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Too many carbs, not fats, may be the culprit in raising risk of premature death, according to a study published online Aug. 29 in the The Lancet to coincide with the European Society of Cardiology Congress 2017, held from Aug. 26 to 30 in Barcelona, Spain. Mahshid Dehghan, Ph.D., an investigator with the Population Health Research Institute at McMaster University in Hamilton, Canada, and colleagues tracked the diet and health of 135,335 people, aged 35 to 70, from 18 countries around the world, to gain a global perspective on the health effects of diet. Participants provided detailed information on their social and economic status, lifestyle, medical history, and current health. They also completed a questionnaire on their regular diet, which researchers used to calculate their average daily calories from fats, carbohydrates, and proteins. The research team then tracked the participants' health for about seven years on average, with follow-up visits at least every three years. The investigators found that high-carbohydrate diets are common, with more than half of the people deriving 70 percent of their daily calories from carbs. People with a high fat intake -- about 35 percent of their daily diet -- had a 23 percent lower risk of early death and 18 percent lower risk of stroke compared to people who ate less fat. The researchers also noted that a very low intake of saturated fats (below 3 percent of daily diet) was associated with a higher risk of death in the study, compared to diets containing up to 13 percent daily. At the same time, high-carb diets -- containing an average 77 percent carbohydrates -- were associated with a 28 percent increased risk of death versus low-carb diets. "The study showed that contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death," Dehghan told HealthDay. "We found no evidence that below 10 percent of energy by saturated fat is beneficial, and going below 7 percent may even be har

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Aspirin therapy is associated with a reduced risk of hepatitis B virus-related hepatocellular carcinoma (HCC), according to a study scheduled for presentation at The Liver Meeting, held by the American Association for the Study of Liver Diseases from Oct. 20 to 24 in Washington, D.C. Teng-Yu Lee, M.D., Ph.D., from Taichung Veterans General Hospital in Taiwan, and colleagues used data from Taiwan's National Health Insurance Research Database from 1998 to 2012. Patients with non-hepatitis B infections were excluded, as were those with HCC before the follow-up index dates. A total of 1,553 patients who continuously received daily aspirin ≥90 days were randomly matched (1-to-4 ratio) with 6,212 patients who never received anti-platelet therapy based on baseline characteristics, the index date, and nucelos(t)ide analogue (NA) use during follow-up. The researchers found that the cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group in five years (2.86 percent versus 5.59 percent). Aspirin therapy was independently associated with a reduced HCC risk (hazard ratio [HR], 0.63) in a multivariable regression analysis. An increased HCC risk was independently associated with older age (HR, 1.03 per year), male gender (HR, 2.65), cirrhosis (HR, 1.89), and diabetes mellitus (HR, 1.51). NA (HR, 0.57) and statin (HR, 0.57) use were associated with a decreased HCC risk.

Intensive blood pressure lowering may similarly decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus, according to a study published online Dec. 6 in Diabetes Care. Tom F. Brouwer, M.D., from the University of Amsterdam, and colleagues assessed the effect of both type 2 diabetes and baseline cardiovascular disease risk on the treatment effect of intensive blood pressure lowering based on data and pooled analysis from two randomized trials (ACCORD-BP [Action to Control Cardiovascular Risk in Diabetes Blood Pressure]and SPRINT [Systolic Blood Pressure Intervention Trial] studies; total of 14,094 patients). The researchers found that the mean baseline systolic blood pressure was 139.5 mm Hg for the cohort and just over one-third (33.6 percent) had type 2 diabetes. The hazard ratio for the primary composite end point of unstable angina, myocardial infarction, acute heart failure, stroke, and cardiovascular death was 0.82 (P = 0.0017). There was a nonsignificant interaction between intensive blood pressure lowering and type 2 diabetes (P = 0.13). While the 10-year cardiovascular risk was higher in patients with type 2 diabetes, there was no interaction between the risk and treatment effect (P = 0.84).

