Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, JAMA / 27.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30798" align="alignleft" width="133"]Dr. Dong W. Chang, MD MS</strong> Division of Respiratory and Critical Care Physiology and Medicine Los Angeles Biomed Research Institute at Harbor-University of California Los Angeles, Medical Center Torrance California Dr. Dong Chang[/caption] Dr. Dong W. Chang, MD MS Division of Respiratory and Critical Care Physiology and Medicine Los Angeles Biomed Research Institute at Harbor-University of California Los Angeles, Medical Center Torrance California MedicalResearch.com: What is the background for this study? Response: The study was based on our overall impression that ICU care is often delivered to patients who are unlikely to derive long-term benefit (based on their co-morbidities/severity of illness, etc.). However, what surprised us was the magnitude of this problem. Our study found more than half the patients in ICU at a major metropolitan acute-care hospital could have been cared for in less expensive and invasive settings.
Author Interviews, Cancer Research, Immunotherapy, Nature, Technology, University of Michigan / 27.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30791" align="alignleft" width="168"]James Moon, PhD John Gideon Searle Assistant Professor University of Michigan Dept. of Pharmaceutical Sciences and Biomedical Engineering Biointerfaces Institute Ann Arbor, MI, 48109 Dr. James Moon[/caption] James Moon, PhD John Gideon Searle Assistant Professor University of Michigan Dept. of Pharmaceutical Sciences and Biomedical Engineering Biointerfaces Institute Ann Arbor, MI, 48109 MedicalResearch.com: What is the background for this study? Response: The field of cancer immunotherapy has recently made a breakthrough with the clinical success of immune checkpoint inhibitors, which work by removing the brakes on immunosuppressed T-cells. However, these approaches generally work by augmenting pre-existing T-cell immunity and benefit only a subset of patients. In addition, because the majority of somatic mutations in cancer cells are unique to each patient, cancer immunotherapy may benefit from a personalized approach.
Author Interviews, Hospital Readmissions, JAMA, Yale / 27.12.2016

MedicalResearch.com Interview with: Nihar R. Desai, MD, MPH Assistant Professor of Medicine Section of Cardiovascular Medicine, Yale School of Medicine Center for Outcomes Research and Evaluation Yale New Haven Health System MedicalResearch.com: What is the background for this study? Response: Reducing rates of readmissions after hospitalization has been a major focus for patients, providers, payers, and policymakers because they reflect, at least partially, the quality of care and care transitions, and account for substantial costs. The Hospital Readmission Reduction Program (HRRP) was enacted under Section 3025 of the Patient Protection and Affordable Care Act (ACA) in March 2010 and imposed financial penalties beginning in October 2012 for hospitals with higher than expected readmissions for acute myocardial infarction (AMI), congestive heart failure (HF), and pneumonia among their fee-for-service Medicare beneficiaries. In recent years, readmission rates have fallen nationally, and for both target (AMI, HF, pneumonia) and non-target conditions. We were interested in determining whether the Hospital Readmission Reduction Program (HRRP) associated with different changes in readmission rates for targeted and non-targeted conditions for penalized vs non-penalized hospitals?
Asthma, Author Interviews, BMJ, Nutrition / 26.12.2016

MedicalResearch.com Interview with: Zhen LI, MD, MPH, PhD Candidate INSERM UMR-S 1168 (ex-Equipe 5 du CESP) (VIMA : Aging and chronic diseases. Epidemiological and public health approaches.), Hôpital Paul Brousse France MedicalResearch.com: What is the background for this study? What are the main findings? Response: -Cured meat, which is rich in nitrite, has been known as a probable carcinogen. However, although some studies have suggested a potential deleterious role of cured meat intake in lung health, its role in asthma remained unknown. This study was conducted using data from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA). Using data from 971 participants with seven years' follow-up, we found that participants who ate frequently cured meat, including ham, sausages, and dried sausages, had a high likelihood of having worsening asthma symptoms. The highest likelihood (76% more) was observed among participants who ate cured meats four or more servings per week, compared with those who ate less than one serving per week. Moreover, as previous studies suggested that obesity is linked to worsening asthma, we used a newly developed method to estimate if this effect was mediated by Body Mass Index (BMI), and we found that overweight/obesity only partly explained the association (14%).
