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Health

Biologics-naive juvenile idiopathic arthritis patients have elevated risk of cancer

Rome, Italy, Thursday 17 June 2010: Biologics-naïve Juvenile Idiopathic Arthritis (JIA) patients may have an increased risk of cancer compared with the general Swedish population, according to research presented today at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. Results of an additional study, which researched a small cohort of patients showed an increased frequency of cancer in those receiving the biologic etanercept, however, results were deemed not statistically significant by researchers. The results of a population-based Swedish cohort study found that the incidence of cancer among paediatric patients with JIA identified during the last 40 years was comparable to that seen in the general population, (0.5 vs. 0.4 cases per 1000 person years, Relative Risk (RR)=1.1, 95%CI 0.9-1.5). Subset analyses however indicated that subjects diagnosed with JIA since 1987 (the year that the Swedish patient registry attained nationwide coverage) were at elevated risk of developing cancer (RR=2.3, 95%CI 1.2-4.4, 13 JIA cancers vs. 30 in comparator), attributed to an increased occurrence of cancers of the lymphatic system (RR=4.2, 95%CI 1.7-10.7, 8 cancers in JIA vs. 10 in comparator). "These results are intriguing and suggest that in the past 20 years, patients with JIA not treated with biological therapies appear to have an elevated risk of cancer compared with the general population," said lead author of the study Dr. Julia Simard, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden. "The results of our study indicate that evaluation of cancer risks with biologics in paediatric populations need to factor in differences in incidence of cancer between these patients and the general population. From a clinical point of view, it should be remembered that although we noted an increased risk in relative terms, the excess risks remain low in absolute terms." The Swedish study assessed a national JIA cohort of 9,020 patients. For each JIA patient, up to five general-population comparators were identified (n=44,858). In the biologics-naïve JIA cohort, 60 cancers were observed during 131,144 person-years compared to 266 cancers during 661,758 person-years in the population comparator. Researchers noted that sensitivity analyses did not reveal an explanation for the differences seen between patients identified before and after 1987. The results of the second study combined data on 1,721 patients treated with etanercept from three prospective JIA registries in Germany, the UK and the US. Of the 1,641 patients who qualified for the primary analysis, two cancers were reported. Whilst this yielded a rate higher than expected when compared to the general population, it was not statistically significant (RR estimated using a Standardized Incident Ratio (SIR) of 3.7 (0.5-13.4, 95%CI)). This is believed to be in part due to the low event rate. The interpretation of these findings may be further limited by the fact that the comparator rates were based on a general population and not a biologics-naïve JIA population, as per the Swedish study, which suggests this may indicate an increased underlying risk of cancer. Abstract Numbers: OP0086 & OP0274 For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office on the 1st floor in Hall 5 of the Congress Centre during EULAR 2010 or on: Email: [email protected] Rory Berrie: Onsite tel: +44 7901 513 297 Caroline Butt: Onsite tel: +44 7789 270392 About EULAR The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations. In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems. The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases. EULAR 2010 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, almost 300 oral and more than 1600 poster abstract presentations will be featured, with 300 invited speaker lectures taking place in more than 140 sessions. To find out more about the activities of EULAR, visit: www.eular.org

Jun 17, 2010

Health

Smoking cigarettes is a predictor of RA and may negatively impact on efficacy of anti-TNFs

Rome, Italy, Thursday 17 June 2010: Smoking cigarettes is a significant risk factor for developing rheumatoid arthritis (RA) and may have a negative impact on the effectiveness of anti-tumour necrosis factor (anti-TNF) inhibitors in RA patients taking these treatments, according to results of two studies presented today at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. A further study has shown that smoking interferes with the expression of several genes which, when over-expressed can contribute to processes which exacerbate disease activity. Results of a Swedish study1 showed that for both men and women, smoking at the time of study initiation was shown to be a predictor for future diagnosis with RA (Odds Ratio (OR) 1.55 95% CI 1.20-2.01). Socio-economic status also had an impact on the risk of developing RA with "Blue-collar workers" (those who do manual labour and earn an hourly wage) having an increased risk compared with white-collar workers (salaried professionals or educated workers) (OR 1.41: CI 1.02-1.94). "The results of our study have confirmed that whether or not an individual smokes cigarettes, and the type of job that they do are surprisingly robust predictors of developing RA," said Dr Ulf Bergström, Department of Rheumatology, Skåne University Hospital, Malmö, Sweden, and lead author of the first study. "Investigating the impact of socio-economic factors on the development of RA could help us to understand disease mechanisms and identify preventative strategies in the future." Results of a second Swedish study2 showed that smoking predicted a poor response to anti-TNFs, as measured by two indices of disease activity: •A 'poor' EULAR response (based on the assessment of disease activity) at 3 months (OR 0.53, (95% CI 0.32-0.87), p=0.012) •A poor Simplified Disease Activity Index (SDAI) response at 6 months (OR 0.45 (CI 0.27-0.77), p=0.0003) and at 6 months (OR 0.47, (CI 0.25-0.88), p=0.02). Results of one further study undertaken in Switzerland3 showed that in experimental mice, the presence of smoke in the air induced the expression of the following genes: •A 2.3 fold (p=0.02) induction of the expression of vascular endothelial growth factor (VEGF) was seen. VEGF is a growth signal that, when over-expressed, can stimulate the over-production of new blood vessels which can contribute to disease progression. •A 2.7 fold (p=0.03) induction of the heat-shock protein DNAJC6 was seen. Heat shock proteins are induced in response to environmental stress and help to maintain cell function, but can also lead to activation of the immune system. "The results of our study show that smoking (or the presence of smoke in the air) has an effect on the expression of the same genes and causes modifications in the same proteins in both mouse models and in human beings," said Dr. Caroline Ospelt, Centre of Experimental Rheumatology, University Hospital Zurich, Switzerland. "We hypothesise that this is because smoking alters the ability of certain proteins to elicit an immune response in those with a genetic pre-disposition to rheumatic conditions. This could be a contributing factor to the symptoms experienced and an individual's disease progression." Study designs and key statistics The first Swedish study1 (OP0045) assessed a total of 33,346 individuals who were included in the Swedish Preventive Medicine Program (PMP) between 1974 and 1992 (male n=22,444, female n=10,902; incident RA cases n=296). The median time from inclusion to RA diagnosis was 12 years with a mean age of RA diagnosis at 60 years. In the second Swedish study2 (OP0014) 934 RA patients from the South Swedish Arthritis Treatment Group responded to a questionnaire sent out in 2005 that covered smoking habits. In the Swiss study3 (OP0081) investigators compared tissues samples from mice exposed to room air (n=8) compared with cigarette smoke (n=6) with samples from the joints from smoking (n=3) and non smoking (n=5) RA patients undergoing joint replacement surgery. Changes in gene expression were measured using whole genome microarrays and verified using real time Polymerase Chain Reaction (PCR, a DNA amplifying technique), and two assays to determine levels of protein presence - immunoblotting and ELISA (Enzyme-Linked Immuno Sorbent Assay). Abstract Numbers: OP0014, OP0045, OP0081 For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office on the 1st floor in Hall 5 of the Congress Centre during EULAR 2010 or on: Email: [email protected] Rory Berrie: Onsite tel: +44 7901 513 297 Caroline Butt: Onsite tel: +44 7789 270 392 About EULAR The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations. In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems. The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases. EULAR 2010 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, almost 300 oral and more than 1600 poster abstract presentations will be featured, with 300 invited speaker lectures taking place in more than 140 sessions. To find out more about the activities of EULAR, visit: www.eular.org

