MedicalResearch.com Interview with:Catherine A. Matthews, MD
Associate Professor and Division Chief
Urogynecology and Reconstructive Pelvic Surgery
University of North Carolina, Chapel Hill
MedicalResearch.com: What are the main findings of the study?Dr. Matthews: Women under 50 should try and preserve their ovaries at the time of hysterectomy for benign disease; however, women over 50 should consider elective ovarian removal as a way to reduce ovarian cancer. There is no adverse impact on cardiovascular, bone or sexual health in women over 50 who elect ovarian removal.
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MedicalResearch.com Interview with:Michelle N. McDonnell, PhD
Division of Health Sciences
International Centre for Allied Health Evidence
University of South Australia
Adelaide, SA 5001 Australia.
MedicalResearch.com: What are the main findings of the study?Dr. McDonnell:In this study, we asked people how many times a week they engaged in intense physical activity, enough to work up a sweat. People responded that they were physically active 0, 1-3 or 4 or more times a week. When we followed up these people for several years, those who did not do any vigorous exercise were 20% more likely to have a stroke, compared to those who exercised four or more times a week. However, when we adjusted these results for other risk factors, this attenuated the effect down to 14% which was not statistically significant. We also noticed that people who exercised four or more times a week had less hypertension (high blood pressure), were less likely to be obese and less likely to have diabetes. Each of these things on their own reduces your risk of stroke, so when we adjust for that the association between physical activity and stroke is weaker (20% to 14%). So physical activity seems to have an effect on stroke risk by improving these other risk factors.
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MedicalResearch.com Interview with: Xiaolu Yang, Ph.D.
Professor of Cancer Biology at the Perelman School of Medicine
University of Pennsylvania
and the Abramson Family Cancer Research Institute,
MedicalResearch.com: What are the main findings of the study?Dr. Yang: TAp73 is a structural homologue of the preeminent tumor suppressor p53, but its role in tumorigenesis has been unclear. In this study, we show that TAp73 supports the proliferation of tumor cells. Mechanistically, TAp73 activates the expression of glucose-6-phosphate dehydrogenase (G6PD), a rate-limiting enzyme in the pentose phosphate pathway. This function of TAp73 is required for maintaining a robust biosynthesis and anti-oxidant defense in tumor cells. These finding connects TAp73 to oncogenic growth and suggest that G6PD may be a valuable target for tumor therapy.
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MedicalResearch.com Interview with:
Helena Hallström Ph.D., M.Sc. (Toxicology)
Department of Surgical Sciences, Section of Orthopedics
Uppsala University, Uppsala, Sweden and
Risk and Benefit Assessment Department National Food Agency, Uppsala, Sweden.
MedicalResearch.com: What are the main findings of the study?Answer: The aim of the study was to investigate whether high consumption of coffee is associated with osteoporosis and development of osteoporotic fractures, since results from previous fracture studies regarding potential associations between coffee drinking and fracture risk are inconsistent. The longitudinal population-based Swedish Mammography Cohort, including 61,433 women born between 1914 and 1948, was followed from 1987 through 2008. Coffee consumption was assessed with repeated food frequency questionnaires. During follow-up, 14,738 women experienced any type of fracture and of these 3,871 had a hip fracture. In a sub-cohort (n=5,022), bone density was measured and osteoporosis was determined (n=1,012). There was no evidence of a higher rate of any fracture or hip fracture with increasing coffee consumption. However, a high coffee intake (≥4 cups) in comparison with a low intake (<1 cup) was associated with a 2-4% reduction in bone mineral density (BMD), depending on site (p<0.001), but the odds ratio of osteoporosis was only 1.28 (95% confidence interval: 0.88, 1.87). Thus, high coffee consumption was associated with a small reduction in bone density that did not translate into an increased risk of fracture.
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MedicalResearch.com Interview with:
Jon C. Tilburt, MD, MPH
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
Biomedical Ethics Program, Mayo Clinic
Knowledge & Evaluation Research Unit, Mayo Clinic
Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery
Division of Health Care Policy and Research, Mayo Clinic
What did you set out to find, what was your objective in this study?
