Bern, Switzerland
Bern, Switzerland

Time filter

Source Type

The OHSU Knight Cancer Institute's project aims to develop strategies for improving treatment-resistant triple negative breast cancer, an aggressive form of breast cancer that lacks key receptors known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). Using advanced microscopy, the team will leverage tools for quantitative analysis and visualization of images generated, together with computational approaches for integrating diverse molecular data types. Through analysis of core cell lines, patient-derived cultures and primary tumors, the team aims to uncover molecular networks that underlie disease progression and therapeutic response. Joe Gray, Ph.D., director of the OHSU Center for Spatial Systems Biomedicine (OCSSB) and the OHSU Knight Cancer Institute associate director for biophysical oncology will lead the investigative team as a principal investigator. "Triple negative breast cancer is a particularly difficult form of the disease to treat," said Gray. "Our goals in the CSBC Research Center are to identify the mechanisms by which these cancers evolve and adapt to become resistant to treatment, and to develop new strategies to counter these mechanisms. Our multidisciplinary approach treats these cancers as adaptive systems that can be controlled using multiple drug combinations." Co-principal investigators on the project include: Rosalie Sears, Ph.D., professor of molecular and medical genetics in the OHSU School of Medicine and a senior member of the Knight Cancer Institute; Claire Tomlin, Ph.D., the Charles A. Desoer Professor of Engineering in the Department of Electrical Engineering and Computer Sciences at the University of California, Berkeley; Adam Margolin, Ph.D., associate professor of biomedical engineering and director of computational biology in the OHSU School of Medicine and the Knight Cancer Institute. Overall research themes of the consortium's Research Centers address important questions in basic cancer research, including the emergence of drug resistance, the mechanisms underlying cancer metastasis, and the role of the immune system in cancer progression and treatment. The interdisciplinary investigators of the CSBC will integrate experimental biology with mathematical and computational modeling to gain insight into processes relevant to cancer initiation, progression and treatment options. The consortium brings together clinical and basic science cancer researchers with physician-scientists, engineers, mathematicians and computer scientists to tackle key questions in cancer biology from a novel point of view. "Cancer is a complex disease and it challenges our traditional approaches, making it hard to predict tumor growth and drug response," said Daniel Gallahan, Ph.D., deputy director of NCI's Division of Cancer Biology. "Cancer systems biologists embrace that complexity and use many different types of data to build mathematical models that allow us to make predictions about whether a tumor will metastasize or what drug combinations will be effective." In addition to applying systems biology approaches to gain important insight into cancer, each consortium Research Center supports an outreach program to promote training in interdisciplinary science, disseminate important research findings to the community, and to engage the public in cancer systems biology research. Sage Bionetworks in Seattle serves as the consortium's Coordinating Center, facilitating data and resource sharing and collaborative scientific activities across the nine Research Centers as well as two new Research Projects. More information can be found on the project website. The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of precision cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down just the cells that enable cancer to grow. This breakthrough has made once-fatal forms of the disease manageable and transformed how cancer is treated. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It is headquarters for one of the National Cancer Institute's largest research collaboratives, SWOG, in addition to offering the latest treatments and technologies as well as hundreds of research studies and clinical trials. For additional information on the OHSU Knight Cancer Institute visit www.ohsu.edu/xd/health/services/cancer or follow us on Facebook and Twitter. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/ohsu-knight-cancer-institute-selected-to-join-prestigious-national-consortium-receive-92-million-300464180.html


