Author Interviews, Critical Care - Intensive Care - ICUs, Mental Health Research, NEJM, Vanderbilt / 24.10.2018

MedicalResearch.com Interview with: Eugene Wesley Ely, M.D. Dr. E. Wesley Ely is a Professor of medicine at Vanderbilt University School of Medicine with subspecialty training in Pulmonary and Critical Care Medicine.  MedicalResearch.com: What is the background for this study? Response: Critically ill patients are not benefitting from antipsychotic medications that have been used to treat delirium in intensive care units (ICUs) for more than four decades, according to a study released today in the New England Journal of Medicine. Each year, more than 7 million hospitalized patients in the United States experience delirium, making them disoriented, withdrawn, drowsy or difficult to wake. The large, multi-site MIND USA (Modifying the INcidence of Delirium) study sought to answer whether typical and atypical antipsychotics — haloperidol or ziprasidone —affected delirium, survival, length of stay or safety. Researchers screened nearly 21,000 patients at 16 U.S. medical centers. Of the 1,183 patients on mechanical ventilation or in shock, 566 became delirious and were randomized into groups receiving either intravenous haloperidol, ziprasidone or placebo (saline). (more…)
Annals Internal Medicine, Author Interviews, Blood Pressure - Hypertension, Kidney Disease, UCSF / 23.10.2018

MedicalResearch.com Interview with: Michael G. Shlipak, MD, MPH Scientific Director , Kidney Health Research Collaborative (khrc.ucsf.edu) Professor of Medicine, Epidemiology & Biostatistics University of California, San Francisco Associate Chief of Medicine for Research Development San Francisco VA Medical Center MedicalResearch.com: What is the background for this study?
  • Our study represents major advancements in our understanding of whether kidney tissue damage accompanies the diagnosis of chronic kidney disease during hypertension therapy.
  • The Systolic Blood Pressure Intervention Trial (SPRINT) was a landmark clinical trial that demonstrated that more intensive systolic blood pressure management (target <120 mmHg) reduced rates of major cardiovascular events and mortality compared with standard therapy (<140 mmHg). A recent announcement indicated that the lower systolic blood pressure target also slowed the rate of cognitive decline and dementia incidence.
  • The major concern with intensive blood pressure lowering in SPRINT is the 3-fold incidence of chronic kidney disease, as defined using the clinical standard of serum creatinine levels. This detrimental impact on the kidney was surprising because hypertension is a predominant risk factor for kidney disease, and hypertension therapy should reduce CKD risk.
  • Given the lower blood pressure targets in the recently-updated national hypertension guidelines, there has been substantial concern that guideline implementation of blood pressure targets could cause an epidemic of CKD and the attendant suffering from its downstream consequences of cardiovascular disease, heart failure, and kidney failure.
  • In our study, we compared SPRINT participants who developed CKD with matched controls, using a panel of validated urinary biomarkers of kidney damage. These urine tests can measure actual kidney damage, rather than relying on the creatinine which is an indirect reflection of the kidney’s filtering function.
  • In the group undergoing intensive blood pressure lowering in SPRINT, we found that the new cases of CKD had an overall lowering of the kidney damage biomarkers compared with the controls, contrary to what would have been expected if they were developing “real” CKD.
  • In contrast, the new CKD cases that developed in the standard treatment group did have overall elevations in the urinary biomarkers of kidney damage; 5 of the 9 biomarkers significantly increased relative to the CKD cases in the intensive treatment group. 
(more…)
Author Interviews, Pediatrics, Stanford, Surgical Research, Weight Research / 22.10.2018

MedicalResearch.com Interview with: Dr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford UniversityDr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford University MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2013 obesity became recognized as a disease.  The rate of pediatric obesity continues to rise.  Severe pediatric obesity is rising at a even faster rate than obesity in pediatrics.  Despite this Metabolic and Bariatric Surgery (MBS) remains underutilized in the treatment of severe pediatric obesity.  There is a significant amount of adult data and now pediatric data about effective treatments for severe obesity.  These support the use of MBS as a primary treatment for severe obesity in children. (BMI > 120% of 95th percentile with a comorbidity or BMI > 140% of 95th percentile). (more…)
Author Interviews, CDC, Pediatrics, Vaccine Studies, Vanderbilt / 18.10.2018

