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News Article | May 11, 2017
Site: www.eurekalert.org

Hepatitis C infections among pregnant women nearly doubled from 2009-2014, likely a consequence of the country's increasing opioid epidemic that is disproportionately affecting rural areas of states including Tennessee and West Virginia. Injection drug use is the main risk factor for the hepatitis C virus, now the country's most common blood-borne infection with an estimated 3.5 million people living with chronic infection. "We have seen a dramatic increase in opioid use in pregnancy and in the number of infants having drug withdrawal," said lead author Stephen Patrick, M.D., assistant professor of Pediatrics and Health Policy at Vanderbilt University Medical Center. "Taken together, this suggests that efforts targeted at preventing and expanding treatment for opioid use disorder may help mitigate some of the increases we see," Patrick said. Patrick co-authored a study with the Tennessee Department of Health (TDH) that was released today in the Center for Disease Control and Prevention's weekly epidemiological digest Morbidity and Mortality Weekly Report (MMWR). Hepatitis C infection present at the time of delivery increased 89 percent, from 1.8 to 3.4 per 1,000 live births from 2009-2014, equaling 35 infants a day exposed to the virus. Authors reported notable increases in rural counties in Tennessee and in rural states like West Virginia, which had the highest infection rate in 2014 (22.6 per 1,000 live births). "We found substantial state-to-state variation in hepatitis C infection rates," Patrick said. "West Virginia had the highest prevalence of infection among pregnant women ¬-- 1 in 50 newborns were exposed to the virus." In Tennessee, the odds of a hepatitis C infection at birth were approximately threefold higher for women residing in rural counties, 4.5-fold higher for women who smoked cigarettes during pregnancy, and nearly seventeenfold higher for women with concurrent hepatitis B virus infection. Tennessee had 10.1 hepatitis C infections per 1,000 live births in 2014. "We found that rural and Appalachian counties were particularly impacted by the virus," Patrick said. "In some counties in Tennessee, nearly 8 percent of pregnant women were documented as being infected with hepatitis C at the time of delivery." Senior author and TDH Medical Director for HIV, STD & Viral Hepatitis Carolyn Wester, M.D, said the increase highlights the importance of ensuring that women of childbearing age have access to hepatitis C testing and treatment. Patrick agreed, noting that women who know they have the virus before pregnancy can be treated to hopefully clear the virus prior to becoming pregnant. He also said that it is increasingly important that infants exposed to hepatitis C are monitored to see if they get the virus. "We need to build systems of care to ensure that all infants exposed to the virus are adequately followed," Patrick said. TDH State Epidemiologist Tim Jones, M.D., said the study is an important reminder of the threat of this growing epidemic to high-risk populations throughout the U.S. "While this study focuses on pregnant women and a high-risk area in Tennessee, it is also important to remember that hundreds of thousands of people throughout the U.S. have hepatitis C, and a large percentage of them do not know it," Jones said. "Anyone born between 1945-1965, or who has ever used IV drugs, or is otherwise worried about hepatitis infection, is encouraged to discuss with their clinicians whether testing may be appropriate for them," he said.


