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Traditional Solutions to the Diabetes Problem
Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.
Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.
In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.
The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.
Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.
The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.
Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.
Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.
In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.
The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.
Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.
The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.
Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.
Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.
In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.
The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.
Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.
The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.
Robotic Surgery for Older Cancer Patients
A review by researchers from Hôpital Sud, Rennes, France, and McGill University, Montreal showed that surgery by robot—rather than traditional open surgery—may improve outcomes in elderly patients with pelvic cancer, however the research is sparse. For instance, only 6 published studies specifically address surgery in the elderly with endometrial cancer, the most common gynecologic malignancy in the western world. However, because surgery is challenging for these often-frail patients, minimally invasive (or minimal access) surgery could be the answer. When comparing robotics to standard laparoscopy in treating endometrial cancer, the data suggest significantly less blood loss, reduced operative time, and higher node counts.
Related: A Team Approach to Nonmelanotic Skin Cancer Procedures
Similar to many others, the researchers’ academic center was slow to adopt minimally invasive standard (MIS) laparoscopy. But within 2 years of the introduction of robotic surgery in 2007, more than 95% of patients requiring surgery to treat endometrial cancer undergo MIS. Now, the surgery is offered to each operable patient unless the cancer cannot be extracted intact or in a 15-cm diameter endobag via the vagina.
Related: Solid-Organ Transplant Recipients May Be at Greater Risk for Cancer
The researchers note that the MIS procedure has some unique risks. For example, once the patient is “docked” to the robot, the Trendelenburg position can’t be reversed without undocking. This may adversely affect the respiratory and cardiovascular system. Despite case reports about such adverse effects, though, the researchers say most data support the safety of robotic surgery in the elderly. Moreover, the newest versions of robots allow for multiple quadrant access without the need to undock.
Related:Gene Expression Signatures in Breast Cancer: A Surgical Oncologist’s Perspective
The oncologic safety of robotic surgery seems similar to that of open surgery or laparoscopic surgery. After 2 years of follow-up in 1 study, rates of progression-free survival were similar for the different methods. The researchers advise surgeons to work toward improving preoperative frailty assessments that will help tailor the right surgery for the right subgroup of elderly patients.
Lavoué V, Gotlieb W. Cancers (Basel). 2016;8(1):E12.
doi: 10.3390/cancers8010012.
A review by researchers from Hôpital Sud, Rennes, France, and McGill University, Montreal showed that surgery by robot—rather than traditional open surgery—may improve outcomes in elderly patients with pelvic cancer, however the research is sparse. For instance, only 6 published studies specifically address surgery in the elderly with endometrial cancer, the most common gynecologic malignancy in the western world. However, because surgery is challenging for these often-frail patients, minimally invasive (or minimal access) surgery could be the answer. When comparing robotics to standard laparoscopy in treating endometrial cancer, the data suggest significantly less blood loss, reduced operative time, and higher node counts.
Related: A Team Approach to Nonmelanotic Skin Cancer Procedures
Similar to many others, the researchers’ academic center was slow to adopt minimally invasive standard (MIS) laparoscopy. But within 2 years of the introduction of robotic surgery in 2007, more than 95% of patients requiring surgery to treat endometrial cancer undergo MIS. Now, the surgery is offered to each operable patient unless the cancer cannot be extracted intact or in a 15-cm diameter endobag via the vagina.
Related: Solid-Organ Transplant Recipients May Be at Greater Risk for Cancer
The researchers note that the MIS procedure has some unique risks. For example, once the patient is “docked” to the robot, the Trendelenburg position can’t be reversed without undocking. This may adversely affect the respiratory and cardiovascular system. Despite case reports about such adverse effects, though, the researchers say most data support the safety of robotic surgery in the elderly. Moreover, the newest versions of robots allow for multiple quadrant access without the need to undock.
Related:Gene Expression Signatures in Breast Cancer: A Surgical Oncologist’s Perspective
The oncologic safety of robotic surgery seems similar to that of open surgery or laparoscopic surgery. After 2 years of follow-up in 1 study, rates of progression-free survival were similar for the different methods. The researchers advise surgeons to work toward improving preoperative frailty assessments that will help tailor the right surgery for the right subgroup of elderly patients.
Lavoué V, Gotlieb W. Cancers (Basel). 2016;8(1):E12.
doi: 10.3390/cancers8010012.
