Author Interviews, Neurological Disorders, Zika / 19.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32197" align="alignleft" width="134"]Ping Wu, MD, PhD John S. Dunn Distinguished Chair in Neurological Recovery Professor, Department of Neuroscience & Cell Biology University of Texas Medical Branch Galveston, TX 77555-0620 Dr. Ping Wu[/caption] Ping Wu, MD, PhD John S. Dunn Distinguished Chair in Neurological Recovery Professor, Department of Neuroscience & Cell Biology University of Texas Medical Branch Galveston, TX 77555-0620 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Zika viral infection poses a major global public health threat, evidenced by recent outbreaks in America with many cases of microcephaly in newborns and other neurological impairments. A critical knowledge gap in our understanding is the role of host determinants of Zika-mediated fetal malformation. For example, not all infants born to Zika-infected women develop microcephaly, and there is a wide range of Zika-induced brain damage. To begin to fill the gap, we infected brain stem cells that were derived from three human donors, and found that only two of them exhibited severer deficits in nerve cell production along with aberrant alterations in gene expression.
Author Interviews, Global Health, HIV, Lancet / 19.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32187" align="alignleft" width="132"]Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065 Dr. Jennifer Downs[/caption] Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between 2002 and 2006, three large randomized controlled trials in sub-Saharan Africa demonstrated that male circumcision reduces new HIV infections in men by approximately 60%. Based on these findings, the World Health Organization recommended male circumcision as an HIV prevention strategy in countries with high levels of HIV and a low prevalence of male circumcision. This led to prioritization of 14 countries in Eastern and Southern Africa for massive scale-up of male circumcision beginning in 2011. In many of these countries, the uptake of male circumcision was lower than expected. In northwest Tanzania, where we work, there are a number of barriers to male circumcision. Some of these barriers are cultural, tribal, economic, and religious. We conducted focus group interviews in 2012 that showed that many Christian church leaders and church attenders in our region in Tanzania had major concerns about whether male circumcision was compatible with their religious beliefs. This led us to hypothesize that the uptake of male circumcision could be increased when religious leaders were taught about male circumcision, with the goal that they would then be equipped to discuss this issue with their congregations.
Author Interviews, HIV, Immunotherapy / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32115" align="alignleft" width="149"]Brinda Emu MD Assistant Professor of Medicine (Infectious Diseases Yale University New Haven, CT Dr. Brinda Emu[/caption] Brinda Emu MD Assistant Professor of Medicine (Infectious Diseases Yale University New Haven, CT  MedicalResearch.com: What is the background for this study? Response: Ibalizumab is a fully humanized monoclonal antibody that targets the CD4 receptor.  This Phase III registrational study enrolled individuals with HIV infection that harbor high levels of multi-drug resistance, with limited treatment options.  At IDWeek in October, 2016, data was presented that demonstrated patients experienced a significant decrease in viral load after receiving a single loading dose of ibalizumab 2,000 mg intravenously (IV) in addition to their failing antiretroviral therapies (ART) (or no therapy). Seven days after this loading dose, 83% of patients achieved a ≥ 0.5 log10 decrease from baseline compared with 3% during the seven-day control period .These results were statistically significant (p<0.0001). At CROI, additional data on the Week 24 results from this study are now presented.
Author Interviews, CDC, NEJM, Zika / 16.02.2017

MedicalResearch.com Interview with: Gabriela Paz-Bailey MD PhD Senior Epidemiologist Centers for Disease Control and Prevention  MedicalResearch.com: What is the background for this study? Response: Zika virus is recognized as a cause of microcephaly and other severe birth defects when a woman is infected during pregnancy. Additionally, it has been associated with potentially fatal complications, such as Guillain-Barré syndrome. It is not well understood how often Zika virus particles can be detected in semen and other body fluids and for how long they remain detectable. Existing evidence is based on case reports and cross-sectional observations, primarily from returning travelers. A more comprehensive description of the dynamics of the early stages of Zika virus infection, observed within infected people over time, is needed to inform diagnostic testing as well as prevention recommendations and interventions.
