The virus that causes winter vomiting disease invades cells by attaching to particular sugar molecules on the surface of the cells. This is the conclusion of a thesis presented at the Sahlgrenska Academy, University of Gothenburg, Sweden. This result may be an important step in the development of a drug against the regular hospital-based epidemics caused by the virus.
Winter vomiting disease is an infectious inflammation of the gastro-intestinal tract, which occurs principally during the winter months. There is presently no vaccine, and no drugs to combat the infection. The disease causes diarrhoea and vomiting, and its consequences may be very serious for people who are already seriously ill or weak.
"We are aiming to develop a drug that can be given to vulnerable persons and to children in day-care when it has become clear that another epidemic is starting to break out. More research will, however, be required. Our results are important steps along the way, but it will probably be several years before a drug is commercially available", says Gustaf Rydell who successfully defended his PhD thesis on June 8, 2009.
The thesis describes how the virus for winter vomiting disease can attach to cells by binding to special sugar chains. One of these chains is characterised in that it has a monosaccharide known as sialic acid at its end. The thesis also shows that the virus binds to such sugar chains even when they are not part of the cell surface. This means that it may be possible for the sugar chains to prevent the virus infecting the cells by blocking its binding structures.
"Our results suggest that the sugar chains that have sialic acid are important for infection by the virus, but this must be confirmed. If it is true, it would be possible to develop a drug that blocks the access of the virus to the sugar molecule. One thing that we must investigate first, however, is whether there are other target molecules that the virus can use to enter the cell. These may be the starting point for even more effective drugs", says Gustaf Rydell.
NOROVIRUSES
Noroviruses are considered to be the micro-organism that causes the greatest incidence of vomiting and diarrhoea in the world. The viruses are responsible for approximately 200,000 child deaths in developing countries each year. Development of pharmaceuticals is made difficult by the fact that new virus strains arise continuously. One fifth of the population of Europe are "secretor negative" individuals, and these people have an inherited resistance to noroviruses.
Source:
Elin Lindstr?¶m Claessen
University of Gothenburg
суббота, 26 ноября 2011 г.
суббота, 19 ноября 2011 г.
Study Of Esophageal Cancer Patients Found That Marital Status Affected Quality Of Life
In a surprising finding, American scientists have discovered that when battling oesophageal cancer, married patients don't fare as well as their single counterparts in certain aspects of their quality of life.
In the study, presented at the European Cancer Conference (ECCO 14) in Barcelona, 212 oesophageal cancer patients and 489 patients with Barrett's oesophagus, a non-cancerous condition linked to acid reflux, filled out two quality of life questionnaires a year apart. Changes in the scores between the two assessments were analysed according to marital status.
No differences in quality of life changes over time were seen between marital states in the patients with Barrett's oesophagus. That finding was expected because the condition is not a potentially fatal one requiring stressful major treatment.
"In general, there were not major differences in quality of life between single and married oesophageal cancer patients, but there were slight differences in some aspects," said the study's lead researcher, Dr. Robert Miller, an assistant professor of oncology at the Mayo Clinic in Rochester, Minnesota.
For the single patients, quality of life scores relating to pain frequency, overall physical wellbeing and legal worries improved between the first and second questionnaire. However, married patients reported less improvement in their legal worries than the single patients did, and worsening physical wellbeing and increasing pain frequency over time.
"In the second questionnaire, single people rated their overall physical quality of life at a score 0.7 points higher on a scale of one to 10 than they did on the first questionnaire. However, for married people, the score dropped 0.4 points," Miller said.
The results for pain frequency were similar, with the singles improving by 0.6 points and the married patients reporting a 0.9-point deterioration.
When it came to perceptions of legal worries, all patients reported improvement, but the singles moved 1.1 points up the scale, while the married patients gained only 0.2 points.
"These findings were surprising, as we thought we'd be demonstrating improved outcomes in married patients," Miller said.
Most previous studies comparing the quality of life of married and single cancer patients, chiefly in breast but also in brain cancer, indicate that married people do better than single people, noted Miller. He said one reason why the current study came out differently could be that oesophageal cancer has a worse prognosis in comparison to some of the other types of cancers previously studied.
Also, there were approximately nine men to every woman in the oesophageal cancer group. This gender ratio may account for the difference between the latest results and those seen in studies of breast cancer patients.
"It's hard to interpret why married patients didn't do as well as single patients, but one explanation could be that having a family to support and care for when you have a serious and potentially life-threatening disease may increase a person's worries, leading to a decrease in quality of life," said Miller. "Being single may be associated with less negative changes in quality of life over time because the disease is more disruptive if you have others relying on one's participation in family social and economic activities."
Married patients diagnosed with oesophageal cancer may require extra diligence when evaluating pain and other somatic complaints, and there may be issues outside the standard concerns of medicine, Miller said.
Catalogue no: 1107
Source: Emma Ross
ECCO-the European CanCer Conference
In the study, presented at the European Cancer Conference (ECCO 14) in Barcelona, 212 oesophageal cancer patients and 489 patients with Barrett's oesophagus, a non-cancerous condition linked to acid reflux, filled out two quality of life questionnaires a year apart. Changes in the scores between the two assessments were analysed according to marital status.
