New device to test blood can spot cancer cells, HIV on the fly
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A Harvard bioengineer and an MIT aeronautical engineer have created a new device that can detect single cancer cells in a blood sample, potentially allowing doctors to quickly determine whether cancer has spread from its original site.
The microfluidic device, described in the March 17 online edition of the journal Small, is about the size of a dime, and could also detect viruses such as HIV. It could eventually be developed into low-cost tests for doctors to use in developing countries where expensive diagnostic equipment is hard to come by, says Mehmet Toner, professor of biomedical engineering at Harvard Medical School and a member of the Harvard-MIT Division of Health Sciences and Technology.
Toner built an earlier version of the device four years ago. In that original version, blood taken from a patient flows past tens of thousands of tiny silicon posts coated with antibodies that stick to tumor cells. Any cancer cells that touch the posts become trapped. However, some cells might never encounter the posts at all.
Smoking in combination with immunosuppression poses greater risk for transplant-related carcinoma
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Spanish researchers have found that liver transplant recipients who quit smoking have a lower incidence of smoking-related malignancies (SRM) than patients who keep smoking. In fact, SRMs were identified in 13.5% of deceased patients and smoking was associated with a higher risk of malignancy in this study. Full findings are published in the April issue of Liver Transplantation, a journal of the American Association for the Study of Liver Diseases.
While smoking is a well-known malignancy risk factor both in the general population and in liver transplant recipients, smoking in combination with immunosuppression is presumed to be the main risk factor for transplant-related carcinomas. Several authors have suggested that a longer duration of immunosuppressive treatment or a stronger immunosuppression could be related to a higher risk of malignancy. However, the Spanish researchers failed to find such an association. Rather, they suggest that smoking after transplant which increases the risk, and smoking cessation following transplant surgery which decreases the risk, are more significant indicators.
“Smoking is related to some of the most frequent causes of post-transplant malignancy,” says study leader Dr. J. Ignacio Herrero of the Clínica Universidad de Navarra in Pamplona, Spain. “We investigated whether the risks of developing malignancies was different in patients who ceased smoking than in patients who maintained smoking after transplantation.” Risk factors of lung, head and neck, esophagus, kidney and urinary tract (other than prostate) cancers after liver transplantation were examined in the present study.
Study shows secondhand smoke a serious health threat to casino workers, patrons
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Hitting the tables could be as risky for your health as it is for your pocketbook, according to new research from Stanford and Tufts showing pervasive secondhand smoke in casinos poses a grave health threat to patrons and employees.
In the study (subscription required), researchers covertly measured pollution levels in 66 casinos, including three smoke-free establishments, in five states. Combining this data with previously published measurements from three other states, the team developed nationwide averages and ranges for pollution levels inside casinos. An article in today’s Stanford Report discusses the findings:
Research finds ‘dispense as written’ prescriptions may add $7.7 billion to annual health care costs
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Approximately five percent of prescriptions submitted by CVS Caremark Pharmacy Benefit Management (PBM) members in a 30-day period during 2009 included a “dispense as written” (DAW) designation. This practice – whereby doctors or patients demand the dispensing of a specific brand-name drug and not a generic alternative – costs the health care system up to $7.7 billion annually, according to a new study by researchers at Harvard University, Brigham and Women’s Hospital and CVS Caremark. Moreover, these requests reduce the likelihood that patients actually fill new prescriptions for essential chronic conditions.
In a study published this week in the American Journal of Medicine, the researchers demonstrate that DAW designations for prescriptions have important implications for medication adherence. They found that when starting new essential therapy, chronically ill patients with DAW prescriptions were 50 to 60 percent less likely to actually fill the more expensive brand name prescriptions than generics. “Although dispense as written requests would seem to reflect a conscious decision by patients or their physicians to use a specific agent, the increased cost sharing that results for the patient may decrease the likelihood that patients actually fill their prescriptions,” the researchers said.
