Author Interviews, Colon Cancer, Erasmus / 17.12.2014

MedicalResearch.com Interview with: Reinier G.S. Meester, M.Sc Department of Public Health, ErasmusMC, Rotterdam, Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Despite decreasing death rates from colorectal cancer over the past decades, it still ranks as the second leading cause of cancer deaths in the U.S. Screening for colorectal cancer is highly effective, but only 58% of the eligible population reported up-to-date with screening. This suggests that a substantial proportion of current colorectal cancer deaths in the U.S. are avoidable. We found that approximately 60% (32,200 deaths) of current deaths from colorectal cancer may be due to not receiving screening. (more…)
Author Interviews, Breast Cancer, University of Pittsburgh / 17.12.2014

Dr. Ryan Hartmaier PhD Postdoctoral Associate Magee-Womens Research Institute (MWRI) and the University of Pittsburgh Cancer InstituteMedicalResearch.com Interview with: Dr. Ryan Hartmaier PhD Postdoctoral Associate Magee-Womens Research Institute (MWRI) and the University of Pittsburgh Cancer Institute Medical Research: What is the background for this study? What are the main findings? Response: The inhibition of signaling through the estrogen receptor is a major target in breast cancer therapy. However, within recurrent disease others have recently identified point mutations within the estrogen receptor as a mechanism of resistance to this therapy. We undertook a comprehensive study of breast cancer progression by applying many next-generation sequencing technologies to a collection of paired primary-metastasis tissue samples from 6 patients. We placed special emphasis on the identification of structural variants (i.e. translocations, duplications, inversions, and deletions) acquired in metastatic breast cancer. In one patient with recurrent disease while on endocrine therapy, we identified a fusion gene between ESR1 (estrogen receptor alpha) and DAB2 (disabled-2). In vitro functional studies indicate that this fusion is constitutively active and hormone independent. (more…)
Author Interviews, Breast Cancer, Imperial College / 17.12.2014

Fiona Larner, PhD Postdoctoral Research Associate Department of Earth Sciences, University of Oxford, South Parks Road, Oxford, UK Department of Earth Science & Engineering, Imperial College London, Exhibition Road, South Kensington, London, UKMedicalResearch.com Interview with: Fiona Larner, PhD Postdoctoral Research Associate Department of Earth Sciences, University of Oxford, South Parks Road, Oxford, UK Department of Earth Science & Engineering, Imperial College London, Exhibition Road, South Kensington, London, UK Medical Research: What is the background for this study? What are the main findings? Response: Zinc has been identified to have a role in breast tissue and breast cancer for over a decade. Zinc has several isotopes (different versions of zinc due to varying numbers of neutrons), which require slightly different amounts of energy to go through biological processes. By measuring the changes in the zinc isotopic signature, we can probe it's behaviour to a greater resolution to that currently available in medical institutions. We looked at the isotopic signatures in different tissues of healthy patients and those with breast cancer in order to understand the mechanisms involved in more detail and in search for a biomarker that uses these signatures to diagnose breast cancer. We found that preferentially retains the lighter isotopes of zinc to a greater extent than healthy breast tissue. This means that the partnering heavy isotopes must be ejected from the cell, and may provide a biomarker for cancer in the future. (more…)
Author Interviews, Education / 17.12.2014

Francesco Brigo, MD Department of Neurological and Movement Sciences. Section of Clinical Neurology. University of Verona. Division of Neurology, "Franz Tappeiner" Hospital. Merano (BZ), ItalyMedicalResearch.com Interview with: Francesco Brigo, MD Department of Neurological and Movement Sciences. Section of Clinical Neurology. University of Verona. Division of Neurology, "Franz Tappeiner" Hospital. Merano (BZ), Italy Medical Research: What is the background for this study? What are the main findings? Dr. Brigo: Millions of people surf the Internet every day as a source of health care information looking for materials about symptoms, diagnosis, treatments and their possible adverse effects, or diagnostic procedures. The increasing number of online searches conducted using popular Web search engines, such as Google, generates so-called ‘big data’. This data provides information about online health-related behavior. In this study, I found that the highest peak in Google search volumes related to the terms “Parkinson´s disease” since January 2004 was observed on 15th August 2014, the day after Robin Williams' wife has revealed the late actor, who died of suicide on 11th August, was in the early stages of Parkinson's disease.  I proposed to call the phenomenon of increased online searches for a certain disease driven by news of celebrities having that disease as “Robin Williams´ phenomenon”, in honor of the American actor. (more…)
Author Interviews, CDC, Cost of Health Care, Smoking / 17.12.2014

