Medical Research Centers
01 Feb Chronic Disease Linked To Increased Risk of Cancer and Cancer Death
MedicalResearch.com Interview with: [caption id="attachment_23591" align="alignleft" width="114"]
Dr. Xifeng Wu[/caption]
Xifeng Wu MD PhD
Prevention and Population Sciences
MD Anderson Center
MedicalResearch.com: What is the background for this study?
Response: Previous studies have shown that certain chronic diseases may predispose to cancer. These studies generally assessed chronic diseases or disease markers individually. As chronic diseases are typically clustered, it is necessary to study them simultaneously to elucidate their independent and joint impact on cancer risk. Therefore, we investigated the independent and joint effect of several common chronic diseases or disease markers on cancer and life span in a large prospective cohort. Also, we compared the contribution of chronic diseases or disease markers to cancer risk with that of lifestyle factors. We further assessed whether physical activity could attenuate the cancer risk associated with chronic diseases or disease markers. We hope the results of this study can contribute to evidence-based recommendations for future cancer prevention strategies.
31 Jan Virtual Reality Study Helps Identify How Memories Are Stored and Retrieved
MedicalResearch.com Interview with: [caption id="attachment_39731" align="alignleft" width="147"]
Halle Dimsdale-Zucker[/caption]
Halle Dimsdale-Zucker
University of California, Davis
Center for Neuroscience | Ph.D. Candidate
Dynamic Memory Lab
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study sought to test competing models for how different types of retrieved contextual information (spatial, episodic - which is spatial AND temporal information) are supported by the hippocampus and its subfields. We only found differences between the subfields when people were spontaneously reactivating episodic, but not spatial information. This is surprising because a dominant view of the hippocampus is that it is specialized to represent spatial information.
What this suggests is that when there is more than just spatial information that can be remembered that the hippocampus is able to flexibly represent whatever information is most task-relevant for remembering and distinguishing items from one another.
Intriguingly, we found that different subfields represented shared episodic contextual information and item-unique contextual information. This highlights that our memories need to both link together common features of related events while retaining the event-specific details.
[caption id="attachment_39726" align="alignleft" width="540"]
UC Davis neuroscientists are using virtual reality to investigate how memories are organized. Graduate student Halle Dimsdale-Zucker showed subjects movies created with virtual sketching software and asked them questions about objects inside the houses. She was able to show that different regions of a brain structure called the hippocampus play different roles in remembering items in context.Credit: Halle Dimsdale-Zucker, UC Davis[/caption]
29 Jan Genetic Risk Score Predictive of Aggressive Prostate Cancer
MedicalResearch.com Interview with:
Tyler Seibert, MD, PhD
Radiation Oncology
Center for Multimodal Imaging & Genetics
UC San Diego
MedicalResearch.com: What is the background for this study?
Response: Prostate cancer is an extremely common condition in men. Many die from it each year, and many others live with debilitating pain caused by prostate cancer. Screening for prostate cancer with prostate-specific antigen (PSA) testing can be effective, but there are concerns with the test.
- First, screening everyone gives a large proportion of false-positive results, and those men end up undergoing unnecessary procedures such as prostate biopsy. S
- econd, a significant portion of men who develop prostate cancer will develop a slow-growing form of the disease that is likely not life-threatening and may not require treatment. These concerns have led to a drop in prostate cancer screening. But avoiding screening leaves a large number of men vulnerable to diagnosis of an aggressive prostate cancer at a later stage, when it is more difficult—or impossible—to be cured. Doctors are left to guess which of their patients are at risk of aggressive disease and at which age they need to start screening those patients.
28 Jan Improving Adjuvant Clinical Trials By Including Only Patients For Whom Current Therapies Do Not Work Well
MedicalResearch.com Interview with: [caption id="attachment_39559" align="alignleft" width="130"]
Dr. Pusztai[/caption]
Lajos Pusztai, M.D, D.Phil.
Professor of Medicine
Director of Breast Cancer Translational Research
Co-Director of the Yale Cancer Center Genetics, Genomics and Epigenetics Program
Yale School of Medicine
New Haven, CT 06511
MedicalResearch.com: What is the background for this study?