“This study shows that dispense as written requests are costing the health care system billions,” said William H. Shrank, MD, MSHS, of Brigham and Women’s Hospital and Harvard, and the study’s lead author. “The further irony is that patients with prescriptions specifying a certain brand seem less likely to fill their initial prescriptions, adding to the medication non-adherence problem.”
Johns Hopkins scientists link DNA ‘end-caps’ length to diabetes risk
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New evidence has emerged from studies in mice that short telomeres or “caps” at the ends of chromosomes may predispose people to age-related diabetes, according to Johns Hopkins scientists.
Telomeres are repetitive sequences of DNA that protect the ends of chromosomes, and they normally shorten with age, much like the caps that protect the end of shoelaces. As telomeres shorten, cells lose the ability to divide normally and eventually die. Telomere shortening has been linked to cancer, lung disease, and other age-related illnesses. Diabetes, also a disease of aging, affects as many as one in four adults over the age of 60.
The Johns Hopkins research, described in the March 10 issue of PLoS One, arose from scientist Mary Armanios’ observation that diabetes seems to occur more often in patients with dyskeratosis congenita, a rare, inherited disease caused by short telomeres. Patients with dyskeratosis congenita often have premature hair graying and are prone to develop early organ failure.
Researchers develop a halometer that tests alterations in night vision
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Researchers from the Department of Optics of the University of Granada, belonging to the Laboratorio de Ciencias de la Visión y Aplicaciones, have developed a programme for testing alterations in night vision, and the tool required to implement it, which has been named “halometer”.
This instrument consists on a software named Software Halo v1.0, and a computer where the mouse is used as a response button, and a chin cup with a forehead holder to fix the observer’s position. Software Halo v1.0 was initially presented as freeware available on LabVisGra’s website at http://www.ugr.es/local/labvisgr and at the University of Granada’s institutional repository at http://digibug.ugr.es/handle/10481/5478. Nevertheless, it was recently released by the Free-Software Bureau of the University of Granada so, it has become a scientific freeware application.
This software was developed by a group coordinated by Rosario González Anera, receiving technical support of the Granadian company Seven Solutions and of an ophthalmological clinic set in Madrid and named Novovision. The research group was integrated by researchers José Juan Castro, Carolina Ortiz and Aixa Alarcón, and receives fundings from the regional government of Economy, Innovation and Science of the Junta de Andalucía.
Protein associated with allergic response causes airway changes in asthma patients
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Changes that occur in the airways of asthma patients are in part caused by the naturally occurring protein interleukin-13 (IL-13) which stimulates invasion of airway cells called fibroblasts, according to a study conducted by researchers at Duke University. The study is the latest effort by researchers to better understand the processes that are involved in airway remodeling that can cause breathing difficulties in patients with asthma. The findings were published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.
“In the present study, we show for the first time that airway fibroblasts, isolated directly from patients with asthma and stimulated with IL-13, invade in significantly greater numbers than those isolated from normal control subjects,” said Jennifer Ingram, PhD, assistant research professor of medicine at Duke University.
“In this novel mechanism of airway remodeling in asthma patients, IL-13 acts in combination with other mediators produced by cells in the airways: transforming growth factor-β1 (TGF-β1), which causes cellular changes, and matrix metalloproteinases (MMPs), which act to break down proteins,” she added. “Together, these agents cause cellular changes that lead to loss of lung function in asthma patients.”
Injured patients fare slightly better on weekends
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Injured patients who are treated by trauma teams at hospitals are less likely to die when they are admitted on weekends versus weekdays, new research from Pennsylvania shows.
The results contrast with studies of intensive care units and stroke patients that have revealed a “weekend effect,” in which patients landing in the hospital from Friday night to Monday morning are more likely to have complications or die (see Reuters Health reports, July 6, 2010 and November 1, 2010).
The researchers looked at records from Pennsylvania hospitals, including more than 90,000 patients over a 5-year period. All the patients came in with an injury, for instance from a gunshot or car accident.