A review by researchers from Hôpital Sud, Rennes, France, and McGill University, Montreal showed that surgery by robot—rather than traditional open surgery—may improve outcomes in elderly patients with pelvic cancer, however the research is sparse. For instance, only 6 published studies specifically address surgery in the elderly with endometrial cancer, the most common gynecologic malignancy in the western world. However, because surgery is challenging for these often-frail patients, minimally invasive (or minimal access) surgery could be the answer. When comparing robotics to standard laparoscopy in treating endometrial cancer, the data suggest significantly less blood loss, reduced operative time, and higher node counts.
Related: A Team Approach to Nonmelanotic Skin Cancer Procedures
Similar to many others, the researchers’ academic center was slow to adopt minimally invasive standard (MIS) laparoscopy. But within 2 years of the introduction of robotic surgery in 2007, more than 95% of patients requiring surgery to treat endometrial cancer undergo MIS. Now, the surgery is offered to each operable patient unless the cancer cannot be extracted intact or in a 15-cm diameter endobag via the vagina.
Related: Solid-Organ Transplant Recipients May Be at Greater Risk for Cancer
The researchers note that the MIS procedure has some unique risks. For example, once the patient is “docked” to the robot, the Trendelenburg position can’t be reversed without undocking. This may adversely affect the respiratory and cardiovascular system. Despite case reports about such adverse effects, though, the researchers say most data support the safety of robotic surgery in the elderly. Moreover, the newest versions of robots allow for multiple quadrant access without the need to undock.
Related:Gene Expression Signatures in Breast Cancer: A Surgical Oncologist’s Perspective
The oncologic safety of robotic surgery seems similar to that of open surgery or laparoscopic surgery. After 2 years of follow-up in 1 study, rates of progression-free survival were similar for the different methods. The researchers advise surgeons to work toward improving preoperative frailty assessments that will help tailor the right surgery for the right subgroup of elderly patients.
Lavoué V, Gotlieb W. Cancers (Basel). 2016;8(1):E12.
doi: 10.3390/cancers8010012.
A Newly Discovered Source of Lyme Disease
After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.
Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.
The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.
Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.
After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.
Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.
The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.
Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.
After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.
Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.
The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.
Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.
Hypertension and Brain Health
Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).
To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.
The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.
The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”
Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).
To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.
The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.
The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”
Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).
To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.
The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.
The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”
“Streamlining” Gene May Raise Risk of Schizophrenia
A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.
Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.
In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.
Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”
A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.
Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.
In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.
Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”
A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.
Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.
In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.
Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”
Effective HCV Treatment Raises Risk of Infections
Triple therapy with first-generation protease inhibitors may be a milestone for chronic hepatitis C infection (HCV) treatment, but it also substantially increases rates of infection, especially in patients with advanced liver disease. Researchers from Medical University of Graz, Austria, citing reports that link boceprevir and telaprevir to impaired neutrophil elastase activity in vitro, conducted a study to determine whether protease inhibitors were at the root of the infections.
Related: Needlesticks and Infections: Still Not Enough Information
The study compared 152 chronic HCV patients treated with peginterferon and ribavirin, either with or without boceprevir and telaprevir, against 33 control patients. In both retrospective and prospective cohorts, clinically relevant infections were significantly more common during protease inhibitor therapy. Thirteen percent of retrospective patients developed infections on peginterferon and ribavirin vs 31% on protease inhibitors; 18% of the prospective patients on telaprevir and 33% of the boceprevir group developed clinically relevant infections. None of the patients receiving peginterferon and ribavirin developed infections, and they less often required hospitalization or treatment discontinuation.
Related: FDA Approves Zepatier for HCV Genotypes 1 and 4
The researchers also found neutrophil phagocytosis in patients dropped to 40% of baseline when protease inhibitors were added to peginterferon and ribavirin but returned to normal 6 months after treatment ended.
The researchers advise selecting patients for triple therapy carefully by focusing on other risk factors for infection and monitoring them closely during treatment.
Source:
Spindelboeck W, Horvath A, Tawdrous M, et al. PLoS ONE. 2016;11(3): e0150299. doi:10.1371/journal.pone.0150299
Triple therapy with first-generation protease inhibitors may be a milestone for chronic hepatitis C infection (HCV) treatment, but it also substantially increases rates of infection, especially in patients with advanced liver disease. Researchers from Medical University of Graz, Austria, citing reports that link boceprevir and telaprevir to impaired neutrophil elastase activity in vitro, conducted a study to determine whether protease inhibitors were at the root of the infections.