MedicalResearch.com Interview with: Xin Xu, Ph.D. Senior Economist Office on Smoking and Health and Darryl Konter Health Communications Specialist McNeal Professional Services Centers for Disease Control and Prevention Office on Smoking and Health Atlanta, GA 30341 Medical Research: What is the background for this study? What are the main findings? Response: Tips From Former Smokers (Tips), the first federally funded national mass media antismoking campaign, launched by the CDC, provides a unique opportunity to assess the cost effectiveness of a nationwide public health intervention that meets the ad exposure recommendation in CDC’s 2014 Best Practices for Comprehensive Tobacco Control Programs.  The 2012 campaign spent $393 per year of life saved—far less than the $50,000 per year of life saved figure used as a common threshold for cost-effectiveness. The campaign  added about 179,000 healthy life years, at $268 per healthy year gained. The campaign spent about $480 per smoker who quit. The campaign averted more than 17,000 premature deaths, at a cost of about $2,200 per premature death averted. (more…)
Author Interviews, CDC, Dermatology, Emergency Care, JAMA / 16.12.2014

Gery P. Guy Jr., PhD, MPH Health economist Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch CDCMedicalResearch.com Interview with: Gery P. Guy Jr., PhD, MPH Health economist Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch CDC Medical Research: What is the background for this study? What are the main findings? Dr. Guy: Indoor tanning exposes users to intense UV radiation and is associated with an increased risk of skin cancer. However, little is known about the more immediate adverse outcomes of indoor tanning. This study provides the first national estimates of visits to emergency departments related to indoor tanning. We examined cases from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), a national probability sample of hospitals in the U.S. and its territories. Patient information is collected from each NEISS hospital for every emergency visit involving an injury associated with consumer products. From this sample, the total number of product-related injuries treated in hospital emergency rooms nationwide can be estimated. (more…)
Author Interviews, Breast Cancer, NEJM / 16.12.2014

Prudence A. Francis, M.D Associate Professor , Peter MacCallum Cancer Centre Melbourne, AustraliaMedicalResearch.com Interview with: Prudence A. Francis, M.D Associate Professor, Peter MacCallum Cancer Centre Melbourne, Australia Medical Research: What is the background for this study? What are the main findings? Response: The background for this study was the observation that premenopausal women diagnosed with hormone receptor positive breast cancer under age 35, had an increased risk of recurrence, as compared with older premenopausal women. We postulated that this might be because this age group was less likely to enter menopause after receiving chemotherapy, and so their ovaries were continuing to produce estrogen, which might have the effect of stimulating any remaining cancer cells. The main findings were that while not all premenopausal women benefit from the addition of treatment with ovarian function suppression to , the women who underwent chemotherapy and remained premenopausal (median age 40) did have improved breast cancer outcomes. This same group of women had even further improvement in recurrence rates if the ovarian suppression was combined with an aromatase inhibitor exemestane, as compared with tamoxifen. The effects of including ovarian suppression were particularly striking in women under 35 years of age. Those premenopausal women who did not receive chemotherapy (median age 46) after discussion with their doctor, did well with tamoxifen alone and do not appear to benefit from ovarian suppression currently. (more…)
Author Interviews, Heart Disease / 16.12.2014

Winnie Nelson PharmD, MS, MBA Director, Health Economics & Outcomes Research Janssen PharmaceuticalsMedicalResearch.com Interview with: Winnie Nelson PharmD, MS, MBA Director, Health Economics & Outcomes Research Janssen Pharmaceuticals Medical Research: What is the background for this study? What are the main findings? Dr. Nelson: Although warfarin has long served as the standard of care for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), research has shown nearly one-third of international normalized ratio (INR) levels among stabilized patients on warfarin are out-of-range. Data recently published in the International Journal of Clinical Pharmacy underscores the potential complications of out-of-range INRs, with the aim of informing patient care. The analysis of a U.S. Veterans Health Administration dataset showed out-of-range INRs were associated with a significantly increased risk of adverse clinical outcomes, including stroke and major bleeding. Of particular interest, the study also showed the magnitude of risk of thromboembolic events – such as ischemic stroke – was several folds higher in sub-therapeutic INR levels (i.e., INR <2) than risk of bleeding events when INR measures were >3. In another words, the research found more risks to patients when INRs were too low than when INRs were too high. (more…)
Author Interviews, FASEB, Weight Research / 15.12.2014

Dr. Richard Phipps PhD Department of Environmental Medicine and Flaum Eye Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New YorkMedicalResearch.com Interview with: Dr. Richard Phipps PhD Department of Environmental Medicine and Flaum Eye Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New York Medical Research: What is the background for this study? What are the main findings? Response: Obesity has risen dramatically over the past 30 years in the United States and throughout the world. Obesity increases morbidity and mortality by increasing health problems such as Type 2 diabetes, cardiovascular disease and cancer. Thus, obesity is one of our greatest challenges worldwide. Our laboratory has been studying a protein called Thy-1 for several decades. Until now its’ true function was unknown. The main finding from our research is that when cells express this protein on their surface, they are inhibited from becoming fat cells. We show in a mouse model system that mice, which lack Thy-1, and given a high fat diet, increase weight much faster than mice that express Thy-1. These mice that lack Thy-1, also have increased levels of many proinflammatory mediators in their blood. In human cells, those that express high levels of Thy-1 are blocked in their ability to become fat cells, unlike the human cells from different tissues that do not express Thy-1. Thus, the main finding is that learning how to manipulate Thy-1 expression could lead to reduced fat cells and reduced fat production. Not only is this an important finding for obesity, but there are many human diseases that are caused by excess fat production in organs, such as, the orbit of the eye, the liver, and the bone marrow. (more…)
Author Interviews, Weight Research / 15.12.2014

