Author Interviews, MRSA, PNAS, UCLA, Vaccine Studies / 14.12.2014

Dr. Michael Yeaman Ph.D. Professor of Medicine, Infectious Disease Specialist Chief, Division of Molecular Medicine David Geffen School of Medicine at UCLA Los Angeles Biomedical Research Institute at Harbor-UCLA Medical CenterMedicalResearch.com Interview with: Dr. Michael Yeaman Ph.D. Professor of Medicine, Infectious Disease Specialist Chief, Division of Molecular Medicine David Geffen School of Medicine at UCLA Los Angeles Biomedical Research Institute Harbor-UCLA Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Yeaman: In the U.S. and around the globe, skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA) continue to endanger the health and lives of patients and otherwise healthy individuals. Treatment is difficult because MRSA is resistant to many antibiotics, and the infections can recur, placing family members and other close contacts at risk of infection. Infectious disease specialists at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) tested a new investigational vaccine, NDV-3, and found it holds new hope for preventing or reducing the severity of infections caused by the "superbug" MRSA. In the study, which was published Dec. 8 in the Proceedings of the National Academy of Sciences USA, the researchers reported that NDV-3, employing the recombinant protein Als3, can mobilize the immune system to fight off MRSA skin infections in an experimental model. The researchers found the vaccine works by enhancing molecular and cellular immune defenses of the skin in response to MRSA and other S. aureus bacteria in disease models. This is the first published study to demonstrate the effectiveness of a cross-kingdom recombinant vaccine against MRSA skin infections. NDV-3 is unique as it is the first vaccine to demonstrate it can be effective in protecting against infections caused by both S. aureus and the fungus Candida albicans. NDV-3 represents a novel approach to vaccine design that pioneers an approach termed convergent immunity. (more…)
Author Interviews, Infections / 02.12.2014

Jack A Gilbert PhD Department of Ecology & Evolution Graduate Program in Biophysical Sciences University of Chicago, Chicago, IL 60637,MedicalResearch.com Interview with: Jack A Gilbert PhD Department of Ecology & Evolution Graduate Program in Biophysical Sciences University of Chicago, Chicago, IL 60637 MedicalResearch: What is the background for this study? What are the main findings? Dr. Gilbert: We have performed extensive analysis of the microbial distribution between humans and home surfaces in peoples houses. And are still exploring how bacteria are distributed around hospitals. Here we wanted to explore how bacteria from humans were distributed into a space in real time. By taking samples every hour post sterilization and seeing how the community stabilized, who remained active and whether they were pathogenic. We found that communities stabilized on a skin-associated microbiome within 5 hours, that staphylococcus remained active and yet none of these were particularly pathogenic. Yet we were able to identify pathogenic MRSA on surfaces around the bathroom, but they were extremely rare. (more…)
Author Interviews, Dermatology, Ebola / 01.12.2014

Victoria Vaughan Medical College of Georgia, Augusta, GeorgiaMedicalResearch.com Interview with: Victoria Vaughan Medical College of Georgia, Augusta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: The Global Mortality of Skin Disease study compares age adjusted mortality of disease with skin manifestations between developing and developed countries for the years 1990 and 2010. The main findings were that mortality from infectious conditions was greater in the developing world while melanoma contributed to mortality in the developed world. Ebola Virus Disease has cutaneous manifestations and affects the developing world preferentially. As of November 27, 2014, the mortality in West Africa totals 5444 according to the CDC. However, the United States has had only two deaths from Ebola Virus Disease. (more…)
Author Interviews, CDC, HIV / 26.11.2014

MedicalResearch.com Interview with: Heather Bradley, PhD Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC Medical Research: What is the background for this study? What are the main findings? Dr. Bradley: The key to controlling the HIV epidemic is controlling the virus.  When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Yet, only one-third of the 1.2 million people with HIV in the U.S. have the virus under control.  Among those who did not have the virus under control, approximately two-thirds had been diagnosed but were not in medical care. Young people were least likely to have the virus under control.  Only 13 percent of 18 – 24 year olds were virally suppressed, primarily because half don’t know they are infected.  To close this gap among young people, increased HIV testing is critical. The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, Mayo Clinic / 26.11.2014

Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale ArizonaMedicalResearch.com Interview with: Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale Arizona Medical Research: What is the background for this study? What are the main findings? Dr. DiBaise: Despite nearly 25 years of safe and effective use of proton pump inhibitors (PPI), in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use.  One such association with PPI use has been Clostridium difficile infection (CDI) which can cause severe and recurrent episodes of diarrhea.  Previous reports evaluating the microbes present within the gastrointestinal tract (ie, gut microbiome) of individuals with CDI have shown a reduction in overall microbial community diversity.  We studied the gut microbiome in healthy individuals both before and after using a proton pump inhibitors for one month and found a similar reduction in microbial diversity while taking the PPI that did not entirely revert back to the ‘normal’ baseline after being off the medication for a month.  While this does not demonstrate a causal association between proton pump inhibitors use and CDI, it demonstrates that PPI use creates a situation in the gut microbial environment that may increase the individual’s susceptibility to CDI. (more…)
Author Interviews, CDC, JAMA, Lyme / 25.11.2014

MedicalResearch.com Interview with: Christina Nelson, MD, MPH, FAAP Medical Epidemiologist Centers for Disease Control and Prevention Division of Vector-Borne Diseases | Bacterial Diseases Branch Fort Collins, CO Medical Research: What is the background for this study? Dr. Nelson: Evidence-based guidelines for the diagnosis and treatment of Lyme disease have been provided by the Infectious Diseases Society of America for many years. These comprehensive guidelines have been vetted by external review panels as the best option for patient care. In endemic areas, patients with the typical rash (erythema migrans) can be diagnosed with Lyme disease clinically. Otherwise, the guidelines recommend that diagnosis be based on a history of possible exposure, compatible clinical features, and positive two-tier serologic testing. Some patients who have been treated for Lyme disease may develop post-treatment Lyme disease syndrome (PTLDS) – fatigue, arthralgias, or other symptoms that persist after completing antibiotic treatment. Although the exact cause of post-treatment Lyme disease syndrome is unknown, it is thought to be due to an altered immune response or residual damage to tissues during the acute infection. A diagnosis of exclusion, PTLDS should only be diagnosed after the patient has been thoroughly evaluated and other potential causes of symptoms ruled out. On the other hand, “chronic Lyme disease” is a loosely defined diagnosis that has been used to describe a variety of ailments. A small cadre of providers use unconventional methods to diagnose patients with chronic Lyme disease, and sometimes there is no objective evidence that the patient ever had Lyme disease. Multiple factors contribute to this phenomenon, including misconceptions about serologic testing, use of unvalidated diagnostic tests, and clinical diagnosis of Lyme disease based on nonspecific symptoms alone. We know that patients have been – and continue to be – harmed by treatments for chronic Lyme disease. Patients have suffered from emboli, severe allergic reactions to antibiotics, neutropenia, and infections such as Clostridium difficile. This is terrible and should never happen. However, there is another important danger related to these alternative practices. Some patients who have been diagnosed and treated for chronic Lyme disease later discover that another condition is the root of their physical problem. We wanted to highlight some of these cases in order to help educate providers and patients about this issue. (more…)
Author Interviews, Heart Disease, Infections, Lancet / 24.11.2014

MedicalResearch.com Interview with: Dr. Martin Thornhill PhD Department of Cardiology, Taunton and Somerset NHS Trust Taunton, Somerset, UK Medical Research: What is the background for this study? What are the main findings? Dr. Thornhill: In 2008 NICE introduced controversial new guidance recommending that antibiotic prophylaxis to prevent infective endocarditis should no longer be used. It was a rational decision, given the evidence for the effectiveness of antibiotic prophylaxis and potential concerns about costs, the development of antibiotic resistance and possible side effects from antibiotics, but it went against other guidelines from around the world that existed at the time. The main findings are that in England:
  1. There has been a large and significant decline in the use of antibiotic prophylaxis.
  2. There has been a significant increase in the number of cases of infective endocarditis, above the baseline trend, using hospital coding data, corrected for changes in the size of the English population.
(more…)
HPV, Vaccine Studies / 24.11.2014