Author Interviews, Infections, Lancet, Vitamin D / 14.02.2017

MedicalResearch.com Interview with: Dr. Adrian R Martineau B Med Sci DTM&H MRCP PhD Clinical Professor of Respiratory Infection and Immunity Centre for Primary Care and Public Health. Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary, University of London MedicalResearch.com: What is the background for this study? Response: In addition to its well-known effects on bone, Vitamin D has also been shown to boost immune responses to viruses and bacteria that cause respiratory infections in lab experiments. In order to see whether these effects translate into a health benefit, a total of 25 clinical trials of vitamin D supplementation to prevent various respiratory infections have been carried out in around 11,000 people living in 14 different countries over the last decade. These trials have yielded conflicting results: in some, vitamin D reduced the risk of infections, but in others it did not. The reason why vitamin D ‘worked’ in some trials, but not in others, has been the subject of much debate. In order to answer this question, we assembled an international consortium of investigators and compiled the raw data from every trial into a single database containing information from 10,933 people in total. This allowed us to run sub-group analyses to determine whether particular groups of people benefit more from vitamin D supplementation than others.
Author Interviews, Gastrointestinal Disease, Infections, Microbiome, Rheumatology, Science / 11.02.2017

MedicalResearch.com Interview with: [caption id="attachment_31926" align="alignleft" width="150"]Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021 Dr. Randy Longman[/caption] Randy Longman, M.D. / Ph.D. Assistant Professor of Medicine Jill Roberts Center and Institute for Research in Inflammatory Bowel Disease Weill Cornell Medicine Division of Gastroenterology and Hepatology Joan and Sanford I. Weill Department of Medicine Department of Microbiology and Immunology New York, NY 10021  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Inflammatory bowel disease is not limited to intestinal inflammation.  Up to 1/3 of patients with active disease suffer from extra-intestinal manifestations. The most common extra-intestinal manifestations in IBD is joint inflammation or spondyloarthritis.  Peripheral joint spondyloarthritis  carries a prevalence of 20% in Crohn’s Disease and 10% in Ulcerative Colitis, predominantly affecting joints of the lower limbs.  It has long been suggested that gut bacteria can drive this systemic joint inflammation, but microbial targets have not been characterized.
Author Interviews, Infections, Pharmacology / 09.02.2017

MedicalResearch.com Interview with: Dr. Fernanda Buzzola IMPaM, UBA-CONICET MedicalResearch.com: What is the background for this study? Response: Staphylococcus aureus represents a serious problem to public health due to methicillin-resistance and the bacterial persistence over a long period of time in the host. Approximately the 20% of the human population is at risk to acquire an endogenous infection by S. aureus as a consequence of its asymptomatic nasal colonization. Aspirin, the main source of salicylic acid in the human host, is currently taken by millions of human beings worldwide without medical prescription and widely indicated for defined purposes, including prevention of coronary thrombosis. Salicylic acid is a plant hormone known too for its use as a key ingredient in anti-acne preparations and medications for skin conditions. We also consume mild doses of salicylic acid when we eat fruits and vegetables. Iron is an important trace element for the human body and plays an essential role in blood formation. The metabolism of many bacteria, including S. aureus, also depends on the availability of iron molecules. Salicylic acid forms complexes with iron ions in the blood and so deprives not only us but also the staphylococcal bacteria of this element. S. aureus modifies its metabolism if the iron content is insufficient. The microorganism reacts to the changed – from its perspective, negative – conditions through the intensified formation of a biofilm, a sort of layer of slime formed by the aggregation of individual bacteria. The enhanced biofilm production allows the bacteria to survive for an even longer period under unfavourable living conditions.