Susanne Mandrup Professor, Department of Biochemistry and Molecular Biology Odense M · DenmarkMedicalResearch.com Interview with: Susanne Mandrup Professor, Department of Biochemistry and Molecular Biology Odense M · Denmark Medical Research: What is the background for this study? What are the main findings? Prof. Mandrup: Obesity affects more than 1 billion adults globally and represents one of the greatest current threats to human health. Paradoxially, the fat tissues in the human body that stores excess calories might hold the key for a future obesity treatment. Most human fat depots are white fat tissues that store energy as fat; however, humans also have small amounts of brown fat, which primarily acts as an effective fat burner for the production of heat. Recent studies have shown that it is possible to “brown” white fat tissues (e.g. by prolonged cold-exposure) leading to an increase in the energy consumption of the body. The challenge is to understand how energy storing white fat cells are reprogrammed into so-called "brite" (brown-in-white) fat cells in the white adipose tissue and thus make adipose tissue burn off excess energy as heat instead of storing it. In this study we have for the first time investigated how the genome of white fat cells is reprogrammed during browning. We stimulated browning in human white adipocytes by a drug used to treat type II diabetes and compared white and "brite" fat cells. This showed that "brite" fat cells have distinct gene programs which, when active, make these cells particularly energy-consuming. Furthermore, we identified an important factor in the browning process - the gene regulatory protein KLF11 (Kruppel Like Factor-11). (more…)
Author Interviews / 15.12.2014

Bradley M. Gray, PhD American Board of Internal MedicineMedicalResearch.com Interview with: Bradley M. Gray, PhD American Board of Internal Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Gray: The American Board of Internal Medicine (ABIM) is committed to evaluating the impact its physician certification programs, including Maintenance of Certification (MOC). That motivated us to investigate the relationship between the MOC requirement and the practice patterns of internists subject to it. We looked to see whether the original MOC requirement was associated with health care costs and measures of hospitalizations drawn from Medicare claims. Our primary measure of hospitalizations was Prevention Quality Indicators, which were developed by the Agency for Health Care Research and Quality to measure impacts of primary care. These include such things as hospitalizations for an amputation due to diabetic complications. Our health care cost measure included outpatient and inpatient costs. To examine these associations, we took advantage of a natural experiment that occurred when one group of general internists who originally certified in 1991 were subject to the MOC requirement by 2001, while another group of internists, who originally certified just two years earlier in 1989, were grandfathered out of this requirement. In essence we can think of the 1991 required group of internists as a group treated by the effects of MOC and the 1989 grandfathered group as a control group in a natural experiment. We estimated associations with this requirement by comparing outcomes among Medicare beneficiaries treated by the required group of internists before and after the requirement took effect in 2001. Also before and after the 2001 requirement, we compared this difference to a similar difference in outcomes for a control group of beneficiaries treated by the grandfathered group of internists. At base line before 2001, these beneficiaries had almost identical characteristics and co-morbidities as the beneficiaries treated by the required group of internists. We did this to account for the natural increase in hospitalizations and health care costs that occur as beneficiaries age, as well as other important factors that might have been coincident with the MOC requirement. (more…)
Author Interviews, Stroke, Technology / 15.12.2014

Dr. Emmanuel Tsekleves Senior Lecturer in Design Interactions ImaginationLancaster LICA |Lancaster UniversityMedicalResearch.com Interview with: Dr. Emmanuel Tsekleves Senior Lecturer in Design Interactions ImaginationLancaster LICA |Lancaster University Medical Research: What is the background for this study? What are the main findings Dr. Tsekleves: The study was influenced by the anecdotal use of the Nintendo Wii in therapy in NHS physiotherapy clinics back in 2010/11. This led to the need for conducting a study with therapists and patients (33 questionnaires and 10 interviews were completed) to explore the current use of the Nintendo Wii console technology in physical rehabilitation programmes across four NHS Trusts in London. The study revealed that although respondents felt the Wii helped with rehabilitation, over half of them  reported difficulty using equipment (such as using the hand-held remote controls). Therapists believed use of standard Wii was limited due to the high level of dexterity, movement and coordination necessary to operate the system. Adapting Nintendo Wii To Enhance Stroke Rehabilitation The results of the aforementioned study informed the development of a personalised stroke treatment, using adapted Wii technology, for arm re-education post-stroke (that is reported in the article http://informahealthcare.com/doi/abs/10.3109/17483107.2014.981874). The developed system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed (Fugl-Meyer Assessment, Nine Hole Peg Test, Motor Activity Log – Amount of Use  sub-scale] and the Modified Ashworth Scale), with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. (more…)
Author Interviews, Flu - Influenza, PLoS, Vaccine Studies / 15.12.2014

