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MedicalResearch.com
Exclusive Interviews with Medical Research and
Health Care Researchers from Major and Specialty Medica...
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Emergency Room Coding Of Heart Failure Diagnosis Validated
MedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh ...
Emergency Room Coding Of Heart Failure Diagnosis Validated
MedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh ...
Emergency Room Coding Of Heart Failure Diagnosis Validated
MedicalResearch.com Interview with:
Justin A. Ezekowitz, MBBCh ...
Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work
MedicalResearch.com Interview with:
Kristian Kragholm,...
Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work
MedicalResearch.com Interview with:
Kristian Kragholm,...
Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work
MedicalResearch.com Interview with:
Kristian Kragholm,...
Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work
MedicalResearch.com Interview with:
Kristian Kragholm,...
Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits
MedicalResearch.com Interview with:
Karoline M...
Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits
MedicalResearch.com Interview with:
Karoline M...
Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits
MedicalResearch.com Interview with:
Karoline M...
Genes Identified That May Be New Drug Targets In HER2 Breast Cancer
MedicalResearch.com Interview with:
Ahmad M. Khalil, P...
Genes Identified That May Be New Drug Targets In HER2 Breast Cancer
MedicalResearch.com Interview with:
Ahmad M. Khalil, P...
Genes Identified That May Be New Drug Targets In HER2 Breast Cancer
MedicalResearch.com Interview with:
Ahmad M. Khalil, P...
Genes Identified That May Be New Drug Targets In HER2 Breast Cancer
MedicalResearch.com Interview with:
Ahmad M. Khalil, P...
Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births
MedicalResearch.com Inter...
Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births
MedicalResearch.com Inter...
Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births
MedicalResearch.com Inter...
Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births
MedicalResearch.com Inter...
Timely Pertussis Vaccination Important For Preventing Infant Deaths
MedicalResearch.com Interview with: Tejpratap S.P. Tiw...
Timely Pertussis Vaccination Important For Preventing Infant Deaths
MedicalResearch.com Interview with: Tejpratap S.P. Tiw...
Timely Pertussis Vaccination Important For Preventing Infant Deaths
MedicalResearch.com Interview with: Tejpratap S.P. Tiw...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Deficient Calcium Channels Weaken Immune Response To ChronicInfections
MedicalResearch.com Interview
Dr. Ludovic Desvignes...
Hospitals Vary In Treatment Of 22-24 Week Preterm Infants
MedicalResearch.com Interview with:
Mr. Matthew A. Rysavy, B.S a...
Hospitals Vary In Treatment Of 22-24 Week Preterm Infants
MedicalResearch.com Interview with:
Mr. Matthew A. Rysavy, B.S a...
Hospitals Vary In Treatment Of 22-24 Week Preterm Infants
MedicalResearch.com Interview with:
Mr. Matthew A. Rysavy, B.S a...
Orthopedic Patients and Their Families At Risk For Opioid Abuse
MedicalResearch.com Interview with:
Hassan R. Mir, MD, MBA...
Orthopedic Patients and Their Families At Risk For Opioid Abuse
MedicalResearch.com Interview with:
Hassan R. Mir, MD, MBA...
Orthopedic Patients and Their Families At Risk For Opioid Abuse
MedicalResearch.com Interview with:
Hassan R. Mir, MD, MBA...
Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke
MedicalResearch.com Interview with:
James S Mc...
Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke
MedicalResearch.com Interview with:
James S Mc...
Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke
MedicalResearch.com Interview with:
James S Mc...
Childhood Obesity Presents Opportunities and Challenges
MedicalResearch.com Interview with:
Rebecca Jones, MSPH
Nutrition ...
Childhood Obesity Presents Opportunities and Challenges
MedicalResearch.com Interview with:
Rebecca Jones, MSPH
Nutrition ...
Childhood Obesity Presents Opportunities and Challenges
MedicalResearch.com Interview with:
Rebecca Jones, MSPH
Nutrition ...
Childhood Obesity Presents Opportunities and Challenges
MedicalResearch.com Interview with:
Rebecca Jones, MSPH
Nutrition ...
Obese Patients Face Stigma and Discrimination
MedicalResearch.com Interview with: Claudia Sikorski
Dr. rer. med. Claudia S...
Obese Patients Face Stigma and Discrimination
MedicalResearch.com Interview with: Claudia Sikorski
Dr. rer. med. Claudia S...
Measures To Reduce Sugary Drinks Gains Public Acceptance
MedicalResearch.com Interview with:
Dr. Dragos Petrescu
Departmen...
Measures To Reduce Sugary Drinks Gains Public Acceptance
MedicalResearch.com Interview with:
Dr. Dragos Petrescu
Departmen...
Measures To Reduce Sugary Drinks Gains Public Acceptance
MedicalResearch.com Interview with:
Dr. Dragos Petrescu
Departmen...
Sleep Loss Impairs Decision Making
MedicalResearch.com Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Per...
Sleep Loss Impairs Decision Making
MedicalResearch.com Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Per...
Sleep Loss Impairs Decision Making
MedicalResearch.com Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Per...
Sleep Loss Impairs Decision Making
MedicalResearch.com Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Per...
Sleep Loss Impairs Decision Making
MedicalResearch.com Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Per...
Viagra Derivatives May Block Malaria Transmission
MedicalResearch.com Interview with:
Dr. Gordon Langsley
Laboratoire de B...
Viagra Derivatives May Block Malaria Transmission
MedicalResearch.com Interview with:
Dr. Gordon Langsley
Laboratoire de B...
Frequent Emergency Department Users More Likely To Die Or Be Admitted
MedicalResearch.com Interview with:
Dr. Brian Rowe, ...
Frequent Emergency Department Users More Likely To Die Or Be Admitted
MedicalResearch.com Interview with:
Dr. Brian Rowe, ...
Frequent Emergency Department Users More Likely To Die Or Be Admitted
MedicalResearch.com Interview with:
Dr. Brian Rowe, ...
Frequent Emergency Department Users More Likely To Die Or Be Admitted
MedicalResearch.com Interview with:
Dr. Brian Rowe, ...
Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers
MedicalRes...
Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers
MedicalRes...
Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers
MedicalRes...
Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers
MedicalRes...
Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care
MedicalResearch.com Interview with:
Karen E....
Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care
MedicalResearch.com Interview with:
Karen E....
Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care
MedicalResearch.com Interview with:
Karen E....
Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment
MedicalResearch.com Interview with:
Ma...
Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment
MedicalResearch.com Interview with:
Ma...
Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment
MedicalResearch.com Interview with:
Ma...
Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency
MedicalResearch.com Interview with:
Wil...
Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency
MedicalResearch.com Interview with:
Wil...
Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency
MedicalResearch.com Interview with:
Wil...
Wide US Regional Variation In Organ Donation Rates
MedicalResearch.com Interview with:
Dr. David Goldberg MD, MSCE
Assista...
Wide US Regional Variation In Organ Donation Rates
MedicalResearch.com Interview with:
Dr. David Goldberg MD, MSCE
Assista...
Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms
MedicalResearch.com Interview with:
...
Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms
MedicalResearch.com Interview with:
...
Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms
MedicalResearch.com Interview with:
...
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MedicalResearch.com: Medical Research Exclusive Interviews May 12 2015

  1. 1. MedicalResearch.com Exclusive Interviews with Medical Research and Health Care Researchers from Major and Specialty Medical Research Journals and Meetings Editor: Marie Benz, MD info@medicalresearch.com May 13 2015 For Informational Purposes Only: Not for Specific Medical Advice.