Jun 17, 2010

Health

Experiment turns up the heat on natural selection, reveals new details of an evolutionary mechanism

Scientists in Munich report evidence that high concentrations of the molecular "chaperone" proteins GroEL and GroES -- intracellular machines that can stabilize folding proteins under stress -- play a critical role in increasing the maximum temperature at which E. coli bacteria can grow. Massively and permanently elevated levels of the GroE proteins were found in bacteria adapted, step-wise over a period of years, for growth at 48.5 degrees C. This genomic change persisted for more than 600 generations, and molecular analyses ruled out other mechanisms that might account for the increase in heat resistance. The researchers' findings, published in the June 18 edition of the Journal of Biological Chemistry, have important implications for both fundamental evolutionary studies and biotechnology applications. In addition to being a well established resident of the human digestive tract, Escherichia coli is at home in the lab. It is a model organism as important to biological research as brewer's yeast, the fruit fly, and the mouse. Having evolved for life at our body temperature of around 37 degrees C., wild-type E. coli can be cultivated in the laboratory at temperatures up to but not beyond 44 to 46 degrees C. Pushing the upper temperature at which E. coli could grow to 48.5 degrees C. does not approach the level of heat resistance found in thermophile species, but what this experiment required was a distinct and significant redefinition of "extreme" for E. coli. To achieve that, Dr. Jeannette Winter and colleagues at the Technische Universitaet Muenchen (TUM) founded three lines of E. coli bacteria from a common ancestor and propagated them under heat stress for hundreds of generations. The step-wise process they designed created conditions under which a combination of normal genomic instability and natural selection would be likely to produce adaptations for growth at extreme temperatures. It took around two years to reach 48.5 degrees C, but after that, adaptation to this new extreme was inherited. The researchers propagated a control population, also descended from the common ancestor, at 37 degrees C. Exhaustive analysis of cell physiology, protein expression, and genome sequences revealed a number of significant changes. Compared with the control group, the adapted lines of E. coli showed a clearly enhanced capability for living under conditions of heat stress. This was accompanied by reduced growth rates, showing that survival came at a cost in terms of overall fitness, a typical indicator of genomic mutations. One of the most striking changes measured was a 16-fold increase in GroE levels, more than five times what a normal heat shock response in E. coli would be expected to produce. Further analyses of heat shock genes and proteins ruled out other mechanisms -- beyond the role of GroE alone -- as being critical for evolution for life at 48.5 degrees C. GroE chaperones are known to play an active role in assisting the folding process of other proteins, especially in cases where mutations that could cause improper folding threaten the survival of the cell. This experiment shows that they likely play a uniquely important role -- by mitigating the potentially damaging effects of accumulating mutations on protein folding -- in the evolution of heat resistance in E. coli. "The correlation between genetic changes and chaperones has been shown not only in bacteria, but also in eukaryotes such as yeast, fruit flies, and fungi," says Dr. Jeannette Winter, a researcher in the TUM Department of Chemistry and a member of the Center for Integrated Protein Science Munich. Beyond yielding insights into evolutionary history, Winter says, further research on these highly conserved mechanisms could shed light on how organisms evolve in response to climate-related stresses in the future. "Better understanding of chaperones might also open the way to targeted generation of organisms for specific purposes -- enhancing their ability, for example, to live under stressful conditions, to break down harmful pollutants, or to produce specific, biotechnologically relevant proteins." This research was supported by the Emmy-Noether program of the German Research Foundation (DFG), the Elitenetzwerk Bayern, the Fonds der chemischen Industrie, and SFB 594. Publication: Evolution of Escherichia coli for growth at high temperatures. Birgit Rudolph, Katharina M. Gebendorfer, Johannes Buchner, and Jeannette Winter. J Biol Chem. 2010 Jun18;285(25):19029-34. Contact: Dr. Jeannette Winter Center for Integrated Protein Science Munich Department of Chemistry Technische Universitaet Muenchen Lichtenbergstrasse 4 85747 Garching, Germany Tel: +49 89 289 13191 Fax: +49 89 289 13345 [email protected] Technische Universitaet Muenchen (TUM) is one of Europe's leading universities. It has roughly 420 professors, 7,500 academic and non-academic staff (including those at the university hospital "Rechts der Isar"), and 24,000 students. It focuses on the engineering sciences, natural sciences, life sciences, medicine, and economic sciences. After winning numerous awards, it was selected as an "Elite University" in 2006 by the Science Council (Wissenschaftsrat) and the German Research Foundation (DFG). The university's global network includes an outpost in Singapore. TUM is dedicated to the ideal of a top-level research based entrepreneurial university. http://www.tum.de