Terumo to stop selling two cardiac products in US
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A U.S.-based unit of Terumo Corp said it has entered into a consent decree with the U.S. Food and Drug Administration and agreed to stop selling two of its products used in cardiopulmonary bypass surgery.
The consent decree stems from concerns raised by the FDA about quality system procedures at Terumo Cardiovascular Systems’ manufacturing plant in Ann Arbor, Michigan.
The products that can no longer be sold are the CDI 101 Hematocrit Oxygen Saturation Monitoring System and the Tenderflow Pediatric Arterial Cannulae. Cannulae are devices inserted into the heart to facilitate blood flow during surgery.
Commentary on Unique Contributions of Different Types of Evidence to Research Conclusions
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Charles H. Hennekens, M.D., DrPH, the first Sir Richard Doll Research Professor of Medicine in the Charles E. Schmidt College of Medicine at Florida Atlantic University, has published a commentary for clinicians in this week’s issue of The Journal of the American Medical Association (JAMA). In the commentary titled “Statistical Association and Causation: Contributions of Different Types of Evidence,” Hennekens describes the unique contributions, as well as strengths and limitations, of different types of evidence to research conclusions. According to Science Watch, Hennekens was the 3rd most widely cited medical researcher in the world from 1995-2005, and five of the top 20 were his former trainees and/or fellows.
Hennekens explains how each type of evidence contributes to a different piece of the puzzle and cautions against over interpretation of studies not designed in advance to test a particular research question. He further explains which type of evidence can be used to conclude whether there is a valid statistical association, as well as how to rely on the totality of evidence to judge causality. Hennekens also emphasizes that when the totality of evidence is sufficient, health care providers can make the most rational decisions for individual patients, and policy makers can make the most rational decisions for the health of the general public.
Blue Shield California withdraws planned rate hikes
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Blue Shield of California, a nonprofit health insurer, has withdrawn plans to raise rates for its individual and family policies this year, citing a commitment to make reform work and keep costs down.
The insurer, which has 340,000 individual and family-plan members in California, had filed with state officials earlier this year to raise rates by as much as 59 percent.
Blue Shield said the previously proposed increases reflected a two-year cumulative average increase of about 30 percent.
Dine or dash? Genes help decide when to look for new food
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For worms, choosing when to search for a new dinner spot depends on many factors, both internal and external: how hungry they are, for example, how much oxygen is in the air, and how many other worms are around. A new study demonstrates this all-important decision is also influenced by the worm’s genetic make-up.
In the simple Caenorhabditis elegans nematode, the researchers found that natural variations in several genes influence how quickly a worm will leave a lawn of bacteria on which it’s feeding. One of the genes, called tyra-3, produces a receptor activated by adrenaline - a chemical messenger involved in the ‘fight-or-flight’ response. The findings appeared online March 16, 2011, in the journal Nature.
“What’s encouraging to us about this story is that molecules related to adrenaline are implicated in arousal systems and in decision-making across a lot of different animals, including humans,” says Howard Hughes Medical Institute investigator Cornelia Bargmann of Rockefeller University in New York, who mentored the work of graduate student Andres Bendesky. These parallels between diverse species suggest that aspects of our decision-making abilities have ancient evolutionary roots.
New insights into cancer treatment
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Leuven - Jean-Christophe Marine (VIB, K.U.Leuven) strongly argues against the use of Cop1-inhibitory drugs. The protein Cop1 has –for a long time - been seen as an attractive drug target for cancer. But Jean-Christophe Marine found out that Cop1 acts as a tumor suppressor, and thus inhibits tumor formation. His new data will have direct implications for the development of cancer drug targets.
Tumorigenesis: loss of control
Tumors form when control over the cell division is lost; a process that could be compared to losing control over the speed of your car. Two main players are involved; oncogenes which could be compared to the gas pedal of the car. A defective oncogene would be analogous to a gas pedal that is stuck in the ‘on’ position. In such a situation the tumor suppressor genes function as the brakes of the car - they keep the cell from dividing even in response to oncogene activation. If the brakes fail, the car goes out of control; similarly, when something goes wrong with the tumor suppressor genes, cell division gets out of control.