MedicalResearch.com Interview with: "Vacuna influenza / Flu vaccine" by El Alvi is licensed under CC BY 2.0Kathryn M. Edwards, M.D. Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics Professor of Pediatrics Vanderbilt University School of Medicine Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States. MedicalResearch.com: What is the background for this study? What are the main findings? Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year.  This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age.  The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received.  The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted.  Overall 15, 333 children had their immunization records reviewed. When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered. First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage.  Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%). There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates.  In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine. (more…)
Alzheimer's - Dementia, Author Interviews, University of Pittsburgh / 18.10.2018

MedicalResearch.com Interview with: Rachel H. Mackey, PhD, MPH, FAHA Assistant Professor of Epidemiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: “Hardening,” or stiffening, of the arteries is a risk factor for heart attacks and other cardiovascular disease. Arterial stiffness can be measured by pulse wave velocity (PWV), because the pulse pressure wave travels faster in stiffer arteries. Stiffer arteries transmit increased pulsatile blood flow to the brain and are linked with markers of silent, or subclinical, brain disease, which are related to increased risk of dementia. However, it was not clear whether arterial stiffening would predict risk of dementia, especially in older adults, who often have existing subclinical brain disease. Therefore, a University of Pittsburgh team, led by Chendi Cui, M.S, doctoral student, and Rachel Mackey, PhD, MPH, FAHA, assistant professor of epidemiology at Pitt Public Health, analyzed the association between arterial stiffness and 15-year risk of dementia among 356 older adults, with an average age of 78. Study participants were part of the Cardiovascular Health Study Cognition Study (CHS‐CS), a long‐term study to identify dementia risk factors, led by coauthors Oscar Lopez MD and Lewis Kuller, MD, DrPH. In 1996-2000, study participants had had arterial stiffness measured by pulse wave velocity (PWV), brain imaging by MRI, and had annual follow-up visits for cognitive status. (more…)
Author Interviews, Brain Injury, Pediatrics, Pediatrics, University Texas / 18.10.2018

MedicalResearch.com Interview with: Dr. Linda Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children may have long-lasting psychological and physical symptoms after an injury. Post-concussive symptoms (PCS) are nonspecific cognitive, physical, and mood symptoms such as difficulty concentrating, headache, and irritability. These symptoms occur in approximately 15 to 30% children after mild traumatic brain injury (TBI). Although PCS often resolve within one month, some children experience symptoms for longer periods of time. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, JAMA, Weight Research / 15.10.2018

MedicalResearch.com Interview with: Stuart Po-Hong Liu, MD, MPH Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50. However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, Surgical Research / 12.10.2018

MedicalResearch.com Interview with: Scott A. LeMaire, MD Jimmy and Roberta Howell Professor of Cardiovascular Surgery Vice Chair for Research, Michael E. DeBakey Department of Surgery Professor of Molecular Physiology and Biophysics Director of Research, Division of Cardiothoracic Surgery Baylor College of Medicine Department of Cardiovascular Surgery Texas Heart Institute Baylor St. Luke’s Medical Center CHI St. Luke’s Health Editor-in-Chief, Journal of Surgical Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: We performed this study because of concerns about the potential association between fluoroquinolones and aortic aneurysms and dissection raised in two large clinical studies. This concern was noted by the US Food and Drug Administration in May 2016, but the evidence was not deemed sufficient to warrant a warning. Hence, there was a clear need for additional studies to evaluate the problem. Our study was designed to determine whether there is biological evidence that ciprofloxacin—the most commonly prescribed fluoroquinolone—exacerbates aortic disease in a well-established mouse model. The model uses high-fat diet and angiotensin II infusion to stress the aorta and cause aneurysm and dissection. Using this model, we compared mice that received ciprofloxacin to control mice that received only vehicle, and we found that mice that received ciprofloxacin had significant increases in the incidence of aortic dilatation, severe aortic aneurysm and dissection, and aortic rupture and premature death. Importantly, these findings were consistent in male and female mice. Further, we investigated the potential underlying mechanisms and found that the aortas from mice that received ciprofloxacin had decreased levels of lysyl oxidase, increased levels of matrix metalloproteinases, and increased levels of apoptosis and necroptosis. (more…)
Author Interviews, Infections, MRSA, NIH, Probiotics / 12.10.2018