Jun 17, 2010

Health

More action needed to prevent stomach problems in NSAID users, despite recent progress

Four out of ten high-risk patients prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) also received appropriate measures to prevent upper-gastrointestinal (UGI) problems, but the remainder did not receive adequate protection, according to a study in the June issue of Alimentary Pharmacology and Therapeutics. Although the number of patients receiving preventative strategies increased five-fold over the 11-year period studied by researchers in The Netherlands, greater steps need to be taken to protect patients who face a high risk of side effects. "NSAIDs are among the world's most frequently prescribed drugs for arthritis and inflammatory conditions, but their use can quadruple the risk of upper gastrointestinal problems" explains lead researcher Dr Vera Valkhoff from the Erasmus University Medical Centre in Rotterdam. "These can range from mild symptoms like indigestion to more serious conditions like bleeding, perforation or obstructions, which can lead to hospital admissions or, in some cases, death. "Preventative strategies include using a COX inhibitor NSAID instead of a nonselective NSAID and combining NSAIDs with gastroprotective agents. However international studies suggest that as many as three-quarters of high- risk patients are not receiving adequate protection from the side effects of NSAIDs." The research team looked at the records of 50,126 NSAID users aged 50 or over from the Integrated Primary Care Database, using the latest figures available (1996 to 2006). This showed that just under seven per cent of high-risk patients had been correctly prescribed preventative strategies in 1996, but by 2006 this had risen to over 39 per cent. However, the latest figure was nine per cent higher for patients who had a medical history of UGI problems. A correct prescription was defined as a patient receiving a preventative strategy if they were defined as high risk because of a history of UGI bleeding/ulceration, being 65 or over or using anticoagulants, aspirin or corticosteroids. This category also included low-risk patients who were not receiving a preventative strategy, as there is no indication that this is necessary in such cases. Under-prescription was defined as a high-risk patient not receiving a strategy and over prescription as a low-risk patient receiving a strategy. Key findings of the study include: • Just over 43 per cent of NSAID users were defined as high-risk because of at least one risk factor. Being aged 65 or over was the most frequent risk factor (40 per cent) followed by use of anticoagulants (nine per cent) and having diabetes mellitus (eight per cent). • The researchers found that the remaining 57 per cent of the study population had no NSAID-related upper-gastrointestinal (UGI) risk factors and were therefore deemed as low risk. • Correct prescriptions among high-risk users rose from seven per cent in 1996 to 39 per cent in 2006. But the number of low-risk users who received unnecessary preventative strategies also rose, from three per cent in 1996 to 12 per cent in 2006. • Preventative strategies for patients with a medical history of UGI events rose from 27 per cent in 1996 to 48 per cent in 2006. When older age was factored in (75 plus) these figures rose from nine per cent in 1996 to 49 per cent in 2006. • High-risk patients had a higher average age than low-risk patients (73 versus 55.6 years) and were more likely to be female than male (60 per cent versus 54 per cent). "Our study shows that, although considerable improvements have been made in prescribing preventative strategies for people taking NSAIDs, the majority of high-risk users, including those with a history of UGI events, are not receiving adequate protection from side effects. "We hope that our study will draw attention to the international need for patient risk to be evaluated and appropriate action taken to ensure that NSAID use does not lead to UGI problems." The article can be accessed free at http://www3.interscience.wiley.com/cgi-bin/fulltext/123307537/PDFSTART Notes to editors Time-trends in gastroprotection with nonsteroidal anti-inflammatory drugs (NSAIDS). Valkhoff et al. Alimentary Pharmacology & Therapeutics. 31, pp1218-1228. (June 2010). DOI: 10.1111/j.1365-2036.2010.04281.x Alimentary Pharmacology & Therapeutics is an international journal of Gastroenterology and Hepatology. The journal accepts original papers and systematic reviews concerned with clinical Gastroenterology, Hepatology and Endoscopy. AP&T is particularly interested in therapies and diagnostics, including all aspects of translation from bench to bedside: identification of novel therapeutic targets, epidemiology, clinical trials, drug safety and meta-analyses. www.apandt.org Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or www.interscience.wiley.com

Jun 17, 2010

Health

Low calcium intake linked with increased risk of osteoporosis and hypertension in postmenopausal women

