MedicalResearch.com Interview with David S.H. Lee, Pharm.D., Ph.D.
Assistant Professor
Department of Pharmacy Practice
College of Pharmacy
Oregon State University/Oregon Health and Science University
Portland OR, 97239
MedicalResearch: What are the main findings of the study?Dr. Lee: We found that older men taking a statin were less physically active and had more sedentary behavior. They had about 37 minutes of less moderate exercise per week. For comparison, the American heart Association recommends about 40 minutes of moderate activity 3-4 times per week. We also found that those that started using a statin during the study had the largest drop in physical activity.
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MedicalResearch.com Interview with:Aurélie Lasserre ,MD
Center for psychiatric epidemiology and psychopathology
Department of Psychiatry
Lausanne University Hospital (CHUV)
Site de Cery, Switzerland
MedicalResearch: What are the main findings of this study?Dr. Lasserre: Several recent studies have shown that Major Depressive Disorder with atypical features (defined as having a depressive episode where mood reactivity is maintained and two of the following features: increase in appetite, hypersomnia (oversleeping), leaden paralysis (heavy limbs) and increased sensitivity to rejection) was associated with obesity, but the temporal sequence was not known, i.e. it was not clear whether atypical depression predisposes to obesity or the converse. Our study revealed that Major Depressive Disorder with atypical features does lead to an increase in body-mass index, obesity, waist circumference and fat mass over a period of 5 years. This result was not explained by socio-demographic characteristics, alcohol or tobacco consumption, physical activity, co-existing mental disorders or medication. Interestingly, we also observed that the weight gain in subjects with atypical features was not a temporary phenomenon but it persisted after the remission of the depressive episode and was not attributable to new episodes.
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MedicalResearch.com Interview with: Dr. Eric M. Mortensen, M.D., M.Sc.
VA North Texas Health Care System and
University of Texas Southwestern Medical Center, Dallas
MedicalResearch: What are the main findings of the study?Dr. Mortensen: The main findings of our study was that for older patients hospitalized with pneumonia that with the use of azithromycin although there is a small increase in the number of non-fatal heart attacks there was a much lower decrease in mortality. In addition there were no other significant increases in cardiac events. So the overall risk:benefit ratio was that for each non-fatal heart attack there were 7 deaths that were prevented.
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MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS
Duke Clinical Research Institute
Duke University School of Medicine
Durham, NC,
MedicalResearch: What are the main findings of the study? Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator.
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MedicalResearch.com Interview with Dr. Christopher Wildeman PhD
Associate Professor of Sociology
Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University.
MedicalResearch.com: What are the main findings of the study?Dr. Wildeman: There are four key findings in the study.
First, the cumulative risk of having a confirmed maltreatment report any time between birth and age 18 is much higher than most people would have thought. Fully 1 in 8 American children will experience this event at some point.
Second, the risk of experiencing this event is highly unequally distributed, with Black and Hispanic experiencing it much more than Hispanic, White, and (especially) Asian children. Between 1 in 4 and 1 in 5 Black children will have a confirmed maltreatment report at any time in their childhood. For Native American, the risk is about 1 in 7.
Third, the risk of maltreatment is quite similar for boys and girls.
Finally, the highest risks of child maltreatment are in the first few years of life, suggesting that interventions aiming to diminish maltreatment should focus on parents with very young children.
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MedicalResearch.com Interview with: Reed Jost, MS
Retina Foundation of the Southwest
9600 N Central Expwy, Suite 200
Dallas, TX 75231
MedicalResearch: What are the main findings of the study?Answer: Commercially available automated screening devices assess refractive risk factors, not amblyopia or strabismus, resulting in under-referral of affected children and over-referral of healthy children to pediatric eye care professionals. The Pediatric Vision Scanner is a binocular retinal birefringence scanner that directly detects strabismus and amblyopia by analyzing binocular scans for the presence or absence of birefringence, which is characteristic of steady, bifoveal fixation. We found that the Pediatric Vision Scanner outperformed an automated, refractive error screener (SureSight Autorefractor) in a cohort of 300 patients (2-6 years) tested in a pediatric ophthalmology setting. Compared to the SureSight, the Pediatric Vision Scanner had significantly higher sensitivity and higher specificity in the detection of strabismus and amblyopia. (more…)
MedicalResearch.com Interview with:Dr David A Hanauer MD MS
Department of Pediatrics
University of Michigan Medical School
Ann Arbor, MI
MedicalResearch.com: What are the main findings of the studyDr. Hanauer: The main findings of our study were that:
(1) Awareness and usage of rating sites for physicians appears to be growing,
(2) The public is using these sites to make decisions about selecting (or avoiding) a physician, and
(3) The percentage of people leaving ratings is still low (about 5%) suggesting that the results may not be representative of the majority of patient experiences.
