Could Treatment for Herpes Virus Reduce Risk of Alzheimer’s Disease?

MedicalResearch.com Interview with:

This photograph depicts a close-up of the lips of a patient with a herpes simplex lesion on the lower lip, due to the herpes simples virus-1 (HSV-1) CDC image

This photograph depicts a close-up of the lips of a patient with a herpes simplex lesion on the lower lip, due to the herpes simples virus-1 (HSV-1)
CDC image

Prof Ruth Itzhaki
Emeritus Professor
Division of Neuroscience & Experimental Psychology
The University of Manchester

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

Response: The background arises from the unexpected discovery, made by my lab almost 30 years ago, that the DNA of the common virus, herpes simplex virus type 1 (HSV1), known as the “cold sore” virus, was present in a high proportion of autopsy brains from elderly humans. Subsequently, we found that HSV1, when in brain of people who have a specific genetic factor, APOE-e4, confers a strong risk of developing Alzheimer’s disease. We found also a parallelism with cold sores in that APOE-e4 is a risk for the sores, which occur in about 25-40% of people infected with HSV1.

We then looked for links between the effects of HSV1 infection of cells in culture and AD, and found some major associations between virus and disease.

Firstly, HSV1 causes an increase in the formation of a small protein called beta amyloid, which is the main component of the abnormal “plaques” seen in Alzheimer’s Disease brains.

Secondly, we discovered that in AD brains, the viral DNA is located precisely within amyloid plaques, which suggests that the virus is responsible for the formation of these abnormal structures. Thirdly, we confirmed the finding of another lab that HSV1 causes the increased formation of an abnormal form of the protein known as tau, which is the main component of the other characteristic abnormality of Alzheimer’s Disease brains – “neurofibrillary tangles”.

All these discoveries suggested that the damage caused by HSV1 leads eventually to the development of AD.

Lastly, we showed that treating HSV1-infected cells in culture greatly reduces the formation of beta amyloid and abnormal tau. This suggests that antiviral agents might be used for treating Alzheimer’s Disease patients.

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Biomarker Procalcitonin Offered Limited Benefit Over Clinical Judgement In Antibiotic Prescribing Patterns

MedicalResearch.com Interview with:

David T. Huang, MD, MPH Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science Director, MACRO (Multidisciplinary Acute Care Research Organization) Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness) University of Pittsburgh

Dr. David Huang

David T. Huang, MD, MPH
Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science
Director, MACRO (Multidisciplinary Acute Care Research Organization)
Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness)
University of Pittsburgh

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

Response: The overuse of antibiotics has become a serious threat to global public health, causing antibiotic resistance and increasing health care costs. Physicians have long known that antibiotics are usually unnecessary for acute bronchitis and for some other cases of lower respiratory tract infections, and that antibiotics treat only bacterial infections, not viral. But in daily practice, many physicians often prescribe them.

Previous research had reported that using a biomarker blood test and following an antibiotic guideline tied to the test results could reduce antibiotic use in lower respiratory tract infections. In February 2017, the U.S. Food and Drug Administration approved the biomarker test that measures procalcitonin – a peptide that typically increases in bacterial infections, but not viral.

We conducted the Procalcitonin Antibiotic Consensus Trial (ProACT) trial to evaluate whether a procalcitonin antibiotic prescribing guideline, implemented for the treatment of suspected lower respiratory tract infection with reproducible strategies, would result in less exposure to antibiotics than usual care, without a significantly higher rate of adverse events.

The ProACT trial involved 14 predominately urban academic hospitals. We enrolled 1,656 adult patients who presented to the hospital emergency department and were initially diagnosed with a lower respiratory tract infection. All the patients were tested for their procalcitonin levels, but the results were shared only with the physicians of the patients randomly assigned to procalcitonin-guided antibiotic prescription.

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To Avoid Leprosy, Stay Away from Armadillos!

MedicalResearch.com Interview with:

Nine-banded armadillo image credit: Dr. Richard Truman, USPHS, Public Domain (2014)John S. Spencer, Ph.D.
Colorado State University
Fort Collins, Colorado

MedicalResearch.com: What is the background for this study? Where can armadillos be found? What are the main findings? 

