Author Interviews, Cost of Health Care, JAMA, NYU, Ophthalmology, Pharmaceutical Companies / 02.08.2019

MedicalResearch.com Interview with: Cassandra L. Thiel, PhD Assistant Professor NYU Langone School of Medicine Department of Population Health NYU Wagner Graduate School of Public Service NYU Tandon School of Engineering MedicalResearch.com: What is the background for this study? Response: Most healthcare professionals and researchers are aware that the healthcare sector makes up about 18% of the US Gross Domestic Product. What many do not realize is that all of that economic activity results in sizable resource consumption and environmental emissions. The healthcare industry is responsible for 10% of the US’s greenhouse gas (GHG) emissions and 9% of air pollutants.1 Sustainability in healthcare is a developing field of research and practice, and my lab offers data and information by quantifying resource use and emissions of healthcare delivery. We started looking at cataract surgery a few years ago, in part because operating rooms (ORs) typically represent the largest portion of spending and garbage generation in a hospital.2,3 Cataract surgeries are interesting because they are one of the most common surgeries performed in the world. In the US, we spend $6.8 billion on them each year. Any changes we can make to individual cases would have much larger, global impacts. I studied cataract surgeries at a world-renowned, high-volume eye surgery center in India and helped validate that clinical care could be designed in a way that was effective, cost-efficient, and resource efficient. Compared to the same procedure in the UK, this surgery center generates only 5% of the carbon emissions (with the same outcomes).2 This site’s standard policy is to multi-dose their eye drops, or use them on multiple patients until the bottle was empty. As such, the site generated very little waste. Returning to the US, I observed cataract cases and heard the complaints of OR staff that they had to throw out many partially used or unused pharmaceuticals. In reviewing the literature, we could not find a study that quantified how much we were throwing away and what it cost us to do so. We, therefore, set up a study to look at this particular issue. (more…)
Author Interviews, Environmental Risks, NYU, Pediatrics, Weight Research / 26.07.2019

MedicalResearch.com Interview with: Melanie Jacobson, PhD, MPH NYU School of Medicine New York, N.Y.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was about exposure to bisphenols, which are synthetic chemicals found in aluminum can linings, plastics, thermal paper receipts and other consumer products, and their association with obesity among a nationally representative sample of US children and adolescents. We found that children who had greater levels of these chemicals in their urine were more likely to be obese compared with children with lower levels. (more…)
Author Interviews, JACC, Kidney Disease, NYU / 13.06.2019

MedicalResearch.com Interview with: David Charytan, MD MSc Chief, Nephrology Division NYU Langone Medical Center New York, NY 10010  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Cardiovascular events are much more frequent in patients with impaired kidney function (chronic kidney disease), and cardiovascular disease is the most common cause of death in advanced chronic kidney disease. This risk remains high despite the use of standard medical therapies including statins, the most commonly used cholesterol lowering agents. The PCSK9 inhibitor evolocumab is a new class of highly potent cholesterol lowering medications that can further reduce the risk of cardiovascular events in patients already taking statins. We analyzed data from the FOURIER trial, which randomized study patients with clinically evident atherosclerosis and an LDL cholesterol level >=70 mg/dL or HDL cholesterol level >= while on a statin, to assess the safety and efficacy of evolocumab, a PCSK9 inhibitor, compared with placebo in individuals with mild to moderate chronic kidney disease. There were several major findings
  • a) evolocumab appears to be equally safe in individuals with preserved and mild to moderately impaired kidney function
  • b) evolocumab appears to have preserved efficacy at preventing cardiovascular events as kidney function declines.
  • c) We were unable to detect any significant impact on kidney function.
  • In addition, because the baseline risk of cardiovascular events is much higher in individuals with  chronic kidney disease, the absolute benefits of treatment with evolocumab appear  to be magnified as kidney function declines.  (more…)
ASCO, Author Interviews, Biomarkers, Melanoma, NYU / 02.06.2019

