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Newswise — Consumption of fructose, a fruit-derived sugar present in many sweetened beverages and processed foods, has been associated with epidemic levels of diabetes, obesity, metabolic syndrome and hypertension in the U.S. and around the world. New research presented today at the Experimental Biology 2016 meeting in San Diego further supports this link, finding that high levels of fructose similar to amounts consumed within the American diet may predispose individuals to fast-onset, salt-sensitive hypertension. “A majority of American adults consume 10 percent or more of total calories from added sugars with a subset taking in more than 25 percent of total calories from added sugars,” said lead author Kevin Gordish, PhD. Because beverages are the most common source of added sugars in the American diet, the research team gave rats drinking water with 20 percent fructose—to simulate excessive human soft-drink consumption—and compared them with rats who received plain water in addition to their food for two weeks. During the second week, the rats receiving 20 percent fructose were also given additional salt in their diets. “The specific combination of fructose and high salt introduced in the second week rapidly increased blood pressure, resulting in hypertension. Fructose-linked hypertension was associated with increased sodium retention, decreased sodium excretion and diminished factors that help rid the body of excess salt. This observation of fructose-linked hypertension was only seen a diet with fructose and high salt and not a normal salt diet,” Gordish said. “Fructose intake, similar to amounts consumed within the American diet, predisposed normal rats to a rapid onset of salt-sensitive hypertension. Fructose-linked hypertension was unambiguously due to fructose (and not glucose). Further, fructose had distinct deleterious effects in the kidney not seen with the same amount of glucose.” The results have implications for the U.S. in general and certain ethnic groups such as African Americans, who have a high rate of incidence of salt-sensitive hypertension, in particular. Overall, these findings raise concern about the amount of fructose and salt found in the American diet.
Newswise — A simple blood test can rapidly and accurately detect mutations in two key genes in non-small cell lung tumors, researchers at Dana-Farber Cancer Institute and other institutions report in a new study – demonstrating the test’s potential as a clinical tool for identifying patients who can benefit from drugs targeting those mutations. The test, known as a liquid biopsy, proved so reliable in the study that the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) this week became the first medical facility in the country to offer it to all patients with non-small cell lung cancer (NSCLC), either at the time of first diagnosis or of relapse following previous treatment. NSCLC is the most common form of lung cancer, diagnosed in more than 200,000 people in the United States each year, according to the American Cancer Society. An estimated 30 percent of NSCLC patients have mutations in either of the genes included in the study, and can often be treated with targeted therapies. The study is being published online today by the journal JAMA Oncology. The liquid biopsy tested in the study – technically known as rapid plasma genotyping – involves taking a test tube-full of blood, which contains free-floating DNA from cancer cells, and analyzing that DNA for mutations or other abnormalities. (When tumor cells die, their DNA spills into the bloodstream, where it’s known as cell-free DNA.) The technique, which provides a “snapshot” of key genetic irregularities in a tumor, is a common tool in research for probing the molecular make-up of different kinds of cancers. “We see plasma genotyping as having enormous potential as a clinical test, or assay – a rapid, noninvasive way of screening a cancer for common genetic fingerprints, while avoiding the challenges of traditional invasive biopsies,” said the senior author of the study, Geoffrey Oxnard, MD, thoracic oncologist and lung cancer researcher at Dana-Farber and Brigham and Women’s Hospital. “Our study was the first to demonstrate prospectively that a liquid biopsy technique can be a practical tool for making treatment decisions in cancer patients. The trial was such a success that we are transitioning the assay into a clinical test for lung cancer patients at DF/BWCC.” The study involved 180 patients with