Dr. Raquel Qualls-Hampton MD, MS Assistant Professor University of North Texas Health Science CenterMedicalResearch.com Interview with: Dr. Raquel Qualls-Hampton MD, MS Assistant Professor University of North Texas Health Science Center Medical Research: What is the background for this study? What are the main findings? Dr. Qualls-Hampton: There are currently two vaccines approved by the Food and Drug Administration (FDA)—Gardasil for males and Gardasil and Cervix for females – that protect against the human papilloma virus (HPV). These vaccines are recommended by the ACIP for females ages 9 to 26 years and males ages 9 to 21 years. Both vaccines protect males and females against some of the most common types of HPV.  HPV vaccines are administered in three doses over six months and are considered safe and effective. However, the promise of these vaccines is going unfulfilled as initiation and completion rates for the three doses are suboptimal among females and males. Nationally, although HPV vaccination initiation coverage is increasing, overall vaccine completion rates are at suboptimal levels and below the U.S. Department of Health and Human Services’ Healthy People 2020 initiative target of 80%. Thus, many states are turning to legislative interventions in efforts to increase initiation and completion rates. This study examines HPV vaccination legislative initiatives and their impact, specifically in estimating state legislation’s effects on HPV vaccine initiation, completion and patient care provider recommendations by gender. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 23.11.2014

MedicalResearch.com Interview with: Maryam Darvishian MSc Department of Epidemiology, University Medical Center Groningen, Unit of PharmacoEpidemiology and PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, and  Prof Edwin R van den Heuvel Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsDepartment of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, Netherlands Medical Research: What is the background for this study? Reply: In most developed countries, seasonal influenza vaccine is the standard care for elderly people, but there exists still discussions on whether vaccination is effective. Conducting RCT is not considered ethical and thus the main body of evidence comes from observational studies. Unfortunately, these studies (e.g. cohort studies) are susceptible to different sources of biases especially selection bias which makes it difficult to judge the effectiveness. In recent years test-negative design (TND) studies has been designed. It is a special type of case-control study which would limit the bias, due to similar health care-seeking behavior in cases and controls. The current study is a meta-analysis of TND case-control studies. It is the first meta-analysis of this type of studies and also the first meta-analysis that combined 35 studies for estimation of influenza vaccine effectiveness. More specifically, the meta-analysis assesses the influenza vaccine effectiveness against laboratory-confirmed influenza (LCI) among the elderly population. (more…)
Flu - Influenza, Heart Disease / 21.11.2014

MedicalResearch.com Interview with: Harleen Sandhu, MD MPH Senior Researcher University of Texas Health Science Center at Houston Medical Research: What is the background for this study? What are the main findings? Dr. Sandhu: Previous studies have shown a correlation between seasonal variations and occurrence of acute aortic dissection, however, reasons for such associations are unknown. Seasonal flu activity has been associated with the occurrence of cardiovascular diseases such as acute myocardial infarction in the past. This led us to verify this seasonal correlation in our experience with acute aortic dissection patients and to further investigate if its incidence was associated with flu activity. Our results confirmed the seasonal variation in acute aortic dissection as well as demonstrated a positive correlation with seasonal flu activity. (more…)
Author Interviews, Biomarkers, Infections, Nature, UCLA / 19.11.2014

Weian Zhao PhD Assistant Professor at the Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center, Department of Biomedical Engineering, Edwards Lifesciences Center for Advanced Cardiovascular Technology and Department of Pharmaceutical Sciences at University of California, Irvine. Founder of Velox BiosystemsMedicalResearch.com Interview with: Weian Zhao PhD Assistant Professor at the Sue and Bill Gross Stem Cell Research Center, Chao Family Comprehensive Cancer Center, Department of Biomedical Engineering, Edwards Lifesciences Center for Advanced Cardiovascular Technology and Department of Pharmaceutical Sciences at University of California, Irvine. Medical Research: What is the background for this study? Dr. Zhao: Bloodstream infections are a major cause of illness and death. In particular, infections associated with antimicrobial-resistant pathogens are a growing health problem in the U.S. and worldwide. According to the Centers for Disease Control & Prevention, more than 2 million people a year globally get antibiotic-resistant blood infections, with about 23,000 deaths. The extremely high mortality rate for blood infections is due, in part, to the inability to rapidly diagnose and treat patients in the early stages. The present gold standard to detect a blood infections, is a blood culture and it takes 2-5 days for the detection and the identification of the bacteria. Recent molecular diagnosis methods, including polymerase chain reaction, can reduce the assay time to hours but are often not sensitive enough to detect bacteria that occur at low concentrations in blood, as is common in patients with blood infections.  Therefore, less expensive and less technically demanding methods are urgently needed for the rapid and sensitive identification of blood infections. (more…)
Author Interviews, Ebola, Lancet / 16.11.2014