Author Interviews, CDC, Gender Differences, HIV, Race/Ethnic Diversity / 09.02.2017

MedicalResearch.com Interview with: Donna Hubbard McCree, PhD MPH, RPh Association Director for Health Equity/Division of HIV/AIDS Prevention Centers for Disease Control and Prevention  MedicalResearch.com: What is the background for this study? What are the main findings? Response: HIV diagnosis rates among women declined 40% between 2005 and 2014 with the largest decline, 42%, occurring in black women. However, in 2015 black women represented 61% of HIV diagnoses among women. Our goal in this analysis was to determine whether the decline resulted in a decrease in the disparities among African American, Hispanic and white women between 2010 and 2014. There is currently not a standard method for measuring HIV-related disparity. However, for this analysis we used three different measures – the absolute rate difference (the difference between the group with the lowest rate and the group with the highest rate); 2) the diagnosis disparity ratio (the ratio of the difference between the group rate and the overall population rate to the overall rate); and 3) the Index of Disparity (the average of the differences between rates for specific groups and the total rate divided by the total rate, expressed as a percentage). The absolute rate difference between black women and white women decreased annually, from 36.9 in 2010 to 28.3 in 2014. The diagnosis disparity ratio for black women compared to the total population decreased from 1.7 in 2010 to 1.2 in 2014. The Index of Disparity increased during 2010–2011, and then decreased each year during 2012–2014. Although disparities still exist, these findings indicate improvement.
Asthma, Author Interviews, Infections, Pediatrics / 08.02.2017

MedicalResearch.com Interview with: Hiroyuki Mochizuki, M.D., Ph.D. Professor & Chairman Department of Pediatrics Tokai University School of Medicine Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: My major is allergy and respiratory health of children. By this examination, we wanted to know the true influence of respiratory syncytial virus infection on childhood atopic asthma. We have confirmed that infantile asthma is heterogenic, and at least two kinds of phenotypes are present.
Author Interviews, Critical Care - Intensive Care - ICUs, Emergency Care, Infections / 07.02.2017

MedicalResearch.com Interview with: [caption id="attachment_31808" align="alignleft" width="200"]Anish Agarwal, MD, MPH The Hospital of the University of Pennsylvania Department of Emergency Medicine Philadelphia, PA Dr. Anish Agarwal[/caption] Anish Agarwal, MD, MPH The Hospital of the University of Pennsylvania Department of Emergency Medicine Philadelphia, PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The morbidity and mortality of severe sepsis has been well studied and documented. An aggressive approach to protocolized care for patients suffering from severe sepsis and septic shock has been shown to improve mortality and should be started as early in the time course of a patient's presentation. Emergency departments (ED) are designed to deliver time-sensitive therapies, however, they also may suffer from crowding due to multiple factors. This study aimed to assess the impact of ED crowding upon critical interventions in the treatment of severe sepsis including time to intravenous fluids, antibiotics, and overall delivery of a protocolized bundle of care. The study found that as ED crowding increased, time to critical therapies significantly increased and the overall implementation of procotolized care decreased. More specifically as ED occupancy and total patient hours within the ED increased, time to intravenous fluids decreased and time to antibiotics increased as occupancy, hours, and boarding increased.
Author Interviews, Infections, Inflammation, Sleep Disorders / 07.02.2017

MedicalResearch.com Interview with: Mark Robert Zielinski, MD Department of Psychiatry Harvard Medical School and Veterans Affairs Boston Healthcare System West Roxbury, MA 02132 MedicalResearch.com: What is the background for this study? Response: Anecdotally, people have known that the immune system and sleep are related. In the last several decades this relationship has been systematically investigated. This work led to important findings that several molecules that enhance inflammation including interleukin-1 beta regulate sleep. Interleukin-1 beta is known to increase sleep and sleep intensity after sleep loss and in response to pathogens. However, it was unknown how these effects are connected. Interestingly, the NLRP3 inflammasome is a protein complex that senses changes in the local environment and subsequently activates pro-inflammatory molecules including interleukin-1 beta. Therefore, we wanted to see if the NLRP3 inflammasome is involved in sleep regulation. 
Author Interviews, C. difficile, Hospital Acquired, JAMA / 06.02.2017

MedicalResearch.com Interview with: [caption id="attachment_31754" align="alignleft" width="200"]Vanessa W. Stevens, PhD IDEAS 2.0 Center, Veterans Affairs (VA) Salt Lake City Health Care System Division of Epidemiology, Department of Internal Medicine University of Utah School of Medicine Salt Lake City, Utah Dr. Vanessa Stevens[/caption] Vanessa W. Stevens, PhD IDEAS 2.0 Center, Veterans Affairs (VA) Salt Lake City Health Care System Division of Epidemiology, Department of Internal Medicine University of Utah School of Medicine Salt Lake City, Utah MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although metronidazole remains the most commonly used drug to treat Clostridium difficile infection (CDI), there is mounting evidence that vancomycin is a better choice for some patients. Most previous studies have focused on primary clinical cure, but we were interested in downstream outcomes such as disease recurrence and mortality. We found that patients receiving metronidazole and vancomycin had similar rates of recurrence, but patients who were treated with vancomycin had lower risks of all-cause mortality. This was especially true among patients with severe Clostridium difficile.