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MedicalResearch.com Interview with:Theodore J. Cicero, PhD
Professor, Vice Chairman for Research
Department of Psychiatry
Washington University in St Louis
St Louis, Missouri
MedicalResearch: What are the main findings of the study?Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin.
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MedicalResearch.com Interview with: Susan WuMD
Division of Hospital Medicine, Children's Hospital Los Angeles
Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California
MedicalResearch: What are the main findings of the study?Dr. Wu: We performed a randomized trial at 2 urban free-standing children's hospitals, comparing inhaled 3% hypertonic saline to 0.9% normal saline in patients under 24 months with bronchiolitis. Patients with prematurity less than 34 weeks, cyanotic heart disease, chronic pulmonary disease, and previous episodes of wheezing or bronchodilator use were excluded. Patients were 4 mL of study medication nebulized up to 3 times in the emergency department; if admitted, patients continued to receive the assigned study medication three times a day until discharge. A total of 408 patients were analyzed. We found that 28.9% of patients treated with hypertonic saline required hospital admission, compared with 42.6% of patients in the normal saline group.
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MedicalResearch.com Interview with: Kimford J. Meador, MD
Professor
Department of Neurology & Neurological Sciences
Stanford Comprehensive Epilepsy Center
Stanford University School of Medicine
Stanford, CA 94305-5235.
MedicalResearch: What are the main findings of the study?Dr. Meador:Breastfeeding while taking antiepileptic drugs does not appear to pose a risk to the child's development, and in fact the cognitive outcomes were better for those children who were breastfed vs. those were not.
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MedicalResearch.com Interview withDr. Edythe D.London PhD
Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology
David Geffen School of Medicine, UCLA
MedicalResearch: What are the main findings of the study?Dr. London: Brain function related to risky decision-making was different in stimulant users (methamphetamine users) than in healthy control subjects. In healthy controls, activation in the prefrontal cortex (right dorsolateral prefrontal cortex) during risk-taking in the laboratory was sensitive to the level of risk. This sensitivity of cortical activation was weaker in stimulant users, who instead had a stronger sensitivity of striatum activation. The groups also differed in circuit-level activity (network activity) when they were not performing a task but were “at rest.” Stimulant users showed greater connectivity within the mesocorticolimbic system, a target of abused drugs. This connectivity was negatively related to sensitivity in the prefrontal cortex to risk during risky decision-making. In healthy control subjects, connectivity between the right dorsolateral prefrontal cortex and striatum was positively related to sensitivity of prefrontal cortical activation to risk during risky decision-making.
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MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic
MedicalResearch: What are the main findings of the study?Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.
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MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE
Chief of Staff, John D. Dingell VA Medical Center
Associate Dean for Veterans Affairs & Professor of Surgery
Wayne State University School of Medicine
John D. Dingell VA Medical Center Chief of Staff
Detroit, MI 48201
MedicalResearch: What are the main findings of the study?Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.
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MedicalResearch.com Interview with:Dr. Sarah Hawley PhD MPH
Associate Professor in the Division of General Medicine
University of Michigan
Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development
MedicalResearch: What are the main findings of the study?Dr. Hawley: There are a couple of main findings.
First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
MedicalResearch.com Interview with:Neel M. Butala, AB
Medical student at Yale School of Medicine
New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?
Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010.
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MedicalResearch.com Interview with:Scott Stroup, MD, MPH
Professor of Psychiatry
Director, Program for Intervention Effectiveness Research,
Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric InstituteDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
MedicalResearch: What are the main findings of the study?Dr. Stroup:We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.