Adrian Egli, MD PhD Research Group leader Infection Biology Laboratory Department of Biomedicine University of Basel and University Hospital Basel Basel, SwitzerlandMedicalResearch.com Interview with: Adrian Egli, MD PhD Research Group leader Infection Biology Laboratory Department of Biomedicine University of Basel and University Hospital Basel Basel, Switzerland Medical Research: What is the background for this study? What are the main findings? Dr. Egli: Infections with influenza viruses are associated with a high morbidity and mortality. In particular, people with a weak immune system are at danger for more severe complications. This includes elderly people, pregnant women, patients after transplantation, patients with HIV infection, chronic diseases such as diabetes and many more. In these high-risk groups, annual vaccination is clearly recommended. However, due to the immunsuppressive condition the immune response to the influenza vaccine is often reduced. The seroconversion rate - a 4-fold antibody titer increase upon vaccination - is one of the key markers for a successful vaccination. In young adults the seroconversion rate is normally >85%; however, in patients with immunosuppression, this can be lower than 40%. Improving vaccine efficacy is one of the key focuses of my research group. We try to understand, how to improve vaccines and better protect the people at the highest risks for influenza-associated complications. In this study, we could show that an important cytokine, called Interferon lambda, is clearly associated with the vaccine induced antibody response upon influenza vaccination. We could show that genetic polymorphisms, in one of the Interferon lambda gene family (IFNL3), are modulating the expression of this gene. This strongly affects the cross talk between the innate and adaptive immune response in the context of vaccination. We observed that, the more Interferon lambda is present, the lower the antibody response is. People with a lower expression of Interferon lambda had a significant higher response to the vaccine. Therefore, we developed substances to block the effect of Interferon lambda. We could show in vitro, that due to the Interferon lambda blockade, the antibody production was improved. (more…)
Author Interviews, Dermatology, Nature, Sleep Disorders / 14.12.2014

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, IllinoisMedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois Medical Research: What is the background for this study? What are the main findings? Dr. Silverberg: Chronic itch related to childhood eczema has been shown to cause worsened sleep quality with shorter sleep duration, more frequent and prolonged awakening, and overall lower sleep efficiency. However, little is known about the sleep disturbances that occur in adults with eczema. (more…)
Author Interviews, CMAJ, HPV, McGill, Vaccine Studies / 14.12.2014

Leah M. Smith PhD Department of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf) McGill University, Montréal, QuebecMedicalResearch.com Interview with: Leah M. Smith PhD Department of Epidemiology, Biostatistics, and Occupational Health  (Smith, Kaufman, Strumpf) McGill University, Montréal, Quebec   Medical Research: What is the background for this study? What are the main findings? Dr. Smith: The human papillomavirus (HPV) vaccine protects against types of HPV that cause cervical cancer and anogenital warts. The vaccine first became available in 2006. Since then, it has faced a great deal of controversy surrounding, in part, some of the unanswered questions about the real-world effects of the vaccine, especially on the young girls targeted for immunization. One issue that has received a great deal of public attention has been the concern that HPV vaccination might give girls a false sense of protection against all sexually transmitted infections that might lead them to be more sexually active than they would otherwise. As a result, some parents have been reluctant to have their daughters vaccinated. It is also reason why some religious groups have spoken out against the vaccine. This question is further important from a public health perspective because increases in risky sexual behaviour would inevitably also lead to increases in teen pregnancy and sexually transmitted infections (excluding anogenital warts), which would of course undermine the potential health benefits of the vaccine.  In this study, we directly addressed the question of whether HPV vaccination has led to increases in pregnancy and non-HPV-related sexually transmitted infections (both of which are proxies for risky sexual behaviour) among adolescent girls. In our study of over 260,000 girls, we did not find any evidence that the HPV vaccine had a negative impact on these outcomes. (more…)
Author Interviews, BMJ, Surgical Research / 14.12.2014