NSCLC, 120 of whom were newly diagnosed, and 60 of whom had become resistant to a previous treatment, allowing the disease to recur. Participants’ cell-free DNA was tested for mutations in the EGFR and KRAS genes, and for a separate mutation in EGFR that allows tumor cells to become resistant to front-line targeted drugs. The test was performed with a technique known as droplet digital polymerase chain reaction (ddPCR), which counts the individual letters of the genetic code in cell-free DNA to determine if specific mutations are present. Each participant also underwent a conventional tissue biopsy to test for the same mutations. The results of the liquid biopsies were then compared to those of the tissue biopsies. The data showed that liquid biopsies returned results much more quickly. The median turnaround time for liquid biopsies was three days, compared to 12 days for tissue biopsies in newly diagnosed patients and 27 days in drug-resistant patients. Liquid biopsy was also found to be highly accurate. In newly diagnosed patients, the “predictive value” of plasma ddPCR was 100 percent for the primary EGFR mutation and the KRAS mutation – meaning that a patient who tested positive for either mutation was certain to have that mutation in his or her tumor. For patients with the EGFR resistance mutation, the predictive value of the ddPCR test was 79 percent, suggesting the blood test was able to find additional cases with the mutation that were missed using standard biopsies. “In some patients with the EGFR resistance mutation, ddPCR detected mutations missed by standard tissue biopsy,” Oxnard remarked. “A resistant tumor is inherently made up of multiple subsets of cells, some of which carry different patterns of genetic mutations. A single biopsy is only analyzing a single part of the tumor, and may miss a mutation present elsewhere in the body. A liquid biopsy, in contrast, may better reflect the distribution of mutations in the tumor as a whole.” When ddPCR failed to detect these mutations, the cause was less clear-cut, Oxnard says. It could indicate that the tumor cells don’t carry the mutations or, alternatively, that the tumor isn’t shedding its DNA into the bloodstream. This discrepancy between the test results and the presence of mutations was less common in patients whose cancer had metastasized to multiple sites in the body, researchers found. The ddPCR-based test, or assay, was piloted and optimized for patients at the Translational Resarch lab of the Belfer Center for Applied Cancer Science at Dana-Farber. It was then validated for clinical use at Dana-Farber’s Lowe Center for Thoracic Oncology. An advantage of this form of liquid biopsy is that it can help doctors quickly determine whether a patient is responding to therapy. Fifty participants in the study had repeat testing done after starting treatment for their cancer. “Those whose blood tests showed a disappearance of the mutations within two weeks were more likely to stay on the treatment than patients who didn’t see such a reduction,” said the study’s lead author, Adrian Sacher, MD, of Dana-Farber and Brigham and Women’s Hospital. And because tumors are constantly evolving and acquiring additional mutations, repeated liquid biopsies can provide early detection of a new mutation – such as the EGFR resistance mutation – that can potentially be treated with targeted agents. “The study data are compelling,” said DF/BWCC pathologist Lynette Sholl, MD, explaining the center’s decision to begin offering ddPCR-based liquid biopsy to all lung cancer patients. “We validated the authors’ findings by cross-comparing results from liquid and tissue biopsies in 34 NSCLC patients. To work as a real-world clinical test, liquid biopsy needs to provide reliable, accurate data and be logistically practical. That’s what we’ve seen with the ddPCR-based blood test. “The test has great utility both for patients newly diagnosed with NSCLC and for those with a recurrence of the disease,” she continued. “It’s fast, it’s quantitative (it indicates the amount of mutant DNA in a sample), and it can be readily employed at a cancer treatment center.” The co-authors of the study are Cloud Paweletz, PhD, Allison O’Connell, BSc, and Nora Feeney, BSc, of the Belfer Center for Applied Cancer Science at Dana-Farber; Ryan S. Alden BSc, and Stacy L. Mach BA, of Dana-Farber; Suzanne E. Dahlberg, PhD, of Dana-Farber and Harvard T.H. Chan School of Public Health; and Pasi A. Jänne, MD, PhD, of Dana-Farber, the Belfer Center, and Brigham and Women’s Hospital.
