New York City, NY, United States
New York City, NY, United States

Time filter

Source Type

News Article | May 10, 2017
Site: www.techtimes.com

Nearly three dozen children in the United States are sent to hospital emergency departments daily because of injuries caused by using cotton-tipped swabs for cleaning their ears. The highest rate of these cotton-tipped swab-related ear injuries occur in children below the age of 3. Kris Jatana, from the Nationwide Children's Hospital in Columbus, Ohio, said that despite being seemingly harmless, cotton-tipped applicators certainly come with a lot of potential risks when they are used to clean the ears. For the new study published in the Journal of Pediatrics, Jatana and colleagues looked at data from the National Electronic Injury Surveillance System, which include those from emergency departments to evaluate the extent of ear injuries associated with cotton-tipped swabs in children. The researchers found that from 1990 to 2010, 263,338 children below 18 years old were sent to the emergency room because of ear injuries linked to the use of cotton-tipped swabs. The number is equivalent to about 12,500 incidents per year or about 34 injuries per day. About 40 percent of these emergency visits were attributed to the feeling of something having stuck in the ears of the children. About 35 percent were because of bleeding and about 17 percent were because of ear pain. After examination, about 30 percent were found to have a foreign body in their ears while a quarter of the children had broken eardrums, or tympanic membrane perforations. About 23 percent had soft tissue injuries to their ear. Most of the injuries happened at home and nearly all children were released without requiring hospitalization. Of the cases where the cause of the injury was documented, researchers found that most were due to cleaning. Jatana said that they have long learned that it is not safe to insert cotton-tipped swabs into ears, and ear, nose, and throat doctors do not recommend these products for cleaning out earwax. "The ear canals are usually self-cleaning. Using cotton tip applicators to clean the ear canal not only pushes wax closer to the ear drum, but there is a significant risk of causing minor to severe injury to the ear," Jatana said. "These products may seem harmless, but this study shows how important it is that they not be used to clean ears." Alyssa Hackett from the New York Eye and Ear Infirmary of Mount Sinai in New York, who was not involved in the research, said that serious injuries rarely occur but what commonly happens is that the wax gets pushed deep into the ear canal instead of being removed by the cotton swab, which then causes temporary hearing loss. Experts recommend using a cotton ball to remove the wax visible from the entrance to the ear or using soapy water and a wash cloth when bathing. "Despite manufacturers' warning labels and clinicians' advice to avoid using cotton-tip applicators (CTAs) inside the ear canal, CTA use remains the most common cause of accidental penetrating ear injury in children," the researchers wrote in their study. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


News Article | May 17, 2017
Site: www.eurekalert.org

(NEW YORK -- May 17, 2017) Biomarkers in the teeth of wild orangutans indicate nursing patterns related to food fluctuations in their habitats, which can help guide understanding of breast-feeding evolution in humans, according to a study published today in Science Advances. This work was led by researchers in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai and evolutionary biologists at Griffith University in Australia. Breast-feeding is a critical aspect of human development, and the duration of exclusive nursing and timing of introducing solid food to the diet are also important determinants of health in human and other primate populations. Many aspects of nursing, however, remain poorly understood. Orangutan nursing habits have also been difficult to study due to challenges in observing this behavior in their natural environment. To work around these challenges, researchers reconstructed diet histories of wild orangutans by using their teeth as biomarkers. The growth patterns of teeth, which resemble tree rings, allows investigators to determine concentrations of the maternal elements in the infants' teeth over time, which yields information about their nursing and dietary patterns. "Early-life dietary transitions reflect fundamental aspects of primate life, history, and evolution," said Christine Austin, PhD, a postdoctoral fellow in the Department of Environmental Medicine and Public Health and second study author. "By first studying nursing patterns of our primate cousins, we can apply these findings to future studies in humans. This method can be used to reconstruct the diet histories of contemporary humans in order to reliably and accurately study the relationship between infant diet and health outcomes in childhood or later life, as well as inform models of population growth." In this study, the researchers examined levels of the element barium in teeth samples from deceased Sumatran and Bornean orangutans housed in zoological museums. Teeth analyses showed that the orangutans consumed maternal milk exclusively for their first year, as determined by a gradual increase in barium levels over the first 12 months. After the first year, the teeth indicated cycles that alternated between more and less milk consumption, which may occur until eight to nine years of age, a later weaning age than any other primate. This cycling is believed to result from the changing and unpredictable availability of fruit, which leads young orangutans to rely on maternal milk for a longer period of time. "The evidence of cyclical multi-year nursing patterns and late weaning ages in orangutans, reported here for the first time, will lead to further studies of how food availability and other environmental factors affect nursing patterns in primates," said Tanya Smith, PhD, Associate Professor at Griffith University and lead study author. "Additional research is needed to determine whether similar breast-feeding patterns help human babies increase resilience to environmental stressors in infancy." For more information on exposure biology research at Mount Sinai, please visit http://labs. . The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services--from community-based facilities to tertiary and quaternary care. The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals." For more information, visit http://www. , or find Mount Sinai on Facebook, Twitter and YouTube.


News Article | May 15, 2017
Site: www.prweb.com

The Mount Sinai Health System and The New Jewish Home are continuing their expansion of services to improve the care of hospitalized patients who require specialized post-acute or long-term care at a skilled nursing facility after leaving the hospital. Through the Mount Sinai-New Jewish Home Hospitalist Program, Mount Sinai doctors specializing in hospital care (known as hospitalists) will provide a seamless transition for patients who need nursing care at The New Jewish Home. The transition of care between hospitals and skilled nursing facilities is a highly vulnerable time for patients. Information may not be adequately relayed and urgent priorities can be overlooked. This innovative model will facilitate greater communication and ensure the transfer of vital information between these venues, allowing patients to receive the expert care they need without interruption. The joint expertise of these two renowned institutions will provide enhanced protocols for follow-up care and will reduce the risk of re-hospitalization in order to provide the best possible outcomes for patients discharged from the hospital. “Building on The New Jewish Home’s already deep and long-standing relationship with Mount Sinai, this new partnership will help accomplish our shared goal of improving care transitions for our patients,” said Audrey Weiner, PhD, President and CEO, The New Jewish Home. “This innovative model ensures the highest quality care for our patients.” “We are excited about this next step in our partnership with The New Jewish Home,” said Andrew Dunn, MD, MPH, SFHM, FACP, Chair-elect of the American College of Physicians Board of Regents, Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and Chief of the Division of Hospital Medicine at Mount Sinai Health System. “The collaboration will allow us to meet a growing need for high-quality nursing home care while strengthening our commitments to the patients and community we serve.” About The New Jewish Home Serving New Yorkers of all faiths and ethnicities for 168 years, The New Jewish Home is transforming eldercare as we know it. One of the nation’s largest and most diversified not‐for‐profit geriatric health and rehabilitation systems, Jewish Home serves 12,000 older adults each year, in their homes and on campuses in Manhattan and Westchester, through short-term rehabilitation, long‐term skilled nursing, low-income housing, and a wide range of home health programs. Jewish Home believes that high quality care and personal dignity are everyone’s right, regardless of background or economic circumstances. Technology, innovation, applied research and new models of care put The New Jewish Home at the vanguard of eldercare providers across the country. About the Mount Sinai Health System The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care. The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the “Honor Roll” of best hospitals in America, ranked No. 15 nationally in the 2016-2017 “Best Hospitals” issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation’s top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai’s Kravis Children’s Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals." For more information, visit http://www.mountsinai.org/, or find Mount Sinai on Facebook, Twitter and YouTube.


News Article | May 25, 2017
Site: www.prweb.com

May 2017 – More than 100,000 women have mastectomies in the United States every year. And, with surgical advances that promise a soft, warm breast that will look and feel like her original breast, more and more women now opt for breast reconstruction, either at the time of the mastectomy or later. But many of these women who undergo reconstruction discover that the natural “look and feel” of her restored breast refers to how the breast will look and feel to someone else. Often the breast does not feel at all natural to the woman herself and her reconstructed breast may lack all feeling and be completely numb to touch and sexual arousal. “Our society has always put a premium on how a woman looks,” says Dr. Constance M Chen, plastic surgeon and breast reconstruction specialist. “And while our ability to reconstruct a woman's breast has come a long way, the emphasis has been on restoring her appearance. Restoring sensation wasn't a priority and women haven't always been made aware of what to expect. The good news is that we are now pioneering techniques that show great promise in reconnecting nerves and restoring sensation.” During a mastectomy, the nerves that provide feeling to the breast and nipple are severed, causing loss of sensation in the remaining skin whether the woman undergoes reconstruction or not. Over time, some women experience a return of feeling but it is typically minimal. When the reconstruction choice is implants, there is no opportunity to restore sensation because the implant forms a physical barrier that prevents nerves from growing through it to reach the skin. With certain types of autologous reconstruction, however, it is possible to suture together nerves along with a woman's own tissue to create a new breast. Reconnecting blood vessels and nerves allows them to grow through the transferred tissue to reach the skin and significantly improve the return of sensation. In general, nerves grow very slowly, with an average rate of 1 millimeter per day. There are also different types of sensation – deep pressure, light touch, pain, and temperature – and they return at different rates. Deep pressure sensation usually returns most quickly and temperature most slowly. Thus, regenerated nerves can take months or even years to reach the skin, and the quality of sensation is variable. “Since nerve growth is slow and unpredictable and full return of sensation is not guaranteed, reconnecting the nerves has not always been a priority in reconstructive surgery,” says Dr. Chen. “We believe that it is important to make every effort and provide every possible opportunity to restore full sensation to the breast, however. Studies have shown that taking the time in surgery to meticulously repair the nerves results in more rapid return of feeling and improved sensation.” While results vary, innovative microsurgical techniques that use neural tubes and nerve grafts have provided some patients with near-normal sensation and even erectile function of the nipple. “Restoring sensation is the next frontier in breast reconstruction,” Dr. Chen concludes. “What makes a woman feel 'whole' again after mastectomy is an individual matter for each woman but we will continue to pursue solutions that enable her to regain not just her health but her sense of self.” Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Chief of Microsurgery at New York Eye and Ear Infirmary of Mount Sinai. She is also Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. http://www.constancechenmd.com


News Article | May 5, 2017
Site: www.eurekalert.org

(New York - May 5, 2017) - Much is known about flu viruses, but little is understood about how they reproduce inside human host cells, spreading infection. Now, a research team headed by investigators from the Icahn School of Medicine at Mount Sinai is the first to identify a mechanism by which influenza A, a family of pathogens that includes the most deadly strains of flu worldwide, hijacks cellular machinery to replicate. The study findings, published online today in Cell, also identifies a link between congenital defects in that machinery -- the RNA exosome -- and the neurodegeneration that results in people who have that rare mutation. It was by studying the cells of patients with an RNA exosome mutation, which were contributed by six collaborating medical centers, that the investigators were able to understand how influenza A hijacks the RNA exosome inside a cell's nucleus for its own purposes. "This study shows how we can discover genes linked to disease -- in this case, neurodegeneration -- by looking at the natural symbiosis between a host and a pathogen," says the study's senior investigator, Ivan Marazzi, PhD, an assistant professor in the Department of Microbiology at the Icahn School of Medicine at Mount Sinai. Influenza A is responsible in part not only for seasonal flus but also pandemics such as H1N1 and other flus that cross from mammals (such as swine) or birds into humans. "We are all a result of co-evolution with viruses, bacteria, and other microbes, but when this process is interrupted, which we call the broken symmetry hypothesis, disease can result," Dr. Marazzi says. The genes affected in these rare cases of neurodegeneration caused by a congenital RNA exosome mutation may offer future insight into more common brain disorders, such as Alzheimer's and Parkinson's diseases, he added. In the case of Influenza A, the loss of RNA exosome activity severely compromises viral infectivity, but also manifests in human neurodegeneration suggesting that viruses target essential proteins implicated in rare disease in order to ensure continual adaptation. Influenza A is an RNA virus, meaning that it reproduces itself inside the nucleus. Most viruses replicate in a cell's cytoplasm, outside the nucleus. The researchers found that once inside the nucleus, influenza A hijacks the RNA exosome, an essential protein complex that degrades RNA as a way to regulate gene expression. The flu pathogen needs extra RNA to start the replication process so it steals these molecules from the hijacked exosome, Dr. Marazzi says. "Viruses have a very intelligent way of not messing too much with our own biology," he says. "It makes use of our by-products, so rather than allowing the exosome to chew up and degrade excess RNA, it tags the exosome and steals the RNA it needs before it is destroyed. "Without an RNA exosome, a virus cannot grow, so the agreement between the virus and host is that it is ok for the virus to use some of the host RNA because the host has other ways to suppress the virus that is replicated," says the study's lead author, Alex Rialdi, MPH, a graduate assistant in Dr. Marazzi's laboratory. Co-authors include investigators from the University of California-San Francisco, Columbia University, Regeneron Pharmaceuticals and Regeneron Genetics Center, Burnham Institute for Medical Research, and the University of California-Los Angeles. The study was supported by NIH grants 2RO1AI099195 and DP2 2OD008651 (U.B.), and partially supported by HHSN272201400008C - Center for Research on Influenza Pathogenesis (CRIP) a NIAID-funded Center of Excellence for Influenza Research and Surveillance (A.G.S, H.v.B., R.A., and I.M.). Other support includes the Department of Defense W911NF-14-1-0353 (to I.M.) NIH grant 1R56AI114770-01A1 (to I. M.), NIH grant 1R01AN3663134 (I.M. and H.v.B), and NIH grant U19AI106754 FLUOMICS (I.M., R.A., S.C., N.K., A.G.S.). The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services -- from community-based facilities to tertiary and quaternary care. The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals." For more information, visit http://www. , or find Mount Sinai on Facebook, Twitter and YouTube.


News Article | May 4, 2017
Site: www.eurekalert.org

(New York, NY - May 4, 2017) -- Immunotherapy, which has achieved remarkable results in late-stage lung cancer patients, can also hold great hope for newly diagnosed patients, cutting the deadly disease off before it has the chance to take hold and offering a potential cure, according to a new Mount Sinai study published today in Cell. Researchers at The Tisch Cancer Institute at Mount Sinai discovered that some of the same immune cells that allow immunotherapy to turn around some late-stage lung cancers are also present just as the disease takes hold. Before now, little was known about the immune response in early lung cancer, said Miriam Merad, MD, PhD, Professor of Oncological Sciences and of Medicine (Hematology and Medical Oncology) at The Tisch Cancer Institute at Mount Sinai. Dr. Merad and a multidisciplinary team of thoracic surgeons, pathologists, and scientists devised a comprehensive study that began when patients went into surgery to have cancerous lesions removed. The patients' lung tumor samples, samples of surrounding healthy lung tissue, and blood samples were immediately analyzed on a cellular level to map out the immune system components present. The team of researchers crafted a barcoding method that attaches cells in each sample to a different metal isotope, allowing the samples to be pooled for a simultaneous analysis of cells from all three tissue types. The scientists combined this barcoding approach with high-dimensional profiling to map the complete immune landscape to search for tumor-driven changes that would be vulnerable to targeted immunotherapy. The analysis of the samples showed that stage I lung cancer lesions already harbor immune system components that likely compromise anti-tumor T cells' ability to fend off cancer. These single-cell analyses offered unprecedented detail of tumor-driven immune changes, providing a powerful tool for the future design of immunotherapies such as checkpoint inhibitors, particularly those that target the PD-1 and PD-L1 proteins that shield cancer from the immune system; these checkpoint inhibitors have shown great promise in later-stage cancers. "Immunotherapy has mostly been used in advanced or metastatic lung cancer, but its benefit in early-stage tumors remains unknown," Dr. Merad said. "The standard treatment for early lung cancer is normally surgical removal of the lesions--sometimes with chemotherapy and radiation. Our study reveals that early lung lesions are heavily infiltrated with many different immune cells, suggesting that immunotherapy could also work on very early lesions and potentially lead to a cure by heading cancer off at the pass before it really takes root in the lungs." This new research also identified a multitude of additional immunotherapy targets to increase the number of patients that would significantly benefit from immunotherapy, which at the moment remains fairly small. This research is being used to develop immunotherapy trials with early lung cancer patients. "About 50 percent of patients with small lung cancer lesions relapse," Merad said. "And when lung cancer is advanced, chemotherapy does not have a great success rate, so knowing how to attack the cancer at an early stage could have huge impacts on the number of patients relapsing and their overall survival. Our research further corroborates the belief that immunotherapy agents are most efficient at early stages of cancer, particularly in patients who have never been treated with chemotherapy." Raja M. Flores, MD, Chair of the Department of Thoracic Surgery at Mount Sinai Health System, and his team contributed significantly to the study by identifying patients and providing their tissue samples. Mount Sinai's Human Immune Monitoring Center (HIMC) also played an integral role, by providing a platform to analyze patient samples using quality control assays and cutting-edge technology. Through the HIMC, Dr. Merad plans to build a portal to share the results of this study and of other HIMC research to collaborate with colleagues at other cancer centers in the hopes of promoting further cancer and immunology research. This study was funded by Foundation pour la Recherche Medicale DEA20150633125 and NIH grants R01, R01 CA173861, U19AI128949, U24 AI 118644, U19 AI 117873-01. The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services--from community-based facilities to tertiary and quaternary care. The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is on the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals." For more information, visit http://www. or find Mount Sinai on Facebook, Twitter and YouTube.


