New CDC Study Assesses Impact of Genetic Testing on Health Outcomes
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Some genomic tests developed to personalize medical decisions about cancer care are beneficial, while for others the evidence is uncertain and reliance on the test might even lead to poorer medical management of cancer in some cases, according new recommendation statements from an expert panel. The statements appear in the January issue of Genetics in Medicine, the official peer-reviewed journal of The American College of Medical Genetics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
Genetic tests for tumor gene expression in women with early-stage breast cancer to detect those at risk for cancer recurrence, the panel wrote, are based on insufficient evidence to determine whether they offer any improvement in health outcomes. The panel also found insufficient evidence to recommend testing for variants of the gene UGT1A1 in patients undergoing chemotherapy for metastatic colorectal cancer to inform use of the chemotherapy drug irinotecan. While the test might be useful in identifying patients at risk of side effects from the drug, reducing irinotecan dosage may be more harmful than the side effects, so the clinical utility of the UGT1A1 test is questionable, at best, it said.
On the other hand, genetic testing for Lynch syndrome, a hereditary condition that increases the risk of colorectal cancer, is useful to recommend screening relatives for the mutations that cause the syndrome and encouraging them to have regular colorectal cancer exams, the panel found.
Predicting the Future Spread of Infectious-Disease Vectors
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As global warming raises concerns about potential spread of infectious diseases, a team of researchers has demonstrated a way to predict the expanding range of human disease vectors in a changing world.
Researchers from Australia and the University of Wisconsin-Madison have identified the key biological and environmental factors constraining a population of the dengue fever vector, the mosquito Aedes aegypti. In a study publishing online Jan. 28 in the British Ecological Society’s journal Functional Ecology, they report that climate changes in Australia during the next 40 years and the insect’s ability to adapt to new conditions may allow the mosquitoes to expand into several populated regions of the continent, increasing the risk of disease transmission.
While the current study focuses on the Australian population of the dengue mosquito, these mosquitoes live around the world and present a global threat similar in scope to malaria, according to the Centers for Disease Control and Prevention. Study author and UW-Madison zoologist Warren Porter says that the Australian findings are likely to apply to other worldwide mosquito populations as well.
Mobile phone use not linked to eye cancer
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German investigators have reversed their previous finding that the use of mobile phones appears to be associated with an increased risk of developing melanoma of the eye (uveal melanoma); new results indicate that the association does not exist.
“We recently reported an increased risk of uveal melanoma for subjects who reported frequent use of mobile phones at work,” Dr. Andreas Stang, of Martin-Luther-University of Halle-Wittenberg, and colleagues note in the current Journal of the National Cancer Institute.
“However, this study suffered from incomplete exposure assessment and relatively low statistical power due to low exposure prevalence, which triggered some discussion about the validity of these findings,” they add.
Bilingual children more likely to stutter
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Young bilingual children have a heightened risk of stuttering, according to a new study. These children also have less chance of recovery from stuttering than monolingual speakers who stutter.
Bilingualism is considered a risk factor for stuttering, Dr. Peter Howell, of University College London, and colleagues point out in the Archives of Disease in Childhood, but “there is little information about how a second language affects the chances of stuttering onset and of recovery.”
Howell and colleagues studied a total of 317 children between the ages of 8 and 12 years who stuttered. The 69 children who were bilingual were matched to a group of fluent bilingual controls.
Scientists want DNA tests on Galileo for “eye test”
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Italian and British scientists want to exhume the body of 16th century astronomer Galileo for DNA tests to determine if his severe vision problems may have affected some of his findings.
The scientists told Reuters on Thursday that DNA tests would help answer some unresolved questions about the health of the man known as the father of astronomy, whom the Vatican condemned for teaching that the earth revolves around the sun.
“If we knew exactly what was wrong with his eyes we could use computer models to recreate what he saw in his telescope,” said Paolo Galluzzi, director of the Museum of History and Science in Florence, the city where Galileo is buried.
Sleep disordered breathing and obesity: Independent effects, causes
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In a study that addressed the issue of insulin sensitivity with respect to sleep disordered breathing (SDB), Naresh Punjabi, M.D., Ph.D. sought to examine the relationship between SDB and insulin resistance using the best tools at his disposal to do so.
The results definitively link SDB to pre-diabetic changes in insulin production and glucose metabolism. It was published in the first issue for February of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
“In the past researchers have used body mass index, or BMI, as a proxy measure for body fat, but we know this to be a variable and crude tool to assess the true percentage of body fat,” said Dr. Punjabi. “In addition, previous studies have used surrogate measurements to assess the body’s response to insulin without investigating the interaction that occurs between reduced insulin sensitivity and increased insulin production in the body.”
ARDS mortality is unchanged since 1994
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Mortality in patients with acute respiratory distress syndrome (ARDS) has not fallen since 1994, according to a comprehensive review of major studies that assessed ARDS deaths. This disappointing finding contradicts the common wisdom that ARDS mortality has been in steady decline.
The study was published in the first issue for February of the American Journal of Respiratory and Critical Care Medicine.
The authors reviewed all prospective observational and randomized controlled trials between 1984 and 2006 that included more than 50 ARDS/ALI patients and reported mortality.
How natural oils can be hydrogenated without making unhealthy trans fats
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To prolong the shelf life of foods, manufacturers often add hydrogen to natural oils, a process called hydrogenation. But hydrogenation also results in the production of trans fats, which have adverse health effects such as raising bad cholesterol and increasing the risk for coronary heart disorders.
Trans fats are found in vegetable shortenings, some margarines, crackers, cookies and snacks. Health authorities worldwide recommend that people reduce their consumption of trans fats.
Now UC Riverside chemists have designed a catalyst – a substance that accelerates a chemical reaction – that allows hydrogenated oils to be made while minimizing the production of trans fats.