Rome, Italy, Thursday 17 June 2010: Italian postmenopausal women who have a low calcium intake show a higher risk of developing both osteoporosis and hypertension (a chronic medical condition in which arterial blood pressure is elevated) than those who consume higher levels of calcium according to research presented today at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. In this Italian study of 825 postmenopausal women with hypertension, a significantly increased proportion of women (35.4%) who consumed a lower amount of calcium through intake from dairy sources, had a concurrent diagnosis of both hypertension and osteoporosis, compared with women who consumed a higher amount of calcium (19.3% p<0.001). Further statistical analyses revealed that a lower calcium intake was associated with an increased risk of developing hypertension or osteoporosis over time when compared with controls (Odds Ratio (OR) hypertension: 1.43; 95%CI: 1.12-1.82, osteoporosis: OR 1.46; CI: 1.15-1.85). Women who consumed a lower amount of calcium were shown to be most likely to develop both conditions over time compared with women consuming a higher amount of calcium (OR 1.60; CI: 1.09-2.34). "Our study confirms that there may be a link between hypertension and low bone mass and that a low calcium intake could be a risk factor for the development of osteoporosis in postmenopausal women" said Professor Maria Manara, Department of Rheumatology, Gaetano Pini Institute, Milan, Italy, and lead author of the study. "Our study has also shown that a low calcium intake from dairy foods may be involved in this association and could be considered a risk factor for the development of hypertension and osteoporosis." The 825 subjects involved in the study were recruited from a cohort of 9,898 postmenopausal women referred to the Osteometabolic unit of the Gaetano Pini Institute in Italy, from 2002. Calcium intake from dairy sources was assessed by the number of standard servings of ~300mg calcium consumed by women in a week and subjects were stratified into 'quartiles'(lower 25%, median 50% and upper 25%). For each case, three controls were selected and matched for age. Women who had been treated with diuretics (drugs known to affect the generation of new bone material) were excluded from the study. Abstract Number: OP0055 Notes to authors: The reference nutrient intake (RNI, the amount estimated to be sufficient for 97% of a specified population group) for calcium is ~700mg/daily in the UK -- according to the UK Department of Health Dietary Reference Values (DRVs). For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office on the 1st floor in Hall 5 of the Congress Centre during EULAR 2010 or on: Email: [email protected] Rory Berrie: Onsite tel: +44 7901 513 297 Caroline Butt: Onsite tel: +44 7789 270 392 About EULAR The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations. In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems. The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases. EULAR 2010 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, almost 300 oral and more than 1600 poster abstract presentations will be featured, with 300 invited speaker lectures taking place in more than 140 sessions. To find out more about the activities of EULAR, visit: www.eular.org

Jun 17, 2010

Health

The experience of arterial reconstruction in adult-to-adult living donor liver transplantation

Hepatic artery thrombosis (HAT), which is the most common vascular complication after living donor liver transplantation (LDLT), can result in graft loss and devastating consequences. Surgical techniques are suggested to an important factor in causing HAT. Despite improvements in surgical techniques, arterial reconstruction in LDLT has a high risk of thrombosis. With atraumatic microsurgical techniques, the reconstruction of HA was accomplished in 182 recipients (192 grafts) of adult-to-adult LDLT performed from January 2001 to September 2009 by a settled group of vascular surgeons of a research team from China. Their study will be published on June 7, 2010 in the World Journal of Gastroenterology. Running sutures with back-wall first techniques were employed in all hepatic arterial reconstruction procedures by a settled group of vascular surgeons with low incidence of HAT. Interposition of great saphenous vein or cryoperserved vessel between recent and graft was performed for handling recipient hepatic arterial dissection with relatively good outcome. In the authors' view, in order to decrease the incidence of HAT, the principle of hepatic arterial reconstruction will be followed in future clinical procedures, including: a settled group of vascular surgeons, running suture with intimal eversion, sufficient large caliber of stoma and atraumatic manipulation. Running suture may be a reliable alternative for anastomsis of small hepatic artery in diameter with low incidence of HAT following A-A LDLT. Nevertheless, randomized prospective controlled studies should be performed to validate these results. Reference: Yang Y, Yan LN, Zhao JC, Ma YK, Huang B, Li B, Wen TF, Wang WT, Xu MQ, Yang JY. Microsurgical reconstruction of hepatic artery in A-A LDLT: 124 consecutive cases without HAT. World J Gastroenterol 2010; 16(21): 2682-2688 http://www.wjgnet.com/1007-9327/full/v16/i21/2682.htm Correspondence to: Lu-Nan Yan, MD, PhD, Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. [email protected] Telephone: +86-28-85422469 Fax: +86-28-85422469 About World Journal of Gastroenterology World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

Jun 17, 2010

Health

UBC study offers ethical and cost-effective strategy for managing MRI incidental findings