News Article | May 18, 2017
Site: www.sciencemag.org

As health officials and aid workers head to a remote corner of the Democratic Republic of the Congo to respond to an outbreak of Ebola virus disease, a key question remains: Will the government authorize the use of a promising experimental vaccine? The vaccine had stunning results in a clinical trial in Guinea in 2015, but it has yet to be licensed for broad use. As DRC officials weigh whether to use the vaccine, new details are emerging about the outbreak, which so far includes 20 suspected cases and three deaths, including the first, or “index,” case. Most cases are in the Bas-Uélé health zone that borders the Central African Republic. Three teams there are working on identifying suspect cases, educating the communities, and investigating villages where “nonsecure” funerals have taken place. They are also contacting a traditional healer in Nambwa who “received the index case"—a 45-year-old man who first sought help on 22 April—for 6 days. In Likati, the largest town in the area, another team is overseeing a database of the cases. Two mobile laboratories are on their way, as are personal protective equipment for frontline responders, reagents for 100 tests, and GPSs for field crews. More experts from the government, the World Health Organization (WHO), Doctors Without Borders (MSF), and the Alliance for International Medical Action are on the way, and a helicopter is being arranged to bridge Likati to other places. A WHO situation report issued 16 May ups the ante further: It says health workers are following about 400 close contacts of cases—a jump from 125 in the report from the day before. And one of the latest suspected cases inexplicably is several hundred kilometers from the confirmed outbreak—in the Haut-Uélé province that borders South Sudan. Some experts question why DRC officials have been slow to request deployment of the vaccine. WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) met 25–27 April and, in meeting notes that are publicly available, explicitly spells out recommendations for deploying the still-unlicensed Ebola vaccine, technically known as rVSVΔG-ZEBOV-GP. The vaccine is manufactured by Merck, which has some 700,000 doses on ice in the United States. According to SAGE recommendations, the vaccine should “be promptly deployed” if a confirmed case of Ebola occurs that matches the Zaire strain used to make the vaccine—which is the case in the DRC (two cases have been confirmed to date). Given that it’s unlicensed, the vaccine must be used in a clinic study, and SAGE specifically suggests countries use the same “ring vaccination” design used in the Guinea trial that vaccinates people who came in contact with cases, and frontline responders like doctors, nurses, and funeral staff. Epidemiologist Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, says the DRC—and every country at risk of Ebola virus—should have approved the use of the vaccine months ago and it should be given to contacts and frontline responders as soon as possible. Osterholm co-chaired a group of experts known as Team B that in January published a report, Completing Development of Ebola Vaccines, that warned that critical gaps stood in the way of using rVSVΔG-ZEBOV-GP before it receives approval. “This gets down to granular planning,” Osterholm says. “We want the initial response to be overwhelming so we never give an outbreak a chance to do what it did in West Africa. We want to throw everything at it in a reasonable way and a vaccine is part of that.” Marie-Paule Kieny, a WHO assistant director-general who oversaw the agency’s response to the Ebola epidemic that raged through West Africa in 2014–16, on 17 May spoke with Insider about the question of whether the vaccine will be used. Kieny, who is based in Geneva, Switzerland, is not heading the response to this outbreak, but has a long history of coordinating responses to outbreaks of infectious diseases and deploying vaccines. The interview has been edited for clarity and brevity. Q: Do you have any concern about there being a delay in the process regardless of whether the vaccine is used? A:  WHO is strongly in favor of using the vaccine in conjunction with the other interventions available. That said, the rVSV-ZEBOV Ebola vaccine is not yet available commercially, because it is still under review by the U.S. Food and Drug Administration and other regulatory agencies. In these circumstances the Ebola vaccine can only be used in a study protocol that includes ethical oversight and informed consent of individuals who agree to receive the vaccine. Vaccine use needs to be in compliance with Good Clinical Practice, in order to maximize opportunities to gather additional information on vaccine safety, efficacy, and effectiveness. Governments also must assess their need for the vaccine and their ability to deploy it. The DRC government wants to have a better understanding of the situation before deciding whether, in view of the logistical difficulties, they’d rather concentrate on classical containment control, which has always been successful in this country. You shouldn’t underestimate the logistical challenge [of doing] a vaccination study in a place that is very difficult to access. Q: WHO doesn’t have the power to enforce anything and is just making a recommendation. Is what the DRC government is doing different from the recommendation? A: This SAGE recommendation is very recent, and the full report of the SAGE meeting that came to this recommendation has not yet been published. In addition, DRC has already successfully managed seven Ebola outbreaks without a vaccine. So we have the combination of a new recommendation, a new vaccine not yet registered, and the substantial experience of the country to handle Ebola outbreaks. The government will determine the course that is most appropriate for them in this situation. Q: If the DRC decides 1 week from now they want to do a vaccine study, will they still have to complete a number of steps that would further delay deployment? A: Actions are already being undertaken that would shorten the timeline. We know already which vaccine would be shipped. All the documentation is ready. Cold chain equipment to maintain the vaccine at –80°C in Kinshasa is in place, so the vaccine could be stored properly in the capital if it were to be imported. In order to transport the vaccine to the field they could use ARKTEK containers, a technology that doesn't need ice packs to keep the vaccine at very low temperature. They are not available yet in DRC, but WHO has received them from the government of Guinea, which is happy to provide ones they used in the Ebola ring vaccination trial. Once the determination has been made to use the vaccine, it is likely to take only 2 days to ship the vaccine to Kinshasa. From there to the field will not be an easy trip. Material may need to be transported by helicopter. There are some roads, but trees often block them, so the only way is going with motorcycle. This is good in terms of slowing down transmission because this is not a highway—you have less mixing of populations. But it does not make it easy in terms of intervention. Q: Are you concerned that a delay in the decision by the government to say yes might cause delays somewhere along the way? A: The key issue to keep in mind is that the actions happening already—the epidemiological investigation, the contact monitoring, the social mobilization, improving access through direct flights for supplies, the people going to the field—are all part of the response needed if there is a vaccination campaign. And the other parts, such as working with the vaccine manufacturer and working with the country’s regulator, we are also already working on. A: I do agree the clock is ticking. But honestly speaking, I don't think the time is wasted because everything has been moving in parallel. In terms of operation, time hasn’t been lost because there needs to be a lot of preparation. Q: How many doses of the vaccine leftover from the Guinea trial are in Geneva? A: We still have 240 vials, which were re-exported out of Guinea. Each vial has four doses, so it’s a bit less than 1000 doses. Q: The frontline responders may or may not be from the DRC. They of course are highly vulnerable. Has there been a discussion about offering them vaccine? A: For the time being, we are still waiting on the decision of whether to move or not on vaccines. There’s a plan to offer them the vaccine. In the trial in Guinea, none of the MSF or WHO staff who administered the vaccine was vaccinated—although others did get the vaccine, as participants in a study in Geneva, myself included. Now, because there are results, we think there’d be more willingness to be vaccinated. Q: In the past in the DRC, health care workers have always become sick and died. They’ve contained it but at a huge cost. A: True, but now we have more materials, more personal protective equipment in place, than we had early on with the West Africa Ebola outbreak. Q: But it’s not either/or—conventional containment or vaccinate? A: Of course all options should be considered. WHO and its partners are supporting the Ministry of Health in all areas of the response, including epidemiological assessment, surveillance, logistics and supplies, communications, and community engagement. We are confident in the government’s experience and ability to respond, while providing the support that is needed. We have learned to never underestimate this virus.