Dr Aneel Bhangu Clinical Lecturer in Surgery Queen Elizabeth Hospital, Edgbaston, Birmingham UKMedicalResearch.com Interview with: Dr Aneel Bhangu Clinical Lecturer in Surgery Queen Elizabeth Hospital, Edgbaston, Birmingham UK Medical Research: What is the background for this study? What are the main findings? Dr. Bhangu: Randomised clinical trials are widely regarded as the type of evidence in medical research most likely to change practice and improve patient care. However, they are challenging to perform, expensive to deliver and rely on patients’ willingness to participate for the benefit of their wider community. Results of these studies should be disseminated widely in order to promote new medical knowledge. Unfortunately, some clinical trials are terminated early or fail to reach publication after completion. This leads to lost data and wastage of finite resources. Clinical trials within surgical disciplines present unique challenges, which may further impact on dissemination of evidence. We aimed to investigate the fate of surgical trials. Disappointingly, we found that 1 in 5 surgical trials are terminated early before completion, most commonly due to poor recruitment of research participants. Of trials which do reach completion, 1 in 3 are not published, indicating a significant waste of resources. A systematic approach to contact trial investigators during the study proved largely unsuccessful, implicating further hidden barriers to identifying trial data. (more…)
Author Interviews, Pulmonary Disease, Vitamin C / 14.12.2014

Harri Hemilä, MD PhD Department of Public Health University of Helsinki, POB 41 Helsinki, FinlandMedicalResearch.com Interview with: Harri Hemilä, MD PhD Department of Public Health University of Helsinki, POB 41 Helsinki, Finland   Medical Research: What is the background for this study? What are the main findings? Dr. Hemilä: I have a two decade interest in the effects of vitamin C on respiratory symptoms and I am the first author of the Cochrane review on vitamin C and the common cold. Since there is very strong evidence that vitamin C is better than placebo, in the Cochrane review we encourage common cold patients to try if vitamin C helps them. In 2009, I was taking a look at the Cochrane review on vitamin C and asthma. I was puzzled with the text and figures since my own impression of the RCTs on vitamin C and asthma was quite different from what the review presented. Therefore I took a close look at the Cochrane review and I saw that it was sloppy. There were severe errors in data extraction and data analysis. For example, they used un-paired t-test when they should have used the paired t-test. That types of questions are very basic in biostatistics. I wrote a feedback to that Cochrane review and the review was withdrawn in 2013. It had been misleading readers for a decade. As a positive result of that incident, I became interested in the effects of vitamin C on asthma and I conducted a meta-analysis of three RCTs on vitamin C and exercise-induced bronchoconstriction (EIB). I calculated that vitamin C caused a 48% reduction (95% CI 33% to 64%) in the postexercise FEV1 decline. That study was published in BMJ Open in 2013 (http://www.ncbi.nlm.nih.gov/pubmed/23794586). (more…)
Author Interviews, Breast Cancer, JNCI, Mayo Clinic / 14.12.2014

Dr. Matthew P. Goetz, MD Associate Professor of Pncology Mayo ClinicMedicalResearch.com Interview with: Dr. Matthew P. Goetz, MD Associate Professor of Pncology Mayo Clinic Medical Research: What is the background for this study? What are the main findings? Dr. Goetz: There has been conflicting data with regard to the importance of metabolism as measured by CYP2D6 genetic variation.   Two large “negative” studies were reported simultaneously in 2012 and these were referenced by guidelines that CYP2D6 should not be used to select hormonal therapy.   Our findings demonstrated that these studies were flawed in part based on analytical validity issues.  In short, the use of tumor tissue to derive CYP2D6 germline genotype leads to genotyping error in up to 45% of samples. (more…)
Author Interviews, Parkinson's / 14.12.2014

Filip Scheperjans MD Department of Neurology Helsinki University Central Hospital Department of Neurological Sciences University of Helsinki, Helsinki, FinlandMedicalResearch.com Interview with: Filip Scheperjans MD Department of Neurology Helsinki University Central Hospital Department of Neurological Sciences University of Helsinki, Helsinki, Finland Medical Research: What is the background for this study? What are the main findings? Dr. Scheperjans: In Parkinson’s disease (PD), the first neurodegenerative changes are seen in the olfactory bulb and enteric nervous system. Correspondingly, most Parkinson’s disease patients suffer from hyposmia and gastrointestinal symptoms, frequently years before motor symptoms evolve. Therefore, it has been suggested that an environmental factor acting through the nose or gut, could be involved in Parkinson’s disease. Interestingly, those two habitats are where our body gets mostly exposed to environmental agents, including microbes. Previous attempts to identify microbes related to Parkinson’s disease pointed to Helicobacter pylori and small intestinal bacterial overgrowth, but in the end had been somewhat inconclusive. But there possibly was a signal. We saw next generation sequencing approaches as a new opportunity to revisit the microbe theory in PD. Studies of gut microbiome composition in neurodegenerative disease have not been published before, although alterations in gut microbiota have been demonstrated in many other diseases and gut microbiota are in close interaction with the central nervous system. The fecal microbiome of Parkinson’s disease subjects clearly differed from that of matched controls and this difference was independent of the potential confounders that we assessed. The most significant finding was that the abundance of bacteria from the Prevotellaceae family was reduced by 78% in Parkinson’s disease patients. A low abundance of Prevotellaceae was 86% sensitive for PD, but rather unspecific. However, a combination of 4 bacterial families increased specificity for PD to 90%. So microbiome analysis performed quite well in distinguishing Parkinson’s disease patients from control subjects. Another interesting finding was that, within the Parkinson’s disease group, abundance of Enterobacteriaceae bacteria was related to the motor symptoms of patients. They were positively associated with the severity of postural instability and gait difficulty. (more…)
Author Interviews, Heart Disease, Mayo Clinic, Outcomes & Safety / 14.12.2014

