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AATS/AmSECT Welcome Reception
The AATS and AmSECT Welcome Reception will be held on Sunday, April 30, from 5:00 p.m. to 7:00 p.m. in the Exhibit Hall of the Hynes Convention Center. Admission to this event is complimentary to all registered attendees and exhibitors of both the AATS and AmSECT meetings.
Join the AATS and AmSECT, for the official opening to this year’s meeting. Visit with valued exhibitors and supporters in the Exhibition Hall, where you will learn cutting-edge techniques, and discover groundbreaking new products while networking with other attendees.
In celebration of the Centennial for AATS, many exhibits will include historic artifacts in the field of cardiothoracic surgery for all to see. The AATS and AmSECT Exhibition offers a number of exciting learning opportunities:
AATS Mini Theaters: “Deep Dive” presentations of top abstracts from this year’s Annual Meeting as well as product demonstrations by from industry partners.
AATS Learning Center: Innovative surgical procedures as well as webcasts from other AATS events such as the Mitral Conclave meeting.
AmSECT Poster Presentations
AATS Resident Poster CompetitionThe Perioperative/Team-Based Care Poster Competition
The AATS and AmSECT Welcome Reception will be held on Sunday, April 30, from 5:00 p.m. to 7:00 p.m. in the Exhibit Hall of the Hynes Convention Center. Admission to this event is complimentary to all registered attendees and exhibitors of both the AATS and AmSECT meetings.
Join the AATS and AmSECT, for the official opening to this year’s meeting. Visit with valued exhibitors and supporters in the Exhibition Hall, where you will learn cutting-edge techniques, and discover groundbreaking new products while networking with other attendees.
In celebration of the Centennial for AATS, many exhibits will include historic artifacts in the field of cardiothoracic surgery for all to see. The AATS and AmSECT Exhibition offers a number of exciting learning opportunities:
AATS Mini Theaters: “Deep Dive” presentations of top abstracts from this year’s Annual Meeting as well as product demonstrations by from industry partners.
AATS Learning Center: Innovative surgical procedures as well as webcasts from other AATS events such as the Mitral Conclave meeting.
AmSECT Poster Presentations
AATS Resident Poster CompetitionThe Perioperative/Team-Based Care Poster Competition
The AATS and AmSECT Welcome Reception will be held on Sunday, April 30, from 5:00 p.m. to 7:00 p.m. in the Exhibit Hall of the Hynes Convention Center. Admission to this event is complimentary to all registered attendees and exhibitors of both the AATS and AmSECT meetings.
Join the AATS and AmSECT, for the official opening to this year’s meeting. Visit with valued exhibitors and supporters in the Exhibition Hall, where you will learn cutting-edge techniques, and discover groundbreaking new products while networking with other attendees.
In celebration of the Centennial for AATS, many exhibits will include historic artifacts in the field of cardiothoracic surgery for all to see. The AATS and AmSECT Exhibition offers a number of exciting learning opportunities:
AATS Mini Theaters: “Deep Dive” presentations of top abstracts from this year’s Annual Meeting as well as product demonstrations by from industry partners.
AATS Learning Center: Innovative surgical procedures as well as webcasts from other AATS events such as the Mitral Conclave meeting.
AmSECT Poster Presentations
AATS Resident Poster CompetitionThe Perioperative/Team-Based Care Poster Competition
Focus on Thoracic Tumor Management
Managing thoracic tumors will be the focus of a multifaceted course set to take place in Saturday morning’s “General Thoracic Skills: Management of Thoracic Tumors in 2017” session.
“Thoracic surgical approaches and techniques are in constant evolution,” said course chair Virginia R. Litle, MD, of the Boston Medical Center. “Less invasive approaches are available for diagnosing and staging thoracic malignancies, for preoperative planning and avoidance, and for management of complications, [so] we will hear from experts in the field about preoperative planning techniques that are increasingly available.”
Of particular interest will be a brief talk on the use of social media and what boundaries exist, if any, between clinicians and their patients. Brendon M. Stiles, MD, of New York Presbyterian Hospital, will discuss “responsible social media use,” an increasingly relevant concern for their use in health care.
The following session will cover innovative approaches to esophageal replacement, minimally invasive esophagectomy in both prone and lateral orientations, and segmental lung resections, along with talks about helping patients quit smoking and enrolling patients in clinical trials. Shanda H. Blackmon, MD, of the Mayo Clinic, will summarize 3-D printing for operative planning and Yolonda L. Colson, MD, of Brigham & Women’s Hospital, will outline experimental sentinel node mapping for non–small cell lung cancer.
After lunch, there will be an hour of presentations and discussion dedicated to imaging, which will include talks on the optimal surveillance imaging after stereotactic body radiation therapy, image-based therapy for ground glass opacities, and use of the hybrid operating room. The course’s final session will focus on rescue strategies for procedures such as esophagectomies, video and robot-assisted thoracic surgery, and postoperative air leaks in endobronchial valves.
“Management of clinical challenges such as creative esophageal replacement, vascular injuries during robotic surgery, and conduit revision after minimally invasive esophagectomies, will be of interest to thoracic surgeons,” Dr. Litle noted.
Managing thoracic tumors will be the focus of a multifaceted course set to take place in Saturday morning’s “General Thoracic Skills: Management of Thoracic Tumors in 2017” session.
“Thoracic surgical approaches and techniques are in constant evolution,” said course chair Virginia R. Litle, MD, of the Boston Medical Center. “Less invasive approaches are available for diagnosing and staging thoracic malignancies, for preoperative planning and avoidance, and for management of complications, [so] we will hear from experts in the field about preoperative planning techniques that are increasingly available.”
Of particular interest will be a brief talk on the use of social media and what boundaries exist, if any, between clinicians and their patients. Brendon M. Stiles, MD, of New York Presbyterian Hospital, will discuss “responsible social media use,” an increasingly relevant concern for their use in health care.
The following session will cover innovative approaches to esophageal replacement, minimally invasive esophagectomy in both prone and lateral orientations, and segmental lung resections, along with talks about helping patients quit smoking and enrolling patients in clinical trials. Shanda H. Blackmon, MD, of the Mayo Clinic, will summarize 3-D printing for operative planning and Yolonda L. Colson, MD, of Brigham & Women’s Hospital, will outline experimental sentinel node mapping for non–small cell lung cancer.
After lunch, there will be an hour of presentations and discussion dedicated to imaging, which will include talks on the optimal surveillance imaging after stereotactic body radiation therapy, image-based therapy for ground glass opacities, and use of the hybrid operating room. The course’s final session will focus on rescue strategies for procedures such as esophagectomies, video and robot-assisted thoracic surgery, and postoperative air leaks in endobronchial valves.