MedicalResearch.com Interview with: "staph aureus on blood agar" by Iqbal Osman is licensed under CC BY 2.0Pipat Piewngam Postdoctorol fellow Pathogen Molecular Genetics Section, Laboratory of Bacteriology, NIAID/NIH Bethesda, MD, USA 20892  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our team at National Institutes of health, Mahidol University and Rajamangala University of Technology in Thailand has reported that the consumption of probiotic Bacillus bacteria comprehensively abolishes colonization with the dangerous pathogen, Staphylococcus aureus. We hypothesized that the composition of the human gut microbiota affects intestinal colonization with S. aureus. We collected fecal samples from 200 healthy individuals from rural populations in Thailand and analyzed the composition of the gut microbiome by 16S rRNA sequencing. Surprisingly, we did not detect significant differences in the composition of the microbiome between S. aureus carriers and non-carriers. We then sampled the same 200 people for S. aureus in the gut (25 positive) and nose (26 positive). Strikingly, we found no S. aureus in any of the samples where Bacillus were present. In mouse studies, we discovered S. aureus Agr quorum-sensing signaling system that must function for the bacteria to grow in the gut. Intriguingly, all of the more than 100 Bacillus isolates we had recovered from the human feces efficiently inhibited that system. Then, we discovered that the fengycin class of Bacillus lipopeptides achieves colonization resistance by inhibiting that system. To further validate their findings, we colonized the gut of mice with S. aureus and fed them B. subtilis spores to mimic probiotic intake. Probiotic Bacillus given every two days eliminated S. aureus in the guts of the mice. The same test using Bacillus where fengycin production had been removed had no effect, and S. aureus grew as expected. This is one of the first study that provide human evidence supporting the biological significance of probiotic bacterial interference and show that such interference can be achieved by blocking a pathogen’s signaling system. (more…)
ADHD, Author Interviews, Psychological Science, University of Michigan / 11.10.2018

MedicalResearch.com Interview with: Holly White, PhD Research Scientist Basic and Applied Cognition Laboratory Department of Psychology University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was inspired by my previous findings of higher originality and creative achievement among adults with ADHD, as well as my personal observations of individuals with ADHD choosing non-traditional approaches to problem solving. College students with ADHD sometimes ignore task instructions and examples, and while this may lead to errors, it may also lead to extraordinarily unique answers and solutions. I was curious as to whether this tendency of ADHD individuals to think in an unconventional and expansive manner might lead to resistance to conformity during creative tasks. In the present study, college students with ADHD were less likely to copy experimenter-provided task examples, compared to non-ADHD peers, on a product label invention task. ADHD participants were also less likely to create imaginary fruits that resembled typical Earth fruit, compared to non-ADHD participants. Students with ADHD were less likely to conform to pre-existing prototypes of fruit and therefore invented more original creations. Individuals with ADHD may be more flexible in tasks which require creating something new, and less likely to rely on examples and previous knowledge. As a result, the creative products of individuals with ADHD may be more innovative, relative to creations of non-ADHD peers.  (more…)
Author Interviews, Johns Hopkins, Smoking, Tobacco, Tobacco Research / 11.10.2018

MedicalResearch.com Interview with: "Electronic Cigarette/E-Cigs/E-Cigarettes" by Chris F is licensed under CC BY 2.0Mohammadhassan (Hassan) Mirbolouk, MD American Heart Association Tobacco Regulation Center (A-TRAC) Johns Hopkins Hospital Baltimore, MD 21224. MedicalResearch.com: What is the background for this study? Response: E-cigarettes were introduced first in US market as a less harmful method of nicotine delivery which potentially would help smokers to have a less harmful option. However, overtime e-cigarette found its niche of consumers in the younger/tobacco naïve population. Our study is amongst the first studies that describes those who use e-cigarette without any history of combustible-cigarette smoking.  (more…)
Alzheimer's - Dementia, Author Interviews, Critical Care - Intensive Care - ICUs, Geriatrics, Inflammation, Johns Hopkins / 11.10.2018

