Author Interviews, C. difficile, Hand Washing / 30.09.2014

Kelly R. Reveles, PharmD, PhD The University of Texas College of Pharmacy MedicalResearch.com Interview with: Kelly R. Reveles, PharmD, PhD The University of Texas College of Pharmacy Medical Research: What are the main findings of the study? Dr. Reveles: Our study utilized data from the Centers for Disease Control and Prevention’s National Hospital Discharge Surveys. Patients were selected for this study if they were at least 18 years of age and had an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) (ICD-9-CM code 008.45). We found that Clostridium difficile infection incidence increased from 4.5 CDI discharges/1,000 total discharges in 2001 to 8.2 CDI discharges/1,000 total discharges in 2010. Mortality varied over the study period with peak mortality occurring in 2003 (8.7%) and the lowest rate occurring in 2009 (5.6%). Median hospital length of stay (LOS) was 8 days and remained stable over the study period. In summary, the incidence of Clostridium difficile infection in U.S. hospitals nearly doubled from 2001 to 2010, with little evidence of recent decline. Additionally, there does not appear to be a significant decline in mortality or hospital LOS among patients with Clostridium difficile infection. (more…)
Author Interviews, Ebola / 19.09.2014

Thomas House Warwick Mathematics Institute University of Warwick, Coventry. Medical Research Interview with: Thomas House Warwick Mathematics Institute University of Warwick, Coventry. Medical Research: What are the main findings of this report? Dr House: I analysed the historic patterns of Ebola outbreaks, in particular their rate of introduction (about every 1.5 years), case fatality ratio (which varied between outbreaks but was typically high) and overall severity (which was very variable). (more…)
Author Interviews, BMJ, HPV / 17.09.2014

Dr Neha Pathak, MBBS MA(Cantab) Academic Clinical Fellow in Obstetrics and Gynaecology Queen Mary University London. MedicalResearch.com Interview with: Dr Neha Pathak, MBBS MA(Cantab) Academic Clinical Fellow in Obstetrics and Gynaecology Queen Mary University London. Medical Research: What are the main findings of the study? Dr. Pathak: Cervical testing for human papillomavirus (HPV) is being piloted as a more accurate method for cervical cancer screening than current cytology-based ("Pap smears"). However, cervical testing still requires gynaecological examination and a doctor or nurse to take the sample. This could be a deterrent to attending screening as it is invasive and time-consuming. Urine-based HPV testing would be a less invasive and more convenient alternative. Our study was completed at the Queen Mary University London Women's Health Research Unit. We pooled the results of 14 studies from around the world which tested 1443 women for HPV in urine and cervical samples. We found that detection of HPV in urine seems to have good accuracy for the detection of HPV present in the cervix. We also found that using first void samples (the first part of the stream of urine) was twenty-two times more accurate than random or midstream urine samples. (more…)
Author Interviews, Ebola, Infections / 12.09.2014

Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State University MedicalResearch.com: Interview with: Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State University Medical Research: What are the main findings of the study? Dr. Chowell-Puente: 1.We estimated the effective reproduction number of Ebola virus disease, i.e. average number of secondary cases produced by a single primary case at calendar time t (Rt), for the ongoing epidemic in West Africa from March to August 2014. Estimates of Rt for the Guinea, Sierra Leone and Liberia, countries that are experiencing sustained community transmission were consistently above 1.0 since June 2014. 2.Country-specific estimates of the reproduction number for Liberia and Sierra Leone lied between 1.0 and 2.0, reflecting continuous growth of cases in these countries 3. Effective reproduction number below 2 indicate that control could be attained by preventing over half of the secondary transmissions per primary case (e.g. by means of effective case isolation and contact tracing). (more…)
Author Interviews, CHEST, Infections, Rheumatology / 12.09.2014

