Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, Pulmonary Disease / 15.01.2021

MedicalResearch.com Interview with: Dr Andrew Conway Morris Wellcome Trust Clinical Research Career Development Fellow University of Cambridge Hon Consultant in Intensive Care Medicine Addenbrookes Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Patients with COVID-19 frequently need to come to the intensive care unit (ICU), where we use mechanical ventilation to support their lungs as they get over the intense inflammation caused by the virus.  During the first wave of the virus we noted that a lot of our patients appeared to be developing secondary infections (infections they didn’t have when they came into the ICU). We therefore rolled out a rapid diagnostic test for these secondary bacterial infections that we had developed previously, and this study reports the use of this diagnostic and also describes the types of bacteria seen.  To see if the increase in secondary infections was due to COVID specifically, we compared them to patients who were managed in the same ICU but who did not have COVID. (more…)
Author Interviews, COVID -19 Coronavirus / 17.12.2020

MedicalResearch.com Interview with: Xiaolei Yang  The State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics School of Engineering Sciences University of Chinese Academy of Sciences Beijing, China hallway-air-flow.jpegMedicalResearch.com: What is the background for this study? What are the main findings? Response: The most important finding of this study is that the transmission of COVID-19 is highly influenced by the airflow and that a slight difference in the airflow can significantly alter the virus spreading pattern in the air. In this study, the change of airflow is caused by a minor difference in the corridor width and the walking speed. However, such a change can also come from other factors, such as the indoor architectural structure, the temperature, the humidity, etc. In many of these cases, the common guideline of 6-feet may not be enough when the influence of airflow is taken into account. Due to this complexity, there is still a gap of knowledge to fill before a safety guideline for different indoor environments can be provided to the public, many research efforts are needed from the fluid mechanics’ aspect. (more…)
Author Interviews, Infections / 09.12.2020

MedicalResearch.com Interview with: Ed Breitschwerdt, DVM, DACVIM The Melanie S. Steele Distinguished Professorship in Medicine Professor, Internal Medicine NC State College of Veterinary Medicine MedicalResearch.com: What is the background for this study? Response: Bartonella species represent a medically underappreciated group of vector-transmitted bacteria that are increasingly implicated in a spectrum of animal and human diseases. Most recently, our research group has focused on the potential role of these bacteria as a cause or co-factor in patients with neuropsychiatric symptoms. This focus is based upon prior case reports and case series generated by our research group and others. (more…)
Author Interviews, Infections, OBGYNE, Pediatrics / 26.11.2020

MedicalResearch.com Interview with: Jessica Miller PhD Postdoc Fellow Murdoch Childrens Research Institute  MedicalResearch.com: What is the background for this study? Response: Cesarean section (CS) may be a lifesaving intervention for women and babies. However, the global proportion of CS births is rapidly increasing and may not be medically justified. As CS has implications for both mother and child, the increasing rates warrant population-level analyses of potential risks. Many suggested long-term outcomes in CS-born children relate to altered immune development. It is possible that differences in the newborn microbiome by mode of birth contribute to the development of early immune responses which may influence the risk of immune-related outcomes, including infection. CS has been associated with an increased risk for specific infection-related hospitalisations, mainly lower respiratory tract and gastrointestinal infections, but it remains unclear whether CS is associated with increased risk of overall infection-related hospitalisation or only certain infection types, and whether risk differs for emergency versus elective/pre-labour CS. (more…)
Author Interviews, Infections, JAMA / 21.10.2020