Dublin, May 24, 2017 (GLOBE NEWSWIRE) -- Research and Markets has announced the addition of the "Systemic Lupus Erythematosus (SLE) Market and Forecast Analysis" report to their offering. Lupus is a chronic inflammatory autoimmune disorder that can affect many different body systems, including the joints, skin, kidneys, blood cells, brain, heart, and lungs. Systemic lupus erythematosus refers to the systemic form of the disease, which includes organ-specific variants, such as lupus nephritis. This disorder can be very difficult to diagnose as its signs and symptoms often mimic those of other conditions, and a physician is unlikely to ever see two cases that are alike. The most concerning symptoms are the ones that do not currently respond well to treatment, including renal and neurologic symptoms, as these can cause severe morbidity, disability, and ultimately fatal outcomes. Benlysta (belimumab; GlaxoSmithKline) became the first new therapy for lupus in over 50 years when it gained approval in 2011. However, despite significant hype surrounding its launch, uptake has been low, and the market remains open and eager for effective targeted therapies. Key Topics Covered: 1. Forecast: Systemic Lupus Erythematosus - Executive Summary - Market Overview and Trends - Market Definition and Methodology - anifrolumab - Benlysta SLE (belimumab) - blisibimod - Primary Research Methodology 2. Epidemiology: Systemic Lupus Erythematosus - Executive Summary - Disease Background - Sources and Methodology - Forecast - Epidemiologist Insight - Strengths and Limitations - Appendix: Additional Sources 3. Marketed Drugs: Systemic Lupus Erythematosus - Executive Summary - Product Overview - Primary Research Methodology - Product profile: Benlysta - Product profile: Off-label: CellCept - Product profile: Off-label: Rituxan 4. Pipeline: Systemic Lupus Erythematosus - Executive Summary - Clinical Pipeline Overview - Comparator Therapy - Clinical Trial Design - Recently Discontinued Drugs - Product profile (late stage): Lupuzor - Product profile (late stage): Orencia - Product profile (late stage): anifrolumab - Product profile (late stage): atacicept - Product profile (late stage): blisibimod For more information about this report visit http://www.researchandmarkets.com/research/79djqh/systemic_lupus


Dublin, May 24, 2017 (GLOBE NEWSWIRE) -- Research and Markets has announced the addition of the "Systemic Lupus Erythematosus (SLE) Market and Forecast Analysis" report to their offering. Lupus is a chronic inflammatory autoimmune disorder that can affect many different body systems, including the joints, skin, kidneys, blood cells, brain, heart, and lungs. Systemic lupus erythematosus refers to the systemic form of the disease, which includes organ-specific variants, such as lupus nephritis. This disorder can be very difficult to diagnose as its signs and symptoms often mimic those of other conditions, and a physician is unlikely to ever see two cases that are alike. The most concerning symptoms are the ones that do not currently respond well to treatment, including renal and neurologic symptoms, as these can cause severe morbidity, disability, and ultimately fatal outcomes. Benlysta (belimumab; GlaxoSmithKline) became the first new therapy for lupus in over 50 years when it gained approval in 2011. However, despite significant hype surrounding its launch, uptake has been low, and the market remains open and eager for effective targeted therapies. Key Topics Covered: 1. Forecast: Systemic Lupus Erythematosus - Executive Summary - Market Overview and Trends - Market Definition and Methodology - anifrolumab - Benlysta SLE (belimumab) - blisibimod - Primary Research Methodology 2. Epidemiology: Systemic Lupus Erythematosus - Executive Summary - Disease Background - Sources and Methodology - Forecast - Epidemiologist Insight - Strengths and Limitations - Appendix: Additional Sources 3. Marketed Drugs: Systemic Lupus Erythematosus - Executive Summary - Product Overview - Primary Research Methodology - Product profile: Benlysta - Product profile: Off-label: CellCept - Product profile: Off-label: Rituxan 4. Pipeline: Systemic Lupus Erythematosus - Executive Summary - Clinical Pipeline Overview - Comparator Therapy - Clinical Trial Design - Recently Discontinued Drugs - Product profile (late stage): Lupuzor - Product profile (late stage): Orencia - Product profile (late stage): anifrolumab - Product profile (late stage): atacicept - Product profile (late stage): blisibimod For more information about this report visit http://www.researchandmarkets.com/research/79djqh/systemic_lupus