Response: Overall, about 85% of newly diagnosed stage I-III breast cancer patients will not die of their disease, and this roughly equates to an 85% cure rate. Of course cure rates are higher for stage I cancers and lower for stage III cancers. An 85% overall cure rate is good but not good enough, we continuously try to develop new therapies hoping to push these rates to 90%...,95%...etc. However, it is not possible to cure a patient twice over. For example, if surgery plus endocrine therapy cures all patients, the addition of chemotherapy cannot improve on it no matter how effective it is. If surgery plus endocrine therapy cures 95%, adding the perfect chemo to this treatment can only bring about a 5% improvement, and very good chemo that would push cure from 95% to 97%, would require a very large trial including many thousands of patients.
This is an increasingly common scenario in modern breast cancer adjuvant trials (where the goal is to improve survival and cure); the control arm that receives the current standard of care invariably does better than expected and the experimental arm only improves outcome by 1-3% that does not reach statistical significance. The painful conclusion from these trials is that we do not know if the new drug actually works or not because there were not enough events to demonstrate an effect.
Of course, a lot of patients in the study were also exposed to a new drug with all of its associated toxicities who could not possibly benefit from it.
25 Jan Personality Changes Can Presage Cognitive Impairment
MedicalResearch.com Interview with: [caption id="attachment_39613" align="alignleft" width="165"]
Dr. Caselli[/caption]
Richard J. Caselli MD
Department of Neurology
Mayo Clinic Arizona
Scottsdale, AZ
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Personality changes are common in patients with a variety of dementing illnesses, and underlie the behavioral disturbances that complicate the course of dementia patients. We have a been conducting a large longitudinal study of cognitive aging in individuals at genetically defined risk for Alzheimer’s disease (AD) based on their APOE genotype, and have been administering a large battery of neuropsychological tests as well as the gold standard personality questionnaire (the NEO-PI-R) in order to determine whether personality changes during the transition from normal cognition/preclinical AD to mild cognitive impairment.
25 Jan Children with ADHD Found To Abuse Drugs and Alcohol At Early Age
MedicalResearch.com Interview with: [caption id="attachment_39573" align="alignleft" width="149"] Dr. Molina[/caption] Brooke S. G. S Molina, PhD Professor of Psychiatry, Psychology and Pediatrics University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been inconsistency across previous studies of children with ADHD and their risk of substance use in...
24 Jan PCOS: Hyperandrogenism Associated With Changes in Gut Microbiome
MedicalResearch.com Interview with: [caption id="attachment_39566" align="alignleft" width="133"]
Dr. Thackray[/caption]
Varykina Thackray, Ph.D.
Associate Professor of Reproductive Medicine
University of California, San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies have shown that changes in the composition of intestinal microbes (gut microbiome) are associated with metabolic diseases. Since many women with polycystic ovary syndrome (PCOS) have metabolic dysregulation that increases the risk of developing type 2 diabetes and cardiovascular disease, we wondered whether PCOS was associated with changes in the gut microbiome and if these changes were linked to any clinical features of PCOS.
We collaborated with Beata Banaszewska and her colleagues at the Poznan University of Medical Sciences in Poznan, Poland to obtain clinical data and fecal samples from 163 premenopausal women recruited for the study. In collaboration with Scott Kelley at San Diego State University, we used 16S ribosomal RNA gene sequencing and bioinformatics analyses to show that the diversity of the gut microbiome was reduced in Polish women with PCOS compared to healthy women and women with polycystic ovaries but no other symptoms of PCOS.
The study confirmed findings reported in two other recent studies with smaller cohorts of Caucasian and Han Chinese women. Since many factors could affect the gut microbiome in women with PCOS, regression analysis was used to identify clinical hallmarks that correlated with changes in the gut microbiome. In contrast to body mass index or insulin resistance, hyperandrogenism was associated with changes in the gut microbiome in this cohort of women, suggesting that elevated testosterone may be an important factor in shaping the gut microbiome in women.
24 Jan Medicaid Expansion Led To Better, More Timely Surgical Care
MedicalResearch.com Interview with: [caption id="attachment_39550" align="alignleft" width="199"]
Dr. Loehrer[/caption]
Andrew Phillip Loehrer MD MPH
Fellow in Surgical Oncology Department
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A growing number of studies have examined the effects of the Affordable Care Act’s Medicaid expansion. But none to date have looked at effects on surgical conditions, which are both expensive and potentially life-threatening. We examined data for nearly 300,000 patients who presented to hospitals with common and serious surgical conditions such as appendicitis and aortic aneurysms.