Related: Needlesticks and Infections: Still Not Enough Information
The study compared 152 chronic HCV patients treated with peginterferon and ribavirin, either with or without boceprevir and telaprevir, against 33 control patients. In both retrospective and prospective cohorts, clinically relevant infections were significantly more common during protease inhibitor therapy. Thirteen percent of retrospective patients developed infections on peginterferon and ribavirin vs 31% on protease inhibitors; 18% of the prospective patients on telaprevir and 33% of the boceprevir group developed clinically relevant infections. None of the patients receiving peginterferon and ribavirin developed infections, and they less often required hospitalization or treatment discontinuation.
Related: FDA Approves Zepatier for HCV Genotypes 1 and 4
The researchers also found neutrophil phagocytosis in patients dropped to 40% of baseline when protease inhibitors were added to peginterferon and ribavirin but returned to normal 6 months after treatment ended.
The researchers advise selecting patients for triple therapy carefully by focusing on other risk factors for infection and monitoring them closely during treatment.
Source:
Spindelboeck W, Horvath A, Tawdrous M, et al. PLoS ONE. 2016;11(3): e0150299. doi:10.1371/journal.pone.0150299
Triple therapy with first-generation protease inhibitors may be a milestone for chronic hepatitis C infection (HCV) treatment, but it also substantially increases rates of infection, especially in patients with advanced liver disease. Researchers from Medical University of Graz, Austria, citing reports that link boceprevir and telaprevir to impaired neutrophil elastase activity in vitro, conducted a study to determine whether protease inhibitors were at the root of the infections.
Related: Needlesticks and Infections: Still Not Enough Information
The study compared 152 chronic HCV patients treated with peginterferon and ribavirin, either with or without boceprevir and telaprevir, against 33 control patients. In both retrospective and prospective cohorts, clinically relevant infections were significantly more common during protease inhibitor therapy. Thirteen percent of retrospective patients developed infections on peginterferon and ribavirin vs 31% on protease inhibitors; 18% of the prospective patients on telaprevir and 33% of the boceprevir group developed clinically relevant infections. None of the patients receiving peginterferon and ribavirin developed infections, and they less often required hospitalization or treatment discontinuation.
Related: FDA Approves Zepatier for HCV Genotypes 1 and 4
The researchers also found neutrophil phagocytosis in patients dropped to 40% of baseline when protease inhibitors were added to peginterferon and ribavirin but returned to normal 6 months after treatment ended.
The researchers advise selecting patients for triple therapy carefully by focusing on other risk factors for infection and monitoring them closely during treatment.
Source:
Spindelboeck W, Horvath A, Tawdrous M, et al. PLoS ONE. 2016;11(3): e0150299. doi:10.1371/journal.pone.0150299
Americans Are Getting Healthier in Some Ways
The behavioral health of the nation is improving, according to the 2015 National Behavioral Health Barometer report, published recently by the Substance Abuse and Mental Health Services Administration.
The Barometer covers key health care issues, such as substance use, mental illness, suicidal thoughts, and treatment seeking at the national level. It also includes, for comparative purposes, data from several national surveys to help health care providers and policy makers better understand what is going on state by state.
For instance, among adolescents, between 2002 and 2014, nonmedical pain reliever use, binge drinking, and cigarette smoking declined . Among adults 21 and older, since 2010, the percentage reporting heavy alcohol use in the month prior to the survey had not changed significantly. From 2010 to 2014, the percentage of adults who had thoughts of suicide and number of adults who had a serious mental illness did not change significantly.
The percentage of adults who had thoughts of suicide did not change significantly from 2010 to 2014. The number of adults who had a serious mental illness in the previous year also did not change significantly from 2010 to 2014. The number was higher for women and whites compared with that of blacks, Asians, and Hispanics. Serious mental illness was lower among adults aged ≥ 65 years than in other age groups.
In 2014, 69% of adults with serious mental illness received mental health treatment or counseling the year before being surveyed. The percentage was higher than that of 2012, but not significantly different from any other year from 2010 to 2013. However, in 2014, men were less likely to have received mental health treatment or counseling, and adults aged 18 to 25 years were less likely than those aged 26 to 64 years to have received mental health treatment or counseling.
The behavioral health of the nation is improving, according to the 2015 National Behavioral Health Barometer report, published recently by the Substance Abuse and Mental Health Services Administration.
The Barometer covers key health care issues, such as substance use, mental illness, suicidal thoughts, and treatment seeking at the national level. It also includes, for comparative purposes, data from several national surveys to help health care providers and policy makers better understand what is going on state by state.