A 10-year trial involving osteoarthritis and rheumatoid arthritis patients in 13 countries reveals new insights on the cardiovascular safety of widely used nonsteroidal anti-inflammatory drugs and COX-2-specific inhibitors, according to new research findings to be presented on this week at the 2016 ACR/ARHP Annual Meeting. Osteoarthritis, or OA, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage -- the cushioning material at the end of long bones -- and causes changes in the structures around the joint. Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. Chronic use of non-selective, nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 NSAIDs (such as celecoxib) is widespread among OA and RA patients, although these diseases have an associated risk of cardiovascular disease (CVD). The relative cardiovascular safety of these drugs remains unclear. So a group of researchers, led by Cleveland Clinic Coordinating Center for Clinical Research, in collaboration with colleagues at Brigham and Women's Hospital, conducted the PRECISION trial -- a very large randomized controlled trial (RCT) -- to directly and prospectively compare the CV safety of these anti-inflammatory agents. "The results of the PRECISION trial offer clinicians increased detail on how to monitor patients who take chronic NSAIDs with a more individualistic approach," says Elaine Husni, M.D., MPH says M. Elaine Husni, MD, MPH; vice chair, Department of rheumatic and immunologic diseases; director, Arthritis Center, Orthopedic and Rheumatologic Institute; Cleveland Clinic. "The PRECISION Trial provides critical information for patients and their providers about the safe use of commonly used analgesics, including celecoxib, ibuprofen and naproxen," says Daniel Solomon, MD, MPH, chief, Section of Clinical Sciences, Division of Rheumatology and Division of Pharmacoepidemiology at Brigham and Women's Hospital. "The analyses presented at the ACR focusing on osteoarthritis and rheumatoid arthritis add even more precise information allowing providers to tailor analgesic recommendations for patients. The PRECISION Trial has taught us that there is tremendous nuance to the comparative safety of these agents." There is an ongoing debate over the benefits and risks of using non-steroidal anti-inflammatory drugs for patients with OA and RA. Studies have demonstrated adverse cardiovascular outcomes which resulted in the withdrawal of the selective COX-2 inhibitor rofecoxib in 2004. This led the U.S. Food and Drug Administration (FDA) to mandate a cardiovascular safety trial for the remaining selective COX-2 inhibitor, celecoxib. The Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen (PRECISION) trial sought to determine whether celecoxib shares the same CV toxicity observed in the rofecoxib trials using a non-inferiority trial design. PRECISION was a double-blind, triple-dummy RCT conducted in 13 countries over 10 years, including 24,081 patients in 923 study sites. Eighty percent of the participants came from the United States. Subjects were required to have a known history of CV events, such as myocardial infarction, stroke or coronary re-vascularization, or evidence of CV risk based on traditional risk factors. Participants also were required to have a physician diagnosis of OA or RA, daily need for NSAID therapy, no CV events within the last 90 days and no contraindications to the use of these agents. Ninety percent of the enrolled patients in the trial and final analyses had OA, and 10 percent had RA. The mean age of participants with OA was 64 years and with RA was 61 years. Of the OA subjects, 63 percent were female. Of the RA subjects, 73 percent were female. Age and gender distribution did not differ by NSAID treatment assignment. Adherence was 80 percent over at least six months of follow-up, with a median follow-up of 18 months. Cardiovascular (CV), gastrointestinal (GI), renal adverse events, and all-cause mortality were analyzed for both subjects with OA and RA by treatment arms. Subjects were randomized to receive 100-200 mg of celecoxib twice a day, 600-800 mg of ibuprofen three times a day, or 375-500 mg of naproxen twice a day. All subjects were provided with open-label esomeprazole at a dose of 20-40 mg once a day, and aspirin was allowed as part of standard of care if applicable.


