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Bradycardia guidelines, hypertension’s risk in young adults, and more
This week on Cardiocast, guidelines for bradycardia set a new bar for shared decision-making in pacemaker placement, young adults with hypertension may be at higher CVD risk, how sleep quality affects cardiovascular risk, and a strong showing for exercise in patients with both heart failure and sleep apnea.
Tune in next Friday for the most exciting news from the scientific sessions of the American Heart Association, as told by the reporters who cover it.
Subscribe to Cardiocast wherever you get your podcasts.
This week on Cardiocast, guidelines for bradycardia set a new bar for shared decision-making in pacemaker placement, young adults with hypertension may be at higher CVD risk, how sleep quality affects cardiovascular risk, and a strong showing for exercise in patients with both heart failure and sleep apnea.
Tune in next Friday for the most exciting news from the scientific sessions of the American Heart Association, as told by the reporters who cover it.
Subscribe to Cardiocast wherever you get your podcasts.
This week on Cardiocast, guidelines for bradycardia set a new bar for shared decision-making in pacemaker placement, young adults with hypertension may be at higher CVD risk, how sleep quality affects cardiovascular risk, and a strong showing for exercise in patients with both heart failure and sleep apnea.
Tune in next Friday for the most exciting news from the scientific sessions of the American Heart Association, as told by the reporters who cover it.
Subscribe to Cardiocast wherever you get your podcasts.
Venous Venous Venous @VEITHsymposium
The Venous Venous Venous @VEITHsymposium program has become a popular staple of the meeting. With a mixture of didactic sessions and workshops, the Venous Venous Venous program, which will be held on Thursday, Friday, and Saturday, will cover the full gamut of venous disorders and their treatments, surgical, endovascular, and medical.
The didactic Program J (Sessions 63-67) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will detail the latest developments in venous clinical examinations and imaging, superficial vein strategies and techniques, thermal and non-thermal ablation, and there will be a special session on venous societal issues and governance. Moderated by Elna M. Masuda, MD, and Marc A. Passman, MD, this special session will feature discussions of the Centers for Medicare & Medicaid policy update on venous ablation, dealing with MACRA, the RUC, and the reevaluation of phlebectomy, and more.
The didactic Program N (Sessions 88-92) on Deep Venous Disease will be all day Friday and will cover pelvic venous disorders, femoro-iliocaval interventions, deep vein reflux, wounds, and endovascular and open solutions for inferior vena cava disorders, and more.
The didactic Program R (Sessions 109-114) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will cover all aspects of venous disease, from venous imaging, thrombophilia, schelrotherapy, phlebectomy, and more.
This year’s workshops will be held on Thursday afternoon and early evening, Nov. 15, and will feature video case presentations, and lectures and demonstrations on managing venous disease by leading experts in the field. In addition, there will be hands-on work station opportunities for participants to work with trained professionals to hone their skills.Two workshop modules are being offered this year:
1) Thrombus Management, which will focus on thromolysis, thrombectomry, the latest in stents and filters, difficult recanalizations, and issues in anticoagulation.
2) Superficial Venous Disease and Compression Management, which will deal with venous ablation, phelebctomy, schlerotherapy, and the critical areas of lymphedema, lipedema, and venous edema treatment, as well as wound care and compression.
The Venous Venous Venous @VEITHsymposium program has become a popular staple of the meeting. With a mixture of didactic sessions and workshops, the Venous Venous Venous program, which will be held on Thursday, Friday, and Saturday, will cover the full gamut of venous disorders and their treatments, surgical, endovascular, and medical.
The didactic Program J (Sessions 63-67) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will detail the latest developments in venous clinical examinations and imaging, superficial vein strategies and techniques, thermal and non-thermal ablation, and there will be a special session on venous societal issues and governance. Moderated by Elna M. Masuda, MD, and Marc A. Passman, MD, this special session will feature discussions of the Centers for Medicare & Medicaid policy update on venous ablation, dealing with MACRA, the RUC, and the reevaluation of phlebectomy, and more.
The didactic Program N (Sessions 88-92) on Deep Venous Disease will be all day Friday and will cover pelvic venous disorders, femoro-iliocaval interventions, deep vein reflux, wounds, and endovascular and open solutions for inferior vena cava disorders, and more.
The didactic Program R (Sessions 109-114) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will cover all aspects of venous disease, from venous imaging, thrombophilia, schelrotherapy, phlebectomy, and more.
This year’s workshops will be held on Thursday afternoon and early evening, Nov. 15, and will feature video case presentations, and lectures and demonstrations on managing venous disease by leading experts in the field. In addition, there will be hands-on work station opportunities for participants to work with trained professionals to hone their skills.Two workshop modules are being offered this year:
1) Thrombus Management, which will focus on thromolysis, thrombectomry, the latest in stents and filters, difficult recanalizations, and issues in anticoagulation.
2) Superficial Venous Disease and Compression Management, which will deal with venous ablation, phelebctomy, schlerotherapy, and the critical areas of lymphedema, lipedema, and venous edema treatment, as well as wound care and compression.
The Venous Venous Venous @VEITHsymposium program has become a popular staple of the meeting. With a mixture of didactic sessions and workshops, the Venous Venous Venous program, which will be held on Thursday, Friday, and Saturday, will cover the full gamut of venous disorders and their treatments, surgical, endovascular, and medical.
The didactic Program J (Sessions 63-67) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will detail the latest developments in venous clinical examinations and imaging, superficial vein strategies and techniques, thermal and non-thermal ablation, and there will be a special session on venous societal issues and governance. Moderated by Elna M. Masuda, MD, and Marc A. Passman, MD, this special session will feature discussions of the Centers for Medicare & Medicaid policy update on venous ablation, dealing with MACRA, the RUC, and the reevaluation of phlebectomy, and more.
The didactic Program N (Sessions 88-92) on Deep Venous Disease will be all day Friday and will cover pelvic venous disorders, femoro-iliocaval interventions, deep vein reflux, wounds, and endovascular and open solutions for inferior vena cava disorders, and more.