“Management of clinical challenges such as creative esophageal replacement, vascular injuries during robotic surgery, and conduit revision after minimally invasive esophagectomies, will be of interest to thoracic surgeons,” Dr. Litle noted.
Managing thoracic tumors will be the focus of a multifaceted course set to take place in Saturday morning’s “General Thoracic Skills: Management of Thoracic Tumors in 2017” session.
“Thoracic surgical approaches and techniques are in constant evolution,” said course chair Virginia R. Litle, MD, of the Boston Medical Center. “Less invasive approaches are available for diagnosing and staging thoracic malignancies, for preoperative planning and avoidance, and for management of complications, [so] we will hear from experts in the field about preoperative planning techniques that are increasingly available.”
Of particular interest will be a brief talk on the use of social media and what boundaries exist, if any, between clinicians and their patients. Brendon M. Stiles, MD, of New York Presbyterian Hospital, will discuss “responsible social media use,” an increasingly relevant concern for their use in health care.
The following session will cover innovative approaches to esophageal replacement, minimally invasive esophagectomy in both prone and lateral orientations, and segmental lung resections, along with talks about helping patients quit smoking and enrolling patients in clinical trials. Shanda H. Blackmon, MD, of the Mayo Clinic, will summarize 3-D printing for operative planning and Yolonda L. Colson, MD, of Brigham & Women’s Hospital, will outline experimental sentinel node mapping for non–small cell lung cancer.
After lunch, there will be an hour of presentations and discussion dedicated to imaging, which will include talks on the optimal surveillance imaging after stereotactic body radiation therapy, image-based therapy for ground glass opacities, and use of the hybrid operating room. The course’s final session will focus on rescue strategies for procedures such as esophagectomies, video and robot-assisted thoracic surgery, and postoperative air leaks in endobronchial valves.
“Management of clinical challenges such as creative esophageal replacement, vascular injuries during robotic surgery, and conduit revision after minimally invasive esophagectomies, will be of interest to thoracic surgeons,” Dr. Litle noted.
AmSECT Celebrates Collaboration
The American Society of ExtraCorporeal Technology (AmSECT) is excited to collaborate with AATS for a shared educational program.
Open communication is critical for a high-functioning team, ultimately leading to the best in patient care. During the AmSECT International Conference and AATS Centennial, there will be great opportunities for perfusionists, surgeons, and health care professionals to collaborate, learn together, and make connections. There will be collaborative parallel sessions during the didactic portion of the program on Saturday and Sunday. The combined sessions on Saturday and the Postgraduate Symposia on Sunday include educational content on adult and congenital practice, ethics, transplant and mechanical assist, teamwork, and communication.
[[{"fid":"193783","view_mode":"medstat_image_full_text","attributes":{"height":"73","width":"303","class":"media-element file-medstat-image-full-text","data-delta":"1"},"fields":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":"","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":""}}}]]AmSECT President Kenny Shann says that AmSECT and the AATS have worked together to eliminate silos of care and bring surgeons and perfusionists together to learn. “We believe that better teams will lead to better outcomes. In my career, learning alongside members of the team, regardless of their specific role, has strengthened my ability to care for patients. Co-learning allows team members to develop a shared mental model and facilitates interdisciplinary communication, which will ultimately result in better patient care.”
Perfusionists: continue the power of collaboration after the Conference by becoming an AmSECT member. In a profession that embraces innovation and ingenuity, our community of connected perfusionists helps you keep up with changing demands and emerging technologies. As a member of AmSECT, you will be supporting efforts to help you do your job better. The AmSECT community focuses on developing practice documents, protocols, best practices, and other value-add guidelines. When the members of AmSECT come together, there is greater potential to meet new opportunities and practice expansions with unbiased results.
Go online to www.amsect.org to learn more and join today.
The American Society of ExtraCorporeal Technology (AmSECT) is excited to collaborate with AATS for a shared educational program.
Open communication is critical for a high-functioning team, ultimately leading to the best in patient care. During the AmSECT International Conference and AATS Centennial, there will be great opportunities for perfusionists, surgeons, and health care professionals to collaborate, learn together, and make connections. There will be collaborative parallel sessions during the didactic portion of the program on Saturday and Sunday. The combined sessions on Saturday and the Postgraduate Symposia on Sunday include educational content on adult and congenital practice, ethics, transplant and mechanical assist, teamwork, and communication.
[[{"fid":"193783","view_mode":"medstat_image_full_text","attributes":{"height":"73","width":"303","class":"media-element file-medstat-image-full-text","data-delta":"1"},"fields":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":"","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":""}}}]]AmSECT President Kenny Shann says that AmSECT and the AATS have worked together to eliminate silos of care and bring surgeons and perfusionists together to learn. “We believe that better teams will lead to better outcomes. In my career, learning alongside members of the team, regardless of their specific role, has strengthened my ability to care for patients. Co-learning allows team members to develop a shared mental model and facilitates interdisciplinary communication, which will ultimately result in better patient care.”
Perfusionists: continue the power of collaboration after the Conference by becoming an AmSECT member. In a profession that embraces innovation and ingenuity, our community of connected perfusionists helps you keep up with changing demands and emerging technologies. As a member of AmSECT, you will be supporting efforts to help you do your job better. The AmSECT community focuses on developing practice documents, protocols, best practices, and other value-add guidelines. When the members of AmSECT come together, there is greater potential to meet new opportunities and practice expansions with unbiased results.
Go online to www.amsect.org to learn more and join today.
The American Society of ExtraCorporeal Technology (AmSECT) is excited to collaborate with AATS for a shared educational program.
Open communication is critical for a high-functioning team, ultimately leading to the best in patient care. During the AmSECT International Conference and AATS Centennial, there will be great opportunities for perfusionists, surgeons, and health care professionals to collaborate, learn together, and make connections. There will be collaborative parallel sessions during the didactic portion of the program on Saturday and Sunday. The combined sessions on Saturday and the Postgraduate Symposia on Sunday include educational content on adult and congenital practice, ethics, transplant and mechanical assist, teamwork, and communication.
[[{"fid":"193783","view_mode":"medstat_image_full_text","attributes":{"height":"73","width":"303","class":"media-element file-medstat-image-full-text","data-delta":"1"},"fields":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":"","field_file_image_caption[und][0][format]":"plain_text","field_file_image_credit[und][0][format]":"plain_text"},"type":"media","field_deltas":{"1":{"format":"medstat_image_full_text","field_file_image_caption[und][0][value]":"","field_file_image_credit[und][0][value]":""}}}]]AmSECT President Kenny Shann says that AmSECT and the AATS have worked together to eliminate silos of care and bring surgeons and perfusionists together to learn. “We believe that better teams will lead to better outcomes. In my career, learning alongside members of the team, regardless of their specific role, has strengthened my ability to care for patients. Co-learning allows team members to develop a shared mental model and facilitates interdisciplinary communication, which will ultimately result in better patient care.”