Atsushi Sorita, MD, MPH Mayo Clinic, Division of Preventive Medicine Rochester, MN 55905.MedicalResearch.com Interview with: Atsushi Sorita, MD, MPH Mayo Clinic, Division of Preventive Medicine Rochester, MN 55905.   Medical Research: What is the background for this study? What are the main findings? Dr. Sorita: Prior studies have suggested that patients with heart attack who are admitted during off-hours (weekends, nights and holidays) have higher risk of death when compared with patients admitted during regular hours. In our study, we found that patients undergoing percutaneous coronary interventions for heart attack who were admitted during off-hours did not have higher mortality or readmission rates as compared with ones admitted during regular hours at a highly-integrated academic center in the United States. (more…)
Author Interviews, Cost of Health Care, Smoking / 14.12.2014

MedicalResearch.com Interview with: Darryl Konter Health Communications Specialist McNeal Professional Services Centers for Disease Control and Prevention Office on Smoking and Health Atlanta, GA 30341 Medical Research: What is the background for this study? What are the main findings? Darryl Konter:         Fifty years after the first Surgeon General’s report, tobacco use remains the nation’s leading preventable cause of death and disease, despite declines in adult cigarette smoking prevalence. Smoking-attributable healthcare spending is an important part of overall smoking attributable costs in the U.S.         Data came from the 2006–2010 Medical Expenditure Panel Survey (MEPS) linked to the 2004–2009 National Health Interview Survey (NHIS). The MEPS is a nationally representative survey of civilian non-institutionalized families and individuals, their medical providers, and employers that collects information on individual healthcare utilization and medical expenditures.         By 2010, 8.7% of annual healthcare spending in the U.S. could be attributed to cigarette smoking, amounting to as much as $170 billion per year.  More than 60% of the attributable spending was paid by public programs, including Medicare, other federally-sponsored programs, or Medicaid. (more…)
Author Interviews, MRSA, PNAS, UCLA, Vaccine Studies / 14.12.2014

Dr. Michael Yeaman Ph.D. Professor of Medicine, Infectious Disease Specialist Chief, Division of Molecular Medicine David Geffen School of Medicine at UCLA Los Angeles Biomedical Research Institute at Harbor-UCLA Medical CenterMedicalResearch.com Interview with: Dr. Michael Yeaman Ph.D. Professor of Medicine, Infectious Disease Specialist Chief, Division of Molecular Medicine David Geffen School of Medicine at UCLA Los Angeles Biomedical Research Institute Harbor-UCLA Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Yeaman: In the U.S. and around the globe, skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA) continue to endanger the health and lives of patients and otherwise healthy individuals. Treatment is difficult because MRSA is resistant to many antibiotics, and the infections can recur, placing family members and other close contacts at risk of infection. Infectious disease specialists at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) tested a new investigational vaccine, NDV-3, and found it holds new hope for preventing or reducing the severity of infections caused by the "superbug" MRSA. In the study, which was published Dec. 8 in the Proceedings of the National Academy of Sciences USA, the researchers reported that NDV-3, employing the recombinant protein Als3, can mobilize the immune system to fight off MRSA skin infections in an experimental model. The researchers found the vaccine works by enhancing molecular and cellular immune defenses of the skin in response to MRSA and other S. aureus bacteria in disease models. This is the first published study to demonstrate the effectiveness of a cross-kingdom recombinant vaccine against MRSA skin infections. NDV-3 is unique as it is the first vaccine to demonstrate it can be effective in protecting against infections caused by both S. aureus and the fungus Candida albicans. NDV-3 represents a novel approach to vaccine design that pioneers an approach termed convergent immunity. (more…)
Author Interviews, Imperial College, Sugar, Weight Research / 13.12.2014