MedicalResearch.com Interview with: Liliana Sanchez-Gonzalez MD, MPH Medical Epidemiologist Dengue Branch – Division of Vector Borne Diseases Centers for Disease Control and Prevention San Juan, PR MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of prion disease? Response: Prion diseases are neurodegenerative diseases that occur in animals and humans. These diseases are caused by an infectious agent known as a prion. While the accuracy of diagnostic tests using cerebrospinal fluid or brain imaging from living patients has improved greatly in recent years, analysis of brain tissue is still necessary to confirm the diagnosis of these diseases. Human prion disease cases are rare, but always fatal. There have been around 500 reported cases annually in the US in recent years. A very small percentage of human prion disease cases are acquired, meaning they are caused by an exposure to the infectious agent from an external source. The most well-known acquired human prion disease is variant Creutzfeldt-Jakob disease (vCJD), which was first described in the United Kingdom in 1996 and linked to consumption of contaminated beef from cattle with the animal prion disease bovine spongiform encephalopathy (BSE, or “mad cow” disease). The only US state where classic BSE has been reported is Washington, where an infected dairy cow was imported from Canada in 2003. Beef from the slaughtered cow was processed for human consumption, and beef from cattle slaughtered the same day at the involved slaughter plant was recalled. After this incident, the Washington State Department of Health, in collaboration with the US Centers for Disease Control and Prevention and the National Prion Disease Pathology Surveillance Center (NPDPSC), implemented enhanced human prion disease surveillance. All patients with positive results from tests conducted at the NPDPSC are investigated. We present the results of 12 years of human prion disease surveillance, from 2006 to 2017, plus results of surveillance for vCJD through July 2020. (more…)
Author Interviews, BMJ, Surgical Research / 15.10.2020

MedicalResearch.com Interview with: Sebastian Straube, BM BCh, MA (Oxon), DPhil Professor and Director, Division of Preventive Medicine, Department of Medicine University of Alberta Zone Section Chief, Occupational Medicine Edmonton Zone, Alberta Health Services Director, Foundation Course in Occupational Medicine surgery-aerosols-covid-19MedicalResearch.com: What is the background for this study?   Response: In view of the COVID-19 pandemic, medical procedures that generate aerosols require a higher grade of personal protective equipment, typically including filtering facepiece respirators (e.g. N95 masks). We wanted to know which procedures were aerosol-generating and would require such enhanced precautions. MedicalResearch.com: How did you approach that question? Response: We conducted a systematic review of the literature and aimed to find those procedures for which there is widespread agreement that they are aerosol-generating. We assembled a team of researchers with expertise in the subject matter as well as in systematic review methodology, and we searched widely for relevant guidelines, policy documents, and academic papers. (more…)
Author Interviews, BMJ, COVID -19 Coronavirus / 23.09.2020

MedicalResearch.com Interview with: Joon Seo Lim, PhD, ELS Clinical Research Center Asan Institute for Life Sciences Asan Medical Center, Songpa-gu Seoul, Republic of Korea MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic is continuing to spread at an alarming rate in all parts of the world, and screening individuals based on symptoms (e.g., fever, cough, anosmia) does not seem to be effective in sufficiently curbing the transmission of the disease. This suggests that asymptomatic individuals infected with SARS-CoV-2 may be a driving force of the ongoing pandemic, but empirical evidence on this issue has been lacking because asymptomatic individuals are likely to go unnoticed unless subjected to systematic contact tracing. A large-sized outbreak of COVID-19 from a single religious group in South Korea enabled us to identify and test a large number of asymptomatic individuals with SARS-CoV-2 alongside symptomatic patients from the same cluster.  (more…)
Abuse and Neglect, COVID -19 Coronavirus, Infections / 10.06.2020

MedicalResearch.com Interview with: Edmond A. Hooker, MD, DrPH Professor, Department of Health Services Administration MHSA Associate Director for Accreditation Xavier University Cincinnati, Ohio  MedicalResearch.com: What is the background for this study? Response: Healthcare acquired infections are still a huge problem in the US. Most hospitals are not following the hospital bed manufacturers guidelines for cleaning these mattresses and bed decks (the metal bed frame). Many use only a single step, when the manufacturers recommend a 5-6 step process (pre-clean any obvious soil, clean, rinse off cleaner, disinfect, rinse off disinfectant, inspect mattress for damage). The problem is that, if done, this takes 45 minutes to 1 hours. Most hospitals turn over a hospital room in less than 30 minutes. The launderable bed cover allows the bed to be cleaned and turned over in minutes, not an hours.  (more…)
Author Interviews, COVID -19 Coronavirus, Infections / 04.06.2020