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, University of Pittsburgh / 26.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31417" align="alignleft" width="100"]Sachin Yende, M.D., M.S., Associate professor University of Pittsburgh School of Medicine’s departments of Critical Care Medicine and Clinical and Translational and Vice president of Critical Care at the VA Pittsburgh. Dr. Yende[/caption] Sachin Yende, M.D., M.S., Associate professor University of Pittsburgh School of Medicine’s departments of Critical Care Medicine and Clinical and Translational and Vice president of Critical Care at the VA Pittsburgh. [caption id="attachment_31418" align="alignleft" width="66"]Florian B. Mayr, M.D., M.P.H. Faculty member in University of Pittsburgh Department of Critical Care Medicine and the Center for Health Equity Research and Promotion Dr. Mayr[/caption] Florian B. Mayr, M.D., M.P.H. Faculty member in University of Pittsburgh Department of Critical Care Medicine and the Center for Health Equity Research and Promotion MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Centers for Medicare and Medicaid Services and the Veteran Health Administration currently track readmission rates for pneumonia, acute heart attacks, heart failure and chronic obstructive lung disease for quality purposes and pay for performance. In our study, we were able to demonstrate that unplanned readmissions after sepsis (defined as life threatening organ failure due to the body's response to an overwhelming infection) are more common than readmission for these other conditions stated above and associated with significant excess costs.
Author Interviews, Hospital Acquired, Infections, Surgical Research / 24.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31455" align="alignleft" width="200"]Kristen A. Ban, MD Loyola University American College Surgery Clinical Scholar Dr. Kristen Ban[/caption] Kristen A. Ban, MD Loyola University American College Surgery Clinical Scholar MedicalResearch.com: What is the background for this study? What are the main findings? Response: The American College of Surgeons previously released surgical site infections (SSI) guidelines, and we wanted to update them with the most recent literature to give surgeons a concise, comprehensive document of recommended practices to reduce SSI. We were very fortunate to partner with our colleagues and content experts at the Surgical Infection Society for this update. There are a few areas where we had additional literature to support new or different guidelines. Blood glucose control is now recommended for all patients regardless of diabetic status. SSI reduction bundles have become very popular, and we emphasize that compliance must be high with all parts of these bundles to obtain the maximum benefit. Finally, we recommend cessation of prophylactic antibiotics at incision closure with some exceptions (mainly in regard to implanted material/hardware).
Author Interviews, Environmental Risks, Herpes Viruses, Pulmonary Disease / 20.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31387" align="alignleft" width="100"]Dr. Tobias Stöger Group Leader, Dynamics of Pulmonary Inflammation Comprehensive Pneumology Center Institute of Lung Biology and Disease (iLBD) Helmholtz Zentrum München Dr. Tobias Stöger[/caption] Dr. Tobias Stöger Group Leader, Dynamics of Pulmonary Inflammation Comprehensive Pneumology Center Institute of Lung Biology and Disease (iLBD) Helmholtz Zentrum München  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Particulate air pollution is common in urban areas and the inhalation of nanoparticles is known to trigger inflammatory effects in humans potentially altering the immune system. Herpes viruses are ubiquitous and well adapted pathogens hiding in host cells and persist thus continuing in a greater part of our population. Under certain stress conditions and if the immune system becomes weakened, the viruses can become active again, begin to proliferate and destroy the host cell. Thus we raised the question whether NP-exposure of persistently herpesvirus-infected cells as a second hit might provoke reactivation of latent virus and eventually lead to an inflammatory response and tissue damage. Our main finding is that NP-exposure of persistently herpesvirus-infected cells – murine or human – restores molecular signatures found in acute virus infection and boosts production of lytic viral proteins.