MedicalResearch.com Interview with: Theodore Marras, MD, FRCPC, M.Sc. Assistant Professor, University of Toronto Respirologist, Toronto Western Hospital University Health Network Toronto, ON, Canada Medical Research: What are the main findings of the study? Dr. Marras: Mycobacterial infections (TB and nontuberculous mycobacteria (NTM)) are more common in patients with rheumatoid arthritis (RA). Nontuberculous mycobacteria disease was far more common than TB disease in RA patients in Ontario, Canada. Nontuberculous mycobacteria disease was also associated with increased age, COPD, asthma, and GERD. The presence of nontuberculous mycobacteria disease was associated with increased mortality. (more…)
Flu - Influenza, Infections / 10.09.2014

Allison Weinmann MBBS, FRACP Senior Staff, Division Infectious Diseases Director HFHS Immunization Team Medical Director Infection Control and Prevention, West Bloomfield Hospital Henry Ford Health System Clinical Assistant Professor, Wayne State University Detroit, Mi 48202 MedicalResearch.com Interview with: Allison Weinmann MBBS, FRACP Senior Staff, Division Infectious Diseases Director HFHS Immunization Team Medical Director Infection Control and Prevention, West Bloomfield Hospital Henry Ford Health System Clinical Assistant Professor, Wayne State University Detroit, Mi 48202 Medical Research: What are the main findings of this study? Dr. Weinmann: The main findings included:
  • Mandatory influenza immunization for health care workers without allowing optional opt-out (and only allowing for documented medical or religious exemption) successfully raised our immunization uptake among all our employees to over 99% sustainable for the last 2 years which we consider a very important patient safety initiative.
  • Less than 2% of workers met a medical or religious exemption.
  • A prior optional opt out with mask wearing was problematic for staff and patients and did not reach our goal of close to 100% immunization uptake.
(more…)
Author Interviews, Infections, NEJM / 08.09.2014

MedicalResearch.com Interview with: Stephen H. Gillespie, M.D., D.Sc University of St. Andrews Medical School, St. Andrews Stephen H. Gillespie, M.D., D.Sc University of St. Andrews Medical School, St. Andrews Medical Research: What are the main findings of the study? Dr. Gillespie: REMox TB was a pioneering trial that has shown that a large-scale trial can be run efficiently in resource-poor settings with a high TB burden, adhere to the highest standards of good clinical trial practices, and deliver a clear, unequivocal result. REMoxTB was among the most rigorous Tuberculosis drug trials ever conducted in the modern era of TB treatment and among the largest ever conducted for a new TB treatment. It enrolled 1,931 patients at 50 sites in nine countries, mostly in Africa and Asia. Previously, there were thought to be regional differences in way in which patients' response to treatment across the world but we showed that a rigorous approach to trial conduct there was no evidence for that difference. The study confirmed that daily moxifloxacin was safe over four months of therapy and the moxifloxacin containing arms were more bactericidal initially. Despite its substantial anti-TB activity it did not prove possible to shorten therapy to four months. . These findings, with the safety of moxifloxacin, and its activity against TB, support the continued clinical testing of moxifloxacin as a component of other novel regimens. (more…)
Author Interviews, HIV, Infections, NEJM / 04.09.2014

Bongani M. Mayosi, M.B., Ch.B., D.Phil. Department of Medicine, Old Groote Schuur Hospital Cape Town, South Africa MedicalResearch.com Interview with: Bongani M. Mayosi, M.B., Ch.B., D.Phil. Department of Medicine, Old Groote Schuur Hospital Cape Town, South Africa Medical Research: What are the main findings of this study? Dr. Mayosi: In those with definite or probable tuberculous pericardial effusion: (1) Prednisolone for 6 weeks and Mycibacterium indicus pranii for three months had no significant effect on the combined outcome of death from all causes, cardiac tamponade requiring pericardiocentesis or constrictive pericarditis. (2) Both therapies were associated with an increased risk of HIV-associated malignancy. (3) However, use of prednisolone reduced the incidence of constrictive pericarditis and hospitalization. (4) The beneficial effects of prednisolone on constriction and hospitalization were similar in HIV-positive and HIV-negative patients (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Ebola, General Medicine / 29.08.2014