Author Interviews, Blood Pressure - Hypertension, Genetic Research, PLoS, Race/Ethnic Diversity, Social Issues / 25.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30767" align="alignleft" width="132"]Connie J. Mulligan, PhD Professor, Department of Anthropology University of Florida Gainesville, FL Dr. Connie J. Mulligan[/caption] Connie J. Mulligan, PhD Professor, Department of Anthropology University of Florida Gainesville, FL MedicalResearch.com: What is the background for this study? Response: Lance Gravlee (UF Dept of Anthropology, UF Genetics Institute) started this research over 10 years ago. As a cultural anthropologist, Lance uses ethnographic (open-ended questions) interviews and discovered that over half of the participants in our study talked about experiences of discrimination that happened to people close to them. As a geneticist (UF Dept of Anthropology, UF Genetics Institute), I came into the project because I was interested in seeing how genetics and sociocultural stressors, like discrimination, interact. In our project, we look at blood pressure because hypertension is a disease that shows racial disparities and also because it is a complex disease that is caused by both genetic and environmental factors (like discrimination).
Author Interviews, Electronic Records, Genetic Research, Heart Disease, Lipids, Science / 25.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30763" align="alignleft" width="133"]Michael F. Murray MD Geisinger Health System Danville, PA 17822 Dr. Michael Murray[/caption] Michael F. Murray MD Geisinger Health System Danville, PA 17822 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The DiscovEHR cohort was formed as a result of a research collaboration between Geisinger Health System and Regeneron Pharmaceuticals. There are over 50,000 patient participants in the cohort who have volunteered to have their de-identified genomic sequence data linked to their de-identified EHR data for research purposes. We report in this paper findings around the identification of 229 individuals (1:256) with pathogenic or likely pathogenic variants in one of the three genes (LDLR, APOB, PCSK9) associated with Familial Hypercholesterolemia (FH). The study found that these individuals are unlikely to carry a diagnosis of FH and are at risk for early coronary artery disease.
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.
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 22.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30728" align="alignleft" width="153"]Sandra Costa Fuchs, MD, PhD Dr. Sandra Costa Fuchs[/caption] MedicalResearch.com: What is the background for this study? Response: High blood pressure is the worldwide leading cause of cardiovascular disease. It has been estimated that more than 50%, maybe as much as 70%, of cardiovascular diseases are due to hypertension. Approximately 30% among the Brazilian adult population has hypertension and can reach 70% of individuals over 60 years of age. Prehypertension (systolic BP 120–139 or diastolic BP 80–89 mm Hg) conveys three potentially deleterious consequences.
  • First, it substantially increases the risk of developing hypertension.
  • Second, patients with prehypertension have evidence of end-organ damage, such as left ventricular geometric and functional abnormalities.
  • Third, there are evidence that adults with prehypertension are at a substantially higher risk of cardiovascular mortality.
The PREVER-Prevention study aimed to assess the efficacy and safety of a low-dose diuretic versus placebo for the prevention of hypertension and end-organ damage.
Author Interviews, Herpes Viruses, JAMA / 22.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30723" align="alignleft" width="125"]Ann Kurth, Ph.D., C.N.M., R.N. Dr. Ann Kurth[/caption]   MedicalResearch.com: What is the background for this study?  What are the main findings? Genital herpes is a sexually transmitted infection that is caused by one of two subtypes of the herpes simplex virus (HSV-1 and HSV-2). The condition is common in the United States, as the CDC estimates that almost one in six people between the ages of 14 and 49 are afflicted. Unfortunately, there are no good screening tests for herpes and it cannot be cured. After a systematic review of the evidence, the U.S. Preventive Services Task Force determined that, for adolescents and adults who have no signs or symptoms, including pregnant women, the harms of screening for genital herpes outweigh the benefits. These harms include high rates of false-positive screening tests, potential concerns around unnecessary antiviral medication use, and anxiety and relationship issues related to diagnosis. Additionally, the benefits of screening proved small, in part because early identification and treatment do not alter the course of the condition. In the end, due to the lack of benefits in the face of serious harms, the Task Force recommended against routine serologic screening for genital herpes simplex virus (HSV) infection.