MedicalResearch.com Interview with: Dr James Gardiner Reader in Molecular Physiology Imperial College Hammersmith Campus London 0NN Medical Research: What is the background for this study? What are the main findings? Response: It is well known that glucose is a preferred food and is consumed in preference to other nutrients. Food intake is controlled by the brain in part this it is regulated by part of the brain called the hypothalamus.   Glucokinase is an important component of glucose sensing and is expressed in the hypothalamus and specifically in the arcuate nucleus. A hypothalamic mechanism regulating glucose intake has not previously been identified. Using a rodent model we demonstrated that increasing glucokinase activity in the arcuate nucleus increased food intake and body weight. If glucose was available as separately then glucose intake is increased but not weight. Decreasing glucokinase activity in the arcuate nucleus had the opposite effect, reducing glucose intake when it was available.   Our results suggest that glucokinase controls glucose appetite and hence the amount of glucose consumed. This is the first time a mechanism controlling the intake of a specific nutrient has been described. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition, Sugar, Weight Research / 13.12.2014

Dr James J DiNicolantonio PharmD Ithaca, New YorkMedicalResearch.com Interview with: James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute Medical Research: What is the background for this study? What are the main findings? Dr. DiNicolantonio: Cardiovascular disease is the leading cause of premature mortality in the developed world, and hypertension is its most important risk factor. Controlling hypertension is a major focus of public health initiatives, and dietary approaches have historically focused on sodium. A reduction in the intake of added sugars, particularly fructose, and specifically in the quantities and context of industrially-manufactured consumables, would help not only curb hypertension rates, but would also help address broader problems related to cardiometabolic disease. (more…)
Author Interviews, Cognitive Issues, Genetic Research, JAMA / 13.12.2014

David H. Ledbetter, Ph.D., FACMG Executive Vice President & Chief Scientific Officer, Geisinger Health System Danville, PA 17822MedicalResearch.com Interview with: David H. Ledbetter, Ph.D., FACMG Executive Vice President & Chief Scientific Officer, Geisinger Health System Danville, PA 17822 Medical Research: What is the background for this study? What are the main findings? Dr. Ledbetter: One of the biggest challenges in clinical care and research of children with autism and related neurodevelopment disorders is the remarkable clinical variability between individuals. This heterogeneity is reduced, but still significant, when considering individuals who have neurodevelopment disorders due to the identical genetic mutation such as deletion 16p11.2. We proposed that family background, genetic or environmental, may contribute to the variability in cognitive, behavioral and motor performance profiles of children with a sporadic (new) mutation in 16p11.2. Our study confirmed that a significant portion of the clinical variability seen in these children is due to the performance level of their parents and unaffected siblings and suggested that this may be due in part to genetic background effects as these traits are all known to have very high heritability. (more…)
Author Interviews, Biomarkers, Heart Disease / 13.12.2014

MedicalResearch.com Interview with: Mette Bjerre, Associate Professor, PhD Medical Research Laboratory Aarhus University Hospital & Aarhus University Aarhus C Denmark Medical Research: What is the background for this study? What are the main findings? Dr.Bjerre: Recently, a connection between bone regulatory proteins and vascular biology has attracted attention, suggesting osteoprotegerin (OPG), a secreted glycoprotein that regulates bone resorption, as a possible mediator of vascular calcification. Indeed, we and others has shown that high levels of circulating OPG predicts long-term outcome in patients with cardiovascular disease (CVD). However, the mechanism remains poorly understood. In order to elucidate the role of OPG in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), our study aimed to evaluate the progression of OPG levels, in four consecutive blood-samples obtained pre-PCI, post-PCI, day 1 and day 2. OPG levels did indeed change during treatment. OPG levels peaked post-PCI and then decreased; mean concentrations (95% confidence interval) pre-PCI 2650ng/L (2315-3036ng/L), post-PCI 2778ng/L (2442-3363ng/L), day 1 2024ng/L (1775-2306ng/L) and day 2 1808ng/L (1551-2106), (repeated measures ANOVA, F=33.192, p<0.001). Additional, high OPG level is independently associated with impaired LVEF (LVEF < 40%). Adjustment for BMI and traditional cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes and current smoking) did not significantly impact the association between OPG response and reduced LVEF. (more…)
Addiction, ADHD, Author Interviews / 13.12.2014

William Brinkman, MD, MEd, MSc Associate Professor of Pediatrics Director, Research Section, Division of General & Community Pediatrics Research Director, Cincinnati Pediatric Research Group James M. Anderson Center for Health Systems Excellence Cincinnati Children’s Hospital Medical CenterMedicalResearch.com Interview with: William Brinkman, MD, MEd, MSc Associate Professor of Pediatrics Director, Research Section, Division of General & Community Pediatrics Research Director, Cincinnati Pediatric Research Group James M. Anderson Center for Health Systems Excellence Cincinnati Children’s Hospital Medical Center MedicalResearch.com: What is the background for this study? Dr. Brinkman: Early onset of substance use is a significant public health concern as those who use substances before the mid-teen years are more likely to develop dependence than those who start later. The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population. (more…)
Author Interviews, Brain Injury, NEJM / 13.12.2014