The increasing number of incidental findings in brain imaging can be managed ethically and cost-effectively by screening study participants based on gender, age and family history, according to University of British Columbia researchers. Incidental findings are anomalies discovered unexpectedly during research that utilizes brain imaging techniques such as functional magnetic resonance imaging (fMRI) of the brain. The UBC study, published online today the journal Value in Health, is the first economic analysis of current incidental finding management practices. More than 1,800 fMRI studies were published between 2002 and 2008. Incidental findings that require clinical follow-up are detected in two to three percent of healthy participants in these studies. At an average of 10 participants per study, that is two to three percent of 18,000 volunteers. Currently, protocols for handling incidental findings vary widely across institutions, ranging from costly, full clinical-grade imaging for all study participants before enrolment to "don't look, don't tell," where brain images aren't screened for anomalies. "The lack of consensus in incidental finding protocols creates both ethical and financial challenges for researchers and the health care system," says UBC Neurology Prof. Judy Illes, co-author of the study. "By examining this issue from a health economics viewpoint for the first time, we show that a strategy tailored to the health characteristics of research participants can safeguard the welfare of study participants while saving cost to the health care system," says Illes, who's also director of the National Core for Neuroethics at UBC. The researchers applied health economics modeling to intracranial aneurysm, a potentially fatal brain disorder if left untreated. They found that it is cost-effective to perform a full radiological exam before enrolling women with a family history of aneurysm in a brain imaging study. Men with no such family history have a lower risk of developing aneurysm and thus the cost of performing full neurologic scans prior to enrolling in a study is not justified. Meanwhile, the common practice of pre-screening brain scans by students and other individuals who have not been trained in brain imaging is not a cost-effective use of resources, regardless of participant profile, according to the study. "Discussions around incidental findings have so far centred around the duty to inform and care," says co-author Mohsen Sadatsafavi, a PhD student in UBC's Faculty of Pharmaceutical Sciences. "Our analysis looks at the issue from the cost-to-society perspective to define the optimal way to manage incidental findings. We've found that a universal approach simply isn't an optimal choice." "With widespread growth in brain imaging research -- an annual increase rate of 5.8 per cent for fMRI studies alone -- and vast improvements in the precision of brain imaging techniques, more and more healthy individuals can expect to be confronted with incidental findings," says Illes, who will lead similar research on other serious brain disorders. "Better harmonization of protocols is the ethical and economically prudent way of advancing research and the health of our society." Other co-authors include UBC Radiology Prof. David Li and Pharmaceutical Sciences Assoc. Prof. Carlo Marra.

Jun 17, 2010

Health

Researchers predict human visual attention using computer intelligence for the first time

Rockville, MD -- Scientists have just come several steps closer to understanding change blindness -- the well studied failure of humans to detect seemingly obvious changes to scenes around them -- with new research that used a computer-based model to predict what types of changes people are more likely to notice. These findings on change blindness were presented in a Journal of Vision article, "A semi-automated approach to balancing bottom-up salience for predicting change detection performance." "This is one of the first applications of computer intelligence to help study human visual intelligence, " said author Peter McOwan, professor at Queen Mary, University of London. "The biologically inspired mathematics we have developed and tested can have future uses in letting computer vision systems such as robots detect interesting elements in their visual environment." During the study, participants were asked to spot the differences between pre-change and post-change versions of a series of pictures. Some of these pictures had elements added, removed or color altered, with the location of the change based on attention grabbing properties (this is the "salience" level referred to in the article). Unlike previous research where scientists studied change blindness by manually manipulating such pictures and making decisions about what and where to make a change, the computer model used in this study eliminated any human bias. The research team at Queen Mary's School of Electronic Engineering and Computer Science developed an algorithm that let the computer "decide" how to change the images that study participants were asked to view. While the experiments confirmed that change blindness can be predicted using this model, the tests also showed that the addition or removal of an object from the scene is detected more readily than changes in the color of the object, a result that surprised the scientists. "We expected a color change to be a lot easier to spot, since color plays such an important role in our day-to-day lives and visual perception," said lead researcher Milan Verma of Queen Mary. The authors suggest that the computer-based approach will be useful in designing displays of an essential nature such as road signs, emergency services, security and surveillance to draw attention to a change or part of the display that requires immediate attention. "We live in a world in which we are immersed in visual information," explained Verma. "The result is a huge cognitive burden which may hinder our ability to complete a given task. This study is an important step toward understanding how visual information is processed and how we can go about optimizing the presentation of visual displays." The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include some 12,500 eye and vision researchers from over 80 countries. The Association encourages and assists research, training, publication and dissemination of knowledge in vision and ophthalmology. For more information, visit www.arvo.org. ARVO's Journal of Vision (www.journalofvision.org) is an online-only, peer-reviewed, open-access publication devoted to visual function in humans and animals. It explores topics such as spatial vision, perception, low vision, color vision and more, spanning the fields of neuroscience, psychology and psychophysics. JOV is known for hands-on datasets and models that users can manipulate online. Queen Mary, University of London is one of the UK's leading research-focused higher education institutions with some 15,000 undergraduate and postgraduate students. Amongst the largest of the colleges of the University of London, Queen Mary's 3,000 staff deliver world class degree programmes and research across 21 academic departments and institutes, within three sectors: Science and Engineering; Humanities, Social Sciences and Laws; and the School of Medicine and Dentistry. Ranked 11th in the UK according to the Guardian analysis of the 2008 Research Assessment Exercise, Queen Mary has been described as 'the biggest star among the research-intensive institutions' by the Times Higher Education and also won the 'Most Improved Student Experience' award for 2009, reflecting the superb academic and social experience offered to all students at the College. The College has a strong international reputation, with around 20 per cent of students coming from over 100 countries. Queen Mary has an annual turnover of £220 million, research income worth £61 million, and generates employment and output worth £600 million to the UK economy each year. As a member of the 1994 Group of research-focused universities, Queen Mary has made a strategic commitment to the highest quality of research, but also to the best possible educational, cultural and social experience for its students. The College is unique amongst London's universities in being able to offer a completely integrated residential campus, with a 2,000-bed award-winning Student Village on its Mile End campus. Media Contact: Simon Levey +44 (0)20 7882 5404 [email protected] Website: http://www.qmul.ac.uk Twitter: http://twitter.com/QMUL

Jun 16, 2010

Health

Research is getting closer to understanding critical nucleus in haze formation, prof says

