Author Interviews, Lancet, MRSA, NIH / 18.01.2023

MedicalResearch.com Interview with: Michael Otto PhD Senior Investigator Laboratory of Bacteriology Chief of the Pathogen Molecular Genetics Section NIAID, NIH Bethesda, MD 20814 MedicalResearch.com: What is the background for this study? Response:  Staphylococcus aureus is one the of the most important causes of infectious diseases worldwide. It is known mostly for causing skin infections in the community and as a hospital-associated pathogen. It is in fact the most frequent cause of infections patients acquire in the hospital when they are weakened by underlying diseases or immune-suppressing therapy. The type of infections Staph can cause in these situations are diverse – comprising bone, lung, and blood infections (sepsis) - and can be quite severe and often fatal. Except for moderately severe skin infections that may not require antibiotic treatment, treatment of Staph infections is by antibiotics. S. aureus has naturally been very responsive to penicillin-type antibiotics, but already in the mid of the last century, resistance to penicillin spread worldwide. Then, methicillin was invented to overcome this resistance, but nowadays there also is considerable spread of methicillin-resistant strains (MRSA). The current situation is difficult for two reasons:
  • First, S. aureus has become increasingly resistant to many antibiotics, and
  • Second, the alternatives to methicillin are often by far not as efficient as penicillin/methicillin against Staph.
Researchers have therefore been searching for alternatives to antibiotics to treat Staph infections. Unfortunately, vaccines that work against Staph have not yet been produced despite intensive efforts for decades. Other modern approaches of treatment, like virulence-targeted drugs or phages are still only at the early investigational level. As with many diseases, an alternative to treatment is prevention. In the case of S. aureus, a type of preventative strategy that has often been proposed and tested is decolonization. This is based on the fact that ~ 1/3 of the population is naturally colonized with S. aureus (asymptomatically), and these colonized people have an increased risk of being infected. In other words, Staph infections stem from the Staph you carry on your body and which only under certain conditions causes infection. Thus, eliminating the colonizing Staph would reduce the risk for infection, which is the basis for Staph decolonization-based infection prevention strategies. (more…)
Author Interviews, Dermatology, Lancet / 13.12.2022

MedicalResearch.com Interview with: Dr. Emma Guttman-Yassky, MD, PhD Waldman Professor and System Chair The Kimberly and Eric J. Waldman Department of Dermatology Director, Center of Excellence in Eczema Director, Laboratory of Inflammatory Skin Diseases Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study are studies that show that OX40 is a pathway that is upregulated in patients with atopic dermatitis (or eczema). OX40 is involved in activation of immune molecules associated with allergy and atopy, and also with formation of memory immune cells that are required for disease recurrence. The hypothesis to the study was that giving an OX40 antagonist will not only ameliorate the disease but perhaps have a remittive effect in that the disease will not come back. Indeed all drug doses were significantly effective at week 16, the primary endpoint compared to placebo and continued to improve towards week 36, the secondary endpoint. In addition, the responders to treatment maintained their responses for an additional 20 weeks, which is unusual, suggesting a potential for disease modification. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lancet, Lung Cancer, Medical Imaging, Technology / 07.09.2022

MedicalResearch.com Interview with: Raymond H. Mak, MD Radiation Oncology Disease Center Leader for Thoracic Oncology Director of Patient Safety and QualityDirector of Clinical Innovation Associate Professor, Harvard Medical School Cancer - Radiation OncologyRadiation Oncology Department of Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What is the algorithm detecting? Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy.  Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase. To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds. We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction. (more…)
Author Interviews, COVID -19 Coronavirus, Lancet / 12.04.2022