Response: The ancient disease leprosy, a disease causing skin lesions, nerve damage, disfigurement and disability, is caused by the bacterium Mycobacterium leprae, and is mainly spread by aerosol infection (coughing and sneezing) from human to human. It is rare in the United States (less than 200 cases on average per year), while it is endemic in Brazil, where over 25,000 new cases were diagnosed last year. In addition, zoonotic transmission of leprosy by nine-banded armadillos (Dasypus novemcintus, pictured at left) has been shown to occur in the southern United States, mainly in Texas, Louisiana and Florida.

Nine-banded armadillos originated from South America, and expanded their range from Mexico into Texas in the 1800’s, eventually spreading north and east throughout the gulf states. People in Brazil, particularly in rural areas, hunt and kill armadillos as a dietary source of protein. In the small town of Belterra in western Pará state in the Brazilian Amazon region, a survey of 146 residents showed that around 65% of people had some contact with armadillos, through hunting, preparing the meat for cooking, or by eating them. A group of individuals who ate armadillos most frequently (more than once per month and up to twice a week) had a significantly higher antibody titer towards the M. leprae-specific antigen PGL-I and an almost two-fold higher risk of being diagnosed with disease, a significant risk.   Continue reading

More Acorns = More Mice = More Lyme Disease

The white-footed mouse has been found to be a competent reservoir for the Lyme disease-causing spirochete, Borrelia burgdorferi – Wikipedia image

MedicalResearch.com Interview
Richard S. Ostfeld, PhD

Distinguished Senior Scientist
Cary Institute of Ecosystem Studies
Millbrook, NY 12545, USA

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

Response: Lyme disease and other tick-borne infections occur in large portions of the eastern and Midwestern United States and adjacent Canada, and the geographic range is expanding rapidly, engulfing new communities every year.  Despite the observed increases in incidence rates and geographic range at the national level, considerable variation occurs across space and time, with persistent hot spots, colder spots, bad years, and not-as-bad years.  We undertook this long-term study (19 years) to ask what causes some places and years to be particularly risky and others not as risky, in terms of human exposure to tick-borne disease.  Because diagnosis and treatment of Lyme disease are problematic and highly controversial, and because no vaccines or effective tick-control methods are currently available, we hoped that understanding the causes of high risk would facilitate prevention of human exposure.

We found that, in the oak-dominated forests that pervade the Lyme-disease-endemic zone, acorn production in the autumn is a strong leading indicator of Lyme disease risk two summers later.  Acorn production is associated with marked population increases of white-footed mice and eastern chipmunks, which use abundant acorns as a key over-winter food source, leading to population growth the following year.  Dense summer populations of mice and chipmunks provide the local population of blacklegged ticks with abundant sources of blood-meal hosts.  These small rodents are more permissive of successful tick feeding (other hosts kill many ticks by grooming them as they attempt to feed), and they are also the primary natural reservoirs of infection with the microbial agents causing Lyme disease, anaplasmosis, and babesiosis.  Larval ticks emerging when rodents are highly abundant are highly likely to survive and acquire infection, molting the next year into infected nymph-stage ticks.  Bites from nymph-stage ticks are responsible for the great majority of tick-borne disease cases.  The one-year lag from acorns to rodent populations plus the one year lag from larval ticks biting rodents to nymphal ticks biting people together are responsible for the total two-year lag.

By using motion-sensitive cameras set in over 100 sites over two years, we were also able to ask whether the local community of mammal predators can affect human risk of exposure.  We found that sites with a diverse assemblage of predators, especially foxes, bobcats, and opossums, were associated with reduced tick infection prevalence with the agents of Lyme disease, anaplasmosis, and babesiosis.  When these predators were absent, which sometimes occurred when coyotes displaced them, infection prevalence was significantly higher.  Infection prevalence was also lower in sites within extensive, unbroken forest, and higher in sites with small forest remnants.  Taken together, we determined that an understanding of the food webs within which ticks and pathogens dwell can strongly facilitate the ability to predict when and where risk will be high.  Acorns exert what ecologists call a “bottom-up” effect, whereas the predators enforce “top-down” control.  We found that the ticks were remarkably resilient to most weather-related factors.  However, when winter-spring weather was particularly warm and dry, tick abundance the following summer was reduced.  Cold winters did not kill off the ticks. 