We found that expansion of Medicaid coverage was linked to increased insurance coverage for these patients, but even more importantly, Medicaid expansion led patients to come to the hospital earlier before complications set in, and they also received better surgical care once they got there.
24 Jan Genetic Link Between Corneal Thickness and Risk of Glaucoma
MedicalResearch.com Interview with: [caption id="attachment_39538" align="alignleft" width="147"]
Dr. Geisert[/caption]
Eldon E. Geisert, PhD
Professor of Ophthalmology
Emory School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the late 1990s a group of doctors began a study of glaucoma patients to determine if there were phenotypes that are predictive for developing glaucoma.
In this Ocular Hypertension Treatment Study (OHTS) one of the highly correlated ocular traits was central corneal thickness (CCT). The early clinical studies found that people with thinner corneas were at a higher risk of developing glaucoma. In two large studies, examining thousands of people a number of genes were identified that were risk factors for glaucoma or that controlled CCT in humans. In both cases the identified genes accounted for less than 10% of the genetic risk for glaucoma and less than for 10% of the genetic control for CCT. There was little data linking the genetic control of CCT to the glaucoma risk.
Our group has taken an indirect approach to the question, using well-defined mouse genetic system to identify genes modulating CCT and then interrogating human glaucoma data to determine if these genes are associated with glaucoma risk.
23 Jan BEACON Triplet Therapy for BRAF Mutant Metastatic Colorectal Cancer Shows Promise
MedicalResearch.com Interview with: [caption id="attachment_39506" align="alignleft" width="140"]
Dr. Kopetz[/caption]
Scott Kopetz, M.D., Ph.D., FACP
Associate Professor Department of Gastrointestinal Medical Oncology
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The BRAF mutation carries a very poor prognosis for patients with advanced colo-rectal cancer (CRC), and is particularly unresponsive after first-line therapy, so additional treatment options for these patients are needed. While treatment with a BRAF inhibitor alone has not been effective in treating this disease, combination therapies have shown promise and lead to the initiation of the BEACON study. The safety lead-in phase of the BEACON CRC trial was designed to assess the safety and tolerability of encorafenib, binimetinib and cetuximab triplet combination prior to the Phase 3 randomized portion of the study. Thirty patients were treated in the safety lead-in and received the triplet combination (encorafenib 300 mg daily, binimetinib 45 mg twice daily, and cetuximab per label). Out of the 30 patients, 29 had a BRAFV600E mutation. Microsatellite instability-high (MSI-H) (resulting from defective DNA mismatch repair) was detected in only 1 patient. The triplet demonstrated good tolerability, supporting initiation of the randomized portion of the study. In addition, promising initial clinical activity was observed.
In patients with the BRAFV600E mutation, the estimated median progression-free survival (mPFS) at the time of analysis was 8 months. The confirmed overall response rate (ORR) in patients with the BRAFV600E mutation was 48%, and 3 patients achieved complete responses (CR). Further, the ORR was 62% in the 16 patients (10/16) who received only one prior line of therapy.
Additionally, the triplet combination was generally well-tolerated. Two patients discontinued treatment due to AEs with only one of these considered related to treatment. The most common grade 3 or 4 AEs seen in at least 10% of patients were fatigue (4/30), urinary tract infection (3/30), increased aspartate aminotransferase (AST; 3/30) and increased blood creatine kinase (CK; 3/30).
23 Jan Unnecessary Routine Preoperative Cataract Testing Costs Medicare Millions
Posted at 12:56h
in Author Interviews, Cost of Health Care, JAMA, Ophthalmology, Surgical Research, UCSF
MedicalResearch.com Interview with:
Catherine L. Chen, MD, MPH
Assistant Professor
UCSF Department of Anesthesia & Perioperative Care
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Routine preoperative medical testing (such as common laboratory tests looking at a patient's blood cell counts and kidney function, or cardiac tests like an EKG) are not recommended in patients undergoing cataract surgery, but these tests still occur quite frequently among Medicare cataract surgery patients because these patients tend to be older and sicker than the general population. In the past, researchers have used a 30-day window counting backwards from the date of surgery to determine whether a given test should be categorized as a routine preoperative test. However, we know that testing often takes place outside this window and therefore, the frequency and cost of routine preoperative medical testing has generally been underreported.
