Author Interviews, C. difficile, Columbia, Hospital Acquired, JAMA / 12.10.2016

MedicalResearch.com Interview with: Dr. Daniel E. Freedberg MD MS Division of Digestive and Liver Diseases Columbia University Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: We conducted this study because previous studies indicate that the gastrointestinal microbiome is easily shared between people who co-occupy a given space (such as a hospital room).  We wondered if antibiotics might exert an effect on the local microbial environment. (more…)
Author Interviews, Infections, JAMA, Pediatrics / 12.10.2016

MedicalResearch.com Interview with: Dr. Soren Gantt MD, PhD, MPH Investigator, BC Children's Hospital Associate Professor, Department of Infectious and Immunological Diseases (Pediatrics) Faculty of Medicine, University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cytomegalovirus (CMV) is a common virus that is usually transmitted through bodily fluids such as saliva, urine, blood, and breast milk, but it can also cause congenital infection (from a pregnant woman to her fetus). While it doesn’t usually cause problems for most children or adults, congenital CMV often causes serious problems. Congenital CMV causes 25 per cent of all childhood hearing loss and it’s the second most common cause of intellectual disability. Without screening, most infected newborns are not diagnosed in time to treat them with antivirals or provide other care that can make a big difference to improving their life-long outcomes. Our study showed that screening programs for congenital CMV infection are cost-effective. We found that the cost of identifying one case of congenital CMV ranges from US$2000 to US$10,000 through universal screening, or US$566 to $2833 through a targeted screening approach. Our model showed that screening programs resulted in a net savings for the health care system of approximately USD$21 to $32 per newborn for universal screening or USD$11-$27 per newborn for targeted screening by reducing lifetime costs for therapies and lost productivity due to CMV-related health problems. This finding addresses a major barrier to implementing CMV screening programs, as costs have often been viewed as an issue. (more…)
Author Interviews, Gastrointestinal Disease, Infections, PLoS / 10.10.2016

MedicalResearch.com Interview with: Brian K. Coombes, PhD Professor & University Scholar Associate Chair, Graduate Education Department of Biochemistry & Biomedical Sciences Assistant Dean, Biochemistry Graduate Program Canada Research Chair in Infectious Disease Pathogenesis MedicalResearch.com: What is the background for this study? Response: North Americans have among the highest reported prevalence and incidence of inflammatory bowel disease (IBD) in the world. This is a lifelong disease that often strikes people in their early years, leading to decades of suffering, increased risk of colorectal cancer, and 50% increased risk of premature death. Compared to the general population, quality of life for those with Crohn’s disease is low across all dimensions of health. The need to understand the root origins of this disease and to use this information to invigorate a new pipeline of treatments and preventions has never been more pressing. (more…)
Author Interviews, Infections, NEJM / 10.10.2016

MedicalResearch.com Interview with: Simon I. Hay, BSc, DPhil, DSc Professor of Global Health University of Washington Director of Geospatial Science Institute for Health Metrics and Evaluation (IHME). MedicalResearch.com: Why did you undertake this study? Response: As malaria control has not been routinely informed by subnational variation of malaria burden, we undertook the study to highlight the potential for high-resolution maps of disease burden to better understand the epidemiology of malaria as well as the contribution of recent control efforts as well as to better inform future malaria control efforts. (more…)
Author Interviews, CDC, Gender Differences, STD / 06.10.2016

MedicalResearch.com Interview with: Alex de Voux, PhD, Epidemiologist Centers for Disease Control Division of STD Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reported cases of primary and secondary syphilis have been increasing steadily in the United States since 2001, with men-who-have-sex-with-men (MSM) accounting for 83% of male primary and secondary syphilis cases with information on sex of sex partner in 2014. However calculating the true disparity of primary and secondary syphilis cases relative to the MSM population size has been difficult because census data does not routinely collect information on sexual orientation or same-sex behavior. Through a recent collaboration with Emory University and CDC, Grey and colleagues developed refined estimates of the population size of MSM by state allowing us to calculate state-specific rates of primary and secondary syphilis for the first time. Looking at data from 44 states that had information on sex of sex partner for at least 70% of their male primary and secondary syphilis cases, the overall rate of syphilis was 309 per 100,000. The state level data found syphilis rates among gay and bisexual men ranged widely among the 44 states, from 73.1 per 100,000 in Alaska to 748.3 per 100,000 in North Carolina. Some of the highest rates among MSM were in states in the Southeast and the West. Comparing rates of syphilis among MSM to men reporting sex with women only (MSW), the overall rate for MSM was 107 times the rate for MSW. By state, the rate among MSM was at least 40 times the rate among MSW – and at most, 340 times the rate among MSW. (more…)
Author Interviews, Cancer Research, ENT, HPV / 04.10.2016

