcal disease is a serious and often life-threatening condition. In the past several years, multiple outbreaks caused by meningococcal serogroup B (MenB) have occurred on college campuses in the US. Recently, a new meningococcal B vaccine known as 4CMenB or Bexsero was developed. The FDA granted special approval to use the vaccine to control an outbreak at a University in New Jersey prior to its licensure. We took advantage of this unique opportunity to investigate the impact of Bexsero during the outbreak. In doing so, we conducted the first clinical study of Bexsero among teens and young adults in the US. (more…)
Author Interviews, Dermatology, Infections, Technology / 19.07.2016

MedicalResearch.com Interview with: Dr. Kerry Zang Founder of the Arizona Institute of Footcare and Dr. Robert Sullivan Clinical Director, Midleton Foot Clinic MedicalResearch.com Editor's note: Dr. Zang and Dr. Sullivan discuss the recent announcement of FDA approval of the Lunula Laser for the treatment of Onychomycosis. MedicalResearch.com: What is the background for this new technology? Response: “For two decades, Erchonia Corporation studied the clinical utility of low-level laser devices for the treatment of numerous medical ailments. Dr. Sullivan and I worked with Erchonia on the Lunula laser to revolutionize the way the medical community treats onychomycosis. Lunula underwent four independent clinical investigations for the treatment of onychomycosis. More than 500 subjects participated with increasingly effective results and each completed without a single adverse event.” - Dr. Kerry Zang Response: “There has never been a non-pharmaceutical treatment for onychomycosis. When I became aware that there was a small study completed by Dr. Zang, I became interested in the potential of this new technology. Erchonia was very helpful in bringing me up to speed with what this technology may do. The results of my extended study were unbelievable.” -Robert Sullivan (more…)
Author Interviews, Infections, Technology / 18.07.2016

MedicalResearch.com Interview with: MedicalResearch.com: What is the background for this study? Response: For the past 5 years or so, my collaborators and I have been working on several issues leading to the realization of the so-called “Windows to the Brain (WttB)” platform. WttB are transparent nanocrystalline yttria-stabilized-zirconia (nc-YSZ) cranial implants capable of replacing portions of the skull to allow non-invasive optical interrogation of the brain on an ongoing recurring basis. This new technological advancement could eventually afford for: a) advancing understanding of the brain, by facilitating the clinical translation of emerging optogenetic neurotechnologies; and b) facilitating the diagnosis and treatment of a wide variety of brain pathologies and neurological disorders, such as traumatic brain injury, stroke, brain cancer, and others. (more…)
Author Interviews, Infections / 12.07.2016

MedicalResearch.com Interview with: Jenny A. K. Ekberg Eskitis Institute for Drug Discovery Faculty of Health Sciences and Medicine, Bond University Institute for Health and Biomedical Innovation, Queensland University of Technology, School of Medical Science, Griffith University Queensland, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Melioidosis is a tropical bacterial infection that causes around 90,000 deaths world-wide each year. It is caused by the bacteria Burkholderia pseudomallei which can cause pneumonia and a serious flu-like illness which can cause death, however if the brain is infected, which happens in particular with the Australian variant of the disease, the mortality is particularly high (~25 %). The route by which the bacteria invade and progress through the central nervous system is to date largely unknown. We have now shown in an animal model that the bacteria can penetrate the trigeminal nerve within the nasal cavity and then rapidly invade the brainstem and spinal cord only 24 hours after intranasal inoculation. By migrating along the trigeminal nerve, the bacteria bypasses the blood-brain barrier.This study constitutes the first characterization of the path by which B. pseudomallei bacteria migrate all the way from the nasal cavity into the spinal cord. (more…)
Author Interviews, Infections / 11.07.2016

MedicalResearch.com Interview with: Hemilä Harri Hemilä, MD, PhD Department of Public Health, University of Helsinki MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our meta-analysis of 3 randomized controlled trials on zinc acetate lozenges was motivated by an early trial which indicated that zinc lozenges might be more effective for patients with allergies. We found that allergy, sex, age, and ethnic bacground did not influence the effect of zinc acetate lozenges. Thus, the average effect of 3 day reduction in colds seems to be applicable for a wide range of common cold patients. (more…)
Author Interviews, Fertility, Herpes Viruses, Infections, PLoS / 09.07.2016

MedicalResearch.com Interview with: Roberta Rizzo PhD Department of Medical Sciences Section of Microbiology University of Ferrara Ferrara, Italy MedicalResearch.com: What is the background for this study? Response: Infertility affects approximately 6% of 15-44 year old women or 1.5 million women in the US, according to the CDC. Approximately 25% of female infertility cases are unexplained, leaving women with few options other than expensive fertility treatments. Researchers are trying to identify factors and mechanisms at the basis of this condition. (more…)
Author Interviews, Infections, Microbiome, Pulmonary Disease / 06.07.2016