The didactic Program R (Sessions 109-114) on Superficial Venous Disease will be held on Thursday morning and early afternoon and will cover all aspects of venous disease, from venous imaging, thrombophilia, schelrotherapy, phlebectomy, and more.
This year’s workshops will be held on Thursday afternoon and early evening, Nov. 15, and will feature video case presentations, and lectures and demonstrations on managing venous disease by leading experts in the field. In addition, there will be hands-on work station opportunities for participants to work with trained professionals to hone their skills.Two workshop modules are being offered this year:
1) Thrombus Management, which will focus on thromolysis, thrombectomry, the latest in stents and filters, difficult recanalizations, and issues in anticoagulation.
2) Superficial Venous Disease and Compression Management, which will deal with venous ablation, phelebctomy, schlerotherapy, and the critical areas of lymphedema, lipedema, and venous edema treatment, as well as wound care and compression.
VEITHsymposium: Focusing on (clinical) trials and tribulations
A hallmark of the VEITHsymposium has always been its focus on the results of recent and ongoing clinical trials, and this year is no exception. These trials will be presented by experts in their various fields who will discuss how the results will affect your daily practice.
A plethora of such clinical trials take center stage throughout the week and Tuesday alone has its fair share of highlighted studies.
For example, Tuesday morning, Jan D. Blankensteijn, MD, will discuss how and why the late results of the Dutch Randomised Endovascular Aneurysm Management (DREAM) and the Standard Open Surgery Versus Endovascular Repair of Abdominal Aortic Aneurysm (OVER) randomized controlled trials did not show the same late survival benefit for open repair as for EVAR and will address the issue of whether EVAR should be the treatment of choice for all anatomically suitable AAA patients.
Intracranial treatments for stroke will be a key interest of three trial presentations: Colin P. Derdeyn, MD, will present new findings from the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) randomized controlled trial comparing intracranial stenting to best medical treatments, highlighting the high incidence of in-stent restenosis causing strokes that were observed. Alejandro M. Spiotta, MD, will discuss how the COMPASS Trial: a Direct Aspiration First Pass Technique (COMPASS) shows that new aspiration systems are equivalent to stentrievers for removing intracranial clots to treat acute strokes, and address when they appear to be actually better. In addition, L. Nelson Hopkins, MD, will present an update on the value of intracranial clot removal for acute strokes, highlighting the question of when a longer window after symptom onset (up to 24 hours) is acceptable, as seen in recent trials such as the Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo (DAWN) and Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke (EXTEND-IA TNK) studies.
Switching gears later in the day, the 1-year results of the Bare Metal Stent Versus Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate Length Femoropopliteal Lesions (BATTLE) multicenter randomized controlled trial, will be presented by Yann Gouëffic, MD, PhD.
Be sure to catch up with these trial results and others on Tuesday and the host of trials to be presented and discussed throughout the week at the 2018 VEITHsymposium.
A hallmark of the VEITHsymposium has always been its focus on the results of recent and ongoing clinical trials, and this year is no exception. These trials will be presented by experts in their various fields who will discuss how the results will affect your daily practice.
A plethora of such clinical trials take center stage throughout the week and Tuesday alone has its fair share of highlighted studies.
For example, Tuesday morning, Jan D. Blankensteijn, MD, will discuss how and why the late results of the Dutch Randomised Endovascular Aneurysm Management (DREAM) and the Standard Open Surgery Versus Endovascular Repair of Abdominal Aortic Aneurysm (OVER) randomized controlled trials did not show the same late survival benefit for open repair as for EVAR and will address the issue of whether EVAR should be the treatment of choice for all anatomically suitable AAA patients.
Intracranial treatments for stroke will be a key interest of three trial presentations: Colin P. Derdeyn, MD, will present new findings from the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) randomized controlled trial comparing intracranial stenting to best medical treatments, highlighting the high incidence of in-stent restenosis causing strokes that were observed. Alejandro M. Spiotta, MD, will discuss how the COMPASS Trial: a Direct Aspiration First Pass Technique (COMPASS) shows that new aspiration systems are equivalent to stentrievers for removing intracranial clots to treat acute strokes, and address when they appear to be actually better. In addition, L. Nelson Hopkins, MD, will present an update on the value of intracranial clot removal for acute strokes, highlighting the question of when a longer window after symptom onset (up to 24 hours) is acceptable, as seen in recent trials such as the Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo (DAWN) and Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke (EXTEND-IA TNK) studies.
Switching gears later in the day, the 1-year results of the Bare Metal Stent Versus Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate Length Femoropopliteal Lesions (BATTLE) multicenter randomized controlled trial, will be presented by Yann Gouëffic, MD, PhD.
Be sure to catch up with these trial results and others on Tuesday and the host of trials to be presented and discussed throughout the week at the 2018 VEITHsymposium.
A hallmark of the VEITHsymposium has always been its focus on the results of recent and ongoing clinical trials, and this year is no exception. These trials will be presented by experts in their various fields who will discuss how the results will affect your daily practice.
A plethora of such clinical trials take center stage throughout the week and Tuesday alone has its fair share of highlighted studies.
For example, Tuesday morning, Jan D. Blankensteijn, MD, will discuss how and why the late results of the Dutch Randomised Endovascular Aneurysm Management (DREAM) and the Standard Open Surgery Versus Endovascular Repair of Abdominal Aortic Aneurysm (OVER) randomized controlled trials did not show the same late survival benefit for open repair as for EVAR and will address the issue of whether EVAR should be the treatment of choice for all anatomically suitable AAA patients.
Intracranial treatments for stroke will be a key interest of three trial presentations: Colin P. Derdeyn, MD, will present new findings from the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) randomized controlled trial comparing intracranial stenting to best medical treatments, highlighting the high incidence of in-stent restenosis causing strokes that were observed. Alejandro M. Spiotta, MD, will discuss how the COMPASS Trial: a Direct Aspiration First Pass Technique (COMPASS) shows that new aspiration systems are equivalent to stentrievers for removing intracranial clots to treat acute strokes, and address when they appear to be actually better. In addition, L. Nelson Hopkins, MD, will present an update on the value of intracranial clot removal for acute strokes, highlighting the question of when a longer window after symptom onset (up to 24 hours) is acceptable, as seen in recent trials such as the Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo (DAWN) and Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke (EXTEND-IA TNK) studies.
