Australian Scientists Discover New Disease
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Extreme laziness may have a medical basis, say a group of Australian scientists in this week’s BMJ, as they describe a new condition called motivational deficiency disorder (MoDeD).
The condition is claimed to affect up to one in five Australians and is characterised by overwhelming and debilitating apathy. Neuroscientists at the University of Newcastle in Australia say that in severe cases motivational deficiency disorder can be fatal, because the condition reduces the motivation to breathe.
Neurologist Leth Argos is part of the team that has identified the disorder. “This disorder is poorly understood,” he says. “It is underdiagnosed and undertreated.”
Serum tumor markers predict extravesical disease in clinical stage T2 bladder cancer
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Bladder cancer clinical staging is notoriously poor in patients with muscle invasive disease.
While prospective randomized trials have demonstrated a small survival benefit when neoadjuvant chemotherapy strategies are employed, the selection criteria for preoperative chemotherapy are not well defined. Improving clinical staging with novel imaging or laboratory modalities remains a challenge.
In the April issue of the Journal of Urology, Margel and colleagues evaluated the utility of preoperative levels of CEA, CA-125 or CA 19-9 to predict extravesical disease in patients with clinical stage T2 bladder cancer. Quantitative beta-hcg was not measured. Serum levels of these markers were measured in 91 patients treated with radical cystectomy. Of these patients, 51% (46) had disease localized to the bladder and 49% had extravesical disease. Nineteen percent of patients had evidence of lymph node metastases.
Underutilization of partial nephrectomy for localized renal cell carcinoma in the U.S.
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In the past, the gold standard for the treatment of localized renal tumors has been radical nephrectomy. Over time however, experience with nephron sparing surgery and, now, laparoscopic approaches have demonstrated oncologic equipoise and may provide for an improved quality of life for patients as compared to those undergoing radical nephrectomy for localized renal masses.
The incidence of localized small renal tumors is increasing (3.8-5.6% annually) and one would predict that the incidence of nephron sparing approaches would increase in concert. Though more technically demanding than radical nephrectomy, nephron sparing offers the intuitive benefit of maximizing residual functioning renal tissue, while maintaining cancer control. A recent evaluation of the SEER database revealed that in 2001, 58% of patients with tumors < 2cm, and 80% of patients with tumors 2-4 cm were managed with radical nephrectomy. This study by Hollenbeck and colleagues suggests that while the use of nephron sparing approaches in the management of small renal masses has increased, it remains underutilized and very much regionalized to urban, teaching, high volume centers in the United States.
UK Plans for Pandemic Flu Don’t Go Far Enough
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The UK’s contingency plans for pandemic flu don’t go far enough, argues a director of public health in this week’s BMJ.
Plans for pandemic flu in the United Kingdom are said to be among the best in the developed world, but important lessons from the past have been missed, writes Hilary Pickles. These include the need to prepare for high death rates, being open with the public, and understanding population behaviour. Clear and appropriate accountability and communications are also needed, she concludes.
In response, David Salisbury, Director of Immunisation at the Department of Health, argues that preparedness has been strengthened through cross government working, enhanced communications, and international cooperation.
Real Battle Over Mental Health Law About to Begin
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The UK government’s climb down on reform of mental health legislation is not a victory - the real battle is about to begin, warns a senior doctor in this week’s BMJ.
The UK government’s announcement that it has abandoned its eight year attempt to achieve a new Mental Health Act for England and Wales is an apparent victory for patients, professionals, and liberal democracy, writes Professor Nigel Eastman of St George’s Hospital, London.
But faced with almost unanimous opposition from those with an interest in mental health care, the government has stated that it will instead introduce a shortened and streamlined bill amending the 1983 Mental Health Act.
Treatment reduces gastric ulcers in at-risk patients using long-term NSAIDS
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Results from two clinical trials, to be published in the April 2006 edition of the American Journal of Gastroenterology, indicate that esomeprazole magnesium can reduce the incidence of gastric (stomach) ulcers in patients at risk of developing gastric ulcers and who regularly take either non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) or COX-2-selective NSAIDs.
NSAIDs are a class of pain relief medications that include traditional, non-selective drugs, such as ibuprofen, naproxen and aspirin, and newer COX-2-selective agents. Nonselective NSAIDs are known for increasing the risk of gastric ulcers, particularly among older patients who take them regularly or who have a history of gastric ulcers.
Pooled data from the double-blind, randomized, six-month trials showed that significantly fewer patients taking either NEXIUM 20 mg or NEXIUM 40 mg, in addition to their regular non-selective NSAID/selective-COX-2 therapy, developed an ulcer at six months, compared to those taking a placebo (5.2 percent and 4.6 percent, respectively, vs. 17 percent, p<0.001). These differences were seen as early as the first month of treatment and maintained throughout the study duration.
Minimal genome should be twice the size
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The simplest bacteria need almost twice as many genes to survive than scientists first believed, according to new research published in Nature (30 March 2006).