MedicalResearch.com: What should readers take away from your report?

Response: The ecology of tick-borne disease is incredibly complex, but still we can find big signals amongst the noise and predict risk with a good degree of confidence.  Predicting times and places of enhanced risk is particularly important given the frustrations within the public health community and the public at large over the slow pace of progress in improving diagnostic capabilities and treatments.  We are still relying fundamentally on individual efforts to prevent exposure using various self-protections, such as repellents, tick-checks, protective clothing and the like.  Targeting these efforts to times and places where risk is particularly high should help protect public health. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Long-term monitoring of tick populations is crucial for evaluating the importance of ecological variables, like wildlife abundance and weather, in determining risk of human exposure.  In addition, the longer we monitor these variables the more likely we are to see extreme events, which might play outsized roles.  Intensive monitoring like this is also crucial for detecting invasions by other species of tick that are important to public health. For instance, we expect lone star ticks to invade our area from the south, with unpredictable consequences for blacklegged ticks and human health.  We are also concerned about potential invasions by non-native ticks, like the long-horned tick that was recently detected in several eastern and Midwestern states to our south. 

No disclosures 

Citation:

Richard S. Ostfeld, Taal Levi, Felicia Keesing, Kelly Oggenfuss, Charles D. Canham. Tick-borne disease risk in a forest food web. Ecology, 2018; 99 (7): 1562 DOI: 1002/ecy.2386

 

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Biomarker Can Identify Aggressive Form of Bacteria Klebsiella pneumoniae

MedicalResearch.com Interview with:

This blood agar plate (BAP) grew colonies of Gram-negative, small rod-shaped and facultatively anaerobic Klebsiella pneumoniae bacteria- CDC image

This blood agar plate (BAP) grew colonies of Gram-negative, small rod-shaped and facultatively anaerobic Klebsiella pneumoniae bacteria- CDC image

Thomas A Russo, MD, CM
The Departments of Medicine, and Microbiology and Immunology
The Witebsky Center for Microbial Pathogenesis
University at Buffalo-State University of New York, and the
Veterans Administration Western New York Healthcare System
Buffalo, New York

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

Response: K. pneumoniae is an important bacterial pathogen that cause a number of different infections. Presently, two pathotypes exist that behave very differently.

Classical K. pneumoniae, which is most common in North America and Europe primarily causes infections in the healthcare setting, usually in patients with co-morbidities. Also, it is becoming increasingly antimicrobial resistant, making treatment challenging.

Hypervirulent K. pneumoniae, which is more common in the Asian Pacific Rim,  can cause infections in otherwise healthy individuals, often causes infection in multiple sites, and these sites are usually not infected by classical K. pneumonia, such as the eye, brain, and aggressive soft-tissue infection (necrotizing fasciitis). Hypervirulent K. pneumonia strains are also becoming antimicrobial resistant, albeit at a slower rate than classical K. pneumoniae at this time.

There are some differences how infections due to these two pathotypes are managed. It would also be ideal to track the prevalence and relative antimicrobial resistance of these two pathotypes, but up until now this could not be reliably done because there was not a validated test that could differentiate them. The goal of this study was to identify biomarkers that could accurately differentiate classical from hypervirulent K. pneumoniae.  Continue reading

New HIV Vaccine Advances in Phase 2 Studies

MedicalResearch.com Interview with:

Dan Barouch, M.D., Ph.D. Professor of Medicine Harvard Medical School Ragon Institute of MGH, MIT, and Harvard Director, Center for Virology and Vaccine Research Beth Israel Deaconess Medical Center Boston, MA 02215

Dr. Barouch

Dan Barouch, M.D., Ph.D.
Professor of Medicine
Harvard Medical School
Ragon Institute of MGH, MIT, and Harvard
Director, Center for Virology and Vaccine Research
Beth Israel Deaconess Medical Center
Boston, MA 02215

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

Response: This study demonstrates that the mosaic Ad26/Env HIV vaccine candidate induced robust and comparable immune responses in humans and monkeys.

Moreover, the vaccine provided 67% protection against viral challenge in monkeys.   

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TPOXXÒ (tecovirimat): Novel Antiviral Agent in the Event of a Smallpox Epidemic

MedicalResearch.com Interview with:

This 1967 photograph, which was captured in Accra, Ghana, depicts the face of a smallpox patient CDC/ John Noble, Jr., M.D.