Switching gears later in the day, the 1-year results of the Bare Metal Stent Versus Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate Length Femoropopliteal Lesions (BATTLE) multicenter randomized controlled trial, will be presented by Yann Gouëffic, MD, PhD.
Be sure to catch up with these trial results and others on Tuesday and the host of trials to be presented and discussed throughout the week at the 2018 VEITHsymposium.
Hypertension and CVD risk for young adults
The medical community is struggling to reach a vaccine for Hepatitis C virus, many teens don’t know that e-cigarettes contain nicotine, and there’s a duel in SLE classification criteria,
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The medical community is struggling to reach a vaccine for Hepatitis C virus, many teens don’t know that e-cigarettes contain nicotine, and there’s a duel in SLE classification criteria,
Amazon Alexa
Apple Podcasts
Spotify
The medical community is struggling to reach a vaccine for Hepatitis C virus, many teens don’t know that e-cigarettes contain nicotine, and there’s a duel in SLE classification criteria,
Amazon Alexa
Apple Podcasts
Spotify
Petrous Levounis: Substance Abuse Disorders
Caffeinated coffee intake linked to lower rosacea risk
Caffeinated coffee intake is linked to a decreased incidence of rosacea, results of a large, observational study suggest.
Increased levels of caffeinated coffee consumption were associated with progressively lower levels of incident rosacea in a study of more than 82,000 participants representing more than 1.1 million person-years of follow-up.
By contrast, caffeine from other foods was not associated with rosacea incidence, reported Wen-Qing Li, PhD, of the department of dermatology at Brown University, Providence, R.I., and his coinvestigators. Those findings may have implications for the “causes and clinical approach” to rosacea.
“Our findings do not support limiting caffeine intake as a preventive strategy for rosacea,” they concluded in the study, published in JAMA Dermatology.
This is not the first study looking for potential links between rosacea and caffeine or coffee intake. However, previous studies didn’t distinguish between caffeinated coffee versus other beverages, and only one previous study made a distinction between the amounts of caffeine and coffee consumed, according to the authors.
Their research was based on data from the Nurses’ Health Study II, a prospective cohort study started in 1989. They looked specifically at 82,737 women who, in 2005, responded to the question about whether they had been diagnosed with rosacea. They identified 4,945 incident rosacea cases over the 1,120,051 person-years of follow-up.
A significant inverse association was found between caffeinated coffee intake and rosacea: Individuals who consumed four or more servings a day had a significantly lower risk of rosacea, compared with those who consumed one or fewer servings per month (hazard ratio, 0.77; 95% confidence interval, 0.69-0.87; P less than .001). They also found a dose-dependent effect, with the absolute risk of rosacea decreased by 131 per 100,000 person-years with at least four daily servings of caffeinated coffee, compared with under one serving a month.
By contrast, decaffeinated coffee was not associated with a reduced risk of rosacea, and in further analysis, the investigators found that there was no significant inverse association when they looked just at caffeine intake from sources other than coffee, such as chocolate, tea, and soda.
Caffeine could influence rosacea incidence by one of several mechanisms, including its effect on vascular contractility, the investigators hypothesized. “Increased caffeine intake may decrease vasodilation and consequently lead to diminution of rosacea symptoms.”
However, caffeine also has documented immunosuppressant effects that could possibly decrease rosacea-associated inflammation and has been shown to modulate hormone levels. “Hormonal factors have been implicated in the development of rosacea, and caffeine can modulate hormone levels,” they wrote.
Two study authors reported disclosures related to AbbVie, Amgen, Astellas Pharma, Janssen, Merck, Novartis, and Pfizer, among others. Funding for the study came from several sources, including National Institutes of Health grants for the Nurses’ Health Study II.
SOURCE: Li W-Q et al. JAMA Dermatol. 2018 Oct 17. doi: 10.1001/jamadermatol.2018.3301.
This study shows an inverse association between caffeine intake and incidence rosacea, which suggests that patients with rosacea need not avoid coffee, according to Mackenzie R. Wehner, MD, and Eleni Linos, MD, MPH.
For everyone else, the findings offer yet another reason to keep indulging in one of “life’s habitual pleasures,” they wrote. “We will raise an insulated travel mug to that.”
This latest study fits in with numerous studies suggesting coffee may be protective against a number of maladies, including cancer, cardiovascular disease, type 2 diabetes, and Parkinson’s disease, they wrote in their editorial published in JAMA Dermatology.
However, this is an observational study, not a rigorous, randomized trial that could more conclusively prove coffee actually provides an antirosacea benefit that cannot be explained by other factors, such as systematic differences between people who do and do not drink coffee. Enrollment of all women, mostly white, in the Nurses’ Health Study II is another limitation, they added.
Nevertheless, studies like this are the “next-best option” in lieu of randomized, controlled trials to evaluate these relationships, they wrote. “Importantly, the strength of the protective effect noted and the dose-response relationship with increasing coffee and caffeine intake are convincing.”
Dr. Wehner , is with the department of dermatology at the University of Pennsylvania, Philadelphia. Dr. Linos is with the department of dermatology at the University of California, San Francisco. Dr. Wehner reported support from a National Institute of Arthritis and Musculoskeletal and Skin Diseases/National Institutes of Health Dermatology Research Training grant. Dr. Linos reported support from the National Cancer Institute and the National Institute of Aging.
This study shows an inverse association between caffeine intake and incidence rosacea, which suggests that patients with rosacea need not avoid coffee, according to Mackenzie R. Wehner, MD, and Eleni Linos, MD, MPH.
For everyone else, the findings offer yet another reason to keep indulging in one of “life’s habitual pleasures,” they wrote. “We will raise an insulated travel mug to that.”
This latest study fits in with numerous studies suggesting coffee may be protective against a number of maladies, including cancer, cardiovascular disease, type 2 diabetes, and Parkinson’s disease, they wrote in their editorial published in JAMA Dermatology.