News Article | November 14, 2016
Site: www.eurekalert.org

WASHINGTON -- A 10-year trial involving osteoarthritis and rheumatoid arthritis patients in 13 countries reveals new insights on the cardiovascular safety of widely used nonsteroidal anti-inflammatory drugs and COX-2-specific inhibitors, according to new research findings to be presented on this week at the 2016 ACR/ARHP Annual Meeting. Osteoarthritis, or OA, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage--the cushioning material at the end of long bones--and causes changes in the structures around the joint. Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. Chronic use of non-selective, nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 NSAIDs (such as celecoxib) is widespread among OA and RA patients, although these diseases have an associated risk of cardiovascular disease (CVD). The relative cardiovascular safety of these drugs remains unclear. So a group of researchers, led by Cleveland Clinic Coordinating Center for Clinical Research, in collaboration with colleagues at Brigham and Women's Hospital, conducted the PRECISION trial - a very large randomized controlled trial (RCT) - to directly and prospectively compare the CV safety of these anti-inflammatory agents. "The results of the PRECISION trial offer clinicians increased detail on how to monitor patients who take chronic NSAIDs with a more individualistic approach," says Elaine Husni, M.D., MPH says M. Elaine Husni, MD, MPH; vice chair, Department of rheumatic and immunologic diseases; director, Arthritis Center, Orthopedic and Rheumatologic Institute; Cleveland Clinic. "The PRECISION Trial provides critical information for patients and their providers about the safe use of commonly used analgesics, including celecoxib, ibuprofen and naproxen," says Daniel Solomon, MD, MPH, chief, Section of Clinical Sciences, Division of Rheumatology and Division of Pharmacoepidemiology at Brigham and Women's Hospital. "The analyses presented at the ACR focusing on osteoarthritis and rheumatoid arthritis add even more precise information allowing providers to tailor analgesic recommendations for patients. The PRECISION Trial has taught us that there is tremendous nuance to the comparative safety of these agents." There is an ongoing debate over the benefits and risks of using non-steroidal anti-inflammatory drugs for patients with OA and RA. Studies have demonstrated adverse cardiovascular outcomes which resulted in the withdrawal of the selective COX-2 inhibitor rofecoxib in 2004. This led the U.S. Food and Drug Administration (FDA) to mandate a cardiovascular safety trial for the remaining selective COX-2 inhibitor, celecoxib. The Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen (PRECISION) trial sought to determine whether celecoxib shares the same CV toxicity observed in the rofecoxib trials using a non-inferiority trial design. PRECISION was a double-blind, triple-dummy RCT conducted in 13 countries over 10 years, including 24,081 patients in 923 study sites. Eighty percent of the participants came from the United States. Subjects were required to have a known history of CV events, such as myocardial infarction, stroke or coronary re-vascularization, or evidence of CV risk based on traditional risk factors. Participants also were required to have a physician diagnosis of OA or RA, daily need for NSAID therapy, no CV events within the last 90 days and no contraindications to the use of these agents. Ninety percent of the enrolled patients in the trial and final analyses had OA, and 10 percent had RA. The mean age of participants with OA was 64 years and with RA was 61 years. Of the OA subjects, 63 percent were female. Of the RA subjects, 73 percent were female. Age and gender distribution did not differ by NSAID treatment assignment. Adherence was 80 percent over at least six months of follow-up, with a median follow-up of 18 months. Cardiovascular (CV), gastrointestinal (GI), renal adverse events, and all-cause mortality were analyzed for both subjects with OA and RA by treatment arms. Subjects were randomized to receive 100-200 mg of celecoxib twice a day, 600-800 mg of ibuprofen three times a day, or 375-500 mg of naproxen twice a day. All subjects were provided with open-label esomeprazole at a dose of 20-40 mg once a day, and aspirin was allowed as part of standard of care if applicable. For the results of the PRECISION trial, please attend the late-breaking clinical trial presentation on November 15th 4:30 p.m. ET. About the American College of Rheumatology Headquartered in Atlanta, Ga., the American College of Rheumatology is an international medical society representing over 9,400 rheumatologists and rheumatology health professionals with a mission to Advance Rheumatology! In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit http://www. . The ACR/ARHP Annual Meeting is the premier meeting in rheumatology. With more than 450 sessions and thousands of abstracts, it offers a superior combination of basic science, clinical science, tech-med courses, career enhancement education and interactive discussions on improving patient care. For more information about the meeting, visit http://www. , or join the conversation on Twitter by following the official #ACR16 hashtag.


