Author Interviews, Dermatology / 13.05.2020

MedicalResearch.com Interview with: Brian S. Kim, MD, MTR, FAAD Associate Professor of Medicine (Dermatology) Co-Director, Center for the Study of Itch and Sensory Disorders Division of Dermatology, Department of Medicine Washington University School of Medicine St. Louis, MO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Itch is the central and most debilitating symptom of atopic dermatitis. However, surprisingly, measuring itch or quality of life in clinical trials is not often a primary endpoint. Therefore, this study focuses in very detailed fashion on how ruxolitinib cream improves pruritus in a clinically meaningful way and its ultimate impact on quality of life. What patients want to know at the end of the day is how much will this drug change my life?  Not, whether it statistically beat out a placebo group. Indeed, what this study shows is that ruxolitinib cream has a major impact on itch in a meaningful way that is also tied to improvements in quality of life. (more…)
Author Interviews, COVID -19 Coronavirus, Emergency Care, Infections, NEJM, Stroke / 09.05.2020

MedicalResearch.com Interview with: Akash Kansagra, MD, MS Assistant Professor of Radiology Neurological Surgery, and Neurology Director, Endovascular Surgical Neuroradiology Co-Director, Stroke and Cerebrovascular Center Washington University and Barnes-Jewish Hospital MedicalResearch.com: What is the background for this study? Response: Over the past five years, medicine has made enormous strides in stroke treatment. The effectiveness of these therapies has been absolutely astounding, and our ability to get patients to hospitals that can provide this life-saving care has also improved dramatically. (more…)
Author Interviews, Gastrointestinal Disease / 06.05.2020

MedicalResearch.com Interview with: Gregory S. Sayuk, MD, MPH John T. Milliken Department of Medicine Division of Gastroenterology Associate Professor of Medicine and Psychiatry Associate Director, Fellowship Training Program Washington University School of Medicine MedicalResearch.com: What is the background for this study? Response: The primary objective of this analysis, “Plecanatide for Patients with Chronic Idiopathic Constipation and Irritable Bowel Syndrome‒Constipation: Analysis of Abdominal Pain from Four Randomized Phase 3 Clinical Trials,” was to determine the impact of plecanatide on abdominal pain in patients with chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C), in addition to comparing efficacy results in patient populations with minimal to mild pain versus moderate to severe pain at baseline. This was a post hoc analysis of data from the four large, phase 3 plecanatide pivotal trials in CIC and IBS-C. (more…)
Author Interviews, Dermatology, Immunotherapy, Science / 27.02.2020

MedicalResearch.com Interview with: Brian S. Kim, MD, MTR, FAAD Associate Professor of Medicine (Dermatology) Co-Director, Center for the Study of Itch and Sensory Disorders Division of Dermatology, Department of Medicine Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: It has been known well for decades that a specific part of your immune system called the “type 2 immune response” is overactive in atopic disease. Indeed, that is what new drugs like dupilumab block so effectively and thus revolutionized the treatment of atopic disorders just in the last few years. In fact, our lab focuses predominantly on this part of the immune system. However, increasingly it is becoming recognized that the immune system is not just about whether it is “on or off” but rather a balance like yin and yang. Along these lines, we noticed that a cell that could theoretically counterbalance atopic inflammation was significantly deficient in many patients with eczema. This cell is the natural killer (NK) cell. (more…)
Author Interviews, Circadian Rhythm, Gastrointestinal Disease, Genetic Research, Weight Research / 13.10.2019

MedicalResearch.com Interview with: Marco Colonna, MD Robert Rock Belliveau MD Professor Pathology & Immunology Washington University School of Medicine Qianli Wang MD-PhD Student MSTP student Washington University School of Medicine MedicalResearch.com: What is the background for this study? Response: Many aspects of the mammalian digestive system including gut motility, nutrient absorption, and microbiota follow a daily rhythm. This circadian rhythm is generated by the cyclic expressions of molecular clock genes thought to be present in most cells. Group 3 innate lymphoid cells (ILC3) are lymphocytes residing in the intestinal mucosa that respond rapidly to activation in both homeostatic and inflammatory settings. Namely, ILC3s help maintain the mucosal barrier, regulate epithelial lipid transport, and protect against bacterial enteric infections. As tissue resident cells within the highly dynamic and rhythmic environment of the intestine, it may be advantageous for ILC3s to also be synchronized with the circadian rhythm.  (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, Geriatrics, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy. (more…)
Anesthesiology, Author Interviews, JAMA, Surgical Research / 07.02.2019