However, this is an observational study, not a rigorous, randomized trial that could more conclusively prove coffee actually provides an antirosacea benefit that cannot be explained by other factors, such as systematic differences between people who do and do not drink coffee. Enrollment of all women, mostly white, in the Nurses’ Health Study II is another limitation, they added.
Nevertheless, studies like this are the “next-best option” in lieu of randomized, controlled trials to evaluate these relationships, they wrote. “Importantly, the strength of the protective effect noted and the dose-response relationship with increasing coffee and caffeine intake are convincing.”
Dr. Wehner , is with the department of dermatology at the University of Pennsylvania, Philadelphia. Dr. Linos is with the department of dermatology at the University of California, San Francisco. Dr. Wehner reported support from a National Institute of Arthritis and Musculoskeletal and Skin Diseases/National Institutes of Health Dermatology Research Training grant. Dr. Linos reported support from the National Cancer Institute and the National Institute of Aging.
This study shows an inverse association between caffeine intake and incidence rosacea, which suggests that patients with rosacea need not avoid coffee, according to Mackenzie R. Wehner, MD, and Eleni Linos, MD, MPH.
For everyone else, the findings offer yet another reason to keep indulging in one of “life’s habitual pleasures,” they wrote. “We will raise an insulated travel mug to that.”
This latest study fits in with numerous studies suggesting coffee may be protective against a number of maladies, including cancer, cardiovascular disease, type 2 diabetes, and Parkinson’s disease, they wrote in their editorial published in JAMA Dermatology.
However, this is an observational study, not a rigorous, randomized trial that could more conclusively prove coffee actually provides an antirosacea benefit that cannot be explained by other factors, such as systematic differences between people who do and do not drink coffee. Enrollment of all women, mostly white, in the Nurses’ Health Study II is another limitation, they added.
Nevertheless, studies like this are the “next-best option” in lieu of randomized, controlled trials to evaluate these relationships, they wrote. “Importantly, the strength of the protective effect noted and the dose-response relationship with increasing coffee and caffeine intake are convincing.”
Dr. Wehner , is with the department of dermatology at the University of Pennsylvania, Philadelphia. Dr. Linos is with the department of dermatology at the University of California, San Francisco. Dr. Wehner reported support from a National Institute of Arthritis and Musculoskeletal and Skin Diseases/National Institutes of Health Dermatology Research Training grant. Dr. Linos reported support from the National Cancer Institute and the National Institute of Aging.
Caffeinated coffee intake is linked to a decreased incidence of rosacea, results of a large, observational study suggest.
Increased levels of caffeinated coffee consumption were associated with progressively lower levels of incident rosacea in a study of more than 82,000 participants representing more than 1.1 million person-years of follow-up.
By contrast, caffeine from other foods was not associated with rosacea incidence, reported Wen-Qing Li, PhD, of the department of dermatology at Brown University, Providence, R.I., and his coinvestigators. Those findings may have implications for the “causes and clinical approach” to rosacea.
“Our findings do not support limiting caffeine intake as a preventive strategy for rosacea,” they concluded in the study, published in JAMA Dermatology.
This is not the first study looking for potential links between rosacea and caffeine or coffee intake. However, previous studies didn’t distinguish between caffeinated coffee versus other beverages, and only one previous study made a distinction between the amounts of caffeine and coffee consumed, according to the authors.
Their research was based on data from the Nurses’ Health Study II, a prospective cohort study started in 1989. They looked specifically at 82,737 women who, in 2005, responded to the question about whether they had been diagnosed with rosacea. They identified 4,945 incident rosacea cases over the 1,120,051 person-years of follow-up.
A significant inverse association was found between caffeinated coffee intake and rosacea: Individuals who consumed four or more servings a day had a significantly lower risk of rosacea, compared with those who consumed one or fewer servings per month (hazard ratio, 0.77; 95% confidence interval, 0.69-0.87; P less than .001). They also found a dose-dependent effect, with the absolute risk of rosacea decreased by 131 per 100,000 person-years with at least four daily servings of caffeinated coffee, compared with under one serving a month.
By contrast, decaffeinated coffee was not associated with a reduced risk of rosacea, and in further analysis, the investigators found that there was no significant inverse association when they looked just at caffeine intake from sources other than coffee, such as chocolate, tea, and soda.
Caffeine could influence rosacea incidence by one of several mechanisms, including its effect on vascular contractility, the investigators hypothesized. “Increased caffeine intake may decrease vasodilation and consequently lead to diminution of rosacea symptoms.”
However, caffeine also has documented immunosuppressant effects that could possibly decrease rosacea-associated inflammation and has been shown to modulate hormone levels. “Hormonal factors have been implicated in the development of rosacea, and caffeine can modulate hormone levels,” they wrote.
Two study authors reported disclosures related to AbbVie, Amgen, Astellas Pharma, Janssen, Merck, Novartis, and Pfizer, among others. Funding for the study came from several sources, including National Institutes of Health grants for the Nurses’ Health Study II.
SOURCE: Li W-Q et al. JAMA Dermatol. 2018 Oct 17. doi: 10.1001/jamadermatol.2018.3301.
Caffeinated coffee intake is linked to a decreased incidence of rosacea, results of a large, observational study suggest.
Increased levels of caffeinated coffee consumption were associated with progressively lower levels of incident rosacea in a study of more than 82,000 participants representing more than 1.1 million person-years of follow-up.
By contrast, caffeine from other foods was not associated with rosacea incidence, reported Wen-Qing Li, PhD, of the department of dermatology at Brown University, Providence, R.I., and his coinvestigators. Those findings may have implications for the “causes and clinical approach” to rosacea.
“Our findings do not support limiting caffeine intake as a preventive strategy for rosacea,” they concluded in the study, published in JAMA Dermatology.
This is not the first study looking for potential links between rosacea and caffeine or coffee intake. However, previous studies didn’t distinguish between caffeinated coffee versus other beverages, and only one previous study made a distinction between the amounts of caffeine and coffee consumed, according to the authors.