MedicalResearch.com Interview with: Eric M Genden, MD, FACS Isidore Friesner Professor and Chairman Department of Otolaryngology-Head and Neck Surgery The Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this report? How has the clinical picture of HPV infections of oral and throat cancers changed over the past two decades? Response: There has been no change however there has been a epidemic of viral induced throat cancer in men. The HPV virus has been established a the causative agent in cervical cancer in women. It has now been identified as a major causative agent in tonsillar and base of tongue cancer. (more…)
Author Interviews, Biomarkers, Cancer Research, ENT, HPV / 03.10.2016

MedicalResearch.com Interview with: Elizabeth Franzmann, M.D. Scientific Founder and Chief Scientific Officer Vigilant Biosciences MedicalResearch.com: What is the background for this study? Response: Head and neck cancer involves cancers of the oral cavity, oropharynx and larynx. It is difficult to treat. Part of the challenge is that it is distinguishing the patients with tumors that are going to behave aggressively from those with less aggressive disease. As a result, many patients undergo treatment that may be more intensive and morbid than they need while others need more aggressive treatment. Tissue markers associated with prognosis may be able to help clinicians differentiate patients who need more aggressive treatment from those whose treatment can be less intensive. CD44 is a cell surface glycoprotein and tumor-initiating marker. CD44 and another surface protein, EGFR, are involved in tumor extension and are associated with poor prognosis. Certain forms of Human Papillomavirus (HPV) are known to cause oropharyngeal cancer and are associated with a good prognosis. P16 is a surrogate marker for the kind of HPV that causes cancer. Understanding the relationships between how these markers are expressed in cancer tissue may direct patient treatment in the future. (more…)
Author Interviews, Infections, Lancet, Pediatrics, Surgical Research / 30.09.2016

MedicalResearch.com Interview with: Dr Marjo Renko MD PEDEGO Research Unit University of Oulu Oulu, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: For over a decade there has been suture materials containing antiseptic agent in the market. Trials in adults have shown some possible benefits from these sutures as in some studies they have reduced occurrence of surgical site infections. Only one small study had so far been published in children and thus we decided to carry out a large trial comparing sutures containing triclosan with ordinary ones. Our trial included over 1500 children who came to Oulu University Hospital for surgery. Surgical site infections were carefully monitored. Surgical site infections occurred in 2.6 % of the children who received absorbing sutures containing triclosan while that occurred in 5,4 % of the children who received ordinary sutures. (more…)
Author Interviews, HIV, Pediatrics, PLoS / 28.09.2016

MedicalResearch.com Interview with: Kenneth K. Mugwanya MBChB, MS Department of Epidemiology andDepartment of Global Health University of Washington, Seattle, Washington, USA Division of Disease Control, School of Public Health Makerere University Kampala, Uganda MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women living in regions with high HIV prevalence are at high risk of HIV acquisition in pregnancy and postpartum because they infrequently use condoms, do not know their partner's HIV status, and have biologic changes or changes in their partner's sexual partnerships that increase susceptibility. Moreover, acute HIV infection during pregnancy or breastfeeding period is associated with high rates of mother-to child HIV transmission because of high circulating level of HIV virus in blood. Oral antiretroviral pre-exposure prophylaxis (PrEP) is a powerful HIV prevention strategy recommended by both the World Health organization and US Centers for Diseases Control and Prevention. PrEP is an attractive prevention strategy for women as it can be used discreetly and independent of sexual partners. However, there is limited research about the safety of PrEP in HIV-uninfected pregnant or breastfeeding mothers and their infants. (more…)
Author Interviews, C. difficile, Microbiome, Nature, Vanderbilt / 28.09.2016