Perfusionists: continue the power of collaboration after the Conference by becoming an AmSECT member. In a profession that embraces innovation and ingenuity, our community of connected perfusionists helps you keep up with changing demands and emerging technologies. As a member of AmSECT, you will be supporting efforts to help you do your job better. The AmSECT community focuses on developing practice documents, protocols, best practices, and other value-add guidelines. When the members of AmSECT come together, there is greater potential to meet new opportunities and practice expansions with unbiased results.
Go online to www.amsect.org to learn more and join today.
Get the 2017 Mobile App
You can get the full AATS meeting experience right in the palm of your hand with the AATS Week Mobile App. Available through the iTunes store, Android Market, and AATS website, the app gives you access to every detail of the AATS Mitral Conclave and the AATS Centennial.
The app features:
- My Schedule and My Notes, which allow you to add your own personalization.
- Complete up-to-date schedule of what is taking place.
- Interactive Exhibit Floor.
- Exhibitors list, with company descriptions, contact information and booth location.
- Floor plans for the New York Hilton Midtown and Boston Hynes Convention Center.
- General meeting information.
You can get the full AATS meeting experience right in the palm of your hand with the AATS Week Mobile App. Available through the iTunes store, Android Market, and AATS website, the app gives you access to every detail of the AATS Mitral Conclave and the AATS Centennial.
The app features:
- My Schedule and My Notes, which allow you to add your own personalization.
- Complete up-to-date schedule of what is taking place.
- Interactive Exhibit Floor.
- Exhibitors list, with company descriptions, contact information and booth location.
- Floor plans for the New York Hilton Midtown and Boston Hynes Convention Center.
- General meeting information.
You can get the full AATS meeting experience right in the palm of your hand with the AATS Week Mobile App. Available through the iTunes store, Android Market, and AATS website, the app gives you access to every detail of the AATS Mitral Conclave and the AATS Centennial.
The app features:
- My Schedule and My Notes, which allow you to add your own personalization.
- Complete up-to-date schedule of what is taking place.
- Interactive Exhibit Floor.
- Exhibitors list, with company descriptions, contact information and booth location.
- Floor plans for the New York Hilton Midtown and Boston Hynes Convention Center.
- General meeting information.
VIDEO: Innovation key to gastroenterology’s future
Many of the disorders that gastroenterologists treat do not have very effective treatments, so there is lots of room for innovation, Sidhartha R. Sinha, MD, told attendees at last year’s AGA Tech Summit.
Gastroenterologists should get involved in innovation early because there is much to learn, Dr. Sinha of Stanford (Calif.) University advised in this video interview from the meeting. It can be a tough business, but if one focuses on the clinical need and considers the number of patients who could benefit from such advances, then innovation can be a rewarding path to pursue, he noted.
Innovation in gastroenterology will be front and center again at the 2017 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Many of the disorders that gastroenterologists treat do not have very effective treatments, so there is lots of room for innovation, Sidhartha R. Sinha, MD, told attendees at last year’s AGA Tech Summit.
Gastroenterologists should get involved in innovation early because there is much to learn, Dr. Sinha of Stanford (Calif.) University advised in this video interview from the meeting. It can be a tough business, but if one focuses on the clinical need and considers the number of patients who could benefit from such advances, then innovation can be a rewarding path to pursue, he noted.
Innovation in gastroenterology will be front and center again at the 2017 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Many of the disorders that gastroenterologists treat do not have very effective treatments, so there is lots of room for innovation, Sidhartha R. Sinha, MD, told attendees at last year’s AGA Tech Summit.
Gastroenterologists should get involved in innovation early because there is much to learn, Dr. Sinha of Stanford (Calif.) University advised in this video interview from the meeting. It can be a tough business, but if one focuses on the clinical need and considers the number of patients who could benefit from such advances, then innovation can be a rewarding path to pursue, he noted.
Innovation in gastroenterology will be front and center again at the 2017 AGA Tech Summit, which is sponsored by the AGA Center for GI Innovation and Technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
FDA approves first home genetic health risk test
The Food and Drug Administration authorized 23andMe’s Personal Genome Service Genetic Health Risk (GHR) test, the first direct-to-consumer genetic screening test, according to a press release on Thursday, April 6.
FDA officials expect the product, which tests individuals for possible genetic predisposition for 10 diseases including Parkinson’s, late-onset Alzheimer’s, celiac disease, and hereditary hemochromatosis, to spur patients to consult with their physicians and make more informed lifestyle decisions.
“Consumers can now have direct access to certain genetic risk information,” said Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health in the release. “But it is important that people understand that genetic risk is just one piece of the bigger puzzle, it does not mean they will or won’t ultimately develop a disease.”
The FDA has exempted all further GHR tests developed by 23andMe from premarket review, noting future GHR tests developed by other makers, excluding those used for diagnostic purposes, may also achieve this exemption after submitting their first premarket review.
For the full details, see the original announcement.
[email protected]
On Twitter @EAZTweets
The Food and Drug Administration authorized 23andMe’s Personal Genome Service Genetic Health Risk (GHR) test, the first direct-to-consumer genetic screening test, according to a press release on Thursday, April 6.
FDA officials expect the product, which tests individuals for possible genetic predisposition for 10 diseases including Parkinson’s, late-onset Alzheimer’s, celiac disease, and hereditary hemochromatosis, to spur patients to consult with their physicians and make more informed lifestyle decisions.
“Consumers can now have direct access to certain genetic risk information,” said Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health in the release. “But it is important that people understand that genetic risk is just one piece of the bigger puzzle, it does not mean they will or won’t ultimately develop a disease.”
The FDA has exempted all further GHR tests developed by 23andMe from premarket review, noting future GHR tests developed by other makers, excluding those used for diagnostic purposes, may also achieve this exemption after submitting their first premarket review.
For the full details, see the original announcement.
[email protected]
On Twitter @EAZTweets
The Food and Drug Administration authorized 23andMe’s Personal Genome Service Genetic Health Risk (GHR) test, the first direct-to-consumer genetic screening test, according to a press release on Thursday, April 6.
FDA officials expect the product, which tests individuals for possible genetic predisposition for 10 diseases including Parkinson’s, late-onset Alzheimer’s, celiac disease, and hereditary hemochromatosis, to spur patients to consult with their physicians and make more informed lifestyle decisions.
“Consumers can now have direct access to certain genetic risk information,” said Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health in the release. “But it is important that people understand that genetic risk is just one piece of the bigger puzzle, it does not mean they will or won’t ultimately develop a disease.”
The FDA has exempted all further GHR tests developed by 23andMe from premarket review, noting future GHR tests developed by other makers, excluding those used for diagnostic purposes, may also achieve this exemption after submitting their first premarket review.