Their research was based on data from the Nurses’ Health Study II, a prospective cohort study started in 1989. They looked specifically at 82,737 women who, in 2005, responded to the question about whether they had been diagnosed with rosacea. They identified 4,945 incident rosacea cases over the 1,120,051 person-years of follow-up.
A significant inverse association was found between caffeinated coffee intake and rosacea: Individuals who consumed four or more servings a day had a significantly lower risk of rosacea, compared with those who consumed one or fewer servings per month (hazard ratio, 0.77; 95% confidence interval, 0.69-0.87; P less than .001). They also found a dose-dependent effect, with the absolute risk of rosacea decreased by 131 per 100,000 person-years with at least four daily servings of caffeinated coffee, compared with under one serving a month.
By contrast, decaffeinated coffee was not associated with a reduced risk of rosacea, and in further analysis, the investigators found that there was no significant inverse association when they looked just at caffeine intake from sources other than coffee, such as chocolate, tea, and soda.
Caffeine could influence rosacea incidence by one of several mechanisms, including its effect on vascular contractility, the investigators hypothesized. “Increased caffeine intake may decrease vasodilation and consequently lead to diminution of rosacea symptoms.”
However, caffeine also has documented immunosuppressant effects that could possibly decrease rosacea-associated inflammation and has been shown to modulate hormone levels. “Hormonal factors have been implicated in the development of rosacea, and caffeine can modulate hormone levels,” they wrote.
Two study authors reported disclosures related to AbbVie, Amgen, Astellas Pharma, Janssen, Merck, Novartis, and Pfizer, among others. Funding for the study came from several sources, including National Institutes of Health grants for the Nurses’ Health Study II.
SOURCE: Li W-Q et al. JAMA Dermatol. 2018 Oct 17. doi: 10.1001/jamadermatol.2018.3301.
FROM JAMA DERMATOLOGY
Key clinical point: Caffeinated coffee intake was linked to decreased incidence of rosacea, while decaffeinated coffee and noncoffee sources of caffeine had no such effect.
Major finding: Consuming four or more servings of caffeinated coffee was associated with lower risk of rosacea versus one or fewer servings per month (hazard ratio, 0.77; P less than .001).
Study details: An analysis based on 82,737 participants in the Nurses’ Health Study II who responded to a question about rosacea.
Disclosures: Two study authors reported disclosures related to AbbVie, Amgen, Astellas Pharma, Janssen, Merck, Novartis, and Pfizer, among others. Funding for the study came from National Institutes of Health grants for the Nurses’ Health Study II and other sources.
Source: Li W-Q et al. JAMA Dermatol. 2018 Oct 17. doi: 10.1001/jamadermatol.2018.3301.
Most nonemergent diagnoses can’t be predicted
Also today, opioids have a negative effect on breathing during sleep, the American Academy of Pediatrics renews its public health approach regarding gun injury prevention, and fever and intestinal symptoms can delay diagnosis of Kawasaki disease in children.
Also today, opioids have a negative effect on breathing during sleep, the American Academy of Pediatrics renews its public health approach regarding gun injury prevention, and fever and intestinal symptoms can delay diagnosis of Kawasaki disease in children.
Also today, opioids have a negative effect on breathing during sleep, the American Academy of Pediatrics renews its public health approach regarding gun injury prevention, and fever and intestinal symptoms can delay diagnosis of Kawasaki disease in children.
New cholesterol, physical activity guidelines on tap at AHA 2018
Two new guidelines are set to be presented at the American Heart Association scientific sessions in Chicago.
First up will be the first update to the controversial 2013 cholesterol guidelines, which will be presented on Saturday, Nov. 10, in two sessions.
Second, the U.S. Department of Health and Human Services will unveil its new national guidelines for physical activity on Monday, Nov. 12.
Cholesterol guidelines
For the cholesterol guidelines, the most important messages for clinical practice will be presented in a session beginning at 10:45 a.m. A second session, beginning at 5:30 p.m. on Saturday, can be considered more of a “deep dive” into the details and rationale, Donald M. Lloyd-Jones, MD, cochair of this year’s Committee on Scientific Sessions Program, said in a teleconference with reporters.
“In the 10:45 session, we plan to cover the most important take-home messages and top-line issues,” explained Dr. Lloyd-Jones, a professor of cardiology at Northwestern University, Chicago, as well as one of the authors of both the 2013 cholesterol guidelines and these updated ones.
This will include the key changes since the AHA/American College of Cardiology Guideline on the Assessment of Cardiovascular Risk guidelines were released 2013. One major update will be the inclusion of the role of PCSK9 inhibitors, which were introduced after the 2013 guidelines were written. Moreover, the new guidelines will devote attention to personalizing treatment choices, according to Dr. Lloyd-Jones.
“The deep-dive session later that day will cover such issues as risk assessment and cost effectiveness of drug treatments for specific populations,” said Dr. Lloyd-Jones, who added that case studies will be presented to illustrate how the new recommendations should affect practice.
Because of changes in risk assessment, the 2013 guidelines, which greatly expanded the candidates for lipid-lowering therapies, were labeled “controversial” in numerous critiques published in peer-reviewed journals and elsewhere. The authors of the new guidelines hope to avoid these problems.
“Since 2013, I think there have been questions about when we should use risk scores, whether there are risk scores that might be better than others, or if there are strategies of risk assessment we should be employing beyond just risk scores,” Dr. Lloyd-Jones acknowledged. “This was a big part of the discussion in developing these guidelines, and I think you will see some pretty significant advances in how we think about which patients are appropriate for treatment and which patients in whom we might think of withholding statin therapy when benefit is unlikely.”
Despite the large number of changes, Dr. Lloyd-Jones emphasized that the document will be more concise and easier to use than the guidelines from 2013.
“The organization is modular, meaning that if you have a question about a certain aspect of management, you can go straight to the recommendation, which is accompanied by very brief text to explain the rationale,” Dr. Lloyd-Jones reported. “The presentation has been very much streamlined.”