Newswise — For most people, the culmination of a good life is a “good death,” though what that means exactly is a matter of considerable consternation. Researchers at the University of California, San Diego School of Medicine surveyed published, English-language, peer-reviewed reports of qualitative and quantitative studies defining a “good death,” ultimately identifying 11 core themes associated with dying well. The findings are published in the April 2016 issue of the American Journal of Geriatric Psychiatry. The research team, headed by senior author Dilip Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences and director of the Sam and Rose Stein Institute for Research on Aging at UC San Diego School of Medicine, focused on three groups of stakeholders: patients, family members (before or during bereavement) and health care providers. “This is the first time that data from all of the involved parties have been put together,” said Jeste, who is also associate dean for healthy aging and senior care at UC San Diego School of Medicine. “Death is obviously a controversial topic. People don’t like to talk about it in detail, but we should. It’s important to speak honestly and transparently about what kind of death each of us would prefer.” The literature search culled through 32 qualifying studies. It identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spirituality, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with the health care provider and “other.” The top three themes across all stakeholder groups were preferences for specific dying process, pain-free status and emotional well-being. For other themes, however, different stakeholders put somewhat different levels of emphasis. For example, patients more often cited religiosity/spirituality as important than did family members, who believed dignity and life completion were more critical to a good death. Health care providers tended to represent a middle ground between patients and family members. “Clinically, we often see a difference between what patients, family members and health care providers value as most important near the end of life”, said first author Emily Meier, PhD, a psychologist at Moores Cancer Center at UC San Diego Health. “Ultimately, existential and other psychosocial concerns may be prevalent among patients, and this serves as a reminder that we must ask about all facets of care that are essential at the end of life.” The bottom line, said Jeste, is “ask the patient.” “Usually, patients know what they want or need and there is relief in talking about it. It gives them a sense of control. I hope these findings spur greater conversation across the spectrum. It may be possible to develop formal rating scales and protocols that will prompt greater discussion and better outcomes. You can make it possible to have a good death by talking about it sometime before.”
Newswise — Chicago, Ill. - Elementary and middle school students who are given at least 25 minutes to eat lunch are more likely to choose fruits and consume more of their entrees, milk, and vegetables according to a new study released in the Journal of the Academy of Nutrition and Dietetics. Each day, over 30 million U.S. students receive a free or discounted meal thanks to the National School Lunch Program. For children from low-income households, these meals can account for almost half of their daily caloric intake, so it is vitally important for schools to find ways to improve student selections and consumption and limit food waste. This new study examined the association between the length of the lunch period and the food choices and intake of students. Data for the study were collected on six nonconsecutive days throughout the 2011 to 2012 school year as part of the MEALS study, a large, school-based randomized controlled trial. The MEALS study was a collaboration between the nonprofit organization Project Bread and the Harvard T. H. Chan School of Public Health to improve the selection and consumption of healthier school foods. Researchers conducted a plate waste study, which is the gold standard for assessing children’s diets. Investigators found that when kids have less than 20 minutes of seated time in the cafeteria to eat lunch, they were significantly less likely to select a fruit when compared to peers who had at least 25 minutes to eat lunch (44% vs 57%, respectively). Furthermore, the study found that children with less than 20 minutes to eat lunch consumed 13% less of their entrees, 10% less of their milk, and 12% less of their veggies when compared to students who had at least 25 minutes to eat their lunch. This indicates that kids who were given less time at lunch may be missing out on key components of a healthy diet such as fiber-rich whole grains and calcium. “Policies that improve the school food environment can have important public health implications in addressing the growing socioeconomic disparities in the prevalence of obesity and in improving the overall nutrient quality of children’s diets,” explained lead investigator Juliana F. W. Cohen, ScD, ScM, Assistant Professor, Department of Health Sciences, Merrimack College, North Andover, MA, and Adjunct Assistant Professor, Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA. “This research suggests that enabling students to have sufficient time to eat their meals can help address this important issue.” According to the study, another challenge kids face is the minutes they must use during their school lunchtime period for activities besides eating or sitting. Many students spend a considerable amount of time