MedicalResearch.com Interview with: Dr Kollengode Ramanathan MD Cardiothoracic Intensive Care Unit National University Heart Centre National University Hospital Singapore MedicalResearch.com:  What is the background for this study?  Response: Globally, more than 10 billion doses of COVID-19 vaccines have been administered as of March 2022. While most side-effects of the vaccine are mild and self-limiting, myopericarditis ( inflammation of the heart) is increasingly being reported after COVID-19 vaccination. Thus far it has only been linked only to smallpox vaccination. However, several studies have suggested that mRNA COVID-19 vaccines significantly increase the risk of myocarditis, particularly in males and in people aged 16-39 years. We reviewed the literature comparing the incidence of myopericarditis following COVID-19 and non-COVID-19 vaccination.   (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections / 29.03.2022

MedicalResearch.com Interview with: Michael J. Mahan Ph.D. Professor Dept of Molecular, Cellular, and Developmental Biology University of California Santa Barbara, CA MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response:  Sepsis is the number one cause of death in US hospitals- but few molecular diagnostics and therapies exist for this condition. In the clinic, sepsis is diagnosed by a symptom-based approach that may include kidney or liver failure, blood clotting or bleeding — which is often well after permanent organ damage. Thus, molecular diagnostics that detect infection at early stages of disease to minimize host injury are sorely needed. (more…)
Author Interviews, Diabetes, Global Health, Lancet / 12.01.2022

MedicalResearch.com Interview with: Prof Dianna J Magliano PhD Baker Heart and Diabetes Institute Melbourne Australia  MedicalResearch.com: What is the background for this study? Response: Mortality among people with diabetes, and how it changes over time, is an important indicator of quality of and access to health care. However, population level trends in mortality among people with diabetes are inadequately described. The establishment of national diabetes registers, health insurance data and administrative data has allowed the examination of mortality among those with diabetes at a granular level which has been previously not possible. This has allowed us to examine whether global efforts in regards to diabetes care over the last couple of decades have been effective. (more…)
Author Interviews, Cancer Research, Dermatology, Lancet, Melanoma, Technology / 11.11.2021

MedicalResearch.com Interview with: Dr David Wen BM BCh NIHR Academic Clinical Fellow in Dermatology University of Oxford MedicalResearch.com: What is the background for this study? Response: Publicly available skin image datasets are commonly used to develop machine learning (ML) algorithms for skin cancer diagnosis. These datasets are often utilised as they circumvent many of the barriers associated with large scale skin lesion image acquisition. Furthermore, publicly available datasets can be used as a benchmark for direct comparison of algorithm performance. Dataset and image metadata provide information about the disease and population upon which the algorithm was trained or validated on. This is important to know because machine learning algorithms heavily depend on the data used to train them; algorithms used for skin lesion classification frequently underperform when tested on independent datasets to which they were trained on. Detailing dataset composition is essential for extrapolating assumptions of generalisability of algorithm performance to other populations. At the time this review was conducted, the total number of publicly available datasets globally and their respective content had not previously been characterised. Therefore, we aimed to identify publicly available skin image datasets used to develop ML algorithms for skin cancer diagnosis, to categorise their data access requirements, and to systematically evaluate their characteristics including associated metadata.   (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, Lancet, Pulmonary Disease / 26.08.2021

MedicalResearch.com Interview with: Jie Li, PhD, RRT, RRT-ACCS, RRT-NPS, FAARC Department of Cardiopulmonary Sciences Division of Respiratory Care Rush University, Chicago MedicalResearch.com: What is the background for this study? Response: Prone positioning has been shown to improve oxygenation and reduce mortality in intubated patients with acute respiratory distress syndrome (ARDS), as placing patients on their stomachs can help open alveoli and reduce ventilation to perfusion mismatch. At early pandemic, clinicians tried prone positioning for non-intubated patients with COVID-19 and found improvement in oxygenation. However, the evidence for patient outcomes such as intubation or mortality is still lacking. Thus we organized this international, multicenter, randomized controlled meta-trial, with 41 hospitals in 6 countries participated. (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology, Lancet / 17.03.2021