SHAPE, the Society for Heart Attack Prevention and Eradication (http://www.shapesociety.org), a nonprofit grassroots organization dedicated to the mission of eradicating heart attacks, today announced the agenda of its first focus group meeting on prediction of near-future heart attacks using artificial intelligence. The meeting is led by Dr. Morteza Naghavi the founder and executive director of SHAPE and features leading cardiovascular researchers from around the world.. This will be the 20th scientific meeting held by SHAPE since 2001. Detailed agenda of the meeting is shown below. The First Machine Learning Vulnerable Patient Symposium A Focus Group Meeting on Developing an Artificial Intelligence-based Forecast System A Satellite Event in Conjunction with 2016 Annual Scientific Sessions of American Heart Association This event is open to public. Participation via GoToMeeting can be requested. Dinner will be served 7:30 PM. This is the 20th Vulnerable Plaque & Vulnerable Patient Symposium held by SHAPE since 2001. Welcome: Morteza Naghavi, M.D. Founder of SHAPE and Executive Chairman of the SHAPE Task Force Opening Remarks: Valentin Fuster, M.D., Ph.D. Professor of Medicine and Physician-in-Chief, Mount Sinai Hospital and Icahn School of Medicine Jagat Narula M.D., Ph.D. Chief of Cardiology, Mount Sinai West & St. Luke’s Hospitals Associate, Dean, Arnhold Institute for Global Health at Mount Sinai Icahn School of Medicine Ioannis Kakadiaris, Ph.D. Professor of Computer Science and Biomedical Engineering, Director of Machine Learning Laboratory University of Houston Topic: What is Machine Learning and How Can It Shape the Future of Healthcare? Invited Online Presentations: Two Examples of Machine Learning Studies in CVD Risk Assessment (10 minutes each) CVD prediction using support vector machine in a large Australian cohort. Dinesh Kumar, Ph.D. and Sridhar Arjunan, Ph.D. Biosignals Lab, School of Electrical and Computer Engineering, RMIT University, Melbourne, Australia (2) Prediction of revascularization after myocardial perfusion SPECT by machine learning in a large clinical population Piotr Slomka, Ph.D. Chief Scientist, Artificial Intelligence in Medicine Program, Department of Imaging Cedars-Sinai Medical Center, Professor, UCLA School of Medicine, Los Angeles, CA Moderated Discussions on the Vulnerable Patient Project Machine Learning for Prediction of Near-Term CHD Events All investigators will be asked to give a very brief introduction of their study and how it can fit in Background: Imagine instead of the existing daily weather forecasts and hurricane alerts we were told the probability of a storm within the next 10 years! This is how heart attacks are predicted today. We teach our physicians to calculate the 10-year probability of a heart attack and sudden cardiac death based on their patients’ risk factors. Long term predictions do not trigger immediate preventive actions. Although some people develop warning symptoms, half of men and two-thirds of women who die suddenly of coronary heart disease (CHD) have no previous symptoms. Imagine if we could alert people months, weeks, or even days before a heart attack and trigger immediate preventive actions. The Idea: Use machine learning to create new algorithms to detect who will experience a CHD event within a year (The Vulnerable Patient). Algorithms will be based on banked biospecimen and information collected days up to 12 months prior to the event. We will utilize existing cohorts such as MESA, Heinz Nixdorf Recall Study, Framingham Heart Study, BioImage Study and the Dallas Heart Study. External validation to test for discrimination and calibration will be conducted using other longitudinal observational studies that provide adjudicated cardiovascular event information such as the MiHeart, JHS, DANRISK and ROBINSCA. Additionally, we will use machine learning to characterize individuals who, despite high conventional risk, have lived over 80 years with no CHD events (The Invulnerable ). We expect to discover new targets for drug and possibly vaccine development. We will make the algorithms available as an open source tool to collect additional data over time and increase its predictive value. Organizers: SHAPE as the originating and organizing center for the entire project, recruiting new studies and biobanks, conducting workshops with researchers from each study, fundraising, creating an open source platform community for future enhancement and collaborations. Stanford as the coordinating center for collecting data and samples, and basic science labs. Mount Sinai as the data review and publication center. Machine Learning Lab to be decided, either Google, Apple, IBM, Facebook, Amazon or wherever we find a strong industry partner or sponsor. Director, Cardiac Computed Tomography, Associate Professor of Medicine, Johns Hopkins University Division of Cardiology, The Johns Hopkins Hospital Imagine the new machine learning Vulnerable Patient detection algorithm (heart attack forecaster) is created and validated. If studies confirm the algorithm is able to detect the Vulnerable Patient with 50% or more certainty. In other words, 1 out of 2 patients classified as Vulnerable Patient goes to have an ASCVD event in the following 12 months. Now the questions are: A)    What preventive actions would you take if your asymptomatic patient tested positive as a Vulnerable Patient? B)    What preventive actions would you take if the patient was you?! (This question is meant to circumvent regulatory and financial limitations that may apply to your patients but may not hold you back). Moderators will invite comments from all participants in the meeting. Invited Key Opinion Leaders (Alphabetic Order) Arthur Agatston, M.D. Founder of South Beach Diet, Director of Wellness at Baptist Hospital and Professor of Medicine at University of Miami, FL Daniel Berman, M.D. Professor of Medicine