traveling to the cafeteria and then waiting in line to get their lunch. After taking this into account, some children in the study had as little as 10 minutes to eat their lunch. “Although not all schools will be able to accommodate longer lunch periods, several other factors have been cited as areas where schools can improve the amount of time students have to eat,” said Cohen. “Increasing the number of serving lines, more efficient cashiers, and/or an automated point of sale system can all lead to enhanced efficiency for students going through lunch lines.” With this research, investigators have shown that there is an association between the amount of time a student is given to eat and how much food they are likely to consume. A shorter lunch period means that children are in danger of missing out on important calories they rely on during the school day. In addition, studies have shown that consuming food too quickly is associated with a decrease in satiety, which can lead to overeating and contribute to obesity. Because of this, having insufficient time for lunch is especially precarious as kids are learning the eating habits they’ll take with them into adulthood. As schools search for ways to increase student consumption of entrees, fruits, and vegetables, offering kids more time to eat may be the key to better choices. “Policies that enable students to have at least 25 minutes of seated time might lead to improvements in students’ diets and decrease plate waste in school cafeterias,” concluded Cohen. “These findings provide evidence that policies at the district, state, or national level may be warranted to ensure all children have sufficient time to eat their meals in schools.” To learn more click here
Newswise — People in addiction treatment programs around the world use tobacco at two to three times the rate of people who are not being treated for addiction, according to a review of research studies from 20 countries other than the United States.  “When people come into treatment for drugs and alcohol, we are not treating another addiction that has a significant chance of eventually killing them, which is tobacco use,” said Guydish. “At a public health level, this means that our addiction treatment efforts should address smoking and tobacco use better than they do now.”  Guydish and his team reviewed 54 studies, involving a total of 37,364 participants in 20 countries on six continents, which were published in English from 1987 to 2013. They found that among people in treatment for drug and alcohol use, the overall rate of smoking was 84 percent, compared with a rate of 31 percent for members of the general population, matched for gender and year of study.  The results agree with an earlier review led by Guydish of smoking addiction treatment programs in the U.S. In that paper, the authors found that the median smoking rate among people in addiction treatment was 76.3 percent, in contrast with the smoking rate in the general U.S. population, which is now estimated at less than 18 percent. “Every person who enters substance abuse treatment ought to have their tobacco use evaluated and treated,” said Guydish. “If they don’t want to be treated and quit right away, they should have some education to help them think more about quitting.”  Guydish observed that “there are data from a number of studies which strongly suggest that you can improve substance treatment outcomes by addressing smoking among the patients in treatment. That’s what we should be doing.”  The World Health Organization (WHO) has created a policy package called MPOWER, noted Guydish, which is designed to assist countries in implementing anti-smoking initiatives. “We would recommend that WHO pay attention to this finding and use it to extend their MPOWER strategies,” said Guydish. “Anyone who is interested in smoking reduction internationally could use this information at the policy level.”  Co-authors of the study are Emma Passalacqua, Anna Pagano, PhD, Thao Le, MPH, Barbara Tajima, MEd, Lindsay Docto, Daria Garina and Kevin Delucchi, PhD, of UCSF; Cristina Martínez of the Catalan Institute of Oncology-Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain; and JongSerl Chun of Ewha Womans University, Seoul, South Korea. The paper is titled, “An International Systematic Review of Smoking Prevalence in Addiction Treatment.” The study was supported by funds from the National Institute on Drug Abuse and the UCSF Tobacco Related Disease Research Program. UCSF is the nation's leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and top-tier hospitals, UCSF Medical Center and UCSF Benioff Children's Hospitals.    
Newswise — Vampires may want your blood for the sake of their longevity, but have you ever wondered why your doctor is also interested in it? Well, unlike the vampire who draws blood for his own benefit, a doctor is interested in your blood for the good of your health. “Blood carries many secrets about your health,” says Karen Rizzo, MD, president of the Pennsylvania Medical Society and a practicing physician in Lancaster. “Through your blood, physicians can have a better understanding of your health as blood tests can help find potential problems early.” One such problem that worries physicians is heart disease. And, through blood tests, physicians can look inside your body to learn if you’re at risk or not. So, it’s not unusual for a physician to order a lipid panel to measure total cholesterol and triglycerides. It’s a common test given to determine the risk of heart disease. The total cholesterol is divided into two subclasses, which are