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, Immunotherapy, Multiple Sclerosis, NEJM, University Texas / 22.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30711" align="alignleft" width="160"]Jerry S. Wolinsky, MD Emeritus Professor in Neurology McGovern Medical School part of UTHealth | The University of Texas Health Science Center at Houston Houston’s Health University Department of Neurology Houston, Texas 77030 Dr. Jerry Wolinsky,[/caption] Jerry S. Wolinsky, MD Emeritus Professor in Neurology McGovern Medical School The University of Texas Health Science Center at Houston Houston’s Health University Department of Neurology Houston, Texas 77030 MedicalResearch.com: What is the background for this study? Response: Multiple sclerosis (MS) clinically is a very heterogeneous disease. It presents in considerably different ways and has a very poorly predictable clinical course. In an attempt to better communicate between experts in the field, there have been multiple attempts to categorize “typical” courses of the disease. How we think about the disease is in part driven by these somewhat artificial categories that lump our patients into those with relapsing forms of the disease (relapsing remitting with or without accumulating clinical disability, and secondary progressive with accumulating disability eventually occurring even in the absence of apparent clinical episodes of the disease), and primary progressive MS, where patients are slowly or sometimes rather rapidly accumulating disability in the absence of prior clinical relapses. However, the distinctions between multiple sclerosis patients are not always as clear as the definitions would suggest, and it is certain that patients with primary progressive multiple sclerosis sometimes have clinical relapses after years of never having had relapses, and show MRI evidence of having accumulated many lesions in the brain over the course of their disease. Until now, none of the drugs that have shown benefit for relapsing disease have been able to convincingly show clinical benefit for patients with primary progressive disease, and for that matter have shown variable results when attempted in patients categorized as having secondary progressive courses. While some of our currently approved drugs have shown hints of benefit when tried in major clinical trials in primary progressive MS, the results were not been robust enough to seek regulatory approval. The Oratorio study design was based on lessons learned from prior trials in primary progressive and relapsing forms of MS, as well as the recognition that B cells might play an important role in the immunopathogenesis of disease based on a considerable amount of preclinical work and observations in patients with multiple sclerosis.
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, Genetic Research, Nature, Weight Research / 21.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30700" align="alignleft" width="100"]Prof. Jamal Tazi Institut de Génétique Moléculaire de Montpellier University of Montpellier Montpellier, Cedex, France Prof. Jamal Tazi[/caption] Prof. Jamal Tazi Institut de Génétique Moléculaire de Montpellier University of Montpellier Montpellier, Cedex, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Intense drug discovery efforts in the metabolic field highlight the need for novel strategies for the treatment of obesity. In this study we have used a novel approach to uncover novel drugs to treat obesity. Our approach is based on the finding that in humans the energy expenditure balance can be controlled by a single gene LMNA gene that can produce two different proteins with opposing effect on energy expenditure. We identified a molecule ABX300 that targets the expression of LMNA gene and favors energy expenditure leading to fat loss.
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, Brain Injury, JAMA, Pediatrics / 21.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30597" align="alignleft" width="137"]Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON Dr. Roger Zemek[/caption] Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Response: While current concussion protocols endorse the conservative view that children should avoid physical activity until completely symptom-free, there is little evidence beyond expert opinion regarding the ideal timing of physical activity re-introduction. In fact, while rest does play a role in concussion recovery, protracted physical rest may actually negatively impact concussion recovery. Further, physiological, psychological, and functional benefits of early physical rehabilitation are observed in other disease processes such as stroke (which is an example of a severe traumatic brain injury). Therefore, our objective was to investigate the relationship between early physical activity (defined within 7 days of the concussion) and the eventual development of persistent post-concussion symptoms at one month.