MedicalResearch.com Interview with: Matt Spick, Post-Graduate Researcher University of Surrey Faculty of Engineering and Physical Sciences Guildford, UK MedicalResearch.com: What is the background for this study? Are you measuring lipids or the virus? Response: In this study, we aimed to detect what the virus does to us, rather than the virus itself. The gold standard for detecting COVID-19 is the RT-PCR test, but by their nature, PCR tests only provide diagnostic information, and at times during the pandemic the availability of PCR tests has been a bottleneck for the identification of the disease. Our goal was to investigate a novel method for the diagnosis of COVID-19, at the same time as learning more about what the disease does to us through lipidomics. (more…)
Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids / 11.11.2020

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark  MedicalResearch.com: What is the background for this study? Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today (more…)
Author Interviews, HIV, Lancet / 18.10.2020

MedicalResearch.com Interview with: Steve Kanters, PhD MSc Rain City AnalyticsPresident and Lead Analyst RainCity Analytics School of Population and Public Health, University of British Columbia Vancouver, British Columbia, Canada MedicalResearch.com: What is the background for this study? Response: A watershed moment for the fight against HIV was the antiretroviral treatment (ART) scale-up that made HIV treatments available around the world. While HIV activism led to its initiation, two key ingredients to the ART scale-up were the advent of a once-daily single-pill HIV treatment and the creation of the World Health Organization (WHO) clinical guidelines for treatment and prevention of HIV. The HIV treatment in question combines three drugs in a single pill and centers around a drug called efavirenz. The WHO guidelines use a public health framework, which is to say that it uses a treatment algorithm that is both equitable and simple enough to allow some task-shifting to less specialized workers. As such, the guidelines suggest a single preferred treatment for people initiating HIV treatment. While resource rich countries can use a personalized medicine approach, many settings where HIV is endemic cannot. In 2015, our review found strong evidence that a newer HIV drug, called dolutegravir, was better than efavirenz in respect to efficacy, tolerability and safety; however, there was not enough evidence to support its use in key populations, such as people with HIV-tuberculosis co-infections and pregnant women. For this and other reasons, the WHO could not recommend its use as the preferred treatment at initiation. Since then, we have continued to dynamically assess the evidence to determine the best treatment to have as the preferred ART for first-time HIV treatment. This is the culmination of 6 years of work and its findings have helped the WHO change its recommended preferred first-line therapy from an efavirenz-based ART to a dolutegravir-based ART.  (more…)
Author Interviews, COVID -19 Coronavirus, Lancet / 02.06.2020

MedicalResearch.com Interview with: Holger Schünemann, MD, PhD, FRCPC Professor of Clinical Epidemiology and of Medicine Co-Director, WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations Director, Cochrane Canada and McMaster GRADE Centre Department of Health Research Methods, Evidence, and Impact Canada  MedicalResearch.com: What is the background for this study? Response: Many countries and regions have issued conflicting advice about physical distancing to reduce transmission of COVID-19, based on limited information. In addition, the questions of whether masks and eye coverings might reduce transmission of COVID-19 in the general population, and what the optimum use of masks in healthcare settings is, have been debated during the pandemic. (more…)
Author Interviews, Cancer Research, Lancet, Nature / 19.05.2020

MedicalResearch.com Interview with: Matthew Galsky, MD Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: Standard first-line treatment for metastatic urothelial (bladder) cancer has been platinum-based chemotherapy for decades. In 2016, atezolizumab, an immunotherapy that inhibits PD-L1, received accelerated approval by the FDA for the treatment of metastatic urothelial cancer for patients progressing despite prior platinum-based chemotherapy and this was followed by approvals for 4 additional PD-1 or PD-L1 inhibitors in this setting over the next couple years. With this first new drug class approved, representing the first new drugs approved for metastatic urothelial cancer for decades, logical question arose (a) should we combine these drugs with platinum-based chemotherapy in the first-line metastatic treatment setting and (b) is there a role to replace first-line chemotherapy with atezolizumab monotherapy. The IMvigor 130 trial was designed to address these questions. The trial enrolled 1213 patients who were randomized to treatment with (a) atezolizumab plus platinum-based chemotherapy, (b) placebo + platinum-based chemotherapy, or (c) atezolizumab monotherapy. The trial employed a hierarchical analysis plan such that comparisons between arms for certain endpoints could only be formally tested if other the preceding comparisons demonstrated a significant improvement.  (more…)
AHA Journals, Author Interviews, Pharmaceutical Companies, Stroke / 21.02.2020

