Author Interviews, Lancet, Multiple Sclerosis, Neurological Disorders, Pharmacology / 12.02.2017

MedicalResearch.com Interview with: [caption id="attachment_31938" align="alignleft" width="147"]Tomas Kalincik, MD, PhD, PGCertBiostat Neurologist and Senior Research Fellow Melbourne Brain Centre | Department of Medicine | University of Melbourne Department of Neurology | Royal Melbourne Hospital Melbourne | Victoria | Australia Dr. Tomas Kalincik[/caption] Tomas Kalincik, MD, PhD, PGCertBiostat Neurologist and Senior Research Fellow Melbourne Brain Centre | Department of Medicine | University of Melbourne Department of Neurology | Royal Melbourne Hospital Melbourne | Victoria | Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multiple sclerosis is a disease predominantly of young adults, with the peak of incidence in the 3rd and 4th decades. It is the most common cause of neurological disability in young adults. Only in Australia, 23,000 people are living with MS, with MS representing an annual cost of almost 1 billion $AU to the Australian society. It is a disease that presents with broad range of neurological symptoms and signs, which are typically temporary (these are called relapses) that with time can lead to permanent neurological disability. While there is currently no cure for MS, with appropriate therapy, its symptoms can be controlled and the disability progression slowed down.
Author Interviews, Lancet, Lipids, Thromboembolism / 21.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31414" align="alignleft" width="133"]Setor Kunutsor BSc MD MPhil(cantab) PhD(cantab) Research Fellow/Epidemiologist Musculoskeletal Research Unit University of Bristol School of Clinical Sciences Learning & Research Building (Level 1) Southmead Hospital Dr. Setor Kunutsor[/caption] Setor Kunutsor BSc MD MPhil(cantab) PhD(cantab) Research Fellow/Epidemiologist Musculoskeletal Research Unit University of Bristol School of Clinical Sciences Southmead Hospital MedicalResearch.com: What is the background for this study? Response: Statins are well established for the prevention of cardiovascular disease and this is based on their ability to lower levels of circulating lipids in the blood. However, statins are also known to have pleotropic effects and these include potential protective effects on multiple disease conditions. Based on their anti-inflammatory and antithrombotic properties, there have been suggestions that statins may prevent venous thromboembolism (VTE) (which comprises of pulmonary embolism and deep vein thrombosis). The evidence is however uncertain. Several studies utilizing both observational cohort and randomized controlled designs have been conducted to evaluate whether statin therapy or use is associated with a reduction in the incidence of VTE, but the results have been inconclusive. In a recent review that was published in 2012, Rahimi and colleagues pooled the results of several randomized controlled trials (RCTs), but found no significant reduction in the risk of VTE with statin therapy [REF]. Given the publication of new studies since this study was published and the existing uncertain evidence on the effect of statins on VTE, we decided it was time to bring all the evidence together and evaluate if statin therapy really did have a protective effect on the risk of venous thromboembolism.
Author Interviews, Lancet, Prostate Cancer / 20.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31606" align="alignleft" width="200"]Dr. Nina Klemann MD, PhD-student Copenhagen Prostate Cancer Center Copenhagen Dr. Nina Klemann[/caption] Dr. Nina Klemann MD, PhD-student Copenhagen Prostate Cancer Center Copenhagen MedicalResearch.com: What is the background for this study? Response: For 30 years, ultrasound-guided biopsies of the prostate have been used in the evaluation of men suspected for prostate cancer. The biopsy needles are employed systematically into the prostate at different sites where prostate cancer is typically present. However, it has been recognized for years, that there is a risk of not hitting the cancer areas, simply by chance. Although cancer diagnosis may be missed in the initial biopsy set by sampling error, it has been a continuous debate whether lethal prostate cancer is missed. Today, we know that prostate cancer is a common finding in men age 50-80, but that the life-time risk of prostate cancer death in this age-group is low. Consequently, we know that there is a considerable risk of diagnosing, and ultimately treating, a disease that will never result in symptoms or death.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Lancet, Medical Imaging, MRI, Social Issues / 12.01.2017

