Author Interviews, Brigham & Women's - Harvard, Flu - Influenza, Heart Disease, JAMA / 27.03.2019

MedicalResearch.com Interview with: Sonja Kytomaa MA Research Associate Brigham and Women’s Hospital 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. (more…)
Author Interviews, Infections, Schizophrenia / 21.03.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Urinary Tract Infections / 21.03.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Heart Disease, Infections, Opiods / 18.03.2019

MedicalResearch.com Interview with: 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%. (more…)
Author Interviews, Infections, NEJM / 13.03.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Brigham & Women's - Harvard, Critical Care - Intensive Care - ICUs, Infections, JAMA / 12.03.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Infections, Nature / 28.02.2019

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.  (more…)
Author Interviews, BMJ, Cancer Research, HPV, OBGYNE / 13.02.2019

MedicalResearch.com Interview with: Matejka Rebolj, PhD King’s College London, London, UK   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.  (more…)
Author Interviews, Infections, Vitamin D / 10.02.2019

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 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. (more…)
Author Interviews, CDC, Flu - Influenza, OBGYNE, Pediatrics / 07.02.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, Health Care Systems, Hospital Acquired, JAMA, Urinary Tract Infections / 06.02.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics, STD, USPSTF / 05.02.2019

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 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.  (more…)
Author Interviews, Dermatology, Infections / 01.02.2019

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 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.  (more…)
Author Interviews, Flu - Influenza, Infections, PLoS, University of Michigan / 25.01.2019

MedicalResearch.com Interview with: Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 MedicalResearch.com: What is the background for this study? Response: Influenza is a major cause of human illness and death worldwide. Vaccines are the best available means of prevention. However, vaccine effectiveness has been low to moderate in recent years and coverage remains low in many countries. There is increasing evidence suggesting the microbiome plays an important role in shaping host immunity and may be a potential target for reducing disease. In our study, we used a household transmission study to explore whether the respiratory microbiome was associated with influenza susceptibility.  (more…)
Author Interviews, Cancer Research, HPV, Infections / 25.01.2019

MedicalResearch.com Interview with: Prof. J. (Hans) Berkhof PhD Vrije Universiteit Amsterdam  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In most countries, the Pap test is used for cervical cancer screening but recently several countries have switched from Pap testing to HPV testing. Like the Pap test, the HPV test requires a cervical sample to be taken by a clinician. Vaginal self-sampling is also used, but only in underscreened women. We know that self-sampling increases screening participation in underscreened women and it is likely that many women that attend screening also prefer self-sampling if it had been offered to them. We studied whether an HPV self-sampling test is an accurate alternative to a regular HPV test in women invited for routine screening. We randomized about 14,000 women, invited for screening, to self-sampling or clinician-sampling. Women with a positive HPV test result also received the other HPV test. We found that the HPV self-sampling test yielded similar performance as the regular HPV test for detection of cervical pre-cancerous lesions (CIN3 and CIN2).  (more…)
Author Interviews, Hospital Acquired, Infections, Technology / 23.01.2019

MedicalResearch.com Interview with: Donna Armellino RN, DNP, CIC Vice President, Infection Prevention Northwell Health, Infection Prevention Lake Success, N. Y. MedicalResearch.com: What is the background for this study?  Response: The background for initiating this study was to assess frequently used equipment within the patient care environment following standard manual cleaning and disinfection compared to disinfection with PurpleSun’s shadowless 90-second cycle focused multivector ultraviolet (FMUV) delivery system. Microbes exist within the environment. Cleaning followed by disinfection, regardless of method, is intended to decrease levels of these microbes to minimize exposure and the risk of infection. To measure the effectiveness of the two methods of disinfection a five-point culturing method was used to assess microbial burden. This method was used to assess patient care equipment cleanliness after manual cleaning/disinfection and following the use of FMUV after an operative case and was used to sample equipment deemed cleaned/disinfected and ready for use outside the operative environment. Microbial burden was reported as colony forming units (CFUs). Comparison of the CFUs before cleaning/disinfection, after cleaning/disinfection, and after the use of FMUV allowed efficacy of the disinfection methods to be compared.  (more…)
Author Interviews, Infections, Vaccine Studies / 23.01.2019