MedicalResearch.com Interview with: Dr. Brett E. Skolnick PhD Department of Neurosurgery Cushing Neuroscience Institute Hofstra North Shore–LIJ School of Medicine, Manhasset, NY Medical Research: What is the background for this study? What are the main findings? Dr. Skolnick: The experimental evidence for a role of progesterone is based on extensive non-clinical studies in non-primate species (4 animal species such as rat, mice) the majority of which indicate that progesterone has a variety of neuroprotective properties. The animal models of injury in traumatic brain injury (TBI) have included models of blunt trauma, fluid percussion injury, cortical aspiration but similar effects have been seen stroke models and models of spinal cord injury. In these experiments progesterone has been shown to reduce cerebral edema thus limiting the effects or preventing intracranial pressure increases which can lead to secondary injury. Progesterone has also been shown to exert anti-inflammatory, anti-apopotic and perhaps even anti-oxidant effects. All of these effect are postulated to work synergistically to prevent cell death which could result in improved functional outcomes. Two small single center clinical trials provided the support in traumatic brain injury patients that progesterone could have impact on functional outcomes in larger, properly powered trials.  The results of which are summarized in the NEJM article. In the current trial evaluated the Glasgow Outcome Scale and the extended version of the Glasgow Outcome scale at 6 months following injury. These scales are well validated scales that are used to determine the degree of recovery in terms of disability and handicap due to TBI rather than the degree of impairment. The GOS has 5 levels: death, vegetative state, severe disability, moderate disability and good recovery with death and vegetative state typically collapsed because they are considered equally undesirable. The Extended GOS takes the three best levels of recovery and subdivides these into a upper and lower category to increase the granularity of the outcome measure. Progesterone was administered within 8 hour of injury (loading dose followed by continuous infusions) for a total of 120 hours.  Careful assessments were performed to ensure optimal patient management during the trial to provide the best background to evaluate the impact of the addition of progesterone or placebo (1  to 1 randomization).  No effect was seen on the GOS or the extended GOS. In addition a fairly new approach of categorizing patients based on prognostic factors known at time of randomization (such as Age, baseline GCS, pupillary response, hypoxia, hypotension, Marshall Classification or presence/absence of subarachnoid hemorrhage) as developed by Hukkelhoven and colleagues was used. This was expected to tease out improvements, if they existed in subgroups of patients where perhaps progesterone could work better in the most severe or less severe traumatic brain injury patients. But again no effects were seen. The unfavorable outcomes (see NEJM paper for details) were essentially identical between progesterone and placebo groups whether they had the worst prognosis or the best prognosis. (more…)
Author Interviews, Genetic Research, NEJM, NIH / 13.12.2014

Dr. Constantine A. Stratakis, M.D., D.Sc National Institutes of Health, Clinical Research Center Bethesda, MD 20892-1862MedicalResearch.com Interview with: Dr. Constantine A. Stratakis, M.D., D.Sc National Institutes of Health, Clinical Research Center Bethesda, MD 20892-1862 Medical Research: What is the background for this study? What are the main findings? Dr. Stratakis: We have been working for years on the genetics of pituitary tumors in association with other conditions. A few years ago (attached), we studied for the first time a series of pediatric giants that we sequenced for then known genes. We found a few MEN1 and AIP mutations but all mutations were present in older kids with gigantism. This left out the youngest among the giants without any genetic defect. This was the first time I realized that I was dealing with a different disease. We started looking for additional genetic defects and when we found the Xq26 microduplications in 3 kindreds. We contacted the custodians of the largest series in the world - Dr. Beckers in Liege. He screened his cases, once we gave him the coordinates, and boom - it was there... The most significant thing here is that this is a new disease really: the early pediatric gigantism is almost exclusively due to Xq26 microduplications unless it is part of a family with another syndrome (AIP, MEN1, Carney complex). If there is no family history and you are dealing with a toddler with gigantism, based in these data, there is a more than 80% chance of having an Xq26 defect. This is pretty amazing! In addition, assuming that GPR101 is the responsible gene (which needs to be confirmed with additional studies) this identifies a new molecular pathway of increasing growth hormone secretion, most likely due to upregulation of GHRH - all of this needs to be confirmed in further human and animal studies. The Xq26 genomic micro-arrangements (which contain the GPR101, but also 3 other genes) is the big news here... (more…)
Author Interviews, Ophthalmology, Weight Research / 13.12.2014

MedicalResearch.com Interview with: Rui Azevedo Guerreiro Centro Hospitalar de Lisboa Central Portugal Medical Research: What is the background for this study? What are the main findings? Response: This article aims to summarise the current state of understanding on the possible ophthalmic complications that can occur after a bariatric surgery. The main finding of this review article is that ophthalmic complications after bariatric surgeries are more frequent that we could thought initially, especially in patients not adherent to their vitamin supplements. In one study, the percentage of patients with vitamin A deficiency 4 years after the surgery reached up to 69%. (more…)