Professor Tom Solomon, FRCP PhD Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections Director, Institute of Infection and Global Health, University of Liverpool MedicalResearch.com Interview with: Professor Tom Solomon, FRCP PhD Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections Director, Institute of Infection and Global Health, University of Liverpool Medical Research: What is the background for this study? What are the main findings? Dr. Solomon: Since the Ebola outbreak began there has been concern about transmission to new countries by airline passengers who were infected, but didn’t know it. This was underscored by such transmission to Nigeria, and to USA. Screening for symptoms of Ebola virus disease in airline passengers whose journeys originated from the three most affected countries—Guinea, Liberia, and Sierra Leone—has recently been introduced at some airports. We examined the current growth rate of the epidemic in West Africa, and airline travel patterns to predict how many people with Ebola are likely to attempt to fly. Our research showed that we can expect approximately 29 infected passengers to try and leave West Africa by the end of the year. Based on the incubation period of the virus, and looking at how long people have symptoms before they are hospitalised, we estimated ten of these people with Ebola would have symptoms of the disease as they leave the affected countries, and so would be detected by exit screening. Of the remaining 19, one to two would be expected to fly to the UK, and up to three to the USA, based on current airline passenger data. At most one of these passengers would have developed symptoms by the time they arrive in the UK or USA, and thus would be detected by entry screening (more…)
Author Interviews, HPV, Sexual Health / 16.11.2014

Eduardo L. Franco DrPH, FRSC, FCAHS James McGill Professor Departments of Oncology and Epidemiology & Biostatistics, Director, Division of Cancer Epidemiology Minda de Gunzburg Chair, Department of Oncology, Division of Cancer Epidemiology Department of Oncology McGill University Montreal, Quebec, CanadaMedicalResearch.com Interview with; Eduardo L. Franco DrPH, FRSC, FCAHS James McGill Professor Departments of Oncology and Epidemiology & Biostatistics, Director, Division of Cancer Epidemiology, Minda de Gunzburg Chair, Department of Oncology, Division of Cancer Epidemiology Department of Oncology McGill University, Montreal, Quebec, Canada Medical Research: What should clinicians and patients take away from your report? Dr. Franco: Our findings of oral transmission of human papillomavirus (HPV) infection in men are part of a larger molecular epidemiologic study called ‘HPV Infection and Transmission among Couples through Heterosexual Activity’ (HITCH) cohort study. The focus of the HITCH study is to understand how HPV is transmitted within couples via sexual contact and other behaviors. We measure the presence of this virus using highly-sensitive molecular assays for HPV DNA in the genital surfaces (vagina and penis), oral cavity, and hands. We also take a blood sample to look for the presence of antibodies against HPV. We take multiple samples over a period of two years at pre-scheduled visits. We have previously published results focused exclusively on genital transmission. The present report is the first in the HITCH study to look at what happens in terms of characteristics that place male participants to be at risk of oral HPV infection. To our knowledge, this is the first study to show a high risk of oral HPV infection among men whose female partners had a genital or oral HPV infection, suggesting that transmission may occur through oral or genital routes. We looked at transmission for 36 individual HPV genotypes, which improved our ability to study risk determinants. Risk was also significantly higher among men who had ever smoked, had a high number of lifetime sex partners, or were in non-monogamous relationships. Our results are largely consistent with previous studies that have found male sex practices and smoking to be the most significant risk factors for oral HPV infection. (more…)
Author Interviews, HIV / 15.11.2014