Author Interviews, Genetic Research, Infections, Pediatrics / 19.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31340" align="alignleft" width="200"]Prof. Adrian Liston (VIB-KU Leuven) Prof. Adrian Liston[/caption] Prof. Adrian Liston (VIB-KU Leuven) MedicalResearch.com: What is the background for this study? Response: With vaccinations, sanitation, antibiotics and general improvements in living standards, infectious disease is no longer a major killer of children. Death or hospitalisation of children from infection is rare in countries with modern health care systems. Those rare events were once thought to be chance outcomes on the roulette of bad luck, but increasingly we are recognising that genetic mutations underlie severe pediatric infections. In our study we are seeking to identify the mutations and immunological changes that occur in children, causing them to have severe reactions to infectious disease.
Author Interviews, CDC, Lyme / 17.01.2017

MedicalResearch.com Interview with: Tammi L. Johnson PhD, Microbiologist Division of Vector-Borne Diseases CDC MedicalResearch.com: What is the background for this study? Response: Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks, also called deer ticks. Lyme disease is the most commonly reported vectorborne illness in the United States, with approximately 300,000 humans becoming infected each year. While Lyme disease infections are highly concentrated in the northeast and upper Midwest, the number of counties in which the blacklegged tick has become “established” has more than doubled in the past two decades. Established populations of these ticks are found in 35 states. Knowing that Lyme disease is increasing both in numbers of infections and in geographic range in the United States, we did this study to determine if people are at risk of encountering infected ticks while recreating in eastern national parks. This is the first large-scale survey in multiple national parks, and though suspected, it had not been confirmed that ticks in many of these parks were infected. So the purpose of the study was to survey national park units across six Northeastern and Mid-Atlantic States and the District of Columbia, ranging from Maine in the north to Virginia in the south and characterize the risk of human exposure to ticks-borne bacteria. Researchers from the Centers for Disease Control and Prevention and the National Park Service evaluated frequently used trails in Acadia National Park, Catoctin Mountain Park, Fire Island National Seashore, Gettysburg National Military Park, Manassas National Battlefield Park, Monocacy National Battlefield, Prince William Forest Park, Rock Creek Park, and Shenandoah National Park.
Author Interviews, BMJ, HIV, STD / 17.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31241" align="alignleft" width="200"]Michael Rekart, MD, DTM&H Clinical Professor, Medicine and Global Health The University of British Columbia .... On behalf of my co-authors Dr. Michael Rekart[/caption] Michael Rekart, MD, DTM&H Clinical Professor, Medicine and Global Health The University of British Columbia .... On behalf of my co-authors MedicalResearch.com: What is the background for this study? Response: The background for this study is the observation that new syphilis cases over the last decade in British Columbia, Canada, have been escalating more rapidly than anyone could have predicted and that syphilis incidence has outpaced the incidence of other sexually transmitted diseases (STDs), including gonorrhea and chlamydia. This unexpected increase in syphilis has been almost wholly concentrated in men who have sex with men (MSM). Most of these MSM are HIV-1 infected and many are taking highly active antiretroviral therapy (HAART). In fact, the expansion in HAART coverage in MSM parallels the growth in syphilis in the same population. In addition, my co-authors and I had serious doubts as to whether 'treatment optimism', the generally accepted explanation for this phenomenon, was robust enough to account for such a dramatic increase in new syphilis cases. Treatment optimism posits that HAART availability and effectiveness have led to the perception in both HIV-1-infected and HIV-1-uninfected individuals that HIV-1 transmission has become much less likely, and the effects of HIV-1 infection less deadly. This is expected to result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 STDs, including gonorrhea, chlamydia and syphilis.
Author Interviews, Biomarkers, Critical Care - Intensive Care - ICUs, Infections, JAMA, Pediatrics / 11.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31122" align="alignleft" width="140"]Halden F. Scott MD, Assistant Professor Departments of Pediatrics and Emergency Medicine University of Colorado School of Medicine Dr. Halden F. Scott[/caption] Halden F. Scott MD, Assistant Professor Departments of Pediatrics and Emergency Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? Response: Sepsis, a dysregulated immune response to infection, is a leading cause of death for children. Survival depends on rapid diagnosis and timely delivery of life-saving resuscitative care, including fluids and antibiotics. However, it can be challenging to make an early diagnosis of sepsis in children. Millions of children present for emergency care of infection and fever every year, most of whom will not develop sepsis. Tools that assist providers in distinguishing the sickest children with infection at an early stage could enable the early delivery of life-saving treatments. Lactate is a clinically-available laboratory test that has played a critical role in improving the diagnosis and treatment of sepsis in adults. Sepsis may cause lactate levels to rise in the blood during sepsis, through reduced delivery of oxygen to the tissues, as well as through changes in how energy is produced and in how lactate is cleared by the kidney and liver. Data about lactate in pediatric sepsis, particularly early levels and whether it is associated with mortality, have been limited.