MedicalResearch.com Interview with: Michael Tymianski, CM, MD, PhD, FRCSC, FAHA Head, Division of Neurosurgery, University Health Network Medical Director, Neurovascular Therapeutics Program, University Health Network Professor, Departments of Surgery and Physiology, University of Toronto Senior Scientist, Toronto Western Hospital Research Institute Director, Neuroprotection Laboratory, Toronto Western Hospital President and CEO, NoNO Inc MedicalResearch.com: What is the background for this study? How is alteplase related to and affect nerinetide? Response: Cerebral neuroprotection for acute ischemic stroke (AIS) is defined as a therapy aimed at enhancing the brain’s resilience to ischemia to improve the clinical outcome of affected individuals. Although traditionally aimed at the salvage of neurons, this term may be equally applicable to all the cellular constituents of the brain, including cells of cerebral blood vessels, neurons, and glia. Pharmacological neuroprotection (hereafter referred to as neuroprotection) would be achieved by drugs targeting one or more critical components of the ischemic cascade that lead to ischemic damage. The feasibility of neuroprotection has a strong basis in animal experiments, but research for several decades has failed to translate neuroprotective treatments from animals to humans. The disappointing results of all controlled clinical neuroprotection trials for AIS have cast doubts as to whether neuroprotection in humans is biologically possible and, given the complexities of human stroke syndromes, whether it is a clinically practicable therapy for patients experiencing AIS in the community. In the case of neuroprotection trials for acute ischemic stroke, all to date have failed to demonstrate a clinical benefit of the study agent. Our review of studies since the year 2000 shows that many were not conducted in accordance with the animal studies that supported efficacy. They enrolled a heterogeneous subject population with varying (small and large) vessel occlusions and without knowledge of the degree of completed infarctions. Most had not implemented a strategy to ensure that the treatment effect size was maximized, and all in-hospital trials enrolled in treatment windows that exceeded 4 hours, at which an important proportion of enrolled subjects cannot respond to treatment because they no longer have salvageable brain. The ESCAPE-NA1 addressed past deficiencies of AIS trials. It was based on a sound scientific foundation including extensive animal studies, and capitalized on the designs that led to success in AIS trials of endovascular thrombectomy. ESCAPE-NA1 enrolled patients proven by these past trials to have salvageable brain at the time that the treatment was given, and tested the drug in an ischemia-reperfusion scenario in which it was anticipated to be most effective. The enrollment was over 12 hours, but only including patients who had medical imaging suggestive that they still had salvageable brain. Alteplase is an agent that activates the protease plasmin in the bloodstream. Plasmin cleaves peptides at certain spots within their structure, and it is a known biological fact that plasmin is able to cleave nerinetide. What was not known at the time of the trial was the degree to which this would reduce nerinetide plasma leves in humans, and the impact that this would have on the therapeutic effects of nerinetide. This is why we conducted a very large trial in which the participants’ enrollment was stratified according to whether or not they received alteplase. This ensured that there was good balance within each stratum, thereby enabling us to make more robust conclusions. (more…)
Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Diabetes, Heart Disease, Lancet / 08.09.2019