HHS Guidelines on Physical Activity
The HHS guidelines on physical activity will be presented at 9 a.m. on Monday, Nov. 12. The 2018 version will be the first update since the original guidelines were made available in 2008.
“It has been 10 years since the last set of guidelines, and I think we are all looking forward to what these new recommendations will offer,” Dr. Lloyd-Jones said. He believes that the science has progressed significantly over the past decade.
“In addition to our longstanding understanding that doing something is better than doing nothing and doing more is better than doing something, I think we have seen some really interesting data in the last 10 years on intensity and duration of exercise and how those can be considered when trying to improve health-related outcomes,” said Dr. Lloyd-Jones.
The specifics of these guidelines will not be known until they are presented on Monday, but there is abundant evidence that a healthy lifestyle is the first defense against illness in general and against cardiovascular disease in particular. Dr. Lloyd-Jones indicated that authoritative and evidence-based guidelines could prove to a useful tool for empowering patients to make changes that reduce an array of health risks not just those related to vascular disease.
Two new guidelines are set to be presented at the American Heart Association scientific sessions in Chicago.
First up will be the first update to the controversial 2013 cholesterol guidelines, which will be presented on Saturday, Nov. 10, in two sessions.
Second, the U.S. Department of Health and Human Services will unveil its new national guidelines for physical activity on Monday, Nov. 12.
Cholesterol guidelines
For the cholesterol guidelines, the most important messages for clinical practice will be presented in a session beginning at 10:45 a.m. A second session, beginning at 5:30 p.m. on Saturday, can be considered more of a “deep dive” into the details and rationale, Donald M. Lloyd-Jones, MD, cochair of this year’s Committee on Scientific Sessions Program, said in a teleconference with reporters.
“In the 10:45 session, we plan to cover the most important take-home messages and top-line issues,” explained Dr. Lloyd-Jones, a professor of cardiology at Northwestern University, Chicago, as well as one of the authors of both the 2013 cholesterol guidelines and these updated ones.
This will include the key changes since the AHA/American College of Cardiology Guideline on the Assessment of Cardiovascular Risk guidelines were released 2013. One major update will be the inclusion of the role of PCSK9 inhibitors, which were introduced after the 2013 guidelines were written. Moreover, the new guidelines will devote attention to personalizing treatment choices, according to Dr. Lloyd-Jones.
“The deep-dive session later that day will cover such issues as risk assessment and cost effectiveness of drug treatments for specific populations,” said Dr. Lloyd-Jones, who added that case studies will be presented to illustrate how the new recommendations should affect practice.
Because of changes in risk assessment, the 2013 guidelines, which greatly expanded the candidates for lipid-lowering therapies, were labeled “controversial” in numerous critiques published in peer-reviewed journals and elsewhere. The authors of the new guidelines hope to avoid these problems.
“Since 2013, I think there have been questions about when we should use risk scores, whether there are risk scores that might be better than others, or if there are strategies of risk assessment we should be employing beyond just risk scores,” Dr. Lloyd-Jones acknowledged. “This was a big part of the discussion in developing these guidelines, and I think you will see some pretty significant advances in how we think about which patients are appropriate for treatment and which patients in whom we might think of withholding statin therapy when benefit is unlikely.”
Despite the large number of changes, Dr. Lloyd-Jones emphasized that the document will be more concise and easier to use than the guidelines from 2013.
“The organization is modular, meaning that if you have a question about a certain aspect of management, you can go straight to the recommendation, which is accompanied by very brief text to explain the rationale,” Dr. Lloyd-Jones reported. “The presentation has been very much streamlined.”
HHS Guidelines on Physical Activity
The HHS guidelines on physical activity will be presented at 9 a.m. on Monday, Nov. 12. The 2018 version will be the first update since the original guidelines were made available in 2008.
“It has been 10 years since the last set of guidelines, and I think we are all looking forward to what these new recommendations will offer,” Dr. Lloyd-Jones said. He believes that the science has progressed significantly over the past decade.
“In addition to our longstanding understanding that doing something is better than doing nothing and doing more is better than doing something, I think we have seen some really interesting data in the last 10 years on intensity and duration of exercise and how those can be considered when trying to improve health-related outcomes,” said Dr. Lloyd-Jones.
The specifics of these guidelines will not be known until they are presented on Monday, but there is abundant evidence that a healthy lifestyle is the first defense against illness in general and against cardiovascular disease in particular. Dr. Lloyd-Jones indicated that authoritative and evidence-based guidelines could prove to a useful tool for empowering patients to make changes that reduce an array of health risks not just those related to vascular disease.
Two new guidelines are set to be presented at the American Heart Association scientific sessions in Chicago.
First up will be the first update to the controversial 2013 cholesterol guidelines, which will be presented on Saturday, Nov. 10, in two sessions.
Second, the U.S. Department of Health and Human Services will unveil its new national guidelines for physical activity on Monday, Nov. 12.
Cholesterol guidelines
For the cholesterol guidelines, the most important messages for clinical practice will be presented in a session beginning at 10:45 a.m. A second session, beginning at 5:30 p.m. on Saturday, can be considered more of a “deep dive” into the details and rationale, Donald M. Lloyd-Jones, MD, cochair of this year’s Committee on Scientific Sessions Program, said in a teleconference with reporters.
“In the 10:45 session, we plan to cover the most important take-home messages and top-line issues,” explained Dr. Lloyd-Jones, a professor of cardiology at Northwestern University, Chicago, as well as one of the authors of both the 2013 cholesterol guidelines and these updated ones.
This will include the key changes since the AHA/American College of Cardiology Guideline on the Assessment of Cardiovascular Risk guidelines were released 2013. One major update will be the inclusion of the role of PCSK9 inhibitors, which were introduced after the 2013 guidelines were written. Moreover, the new guidelines will devote attention to personalizing treatment choices, according to Dr. Lloyd-Jones.
“The deep-dive session later that day will cover such issues as risk assessment and cost effectiveness of drug treatments for specific populations,” said Dr. Lloyd-Jones, who added that case studies will be presented to illustrate how the new recommendations should affect practice.