Prof. Dr. Jan Münch Institute of Molecular Virology Ulm University Medical Center Ulm, GermanyMedicalResearch.com Interview with Prof. Dr. Jan Münch Institute of Molecular Virology Ulm University Medical Center Ulm, Germany Medical Research: What is the background for this study? Dr. Münch: Most anti-HIV microbicides have potent antiviral activity in vitro but were largely inactive in clinical trials. Here we set out to explore whether the HIV infection enhancing activity of amyloid fibrils in human semen interferes with the antiviral efficacy of microbicides and antiviral drugs.  (more…)
Author Interviews, HIV, Occupational Health / 13.11.2014

MedicalResearch.com Interview with: Luís Fernando de Macedo Brígido M.D. Ph.D. Núcleo de Doenças de Vinculação Sanguínea e Sexual Centro de Virologia  Instituto Adolfo Lutz São Paulo Brasil Medical Research: What is the background for this study? What are the main findings? Response: Fomite transmission of HIV, especially in occupational exposure, have been reported, but the use of manicure utensils has not been previously associated to HIV transmission.  We report a case where none of the classical modes of transmission were identified, and a detailed review of clinical history and phylogenetic analysis allowed the association of the case’s infection to manicure care episodes at home with an HIV infected women many years ago. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Hospital Readmissions, Infections, University of Pennsylvania / 10.11.2014

Mark E Mikkelsen, MD, MSCE Assistant Professor of Medicine Hospital of the University of PennsylvaniaMedicalResearch.com Interview with: Mark E Mikkelsen, MD, MSCE Assistant Professor of Medicine Hospital of the University of Pennsylvania Medical Research: What is the background for this study? What are the main findings? Dr. Mikkelsen: Sepsis is common, afflicting as many as 3 million Americans each year. It is also costly, both in terms of health care expenditures that exceed $20 billion for acute care and in terms of the impact it has on patients and their families. To date, studies have focused on what happens to septic shock patients during the initial hospitalization. However, because more patients are surviving sepsis than ever, we sought to examine the enduring impact of septic shock post-discharge. We focused on the first 30 days after discharge and asked several simple questions. First, how often did patients require re-hospitalization after septic shock? And second, why were patients re-hospitalized? We found that 23% of septic shock survivors were re-hospitalized within 30 days, many of them within 2 weeks. A life-threatening condition such as recurrent infection was the reason for readmission and 16% of readmissions resulted in death or a transition to hospice. (more…)
Author Interviews, CDC, Infections, Pediatrics, Vaccine Studies, Vanderbilt / 07.11.2014

MedicalResearch.com Interview with: Marie R Griffin MD MPH Director, Vanderbilt MPH Program Department of Health Policy Vanderbilt University Medical Center Nashville TN 37212 Marie R Griffin MD MPH Director, Vanderbilt MPH Program Department of Health Policy Vanderbilt University Medical Center Nashville TN 37212 Medical Research: What is the background for this study? What are the main findings? Dr. Griffin: In Tennessee, the introduction in 2010 of a new pneumococcal vaccine for infants and young children was associated with a 27 percent decline in pneumonia hospital admissions across the state among children under age 2. The recent decline in Tennessee comes on top of an earlier 43 percent decline across the United States associated with the introduction in 2000 of the first pneumococcal vaccine for children under 2 years of age. (more…)
Author Interviews, MRSA / 05.11.2014

Melissa Ward PhD CIIE Research Fellow Centre for Immunity, Infection and Evolution University of EdinburghMedicalResearch.com Interview with: Melissa Ward PhD CIIE Research Fellow Centre for Immunity, Infection and Evolution University of Edinburgh   Medical Research: What is the background for this study? What are the main findings? Dr. Ward: We studied a strain of the bacterium Staphylococcus aureus known as CC398, which can colonise and cause MRSA infection in humans and livestock. People and animals generally harbour genetically distinct variants of CC398, but we found human isolates, including a small number from Scottish hospitals, which were more similar to the livestock strains. Such isolates were resistant to a larger number of antibiotics than the CC398 strain which typically circulates in humans. By looking at the genetic sequences of strains from across the globe, we also inferred that CC398 has entered Scotland on multiple occasions. (more…)
Annals Internal Medicine, Author Interviews, Ebola, Yale / 30.10.2014