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MedicalResearch.com Interview with:Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch: What are the main findings of the study?Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:
(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).
(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.
(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
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MedicalResearch.com Interview with:James Chamberlain, MD
Division Chief, Emergency Medicine
Children’s National Health System
Washington, DC
MedicalResearch: What are the main findings of the study?Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes.
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MedicalResearch.com Interview Professor Kim Bennell
ARC Future Fellow
Department of Physiotherapy
University of Melbourne
Parkville, Vic 3010 Australia
MedicalResearch: What are the main findings of the study?Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment. (more…)
MedicalResearch Interview with: Charles D. Scales, Jr MD MSHS
Assistant Professor of Surgery
Division of Urologic Surgery
Duke University Medical Center
MedicalResearch: What are the main findings of the study?Dr. Scales:When it comes to treating kidney stones, less invasive is not always better.
We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure.
When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS.
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MedicalResearch.com Interview with:Flor M. Munoz, MDDepartment of Pediatrics
Department of Molecular Virology and Microbiology
Baylor College of Medicine, Houston, Texas
MedicalResearch.com: What are the main findings of the study?Dr. Munoz:
1. Tdap vaccine was safe and well tolerated during pregnancy
2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant.
3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum.
4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability
5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.
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MedicalResearch Interview with: Patrick S. F. Bellgowan, PhD
Laureate Institute for Brain Research
Faculty of Community Medicine, The University of Tulsa,
Tulsa, Oklahoma
MedicalResearch: What are the main findings of the study?Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus.
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MedicalResearch.com Interview with:
Jennifer G. Robinson, MD, MPH
Professor ,Departments of Epidemiology & Medicine
Director, Prevention Intervention Center
Department of Epidemiology
College of Public Health
University of Iowa
Iowa City, IA 52242-2007
MedicalResearch: What are the main findings of the study?Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo.
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MedicalResearch.com Interview with: Aaron L. Leppin, MD
Knowledge and Evaluation Research Unit
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis.
Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%.
The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period.
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MedicalResearch Interview with: Charbel El Bcheraoui, PhD, MSc
Acting Assistant Professor, Global Health
Institute for Health Metrics and Evaluation
University of Washington
Seattle, WA 98121
MedicalResearch: What are the main findings of the study?Dr. El Bcheraoui: We found a low rate of adverse events associated with male circumcision from U.S. hospital settings, especially if the procedure is performed within the first year of life. The rate of adverse events increased about 10 - 20 times if the procedure was performed later in life.
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MedicalResearch.com Interview with:Richard D. Semba, MD MPH
W. Richard Green Professor of Ophthalmology
The Johns Hopkins University School of Medicine
Baltimore, MD 21287
MedicalResearch: What are the main findings of the study?Dr. Semba: Resveratrol levels in older adults are not related to the risk of heart disease or cancer and are not related with lifespan. These findings were made in the InCHIANTI Study, a rigorously conducted study of human aging that is sponsored by the National Institute on Aging.
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MedicalResearch.com Interview with: Dr. Carlo Riccardo Rossi, MD
Melanoma and Sarcoma Unit, Veneto Institute of Oncology
Surgery Branch, Department of Surgery
Oncology, and Gastroenterology, University of Padova,
Padova, Italy
MedicalResearch: What are the main findings of the study?
Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively.
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MedicalResearch.com Interview with:Kwang-il Kim, MD, PhD
Associate Professor, Department of Internal Medicine,
Seoul National University College of Medicine,
Seoul National University Bundang Hospital,
Seoul, Republic of Korea
MedicalResearch: What are the main findings of the study?Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly.
MedicalResearch: Were any of the findings unexpected?Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point.
MedicalResearch: What should clinicians and patients take away from your report?Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery.
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MedicalResearch.com Interview with:
Niklas Mattsson MD, PhD
University of California San Francisco
Center for Imaging of Neurodegenerative Diseases
VA Medical Center
San Francisco, CA 94121,...
MedicalResearch.com Interview with: Dana Dabelea, MD, PhD
Professor and Associate Dean, Faculty Affairs
Colorado School of Public Health
University of Colorado Denver
Aurora, CO 80045
MedicalResearch.com: What are the main findings of the study?Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups. While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages.
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