Author Interviews, Biomarkers, Brain Injury, Emergency Care, Pediatrics / 31.08.2019 Interview with: Linda Papa, MD Emergency Physicians of Central Florida Orlando Health Orlando, Florida What is the background for this study? Response: In 2018 serum biomarkers Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal hydrolase (UCH-L1) were FDA-approved in adults to detect abnormalities on CT scan in mild to moderate traumatic brain injury. However, they have not been approved to detect concussion and they have not been approved for use in children. Previous studies have focused on detecting lesions on CT in more severely injured patients. However, not having brain lesions on a CT scan does not mean there is no brain injury or concussion. Therefore, this study focused on patients with concussion who looked well and likely had normal-appearing CT scans of the brain. This study includes THREE groups of trauma patients:
  • 1) those with concussion,
  • 2) those who hit their head but had no symptoms (subconcussive), and
  • 3) those who injured their bones but did not hit their head (no concussion).
There is a group of individuals with head trauma who have been significantly understudied, and in whom biomarkers are rarely, if at all, examined. These are people who experience head trauma without symptoms of concussion. They may be classified as having “no injury” or they may represent milder forms of concussion that do not elicit the typical signs or symptoms associated with concussion and are referred to as “subconcussive” injuries.  (more…)
Author Interviews, Endocrinology, NEJM / 01.08.2018 Interview with: Prof. Dr. Mirjam Christ-Crain Professor of endocrinology, diabetes and metabolism Heads the Department of Clinical Research University and University Hospital of Basel What is the background for this study? Would you briefly explain what is meant by Diabetes Insipidus? Response: Drinking more than three litres per day with the equivalent increase in urination is regarded as too much. This drinking by the liter – known as “polyuria polydipsia syndrome" – usually develops over time through habit, or can be a side effect of a mental illness. In rare cases, however, it may be caused by diabetes insipidus. This is when the pituitary gland lacks the hormone vasopressin, which regulates the water and salt content in our body. Patients have a decreased ability to concentrate the urine, therefore lose a lot of fluid and have to increase their fluid intake accordingly to prevent dehydration (= Diabetes insipidus). The distinction between what is considered a "harmless" primary polydipsia and a diabetes insipidus is crucial, as their therapy is fundamentally different. Diabetes insipidus must be treated with the hormone vasopressin, while patients with primary polydipsia require behavioural therapy to reduce their habitual drinking. A wrong therapy can have life-threatening consequences as treatment with vasopressin without indication can lead to water intoxication. (more…)
Author Interviews, Depression, Emory, Heart Disease, JAMA / 22.05.2018 Interview with: Viola Vaccarino, MD, PhD Department of Epidemiology and Division of Cardiology Professor, Department of Medicine Emory University School of Medicine Atlanta, Georgia What is the background for this study? What are the main findings? Response: Previous studies have shown that people with depression tend to have lower heart rate variability (HRV), an index of autonomic nervous system dysregulation derived by monitoring the electrocardiogram over time, usually for 24 hours. Other literature, however, has pointed out that autonomic dysregulation (as indexed by reduced HRV) may also cause depression. Thus, the direction of the association between reduced HRV and depression still remains unclear. In addition, these two characteristics could share common pathophysiology, making shared familial background and genetic factors potential determinants of this association. (more…)