Dr. Dan YasminMedicalResearch.com Interview with: Dan Yamin PhD Postdoctoral Associate Yale School of Public Health New Haven, CT 06520   Medical Research: What is the background for this study? Dr. Yamin: With limited resources, West Africa is currently overwhelmed by the most devastating Ebola epidemic known to date. In our research, we seek to address two questions:
  • 1) who is mostly responsible for transmission? and 2) what intervention programs should be applied to contain the current Ebola outbreak?
(more…)
Author Interviews, Ebola, Vaccine Studies / 28.10.2014

Prof. Clive Maurice Gray Division of Immunology, Institute of Infectious Diseases and Molecular Medicine,National Health Laboratory Services University of Cape Town, Cape Town, South AfricaMedicalResearch.com Interview with: Prof. Clive Maurice Gray   Division of Immunology, Institute of Infectious Diseases and Molecular Medicine,National Health Laboratory Services University of Cape Town, Cape Town, South Africa Medical Research: What is the background for this report? What are the main findings? Prof. Gray: This report is a response on behalf to the International Union of Immunology Societies (IUIS) and is designed to focus a message from the global immunology community to those who are making vaccines and therapies implementing clinical trials and very importantly on Governments and funding bodies. Time is not our side and that vaccine efforts need to be expedited and that production of therapeutics needs to be ramped up. Due to the fact that many people in West Africa are dying, we wish to convey a strong message that to curb this outbreak, therapies and especially vaccines must be rolled out as soon as possible. (more…)
Author Interviews, Infections / 27.10.2014

Dr. Simon Corrie PhD The University of Queensland, Australian Institute for Bioengineering and Nanotechnology, Delivery of Drugs and Genes Group Australian Infectious Diseases Research Centre, St. Lucia, Queensland, AustraliaMedicalResearch.com: Interview with: Dr. Simon Corrie PhD The University of Queensland, Australian Institute for Bioengineering and Nanotechnology, Delivery of Drugs and Genes Group Australian Infectious Diseases Research Centre, St. Lucia, Queensland, Australia Medical Research: What is the background for this study? What are the main findings? Dr. Corrie: P. falciparum malaria is a major cause of morbidity and mortality around the world, particularly in developing countries. Some estimates also suggest that in developing countries, children under 5 account for ~90% mortality. As malaria is treatable, positive detection is important rule out other causes, avoid over-treatment leading to resistance, and to guide appropriate treatment. Our focus is on developing diagnostic devices for infectious diseases, which do not require needles, lancets or laboratory processing. These devices are “microprojection arrays”, silicon chips that can be applied to the skin to capture circulating protein biomarkers in the interstitial fluid of the skin. In this publication we: (a) developed methods to improve the sensitivity of the devices for capturing HRP2, (b) confirmed that HRP2 protein injected intravenously is detectable in skin fluid and (c) showed that we could capture both HRP2 and total IgG (as a positive control for penetration into skin) at the same time. (more…)
Author Interviews, Diabetes, Infections, OBGYNE / 27.10.2014

Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head of the WHO Collaborating Center for the Study of Diabetes in YouthMedicalResearch.com Interview with: Prof. Zvi Laron Professor Emeritus of Pediatric Endocrinology TAU's Sackler Faculty of Medicine, Director of the Endocrinology and Diabetes Research Unit Schneider Children's Medical Center of Israel Head WHO Collaborating Center for the Study of Diabetes in Youth Medical Research: What are the main findings of the study? What was most surprising about results? Prof. Laron: The main findings were the finding of specific antibodies to the pancreatic insulin secreting beta cells together with antibodies against rota-virus in both the mother at delivery and in the newborn's cord blood. We were not surprised, but pleased to find proof to our hypothesis that part, if not the majority of childhood onset Type 1 (autoimmune diabetes) starts "in utero". (more…)
Author Interviews, Genetic Research, Infections / 25.10.2014