MedicalResearch.com Interview with: Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC Professor of Medicine, Harvard Medical School Executive Director of Interventional Cardiovascular Programs, Brigham and Women’s Hospital Heart & Vascular Center MedicalResearch.com: What is the background for this study? Response: Dual antiplatelet therapy (DAPT) is known to improve outcomes in patients with acute coronary syndromes (ACS), prior myocardial infarction (MI), or recent coronary stenting. What was unknown is whether patients with diabetes and stable coronary artery disease – a group generally believed to be at high ischemic risk – would benefit from initiation of long-term DAPT with low-dose aspirin plus ticagrelor versus low-dose aspirin (plus placebo). This is what THEMIS was designed to test, with THEMIS-PCI designed prospectively to examine those patients specifically who had a history of previous percutaneous coronary intervention (PCI). (more…)
Author Interviews, Brigham & Women's - Harvard, Global Health, Infections, Lancet, Pediatrics / 21.08.2019

MedicalResearch.com Interview with: Tori Cowger, MPH Ph.D Student | Population Health Sciences Department of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Globally, approximately one million cases of tuberculosis disease (TB) and 233,000 TB-related deaths occurred among children aged younger than 15 years during 2018. TB in children and adolescents is clinically and epidemiologically heterogeneous, making diagnosis, care, and prevention challenging. Understanding this heterogeneity can inform TB care and prevention efforts, and efforts to eliminate disparities in TB incidence and mortality in these groups. In this study, we describe the epidemiology of TB among children and adolescents in the United States, and report TB incidence rates for US territories and freely associated states and by parental country of birth, which have not been previously described. (more…)
Author Interviews, Heart Disease, Lancet, Mayo Clinic, Technology / 02.08.2019

MedicalResearch.com Interview with: Paul Friedman, M.D. Professor of Medicine Norman Blane & Billie Jean Harty Chair Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D. MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is an irregular heart rhythm that is often intermittent and asymptomatic.  It is estimated to affect 2.7–6.1 million people in the United States, and is associated with increased risk of stroke, heart failure and mortality. It is difficult to detect and often goes undiagnosed. After an unexplained stroke, it is important to accurately detect atrial fibrillation so that patients with it are given anticoagulation treatment to reduce the risk of recurring stroke, and other patients (who may be harmed by this treatment) are not. Currently, detection in this situation requires monitoring for weeks to years, sometimes with an implanted device, potentially leaving patients at risk of recurrent stroke as current methods do not always accurately detect atrial fibrillation, or take too long. We hypothesized that we could train a neural network to identify the subtle findings present in a standard 12-lead electrocardiogram (ECG) acquired during normal sinus rhythm that are due to structural changes associated with a history of (or impending) atrial fibrillation.   Such an AI enhanced ECG (AI ECG) would be inexpensive, widely available, noninvasive, performed in 10 seconds, and immensely useful following embolic stroke of unknown source to guide therapy. To test this hypothesis, we trained, validated, and tested a deep convolutional neural network using a large cohort of patients from the Mayo Clinic Digital Data Vault. (more…)
Author Interviews, Lancet, Neurology, Surgical Research / 05.07.2019

MedicalResearch.com Interview with: Dr. Natasha van Zyl, MBChB (Cape Town), FRACS FRACS Plastic and Reconstructive Surgeon Melbourne, Australia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The estimated global incidence of spinal cord injury (SCI) from all causes is 40 to 80 new cases per million population per year which means that every year between 250 000 to 500 000 people worldwide suffer SCI (1)(chap 2 p 17). In Australia the age standardised, annual incident rate of persisting traumatic SCI for Australian residents aged 15 years and above is 11.8 cases per million.(2) Just over 50% of all spinal cord injuries  in Australia occur at the cervical level resulting in tetraplegia. (2) Cervical spinal cord injury is a devastating, life-changing injury impacting almost every aspect of a person’s work, family and social life. Although compared to many other health conditions it has a relatively low incidence, it is certainly a high cost health condition, with the lifetime cost per tetraplegia incident case estimated to be AU$9.5 million.(3) For those living with tetraplegia improvement in hand function is their highest ranked goal.(4) As such, reconstruction of upper extremity function in cervical spinal cord injury is a crucial component of the surgical rehabilitation of people with mid/low cervical spinal cord injury as it has the capacity to restore critical functions such as elbow extension, wrist extension, grasp, key pinch and release. Traditionally these functions have been reconstructed using tendon transfers, which move a functioning muscle to a new insertion site to recreate the function of a paralysed muscle.(5) (more…)
Allergies, Author Interviews, Immunotherapy, Lancet / 02.04.2019