This 1967 photograph, which was captured in Accra, Ghana, depicts the face of a smallpox patient.

Dr. Dennis E. Hruby PhD
Chief Science Officer of SIGA Technologies
Corvallis, OR

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

Response: Naturally occurring smallpox was declared eradicated in 1980 following coordinated decades-long global vaccination campaigns. However, there is a significant concern that smallpox, which is both highly contagious and highly lethal, could be used as a potential bioweapon.

DNA synthesis technology and the possibility of unaccounted for smallpox stocks pose significant risks. While there are two publicly acknowledged stocks of smallpox virus held by the United States and Russia, some believe that additional stores of the virus could be in the hands of governments or organizations that might use them to cause harm. The DNA sequence of the smallpox genome is in the public domain and could potentially be synthesized in a laboratory from scratch or created by genetically modifying a similar virus.

Currently, there are no therapies approved for the treatment of smallpox infection. A smallpox bioterror attack could be especially damaging because the majority of today’s population is not immune to the virus, as routine vaccination ended in the 1970s. It is estimated that without vaccination or treatment, each person infected with smallpox would infect 5 – 7 others. Rapid spread from person-to-person can occur through speaking, breathing or touching. Smallpox also can be transmitted by direct contact with infected fluids and contaminated objects. Furthermore, vaccination must occur within 3-5 days of exposure to smallpox, when patients are still asymptomatic, to be effective. These limitations underscore the need for an effective smallpox antiviral therapy, in addition to any available vaccine.

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Coding Changes Limited Penalty Impact From CMS Hospital-Acquired Conditions Policy

MedicalResearch.com Interview with:

Michael S. Calderwood, MD, MPH, FIDSA Regional Hospital Epidemiologist Assistant Professor of Medicine Infectious Disease & International Health

Dr. Calderwood

Michael S. Calderwood, MD, MPH, FIDSA
Regional Hospital Epidemiologist
Assistant Professor of Medicine
Infectious Disease & International Health

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

Response: Prior work by Lee et al. (N Engl J Med 2012;367:1428–1437) found that the 2008 CMS Hospital-Acquired Conditions (HAC) policy did not impact already declining national rates of central line-associated bloodstream infections (CLABSIs) or catheter-associated urinary tract infections (CAUTIs). We studied why this policy did not have its intended impact by looking at coding practices and the impact of the policy on the diagnosis-related group (DRG) assignment for Medicare hospitalizations. The DRG assignment determines reimbursement for inpatient hospitalizations.

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More Evidence Ancient Retrovirus Linked to Type 1 Diabetes

MedicalResearch.com Interview with:

Sandrine Levet PhD Student Preclinical Study Manager GeNeuro

Sandrine Levet

Sandrine Levet PhD
Preclinical Study Manager
GeNeuro

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

Response: Human endogenous retroviruses (HERVs), remnants of ancestral viral genomic insertions, are known to represent 8% of the human genome and are associated with several pathologies. In particular, the envelope protein of HERV-W family (HERV-W Env) has been involved in multiple sclerosis pathogenesis.

A previous study published in JCI Insight revealed that HERV-W Env is also involved in Type 1 diabetes (T1D) pathogenesis. In this study, we observed that HERV-W-Env protein and RNA are detected respectively in sera and peripheral blood mononuclear cell (PBMC) of T1D patients.

We also demonstrated that this pathogenic protein is expressed by acinar cells in human T1D pancreas and is associated with the recruitment of macrophages within the pancreas of these patients. HERV-W Env also displays direct pathogenic properties as it inhibits insulin secretion by human islets of Langerhans.

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CDC’s Change in HIV Policy Impacted Providers’ Role in Prevention

MedicalResearch.com Interview with:

Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA

Dr. Pinto

Rogério M. Pinto, LCSW, Ph.D.
Associate Professor
Associate Dean for Research
School of Social Work
University of Michigan
Ann Arbor, Michigan

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

Response: This research, published in Health Education & Behavior (https://doi.org/10.1177/1090198118760681),highlights the crucial role of providers of social and public health services in helping patients to access lifesaving HIV services. Before 2012, providers were encouraged and trained to link patients to behavioral interventions to help patients modify their behaviors to protect themselves against HIV transmission and infection. A shift in policy from targeting anyone at risk to those at highest risk (called “High Impact Prevention”) made these interventions less available (they were actually discontinued) and new policy dictated that providers should have as many people as possible access HIV testing and link them to HIV primary care in order to receive antiretroviral medication.

