Childhood stress raises allergy risk
Friday June 27th, 2008
Major distressing life events put children at a increased risk of allergy and asthma, new research suggests.
Family break-up and moving house are among the most traumatic events that can trigger allergy, researchers found.
This is because major changes have a direct effect on the immune system, according to German experts.
The researchers took blood samples from 234 six-year old children to measure levels of a stress-related hormone called VIP and immune markers such as IL-4. Children with separated or divorced parents showed particularly high VIP levels, as did those who had recently moved house.
Not all sad life events seemed to trigger the same reactions.
Severe disease, parental unemployment and death of a family member led to "no remarkable changes", say Dr Gunda Herberth of the Helmholtz Centre for Environmental Research in Leipzig, Germany, and colleagues.
They believe that "as tragic as these events are, they are obviously however of less significance for the stress reactions of children than for example a separation or the divorce of parents".
Full details are published in the journal Pediatric Allergy and Immunology.
The researchers explain that it is widely believed that major events influence the development of allergies.
They write: "Stressful life events evidently have an impact on development of allergic diseases, but the mechanism linking stress to pathological changes of immune system function is still not fully understood.
"VIP might be a mediator between stressful life events and immune regulation," they add, because it influences the behaviour of the immune system.
The results "provide valuable indications as to what exactly happens to the body through stress", they conclude.
Herberth, G. et al. Relation between stressful life events, neuropeptides and cytokines: an epidemiological study. Pediatric Allergy and Immunology, published online February 25, 2008.
Novel gene test shows breast cancer risk
Friday June 27th, 2008
A new gene test is on the horizon which could indicate whether women are likely to develop breast cancer, it was announced yesterday.
Researchers from Cambridge University, UK, say that if the simple mouth swab test detects a predisposition in women around the age of 30, they could be called for mammograms at a younger age. Women are currently invited for their first mammogram at the age of 50.
The necessary technology is already in existence, explains Dr Paul Pharoah. "To design a test is relatively straightforward if the powers that be thought it was worthwhile," he said.
"We believe genetic testing has the potential to enable doctors to identify a woman at an increased risk of breast cancer who would benefit from mammography at an early age or woman who may benefit from regular MRI scanning as well. This approach would also identify a 55 year old woman with a low chance of breast cancer who possibly wouldn't need such regular checks."
This could have "profound implications for the NHS breast screening programme", he adds.
His team's research has found seven genetic variants which together increase the risk of breast cancer, in addition to the better-known, higher-risk genes such as BRCA1 and BRCA2. Details appear in the New England Journal of Medicine.
"The clinical use of single, common, low-penetrance genes is limited, but a few susceptibility alleles may distinguish women who are at high risk for breast cancer," the authors write.
Professor Sir Bruce Ponder commented: "It is very exciting to see workable and affordable approaches to genetic screening for breast cancer on the horizon. We expect such technology to develop very fast in the next decade."
Pharoah, P. D. P. et al. Polygenes, Risk Prediction, and Targeted Prevention of Breast Cancer. The New England Journal of Medicine, Vol. 358, June 26, 2008, pp. 2796-2803.
Gene link to prostate cancer mortality
Thursday June 26th, 2008
Researchers have identified a genetic clue to survival rates from prostate cancer.
Certain cases of prostate cancer are linked to mutations in the genes BRCA1 and BRCA2. A team led by Dr Steven Narod of the University of Toronto, Canada, have found evidence that prostate cancers caused by mutations in the BRCA2 gene are more than twice as likely to lead to death than those with mutations in the BRCA1 gene.
BRCA2 patients in their study lived for an average of four years after diagnosis, compared to an average of eight years for BRCA1 patients, the team report in the British Journal of Cancer.
"We know that carrying a faulty BRCA2 gene increases a man's risk of getting prostate cancer, and our study shows that it also affects how long he will survive a diagnosis of the disease," said Dr Narod.
"This information is important because it shows that men with BRCA2 are not responding as well to current therapies, so we hope these findings could help doctors more effectively tailor treatment to this group."
Earlier studies suggest that men with a faulty BRCA2 gene can be up to five times more likely to develop prostate cancer than the general population.
Dr Lesley Walker of Cancer Research UK, which publishes the journal, said: "Although only a very small percentage of men with prostate cancer will carry a faulty BRCA2 gene, they're much more likely to die from the disease.