MedicalResearch.com Interview with: Arnon Elizur MD Director, The Institute of Allergy, Immunology & Pediatric Pulmonology Yitzhak Shamir Medical Center Zerifin, Israel MedicalResearch.com: What is the background for this study?   Response: Tree nuts are among the most common food allergies and are a major cause of fatal and near fatal reactions. Patients with tree nut allergy are often allergic to several nuts, further increasing the risk of accidental exposures, dietary limitations, and the emotional burden and anxiety in affected patients. In the past 10 years, oral immunotherapy (OIT) has shown promise as a treatment modality for milk, egg and peanut allergies. However, limited data exists on oral immunotherapy for tree nuts and the treatment is complicated by the high prevalence of co-allergy to several nuts. (more…)
Author Interviews, Biomarkers, Lancet, OBGYNE, Pediatrics / 01.04.2019

MedicalResearch.com Interview with: Catalin S. Buhimschi MD, MMS, MBA Professor of Obstetrics and Gynecology Division of Maternal Fetal Medicine Director of Obstetrics Department of Obstetrics and Gynecology Chicago, IL, 60612 MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2008, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal–Fetal Medicine Units Network published the results of a randomized controlled trial of magnesium sulfate for the prevention of cerebral palsy (CP). The results of this trial suggested that fetal exposure to magnesium sulfate before anticipated early preterm delivery did not reduce the combined risk of moderate to severe cerebral palsy or death, although the rate of cerebral palsy was reduced among survivors. As such, the search for a biomarker or a therapeutic solution to prevent CP had to continue. We are grateful to the NICHD for giving us access to the umbilical cord blood samples retrieved at the time of birth for the infants enrolled, who were also followed for 2 years postnatally. We discovered that fetus’s ability to switch-on haptoglobin (Hp) expression in response to inflammation was associated with reduction of intra-ventricular hemorrhage (IVH) and/or death, and cerebral palsy and/or death. Fetuses unable to mount such a response in-utero had an increased risk of adverse outcomes. (more…)
Author Interviews, Lancet, OBGYNE, Pediatrics, Weight Research / 28.03.2019

MedicalResearch.com Interview with: Liv Guro Engen Hanem, PhD Candidate Department of Clinical and Molecular Medicine Norwegian University of Science and Technology MedicalResearch.com: What is the background for this study?   Response: The antidiabetic drug metformin is increasingly used in pregnancy: to treat gestational diabetes and type 2 diabetes, and to prevent pregnancy complications related to polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta, and the fetus is thus exposed to the drug. Although no teratogenicity has been reported, metformin might have long-term effects on offspring health. This study is a follow-up of cardiometabolic risk factors of 141 5- to 10-year-old children born in the PregMet study. This study was a double-blind, randomized controlled trial (RCT) designed to test the hypothesis that metformin given throughout pregnancy reduces the prevalence of pregnancy complications that are associated with the common endocrine disorder PCOS. Pregnant women with PCOS were randomized to receive metformin or placebo throughout pregnancy.  (more…)
Author Interviews, Cancer Research, Global Health, Lancet, Weight Research / 04.02.2019