Author Interviews, Biomarkers, Radiation Therapy / 06.07.2015 Interview with: Dr Ananya Choudhury Consultant and Honorary Senior Clinical Lecturer, Clinical Oncology The Christie NHS Foundation Trust, Wilmslow Road Withington, Manchester, UK Medical Research: What is the background for this study? What are the main findings? Response: Although more than half of newly diagnosed cancer patients are treated with radiotherapy, it is still not possible to select patients who will respond and tolerate radiotherapy compared to those who do not. There has been a lot of work done to try and isolate intrinsic biomarkers which will identify either radio-responsive or radio-resistant disease. We have undertaken a systematic view summarising the evidence for biomarkers as predictors of radiotherapy. Despite identifying more than 500 references during a systematic literature search, we found only twelve studies which fulfilled our inclusion criteria. Important exclusion criteria included pre-clinical studies, studies with no control population and a sample size of less than 100 patients. Only 10 biomarkers were identified as having been evaluated for their radiotherapy-specific predictive value in over 100 patients in a clinical setting, highlighting that despite a rich literature there were few high quality studies suitable for inclusion. The most extensively studied radiotherapy predictive biomarkers were the radiosensitivity index and MRE11; however, neither has been evaluated in a randomised controlled trial. (more…)
Author Interviews, Biomarkers, Heart Disease / 18.05.2015 Interview with: Dr Pascal Stammet Dépt. Anesthésie-Réanimation Centre Hospitalier de Luxembourg Luxembourg MedicalResearch: What is the background for this study? What are the main findings? Dr Stammet: Patients hospitalized after an out-of-hospital cardiac arrest (OHCA) survive in about fifty percent and nine out of ten survivors have a good functional level six months after the arrest. However, in the early days after the cardiac arrest it is difficult to distinguish those who will survive from those who have very severe brain damage, not compatible with life. Biomarkers, like neuron specific enolase (NSE) have shown a prognostic value for outcome prediction. As a consequence of the widespread use of induced hypothermia, to improve survival and neurological function, for patients resuscitated form cardiac arrest, concerns have arisen about the impact of body temperature on previously published cut-off values for poor outcome. NSE has thus been questioned as a useful clinical tool. Recently, the Target Temperature Management trial (TTM-trial) published in November 2013 in the NEJM has shown no benefit of a target body temperature of 33°C over 36°C in patients with out-of-hospital cardiac arrest admitted to the ICU. In the present sub-study, we have analyzed the value of NSE to predict outcome in a cohort of 686 patients of the TTM-trial. Importantly, serial measurements of NSE at 24, 48 and 72 hours allowed accurate outcome prediction, with better performance than clinical and peri-arrest data alone. NSE did not significantly differ between temperature groups meaning that clinicians can use NSE as an adjunct prognostic tool regardless of the chosen temperature management strategy. (more…)
Author Interviews, Biomarkers, Heart Disease / 03.02.2015 Interview with: Dr. Matthias Bossard, MD Clinical and Research Fellow Cardiology Division Department of Medicine University Hospital Basel Basel Switzerland MedicalResearch: What is the background for this study? What are the main findings? Dr. Bossard: Endothelin-1 (ET-1) and its pleiotropic effects have been implicated in the regulation of vascular and renal physiology as well as inflammation. Moreover, elevated ET-1 levels have been associated with endothelial dysfunction and atherosclerosis. Until now, data on the relationships between ET-1 and individual cardiovascular risk factors were scarce, especially from large-scale population based studies. This may be attributable to the previously used laboratory assays.The emergence of new ET-1 assays has facilitated ET-1 measurement in large populations. Our main findings are that ET-1 levels are independently associated with several individual cardiovascular risk factors an overall cardiovascular risk in a large cohort of young and healthy adults.Specifically, ET-1 levels were significantly associated with systolic blood pressure, current smoking, glomerular filtration rate and high-sensitivity C-reactive protein. (more…)
Author Interviews, Biomarkers / 28.10.2014

Dr. Adam Woolley PhD Department of Chemistry and Biochemistry Brigham Young Interview with: Dr. Adam Woolley PhD Department of Chemistry and Biochemistry Brigham Young University Medical Research: What is the background for this study? What are the main findings? Dr. Woolley: High-performance biomarker analysis methods are usually complex and expensive. In contrast, simple and inexpensive biomarker detection methods typically have low performance. Our study demonstrates a simple nucleic acid measurement system that requires no detection instrumentation. Nucleic acid mimics of microRNA were quantified with sequence specificity down to 10 pg/mL levels. (more…)