MedicalResearch.com Interview with: Eric P Skaar, Ph.D., MPH Director, Division of Molecular Pathogenesis Ernest W. Goodpasture Professor of Pathology Vice Chair for Basic Research, Department of Pathology, Microbiology, and Immunology Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nutrient metals are known to be a critical driver of the outcome of host-pathogen interactions, and C. difficile is the most common cause of hospital-acquired infections. C. difficile infection typically occurs following antibiotic-mediated disruption of the healthy microbiome. We were interested in learning how nutrient metals can shape the microbiome and impact the outcome of Clostridium difficile infection. We found that excess zinc alters the structure of the microbiome and increases the severity of C. difficile infection in mice. (more…)
Author Interviews, Infections / 28.09.2016

MedicalResearch.com Interview with: Dr. Bashir A. Lwaleed PhD, FRCPath, PGCAP, FHEA, CBiol FSB, FIBMS Faculty of Health Sciences University of Southampton South Academic and Pathology Block (MP 11) Southampton General Hospital Southampton UK MedicalResearch.com: What is the background for this study? Response: The study merges two longstanding interests. We have long worked out of several departments at Southampton and Portsmouth on the therapeutic potential for natural products (including the medium – chain fatty acids GLA (evening primrose oil) and EPA (fish oil) as well as honeys from a number of floral sources. Secondly, there is an established research theme in the Faculty of Healthcare Science at Southampton addressing continence related issues; moreover catheter management as an economic and infection control issue is a major concern in the NHS Trust Urology department. Biofilms on catheters are sources of infection, honey has proven antibacterial (and other therapeutic) properties in topical applications such as skin ulceration. It is a logical step to assess whether a similar use may be made for honey instilled into the bladder and/or flushing the lumen of a catheter. (more…)
Author Interviews, Global Health, Infections, NEJM / 21.09.2016

MedicalResearch.com Interview with: Dr. Heinke Kunst, M.D. Queen Mary University Hospital, London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multidrug resistant tuberculosis (MDR-TB) has been on the increase worldwide over the past decade. Many patients who have been identified with MDR-TB live in the European region. Despite treatment with expensive second-line drug regimens, curing MDR TB remains a challenge and cure rates were thought to be very low. As part of the EU Commission funded TB-PANNET project 380 patients with MDR-TB were observed at 23 TB centers in countries of high, intermediate and low TB burden in Europe over a period of 5 years. Observation started from the time of diagnosis and lasted until one year after the end of the treatment. The TBNET proposed new definitions for “cure” and “failure” of MDR-TB treatment based on the sputum culture status at 6 month after the initiation of therapy and whether patients were free from disease recurrence one year after the end of therapy. The researchers found that the WHO criterion for “cure” could not be applied in the majority of patients, simply because most patients who were being treated successfully were not able to produce sputum after 8 months of therapy. The TB-PANNET study showed much higher cure rates using a new definition of cure and failure of treatment for MDR TB in the European region. (61% cure rates compared to only 31% when using WHO criteria.) The study also demonstrates that the results for “cure” from MDR-TB correlate very well with the level of drug resistance and the time to culture conversion that means the time when TB bacilli are no longer detectable in sputum. The new definitions are also independent of the total duration of treatment and can be applied to the standard 20 months MDR-TB regimen as well as to the 9-12 months shorter course MDR-TB treatment that was recently proposed by the WHO. (more…)
Author Interviews, CDC, Infections, Outcomes & Safety / 19.09.2016

MedicalResearch.com Interview with: James Baggs, PhD Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: We used medical claims data to estimate the amount of antibiotics used in US hospitals from 2006 - 2012. Data came from the Truven Health MarketScan Hospital Drug Database, which included about 300 hospitals and more than 34 million discharges. Antibiotic use in hospitals was very common with more than half of patients receiving at least one antibiotic during their hospital stay. Overall rates of antibiotic use in U.S. hospitals did not change over time; however, there were significant changes in the types of antibiotics prescribed. Importantly, the types of antibiotics with the largest increases in use were the types of antibiotics often considered to be the most powerful. Of particular concern, there was a 37% rise in the use of carbapenems, commonly referred to as “last resort” antibiotics. (more…)
Author Interviews, Brigham & Women's - Harvard, Infections, JAMA, Ophthalmology / 17.09.2016