For the full details, see the original announcement.
[email protected]
On Twitter @EAZTweets
AATS Centennial Gala
This once-in-a-lifetime celebration of the 100th anniversary of AATS at the Centennial Gala will be held on Monday, May 1, at the famed Wang Theater at the Boch Center.
During this historic evening, the documentary film “In the Beginning” will be unveiled, which features an in-depth look at the formative years and challenges faced in cardiothoracic surgery and also includes interviews with Past Presidents and members of the Centennial Committee.
Buses depart from all meeting hotels (Sheraton, Marriott, and Westin) at 6:15 p.m.
This once-in-a-lifetime celebration of the 100th anniversary of AATS at the Centennial Gala will be held on Monday, May 1, at the famed Wang Theater at the Boch Center.
During this historic evening, the documentary film “In the Beginning” will be unveiled, which features an in-depth look at the formative years and challenges faced in cardiothoracic surgery and also includes interviews with Past Presidents and members of the Centennial Committee.
Buses depart from all meeting hotels (Sheraton, Marriott, and Westin) at 6:15 p.m.
This once-in-a-lifetime celebration of the 100th anniversary of AATS at the Centennial Gala will be held on Monday, May 1, at the famed Wang Theater at the Boch Center.
During this historic evening, the documentary film “In the Beginning” will be unveiled, which features an in-depth look at the formative years and challenges faced in cardiothoracic surgery and also includes interviews with Past Presidents and members of the Centennial Committee.
Buses depart from all meeting hotels (Sheraton, Marriott, and Westin) at 6:15 p.m.
A viral inducer of celiac disease?
A viral infection may be the culprit behind celiac disease, which is caused by an autoimmune response to dietary gluten. The findings are based on an engineered reovirus, which is normally benign. The researchers believe that a reovirus may disrupt intestinal immune homeostasis in susceptible individuals as a result of infection during childhood.
According to in vitro and mouse studies carried out by the researchers, one strain of reovirus suppresses peripheral regulatory T-cell conversion and promotes T helper 1 immune response at sites that normally induce tolerance to dietary antigens. The work appeared in the April issue of Science (2017;356:44-50).
The researchers decided to investigate reoviruses. They often infect humans, commonly in early childhood when gluten usually is first introduced. They also infect humans and mice similarly, allowing a more straightforward comparison between human and mouse studies than would be possible in other virus types.
The researchers created an engineered virus made from two reovirus strains, T1L and T3D, which naturally reassort in human hosts. T1L infects the intestine, while T3D does not. The new strain, T3D-RV, retains most of the characteristics of T3D but can also infect the intestine.
The researchers then conducted mouse studies and showed that both T1L and T3D-RV affect immune responses to dietary antigens at the inductive and effector sites of oral tolerance. However, the original T1L strain caused more changes in gene transcription, both in the number of genes and the intensity of transcription level. This suggested that T1L might uniquely alter immunogenic responses to dietary antigens.
A further test in mice showed that T1L also prompted a proinflammatory response in dendritic cells that take up ovalbumin, but T3D-RV did not. Furthermore, T1L interfered with induction of peripheral tolerance to oral ovalbumin, and T3D-RV did not.
With this data in hand, the researchers turned to human subjects. They compared 73 healthy controls to 160 patients with celiac disease who were on a gluten-free diet. Celiac disease patients had higher mean antireovirus antibody titers, though the result fell short of statistical significance (P = .06), and subjects with celiac disease were over-represented among subjects who had antireovirus titers above the median value.
“You can have two viruses of the same family infecting the intestine in the same way, inducing protective immunity, and being cleared, but only one sets the stage for disease. Finally, using these two viruses allows [us] to dissociate protective immunity from immunopathology. Only the virus that has the capacity to enter the site where dietary proteins are seen by the immune system can trigger disease,” said Bana Jabri, MD, PhD, professor of medicine at the University of Chicago.
Reovirus is unlikely to be the only, otherwise harmless, virus that could prompt wayward immune responses. The research points the way to the identification of viruses linked to celiac disease and other autoimmune diseases and could inform vaccine strategies to prevent such conditions.
The study received funding from the National Institutes of Health and the University of Chicago. No conflict of interest information was disclosed in the article.
A viral infection may be the culprit behind celiac disease, which is caused by an autoimmune response to dietary gluten. The findings are based on an engineered reovirus, which is normally benign. The researchers believe that a reovirus may disrupt intestinal immune homeostasis in susceptible individuals as a result of infection during childhood.
According to in vitro and mouse studies carried out by the researchers, one strain of reovirus suppresses peripheral regulatory T-cell conversion and promotes T helper 1 immune response at sites that normally induce tolerance to dietary antigens. The work appeared in the April issue of Science (2017;356:44-50).
The researchers decided to investigate reoviruses. They often infect humans, commonly in early childhood when gluten usually is first introduced. They also infect humans and mice similarly, allowing a more straightforward comparison between human and mouse studies than would be possible in other virus types.
The researchers created an engineered virus made from two reovirus strains, T1L and T3D, which naturally reassort in human hosts. T1L infects the intestine, while T3D does not. The new strain, T3D-RV, retains most of the characteristics of T3D but can also infect the intestine.
The researchers then conducted mouse studies and showed that both T1L and T3D-RV affect immune responses to dietary antigens at the inductive and effector sites of oral tolerance. However, the original T1L strain caused more changes in gene transcription, both in the number of genes and the intensity of transcription level. This suggested that T1L might uniquely alter immunogenic responses to dietary antigens.
A further test in mice showed that T1L also prompted a proinflammatory response in dendritic cells that take up ovalbumin, but T3D-RV did not. Furthermore, T1L interfered with induction of peripheral tolerance to oral ovalbumin, and T3D-RV did not.
With this data in hand, the researchers turned to human subjects. They compared 73 healthy controls to 160 patients with celiac disease who were on a gluten-free diet. Celiac disease patients had higher mean antireovirus antibody titers, though the result fell short of statistical significance (P = .06), and subjects with celiac disease were over-represented among subjects who had antireovirus titers above the median value.
“You can have two viruses of the same family infecting the intestine in the same way, inducing protective immunity, and being cleared, but only one sets the stage for disease. Finally, using these two viruses allows [us] to dissociate protective immunity from immunopathology. Only the virus that has the capacity to enter the site where dietary proteins are seen by the immune system can trigger disease,” said Bana Jabri, MD, PhD, professor of medicine at the University of Chicago.
Reovirus is unlikely to be the only, otherwise harmless, virus that could prompt wayward immune responses. The research points the way to the identification of viruses linked to celiac disease and other autoimmune diseases and could inform vaccine strategies to prevent such conditions.
The study received funding from the National Institutes of Health and the University of Chicago. No conflict of interest information was disclosed in the article.