In our study, we used a new method to figure out how to determine the start of the routine preoperative testing period. In cataract patients, ocular biometry is a diagnostic test that is performed in anticipation of cataract surgery, and this test is only performed in cataract patients who will be having cataract surgery in the near future. For each patient, we calculated the elapsed time between the ocular biometry and cataract surgery dates to get a better idea of when to start looking for unnecessary routine preoperative testing. Our goal was to identify all the routine preoperative medical testing that occurs once the decision has been made to operate and better estimate the cost to Medicare of this unnecessary testing.
In a previous study that we published in the New England Journal of Medicine, we reported a significant spike in the rate of routine preoperative medical testing that occurs in the 30 days before surgery compared to the baseline rate of testing. In our current study, we discovered that there is a second spike in testing that occurs in the 30 days after ocular biometry. In fact, even if you exclude the testing that takes place during the 30 days before surgery, there is still a 41% increase in testing rates during the interval between ocular biometry and cataract surgery over the baseline rate of testing. In addition, we found that the cost of routine preoperative testing was 47% higher when looking at the entire biometry to surgery timeframe compared to testing that occurs just in the 30 days before surgery.
We estimate that the cost to Medicare of all of this unnecessary testing approaches $45.4 million annually.
23 Jan Despite 20 Years of Programs and Policies, Racial Disparities in Kidney Transplants Widen
MedicalResearch.com Interview with: [caption id="attachment_39487" align="alignleft" width="140"]
Dr. Purnell[/caption]
Tanjala S. Purnell, PhD MPH
Assistant Professor of Surgery, Epidemiology, and Health Behavior and Society
Core Faculty, Epidemiology Research Group in Organ Transplantation
Johns Hopkins University
Associate Director for Education and Training, Johns Hopkins Center for Health Equity
Member, OPTN/UNOS Minority Affairs Committee
MedicalResearch.com: What is the background for this study?
- Our study was motivated by the fact that we know live donor kidney transplants are associated with longer life expectancy and higher quality of life than deceased donor kidney transplants or long-term dialysis treatment. We also know that Black and Hispanic adults are more likely than White adults to have end-stage kidney disease but are less likely than White patients to receive live donor kidney transplants.
- Over the last 2 decades, there have been several transplant education programs implemented within transplant centers and dialysis centers, and legislative policies enacted to improve overall access to live donor kidney transplants for patients. We wanted to see whether these programs and policies resulted in narrowed racial and ethnic disparities in access to live donor kidney transplants in the United States.
22 Jan Repurposed Drug Hydroxyurea May Improve Glioblastoma’s Response to Chemotherapy
MedicalResearch.com Interview with: [caption id="attachment_39476" align="alignleft" width="149"]
Dr. Tannous[/caption]
Bakhos Tannous, PhD
Neuro-Oncology Division
Department of Neurology
MGH
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Glioblastoma (GBM) is the most common and most aggressive type of brain tumors in adults. Over the last two decades, the major improvement in the treatment for GBM has been the addition of the chemotherapeutic temozolomide (TMZ) to the standard of care (surgery and radiation), however, despite this aggressive therapy, over 90% of patients die within five years after diagnosis. Further, only about half of GBM patients really benefit from TMZ treatment, while the other half are somewhat resistant to TMZ since their tumor endogenously carry a DNA repair mechanism that removes DNA adducts caused by TMZ.
We therefore wanted to find a combination therapy that overcomes TMZ resistance and works in all GBM patient populations, with a fast transition to the clinic. Through a repurposing drug screening aiming at recycling of old known drugs for new therapies, we found that the FDA-approved drug hydroxyurea to synergizes with temozolomide in patient-derived GBM cells from newly diagnosed and recurrent tumors, irrespective of their DNA repair mechanism. The combination of hydroxyurea and TMZ worked very well in all different patient cell population tested, and was not specific to one subtype, and lead to a significant increase in survival rate in different mouse models.