Dr R.E.W. (Bob) Hancock, OC, OBC, FRSC {Canada Research Chair and Professor, Department of Microbiology and Immunology,UBC} Director, Centre for Microbial Diseases and Immunity Research University of British Columbia, Vancouver, British Columbia, CanadaMedicalResearch.com Interview with: Dr R.E.W. (Bob) Hancock, OC, OBC, FRSC {Canada Research Chair and Professor, Department of Microbiology and Immunology,UBC} Director, Centre for Microbial Diseases and Immunity Research University of British Columbia, Vancouver, British Columbia,  Canada MedicalResearch: What is the background for this study? What are the main findings? Dr. Hancock: We wanted to understand how patients transitioned from the hyperinflammatory phase (cytokine storm) of sepsis to the hypoinflammatory (immunosuppressive) phase of sepsis (inability to respond appropriately to infections). About 15% of patients die in this first phase and 20% in the second phase, making sepsis one of the most deadly syndromes (35% overall mortality, 5 million deaths [8.3% of all deaths] annually worldwide). We hypothesized that immunosuppression was characterized by a state termed endotoxin tolerance a cellular amnesia (termed cellular reprogramming) in which cells fail to respond to microbial cues. Overall we found that an Endotoxin Tolerance gene signature is significantly associated with the subsequent development of confirmed sepsis and new organ dysfunction in patients who had suspected sepsis. All 620 sepsis patients in retrospective and new analyses presented with an expression profile strongly associated with the endotoxin tolerance signature (p<0.01; AUC 96.1%). This occurred in fact very early in sepsis and in a new clinical study we found that the signature could be detected already in the emergency ward at first clinical  presentation and 24-48 hours prior to definitive diagnosis. Importantly, this signature further differentiated between suspected sepsis patients who did, or did not, go on to develop confirmed sepsis, and predicted the development of organ dysfunction. (more…)
Allergies, Author Interviews, Infections, Nutrition, Pediatrics / 22.10.2014

Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, GermanyMedicalResearch.com Interview with: Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, Germany Medical Research: What are the main findings of the study? Dr. Loss: In this large population based cohort study we observed that consumption of fresh unprocessed cow’s milk protected from respiratory infections, febrile illness and inflammation of the middle ear during the first year of life. The risk of developing these conditions was reduced by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT (Ultra-heat-treatment) processing eliminated the effect altogether. Importantly, the positive impact of fresh milk could be clearly separated from the confounding effects of other elements of the children’s nutrition. Furthermore, infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies, Wistar / 22.10.2014

Scott E. Hensley, Ph.D. Assistant Professor, The Wistar Institute Philadelphia, PA 19104MedicalResearch.com Interview with Scott E. Hensley, Ph.D. Assistant Professor, The Wistar Institute Philadelphia, PA 19104   Medical Research: What are the main findings of the study? Dr. Hensley: We found that H1N1 viruses recently acquired a mutation that abrogates binding of influenza antibodies that are present in a large number of middle-aged adults.  We propose that this mutation lead to increased disease among middle-aged adults during the 2013-2014 influenza season. (more…)
Infections, Respiratory, Vaccine Studies / 20.10.2014

Dr. Susanne Huijts – Pulmonary resident UMC Utrecht | Research physician UMCU Julius Center for Health Sciences and Primary Care NetherlandsMedicalResearch.com Interview with:  Dr. Susanne Huijts Research Physician at UMCU Julius Center for Health Sciences Pulmonary resident, UMC Utrecht Center Utrecht, Netherlands   Medical Research: What are the main findings of the study? Dr. Huijts: The CAPiTA trial evaluated the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults of 65 years and older. In the per protocol analysis vaccine efficacy of 45.6% was demonstrated for the first episode vaccine type (VT) pneumococcal community acquired pneumonia (CAP); 45.0% for the first episode of non-bacteremic/ non-invasive (NB/NI) VT-CAP, and 75.0% for the first episode of VT-invasive pneumococcal disease. (more…)
Author Interviews, Diabetes, Infections / 20.10.2014