A viral infection may be the culprit behind celiac disease, which is caused by an autoimmune response to dietary gluten. The findings are based on an engineered reovirus, which is normally benign. The researchers believe that a reovirus may disrupt intestinal immune homeostasis in susceptible individuals as a result of infection during childhood.
According to in vitro and mouse studies carried out by the researchers, one strain of reovirus suppresses peripheral regulatory T-cell conversion and promotes T helper 1 immune response at sites that normally induce tolerance to dietary antigens. The work appeared in the April issue of Science (2017;356:44-50).
The researchers decided to investigate reoviruses. They often infect humans, commonly in early childhood when gluten usually is first introduced. They also infect humans and mice similarly, allowing a more straightforward comparison between human and mouse studies than would be possible in other virus types.
The researchers created an engineered virus made from two reovirus strains, T1L and T3D, which naturally reassort in human hosts. T1L infects the intestine, while T3D does not. The new strain, T3D-RV, retains most of the characteristics of T3D but can also infect the intestine.
The researchers then conducted mouse studies and showed that both T1L and T3D-RV affect immune responses to dietary antigens at the inductive and effector sites of oral tolerance. However, the original T1L strain caused more changes in gene transcription, both in the number of genes and the intensity of transcription level. This suggested that T1L might uniquely alter immunogenic responses to dietary antigens.
A further test in mice showed that T1L also prompted a proinflammatory response in dendritic cells that take up ovalbumin, but T3D-RV did not. Furthermore, T1L interfered with induction of peripheral tolerance to oral ovalbumin, and T3D-RV did not.
With this data in hand, the researchers turned to human subjects. They compared 73 healthy controls to 160 patients with celiac disease who were on a gluten-free diet. Celiac disease patients had higher mean antireovirus antibody titers, though the result fell short of statistical significance (P = .06), and subjects with celiac disease were over-represented among subjects who had antireovirus titers above the median value.
“You can have two viruses of the same family infecting the intestine in the same way, inducing protective immunity, and being cleared, but only one sets the stage for disease. Finally, using these two viruses allows [us] to dissociate protective immunity from immunopathology. Only the virus that has the capacity to enter the site where dietary proteins are seen by the immune system can trigger disease,” said Bana Jabri, MD, PhD, professor of medicine at the University of Chicago.
Reovirus is unlikely to be the only, otherwise harmless, virus that could prompt wayward immune responses. The research points the way to the identification of viruses linked to celiac disease and other autoimmune diseases and could inform vaccine strategies to prevent such conditions.
The study received funding from the National Institutes of Health and the University of Chicago. No conflict of interest information was disclosed in the article.
FROM SCIENCE
Key clinical point: Celiac disease patients have high reovirus antibody titers.
Major finding: Researchers detail mechanistic pathway that could explain a viral link.
Data source: In vitro, human, and mouse observational studies.
Disclosures: The study received funding from the National Institutes of Health and the University of Chicago. No conflict of interest information was disclosed in the article.
Registration and Discount Package Information
Attendees may register for the Annual Meeting in three ways, although online registration is strongly encouraged.
1. Internet registration
Go to https://registration.experientevent.com/ShowAAT171/Attendee/Login.aspx
2. Register by phone
Call the AATS/Experient Customer Service Desk
(800) 424-5249 - Toll-free within the USA
(847) 996-5829 - International
3. Mail/fax registration
Send the meeting registration form, along with a check or credit card information, to:
AATS/Experient
5202 Presidents Court, Suite G100
Frederick, MD 21703
Fax: (301) 694-5124 (fax requires credit card information)
You cannot email a copy of your registration form.
Registration Cancellation Policy
Written requests for cancellations and refunds for registration must be received by April 26, 2017. Refunds will be subject to a $50 administrative fee and will be processed after the meeting. Refunds are not available after April 26, 2017. Requests can be sent to [email protected].
Information for International Travelers
Please be sure to check with your local embassy or consulate regarding the required travel documents for visiting Boston. Travel documents may take time to prepare in order to gain access to the United States. Refunds for registration fees will not be issued by the AATS if attendees are unable to travel into the United States due to inadequate travel documents.
For more information, please visit: http://travel.state.gov/content/visas/english/visit/visitor.html.
For information on what to expect if you are applying for a Visa to the United States and to review the Visa Application Guidelines, go to the U.S. Department of State’s website. Additionally, the International Visitors Office (IVO) of the National Academies has resources on all visa-related issues for the scientific community.
The AATS provides several documents that document your participation in the meeting. Official Letters of Invitation are available for meeting attendees. A personalized letter of invitation can be generated after you have been fully registered. Once your registration is fully paid and all verification documents have been received, a personalized letter of invitation can be generated for you. Please contact [email protected] with your request. Please note that you will receive an email confirmation, which you can also bring to your visa interview.
Please contact [email protected] with any further questions pertaining to invitation letters.
Attendees may register for the Annual Meeting in three ways, although online registration is strongly encouraged.
1. Internet registration
Go to https://registration.experientevent.com/ShowAAT171/Attendee/Login.aspx
2. Register by phone
Call the AATS/Experient Customer Service Desk
(800) 424-5249 - Toll-free within the USA
(847) 996-5829 - International
3. Mail/fax registration
Send the meeting registration form, along with a check or credit card information, to:
AATS/Experient
5202 Presidents Court, Suite G100
Frederick, MD 21703
Fax: (301) 694-5124 (fax requires credit card information)
You cannot email a copy of your registration form.
Registration Cancellation Policy
Written requests for cancellations and refunds for registration must be received by April 26, 2017. Refunds will be subject to a $50 administrative fee and will be processed after the meeting. Refunds are not available after April 26, 2017. Requests can be sent to [email protected].
Information for International Travelers
Please be sure to check with your local embassy or consulate regarding the required travel documents for visiting Boston. Travel documents may take time to prepare in order to gain access to the United States. Refunds for registration fees will not be issued by the AATS if attendees are unable to travel into the United States due to inadequate travel documents.
For more information, please visit: http://travel.state.gov/content/visas/english/visit/visitor.html.
For information on what to expect if you are applying for a Visa to the United States and to review the Visa Application Guidelines, go to the U.S. Department of State’s website. Additionally, the International Visitors Office (IVO) of the National Academies has resources on all visa-related issues for the scientific community.
The AATS provides several documents that document your participation in the meeting. Official Letters of Invitation are available for meeting attendees. A personalized letter of invitation can be generated after you have been fully registered. Once your registration is fully paid and all verification documents have been received, a personalized letter of invitation can be generated for you. Please contact [email protected] with your request. Please note that you will receive an email confirmation, which you can also bring to your visa interview.
Please contact [email protected] with any further questions pertaining to invitation letters.
Attendees may register for the Annual Meeting in three ways, although online registration is strongly encouraged.