MedicalResearch.com Interview with: David Polsky, MD, PhD Dermatologist and Director of the Digmented Lesion Service Mahrukh M. Syeda, MS Research Associate Ronald O. Perelman Department of Dermatology NYU Langone Health MedicalResearch.com: What is the background for this study? Response: Several studies of metastatic melanoma patients have demonstrated that measuring circulating tumor DNA (ctDNA) associates with their disease burden and survival.  Generally, patients with detectable pre-treatment ctDNA levels and/or detectable ctDNA at various time intervals after starting treatment have shorter survivals than patients with lower pre-treatment or on-treatment ctDNA levels.  Studies have varied in their methods to detect ctDNA, the thresholds chosen to call a sample positive or negative, and the follow up time point for measurement, if any. In this study, we examined pre-treatment and week 4 on-treatment plasma samples from patients enrolled in Combi-D, the Phase III, randomized, double-blind trial of the BRAF and MEK inhibitors Dabrafenib and Trametinib, which led to FDA approval of the combination therapy for patients with unresectable stage III/IV melanoma. Only patients with BRAF V600E or V600K mutations identified from tumor genotyping were enrolled in the clinical trial. (more…)
Author Interviews, Hearing Loss, JAMA, NIH, NYU / 24.05.2019

MedicalResearch.com Interview with: Jan Blustein, MD PhD Professor of Health Policy and Medicine Wagner Graduate School and School of Medicine New York University, New York MedicalResearch.com: What is the background for this study?   Response: The National Institutes of Health (NIH), the nation’s largest public funder of health research, provides annual reports about levels of funding for many diseases and conditions.  These reports, issued as part of the NIH’s Research, Condition and Disease Categorization (RCDC) process, allow members of the public to track funding across key conditions and across time. Hearing loss is not included among the reported conditions. This runs counter to two of the NIH’s stated goals, according to researcher Jan Blustein (M.D., Ph.D.), professor of health policy and medicine at New York University’s Robert F. Wagner Graduate School of Public Service, in a Research Letter in the May 15th issue of the Journal of the American Medical Association Otolaryngology and Head & Neck Surgery. “First, the NIH is committed to transparency about how it divides funds across diseases and conditions,” said Dr. Blustein.  “Second, it has said that it will prioritize its funding to those conditions that cause the greatest disease burden.”  Hearing loss causes great disease burden, ranking 10th in the U.S. among all conditions as a contributor to Disability Adjusted Life Years (a widely-used measure of disease burden), according to the World Health Organization. (more…)
Author Interviews, Education, Neurology, NYU / 17.05.2019

MedicalResearch.com Interview with: Dr. Rebecca Stainman Dr. Arielle Kurzweil MD Adult Neurology Program Director New York University School of Medicine NYU Langone Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physician burnout is prevalent. Neurologists have among the highest burnout rates, ranked third among specialties in a 2011 study, and over half of US Neurologists report at least 1 symptom of burnout in a 2016 survey.  Efforts to address burnout in training programs have mostly been aimed at implementing wellness curricula and offering mental health resources. Training neurology residents to effectively identify, address, and help impaired colleagues is equally crucial in these efforts, yet there is a paucity of literature on this topic. We used simulation as a means of addressing this topic, via identifying and addressing an impaired colleague through an objective structured clinical examination (OSCE).  (more…)
Author Interviews, NYU, PTSD, Technology / 22.04.2019

MedicalResearch.com Interview with: Charles R. Marmar, MD The Lucius N. Littauer Professor Chair of the Department of Psychiatry NYU Langone School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Several studies in recent years have attempted to identify biological markers that distinguish individuals with PTSD, with candidate markers including changes in brain cell networks, genetics, neurochemistry, immune functioning, and psychophysiology. Despite such advances, the use of biomarkers for diagnosing PTSD remained elusive going into the current study, and no physical marker was applied in the clinic. Our study is the first to compare speech in an age and gender matched sample of a military population with and without PTSD, in which PTSD was assessed by a clinician, and in which all patients did not have a major depressive disorder. Because measuring voice qualities in non-invasive, inexpensive and might be done over the phone, many labs have sought to design speech-based diagnostic tools  (more…)
Author Interviews, Cancer Research, Cannabis, End of Life Care, NYU / 28.03.2019