MedicalResearch.com Interview with: [caption id="attachment_31180" align="alignleft" width="135"]Dr Ahmed Tawakol MD Massachusetts General Hospital and Harvard Medical Schoo Dr Ahmed Tawakol[/caption] Dr Ahmed Tawakol MD Co-Director, Cardiac MR PET CT Program Massachusetts General Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While the link between stress and heart disease has long been established, the mechanism mediating that risk hasn’t been clearly understood. Animal studies showed that stress activates bone marrow to produce white blood cells, leading to arterial inflammation.  This study suggests an analogous path exists in humans. Moreover, this study identifies, for the first time in animal models or humans, the region of the brain (the amygdala) that links stress to the risk of heart attack and stroke. The paper reports on two complementary studies. The first analyzed imaging and medical records data from almost 300 individuals who had PET/CT brain imaging, primarily for cancer screening, using a radiopharmaceutical called FDG that both measures the activity of areas within the brain and reflects inflammation within arteries.  All participants in that study had no active cancer or cardiovascular disease at the time of imaging and each had information in their medical records on at least three additional clinical visits after imaging. The second study enrolled 13 individuals with a history of post-traumatic stress disorder, who were evaluated for their current levels of perceived stress and received FDG-PET scanning to measure both amygdala activity and arterial inflammation.
Author Interviews, Lancet, Pediatrics, Surgical Research, Weight Research / 10.01.2017

MedicalResearch.com Interview with: Dr Thomas H. Inge MD University of Colorado Denver School of Medicine Aurora, CO 80045 MedicalResearch.com: What is the background for this study? Response: Gastric bypass surgery helps severely obese teenagers lose weight and keep it off, according to the first long term follow up studies of teenagers who had undergone the procedure 5-12 years earlier. However, the studies show some patients will need further surgery to deal with complications or may develop vitamin deficiencies later in life, according to two studies published in The Lancet Diabetes & Endocrinology. Severe obesity is classified as having a BMI of 40 or over (around 100 pounds overweight) and affects around 4.6 million children and teenagers in the USA. It causes ill health, poor quality of life and cuts life expectancy. The studies are the first to look at long-term effects of gastric bypass surgery in teenagers. Until now, it has been unclear how successful the surgery is in the long-term and whether it can lead to complications. Thousands of teenagers are offered surgical treatment each year.
Author Interviews, Lancet, Pediatrics, Surgical Research, Weight Research / 07.01.2017

MedicalResearch.com Interview with: Dr Torsten Olbers PhD Department of Gastrosurgical Research Institute of Clinical Sciences University of Gothenburg, Sahlgrenska University Hospital Gothenburg Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background to study was the lack of effective treatments for adolescents with severe obesity and the observation that many adults undergoing gastric bypass regret that they didn't´t do it earlier. The medical indication is to hopefully prevent development of diseases and organ damage due to cardiovascular risk factors and to enable them to have normalised psychosocial development (education, relation etc). In fact most of the adolescents undergoing surgery had parents having undergone surgery.
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Environmental Risks, Lancet / 05.01.2017

MedicalResearch.com Interview with: [caption id="attachment_30933" align="alignleft" width="150"]Hong Chen, PhD Scientist, Environmental Health Assessment Public Health Ontario | Santé publique Ontario Assistant Professor, Dalla Lana School of Public Health, University of Toronto Adjunct Scientist, Institute for Clinical Evaluative Sciences (ICES) Toronto, ON Dr. Hong Chen[/caption] Hong Chen, PhD Scientist, Environmental Health Assessment Public Health Ontario | Santé publique Ontario Assistant Professor, Dalla Lana School of Public Health University of Toronto Adjunct Scientist, Institute for Clinical Evaluative Sciences Toronto, ON MedicalResearch.com: What is the background for this study? Response: Over the past several decades, there is unequivocal evidence that living close to major roadways may lead to various adverse health outcomes, such as cardio-respiratory related mortality and mortality. In the past decade, concern is growing that exposures associated with traffic such as air pollution and noise may also have an adverse impact on brain health. Several experimental studies show that air pollutants and diesel exhaust induce oxidative stress and neuroinflammation, activate microglia (which act as the first and main form of immune defense in the central nervous system), and stimulate neural antibodies. There are also a small number of epidemiological studies linking traffic-related noise and air pollution to cognitive decline and increased incidence of Parkinson’s disease and Alzheimer’s disease. Studies also showed that living near roads was associated with reduced white matter hyperintensity volume and cognition, but its effect on the incidence of dementia, Parkinson’s disease, and multiple sclerosis is unknown. Given hundreds of millions of people worldwide live close to major roads, we conducted this population-based cohort study to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada.
Author Interviews, Kaiser Permanente, Lancet, Pediatrics, Weight Research / 29.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30846" align="alignleft" width="150"]De-Kun Li, MD, PhD Senior Research Scientist Division of Research Kaiser Foundation Research Institute Kaiser Permanente Oakland, CA 94612 Dr. De-Kun Li,[/caption] De-Kun Li, MD, PhD Senior Research Scientist Division of Research Kaiser Foundation Research Institute Kaiser Permanente Oakland, CA 94612 MedicalResearch.com: What is the background for this study? Response: The composition of gut microbia (microbiome) has emerged as a key contributor to human disease risk. The external influence on the composition of microbiome in early childhood, especially in infancy, has been linked to increased risk of childhood obesity. Several studies have examined use of antibiotics in infancy and reported an association between use of antibiotics and increased risk of childhood obesity. This has caused a great uncertainty among both pediatricians and parents regarding treatment of infant infections. However, the previous studies failed to separate the effect of underlying infections for which antibiotics were used from the effect of the antibiotics itself. The contribution of our study was to examine the effects of infections and antibiotic use separately.
Addiction, Author Interviews, Hepatitis - Liver Disease, Lancet / 27.12.2016