For instance, among adolescents, between 2002 and 2014, nonmedical pain reliever use, binge drinking, and cigarette smoking declined . Among adults 21 and older, since 2010, the percentage reporting heavy alcohol use in the month prior to the survey had not changed significantly. From 2010 to 2014, the percentage of adults who had thoughts of suicide and number of adults who had a serious mental illness did not change significantly.
The percentage of adults who had thoughts of suicide did not change significantly from 2010 to 2014. The number of adults who had a serious mental illness in the previous year also did not change significantly from 2010 to 2014. The number was higher for women and whites compared with that of blacks, Asians, and Hispanics. Serious mental illness was lower among adults aged ≥ 65 years than in other age groups.
In 2014, 69% of adults with serious mental illness received mental health treatment or counseling the year before being surveyed. The percentage was higher than that of 2012, but not significantly different from any other year from 2010 to 2013. However, in 2014, men were less likely to have received mental health treatment or counseling, and adults aged 18 to 25 years were less likely than those aged 26 to 64 years to have received mental health treatment or counseling.
The behavioral health of the nation is improving, according to the 2015 National Behavioral Health Barometer report, published recently by the Substance Abuse and Mental Health Services Administration.
The Barometer covers key health care issues, such as substance use, mental illness, suicidal thoughts, and treatment seeking at the national level. It also includes, for comparative purposes, data from several national surveys to help health care providers and policy makers better understand what is going on state by state.
For instance, among adolescents, between 2002 and 2014, nonmedical pain reliever use, binge drinking, and cigarette smoking declined . Among adults 21 and older, since 2010, the percentage reporting heavy alcohol use in the month prior to the survey had not changed significantly. From 2010 to 2014, the percentage of adults who had thoughts of suicide and number of adults who had a serious mental illness did not change significantly.
The percentage of adults who had thoughts of suicide did not change significantly from 2010 to 2014. The number of adults who had a serious mental illness in the previous year also did not change significantly from 2010 to 2014. The number was higher for women and whites compared with that of blacks, Asians, and Hispanics. Serious mental illness was lower among adults aged ≥ 65 years than in other age groups.
In 2014, 69% of adults with serious mental illness received mental health treatment or counseling the year before being surveyed. The percentage was higher than that of 2012, but not significantly different from any other year from 2010 to 2013. However, in 2014, men were less likely to have received mental health treatment or counseling, and adults aged 18 to 25 years were less likely than those aged 26 to 64 years to have received mental health treatment or counseling.
Findings From the Veteran Health Data Bank
The Million Veteran Program (MVP)—a “mega-biobank”—began enrolling volunteers in 2011, and the program is going strong. As of 2015, 50 recruiting sites and nearly 400,000 veterans had enrolled.
For genomic and other sampling, the Million Veteran Program gathers information via questionnaires, the VA electronic health record, and blood samples from volunteers.
Researchers who conducted a study of the observational, longitudinal program say the strengths of the MVP lie in that it is a VHA program that includes more than 100 research-ready medical centers, a state -of-the-art biorepository, and the “altruistic veteran population.” Most of the health care experiences of the veterans who use the VHA already have been captured electronically for many years.
So what have researchers learned so far? Of the 20 most common self-reported conditions among 224,610 veterans, the top 5 are hypertension (63%), hyperlipidemia (57%), gastroesophageal reflux disease (34%), tinnitus (32%), and hearing loss (31%).
A “linked but separate” ongoing project of schizophrenia and bipolar disorder enrolled more than 9,500 case patients, who will be matched with control patients from MVP. An intra-MVP study of posttraumatic stress disorder is also under way.
Although attempts to assemble large cohorts don’t always succeed, the feasibility of MVP has been confirmed by progress to date, and plans are ongoing to expand enrollment using web-based strategies, say researchers. They predict the program’s potential includes using the genomic studies as an evidence base for precision medicine in the future.
The Million Veteran Program (MVP)—a “mega-biobank”—began enrolling volunteers in 2011, and the program is going strong. As of 2015, 50 recruiting sites and nearly 400,000 veterans had enrolled.
For genomic and other sampling, the Million Veteran Program gathers information via questionnaires, the VA electronic health record, and blood samples from volunteers.
Researchers who conducted a study of the observational, longitudinal program say the strengths of the MVP lie in that it is a VHA program that includes more than 100 research-ready medical centers, a state -of-the-art biorepository, and the “altruistic veteran population.” Most of the health care experiences of the veterans who use the VHA already have been captured electronically for many years.