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Unrelated Bacterial Strains Can Transfer Antibiotic Resistance Genes To Each Other

MedicalResearch.com Interview with:

CRE bacteria - CDC image

CRE bacteria – CDC image

Richard Stanton, PhD
Health Scientist, Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention

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

Response: We used whole genome sequencing (WGS) to investigate an outbreak of carbapenem-resistant Enterobacteriaceae (CRE) that occurred in an acute care hospital in Kentucky over a six month period in late 2016. The outbreak included 18 cases of CRE.

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Red Meat Allergy Caused by Lone Star Tick Linked to Coronary Artery Disease

MedicalResearch.com Interview with:
“Lone Star Tick” by Katja Schulz is licensed under CC BY 2.0Jeffrey Wilson, MD, PhD

Research Fellow, Allergy & Immunology
University of Virginia 

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

Response: Galactose-α-1,3-galactose (α-Gal) represents an oligosaccharide that is present in mammalian products and is the causal allergen in a syndrome of delayed red meat allergy (commonly called α-Gal syndrome). Sensitization to this allergen has been linked to tick bites, specifically the lone star tick in the United States.

Thus, sensitization to α-Gal (and the prevalence of subjects with symptomatic red meat allergy) is relatively common where the lone star tick is common, i.e- the southeast.

For a variety of reasons we hypothesized that specific immune sensitization (which relates to IgE antibody production) to α-Gal would be a risk factor for coronary artery disease. To address this possibility we measured IgE specific to α-Gal in 118 adults subjects from central Virginia who had undergone advanced cardiac imaging with a technique called intravascular ultrasound. Out of the cohort 26% of the subjects in the study had the sensitivity to α-Gal.

The main finding was that subjects with the IgE sensitization to α-Gal had greater amounts of atherosclerosis, as well as atherosclerotic plaques with more unstable characteristics. This association was significant when controlled for traditional cardiovascular risk factors such as hypertension, diabetes and lipids levels.

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Ornamental Bromeliad Plants Contribute to Zika-Carrying Mosquitoes

MedicalResearch.com Interview with:
“Bromeliad” by Selena N. B. H. is licensed under CC BY 2.0André Wilke, Ph.D.
Post Doctoral Associate
Division of Environment & Public Health
Department of Public Health Sciences
University of Miami Miller School of Medicine
Clinical Research Building
Miami, Florida 33136

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

Response: As vector-borne diseases pose an increasing public health threat to communities in South Florida and elsewhere, a new study led by public health researchers at the University of Miami Miller School of Medicine has revealed that ornamental bromeliad plants contribute to breeding of the Aedes aegypti mosquito—a key culprit for the Zika outbreak that hit Miami-Dade County and other areas of Florida and the Americas in 2016.

In addition to Zika, bites from the Aedes aegypti mosquito can cause dengue, yellow fever and chikungunya. Zika has been linked to microcephaly and other birth defects in unborn babies when pregnant women contract the disease. The family of diseases linked to the Aedes aegypti can cause other severe symptoms. Yellow fever can be fatal.

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TDAP Vaccine During Pregnancy Protects Infants Against Whooping Cough

MedicalResearch.com Interview with:

Sylvia Becker-Dreps, MD MPH Associate Professor, Department of Family Medicine Associate Director, Office of International Activities (Latin America Focus) Director, UNC Program in Nicaragua University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7595

Dr. Becker-Dreps

Sylvia Becker-Dreps, MD MPH
Associate Professor, Department of Family Medicine
Associate Director, Office of International Activities (Latin America Focus)
Director, UNC Program in Nicaragua
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7595

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

 Response: Pertussis (or whooping cough) is a respiratory infection caused by bacteria. It has been becoming more common in the US over the past two decades. Infants are more likely to be hospitalized and die of the disease. They are especially vulnerable in the first months of life because they have not yet had time to complete the DTaP vaccine series themselves. (Currently, infants receive 3 doses of DTaP at 2,4, and 6 months of age.) Immunizing mothers allows the mothers to pass antibodies against pertussis through the placenta and provide passive immunity to infants early in life. In early 2013, the CDC recommended that pregnant women receive a Tdap vaccine in every pregnancy. That recommendation was based on studies of the immune response to the vaccine, not real cases of pertussis.