The American College of Chest Physicians released an expert consensus statement, Care of the Critically Ill and Injured During Pandemics and Disasters while the global health-care community cares for patients with the Ebola virus.Three of the authors discussed this important statement with MedicalResearch.com. Asha V. Devereaux, MD, MPH Sharp Hospital, Coronado, CA Asha V. Devereaux, MD, MPH Sharp Hospital Coronado, CA Jeffrey R. Dichter, MD Allina Health, Minneapolis, MN, and Aurora Health, Milwaukee, WI Jeffrey R. Dichter, MD Allina Health, Minneapolis, MN and Aurora Health, Milwaukee, WI   Niranjan Kissoon, MBBS, FRCP(C) BC Children's Hospital and Sunny Hill Health Centre University of British Columbia, Vancouver, Canada Niranjan Kissoon, MBBS, FRCP(C) BC Children's Hospital and Sunny Hill Health Centre University of British Columbia, Vancouver, Canada Medical Research: What are the main ethical concerns and criteria for evaluating who may be eligible for treatment during a pandemic or disaster? Dr. Asha Devereaux: The main ethical concerns regarding eligibility for treatment during a pandemic will be access to limited or scarce resources. Who should get treatment and who decides will be some significant questions whenever there is a scarcity of healthcare resources. Transparency and the fairness of the ethical framework for decision-making will need to be made public and updated based upon the changing dynamics of resources and disease process. Dr. Niranjan Kissoon: There is work to be done in this area and engagement of citizens, government, medical community, ethicists and legal experts in the process is important. (more…)
Author Interviews, Infections / 29.08.2014

Dr. Asha Bowen FRACP Menzies School of Health Research Charles Darwin University Darwin, NT, Australia MedicalResearch.com Interview with: Dr. Asha Bowen FRACP Menzies School of Health Research Charles Darwin University Darwin, NT, Australia Medical Research: What are the main findings of the study? Dr. Bowen: The Skin Sore Trial found that short courses (3 days of twice daily dosing or 5 days of once daily dosing) of oral co-trimoxazole worked just as well for treating impetigo in remote Indigenous Australian children as the standard treatment with an intramuscular injection of penicillin (BPG). Despite many randomised controlled trials (RCTs) on this common infection of childhood, few have been conducted where impetigo is severe and endemic and with over 100 million children affected at any one time, ongoing research is needed. This is only the second RCT to study impetigo in children where the problem is endemic and often severe. In our study, 70% of children had severe impetigo with a median of 3 body regions affected. BPG injections are painful and we knew from previous studies that not many children were receiving them. Our study confirmed that 30% of children had injection site pain 48 hours after receipt of the injection and 5 children ran away when they found out that they were randomised to the injection arm of the study. (more…)
Author Interviews, Hospital Acquired, JAMA, Surgical Research / 28.08.2014

Christopher Mantyh, M.D. Associate Professor of Surgery Chief of Colorectal Surgery NSQIP Surgical Champion Duke University Medical Center MedicalResearch.com Interview with: Christopher Mantyh, M.D. Associate Professor of Surgery Chief of Colorectal Surgery NSQIP Surgical Champion Duke University Medical Center Medical Research: What are the main findings of the study? Dr. Mantyh: Specific perioperative bundles can drastically reduce surgical site infections in colorectal surgery patients. (more…)
Author Interviews, Infections, NEJM / 27.08.2014

MedicalResearch.com Interview with: Ziad A. Memish, M.D. Alfaisal University Riyadh Saudi Arabia Medical Research: What are the main findings of the study? Dr. Memish: This is an important study as we looked at the secondary transmission of MERS-CoV among household/family contacts. Of the total study population of 280 contacts from 26 clusters collected over 6 months period last year, only 12 family contacts were positive for MERS-CoV. Knowing that 7 (2.5%) were positive by PCR, only additional 5 probable secondary transmission were identified by serology which is a very small fraction missed by PCR. (more…)
Author Interviews, Infections, JAMA, Pediatrics / 27.08.2014

Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta Georgia MedicalResearch.com Interview with: Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta Georgia   Medical Research: What are the main findings of the study? Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period. In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol. The key finding is the durability of the results - 3 years in the life of an adolescent is a long period. (more…)
AHRQ, Author Interviews, Electronic Records, Urinary Tract Infections / 26.08.2014

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania, Philadelphia, PA 19104 MedicalResearch.com Interview with: Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania, Philadelphia, PA 19104 Medical Research: What are the main findings of the study? Dr. Umscheid: We found that targeted automated alerts in electronic health records significantly reduce urinary tract infections in hospital patients with urinary catheters. In addition, when the design of the alert was simplified, the rate of improvement dramatically increased. Approximately 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. According to the Centers for Disease Control and Prevention, 15 to 25 percent of hospitalized patients receive urinary catheters during their hospital stay. As many as 70 percent of urinary tract infections in these patients may be preventable using infection control measures such as removing no longer needed catheters resulting in up to 380,000 fewer infections and 9,000 fewer deaths each year. Our study has two crucial, applicable findings. First, electronic alerts do result in fewer catheter-associated urinary tract infections. Second, the design of the alerts is very important. By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them. Fewer catheters means fewer infections, fewer days in the hospital, and even, fewer deaths. Not to mention the dollars saved by the health system in general. In the first phase of the study, two percent of urinary catheters were removed after an initial “off-the-shelf” electronic alert was triggered (the stock alert was part of the standard software package for the electronic health record). Hoping to improve on this result in a second phase of the study, we developed and used a simplified alert based on national guidelines for removing urinary catheters that we previously published with the CDC. Following introduction of the simplified alert, the proportion of catheter removals increased more than seven-fold to 15 percent. The study also found that catheter associated urinary tract infections decreased from an initial rate of .84 per 1,000 patient days to .70 per 1,000 patient-days following implementation of the first alert and .50 per 1,000 patient days following implementation of the simplified alert. Among other improvements, the simplified alert required two mouse clicks to submit a remove-urinary-catheter order compared to seven mouse clicks required by the original alert. The study was conducted among 222,475 inpatient admissions in the three hospitals of the University of Pennsylvania Health System between March 2009 and May 2012. In patients’ electronic health records, physicians were prompted to specify the reason (among ten options) for inserting a urinary catheter. On the basis of the reason selected, they were subsequently alerted to reassess the need for the catheter if it had not been removed within the recommended time period based on the reason chosen. (more…)
Author Interviews, Infections, Ophthalmology / 26.08.2014

Ronald C Gentile, MD, FACS, FASRS Professor of Ophthalmology Chief, Ocular Trauma Service (Posterior Segment) Surgeon Director The New York Eye and Ear Infirmary of Mount Sinai New York, NY 10003 President: operationrestorevision.org MedicalResearch.com Interview with Ronald C Gentile, MD, FACS, FASRS Professor of Ophthalmology Chief, Ocular Trauma Service (Posterior Segment) Surgeon Director The New York Eye and Ear Infirmary of Mount Sinai New York, NY 10003 President: operationrestorevision.org Medical Research: What are the main findings of the study? Dr. Gentile: We had three main findings in our study on the microbiological spectrum and antibiotic sensitivity in endophthalmitis over the past twenty- five years at the New York Eye and Ear Infirmary of Mount Sinai. First Finding: The first main finding of the study was that there has not been any major change in the types of organisms causing endophthalmitis over the past 25 years. The most common cause of endophthalmitis in the study was bacteria, 95%, with most, 85%, being Gram-positive bacteria. The most prevalent organisms isolated were coagulase-negative staphylococcus, making up about 40% of the cases. This was followed by Streptococcus viridans species in about 12% and Staphylococcus aureus in about 11%. Gram-negative organisms accounted for about 10% and fungi for about 5%. Second Finding: The second main finding of the study was that the current empiric intravitreal antibiotics used for treating endophthalmitis, vancomycin and ceftazidime, continue to be an excellent choice. The overwhelming majority of microorganisms causing endophthalmitis are susceptible to this combination. Over 99% of the Gram-positive isolates were susceptible to the vancomycin and about 92 percent of the Gram-negative isolates were susceptible to ceftazidime. Third Finding: The third main finding of the study was that there was increasing microbial resistance to eight antibiotics including cefazolin, cefotetan, cephalothin, clindamycin, erythromycin, methicillin/oxacillin, ampicillin, ceftriaxone and decreasing microbial resistance to three antibiotics including gentamicin, tobramycin, and imipenem. For example, Staph Aureus isolates resistant to methicillin increased from 18% in the late 1980s to just over 50% this past decade while gentamicin-resistance endophthalmitis isolates decreased during the same time period from 42% to 6%. (more…)
Author Interviews, General Medicine, Infections, NEJM / 26.08.2014