MedicalResearch.com Interview with: ValnevaThomas Lingelbach President & CEO of Valneva MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of Chikungunya disease? Response: Chikungunya is a mosquito-borne viral disease caused by the Chikungunya virus (CHIKV), a Togaviridae virus, transmitted by Aedes mosquitoes. The chikungunya virus causes clinical illness in 72-92% of infected humans around four to seven days after an infected mosquito bite. People infected with chikungunya may suffer from acute onset of fever, debilitating joint and muscle pain, headache, nausea and rash, potentially developing into long-term, serious health impairments such as visual, neurological, heart and gastrointestinal manifestations that in some extreme cases can lead to fatalities. Chikungunya outbreaks have been reported in Asia, Africa, the Americas and Europe. As of 2017, there have been more than one million reported cases in the Americas. The medical burden is expected to grow as the CHIKV primary mosquito vectors continue to further spread geographically. Currently there are no preventive vaccines against Chikungunya making it a major threat to public health. We set out to develop VLA1553, a live-attenuated vaccine candidate, as a potential solution to the growing unmet need chikungunya poses. Our hope is that having a preventative vaccine for chikungunya will allow people living in endemic areas to have peace of mind while enjoying the outdoors. (more…)
Author Interviews, Diabetes, Infections, JAMA, Pediatrics, Vaccine Studies / 22.01.2019

MedicalResearch.com Interview with: Dr Kirsten Perrett MBBS FRACP PhD Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children's Research Institute Consultant Paediatrician, Department of Allergy and Immunology and General Medicine The Royal Children's Hospital Fellow, School of Population and Global Health The University of Melbourne Parkville, Victoria  Australia MedicalResearch.com: What is the background for this study? Response: Before rotavirus vaccines were available, rotavirus infection was the most common cause of severe gastroenteritis in infants and young children. Because it is so contagious, infection in childhood is thought to be universal in unvaccinated children. Previous studies indicated that rotavirus infection of infants might be an environmental promoter of type 1 diabetes. Therefore, we anticipated that the introduction of the rotavirus vaccine might alter the disease incidence in young children.  (more…)
Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika / 21.01.2019

MedicalResearch.com Interview with: Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age. We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months. We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early. (more…)
Author Interviews, CDC, Infections, Pediatrics, Vaccine Studies / 18.01.2019

MedicalResearch.com Interview with: Sarah Anne Mbaeyi MD MPH Division of Bacterial Diseases CDC  MedicalResearch.com: What is the background for this study? Response: College freshman living in residence halls, though not college students overall, have previously been identified as being at increased risk for meningococcal disease. However, these evaluations were conducted in the 1990s when rates of disease were higher, serogroup C was the predominant cause of disease, and before the availability of quadrivalent meningococcal conjugate (MenACWY) or serogroup B meningococcal (MenB) vaccines. MenACWY vaccine is routinely recommended for all adolescents at age 11 years and 16 years, as well as unvaccinated or undervaccinated college freshmen living in residence halls. MenB vaccine is not routinely recommended for all adolescents or college students, but may be administered to persons aged 16-23 years, with the preferred age of 16-18 years, based on clinical decision-making. Meningococcal vaccines are also recommended during an outbreak, and in recent years MenB vaccines have been used during multiple outbreaks on college campuses. In this evaluation, we aimed to describe the current epidemiology of meningococcal disease among college-aged young adults in the United States. (more…)
Author Interviews, CDC, Infections, JAMA, Pediatrics / 15.01.2019

MedicalResearch.com Interview with: Dr. Srinivas Acharya Nanduri, MBBS, MD, MPH Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases Centers for Disease Control and Prevention Roybal Campus Atlanta, GA 3033 MedicalResearch.com: What is the background for this study? Response: Group B Streptococcus (GBS) is a leading cause of serious illness such as meningitis and sepsis in infants. Among infants, there are two main types of GBS disease. Early-onset GBS disease occurs during the first week of life and late-onset GBS disease occurs from the first week through three months of life. Rates of early-onset disease in the United States have decreased significantly since the 1990s through widespread implementation of intrapartum antibiotic prophylaxis (IAP) guidelines. However, IAP does not prevent late-onset disease. Maternal immunization represents a nonantibiotic strategy to prevent both early and late-onset disease. Multivalent polysaccharide-protein conjugate vaccines are under development against GBS capsular types, with candidate vaccines in phase I and II trials. Active Bacterial Core surveillance (ABCs) conducts active surveillance for early and late-onset GBS disease among infants in select counties of 10 states, covering about 10% of live births across the United States. We analyzed data from early and late-onset GBS cases identified from ABCs between 2006 and 2015 to describe their epidemiology, incidence trends, and associated strain characteristics. (more…)
Author Interviews, CDC, Global Health, Infections, Vaccine Studies / 11.01.2019