19 Jan How Much DASH Diet is Required To Reduce Uric Acid?
Posted at 13:17h
in Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout, Nutrition, Race/Ethnic Diversity
MedicalResearch.com Interview with:
Stephen P. Juraschek, MD, PhD
Instructor of Medicine
Beth Israel Deaconess Medical Center/Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recent evidence suggests that the DASH diet is associated with lower uric acid levels and lower risk of gout. Furthermore, a secondary analysis of the DASH trial showed that complete replacement of a typical American diet with the DASH diet lowered uric acid levels. However, it is unknown if partial replacement of a typical American diet with DASH foods might lower uric acid.
18 Jan Brief Interruption of HIV Treatment Did Not Lead To Irreversible Expansion of Viral Reservoir
MedicalResearch.com Interview with: [caption id="attachment_39372" align="alignleft" width="300"]
HIV-infected T-cellNIAID image[/caption] Tae-Wook Chun, Ph.D. National Institutes of Health Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: While antiretroviral therapy (ART) has improved the clinical outcome for people living with HIV, persistence of viral reservoirs in the peripheral blood and lymphoid tissues remains a hurdle to complete eradication of virus and cure of the infection. We know the vast majority of people living with HIV will experience plasma viral rebound within weeks of cessation of therapy. Considering that current research on the treatment of people living with HIV has been heavily focused on developing strategies aimed at achieving sustained virologic remission in the absence of ART, it is of great interest to investigate whether treatment interruption results in expansion of the viral reservoir and/or damage to the immune system. Using data from a recently concluded trial that employed short-term analytical treatment interruption (ATI), we found that, as expected, HIV DNA increased in the CD4+ T cells of individuals living with HIV during the treatment interruption phase. However, the size of the HIV reservoirs as well as immune parameters returned to baseline 6–12 months after the participants resumed ART.
18 Jan Frequent Exertion and Frequent Standing at Work Varies By Industry and Occupation Group
MedicalResearch.com Interview with: Taylor M. Shockey, MPH Title 42 Fellow Division of Surveillance, Hazard Evaluations and Field Studies NIOSH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Research has linked repeated exposure to occupational ergonomic hazards, such as frequent exertion and frequent standing, to injuries and musculoskeletal disorders (MSDs) among workers. To determine the industry and occupation groups that have the highest prevalence rates of frequent exertion at work and frequent standing at work, NIOSH researchers analyzed 2015 National Health Interview Survey data. The results showed large differences among the groups with the agriculture, forestry, fishing, and hunting industry group having the highest prevalence of frequent exertion and standing at work (70.9%) and the construction and extraction occupation group having the highest prevalence of frequent exertion and standing at work (76.9%). These differences indicate a need for targeted interventions to reduce workplace exposure.15 Jan LUXTURNA Proves Effectiveness of Single Gene Therapy To Cure Rare Cause of Blindness
MedicalResearch.com Interview with: [caption id="attachment_38055" align="alignleft" width="190"]
Foundation Fighting Blindness[/caption]
Dr. Stephen Rose PhD
Chief Research Officer
Foundation Fighting Blindness (FFB)
Dr. Rose comments on the announcement of the FDA approval of voretigene neparvovec (LUXTURNA™) gene therapy for inherited blindness due to mutations in the RPE65 gene.
What is the background for this announcement? What were the main findings from the study?
Response: While it has been 30 years since the RPE65 gene was identified as causing Leber’s Congenital Amaurosis, this shows that it is possible to have an effective gene therapy for an inherited disease. As the first gene therapy for the eye or for an inherited disease, LUXTURNA is a historic milestone in the search for cures for all inherited retinal diseases (IRDs). As a one-time gene therapy, LUXTURNA will not only be life-changing for patients with vision loss due to mutations in the RPE65 gene, it also provides critical momentum for gene therapies - for the eye and other diseases - now in the clinic.
07 Jan Viral Vector Delivered Gene Therapy That Reversed Diabetes in Mice
Posted at 18:02h
in Annals Internal Medicine, Author Interviews, Diabetes, Genetic Research, University of Pittsburgh
MedicalResearch.com Interview with:
Xiangwei Xiao, M.D., Ph.D.