Author Interviews, Diabetes, Diabetologia, Infections, Pediatrics / 11.01.2017

MedicalResearch.com Interview with: Dr. Hanna Honkanen PhD University of Tampere. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association between enteroviruses and type 1 diabetes has been suggested for long and analyzed in several studies. However, only few studies have been able to study this association at the time when the disease process starts, which happens several months or years before type 1 diabetes is diagnosed. Our study made this possible since it was based on a large cohort of children who were followed from birth and samples were collected already before the disease process had started (prospective DIPP-study in Finland). Enterovirus infections were detected by analyzing the presence of viral nucleic acids in longitudinal stool sample series. Infections were found more frequently in case children who developed islet autoantibodies compared to control children. This excess was detected several months before islet autoimmunity appeared. This study is the largest such study carried out so far. The results suggest that enterovirus infections may contribute to the initiation of the disease process that eventually leads to type 1 diabetes.
Author Interviews, Hospital Acquired, Infections, Surgical Research, Technology / 10.01.2017

MedicalResearch.com Interview with: Alex Carignan, MD, MSc Department of Microbiology and Infectious Diseases Université de Sherbrooke, Quebec, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although reports of iatrogenic transmission directly linked to surgical power tools (SPTs) are rare, the decontamination of such instruments is challenging due to their complex designs, which may restrict access to cleaning and sterilization agents, and because they often become contaminated after use. Most studies on infection risk with ultrasonic surgical power tools include patients who underwent phacoemulsification surgeries,but it is logical to assume that lumen contaminants, including bacteria and proteinaceous material from previous operations, may be found in neurosurgery SPTs as well. During June 2015, the infection control department at our institution was notified of an increase in the number of surgical site infection cases following craniotomy since January 2015. We investigated an outbreak of neurosurgical SSIs at a tertiary care hospital in Quebec, Canada, to identify the outbreak’s cause, and our investigation strongly suggests that modifying the reprocessing procedure of an ultrasonic surgical aspirator caused the outbreak.
Author Interviews, Infections, Nature, Technology / 08.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31071" align="alignleft" width="144"]Hyo-Jick Choi, PhD Assistant Professor, Department of Chemical and Materials Engineering University of Alberta Edmonton, AB, Canada T6G 1H9 Dr. Hyo-Jick Choi[/caption] Hyo-Jick Choi, PhD Assistant Professor, Department of Chemical and Materials Engineering University of Alberta Edmonton, AB, Canada T6G 1H9 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Respiratory diseases such as influenza transmitted either through breathing aerosols exhaled/coughed out by an infected person or through direct contact. Despite controversy over its efficacy, surgical mask has been widely used by general public during the past respiratory disease outbreaks because of low cost, easy wearability, and widespread use in normal day-to-day situation. Critical issue is that virus captured on the filter of the mask still maintains infectivity for long time, raising concerns of secondary infections and transmissions. This led us to develop a strain-nonspecific and reusable airborne virus deactivation system based on salt recrystallization principle. Salt recrystallization is hypothesized to cause deactivation of viruses transmitted through aerosols via two successive processes: 1) salt on filter fiber dissolves upon exposure to the pathogenic aerosols and 2) salt crystallizes as aerosols evaporate. To demonstrate the concept, we coated the fiber of the surgical mask filter with sodium chloride (NaCl) salt crystal and tested its performance using three different types of influenza viruses. Salt-treated filter provided higher filtration efficiency compared to non-treated regular filter and successfully destroyed multiple subtypes of influenza viruses trapped on the filter within few minutes, leading to significant infectivity loss.