MedicalResearch.com Interview with: Michael Avidan, MBBCh, FCA SA Dr. Seymour and Rose T. Brown Professor of Anesthesiology Chief of the Division of Clinical and Translational Research Director of the Infrastructure of Quality Improvement, Research and Informatics Washington University School of Medicine St Louis, MO  MedicalResearch.com: What is the background for this study? Response: Postoperative delirium, a temporary state of confusion and inattention, is common in older adults after major surgery. Delirium can be distressing to patients, family members and clinicians. It is associated with longer hospital stays, other medical complications, cognitive decline, and death. Some previous studies have found that using electroencephalography (EEG) monitoring of the brain during general anesthesia decreases the occurrence of delirium following surgery. Therefore we conducted a rigorous study to determine whether using information from the EEG to guide the safe reduction of inhaled anesthetic drugs would prevent postoperative delirium and improve other outcomes in older adults following major surgery. (more…)
Alzheimer's - Dementia, Author Interviews, Science, Sleep Disorders / 13.01.2019

MedicalResearch.com Interview with: Brendan P. Lucey, MD, MSCI Assistant Professor of Neurology Director, Sleep Medicine Section Washington University School of Medicine Saint Louis, Missouri 63110 MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and sleep are currently thought to have a two-way or bidirectional relationship. First, sleep disturbances may increase the risk of developing AD. Second, changes in sleep-wake activity may be due to Alzheimer’s disease pathology and our paper was primarily focused on this aspect of the relationship.    If sleep changes were a marker for AD changes in the brain, then this would be very helpful in future clinical trials and possibly screening in the clinic. (more…)
Alcohol, Author Interviews, Heart Disease, JAMA / 29.12.2018

MedicalResearch.com Interview with: David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The genesis of this study was a patient asking me if he could continue to have a nightly cocktail or two after he was hospitalized with the new diagnosis of heart failure. The main findings are that moderate drinking after the diagnosis of heart failure in older adults is probably safe and is associated with longer survival. These types of studies can not prove a causal relationship between alcohol consumption and survival.  (more…)
Author Interviews, Diabetes, Geriatrics, JAMA, Kidney Disease / 01.12.2018

MedicalResearch.com Interview with: Dr. Ziyad Al-Aly, MD Associate Chief of Staff for Research and Education Veterans Affairs St. Louis Health Care System Institute for Public Health Washington University, St. Louis MO MedicalResearch.com: What is the background for this study? Response: A lot has changed in the US over the past 15 years including aging, population growth, and increased exposure to risk factors such as obesity, elevated blood pressure, etc. With all of these changes, we wondered, how did the burden of kidney disease change in the United States over the past 15 years. (more…)
Alzheimer's - Dementia, Author Interviews, MRI / 29.11.2018

MedicalResearch.com Interview with: Cyrus A. Raji, MD PhD Asst Prof of Radiology, Mallinckrodt Institute of Radiology Neuroradiology Faculty and the Neuoimaging Laboratories Washington University School of Medicine St. Louis MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Alzheimer's disease is the most common cause of dementia and every patient suspected of having this disorder receives an MRI scan of the brain. MRI scans of the brain in dementia are currently limited to evaluating for structural lesions that could be leading to memory loss such as stroke or tumor. What this study sought to accomplish was to determine if a newer type of MRI scan called diffusion tensor imaging (DTI) can predict who will experience cognitive decline and dementia. We found that DTI can predict persons who will demented 2.6 years before the earliest onset of symptoms. This study was done in 61 individuals, 30 converters and 31 non-converters, from the Alzheimer's Disease Neuroimaging Initiative and we found that DTI metrics could predict dementia 2.6 years later with 89-95% accuracy. (more…)