"It's important that more research is done in this area to ensure that this group is targeted effectively so cancer is picked up at an early stage and, more importantly, that they are given the most appropriate treatment."
Narod, S. A. et al. Rapid progression of prostate cancer in men with a BRCA2 mutation. Narod et al. The British Journal of Cancer, published online June 24, 2008.
Pain finding challenges anaesthetists
Wednesday June 25th, 2008
British anaesthetists have resolved to rise to the challenge of new findings about post-operative pain.
The research in the Proceedings of the National Academy of Sciences explains how common anaesthetic agents can lead to chronic pain after an operation.
British specialists said the findings highlighted the need for better research into anaesthesia.
Dr Gerard Aherne, of Georgetown University, Washington DC, report that the effects of general anaesthetics "combined with surgical tissue damage could lead to a paradoxical increase in postoperative pain and inflammation".
The Association of Anaesthetists said a new collaboration between British research organisations is hoping to attract funding from British sources.
President Dr David Whitaker said: "Earlier work suggested this phenomenon only occurred at low concentrations of anaesthetic agents and was reversed by morphine type pain killers.
"However the discovery of specific receptors involved in pain after surgery should lead to research into the development of even better anaesthetic agents for our patients."
PNAS June 24 2008, 105.25, 8784-8789
Overcrowding and understaffing blamed for infections
Tuesday June 24th, 2008
Hospital infection is running rife because of overcrowding and understaffing, according to a major international study published today.
Developed countries are struggling to recruit nurses and are also under pressure to increase efficiency, according to the report in The Lancet Infectious Diseases.
Expert Dr Archie Clements,of the University of Queensland, Australia, says there is strong research evidence that staffing rates affect infection rates. As many as a quarter of infections can be avoided when hospitals have a ratio of no more than 2.2 patients per health care worker.
The report says Australia has seen a 40 per cent decrease in hospital beds in 20 years.
In Britain 71 per cent of hospital trusts exceed bed occupancy rates of 82 per cent, the government target rate.
The researchers write: "The drive towards greater efficiency by reducing the number of hospital beds and increasing patient throughput has led to highly stressed health-care systems with unwelcome side-effects."
They add: "Overcrowding and understaffing have had a negative effect on patient safety and quality of care, evidenced by the flourishing of health-care-acquired MRSA infections in many countries, despite efforts to control and prevent these infections occurring.
"There is an urgent need for detailed study of the relative effects of acute short-term and chronic long-term resource constraints on the dynamics of MRSA infection and a concurrent requirement for developing resource allocation strategies that minimise MRSA transmission without compromising the quality and level of patient care."
Lancet Infectious Diseases July 2008
Surgical safety plan launched
Tuesday June 24th, 2008
An international initiative to improve the safety of surgical procedures worldwide was launched yesterday.
The World Health Organisation is promoting a "safe surgery checklist" system.
WHO said safety remains a problem in developed countries with estimates suggesting between three and 16 per cent of in-patient operations resulting in complications.
In developing countries death rates reach five to ten per cent for major surgery.
WHO said the checklist had been tested in eight pilot sites - where evidence showed it doubled the chances that patient care would reach proven standards.
The list sets out all steps to be taken, including the marking of surgical sites and the checking of allergies.
Developer Professor Atul Gawande, of Harvard University, Massachusetts, USA, said: "Surgical care has been an essential component of health systems worldwide for more than a century.
"Although there have been major improvements over the last few decades, the quality and safety of surgical care has been dismayingly variable in every part of the world.
"The Safe Surgery Saves Lives initiative aims to change this by raising the standards that patients anywhere can expect."
NHS may face age laws
Monday June 23rd, 2008
The government is planning to legislate against alleged age discrimination in the NHS, it was reported today.
The NHS would be a key focus of new anti-ageism laws, equality minister Harriet Harman has revealed.
Reports said a key target would be allegations that elderly people may be denied operations because of their age.
According to the Daily Telegraph, the bill would also prevent doctors from "patronising" elderly patients.
Kate Jopling, of Help the Aged, told the paper the bill would be a "massive step forward".
She said: "The timetable for implementation is crucial. The Government acknowledged the problem of age discrimination as far back as 2001 - older people sitting in a doctor's surgery or a hospital bed should not be forced to wait any longer for equal treatment."
Ms Harman told MPs last week: "The last frontier of equality is ensuring that the growing number of older people in this country don't face unfair prejudice and discrimination."
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