called high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Science has proven that the lower your LDL, triglycerides, and total cholesterol, the lower your risk of heart disease. People with heart disease tend to have elevated cholesterol, especially LDL and triglycerides. “Cholesterol is important piece of your health puzzle,” says Pennsylvania Academy of Family Physicians President Nicole Davis, MD, who practices in Wyncote. “Keeping it in check and under control can lead to longer, healthier lives, while abnormal numbers can be traced to serious issues like heart attack and stroke.” In Pennsylvania it’s no laughing matter. According to the Pennsylvania Department of Health, heart disease is the number one killer of Pennsylvanians. Stroke ranks up there too and is the third leading cause of death in women, and fifth for men. On an average day in 2010, there were 86 deaths due to heart disease and 18 deaths due to stroke. For that year, 31,274 Pennsylvanians died due to heart disease, representing 25.3 percent of all deaths. In that same year, 6,629 or 5.4 percent of deaths in Pennsylvania were the result of a stroke. Certain blood tests are also used to detect signs of cancer, although patients should not jump to conclusions if their physician orders a cancer blood test. Diagnosing a patient can be a process of elimination to find exactly what is wrong. But a complete blood count (CBC) is a common blood test that a doctor may recommend to help diagnose leukemia and lymphoma. It may also be used with current cancer patients to see if cancer has spread to bone marrow or to determine how a person is handling treatment. Most recently, Science Translational Medicine, a medical journal from the American Association for the Advancement of Science, published an article that reported a new blood test could help detect a relapse of breast cancer. This blood test uses a technique called mutation tracking and has been making national headlines. “It’s exciting to learn of these types of advancements, and as we’ve known for many other diseases, blood can tell us a lot about a patient,” says Margaret A. O’Grady, RN, MSN, OCN, who is currently president of the Pennsylvania Society of Oncology & Hematology. According to state statistics from the Pennsylvania Cancer Incidence and Mortality 2012 Executive Summary, there were 10,652 cases of female breast cancer in Pennsylvania. Another blood test is the prostate-specific antigen (PSA) blood test. This test is used to look for warning signs of prostate cancer; however, this detection test can’t fully tell a physician if a man has cancer. But, if the results are at a level that may be of a concern to the physician, this test could lead to a physician to order a biopsy. According to Cancer Facts and Figures, Pennsylvania 2014, prostate cancer was the third most common cancer in the Keystone State behind lung and breast. Fortunately, the age-adjusted rates of prostate cancer in Pennsylvania as well as the country showed a decreasing trend from 2001 to 2011 while the Pennsylvania rate was lower than the national rate. “It’s very clear that early detection plays an important role in beating any type of cancer,” says O’Grady. “Blood tests can and do play a role in early detection for many patients of certain types of cancer.” For those planning to have a baby, expect your physician to also be interested in your blood during pregnancy. For pregnant women, a blood test might be used to monitor potential problems such as anemia, or diagnosis of possible infections such as toxoplasmosis. Toxoplasmosis is harmless to the pregnant woman, but it may cross the placenta and cause harm to the baby. “It’s important for a mother-to-be to pay close attention to their health during pregnancy,” says Kurt T. Barnhart, MD, FACOG, who is currently the chair of the Pennsylvania Section of the American Congress of Obstetricians and Gynecologists. “Women should see their physician throughout pregnancy for the safety of both themselves and their baby,” says Dr. Barnhart, who practices in Philadelphia. “Blood tests can be expected periodically.” Finally, when it comes to blood, the Pennsylvania Medical Society says community members should consider becoming blood donors. According to the organization, there’s no substitute for human blood and one pint of donated blood could save as many as four lives. This news release is brought to you by the Pennsylvania Health News Service Project, consisting of 21 Pennsylvania-based medical and specialty associations and societies. Members of PHNS include Pennsylvania Allergy & Asthma Association, Pennsylvania Dental Association, Pennsylvania Academy of Dermatology & Dermatologic Surgery, Pennsylvania Academy of Ophthalmology, Pennsylvania Academy of Otolaryngology, Pennsylvania Academy of Family Physicians, Pennsylvania American Congress of Obstetricians and Gynecologists, Pennsylvania Chapter of the American College of Cardiology, Pennsylvania Chapter of the American College of Emergency Physicians, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Medical Society Alliance, Pennsylvania Medical Society, Pennsylvania Neurosurgical Society, Pennsylvania Orthopaedic Society, Pennsylvania Psychiatric Society, Pennsylvania Society of Anesthesiologists, Pennsylvania Society of Gastroenterology, Pennsylvania Society of Oncology & Hematology, Robert H. Ivy Society of Plastic Surgeons, and Urological Association of Pennsylvania. Inquiries about PHNS can be directed to Chuck Moran via the Pennsylvania Medical Society at (717) 558-7820, cmoran@pamedsoc.org, or via Twitter @ChuckMoran7.