at UCLA, Director of Cardiac Imaging and Nuclear Cardiology at Cedars-Sinai, Los Angeles, CA Michael Blaha, M.D., M.P.H., Director of Clinical Research, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD Mathew Budoff, M.D. Professor of Medicine and Director of Preventive Cardiology, UCLA Harbor, Los Angeles, CA Adolfo Correa, M.D., Ph.D. Chief Science Officer, Jackson Heart Study, Professor of Medicine and Pediatrics, University of Mississippi, Jackson, MS Rahul Deo, M.D., Ph.D. Assistant Professor of Medicine, Division of Cardiology, University of California, San Francisco, CA Raimund Erbel, M.D. Professor of Medicine, Chief of Cardiology and Director of West German Heart Centre, University Essen, Germany Sergio Fazio, M.D., Ph.D. Chair of Preventive Cardiology and Professor of Medicine, Oregon Health and Science University, Portland, OR Zahi Fayad, M.D. Professor of Radiology and Medicine (Cardiology), Director of the Translational and Molecular Imaging Institute, Mount Sinai Hospital, New York, NY Philip Greenland, M.D., Professor of Cardiology, Director, Institute for Public Health and Medicine, Center for Population Health Sciences, Chicago, IL Robert Harrington, M.D. Chair of the Department of Medicine, Professor of Medicine, Stanford University School of Medicine, Stanford, CA Harvey Hecht, M.D., Director of Cardiac CT Imaging Laboratory, Mount Sinai School of Medicine, New York, NY Karl-Heinz Jöckel, Ph.D. Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Germany Ioannis Kakadiaris, Ph.D. Professor of Computer Science and Biomedical Engineering, University of Houston, Houston, TX Stanley Kleis, Ph.D. Professor of Mechanical Engineering and Biomedical Engineering, University of Houston, Houston, TX Tatiana Kuznetsova, M.D. Professor and Director, Hypertension and Cardiovascular Epidemiology, University of Leuven, Leuven, Belgium Daniel Levy, M.D. Director of Framingham Heart Study, and Intramural Investigator, National Institute of Health, Bethesda, MD Roxana Mehran, M.D. Professor of Medicine and Director of Interventional Clinical Trials, Mount Sinai School of Medicine, New York, NY Ralph Metcalfe, Ph.D. Professor of Mechanical and Biomedical Engineering, University of Houston, Houston, TX Susanne Moebus, Ph.D., M.P.H. Biologist & Epidemiologist, Head of the Centre for Urban Epidemiology, University Essen, Germany Morteza Naghavi, M.D. Founder and Executive Chairman of the SHAPE Task Force, President of MEDITEX, Houston, TX Tasneem Z. Naqvi, M.D. Professor of Medicine and Director of Echocardiography, College of Medicine, May Clinic, Scottsdale, AZ Jagat Narula, M.D., Ph.D. Associate Dean for Global Affairs, Professor of Medicine (Cardiology), Mount Sinai Hospital and School of Medicine, New York, NY Ulla Roggenbuck, Ph.D. Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Germany Henrik Sillesen, M.D. Professor and Head of Dept. of Vascular Surgery, Rigs Hospitalet, University of Copenhagen, Copenhagen, Denmark Robert Superko, M.D. Professor of Medicine and President at Cholesterol, Genetics, and Heart Disease Institute, Carmel, CA Pierre-Jean Touboul, M.D. Professor of Neurology, Department of Neurology and Stroke Center, AP-HP Bichat University Hospital, Neurology and Stroke Center, Paris, France Nathan Wong, M.P.H., Ph.D. Professor of Epidemiology and Director, Heart Disease Prevention Program, University of California, Irvine, CA Symposium Registration http://shapesociety.org/the-first-machine-learning-heart-attack-forecast-symposium/ About SHAPE The Society for Heart Attack Prevention and Eradication (SHAPE) is a non-profit organization that promotes education and research related to prevention, detection, and treatment of heart attacks. SHAPE is committed to raising public awareness about revolutionary discoveries that are opening exciting avenues that can lead to the eradication of heart attacks. SHAPE's mission is to eradicate heart attacks in the 21st century. SHAPE has recently embarked on “Machine Learning Heart Attack Forecast System (Vulnerable Patient Project)” Project which is a collaborative effort between world’s leading cardiovascular researchers to develop a new Heart Attack Forecast System empowered by artificial intelligence. Additional information on this innovative project will be announced soon. To learn more about SHAPE visit http://www.shapesociety.org. Contact information: 1-877-SHAPE11 and info(at)shapesociety(dot)org. Learn more about the Vulnerable Patient http://shapesociety.org/the-first-machine-learning-heart-attack-forecast-symposium About SHAPE Task Force The SHAPE Task Force, an international group of leading cardiovascular physicians and researchers, has created the SHAPE Guidelines, which educates physicians on how to identify asymptomatic atherosclerosis (hidden plaques) and implement proper therapies to prevent a future heart attack. According to the SHAPE Guidelines, men 45-75 and women 55-75 need to be tested for hidden plaques in coronary or carotid arteries. Individuals with high risk atherosclerosis (high plaque score) should be treated even if their cholesterol level is within statistical “normal range.” If they have plaques, the so-called normal is not normal for them. The higher the amount of plaque burden in the arteries the higher the risk and the more vulnerable to heart attack. SHAPE Guideline aims to identify the asymptomatic “Vulnerable Patient” and offer them intensive preventive therapy to prevent a future heart attack. Knowing one's plaque score can be a matter of life and death. The SHAPE Task Force includes the following: Click below to learn about SHAPE Centers of Excellence http://shapesociety.org/centers-of-excellence/ Drs Naghavi, PK Shah, Daniel Berman, and Mathew Budoff members of the SHAPE Task Force explain how hospitals and community clinics can become a SHAPE Center of Excellence and establish themselves a leader in preventive health.