MedicalResearch.com Interview with: Naveed Zafar Janjua, MBBS, MSc, DrPH Senior Scientist, Clinical Prevention Services BC Centre for Disease Control Clinical Associate Professor, School of Population and Public Health University of British Columbia MedicalResearch.com: What is the background for this study? Response: Hepatitis C is a viral infection that affects the liver. About quarter of people infected with hepatitis C clear their infection spontaneously rest develop chronic infection. Left untreated, hepatitis C could results in scarring of liver (liver cirrhosis), liver cancer or death. New anti-viral drugs are highly effective in curing hepatitis C, about than 95 per cent of those treated can be cured. However, people who engage in high risk activities such as people who inject drugs (PWID) remain at risk of reinfection. As the cost of treatment is very high, re-infection is a concern among physicians and policy makers in Canada and around the world.
Author Interviews, Immunotherapy, Lancet, Lung Cancer / 23.12.2016

MedicalResearch.com Interview with: Dr Kiyotaka Yoh Department of Thoracic Oncology National Cancer Center Hospital East Kashiwa, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: LURET is multicenter, single-arm, phase II study to evaluate the efficacy and safety of vandetanib as RET inhibitor in patients with advanced RET-rearranged non-small-cell lung cancer (NSCLC). In 2012, RET rearrangements were identified as rare oncogenic alterations for NSCLC. Among 17 eligible patients included in primary analysis, the objective response rate was 53% (95% CI 28–77), which met the primary endpoint. At the data cutoff, median progression-free survival was 4.7 months (95% CI 2.8–8.5). Overall, vandetanib was tolerated, with an adverse event profile similar to those seen in previous large population studies of vandetanib in patients with unselected NSCLC.
Author Interviews, Lancet, OBGYNE, Surgical Research / 22.12.2016

MedicalResearch.com Interview with: Dr Rachael Wood PhD Consultant in Public Health Medicine - women and children's health NHS National Services Scotland Information Services Division Edinburgh MedicalResearch.com: What is the background for this study? Response: Mesh surgery for female stress urinary incontinence and pelvic organ prolapse is currently controversial. Mesh surgery was introduced to overcome recognised limitations of traditional, non-mesh, surgery for these conditions, in particular extensive surgery and long hospital stays for incontinence and high failure/recurrence rates for prolapse. Mesh surgery may therefore offer additional benefits over traditional surgery. Mesh surgery may also carry additional risks however, with patient advocacy groups highlighting cases of severe, long term, mesh-related complications in some women who have undergone mesh surgery. We therefore used routinely available, population based hospital discharge records from Scotland to identify women having mesh and non-mesh procedures for incontinence and prolapse. We then followed the women up for up to 5 years to assess how often they were readmitted for complications or further incontinence or prolapse surgery.
Author Interviews, Lancet, Prostate Cancer / 22.12.2016