Newswise —  Washing those dreadful dishes after a long day seems like the furthest thing from relaxation. Or is it? Student and faculty researchers at Florida State University have found that mindfully washing dishes calms the mind and decreases stress. Published in the journal Mindfulness, the study looked at whether washing dishes could be used as an informal contemplative practice that promotes a positive state of mindfulness — a meditative method of focusing attention on the emotions and thoughts of the present moment. “I’ve had an interest in mindfulness for many years, both as a contemplative practitioner and a researcher,” said Adam Hanley, a doctoral candidate in FSU College of Education’s Counseling/School Psychology program and one of the study’s authors. “I was particularly interested in how the mundane activities in life could be used to promote a mindful state and, thus, increase overall sense of well-being.” After conducting a study with 51 students, the researchers found that mindful dishwashers — those who focused on the smell of the soap, the warmth of the water, the feel of the dishes — reported a decrease in nervousness by 27 percent and an increase in mental inspiration by 25 percent. The control group, on the other hand, didn’t experience any benefits. The research team also included Alia Warner and Vincent Delhili, doctoral candidates at Florida State; Angela Canto, assistant professor at Florida State; and Eric Garland, associate professor at University of Utah. ###  
Newswise — A Case Western Reserve University School of Medicine team received $2 million from the Patient-Centered Outcomes Research Institute (PCORI) to study a combination approach to help patients stop smoking, particularly those who are socially and economically disadvantaged. The project involves partnership with faculty and staff at MetroHealth Medical Center, the Ohio Department of Health and National Jewish Health, the Quitline providers for Ohio. The study team, led by Susan Flocke, PhD, will determine whether pairing the Teachable Moment Communication Process (TMCP) with the Ask-Advise-Connect (AAC) strategy will bolster smoking cessation outcomes. The AAC approach focuses on a systems-based strategy for identifying routinely the smoking status of patients, providing brief advice and offering a referral to the Quitline, a hotline staffed by professionals trained in smoking cessation counseling. This study will implement changes in the electronic health record to allow an electronic referral so that patients who want smoking cessation assistance are contacted proactively by the Quitline. TMCP, on the other hand, uses a communication strategy developed by Flocke’s team that incorporates the patient’s concerns into a clinician partnership-oriented discussion about stopping tobacco use. The problem with AAC alone is that many patients referred to the Quitline are not ready to stop smoking, but they may feel obligated to accept the referral to the hotline from their primary care team. In prior studies, less than 50 percent of patients who agreed to be referred to Quitline were successfully contacted by its counselors, even after five call attempts. However, among those who are contacted, enrollment and engagement in counseling services are good and have a positive effect on cessation attempts. By combining TMCP with AAC, the goal is to increase the numbers of patients referred to Quitline who are truly committed to smoking cessation and therefore more likely to enroll and benefit from tailored counseling. Investigators will pay particular attention to improving how smoking cessation advice and assistance are delivered to socially and economically disadvantaged patients. The Case Western Reserve research team will conduct a randomized trial of the TMCP and AAC combo in eight clinics serving more than 25,000 patients who smoke. Data will be collected through patient surveys, electronic health records, and Quitline participation. Additionally, the study will involve in-depth interviews with subgroups of patients to learn ways to improve their referral to the Quitline. “Research has shown that economically and socially disadvantaged individuals are more likely to smoke and less likely to use smoking cessation services,” said Flocke, Associate Professor, Department of Family Medicine & Community Health and Associate Director of the Prevention Research Center, Case Western Reserve University School of Medicine. “With our research, we plan to systematically create linkages between primary care clinics and community resources to increase smoking cessation services to those people who are least likely to access them.” “This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Joe Selby, MD, MPH. “We look forward to following the study’s progress and working with Case Western Reserve University School of Medicine to share the results.” Flocke’s study was selected for PCORI funding through a highly competitive review process in which patients, clinicians, and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders, and their methodological rigor among other criteria. The award to Flocke has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract. PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org/funding/opportunities http://pcori.org/funding/opportunities