We wanted to know physicians perceived roles and responsibilities in addressing health care costs as well as their enthusiasm for proposed strategies to contain health care spending.
Who did you study and what did you look at?
Practicing US physicians under age 65, we randomly selected 3900 physicians representing all specialties and mailed them an 8-page survey entitled “Physicians, Health Care Costs, and Society.” We received 2,556 completed surveys (65% response rate).
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MedicalResearch.com Interview with: Lillian S. Kao, MD, MS
Associate Professor, Department of Surgery
The University of Texas School of Medicine at Houston
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?Dr. Kao:
-The internal validity (methodological rigor) and external validity (generalizability) of quality improvement (QI) studies of implementation of surgical antibiotic prophylaxis measures are poor.
-Studies demonstrating large positive effect on compliance were often performed in settings where the baseline compliance was extremely low (i.e., less than 20%), thus further limiting their generalizability.
-Very few studies evaluated the effect of the QI interventions to increase appropriate antibiotic prophylaxis use on surgical site infections (SSIs). Moreover, those studies that included SSI as an outcome measures were usually underpowered to identify a significant effect.
-The majority of studies failed to report metrics relating to the quality of the implementation of the interventions to increase antibiotic prophylaxis compliance. Effectiveness of evidence-based measures is dependent upon their implementation. For example, did all of the targeted groups adopt the intervention? Or were the QI interventions sustained beyond the initial measurement or study period?
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MedicalResearch.com Interview with:Susan Matulevicius, MD, MSCS
Department of Medicine, The University of Texas Southwestern Medical Center, Dallas
MedicalResearch.com: What are the main findings of the study?Dr. Matulevicius: In our cohort of 535 transthoracic echocardiograms performed at a single academic medical center, we found that the majority (92%) of echocardiograms were appropriate by the 2011 Appropriate Use Criteria; however, only 1 in 3 echocardiograms lead to an active change in patient care while 1 in 5 resulted in no appreciable change in patient care.
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MedicalResearch.com Interview with: Roberta Re, Ph.D.
Nutrition research manager at Leatherhead Food Research in Surrey, England.
MedicalResearch.com: What are the main findings of the study?Dr. Re:The main finding of the study on snacking is that consumption of nuts (almonds and peanuts in particular) can help to a reduced subjective perception of appetite and reduce energy intake at the next meal.
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MedicalResearch.com Interview with: Sheree Boulet, DrPH, MPH
Assisted Reproductive Technology Surveillance and Research Team
Women's Health and Fertility Branch
Division of Reproductive Health
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?Dr. Boulet: Between 1994-2009, the rate of pregnancy-related hospitalizations with venous thromboembolism (VTE) increased by 14%. We also found that the prevalence of hypertension, obesity, diabetes, and heart disease increased over the same time period for pregnancy hospitalizations with VTE.
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MedicalResearch.com Interview with:Alexey V. Pshezhetsky, Ph.D.
Professor
Departments of Pediatrics and Biochemistry
University of Montreal
Division of Medical Genetics
Sainte-Justine University Hospital
Research Center
Montréal, PQ, Canada, H3T 1C5.
MedicalResearch.com: What are the main findings of the study?Dr. Pshezhetsky: Our laboratory found that the presence of sugar known as sialic acid on the insulin receptor can determine whether cells react normally to insulin or are resistant. Sialic acid modifies molecules like the insulin receptor, and reduces their activity. We studied the enzyme that removes sialic acid, known as neuraminidase 1 or Neu1. Cells that lacked Neu1 had more sialic acid on the insulin receptor and were resistant to insulin. Genetically-modified mice with ~10% of the normal Neu1 activity exposed to a high-fat diet develop hyperglycemia and insulin resistance twice as fast as their wild type counterparts. Together, these studies identify Neu1 and sialic acid as novel components of the signaling pathways of energy metabolism and glucose uptake.