MedicalResearch.com Interview with: Joseph Roth Graduate Student Dr. Roman Engel-Herbert PhD Assoc. Prof. of Materials Science & Engineering, Chemistry and Physics The Pennsylvania State University University Park, PA 16802 MedicalResearch.com: What is the background for this study?   Response: UV disinfection is currently a hot topic as there have been many studies on its effectiveness against COVID-19. Typically, this disinfection is done with expensive, mercury containing gas discharge lamps that have major downsides including high power requirements, short lifetimes, and bulky form factors. Ideally these disinfection devices would be replaced with high performance UV LEDs that are far more energy efficient, long lasting, and compact. Currently the development of these LEDs is limited by a lack of effective UV transparent electrode materials. The introduction of an effective UV transparent electrode will greatly expedite the process of making UV disinfection devices widely available. (more…)
Author Interviews, COVID -19 Coronavirus, Duke / 27.03.2020

MedicalResearch.com Interview with: Dr. Rupesh Agrawal, MD Associate Professor Senior Consultant Ophthalmologist Duke-NUS Medical School, Singapore MedicalResearch.com: What is the background for this study? Wasn't Dr Li Wenliang, the Chinese physician who first alerted his community of coronavirus an opthalmologist, with possible exposure to tears from this surgical work with glaucoma patients? Response: Since the start of the pandemic, there have been multiple reports which suggested the transmission of SARS-CoV-2 via ocular fluids. As ophthalmologists, we come into close contact with tears on a daily basis during our clinical examination. Furthermore, many equipment in the clinic like the Goldman tonometer come into direct contact with such ocular fluids, providing a channel for viral transmission. The evidence, as of date, were mainly anecdotal reports included in newspaper articles and media interviews. We wanted to know if the virus can truly be found in tears, so we decided to embark on this study. (more…)
Author Interviews, Biomarkers, Cancer Research / 21.12.2019

MedicalResearch.com Interview with: https://www.kariusdx.com/ Dr. Asim Ahmed MD co-author of the study Senior medical director at Karius  MedicalResearch.com: What is the background for this study? Would you briefly explain the basis of the Karius Test? Response: The Karius Test is a non-invasive blood test that uses next-generation sequencing of microbial cell-free DNA to rapidly detect over 1,400 bacteria, DNA viruses, fungi, and other pathogens. Doctors primarily use the test to detect specific causative pathogens, complicated pneumonia, cardiovascular infections, and infections in immunocompromised hosts. The Karius Test is transforming how doctors diagnose infectious diseases by helping doctors identify the precise pathogens infecting patients. The Karius Test offers a higher diagnostic yield and faster time-to-diagnosis than conventional tests - with the potential to eliminate invasive diagnostic procedures like biopsies. (more…)
Author Interviews, Infections / 20.12.2019

MedicalResearch.com Interview with: Konstans Wells, PhD Lecturer in Biosciences Swansea University  MedicalResearch.com: What is the background for this study? Response:  Cross‐species transmission of harmful viruses between animals and humans is a major source of infectious diseases and a considerable global public health burden. We assessed patterns of virus sharing among a large diversity of mammals, including humans and domestic species. (more…)
Author Interviews, Infections, OBGYNE / 04.12.2019

MedicalResearch.com Interview with: Giovanni Piedimonte, MD, FAAP, FCCP Vice President for Research Institutional Official Professor of Pediatrics Tulane University MedicalResearch.com: What is the background for this study? Response: We have been testing the hypothesis that, when a pregnant woman catches a common cold with a virus called respiratory syncytial virus (RSV), viral particles can spread from the mother’s respiratory tract to the unborn child via the placenta. Preliminary data in animal models suggest that this is possible, and might cause changes in lung growth predisposing the offspring to develop asthma after birth. Recently, also human data have supported this theory. However, an essential step to conclusively demonstrate vertical transmission of respiratory viruses was the confirmation that human placentas can be infected and allow the transmission of such germs, which is the main finding of this study. (more…)
Author Interviews, Diabetes, Heart Disease, Infections / 13.10.2019