Our study examined clinical cases of pertussis in over 675,000 infants throughout the US. We found that in the first six months of life, infants of vaccinated mothers (those that received Tdap during pregnancy) had 75% less pertussis hospitalizations and 50% less pertussis cases overall.  Continue reading

Parent Skin Cleansing Prior to Infant Contact in NICU Important to Reduce Staph Infections

MedicalResearch.com Interview with:
“Bart Infant” by Bart Everson is licensed under CC BY 2.0Gwen M. Westerling, BSN, RN, CIC
Infection Preventionist
Helen DeVos Children’s Hospital

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

Response: The setting of this study is a Level III Neonatal Intensive Care Unit (NICU) with 106 beds.

In 2016, an increase in Hospital Acquired Infections (HAI) was noted in the Neonatal Intensive Care Unit (NICU) caused by Staphylococcus aureus (SA) through diligent Infection Prevention Surveillance. When we reviewed the literature we found the SA is a common skin colonizer and can be a problem for neonates with immature skin and immune systems.

Staphylococcus aureus is easily transmitted through direct contact with skin, the contaminated hands of health care workers, the environment and equipment. We also found one study that listed skin to skin care as a risk factor for acquisition of SA. Before we saw the increase in infections some process changes occurred in our NICU that included increased skin to skin care, meaningful touch between neonates and parents, and two person staff care. We hypothesized that the process changes were exposing neonates to increased amounts of Staphylococcus aureus and contributing to the increase in infections.

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Why So Many New HIV Infections in US, Despite PrEP Availability?

MedicalResearch.com Interview with:

Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA

Dr. Pinto

Rogério M. Pinto, LCSW, Ph.D.
Associate Professor
Associate Dean for Research
School of Social Work
University of Michigan
Ann Arbor, USA

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

Response: This integrative review, published in the journal AIDS and Behavior, includes content from 47 peer-reviewed scholarly articles reporting multiple barriers to high-risk individuals trying to access pre-exposure prophylaxis (PrEP), the HIV drugs that reduce subsequent risk of infection. We found 31 potential solutions to 30 barriers at the patient, provider and health-system levels. In synthesizing this research from a multi-level perspective, based upon a socioecological model, our report contributes much-needed analysis to the rapidly expanding field of PrEP implementation research.

At this stage in the scale-up of U.S. PrEP programs, it is important to systematically and comprehensively analyze and integrate knowledge about the successes of and the barriers to PrEP implementation. Our review provides a comprehensive analysis and informs the direction of PrEP implementation across a variety of settings.

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What Causes Failures in Personal Protective Equipment Use in Hospitals?

MedicalResearch.com Interview with:

Sarah L. Krein, PhD, RN Research Career Scientist VA Ann Arbor Healthcare System Ann Arbor, MI 

Sarah L. Krein, PhD, RN
Research Career Scientist
VA Ann Arbor Healthcare System
Ann Arbor, MI

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

Response: We conducted this study to better understand the challenges faced by health care personnel when trying to follow transmission based precaution practices while providing care for hospitalized patients.  We already know from other studies that there are breaches in practice but our team was interested in better understanding why and how those breaches (or failures) occur so we can develop better strategies to ensure the safety of patients and health care personnel.

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Mathematical Model Investigates Spread of Cholera In Limited Resource Setting

MedicalResearch.com Interview with:
“Cholera Hospital 3” by Mark Knobil is licensed under CC BY 2.0Dr. Daihai He
Assistant Professor
Department of Applied Mathematics
Hong Kong Polytechnic University  

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

Response: A large-scale cholera outbreak hit Yemen in 2017-2018 and caused an estimated 1,100,720 suspected cases and 2291 associated deaths between 27 April 2017 and 20 May 2018, thus a case fatality ratio 0.21%.