MedicalResearch.com Interview with: Prof Mark Emberton UCL Faculty of Medical Sciences London MedicalResearch.com: What is the background for this study? What are the main findings? Response: The key driver was a desire to come up with a treatment for men with localised prostate cancer that was better tolerated that the traditional options. The intervention is a combination of padeliporphin, a short acting photosensitiser which was developed by Drs Shertz and Salomon at the Weismann Institute. This is activated by a laser inserted into the prostate.
Author Interviews, Genetic Research, Lancet, Pediatrics, Schizophrenia / 22.12.2016

MedicalResearch.com Interview with: Dr Lucy Riglin Division of Psychological Medicine and Clinical Neurosciences MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University School of Medicine Cardiff UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a mental disorder that usually occurs after puberty. However, previous research suggests that individuals who go on to develop schizophrenia often presented cognitive, social, behavioural, and emotional impairments in childhood. Our study found that, in a general population sample, genetic risk for schizophrenia was associated with these childhood impairments as early as age 4 years.
Author Interviews, Gender Differences, Lancet, OBGYNE, Surgical Research / 21.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30694" align="alignleft" width="140"]Prof. Cathryn Glazener PhD Health Services Research Unit University of Aberdeen Aberdeen,UK Prof. Cathryn Glazener[/caption] Prof. Cathryn Glazener PhD Health Services Research Unit University of Aberdeen Aberdeen,UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prolapse is a condition that affects up to half of all women after childbirth. Women notice a bulge or discomfort in their vaginas due to pressure from the bladder, bowel or womb moving downwards. Women who have surgery for their prolapse have a 3 in 10 chance of needing at least one more operation, so the success rate is not great. Gynaecologists hoped that by reinforcing their repairs the success rate would get better. PROSPECT was a pragmatic, multicentre randomised controlled trial conducted in 35 centres across the UK. Women undergoing their first operation for prolapse were randomised to having a standard repair of the front or back wall of the vagina, or a repair reinforced by synthetic non-absorbable mesh, or a biological graft. We found that, in contrast to previous research, women were just as likely to be cured after standard surgery rather than reinforced repairs. They were just as likely to have other symptoms such as bladder or sexual problems, and other adverse effects such as infection, bleeding or pain. However, about 1 in 10 of the women who had mesh did have mesh exposure when a small portion of the mesh becomes visible through the vaginal wall. Although many women did not have symptoms, about half of those women needed a small operation to remove or bury the exposed mesh.
Author Interviews, Lancet, Outcomes & Safety, Thromboembolism, Transfusions / 28.11.2016

MedicalResearch.com Interview with: Mary A.M. Rogers, PhD, MS Research Associate Professor Research Director, Patient Safety Enhancement Program Department of Internal Medicine University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: Peripherally inserted central catheters (PICCs) are commonly used for vascular access in hospitalized patients. Previous studies have shown that PICCs of larger gauge (diameter) increase the risk of developing venous thromboembolism (blood clots in the deep veins that sometimes travel to the lung). Red blood cell transfusion is also known to increase the risk of venous thromboembolism. Because PICCs are often used to transfuse blood, we designed a study to investigate whether the method of transfusion delivery influences the risk of developing venous thromboembolism.
Author Interviews, Kidney Disease, Lancet, Transplantation / 28.11.2016

MedicalResearch.com Interview with: Prof. Dr. med. Christian Hugo Head, Division of Nephrology Medical Clinic III Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden Dresden MedicalResearch.com: What is the background for this study? Response: At the end of 2007, the harmony trial was designed predominantly based on the one year results of the ELITE-Symphony trial, demonstrating that low dose tacrolimus, mycophenolate mofetile, and steroids together with monoclonal interleukin-2-receptor (CD 25 antigen) antibody induction therapy has superior efficacy in renal transplant patients compared to all other regimens (low or normal dose cyclosporine or sirolimus) tested. While these advantages of the low dose tacrolimus protocol were so convincing to become the new gold standard of immunosuppressive therapy within the next few years (see KDIGO guide lines for renal transplantation in 2009), the low dose tacrolimus treatment arm also demonstrated increased incidence rates regarding post-transplantation diabetes mellitus (PTDM, at that time called new onset of diabetes after transplantation - NODAT) compared to the low cyclosporine treatment arm. Previous studies had also demonstrated a detrimental association between NODAT and cardiovascular events and mortality, the leading cause of death in renal transplant recipients. Corticosteroid-free or rapid withdrawal regimens were relatively encouraging regarding influencing NODAT rates but only at the price of an increased rate of T cell mediated acute rejections.
Author Interviews, Lancet, Primary Care, Weight Research / 26.10.2016