MedicalResearch.com Interview with: Arum Kim, MD Assistant Professor Medicine and Rehabilitation Medicine NYU School of Medicine Director of the Supportive Oncology Program Perlmutter Cancer Center MedicalResearch.com: What is the background for this study?   Response: There is increasing interest in medical marijuana and its applications for patients with cancers. Despite increasing access, little is known regarding doses of cannabinoids - specifically delta-8-tetrahydrocannabinol (delta-8-THC)  and cannabidiol (CBD), methods of drug delivery, and differences in patterns of use between cancer and non-cancer patients. (more…)
Anesthesiology, Author Interviews, Dermatology, JAMA, NYU, Pediatrics / 14.03.2019

MedicalResearch.com Interview with: Roy G. Geronemus, M.D. Director, Laser & Skin Surgery Center of New York Clinical Professor of Dermatology New York University Medical Center New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We made the observation in clinical practice that port wine stain birthmarks can be safely and effectively treated in early infancy without the need for general anesthesia. This observation is particularly important because of the FDA warnings regarding multiple exposures to general anesthesia under the age of 3 and the potential impact on neurocognitive development as these patients require multiple treatments. (more…)
Author Interviews, Dermatology, JAMA, NYU / 19.12.2018

MedicalResearch.com Interview with: Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York MedicalResearch.com: What is the background for this study? Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines. However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails.  Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent. (more…)
Author Interviews, Gastrointestinal Disease, NYU, Surgical Research, Weight Research / 10.10.2018

MedicalResearch.com Interview with: Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions. We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  (more…)
Author Interviews, Lung Cancer, Nature, NYU, Technology / 17.09.2018

MedicalResearch.com Interview with: Aristotelis Tsirigos, Ph.D. Associate Professor of Pathology Director, Applied Bioinformatics Laboratories New York University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pathologists routinely examine slides made from tumor samples to diagnose cancer types. We studied whether an AI algorithm can achieve the same task with high accuracy. Indeed, we show that such an algorithm can achieve an accuracy of ~97%, slightly better than individual pathologists. In addition, we demonstrated that AI can be used to predict genes that are mutated in these tumors, a task that pathologists cannot do. Although the accuracy for some genes is as high as 86%, there is still room for improvement. This will come from collecting more training data and also from improvement in the annotations of the slides by expert pathologists.   (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare, NYU, Prostate Cancer / 22.08.2018

MedicalResearch.com Interview with: Danil V. Makarov, MD, MHS Department of Urology and Department of Population Health New York University Langone School of Medicine VA New York Harbor Healthcare System, Robert F. Wagner Graduate School of Public Service Cancer Institute, New York University School of Medicine, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Reducing prostate cancer staging imaging for men with low-risk disease is an important national priority to improve widespread guideline-concordant practice, as determined by the National Comprehensive Cancer Network guidelines. It appears that prostate cancer imaging rates vary by several factors, including health care setting. Within Veterans Health Administration (VHA), physicians receive no financial incentive to provide more services. Outside VHA, the fee-for-service model used in Medicare may encourage provision of more healthcare services due to direct physician reimbursement. In our study, we compared these health systems by investigating the association between prostate cancer imaging rates and a VA vs fee-for-service health care setting. We used novel methods to directly compare Veterans, Medicare Recipients, and Veterans that chose to receive care from both the VA at private facilities using Medicare insurance through the Choice Act with regard to rates of guideline-discordant imaging for prostate cancer. We found that Medicare beneficiaries were significantly more likely to receive guideline-discordant prostate cancer imaging than men treated only in VA. Moreover, we found that men with low-risk prostate cancer patients in the VA-only group had the lowest likelihood of guideline-discordant imaging, those in the VA and Medicare group had the next highest likelihood of guideline-discordant imaging (in the middle), and those in the Medicare-only group had the highest likelihood of guideline-discordant imaging.  (more…)
Author Interviews, Biomarkers, NYU, Pediatrics, Pulmonary Disease / 29.07.2018