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MedicalResearch.com Interview with: Maya Leventer-Roberts, MD, MPH
Fellow Trainee
Department of Preventive Medicine
Mount Sinai School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Leventer-Roberts: Overweight status among medical and surgical residents is more likely by increasing PGY of training. Overweight residents are also unlikely to acknowledge their overweight status. These changes can differ significantly from matched controls and may affect long-term health.
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MedicalResearch.com Interview with:Professor John Zajicek
Professor of Clinical Neuroscience, Centre for Clinical Trials & Health Research - Translational & Stratified Medicine (Peninsula Schools of Medicine and Dentistry)
MedicalResearch.com: What are the main findings of the study?Prof. Zajicek: Our study investigated whether dronabinol (one of the major active ingredients of cannabis) may slow the progression of multiple sclerosis. We currently have no treatments that are effective in modifying the disease course in people with either primary or secondary MS. We did a clinical trial across the UK involving nearly 500 patients, who were randomly allocated to dronabinol or placebo, and followed them up for three years to look at progression on rates. Overall we failed to find an effect of dronabinol on disease progression, either clinically (using a variety of clinical measures) or using magnetic resonance imaging (MRI). There was a suggestion of an effect in people with the least disability (who didn't need a stick to help them walk), and there were no major problems with serious side effects. However, over all the population that took part in the study also progressed less than we expected, which reduced our chances of finding an effect of treatment. The study was not designed to investigate an effect on MS-related symptoms (such as pain and muscle stiffness), which have been investigated before.
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MedicalResearch.com Interview with:Abigail Franklin
Vice President for Development & Communications
The New York Academy of Medicine
MedicalResearch.com: What are the main findings of the study?Answer: The New York State Department of Health (NYSDOH) Overweight and Obesity Brief was derived from information gathered for the NYS Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an annual statewide telephone survey of adults administered by the provide information on behaviors, risk factors, and utilization of preventive services. The survey conducted in 2011 found that nearly 25% of adults in NYS are obese and another 36% overweight. It also found that obesity rates are higher among adults who are Black (32.5%), earn an annual household income less than $25,000 (26.8%), have less than a college education (27.1%), or are currently living with a disability (34.9%). These findings bring to light that social and economic factors in our communities can be a major contributor to health disparities, like greater risk of obesity among people of color, low income individuals, and people who are disabled.
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MedicalResearch.com Interview with: Alai Tan, MD, PhD
Assistant Professor, Dept. of Preventive Medicine & Community Health
Sr. Biostatistician, Sealy Center on Aging
Univerisity of Texas Medical Branch
301 University Blvd., Galveston, TX 77555-0177
MedicalResearch.com: What are the main findings of the study?
Dr. Tan:The study developed and validated sex-specific Cox proportional-hazards models with predictors of age and comorbidities to predict patient life expectancy using Medicare claims data. The predictive model was well-calibrated and showed good predictive discrimination for risk of mortality between 5 and 10 years.
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MedicalResearch.com Interview with Dr. Vinay Prasad, MD
Medical Oncology Branch, National Cancer Institute
National Institutes of Health, 10 Center Dr 10/12N226, Bethesda, MD20892.
MedicalResearch.com: What are the main findings of the study?Dr. Prasad:We reviewed all original articles in the New England Journal of Medicine over ten years. 1344 articles tested some medical practice-- which is a screening or diagnostic test, medication, procedure or surgery. Only 27% or 363 articles tested current medical practice. And of these articles 146 (40%) contradicted current standard of care, constituting a medical reversal.
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MedicalResearch.com Interview with:Igor F. Tsigelny, Ph.D.
Department of Neurosciences, University of California at San Diego
San Diego Supercomputer Center, University of California at San Diego
Moores Cancer Center, University of California at San Diego
La Jolla, California 92093
MedicalResearch.com: What are the main findings of the study?Dr. Tsigelny: We find a new set of possible very effective drug-candidates for cure of hypertension. According to our preliminary testing these molecules are not toxic and can start a new series of drugs.