1. Internet registration
Go to https://registration.experientevent.com/ShowAAT171/Attendee/Login.aspx
2. Register by phone
Call the AATS/Experient Customer Service Desk
(800) 424-5249 - Toll-free within the USA
(847) 996-5829 - International
3. Mail/fax registration
Send the meeting registration form, along with a check or credit card information, to:
AATS/Experient
5202 Presidents Court, Suite G100
Frederick, MD 21703
Fax: (301) 694-5124 (fax requires credit card information)
You cannot email a copy of your registration form.
Registration Cancellation Policy
Written requests for cancellations and refunds for registration must be received by April 26, 2017. Refunds will be subject to a $50 administrative fee and will be processed after the meeting. Refunds are not available after April 26, 2017. Requests can be sent to [email protected].
Information for International Travelers
Please be sure to check with your local embassy or consulate regarding the required travel documents for visiting Boston. Travel documents may take time to prepare in order to gain access to the United States. Refunds for registration fees will not be issued by the AATS if attendees are unable to travel into the United States due to inadequate travel documents.
For more information, please visit: http://travel.state.gov/content/visas/english/visit/visitor.html.
For information on what to expect if you are applying for a Visa to the United States and to review the Visa Application Guidelines, go to the U.S. Department of State’s website. Additionally, the International Visitors Office (IVO) of the National Academies has resources on all visa-related issues for the scientific community.
The AATS provides several documents that document your participation in the meeting. Official Letters of Invitation are available for meeting attendees. A personalized letter of invitation can be generated after you have been fully registered. Once your registration is fully paid and all verification documents have been received, a personalized letter of invitation can be generated for you. Please contact [email protected] with your request. Please note that you will receive an email confirmation, which you can also bring to your visa interview.
Please contact [email protected] with any further questions pertaining to invitation letters.
Epilepsy or Seizure Disorder? The Effect of Cultural and Socioeconomic Factors on Self-Reported Prevalence
Barbara L. Kroner, PhD, MPH
Disclosure Information:
Dr. Kroner has no disclosures.
Dr. Kroner was lead author on the screening survey study discussed in this article (Kroner BL, et al. Epilepsy or seizure disorder? The effect of cultural and socioeconomic factors on self-reported prevalence. Epilepsy Behav. 2016;62:214-217).
Approximately three-quarters of 6420 adult residents of the District of Columbia (DC) screened for epilepsy said they were diagnosed with a seizure disorder rather than epilepsy when given both choices in our population-based survey. The term ‘seizure disorder’ was chosen consistently more often than ‘epilepsy’ in all demographic subgroups, including gender, age, income, education, race, and ethnicity—suggesting there may be a general lack of understanding among patients about what epilepsy means. An implication of these findings is that, although a wealth of information about epilepsy is publicly available for or disseminated by medical providers to people with epilepsy, they may not be getting the message.
Epilepsy can be a complex diagnosis, and people may not associate their seizure condition with the term epilepsy for a variety of reasons. Such reasons include stigma, symptomatic etiology, cultural background, and the terminology used by their medical providers. When there is a known cause for the seizures, such as injury, cancer, stroke, or underlying syndrome, the affected individuals may be more inclined to associate their diagnosis with descriptive phrases that include the term seizure disorder. Medical providers may also tend to use these phrases more often with certain demographic populations, such as the elderly and those with diverse cultural backgrounds.
We conducted the survey in DC, one of the nation’s most culturally, racially, and economically diverse populations, to estimate the prevalence and incidence of epilepsy in various demographic categories associated with the clinical term epilepsy or the more generic term seizure disorder. A single-page, bilingual epilepsy survey was mailed to a representative sample of 20,000 households; it included the standard epilepsy screening question, “Ever diagnosed with epilepsy or a seizure disorder?” Rather than the traditional Yes/No answer choices, we provided answer choices of No, Yes epilepsy, and Yes seizure disorder. A positive response to the screening question, “Currently taking any medicine to control seizures?” was categorized as having active epilepsy or seizure disorder. All response data then were weighted to the DC population size at the time the survey was conducted and to reflect the sampling design. Respondents indicating a diagnosis of epilepsy or seizure disorder were sent a follow-up survey about the etiology of the seizures. The follow-up surveys were reviewed by an epileptologist, who categorized the etiology for each respondent as symptomatic or not symptomatic.
A total of 6420 adults responded to the screening survey, for an overall adjusted response rate of 37%. Among the respondents, there were more females (60.5%) than males (39.5%) and slightly more blacks (45.2%) than whites (44.4%). Half of the adults were at least 50 years of age, and 40% had attended at least some graduate school. There were 107 respondents who reported they had received a diagnosis of epilepsy or a seizure disorder at some time in their life. Subsequent weighted estimates and 95% confidence intervals (CI) for individual lifetime prevalence were 0.54% (95% CI, 0.34-0.74) for epilepsy and 1.30% (95% CI, 0.98-1.62) for seizure disorder, for an overall lifetime prevalence of 1.84% (95% CI, 1.47-2.21) for either condition. Adults with active epilepsy were also significantly more likely to identify their condition as seizure disorder than as epilepsy—0.70% (95% CI, 0.47-0.94) vs 0.21% (95% CI, 0.08-0.33).
For lifetime prevalence, seizure disorder was reported 2 to 3 times more often than epilepsy in almost all demographic subgroups except those 18 to 30 years of age, in whom the lifetime prevalence rates were equal for the 2 conditions. The prevalence of seizure disorder was significantly higher than epilepsy (non-overlapping 95% CI) among non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5 years.
Similarly, the prevalence of active seizure disorder was higher than the prevalence of active epilepsy in all subgroups, including those 18 to 30 years of age. Active seizure disorder was significantly higher than active epilepsy among the same 6 demographic subgroups that were identified for lifetime prevalence: non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5years. In 4 subgroups (young adults, Hispanic, race other than white or black, and those residing in DC for less than 5 years), all of the affected respondents identified their condition as seizure disorder, not as epilepsy.
Additional surveys about epilepsy and seizure history were completed by 70 (65.4%) of the 107 respondents. Of these 70 respondents, 22 (31.4%) reported they were diagnosed with epilepsy and 48 (68.6%) reported they were diagnosed with seizure disorder. Symptomatic seizure etiology was noted by 35 (50%) of the respondents, and these were significantly more likely to identify their condition as seizure disorder than as epilepsy (29 [60.4%] vs 6 [27.3%]; P=.02). Specific causes of seizures in both groups included trauma only, stroke only, drugs or alcohol only, trauma plus stroke, alcohol or drug use, and chronic medical condition such as multiple sclerosis, hypertension, congenital arteriovenous malformation, migraines, and brain tumor. Of note, in the overall group of 19 respondents who had seizures due to trauma, 3 had gunshot wounds to the head, which might occur less frequently in the general adult epilepsy population than in DC. Because of the small numbers involved, we were not able to calculate prevalence rates for the symptomatic respondents stratified by demographic characteristics.