Because of changes in risk assessment, the 2013 guidelines, which greatly expanded the candidates for lipid-lowering therapies, were labeled “controversial” in numerous critiques published in peer-reviewed journals and elsewhere. The authors of the new guidelines hope to avoid these problems.
“Since 2013, I think there have been questions about when we should use risk scores, whether there are risk scores that might be better than others, or if there are strategies of risk assessment we should be employing beyond just risk scores,” Dr. Lloyd-Jones acknowledged. “This was a big part of the discussion in developing these guidelines, and I think you will see some pretty significant advances in how we think about which patients are appropriate for treatment and which patients in whom we might think of withholding statin therapy when benefit is unlikely.”
Despite the large number of changes, Dr. Lloyd-Jones emphasized that the document will be more concise and easier to use than the guidelines from 2013.
“The organization is modular, meaning that if you have a question about a certain aspect of management, you can go straight to the recommendation, which is accompanied by very brief text to explain the rationale,” Dr. Lloyd-Jones reported. “The presentation has been very much streamlined.”
HHS Guidelines on Physical Activity
The HHS guidelines on physical activity will be presented at 9 a.m. on Monday, Nov. 12. The 2018 version will be the first update since the original guidelines were made available in 2008.
“It has been 10 years since the last set of guidelines, and I think we are all looking forward to what these new recommendations will offer,” Dr. Lloyd-Jones said. He believes that the science has progressed significantly over the past decade.
“In addition to our longstanding understanding that doing something is better than doing nothing and doing more is better than doing something, I think we have seen some really interesting data in the last 10 years on intensity and duration of exercise and how those can be considered when trying to improve health-related outcomes,” said Dr. Lloyd-Jones.
The specifics of these guidelines will not be known until they are presented on Monday, but there is abundant evidence that a healthy lifestyle is the first defense against illness in general and against cardiovascular disease in particular. Dr. Lloyd-Jones indicated that authoritative and evidence-based guidelines could prove to a useful tool for empowering patients to make changes that reduce an array of health risks not just those related to vascular disease.
AHA 3-day format syncs with new direction in scientific meetings
Although a day shorter than meetings over recent years, more than 4,000 abstracts, keynote addresses, special sessions, and education programs have been squeezed into 800 sessions divided into 26 tracks of interest at the American Heart Association Scientific Sessions.
“We think that, for both for the presenters as well as for the attendees, ,” explained Eric Peterson, MD, chair of this year’s Committee on Scientific Sessions Program in a teleconference with reporters.
The shorter program is just one of many substantive changes made by the program committee to enhance the value of attendance, according to Dr. Peterson, professor of medicine, Duke University, Durham, N.C. In particular, the committee worked to make the sessions more interactive.
“There will be much less of someone just standing up and delivering slides,” he said. Through phone apps that will allow the audience to pose questions and comments to speakers in every major session, “there will be more opportunities for the audience to give their impression of the science being delivered.”
From the beginning, it was the intention of the program committee “to do things differently,” according to Dr. Peterson as well as his cochair Donald M. Lloyd-Jones, MD, professor of cardiology at Northwestern University, Chicago.
“The 3-day format means full days, but I think that we have packed in some really exciting science,” said Dr. Lloyd-Jones, who described a diverse slate of programming goals. In addition to the traditional emphasis on new science, he said there will be more attention on “new management and new practice opportunities for clinicians to really hone their skills.”
Those coming to the Scientific Sessions will see a difference on the first day. In place of an awards ceremony and presidential address, which have long been staples of the opening sessions, this year’s meeting will begin with a series of simultaneous programs delving into key issues in cardiology and medical practice.
“We are starting things off with a bang with TED-like lectures given in multiple locations addressing the cutting edge of where we are with the hottest things in science,” Dr. Peterson said. “These will cover everything from how your microbiome might be affecting your risk for cardiovascular events to progress toward vaccines that might some day prevent cardiovascular disease.”
Innovative and forward-thinking programs unfold from there, according to Dr. Lloyd-Jones.
Health technology will be a common thread across all 3 days of the Scientific Sessions, according to Dr. Peterson. One of the 26 tracks of this year’s meeting, health technology is imposing fundamental shifts in medical practice and how health care is delivered.
“This is a topic that covers electronic medical records, your cell phone, and mobile wearable devices that can help us as clinicians better understand what is going on with cardiovascular disease as well as help ourselves as individuals modify our risks,” said Dr. Peterson. Within this track, session programs range from how-to instruction to a technology forum organized like the “Shark Tank” television program.
“Health technology is moving rapidly,” Dr. Peterson pointed out. He suggested that the AHA Scientific Sessions provide a unique opportunity for cardiologists to stay current with evolving strategies for efficient care.
Within the effort to update the meeting format, traditional forms of late-breaking science, particularly late-breaking trials with potentially practice changing data, will not be lost. However, Dr. Peterson indicated that he expects this year’s meeting to have a somewhat different pace and sensibility.
“We believe that what we have been doing will not work any longer, and we needed to do things differently,” Dr. Peterson said. While the shorter more concentrated program is one example, Dr. Peterson also believes that the effort to diminish the distance between those who are speaking and those who are listening will lead to a richer experience for everyone.
Although a day shorter than meetings over recent years, more than 4,000 abstracts, keynote addresses, special sessions, and education programs have been squeezed into 800 sessions divided into 26 tracks of interest at the American Heart Association Scientific Sessions.
“We think that, for both for the presenters as well as for the attendees, ,” explained Eric Peterson, MD, chair of this year’s Committee on Scientific Sessions Program in a teleconference with reporters.
The shorter program is just one of many substantive changes made by the program committee to enhance the value of attendance, according to Dr. Peterson, professor of medicine, Duke University, Durham, N.C. In particular, the committee worked to make the sessions more interactive.
“There will be much less of someone just standing up and delivering slides,” he said. Through phone apps that will allow the audience to pose questions and comments to speakers in every major session, “there will be more opportunities for the audience to give their impression of the science being delivered.”
From the beginning, it was the intention of the program committee “to do things differently,” according to Dr. Peterson as well as his cochair Donald M. Lloyd-Jones, MD, professor of cardiology at Northwestern University, Chicago.