COLLEGE STATION, June 14, 2010 - Haze, scientifically known as atmospheric aerosols - microscopic particles suspended in the Earth's atmosphere - represents a major environmental problem because it degrades visibility, affects human health and influences the climate. Despite its profound impacts, how the haze is formed is not fully understood, says a Texas A&M University professor of atmospheric sciences and chemistry who has studied air chemistry for more than 20 years. Professor Renyi Zhang published his work in the June 11 issue of Science magazine, summarizing recent findings and new research directions that could pave the way for a better understanding of aerosol formation. "Aerosols, also referred to as haze, influence climate by absorbing and reflecting solar radiation and modifying cloud formation," he explains. "A better understanding of how aerosols form in the atmosphere will greatly improve climate models. "But, formation of aerosols in the atmosphere is not fully understood, particularly at the molecular level, creating one of the largest sources of uncertainty in climate predictions," he adds. For aerosols to form, the bonding particles must cross an energy threshold, which the scientists call nucleation barrier. Once the barrier is crossed, aerosol formation can happen spontaneously, he notes. The interaction between organic acids and sulfuric acid can facilitate the crossing of the barrier by creating a critical nucleus, the Texas A&M professor says in the Science article. Large amounts of organic gases are emitted to the atmosphere by plants, industry and automobiles and form organic acids; sulfur dioxide, on the other hand, are produced by human activities, such as burning coals, and then form sulfuric acid. To better understand aerosol formation, scientists need to predict the nucleation rate based on knowledge of the composition of the critical nucleus, Zhang explains. This knowledge can be obtained by combining theoretical approaches with "measurements of the size and chemical composition of freshly nucleated nanoparticles in the laboratory and in the field," Zhang notes. Understanding and eventually controlling aerosol formation may help the environment, benefit human health and improve climate prediction, he says. About research at Texas A&M University: As one of the world's leading research institutions, Texas A&M is in the vanguard in making significant contributions to the storehouse of knowledge, including that of science and technology. Research conducted at Texas A&M represents an annual investment of more than $582 million, which ranks third nationally for universities without a medical school, and underwrites approximately 3,500 sponsored projects. That research creates new knowledge that provides basic, fundamental and applied contributions resulting in many cases in economic benefits to the state, nation and world. Contact: Keith Randall, News & Information Services, at (979) 845-4644 or [email protected]; or Miao Jingang, News & Information Services, at [email protected] or Renyi Zhang at (979) 845-7656 or [email protected].

Jun 16, 2010

Health

Male desire to be strong and protect family key to preventing suicides: UBC study

Masculine ideals of strength coupled with strong family ties can help men combat depression and overcome thoughts of suicide, according to University of British Columbia research. In a study to appear in a forthcoming issue of Social Science and Medicine, UBC researchers John Oliffe and John Ogrodniczuk looked at how men's ideas of masculinity served or hindered them during bouts of severe depression. Their findings shed light on risk factors and prevention strategies for suicide. The authors analyzed qualitative data from interviews with 38 men between 24 and 50 years of age living in Vancouver and Prince George. The participants were self-identified or were formally diagnosed with depression. The study suggests that men can best counter suicidal thoughts by connecting with others -- namely intimate partners and family -- to regain some stability and to secure emotional support from others. "Support from friends and connecting to other things including spirituality is often the conduit to men seeking professional help to overcome the suicidal thoughts that can accompany severe depression" says lead author Oliffe, an associate professor in the School of Nursing. Men die by suicide at least three times more than women although it is women who are diagnosed at twice the rate of men for depression. Men aged 20-29 have the highest rate of suicide. Statistics Canada reports that in 2003, the last year for which data is available, more than 2,900 men committed suicide. The investigators found that most study participants expressed a strong commitment to their families and turned away from suicide for the hurt and trauma it would cause loved ones. "Here, men's strong sense of masculine roles and responsibility as a provider and protector enables men to hold on while seeking support to regain some self-control," says Oliffe. But Ogrodniczuk says the "stoic warrior" ideal also presents a downside that can lead men to shut down and look for escape. In these situations, study participants chose to mute their feelings or disconnect from others. They often overused alcohol and other drugs. "Instead of finding respite from their emotional, mental and physical pain, self-harm emerged as the most common outcome of these actions," says Ogrodniczuk, an associate professor in the Dept. of Psychiatry The study received support from the Canadian Institutes of Health Research (CIHR), which supports better health and healthcare for Canadians. As the Government of Canada's health research investment agency, CIHR enables the creation of evidence-based knowledge and its transformation into improved treatments, prevention and diagnoses, new products and services, and a stronger, patient-oriented healthcare system. Composed of 13 internationally-recognized institutes, CIHR supports more than 13,000 health researchers and trainees across Canada. www.cihr-irsc.gc.ca

Jun 16, 2010

Health

SNM's 2010 Annual Meeting reveals latest developments in molecular imaging and nuclear medicine