Author Interviews, JAMA, Pediatrics / 21.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30599" align="alignleft" width="150"]Eyal Cohen, MD, MSc, FRCP(C) Staff Physician, Paediatrics The Hospital for Sick Children Associate Scientist, Research Institute Child Health Evaluative Sciences Associate Professor, University of Toronto Dr. Eyal Cohen[/caption] Eyal Cohen, MD, MSc, FRCP(C) Staff Physician, Paediatrics The Hospital for Sick Children Associate Scientist, Research Institute Child Health Evaluative Sciences Associate Professor, University of Toronto   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Major structural or genetic congenital anomalies affect approximately 2 percent to 5 percent of all births in the United States and Europe. Mothers of children born with major congenital anomalies face serious challenges such as high financial pressures, as well as the burden of providing care to a child with complex needs within the home setting, which can impair a mother's health. Little is known about the long-term health consequences for the mother. We assessed whether the birth of an infant with a major congenital anomaly was subsequently associated with an increased risk of death of the infant's mother. The population-based study (n = 455,250 women) used individual-level linked Danish registry data for mothers who gave birth to an infant with a major congenital anomaly between 1979 and 2010, with follow-up until December 31, 2014. A comparison group was constructed by randomly sampling, for each mother with an affected infant, up to 10 mothers matched on maternal age, parity (the number of children a woman has given birth to), and year of infant's birth. Mothers in both groups were an average age of 29 years at delivery. After a median follow-up of 21 years, there were 1,275 deaths (1.60 per 1,000 person-years) among 41,508 mothers of a child with a major congenital anomaly vs 10,112 deaths (1.27 per 1,000 person-years) among 413,742 mothers in the comparison group. Mothers with affected infants were more likely to die of cardiovascular disease, respiratory disease, and other natural causes.
Accidents & Violence, Author Interviews, BMJ, Emergency Care, Pediatrics / 21.12.2016

MedicalResearch.com Interview with: Dr Jamie G Cooper Consultant in Emergency Medicine Aberdeen Royal Infirmary Aberdeen UK MedicalResearch.com: What is the background for this study? [caption id="attachment_30632" align="alignleft" width="200"]MedicalResearch.com Interview with: Jamie Cooper Consultant in Emergency Medicine Aberdeen Royal Infirmary Aberdeen MedicalResearch.com: What is the background for this study? Response: Choking in children can be fatal and regularly grapes can be the cause. We believe that public awareness of the choking hazard posed by grapes (and other similarly shaped foods, such as cherry tomatoes) is not wide spread. By publishing this article we aimed to highlight the problem to health professionals who look after children and also to the public at large in an attempt to reduce the number of future episodes. MedicalResearch.com: What are the main findings? Response: With parental consent we published the cases of three small children who suffered choking episodes as a result of whole grapes, two of whom died as a result. In each case it was not possible to dislodge the grape using first aid techniques. MedicalResearch.com: What should readers take away from your report? Response: Small children are at risk from choking because they have smaller airways, reduced ability to chew foods, underdeveloped swallowing coordination and can be easily distracted when eating. Grapes are a healthy and popular snack but are ideally suited to cause airway obstruction, particularly if inhaled whole. Small children (up to 5 years) should always be supervised by adults while eating; and grapes should be halved, or ideally quartered, before consumption. We hope that by drawing attention to this issue that consideration will be given at a political level to wider dissemination of this information so as to prevent further occurrences. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: BMJ The choking hazard of grapes: a plea for awareness Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. More Medical Research Interviews on MedicalResearch.com Grapes
Wikipedia image[/caption] Response: Choking in children can be fatal and regularly grapes can be the cause.  We believe that public awareness of the choking hazard posed by grapes (and other similarly shaped foods, such as cherry tomatoes) is not wide spread.  By publishing this article we aimed to highlight the problem to health professionals who look after children and also to the public at large in an attempt to reduce the number of future episodes.
Annals Internal Medicine, Author Interviews, Hematology, Karolinski Institute / 21.12.2016

MedicalResearch.com Interview with: Märit Halmin, MD, PhD student Department of Medical Epidemiology and Biostatistics, Karolinska Institutet,  Stockholm, Sweden MedicalResearch.com: What is the background for this study? Response: During recent years the possible negative effects among recipients of stored red blood cells have been investigated.  Despite a large number of studies, including four randomized trials, no consensus exists. We therefore performed the hitherto largest register based cohort study of transfused patients, assessing the association between length of storage of red blood cells and mortality. Our design allowed for detection of small but still clinically significant effect, if such exists.