MedicalResearch.com Interview with: Hean Teik Humphrey Ko PhD candidate School of Pharmacy and Biomedical Sciences Faculty of Health Sciences, Curtin University Perth, Western Australia, Australia MedicalResearch.com: What is the background for this study? Response: Bacterial skin infections consume precious healthcare resources because such infections are common and may sometimes be severe. Statins are relatively affordable and extensively prescribed worldwide to prevent cardiovascular diseases. Additionally, the safety/adverse effects of statins have been well documented. Staphylococcus aureus is a major cause of bacterial skin infections, and statins have been separately reported to exert antibacterial effects against S. aureus, as well as reduce the risk of S. aureus related blood infections. As such, it seemed plausible that statins may prove beneficial in S. aureus related skin infections. However, statins may also induce new-onset diabetes mellitus, a condition which in turn, is a risk factor for skin infections. Therefore, in order to determine if statins could potentially serve as a novel therapeutic agent for skin infections to reduce healthcare costs, this study was conducted to examine the interrelationships between statins, diabetes, and skin infections.  (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 16.09.2019

MedicalResearch.com Interview with: Carrie C. Coughlin, MD Member of the Society for Pediatric Dermatology Assistant Professor, Dermatology Departments of Medicine and Pediatrics Washington University School of Medicine / St. Louis Children's Hospital   Cristopher C. Briscoe, MD Dermatology Resident, PGY-2 Washington University School of Medicine in St. Louis    MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Briscoe: Superinfection of atopic dermatitis (AD) in pediatric patients is a common complication. Our study sought to determine the best empiric antibiotic choice for these patients while a bacterial culture is pending. We retrospectively analyzed 182 skin cultures from pediatric atopic dermatitis patients seen in the outpatient setting over five years and found that 170 (93.4%) grew Staphylococcus aureus. Of these, 130 (76.5%) grew methicillin-sensitive S. aureus (MSSA), 37 (21.8%) grew methicillin-resistant S. aureus (MRSA), and 3 (1.8%) grew both MSSA and MRSA. There was no statistically significant relationship between age, sex, race, or dilute bleach bath usage and MRSA infection. Interestingly, as compared to a separate group of pediatric atopic dermatitis patients seen in the emergency room, our patients had lower rates of MSSA susceptibility to doxycycline and MRSA susceptibility to TMP-SMX. (more…)
Author Interviews, Infections, Nutrition, PLoS, Red Meat / 05.09.2019

MedicalResearch.com Interview with: Christopher A. McDevitt B.Sc. (Hons) Ph.D , Associate Professor Group Leader, ARC Future Fellow The Peter Doherty Institute for Infection and Immunity Melbourne | Victoria | Australia MedicalResearch.com: What is the background for this study? Response: Zinc-deficiency affects nearly one-third of the world’s population and is associated with an increased susceptibility to respiratory and enteric infections. The foremost global respiratory disease is pneumonia, which kills more than 1 million people per year with young children and the elderly being at greatest risk. This study investigated how zinc-deficiency affected Streptococcus pneumoniae infection, the primary bacterial cause of pneumonia. (more…)
Author Interviews, Hospital Acquired, JAMA / 20.08.2019

MedicalResearch.com Interview with: Todd Campbell Lee MD MPH FACP FIDSA Consultant in Internal Medicine and Infectious Diseases Director, MI4 Clinical Trials Platform Associate Professor of Medicine, McGill University Montreal, Quebec  MedicalResearch.com: What is the background for this study? Response: For a number of years people have been advocating for a move towards single-patient rooms in hospital design.  This was articulately argued for in an opinion piece by Detsky and Etchells in 2008 (https://jamanetwork.com/journals/jama/article-abstract/182433) as being important for a move to safe and patient-centered design. One of the major selling points has always been a reduction in the risk of nosocomial, or hospital-associated, infections given reduced opportunities for contamination between patients; however, only a few studies have specifically looked at this issue.  Overall, despite some strong work, many of these studies were limited by only looking at specific units, over limited periods of time,  and using before-after comparisons which did not account for change over time either within or outside of the institution. We knew that in 2015 our old hospital would close and within the same day all patients would be moved to a brand new hospital with 100% single patient rooms -- most of which have a private bathroom for patients and a separate hand-washing sink for staff.  So in 2014, we designed this study, obtained ethics review, and then waited patiently for several years to pass after the move so that we could rigorously evaluate the impact.  We looked at monthly rates of vancomycin-resistant Enterococcus (VRE) colonizations and infections, methicillin-resistant Staphylococcus aureus (MRSA) colonization and infections, and Clostridium (now Clostrideroides) difficile infections (CDI). We chose these because we had good long term data on their rates and because we could compare the rates over time before and after the move and contrast them with the province of Quebec as a whole. (more…)
Author Interviews, Global Health, HIV, NEJM / 17.07.2019