The consistently higher number of respondents who self-identified with seizure disorder rather than with epilepsy across all subgroups, including the highly educated, suggests that those who chose seizure disorder are unlikely to be false positive cases of epilepsy. In addition to respondents in the lower socioeconomic groups, females identified significantly more often with seizure disorder than with epilepsy, a finding that may be related to social factors such as stigma. Also, cultural factors and beliefs likely influenced the preference for reporting seizure disorder over epilepsy.
In summary, our findings suggest that both epilepsy and seizure disorder and perhaps other culturally sensitive terms need to be used with patients in clinical practice to ensure they understand their diagnosis and to maximize adherence to treatment and disease management. Patients should understand the synonymy of the 2 terms, particularly because of the overabundance of information available to the public and on the internet that is labeled as epilepsy-specific. In addition, epilepsy education and awareness campaigns ideally should include a more diverse definition of epilepsy in their messages to reach the broadest population of affected individuals, many of whom are in socioeconomic groups at high risk for epilepsy.
To read the full article about this study, please click here.
Barbara L. Kroner, PhD, MPH
Disclosure Information:
Dr. Kroner has no disclosures.
Dr. Kroner was lead author on the screening survey study discussed in this article (Kroner BL, et al. Epilepsy or seizure disorder? The effect of cultural and socioeconomic factors on self-reported prevalence. Epilepsy Behav. 2016;62:214-217).
Approximately three-quarters of 6420 adult residents of the District of Columbia (DC) screened for epilepsy said they were diagnosed with a seizure disorder rather than epilepsy when given both choices in our population-based survey. The term ‘seizure disorder’ was chosen consistently more often than ‘epilepsy’ in all demographic subgroups, including gender, age, income, education, race, and ethnicity—suggesting there may be a general lack of understanding among patients about what epilepsy means. An implication of these findings is that, although a wealth of information about epilepsy is publicly available for or disseminated by medical providers to people with epilepsy, they may not be getting the message.
Epilepsy can be a complex diagnosis, and people may not associate their seizure condition with the term epilepsy for a variety of reasons. Such reasons include stigma, symptomatic etiology, cultural background, and the terminology used by their medical providers. When there is a known cause for the seizures, such as injury, cancer, stroke, or underlying syndrome, the affected individuals may be more inclined to associate their diagnosis with descriptive phrases that include the term seizure disorder. Medical providers may also tend to use these phrases more often with certain demographic populations, such as the elderly and those with diverse cultural backgrounds.
We conducted the survey in DC, one of the nation’s most culturally, racially, and economically diverse populations, to estimate the prevalence and incidence of epilepsy in various demographic categories associated with the clinical term epilepsy or the more generic term seizure disorder. A single-page, bilingual epilepsy survey was mailed to a representative sample of 20,000 households; it included the standard epilepsy screening question, “Ever diagnosed with epilepsy or a seizure disorder?” Rather than the traditional Yes/No answer choices, we provided answer choices of No, Yes epilepsy, and Yes seizure disorder. A positive response to the screening question, “Currently taking any medicine to control seizures?” was categorized as having active epilepsy or seizure disorder. All response data then were weighted to the DC population size at the time the survey was conducted and to reflect the sampling design. Respondents indicating a diagnosis of epilepsy or seizure disorder were sent a follow-up survey about the etiology of the seizures. The follow-up surveys were reviewed by an epileptologist, who categorized the etiology for each respondent as symptomatic or not symptomatic.
A total of 6420 adults responded to the screening survey, for an overall adjusted response rate of 37%. Among the respondents, there were more females (60.5%) than males (39.5%) and slightly more blacks (45.2%) than whites (44.4%). Half of the adults were at least 50 years of age, and 40% had attended at least some graduate school. There were 107 respondents who reported they had received a diagnosis of epilepsy or a seizure disorder at some time in their life. Subsequent weighted estimates and 95% confidence intervals (CI) for individual lifetime prevalence were 0.54% (95% CI, 0.34-0.74) for epilepsy and 1.30% (95% CI, 0.98-1.62) for seizure disorder, for an overall lifetime prevalence of 1.84% (95% CI, 1.47-2.21) for either condition. Adults with active epilepsy were also significantly more likely to identify their condition as seizure disorder than as epilepsy—0.70% (95% CI, 0.47-0.94) vs 0.21% (95% CI, 0.08-0.33).
For lifetime prevalence, seizure disorder was reported 2 to 3 times more often than epilepsy in almost all demographic subgroups except those 18 to 30 years of age, in whom the lifetime prevalence rates were equal for the 2 conditions. The prevalence of seizure disorder was significantly higher than epilepsy (non-overlapping 95% CI) among non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5 years.
Similarly, the prevalence of active seizure disorder was higher than the prevalence of active epilepsy in all subgroups, including those 18 to 30 years of age. Active seizure disorder was significantly higher than active epilepsy among the same 6 demographic subgroups that were identified for lifetime prevalence: non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5years. In 4 subgroups (young adults, Hispanic, race other than white or black, and those residing in DC for less than 5 years), all of the affected respondents identified their condition as seizure disorder, not as epilepsy.
Additional surveys about epilepsy and seizure history were completed by 70 (65.4%) of the 107 respondents. Of these 70 respondents, 22 (31.4%) reported they were diagnosed with epilepsy and 48 (68.6%) reported they were diagnosed with seizure disorder. Symptomatic seizure etiology was noted by 35 (50%) of the respondents, and these were significantly more likely to identify their condition as seizure disorder than as epilepsy (29 [60.4%] vs 6 [27.3%]; P=.02). Specific causes of seizures in both groups included trauma only, stroke only, drugs or alcohol only, trauma plus stroke, alcohol or drug use, and chronic medical condition such as multiple sclerosis, hypertension, congenital arteriovenous malformation, migraines, and brain tumor. Of note, in the overall group of 19 respondents who had seizures due to trauma, 3 had gunshot wounds to the head, which might occur less frequently in the general adult epilepsy population than in DC. Because of the small numbers involved, we were not able to calculate prevalence rates for the symptomatic respondents stratified by demographic characteristics.
The consistently higher number of respondents who self-identified with seizure disorder rather than with epilepsy across all subgroups, including the highly educated, suggests that those who chose seizure disorder are unlikely to be false positive cases of epilepsy. In addition to respondents in the lower socioeconomic groups, females identified significantly more often with seizure disorder than with epilepsy, a finding that may be related to social factors such as stigma. Also, cultural factors and beliefs likely influenced the preference for reporting seizure disorder over epilepsy.