“The 3-day format means full days, but I think that we have packed in some really exciting science,” said Dr. Lloyd-Jones, who described a diverse slate of programming goals. In addition to the traditional emphasis on new science, he said there will be more attention on “new management and new practice opportunities for clinicians to really hone their skills.”
Those coming to the Scientific Sessions will see a difference on the first day. In place of an awards ceremony and presidential address, which have long been staples of the opening sessions, this year’s meeting will begin with a series of simultaneous programs delving into key issues in cardiology and medical practice.
“We are starting things off with a bang with TED-like lectures given in multiple locations addressing the cutting edge of where we are with the hottest things in science,” Dr. Peterson said. “These will cover everything from how your microbiome might be affecting your risk for cardiovascular events to progress toward vaccines that might some day prevent cardiovascular disease.”
Innovative and forward-thinking programs unfold from there, according to Dr. Lloyd-Jones.
Health technology will be a common thread across all 3 days of the Scientific Sessions, according to Dr. Peterson. One of the 26 tracks of this year’s meeting, health technology is imposing fundamental shifts in medical practice and how health care is delivered.
“This is a topic that covers electronic medical records, your cell phone, and mobile wearable devices that can help us as clinicians better understand what is going on with cardiovascular disease as well as help ourselves as individuals modify our risks,” said Dr. Peterson. Within this track, session programs range from how-to instruction to a technology forum organized like the “Shark Tank” television program.
“Health technology is moving rapidly,” Dr. Peterson pointed out. He suggested that the AHA Scientific Sessions provide a unique opportunity for cardiologists to stay current with evolving strategies for efficient care.
Within the effort to update the meeting format, traditional forms of late-breaking science, particularly late-breaking trials with potentially practice changing data, will not be lost. However, Dr. Peterson indicated that he expects this year’s meeting to have a somewhat different pace and sensibility.
“We believe that what we have been doing will not work any longer, and we needed to do things differently,” Dr. Peterson said. While the shorter more concentrated program is one example, Dr. Peterson also believes that the effort to diminish the distance between those who are speaking and those who are listening will lead to a richer experience for everyone.
Although a day shorter than meetings over recent years, more than 4,000 abstracts, keynote addresses, special sessions, and education programs have been squeezed into 800 sessions divided into 26 tracks of interest at the American Heart Association Scientific Sessions.
“We think that, for both for the presenters as well as for the attendees, ,” explained Eric Peterson, MD, chair of this year’s Committee on Scientific Sessions Program in a teleconference with reporters.
The shorter program is just one of many substantive changes made by the program committee to enhance the value of attendance, according to Dr. Peterson, professor of medicine, Duke University, Durham, N.C. In particular, the committee worked to make the sessions more interactive.
“There will be much less of someone just standing up and delivering slides,” he said. Through phone apps that will allow the audience to pose questions and comments to speakers in every major session, “there will be more opportunities for the audience to give their impression of the science being delivered.”
From the beginning, it was the intention of the program committee “to do things differently,” according to Dr. Peterson as well as his cochair Donald M. Lloyd-Jones, MD, professor of cardiology at Northwestern University, Chicago.
“The 3-day format means full days, but I think that we have packed in some really exciting science,” said Dr. Lloyd-Jones, who described a diverse slate of programming goals. In addition to the traditional emphasis on new science, he said there will be more attention on “new management and new practice opportunities for clinicians to really hone their skills.”
Those coming to the Scientific Sessions will see a difference on the first day. In place of an awards ceremony and presidential address, which have long been staples of the opening sessions, this year’s meeting will begin with a series of simultaneous programs delving into key issues in cardiology and medical practice.
“We are starting things off with a bang with TED-like lectures given in multiple locations addressing the cutting edge of where we are with the hottest things in science,” Dr. Peterson said. “These will cover everything from how your microbiome might be affecting your risk for cardiovascular events to progress toward vaccines that might some day prevent cardiovascular disease.”
Innovative and forward-thinking programs unfold from there, according to Dr. Lloyd-Jones.
Health technology will be a common thread across all 3 days of the Scientific Sessions, according to Dr. Peterson. One of the 26 tracks of this year’s meeting, health technology is imposing fundamental shifts in medical practice and how health care is delivered.
“This is a topic that covers electronic medical records, your cell phone, and mobile wearable devices that can help us as clinicians better understand what is going on with cardiovascular disease as well as help ourselves as individuals modify our risks,” said Dr. Peterson. Within this track, session programs range from how-to instruction to a technology forum organized like the “Shark Tank” television program.
“Health technology is moving rapidly,” Dr. Peterson pointed out. He suggested that the AHA Scientific Sessions provide a unique opportunity for cardiologists to stay current with evolving strategies for efficient care.
Within the effort to update the meeting format, traditional forms of late-breaking science, particularly late-breaking trials with potentially practice changing data, will not be lost. However, Dr. Peterson indicated that he expects this year’s meeting to have a somewhat different pace and sensibility.
“We believe that what we have been doing will not work any longer, and we needed to do things differently,” Dr. Peterson said. While the shorter more concentrated program is one example, Dr. Peterson also believes that the effort to diminish the distance between those who are speaking and those who are listening will lead to a richer experience for everyone.
CMS pulls back on E/M payment proposal
Also today, exercise improves outcomes for patients with heart failure and obstructive sleep apnea, FDA panels back brexanolone infusion for postpartum depression, and sleep could be the new frontier in cardiovascular prevention.
Amazon Alexa
Apple Podcasts
Spotify
Also today, exercise improves outcomes for patients with heart failure and obstructive sleep apnea, FDA panels back brexanolone infusion for postpartum depression, and sleep could be the new frontier in cardiovascular prevention.
Amazon Alexa
Apple Podcasts
Spotify
Also today, exercise improves outcomes for patients with heart failure and obstructive sleep apnea, FDA panels back brexanolone infusion for postpartum depression, and sleep could be the new frontier in cardiovascular prevention.
Amazon Alexa
Apple Podcasts
Spotify