Author Interviews, Breast Cancer, Chemotherapy, Cleveland Clinic, NEJM / 04.03.2015

Halle C.F. Moore, M.D. Cleveland Clinic Foundation Taussig Cancer Institute Cleveland, OH 44195MedicalResearch.com Interview with: Halle C.F. Moore, M.D. Cleveland Clinic Foundation Taussig Cancer Institute Cleveland, OH 44195 Medical Research: What is the background for this study? What are the main findings? Dr. Moore: Ovarian failure is a common long-term side effect of chemotherapy. Previous studies investigating whether suppressing ovarian function during chemotherapy treatment will preserve ovarian function following chemotherapy have had mixed results. Our study found that suppressing the ovaries with the GnRH analog goserelin during chemotherapy treatment for early stage ER-negative breast cancer resulted in a reduced risk of ovarian failure two years after initiation of treatment. Also, more women who received the goserelin with chemotherapy became pregnant than women who received chemotherapy without goserelin. In addition, there was an apparent improvement in survival among the goserelin group, confirming the safety of this approach in this patient population.
AHA Journals, Author Interviews, Cleveland Clinic, Heart Disease, Kidney Disease / 05.02.2015

MedicalResearch.com Interview with: W. H .Wilson Tang, M.D., F.A.C.C., F.A.H.A. Professor in Medicine, Cleveland Clinic Lerner College of Medicine Cleveland Clinic, Cleveland, OH 44195MedicalResearch.com Interview with: W. H .Wilson Tang, M.D., F.A.C.C., F.A.H.A. Professor in Medicine, Cleveland Clinic Lerner College of Medicine Cleveland Clinic, Cleveland, OH 44195.   Medical Research: What is the background for this study? What are the main findings? Dr. Tang: Our group has previously demonstrated that TMAO is linked to future cardiac risks in both humans and in animal models.  We now show that long-term exposure to higher levels of TMAO promotes renal functional impairment and fibrosis in animal studies.  We also show that in humans, as the kidneys lose function, TMAO isn’t eliminated as easily, and their blood levels further rise, thereby increasing cardiovascular and kidney disease risks further.  This newly discovered TMAO link offers further insight into the relationship between cardiovascular disease and chronic kidney disease.
Author Interviews, Cleveland Clinic, Kidney Disease, Social Issues / 21.01.2015

MedicalResearch.com Interview with: Suma Prakash MD, MSc, FRCPC Department of Medicine, Division of Nephrology Case Western Reserve University MetroHealth Medical Center Cleveland, Ohio Medical Research: What is the background for this study? What are the main findings? Dr. Prakash: Patients with advanced chronic kidney disease are often faced with difficult decisions of having to choose between options to replace their kidney function. Many patients may not be ready to make treatment decisions since most people don’t want to need a chronic medical treatment. The behavioural stage of change model originally used to help people with smoking cessation has been used to help patients make decisions about self-care with diabetes and undergo cancer screening. It has not been studied in patients with chronic kidney disease. As patients progress through the stages, they are more ready to make decisions. Focusing on better understanding the decision making process from patients’ perspectives allows us as medical professionals to help patients make timely decision about their options.
Author Interviews, Cleveland Clinic, Heart Disease, JACC / 29.10.2014

Professor of Medicine, Cleveland Clinic Lerner College of Medicine at CWRU Director, Cardiomyopathy Program, Kaufman Center for Heart Failure Research Director, Section of Heart Failure and Cardiac Transplantation Medicine Heart and Vascular Institute, Cleveland Clinic Cleveland, OH 44195MedicalResearch.com Interview with: W. H. Wilson Tang, MD FACC FAHA Professor of Medicine, Cleveland Clinic Lerner College of Medicine at CWRU Director, Cardiomyopathy Program, Kaufman Center for Heart Failure Research Director, Section of Heart Failure and Cardiac Transplantation Medicine Heart and Vascular Institute, Cleveland Clinic Cleveland, OH 44195 Medical Research: What are the main findings of the study? Dr. Tang: A chemical byproduct of gut bacteria-dependent digestion, TMAO (trimethylamine N-oxide), was previously shown to contribute to heart disease development. In this study, blood levels of TMAO for the first time are linked to heart failure development and mortality risk.
Cleveland Clinic, Multiple Sclerosis / 16.09.2014