BOSTON--(BUSINESS WIRE)--T1D Exchange, a nonprofit organization accelerating research to improve outcomes in type 1 diabetes, today published a major research study in Diabetes Care that confirms the use of Continuous Glucose Monitoring (CGM) without regular use of confirmatory Blood Glucose Measurements (BGM) is safe and effective. For years, patients with type 1 diabetes have relied on blood glucose monitoring (BGM), widely known as the finger prick method, to measure their blood glucose levels many times each day and make insulin dosing decisions based on this information. CGM monitors are small wearable devices that automatically capture real-time glucose measures via a sensor that is inserted under the skin and transmits the information wirelessly to a monitoring and display device. CGM systems can detect and alert patients when they may be at risk of hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose), both of which require intervention to avoid more dangerous complications. Over the past few years, adoption of CGM to monitor blood glucose levels has widely grown, according to T1D Exchange’s Clinical Registry which has health data on 32,000 patients with type 1 diabetes. Specifically, adoption of CGM in the registry cohort has grown from 7% CGM use overall (in analysis completed in 2010-2012) to 21% CGM use overall (in analysis completed during 2014-2015). The T1D Exchange Replace-BG research study was conceived to better understand how CGM systems are used by patients, how they affect their health outcomes and to build evidence that will be required to support access to and reimbursement of CGM systems. This research is also critical to advance the field of automated insulin delivery. Automated insulin delivery (AID), commonly referred to the “artificial pancreas,” is the evolution of current diabetes management devices to an integrated system incorporating insulin pumps, algorithms and CGM technology that will allow insulin delivery with little or no input from the patient – thereby relieving a significant burden while improving outcomes. As the first major study of its kind, T1D Exchange coordinated the multi-center study through its clinic network and enrolled 226 adults with type 1 diabetes. All study participants were provided with a Dexcom’s G4 Continuous Glucose Monitoring System with an enhanced algorithm, which was used for the 6-month duration of the study. Participants were split into two study arms: 149 participants dosed their insulin based on the CGM reading alone without first confirming with a blood glucose meter measurement and 77 were required to confirm the CGM reading with a blood glucose measurement before dosing insulin. Among the major findings of the study is the confirmation there was no difference in outcomes for those using only CGM and those using both CGM and BGM. “This study is an important step to support regulatory pathways for the automation of insulin delivery for people with type 1 diabetes,” says Dana Ball, executive director and co-founder of T1D Exchange. “These data are supportive of the recent FDA decision to approve the Dexcom G5 indication for insulin dosing and removes a key obstacle that has prevented reimbursement of CGM by Medicare.” "We are grateful that organizations such as T1D Exchange recognize the need to build evidence around the safety and efficacy of CGM use in treatment decisions,” says Kevin Sayer, president and chief executive officer of Dexcom. “We hope results from this study and the recent FDA decision to expand the indication of the Dexcom G5 system will diminish the hassle and pain of finger stick testing and expand access to CGM technology—ultimately leading to improved control for people with diabetes." This study was funded by The Leona M. and Harry B. Helmsley Charitable Trust and CGMs were donated by Dexcom. The research is being presented today at Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France by principal investigators from the Jaeb Center for Health Research in Tampa, FL, Katrina J. Ruedy, MSPH, and Roy W. Beck M.D., Ph.D., Director, T1D Exchange Clinic Coordinating Center. “As a practicing endocrinologist, I typically advise my patients who use CGM technology to make treatment decisions based on a BGM reading; however, many of my patients often use CGM readings to make decisions about insulin doses,” stated Grazia Aleppo, MD, Northwestern University and lead author of the study. “The results of this study assures clinicians that patients using CGM for treatment decisions is as safe and effective as BGM.” About T1D Exchange T1D Exchange was founded on the belief that people affected by type 1 diabetes need better solutions faster – better treatments and better care. Our nonprofit organization takes an innovative approach that puts the community of people touched by type 1 diabetes at the center of research that will meaningfully impact their lives. Our integrated model offers researchers access to aggregated clinical, biological, patient-reported outcomes and electronic health record data, all while fostering collaboration among patients, physicians, researchers and industry. Our model is multi-faceted and complex, but our goal is simple: to tangibly improve outcomes for people with type 1 diabetes as fast as humanly possible.