More than 5,100 physicians, technologists and members of the molecular imaging and nuclear medicine communities gathered in Salt Lake City for SNM's 57th Annual Meeting, held June 5-9. The meeting featured more than 1,400 scientific papers that represented groundbreaking research and development worldwide in molecular imaging and nuclear medicine. "SNM's 57th Annual Meeting brought together basic and clinical scientists representing all aspects of molecular imaging," said Dominique Delbeke, Ph.D., M.D., who was inducted as president of SNM during the meeting. "Those who attended the meeting are conducting research that represents the future of clinical practice and patient care." A highlight of the Annual Meeting's first plenary session, held Sunday, June 6, was the Henry J. Wagner Jr. Lectureship, delivered by Larry Kessler, Sc.D., professor and chair of the department of health services, School of Public Health, University of Washington. In the lecture, "Strange Bedfellows? Comparative Effectiveness Research, Molecular Imaging Medical Practice, and Health Policy," Kessler discussed both the challenges and promise of evidence-based medicine with respect to molecular imaging and how the health policy and decision-making landscape may change. Two prestigious SNM awards were presented during the first plenary lecture. Bengt Roland Långström, Ph.D., a professor in the department of biochemistry and organic chemistry at Uppsala University in Sweden, was named this year's recipient of the Georg Charles de Hevesy Nuclear Pioneer Award for his contributions to the nuclear medicine profession. In addition, Chester A. Mathis, Ph.D., director of the PET facility in the department of radiology at the University of Pittsburgh, was named the recipient of the prestigious Paul C. Aebersold Award for his long-standing work in the field of neuroimaging. At the second plenary session on Monday, June 7, Sung-Cheng (Henry) Huang, D.Sc., a pioneer in the development of positron emission tomography (PET), presented the Cassen lectureship on the perspective of quantitative imaging. The lecture focused on learning more about molecular processes and pathways in cellular function using labeled biomarkers and integrating information for practical applications. Huang said that as imaging technology becomes more sophisticated, there is a greater need for analytical approaches that can analyze the image data, extract biological information and determine its medical relevance. Also on June 7, SNM leadership called attention to three shortages that are currently plaguing the medical community: a shortage of radioisotopes, a shortage of reimbursement and a shortage of jobs for physicians and technologists. The 57th Annual Meeting concluded on Wednesday, June 9, with an overview of the cutting-edge research presented throughout the sessions. The research demonstrated groundbreaking advances in many areas, including research on molecular imaging to identify the first signs of Alzheimer's disease and research on the detection of recurrent prostate cancer. "We had a tremendous international presence at our meeting, with molecular imaging science as our common language," said Peter Herscovitch, M.D., chair of SNM's Scientific Program Committee. "Scientific abstract submissions came from 70 countries. In fact, 56% of this year's abstract submissions came from outside the United States." Herscovitch said that the common theme that linked all of these participants together was the focus on using molecular imaging to understand the mechanisms of disease, to diagnose and determine the extent of disease and, ultimately, to improve the health of patients. About SNM -- Advancing Molecular Imaging and Therapy SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today's medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated. SNM's more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit http://www.snm.org.

Jun 16, 2010

Health

'Fowl' news: Hints from Taiwan that free-range eggs may be less healthy than regular eggs

Contrary to popular belief, paying a premium price for free-range eggs may not be healthier than eating regular eggs, a new study reports. Scientists found that free-range eggs in Taiwan contain at least five times higher levels of certain pollutants than regular eggs. Their findings appear in ACS' bi-weekly Journal of Agricultural and Food Chemistry. In the new study, Pao-Chi Liao and colleagues note that free-range chickens are those that have continuous access to fresh air, sunshine, and exercise, in contrast to chickens that are confined to cages. Demand for eggs from free-range chickens has increased steadily due to their supposed better nutrition qualities, including higher levels of certain healthy fats. But scientists suspect that free-range chickens may risk getting higher levels of exposure to environmental pollutants, particularly PCDDs and PCDFs, potentially toxic substances that are produced as by-products of burning waste. Also known as dioxins, these substances may cause a wide range of health problems in humans, including reproductive and developmental problems and cancer. The scientists collected six free-range eggs and 12 regular eggs from farms and markets in Taiwan and analyzed the eggs for their content of dioxins. Taiwan, they note, is a heavily populated, industrialized island with many of the municipal incinerators that release PCDDs and PCDFs. They found that the free-range eggs contained 5.7 times higher levels of PCDDs and PCDFs than the regular eggs. The scientists suggest that the findings raise concern about the safety of eating free-range chicken eggs. ARTICLE FOR IMMEDIATE RELEASE "Elevated PCDD/F Levels and Distinctive PCDD/F Congener Profiles in Free Range Eggs" DOWNLOAD FULL TEXT ARTICLE http://pubs.acs.org/stoken/presspac/presspac/full/10.1021/jf100456b CONTACT: Pao-Chi Liao, Ph.D. Department of Environmental and Occupational Health College of Medicine National Cheng Kung University Tainan, Taiwan Phone: 886-6-2353535, ext. 5566 Fax: 886-6-3028095 Email: [email protected]

Jun 16, 2010

Earth & Environment

Consumer responses to Gulf oil spill reflect Americans' changing corporate expectations