MedicalResearch.com Interview with: Dr. Richard J. Hayes, DSc, FMedSci Professor of Epidemiology and International Health London School of Hygiene and Tropical Medicine MedicalResearch.com: What is the background for this study? Response: HIV incidence rates remain at very high levels in many parts of southern Africa. Universal testing and treatment (i.e., ensuring that everyone in a community tests for HIV and that everyone diagnosed with HIV is started on treatment as soon as possible) has been proposed as a strategy to achieve steep reductions in HIV incidence in generalized epidemics. Prior trials have shown inconsistent results as to whether this strategy could be effective. HPTN 071 (PopART) was carried out in 21 urban communities in Zambia and South Africa, with individual communities randomly assigned into one of three arms: A, B or C. The 14 communities in Arms A and B received annual rounds of home-based HIV testing by community health workers who supported linkage to care, antiretroviral therapy (ART) adherence and other HIV services. The seven communities in Arm C received the local standard of care. We looked to see if the HIV incidence in the communities receiving universal testing and treatment would be lower (over time) compared to the incidence in the standard of care communities. (more…)
Author Interviews, Infections / 24.06.2019

MedicalResearch.com Interview with: David Houston PhD Senior Scientist and wound project Neem Biotech MedicalResearch.com: What is the background for this study?   Response: Biofilms are complex bacterial communities formed during the natural infection process as a protection mechanism and controlled by bacterial quorum sensing. These biofilm communities allow infections to spread by producing toxins that inhibit the body’s immune system, generating exopolysaccharide and changes in metabolic state that reduce the efficacy of antibiotics and activating virulence factors, which ultimately drive the spread of infection. Stopping the spread of infection by inhibition of quorum sensing has potential to manage a wide range of infections, including in wounds. In chronically-infected wounds, the prevention of biofilm formation, disruption of mature biofilms, reduction of virulence factors and thereby the spread of infection remains clinically elusive. Quorum sensing (QS) pathways regulate microbial motility, virulence factor production and the formation and maturation of biofilms. Inhibiting QS therefore presents a potential mode of therapeutic intervention for infections. (more…)
Author Interviews, Dermatology, Infections, JAMA / 19.06.2019

MedicalResearch.com Interview with: Richard Brindle DM FRCP Honorary Reader, University of Bristol, UK  MedicalResearch.com: What is the background for this study? Response: This review is an update of the 2010 Cochrane Review of Interventions for cellulitis and erysipelas (DOI: 10.1002/14651858.CD004299) but focusing on antibiotics.  It provides a valuable resource for clinicians in summarizing current best evidence and highlighting gaps in the research. This review will inform the production of evidence-based guidelines covering antibiotic choice, route of administration, duration of treatment and the role of combinations of antibiotics. (more…)
Author Interviews, Biomarkers, Genetic Research, Infections, NEJM, UCSF / 13.06.2019

MedicalResearch.com Interview with: Dr. Charles Chiu, M.D./Ph.D. Professor, Laboratory Medicine and Medicine / Infectious Diseases Director, UCSF-Abbott Viral Diagnostics and Discovery Center Associate Director, UCSF Clinical Microbiology Laboratory UCSF School of Medicine MedicalResearch.com: What is the background for this study? Would you describe what is meant by metagenomic sequencing? Response: Metagenomic next-generation sequencing (mNGS) is the use of technology to generate millions of sequence reads to diagnose infection sin patients by characterizing the full range of potential pathogens (bacteria, viruses, fungi, and parasites) in a single sample. Although shown to be a promising diagnostic tool for  infectious diseases in case reports and limited case series (Chiu and Miller Nature Reviews Genetics 20, 341-355 (2019)), to date the “real-life” utility of this approach for patient care has hitherto not been demonstrated.  This study is the first prospective, multi-center study of clinical mNGS testing for the diagnosis of neurological infections in acutely ill hospitalized patients presenting with meningitis and/or encephalitis. (more…)
Annals Internal Medicine, Author Interviews, Critical Care - Intensive Care - ICUs, Infections, University of Pittsburgh / 15.05.2019