MedicalResearch.com Interview with: Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? How common is the problem of chronic cough in children?  Is it more common in children with allergies, asthma or reflux? Response: Chronic cough is one of the leading causes of pediatric referrals to subspecialty physicians.  Its prevalence in the general pediatric population may approach 3% (Galassi et al, Epidemiol. Prev. 2005;29,Suppl.:9–13). It is important to recognize that the main causes of chronic cough in children are completely different for those in adults.  Specifically, gastroesophageal reflux and postnasal drip are not considered to be important causes of cough in children.  Cough variant asthma, although is a common cause of cough in adults, does not seem to be frequently diagnosed and a cause of chronic cough in children. The main cause of chronic wet cough in children is protracted bacterial bronchitis (Chang et al, Chest. 2017 Apr;151:884-890).  It is important to recognize that neurologically impaired children have completely different pathogenesis of chronic cough, which is mostly related to aspiration into the lower airway and development of aspiration-related lung disease. (more…)
Author Interviews, NYU, Sexual Health, Sleep Disorders / 11.07.2018

MedicalResearch.com Interview with: Dustin T. Duncan, ScD Associate Professor Director, NYU Spatial Epidemiology Lab Department of Population Health NYU School of Medicine NYU Langone Health MedicalResearch.com: What is the background for this study? Response: Sleep and sleep hygiene have emerged as one of the major determinants of health and wellbeing (alongside good diet, regular exercise, and not smoking). However, a small number of studies have used population-representative samples to examine sexual orientation disparities in sleep. Our study aimed to fill this gap in knowledge. (more…)
Author Interviews, Epilepsy, Neurological Disorders, NYU, Pharmaceutical Companies / 17.05.2018

MedicalResearch.com Interview with: https://www.gwpharm.com/epilepsy-patients-caregivers/patientsAnup Patel, M.D. Section Chief of Neurology Interim Division Chief of Neurology Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? Response: The study evaluated kids and adults with an epilepsy syndrome (Lennox Gastaut Syndrome – LGS) that is often difficult to treat and does not respond well to current medical treatment.  The study was a double blind randomized control trial evaluating how well a plant based, liquid solution, cannabidiol (CBD) product made by Greenwich Biosciences called Epidiolex helped to treat drop seizures (the most common seizure type in LGS) and how safe it was compared to placebo.  Two doses (10 mg/kg/day and 20 mg/kg/day) were evaluated compared to placebo. (more…)
AACR, Author Interviews, Microbiome, NYU, Pancreatic / 28.03.2018

MedicalResearch.com Interview with: Mautin Hundeyin MD Post-doctoral Research Fellow George Miller, MD is Principal Investigator and Director of the S. Arthur Localio Laboratory in the Department of Surgery at NYU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pancreatic ductal adenocarcinoma (PDA) is the devastating disease with grim prognosis. The microbiome has emerged as a contributor to oncogenesis in a number of intestinal tract malignancies. We found that PDA is associated with a distinct stage-specific gut and pancreatic microbiome that drives disease progression by inducing intra-tumoral immune suppression. Targeting the microbiome protects against oncogenesis, reverses intra-tumoral immune-tolerance, and enables efficacy for check-point based immunotherapy. These data have implications for understanding immune-suppression in pancreatic cancer and its reversal in the clinic.  (more…)
Author Interviews, NYU, Rheumatology, Surgical Research, Weight Research / 20.03.2018

MedicalResearch.com Interview with: Jonathan Samuels, MD Associate Professor of Medicine Division of Rheumatology NYU Langone Health MedicalResearch.com: What is the background for this study?  Response: A high percentage of obese patients have painful knee osteoarthritis, and have difficulty losing weight as well as treating the knee pain with a self-perpetuating cycle.  MedicalResearch.com: What are the main findings? Response:  Patients who lost weight with their laparoscopic banding surgeries also experienced marked improvement of their knee pain. We found a significant correlation between the degree of improvement in the body mass index and reduction of knee pain in our cohort. In addition, the patients who experienced the most relief from weight loss surgeries had their procedures at earlier ages, as well as those who never had a traumatic knee injury nor developed osteoarthritis in other joints. (more…)
Author Interviews, HIV, NYU, PLoS, Zika / 23.02.2018