Author Interviews, BMJ, Weight Research / 20.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30676" align="alignleft" width="200"]Igho Onakpoya MD MSc University of Oxford Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health Sciences Oxford UK Dr. Igho Onakpoya[/caption] Igho Onakpoya MD MSc University of Oxford Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health Sciences Oxford UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several medicines used to treat obesity have been withdrawn from the market over the last few years. However, the reasons for, and time trends about their withdrawals have not been systematically researched. We identified 25 anti-obesity medicines withdrawn from the market over the last 50 years. 23 of these analogues of amphetamine or fenfluramine, i.e., neurotransmitters. The reasons for withdrawal in the overwhelming majority of instances were cardiovascular or psychiatric adverse reactions, and drug abuse and dependence.
Author Interviews, Cancer Research, JNCI / 20.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30667" align="alignleft" width="133"]Theodore Brasky, PhD Research Assistant Professor Center of Excellence in Regulatory Tobacco Science Epidemiology College of Public Health The Ohio State University Dr. Theodore Brasky[/caption] Theodore Brasky, PhD The Ohio State University Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a significant amount of data to suggest that long-term, regular use of nonsteroidal anti-inflammatory drugs (NSAIDS; examples include aspirin and ibuprofen) are associated with reduced risks of several cancers. Although the data across studies are inconsistent, one such candidate is endometrial cancer, which is the most common gynecologic cancer. There is good evidence that the use of these medications is associated with improved prognosis among patients diagnosed with colon cancer. Despite the importance of inflammation in endometrial cancer progression, very few have examined whether use of NSAIDs is associated with risk of death or recurrence from the disease. The study we published is the first of its kind to examine NSAID use comprehensively and in a study of over 4,000 patients.
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Hospital Readmissions, JAMA / 20.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30658" align="alignleft" width="180"]Yusuke Tsugawa, MD, MPH, PhD Department of Health Policy and Management Harvard T. H. Chan School of Public Health, Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts Dr. Yusuke Tsugawa[/caption] Yusuke Tsugawa, MD, MPH, PhD Department of Health Policy and Management Harvard T. H. Chan School of Public Health, Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We analyzed a 20% sample of Medicare beneficiaries hospitalized with a medical condition in 2011-2014, and found that patients treated by female doctors have lower mortality and readmission rates than those cared for by male doctors.
Author Interviews, Cancer Research, Nature, Wistar / 20.12.2016

MedicalResearch.com Interview with: Cecilia Caino, Ph.D. The Wistar Institute 3601 Spruce Street Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mitochondria have recently experienced a resurgence of interest in the field of cellular biology. Traditionally known for their role in energy production and in programmed cell death, mitochondria are more broadly recognized as signaling hubs and biosynthetic factories. Not surprisingly, mitochondria have been linked to several hallmarks of cancer, including evasion of apoptosis, tissue invasion and metastasis and abnormal metabolic pathways. It has become clear that mitochondria quality control and metabolism-regulated shape changes are dysregulated in cancer. Recent studies identified a novel therapy-resistance mechanism that involves mitochondrial subcellular re-localization and is responsible for enhanced metastatic potential of cancer cells. In this context, the molecular regulators of mitochondrial trafficking in cancer are largely unknown. Through analysis of shRNA screening results, we identified Syntaphilin (SNPH), which is considered to moderate mitochondrial trafficking in neurons, as a non-neuronal tissue specific factor to suppress cancer cell invasion. Using multi-disciplinary cell biological, real time imaging, in vivo studies and human clinical studies, SNPH was revealed to block cell motility and tumor metastasis by regulation of reprogramming of mitochondrial dynamics. We provided evidence from public databases and clinical samples that SNPH levels are decreased in different types of human tumors and low SNPH levels correlate with worse patient prognosis. Overall this study demonstrated a new mechanism by which tumor cell invasion is regulated by a SNPH-mediated pathway.