So what have researchers learned so far? Of the 20 most common self-reported conditions among 224,610 veterans, the top 5 are hypertension (63%), hyperlipidemia (57%), gastroesophageal reflux disease (34%), tinnitus (32%), and hearing loss (31%).
A “linked but separate” ongoing project of schizophrenia and bipolar disorder enrolled more than 9,500 case patients, who will be matched with control patients from MVP. An intra-MVP study of posttraumatic stress disorder is also under way.
Although attempts to assemble large cohorts don’t always succeed, the feasibility of MVP has been confirmed by progress to date, and plans are ongoing to expand enrollment using web-based strategies, say researchers. They predict the program’s potential includes using the genomic studies as an evidence base for precision medicine in the future.
The Million Veteran Program (MVP)—a “mega-biobank”—began enrolling volunteers in 2011, and the program is going strong. As of 2015, 50 recruiting sites and nearly 400,000 veterans had enrolled.
For genomic and other sampling, the Million Veteran Program gathers information via questionnaires, the VA electronic health record, and blood samples from volunteers.
Researchers who conducted a study of the observational, longitudinal program say the strengths of the MVP lie in that it is a VHA program that includes more than 100 research-ready medical centers, a state -of-the-art biorepository, and the “altruistic veteran population.” Most of the health care experiences of the veterans who use the VHA already have been captured electronically for many years.
So what have researchers learned so far? Of the 20 most common self-reported conditions among 224,610 veterans, the top 5 are hypertension (63%), hyperlipidemia (57%), gastroesophageal reflux disease (34%), tinnitus (32%), and hearing loss (31%).
A “linked but separate” ongoing project of schizophrenia and bipolar disorder enrolled more than 9,500 case patients, who will be matched with control patients from MVP. An intra-MVP study of posttraumatic stress disorder is also under way.
Although attempts to assemble large cohorts don’t always succeed, the feasibility of MVP has been confirmed by progress to date, and plans are ongoing to expand enrollment using web-based strategies, say researchers. They predict the program’s potential includes using the genomic studies as an evidence base for precision medicine in the future.
Tracking a Tumor
Is there a universal cancer fingerprint? Researchers at the National Institutes of Health believe they may have found a potential common biomarker for 5 different tumor types. The clue is a “methylation signature”—evidence of a chemical modification of DNA. Methylation controls the expression of genes, and higher amounts of DNA methylation reduce a gene’s activity, like a dimmer switch on a light fixture.
In an earlier study using DNA taken from solid tumors, the researchers found a methylation signature in 15 tumor types in 13 different organs around the gene called ZNF154. In the new study, the researchers uncovered methylation in colon, lung, breast, stomach, and endometrial cancers. All the tumor types and subtypes consistently produced the same methylation mark around ZNF154.
Researchers developed a computer program that looked at methylation marks in the DNA of people with and without cancer and were able to predict a threshold for detecting tumor DNA. Because tumors often shed DNA into the bloodstream, the researchers were able to calculate the proportions of circulating tumor DNA. The researchers hope their results lead to a blood test that can diagnose cancers at early stages.
Currently, blood tests are specific to a known tumor type. Clinicians must first find the tumor and then sequence a sample from it before they can track the tumor-specific mutations in the blood. By contrast, a method derived from the methylation signatures would mean no prior knowledge of the cancer was required. The tests would be less intrusive than that of other screening methods and could be used to follow high-risk patients or monitor the activity of a tumor during treatment.
Source:
National Institutes of Health. NIH researchers identify striking genomic signature shared by five types of cancer [news release]. National Institutes of Health Website. http://www.nih.gov/news-events/news-releases/nih-researchers-identify-striking-genomic-signature-shared-five-types-cancer. Published February 5, 2016. Accessed February 29, 2016.
Is there a universal cancer fingerprint? Researchers at the National Institutes of Health believe they may have found a potential common biomarker for 5 different tumor types. The clue is a “methylation signature”—evidence of a chemical modification of DNA. Methylation controls the expression of genes, and higher amounts of DNA methylation reduce a gene’s activity, like a dimmer switch on a light fixture.
In an earlier study using DNA taken from solid tumors, the researchers found a methylation signature in 15 tumor types in 13 different organs around the gene called ZNF154. In the new study, the researchers uncovered methylation in colon, lung, breast, stomach, and endometrial cancers. All the tumor types and subtypes consistently produced the same methylation mark around ZNF154.