MedicalResearch.com Interview with: Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School Massachusetts Eye and Ear Infirmary Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: A specific clone of E. coli, type ST131, which produces an extended-spectrum beta-lactamase (ESBL – an enzyme that inactivates many penicillin-type antibiotics), has rapidly spread around the globe to become the leading cause of multidrug-resistant, non-intestinal E. coli infection. Despite this, E. coli is a rare cause of infection of the cornea. A patient was recently seen at the Massachusetts Eye and Ear Infirmary with a severe E. coli infection of the cornea, and the large number of antibiotic resistances of this strain tipped us off to the possibility that it might be the highly virulent ST131 ESBL type. By sequencing the DNA of its genome, we found that it was indeed ST131 ESBL E. coli. Moreover, we discovered a new mutation in this strain that allows it to produce a slimy outer coating on its surface. This slime layer, or capsule, makes the bacteria more resistant to removal by phagocytic cells of the immune system. The slime layer also makes these particular colonies appear different on a special type of agar that contains the dye Congo Red. (more…)
Author Interviews, HIV, Infections, STD / 16.09.2016

MedicalResearch.com Interview with: Noah Kojima David Geffen School of Medicine University of California Los Angeles, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the most exciting new methods to prevent human immunodeficiency virus (HIV) type 1 infection is through the use of chemical pre-exposure prophylaxis (PrEP), which has been shown to be safe and effective in randomized-controlled trials and “real world” studies among men who have sex with men (MSM). However, reports of high incidence of sexually transmitted infections (STIs) and condomless sex in PrEP trials has led clinicians and public health advocates to be concerned that the use of PrEP for HIV might lead to higher STI incidence due to increased sexual risk behavior. We found that PrEP for HIV infection is associated with increased risk of STI acquisition among MSM in a meta-analysis of prior studies. (more…)
Author Interviews, Infections, JAMA, Pediatrics / 14.09.2016

MedicalResearch.com Interview with: Johanna M. Uitti, MD Department of Paediatrics and Adolescent Medicine Turku University Hospital Turku, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to several national guidelines, close follow-up is required if initial observation without antimicrobial agents is chosen for the management of acute otitis media (AOM) in children. The aim of this study was to examine whether close follow-up with reexamination is needed for children with AOM initially managed without antimicrobial agents who have symptomatic improvement during the first week after diagnosis, as assessed by their parents. Of the 104 children with symptomatic improvement, 3 (2.9%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. In contrast, of the 54 children with symptomatic failure, 16 (29.6%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. (more…)
Author Interviews, Heart Disease, Infections, Surgical Research / 14.09.2016

MedicalResearch.com Interview with: Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infectious endocarditis (IE) is one of the most serious complications after surgical prosthetic valve replacement. There are however scarce data regarding the incidence, predictive factors, treatment, and outcomes of IE post-TAVR. To date, the present study represents the largest series of IE post-TAVR, and the main findings can be summarized as follows: (1) the incidence of infective endocarditis (IE) post-TAVR is similar to that reported for IE after surgical prosthetic valve replacement; (2) among patients undergoing TAVR, younger age, male sex, a history of diabetes mellitus, and moderate-to-severe residual aortic regurgitation were associated with a higher risk of IE, (3) Enterococci species was the most frequently isolated pathogen, (4) IE post-TAVR was associated with a very high rate of in-hospital complications and mortality during index hospitalization and at follow-up. (more…)
Author Interviews, CDC, Infections / 12.09.2016

MedicalResearch.com Interview with: Anita D. Sircar, MD Epidemic Intelligence Service Division of Parasitic Diseases and Malaria Center for Global Health CDC MedicalResearch.com: What is the background for this study? Response: Baylisascaris procyonis is a roundworm commonly found in raccoons. It can be found anywhere in the United States where raccoons live. People, especially children, can be infected by this roundworm when they accidentally ingest contaminated raccoon feces. Infection with Baylisascaris procyonis can have severe outcomes in people such as blindness and even death if not treated promptly. Despite expansion of the geographic distribution of Baylisascaris procyonis in the last 14 years and probable increasing human exposure, baylisascariasis is likely an underreported disease: only 22 documented cases were reported in the United States during 1973–2010. During May 2013–December 2015, seven additional cases of baylisascariasis were identified among patients in the United States through testing at CDC, including six cases of central nervous system disease and one of ocular disease. Laboratory and clinical information for each patient was gathered and reviewed in a case series to contribute to knowledge about Baylisascaris procyonis infection. All seven patients survived, although approximately half had residual neurologic sequelae. (more…)
Author Interviews, Infections, JAMA / 08.09.2016