For patients undergoing right heart catheterization (RHC), borderline pulmonary hypertension (PH) is associated with increased risk of mortality, according to a study published online Oct. 25 in JAMA Cardiology. Tufik R. Assad, M.D., from Vanderbilt University School of Medicine in Nashville, Tennessee, and colleagues conducted a retrospective cohort study involving patients undergoing routine RHC for clinical indication. Patients were classified according to mean pulmonary arterial pressure (mPAP) values as reference, borderline PH, and PH (mPAP values of ≤18, 19 to 24, and ≥25 mmHg, respectively). The researchers found that the prevalence of PH and borderline PH was 62 and 18 percent, respectively, among 4,343 patients. Independent associations were seen for advanced age, features of the metabolic syndrome, and chronic heart and lung disease with increased likelihood of borderline PH versus reference patients. Borderline PH was correlated with increased mortality compared with reference patients after adjustment for 34 variables (hazard ratio, 1.31). With higher mPAP there was an incremental increase in the risk of death, without an observed threshold. Sixty-one percent of the 70 patients with borderline PH who underwent repeated RHC had developed overt PH, with a 5 mmHg median increase in mPAP (interquartile range, -1 to 11 mmHg; P < 0.001).

For patients with acute coronary syndromes (ACS), diabetes mellitus (DM), but not pre-DM, is associated with an increased risk of major adverse cardiac events (MACE), according to a study published online Oct. 18 in the Journal of the American College of Cardiology. Serdar Farhan, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the impact of pre-DM on coronary plaque characteristics and ischemic outcome in patients with ACS. Participants underwent quantitative coronary angiography, grayscale intravascular ultrasound (IVUS), and radiofrequency IVUS after successful percutaneous coronary intervention. Patients were categorized based on their glucometabolic status as normal glucose metabolism (NGM; 162 patients), pre-DM (202 patients), and DM (183 patients). The researchers found that there were no significant between-group differences with respect to IVUS findings indicative of vulnerable plaques. Compared to patients with pre-DM or NGM, patients with DM had a higher crude rate of MACE (25.9 versus 16.3 and 16.1 percent; P = 0.03 and 0.02, respectively). Using NGM as the reference group, DM, but not pre-DM, was correlated with increased risk of MACE in an adjusted model (hazard ratios, 2.2 [95 percent confidence interval, 1.25 to 3.86; P = 0.006] and 1.29 [95 percent confidence interval, 0.71 to 2.33; P = 0.41]).

For patients with unruptured intracranial aneurysms (UIAs) that are 3 mm or smaller, no preventive treatment or imaging follow-up is the most effective management strategy, according to a study published online Nov. 20 in JAMA Neurology. Ajay Malhotra, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues used inputs from the medical literature to conduct a decision-analytic model-based comparative effectiveness analysis. Five management strategies were assessed: annual magnetic resonance angiography (MRA) screening, biennial MRA screening, MRA screening every five years, aneurysm coiling and follow-up, and no treatment or preventive follow-up. In an analysis of 10,000 iterations simulating adult patients, the researchers found that the highest health benefit was seen for the management strategy of no treatment or preventive follow-up (mean quality-adjusted life-years, 19.40). MRA every five years was the best of the management strategies that incorporate follow-up imaging, with the next highest effectiveness (mean quality-adjusted life-years, 18.05). When the annual growth rate and risk of rupture of growing aneurysms are varied, no routine follow-up remains the optimal strategy. No follow-up is the optimal strategy when the annual risk of rupture of nongrowing UIAs is less than 1.7 percent; coiling should be performed directly if the annual risk of rupture is >1.7 percent.

A new screening tool can adequately detect risk of diabetic retinopathy in adults with diabetes in low-income communities in Mexico, according to a study published in the October issue of Preventing Chronic Disease. Kenny Mendoza-Herrera, from the National Institute of Public Health in Mexico, and colleagues analyzed biochemical, clinical, anthropometric, and sociodemographic information from 1,000 adults with diabetes in low-income communities in Mexico in order to develop a screening tool based on a predictive model for early detection of diabetic retinopathy. Time since diabetes diagnosis, high blood glucose levels, systolic hypertension, and physical inactivity were risk factors included in the screening tool. The researchers found that the model had a mean area under the receiver operating characteristic curve (AUC ROC) of 0.78 in the validation data set. Using the optimized cut point that best represented the study population, the model had a sensitivity of 82.9 percent and a specificity of 61.9 percent. "We developed a low-cost and easy-to-apply screening tool to detect people at high risk of diabetic retinopathy in Mexico," the authors write. "Although classification performance of our tool was acceptable (AUC ROC > 0.75), error rates (precision) depend on false-negative and false-positive rates. Therefore, confirmatory assessment of all cases in mandatory."