Assistant Professor of Department of Surgery,
Children’s Hospital of Pittsburgh
University of Pittsburgh School of Medicine,
Pittsburgh, PA
MedicalResearch.com: What is the background for this study?
Response: Diabetes is a prevalent chronic disease characterized by persistently high blood glucose. Diabetes has two main subtypes, type 1 diabetes and type 2 diabetes. In type 1 diabetes, the immune system attacks and destroys insulin-producing beta cells in the pancreas, resulting in high blood levels of glucose. In type 2 diabetes, the beta cells do not produce enough insulin or the body is not able to use insulin effectively.
07 Jan Non-Cigarette Tobacco Products Double Chances of Youth Smoking Within a Year
MedicalResearch.com Interview with:
Benjamin Chaffee, DDS MPH PhD
UCSF School of Dentistry
San Francisco, CA 94118
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Non-cigarette tobacco products, which include electronic cigarettes, hookah (tobacco waterpipe), smokeless tobacco, and non-cigarette combustibles, like cigars, are increasingly popular among young people. Considerable debate surrounds whether use of these non-cigarette products encourages youth to begin smoking conventional cigarettes.
Several previous studies have shown associations between non-cigarette tobacco use and youth smoking. These studies had largely looked at only one type of tobacco product at a time. This study included more than 10,000 adolescents from all over the United States, surveyed at two time points one year apart. Therefore, this study featured enough participants and detailed information about tobacco behaviors to consider all types of tobacco products in a comprehensive way.
We found that each type of non-cigarette tobacco product (i.e., e-cigarettes, hookah, combustibles, or smokeless tobacco) added to smoking risk. Among youth who had never smoked a cigarette at the start of the survey, use of any of the non-cigarette products approximately doubled the odds of cigarette smoking within a year, after adjusting for multiple smoking-related risk factors. Each product independently increased risk. The adolescents most susceptible to future smoking to were those who had tried two or more types of non-cigarette tobacco.
05 Jan Sugar Compound In Food Products May Have Encouraged Growth of Dangerous C. diff Bacteria
MedicalResearch.com Interview with: [caption id="attachment_39226" align="alignleft" width="200"]
Prof. Britton[/caption]
Professor Robert Britton PhD
Therapeutic Microbiology Laboratory
Department of Molecular Virology and Microbiology
Alkek Center for Metagenomics and Microbiome Research
Baylor College of Medicine
MedicalResearch.com Interview: How would you summarise your findings?
Response: As a brief summary of our work, certain strains of Clostridium difficile have emerged in the past 20 years that have resulted in epidemics worldwide, leading to C. difficile becoming one of the most common causes of hospital acquired infections. Two ribotypes of C. difficile, RT027 and RT078, emerged as key epidemic ribotypes associated with increased disease prevalence and increased mortality in patients. We found that both of these ribotypes have acquired the ability to consume the disaccharide trehalose by two completely independent mechanisms. We further show that trehalose enhances disease severity of C. difficile infection in a manner that requires C. difficile to metabolize trehalose in mice. We also show that trehalose is present in the distal intestine of mice and humans in concentrations that the RT027 ribotype can metabolize. Because RT027 and RT078 strains were present in clinics at least 10-20 years prior to their becoming epidemic isolates, we looked where people would acquire trehalose in the diet.
In 2000 the FDA approved trehalose for human consumption (EFSA did so in 2001) and based on the GRAS report from the FDA the amount of trehalose predicted to be consumed once released on the market would vastly increase what people get naturally from the diet. Our data support that these two ribotypes increased in prevalence due to a change in the human diet.
05 Jan Benefits of Transplanting Hepatitis C Infected Livers May Outweigh Risks
Posted at 01:40h
in Author Interviews, Brigham & Women's - Harvard, Hepatitis - Liver Disease, Transplantation
MedicalResearch.com Interview with:
[caption id="attachment_39202" align="alignleft" width="200"]
Dr. Chhatwal[/caption]
Jagpreet Chhatwal, PhD
Assistant Professor, Harvard Medical School
MGH Institute for Technology Assessment
Boston, MA and
[caption id="attachment_39221" align="alignleft" width="107"]
Dr. Samur[/caption]
Sumeyye Samur PhD
Postdoctoral Fellow
MGH-Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: The number of patients who are in need of liver transplant continues to rise whereas the availability of organs remains limited, therefore, it becomes is important to utilize all available livers.