In summary, our findings suggest that both epilepsy and seizure disorder and perhaps other culturally sensitive terms need to be used with patients in clinical practice to ensure they understand their diagnosis and to maximize adherence to treatment and disease management. Patients should understand the synonymy of the 2 terms, particularly because of the overabundance of information available to the public and on the internet that is labeled as epilepsy-specific. In addition, epilepsy education and awareness campaigns ideally should include a more diverse definition of epilepsy in their messages to reach the broadest population of affected individuals, many of whom are in socioeconomic groups at high risk for epilepsy.
To read the full article about this study, please click here.
Barbara L. Kroner, PhD, MPH
Disclosure Information:
Dr. Kroner has no disclosures.
Dr. Kroner was lead author on the screening survey study discussed in this article (Kroner BL, et al. Epilepsy or seizure disorder? The effect of cultural and socioeconomic factors on self-reported prevalence. Epilepsy Behav. 2016;62:214-217).
Approximately three-quarters of 6420 adult residents of the District of Columbia (DC) screened for epilepsy said they were diagnosed with a seizure disorder rather than epilepsy when given both choices in our population-based survey. The term ‘seizure disorder’ was chosen consistently more often than ‘epilepsy’ in all demographic subgroups, including gender, age, income, education, race, and ethnicity—suggesting there may be a general lack of understanding among patients about what epilepsy means. An implication of these findings is that, although a wealth of information about epilepsy is publicly available for or disseminated by medical providers to people with epilepsy, they may not be getting the message.
Epilepsy can be a complex diagnosis, and people may not associate their seizure condition with the term epilepsy for a variety of reasons. Such reasons include stigma, symptomatic etiology, cultural background, and the terminology used by their medical providers. When there is a known cause for the seizures, such as injury, cancer, stroke, or underlying syndrome, the affected individuals may be more inclined to associate their diagnosis with descriptive phrases that include the term seizure disorder. Medical providers may also tend to use these phrases more often with certain demographic populations, such as the elderly and those with diverse cultural backgrounds.
We conducted the survey in DC, one of the nation’s most culturally, racially, and economically diverse populations, to estimate the prevalence and incidence of epilepsy in various demographic categories associated with the clinical term epilepsy or the more generic term seizure disorder. A single-page, bilingual epilepsy survey was mailed to a representative sample of 20,000 households; it included the standard epilepsy screening question, “Ever diagnosed with epilepsy or a seizure disorder?” Rather than the traditional Yes/No answer choices, we provided answer choices of No, Yes epilepsy, and Yes seizure disorder. A positive response to the screening question, “Currently taking any medicine to control seizures?” was categorized as having active epilepsy or seizure disorder. All response data then were weighted to the DC population size at the time the survey was conducted and to reflect the sampling design. Respondents indicating a diagnosis of epilepsy or seizure disorder were sent a follow-up survey about the etiology of the seizures. The follow-up surveys were reviewed by an epileptologist, who categorized the etiology for each respondent as symptomatic or not symptomatic.
A total of 6420 adults responded to the screening survey, for an overall adjusted response rate of 37%. Among the respondents, there were more females (60.5%) than males (39.5%) and slightly more blacks (45.2%) than whites (44.4%). Half of the adults were at least 50 years of age, and 40% had attended at least some graduate school. There were 107 respondents who reported they had received a diagnosis of epilepsy or a seizure disorder at some time in their life. Subsequent weighted estimates and 95% confidence intervals (CI) for individual lifetime prevalence were 0.54% (95% CI, 0.34-0.74) for epilepsy and 1.30% (95% CI, 0.98-1.62) for seizure disorder, for an overall lifetime prevalence of 1.84% (95% CI, 1.47-2.21) for either condition. Adults with active epilepsy were also significantly more likely to identify their condition as seizure disorder than as epilepsy—0.70% (95% CI, 0.47-0.94) vs 0.21% (95% CI, 0.08-0.33).
For lifetime prevalence, seizure disorder was reported 2 to 3 times more often than epilepsy in almost all demographic subgroups except those 18 to 30 years of age, in whom the lifetime prevalence rates were equal for the 2 conditions. The prevalence of seizure disorder was significantly higher than epilepsy (non-overlapping 95% CI) among non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5 years.
Similarly, the prevalence of active seizure disorder was higher than the prevalence of active epilepsy in all subgroups, including those 18 to 30 years of age. Active seizure disorder was significantly higher than active epilepsy among the same 6 demographic subgroups that were identified for lifetime prevalence: non-Hispanic blacks, females, those 50 years of age or older, those with only a high school education, those living in low-income neighborhoods, and those who had resided in DC for at least 5years. In 4 subgroups (young adults, Hispanic, race other than white or black, and those residing in DC for less than 5 years), all of the affected respondents identified their condition as seizure disorder, not as epilepsy.
Additional surveys about epilepsy and seizure history were completed by 70 (65.4%) of the 107 respondents. Of these 70 respondents, 22 (31.4%) reported they were diagnosed with epilepsy and 48 (68.6%) reported they were diagnosed with seizure disorder. Symptomatic seizure etiology was noted by 35 (50%) of the respondents, and these were significantly more likely to identify their condition as seizure disorder than as epilepsy (29 [60.4%] vs 6 [27.3%]; P=.02). Specific causes of seizures in both groups included trauma only, stroke only, drugs or alcohol only, trauma plus stroke, alcohol or drug use, and chronic medical condition such as multiple sclerosis, hypertension, congenital arteriovenous malformation, migraines, and brain tumor. Of note, in the overall group of 19 respondents who had seizures due to trauma, 3 had gunshot wounds to the head, which might occur less frequently in the general adult epilepsy population than in DC. Because of the small numbers involved, we were not able to calculate prevalence rates for the symptomatic respondents stratified by demographic characteristics.
The consistently higher number of respondents who self-identified with seizure disorder rather than with epilepsy across all subgroups, including the highly educated, suggests that those who chose seizure disorder are unlikely to be false positive cases of epilepsy. In addition to respondents in the lower socioeconomic groups, females identified significantly more often with seizure disorder than with epilepsy, a finding that may be related to social factors such as stigma. Also, cultural factors and beliefs likely influenced the preference for reporting seizure disorder over epilepsy.
In summary, our findings suggest that both epilepsy and seizure disorder and perhaps other culturally sensitive terms need to be used with patients in clinical practice to ensure they understand their diagnosis and to maximize adherence to treatment and disease management. Patients should understand the synonymy of the 2 terms, particularly because of the overabundance of information available to the public and on the internet that is labeled as epilepsy-specific. In addition, epilepsy education and awareness campaigns ideally should include a more diverse definition of epilepsy in their messages to reach the broadest population of affected individuals, many of whom are in socioeconomic groups at high risk for epilepsy.
To read the full article about this study, please click here.