Physicians Agree Moderate Weight Loss Will Help Patients Manage Their Type 2 Diabetes
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Physicians say they are counseling their overweight type 2 diabetes patients to lose weight, but patients say that the message is not getting through, according to a new survey announced today by the Behavioral Diabetes Institute.
Eight in 10 physicians surveyed said that they discuss weight issues with their patients every/almost every visit, yet half as many patients – only four in 10 – report having these discussions with such frequency. In particular, roughly half of overweight patients and a third of obese patients say their physician seldom or never discusses their weight with them.
Almost all of surveyed physicians (85 percent) acknowledge that losing even a little weight can help manage type 2 diabetes. When discussing weight issues with their patients, 90 percent of physicians surveyed report that they tell their overweight patients to lose weight. However, when the surveyed patients were asked whether or not their doctor ever suggested that they lose weight, only 66 percent of them said yes.
Help Possible for People Obsessed With Imaginary Physical Flaws
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Worrying about a bad hair day or idly wishing for a more-perfect profile: we’ve all been there. However, people suffering from body dysmorphic disorder go far beyond that, obsessing over exaggerated or even imaginary physical defects, to the point where it affects their ability to work, attend school or have ordinary social contacts.
Now, a new review finds that both drug therapy and psychotherapy, alone or in combination, can effectively treat the condition. Moreover, treatment can bring be long-lasting relief, according to the South African research team.
“The key finding that treatment effects were maintained over a 4.5 month follow-up [period] after 12 weeks of cognitive behavioral psychotherapy indicates that such therapy may be effective in preventing remission over the longer term,” said lead reviewer Jonathan Ipser, whose work at the University of Stellenbosch in Tygerberg encompasses stress and anxiety disorders.
Experimental Therapy Turns on Tumor Suppressor Gene in Cancer Cells
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Researchers at Mayo Clinic have found that the experimental drug they are testing to treat a deadly form of thyroid cancer turns on a powerful tumor suppressor capable of halting cell growth. Few other cancer drugs have this property, they say.
In the Feb. 15 issue of Cancer Research (available online Jan. 20), they report that RS5444, being tested in a Phase 1/2 clinical trial to treat anaplastic thyroid cancer, might be useful for treating other cancers. The agent is also known as CS-7017.
From previous research, the investigators knew that RS5444 binds to a protein known as PPAR-gamma, a transcriptional factor that increases the expression of many genes. They had found that human anaplastic thyroid tumor cells treated with RS5444 expressed a protein known as p21, which inhibited cell replication and tumor growth. But they did not understand how. They have now discovered that the agent actually forces PPAR-gamma to turn on the RhoB tumor suppressor gene, which in turn induces p21 expression.
Scientists find way to remove lead from blood
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South Korean scientists may have found a way to remove dangerous heavy metals such as lead from blood by using specially designed magnetic receptors.
The receptors bind strongly to lead ions and can be easily removed, along with their lead cargo, using magnets, they wrote in an article in Angewandte Chemie International Edition, a leading chemistry journal.
“Detoxification could theoretically work like hemodialysis: the blood is diverted out of the body and into a special chamber containing the biocompatible magnetic particles,” they wrote in a statement.
In-home counseling and peer support keep postnatal depression in check
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In-home counseling by health visitors trained to identify depression in new mothers reduces the prevalence of postnatal depression at 12 months, according to a trial in the UK, while a Canadian study indicates that telephone-based peer support is also effective in preventing postnatal depression among women at risk.
Both studies are reported in the January 16 issue of BMJ Online First.
To determine the long-term effectiveness of an in-home psychological intervention for postnatal depression, Dr. C. Jane Morrell at the University of Huddersfield and colleagues conducted a prospective, cluster-randomized trial among 4084 women from 101 general practices near Trent, England.
“Health visitors are qualified nurses, with special experience in child health, health promotion and health education, employed as part of the NHS community health service,” Dr. Morrell told Reuters Health. “Part of a health visitor’s role is to visit families with new babies, in their home, as part of routine child health surveillance.”
No drop in US preterm births, 2006 stats show
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The Centers for Disease Control and Prevention’s newest statistics on US births show that preterm births continue to rise, while C-sections accounted for 31.1 percent of births in 2006-an all-time high.
Since 1990, there has been a 20 percent increase in the percentage of babies born preterm, or before 37 weeks gestation. Most of this rise has been driven by so-called “late-preterm” births, or infants born between 34 and 36 weeks’ gestation, Joyce A. Martin and colleagues from the CDC’s Division of Vital Statistics note in the January 7 issue of National Vital Statistics Reports.
There were nearly 4.3 million babies born in the US in 2006, the report shows, the largest number in more than four decades. While the Healthy People 2010 set a goal of 7.6 percent of babies born preterm, the actual 2006 number was far higher, with 12.8 percent of babies born before 37 weeks in the womb.
Oral immunotherapy promising for children with milk allergy
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Oral immunotherapy for cow’s milk allergy appears to effectively desensitize allergic children, a new study indicates, although further work is needed to determine the best dosing, duration of therapy, and whether permanent tolerance can be achieved, the study team emphasizes.
Twenty children, 6 to 17 years of age, with a known history of milk allergy were randomly assigned to placebo or to milk in a three-phase dosing schedule. On the first day, a dose of 0.4 mg milk protein was administered, and escalated about every 30 minutes to a maximum first-day dose of 50 mg.
Home dosing was then initiated at the highest tolerated dosage, followed by 8 weekly in-office dose increases to a maximum of 500 mg. Once a dose of 500 mg (equivalent to 15 mL of milk) was achieved, participants remained on this daily maintenance dose for 13 weeks.