Medical Research Interview with: Brian Dannemann, MD, FACP Senior Director, JNJ Pharmaceutical Research and Development Titusville, NJ 08560 MedicalResearch: What are the main findings of the study? Dr. Dannemann : The final investigational 120-week results from the TMC207-C208 Phase 2 study demonstrated that bedaquiline (SIRTURO®) showed nearly twice an many patients in the bedaquiline group as in the placebo group were cured on the basis of the World Health Organization (WHO) outcome definitions for Multidrug-Resistant Tuberculosis which was statistically significant (38 of 66 patients [58%] and 21 of 66 patients [32%] respectively; p = 0.003). (more…)
Author Interviews, Urinary Tract Infections, Urology / 23.08.2014

Steve J. Hodges MD Associate Professor, Department of Urology Wake Forest University School of Medicine Medical Center Blvd, Winston-Salem, NC MedicalResearch.com Interview with: Steve J. Hodges MD Associate Professor, Department of Urology Wake Forest University School of Medicine Medical Center Blvd, Winston-Salem, NC Medical Research: What are the main findings of this study? Dr. Hodges: The main findings of this study were that skin irritants (typically urine) may cause vulvitis in prepubertal girls, which leads to an alteration of their perineal microbiome, with increased colonization by uropathogenic bacteria, increasing the risk of UTI. (more…)
Author Interviews, Case Western, Lyme / 22.08.2014

Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State University MedicalResearch.com Interview with: Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State University Medical Research: What are the main findings of the study that were just published in Ticks and Tick-borne Diseases? Dr. Salkeld: The primary findings of this new study show that western black-legged ticks, which can transmit Lyme disease, are active throughout the year in Northwest California, making the threat of Lyme disease year-round phenomenon. More specifically, my colleagues from California Department of Public Health Vector-borne Disease Section and University of California, Berkeley and I found that the activity of Western Black-legged ticks (Ixodes pacificus), which are the ticks most commonly known to carry Lyme disease (caused by Borrelia burgdorferi) in Northwest California, is largely predictable and year-round. In general, tick larvae (newly hatched immature ticks) are active April to June, and sometimes activity extends into October, while adult ticks are active from October to May. Nymphal ticks (the tick stage following larvae and preceding adults) are active from January to October but peak from April-June. This is important because nymphs are responsible for most Lyme disease infections. (more…)
Author Interviews, NEJM, Respiratory / 22.08.2014

John DeVincenzo, M.D. Professor of Pediatrics Division of Infectious Diseases Professor of Microbiology, Immunology and Biochemistry University of Tennessee School of Medicine. University of Tennessee. Medical Director, Molecular Diagnostics and Virology Laboratories Le Bonheur Children's Hospital Memphis, Tennessee MedicalResearch.com Interview with: John DeVincenzo, M.D. Professor of Pediatrics Division of Infectious Diseases Professor of Microbiology, Immunology and Biochemistry University of Tennessee School of Medicine. Le Bonheur Children's Hospital Memphis, Tennessee Medical Research: What are the main findings of the study? Dr. DeVincenzo: The main findings are
  • a) This is the first time that anyone has shown that the infection caused by the RSV virus can be effectively reduced in a human after the infection has already started.
  • b) We also show for the first time that once we reduce the amount of virus in the patient, that very quickly, they start to feel better. This clinical improvement was not expected to occur so rapidly.
  • c) The antiviral appeared safe and it was easy to give.
(more…)
Author Interviews, MRSA / 15.08.2014