Newswise — Vampires may want your blood for the sake of their longevity, but have you ever wondered why your doctor is also interested in it? Well, unlike the vampire who draws blood for his own benefit, a doctor is interested in your blood for the good of your health. “Blood carries many secrets about your health,” says Karen Rizzo, MD, 2015 president of the Pennsylvania Medical Society and a practicing physician in Lancaster. “Through your blood, physicians can have a better understanding of your health as blood tests can help find potential problems early.” One such problem that worries physicians is heart disease. And, through blood tests, physicians can look inside your body to learn if you’re at risk or not. So, it’s not unusual for a physician to order a lipid panel to measure total cholesterol and triglycerides. It’s a common test given to determine the risk of heart disease. The total cholesterol is divided into two subclasses, which are called high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Science has proven that the lower your LDL, triglycerides, and total cholesterol, the lower your risk of heart disease. People with heart disease tend to have elevated cholesterol, especially LDL and triglycerides. “Cholesterol is important piece of your health puzzle,” says Pennsylvania Academy of Family Physicians President Nicole Davis, MD, who practices in Wyncote. “Keeping it in check and under control can lead to longer, healthier lives, while abnormal numbers can be traced to serious issues like heart attack and stroke.” In Pennsylvania it’s no laughing matter. According to the Pennsylvania Department of Health, heart disease is the number one killer of Pennsylvanians. Stroke ranks up there too and is the third leading cause of death in women, and fifth for men. On an average day in 2010, there were 86 deaths due to heart disease and 18 deaths due to stroke. For that year, 31,274 Pennsylvanians died due to heart disease, representing 25.3 percent of all deaths. In that same year, 6,629 or 5.4 percent of deaths in Pennsylvania were the result of a stroke. Certain blood tests are also used to detect signs of cancer, although patients should not jump to conclusions if their physician orders a cancer blood test. Diagnosing a patient can be a process of elimination to find exactly what is wrong. But a complete blood count (CBC) is a common blood test that a doctor may recommend to help diagnose leukemia and lymphoma. It may also be used with current cancer patients to see if cancer has spread to bone marrow or to determine how a person is handling treatment. Most recently, Science Translational Medicine, a medical journal from the American Association for the Advancement of Science, published an article that reported a new blood test could help detect a relapse of breast cancer. This blood test uses a technique called mutation tracking and has been making national headlines. “It’s exciting to learn of these types of advancements, and as we’ve known for many other diseases, blood can tell us a lot about a patient,” says Margaret A. O’Grady, RN, MSN, OCN, who is currently president of the Pennsylvania Society of Oncology & Hematology. According to state statistics from the Pennsylvania Cancer Incidence and Mortality 2012 Executive Summary, there were 10,652 cases of female breast cancer in Pennsylvania. Another blood test is the prostate-specific antigen (PSA) blood test. This test is used to look for warning signs of prostate cancer; however, this detection test can’t fully tell a physician if a man has cancer. But, if the results are at a level that may be of a concern to the physician, this test could lead to a physician to order a biopsy. According to Cancer Facts and Figures, Pennsylvania 2014, prostate cancer was the third most common cancer in the Keystone State behind lung and breast. Fortunately, the age-adjusted rates of prostate cancer in Pennsylvania as well as the country showed a decreasing trend from 2001 to 2011 while the Pennsylvania rate was lower than the national rate. “It’s very clear that early detection plays an important role in beating any type of cancer,” says O’Grady. “Blood tests can and do play a role in early detection for many patients of certain types of cancer.” For those planning to have a baby, expect your physician to also be interested in your blood during pregnancy. For pregnant women, a blood test might be used to monitor potential problems such as anemia, or diagnosis of possible infections such as toxoplasmosis. Toxoplasmosis is harmless to the pregnant woman, but it may cross the placenta and cause harm to the baby. “It’s important for a mother-to-be to pay close attention to their health