Under the current practices, only Hep-C infected patients are eligible to receive infected livers. However, with the advent of high efficacy drugs, number of infected recipients has decreased over the last decade. On the other hand, with the rise of opioid use, number of Hep-C infected organs increased. With this contradiction, it becomes paramount of importance to utilize the infected livers which could help save more lives on the transplant waiting list.
04 Jan Children with Heart Failure from Dilated Cardiomyopathy are Surviving Longer in the Most Recent Era
[caption id="attachment_39174" align="alignleft" width="300"]
Structural categories of cardiomyopathy Wikipedia image[/caption]
MedicalResearch.com Interview with:
Rakesh K. Singh MD, MS
Department of Pediatrics, University of California–San Diego and
Rady Children’s Hospital
San Diego, California
Steven E. Lipshultz MD
Department of Pediatrics
Wayne State University School of Medicine and
Children’s Hospital of Michigan
Detroit, Michigan
MedicalResearch.com: What is the background for this study?
Response: Dilated cardiomyopathy (DCM) is a disease characterized by dilation and dysfunction of the left ventricle of the heart. While DCM is a relatively rare disease in children, nearly 40% of children with DCM require a heart transplant or die within 2 years of diagnosis. Heart transplantation has improved the outcomes of children with DCM over the last 3 decades, but is limited by donor heart availability. Newer therapies, including advanced ICU care and artificial heart machines, are now being used to treat children with DCM.
This study published in the November 28, 2017 issue of the Journal of American College of Cardiology (JACC) sought to determine whether more children with DCM were surviving longer in the more recent era. Specifically, it investigated whether children with DCM were surviving longer without the need for heart transplantation. Rakesh Singh, MD is the first author and an Associate Professor of Pediatrics at UC San Diego/Rady Children’s Hospital, while the senior author is Steven Lipshultz, MD, Professor at Wayne State University School of Medicine/Detroit Medical Center’s Children’s Hospital of Michigan and Director of Children’s Research Center of Michigan.
The Pediatric Cardiomyopathy Registry (PCMR) is a National Heart, Lung, and Blood Institute (NHLBI) sponsored registry from 98 pediatric centers in United States and Canada created to study the outcomes of children with various heart muscle disorders known as cardiomyopathies. For this study, outcomes of 1,199 children diagnosed with DCM from 1990-1999 were compared with 754 children diagnosed with DCM from 2000-2009.
04 Jan ACA Pay-For-Performance Programs Not Living Up To Expectations
Posted at 12:38h
in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Outcomes & Safety
MedicalResearch.com Interview with:
[caption id="attachment_39170" align="alignleft" width="161"]
Dr. Bonfrer[/caption]
Dr. Igna Bonfrer PhD
Post-Doctoral Research Fellow
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One of the two main elements of the Affordable Care Act, generally known as Obama Care, is the implementation of value based payments through so called “pay-for-performance” initiatives. The aim of pay-for-performance (P4P) is to reward health care providers for high-quality care and to penalize them for low-quality care.
We studied the effects of the P4P program in US hospitals and found that the impact of the program as currently implemented has been limited.
04 Jan Stem Cell Transplantation Offers Hope For Severe Scleroderma
MedicalResearch.com Interview with: [caption id="attachment_39161" align="alignleft" width="300"]
Picture of a female patient's left arm, showing skin lesions caused by SclerodermaWikipedia image[/caption] Keith M. Sullivan, M.D. James B. Wyngaarden Professor Of Medicine Division of Cellular Therapy Duke University Medical Center Durham, North Carolina 27710, USA MedicalResearch.com: What is the background for this study? What are the main findings?
- Scleroderma with internal organ involvement is a devastating autoimmune disorder with considerable morbidity and high mortality which have not changed in 40 years of reporting. Effective new therapies are needed.
- Despite 2 prior randomized trials showing benefit for reduced-intensity stem cell transplant vs. conventional cyclophosphamide immune suppression, clinical practice in the US did not change due in part due to concern about patient safety and durability of response (attached).