News Article | February 15, 2017
Site: www.npr.org

From Vector To Zoonotic: A Glossary For Infectious Diseases The world is in a hyperinfectious era. And that means there are a lot of words being tossed around that you might not be familiar with. Or maybe you have a general idea of what they mean but wish you knew more. Here are some key terms and definitions. And yes, there will be a quiz (coming in March so you have time to study). Epidemic: A sudden increase in the number of cases of a disease in a particular geographic area, beyond the number health officials typically expect. An increase that occurs in a relatively small geographic area or among a small group of people may be called an "outbreak." For example, the Centers for Disease Control and Prevention calls HIV/AIDS, which affects 1.2 million people in the United States, an "epidemic." By contrast, the CDC called two cases of sickness from drinking raw milk (listeriosis) in the United States an "outbreak." Pandemic: An epidemic spanning many countries and/or several continents. The difference between an outbreak, an epidemic and a pandemic can be murky and depends on the opinions of scientists and health officials. Emerging disease: A disease that occurs in the population of a certain geographic region for the first time, or a disease that's been present at low levels in a region but then rapidly reaches new peaks in the number of cases reported. Animal-human interface: The points of contact between animals and humans — when people cut down forests and set up dwellings where forest animals are still prevalent, for example. Some types of diseases spread from animals to humans at this interface. (Note: In all these definitions "animal" refers to nonhuman animals.) Reservoir: An animal, plant or environment in which a disease can persist for long periods of time. For example, some bats serve as a reservoir for rabies and can spread the disease by biting humans. But the bats — and other reservoir species — may not experience symptoms because of built-in immunity. A disease reservoir is analogous to a water reservoir. But instead of supplying water, a disease reservoir serves as a supply for a virus or other pathogen. Vector: Any living creature that can pass an infection to another living creature. Humans are technically vectors, but the term is more commonly applied to nonhuman organisms. Spillover: The transmission of a disease from one species to another. Sometimes a disease may reside in a plant or animal or even in soil, and then spread to humans. This spread of disease is called a "spillover event." Index case: The first case of a disease known to health officials. Some epidemiologists may refer to an index case as "patient zero." Zoonotic: Any disease that spreads from animals to people. The animals can range from tiny ticks to lumbering cattle. One Health: This two-word phrase embodies the view that there's no such thing as just human health or just animal health or just the health of the environment — they're all part of One Health. That's because the health of humans is closely linked to the health of the environment and other animals. Proponents of One Health believe medical doctors, ecologists, veterinarians and other specialists should work together to improve a community's health. Microbe: A living thing too small for the eye to see, such as bacteria, fungi or viruses. Many microbes are harmless and may even benefit other living things. But some can cause disease among humans, other animals and plants. Microbes that cause disease are called "pathogens" and are informally referred to as "germs." Epidemiologist Peter Krause of the Yale School of Public Health provided invaluable input for these definitions. What do you want to know about pandemics? Share your questions by submitting them in our special tool here. Our global health team will answer some of them in an upcoming story.


News Article | February 15, 2017
Site: www.npr.org

From Vector To Zoonotic: A Glossary For Infectious Diseases The world is in a hyperinfectious era. And that means there are a lot of words being tossed around that you might not be familiar with. Or maybe you have a general idea of what they mean but wish you knew more. Here are some key terms and definitions. And yes, there will be a quiz (coming in March so you have time to study). Epidemic: A sudden increase in the number of cases of a disease in a particular geographic area, beyond the number health officials typically expect. An increase that occurs in a relatively small geographic area or among a small group of people may be called an "outbreak." For example, the Centers for Disease Control and Prevention calls HIV/AIDS, which affects 1.2 million people in the United States, an "epidemic." By contrast, the CDC called two cases of sickness from drinking raw milk (listeriosis) in the United States an "outbreak." Pandemic: An epidemic spanning many countries and/or several continents. The difference between an outbreak, an epidemic and a pandemic can be murky and depends on the opinions of scientists and health officials. Emerging disease: A disease that occurs in the population of a certain geographic region for the first time, or a disease that's been present at low levels in a region but then rapidly reaches new peaks in the number of cases reported. Animal-human interface: The points of contact between animals and humans — when people cut down forests and set up dwellings where forest animals are still prevalent, for example. Some types of diseases spread from animals to humans at this interface. (Note: In all these definitions "animal" refers to nonhuman animals.) Reservoir: An animal, plant or environment in which a disease can persist for long periods of time. For example, some bats serve as a reservoir for rabies and can spread the disease by biting humans. But the bats — and other reservoir species — may not experience symptoms because of built-in immunity. A disease reservoir is analogous to a water reservoir. But instead of supplying water, a disease reservoir serves as a supply for a virus or other pathogen. Vector: Any living creature that can pass an infection to another living creature. Humans are technically vectors, but the term is more commonly applied to nonhuman organisms. Spillover: The transmission of a disease from one species to another. Sometimes a disease may reside in a plant or animal or even in soil, and then spread to humans. This spread of disease is called a "spillover event." Index case: The first case of a disease known to health officials. Some epidemiologists may refer to an index case as "patient zero." Zoonotic: Any disease that spreads from animals to people. The animals can range from tiny ticks to lumbering cattle. One Health: This two-word phrase embodies the view that there's no such thing as just human health or just animal health or just the health of the environment — they're all part of One Health. That's because the health of humans is closely linked to the health of the environment and other animals. Proponents of One Health believe medical doctors, ecologists, veterinarians and other specialists should work together to improve a community's health. Microbe: A living thing too small for the eye to see, such as bacteria, fungi or viruses. Many microbes are harmless and may even benefit other living things. But some can cause disease among humans, other animals and plants. Microbes that cause disease are called "pathogens" and are informally referred to as "germs." Epidemiologist Peter Krause of the Yale School of Public Health provided invaluable input for these definitions. What do you want to know about pandemics? Share your questions by submitting them in our special tool here. Our global health team will answer some of them in an upcoming story.