Researchers developed a computer program that looked at methylation marks in the DNA of people with and without cancer and were able to predict a threshold for detecting tumor DNA. Because tumors often shed DNA into the bloodstream, the researchers were able to calculate the proportions of circulating tumor DNA. The researchers hope their results lead to a blood test that can diagnose cancers at early stages.
Currently, blood tests are specific to a known tumor type. Clinicians must first find the tumor and then sequence a sample from it before they can track the tumor-specific mutations in the blood. By contrast, a method derived from the methylation signatures would mean no prior knowledge of the cancer was required. The tests would be less intrusive than that of other screening methods and could be used to follow high-risk patients or monitor the activity of a tumor during treatment.
Source:
National Institutes of Health. NIH researchers identify striking genomic signature shared by five types of cancer [news release]. National Institutes of Health Website. http://www.nih.gov/news-events/news-releases/nih-researchers-identify-striking-genomic-signature-shared-five-types-cancer. Published February 5, 2016. Accessed February 29, 2016.
Is there a universal cancer fingerprint? Researchers at the National Institutes of Health believe they may have found a potential common biomarker for 5 different tumor types. The clue is a “methylation signature”—evidence of a chemical modification of DNA. Methylation controls the expression of genes, and higher amounts of DNA methylation reduce a gene’s activity, like a dimmer switch on a light fixture.
In an earlier study using DNA taken from solid tumors, the researchers found a methylation signature in 15 tumor types in 13 different organs around the gene called ZNF154. In the new study, the researchers uncovered methylation in colon, lung, breast, stomach, and endometrial cancers. All the tumor types and subtypes consistently produced the same methylation mark around ZNF154.
Researchers developed a computer program that looked at methylation marks in the DNA of people with and without cancer and were able to predict a threshold for detecting tumor DNA. Because tumors often shed DNA into the bloodstream, the researchers were able to calculate the proportions of circulating tumor DNA. The researchers hope their results lead to a blood test that can diagnose cancers at early stages.
Currently, blood tests are specific to a known tumor type. Clinicians must first find the tumor and then sequence a sample from it before they can track the tumor-specific mutations in the blood. By contrast, a method derived from the methylation signatures would mean no prior knowledge of the cancer was required. The tests would be less intrusive than that of other screening methods and could be used to follow high-risk patients or monitor the activity of a tumor during treatment.
Source:
National Institutes of Health. NIH researchers identify striking genomic signature shared by five types of cancer [news release]. National Institutes of Health Website. http://www.nih.gov/news-events/news-releases/nih-researchers-identify-striking-genomic-signature-shared-five-types-cancer. Published February 5, 2016. Accessed February 29, 2016.
Tackling Prescription Drug Overdoses
In 2015, the CDC launched several initiatives to help bring down the number of prescription drug overdoses. One initiative called Prevention for States supports states with resources, such as strategies for safe prescribing practices that can be used to advance interventions against overdoses. The CDC also launched When the Prescription Becomes the Problem, a social media site where people tell their stories of opioid abuse to help others learn from their experience.
This year, in an effort to better track drug abuse and deaths and investigate health emergencies related to opioid abuse, the CDC will expand Prevention for States to all 50 states. The CDC is also developing guidelines to help primary care practitioners and other opioid prescribers provide safer care while reducing the risk of addiction and overdose.
In 2015, the CDC launched several initiatives to help bring down the number of prescription drug overdoses. One initiative called Prevention for States supports states with resources, such as strategies for safe prescribing practices that can be used to advance interventions against overdoses. The CDC also launched When the Prescription Becomes the Problem, a social media site where people tell their stories of opioid abuse to help others learn from their experience.
This year, in an effort to better track drug abuse and deaths and investigate health emergencies related to opioid abuse, the CDC will expand Prevention for States to all 50 states. The CDC is also developing guidelines to help primary care practitioners and other opioid prescribers provide safer care while reducing the risk of addiction and overdose.
In 2015, the CDC launched several initiatives to help bring down the number of prescription drug overdoses. One initiative called Prevention for States supports states with resources, such as strategies for safe prescribing practices that can be used to advance interventions against overdoses. The CDC also launched When the Prescription Becomes the Problem, a social media site where people tell their stories of opioid abuse to help others learn from their experience.
This year, in an effort to better track drug abuse and deaths and investigate health emergencies related to opioid abuse, the CDC will expand Prevention for States to all 50 states. The CDC is also developing guidelines to help primary care practitioners and other opioid prescribers provide safer care while reducing the risk of addiction and overdose.