MedicalResearch.com Interview with: Minh-Hong Nguyen, MD Infectious Diseases Professor of Medicine Director, Transplant Infectious Diseases Director, Antimicrobial Management Program Department of Medicine University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Blood cultures, the gold standard for diagnosing blood stream infections, are insensitive and limited by prolonged time to results. Early institution of appropriate antibiotics is a crucial determinant of improved outcomes in patients with sepsis and blood stream infections (BSI). For these reasons, development of rapid non-culture diagnostic tests for blood stream infections is a top priority. The T2Bacteria panel is the first direct from blood, non-culture test cleared by FDA for diagnosis of blood stream infections .  It detects within 4-6 hours the 5 most common ESKAPE bacteria that are frequent causes of hospital infection, and which are often multi-drug resistant.  This study shows that the T2Bacteria panel rapidly and accurately diagnosed and identified ESKAPE bacterial BSIs, and identified probable and possible BSIs that were missed by blood cultures (in particular among patients who were already receiving antibiotics). (more…)
Author Interviews, Hospital Acquired, Infections / 07.05.2019

Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning MethodsThe number of deaths caused by resistant bacteria is expected to reach 10 million by 2025, according to the Centers of Disease Control and Prevention. A highly resistant bacteria found in hospitals - Klebsiella pneumoniae - is now a big global threat, according to a recent (April, 2019) study published by researchers from University College London. Researchers have issued a warning that more stringent cleaning of infectious wards and new air disinfection protocols are key to battling the bug. This is because this bacteria possesses the ability to change genetically at an alarming rate, adapting and essentially nullifying the effect of all current antibiotics. (more…)
Author Interviews, Infections, JAMA / 01.05.2019

MedicalResearch.com Interview with: Nicholas B. DeFelice, PhD Department of Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions. We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported. For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help 1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding), 2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and 3) identify when to intensify blood donor screening. (more…)
Author Interviews, Infections, JAMA, Mental Health Research, Pediatrics / 25.04.2019

MedicalResearch.com Interview with: Lauren Breithaupt, PhD Department of Psychology George Mason University Fairfax, Virginia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders. We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    (more…)
Author Interviews, Hospital Acquired, Infections, Merck / 16.04.2019

MedicalResearch.com Interview with: Elizabeth Rhee, MD Executive Director, Infectious Disease Clinical Research Merck Research Laboratories MedicalResearch.com: What is the background for this study? Would you briefly explain the condition of ventilated nosocomial pneumonias? Dr. Rhee: Nosocomial pneumonia (NP) is a lung infection that occurs during a hospital stay. NP is often serious, and is associated with high mortality. It is one of the most common health-care associated infections in both the U.S. and Europe, accounting for over 20% of such cases. Gram-negative bacteria, mainly Pseudomonas aeruginosa (PSA) and Enterobacteriaceae, are frequent causes of nosocomial pneumonia. Limited options currently exist for the management of NP caused by Gram-negative pathogens. This is concerning because rates of resistance to Gram-negative bacteria are growing, and they are becoming increasingly difficult to treat. Forms of nosocomial pneumonia include hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and ventilated HAP. High rates of death (ranging from 20% to more than 50%) are especially associated with ventilated HAP. Pseudomonas aeruginosa, a Gram-negative bacterium, is the most common cause of HAP/VAP in both the U.S. and Europe. Patients with NP are often critically ill, requiring ventilator support and time in intensive care, and it was important to look at this population as we explore new options for the treatment of NP. Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin/beta-lactamase inhibitor combination with broad in vitro activity against Gram-negative pathogens, including multi-drug resistant (MDR) P. aeruginosa and many extended-spectrum beta-lactamase (ESBL) producers. It is FDA approved for complicated intra-abdominal and urinary tract infections in adults at 1.5g (1g ceftolozane/0.5g tazobactam) q8h. C/T is currently being studied at an investigational new dose of 3g (2g/1g) q8h, for the treatment of ventilated nosocomial pneumonia, in the ASPECT-NP Phase 3 trial. (more…)
Author Interviews, Brigham & Women's - Harvard, Ebola, Global Health, Lancet / 28.03.2019