Liraglutide treatment for weight management is not associated with increased risk of cardiovascular events, according to a study published online Sept. 26 in Diabetes, Obesity and Metabolism. Melanie J. Davies, M.D., from the University Hospitals of Leicester NHS Trust in the United Kingdom, and colleagues conducted post hoc analysis using data from 5,908 participants in five randomized, double-blind, placebo-controlled clinical trials of liraglutide, a glucagon-like peptide-1 receptor agonist approved for weight management, in order to assess cardiovascular risk. The researchers found that with liraglutide (3.0 mg), eight participants had positively adjudicated cardiovascular events (1.54 events/1,000 person-years), compared to 10 participants in the comparators group (3.65 events/1000 person-years). Compared to the non-liraglutide group, the hazard ratio for 3.0 mg liraglutide treatment was 0.42 (95 percent confidence interval, 0.17 to 1.08).

American College of Emergency Physicians (ACEP) Scientific Assembly is organized by American College of Emergency Physicians (ACEP) and would be held during Oct 29 - Nov 01, 2017 at Walter E. Washington Convention Center, Washington, Dist of Col, United States of America. The target audience for this medical event for Emergency Physicians, Emergency Nurses, Nurse Practitioners, Residents and Fellows, Medical Students. This cme conference has been approved with a maximum of 29 AMA PRA Category 1 Credits. This Course will consist of clinical, as well as essential management and risk management tools to aid in your day-to-day practice. With educational courses, skills labs and workshops - ACEP17 is the best source for your emergency medicine education needs! Conference Objectives are : * Abdominal Disorders * Airway, Anesthesia, Analgesia * Cardiovascular * Career Advancement Through Teaching * Critical Care * Critical ED Management * Dematologic Disorders * Emergency Imaging * Head & Neck Disorders * Health Policy * Hematologic Disorders * Infectious Disease * Knowledge Translation * Maintenance of Certification * Metabolic and Endocrine Disorders * Neurology * New Technology * Orthopedics and Sports Medicine * Pediatric Disorders * Prehospital / Disaster Medicine * Professional Skills * Pulmonary Disorders * Risk Management / ED and Law * Toxicology / Environmental * Trauma * Urologic and OB/GYN ACEP17 is the must attend event for anyone engaged in the practice of emergency medicine, including : * Emergency Physicians * Nurse Practitioners * Residents * Medical Students * Physician Assistant * Emergency Department Medical Directors * Hospital Administrators * EMTs/Paramedics

Management of type 2 diabetes should include shared decision making, and patients should be offered individualized diabetes self-management education and glycemic management plans, according to a summary of a clinical practice guideline published online Oct. 23 in the Annals of Internal Medicine. Paul R. Conlin, M.D., from the VA Boston Healthcare System in West Roxbury, Massachusetts, and colleagues convened a joint U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) Evidence-Based Practice Work Group to develop a guideline for management of type 2 diabetes mellitus. The authors provided updates on management within seven areas: patient-centered care and shared decision making, glycemic biomarkers, target ranges of hemoglobin A1c (HbA1c), individualized treatment plans, pharmacologic treatment in the outpatient setting, glucose targets for critically ill patients, and treatment for patients in the hospital. Patients should be offered individualized diabetes self-management education, as well as individualized glycemic management plans and target ranges for HbA1c. "In summary, the VA/DoD CPG [clinical practice guideline] attempts to convey to clinicians, policymakers, and patients the rationale for personalizing treatment on the basis of results from major trials, limitations of the HbA1c test, and evaluation of patient risk for adverse drug events. Conveying complex information in an understandable manner to individual patients and families through a formal process of shared decision making is thus foundational to setting and revising goals that are meaningful, safe, and achievable in everyday clinical practice," the authors write.

Alzheimer disease (AD) is a chronic neuro-degenerative disease accounting for almost 70% of dementia cases. The most common symptom being short term memory loss, the disease leads to a decline in self management and behavior with impacts varying per individual. Though, AD is an age related disorder with people above 60 being most likely to be affected, individuals with a history of frequent head injuries, depression, hypertension may also carry a risk. Researchers and scientists are unsure about the cause of Alzheimers but studies have been conducted and they claim that 7 out of 10 cases are genetically caused (e4 allele of gene apolipoprotein E). Additionally, pathophysiological causes (Plaques and neurofibrillary tangles, neuronal death) cannot be ruled out in the disease pathology and progression. AD forms one of the most actively explored and researched areas in the field of medicine.