News Article | November 16, 2016
Site: www.eurekalert.org

ANN ARBOR and FLINT, Mich. -- Following the onset of a stroke, restoring blood flow to the brain as quickly as possible is critical for preventing disability and improving the chances of recovery. This crucial window for treatment is a narrow one - about 4 ½ hours - and the earlier the treatment, the better the outcome. More than 7 million stroke survivors in the U.S. are left with persistent disability after a stroke, such as weakness or speech and language problems, often because treatment was given too late, or not at all. "Time lost is brain lost," as one saying goes. Each minute of delay results in an estimated loss of 1.9 million neurons, which, over the course of an hour without treatment, can be roughly compared to 3.6 years of normal brain aging. Stroke treatments must be administered in the emergency department, often in the form of a "clot-busting" drug called tPA, and can reduce the risk of disability by more than 30 percent. Yet because of a variety of barriers to timely evaluation and treatment, fewer than 5 percent of those who experience a stroke ever receive these therapies. Under a five-year, $2.5 million grant from the National Institute on Minority Health and Health Disparities, a team of University of Michigan researchers and community partners is embarking on a novel project to increase acute stroke treatment rates in the community of Flint, Michigan. Led by Lesli Skolarus, M.D., M.S., an associate professor of neurology at the U-M Medical School and a board-certified vascular neurologist, the team is testing a hospital- and community-based intervention called the "Stroke Ready" program that will attempt to address delays that can occur before and after arrival to the hospital, ultimately reducing the likelihood of stroke treatment and lessening its effectiveness. Because one of the most significant opportunities to increase stroke treatment rates lies in those critical first few moments immediately following a suspected stroke, a primary goal of the program aims to boost community "stroke preparedness" by helping people recognize the symptoms of stroke and encouraging them to call 9-1-1 immediately to get help on its way. "Acute stroke treatments dramatically reduce post-stroke disability, but they are also extremely underutilized," Skolarus explains. "We hope this program will boost stroke awareness in Flint and help get treatment to more stroke patients, so that the burden of stroke can be reduced in this community." The project is co-led by community partners that include Hurley Medical Center, Bridges into the Future, an African-American faith-based community group in Flint, and Community Based Organization Partners, also headquartered in Flint, all of which Skolarus has collaborated with for many years. The Healthy Flint Research Coordinating Center, a collaboration between the Flint Community, UM-Flint, UM-Ann Arbor, and Michigan State University, is another partner in the project. Community advisory board members, including Dr. Skolarus (back row, second from left), who have partnered on projects to boost stroke treatment and awareness in Flint. Flint, which has received national attention for its ongoing water crisis, also has the lowest acute stroke treatment rate of any community of its size in the country. Flint is an urban, underserved city of nearly 100,000 residents, about 60 percent of whom are African-American - a group which has higher rates of stroke and worse post-stroke outcomes (experiencing 30 percent more disability) compared to whites. The Stroke Ready program builds on Skolarus' previous research that identified stroke-readiness as a prime target for intervention and also demonstrated the effectiveness of working in partnership with faith-based partners in the Flint community. Her previous work also found that even if people were able to identify the warning signs of stroke, they may not be as quick to call 9-1-1 because of concerns about medical costs and ambulance response time, as well as not being familiar with why prompt treatment for stroke at a hospital is so important. The program aims to address some of those barriers. The community component of Stroke Ready will depend on peer leaders based in various faith communities around Flint, while the team will also work with Hurley, Flint's only safety-net hospital, to explore barriers and facilitators to timely acute stroke care and test strategies to reduce treatment delays. The community activities will expand to include workshops, videos, and social media outreach. Skolarus notes that the community partnership has been key to the success of her earlier pilot program and the launch of Stroke Ready. "Our community stakeholders ensure that the intervention is community-relevant, and assist in recruitment, implementation and sharing the findings - their collaboration has been instrumental in this work." The program will assess acute stroke treatment rates in Flint before and after the program, and will also examine the effects of the community and hospital interventions separately and together to inform future projects aimed at increasing treatment rates. It will also evaluate the cost-effectiveness of the intervention. Project co-investigators include Marc Zimmerman, Ph.D., professor of health behavior and health education at the U-M School of Public Health; Lewis Morgenstern, M.D., professor of neurology, neurosurgery, and emergency medicine, at the U-M Medical School, professor of epidemiology at the U-M School of Public Health, and director of the U-M Stroke Program; Anne Sales, M.S.N., Ph.D., R.N., professor of learning health sciences at the U-M Medical School; and James Burke, M.D., M.S., assistant professor of neurology at the U-M Medical School. All U-M members of the project team are affiliated with the Institute for Healthcare Policy & Innovation.