MedicalResearch.com Interview with: Patrick Vinck, PhD Research Director, Harvard Humanitarian Initiative Assistant Professor, Global Health and Population T.H. Chan Harvard School of Public Health; Emergency Medicine Harvard Medical School Lead Investigator, Brigham & Women's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The second worst epidemic of Ebola on record is currently unfolding in the eastern part of the Democratic Republic of the Congo. Whether or not safe practices are implemented to prevent the spread of the epidemic is influenced by the behavior of individuals at-risk of contracting the Ebola Virus Disease (EVD) - Will they follow the recommendations of health professionals? Will they report suspected cases and deaths? Will they seek treatment from health professionals? Will they accept vaccines and adopt preventive behaviors? We find that belief in misinformation about Ebola is widespread and trust in authorities is generally low, likely as a result of decades of violence and poor governance and, more recently, the politicization of the Ebola response. Our analysis shows that trust and (mis-)information influence adherence to risk avoidance behavior and acceptance of vaccination. (more…)
Author Interviews, Brigham & Women's - Harvard, Critical Care - Intensive Care - ICUs, Infections, JAMA / 12.03.2019

MedicalResearch.com Interview with: Chanu Rhee, MD,MPH Assistant Professor of Population Medicine Harvard Medical School / Harvard Pilgrim Health Care Institute Assistant Hospital Epidemiologist Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? Response: Sepsis is the body’s reaction to a serious infection that results a cascade of inflammation in the body and organ dysfunction, such as low blood pressure, confusion, or failure of the lungs, kidneys, or liver.   Sepsis is a major cause of death, disability, and cost in the U.S. and around the world.  Growing recognition of this problem has led to numerous sepsis performance improvement initiatives in hospitals around the country.  Some of these efforts have also been catalyzed by high-profile tragic cases of missed sepsis leading to death, which may have contributed to a perception that most sepsis deaths are preventable if doctors and hospitals were only better at recognizing it. However, the extent to which sepsis-related deaths might be preventable with better hospital-based care is unknown.  In my own experience as a critical care physician, a lot of sepsis patients we treat are extremely sick and even when they receive timely and optimal medical care, many do not survive.  This led myself and my colleagues to conduct this study to better understand what types of patients are dying from sepsis and how preventable these deaths might be.  (more…)
Author Interviews, Infections, Nature / 28.02.2019

MedicalResearch.com Interview with: bats-mattaeMatae Ahn,MD-PhD candidate Emerging Infectious Diseases (EID) Programme Duke-NUS Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bats, as the only flying mammals, are ‘special’ in their ability to host many highprofile viruses without suffering from disease. Such viruses including Ebola virus, Nipah virus and SARS or MERS coronaviruses, are highly pathogenic and often lethal to humans or animals, but yet cause no or minimal disease in bats. In addition, they also live very long relative to their small body size, despite elevated metabolic rates. However, what makes them special is still unclear. In this study, we discovered dampened NLRP3-mediated inflammation in bats in response to both ‘sterile’ stressors and infection with three different types of zoonotic RNA viruses. We identified multiple molecular mechanisms of altered bat NLRP3, a critical regulator of virus-induced and age-related inflammation, as the cause. Importantly, the reduced inflammation had no effect on the viral loads, which suggests enhanced immune tolerance to infection in bats. Bats’ natural ability to dampen stress-related and virusinduced inflammation may be a key mechanism underlying their long lifespans and unique viral reservoir status.  (more…)
Author Interviews, Cancer Research, HPV, Infections / 25.01.2019

MedicalResearch.com Interview with: Prof. J. (Hans) Berkhof PhD Vrije Universiteit Amsterdam  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In most countries, the Pap test is used for cervical cancer screening but recently several countries have switched from Pap testing to HPV testing. Like the Pap test, the HPV test requires a cervical sample to be taken by a clinician. Vaginal self-sampling is also used, but only in underscreened women. We know that self-sampling increases screening participation in underscreened women and it is likely that many women that attend screening also prefer self-sampling if it had been offered to them. We studied whether an HPV self-sampling test is an accurate alternative to a regular HPV test in women invited for routine screening. We randomized about 14,000 women, invited for screening, to self-sampling or clinician-sampling. Women with a positive HPV test result also received the other HPV test. We found that the HPV self-sampling test yielded similar performance as the regular HPV test for detection of cervical pre-cancerous lesions (CIN3 and CIN2).  (more…)