Bacteria are some of the simplest forms of life and have been studied by scientists trying to identify the smallest collection of genes - or minimal genome - that is needed for maintaining life.
Traditionally scientists have done this by removing, or ‘knocking out’, a series of individual genes from a bacterial genome to see what effect this has on its ability to survive.
Calcium, dairy may curb colon cancer risk
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Men with high levels of calcium and dairy foods in their diet have a lower risk of colorectal cancer, research suggests.
Recent studies have generally reported a “modest inverse association between calcium intake and the risk of colorectal cancer,” Dr. Susanna C. Larsson, of Karolinska Institute, Stockholm, and colleagues note in the American Journal of Clinical Nutrition. “However, findings pertaining to specific subsites in the colorectum have been conflicting.”
The researchers studied the association between calcium and dairy foods and colorectal cancer risk in 45,306 Swedish men. The men were between 45 and 79 years of age and free of cancer at baseline.
Two-pronged approach may curb social phobia
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Research suggests that D-cycloserine may be a good adjunct to exposure-based therapy in individuals with social anxiety disorder, a debilitating condition marked by an excessive fear and avoidance of situations in which a person feels he or she will be judged by others, such as public speaking or even eating in front of others.
Exposure therapy, which is commonly used to combat social phobia, relies on extinction to treat the fears underlying the disorder.
Lead investigator Dr. Stefan G. Hofmann of Boston University told Reuters Health that in conducting the study “we argued that D-cycloserine ... which facilitates extinction learning in animals, should also enhance the effects of exposure therapy for social anxiety disorder in humans. Our findings seem to support this notion.”
Why stress exacerbates asthma in kids
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It is known that stress exacerbates the symptoms of asthma in children, but the biological reason for this has been unknown. Now, scientists in Canada have discovered that a stressful home life diminishes the expression of certain proteins on the surface of cells that regulate airway responses and inflammation.
“Collectively, these findings suggest that in children and adolescents with asthma, the quality of home life and family relationships are important determinants of health and well-being and appear to have stronger effects than other life domains, such as academics and peer relationships,” conclude Drs. Gregory E. Miller and Edith Chen, from the University of British Columbia in Vancouver.
They interviewed 39 children with asthma and 38 healthy children, ages 9 to 18, regarding acute and chronic stress over the preceding 6 months. Blood specimens were obtained to measure levels of the so-called glucocorticoid receptor and beta-2-adrenergic receptor.
Czechs confirm first case of H5N1 bird flu strain
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Tests on a dead swan have confirmed the Czech Republic’s first case of the H5N1 strain of the bird flu virus, the Agriculture Ministry said on Wednesday.
The swan was found near the southern town of Hluboka Nad Vltavou, on the Vltava river.
Neighbours Austria, Slovakia, Poland and Germany have already confirmed cases of the virus.
Carrying multiple babies risky for mom: study
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Women with multifetal pregnancies have a higher risk of pregnancy-related death than those with singleton pregnancies, according to a report in the journal Obstetrics and Gynecology.
“This higher risk was seen across the board, regardless of age, race, marital status and level of education,” lead author Andrea P. MacKay, from the National Center for Health Statistics at the Center for Disease Control and Prevention in Hyattville, Maryland, told Reuters Health.
In the past 20 years, twin birth rates have increased 55 percent in the United States and other higher order birth rates increased 388 percent, according to the authors.
SARS prepares Toronto for bird flu
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oronto’s deadly brush with the SARS virus three years ago has uniquely prepared the city for the possibility of a bird flu pandemic, health officials say.
Drawing on lessons from the 2003 outbreak of Severe Acute Respiratory Syndrome, city and provincial experts promise new screening measures, emergency plans to treat patients from home and tough laws detailing what health workers must do.
Rules still under government debate could ban travel, fix prices and order health-care professionals to provide necessary services in the event of a pandemic.
Brain development patterns differ in smartest kids
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A new study ties intelligence to the speed of brain changes in childhood and the teen years, rather than the size of the brain itself.
During childhood and adolescence, the cerebral cortex—the outer layer of the brain, which is involved in learning, language, attention and other higher-order skills, and is also known as the gray matter—gets thicker and thicker until it reaches a peak, and then thins out again. In the current study of 629 brain scans from 307 healthy young people, Dr. Philip Shaw of the National Institutes of Mental Health in Bethesda, Maryland and his colleagues found this process happened more rapidly and dramatically in the most intelligent individuals.
Protein linked to cancer spread identified
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Scientists have identified and blocked the action of a protein linked to the spread of breast, prostate and skin cancer cells to the bones.
The molecule called RANKL is produced in bone marrow. In studies of mice, researchers from Austria and Canada showed that inhibiting the protein could stop the cancerous cells from migrating to the bones.
“RANKL is a protein which tells tumor cells to come to it,” said Professor Josef Penninger, of the Austrian Academy of Sciences in Vienna.
