Helping Adolescents Get Into A Healthy Weight Range

Among adolescents aged 12-19 in the United States, the prevalence of obesity increased from 5% in the late 70s to 18.1% between 2007-2008. It has more than tripled over the last 30 years. Obese children are more likely to have: High blood pressure, high cholesterol, insulin resistance, type 2 diabetes, breathing problems, joint problems, fatty liver disease, gallstones, heartburn, and poor self-esteem. It does not stop there: Obese children are more likely to become obese adults. Obesity in adulthood is associated with many serious health conditions, such as heart disease, diabetes, and cancer. Adolescence is an excellent intervention period as this is a time when lifelong habits and a sense of self are formed. A school setting is ideal because school is where children are accessible and prepared to learn. Because losing weight may be seen as a complex and difficult process, to make this process less daunting we propose to study a simplified, stepwise approach to weight loss in adolescents

Therapeutic benefit of idebenone in patients with Leber hereditary optic neuropathy: The LEROS nonrandomized controlled trial

Leber hereditary optic neuropathy (LHON) is a mitochondrial disease leading to rapid and severe bilateral vision loss. Idebenone has been shown to be effective in stabilizing and restoring vision in patients treated within 1 year of onset of vision loss. The open -label, international, multicenter, natural history -controlled LEROS study (ClinicalTrials.gov NCT02774005) assesses the efficacy and safety of idebenone treatment (900 mg/day) in patients with LHON up to 5 years after symptom onset (N = 199) and over a treatment period of 24 months, compared to an external natural history control cohort (N = 372), matched by time since symptom onset. LEROS meets its primary endpoint and confirms the long-term efficacy of idebenone in the subacute/dynamic and chronic phases;the treatment effect varies depending on disease phase and the causative mtDNA mutation. The findings of the LEROS study will help guide the clinical management of patients with LHON

Therapeutic benefit of idebenone in patients with Leber hereditary optic neuropathy: The LEROS nonrandomized controlled trial

Leber hereditary optic neuropathy (LHON) is a mitochondrial disease leading to rapid and severe bilateral vision loss. Idebenone has been shown to be effective in stabilizing and restoring vision in patients treated within 1 year of onset of vision loss. The open-label, international, multicenter, natural history-controlled LEROS study (ClinicalTrials.gov NCT02774005) assesses the efficacy and safety of idebenone treatment (900 mg/day) in patients with LHON up to 5 years after symptom onset (N = 199) and over a treatment period of 24 months, compared to an external natural history control cohort (N = 372), matched by time since symptom onset. LEROS meets its primary endpoint and confirms the long-term efficacy of idebenone in the subacute/dynamic and chronic phases; the treatment effect varies depending on disease phase and the causative mtDNA mutation. The findings of the LEROS study will help guide the clinical management of patients with LHON

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Implementation of a walking school bus: lessons learned.

BACKGROUND: Obesity is rapidly becoming the most common chronic medical condition affecting children. To address this crisis, an Albuquerque, New Mexico, elementary school partnered with University of New Mexico researchers and conducted a Walking School Bus (WSB). The purpose of this article is to examine the feasibility of implementing a WSB. METHODS: This pilot study featured 2 WSBs conducted for 10 weeks with kindergarten through fifth-grade students from a predominantly Hispanic elementary school. Qualitative and quantitative data, including coordinator field notes, attendance records, surveys of student and parent satisfaction, and a focus group, were used to evaluate feasibility. RESULTS: Student and adult participants expressed a high degree of enthusiasm regarding their involvement in the WSB. Participants uniformly indicated that the WSB provided a supportive and safe environment to promote social interaction and physical activity. Conducting a WSB in an urban, underserved school district is feasible but requires attention to ensure participants\u27 involvement and safety. In particular, it is recommended to begin the planning process early to enhance investment from key stakeholders. CONCLUSION: Effective, low-cost interventions are increasingly desired as solutions to the problem of obesity. The WSB has emerged as a promising strategy to address obesity and encourage partnerships across different social levels. Further research is necessary to assess the logistical challenges associated with conducting a large-scale WSB trial and whether such efforts lead to reductions in obesity risk factors

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

Vitamin K antagonist control in patients with atrial fibrillation in Asia compared with other regions of the world: Real-world data from the GARFIELD-AF registry

Objective: To compare the distribution of international normalized ratios (INRs) in patients receiving vitamin K antagonist (VKA) for newly diagnosed atrial fibrillation in Eastern and Southeastern Asia and in other regions of the world (ORW) represented in the ongoing, global observational study GARFIELD-AF

Evolving antithrombotic treatment patterns for patients with newly diagnosed atrial fibrillation

Objective We studied evolving antithrombotic therapy patterns in patients with newly diagnosed non-valvular atrial fibrillation (AF) and >= 1 additional stroke risk factor between 2010 and 2015