MedicalResearch.com Interview with: Maite Sabalza Ph.D Post Doctoral Associate Department of Basic Science and Craniofacial Biology College of Dentistry, New York University New York, NY 10010 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: With previous NIH funding we were able to develop an automated “dual assay” (able to detect both host antibodies and viral RNA) for HIV. In relatively short time, we were able to migrate those findings into the new assay for ZIKA Virus. (more…)
Author Interviews, NYU, PLoS / 15.02.2018

MedicalResearch.com Interview with: Glenn N. Saxe, MD Professor of Child & Adolescent Psychiatry Hassenfeld Children’s Hospital at NYU Langone Department of Child and Adolescent Psychiatry Child Study Center, One Park Avenue New York, NY 10016  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by brain entropy and how it relates to intelligence? Response: Think of human intelligence as the capacity for a human being to understand their complex and ever-changing world. The world of a person is really complex and constantly in flux so the human brain must be ready to understand whatever may come – when there is no way beforehand to predict what might come. How does the brain understand its world? It creates specific models of the information it receives through specific patterns of neuronal connection. These are called brain states. The way the brain understands its world is largely through using such models, or brain states, to accurately predict what comes next. So you can see that for an intelligent brain to properly understand and predict events in the world, it will need to have access to a very, very large number of brain states. And this is how entropy is defined. Entropy is a very old and very powerful concept in the history of science. Not only is it fundamental for thermodynamics – what we learned in high school physics – but it is also fundamental for the nature of information and it’s processing. Entropy is defined as the number of states – or distinct configurations – any system has access to at any point in time. High entropy means access to a very large number of states. Low entropy means access to a very small number of states. A solid is a phenomenon with very low entropy. A gas is a phenomenon with very high entropy. Life, and the brain, are somewhere in between. Although it is impossible to precisely measure the number of states a brain has access to at any one moment, there is a highly related concept that can be measured. A system with access to a very high number of possible states (like a gas) has components with behavior that is highly unpredictable. A system with access to very few possible states (like a solid) has components whose behavior is highly predictable. We measured brain entropy through the predictability of the brains components at the smallest scale we had access to: what are called voxels in an fMRI scan. These are 3mm cubes of neurons in a functional MRI scan, and there are many thousands of these voxels in our measurement and each of these voxels contains information on the activity of hundreds of thousands of neurons. We measured the predictability of each of these voxels and then found clusters of voxels where their predictability - or entropy - was related to intelligence. (more…)
Author Interviews, Education, NYU, Pediatrics, Pediatrics / 02.01.2018

MedicalResearch.com Interview with: Adriana Weisleder, PhD Research scientist, Department of Pediatrics NYU Langone Medical Center New York  MedicalResearch.com: What is the background for this study? What are the main findings? Response: An estimated 250 million children in low- and middle-income countries do not reach their developmental potential due to poverty. Many programs in the US, such as Reach Out and Read and Video Interaction Project, have shown success in reducing poverty-related disparities in early child development by promoting parent-child interactions in cognitively stimulating activities such as shared bookreading. This randomized study sought to determine whether a program focused on supporting parent-child shared bookreading would result in enhanced child development among 2- to 4-year-old children in a low-resource region in northern Brazil. Families in the program could borrow children’s books on a weekly basis and could participate in monthly parent workshops focused on reading aloud. Findings showed that participating families exhibited higher quantity and quality of shared reading interactions than families in a control group, and children showed higher vocabularies, working memory, and IQ. (more…)
Author Interviews, Environmental Risks, NYU, Ophthalmology / 08.12.2017