MedicalResearch.com Interview with: Hyuna Sung, PHD Principal Scientist, Surveillance Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303  MedicalResearch.com: What is the background for this study? Response: This project was motivated by our previous finding on the rise of colorectal cancer among young adults before age 55. Changes in cancer trends among young age group have significant implications because the newly introduced carcinogenic agents are likely to affect trends among young people before they affect those among older people. Owing to this relationship, cancer trends among young people can be often considered as a bellwether for future disease burden. Given the dramatic increase of the obesity prevalence during 3-4 decades in the US, we wanted to expand the colorectal cancer finding to the more comprehensive list of cancers and explain them in the context of obesity epidemic. (more…)
Author Interviews, Biomarkers, Johns Hopkins, NIH, Pulmonary Disease, Transplantation / 29.01.2019

MedicalResearch.com Interview with: Sean Agbor-Enoh, M.D., Ph.D. Co-Director/Staff Clinician Laboratory of Transplantation Genomics National Heart, Lung, and Blood Institute National Institutes of Health MedicalResearch.com: What is the background for this study? Response: People who receive organ transplants may develop acute or chronic rejection, in which the body’s immune system attacks the transplanted organ. While acute rejection is treatable and reversible, chronic rejection is not and remains the most common cause for organ transplant loss. Lung transplant recipients have the shortest survival rates among patients who get solid organ transplantation of any kind—only about half live past five years. This poor survival rate among lung transplant recipients is due in part to a high incidence of chronic rejection. Existing tools for detecting signs of rejection, such as biopsy, either require the removal of small amounts of lung tissue or are not sensitive enough to discern the severity of the rejection. Building upon earlier work, our research team developed a simple blood test that can detect when a newly transplanted lung is being rejected by a patient, even when no outward signs of the rejection are evident.  The test could make it possible for doctors to intervene faster to prevent or slow down so-called chronic rejection—which is severe, irreversible, and often deadly—in those first critical months after lung transplantation. This same test might also be useful for monitoring rejection in other types of organ transplants. Called the donor-derived cell-free DNA test, the experimental test begins with obtaining a few blood droplets taken from the arm of the transplant recipient. A special set of machines then sorts the DNA fragments in the blood sample, and in combination with computer analysis, determines whether the fragments are from the recipient or the donor and how many of each type are present.  Because injured or dying cells from the donor release lots of donor DNA fragments into the bloodstream compared to normal donor cells, higher amounts of donor DNA indicate a higher risk for transplant rejection in the recipient. (more…)
Author Interviews, Global Health, Health Care Systems, Lancet, Pediatrics / 29.01.2019

MedicalResearch.com Interview with: "By @plumavioleta "Atardecer en #caracas... #avebolivar # ccs #venezuela." via @PhotoRepost_app" by Pedro Fanega is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Ms Jenny García, PhD candidate Institut National d’Études Démographiques INED Institut de Démographie de l'université Paris 1 Panthéon Sorbonne IDUP Paris, France Prof Gerardo Correa, MSc Instituto de Investigaciones Económicas y Sociales IIES Universidad Católica Andrés Bello UCAB Caracas, Venezuela Prof Brenda Rousset, PhD Departamento de Estadística, Escuela de Sociología (FaCES) Universidad Central de Venezuela UCV Caracas, Venezuela MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Venezuela, as many countries in Latin America, showed substantial improvements in infant mortality rates during the last 60 years. However, the decreasing pattern might be reversing. Recent socioeconomic and political events have led to a collapse in living standards, along with a breakdown of the health system. At the same time, a strict secrecy policy has ruled public institutions, and since 2013 the Venezuelan government stopped publishing mortality statistics. This study attempts to fill this gap and estimate infant mortality using hospital and census data after 2013. The main finding is that infant mortality rates in Venezuela may have stopped decreasing and started increasing in 2009 – around the time funding for the Venezuelan health system started to be substantially reduced. By 2016, the infant mortality rate was 21.1 deaths per 1000 live births, which is 1.4 times the rate in 2008 (15.0 deaths per 1000 live births), and equivalent to the rate recorded in the late 1990s, meaning 18 years of progress may have been lost.  (more…)
Aging, Author Interviews, Geriatrics, Lancet, Nutrition, UC Davis, Weight Research / 15.01.2019