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Long Term HIV Viral Suppression Reduces But Does Not Eliminate Elevated Cancer Risk

MedicalResearch.com Interview with:

Lesley S. Park, PhD, MPH Instructor, Medicine- Primary Care and Population Health BioStanford Center for Population Health Sciences (PHS) Associate Director, Research and Data Strategy; Director, PHS Postdoctoral Fellowship Veterans Aging Cohort Study (VACS) Cancer Core Co-Director

Dr. Lesley Park

Lesley S. Park, PhD, MPH
Instructor, Medicine- Primary Care and Population Health
BioStanford Center for Population Health Sciences (PHS) Associate Director, Research and Data Strategy; Director, PHS Postdoctoral Fellowship
Veterans Aging Cohort Study (VACS) Cancer Core Co-Director

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

Response: As the population of persons living with HIV/AIDS is aging, the overall burden of cancer is substantial and increasing; however, we have much to learn about the potential cancer prevention benefits of antiretroviral treatment (ART).

Our study is the first to examine the effects of prolonged periods of viral suppression and potential cancer prevention benefits. While prior randomized clinical trials (RCTs) and observational studies have examined viral suppression and cancer risk, they mostly were limited to small numbers of cancer outcomes or were only focused on few specific cancer types.

Our study demonstrated a benefit of the prevention of cancer development in AIDS-defining cancers (non-Hodgkin lymphoma, Kaposi sarcoma), which was expected, but also in some non-AIDS-defining cancer types (lung, larynx, melanoma, leukemia).  Continue reading

Unique Vaginal Cells Facilitate HIV Infection and Persistence

MedicalResearch.com Interview with:

Manish Sagar, MD Assistant Professor of Medicine, Boston University School of Medicine Boston MA 

Dr. Sagar

Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA 

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

Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure.  The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.

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What Do We Find Disgusting? and Why?

MedicalResearch.com Interview with:
rat- wikipedia imageMícheál de Barra, PhD

Lecturer in Psychology
Brunel University London

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

Response: Disgust has been called the “intuitive microbiologist”  – it tracks the sources of infection in our environment. But so far, there has been little attempt to link the sources of disgust to the sources of infectious disease in a comprehensive way. So we developed a method for developing stimuli based on a random sample illness.

We basically asked ourselves what the kinds of cues that might be associated with that kind of disease risk and asked people to rate disgust responses. The main motive for this was to contribute to a debate in the literature about if there are “kinds of disgust” and if so, how many. I results were a little ambiguous there I’m afraid.

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Guillain-Barré Syndrome With and Without Zika

MedicalResearch.com Interview with:

Dr. Emilio Dirlikov, PhD Office of Epidemiology and Research, Puerto Rico Department of Health Epidemic Intelligence Service Division of Scientific Education and Professional Development CDC

Dr. Dirlikov

Dr. Emilio Dirlikov, PhD
Office of Epidemiology and Research, Puerto Rico Department of Health
Epidemic Intelligence Service
Division of Scientific Education and Professional Development
CDC

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

Response: After reporting local Zika transmission in December 2015, the Puerto Rico Department of Health (PRDH), US Centers for Disease Control and Prevention (CDC), and University of Puerto Rico began identifying cases of Guillain-Barré syndrome (GBS), testing specimens, and conducting follow-up telephone interviews after patients left the hospital.

Through these efforts, we were able to characterize acute clinical features and long-term disability of GBS associated with Zika infection by analyzing data from GBS patients with and without evidence of Zika infection.

This investigation increases scientific and medical understanding of Guillain-Barré syndrome following Zika infection, provides insight into the disease processes involved in GBS following Zika infection, and adds to growing evidence of a causal association between Zika and GBS.  Continue reading

Widely Use Antibacterial in Hand Sanitizers and Toothpaste Can Attack Biofilms

MedicalResearch.com Interview with:

Christopher M. Waters PhD Departments of Microbiology and Molecular Genetics BEACON Center for The Study of Evolution in Actio Michigan State University East Lansing, MI 

Dr. Waters

Christopher M. Waters PhD
Departments of Microbiology and Molecular Genetics
BEACON Center for The Study of Evolution in Actio
Michigan State University
East Lansing, MI 

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

Response: Our research really centers on understanding and targeting bacterial biofilms. These are multicellular communities of bacteria encased in a slimy matrix that protects them from the immune system and antibiotic treatment during infections. One of the most common types of biofilm infections is in the lungs of cystic fibrosis by the bacterium Pseudomonas aeruginosa. CF patients can become chronically colonized by P. aeruginosa, and antibiotics are not able to clear these infections.