dr_kyle_popovich MedicalResearch.com Interview with: Kyle J. Popovich, MD, MS Rush University Medical Center Stroger Hospital of Cook County, Chicago, Illinois   Medical Research: What are the main findings of the study? Dr. Popovich: Colonization with methicillin-resistant Staphylococcus aureus (MRSA) at body sites outside the nares was common, with more than half of all colonized individuals having MRSA colonization in the rectal or groin areas. Resistance to mupirocin was uncommon and molecular testing showed no signs of resistance to chlorhexidine gluconate. (more…)
Author Interviews, Flu - Influenza, NEJM, Vaccine Studies / 15.08.2014

David P. Greenberg, M.D. Vice President, Scientific & Medical Affairs, and Chief Medical Officer Sanofi Pasteur US. MedicalResearch.com Interview with: David P. Greenberg, M.D. Vice President, Scientific & Medical Affairs, and Chief Medical Officer Sanofi Pasteur US.   Medical Research: What are the main findings of the study? Dr. Greenberg: The New England Journal of Medicine published positive results from a randomized, double-blind, large-scale, multi-center efficacy trial, which found that Fluzone® High-Dose (Influenza Vaccine) was more efficacious in preventing influenza illness (“the flu”) in adults 65 years of age and older compared to standard-dose Fluzone vaccine. Fluzone High-Dose vaccine was found to be 24.2 percent (95% CI, 9.7 to 36.5) more effective in preventing influenza relative to standard-dose Fluzone vaccine for the primary endpoint (laboratory-confirmed influenza associated with typical clinical symptoms occurring at least 14 days post-vaccination caused by any viral type or subtype). In other words, investigators determined that participants in the Fluzone High-Dose vaccine group were less likely to get the flu than those in the standard-dose Fluzone vaccine group. The study safety data were consistent with previous Fluzone High-Dose vaccine studies. (more…)
Author Interviews, Hand Washing, Infections / 09.08.2014

Dr. Gianni D'Egidio HBSc, MD, MEng Academic Division of Internal Medicine Ottawa Hospital, Canada MedicalResearch.com Interview with: Dr. Gianni D'Egidio HBSc, MD, MEng Academic Division of Internal Medicine Ottawa Hospital, Canada Medical Research: What are the main findings of the study? Dr. D'Egidio: Baseline hand hygiene compliance at our main entrance in our study was 12.4%. We believe one of the main reasons for such an appalling low compliance was that individuals were distracted. Visitors entering are often preoccupied with acquiring information to help them navigate a large and confusing environment given the multitude of signs, lights, announcements and other people. Also, the majority of individuals entering have objects occupying their hands; keys, hand-held devices, coffee mugs, and during cold weather, gloves. All this together contributes to poor compliance at our front entrance. We hypothesized that a conspicuous flashing red light at 3 Hz (3 flashed per second) attached to alcohol hand dispensers located at our front entrance would attract an individual’s attention and hopefully increase compliance. We measured hand hygiene compliance for 1-week periods from 07:30-08:30 before and after the implementation of our flashing lights. We found that compliance increased by more than double to 25.3% (p<0.0001). (more…)
Author Interviews, Infections, mBio, NEJM / 07.08.2014