Annals Internal Medicine, Author Interviews, Sugar / 19.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30649" align="alignleft" width="150"]Bradley C. Johnston, PhD Prevention Lab, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Room 11.9859 West, Toronto, Ontario Dr. Bradley Johnston[/caption] Bradley C. Johnston, PhD Prevention Lab, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute Peter Gilgan Centre for Research and Learning Toronto, Ontario MedicalResearch.com: What is the background for this study? Response: I am scientist at The Hospital for Sick Children and a professor of clinical epidemiology at the University of Toronto and McMaster University in Canada. I have a particular interest in research methodology and preventive medicine. As a research methodologist I am interested in how researchers get to their conclusions. In particular I am interested in the “uncertainty” in estimated treatment or exposure effects. Many guidelines have methodological issues but it was suspected that the nutritional guidelines were especially problematic. Our study in Annals of Internal Medicine set out to document the issues systematically with respect to sugar intake recommendations from authoritative guidelines.
AHA Journals, Author Interviews, Duke, Social Issues, Stroke / 19.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30645" align="alignleft" width="153"]Matthew E. Dupre, Ph.D. Associate Professor Department of Community and Family Medicine & Duke Clinical Research Institute (DCRI) Duke University Dr. Mathew Dupre[/caption] Matthew E. Dupre, Ph.D. Associate Professor Department of Community and Family Medicine & Duke Clinical Research Institute (DCRI) Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: There have been a handful of recent studies showing how divorce and widowhood increase one’s risk of suffering a serious health event such as a heart attack or stroke. Our research is the first to show that an individual’s marital history can have significant consequences for their prognosis after having a stroke. We found that people who never married and those with a history of marital loss were significantly more likely to die after suffering a stroke than those who were stably married. We also found that adults who experienced more than one divorce or widowhood in their lifetime were about 50% more likely to die after having a stroke than those in a long-term stable marriage. We were also somewhat surprised to find that remarriage did not seem to reduce the risks from past marital losses.
Author Interviews, Brigham & Women's - Harvard, Dental Research, Infections, Rheumatology, Science / 17.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30609" align="alignleft" width="200"]Maximilian F. Konig, MD Department of Medicine Massachusetts General Hospital Harvard Medical School Dr. Maximilian F. Konig[/caption] Maximilian F. Konig, MD Division of Rheumatology, Johns Hopkins University School of Medicine Current affiliation: Department of Medicine Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response:The idea that rheumatoid arthritis (RA), an autoimmune disease that leads to chronic joint inflammation and destruction, may be initiated by a bacterial infection is not novel, but has been posited for more than a century. Based on the clinical observation that patients with RA frequently have severe periodontal disease (gum disease), gum inflammation has long been thought to contribute to disease development in RA. However, limited understanding of the mechanisms that fuel and sustain the autoimmune attack in RA made it difficult to pinpoint a specific bacterial trigger. In recent years, our understanding of the abnormal immune response that attacks the joints in patients with RA has grown exponentially, and we now know that disease-specific autoantibodies (ACPAs) target modified self-proteins (this modification is known as citrullination). It is this abnormal immune response against citrullinated proteins that appears to drive the joint (and sometimes lung) inflammation seen in rheumatoid arthritis. Recent studies from our laboratory at The Johns Hopkins University (led by principle investigator Felipe Andrade, MD, PhD) suggested that an immune cell called the neutrophil, which normally protects us from infection at sites like the oral cavity or anywhere else in the body, also appears to be the source of the proteins attacked in RA. We were therefore interested to understand what drives the association of gum disease, an inflammation commonly triggered by bacteria, with RA.