MedicalResearch.com Interview with: Genevieve Marchand Ph.D., RMCCM SCCM(Env) Microbiologiste agréée & Biochimiste Chercheure, Prévention des risques chimiques et biologiques IRSST MedicalResearch.com: What is the background for this study? Response: It is well known that Health Care Workers (HCWs) are at risk of occupationally acquired infections. Some procedures, such as bronchoscopies, are recognized to be high-risk tasks. Most researches that have linked infectious risk to specific task in healthcare settings did not measure the real bioaerosol exposure. Those link where mostly made from epidemiology observations. The aim of this study was to qualify and quantify the real bioaerosol concentrations found during bronchoscopy procedures in order to estimate the true occupational risk. (more…)
Annals Internal Medicine, Author Interviews, Infections / 05.07.2016

MedicalResearch.com Interview with: Louise Bruun Østergaard MD. Ph.D student Faculty of Medicine and Faculty of Engineering and Science Aalborg University Department of Cardiology, Gentofte Hospital Hellerup MedicalResearch.com: What is the background for this study? What are the main findings? Response: Staphylococcus aureus bacteremia strikes people of all ages resulting in devastating consequence even in young and healthy individuals. Animal studies have shown that the susceptibility to Staphylococcus aureus differs among different genetic strains in mice, suggesting that genetic differences could influence the susceptibility to Staphylococcus aureus in other spices. As a first step in determining whether genetics influence risk of Staphylococcus aureus infections we aimed to study whether a family history of Staphylococcus aureus bacteremia in first-degree relatives was associated with risk of the disease. (more…)
Author Interviews, Infections, NEJM, Vaccine Studies / 29.06.2016

MedicalResearch.com Interview with: Philip Bejon, Ph.D. Professor of Tropical Medicine, Director of the Wellcome-KEMRI-Oxford Collaborative Research Programme, Group Head / PI, Consultant Physician and Unit Director Kilifi, Kenya MedicalResearch.com: What is the background for this study? Response: According to the latest World Health Organisation (WHO) estimates more than 400,000 people died from malaria in 2015, with over 90% of these deaths occurring in sub-Saharan Africa. The vast majority who die are children under 5, and almost all cases are caused by the P. falciparum strain of malaria transmitted by female Anopheles mosquitoes. RTS,S, which protects only against P. falciparum, was developed by GlaxoSmithKline with support from the PATH Malaria Vaccine Initiative (MVI) and with grant funds from the Bill & Melinda Gates Foundation to MVI. In July 2015, it received a positive opinion from the European Medicines Agency. Earlier this year, the WHO recommended further evaluation of the four-dose regimen of RTS,S in a pilot implementation programme in sub-Saharan Africa, to address several knowledge gaps before the vaccine might be rolled out more widely. (more…)
Author Interviews, Infections, JAMA, Primary Care / 28.06.2016

MedicalResearch.com Interview with: Jochen Gensichen, MD, MSc, MPH Institute of General Practice and Family Medicine Konrad Reinhart, MD Center of Sepsis Control and Care Jena University Hospital Friedrich-Schiller-University School of Medicine Jena, Germany MedicalResearch.com: What are the main findings? Response: Sepsis survivors face multiple long-term sequelae which result in increased primary care needs as a basic support in medication, physiotherapy or mental health. Process of care after discharge from the intensive care unit often is fragmented. (more…)
Author Interviews, CDC, Infections, Sexual Health, STD / 28.06.2016

MedicalResearch.com Interview with: Dr. Andrew Amato-Gauci MD Head of the European Centre for Disease Prevention and Control Programme on HIV/AIDS, sexually transmitted infections and viral hepatitis MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our surveillance data (http://bit.ly/1sXdbVv) show that between 2008 and 2014, the overall rate of officially reported gonorrhoea infections has more than doubled across Europe, going up from 8 per 100 000 population to 20 cases per 100 000 persons. In total, 66 413 gonorrhoea cases were reported in 27 countries of the European Union and European Economic Area (EU/EEA) in 2014 – which constitutes an increase of 25% compared with 2013. The majority of gonorrhoea infections were diagnosed among young adults aged 15–24 years who accounted for 38% of cases; followed by the 25–34-year-olds (34%). For the first time since 2010, the number of cases among women was higher than the number of cases among heterosexual men. Given the risk of reproductive tract complications, e.g. pelvic inflammatory disease or, if untreated, infertility, as well as possible transmission from mother to child, this trend among women is of particular concern. (more…)
Author Interviews, Infections, Pharmacology, Urinary Tract Infections / 25.06.2016