News Article | February 23, 2017
Site: www.eurekalert.org

Researchers have identified a novel mutation that may be associated with prostate cancer in African American men, according to a new study published in PLOS Computational Biology. Scientists have long known that a huge variety of DNA mutations can lead to cancer. Some proteins can repair DNA mutations, but when repair proteins are mutated themselves, cancer may arise. Knowing which mutations are linked to which cancer types helps scientists develop new targeted treatments and detection strategies. To improve knowledge of mutations associated with prostate cancer, Alice Walker of The University of North Texas, and colleagues searched for relevant mutations in genes that code for a family of DNA repair proteins known as AlkBH. The researchers ran two separate datasets of DNA sequences through a software program called HyDn-SNP-S, which had previously been developed by members of the team. The software allowed them to compare DNA sequences of AlkBH family proteins from healthy genomes, to those found in genomes derived from prostate cancer tumors. In both datasets, a mutation in the gene that codes for a protein called ALKBH7 was significantly associated with prostate cancer in African American men. Next, the researchers used computer simulations to investigate how the ALKBH7 mutation, R191Q, would affect the protein's structure. They found that the mutation might cause a structural change that significantly decreases the ability of the protein to perform its normal role. Spectroscopy experiments with actual protein samples confirmed these predictions. According to study co-author G. Andrés Cisneros of the University of North Texas, the next steps for research are further experimental exploration of how the R191Q mutation is related to prostate cancer, as well as investigation of potential new avenues for detection and treatment based on the mutation. "Scanning the DNA of individuals in the target population for this mutation could help indicate those with a higher risk of developing prostate cancer before symptoms are evident," Walker says. In your coverage please use this URL to provide access to the freely available article in PLOS Computational Biology: http://journals. Funding: This work was supported by the National Institutes of Health (Grants GM108583 to GAC and GM063584 to RPH). Funding support for the GENEVA Prostate Cancer study was provided through the National Cancer Institute (R37CA54281, R01CA6364, P01CA33619, U01CA136792, and U01CA98758) and the National Human Genome Research Institute (U01HG004726). Assistance with phenotype harmonization, SNP selection, data cleaning, meta-analyses, data management and dissemination, and general study coordination, was provided by the GENEVA Coordinating Center (U01HG004789-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors declare no conflicts of interest.