MedicalResearch.com Interview with: Cassandra Thiel, PhD Assistant Professor in the Departments of Population Health and Opthamology at NYU Langone Health, and Assistant Professor at NYU Wagner and NYU Tandon School of Engineering MedicalResearch.com: What is the background for this study? Response: Everyone is concerned about the health impacts of climate change, from the United Nations to the Lancet. While other industries are trying to monitor and minimize their environmental footprint, healthcare services have been largely overlooked. Yet, the US healthcare sector emits 10% of the US’s total greenhouse gases. Cataract surgery is one of the most commonly performed procedures in the world. In the US, these surgeries generate large quantities of waste due to the use of single-use, disposable materials and supplies. However, at Aravind Eye Care System in southern India, the outcomes for this procedure are the same as in the US, but the materials they use are mostly reusable. This study assessed the environmental footprint of Aravind’s surgical process, to determine how their process design and material selection affected their emissions. (more…)
Alzheimer's - Dementia, Author Interviews, NYU, Obstructive Sleep Apnea / 15.11.2017

MedicalResearch.com Interview with: Ricardo S Osorio MD Center for Brain Health Department of Psychiatry Center of Excellence on Brain Aging NYU Langone Medical Center New York, NY 10016, USA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study that was performed in a group of healthy normal elderly from the community that volunteered for studies on memory and aging. The main findings were that sleep apnea was very common, in almost all cases undiagnosed, and that it was associated with a longitudinal increase in amyloid burden which is considered one of the hallmark lesions of Alzheimer's disease (more…)
Author Interviews, Melanoma, NYU / 13.09.2017

MedicalResearch.com Interview with: Jeffrey Weber, M.D., Ph.D Laura and Isaac Perlmutter Cancer Center New York University Langone Medical Center New York, NY 10016  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a major unmet need for well tolerated and effective adjuvant therapy for high risk melanoma, that is, melanoma that has been removed but the patients have a 50%+ risk of relapse over 5 years, and a 50%+ risk of death over 10 years from melanoma. Since nivolumab is an active and well tolerated drug in metastatic disease, it seemed reasonable to test it after surgery to prevent recurrence. Since ipilimumab is approved for resected stage III melanoma in the US as adjuvant therapy, that was the control arm for comparison, and that is an active control, which prolongs relapse free and overall survival comared to placebo. (more…)
ADHD, Author Interviews, Autism, JAMA, NYU / 12.09.2017

MedicalResearch.com Interview with: Dr. Adriana Di Martino, MD Associate Professor, Department of Child and Adolescent Psychiatry NYU Langone Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: While there has been an increased awareness of the co-occurrence of symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children with a primary diagnosis of ASD, only recently has there been an appreciation that a substantial proportion of children with ADHD may also have ASD traits. These symptom domains overlap pose a challenge for accurate recognition and targeted treatments, yet their underlying mechanisms have been unknown. With more traditional diagnostic group comparisons we detected a significant influence of ASD on white matter organization, but our analyses of the severity of symptoms across individuals revealed an association between autistic traits and white matter organization, regardless of the individual's diagnosis. These findings were mostly centered around the corpus callosum, a structure that enables communication between the left and right cerebral hemispheres. (more…)
Author Interviews, Education, NYU, Sexual Health / 05.07.2017

MedicalResearch.com Interview with: Richard E. Greene, MD, FACP Medical Director, Bellevue Adult Primary Care Center Assistant Professor, NYU School of Medicine Associate Program Director, Primary Care Residency Program Director, Gender and Health Education, Office of Diversity Affairs, NYU School of Medicine, OUTList Medical Director, CHIBPS, The Center for Health, Identity, Behavior and Prevention Studies VP of Membership and Development, GLMA-Health Professionals Advancing LGBT Equality  MedicalResearch.com: What is the background for this study? Response: Transgender individuals face complex health disparities and have historically been mistreated and even denied care in medical settings. As a provider in New York City, I saw how this affected my trans patients, resulting in mistrust of the health care system, resulting in negative health outcomes. This sparked my interest in improving medical education to serve the needs of trans patients. It’s important to teach medical students and residents that they are not just treating a set of symptoms, they are working with a individuals with complex lived experiences who deserve compassionate care. I found with traditional didactic methods, like lectures, learners smiled and nodded in agreement, but when faced with a patient who was transgender, they would stammer and feel uncomfortable with aspects of the cases that were specific to transgender patients, from pronouns to hormones. Residents should be prepared to treat transgender patients not only with dignity, but also in medically appropriate ways. Without exposure to the transgender community, it’s difficult for providers to decipher their trans patients’ health care needs and contextualize them within a care plan. In order to provide a low stakes environment for residents to practice these skills, we developed an OSCE focused on a transgender woman with health care needs specific to her transition. The goal of the case was to discuss the patient’s medical concerns while also taking into consideration her goals around her hormone therapy and surgical interests. (more…)
Author Interviews, Endocrinology, Genetic Research, NYU / 19.06.2017