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

Why Are More Young Americans Getting Colon Cancer? One of the great treats of following an Agatha Christie mystery (my favorite being Hercule Poirot) is that you know there will be an "Aha!" moment at the end. The fastidious, mustachioed detective will pull together all the disparate facts and present a compelling answer. I'm frequently reminded that science doesn't work that way. The latest case in point is an article published Tuesday in the Journal of the National Cancer Institute that sets out to explore a trend in colorectal cancer among younger Americans. More than a decade ago, scientists noticed an odd quirk in the data: While overall rates of colorectal cancer have been falling dramatically since the mid-1980s, there's been a steady uptick of this disease among people younger than 50. The numbers are small. Cancer incidence is creeping up by 1 or 2 cases per 100,000 people under 50. By way of comparison, the disease rate among older Americans has plummeted by more than 100 cases per 100,000 people. And the vast majority of colorectal cancer cases are among people over 50: These older Americans are 16 times more likely to get colon cancer, compared with adults who are younger. That's why a small trend in younger adults is far outweighed by the dramatic decrease of disease among people over 50. Still, the under-50s will eventually grow older. What will happen to their risk then? Will the trends that started in their 20s and 30s continue? If that's the case, overall colorectal cancer rates might ultimately end their steady decline, and could start to rise. Another possibility is that, once people turn 50, they will follow the current medical guidance and get colonoscopies or other recommended screening tests, which can actually prevent colorectal cancer by finding and removing precancerous polyps. And their risk profile could end up looking much like it does today. Here's where even Poirot would be stumped. There simply isn't enough information to know what will happen. Epidemiologist Rebecca Siegel and her colleagues at the American Cancer Society have published their take in the JNCI. In their study, they break down the population into generational cohorts, focusing on millennials and members of Generation X. By breaking down the cases by age group, Siegel says, it's easier to disentangle generational changes such as differences in diet from trends in medical diagnosis and treatment, which vary less by age. Still, she and her colleagues can only say so much. "[T]he results do not provide any direct evidence about the role of specific exposures or interventions," they note in the study. Even so, the researchers say, because trends in the young "could be a bellwether of the future disease burden, our results are sobering." Siegel tells Shots, "It appears that under the surface, the underlying risk for this disease is actually increasing in the population." What's driving that is hard to say. Obesity is more common among younger than it used to be, so perhaps it's partly to blame. Or it may not be obesity itself; it could be that poor diet and lack of exercise, which contribute to obesity, are also influencing colon cancer rates. One study found that people from Africa who were suddenly switched to an American diet had signs of inflammation in their colons within just two weeks, Siegel notes, "so this change can happen fairly rapidly." But that's far from a complete explanation. A large British study published a few years ago suggested that only 11 percent of colon cancer cases could be tied to trends in obesity. There's also a scenario in which this seemingly glum cancer trend is in fact good news. Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy & Clinical Practice, says what look like additional cancers in people under 50 may simply be cases that are being diagnosed earlier than they would have been. Some people are getting colonoscopies for reasons other than cancer screening these days, and doctors are surely coming upon early cases of colon cancer they might not have turned up so soon. There's some evidence to back that claim: While the rate of new cases of colorectal cancer has been climbing in under-50 Americans since the mid-1990s, the death rate among that group has remained remarkably flat. And death rates may be the more telling statistic. Something similar happened with breast cancer in the 1980s — there was a temporary spike in the number of breast cancers diagnosed, as large numbers of women went in for mammography screening for the first time. But death rates didn't rise, and incidence rates of breast cancers fell again after that uptick. Welch notes that we're seeing that again with the rates of thyroid cancer, which are skyrocketing due to intensive screening and diagnosis; but, again, there's been no increase in mortality from thyroid tumors. Welch offers yet another possibility: Maybe the apparent rise in colon cancer among young people is real, but it won't affect them as they age. "The biology of the disease may be different between the young and the old," he says. Welch himself has explored the much larger trend of declining colorectal cancer rates. Some of it is no doubt caused by vastly increased screening for colorectal cancer, though he notes that the decline was well under way before colonoscopies became routine. There's no question that diet and other factors can also have a profound effect on cancer rates. "One of the most dramatic cases of that is stomach cancer, which used to be a very common cause of cancer and has now virtually disappeared, at least in the United States," Welch tells Shots. On one point there is broad agreement among doctors and researchers treating and studying this disease: The increased screening for colorectal cancer, which can involve removing polyps before they become cancer, has been a significant factor in reducing the burden of this illness. Another point of agreement: If the Trump administration eliminates the current insurance benefit for colon cancer screening as it does away with the Affordable Care Act, fewer people are likely to get screened for this deadly malignancy. And the likely impact of that is not a mystery. You can contact Richard Harris at rharris@npr.org.