MedicalResearch.com Interview with: Dr. Francisco García M.D. M.P.H. Task Force member and Director and Chief medical officer at Pima County Department of Health Tucson, AZ MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tuberculosis infection is one of the most common infectious diseases in the world. Although less common in the United States, many people still become infected every year and are at risk of getting sick and spreading the infection to others. We know there are effective screening tests that can detect latent tuberculosis infection before people become sick with active tuberculosis disease. Additionally, there are effective treatments to prevent people from progressing from latent tuberculosis infection to active tuberculosis disease. Thus, for people with increased risk of contracting tuberculosis, the Task Force recommends screening for latent tuberculosis infection. People who are considered at increased risk include those who were born in or have lived in countries where tuberculosis is highly prevalent, or who have lived in congregate settings where exposure to tuberculosis is more likely, such as homeless shelters or correctional facilities. (more…)
Author Interviews, Infections, Inflammation / 07.09.2016

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

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

MedicalResearch.com Interview with: Prof. Alan Irvine DSc Consultant Dermatologist Our Lady’s Children’s Hospital Associate Professor of Dermatology Trinity College Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that atopic dermatitis (AD) has a close relationship with staphylococcus aureus (SA) colonisation, and this is known to drive flares or exacerbations of AD but before our report it was not known which came first-AD colonisation or atopic dermatitis? By following a cohort pf patients very carefully over a 1 year period and regularly sampling their skin microbiome we were able to show that SA colonisation did not precede development of AD and in fact that several non SA species of staphylococcus actually appeared to be protective for developing atopic dermatitis. This is an important new finding in the complex relationship between the microbiome and skin inflammation, suggesting that some commensal bacterial are anti-inflammatory or protective. (more…)
Author Interviews, Lyme / 31.08.2016

MedicalResearch.com Interview with: Audun Aase, PhD Department Director, Infectious Disease Immunology Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? Response: Controversies related to Lyme disease and tick transmitted diseases have gained much attention in the public media in Norway, both regarding treatment regimens and diagnostics. People with long-lasting disease may relate their symptoms to previous tick bite and/or suboptimal-treated Lyme disease and have adopted the diagnosis chronic Lyme disease. As many of these patients lack objective proof of Lyme disease, they look for alternative test to signify their suspicion. A modified microscopy method for detection of the Borrelia burgdorferi s.l. (the causative agent of Lyme disease) in human blood was published in 2013. The authors behind the method examined blood from suspected chronic Lyme disease patients, and the results showed presence of Borrelia spirochetes in most of the specimens. Using the same method, they also claimed to detect the Babesia parasites in many of the samples. The method gained much publicity and the patients advocated strongly for this method as most other laboratory tests had failed to prove their diagnosis. (more…)
Author Interviews, Lyme / 29.08.2016

MedicalResearch.com with Senior Author: Tara Moriarty, Ph.D. University of Toronto, Canada Faculty of Dentistry, Matrix Dynamics Group Faculty of Medicine, Department of Laboratory Medicine and Pathobiology Lead Author: Rhodaba Ebady, Ph.D. student University of Toronto, Canada Faculty of Dentistry, Matrix Dynamics Group MedicalResearch.com: What is the background for this study? What are the main findings? Response: The spread of microbes via the bloodstream (dissemination) is responsible for most of the mortality associated with bacterial infection. Even though this is a clinically important step of many infectious diseases, and likely an important target for disease treatment, we don’t know how most microbes disseminate. One of the key steps in this process is adhesion of bacteria to the inner surfaces of blood vessels. This allows bacteria to slow down enough to grab onto vessel surfaces, then escape from the blood stream into tissues where it’s easier for them to live. It’s a bit like the problem faced by a person being carried down a fast-flowing river who needs to grab onto something on the banks to get out onto dry land. A big problem for bacteria, and any other cells which must stick to blood vessel walls (like white blood cells travelling to a site of infection or inflammation), is that they have to be able to stick to vessel walls without being ripped off by the flow of blood. They have to have adhesion mechanisms strong enough to overcome forces due to flow. It’s also really helpful to be able to hang on but keep moving along walls until they reach a good spot to get out. This is important for white blood cells too, which have to “sample” their environment to get to the right place to get out of blood flow. Even though the problem of how bacteria stick to blood vessel walls is so important clinically, the mechanisms bacteria use to do this are not widely understood. Part of this gap in our knowledge arises because we haven’t had good tools to study this process as it happens, and to understand how force affects bacterial interaction with vessel walls. The process of bacteria sticking to blood vessel walls is very fast, and hard to observe. The methods to observe this have already been developed, but the major technical innovations of our paper were to figure out how to identify and track the movement of the individual bacteria which stuck to vessel walls among millions flowing past, and to figure out how to set up a flow chamber system which replicated certain conditions in human blood vessels. Figuring out how to do this allowed us to figure out a lot about how the bacteria moved, and the forces and mechanisms involved in adhesion. It took a couple of years just to figure out the common patterns in the thousands of tracks of bacteria interacting with blood vessels, after the initial technical innovation. (more…)
Author Interviews, Infections, Outcomes & Safety, Pediatrics / 29.08.2016