MedicalResearch.com Interview with: Amanda Paschke, MD Director, Infectious Disease Clinical Research Merck Research Laboratories MedicalResearch.com: What is the background for this study? What are the main findings? Response: Relebactam is an investigational beta-lactamase inhibitor being developed as a fixed-dose combination with imipenem/cilastatin, which is a broad-spectrum antibiotic in the carbapenem class. In preclinical studies, this combination demonstrated antibacterial activity against a broad range of multidrug-resistant Gram-negative pathogens, including those producing extended-spectrum beta-lactamases such as Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae and AmpC-producing Pseudomonas aeruginosa. Many of the most concerning infections caused by “superbugs” are caused by Gram-negative bacteria. These bacteria have evolved to be resistant to commonly used antibacterials, and even to antibacterials used as “last resort” treatment, which is why finding ways to treat them has become urgent. The addition of relebactam to imipenem is designed to restore activity of imipenem against certain imipenem-resistant strains of Gram-negative bacteria known to cause serious infections among people who often have other underlying medical conditions, which complicates treatment. This was a Phase 2, multicenter, randomized, double-blind, non-inferiority study. The study looked at the use of relebactam plus imipenem versus imipenem alone for the treatment of adult patients with complicated urinary tract infections. The primary endpoint for the trial was microbiological response at the completion of IV study therapy. The study met its primary endpoint, demonstrating that the combination of relebactam with imipenem was as at least as effective as imipenem alone for the treatment of complicated urinary tract infections. The trial also demonstrated that the combination of relebactam plus imipenem is well-tolerated, with a safety profile similar to that of imipenem alone in this patient. (more…)
Author Interviews, Dengue, Infections, Inflammation, Zika / 22.06.2016

MedicalResearch.com Interview with: Clive McKimmie PhD Research Fellow, Virus Host Interaction Team (VHIT), University of Leeds St James’ University Hospital Leeds UK MedicalResearch.com: What is the background for this study? Response: With the rapid spread of Zika in the Americas, attention has been drawn to this group of neglected mosquito-borne viral infections. The Zika virus is not alone in causing problems, others such as dengue and chikungunya viruses are infecting millions of people each year. Yet there’s little doctors can do to help people who get sick. When mosquitoes bite you they can transmit these disease causing viruses. We don’t understand what happens during the early stages of infection very well. However, it is known that the mosquito bite itself somehow helps the virus to infect your body. (more…)
Author Interviews, Dermatology, Infections / 21.06.2016

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis is associated with a number of potential risk factors for developing serious infections, including impaired skin-barrier function, immune dysregulation, use of systemic immunosuppressant and biologic treatments. We hypothesized that adults with psoriasis have higher rates of serious infections. We examined data from the 2002-2012 National Inpatient Sample, which contains a representative 20% sample of all hospitalizations in the United States. We found that psoriasis was associated with multiple serious infections, including methicillin-resistant Staphylococcus aureus, cellulitis, herpes simplex virus infection, infectious arthritis, osteomyelitis, meningitis, encephalitis and tuberculosis. Rates of serious infections increased over all time. Significant predictors of serious infections in patients with psoriasis included non-white race, lower estimated income quartile, and Medicaid, Medicare, or self-pay insurance status. These findings suggest that poor access to adequate dermatologic care may be associated with higher rates of infections. (more…)
Author Interviews, Biomarkers, Cancer Research, Infections, Technology, University of Pittsburgh / 13.06.2016

MedicalResearch.com Interview with: Donald S. Burke, M.D. Dean of the University of Pittsburgh Graduate School of Public Health Director of the University of Pittsburgh Center for Vaccine Research MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Burke: At the University of Pittsburgh we developed a unique method for detecting antibodies in the blood of patients in a proof-of-principle study that opens the door to development of simple diagnostic tests for diseases for which no microbial cause is known, including auto-immune diseases, cancers and other conditions. We used a technique pioneered by co-author Thomas Kodadek, Ph.D., of the Scripps Research Institute, that synthesizes random molecular shapes called “peptoids” hooked onto microscopic plastic beads. The technique can produce millions of molecular shapes. The peptoids are not organic, but if they match to the corresponding shape on an antibody, that antibody will connect to them, allowing the scientist to pull out that bead and examine that peptoid and its corresponding antibody. My team chemically generated a huge library of random molecular shapes. Then, using blood from HIV-infected patients and from non-infected people, we screened a million of these random molecular shapes to find the ones that bound only to antibodies present in the blood of HIV-infected patients, but not the healthy controls. No HIV proteins or structures were used to construct or select the peptoids, but the approach, nonetheless, successfully led to selection of the best molecular shapes to use in screening for HIV antibodies. We then resynthesized that HIV-antibody-targeting peptoid in mass and tested it by screening hundreds of samples from the Multicenter AIDS Cohort Study (MACS), a confidential research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men (supported by the National Institutes of Health). Study co-author Charles Rinaldo, Ph.D., chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology and director of the Pittsburgh arm of the MACS, selected the samples, but blinded the testers to which samples were HIV-positive or -negative. The test distinguished between the samples of HIV-positive blood and HIV-negative blood with a high degree of accuracy. (more…)