Just as President Barack Obama called for in his address to the nation last night, Americans are demanding that BP and all other companies be responsible to both their shareholders and society, according to a new report from Rice University's Jones Graduate School of Business. The rigorous survey-based nationwide study of U.S. adults aware of the oil spill in the Gulf of Mexico found that Republicans, Democrats and Independents strongly agree that the spill shows that businesses need to be more socially responsible and they agree that socially responsible corporations can also create a lot of wealth for their shareholders. "Over the years, there has been a core shift in the American public's expectations," said Vikas Mittal, professor of marketing at the Jones School. "The old idea was that businesses were only responsible to their shareholders. But now people are realizing that this isn't a zero-sum game. No matter their political leanings, Americans expect corporations to be profitable, sustainable and socially responsible." Mittal and his co-author, Rajan Sambandam from the market research company TRC, surveyed a national sample of 522 adults using a scale where zero indicated complete disagreement and 10 indicated complete agreement. On the 0-to-10 scale, Republicans with an average rating of 7.9, Independents (8.3) and Democrats (8.3) agreed that "socially responsible corporations can also create a lot of wealth for their shareholders." Independents (9.0) and Democrats (8.7) agreed somewhat more than Republicans (8.0) that "corporate social responsibility is just as important as corporate shareholder responsibility." Even given the current spill, Americans aren't ready for government to completely ban offshore drilling, according to the study. When asked whether the oil spill made them more likely to support a ban on offshore drilling, Republican ratings averaged 3.3, Democrats 5.8 and Independents 5.3 in support of a ban. Republicans disagreed sharply with Independents and Democrats on issues concerning offshore drilling. On the 0-to-10 scale, Republicans more strongly agreed that: The government should allow offshore exploration (7.8). Offshore drilling is critical for America to maintain its competitiveness (8.2). "People are recognizing business is a key driver of economic and societal progress," Mittal said. "They understand the best way is not to block the economic process of running a business, but to expect companies and their CEOs to create shareholder wealth while being socially responsible." Mittal noted that business executives are realizing the changing expectations. He cited a 2010 study that showed 60 percent of business executives consider sustainability issues to be very or extremely important in their overall corporate strategy. "I expect this proportion to only grow in the coming future," he said. "However, I concur with the public's general view that populist government interventions that block progress are unlikely to solve complex issues facing societies -- of which public, business and government are co-equal key stakeholders." To read the survey questions and to see the complete results, visit www.rice.edu/nationalmedia/multimedia/2010-06-16-mittal.pdf For more information or to interview the study's authors, contact David Ruth at [email protected] or 713-348-6327.

Jun 16, 2010

Health

New world Helicobacter pylori genome sequenced, dynamics of inflammation-related genes revealed

An international team of researchers led by scientists at the Virginia Bioinformatics Institute (VBI) at Virginia Tech have sequenced the genome of an Amerindian strain of the gastric bug Helicobacter pylori, confirming the out-of-Africa migration of this bacterial stowaway to the New World. Experiments in animals have highlighted how specific genes in the bacterial strain may be crucial to the onset of inflammation and disease. H. pylori is a bacterium that colonizes the stomachs of over half the world's human population. Different strains of the bug have lived with, evolved and followed humans on their travels since ancient times. H. pylori is now recognized as a major risk factor in the development of stomach cancer and ulcers. However, the details of what make some strains of the bug trigger disease and others not need to be fully worked out. Martin Blaser of the New York University Langone Medical Center, one of the authors of the study, remarked: "Most sequencing efforts for H. pylori have focused on the bacterial genomes from individuals of European descent. The new sequence information helps to redress the geographic bias of earlier work and reveals important clues about the evolution and migration of the bacterium and its human host into the New World." To help visualize the evolutionary relationships among the different H. pylori strains, the team built a robust phylogenetic tree that helps show the evolutionary relationships among the different biological strains. The tree of life that the scientists were able to piece together reflected the major human migration out of Africa, through Asia and into the New World. Consistent with earlier findings, similarities between the genetic make-up of the Amerindian strain and the genome of a strain from East Asia suggest that the first colonizers of the New World brought H. pylori with them. Josep Bassaganya-Riera, associate professor and leader of the Nutritional Immunology Group at the Virginia Bioinformatics Institute at Virginia Tech, senior author on the paper, commented: "In addition to building a picture of the H. pylori genome, we have been trying to find out what features of the Amerindian strain of H. pylori might be responsible for the low incidence of gastric cancer and other related conditions that have been reported in some geographic areas, including parts of South America. Our experiments show that a cytotoxin-associated gene known as cagA is essential to induce inflammation." He added: "Further experiments in mice have revealed that an unusual arrangement of these inflammation-related genes are lost when the organism interacts with its host in the stomach, which may explain the low incidence of gastric cancer and peptic ulcers in some populations of the New World. Further experiments are in progress to establish the causality of these observations and to develop computational and mathematical models of immune responses to H. pylori." The scientists hope to use the insights gained from the analysis of the H. pylori genome to help in the development of diagnostic tools and therapies for inflammation-related diseases and conditions. Read the paper: Mane SP, Dominguez-Bello MG, Blaser MJ, Sobral BW, Hontecillas R, Skoneczka J, Mohapatra SK, Crasta OR, Evans C, Modise T, Shallom S, Shukla M, Varon C, Mégraud F, Maldonado-Contreras AL, Williams KP, Bassaganya-Riera J. (2010) Host-Interactive Genes in Amerindian Helicobacter pylori Diverge From Their Old World Homologs and Mediate Inflammatory Responses. Journal of Bacteriology 192(12): 3078-3092. Available on-line at http://jb.asm.org/cgi/reprint/JB.00063-10v1?view=long&pmid=20400544 Read about the discovery of the link between H. pylori and cancer: https://www.vbi.vt.edu/public_relations/press_releases/computational_genomics About VBI The Virginia Bioinformatics Institute (http://www.vbi.vt.edu) at Virginia Tech is a premier bioinformatics, computational biology, and systems biology research facility that uses transdisciplinary approaches to science combining information technology, biology, and medicine. These approaches are used to interpret and apply vast amounts of biological data generated from basic research to some of today's key challenges in the biomedical, environmental, and agricultural sciences. With more than 240 highly trained multidisciplinary, international personnel, research at the institute involves collaboration in diverse disciplines such as mathematics, computer science, biology, plant pathology, biochemistry, systems biology, statistics, economics, synthetic biology, and medicine. The large amounts of data generated by this approach are analyzed and interpreted to create new knowledge that is disseminated to the world's scientific, governmental, and wider communities.

Jun 16, 2010