Health Care

7, count ‘em, 7 factors

LOS ANGELES - Keck School of Medicine scientists at the University of Southern California found one of seven genetic risk factors previously identified as raising the probability of prostate cancer also hikes probability of colorectal cancer. The complete findings were online at Nature Genetics. “This is an important finding because, for the first time, a common genetic risk factor for multiple cancers has been identified,” said lead author Christopher Haiman, assistant professor of preventive medicine at Keck. “There appears to be something fundamental occurring in this region that influences not only colorectal and prostate cancer, but also perhaps cancers in general.” For this colorectal cancer study, the USC team genotyped six of the seven variants previously identified as increasing the risk of prostate cancer development. The samples analyzed totaled 1,807 invasive colorectal cancer cases and 5,511 controls drawn from African-Americans, Japanese Americans, Native Hawaiians, Latinos, and European Americans in the Multiethnic Cohort Study.

LAMEZIA TERME, ITALY - HealthDay News noted scientists found a gene mutation linked to frontotemporal dementia (FA), which hits language abilities and socially appropriate behavior in those who have it. FA is the second most common dementia after Alzheimer's disease. Researchers at the Regional Neurogenetic Centre and the Centre for Research in Neurodegenerative Diseases at the University of Toronto identified the mutation in a gene named progranulin by studying the genealogy of 15 generations of an Italian family: 36 members have had FA. Researchers did DNA tests on 70 members, including 13 with FA. The mutation limits output of the protein to half the normal amount, because only one copy of the gene is active. While reduced production of progranulin is related to dementia, an excess has been tied to cancer. Researchers noted the age at which people with the mutation began to see symptoms of FA varied between 35 and 78. The findings were published in Neurology.

LOS ANGELES - HealthDay News disclosed nearly 33% of patients with drug-coated stents implanted in vein grafts to aid coronary blood flow died within 32 months, Dutch cardiologists report. There were no deaths among those who had similar vein grafts with traditional bare metal stents, said the report online at the Journal of the American College of Cardiology. Although the study had only 75 participants, results call for more study to set the safety of drug-coated stents in what are known as saphenous vein grafts, U.S. cardiologists said. "We really don’ have definitive evidence whether drug-eluting [coated] stents work in this particular setting," said Dr. Sanjay Kaul, director of the Vascular Physiology and Thrombosis Research Lab at Cedars-Sinai Medical Center . The saphenous vein, a large blood vessel that runs through the leg and thigh, is often used by cardiac surgeons in coronary artery bypass operations when many such grafts are required, such as occurs in a triple or quadruple bypass. A stent can be implanted to prevent thrombosis - a clot or blockage of the grafted blood vessel.

PHILADELPHIA - Scientists at the University of Pennsylvania School of Medicine report how the gene for utrophin, which codes for a protein very similar to dystrophin (defective protein in Duchenne Muscular Dystrophy, puts the brakes on its own expression in muscle cells. That suggesting a new target for treatment. The findings were online at Molecular Biology of the Cell and in print. Output of utrophin slows in fetal muscles soon after birth, after which dystrophin takes over as the primary muscle-associated protein. How this normal utrophin silencing occurs has been a mystery. If the brakes on utrophin output could be removed by drugs, more utrophin could substitute for dystrophin as a possible therapy for DMD, which affects one in 3,500 males. Because utrophin is over 80% identical to dystrophin in its gene sequence, utrophin could substitute for it in muscle cells. In normal muscle cells dystrophin is part of a large complex of proteins that attaches muscle cells to surrounding tissues. In DMD muscle cells, dystrophin can’t perform this function and the muscles slowly fall apart.

SAN FRANCISCO - A woman's use of a diaphragm doesn’t make her risk of HIV infection any less than if her male partner is using a condom, scientists told MedPage Today. In a randomized controlled trial in three sites in Africa, the HIV infection rate was the same if women used a diaphragm and gel along with condoms or just relied on condoms alone, said Dr. Nancy Padian, of the University of California, and colleagues. The "disappointing" result is the latest in a long list of failed HIV prevention trials, Dr. Padian and her team reported online at The Lancet. Studies have found the tested intervention was useless and possibly harmful, scientists said. The trial was part of a movement to find ways of preventing HIV transmission that, unlike condoms, would be controlled by women. Because diaphragms can be inserted discreetly and there is some evidence they block HIV from getting to especially vulnerable tissues of the cervix, researchers thought diaphragm use might be beneficial.

WORCESTER, MA - mANY hospital patients risk a potentially fatal vein clot, but half of them don't get preventive care, scientists told HealthDay News. Venous thromboembolism (VTE) involves formation of blood clots in a vein and can cause blockage of leg blood vessels (deep vein thrombosis) or a pulmonary embolism, blockage of a lung artery. "We looked at 38 million discharges in a U.S. hospitals database and found about one of every three people in a U.S. hospital bed arguably should be VTE protected because they have a risk," said lead scientist Dr. Frederick Anderson Jr., director of the Center for Outcomes Research at the University of Massachusetts Medical School. The findings were in the American Journal of Hematology. Risk factors include a hospital stay of two days or more, severe medical/surgical conditions, older age, and any operation involving general anesthesia. The study found among surgery patients 24% were at high risk of VTE, 17% were at very high risk.

` BOSTON - About half of those who care for a sick, elderly, or disabled loved one have no added help. Caregiver's Handbook, a guide to caring for the ill, elderly, disabled, and yourself is from Harvard Medical School and suggests tips to help caregivers coordinate care for their loved ones: 1. File paperwork under key topics - medical care, benefits, resources, assisted living, nursing homes, etc. 2. Keep the person’s medical history and meds list handy. Highlight steps you’ll handle or dole out to others. 3. Coordinate medical care. Each doctor should know what the others suggest and meds the patient takes. 4. Don’t be afraid to ask for explanations, a breakdown of risks and benefits of a particular treatment, or a second opinion. Press your case. 5. Gathering basic data via reputable Internet sites and national groups can help prepare for challenging decisions. 6. Be at the hospital. Tell staff if you notice erratic behavior. 7. Get recommendations on nursing homes or home healthcare from social workers, doctors, nurses, friends, family, and co-workers. Caregiver's Handbook is available for $16 from Harvard Health Publications (www.health.harvard.edu/CG, or call 1-877–649–9457 toll free).

LAFAYETTE , IN - Purdue University scientists and the Indiana University School of Medicine found an approach for finding several genetic disorders in infants and young children. Daniel Raftery, professor of analytical and physical chemistry, and his team used a simple chemical reaction to improve ability to detect important molecules in complex fluids like blood and urine. It makes the markers for some genetically caused metabolic disorders up to 100 times more visible, Raftery said. "[It] allows us to profile a class of biomarkers - molecules that indicate disease - that would otherwise be very difficult to detect," he said. "The increased sensitivity could allow doctors to diagnose a range of diseases at very early stages. We examined genetically based metabolic disorders because it is especially important that they be treated early in a child's life in order to prevent tragic effects such as brain damage. The technique could catch borderline cases that may have otherwise gone undiagnosed until serious symptoms arose."

NEW YORK - Anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, used to treat arthritis and other painful conditions, differ in risks of heart attacks and stroke, reports the Annals of the Rheumatic Diseases noted by Reuters Health. Much of the difference seems to depend on how the drug interacts with aspirin, often given to prevent heart attacks. "Traditional NSAIDs, ibuprofen in particular, have potential to interact with the effects of aspirin," Dr. Michael Farkouh, of Mount Sinai School of Medicine, said. "For patients at high (risk of heart attack, stroke), this interaction is serious since these patients require aspirin to prevent" cardiovascular woes. Dr. Farkouh and his team studied cardiovascular outcomes in high-risk patients with arthritis treated with ibuprofen, naproxen, or lumiracoxib. Among those taking low-dose aspirin, the risk of death, heart attack, or stroke at one year was more common with ibuprofen than lumiracoxib, authors report, but didn’t differ much between naproxen and lumiracoxib. Among those not taking low-dose aspirin, there was no difference in outcomes between ibuprofen and lumiracoxib, the report states, but there were fewer cardiovascular events among those taking naproxen rather than lumiracoxib.

CHICAGO - Exploiting interactions between food and drugs could lower dramatically the rapidly rising costs of anti-cancer drugs and perhaps many other meds, two cancer pharmacology specialists note in the Journal of Clinical Oncology. University of Chicago oncologists Drs. Mark Ratain and Ezra Cohen highlight the flip side of recent studies showing how some foods can alter absorption of precisely targeted anti-cancer drugs. Instead of seeing such studies as spotlighting a dosing problem, they argue results like this one should point scientists toward a novel way to cut medication costs and boost benefits from these effective but expensive drugs. The remarks resulted from a study presented at the American Society for Clinical Oncology. Dartmouth University scientists showed taking the breast cancer drug lapatinib with food - instead of on an empty stomach as noted on the label - ended in more drug being absorbed and available to treat the cancer.