No differences in quality of life changes over time were seen between marital states in the patients with Barrett's oesophagus. That finding was expected because the condition is not a potentially fatal one requiring stressful major treatment.
"In general, there were not major differences in quality of life between single and married oesophageal cancer patients, but there were slight differences in some aspects," said the study's lead researcher, Dr. Robert Miller, an assistant professor of oncology at the Mayo Clinic in Rochester, Minnesota.
For the single patients, quality of life scores relating to pain frequency, overall physical wellbeing and legal worries improved between the first and second questionnaire. However, married patients reported less improvement in their legal worries than the single patients did, and worsening physical wellbeing and increasing pain frequency over time.
"In the second questionnaire, single people rated their overall physical quality of life at a score 0.7 points higher on a scale of one to 10 than they did on the first questionnaire. However, for married people, the score dropped 0.4 points," Miller said.
The results for pain frequency were similar, with the singles improving by 0.6 points and the married patients reporting a 0.9-point deterioration.
When it came to perceptions of legal worries, all patients reported improvement, but the singles moved 1.1 points up the scale, while the married patients gained only 0.2 points.
"These findings were surprising, as we thought we'd be demonstrating improved outcomes in married patients," Miller said.
Most previous studies comparing the quality of life of married and single cancer patients, chiefly in breast but also in brain cancer, indicate that married people do better than single people, noted Miller. He said one reason why the current study came out differently could be that oesophageal cancer has a worse prognosis in comparison to some of the other types of cancers previously studied.
Also, there were approximately nine men to every woman in the oesophageal cancer group. This gender ratio may account for the difference between the latest results and those seen in studies of breast cancer patients.
"It's hard to interpret why married patients didn't do as well as single patients, but one explanation could be that having a family to support and care for when you have a serious and potentially life-threatening disease may increase a person's worries, leading to a decrease in quality of life," said Miller. "Being single may be associated with less negative changes in quality of life over time because the disease is more disruptive if you have others relying on one's participation in family social and economic activities."
Married patients diagnosed with oesophageal cancer may require extra diligence when evaluating pain and other somatic complaints, and there may be issues outside the standard concerns of medicine, Miller said.
Catalogue no: 1107
Source: Emma Ross
ECCO-the European CanCer Conference
суббота, 12 ноября 2011 г.
Gene Linked To Vertebral Defects In Patient Populations Identified By Stowers Institute Researchers
Stowers Institute researchers Karen Staehling-Hampton, Ph.D., Managing Director of Molecular Biology, and Olivier Pourqui?©, Ph.D., Investigator, collaborated with colleagues from around the world to show that genes known to cause spinal mutations in chick and mouse model systems also play an important role in human patients with congenital vertebral abnormalities.
The discovery was published on the Web site of the American Journal of Human Genetics.
Working with samples from 31 patients at Boston Children's Hospital with various congenital vertebral defects, the team sequenced five genes thought to be involved in the malformations. In a patient of Puerto Rican descent, the team discovered a mutation in the MESP2 gene - a mutation that completely disrupted the function of the gene.
The affected patient had Spondylothoracic Dysostosis, also known as Jarcho-Levin Syndrome. Spondylothoracic Dysostosis is a rare genetic disorder characterized by distinctive malformations of the vertebrae and ribs, respiratory problems, and other abnormalities. Infants born with Spondylothoracic Dysostosis have short necks, limited neck motion, and are short in stature. Spondylothoracic Dysostosis is prevalent in the Puerto Rican population.
Sequencing of samples from additional Spondylothoracic Dysostosis patients of Puerto Rican descent demonstrated the same mutation in the MESP2 gene.
"Spondylothoracic Dysostosis was first characterized in the Puerto Rican population 70 years ago," said Dr. Staehling-Hampton, co-equal first author on the paper, "but the gene mutation causing the condition was not isolated until now. The MESP2 mutation can be detected by a simple assay, so identification of this mutation will allow people who have a family history of Spondylothoracic Dysostosis to determine if they carry the mutation and whether they are at risk of passing the disorder on to future generations."
"After working for many years to study spinal formation in chicks and mice, it is rewarding to expand our investigation to clinical applications," said Dr. Pourqui?©, senior author on the publication. "We will continue to work with colleagues to collect more samples from patients with congenital vertebral abnormalities and sequence more genes to look for causative mutations. Additionally, we will sequence MESP2 in a larger collection of DNA samples from Puerto Rico to determine the carrier frequency of this MESP2 mutation in the general Puerto Rican population."
Kym Delventhal, a Laboratory Manager in the Stowers Institute's Molecular Biology Facility, also contributed to this publication.
Additional contributing authors include Alberto Cornier, Department of Molecular Medicine, La Concepci??n Hospital, San German, Puerto Rico and Department of Biochemistry, Ponce School of Medicine, Ponce, Puerto Rico; Yumiko Saga, Division of Mammalian Development, National Institute of Genetics, Mishima, Japan; Jean-Francois Caubet, Department of Orthopaedic Surgery, Children's Hospital Boston; Nobuo Sasaki, Division of Mammalian Development, National Institute of Genetics, Mishima, Japan; Sian Ellard, Department of Molecular Genetics, Royal Devon and Exeter Hospital, Exeter, United Kingdom; Elizabeth Young, Department of Molecular Genetics, Royal Devon and Exeter Hospital, Exeter, United Kingdom; