Showing posts with label predicts. Show all posts
Showing posts with label predicts. Show all posts

Tuesday, 20 August 2013

New Risk Score Predicts 10-Year Dementia Risk for Type 2 Diabetes Patients

Main Category: Diabetes
Also Included In: Alzheimer's / Dementia
Article Date: 20 Aug 2013 - 0:00 PDT Current ratings for:
New Risk Score Predicts 10-Year Dementia Risk for Type 2 Diabetes Patients
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Researchers at Kaiser Permanente and the University Medical Centre Utrecht in the Netherlands have created the first risk score that predicts the 10-year individualized dementia risk for patients with type 2 diabetes, as reported in the inaugural issue of Lancet Diabetes & Endocrinology.

The researchers developed and validated the Diabetes-Specific Dementia Risk Score by examining data from nearly 30,000 patients with type 2 diabetes aged 60 and older over a 10-year period. They found eight factors that were most predictive of dementia - including microvascular disease, diabetic foot and cerebrovascular disease - and assigned each a value related to their association with dementia to create an overall score for patients. The researchers found that individuals in the lowest category of the 20-point risk score had a 5.3 percent chance of developing dementia over the next 10 years, while those in the highest category had a 73 percent chance. Compared with those in the lowest category, those in the highest were 37 times more likely to get dementia, according to the study.

"Patients with type 2 diabetes are twice as likely to develop dementia as those without the disease, but predicting who has the highest future risk is difficult," said Rachel Whitmer, PhD, an epidemiologist at the Kaiser Permanente Division of Research in Oakland, California, who led the study. "While a few dementia risk scores exist, this is the first one that has been developed specifically for individuals with type 2 diabetes and encompasses diabetes-specific characteristics."

All predictors included in the Diabetes-Specific Dementia Risk Score are easy to obtain and based primarily on medical history, so the risk score can be calculated during a routine medical visit or with electronic health records. No labor-intensive or expensive tests, such as cognitive function or brain imaging, are required.

"This risk score is crucial for the care of patients with diabetes since they are particularly susceptible to dementia. It provides clinicians with an easy and efficient tool to assess their patients' chances of developing dementia over the next 10 years," Whitmer said. "Early detection of diabetes patients who are at increased future risk of dementia could help to develop and target preventive treatment."

According to the Centers for Disease Control and Prevention, more than 25 million children and adults in the United States have diabetes with type 2 diabetes in particular accounting for more than 90 percent of these cases. In addition to being a risk factor for dementia, diabetes is the leading cause of kidney failure, non-traumatic lower-limb amputations and new cases of blindness among adults in the United States.

"The risk score could be useful in the selection of high-risk patients for early intervention studies and for many applications of personalized medicine," said Geert Jan Biessels, MD, professor of neurology at the University Medical Centre Utrecht and co-author of the study. "Clinicians can use it to guide their decisions in terms of clinical attention to incipient cognitive impairment which makes people vulnerable to dangerous side-effects of diabetes treatment. The risk score will also help us to understand the causes of diabetes associated increased dementia risk, because we can examine those at high risk in early stages of the dementia process."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our diabetes section for the latest news on this subject.

The study is reported in Lancet Diabetes & Endocrinology

Additional authors on the study include Lieza G. Exalto, MD, of the Department of Neurology, University Medical Centre Utrecht, the Netherlands; Andrew J. Karter, PhD, of the Kaiser Permanente Division of Research, Oakland, Calif.; Elbert S. Huang, MD, of the Department of Internal Medicine, University of Chicago; Wayne J. Katon, MD, of the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine; and Jerome R. Minkoff, MD, of the Kaiser Permanente Department of Endocrinology, Santa Rosa, Calif.

Research reported in this press release was supported by Kaiser Permanente Community Benefit, and by the National Institute of Diabetes and Digestive and Kidney Disorders of the National Institutes of Health under award number DK081796.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Kaiser Permanente

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20 Aug. 2013. APA

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'New Risk Score Predicts 10-Year Dementia Risk for Type 2 Diabetes Patients'

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Monday, 19 August 2013

Remote satellite methodology predicts cholera outbreaks months in advance with greater accuracy

Main Category: Tropical Diseases
Also Included In: Public Health
Article Date: 19 Aug 2013 - 0:00 PDT Current ratings for:
Remote satellite methodology predicts cholera outbreaks months in advance with greater accuracy
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In two recently published papers, Tufts University School of Engineering researchers have established new techniques for predicting the severity of seasonal cholera epidemics months before they occur and with a greater degree of accuracy than other methods based on remote satellite imaging. Taken together, findings from these two papers may provide the essential lead time to strengthen intervention efforts before the outbreak of cholera in endemic regions.

Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. It occurs in the spring and fall in the Bengal delta. In past research, scientists have used chlorophyll, a surrogate for phytoplankton, as a measuring stick for cholera. The cholera bacteria lives and thrives among phytoplankton and zooplankton.

In the June issue of Remote Sensing Letters, Antarpreet Jutla, then a doctoral student at Tufts School of Engineering and now on the faculty at West Virginia University, was lead author on a study that measured chlorophyll and other organic matter.

The team, which was led by Shafiqul Islam, Ph.D., professor of civil and environmental engineering at Tufts School of Engineering, used satellite data to measure chlorophyll and algae, organic substances, and flora that also support growth of the cholera bacteria.

Using satellite images, the researchers created a "satellite water marker" (SWM) index to estimate the presence of organic matter including chlorophyll and plankton based on wavelength measurements.

A predominance of green, plankton-rich water - which is measured at 555 nanometers - indicated the degree to which the waters contained chlorophyll, plankton, and other impurities. Clear, blue water - measured at 412 nanometers - indicated low levels of these impurities, according to the researchers.

The researchers targeted the spring epidemic, which is a coastal phenomenon caused by water flow into the delta from three principal rivers - the Brahmaputra, Ganges, and Meghna. Unlike the spring outbreak, the fall epidemic is linked to flooding which follows the monsoons and subsequent breakdown of sanitary conditions rather than coastal conditions.

In their study, the researchers correlated cholera incidence from the International Center for Diarrheal Disease Research, Bangladesh from 1997 to 2010 with satellite imaging data from the National Aeronautics and Space Administration for the same time period.

They discovered a relationship between SWM index measurements taken in early winter - from October to December - and the severity of cholera epidemics in the following spring. "In short, the index for chlorophyll along with readings for other biological matter in early winter indicated severity of cholera incidences in the spring," says Jutla.

The SWM is a more accurate predictor of cholera than the algorithm that measures strictly chlorophyll levels because it also measures a broader range of organic matter, says Islam.

"The probability for error in this index-based estimate is less than 10 percent while the error in using the chlorophyll-based algorithm is about 30 percent," says Islam. To validate their hypothesis that the index can be used in coastal areas outside of the Bengal Delta, the team applied the SWM to coastal waters around Mozambique's capital city, Maputo.

Additional authors on this paper are Abu Syed Golam Faruque, and Rita Colwell of the Center for Bioinformatics and Computational Biology at the University of Maryland, and Anwar Huq of the Maryland Pathogenic Research Institute at the University of Maryland. Another member of the team, Ali Shafqat Akanda, was with the Center for Bioinformatics and Computational Biology at UM and is now on the faculty at the University of Rhode Island. He was a doctoral student at Tufts during the research.

In a separate paper that was published online in the journal Environmental Modeling and Software, ahead of the September 1 print edition, Jutla, Islam, and Akanda showed that air temperature in the Himalayan foothills can also be a factor in predicting spring cholera.

The researchers collected air temperature data during the early winter months (October-December) in the foothills. In seasons of warm temperature, the foothills experienced higher than normal precipitation and early snow melt. This caused higher than normal water flow in the Ganges, Brahmaputra and Meghna Rivers and eventually into the Bay of Bengal during the drought period. Higher river flow into the delta impedes plankton-carrying seawater from moving inland

When correlated with satellite data on chlorophyll levels, the researchers found that air temperatures could lessen the extent of cholera even when chlorophyll levels were high.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our tropical diseases section for the latest news on this subject.

"A Water Marker Monitored by Satellites to Predict Seasonal Endemic Cholera," Antarpreet Jutla, Ali Shafqat Akanda, Anwar Huq, Abu Syed Golam Faruque, Rita Colwell, and Shafiqul Islam, Remote Sensing Letters, published on line before print June 3, 2013, Vol. 4, No. 8, 822.http://dx.doi.org/10.1080/2150704X.2013.802097

The research reported in this paper was supported, in part, from National Institutes of Health (NIH) grants 1RCTW008587-01 and 2R01A1039129-11A2.

"A framework for predicting endemic cholera using satellite derived environmental determinants," Antarpreet S. Jutla, Ali S. Akanda, Shafiqul Islam, Environmental Monitoring and Software, published online before print http://dx.doi.org/10.1016/j.envsoft.2013.05.008

The research reported in this paper was supported through NIH funding under award number 1RCTW008587-01. Dr. Jutla acknowledges the support from Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV.

Tufts University

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Tuesday, 30 July 2013

High platelet reactivity on clopidogrel predicts stent thrombosis, heart attack, and bleeding

Main Category: Cardiovascular / Cardiology
Also Included In: Medical Devices / Diagnostics;  Blood / Hematology
Article Date: 30 Jul 2013 - 0:00 PDT Current ratings for:
High platelet reactivity on clopidogrel predicts stent thrombosis, heart attack, and bleeding
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Patients who receive a drug-eluting stent (DES) and demonstrate high platelet reactivity on clopidogrel are more likely to have blood clots form on the stent and to suffer a heart attack; however, these patients are less likely to develop bleeding complications. One-year results of the ADAPT-DES trial was published online in The Lancet. The findings were first presented at last year's Transcatheter Cardiovascular Therapeutics (TCT) annual scientific symposium.

ADAPT-DES is the largest study ever to explore the overall treatment implications of platelet reactivity on patient outcomes after successful coronary drug-eluting stent implantation. Researchers investigated the relationship between platelet reactivity during dual therapy with aspirin and clopidogrel and clinical outcomes such as stent thrombosis, major bleeding, and other adverse events.

The study enrolled 8,583 patients at 11 sites in the US and Germany who underwent a percutaneous coronary intervention (PCI) with at least one drug-eluting stent between January 7, 2008, and September 16, 2010. Researchers assessed platelet reactivity with the VerifyNow Aspirin, P2Y12, and IIb/IIIa tests. Patients were followed for one year to determine the relationship between platelet reactivity and subsequent events. At one year, stent thrombosis had occurred in 70 patients (0.8 percent), heart attack in 269 (3.1 percent), major bleeding in 531 (6.2 percent), and death in 161 (1.9 percent).

Platelet reactivity units (PRU), an index of platelet inhibition to clopidogrel, were measured by the VerifyNow P2Y12 test. High platelet reactivity, defined as a PRU of greater than 208, was present in 42.7 percent of patients. At one year, researchers found that high platelet reactivity was significantly associated with stent thrombosis (1.3 percent vs. 0.5 percent) and heart attack (3.9 percent vs. 2.7 percent), but was also found to be protective against major bleeding (5.6 percent vs. 6.7 percent). High platelet reactivity was also associated with one-year mortality (2.4 percent vs. 1.5 percent). However, because high platelet reactivity is also associated with other patient risk factors and baseline characteristics, multivariable modeling was also performed; it showed no independent association between high platelet reactivity and mortality.

"Results from the ADAPT-DES registry definitely demonstrate that high platelet reactivity after implantation of drug-eluting stents is an independent predictor of one-year stent thrombosis and heart attack, but it is also protective against major bleeding, both of which impact mortality," said lead investigator Gregg W. Stone, MD. Dr Stone is professor of medicine at Columbia University College of Physicians and Surgeons and Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center. Dr. Stone is also co-director of the Medical Research and Education Division at the Cardiovascular Research Foundation (CRF).

"Because of the counteracting effects of ischemia and bleeding, platelet reactivity was not an independent predictor of one-year mortality. Therefore, overcoming high platelet reactivity with more potent antiplatelet agents is unlikely to improve survival unless the beneficial effect of reducing stent thrombosis and heart attack can be separated from the likely increase in bleeding that results from greater platelet inhibition," said Dr. Stone.

Dr. Stone added: "Platelet reactivity on aspirin was unrelated to stent thrombosis, heart attack, or death, but may be related to bleeding. This raises questions as to the utility of aspirin in patients treated with drug-eluting stents."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cardiovascular / cardiology section for the latest news on this subject.

The ADAPT-DES trial was sponsored by CRF with research support from Boston Scientific, Abbott Vascular, Medtronic, Cordis, Biosensors, The Medicines Company, Daiichi Sankyo, Eli Lilly, Volcano, and Accumetrics.

Cardiovascular Research Foundation

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Foundation, Cardiovascular Research. "High platelet reactivity on clopidogrel predicts stent thrombosis, heart attack, and bleeding." Medical News Today. MediLexicon, Intl., 30 Jul. 2013. Web.
30 Jul. 2013. APA

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'High platelet reactivity on clopidogrel predicts stent thrombosis, heart attack, and bleeding'

Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

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All opinions are moderated before being included (to stop spam). We reserve the right to amend opinions where we deem necessary.

Contact Our News Editors

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Please send any medical news or health news press releases to:

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.



View the original article here