Cop1: brake or gas pedal?
Although Cop1 has been implicated in tumorigenesis, its precise role has remained a conundrum. Biochemical studies had shown that Cop1 promotes the degradation of target proteins. These studies, however, have yielded conflicting results leaving an open question as to whether Cop1 degrade tumor suppressors or oncogenes.
Teens and young adults with cancer face unique challenges and require targeted care
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Adolescents and young adults are neither children nor adults and those affected by cancer require targeted care that crosses the boundaries between pediatric and adult oncology, according to several pioneers in this still-developing field of adolescent and young adult oncology. An illuminating roundtable discussion by these experts will be published in the premier issue of Journal of Adolescent and Young Adult Oncology, a multidisciplinary peer-reviewed publication of Mary Ann Liebert, Inc. (http://www.liebertpub.com). The Roundtable has been published ahead of the print issue and is available at http://www.liebertpub.com/JAYAO. The full issue will launch in April 2011.
“AYA cancer presents the medical community with several unique problems. First, it requires true collaboration between pediatric and medical oncologists as the age range crosses both disciplines. Next, our AYA cancer patients not only have cancer but are also often dealing with ongoing developmental and psychosocial issues at the same time; as such, we must be aware of how a cancer diagnosis interferes with their normal development. The Roundtable discussion helps put AYA cancer in perspective for those who have not yet considered the 15-39 year old cancer patient as a distinct and relevant patient group,” according to Editor-in-Chief Leonard S. Sender, MD, of the University of California, Irvine and CHOC Children’s Hospital.
The roundtable discussion, “Trailblazers in Adolescent and Young Adult Oncology,” was moderated by Archie Bleyer, MD, Medical Director of Clinical Research for the St. Charles Health System in Bend, Oregon. Participants were leading physicians of pediatric, adolescent, and young adult oncology who have helped mold and advance this area of specialization trace the history and driving forces behind programs and disease management strategies now in place that target this patient population. Representing the experiences and revolutionary changes that have taken place in the United States, England, and Canada, Dr. Bleyer was joined by Karen Albritton, MD, Director of the Adolescent and Young Adult Oncology Program at Cook Children’s Medical Center and University of North Texas Health Science Center in Fort Worth; Ronald Barr, MB ChB, MD, Professor of Pediatrics, Pathology and Medicine at McMaster University in Canada; Ian Lewis, MB ChB, Professor of Cancer Research in Children and Young People at Leeds Teaching Hospital in the United Kingdom; and Editor-in-Chief Leonard Sender, MD, Medical Director of the Cancer Institute at CHOC Children’s Hospital and Director of the Young Adult Cancer Program at the University of California, Irvine’s Chao Family Comprehensive Cancer Center in Orange, CA.
Banana peels get a second life as water purifier
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To the surprisingly inventive uses for banana peels — which include polishing silverware, leather shoes, and the leaves of house plants — scientists have added purification of drinking water contaminated with potentially toxic metals. Their report, which concludes that minced banana peel performs better than an array of other purification materials, appears in ACS’s journal Industrial & Engineering Chemistry Research.
Gustavo Castro and colleagues note that mining processes, runoff from farms, and industrial wastes can all put heavy metals, such as lead and copper, into waterways. Heavy metals can have adverse health and environmental effects. Current methods of removing heavy metals from water are expensive, and some substances used in the process are toxic themselves. Previous work has shown that some plant wastes, such as coconut fibers and peanut shells, can remove these potential toxins from water. In this report, the researchers wanted to find out whether minced banana peels could also act as water purifiers.
The researchers found that minced banana peel could quickly remove lead and copper from river water as well as, or better than, many other materials. A purification apparatus made of banana peels can be used up to 11 times without losing its metal-binding properties, they note. The team adds that banana peels are very attractive as water purifiers because of their low cost and because they don’t have to be chemically modified in order to work.
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