Author Interviews, Heart Disease, HIV / 05.01.2017

MedicalResearch.com Interview with: Heidi M. Crane MD, MPH Associate Professor of Medicine Associate Director Clinical Epidemiology and Health Services Research Core Center for AIDS Research University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have suggested that rates of myocardial infarction (MI) are higher in those with HIV, likely for a variety of reasons. However, prior studies have not been able to distinguish MIs by type. The Universal Definition of MI has been recommended by cardiology societies and classifies MIs into types with Type 1 MIs resulting spontaneously from atherosclerotic plaque instability and Type 2 MIs occurring secondary to causes other than atherosclerotic plaque rupture, including hypotension, hypoxia, and stimulant induced spasm resulting in increased oxygen demand or decreased supply. Understanding MI types is likely important as they may indicate a different prognosis and need for different prevention approaches.
Author Interviews, Dermatology, Infections, Transplantation, UT Southwestern / 02.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30884" align="alignleft" width="70"]Richard Wang, M.D., Ph.D. Assistant Professor UT Southwestern Medical Center Dr. Wang[/caption] Richard Wang, M.D., Ph.D. Assistant Professor UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, there are 13 polyomaviruses known to infect humans. Several members of this family of double-stranded DNA viruses—including Merkel Cell Polyomavirus, Trichodysplasia Spinulosa Polyomavirus, Human Polyomavirus 6 (HPyV6), and Human Polyomavirus 7 (HPyV7)—can be shed from skin of healthy individuals. While most polyomavirus infections are common and subclinical, several polyomaviruses have been associated with debilitating diseases in immunocompromised individuals. Most recently, HPyV7 was discovered in a pruritic and dyskeratotic eruption in two immunosuppressed transplant patients. A closely related polyomavirus, Human Polyomavirus 6, has not yet been strongly linked to any infectious diseases. Using the previously described, characteristic histologic pattern, we identify 3 additional cases of skin eruptions associated with infections of HPyV6 and HPyV7. The association of the dermatoses with highly active infections were confirmed through electron microscopy, immunohistochemistry, quantitative PCR, and complete sequencing. HPyV7 infects keratinocytes and affects their normal differentiation. In addition, next generation sequencing revealed that HPyV6 could persist in a latent state in the skin of a previously infected patient.
Author Interviews, Herpes Viruses, JAMA / 22.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30723" align="alignleft" width="125"]Ann Kurth, Ph.D., C.N.M., R.N. Dr. Ann Kurth[/caption]   MedicalResearch.com: What is the background for this study?  What are the main findings? Genital herpes is a sexually transmitted infection that is caused by one of two subtypes of the herpes simplex virus (HSV-1 and HSV-2). The condition is common in the United States, as the CDC estimates that almost one in six people between the ages of 14 and 49 are afflicted. Unfortunately, there are no good screening tests for herpes and it cannot be cured. After a systematic review of the evidence, the U.S. Preventive Services Task Force determined that, for adolescents and adults who have no signs or symptoms, including pregnant women, the harms of screening for genital herpes outweigh the benefits. These harms include high rates of false-positive screening tests, potential concerns around unnecessary antiviral medication use, and anxiety and relationship issues related to diagnosis. Additionally, the benefits of screening proved small, in part because early identification and treatment do not alter the course of the condition. In the end, due to the lack of benefits in the face of serious harms, the Task Force recommended against routine serologic screening for genital herpes simplex virus (HSV) infection.
Author Interviews, OBGYNE, UCLA, Zika / 20.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30670" align="alignleft" width="150"]Karin Nielsen, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA Director, Center for Brazilian Studies Karin Nielsen[/caption] Karin Nielsen, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA Director, Center for Brazilian Studies MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research was a prospective study in which pregnant women in Rio de Janeiro who developed a rash in the last 5 days between the end of 2015 to mid 2016 were screened for possible infection with Zika virus by a special molecular test (PCR) which looked for the virus in blood or urine. Women who were found to have Zika virus in either blood, urine or both were followed throughout time to look for pregnancy and infant outcomes. We also followed women who had a negative PCR test for Zika as a comparison group. By July 2016, we had outcomes known for 125 Zika affected pregnancies, of these 58 had abnormal outcomes, with 9 fetal losses and 49 babies who had abnormal findings on physical exam or brain imaging, all consistent with neurologic abnormalities. This meant 46% of the pregnant women in our study had an abnormal pregnancy outcome, and 42% of live birth infants were found to have an abnormality in the first few months of life.
