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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New study shows government spending preferences of Americans
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In its 27th survey of American spending priorities since 1973 conducted as part of its General Social Survey (GSS), NORC at the University of Chicago Wednesday released a report on its most recent findings. By a notable margin, education and health care were the top two spending priorities of Americans. And Americans are consistent in that: those two categories have finished in the top two in each of the ten surveys since 1990.
The spending priorities report is derived from recently released data of the 2010 General Social Survey which NORC has conducted for forty years. The GSS is a biennial survey that gathers data on contemporary American society in order to monitor and explain trends and constants in attitudes, behaviors, and attributes. NORC makes the high-quality data easily accessible to scholars, students, policy makers, and others. Over 16,000 research uses in articles, textbooks, monographs, dissertations, etc. have been documented. The GSS is supported by the National Science Foundation and it is the second most-referenced survey in America after the U.S. Census.
Rounding out the top ten spending priorities were (3) assistance to the poor (4) halting crime, (5) Social Security, (6) the environment, (7) dealing with drug addiction, (8) childcare, (9) drug rehabilitation, and (10) law enforcement. Finishing lowest in priority, as it has in every survey since 1973, is foreign assistance. The study surveys public preferences on twenty-two spending categories.
Rituximab combined with a TNF inhibitor and methotrexate shows no safety signal in RA treatment
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A recent trial of rituximab in combination with a tumor necrosis factor (TNF) inhibitor and methotrexate (MTX) in patients with active rheumatoid arthritis (RA) found the safety profile to be consistent with other RA trials with TNF inhibitors. While the trial reported no new safety risks, clear evidence of an efficacy advantage in RA patients receiving the combination therapy was not observed in this study sample. Results of the trial are published in the March issue of Arthritis & Rheumatism, a peer-reviewed journal of the American College of Rheumatology.
The National Arthritis Data Workgroup estimates that 1.3 million U.S. adults have RA which is characterized by systemic joint inflammation that often leads to joint damage, functional impairment and significant disability. While MTX is successfully used to treat many RA patients, the severity of the disease in some patient populations requires the use of additional disease-modifying antirheumatic drugs (DMARDs). A specific group of biologic DMARDs, called tumor necrosis factor (TNF) inhibitors and includes such therapies as etanercept and adalimumab, block the immune system response, and have been shown to be safe and effective in clinical trials.
Prior studies, however, have found that up to 40% of RA patients exhibit an inadequate response, intolerance, or inadequate slowing of the rate of joint damage with biologic therapies, and require additional treatment options. “Our objective was to assess the safety of the biologic DMARD, rituximab, in combination with a TNF inhibitor and MTX in patients with active RA,” said lead study author Maria Greenwald, M.D., from Desert Medical Advances in California. This was a small exploratory study to evaluate safety with this combination due to the prolonged effect of rituximab, and the fact that RA patients may switch to an alternate biologic such as a TNF inhibitor before the effects of rituximab may have resolved.
What doctors (and patients) can learn from air traffic controllers: What’s that you say
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A review of 35 years of scientific medical studies confirms that the social and emotional context of the doctor–patient relationship have yet to be incorporated into the equation when it comes to health care.
In spite of its strong endorsement over a decade ago by the influential Institute of Medicine report, “Crossing the Quality Chasm: A New Health System for the 21st Century,” which highlighted the benefits of care that is respectful of and responsive to patients’ needs, values and concerns, patient-centered medicine has not become part of the mainstream.
A review of the medical literature from 1975 to April 2010 found that less than one percent of the 327,219 randomized controlled studies published in peer-reviewed journals over the past 35 years included patient-centered care trials. “Behaviorally–Defined Patient-Centered Communication – A Narrative Review” appears in the February 2011 issue of the Journal of General Internal Medicine
Alcohol consumption after age 75 associated with lower risk of developing dementia
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3202 German individuals (75+) attending general practitioners , who were free of dementia were studied at baseline, were followed up 1.5 years and 3 years later by means of structured clinical interviews including detailed assessment of current alcohol consumption and DSM-IV dementia diagnoses. Associations between alcohol consumption (in grams of ethanol), type of alcohol (wine, beer, mixed alcohol beverages) and incident dementia were examined using Cox proportional hazard models, controlling for several confounders.
There was good ascertainment of the development of dementia, even among subjects who died during follow up. Of 3,202 subjects free of dementia at baseline, 217 subjects met criteria for dementia during follow up. Subjects consuming alcohol had approximately 30% less overall dementia and 40% less Alzheimer dementia than did non-drinking subjects. No significant differences were seen according to the type of alcoholic beverage consumed. Overall, these results are similar to several previous studies in the very elderly and suggest that moderate drinking is associated with less dementia, even among individuals aged 75 years and older.
The authors conclusions suggests that light-to-moderate alcohol consumption is inversely related to incident dementia, also among individuals aged 75 years and older.
Clustering gene expression changes reveals pathways toward glaucoma prevention
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Glaucoma is the second-most common cause of blindness in the US, and occurs due to loss of retinal ganglion cells and degeneration of the optic nerve. Although it is known that high levels of pressure within the eye predispose individuals to the development of glaucoma, the molecular mechanisms involved are poorly defined.
In new research from The Jackson Laboratory in Bar Harbor, Maine, Simon John and colleagues analyzed gene expression patterns in the retina and optic nerves of mice that develop age-related glaucoma. Using a method that involved the clustering of samples that showed similarity in expression profiles, the researchers were able to identify molecular signatures of early events in glaucoma progression- events that were detectable before there was morphological evidence of damage.
Activation of part of the innate immune system called the complement cascade, and upregulation of endothelin 2- a protein that can increase blood pressure- were among these early changes. Notably, the researchers found that genetically and pharmacologically interfering with these changes protected mice from developing glaucoma.
New advances in genetic studies of Fanconi anemia patients
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A consortium of thirty-two researchers worldwide, led by Dr Jordi Surrallés, professor of the Department of Genetics and Microbiology at Universitat Autònoma de Barcelona (UAB) and member of the Centre for Biomedical Network Research on Rare Diseases (CIBERER), genetically and clinically characterised almost all Spanish patients suffering from Franconi anaemia, a rare disease affecting one in every 500,000 persons and which is characterised by severe anaemia in children, congenital malformations and a high predisposition to cancer.
A hundred people in Spain suffer from Fanconi anaemia; 80% of these present mutations in the FANCA gene. In the research, 90% of these patients were studied, as well as patients in Brazil, Mexico, Argentina, Peru, United States, United Kingdom, Portugal, Germany, Pakistan and Nigeria.
The research includes characterisation of over 130 pathogenic mutations in the FANCA gene, present in two of every three cases in almost all of the countries analysed, as well as the study of the origin and world distribution of some of the most frequent mutations. The mutation predominating in Spain and in the rest of countries is an ancestral mutation of Indo-European origin which spread throughout Europe thousands of years ago and which reached America across the Atlantic, producing founder effects in areas such as La Palma, with a high prevalence of the disease, and Brazil, where half of all patients share the same gene mutation.