MedicalResearch.com Interview with: Keenan Walker, PhD Johns Hopkins University School of Medicine Baltimore MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was conducted in response to anecdotal accounts and scientific evidence which suggests that major medical conditions, such as critical illness and severe infections, can have a long-term neurological effect on some individuals. There are quite a few studies to date which have found that critical illnesses, such as severe sepsis, are associated with long-term cognitive impairment. Based on this evidence, we wanted to figure out to what degree critical illness and major infection may affect later brain structure and to determine whether the structural changes associated with these events were similar to those observed in Alzheimer’s disease. Our main finding was that individuals who had one or more critical illness or major infection major infection during the decades leading up to older adulthood were more likely to have smaller brain volumes in brain regions most vulnerable to Alzheimer's disease. (more…)
Author Interviews, Cancer Research, Colon Cancer, Genetic Research, University Texas / 10.10.2018

MedicalResearch.com Interview with: Mohammad Bilal, MD University of Texas Medical Branch MedicalResearch.com: What is the background for this study? Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC. The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population. These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy.  (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, Columbia, Environmental Risks, Genetic Research, Ophthalmology, PLoS / 09.10.2018

MedicalResearch.com Interview with: Andrei V. Tkatchenko, M.D., Ph.D. Associate Professor Columbia University Medical Center Edward S. Harkness Eye Institute New York, NY 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clear distance vision is rapidly becoming a rare privilege around the world, especially in Asia, due to increasing prevalence of myopia. Although much effort has been directed towards elucidating the mechanisms underlying refractive eye development and myopia, treatment options for myopia are mostly limited to optical correction, which does not prevent progression of myopia or pathological blinding complications often associated with the disease. During early childhood development, the axial length of the eye normally grows to match its optical power in a process called emmetropization, producing focused images on the retina. However, very often environmental and genetic factors lead to a mismatch between the optical power of the eye and its axial length resulting in the development of myopia if eyes grow too long for their optical power. Experimental studies in many animal species suggest that emmetropization is regulated by optical defocus. The eye can compensate for imposed negative and positive optical defocus by increasing or decreasing its growth rate, respectively. However, the molecular mechanisms underlying emmetropization are poorly understood which prevents development of anti-myopia drugs. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Red Meat / 05.10.2018

MedicalResearch.com Interview with: "bacon&eggs" by ilaria is licensed under CC BY 2.0 Maryam Farvid, Ph.D., Research Scientist   Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior prospective studies on red and processed meat consumption with risk of breast cancer have produced inconsistent results. Current meta-analysis of 15 prospective studies shows that women who eat a high amount of processed meat each day may have a higher risk of breast cancer than those who don't eat or have a low intake in their diet.  (more…)
Accidents & Violence, Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Pittsburgh / 05.10.2018

MedicalResearch.com Interview with: Syed Mahmood Ali Shah, M.D. Associate Professor of Ophthalmology University of Pittsburgh School of MedicineSyed Mahmood Ali Shah, M.D. Associate Professor of Ophthalmology University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Eye trauma is a significant cause of morbidity throughout the world. In the United States, the incidence of individuals hospitalized with eye trauma from 2001 through 2014 increased. Most of these individuals were above the age of 65 and suffered a fall. This is a worrisome trend in light of an increased awareness and continued and concentrated effort to reduce falls. This is a critical point: We need to improve our existing strategies to reduce falls. The second at-risk group is children and adolescents. Previous studies have shown that effective widespread implementation of injury prevention efforts can lower trauma rates. While we did observe a small decrease in eye trauma as a primary admitting diagnosis, the fact that it was more common in children and adolescents (for whom eye trauma carries devastating consequences and can significantly reduce quality of life) highlights the significance of continued efforts to prevent eye trauma.  (more…)
Author Interviews, Cleveland Clinic, Diabetes, JAMA, Ophthalmology / 05.10.2018

MedicalResearch.com Interview with: Amy Babiuch, M.D. Medical Retina Specialist  |  Cole Eye Institute Assistant Professor Ophthalmology Case Western Reserve University WPSA Regional Focus Committee Chair Cleveland Clinic MedicalResearch.com: What is the background for this study? Response: In previous studies, the disorganization of retinal inner layers (DRIL) has demonstrated its ability to help determine visual acuity (VA) prognosis in diabetic macular edema that requires treatment. Given this association, the research group at Cole Eye Institute studied how DRIL may affect VA outcomes in patients with retinal vein occlusion (RVO) undergoing treatment for secondary macular edema. DRIL is defined as the extent to which there is a failure in the recognition of any of the demarcations between the ganglion cell-inner plexiform layer complex, inner nuclear layer, and outer plexiform layer on optical coherence tomography (OCT). (more…)
Author Interviews, JAMA, Neurology, Outcomes & Safety, Parkinson's, Pharmacology, University of Pennsylvania / 04.10.2018