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Infections / 18.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30621" align="alignleft" width="133"]Dr-Flaminia-Catteruccia.jpg Dr. Catteruccia[/caption] Flaminia Catteruccia PhD Associate Professor of Immunology and Infectious Diseases Department of Immunology and Infectious Diseases Boston, Massachusetts 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mosquito control via lethal insecticides is a key method for reduction of malaria transmission. As insecticide resistance is spreading, new intervention methods are urgent. Our study demonstrates that studies on mosquito biology can provide novel, much needed tools for malaria control. We show how key aspects of mosquito physiology and Plasmodium development can be significantly disrupted in the female Anopheles mosquito by agonists of the insect steroid hormone 20-hydroxyecdysone (20E). Modeling of the data predicts that the integration of 20E agonists in malaria control programs would significantly reduce malaria prevalence to a similar extent as insecticides, but without imposing severe costs to mosquito populations
Author Interviews, Brigham & Women's - Harvard, Dental Research, Infections, Rheumatology, Science / 17.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30609" align="alignleft" width="200"]Maximilian F. Konig, MD Department of Medicine Massachusetts General Hospital Harvard Medical School Dr. Maximilian F. Konig[/caption] Maximilian F. Konig, MD Division of Rheumatology, Johns Hopkins University School of Medicine Current affiliation: Department of Medicine Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response:The idea that rheumatoid arthritis (RA), an autoimmune disease that leads to chronic joint inflammation and destruction, may be initiated by a bacterial infection is not novel, but has been posited for more than a century. Based on the clinical observation that patients with RA frequently have severe periodontal disease (gum disease), gum inflammation has long been thought to contribute to disease development in RA. However, limited understanding of the mechanisms that fuel and sustain the autoimmune attack in RA made it difficult to pinpoint a specific bacterial trigger. In recent years, our understanding of the abnormal immune response that attacks the joints in patients with RA has grown exponentially, and we now know that disease-specific autoantibodies (ACPAs) target modified self-proteins (this modification is known as citrullination). It is this abnormal immune response against citrullinated proteins that appears to drive the joint (and sometimes lung) inflammation seen in rheumatoid arthritis. Recent studies from our laboratory at The Johns Hopkins University (led by principle investigator Felipe Andrade, MD, PhD) suggested that an immune cell called the neutrophil, which normally protects us from infection at sites like the oral cavity or anywhere else in the body, also appears to be the source of the proteins attacked in RA. We were therefore interested to understand what drives the association of gum disease, an inflammation commonly triggered by bacteria, with RA.
Author Interviews, Infections, Nature / 16.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30421" align="alignleft" width="144"]Professor Alistair J P Brown DSc FSB FAAM FRSE Aberdeen Fungal Group, MRC Centre for Medical Mycology, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen UK Prof. Al Brown[/caption] Professor Alistair J P Brown  DSc FSB FAAM FRSE Aberdeen Fungal Group, MRC Centre for Medical Mycology, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen UK  MedicalResearch.com: What is the background for this study? Response: Most of us harbor the yeast Candida albicans, and most of the time it does us no harm.  However, under certain circumstances it can break out to cause nasty infections of the mouth or genitalia (thrush), or potentially fatal infections in vulnerable intensive care patients.  Indeed, over half of women will suffer at least one episode of vulvovaginal candidiasis in their lifetime, and over 5% of women suffer recurrent episodes (four or more episodes per annum).  Also, it has been estimated that there are over 400,000 life-threatening systemic Candida infections worldwide per annum, of which over 40% are fatal (see Science Translational Medicine (2012) vol. 4, 165rv13).  A key to this is the potency of our immunological defenses: the weaker our defenses the more vulnerable we are to fungal infection.  Therefore, we in the Medical Research Council (MRC) Centre for Medical Mycology – and other groups worldwide – are studying the mechanisms by which our immune cells recognize and kill invading Candida cells, thereby protecting us from infection.