Jeffrey Cohen MD Department of Neurology Cleveland ClinicMedicalResearch.com: Interview with: Jeffrey A. Cohen, MD Hazel Prior Hostetler Endowed Chair Professor, Cleveland Clinic Lerner College of Medicine Director, Mellen Center for MS Treatment and Research Neurological Institute Cleveland Clinic Cleveland, OH  44195 Medical Research: What are the main findings of the study? Dr. Cohen: The primary objective of the GATE trial was to compare the efficacy and safety of generic glatiramer acetate to the approved form (Copaxone) in relapsing-remitting multiple sclerosis.  The study demonstrated equivalent efficacy of generic glatiramer acetate and Copaxone measured by gadolinium enhancing brain MRI lesions at months 7, 8, and 9 and a number of additional measures of MRI lesion activity.  The study also showed comparable safety (measured by adverse events) and injection site tolerability.
Author Interviews, Biomarkers, CHEST, Cleveland Clinic, Lung Cancer / 20.04.2014

Daniel I. Sessler, M.D. Michael Cudahy Professor and Chair, Department of Outcomes Research Cleveland Clinic, Cleveland,MedicalResearch.com Interview with: Daniel I. Sessler, M.D. Michael Cudahy Professor and Chair, Department of Outcomes Research Cleveland Clinic, Cleveland, OH MedicalResearch.com: What are the main findings of the study? Dr. Sessler: Free fatty acids, arachidonic acid and linoleic acid, and their metabolites hydroxyeicosatetraenoic acids (5-HETE, 11-HETE, 12-HETE, and 15-HETE) were 1.8 to 5.7-fold greater in 37 patients with adenocarcinoma versus 111 patients without cancer (all P<0.001). Areas under the receiver operating characteristics (ROC) curve were significantly greater than 0.50 discriminating lung cancer patients and controls for all biomarkers and phospholipids, and ranged between 0.69 and 0.82 (all P<0.001) for lung cancer patients versus controls. Arachidonic acid, linoleic acid, and 15-HETE showed sensitivity and specificity >0.70 at the best cutpoint. Concentrations of free fatty acids and their metabolites were similar in 18 squamous-cell carcinoma patients and 54 non-cancer controls.
Author Interviews, Autism, Case Western, Cleveland Clinic / 01.02.2014

Roberto Fernández Galán, PhD Department of Neurosciences, School of Medicine Case Western Reserve University Cleveland, OH, USAMedicalResearch.com Interview with: Roberto Fernández Galán, PhD Department of Neurosciences, School of Medicine Case Western Reserve University Cleveland, OH, USA MedicalResearch.com: What are the main findings of the study? Dr. Galán: The main finding is that autistic brains create more information at rest than non-autistic brains. This is consistent with the classical view on autism as withdrawal into self. It is also consistent with a recent theory on autism, the “Intense World Theory”, which claims that autism results from hyper-functioning neural circuitry, leading to a state of excessive arousal. From both perspectives, the classical and the IWT, communication and social deficits associated with autism result from having a more intense inner life and a higher level of introspection.
Author Interviews, Blood Clots, Case Western, Cleveland Clinic, JAMA / 24.11.2013

Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente  Case Western Reserve University School of Medicine, Cleveland, OhioMedicalResearch.com Interview with: Ilke Sipahi, MD Department of Cardiology Acibadem University Medical School, Istanbul, Turkey Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio MedicalResearch.com: Were you surprised at the extreme difference between these 2 analyses? Answer: I was surprised. However, it is not unusual to find completely contradictory results in medical studies. I was more surprised at the fact that FDA paid more attention to it administrative observational dataset rather than the huge large randomized clinical trials, all showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies.
Author Interviews, Case Western, Cleveland Clinic, Respiratory / 13.09.2013