MedicalResearch.com Interview with: Valter Longo, PhD Edna M. Jones Professor of Gerontology Professor of Biological Sciences Leonard Davis School of Gerontology Director of the USC Longevity Institute USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of a low calorie diet that mimics fasting for 4 days twice a month starting at middle age can extend lifespan and rejuvenate mice. In humans a similar diet once a month causes improvements in cholesterol, blood pressure , inflammation, fasting glucose etc consistent with rejuvenation (more…)
Author Interviews, Depression, Hip Fractures, Lancet / 06.12.2018

MedicalResearch.com Interview with: Prof. Gillian Mead Chair of Stroke and Elderly Care Medicine Prof. Martin Dennis Chair of Stroke Medicine Centre for Clinical Brain Sciences The University of Edinburgh   MedicalResearch.com: What is the background for this study? Response: We are both practicing stroke physicians as well as clinical trialists. Therefore our interest in this area was triggered by the exciting results of the FLAME trial in 2011. This appeared to indicate that fluoxetine might boost the recovery of stroke patients. Potentially this was very important given the increasing numbers of people having disability due to stroke, and the fact that fluoxetine is inexpensive and could be introduced very easily into clinical practice. We were further encouraged by the large numbers of small RCTs we identified when we carried out a Cochrane systematic review on the topic. These trials provided more evidence of potential benefit but there was evidence that trials of greater quality showed less benefit, and benefits were greater in patients who were depressed. We felt there was a need for more evidence derived from much larger numbers of patients. (more…)
Author Interviews, Global Health, Hospital Acquired, Infections, Lancet / 07.11.2018

MedicalResearch.com Interview with: "Antibiotics" by Michael Mortensen is licensed under CC BY-SA 2.0Dr Alessandro Cassini MD Epidemiologist, European Centre for Disease Prevention and Control Solna, Sweden MedicalResearch.com: What is the background for this study? Response: We published an ECDC study estimating attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the European Union and the European Economic Area (EU/EEA). This study is based on 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net). The study was developed by experts at ECDC and the Burden of AMR Collaborative Group, and published in The Lancet Infectious Diseases. (more…)
Author Interviews, Infections, Lancet, Urinary Tract Infections / 27.10.2018

MedicalResearch.com Interview with: https://www.shionogi.com/Simon Portsmouth, MD Senior Medical Director Shionogi Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antibiotics for multidrug resistant  Gram-negative infections are desperately needed. Cefiderocol is the first siderophore antibiotic to reach patients. Siderophore antibiotics bind to free iron and use the bacterial active iron transport channels to cross the outer membrane of Gram-negative bacteria. Laboratory studies have shown that cefiderocol is active against multi-drug resistant Gram-negative bacteria, often where no other antibiotics are active. It is able to overcome most types of antibiotic resistance due to its active transport into cells and stability against all carbapenemases. The need for antibiotics for carbapenem resistant Gram-negative infections is described as a critical need by the WHO. This trial was the first in humans with serious infections and demonstrated excellent efficacy in a complicated patient population where almost ¼ were over 75 years of age. Additionally cefiderocol did not appear to have any safety problems, and was well tolerated. (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, Lancet, Technology / 16.10.2018

MedicalResearch.com Interview with: Qure-ai.jpgSasank Chilamkurthy AI Scientist, Qure.ai MedicalResearch.com: What is the background for this study? Response: Head CT scan is one of the most commonly used imaging protocols besides chest x-ray. They are used for patients with symptoms suggesting stroke, rise in intracranial pressure or head trauma. These manifest in findings like intracranial haemorrhage, midline shift or fracture. Scans with these critical findings need to be read immediately. But radiologists evaluate the scans on first-come-first-serve basis or based on stat/routine markers set by clinicians. If the scans with critical findings are somehow pushed to the top of radiologists’ work list, it could substantially decrease time to diagnosis and therefore decrease mortality and morbidity associated with stroke/head trauma. (more…)