MedicalResearch.com Interview with: [caption id="attachment_29164" align="alignleft" width="200"]Paul Aveyard PhD MRCP FRCGP FFPH Professor of Behavioural Medicine Nuffield Department of Primary Care Health Sciences University of Oxford Radcliffe Primary Care Building Radcliffe Observatory Quarter Oxford Prof. Paul Aveyard[/caption] Paul Aveyard PhD MRCP FRCGP FFPH Professor of Behavioural Medicine Nuffield Department of Primary Care Health Sciences University of Oxford Radcliffe Primary Care Building Radcliffe Observatory Quarter Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that opportunistic brief interventions by physicians can be effective, but there is no evidence that they are so for obesity. Physicians worry that broaching this topic will be offensive, time-consuming, and ineffective. We needed a randomised trial to assess whether physicians’ fears were justified, or in fact brief interventions could be as effective for patients who are overweight as they are for smoking or problem drinking and that’s what we did.
Author Interviews, Autism, Education, Lancet, Pediatrics / 26.10.2016

MedicalResearch.com Interview with: [caption id="attachment_29156" align="alignleft" width="133"]Prof. Tony Charman Chair in Clinical Child Psychology King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) Department of Psychology PO77, Henry Wellcome Building De Crespigny Park Denmark Hill London Prof. Tony Charman[/caption] Prof. Tony Charman Chair in Clinical Child Psychology King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) Department of Psychology PO77, Henry Wellcome Building De Crespigny Park Denmark Hill London MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is a follow-up of a treatment trial on which we have previous reported. In the original Preschool Autism Communication Trial (PACT), 152 children aged 2-4 with autism were randomised to receive the 12 month early intervention or treatment as usual. The type of early intervention used in this study focuses specifically on working with parents. Through watching videos of themselves interacting with their child and receiving feedback from therapists, parents are able to enhance their awareness and response to their child’s unusual patterns of communication; they become better able to understand their child and communicate back appropriately in a focused way. Parents take part in 12 therapy sessions over 6 months, followed by monthly support sessions for the next 6 months. In addition, parents agree to do 20-30 minutes per day of planned communication and play activities with the child. The study published today is the follow-up analysis of the same children approximately 6 years after the end of treatment. The main findings are that children who had received the PACT intervention aged 2-4 had less severe overall symptoms six years later, compared to children who only received ’treatment as usual’ (TAU) with improved social communication and reduced repetitive behaviours, although no changes were seen in other areas such as language or anxiety. These findings on an international recognised and blind rated observational measure of autism symptoms were accompanied by improvements in children’s communication with their parents for the intervention group, but no differences in the language scores of children. Additionally, parents in the intervention group reported improvements in peer relationships, social communication and repetitive behaviours. However, there was no significant difference between the two groups on measures of child anxiety, challenging behaviours (eg, conduct/oppositional disorder) or depression.
Author Interviews, Lancet, Orthopedics, Stem Cells / 21.10.2016

MedicalResearch.com Interview with: [caption id="attachment_29027" align="alignleft" width="100"]Professor Ivan Martin, PhD Department of Surgery and Department of Biomedicine University Hospital Basel University of Basel, Basel, Switzerland Prof. Ivan Martin[/caption] Professor Ivan Martin, PhD Department of Surgery and Department of Biomedicine University Hospital Basel University of Basel Basel, Switzerland MedicalResearch.com: What is the background for this study and new use of autologous nasal chondrocytes? Response: We previously demonstrated that nasal chondrocytes, harvested from the nasal septum, have a larger and more reproducible capacity to form new cartilage than articular chondrocytes, harvested from the knee joint. We further established that the cartilage tissue generated by nasal chondrocytes can respond to physical forces (mechanical loads) similar to articular cartilage and has the ‘plasticity’ to adapt to a joint environment, since it efficiently integrated with surrounding articular cartilage when implanted in goat joints. This was the rationale for using nasal chondrocytes for articular cartilage repair.
Author Interviews, Endocrinology, Lancet, Toxin Research / 18.10.2016