Pranab K. Mukherjee, Ph.D. Assistant Professor Center for Medical Mycology Department of Dermatology University Hospitals Case Medical Center Case Western Reserve University Cleveland, OH 44106-5028MedicalResearch.com Interview with: Pranab K. Mukherjee, Ph.D. Assistant Professor Center for Medical Mycology Department of Dermatology University Hospitals Case Medical Center Case Western Reserve University Cleveland, OH 44106-5028 MedicalResearch.com: What are the main findings of the study? Answer: We performed a randomized double-blinded placebo-controlled pilot clinical trial to assess the safety, tolerability and effectiveness of a cetylpyridinium chloride (CPC)-based oral spray in the prevention of acute upper respiratory tract infections (URIs).
  • The tested CPC spray (ARMS-I, developed by Arms Pharmaceutical LLC, Cleveland, OH) was safe and exhibited high tolerability and acceptability among study participants
  • The product exhibited a trend to protect against URIs (55% relative reduction compared to the placebo), based on confirmed URIs, post-medication exit interviews, and daily electronic diaries completed by study participants
  • There was statistically significant reduction in frequency of cough and sore throat in the active group
  • The number of days (duration) of cough was significantly reduced in the active group compared to placebo arm
  • URI-associated viruses (influenza, rhinovirus and coronavirus) were detected in three individuals, all in the placebo arm. No virus was detected in the active arm/
  • No drug-related adverse events or oral lesions were observed
  • Previous vaccination status of the study participants did not affect the study outcome.
Author Interviews, Case Western, Cleveland Clinic, Cost of Health Care, Pain Research, Surgical Research / 30.08.2013

MedicalResearch.com Interview with: Conor P. Delaney, MD MCh PhD FRCSI FACS FASCRS The Jeffrey L. Ponsky Professor of Surgical Education | Chief, Division of Colorectal Surgery | Vice-Chair, Department of Surgery | Director, CWRU Center for Skills and Simulation | Surgical Director, Digestive Health Institute | University Hospitals Case Medical Center | Case Western Reserve University | 11100 Euclid Avenue Cleveland, OH 44106-5047 MedicalResearch.com: What are the main findings of the study? Answer: Our goal was to see whether the transversus abdominis plane (TAP) block reduced complications and shortened the hospital stay of patients undergoing colorectal operations.  The TAP block is a nerve block injection given at the conclusion of the operation which reduces pain in the operative area.  Results showed that the mean hospital stay dropped to less than 2.5 days after the surgical procedure, significantly lower than the 3.7 days which the University Hospitals Case Medical Center Care pathway had already described for more than 1,000 consecutive patients. In our new study, we employed the TAP block and the Enhanced Recovery Pathway (ERP) on 100 patients.  We found that 27 patients went home the next day and another 35 went home 48 hours after their operations. That is considerably better than the five or six days patients usually stay in the hospital after laparoscopic colorectal procedures, and certainly better than nine days often seen after an open operation.  With a third of patients leaving the day after colorectal resection, we feel these results are significant.
Author Interviews, Cleveland Clinic, Heart Disease, Surgical Research / 17.07.2013

MedicalResearch.com Interview with Dr. Frank Sellke, MD Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals MedicalResearch.com: What are the main findings of the study? Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year.
Author Interviews, Cancer Research, Case Western, Cleveland Clinic, Mental Health Research / 25.04.2013

MedicalResearch.com: eInterview with Siran M. Koroukian, Ph.D. Population Health and Outcomes Research Core, Clinical & Translational Science Collaborative Associate Professor Department of Epidemiology and Biostatistics School of Medicine Case Western Reserve University Cleveland, OH 44106-7281 MedicalResearch.com: What are the main findings of the study? Dr. Koroukian: Among individuals who died of cancer, those with mental illness (MI) died an average of 10 years earlier than those without MI. Overall, there was excess mortality from cancer associated with having mental illness in all the race/sex strata: SMR, 2.16 (95% CI, 1.85-2.50) for black men; 2.63 (2.31-2.98) for black women; 3.89 (3.61-4.19) for nonblack men; and 3.34 (3.13-3.57) for nonblack women. We note statistically significant higher SMRs for every anatomic cancer site in nonblack men and women and for most cancer sites in black men and women.