during pregnancy,” says Kurt T. Barnhart, MD, FACOG, who is currently the chair of the Pennsylvania Section of the American Congress of Obstetricians and Gynecologists. “Women should see their physician throughout pregnancy for the safety of both themselves and their baby,” says Dr. Barnhart, who practices in Philadelphia. “Blood tests can be expected periodically.” Finally, when it comes to blood, the Pennsylvania Medical Society says community members should consider becoming blood donors. According to the organization, there’s no substitute for human blood and one pint of donated blood could save as many as four lives. This news release is brought to you by the Pennsylvania Health News Service Project, consisting of 21 Pennsylvania-based medical and specialty associations and societies. Members of PHNS include Pennsylvania Allergy & Asthma Association, Pennsylvania Dental Association, Pennsylvania Academy of Dermatology & Dermatologic Surgery, Pennsylvania Academy of Ophthalmology, Pennsylvania Academy of Otolaryngology, Pennsylvania Academy of Family Physicians, Pennsylvania American Congress of Obstetricians and Gynecologists, Pennsylvania Chapter of the American College of Cardiology, Pennsylvania Chapter of the American College of Emergency Physicians, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Medical Society Alliance, Pennsylvania Medical Society, Pennsylvania Neurosurgical Society, Pennsylvania Orthopaedic Society, Pennsylvania Psychiatric Society, Pennsylvania Society of Anesthesiologists, Pennsylvania Society of Gastroenterology, Pennsylvania Society of Oncology & Hematology, Robert H. Ivy Society of Plastic Surgeons, and Urological Association of Pennsylvania. Inquiries about PHNS can be directed to Chuck Moran via the Pennsylvania Medical Society at (717) 558-7820, cmoran@pamedsoc.org, or via Twitter @ChuckMoran7.
Newswise — RPB-supported researchers have made a significant discovery that might lead to the delay or prevention of the most common cause of blindness in the elderly: age-related macular degeneration (AMD). Patients who take the drug L-DOPA (for Parkinson Disease, Restless Legs or other movement disorders) are significantly less likely to develop AMD and, if they do, it is at a significantly later age. "There are only limited and highly invasive therapies for those with AMD and no known preventative treatment," said Brian S. McKay, PhD, Department of Ophthalmology and Vision Science, University of Arizona. "Our findings imply that L-DOPA may be repurposed to prevent or delay AMD." Here's how the multi-institution team of scientists made the discovery. The investigators had been conducting basic research into albinism, which causes profound vision loss and changes in the structure of the eye, especially the retina, and specifically the macula, the area of the retina that is associated with central vision lost in AMD. The retina pigment epithelium is a critical support layer of tissue in the retina that fosters macula development and keeps it healthy through L-DOPA signaling. L-DOPA is made in pigmented tissues, and it has been known for a long time that lower risk for AMD is associated with darker pigmentation; Blacks have a five-fold lower risk for AMD than Whites. The researchers postulated that signaling through the L-DOPA receptor may underlie racial disparities in AMD incidence. To test this, they examined the health records of 37,000 patients at the Marshfield Clinic for individuals with AMD, or those taking L-DOPA, or those with both AMD and taking L-DOPA. In patients who were given L-DOPA before being diagnosed with AMD, their AMD was diagnosed 8 years later than those not taking L-DOPA. These results were then confirmed in a much larger data set of 87 million patients, and the study was expanded to include prevention and delay of "wet" AMD, the most devastating form of the disease. "Developing a new drug costs more than $2 billion and takes 13.5 years from discovery to market. Drug repositioning does not require anywhere near those costs," said lead author Murray Brilliant, PhD, Director at the Center for Human Genetics at the Marshfield Clinic Research Foundation. "Our methods illustrate the power of precision medicine research -- using the electronic medical records of large numbers of patients -- to test unexpected drug interactions and find new uses for old drugs." "The results suggest a new path forward in our fight against AMD that may even include a strategy to prevent those at risk of the disease from ever developing it," McKay said. "In the end, L-DOPA may not be the drug that ends the disease, but the pathway identified here is likely to be a key observation as the search for a cure continues." This work was supported by Translational Sciences, The National Human Genome Research Institute, Research to Prevent Blindness, Bright Focus, The Edward N. & Della L. Thome Memorial Foundation, the Wisconsin Genomics Initiative, National Eye Institute, the Marshfield Clinic and the University of Arizona.