American College of Emergency Physicians (ACEP) Scientific Assembly is organized by American College of Emergency Physicians (ACEP) and would be held during Oct 29 - Nov 01, 2017 at Walter E. Washington Convention Center, Washington, Dist of Col, United States of America. The target audience for this medical event for Emergency Physicians, Emergency Nurses, Nurse Practitioners, Residents and Fellows, Medical Students. This cme conference has been approved with a maximum of 29 AMA PRA Category 1 Credits. This Course will consist of clinical, as well as essential management and risk management tools to aid in your day-to-day practice. With educational courses, skills labs and workshops - ACEP17 is the best source for your emergency medicine education needs! Conference Objectives are : * Abdominal Disorders * Airway, Anesthesia, Analgesia * Cardiovascular * Career Advancement Through Teaching * Critical Care * Critical ED Management * Dematologic Disorders * Emergency Imaging * Head & Neck Disorders * Health Policy * Hematologic Disorders * Infectious Disease * Knowledge Translation * Maintenance of Certification * Metabolic and Endocrine Disorders * Neurology * New Technology * Orthopedics and Sports Medicine * Pediatric Disorders

For young patients with type 1 diabetes, insulin pump therapy is associated with lower risks of severe hypoglycemia and diabetic ketoacidosis and better glycemic control than insulin injection therapy, according to a study published online Oct. 10 in the Journal of the American Medical Association. Beate Karges, M.D., from RWTH Aachen University in Germany, and colleagues conducted a population-based cohort study in 446 diabetes centers. They identified patients with type 1 diabetes who were younger than 20 years and had diabetes duration of more than one year. The researchers found that 14,119 patients used pump therapy and 16,460 used insulin injections. A total of 9,814 patients using pump therapy were matched with 9,814 using injection therapy. Compared with injection therapy, pump therapy was correlated with lower rates of severe hypoglycemia (9.55 versus 13.97 per 100 patient-years) and diabetic ketoacidosis (3.64 versus 4.26 per 100 patient-years). Lower levels of glycated hemoglobin were seen with pump versus injection therapy (8.04 versus 8.22 percent). Compared with injection therapy, pump therapy was associated with lower total daily insulin doses (0.84 versus 0.98 U/kg). No significant difference in body mass index was seen between the treatment regimens

Dual-graft (DG) adult living donor liver transplantation (ALDLT) with ABO-incompatible (ABOi) and ABO-compatible (ABOc) graft combination is associated with high rates of graft survival, with no significant difference for ABOi and ABOc grafts, according to research published online July 31 in the American Journal of Transplantation. Jae Hyun Kwon, M.D., from the University of Ulsan College of Medicine in Seoul, South Korea, and colleagues conducted a retrospective review of medical records of patients who underwent ABOi DG ALDLT between 2008 and 2014. The authors also assessed the graft regeneration rate using computed tomography volumetric analysis. During a mean follow-up of 57.0 ± 22.4 months, the researchers found that the one-, three-, and five-year patient survival rate was 96.4 percent. The rate of graft survival at one-, three-, and five-years was 96.4, 94.2, and 92.0 percent, respectively; ABOc and ABOi grafts did not differ significantly (P = 0.145). No significant differences were seen between ABOc and ABOi grafts in the biliary complication rate (P = 0.195). There was no significant difference in regeneration rates for ABOi and ABOc grafts. "DG ALDLT with ABOi and ABOc graft combination seems to be a feasible option for expanding the donor pool without additional donor risks," the authors write.