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

Why Are More Young Americans Getting Colon Cancer? One of the great treats of following an Agatha Christie mystery (my favorite being Hercule Poirot) is that you know there will be an "Aha!" moment at the end. The fastidious, mustachioed detective will pull together all the disparate facts and present a compelling answer. I'm frequently reminded that science doesn't work that way. The latest case in point is an article published Tuesday in the Journal of the National Cancer Institute that sets out to explore a trend in colorectal cancer among younger Americans. More than a decade ago, scientists noticed an odd quirk in the data: While overall rates of colorectal cancer have been falling dramatically since the mid-1980s, there's been a steady uptick of this disease among people younger than 50. The numbers are small. Cancer incidence is creeping up by 1 or 2 cases per 100,000 people under 50. By way of comparison, the disease rate among older Americans has plummeted by more than 100 cases per 100,000 people. And the vast majority of colorectal cancer cases are among people over 50: These older Americans are 16 times more likely to get colon cancer, compared with adults who are younger. That's why a small trend in younger adults is far outweighed by the dramatic decrease of disease among people over 50. Still, the under-50s will eventually grow older. What will happen to their risk then? Will the trends that started in their 20s and 30s continue? If that's the case, overall colorectal cancer rates might ultimately end their steady decline, and could start to rise. Another possibility is that, once people turn 50, they will follow the current medical guidance and get colonoscopies or other recommended screening tests, which can actually prevent colorectal cancer by finding and removing precancerous polyps. And their risk profile could end up looking much like it does today. Here's where even Poirot would be stumped. There simply isn't enough information to know what will happen. Epidemiologist Rebecca Siegel and her colleagues at the American Cancer Society have published their take in the JNCI. In their study, they break down the population into generational cohorts, focusing on millennials and members of Generation X. By breaking down the cases by age group, Siegel says, it's easier to disentangle generational changes such as differences in diet from trends in medical diagnosis and treatment, which vary less by age. Still, she and her colleagues can only say so much. "[T]he results do not provide any direct evidence about the role of specific exposures or interventions," they note in the study. Even so, the researchers say, because trends in the young "could be a bellwether of the future disease burden, our results are sobering." Siegel tells Shots, "It appears that under the surface, the underlying risk for this disease is actually increasing in the population." What's driving that is hard to say. Obesity is more common among younger than it used to be, so perhaps it's partly to blame. Or it may not be obesity itself; it could be that poor diet and lack of exercise, which contribute to obesity, are also influencing colon cancer rates. One study found that people from Africa who were suddenly switched to an American diet had signs of inflammation in their colons within just two weeks, Siegel notes, "so this change can happen fairly rapidly." But that's far from a complete explanation. A large British study published a few years ago suggested that only 11 percent of colon cancer cases could be tied to trends in obesity. There's also a scenario in which this seemingly glum cancer trend is in fact good news. Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy & Clinical Practice, says what look like additional cancers in people under 50 may simply be cases that are being diagnosed earlier than they would have been. Some people are getting colonoscopies for reasons other than cancer screening these days, and doctors are surely coming upon early cases of colon cancer they might not have turned up so soon. There's some evidence to back that claim: While the rate of new cases of colorectal cancer has been climbing in under-50 Americans since the mid-1990s, the death rate among that group has remained remarkably flat. And death rates may be the more telling statistic. Something similar happened with breast cancer in the 1980s — there was a temporary spike in the number of breast cancers diagnosed, as large numbers of women went in for mammography screening for the first time. But death rates didn't rise, and incidence rates of breast cancers fell again after that uptick. Welch notes that we're seeing that again with the rates of thyroid cancer, which are skyrocketing due to intensive screening and diagnosis; but, again, there's been no increase in mortality from thyroid tumors. Welch offers yet another possibility: Maybe the apparent rise in colon cancer among young people is real, but it won't affect them as they age. "The biology of the disease may be different between the young and the old," he says. Welch himself has explored the much larger trend of declining colorectal cancer rates. Some of it is no doubt caused by vastly increased screening for colorectal cancer, though he notes that the decline was well under way before colonoscopies became routine. There's no question that diet and other factors can also have a profound effect on cancer rates. "One of the most dramatic cases of that is stomach cancer, which used to be a very common cause of cancer and has now virtually disappeared, at least in the United States," Welch tells Shots. On one point there is broad agreement among doctors and researchers treating and studying this disease: The increased screening for colorectal cancer, which can involve removing polyps before they become cancer, has been a significant factor in reducing the burden of this illness. Another point of agreement: If the Trump administration eliminates the current insurance benefit for colon cancer screening as it does away with the Affordable Care Act, fewer people are likely to get screened for this deadly malignancy. And the likely impact of that is not a mystery. You can contact Richard Harris at rharris@npr.org.


Dublin, Nov. 23, 2016 (GLOBE NEWSWIRE) -- Research and Markets has announced the addition of the "Bipolar Disorder: Epidemiology and Patient-Based Market Forecasts, Treatment Algorithm, and Marketed and Pipeline Drug Analysis" report to their offering. Generic dominance will prevent the growth of the bipolar disorder market, and few pipeline candidates show promise to completely reverse this trend. This report addresses the following questions: - What are the key events shaping the bipolar disorder market dynamics over 2014-23? - Which segments of the market provide opportunities for growth? - How does the bipolar disorder pipeline compare to other psychiatric indications, and what are the candidates to look out for? - How do currently available bipolar disorder drugs compare to one another? - What is the standard of care in bipolar disorder, and which are the key unmet needs in treatment? Key Topics Covered: FORECAST: BIPOLAR DISORDER - Executive Summary - Market Overview and Trends - Market Definition and Methodology - Abilify (aripiprazole) - Abilify Maintena (aripiprazole) - Latuda (lurasidone) - Risperdal Consta (risperidone) - Saphris (asenapine) - Seroquel/Seroquel XR (quetiapine fumarate) - Vraylar (cariprazine) - Primary Research Methodology TREATMENT: BIPOLAR DISORDER - Executive Summary - Primary Research Methodology, - Disease Definition and Diagnosis - Patient Segmentation - Country Treatment Trees - Current Treatment Options - Prescribing Trends - Unmet Needs in Bipolar Disorder EPIDEMIOLOGY: BIPOLAR DISORDER IN THE US, JAPAN, AND 5EU - Executive Summary - Disease Definition - Global Variation - Risk Factors - Co-Morbidities - Sources and Methodology - Forecast - Forecast: Bipolar Disorder I - Forecast: Bipolar Disorder II - Epidemiologist Insight - Strengths and Limitations - Bibliography MARKETED DRUGS: BIPOLAR DISORDER - Executive Summary - Product Overview - Other Marketed Drugs - Product profile: Abilify - Product profile: Geodon - Product profile: Lamictal - Product profile: Latuda - Product profile: Risperdal/Risperdal Consta - Product profile: Saphris - Product profile: Seroquel/Seroquel XR - Product profile: Vraylar - Product profile: Zyprexa PIPELINE: BIPOLAR DISORDER - Executive Summary - Clinical Pipeline Overview - Target Product Profile - Clinical Trial Design - The Future of Treatment - Recently Discontinued Drugs - Product profile (late stage): ITI-007 For more information about this report visit http://www.researchandmarkets.com/research/d2fd69/bipolar_disorder

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