MedicalResearch.com Interview with: Constantine A. Stratakis, MD, DMSci Section on Endocrinology and Genetics Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health, Bethesda  MedicalResearch.com: What is the background for this study? Response: The pituitary and adrenal glands operate on a kind of feedback loop.  In response to stress, the pituitary release ACTH (Adrenocorticotropic hormone), which signals the adrenal glands to release cortisol.  Rising cortisol levels then act on the pituitary, to shut down ACTH production. In a previous study, Jacque Drouin of the Institute for Clinical Research in Montreal and colleagues had determined that the CABLES1 protein was a key player in this feedback mechanism, switching off pituitary cell division in cultures exposed to cortisol. Since this feedback mechanism appears to be impaired in many corticotropinomas, we investigated the presence of Cables1 gene mutations and copy number variations in a large group of patients with Cushing’s disease. (more…)
ASCO, Author Interviews, Breast Cancer, Merck, NYU / 10.06.2017

MedicalResearch.com Interview with: Sylvia Adams, MD Associate Professor of Medicine Breast Cancer and Cancer Immunotherapy Programs NYU Langone Medical Center Cancer Institute/Clinical Cancer Center New York, NY 10016   MedicalResearch.com: What is the background for the Keynote-086 trial ? What are the main findings? Response: This study is the largest immunotherapy study to date presented in metastatic triple negative breast cancer. This phase 2 trial studied the efficacy and safety of pembrolizumab (P) as single agent in a very aggressive disease and had two cohorts, a cohort of previously untreated patients (Cohort B) and a cohort with patients who had received prior chemotherapy lines in the metastatic setting (Cohort A). The study showed that single agent pembrolizumab can elicit durable responses in a subset of patients. This was found regardless of tumoral PD-L1 expression but appeared to be much more frequent in women without prior chemotherapy treatments in the metastatic setting. Survival is especially promising for patients responding to therapy. (more…)
ASCO, Author Interviews, Cancer Research, NYU / 05.06.2017

MedicalResearch.com Interview with: Prof Francisco J Esteva MD PhD Director of the breast medical oncology program at Perlmutter Cancer Center. NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trastuzumab is a monoclonal antibody directed against the human epidermal growth factor receptor 2 (HER-2). Trastuzumab therapy has been shown to improve survival in patients with early-stage and metastatic her-2 positive breast cancer. In this study, we compared the safety and efficacy of the trastuzumab originator (Herceptin) to a trastuzumab biosimilar (CT-P6) in patients with stage I-III HER-2 positive breast cancer receiving neoadjuvant chemotherapy. The study was a randomized phase III trial. We found the pathological complete response rates were similar in both groups. Both antibodies were safe. Pharmacokinetic studies showed similar plasma concentrations for the trastuzumab originator and the proposed biosimilar. (more…)
Author Interviews, Geriatrics, JAMA, NYU, Primary Care / 22.05.2017

MedicalResearch.com Interview with: Benjamin Han, MD, MPH Assistant professor Departments of Medicine-Division of Geriatric Medicine and Palliative Care, and Population Health NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are an increasing number of older adults being prescribed statins for primary prevention, but the evidence for the benefit for older adults is unclear. Our study finds that in the ALLHAT-LLT clinical trial, there were no benefits in either all-cause mortality or cardiovascular outcomes for older adults who did not have any evidence of cardiovascular disease at baseline. (more…)