Author Interviews, Heart Disease, JACC, Surgical Research / 17.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30605" align="alignleft" width="132"]Frederick L. Grover, M. D. Professor, Division of Cardiothoracic Surgery Past Chair, Department of Surgery University of Colorado School of Medicine-Anschutz Medical Campus Aurora, CO Past President, Society of Thoracic Surgeons Vice Chair, Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry Dr. Frederick Grover[/caption] Frederick L. Grover, M. D. Professor, Division of Cardiothoracic Surgery Past Chair, Department of Surgery University of Colorado School of Medicine-Anschutz Medical Campus Aurora, CO Past President, Society of Thoracic Surgeons Vice Chair, Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry MedicalResearch.com: What is the background for this study? What are the main findings? Response: Following approval of the first transcatheter aortic heart valve late in 2011 the TVT-R was established and data entry was mandated by CMS for all patients who were undergoing transcatheter valve therapy.  Data is currently collected on transcatheter aortic valves (TAVR) from two companies, transcatheter mitral clip procedures (TMC), transcatheter mitral valve in valve or valve in ring procedures and aortic valve in valve procedures.  A report is published annually jointly in the Journal of the American College of Cardiology (JACC) and the Annals of Thoracic Surgery (ATS).  This report contains data from the beginning of 2012 through December 31, 2015.  Peoperative risk factors, operative details and outcomes data are collected prior to procedures, during the hospitalization, 30 days post procedure and at one year and later data can be collected by linking to CMS administrative data. For this annual report we concentrated on touching on some of the highlights since the length of the manuscript is limited. We discussed the trends in TAVR, since this is the most common procedure performed, the last two years’ experience in mitral clips since a very detailed paper was published on this last year, and the mitral valve in valve and ring since the results for this procedure were impressively good. In regard to TAVR, 418 sites perform this procedure and the number of cases in 2015 increased from 16,295 in 2014 to 24,808.  Very importantly, mortality and complications have been decreasing each year, probably related to improvements in the technology with smaller catheter and sheath sizes leading to less vascular complications, greater experience of those doing the procedures, a less sick group of patients going initially from those too ill to do an open operation on, to very high risk to high risk according to approval criteria.    The age of the patients however is most often in the 80s.
Author Interviews, BMJ, Heart Disease, Smoking / 16.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30578" align="alignleft" width="133"]Dr. Kevin Campbell MD FACC Wake Heart and Vascular Assistant Professor of Medicine, UNC School of Medicine Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson North Carolina. Dr. Kevin Campbell[/caption] Dr. Kevin Campbell MD FACC Wake Heart and Vascular Assistant Professor of Medicine,  UNC School of Medicine Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson North Carolina  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study, data was analyzed from nearly 1800 patients who had ST elevation MI.  Findings were published in Heart.  They found that younger  smokers (age under the age of 50)  had an 8-fold increased risk of acute STEMI , when compared to ex- and never smokers. In addition, researchers found that current smokers of all ages were 3.26 times more likely to have STEMI than ex- and never-smokers—suggesting that if you stop smoking, you can reduce your risk for heart attack.
AHA Journals, Author Interviews, Lipids, Pharmacology / 16.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30566" align="alignleft" width="100"]Dr. Eli M. Roth MD, FACC President, Medical Director Sterling Research Group Cincinnati, OH Dr. Eli Roth[/caption] Dr. Eli M. Roth MD, FACC President, Medical Director Sterling Research Group Cincinnati, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: At this year’s AHA 2016, we presented a pharmacodynamics analysis of ODYSSEY CHOICE I, which evaluated the effects of Praluent 300 mg administered every four weeks (Q4W) for 24 weeks in hypercholesterolemia patients at moderate to very high cardiovascular risk who were on maximally tolerated statin or no statin and/or other lipid-lowering therapies. The pharmacodynamic analysis of CHOICE I in patients on statins supports the use of Praluent 300 mg Q4W as an alternative starting dose for patients who prefer a Q4W dosing regimen and demonstrates the value of LDL-C based dosing interval adjustment. The findings from this analysis were consistent with prior ODYSSEY Phase 3 studies, showing that Praluent substantially reduced circulating free PCSK9 concentration, resulting in significant LDL-C reductions. Additionally, Praluent was generally well tolerated.
Author Interviews, Genetic Research, JAMA / 16.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30502" align="alignleft" width="142"]C. Anthony Blau, M.D. Professor of Medicine, Division of Hematology University of Washington School of Medicine Co-Director, University of Washington Institute for Stem Cell and Regenerative Medicine Director, Center for Cancer Innovation Dr. C. Anthony Blau[/caption] C. Anthony Blau, M.D. Professor of Medicine, Division of Hematology University of Washington School of Medicine Co-Director, University of Washington Institute for Stem Cell and Regenerative Medicine Director, Center for Cancer Innovation MedicalResearch.com: What is the background for this study? What are the main findings? Response: Matching cancer treatment to the molecular composition of a patient’s tumor holds promise for making cancer therapies more effective, and molecular testing for cancer patients has become widespread in recent years. Recently molecular testing of tumor samples has been complemented by blood tests that characterize tumor DNA that has been shed into the bloodstream.  Blood tests are attractive because they are much less invasive than obtaining tumor tissue via biopsies.