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

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

MedicalResearch.com Interview with: Lin Op De Beeck, PhD student Laboratory of Aquatic Ecology, Evolution and Conservation University of Leuven Leuven, Belgium MedicalResearch.com: What is the background for this study? Response: Mosquitoes transmit quite a few deadly diseases, including West Nile Virus. Around the world, therefore, the fight against these insects is high on the agenda. Existing strategies for mosquito control often involve the use of chemical pesticides that harm the environment. These pesticides are increasingly less effective as well, as insects can become resistant to existing products relatively quickly. Biopesticides are a possible alternative. The most commonly used biological pesticide is the Bacillus thuringiensis israelensis (Bti) bacteria. Unfortunately, mosquitoes are already developing resistance to this pesticide as well. This means we have to keep increasing the dose of Bti to kill mosquitoes, so that this biological substance, too, is beginning to harm the environment. Therefore we set out to find a new strategy in the fight against mosquitoes. We already knew that chemical substances emitted by the backswimmer – a natural enemy of mosquito larvae in the water – trigger a stress response in mosquitoes. This stress response, in turn, suppresses the mosquito’s immune system. What makes the use of these predator cues even more interesting for mosquito control is that scientists recently found a way to produce a synthetic version of these chemical substances. We discovered that this synthetic version triggers a stress response in the mosquitoes and impairs their immune system, just like the natural predator cues. This gave us the idea to combine these synthetic predator cues with the biological pesticide Bti. (more…)
Author Interviews, Radiology, Zika / 25.08.2016

MedicalResearch.com Interview with: Fernanda Tovar Moll, MD, PhD Vice president of the D'Or Institute for Research and Education Professor,Federal University of Rio de Janeiro Rio de Janeiro, Brazil MedicalResearch.com: What is the background for this study? Response: The consequences of congenital zika virus infection are still under investigation. Recent studies suggest microcephaly as one of the consequences, but we wanted to go deeper in investigating what other kinds of neurological changes could happen in the developing central nervous system. Based on that, we performed a cohort study with multimodal images exams and longitudinal follow up (pre and post natal analyses) of some cases. (more…)
Author Interviews, Depression, Heart Disease, HIV, Vanderbilt / 25.08.2016

MedicalResearch.com Interview with: Matthew S Freiberg, MD, MSc Cardiovascular Medicine Division, Vanderbilt University School of Medicine Tennessee Valley Geriatric Research Education and Clinical Center, Nashville  TN Tasneem Khambaty, PhD Department of Psychology, University of Miami, Coral Gables, Florida Jesse C. Stewart, PhD Department of Psychology, Indiana University–Purdue University , Indianapolis, Indianapolis MedicalResearch.com: What is the background for this study? Response: Due to highly effective antiretroviral therapy, people with HIV are living longer. Unfortunately, these HIV-infected individuals remain at a higher risk for other chronic diseases, with cardiovascular disease (CVD) being one of the leading cause of death in this population. In the general population, depressive disorders, such as major depressive disorder (MDD) and dysthymic disorder, are associated with increased risk of new-onset CVD. Given that roughly 24-40% of HIV-infected individuals have a depressive disorder, we examined whether MDD and dysthymic disorder are also associated with an increased risk of new-onset CVD in people with HIV. (more…)