MedicalResearch.com Interview with: Dr Tsai Chung-Li Graduate Institute of Biostatistics, College of Management, China Medical University,Taichung, Taiwan and Dr. Hsiao-Chuan Lin Department of Public Health, College of Public Health, and Department of Pediatrics, China Medical University, Taichung, Taiwan Medical Research: What are the main findings of the study? Response: We conducted a nationwide population-based cohort study that included two groups. Children with enterovirus infection (aged < 18 years) during 2000-2007 were identified and followed up until December 31, 2008 or until first occurrence of type 1 diabetes. The group without enterovirus infection comprised half of all insured children of the same age and without a diagnosis of enterovirus infection. By use of frequency-matching with sex and birth year, children in the group with enterovirus were selected from those eligible. This nationwide retrospective cohort study found:
  • type 1 diabetes is positively correlated with enterovirus infection in patients younger than 18 years.
  • the incidence rate of type 1 diabetes was lower in the non-enterovirus than the enterovirus group (4 vs 6 per 100,000 person-years; incidence rate ratio 1.48 [95% CI 1.19, 1.83]).
  • children that have been infected with enterovirus are 48% more likely to have developed type 1 diabetes.
  • the risk of developing type 1 diabetes is 2.18 times greater among children aged 10 years and older than among those aged younger than 1 year.
(more…)
AHRQ, Author Interviews, Infections, University of Pennsylvania / 15.10.2014

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 19104MedicalResearch.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 developed an automated early warning and response system for sepsis that has resulted in a marked increase in sepsis identification and care, transfer to the ICU, and an indication of fewer deaths due to sepsis. Sepsis is a potentially life-threatening complication of an infection; it can severely impair the body’s organs, causing them to fail. There are as many as three million cases of severe sepsis and 750,000 resulting deaths in the United States annually. Early detection and treatment, typically with antibiotics and intravenous fluids, is critical for survival. The Penn prediction tool, dubbed the “sepsis sniffer,” uses laboratory and vital-sign data (such as body temperature, heart rate, and blood pressure) in the electronic health record of hospital inpatients to identify those at risk for sepsis. When certain data thresholds are detected, the system automatically sends an electronic communication to physicians, nurses, and other members of a rapid response team who quickly perform a bedside evaluation and take action to stabilize or transfer the patient to the intensive care unit if warranted. We developed the prediction tool using 4,575 patients admitted to the University of Pennsylvania Health System (UPHS) in October 2011.  We then validated the tool during a pre-implementation period from June to September 2012, when data on admitted patients was evaluated and alerts triggered in a database, but no notifications were sent to providers on the ground.  Outcomes in that control period were then compared to a post-implementation period from June to September 2013.  The total number of patients included in the pre and post periods was 31,093. (more…)
Author Interviews, Infections, JAMA / 15.10.2014

Andre Kalil, M.D., M.P.H. Professor of Medicine Director, Transplant ID Program University of Nebraska Nebraska Medical Center Omaha, NE 68198-5400MedicalResearch.com Interview with: Andre Kalil, M.D., M.P.H. Professor of Medicine Director, Transplant ID Program University of Nebraska Nebraska Medical Center Omaha, NE 68198-5400 Medical Research: What are the main findings of the study? Dr. Kalil: In recent years, physicians treating staph infections with vancomycin have seen an increase in the minimum inhibitory concentration (MIC), the lowest concentration of an antimicrobial agent that inhibits the growth of a microorganism. This condition is referred to as vancomycin “MIC creep.” It is an indicator that the bacteria might be developing a reduced susceptibility to vancomycin. There also have been reports suggesting that elevations in vancomycin MIC values may be associated with increased treatment failure and death. To determine the effectiveness of vancomycin and other newer antibiotics used to treat Staphylococcus aureus, the UNMC team analyzed nearly 8,300 episodes of Staphylococcus aureus bloodstream infections from patients around the U.S. and in several other countries. The adjusted absolute risk of mortality among patients with Staphylococcus aureus bloodstream infections with high-vancomycin MIC was not statistically different from patients with Staphylococcus aureus bloodstream infections with low-vancomycin MIC. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, JAMA / 13.10.2014

Dr. Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, MassachusettMedicalResearch.com Interview with: Dr.  Ilan Youngster, MD, MMSc Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Division of Infectious Diseases, Boston Children’s Hospital Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Youngster: The main finding is that oral administration seems to be as safe and effective as more traditional routes of delivery like colonoscopy or nasogastric tube. This is important as it allows Fecal microbiota transplantation (FMT) to be performed without the need of invasive procedures, making it safer, cheaper and more accessible to patients. (more…)