MedicalResearch.com Interview with: Teresa Attina, MD, PhD Research Scientist NYU Langone School of Medicine Department of Pediatrics New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endocrine-disrupting chemicals (EDCs) have been recently documented to contribute substantially to disease and dysfunction in the European Union (EU), with an annual estimated cost of €163 billion, corresponding to 1.28% of EU Gross Domestic Product. Our current study documents even greater annual costs in the US, $340 billion, corresponding to 2.33% of US GDP. These findings speak to the large health and economic benefits to regulating EDCs, which should be weighed against the cost of safer alternatives. The different costs between the EU and the US are due to different exposure levels to EDCs, and policy predicts exposure. US costs are higher mainly because of the widespread use of brominated flame retardants in furniture, whereas Europe restricted its use in 2008. Americans have much higher levels, such that the average American has a serum level of these chemicals that would be in the top 5% of Europeans. As a result, children born to pregnant women have lower IQs, such that more children suffer from intellectual disability. On the other hand, in Americans, levels of certain pesticides in foods are much lower due to the Food Quality Protection Act, which requires additional safety thresholds to protect pregnant women and children from exposure. The costs of pesticide exposures in the US were much lower ($12.6 billion) compared to Europe ($121 billion) because fewer children suffer loss of IQ as a result.
Author Interviews, Infections, Lancet / 17.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28922" align="alignleft" width="180"]John Penders PhD Assistant professor Dept. of Medical Microbiology Maastricht University, Maastricht Dr. John Penders[/caption] John Penders PhD Assistant professor Dept. of Medical Microbiology Maastricht University, Maastricht MedicalResearch.com: What is the background for this study? Response: Antimicrobial resistance (AMR) constitutes an increasingly important human health hazard worldwide. Especially, the rapid emergence and global spread of multidrug resistant Enterobacteriaceae is worrisome. These bacteria often produce enzymes like extended-spectrum beta-lactamases (ESBLs) and carbapenemases, which inactivate most beta-lactam antibiotics, and are often co-resistant to multiple other antibiotic classes. Consequently, treatment options for infections with multidrug resistant Enterobacteriaceae are limited. The prevalence of antimicrobial-resistant bacteria is generally higher in low and middle income countries as a result of inappropriate use of antimicrobial agents, overcrowding and lack of hygiene and infection control measures. The exponential increase of international travel to such endemic areas may substantially contribute to the emergence and spread of AMR as it allows resistant bacteria to be rapidly transported between regions. Indeed several previous studies had already indicated that international travel is a major risk factor for colonisation with ESBL-producing Enterobacteriaceae. However, many questions remained unanswered, such as the travel destinations and potential risk-behaviour that provide the highest risk for colonisation, how long travellers remain colonised after they return and whether they can transmit these resistant bacteria to other people within their household once they returned from their travel. That is why we initiated the largest prospective study on the acquisition and spread of multidrug resistant bacteria in returning travellers. This multicenter study, conducted by Maastricht University Medical Center, Erasmus University Medical Center, Academic Medical Center Amsterdam, Havenziekenhuis and Utrecht University, included 2,001 travellers and 215 household members. Fecal samples of these participants were collected before and immediately after travel as well as 1, 3, 6 and 12 months after travel return and screened for the prescence of multidrug resistant Enterobacteriaceae. Moreover, extensive information on demographics, travel details, illnesses and behaviour were collected at all follow-up moments by repeated questionnaires.
Author Interviews, Duke, Exercise - Fitness, Lancet / 06.10.2016

MedicalResearch.com Interview with: Aarti Sahasranaman, PhD Duke-NUS Gradaute Medical School Singapore MedicalResearch.com: What is the background for this study? Response: More than half of adults in developed countries do not achieve recommended levels of physical activity. Despite the popularity of activity trackers as a tool for motivating and monitoring activity levels, little research exists on whether they can help people lead healthier lives, or if financial incentives could encourage people to wear them for longer and achieve higher fitness levels. One in ten US adults owns an activity tracker but research suggests that about a third of people abandon them within 6 months of purchase.
Author Interviews, Cancer Research, Cognitive Issues, Education, Lancet, Leukemia, Mental Health Research, Pediatrics / 04.10.2016