MedicalResearch.com Interview with: Allison W. Willis, MD, MS Assistant Professor of Neurology Assistant Professor of Biostatistics and Epidemiology Senior Fellow, Leonard Davis Institute Senior Scholar, Center for Clinical Epidemiology and Biostatistics University of Pennsylvania School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was motivated by my own experiences as a neurologist-neuroscientist. I care for Parkinson disease patients, and over the year, have had numerous instances in which a person was taking a medication that could interact with their Parkinson disease medications, or could worsen their PD symptoms. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA, NIH, Nutrition, Race/Ethnic Diversity, Salt-Sodium / 03.10.2018

MedicalResearch.com Interview with: Dr. George Howard DPH, for the research team Professor and Chair of Biostatistics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Perhaps the most important distinction to draw for the readers is that this is not a paper about risk factors for hypertension, but rather a paper that looks for contributors to the black-white difference in the presence of hypertension.  This racial difference in hypertension is the single biggest contributor to the immense disparities in cardiovascular diseases (stroke, MI, etc.) that underpin the approximate 4-year difference in black-white life expectancy.  As such, this work is “going back upstream” to understand the causes that lead to blacks having a higher prevalence of hypertension than whites with hopes that changing this difference will lead to reductions in the black-white disparities in cardiovascular diseases and life expectancy.   This difference in the prevalence of hypertension is immense … in our national study of people over age 45, about 50% of whites have hypertension compared to about 70% of blacks … that is HUGE.   We think that changing this difference is (at least one of) the “holy grail” of disparities research. This study demonstrates that there are several “targets” where changes could be made to reduce the black-white difference in hypertension, and thereby the black-white difference in cardiovascular diseases and life expectancy; however, the most “potent” of these appears to be diet changes.   Even though we know what foods promote a heart healthy lifestyle, we still have major differences in terms of how that message is being adopted by various groups of Americans.  We can’t know from our data what about the Southern diet is driving these racial differences in hypertension but we can begin to design community based interventions that could possibly help to reduce these racial disparities through diet.  It is interested that diet more than being overweight was the biggest contributor to the racial disparities in hypertension.  This would suggest we might want to consider interventions to increase health foods in the diet while minimizing fried foods and processed meats. While this is not a clinical trial that “proves” that changes in diet will reduce the disparity in blood pressure, we consider the “message” of the paper to be good news, as the things that we found that contribute to this black-white difference are things that can be changed.   While it is always hard for individual people to change their diet, it can be done.   More importantly, over time we as a society have been changing what we eat … but we need to “double down” and try to change this faster.   Also, policy changes of play a role to gently make changes in these diet, where for example Great Britain has been making policy changes to slowly remove salt from the diet.   These changes are possible … and as such, we may see a day when the black-white differences in hypertension (and thereby CVD and death) may be reduced.  (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease, JACC / 02.10.2018

MedicalResearch.com Interview with: Scott David Solomon, MD Director, Noninvasive Cardiology Professor, Harvard Medical School Brigham and Women's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The sodium glucose transport proteins are known to be important in regulating uptake of glucose. SGLT-1 is predominantly located in the gut and is responsible for uptake of glucose and galactose in the small intestine. Individuals born with severe mutations of this gene have severe malabsorption syndrome. We looked at genetic variants that lead to reduced function of the protein, but not complete loss of function, in a large cohort of individuals in the NIH funded Atherosclerosis Risk in Communities Study. We found that those with mutations in the gene had reduced glucose uptake, as measured by an oral glucose tolerance test, as well as less obesity, diabetes, heart failure and death. (more…)
Author Interviews, JAMA, Urinary Tract Infections, Urology, UT Southwestern / 02.10.2018