Our idea was can we find other molecules that make antibiotics more effective at killing biofilms? To this end, we screened about 6,000 compounds for those that would make tobramycin more effective at killing P. aeruginosa biofilms, and one of the best hits we found was the antimicrobial triclosan that has been widely used for decades in hand sanitizers, soaps, and tooth paste. Although neither triclosan nor tobramycin can kill biofilms alone, the combination is 100X more effective against virtually every P. aeruginosa strain tested. It also worked against other bacteria that commonly infect cystic fibrosis lungs such as Staphylococcus aureus and Burkholderia cenocepacia.

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Pre-Emptive Therapy of CMV in Allogeneic Hematopoietic Cell Transplant

MedicalResearch.com Interview with:

 Dr-Roy F. Chemaly

Dr. Chemaly

Roy F. Chemaly, MD, MPH F.A.C.P., F.I.D.S.A.
Department of Infectious Diseases
Infection Control and Employee Health
Division of Internal Medicine
MD Anderson Center

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

Response: CytomegalovirusCMV infection is a common cause of morbidity and mortality in allo-HCT recipients. Evidence suggests that CMV infection has not only an enormous clinical burden, but a substantial economic burden as well.

We conducted this study at MD Anderson to determine the economic and clinical burden of preemptive therapy (PET) for CMV infection. Between 2012 and 2015, 100 consecutive patients hospitalized at our institution for allo-HCT who experienced reactivation of CMV and were treated pre-emptively, were enrolled.

The majority of patients were men (55%), who had underlying leukemia (73%), and underwent matched unrelated donor transplant (59%). At the time of hospitalization, most patients had acute GvHD (62%), and were on steroids (58%) within 30 days of CMV reactivation which occurred at a median of 32 days post-HCT (2 -174). A total of 192 episodes of PET occurred in the 100 allo-HCT recipients within 1 year post-HCT. PET consisted of ganciclovir (41%), foscarnet (40%), and valganciclovir (38%). IVIG was also used as adjunct therapy in 20% of episodes.

Progression to Cytomegalovirus disease occurred in 4 patients (4%) and mainly affected the GI tract. Mean length of stay for patients treated with ganciclovir or foscarnet was 32 days (2-141) and 41 days (1-177), respectively. The average direct cost per patient admitted for PET was $126,038 ($7,866-$641,841) and the mean cost of CMV antiviral drug per hospitalization was $6,096 for IVIG, $2,410 for foscarnet, $836 for ganciclovir, and $780 for valganciclovir.

Serious side effects from PET were observed in 35% of patients on ganciclovir and 12% of patients on foscarnet. Total direct cost per encounter was significantly higher in patients who had serious side effects from foscarnet. All-cause mortality was 59% at 1 year post-transplant.

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Ibuprofen Can Not Replace Antibiotics in Uncomplicated UTI

MedicalResearch.com Interview with:

Ingvild Vik MD Doctoral Research Fellow Department of General Practice Institute of Health and Society - UiO University of Oslo, Norway.

Dr. Vik

Ingvild Vik MD
Doctoral Research Fellow
Department of General Practice
Institute of Health and Society – UiO
University of Oslo, Norway

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

Response: Uncomplicated urinary tract infection (UTI) is the most common bacterial infection in women. It is painful and troublesome, and even though it is often self-limiting most women who see a doctor will be prescribed an antibiotic, as antibiotics provide quick symptom relief.  Antibiotic resistance is a growing, serious public health problem. Antibiotic use is the main contributor to antibiotic resistance, and to stop the rapid development it is crucial that we reduce unnecessary use of antibiotics. Antibiotics can cause unpleasant and potentially severe side effects, so avoiding unnecessary use is also beneficial for the individual patient.

A small German trial published in 2010 by Bleidorn et al. suggested that ibuprofen was non-inferior to the antibiotic ciprofloxacin in achieving symptomatic cure in uncomplicated UTI. This inspired us to conduct a larger trial to compare the anti-inflammatory drug ibuprofen to antibiotics in the treatment of uncomplicated UTI.  Continue reading