News Article | February 28, 2017
Site: www.eurekalert.org

A new report published in the Feb. 28 issue of the Journal of the American Medical Association points to a significantly higher burden of diabetes-related complications in adolescents and young adults with type 2 diabetes compared to type 1 diabetes, with greater health complications in minority youth. The study, from researchers involved with the nationwide SEARCH for Diabetes in Youth Study, looked at five health complications and co-morbidities of diabetes, including: retinopathy (eye disease), diabetic kidney disease, peripheral neuropathy (altered sensation in the feet), arterial stiffness and high blood pressure. The researchers studied 1,746 adolescents and young adults with type 1 diabetes and 272 with type 2 diabetes. Their findings showed that, after less than eight years following a diagnosis, approximately one-third of teenagers and young adults with type 1 diabetes and almost 75 percent of those with type 2 diabetes had at least one health complication or comorbidity. Additionally, any adjustment for differences in age, sex, race/ethnicity, and levels of glucose control over time, did not remove the excess prevalence among those with type 2 diabetes. "The high burden of early complications in youth with diabetes requires additional research to clarify the underlying causes and to identify effective intervention strategies," said Dr. Dana Dabelea, lead author and co-chair of the national SEARCH Study and professor of epidemiology at the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus. "It is extremely useful to have these estimates of the presence of complications in adolescents and young adults who are being treated with current therapies, especially because the complications are frequent. We need to make sure each risk factor is under the best control possible to reduce future problems." The SEARCH for Diabetes in Youth Study has been monitoring the burden of diabetes in youth with onset less than 20 years of age since 2000. Five U.S. clinical centers and principal investigators participated, including: Seattle Children's Hospital, (Dr. Catherine Pihoker); Kaiser Permanente Southern California, (Dr. Jean Lawrence); Colorado School of Public Health (Dr. Dana Dabelea); Cincinnati Children's Hospital, (Dr. Larry Dolan); and the Universities of North and South Carolina Schools of Public Health, (Dr. Elizabeth Mayer-Davis, SEARCH co-chair). The central laboratory is at the Northwest Lipid Research Laboratory, (Dr. Santica Marcovina) and the Coordinating Center is at the Wake Forest School of Medicine (Dr. Ralph D'Agostino and Dr. Lynne Wagenknecht, co-directors). SEARCH is funded by the National Institutes of Health and the Centers for Disease Control and Prevention. The Colorado School of Public Health is the first and only accredited school of public health in the Rocky Mountain Region, attracting top tier faculty and students from across the country, and providing a vital contribution towards ensuring our region's health and wellbeing. Collaboratively formed in 2008 by the University of Colorado Anschutz Medical Campus, Colorado State University, and the University of Northern Colorado, the Colorado School of Public Health provides training, innovative research and community service to actively address public health issues including chronic disease, access to healthcare, environmental threats, emerging infectious diseases, and costly injuries.


Schousboe J.T.,Park Nicollet Institute | Kerlikowske K.,Veterans Affairs Medical Center | Loh A.,California Pacific Medical Center Research Institute | Cummings S.R.,Coordinating Center
Annals of Internal Medicine | Year: 2011

Background: Current guidelines recommend mammography every 1 or 2 years starting at age 40 or 50 years, regardless of individual risk for breast cancer. Objective: To estimate the cost-effectiveness of mammography by age, breast density, history of breast biopsy, family history of breast cancer, and screening interval. Design: Markov microsimulation model. Data Sources: Surveillance, Epidemiology, and End Results program, Breast Cancer Surveillance Consortium, and the medical literature. Target Population: U.S. women aged 40 to 49, 50 to 59, 60 to 69, and 70 to 79 years with initial mammography at age 40 years and breast density of Breast Imaging Reporting and Data System (BI-RADS) categories 1 to 4. Time Horizon: Lifetime. Perspective: National health payer. Intervention: Mammography annually, biennially, or every 3 to 4 years or no mammography. Outcome Measures: Costs per quality-adjusted life-year (QALY) gained and number of women screened over 10 years to prevent 1 death from breast cancer. Results of Base-Case Analysis: Biennial mammography cost less than $100 000 per QALY gained for women aged 40 to 79 years with BI-RADS category 3 or 4 breast density or aged 50 to 69 years with category 2 density; women aged 60 to 79 years with category 1 density and either a family history of breast cancer or a previous breast biopsy; and all women aged 40 to 79 years with both a family history of breast cancer and a previous breast biopsy, regardless of breast density. Biennial mammography cost less than $50 000 per QALY gained for women aged 40 to 49 years with category 3 or 4 breast density and either a previous breast biopsy or a family history of breast cancer. Annual mammography was not cost-effective for any group, regardless of age or breast density. Results of Sensitivity Analysis: Mammography is expensive if the disutility of false-positive mammography results and the costs of detecting nonprogressive and nonlethal invasive cancer are considered. Limitation: Results are not applicable to carriers of BRCA1 or BRCA2 mutations. Conclusion: Mammography screening should be personalized on the basis of a woman's age, breast density, history of breast biopsy, family history of breast cancer, and beliefs about the potential benefit and harms of screening. Primary Funding Source: Eli Lilly, Da Costa Family Foundation for Research in Breast Cancer Prevention of the California Pacific Medical Center, and Breast Cancer Surveillance Consortium. © 2011 American College of Physicians.

Loading Coordinating Center collaborators
Loading Coordinating Center collaborators