MedicalResearch.com Interview with: Kevin Chatham-Stephens, MD, MPH, FAAP CDR U.S. Public Health Service MedicalResearch.com: What is the background for this study? Response: Typhoid fever is a life-threatening disease caused by Salmonella Typhi bacteria. It spreads when someone consumes food or water that has been contaminated with feces (poop) from someone carrying the bacteria. About 12–27 million cases of typhoid fever occur worldwide every year. About 350 culture-confirmed cases of typhoid fever in the United States are reported to CDC each year. Most of these cases occur among international travelers. Symptoms of typhoid fever often include high fever, weakness, stomach pain, cough, and loss of appetite. Some people have diarrhea or constipation. Typhoid fever can be prevented through vaccination and safe food and water practices. Typhoid fever is treated with antibiotics, although most infections diagnosed in the United States cannot be successfully treated with the class of antibiotics called fluoroquinolones. (more…)
Author Interviews, C. difficile, Microbiome, Pain Research / 09.01.2019

MedicalResearch.com Interview with: David M. Aronoff, MD, FIDSA, FAAM Professor & Addison B. Scoville Jr. Chair in Medicine Director, Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: Clostridium difficile infection (CDI) is a major cause of antibiotic-associated colitis and diarrhea and a leading cause of hospital-acquired infection. It is caused by the toxin-producing, anaerobic, spore-forming bacterium Clostridium difficile. Antibiotic use is a major risk factor for CDI but epidemiological studies suggest that other factors, some modifiable, some not, can also increase the risk for CDI. Older age is an example of a non-modifiable risk factor for CDI. Some epidemiological studies suggested that taking the prostaglandin synthesis inhibiting drugs called non-steroidal anti-inflammatory drugs (NSAIDs) might also increase the risk for CDI. NSAIDs include medications such as ibuprofen, naproxen, indomethacin, and others. Because NSAID use is so common, if it is a risk factor for the acquisition of, or severity of, CDI, that would be important because that would be a modifiable risk factor. We therefore sought to determine the impact of NSAID exposure on CDI severity in a mouse model of antibiotic-associated CDI. We also sought evidence for possible mechanisms whereby NSAIDs might increase the risk for CDI. (more…)
Author Interviews, Dermatology, Global Health, Infections, PLoS / 28.12.2018

MedicalResearch.com Interview with: Michael Marks MRCP DTM&H PhD Clinical Research Department, Faculty of Infectious & Tropical Diseases London School of Hygiene and Tropical Medicine Hospital for Tropical Diseases London, United Kingdom Twitter @dr_michaelmarks Daniel Engelman MBBS; BMedSci; MPHTM; FRACP; PhD Centre for International Child Health, University of Melbourne, Tropical Diseases Research Group Murdoch Children’s Research Institute Melbourne, Australia Twitter @Dan_Engelman                   MedicalResearch.com: What is the background for this study? MM: Scabies is extremely common. Globally in the region of 100-200 million people are believed to be affected by scabies annually. Recently the WHO has recognised Scabies as a ‘Neglected Tropical Disease’ in response to this burden of disease. There has been increasing interest in using Mass Drug Administration (treating whole communities) as a strategy to control scabies in communities. In order to make this practical countries need an easy mechanism for establishing if scabies is a significant problem in their communities. In general when treating an individual, clinicians would conduct a full body examination to diagnose scabies – however this may not be practical or necessary when making decisions about whether to treat whole communities. DE: Despite the fact that Scabies is a very common condition that causes a great deal of health problems, it has been largely neglected by health, research and funding agencies – but pleasingly, the WHO has now started to take action on scabies control, starting with the recognition of scabies as a "Neglected Tropical Disease" (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA / 26.12.2018

MedicalResearch.com Interview with: Dr. Jianguo Xu, MD West China Hospital, Sichuan University Chengdu, Sichuan, China MedicalResearch.com: What is the background for this study? Response: Since the mid-20th century, corticosteroids have been used as adjuvant therapy in the context of sepsis. Although evaluated in numerous randomized clinical trials and meta-analyses, both the safety and efficacy of corticosteroids remain controversial. (more…)
Author Interviews, HIV, Immunotherapy / 21.12.2018