- The current randomized trial compares 12 monthly infusions of cyclophosphamide with high-dose chemotherapy plus whole-body irradiation designed to wipe-out (myeloablate) the defective, self-reactive immune system and replace with the patients own stem cells which had been treated to remove self-reacting lymphocytes. This was the first study to test if myeloablative autologous could re-establish a normal functioning immune system in patients with scleroderma.
03 Jan Program Improves Sleep For Mothers Hospitalized For Delivery
MedicalResearch.com Interview with:
Kathryn A. Lee, RN, CBSM, PhD
Department of Family Health Care Nursing
University of California at San Francisco
San Francisco, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sleep deprivation can adversely affect health and wellbeing in any patient population.
In pregnancy, adverse outcomes may include preterm birth, longer labor, cesarean birth, and depression.
We found that women with high-risk pregnancies were sleep deprived even prior to hospitalization. Our sample averaged 29 weeks gestation, and half reported getting only between 5 and 6.5 hours of sleep at home before hospital admission. Our sleep hygiene intervention strategies gave them more control over the environment in their hospital room, and they self-reported significantly better sleep than controls. Interestingly, both groups increased their sleep time to almost 7 hours at night, on average, in the hospital before they were discharged home.
03 Jan Even With Preserved Ovaries Hysterectomy Linked To Increased Cardiac and Metabolic Risks
MedicalResearch.com Interview with: [caption id="attachment_39148" align="alignleft" width="166"]
Dr. Laughlin-Tommaso[/caption]
Dr. Shannon Laughlin-Tommaso MD
Associate Professor of Obstetrics and Gynecology
Consultant, Division of Gynecology, Department of Obstetrics & Gynecology
Mayo Clinic, Rochester New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy.
We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure.
02 Jan Program Encouraging Shared Bookreading Improved Vocabulary, Memory and IQ
MedicalResearch.com Interview with: [caption id="attachment_21334" align="alignleft" width="120"]
Dr. Weislander[/caption]
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.
01 Jan Phase I Study Successfully Targets Metastatic Kidney Cancer
Posted at 15:42h
in ASCO, Author Interviews, Cancer Research, Journal Clinical Oncology, Kidney Disease, UT Southwestern
MedicalResearch.com Interview with:
[caption id="attachment_39124" align="alignleft" width="100"]
Dr. Courtney[/caption]
Kevin D. Courtney, M.D., Ph.D.
Assistant Professor
UT Southwestern Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Clear cell renal cell carcinoma (ccRCC) is the most common form of kidney cancer. Metastatic ccRCC does not respond to traditional chemotherapy.
Current standard treatments for metastatic ccRCC include drugs called vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) that block the growth of new blood vessels that feed the cancer, as well as drugs that inhibit an enzyme called mTOR that is involved in ccRCC growth and immune therapies that rev up the body’s immune response to try to fight the cancer. Each of these treatments can have significant side effects for patients that can make them difficult to tolerate.
Metastatic ccRCC is largely incurable, and we need novel and better-tolerated treatments. A central driver of ccRCC is a protein called hypoxia inducible factor 2alpha (HIF-2alpha). This protein has been very difficult to try to target with a drug. This study is the first to test a drug that targets HIF-2alpha in patients with metastatic ccRCC. The study results showed that the HIF-2alpha inhibitor, PT2385 (Peloton Therapeutics) was active in fighting metastatic ccRCC and was well-tolerated.
01 Jan Hypoglycemia All Too Common In Hospice and End of Life Care
Posted at 13:51h
in Author Interviews, Brigham & Women's - Harvard, Diabetes, End of Life Care, JAMA
MedicalResearch.com Interview with:
Dr. Laura A. Petrillo MD
Instructor in Medicine
Harvard Medical School, and Palliative Care Physician
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hospice is end-of-life care focused on maximizing quality of life. Hospice often involves reducing or stopping treatments that are unlikely to have short-term benefit in order to avoid uncomfortable side effects. About a quarter of Americans die in nursing homes, and some of them receive hospice care in their final days. We looked at whether adults with type 2 diabetes experience low blood sugar while on hospice in veterans’ nursing homes, since low blood sugar signals inappropriately aggressive diabetes treatment in patients close to death and contributes to unnecessary discomfort.
We found that one in nine people experienced low blood sugar at least once while receiving hospice care. Among people who were on insulin, the number was one in three.