Researchers comparing leading treatment approaches for patients with severe uveitis have discovered that systemic therapy with oral corticosteroids and immunosuppression can preserve or improve vision in the long term better than regional implant therapy can. The results, published in the May 6, 2017 issue of JAMA, should reassure physicians about the relative safety of this approach, and may lead ophthalmologists to change their treatment protocol for better and safer outcomes. Douglas Jabs, MD, MBA, Director of the Eye and Vision Research Institute, New York Eye and Ear Infirmary of Mount Sinai, and Professor of Ophthalmology and Medicine, Icahn School of Medicine at Mount Sinai, chaired an international team of researchers as they examined the long-term effects of two treatment approaches for patients with vision-threatening uveitis. Uveitis, the fifth leading cause of vision loss in the United States, is a collection of more than 30 diseases characterized by inflammation inside the eye that damages the tissues; without appropriate treatment, it will often lead to visual impairment or blindness. For more severe cases, treatment generally calls for taking oral corticosteroid and immunosuppressive medications. The alternative is regional therapy, either with repetitive corticosteroid injections or with a surgically placed fluocinolone acetonide implant that releases corticosteroid medication over three years. Since most of the more severe uveitis cases are chronic, long-term therapy is typically needed. The Multicenter Uveitis Steroid Treatment (MUST) Trial Follow-up Study followed 215 patients from the original MUST Trial for seven years. The MUST Trial and Follow-up Study were conducted at 21 medical centers across the United States, along with two sites in the United Kingdom and Australia. Patients in the Trial had been randomized to receive either systemic treatment with oral corticosteroids and immunosuppression or regional therapy with the fluocinolone acetonide implant. At the seven-year mark, the findings showed that patients taking oral medications had better vision on average, compared to those in the implant group. The results differ from the initial MUST Trial findings and from the earlier five-year results of the MUST Follow-up Study, in which the same patients had similar visual outcomes at both time points. The MUST Trial and Follow-up Study also showed that there was no significant increase in the risks of systemic side effects for the systemic therapy group compared to implant therapy, with one exception: patients in the systemic group were more likely to receive antibiotics for infections. These outcomes suggest that systemic treatment, if used properly, may be given relatively safely for up to seven years. "The implication of these data is that oral corticosteroids and immunosuppression may be a preferable initial choice for therapy of the more severe uveitides," explained Dr. Jabs. "They have better visual outcomes long-term, fewer ocular side effects, and no apparent significant increase in the risk of systemic side effects, except for the greater use of antibiotics." While the large majority of both groups maintained good vision at the end of seven years, some patients with the fluocinolone acetonide implant did worse in terms of visual acuity. Results of the follow-up study show vision loss occurred more often in the implant group due to damage from inflammatory lesions in the back of the eye, which occurred at the time of relapse of the uveitis. Even though the implant is designed to release corticosteroid medication for three years, the study found that the benefit lasted approximately five years, with relapses beginning at that time. Relapses can be treated with an implant exchange or by switching to systemic therapy. "Although both treatment approaches control the inflammation in the large majority of patients, for the first five years the implant was better than systemic therapy at controlling inflammation. Hence it has value for those patients where systemic therapy cannot control the inflammation or for those patients who cannot tolerate the oral medications," said Dr. Jabs. He notes the implant has an important role to play in the management of these diseases. "The visual loss that occurred in the implant group with relapse of the uveitis emphasizes the need of sustained control of inflammation in order to optimize visual outcomes in patients. These patients need close follow-up for reactivation of the inflammation, so that appropriate adjustments to treatment can be made." The National Eye Institute (NEI), which is part of the National Institutes of Health, supported the MUST Trial and MUST Trial Follow-up Study. The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services--from community-based facilities to tertiary and quaternary care. The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals." For more information, visit http://www. , or find Mount Sinai on Facebook, Twitter and YouTube.

Loading New York Eye and Ear Infirmary of Mount Sinai collaborators
Loading New York Eye and Ear Infirmary of Mount Sinai collaborators