  2. 2. Medical Disclaimer | Terms and Conditions • The contents of the MedicalResearch.com Site, such as text, graphics, images, and other material contained on the MedicalResearch.com Site ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Hemodialysis.com Site! • If you think you may have a medical emergency, call your doctor or 911 immediately. MedicalResearch.com does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by MedicalResearch.com or other Eminent Domains Inc (EDI) websites, EDI employees, others appearing on the Site at the invitation of MedicalResearch.com or EDI, or other visitors to the Site is solely at your own risk. • The Site may contain health- or medical-related materials that are sexually explicit. If you find these materials offensive, you may not want to use our Site. The Site and the Content are provided on an "as is" basis. Read more interviews on MedicalResearch.com
  3. 3. Emergency Room Coding Of Heart Failure Diagnosis Validated MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh MSc Associate Professor, University of Alberta Co-Director, Canadian VIGOUR Centre Director, Heart Function Clinic Cardiologist, Mazankowski Alberta Heart Institute • Medical Research: What is the background for this study? Dr. Ezekowitz: Heart Failure is a prevalent health issue that carries high morbidity and mortality. Most epidemiologic research derives information from hospital discharge abstracts, but emergency department visits are another source of information. Many have assumed this code is accurate in the emergency department but uncertainty remains. • In our study, we assessed patients at their presentation to Emergency Department, which is usually the first medical contact for acutely ill patients with heart failure. • The objective of our study was to compare administrative codes for acute heart failure (I50.x) in the emergency department against a gold standard of clinician adjudication. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  4. 4. Emergency Room Coding Of Heart Failure Diagnosis Validated MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh MSc Associate Professor, University of Alberta Co-Director, Canadian VIGOUR Centre Director, Heart Function Clinic Cardiologist, Mazankowski Alberta Heart Institute • Medical Research: What are the main findings? Dr. Ezekowitz: Emergency department administrative data is highly correlated with a clinician adjudicated diagnosis. The positive predictive value of acute heart failure as the main diagnosis was 93.3% when compared to clinician adjudication, supported by standardized scoring systems and elevated BNP. • Medical Research: What should clinicians and patients take away from your report? • Dr. Ezekowitz: The code for acute heart failure in emergency department administrative data has a high Positive Predictive Value and may be used in outcomes research. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  5. 5. Emergency Room Coding Of Heart Failure Diagnosis Validated MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh MSc Associate Professor, University of Alberta Co-Director, Canadian VIGOUR Centre Director, Heart Function Clinic Cardiologist, Mazankowski Alberta Heart Institute • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Ezekowitz: Studies using administrative codes should exercise caution when evaluating codes related to the acute disease, especially when a diagnosis may evolve, such as in the emergency department. Further validation of other disease states is required, and researchers should use validated, disease-specific scoring systems supported by biomarker or imaging where possible. • Citation: • • Frolova N, Bakal JA, McAlister FA, et al. Assessing the Use of International Classification of Diseases-10th Revision Codes From the Emergency Department for the Identification of Acute Heart Failure. JCHF. 2015;3(5):386-391. doi:10.1016/j.jchf.2014.11.010. • • MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh MSc (2015). Emergency Room Coding Of Heart Failure Diagnosis Validated Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  6. 6. Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work MedicalResearch.com Interview with: Kristian Kragholm, MD, PhD-student Cardiovascular Research Center, Department of Anesthesiology, Aalborg University Hospital Medical Research: What is the background for this study? Dr. Kragholm: During 2001-2010 in Denmark, survival to 30 days and 1 year more than doubled. Whether this substantial improvement in survival was accompanied by good functional recovery in survivors was not clear. Discharge neurological status or post-discharge follow-up assessments were not systematically recorded in Denmark but through nationwide registries employment outcomes were available. Therefore, we examined return to work as a marker of favorable neurological outcome in 30-day survivors of out-of-hospital cardiac arrest in a nationwide study in Denmark between 2001-2011. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  7. 7. Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work MedicalResearch.com Interview with: Kristian Kragholm, MD, PhD-student Cardiovascular Research Center, Department of Anesthesiology, Aalborg University Hospital • Medical Research: What are the main findings? Dr. Kragholm: More than 75% of all 30-day out-of-hospital survivors in Denmark during 2001-2011 who were employed prior to arrest returned to work • Not only did the majority of these survivors return to work, survivors also sustained work without any long-term sick absences for a median time of 3 years and maintained the same income after arrest as before arrest. • Finally, relative to survivors who did not receive bystander cardiopulmonary resuscitation (CPR), chances for return to work were increased by approximately 40% if bystanders had provided CPR in multivariable adjusted modeling. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  8. 8. Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work MedicalResearch.com Interview with: Kristian Kragholm, MD, PhD-student Cardiovascular Research Center, Department of Anesthesiology, Aalborg University Hospital • Medical Research: What should clinicians and patients take away from your report? • Dr. Kragholm: Contrary to a belief that survival and cognitive outcomes following out-of- hospital cardiac arrest are poor, we show that the great majority of survivors of working age who were employed prior to arrest recovered not only to return to work but also to maintain employed to earn the same salary as prior to arrest. • Importantly, more survivors were capable of returning to work if bystanders had provided CPR. In Denmark, CPR courses became mandatory in elementary schools in 2005 and when acquiring a driver’s license in 2006 as well as dispatcher-assisted CPR was introduced at emergency dispatch centers. Healthcare providers and policy makers should set the scene for offering community-based CPR courses as well as dispatcher-assisted guidance of bystanders to perform CPR should be implemented. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  9. 9. Bystander CPR Allows Many Cardiac Arrest Patients To Return To Work MedicalResearch.com Interview with: Kristian Kragholm, MD, PhD-student Cardiovascular Research Center, Department of Anesthesiology, Aalborg University Hospital • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Kragholm: It would be interesting to see results on return to work rates from other sites and countries. Although our findings are very uplifting, return to work is only meaningful to study in survivors of working age. Therefore, together with my research team, we are currently examining other long-term function parameters that can be assessed in all survivors irrespective of their age. Citation: • Return to work in out-of-hospital cardiac arrest survivors : A nationwide register-based follow-up study. / Sørensen, Kristian Dahl Kragholm ; Wissenberg, M.; Fonager, Kirsten; Jensen, Svend Eggert; Lippert, F. K.; Christensen, E. F. ; Hansen, P. A. ; Lang-Jensen, T.; Henriksen, O. M. ; Torp-Pedersen, Christian; Rasmussen, Bodil Steen Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  10. 10. Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits MedicalResearch.com Interview with: Karoline Mortensen, Ph.D. Assistant Professor Department of Health Services Administration University of Maryland College Park, MD Medical Research: What is the background for this study? Dr. Mortensen: For twenty years, use of hospital emergency departments has been on the rise in the United States, particularly among low-income patients who face barriers to accessing health care outside of hospitals including not having an identifiable primary health care provider. Almost half of emergency room visits are considered “avoidable.” The Emergency Department-Primary Care Connect Initiative of the Primary Care Coalition, which ran from 2009 through 2011, linked low-income uninsured and Medicaid patients to safety-net health clinics. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  11. 11. Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits MedicalResearch.com Interview with: Karoline Mortensen, Ph.D. Assistant Professor Department of Health Services Administration University of Maryland College Park, MD Medical Research: What are the main findings? Dr. Mortensen: “Our study found that uninsured patients with chronic health issues – such as those suffering from hypertension, diabetes, asthma, COPD, congestive heart failure, depression or anxiety – relied less on the emergency department after they were linked to a local health clinic for ongoing care,” says Dr. Karoline Mortensen, assistant professor of health services administration at the University of Maryland School of Public Health and senior researcher. “Connecting patients to primary care and expanding the availability of these safety-net clinics could reduce emergency department visits and provide better continuity of care for vulnerable populations.” Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  12. 12. Connecting Chronically Ill Patients To Safety Net Clinics Reduced ER Visits MedicalResearch.com Interview with: Karoline Mortensen, Ph.D. Assistant Professor Department of Health Services Administration University of Maryland College Park, MD • Medical Research: What should clinicians and patients take away from your report? • Dr. Mortensen: The project provides promise not only for hospitals in Maryland but throughout the nation to improve health care experiences and outcomes for their patients. Shared learning systems were an integral component of the project so participants were learning from each other and sharing best practices throughout the project and that learning has now been documented and can be replicated in other communities. • “We created a learning system that permits us to sustain improved communication between patients and their providers, between hospital discharge planners and community based clinics, and across five hospitals operating in Montgomery County” says Barbara H. Eldridge, Manager of Quality Improvement at the Primary Care Coalition. • The initiative has proven successful in Montgomery County, Maryland and is being replicated in communities in other parts of the country. • Citation: • Linking Uninsured Patients Treated In The Emergency Department To Primary Care Shows Some Promise In Maryland • Theresa Y. Kim, Karoline Mortensen, and Barbara Eldridge • Health Aff May 2015 34:5796-804; doi:10.1377/hlthaff.2014.1102 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  13. 13. Genes Identified That May Be New Drug Targets In HER2 Breast Cancer MedicalResearch.com Interview with: Ahmad M. Khalil, PhD Assistant professor, Department of Genetics and Genome Sciences Case Western Reserve University School of Medicine • MedicalResearch: What is the background for this study? What are the main findings? • Dr. Khalil: This study aimed to identify other genes that work synergistically with the oncogene HER2 in HER2positive (HER+) breast cancer. The gene HER2 is amplified in those patients, which results in excess activities that promote uncontrolled cell growth. There are drugs that target HER2 and diminish its activity. However, these drugs can work initially, but patients relapse; or sometimes, the drugs don’t work at all in some patients. • Thus, by identifying other genes that work synergistically with the HER2 gene, we now have more genes to target by various drugs or compounds to destroy the tumor. The challenge was how to identify the key genes that work synergistically with HER2, especially in human subjects. To that end, we used clinical samples from a clinical trial of a drug that is known to inhibit HER2 activity to identify those genes. To further refine our list, we used cell culture models of the disease to also inhibit HER2. By combining those data sets, we identified 44 protein-coding genes. • Next, we wanted to make sure that those genes stand a third independent filter. For that part, we interrogated those 44 genes in HER2+ tumors vs matched normal tissues from The Cancer Genome Atlas database — a collection of hundreds of tumors and normal tissues. Of the 44 genes, 35 genes passed this third filter. By examining the known functions of those genes, we can deduce that those genes work cooperatively with HER2 to promote carcinogenesis. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  14. 14. Genes Identified That May Be New Drug Targets In HER2 Breast Cancer MedicalResearch.com Interview with: Ahmad M. Khalil, PhD Assistant professor, Department of Genetics and Genome Sciences Case Western Reserve University School of Medicine • There are currently known drugs that target some of those genes. We will use these drugs in combination with a drug that target HER2 to determine if the combination works better at destroying the tumor entirely. • Lastly, we found that a special type of genes that we previously discovered, called lincRNAs, could also affect the oncogenic activity of HER2. These lincRNAs can also be targeted with HER2 to eliminate the tumor. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  15. 15. Genes Identified That May Be New Drug Targets In HER2 Breast Cancer MedicalResearch.com Interview with: Ahmad M. Khalil, PhD Assistant professor, Department of Genetics and Genome Sciences Case Western Reserve University School of Medicine • MedicalResearch: What should clinicians and patients take away from your report? • Dr. Khalil: We now have a small set of genes that can be targeted for therapeutics in HER2+ breast cancer. We still need to do those studies to identify potential drugs that can be effective and eventually safe for clinical trials, but our study has now narrowed down the number of genes to study, which is a major step. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  16. 16. Genes Identified That May Be New Drug Targets In HER2 Breast Cancer MedicalResearch.com Interview with: Ahmad M. Khalil, PhD Assistant professor, Department of Genetics and Genome Sciences Case Western Reserve University School of Medicine • MedicalResearch: What recommendations do you have for future research as a result of this study? • Dr. Khalil: It is critical to look at genes and pathways directly in human patients, in addition to cell culture models and/or animal models. In many cases, things that are discovered in these other systems do not work when tested in human patients. ​This is a very unique aspect of our study. We identified those genes by examining human tumors before and during inhibition of the HER2 gene in vivo. • Citation: • Integrative transcriptome-wide analyses reveal critical HER2-regulated mRNAs and lincRNAs in HER2+ breast cancer • Callie R. Merry,Sarah McMahon,Cheryl L. Thompson,Kristy L. S. Miskimen,Lyndsay N. Harris, Ahmad M. Khalil Breast Cancer Research and Treatment April 2015, Volume 150, Issue 2, pp 321-334 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  17. 17. Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births MedicalResearch.com Interview with: Dmitry Kissin, MD Health scientist CDC Division of Reproductive Health Medical Research: What is the background for this study? Dr. Kissin: Due to the frequent transfer of more than one embryo during assisted reproductive technology (ART) treatments, such as in vitro fertilization (IVF), many ART-conceived children are born as multiples (twins, triplets and higher order). Multiple births, even twins, carry increased risk for both mothers and children. In the U.S., the practice guidelines published by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) provide recommendations on how many embryos to transfer in order to balance safety with the effectiveness of assisted reproductive technology. In an effort to reduce multiple births and associated complications, it is important to evaluate embryo transfer practices that contribute to these outcomes. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  18. 18. Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births MedicalResearch.com Interview with: Dmitry Kissin, MD Health scientist CDC Division of Reproductive Health Medical Research: What are the main findings? Dr. Kissin: Using data from the CDC’s National ART Surveillance System (NASS), we found that the majority of ART-related multiple births in the U.S. resulted from assisted reproductive technology cycles practiced in accordance with ASRM/SART guidelines and involved the transfer of two embryos. Almost half of ART-related multiple births resulted from transferring two fresh blastocysts (embryos cultured for 5/6 days) to favorable- or average-prognosis patients less than 35 years and donor-egg recipients, or two frozen/thawed embryos to patients less than 35 years. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  19. 19. Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births MedicalResearch.com Interview with: Dmitry Kissin, MD Health scientist CDC Division of Reproductive Health • Medical Research: What should clinicians and patients take away from your report? • Dr. Kissin: Clinicians practicing IVF know that the decision on the number of embryos to transfer is always a balance between trying to maximize the chance of pregnancy and minimize the chance of multiple birth. The substantial reduction of assisted reproductive technology-related multiple (both twin and triplet or higher order) births in the U.S. could be achieved by single embryo transfers among young patients or recipients of donor eggs. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  20. 20. Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births MedicalResearch.com Interview with: Dmitry Kissin, MD Health scientist CDC Division of Reproductive Health • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Kissin: One of the major barriers to widespread implementation of single embryo transfer in the U.S. is the high out-of-pocket cost of assisted reproductive technology, often not covered by health insurance. Some countries have been successful in achieving marked reductions in multiple births when they removed financial pressures for infertility patients by covering assisted reproductive technology in exchange for mandatory single embryo transfer in the best prognosis groups. Future research on whether such approach will work in the United States is needed and requires coordinated efforts by multiple stakeholders, as outlined in CDC’s “National Public Health Action Plan for the Detection, Prevention and Management of Infertility”. • Citation: • Fertil Steril. 2015 Apr;103(4):954-61. doi: 10.1016/j.fertnstert.2014.12.127. Epub 2015 Jan 27. • Embryo transfer practices and multiple births resulting from assisted reproductive technology: an opportunity for prevention. • Kissin DM1, Kulkarni AD2, Mneimneh A2, Warner L2, Boulet SL2, Crawford S2, Jamieson DJ2; National ART Surveillance System (NASS) group Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  21. 21. Timely Pertussis Vaccination Important For Preventing Infant Deaths MedicalResearch.com Interview with: Tejpratap S.P. Tiwari, MD Meningitis and Bacterial Vaccine Preventable Diseases Branch Division of Bacterial Diseases National Center for Immunization and Respiratory Diseases Division of Global HIV/AIDS, Center for Global Health Centers for Disease Control and Prevention, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Tiwari: Infants younger than one year old in the United States are at highest risk for severe outcomes from pertussis and death. The first childhood pertussis vaccine dose is recommended at 2 months old, with additional doses in the first year of life at 4 and 6 months. Studies have established that pertussis vaccines can protect against pertussis disease, complications, and hospitalization in infants when 1 to 3 doses are administered by six months old. This study’s findings suggest that the first pertussis vaccine dose and appropriate antibiotic treatment protect infants against death, hospitalization, and pneumonia. Improved on-time infant vaccination (at 2, 4, and 6 months) could potentially prevent up to 1 out of every 4 infant pertussis deaths. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  22. 22. Timely Pertussis Vaccination Important For Preventing Infant Deaths MedicalResearch.com Interview with: Tejpratap S.P. Tiwari, MD Meningitis and Bacterial Vaccine Preventable Diseases Branch Division of Bacterial Diseases National Center for Immunization and Respiratory Diseases Division of Global HIV/AIDS, Center for Global Health Centers for Disease Control and Prevention, Atlanta, Georgia • Medical Research: What should clinicians and patients take away from your report? • Dr. Tiwari: Clinicians should ensure timeliness of the first pertussis vaccine dose at 2 months to help prevent infant pertussis death. Additional efforts to protect infants who are too young for vaccination also need to be prioritized. This can be done by reinforcing the recent Advisory Committee on Immunization Practices recommendation for use of the pertussis vaccine called Tdap during the third trimester of each pregnancy, so that mothers may pass on antibodies to their babies to help protect them until they are old enough for their own immunization. For more information about maternal Tdap vaccination, visit www.cdc.gov/pertussis/pregnant. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  23. 23. Timely Pertussis Vaccination Important For Preventing Infant Deaths MedicalResearch.com Interview with: Tejpratap S.P. Tiwari, MD Meningitis and Bacterial Vaccine Preventable Diseases Branch Division of Bacterial Diseases National Center for Immunization and Respiratory Diseases Division of Global HIV/AIDS, Center for Global Health Centers for Disease Control and Prevention, Atlanta, Georgia • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Tiwari: In this study, 24% of nonfatal infant cases and 64% of infant deaths occurred among infants who were too young to receive the first childhood pertussis vaccine dose. This highlights the importance of protect these infants through vaccination recommendations for pregnant women in the United States as well as the need to assess how to best to protect those most vulnerable to pertussis complications and death. • Citation: • First Pertussis Vaccine Dose and Prevention of Infant Mortality • Tejpratap S.P. Tiwari, Andrew L. Baughman, and Thomas A. Clark • Pediatrics peds.2014-2291; published ahead of print May 4, 2015, doi:10.1542/peds.2014- 229 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  24. 24. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • MedicalResearch: What is the background for this study? • Dr. Desvignes: This study is the result of a collaboration at NYU Langone Medical Center, between the laboratories of Dr. Stefan Feske and Dr. Joel Ernst, my mentor. Dr. Feske and colleagues had developed a mouse model of rare, inherited mutations he had identified in infants. These mutations occur in the genes for STIM1 and ORAI1, which are crucial for calcium flux in cells of the immune system. The young patients affected by these mutations suffer from severe, recurrent and chronic infections that often cause death before their first birthday. In particular, some of these patients cannot control infection with BCG, which is a normally innocuous strain of mycobacteria administered to protect against tuberculosis (TB). TB is a chronic infection and one of the leading causes of infection-related death worldwide. Going into this study, Dr. Feske and colleagues knew that without functional calcium channels, immune cells do not function properly. However, they did not fully understand how these channels contribute to immune responses to infectious pathogens in a living organism and in particular, for pathogens that cause chronic infections such as TB. This is why Dr. Ernst and I collaborated with Dr. Feske and provided him with our clinical and research expertise in TB. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  25. 25. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • MedicalResearch: What are the main findings? • Dr. Desvignes: Dr. Feske’s mice are genetically engineered to lack STIM1 in a certain type of immune cells, known as T cells or T lymphocytes. We infected these mice with Mycobacterium tuberculosis, the bacterium causing TB. Mycobacterium tuberculosis causes chronic infection by manipulating the immune system even in healthy people. The first very surprising result of our study was that mice lacking calcium flux in T cells handled acute TB fairly well. Only during the chronic phase of infection did they become unable to control mycobacterial growth and developed a strong inflammation in their lungs, which was due to an infiltration by different types of immune cells, including T cells. We discovered that the accumulation of STIM1-deficient T cells in the lungs resulted from the cells’ inability to die, which is a normal mechanism to limit an immune response and prevent excessive inflammation. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  26. 26. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • Another immune control mechanism that failed in the absence of STIM1 is mediated by a subset of T cells called induced regulatory T cells, or iTreg cells. These cells are essential to prevent normal immune responses from going “overboard” by suppressing the functions of other immune cells, including T cells. We found that calcium signals are required for the development of iTreg cells and that their numbers were strongly reduced in the lungs of infected STIM1-deficient mice. We therefore think that the lack of iTreg cells in the absence of STIM1 contributes to the severe lung inflammation in chronic TB. • The third finding that really surprised us was that T cells accumulating in the lungs of STIM1- deficient mice produced large amounts of a protein called interferon gamma. While interferon gamma is required to control Mycobacterium tuberculosis, it is also a very potent promoter of inflammation and too much of it can lead to tissue damage. Dr. Feske and colleagues had previously observed that calcium fluxes promote the production of interferon gamma in T cells cultured in vitro and we expected the STIM1-deficient T cells to be defective in the production of that protein. During chronic TB, however, calcium signaling turned out to be not only dispensable for the production of interferon gamma by T cells but it was actually required to limit its production and thus, to control inflammation. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  27. 27. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • MedicalResearch: What should clinicians and patients take away from your report? • Dr. Desvignes: Our research is primarily aimed at understanding the fundamental mechanisms of how calcium channels regulate the immune response to chronic inflammation and infections, and we think that our findings may help other scientists to develop new drugs and vaccines that improve immune responses to infections. Of course, we hope that this study helps clinicians understand, and maybe treat, the infectious diseases observed in those rare patients with mutations in STIM1 and ORAI1. • From a drug discovery perspective, it is important to note that several pharmaceutical companies are currently exploring applications for calcium channel blockers, for instance in the treatment of autoimmune or inflammatory diseases, like Multiple Sclerosis, psoriasis or chronic obstructive pulmonary disease (COPD). Inhibition of calcium channels is an effective strategy to suppress certain forms of inflammation. Based on our results, inhibition of calcium channels may however suppress important immune regulatory mechanisms that are required to prevent an overwhelming immune response. During chronic or latent infections such as TB, hepatitis or with herpes viruses, constant triggering of the immune system, without appropriate shutdown mechanisms when calcium channels are inhibited, could result in harmful inflammation. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  28. 28. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • MedicalResearch: What recommendations do you have for future research as a result of this study? • Dr. Desvignes: There are pressing and exciting avenues that should be explored as a direct follow up to our study. For example, we have experimental evidence that inhibition of calcium channels, by genetic deletion or pharmacological inhibition of STIM1 or ORAI1 proteins, prevents the development of T cell-mediated autoimmune diseases such as Multiple Sclerosis and Crohn’s disease in mice. To assess the safety of calcium channel inhibition in patients with these diseases, it will be necessary to test if the degree of inhibition required for treatment increases the risk of reactivating latent or chronic infections such as TB. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  29. 29. Deficient Calcium Channels Weaken Immune Response To ChronicInfections MedicalResearch.com Interview Dr. Ludovic Desvignes PhD. Assistant Professor, Departments of Medicine and Pathology NYU Langone Medical Center • TB remains a global health issue and we are in dire need of a new, more efficacious vaccine. In this respect, our study serves as a cautionary tale and provides ideas to develop better vaccines. For example, a vaccine preparation that would induce large amounts of interferon gamma may seem like a good idea to control Mycobacterium tuberculosis but it could result in uncontrolled, harmful inflammation, and even fuel the infection. Now that we understand better some of the players and the mechanisms of the immune response to TB, we can target specific elements of the immune response that will help fight the infection while limiting its deleterious effects. • Citation: • STIM1 controls T cell–mediated immune regulation and inflammation in chronic infection • Ludovic Desvignes, Carl Weidinger, Patrick Shaw, Martin Vaeth, Theo Ribierre, Menghan Liu, Tawania Fergus, Lina Kozhaya, Lauren McVoy, Derya Unutmaz, Joel D. Ernst, Stefan Feske • Published May 4, 2015 Citation Information: J Clin Invest. 2015. doi:10.1172/JCI80273. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  30. 30. Hospitals Vary In Treatment Of 22-24 Week Preterm Infants MedicalResearch.com Interview with: Mr. Matthew A. Rysavy, B.S and Edward Bell, MD Department of Pediatrics, University of Iowa Iowa City, IA • Medical Research: What is the background for this study? What are the main findings? • Response: We were interested in understanding reasons for differences in outcomes among extremely preterm infants among hospitals. This has been shown in many studies. We found that differences among hospitals in whether treatment was initiated for infants born at very early gestations (22, 23, 24 weeks’ gestation) accounted for a lot of the variation in hospital- level outcomes at these gestational ages Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  31. 31. Hospitals Vary In Treatment Of 22-24 Week Preterm Infants MedicalResearch.com Interview with: Mr. Matthew A. Rysavy, B.S and Edward Bell, MD Department of Pediatrics, University of Iowa Iowa City, IA • Medical Research: What should clinicians and patients take away from your report? • Response: In the editorial accompanying our study, Professor Marlow writes: “Information on survival, morbidity, and policies regarding active intervention should be available to assist parents in making an informed choice about transfer to a specialist hospital, if feasible, and the level of intervention provided after birth.” Ultimately, the care of individual infants must be decided by the parents and doctors based on the best available information. We hope that, by unpacking some of the differences in hospital outcomes, our study sheds some light on what this information is and how to better obtain it. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  32. 32. Hospitals Vary In Treatment Of 22-24 Week Preterm Infants MedicalResearch.com Interview with: Mr. Matthew A. Rysavy, B.S and Edward Bell, MD Department of Pediatrics, University of Iowa Iowa City, IA • Medical Research: What recommendations do you have for future research as a result of this study? • Response: There are still many important questions about differences in hospital outcomes that need further study. For example, in our study, among hospitals that initiated treatment for 100% of infants born at 24 weeks of gestation, rates of risk-adjusted survival still varied from 42 to 70%. It seems important to understand other reasons for the variation in outcomes among hospitals. • Also, there are important questions about how to better make decisions about treatment. The prognosis of extremely preterm infants is often fairly uncertain, and physicians and families have to make decisions based on very limited information. Gestational age alone is not the best indicator of prognosis. Some infants born at 22 weeks survive and do well and many others do not; likewise, some but not all, infants born at 26 weeks or later do well. This is why it is important not to use gestational age as the sole criterion for making decisions about treatment. We need to understand better issues related to the prognosis of extremely preterm infants to improve their care. • Citation: • Between-Hospital Variation in Treatment and Outcomes in Extremely Preterm Infants • Matthew A. Rysavy, B.S., Lei Li, Ph.D., Edward F. Bell, M.D., Abhik Das, Ph.D., Susan R. Hintz, M.D., Barbara J. Stoll, M.D., Betty R. Vohr, M.D., Waldemar A. Carlo, M.D., Seetha Shankaran, M.D., Michele C. Walsh, M.D., Jon E. Tyson, M.D., M.P.H., C. Michael Cotten, M.D., M.H.S., P. Brian Smith, M.D., M.P.H., M.H.S., Jeffrey C. Murray, M.D., Tarah T. Colaizy, M.D., M.P.H., Jane E. Brumbaugh, M.D., and Rosemary D. Higgins, M.D. for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network • N Engl J Med 2015; 372:1801-1811 May 7, 2015 • DOI: 10.1056/NEJMoa1410689 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  33. 33. Orthopedic Patients and Their Families At Risk For Opioid Abuse MedicalResearch.com Interview with: Hassan R. Mir, MD, MBA and Dr. Brent J. Morris, M.D. • Medical Research: What is the background for this study? What are the main findings? Dr. Mir: The past few decades have seen an alarming rise in opioid use in the United States, and the negative consequences are dramatically increasing. The US represents less than 5% of the world’s population, yet consumes 80% of the global opioid supply. Management of pain is an important part of patient care, however, the increased usage of opioids for the treatment of pain has led to several unanticipated aftereffects for individual patients and for society at large. • Orthopaedic surgeons are the third highest prescribers of opioid prescriptions among physicians in the United States. Orthopaedic patients can experience a tremendous amount of pain with acute injuries and chronic conditions, and the treatment plan may involve opioid prescriptions for relief of discomfort. A significant number of orthopaedic patients and their families are at risk for repercussions from opioid use. We must work together to decrease the use of opioids for musculoskeletal pain. • Clinicians should aim to control pain and improve patient satisfaction while avoiding overprescribing opioids. A comprehensive strategy of risk assessment is needed to identify patients who may be at risk for opioid abuse. Objective measures including patient history, recognition of aberrant behavior, urine drug testing, state prescription drug–monitoring programs, and opioid risk-assessment screening tools may be necessary in select cases. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  34. 34. Orthopedic Patients and Their Families At Risk For Opioid Abuse MedicalResearch.com Interview with: Hassan R. Mir, MD, MBA and Dr. Brent J. Morris, M.D. • Medical Research: What should patients and clinicians take away from your report? • Dr. Mir: • 3 tips for patients: • Ask your doctor about ways to control your pain with minimal use of opioids. • Do not seek opioids from multiple physicians as “doctor shopping” for pain medication is dangerous. • Seek help if you or a family member are becoming dependent on opioids. • 3 tips for clinicians: • Counsel patients and establish reasonable expectations for pain as a part of treatment plan discussions and follow-up visits. • Establish a standard pain protocol for specific surgical and nonsurgical treatment plans with an opioid taper. • Be aware of available objective risk-assessment tools and state prescription drug monitoring programs to use as adjuncts to clinical experience and judgment when dealing with challenging patient scenarios. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  35. 35. Orthopedic Patients and Their Families At Risk For Opioid Abuse MedicalResearch.com Interview with: Hassan R. Mir, MD, MBA and Dr. Brent J. Morris, M.D. • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Mir: There are several areas of potential research with regard to opioid medications and musculoskeletal pain, many of which are already underway looking at the potential detrimental effects of opioid medications on clinical outcomes. Other areas for potential research include alternative multi-modal pain control regimens, clinician education, patient education, electronic health records, clinical practice guidelines, and prescription drug monitoring programs all as means to decrease the widespread use of opioid medications for musculoskeletal pain in the United States. • Citation: • J. Morris, H. R. Mir. The Opioid Epidemic: Impact on Orthopaedic Surgery. Journal of the American Academy of Orthopaedic Surgeons, 2015; 23 (5): 267 DOI: 10.5435/JAAOS-D-14- 00163 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  36. 36. Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke MedicalResearch.com Interview with: James S McKinney, MD, FAHA Assistant Professor of Neurology Rutgers-Robert Wood Johnson Medical School Medical Director, RWJUH Comprehensive Stroke Center New Brunswick, NJ 08901 Medical Research: What is the background for this study? What are the main findings? Dr. McKinney: The current study evaluated outcomes of patients admitted to New Jersey hospitals with hemorrhagic stroke, including intracerebral hemorrhage (bleeding into the brain) and subarachnoid hemorrhage (bleeding along the surface of the brain) between 1996 and 2012 using the Myocardial Infarction Data Acquisition System (MIDAS) administrative database. The New Jersey Department of Health and Senior Services designates certain hospitals as comprehensive stroke centers (CSCs). We found that patients admitted to comprehensive stroke centers with hemorrhagic stroke were less likely to die than those admitted to other hospital types. This was particularly true for those patients admitted with subarachnoid hemorrhage, which is usually caused by a ruptured aneurysm. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  37. 37. Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke MedicalResearch.com Interview with: James S McKinney, MD, FAHA Assistant Professor of Neurology Rutgers-Robert Wood Johnson Medical School Medical Director, RWJUH Comprehensive Stroke Center New Brunswick, NJ 08901 • Medical Research: What should clinicians and patients take away from your report? • Dr. McKinney: The stroke center designation process works to identify hospitals that are dedicated to providing the resources to quickly diagnose and treat stroke patients. Patients with complex or serious strokes, such as hemorrhagic stroke, should be treated at hospitals with an appropriate spectrum of resources to manage their condition. Our study indicates that CSC care may lower mortality for patients with hemorrhagic stroke. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  38. 38. Comprehensive Stroke Centers Save Lives In Patients With Hemorrhagic Stroke MedicalResearch.com Interview with: James S McKinney, MD, FAHA Assistant Professor of Neurology Rutgers-Robert Wood Johnson Medical School Medical Director, RWJUH Comprehensive Stroke Center New Brunswick, NJ 08901 • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. McKinney: The current study used administrative data and was unable to adjust for all potential confounding variables, particularly stroke severity. Further, we only were able to study stroke care in New Jersey using statewide department of health stroke center designations. Further research should look at outcomes of hemorrhagic stroke patients admitted to stroke centers adjusting for stroke severity and in other geographic regions. • Citation: • James S. McKinney, Jerry Q. Cheng, Igor Rybinnik, John B. Kostis, and the Myocardial Infarction Data Acquisition System (MIDAS 22) Study Group. Comprehensive Stroke Centers May Be Associated With Improved Survival in Hemorrhagic Stroke. Journal of the American Heart Association, May 2015 DOI: 10.1161/JAHA.114.001448 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  39. 39. Childhood Obesity Presents Opportunities and Challenges MedicalResearch.com Interview with: Rebecca Jones, MSPH Nutrition and Health Sciences Program Graduate Division of Biological and Biomedical Sciences Emory University • Medical Research: What is the background for this study? What are the main findings? • Response: Obesity in children is associated with a wide range of conditions later in life including heart disease, cancer, and diabetes. Even prior to adulthood, children can be affected by a host of non-communicable diseases which are affected by weight status of the child. With an increase in children who are overweight or obese globally, Dr. Chan, Director- General of the World Health Organization, announced a new initiative to combat childhood obesity at the 2014 World Health Assembly. Within childhood obesity the pre-school (under age 5) years are a critical period for prevention due the association of adiposity rebound and obesity in later years as well as the early establishment of taste preferences and attitudes around healthy eating habits. Recent evaluation of incident obesity in the United States has demonstrated a component of the course to obesity is already established by the age of five years. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  40. 40. Childhood Obesity Presents Opportunities and Challenges MedicalResearch.com Interview with: Rebecca Jones, MSPH Nutrition and Health Sciences Program Graduate Division of Biological and Biomedical Sciences Emory University Our main finding is the necessity for better surveillance and comparability of weight status, particularly overweight and obesity, in children under five across countries in the European region. 60% of countries within the region have some form of published data on this particular population however they vary based on level of national representation, cut-off criteria, age and gender. All these different factors can significantly change the prevalence estimates making it very difficult to ascertain the full nature of the problem. Based on the data which was available the European Region has reason for concern about overweight and obesity in young children. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  41. 41. Childhood Obesity Presents Opportunities and Challenges MedicalResearch.com Interview with: Rebecca Jones, MSPH Nutrition and Health Sciences Program Graduate Division of Biological and Biomedical Sciences Emory University Medical Research: What should clinicians and patients take away from your report? Response: Historically, a fat child meant a healthy child and the concept of bigger as better was widely accepted. This perception has begun to shift, however clinicians and patients need to continue to be made aware of the importance of a healthy weight even at such young ages. It is vital that clinicians discuss with patients the long-term problems which can result from an unhealthy weight in children under 5. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  42. 42. Childhood Obesity Presents Opportunities and Challenges MedicalResearch.com Interview with: Rebecca Jones, MSPH Nutrition and Health Sciences Program Graduate Division of Biological and Biomedical Sciences Emory University • Medical Research: What recommendations do you have for future research as a result of this study? • Response: Future research needs to comprehensively evaluate the weight status of children under five, underweight and overweight, within countries with an aim towards having data which is comparable with other countries across the region. This research is pivotal to help in the future development of comparable core indicators for inclusion in national health surveillance systems. To begin to impact the weight status of children in the region, policy makers first need a knowledge base of prevalence estimates of nutritional status. • Citation: • Abstract presented at the European Congress on Obesity May 2015 T7:PO.011 Surveillance of Overweight including Obesity in Children Under 5: Opportunities and Challenges for the European Region Jones R.1,2, Breda J.2 1Department of Public Nutrition, Rollins School of Public Health, Emory University, Atlanta, Georgia, 2Department of Nutrition, Physical Activity and Obesity, Division Noncommunicable Diseases and Lifecourse, World Health Organization European Regional Office, Copenhagen, Denmark Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  43. 43. Obese Patients Face Stigma and Discrimination MedicalResearch.com Interview with: Claudia Sikorski Dr. rer. med. Claudia Sikorski, Dipl.-Psych. Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) Institute of Social Medicine, Occupational Health and Public Health Universität Leipzig, Medizinische Fakultät Leipzig • Medical Research: What is the background for this study? What are the main findings? Response: Obesity is a highly stigmatized condition. People with obesity are often regarded a lazy, slow and sloppy. One consequence of these negative attitudes may be discrimination, e.g. the unfair treatment of individuals with obesity. This study, conducted by Jenny Spahlholz, myself and colleagues reviews observational and experimental studies that investigated the occurrence and nature of discrimination in obesity. • Medical Research: What should clinicians and patients take away from your report? • Response: We find that patients with obesity are indeed faced not only with negative attitudes but also with unfair treatment in every-day life in numerous domains. Heavier individuals and women report more experiences of discrimination and may therefore be more prone to psychosocial effects such as low self-esteem. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  44. 44. Obese Patients Face Stigma and Discrimination MedicalResearch.com Interview with: Claudia Sikorski Dr. rer. med. Claudia Sikorski, Dipl.-Psych. Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) Institute of Social Medicine, Occupational Health and Public Health Universität Leipzig, Medizinische Fakultät Leipzig • Medical Research: What recommendations do you have for future research as a result of this study? • Response: We would like to find out more about the mechanisms of stigmatization and discrimination. We also need to re-think legislative protection for individuals with obesity. • Citation: • upcoming ECO abstract : • Obesity and Discrimination – A Systematic Review • Spahlholz J.1,2, Baer N.2, König H.H.3, Riedel-Heller S.G.2, Sikorski C.1,2 • 1Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany, 2Institute of Social Medicine, Occupational Health and Public Healt (ISAP), Leipzig University, Leipzig, Germany, 3Department of Medical Sociology and Health Economics, University Medical Center Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  45. 45. Measures To Reduce Sugary Drinks Gains Public Acceptance MedicalResearch.com Interview with: Dr. Dragos Petrescu Department of Public Health and Primary Care Cambridge • Medical Research: What is the background for this study? What are the main findings? • Response: Consumption of sugar-sweetened beverages is a major contributor to obesity, particularly in children. Recent systematic reviews provide good evidence that reducing portion size reduces consumption. Similarly, evidence suggests that container shapes and product placement in supermarkets can influence consumption. The public acceptability of “nudging” — altering properties such as the size, the shape, and location of sugar-sweetened beverages — to improve public health is unknown. Here we compared the acceptability in UK and USA samples of government interventions to reduce consumption of sugar-sweetened beverages: three nudge interventions (limiting portion size, changing container shape, and changing shelf location) and two traditional interventions (increased taxation and an education campaign). • We found that for the majority of UK and USA samples, the education campaign and the three nudge interventions were acceptable, with education attracting most support. By contrast, only a minority of participants supported taxation. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  46. 46. Measures To Reduce Sugary Drinks Gains Public Acceptance MedicalResearch.com Interview with: Dr. Dragos Petrescu Department of Public Health and Primary Care Cambridge • Medical Research: What should clinicians and patients take away from your report? • Response: Nudge interventions to reduce consumption of sugary drinks appear to be acceptable to the public. Policymakers can be reassured about the public acceptability of nudging to reduce sugar-sweetened beverages consumption; however our results suggest taxation to lower consumption would not be popular with the majority of both the UK and US populations. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  47. 47. Measures To Reduce Sugary Drinks Gains Public Acceptance MedicalResearch.com Interview with: Dr. Dragos Petrescu Department of Public Health and Primary Care Cambridge • Medical Research: What recommendations do you have for future research as a result of this study? • Response: Future research is needed to explore how best to communicate to the public in order to increase support for unpopular but likely effective policies, such as increased taxation. • Citation: Abstract presented at the European Congress on Obesity • Public acceptability in the UK and USA of nudging to reduce obesity: The example of reducing sugar-sweetened beverages consumption • Petrescu D.C.1, Hollands G.J.1, Ng Y.1, Marteau T.M.1 • 1Behaviour and Health Research Unit, University of Cambridge Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  48. 48. Sleep Loss Impairs Decision Making MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA • MedicalResearch: What is the background for this study? What are the main findings? • Research: Our main interest is in better understanding why people sometimes are able to manage perfectly well with sleep loss, while at other times sleep loss can have profoundly negative effects. We found that sleep deprivation reduces the effectiveness of signals used to tell when you are right or wrong, an effect we labeled feedback blunting. • Subjects in the study performed a decision making task that was simple but required feedback, i.e., a signal indicating the response was correct or incorrect, to perform correctly. We found that people who were sleep deprived were no longer able to use the feedback information to make correct responses. And when people had to adapt to unexpected changes in when to respond, sleep deprived people were completely unable to adapt to these changing circumstances. • The finding of feedback blunting in this study indicates that people who are sleep deprived not only have trouble sustaining attention to details in the environment (a well established effect of sleep loss), they also have trouble changing the focus of attention to deal with changing circumstances. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  49. 49. Sleep Loss Impairs Decision Making MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA • An interesting paradox in the research literature has been that people have been shown in many circumstances to perform complex tasks at a very high level while sleep deprived. Yet, we know from real-world experience that sleep deprived people can make catastrophic, life- threatening decisions that they would never have made if they were well rested. The current study is the first to shed light on this issue. It showed that sleep deprived people who get feedback, telling them that their actions are not effective, are less capable of changing their behavior. • The study is part of a line of research in which we are trying to identify how sleep loss changes specific components of cognition, and how these changes may lead to serious problems in everyday life activities. Being able to study and understand these effects of sleep deprivation under controlled conditions is an important step toward preventing human error under real world conditions. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  50. 50. Sleep Loss Impairs Decision Making MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA • MedicalResearch: What should clinicians and patients take away from your report? • Research: One important lesson is not to ignore the effect of sleep loss just because it hasn’t had much impact in the past. The study findings imply that when circumstances change from the everyday routine is when sleep deprivation will cause the biggest problems. Thus, getting adequate sleep is as important as any other measure taken to promote health and safety. • Sleep loss is inescapably linked with shift work, extended work hours, and emergency situations, as well as with sleep disorders and many other medical conditions. In today’s fast- paced society, people are often called upon to make critical decisions under dynamically changing circumstances and with potentially major consequences. Our study indicates that the circumstances that cause people to be sleep deprived are often precisely the circumstances when the effects of sleep deprivation can be the most dramatic. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  51. 51. Sleep Loss Impairs Decision Making MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA • There are two specific things to note. • First, sustaining attention, even for brief periods of time, is very difficult for people who are sleep deprived. Any task that requires sustained attention is likely to lead to problems under conditions of sleep loss. If you are doing something that is well practiced and there is no novelty or ambiguity to deal with, you can keep doing that task while sleep deprived, but occasional errors will pop up. • Second, any task that requires evaluating changes in the environment, e.g., new events, or changing or ambiguous circumstances, is going to be particularly difficult when people are sleep deprived. That means you may not recognize signals that would ordinarily allow you to avoid errors or prompt you to change your course of action. Serious problems arise even in well practiced activities when you must continually evaluate the environment and adapt to changing circumstances. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  52. 52. Sleep Loss Impairs Decision Making MedicalResearch.com Interview with: Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA • MedicalResearch: What recommendations do you have for future research as a result of this study? • Research: Most conventional test used to measure the impact of sleep loss rely on either subjective measures of sleepiness or objective measures of inability to sustain attention. While useful, these approaches miss the importance of situations that demand attending to signals to change our current pattern of behavior. Future research focusing on people’s processing of feedback information can lead to improved assessment and prediction of failures that can arise from sleep loss. • In addition, we know that there are individual differences in susceptibility to sleep loss, and better understanding the mechanisms of sleep loss effects on performance is a key step in understanding these individual differences. • Citation: Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback • Journal Sleep: VOLUME 38, ISSUE 05 http://dx.doi.org/10.5665/sleep.4668 • Paul Whitney, PhD; John M. Hinson, PhD; Melinda L. Jackson, PhD; Hans P.A. Van Dongen, PhD Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  53. 53. Viagra Derivatives May Block Malaria Transmission MedicalResearch.com Interview with: Dr. Gordon Langsley Laboratoire de Biologie Cellulaire Comparative des Apicomplexes, Institut Cochin, INSERM U1016, CNRS UMR 8104, Faculté de Medecine Université Paris Descartes, Paris • Medical Research: What is the background for this study? What are the main findings? Response: We have been studying the role of cAMP-dependent PKA signaling in Plasmodium falciparum-infected red blood cells for some time; see just a few examples: PMID: 25522250; PMID: 22626931; PMID: 18248092; PMID: 11559352 and we came to the conclusion that intra cellular cAMP levels regulate infected red blood cell deformability and adhesion to for example, brain endothelial cells. • Medical Research: What should clinicians and patients take away from your report? • Response: Drugs that manipulate (alter) cAMP levels in Plasmodium-infected erythrocytes have the potential to become one day new anti-malaria drugs and the proof of principal is the demonstration we provide for inhibitors of phosphodiesterases (PDEs) and deformability of transmissable (step V) gametocytes and their potential to block transmission of malaria. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  54. 54. Viagra Derivatives May Block Malaria Transmission MedicalResearch.com Interview with: Dr. Gordon Langsley Laboratoire de Biologie Cellulaire Comparative des Apicomplexes, Institut Cochin, INSERM U1016, CNRS UMR 8104, Faculté de Medecine Université Paris Descartes, Paris • Medical Research: What recommendations do you have for future research as a result of this study? • Response: First, we do not propose that Viagra should be used as a transmission blocking anti-malaria drug, but rather derivatives, lacking its erectile function, could become malaria transmission blocking drugs. • We envisage in the next couple of years performing clinical trials to test the efficacy of PDE inhibitors to reduce transmission of malaria • Citation: • Ghania Ramdani, Bernina Naissant, Eloise Thompson, Florence Breil, Audrey Lorthiois, Florian Dupuy, Ross Cummings, Yoann Duffier, Yolanda Corbett, Odile Mercereau-Puijalon, Kenneth Vernick, Donatella Taramelli, David A. Baker, Gordon Langsley, Catherine Lavazec. cAMP- Signalling Regulates Gametocyte-Infected Erythrocyte Deformability Required for Malaria Parasite Transmission. PLOS Pathogens, 2015; 11 (5): e1004815 DOI: 10.1371/journal.ppat.1004815 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  55. 55. Frequent Emergency Department Users More Likely To Die Or Be Admitted MedicalResearch.com Interview with: Dr. Brian Rowe, MD, MSc, CCFP(EM), FCCP Professor, Department of Emergency Medicine University of Alberta, Edmonton, Alberta, Canada • MedicalResearch: What is the background for this study? • Dr. Rowe: Frequent users are also called “familiar faces” or “heavy users” and they represent an important sub-group of patients in the emergency setting, with often complex needs that contribute to overcrowding and excess health care costs. The evidence suggests that frequent users account for up to one in 12 patients seeking emergency care, and for around one in four of all visits. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  56. 56. Frequent Emergency Department Users More Likely To Die Or Be Admitted MedicalResearch.com Interview with: Dr. Brian Rowe, MD, MSc, CCFP(EM), FCCP Professor, Department of Emergency Medicine University of Alberta, Edmonton, Alberta, Canada • MedicalResearch: What are the main findings? • Dr. Rowe: Frequent users of emergency department care are more than twice as likely to die, be admitted to hospital, or require other outpatient treatment as infrequent users, concludes an analysis of the available evidence, published in Emergency Medicine Journal. • These conclusions are based on a thorough search of seven electronic databases of relevant research relating to the frequency and outcomes of emergency department use by adults. Out of a total of more than 4000 potential studies, 31 relevant research reports published between 1990 and 2013 were included in the final analysis. Frequent users were variably defined as visiting emergency care departments from four or more times up to 20 times a year. • Among the seven studies looking at deaths, the analysis showed that frequent attenders at emergency care departments were more than twice as likely to die as those who rarely sought emergency care. Most of the studies included hospital admission as an outcome, and these showed that frequent users were around 2.5 times as likely to be admitted as infrequent users. Ten studies looked at use of other hospital outpatient care, and these showed that frequent users were more than 2.5 times as likely to require at least one outpatient clinic after their visit to the emergency care department. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  57. 