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MedicalResearch.com Interview with: Ru-Rong Ji, PhD
Professor, Chief of Pain Research
Department of Anesthesiology and Neurobiology
Duke University Medical Center
Durham, NC 27710
Neuroprotectin/Protectin D1 protects neuropathic pain in mice after nerve trauma
MedicalResearch.com: What are the main findings of the study?Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain.
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MedicalResearch.com Interview with: Robert E. Garfield, PhD
Department of Perinatology, Division of Obstetrics and Gynecology
University Medical Centre Ljubljana, Slovenia
Costs of Unnecessary Admissions and Treatments for “Threatened Preterm Labor”MedicalResearch.com :What are the main findings of the study?Dr. Garfield: Unnecessary admissions and treatments for “threatened preterm labor” are still part of everyday clinical practice and contribute to exploding healthcare costs. This happens despite substantial evidence that measuring CL by trans-vaginal ultrasound can help to avoid needless interventions due to the high negative predictive values of this test.
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MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS
Assistant Professor of Medicine & Epidemiology
The Johns Hopkins University
Early Response to Preventive Strategies in the Diabetes Prevention Program
MedicalResearch.com: What are the main findings of the study?Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road. Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose. These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk.
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MedicalResearch.com Interview with
Prof. Eyal Sheiner MD PhD
Senior Obstetrician
Soroka Medical Center, Israel
MedicalResearch.com: What are the main findings of the study?Dr. Sheiner:The study was aimed to investigate whether a history of preterm delivery (PTD) poses a risk for subsequent maternal long-term cardiovascular morbidity.
During the study period 47,908 women met the inclusion criteria; 12.5% (n=5992) patients delivered preterm. During a follow-up period of more than ten years, patients with PTD had higher rates of simple as well as complex cardiovascular events and higher rate of total cardiovascular related hospitalizations. A linear association was found between the number of previous PTD and future risk for cardiovascular hospitalizations (5.5% for two or more PTD, 5.0% for one PTD vs. 3.5% in the comparison group; P<0.001). The association remained significant for spontaneous vs. induced PTD and for early (<34 weeks) as well as late (34-36+6 weeks) PTD. In a Cox proportional hazards model that adjusted for pregnancy confounders such as labor induction, diabetes mellitus, preeclampsia and obesity, PTD was independently associated with cardiovascular hospitalizations (adjusted HR 1.4, 95% CI 1.2-1.6).
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MedicalResearch.com Interview with: Ru-Rong Ji, PhD
Professor, Chief of Pain Research
Department of Anesthesiology and Neurobiology
Duke University Medical Center
Box DUMC 3094, Durham , NC 27710
MedicalResearch.com: What are the main findings of the study?Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain.
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Interview with: Dr Nicholas D Gollop BSc (Hons) MB BCh
Norfolk and Norwich University Hospital,
Norwich, NR4 7UY
Norfolk, United Kingdom
MedicalResearch.com: What are the main findings of the study?
We completed a best evidence topic in interventional cardiac surgery to investigate the significance of elevated markers of cardiac damage following percutaneous coronary intervention (PCI).
We compared the clinical and prognostic relevance of the elevation of creatinine kinase-myocardial band (CK-MB) and cardiac troponin (cTn) levels during peri-procedural period and post-procedural period, respectively, following an emergency or elective PCI.
We found in excess of 390 papers after a systematic literature search, of which 10 represented the best evidence to answer the clinical question. From the best evidence available we showed that the monitoring of cardiac biomarkers following PCI can provide important clinical information about the health of the myocardium, as well as prognostic information on short to mid-term outcomes of mortality up to 3 years.
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MedicalResearch.com Interview with Dr. Frank Sellke, MD
Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals
MedicalResearch.com: What are the main findings of the study?Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year.
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MedicalResearch.com Interview with: Dr. Bernard Rosner
Harvard School of Public Health
Professor in the Department of Biostatistics
Department of Biostatistics
Channing Laboratory 180 Longwood Avenue
Boston, Massachusetts 02115
MedicalResearch.com: What are the Main Findings of this study?Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls.
Important risk factors for elevated BP were BMI, waist-circumference and sodium intake.
Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile
Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile
Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories.
There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls.
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MedicalResearch.com Interview with: Chiu-Fang Chou DrPH
Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion CDC, 4770 Buford Hwy, NE (K-10)
Atlanta GA 30341-3727
MedicalResearch.com: What are the main findings of the study?A: We estimated nearly 9 million people aged 40 years and older are visually impaired using the National Health and Nutrition Examination Survey. Three out of every four people aged 40 years and older with VI have uncorrected refractive error that could be easily corrected with simple glasses or contact lenses. The ocular disease most associated with visual impairment in our study sample was age-related macular degeneration. Finally, increasing age and low educational attainment were significant predictors of visual impairment.
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MedicalResearch.com Interview with: Susan E. Swithers PhD
Professor, Behavioral NeuroscienceDepartment of Psychological Sciences and Ingestive Behavior Research Center
Purdue University, 703 Third Street
West Lafayette, IN 47907, USA
MedicalResearch.com: What are the main findings of the study?Dr. Swithers: The paper examined the last 5 years of studies that looked at risks associated with consuming artificially sweetened beverages like diet soda. These studies indicated that those who consume diet soda were at significantly greater risk for a variety of negative health outcomes like type 2 diabetes, coronary heart disease, hypertension and stroke, along with being more likely to gain excess weight. These effects might be due to a disruption of basic learned response. The idea is that normally things when things that taste sweet are consumed, the body receives calories and sugar. Our bodies can learn to prepare to deal with these calories and this sugar by starting up our digestive processes as soon as the sweet taste hits our mouth, for example by releasing hormones that not only help us regulate blood sugar, but also can contribute to feelings of fullness. When we consume diet sodas, the mouth gets the sweet taste, but the body doesn't get the calories or the sugar. The body may then learn that a sweet taste in the mouth doesn't always predict sugar and calories, so it makes adjustments in how many hormones it releases. So when we actually consume real sugar, the body doesn't produce the same kinds of physiological responses, which can lead to overeating, higher blood sugar, and over the long term could contribute to diseases like diabetes and stroke.
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MedicalResearch.com Interview with:Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS
Royal Centre for Defense Medicine, Birmingham, England
MedicalResearch.com: What are the main findings of the study? Answer: Our study was a meta-analysis, which combined the findings from 8 randomized controlled trials that included a total of 623 patients. The key finding was that delayed primary skin closure (DPC) for contaminated and dirty abdominal incisions may reduce the rate of surgical site infection. However, due to high risk of bias from the included studies, including flaws in study design, definitive evidence is lacking.
We believe that this meta-analysis represents an exciting development in biomedical publishing; this was a true collaboration between US and UK military surgeons to examine an area of major concern and interest to surgeons everywhere. This work uses experience hard-won on the battlefields of Iraq and Afghanistan, combined with published surgical trials, to inform both future research activity as well as military and civilian surgical practice. This cross-fertilization of ideas is one positive consequence of all the sacrifice and suffering of recent conflicts.
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MedicalResearch.com Interview with: Michael Belkin, MA, MD
Professor of Ophthalmology
Director, Ophthalmic Technologies Laboratory
Goldschleger Eye Research Institute
Tel Aviv University
Sheba Medical Center Tel Hashomer 52621
Israel
MedicalResearch.com: What are the main findings of the study?Dr. Belkin: Modern ophthalmic treatment, when freely availableis able to reduce the incidence of blindness, and presumably visual impairment considerably. In Israel the rate of new cases of blindness per 100.000 people [age adjusted] was reduced between 1999 and 2010 from 33.8 to 14.8, i.e., by over 56%. The reduction was in all major causes of blindness, Age-related Macular Degeneration (AMD), Glaucoma, Diabetic Retinopathy and Cataract. In the non-treatable retinal dystrophies such as retinitis pigmentosa, there was no significant changes over this period.
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MedicalResearch.com Interview with: Andreas Beyerlein, PhD
Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany
MedicalResearch.com What are the main findings of the study?Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity.
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