MedicalResearch.com Interview with: Tatiana Garcia-Bates, Ph.D. Research Assistant Professor Department of Infectious Diseases and Microbiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Human immunodeficiency virus (HIV) infection is now a manageable disease with the advent and availability of highly effective, combination antiretroviral therapy (ART). Unfortunately, as soon as ART is interrupted, the virus quickly rebounds to high levels and again targets the immune system. Therefore, new immunotherapeutic treatments are sought to re-program the immune system to control the virus after ART interruption. In many ways, chronic HIV infection, even when controlled, resembles cancer in how it impacts the immune system. Both conditions for example are associated with immune dysfunction, where the immune cells (specifically T cells) that are supposed to protect our bodies against invading microorganisms or cancers become exhausted and fail to respond effectively. In cancer, effective immunotherapies have been developed to reverse this immune exhaustion to extend the fighting capacity of the T cells. An example of this is drugs that target immune checkpoints, or “shut down” proteins, expressed on activated T cells, such as the programmed death-1 (PD-1) receptor. When engaged, PD-1 sends a negative signal to deactivate the T cell, and this contributes to the immune exhaustion seen in both cancer and in chronic infections. Some cancers express the ligand or the “trigger” for this shut down receptor, called PD-1 ligand (PD-L1). When this interaction between PD-1 and PD-L1 is interrupted, for example by using a blocking antibody, T cells can regain their killing capacity and destroy infected cells or cancer cells. This anti-PD-1 therapy has demonstrated high success against a variety of tumors. Therefore, we tested this approach in the context of HIV infection using a well-characterized cohort of HIV-positive individuals to see if we could improve their T cell responses to HIV in a laboratory setting. (more…)
Author Interviews, Cancer Research, Herpes Viruses / 18.12.2018

MedicalResearch.com Interview with: Jiahui Qian, MPH School of Public Health and Community Medicine University of New South Wales Sydney Australia     MedicalResearch.com: What is the background for this study? Response: Herpes zoster is a neurocutaneous disease caused by the reactivation of latent varicella zoster virus and its risk is related to the cell-mediated immunity. Previous studies have reported a higher zoster risk among patients with haematological cancer and cancer patients receiving chemotherapy. However, the role of the cancer itself and the receipt of cancer treatment is not clearly separated, we therefore started this study and tried to separate the risk of zoster associated with the cancer itself from cancer treatment.  (more…)
Author Interviews, Infections, NIH, Ophthalmology / 05.12.2018

MedicalResearch.com Interview with: Top, retina of a control patient. Bottom, retina from a patient with CJD. Arrowheads point to abnormal prions in the outer plexiform layer (opl), and the asterisk (*) marks more diffuse prions in the inner plexiform layer (ipl).Orrù et al., mBioByron Caughey, Ph.D. Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories Hamilton, MT 59840 USA  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Corneal transplants have caused the transmission of Creutzfeldt-Jakob disease (CJD) in at least two cases, and pathological prion protein has been detected in the retinas of the eyes of sporadic CJD cases. To build on these previous indications of prions in eye tissue, we tested the distribution of prions in various components of eyes from 11 sCJD decedents. We applied a highly sensitive surrogate test for prions (RT-QuIC) that indicated that all of the sCJD cases had prions in multiple parts of their eye, including the cornea and sclera, which is the white outer surface of the eye. Retinas were usually contained the highest levels, in some cases approaching levels in the brain. Some other parts such as the cornea, lens and vitreous had much lower, but detectable, levels.  (more…)
Annals Internal Medicine, Author Interviews, Heart Disease, Infections, Opiods / 04.12.2018

MedicalResearch.com Interview with: Asher Schranz, MD Division of Infectious Disease Department of Medicine UNC School of Medicine MedicalResearch.com: What is the background for this study? Response: The opioid crisis has led to several major infectious diseases concerns, including HIV and Hepatitis C. Drug use-associated infective endocarditis (DUA-IE) is a less commonly discussed consequence of the opioid epidemic. DUA-IE is an infection of one or more heart valves that occurs from injecting drugs. It can be a severe, life-threatening infection and requires a long course of intravenous antibiotics as well as, in some cases, open heart surgery to replace an infected heart valve. Several studies over the past few years have shown that DUA-IE has been increasing. Our study examined hospital discharges in North Carolina statewide from 2007 to 2017. We sought to update trends in DUA-IE and describe how much heart valve surgery was being performed for DUA-IE. We also aimed to report the demographics of persons who are undergoing heart valve surgery for DUA-IE and the charges, lengths of stay and outcomes of these hospitalizations.  (more…)