Vascular Interventional Advances Annual Conference (VIVA) is organized by Vascular Interventional Advances (VIVA) and would be held during Nov 11 - 15, 2017 at Wynn Las Vegas, Las Vegas, Nevada, United States of America. TARGET AUDIENCE : The target audience for this CME activity is physicians who specialize in, among other areas, interventional cardiology, interventional radiology, vascular medicine, vascular surgery, cardiothoracic surgery, neurosurgery, podiatry and neuroradiology, as well as fellows, and allied health professionals (including nurses, vascular clinic staff, endovascular operating room staff, catheterization laboratory and angiography suite staff, nurse practitioners, vascular technologists, and physicians assistants). LEARNING OBJECTIVES : At the conclusion of the course, the targeted learners should be able: * Understand the current indications, risks, complications, and outcome of medical, interventional, and surgical therapies for the treatment of peripheral arterial and venous diseases. * Incorporate advanced medical, endovascular, and surgical techniques and approaches into their own practices to improve the care and outcomes of patients. * Implement high quality guidelines based programs to improve the early identification and care of patients with non- cardiac vascular conditions. * Increase knowledge in critical decision-making and the comprehensive spectrum of care for patients with stroke and intracranial and extracranial carotid artery disease. * Improve the delivery of balanced and scientifically valid vascular care in accordance with expert opinion and practice. * Utilize strategies learned from the meeting including endovascular technologies, open surgical techniques, and hybrid approaches, for the treatment of patients with aortic diseases. * To gain and employ decision making and procedural strategies and techniques in patients with aortic and visceral aneurysms, dissections, deep venous thrombosis, venous insufficiency and pu

American Educational Institute (AEI) Medical-Dental-Legal Update is organized by American Educational Institute (AEI) and will be held during Oct 02, 2017 - Apr 27, 2018 at Grand Wailea Resort, Maui, Hawaii, United States of America. The target audience for this medical event is Dentists. This CME Conference has been approved for a maximum of 20 AMA PRA Category 1 Credits. Conference Description : You practice in a dynamic and challenging environment. While keeping clinically current is imperative, it isn't enough. You must also acquire the skills necessary to navigate a professional liability minefield, manage a more effective and efficient practice, and navigate a maze of healthcare laws and regulations. The 2017-18 Medical-Dental-Legal Update Update is designed to assist you in that endeavor. The course, offered weekly in 32 enviable destinations, is a unique, 20-hour survey of the intersection of medicine and law as well as selected clinical topics. Produced in state-of-the-art production studios with broadcast-grade, HD digital technology. This Conference offers vital instruction from national experts in the fields of law, medicine, dentistry, asset protection, revenue cycle management and practice management. And their presentations include discussions ranging from domestic violence, payment receipt optimization, medical malpractice, fraud and abuse, and optimizing retirement and benefit plan structures, to the oral-systemic connection, medical errors, Hepatitis B & C, neurology and cardiovascular fitness. The Update is presented in a structured classroom setting affording you the opportunity for dialogue with your medical, dental and legal colleagues, and through September 28, 2018, you will have over 900 opportu­nities to attend at your choice of 30 premier sun and ski resorts - virtually any week you choose. Conference Objectives are: * Recommend preventive lifestyle behaviors and protective pharmacothe­rapy. * Assess the appropriate­ness of th

American Educational Institute (AEI) Medical-Dental-Legal Update is organized by American Educational Institute (AEI) and will be held during Oct 02, 2017 - Sep 28, 2018 at Dickenson Square, Maui, Hawaii, United States of America. The target audience for this medical event is Dentists. This CME Conference has been approved for a maximum of 20 AMA PRA Category 1 Credits. Conference Description : You practice in a dynamic and challenging environment. While keeping clinically current is imperative, it isn't enough. You must also acquire the skills necessary to navigate a professional liability minefield, manage a more effective and efficient practice, and navigate a maze of healthcare laws and regulations. The 2017-18 Medical-Dental-Legal Update Update is designed to assist you in that endeavor. The course, offered weekly in 32 enviable destinations, is a unique, 20-hour survey of the intersection of medicine and law as well as selected clinical topics. Produced in state-of-the-art production studios with broadcast-grade, HD digital technology. This Conference offers vital instruction from national experts in the fields of law, medicine, dentistry, asset protection, revenue cycle management and practice management. And their presentations include discussions ranging from domestic violence, payment receipt optimization, medical malpractice, fraud and abuse, and optimizing retirement and benefit plan structures, to the oral-systemic connection, medical errors, Hepatitis B & C, neurology and cardiovascular fitness. Conference Objectives are: * Recommend preventive lifestyle behaviors and protective pharmacothe­rapy. * Assess the appropriate­ness of the direct patient care model for your practice * Utilize a variety of clinically relevant but relatively unknown treatments. * Better recognize and respond to victims of child violence. * Better understand and deal with medical malpractice litigation. * More effectively reduce practice risk and protect assets exposed t