57. Frequent Emergency Department Users More Likely To Die Or Be Admitted MedicalResearch.com Interview with: Dr. Brian Rowe, MD, MSc, CCFP(EM), FCCP Professor, Department of Emergency Medicine University of Alberta, Edmonton, Alberta, Canada MedicalResearch: What should clinicians and patients take away from your report? Dr. Rowe: Our results suggest that, despite heterogeneity, frequent users are a distinct and high risk group. Clinicians should be aware of the important risks associated with this group of patients. Frequent users should not be discouraged from attending emergency departments; however, an organized care plan should be developed. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  58. 58. Frequent Emergency Department Users More Likely To Die Or Be Admitted MedicalResearch.com Interview with: Dr. Brian Rowe, MD, MSc, CCFP(EM), FCCP Professor, Department of Emergency Medicine University of Alberta, Edmonton, Alberta, Canada • MedicalResearch: What recommendations do you have for future research as a result of this study? Dr. Rowe: The lack of any consensus as to what constitutes a frequent user is striking, they emphasize, and this makes it difficult to permit comparison and come up with potentially generalizable recommendations. Proactive, targeted treatment may help patients and clinicians. Further research on these remaining issues is urgently required. • Citation: • Mortality, admission rates and outpatient use among frequent users of emergency departments: a systematic review • Jessica Moe, Scott Kirkland, Maria B Ospina, Sandy Campbell, Rebecca Long, Alan Davidson, Patrick Duke, Tomo Tamura, Lisa Trahan, Brian H Rowe • Emerg Med J emermed-2014-204496Published Online First: 7 May 2015 doi:10.1136/emermed-2014-204496 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  59. 59. Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers MedicalResearch.com Interview with: Bernadette A.M. Heemskerk-Gerritsen, Ph.D. Department of Medical Oncology Erasmus MC Cancer Institute Roterdam, the Netherlands • Medical Research: What is the background for this study? What are the main findings? • Dr. Heemskerk-Gerritsen: Women with a BRCA1 or BRCA2 mutation have substantially higher risks of developing both primary and contralateral breast cancer (BC) and ovarian cancer than women from the general population. Options to reduce these increased cancer risks include risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO). The latter intervention obviously reduces the risk of developing ovarian cancer, but has been reported also to reduce the risk of developing a subsequent breast cancer with approximately 50%. However, studies on the efficacy of risk-reducing surgery in BRCA1/2 mutation carriers are confined to observational studies, thus challenging several methodological issues. Consequently, previous studies on breast cancer risk-reduction after RRSO may have been influenced by bias associated with selection of study subjects, bias associated with start of follow-up, or by confounding, and breast cancer risk-reduction may have been overestimated. • In the current study, we revisited the association between risk-reducing salpingo- oophorectomy and breast cancer risk in BRCA1/2 mutation carriers, focusing on the impact of different analytical methods and potential types of bias. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  60. 60. Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers MedicalResearch.com Interview with: Bernadette A.M. Heemskerk-Gerritsen, Ph.D. Department of Medical Oncology Erasmus MC Cancer Institute Roterdam, the Netherlands • First, we replicated the analyses of four previously performed studies, to examine if our Dutch cohort was comparable with the cohorts used in the previous studies. We replicated the approximately 50% breast cancer risk reduction after RRSO in the Dutch cohort. • Second, we estimated the effect of RRSO on breast cancer risk in the Dutch cohort using a revised analytical approach for observational studies in BRCA1/2 mutation carriers in order to minimize bias as much as possible. Using this method of analysis, we found no evidence of first BC risk-reduction after RRSO in BRCA1/2 mutation carriers. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  61. 61. Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers MedicalResearch.com Interview with: Bernadette A.M. Heemskerk-Gerritsen, Ph.D. Department of Medical Oncology Erasmus MC Cancer Institute Roterdam, the Netherlands • Medical Research: What should clinicians and patients take away from your report? • Dr. Heemskerk-Gerritsen: From the results, we concluded that in previous studies, breast cancer risk reduction after RRSO in BRCA1/2 mutation carriers may have been overestimated because of bias. We suggest that counselors, clinicians, and researchers should consider the potential impact of bias in previous and future observational studies on this topic. For the present, we advise caution in the message regarding breast cancer risk reduction after RRSO, at least for BRCA1 mutation carriers. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  62. 62. Breast Cancer Risk Reduction of Prophylactic Salpingo-Oophorectomy May Be Overestimated For Some BRCA1 Carriers MedicalResearch.com Interview with: Bernadette A.M. Heemskerk-Gerritsen, Ph.D. Department of Medical Oncology Erasmus MC Cancer Institute Roterdam, the Netherlands • Medical Research: What recommendations do you have for future research as a result of this study? • Dr. Heemskerk-Gerritsen: We are very interested in the risk estimates in the previous study cohorts when using our proposed design and analytical method, and in validation of our findings. Additionally, further research with longer follow-up and larger numbers of especially BRCA2 mutation carriers is warranted to explore differential effects on BC risks after RRSO for BRCA1 and BRCA2 mutation carriers. • Citation: • Breast Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation Carriers: Revisiting the Evidence for Risk Reduction • J Natl Cancer Inst. 2015 Mar 18;107(5). pii: djv033. doi: 10.1093/jnci/djv033 Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  63. 63. Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care MedicalResearch.com Interview with: Karen E. Joynt, MD MPH Cardiovascular Division, Brigham and Women’s Hospital and VA Boston Healthcare System Department of Health Policy and Management Harvard T.H. Chan School of Public Health • MedicalResearch: What is the background for this study? What are the main findings? • Dr. Joynt: While there is a great deal of optimism about the potential of Electronic Health Records (EHRs) to improve health care, there is little national data examining whether hospitals that have implemented EHRs have higher-quality care or better patient outcomes. We used national data on 626,473 patients with ischemic stroke to compare quality and outcomes between hospitals with versus without EHRs. We found no difference in quality of care, discharge home (a marker of good functional status), or in-hospital mortality between hospital with versus without EHRs. We did find that the chances of having a long length of stay were slightly lower in hospitals with EHRs than those without them. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  64. 64. Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care MedicalResearch.com Interview with: Karen E. Joynt, MD MPH Cardiovascular Division, Brigham and Women’s Hospital and VA Boston Healthcare System Department of Health Policy and Management Harvard T.H. Chan School of Public Health • MedicalResearch: What should patients and providers take away from this report? • Dr. Joynt: In our sample, EHRs were not associated with overall higher-quality care or better outcomes. Though Electronic Health Records may be necessary for an increasingly high-tech, transparent health care system, as currently implemented, they do not appear to be sufficient to improve outcomes for this important disease. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  65. 65. Electronic Medical Records Did Not Improve Stroke Outcomes Or Quality Of Care MedicalResearch.com Interview with: Karen E. Joynt, MD MPH Cardiovascular Division, Brigham and Women’s Hospital and VA Boston Healthcare System Department of Health Policy and Management Harvard T.H. Chan School of Public Health • MedicalResearch: What future research do you recommend as a result of this study? • Dr. Joynt: Future research should find ways of leveraging EHRs to improve care and outcomes – electronic tools have the potential to improve care, but in order to do so, need to be integrated into clinical workflow and provide meaningful information to the clinician. We don’t yet know enough about how best to use Electronic Health Records to improve care, or what type of innovations in electronic tools might really improve outcomes, and that is an important area of research. • Citation: • Joynt KE, Bhatt DL, Schwamm LH, et al. Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke. J Am Coll Cardiol. 2015;65(18):1964-1972. doi:10.1016/j.jacc.2015.02.059. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  66. 66. Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment MedicalResearch.com Interview with: Manoj Duraisingh Ph.D. John LaPorte Given Professor of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health Department of Immunology and Infectious Diseases Boston, Massachusetts • MedicalResearch: What is the background for this study? What are the main findings? • Dr. Duraisingh: The malaria parasite P. falciparum is one of the most important pathogens of humans, with enormous mortality resulting from blood-stage infections, when parasites replicate exponentially in red blood cells. Although anti-Plasmodial drugs are in clinical use, widespread and increasing parasite drug-resistance has contributed to an ongoing public health crisis, and we urgently need to find novel approaches to prevent and treat disease. • Targeting host red blood cell molecules presents an unexploited alternative. However, the highly differentiated and enucleated red blood cell poses a significant technical hurdle for genetic experimentation, due to the lack of a nucleus. • Here we have developed a novel, forward genetic screen to identify critical factors of malaria infection of red blood cells in an unbiased fashion. Our screen takes advantage of recent advances in human stem cell biology that enable the ex vivo culture of red blood cells from nucleated hematopoietic precursors which are amenable to in vitro genetics. • We have now identified a surface molecule CD55 (alias Decay-Accelerating Factor, DAF) as an essential host factor required for the invasion of red blood cells by P. falciparum. We demonstrate that this protein is required by all P. falciparum strains tested (laboratory and field) for invasion. Furthermore, we demonstrate that CD55 acts at the initial stage of invasion when the P. falciparum parasite attaches to the surface of the red blood cell. • Collectively, our findings indicate that CD55 is an ideal target for the development of new host-directed and vaccine therapeutics for malaria. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  67. 67. Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment MedicalResearch.com Interview with: Manoj Duraisingh Ph.D. John LaPorte Given Professor of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health Department of Immunology and Infectious Diseases Boston, Massachusetts • MedicalResearch: What should clinicians and patients take away from your report? • Dr. Duraisingh: Parasites have evolved to use multiple surface protein receptors to enter red blood cells. Targeting specific receptors was previously thought to be problematic as the notion was that the parasite would simply invade using alternative receptors. Here we have identified an essential surface protein, CD55, required by all P. falciparum parasites for entry into the cell. • Blocking this interaction between CD55 and the parasite should be a very powerful approach in the development of blood-stage therapeutics. This could be either through the development of a drug-like molecule in the form of a CD55-mimetic, or through the identification of the parasite molecule that binds to the CD55 protein, which would immediately become a top vaccine candidate. • Our unbiased screening approach can also be used to identify novel host molecules that the parasite needs for growth in the red blood cell. Targeting host molecules by drugs instead of the parasite would have the advantage that host molecules in the fully differentiated and enucleated red blood cell cannot change to become resistant to drugs. The evolution of drug- resistance in parasitic targets remains one of the greatest challenges of malaria control. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  68. 68. Red Blood Cell Surface Molecule May Be Target For New Malaria Vaccine and Treatment MedicalResearch.com Interview with: Manoj Duraisingh Ph.D. John LaPorte Given Professor of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health Department of Immunology and Infectious Diseases Boston, Massachusetts • MedicalResearch: What recommendations do you have for future research as a result of this study? • Dr. Duraisingh: In the future, we would very much like to explore the exploitation of CD55 for the development of host-targeted therapeutics, as is used in HIV. In addition, CD55 provides a starting point for the search of a parasite ligand that binds to it. As the interaction is essential, the putative CD55-binding protein could be pursued for vaccine development. Finally, CD55 is a blood group protein, and there are a few polymorphisms in this molecule that are at high prevalence in African populations that bear the brunt of malaria, and may confer protection against malaria. It would of great interest to study the effect of these CD55 polymorphisms on human selection by the malaria parasite. • Citation: • A forward genetic screen identifies erythrocyte CD55 as essential for Plasmodium falciparum invasion • Elizabeth S. Egan, Rays H. Y. Jiang, Mischka A. Moechtar, Natasha S. Barteneva, Michael P. Weekes, Luis V. Nobre, Steven P. Gygi, Joao A. Paulo, Charles Frantzreb, Yoshihiko Tani, Junko Takahashi, Seishi Watanabe, Jonathan Goldberg, Aditya S. Paul, Carlo Brugnara, David E. Root, Roger C. Wiegand, John G. Doench, and Manoj T. DuraisinghScience 8 May 2015: 711–714. [DOI:10.1126/science.aaa3526] Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  69. 69. Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency MedicalResearch.com Interview with: William M. Sage MD JD James R. Dougherty Chair for Faculty Excellence School of Law The University of Texas • Medical Research: What is the background for this study? What are the main findings? Response: We reviewed settlement agreements in malpractice claims closed by The University of Texas System as part of a larger study on incorporating patient perspectives into safety improvement funded by the Agency for Health Care Research and Quality. Over the five years studied, we found that 88.7% of the 124 settlement agreements that met our study criteria contained non-disclosure provisions, but with little standardization or consistency. Restrictions on disclosure, which selectively burdened patients and their families, seemed broader than needed to protect health care providers from disparagement or to avoid attracting additional litigation. • Nearly half of the agreements (46.4%) prohibited disclosure of the underlying facts, which may be inconsistent with emerging principles of patient safety and compassionate care, and 26.4% prohibited reporting to regulatory bodies, a restriction that the health system subsequently eliminated in response to our findings. Settlements reached after tort reform took full effect in Texas had stricter non-disclosure provisions than earlier settlements, suggesting greater leverage by defendants notwithstanding the reduced risk of additional litigation. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  70. 70. Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency MedicalResearch.com Interview with: William M. Sage MD JD James R. Dougherty Chair for Faculty Excellence School of Law The University of Texas • Medical Research: What should clinicians and patients take away from your report? • Response: Silence and secrecy around medical error can persist even in a well-intentioned academic health system that faces little litigation risk and generally attempts to treat patients fairly and transparently. The findings are important because they remind us how concerned professionals can be about reputation and how uncomfortable publicity can make them, even when science and ethics have advanced to favor greater information exchange. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  71. 71. Nondisclosure Agreements in Medical Malpractice Settlements May Limit Transparency MedicalResearch.com Interview with: William M. Sage MD JD James R. Dougherty Chair for Faculty Excellence School of Law The University of Texas • Medical Research: What recommendations do you have for future research as a result of this study? • Response: Many health care organizations are implementing “communication and resolution” programs involving medical injuries. These programs include vigilant detection of errors, full disclosure to patients and families, timely redress of injuries, and detailed feedback to improve patient safety. Based on our study, biases and habits involving settlement need to be re-examined in these and other settings, and best practices developed and disseminated. • Citation: • Sage WM, Jablonski JS, Thomas EJ. Use of Nondisclosure Agreements in Medical Malpractice Settlements by a Large Academic Health Care System. JAMA Intern Med. Published online May 11, 2015. doi:10.1001/jamainternmed.2015.1035. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  72. 72. Wide US Regional Variation In Organ Donation Rates MedicalResearch.com Interview with: Dr. David Goldberg MD, MSCE Assistant Professor of Medicine LDI Fellow, Leonard Davis Institute, University of Pennsylvania Medical Director for Living Donor Liver Transplantation, Hospital of the University of Pennsylvania • MedicalResearch: What is the background for this study? What are the main findings? • Dr. Goldberg: While there are data that demonstrate differences in authorization (consent) rates for deceased donation among racial and ethnic minorities, it is unknown how these differences contribute to geographic differences in the number of deceased organ donors. It has been postulated that geographic differences in the distribution of racial and ethnic minorities may contribute to differences in the deceased organ supply, yet there have been no empiric data to support this. Using data on “eligible deaths,” defined as potential brain- dead organ donors <=70 years of age, we demonstrated that even after accounting for differences in the racial/ethnic demographics of the potential donor population, there are dramatic differences in authorization (consent) rates across geographic areas that are not explained by demographics alone. If the source of these differences could be identified, then there could be large increases in the number of organ donors, and lifesaving transplants, in areas with lower authorization rates. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  73. 73. Wide US Regional Variation In Organ Donation Rates MedicalResearch.com Interview with: Dr. David Goldberg MD, MSCE Assistant Professor of Medicine LDI Fellow, Leonard Davis Institute, University of Pennsylvania Medical Director for Living Donor Liver Transplantation, Hospital of the University of Pennsylvania • MedicalResearch: What should clinicians and patients take away from your report? • Dr. Goldberg: The rates of authorization for donation among potential brain-dead organ donors varies dramatically across the United States, and these differences are not explained solely by donor demographics, including race/ethnicity. • MedicalResearch: What recommendations do you have for future research as a result of this study? • Dr. Goldberg: It is necessary to identify what the root causes of the geographic differences in authorization rates are so that interventions can be applied to increase authorization rates, thus increasing the number of lifesaving transplants, in those areas that with lower rates. • Citation: • Increasing the Number of Organ Transplants in the United States by Optimizing Donor Authorization Rates Goldberg,1 B. French,2 P. Abt,3 R. Gilroy.4 • 1Department of Medicine, University of Pennsylvania, Philadelphia, PA 2Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 3Department of Surgery, University of Pennsylvania, Philadelphia, PA 4Department of Medicine, University of Kansas Medical Center, Kansas City, KS. • 2015 American Transplant Congress Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  74. 74. Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms MedicalResearch.com Interview with: Kristina Bečanovič Ph.D. Department of Clinical Neuroscience Karolinska Institutet, Stockholm, Sweden. Medical Research: What is the background for this study? Dr. Becanovic: While the symptoms normally debut in middle-age, there is wide individual variation in how Huntington disease manifests itself, and even though two people carry the exact same genetic mutation that codes for the huntingtin protein, there can be up to a 20-year difference in onset of motor symptoms. This suggests that genetic variants, transcription factors and environmental factors could contribute to the observed differences in disease expressivity. As the identification of regulatory factors of the huntingtin gene would be targets for therapeutic intervention, we set out to study the regulation of the huntingtin gene as it has not been well- known which factors regulate the expression levels. We were interested in identifying both genetic variants and transcription factors that are of importance for gene regulation. We therefore used DNA from Huntington disease patients to study the regulation of the huntingtin gene promoter in cells. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  75. 75. Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms MedicalResearch.com Interview with: Kristina Bečanovič Ph.D. Department of Clinical Neuroscience Karolinska Institutet, Stockholm, Sweden. • Medical Research: What are the main findings? Dr. Becanovic: This study presents multiple findings that are of potential interest for clinicians, patients and other researchers. • Most people who develop Huntington’s disease have a normal and a mutated huntingtin gene. In the present study, we found that when the genetic variant was on the gene copy that codes for the normal Huntington protein, the patients developed motor symptoms on average four years earlier than expected; on the other hand, the genetic variant had a protective effect when sitting on the gene copy that codes for the mutated protein, which is toxic for the brain. These patients developed their motor symptoms on average ten years later than expected. We showed that NF-ĸB which is known to be a central player in the inflammatory response, acts as a transcription factor regulating huntingtin gene expression, but that the genetic variant hindered the binding of NF-ĸB which led to lower levels of the huntingtin protein.This study suggests that the genetic variant therefore leads to lower levels of the normal or the mutated protein depending on which gene copy it sits on, and that this explains the differences in disease onset. Our results emphasize the importance of “allelic imbalance”, where the yin-yang relationship of the normal and the mutant Huntington protein is of significance, and when altered, affects the Huntington disease age of onset in patients. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.
  76. 76. Genetic Variants Explain Differences in Age Of Onset Of Huntington’s Disease Symptoms MedicalResearch.com Interview with: Kristina Bečanovič Ph.D. Department of Clinical Neuroscience Karolinska Institutet, Stockholm, Sweden. • Medical Research: What should clinicians and patients take away from your report? • Dr. Becanovic: Our findings are important for the development of disease-modifying treatments, which not only reduce the symptoms but also protect the brain. Much research has gone into silencing the expression of the huntingtin protein, something that will be tested in patients within the near future. Our work is the first to support the claim that this type of therapy could help people with Huntington’s disease by slowing the progression of the disease. This work further supports continued efforts on allele-specific silencing approaches in Huntington disease. This work also suggests the identified genetic variant to be used as a prognostic marker in Huntington disease patients. Read the rest of the interviews on MedicalResearch.com Content NOT an endorsement of efficacy and NOT intended as specific medical advice.

MedicalResearch.com features exclusive interviews with medical researchers from major and specialty medical and health care journals and meetings.

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