MedicalResearch.com Interview with: Yin Ting Cheung, PhD Department of Epidemiology and Cancer Control and Noah D Sabin, MD Department of Diagnostic Imaging St Jude Children's Research Hospital Memphis, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) who are treated with high-dose intravenous methotrexate or intrathecal chemotherapy are at risk for neurocognitive impairment, particularly in cognitive processes such as processing speed, attention and executive function. However, many children who receive these therapies do not experience significant impairments, suggesting the need for biomarkers to identify patients at greatest risk. Prior research from our team demonstrated that, during chemotherapy, patients were at risk for white matter changes in the brain, also known as leukoencephalopathy. No studies documented the persistence or impact of brain leukoencephalopathy in long-term survivors of childhood ALL treated on contemporary chemotherapy-only protocols. In this study, we included prospective neuroimaging from active therapy to long-term follow-up, and comprehensive assessment of brain structural and functional outcomes in long-term survivors of ALL treated with contemporary risk-adapted chemotherapy. We demonstrated that survivors who developed leukoencephalopathy during therapy displayed more neurobehavioral problems at more than 5 years post-diagnosis. Moreover, these survivors also had reduced white matter integrity at long-term follow-up, and these structural abnormalities were concurrently associated with the neurobehavioral problems.
Author Interviews, Health Care Systems, Lancet, Mayo Clinic / 03.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28502" align="alignleft" width="166"]Colin P. West, MD, PhD, FACP  Divisions of General Internal Medicine and Biomedical Statistics and Informatics Departments of Internal Medicine and Health Sciences Research Mayo Clinic Dr. Colin West[/caption] Colin P. West, MD, PhD, FACP Divisions of General Internal Medicine and Biomedical Statistics and Informatics Departments of Internal Medicine and Health Sciences Research Mayo Clinic MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practicing physicians demonstrating burnout rates in excess of 50%. Consequences include negative effects on patient care, professionalism, physicians’ own care and safety, and the viability of health-care systems. We conducted a systematic review and meta-analysis to better understand the quality and outcomes of the literature on approaches to prevent and reduce burnout. We identified 2617 articles, of which 15 randomized trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Across interventions, overall burnout rates decreased from 54% to 44%, emotional exhaustion score decreased from 23.82 points to 21.17 points, and depersonalization score decreased from 9.05 to 8.41. High emotional exhaustion rates decreased from 38% to 24% and high depersonalization rates decreased from 38% to 34%.
Author Interviews, Infections, Lancet, Pediatrics, Surgical Research / 30.09.2016

MedicalResearch.com Interview with: Dr Marjo Renko MD PEDEGO Research Unit University of Oulu Oulu, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: For over a decade there has been suture materials containing antiseptic agent in the market. Trials in adults have shown some possible benefits from these sutures as in some studies they have reduced occurrence of surgical site infections. Only one small study had so far been published in children and thus we decided to carry out a large trial comparing sutures containing triclosan with ordinary ones. Our trial included over 1500 children who came to Oulu University Hospital for surgery. Surgical site infections were carefully monitored. Surgical site infections occurred in 2.6 % of the children who received absorbing sutures containing triclosan while that occurred in 5,4 % of the children who received ordinary sutures.
Author Interviews, Frailty, Geriatrics, Lancet, Technology / 19.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28141" align="alignleft" width="200"]Anat Mirelman, PhD Director- Laboratory of Early Markers of Neurodegeneration (LEMON) Center for the study of Movement , Cognition and Mobility (CMCM) Department of Neurology Tel Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv 64239, Israel Dr. Anat Mirelman[/caption] Anat Mirelman, PhD Director- Laboratory of Early Markers of Neurodegeneration (LEMON) Center for the study of Movement , Cognition and Mobility (CMCM) Department of Neurology Tel Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv 64239, Israel MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main aim of this research was to evaluate the efficacy of using a motor cognitive training using virtual reality in reducing fall frequency and fall risk in older adults. Falls are a leading cause of morbidity and mortality in older adults. The prevalence of falls is huge, with one out of every 3 adults aged 65 years or older will fall at least once per year, with approximately half of these fallers suffering multiple falls in this period . These statistics are even higher in neurodegenerative conditions such as in Parkinson’s disease and in people with cognitive impairments. For example, studies have shown that as much as 80% of people with Parkinson’s disease fall each year. So many older adults are falling. The consequences of falls are huge. The most dramatic result is hip fracture. But this is relatively rare. However, even in the absence of a fracture or other injury, falls often lead to fear of falling, social isolation, and depression, which in turn often leads to inactivity, muscle weakness, impaired balance and gait, more falls, more social isolation. In other words, falls often start a vicious cycle, which has many important negative health consequences. Falls are associated with morbidity and mortality and they also have a huge economic impact. In many western countries, 1-2% of healthcare dollars are spent on falls. For many years, age-associated changes in muscle strength, balance and gait were viewed as the key factors that contribute to the risk of falls. However, more recently, we and others showed that certain aspects of cognition are also critical to safe ambulation. For example people with AD often fall, almost to the same amount as people with PD, highlighting the cognitive component of falls. This makes sense intuitively if we Imagine the cognitive skills we need just to cross a busy intersection. These tasks require executive function, specially, planning, the ability to avoid obstacles, and the ability to perform two or more tasks at the same time.
Author Interviews, Cannabis, Lancet, NIH / 06.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27683" align="alignleft" width="125"]Dr. Wilson Compton MD, Deputy Director National Institute on Drug Abuse Dr. Wilson Compton[/caption] Dr. Wilson Compton MD, Deputy Director National Institute on Drug Abuse MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study found that overall past year marijuana use by adults in the U.S. increased by more than 30% in the past dozen years, and 10 million more people were using marijuana in 2014 than in 2002. Use of marijuana on a daily (or near daily) basis increased even more markedly. In 2002, 3.9 million adults in the U.S. reported using marijuana daily or nearly every day, and the number more than doubled to 8.4 million by 2014. Along with this increase in use, we found that U.S. adults perceptions of the potential harms from using marijuana greatly decreased. Despite scientific evidence of potential harms, adults are much less convinced about dangers associated with using marijuana. These reductions in perceived harm were strongly associated with the increases in use.
Anemia, Author Interviews, Hematology, Lancet, Surgical Research / 02.09.2016