MedicalResearch.com Interview with: "Glass of Water" by Iwan Gabovitch is licensed under CC BY 2.0Professor Yair Lotan MD Chief of Urologic Oncology Holder of the Helen J. and Robert S. Strauss Professorship in Urology UT Southwestern Medical Center at Dallas Department of Urology Dallas, Texas 75390-9110  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Urinary tract infections are extremely common in women and many women experience recurrent episodes which impact their quality of life.  There are also many women who do not drink as much water as is recommended. This study found that in healthy women with recurrent UTIs who drink less than 1.5 liters per day, the additional intake of 1.5 liters of water daily reduced the risk of recurrent infections by nearly 50%.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics / 01.10.2018

MedicalResearch.com Interview with: Matthew D. Weaver, PhD Instructor in Medicine · Harvard Medical School Associate Epidemiologist · Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response: We were interested whether high school students who tended to sleep less than 8 hours per night reported more risk-taking behaviors compared to high school students who slept at least 8 hours per night on a school night. We utilized a nationally representative dataset from the CDC of surveys that were completed by high school students between 2007 and 2015. Over that time, approximately 67,000 students were surveyed. Students were asked about the hours of sleep that they obtained on an average school night. They were also asked how often, in the month prior to the survey, they engaged in a number of risk-taking behaviors. Some behaviors were related to driving, like driving without a seatbelt or driving drunk, while others were related to using alcohol, doing drugs, or being involved in a fight. They were also asked about their mood, including whether they felt sad or hopeless, considered suicide, and whether they had attempted suicide.  (more…)
AACR, Author Interviews, Cancer Research, MD Anderson, University Texas / 01.10.2018

MedicalResearch.com Interview with: Filip Janku, MD, PhD Associate Professor, Investigational Cancer Therapeutics (Phase I Clinical Trials Program) Center Medical Director, Clinical and Translational Research Center The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clostridium novyi-NT is an attenuated strain of bacteria Clostridium, which induced a microscopically precise, tumor-localized response in a rat brain tumor model and in companion dogs bearing spontaneous cancers. Clostridium novyi-NT can only grow in hypoxic (low-oxygen) tumor environment and destroys cancer cells by secreting lipases, proteases, and other hydrolytic enzymes; recruiting inflammatory cells to tumors eliciting anti-tumor immune responses in animals. Furthermore, intratumoral injection can plausibly induce an immune mediated abscopal effect in non-injected tumor sites. Therefore, we designed a phase I dose-finding study to test for safety and tolerability of the single intratumoral injection of Clostridium novyi-NT in 24 patients with advanced cancers with no available standard therapies. We also designed experiments to study activation of antitumor immune response in blood and tumor samples from patients undergoing the therapy. We demonstrated that single dose of intratumoral injection of Clostridium novyi-NT is feasible and has led to significant destruction of injected tumor masses. Adverse events, which were often related to the tumor destruction at the infected site, could have been significant but mostly manageable. Correlative studies of pre-treatment and post-treatment tumor and blood samples suggested immune response to therapy. (more…)
Author Interviews, Cancer Research, HPV, UCLA / 28.09.2018

MedicalResearch.com Interview with: Manon Eckhardt, PhD Gladstone Institutes The Quantitative Biosciences Institute University of California San Francisco  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infection with Human Papillomavirus (HPV) causes 5% of all cancers worldwide, including cervical cancer and an increasing number of head and neck cancers. Most cancers are caused by mutations in genes, leading to the production of malfunctioning proteins that result in unconstrained cell division. However, certain viruses like HPV can cause cancer without introducing mutations. In this study, we compared cancers of the same type (i.e. head and neck) that are caused by either mutation or virus infection to identify important processes that are dysregulated in both subsets. We hypothesized that identifying which proteins the virus binds can lead the way to prioritize which of the proteins and cellular processes (pathways) that are affected in cancer cells are most important. To do this, we identified the complete set of human proteins that interact with HPV. We next determined genes that were more frequently mutated in non-viral cancers, and combined both data sets. The proteins we find to be both binding to HPV and mutated in non-viral cancers will be potential targets for new, more specific drug development, and help better understand the development of head and neck cancer. From the many pathways we identified in this study, we highlighted two pathways with further mechanistic studies: the oxidative stress response, which helps cancer cells survive, as well as a pathway that allows the cancer to spread to other parts of the body. (more…)