Claudio Soto, PhD Professor of Neurology Director Mitchell Center for Alzheimer's disease and related Brain Disorders University of Texas Medical School at Houston MedicalResearch.com Interview with: Claudio Soto, PhD Professor of Neurology Director Mitchell Center for Alzheimer's disease and related Brain Disorders University of Texas Medical School at Houston Medical Research: What are the main findings of the study? Dr. Soto: In this study we describe for the first time the highly sensitive detection of prions in human urine, specifically in samples from patients affected by the variant form of Creutzfeldt-Jakob disease (vCJD), which is the disease produced by infection with prions associated with bovine spongiform encephalopathy, also known as mad cow disease. For detection we used the protein misfolding cyclic amplification (PMCA) technique which amplifies the amount of abnormal prion protein in a cyclical manner conceptually analogous to the polymerize chain reaction. We detected prions in 13 of the 14 vCJD cases analyzed, and the only negative was a sample coming from a patient under treatment with a experimental drug injected directly into the brain. No false positive were observed in the more than 200 cases analyzed. The concentration of abnormal prion protein in urine was estimated at 1x10^-16 g/ml, or 3x10^-21 moles/ml, which extrapolates to ~40-100 particles per ml of urine. (more…)
Author Interviews, Cancer Research, Herpes Viruses, Vaccine Studies / 06.08.2014

Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation. MedicalResearch.com Interview with: Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation. Medical Research: What are the main findings of the study? Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease. (more…)
Education, HIV, Yale / 24.07.2014

Lynn E. Fiellin, M.D. Associate Professor of Medicine Director, play2PREVENT Lab Yale University School of Medicine New Haven, CT 06510 MedicalResearch.com Interview with Lynn E. Fiellin, M.D. Associate Professor of Medicine Director, play2PREVENT Lab Yale University School of Medicine New Haven, CT 06510 Medical Research: What are the main findings of the study? Dr. Fiellin: The current findings are part of a larger study evaluating an interactive evidence-based video game, PlayForward: Elm City Stories, developed on the iPad and targeting risk reduction and HIV prevention in 333 young teens (ages 11-14). The larger study is examining a range of outcomes including knowledge, intentions, self-efficacy and actual behaviors and we are collecting at baseline, 6 weeks, 3, 6, 12, and 24 months. We are examining these outcomes in our experimental group compared with a control group playing a set of off-the-shelf games on the iPad. The current findings of the 196 teens who have completed the 6 weeks of gameplay and for whom we have baseline and 3 month data, reveal that, while the two groups had no differences in their baseline HIV risk knowledge, the PlayForward group had statistically significant gains in knowledge at 6 weeks (p<0.0001), sustained at 3 months (p<0.01). In addition, examining the association between exposure to the game and performance on the standardized assessments revealed that the number of game levels completed (a measure of exposure to the intervention) was positively correlated with knowledge gains measured at 3 months (r=0.42; p<0.001). (more…)
Author Interviews, Cancer Research, General Medicine, Infections, Journal Clinical Oncology, Sloan Kettering / 23.07.2014

Allison Lipitz-Snyderman, PhD Assistant Attending Outcomes Research Scientist Center for Health Policy and Outcomes Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York, NY 10065 MedicalResearch.com Interview with: Allison Lipitz-Snyderman, PhD Assistant Attending Outcomes Research Scientist Center for Health Policy and Outcomes Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York, NY 10065 Medical Research: What are the main findings of the study? Dr. Lipitz-Snyderman: Long-term central venous catheters are used to administer intravenous fluids and treatments such as chemotherapy. These catheters can also be a source of bloodstream infections which can be harmful to cancer patients. However, this risk is not well understood. In our study, we found that the use of these catheters was associated with an increased risk of infections for patients with cancer. We used a population-based dataset, SEER-Medicare, to study this issue in older adult cancer patients. This dataset allowed us to study patients treated in different institutions and follow them over time. (more…)
Infections / 22.07.2014