MedicalResearch.com Interview with: Alhossain A. Khalafallah, Clinical Professor Menzies Institute for Medical Research, University of Tasmania, Australia Consultant Haematologist Launceston General Hospital Australia MedicalResearch.com: What is the background for this study? Response: There are limited data regarding the effect of postoperative anemia on patient’s outcomes. The issue of postoperative anemia was noticeably to affect a large cohort of patients world-wide. This study was aiming at comparing the new approach with a single ferric carboxymaltose infusion versus standard or routine usual care for management of postoperative anemia.
Asthma, Author Interviews, Lancet, Pediatrics / 01.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27559" align="alignleft" width="125"]Francine M. Ducharme, MD, FRCPC Professor, Departments of Paediatrics and Social and Preventive Medicine University of Montreal Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine Prof. Francine Ducharme[/caption] Francine M. Ducharme, MD, FRCPC Professor, Departments of Paediatrics and Social and Preventive Medicine University of Montreal Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children. We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma. Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).
Author Interviews, Heart Disease, Lancet, Surgical Research / 31.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27529" align="alignleft" width="125"]Prof Lars Wallentin, MD PHD Senior Professor Cardiology, Senior Scientist Cardiology Uppsala Clinical Research Center, Uppsala University Prof. Lars Wallentin[/caption] Prof Lars Wallentin, MD PHD Senior Professor Cardiology Uppsala Clinical Research Center, Uppsala University  MedicalResearch.com: What is the background for this study? Response: The FRISC2 study was performed 1996 – 1998 and reported 1999 for the first time a significant reduction in death and myocardial infarction by early invasive compared to non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). The results at 6 months, 1, 2 and 5 years were published in The Lancet and pivotal in changing the treatment guidelines and thereby improving outcomes in patients with NSTE-ACS. These findings were within the next few years verified in the TACTICS-TIMI18 and RITA3 trials. However the later performed ICTUS trial, starting after these results were published and accordingly with a substantial early crossover to the invasive arm, showed neutral results. Recently the reduction in event rates by an early invasive strategy was again validated in patients above 80 years of age, which were less well represented in the initial trials. These benefits of an early invasive strategy have previously been shown sustained for at least five years based on results from the FRISC2, RITA3, and ICTUS trials. The FRISC2 and TACTICS-TIMI18 trials also showed that the benefits with an early invasive strategy seemed confined to patients with signs of myocardial necrosis as indicated by elevated troponin level at entry. In addition the FRISC2 trial found that the benefits were larger in patients with signs of inflammatory activity as indicated by a high level of growth differentiation factor 15 (GDF-15) at entry. These pivotal results have been the basis for the current international treatment guidelines recommending an early invasive treatment strategy in patients with NSTE-ACS and elevated troponin and/or other indicators of a raised risk.