Dr. Dan Everitt Senior Medical Officer, TB Alliance. MedicalResearch.com Interview with: Dr. Dan Everitt Senior Medical Officer, TB Alliance. Medical Research: What are the main findings of the study? Dr. Everitt: The NC-002 trial tested a new, three-drug TB combination therapy, consisting of PA-824 (a new chemical entity), moxifloxacin (a re-purposed drug, not yet approved for TB treatment), and pyrazinamide (an existing TB drug currently used in standard TB treatment). This regimen is known as "PaMZ" and was tested in both drug-sensitive and multidrug-resistant TB (MDR-TB patients). In the eight-week trial, PaMZ killed more bacteria than standard therapy and did so at a faster rate, showing its potential to shorten therapy to as little as four months for drug-sensitive and some forms of MDR-TB. Additionally, the trial included HIV-positive patients and a formal statistical evaluation found no effect of HIV status on the outcome of the study. (more…)
Author Interviews, HIV / 22.07.2014

 Dr. Nelli Westercamp PhD, MPH, MBA University of Illinois at Chicago School of Public Health Kenya, Epidemiology and Public Health MedicalResearch.com Interview with: Dr. Nelli Westercamp PhD, MPH, MBA University of Illinois at Chicago School of Public Health Kenya, Epidemiology and Public Health Medical Research: What are the main findings of the study? Dr. Westercamp: The three clinical control trials in Kenya, Uganda and South Africa found that male circumcision reduces the risk of female to male transmission by up to 60%, prompting the endorsement of medical male circumcision as an HIV prevention intervention by the WHO and UNAIDS. However, as medical male circumcision services for HIV prevention are being rolled out in the priority countries, questions remain whether the male circumcision promotion will actually translate into decreases in HIV infections. One factor that could reduce the effectiveness of male circumcision for HIV prevention at the population level is the behavioral risk compensation. In other words, if men who become circumcised believe that they are fully protected against HIV and engage in higher sexual risk taking behaviors as a result of this belief, this could reduce or even negate the protective effect of male circumcision against HIV. To answer this question, we conducted a large prospective study concurrently with the scale up of male circumcision services in Western Kenya. We recruited 1,588 men seeking circumcision services as well as 1,598 men who decided to remain uncircumcised and assessed their sexual behaviors over 2 years, every 6 months. We then compared the behaviors of circumcised men before and after circumcision and also the behaviors of circumcised and uncircumcised men over time. In the beginning of the study, we found that men choosing to become circumcised believed they were at higher risk of HIV than their uncircumcised counterparts. This perception of HIV risk declined significantly among the circumcised men after circumcision (from 30% at baseline to 14% at 24 months of follow up), while remaining relatively stable among the uncircumcised men (24% to 21%, respectively). Looking at sexual risk behaviors, we saw that the overall level of sexual activity increased equally in both groups, mostly driven by the youngest age group (18-24 year old). However, despite the decrease in risk perception among circumcised men and the increase in sexual activity among all men, all other risky behaviors decreased in both groups and protective behaviors – such as condom use – increased, particularly among circumcised men. (more…)
Author Interviews, Flu - Influenza, Lancet / 22.07.2014

MedicalResearch.com Interview with: Prof. Jean-Francois Rossignol, FRSC, FRCPath Romark Laboratories, LC MedicalResearch: What are the main findings of the study? Prof. Rossignol: Nitazoxanide, a new orally administered drug in development for treating influenza, reduced the duration of symptoms of uncomplicated influenza compared to a placebo. The drug also reduced viral shedding. Side effects were similar for the drug and placebo treatment arms. The study was designed and conducted in compliance with FDA guidelines for studying new drugs for influenza. (more…)
Author Interviews, Brigham & Women's - Harvard, HIV, JAMA, Weight Research / 21.07.2014

Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com Interview with Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114 Medical Research: What are the main findings of the study? Dr. Grinspoon: The primary finding is that tesamorelin, a hypothalamic peptide that increases the endogenous pulsatile secretion of growth hormone, reduced liver fat in HIV-infected patients with increased visceral (abdominal) fat. Increased visceral fat is very closely linked with increased liver fat in HIV patients, but the effects on liver fat were not known. Our data show that tesamorelin reduces liver fat in conjunction with decreasing visceral fat, which may be clinically important for patients with HIV-infection who have both increased abdominal fat and fatty liver disease. In addition the study demonstrated that this treatment strategy was neutral to glucose by the end of the 6 month study. (more…)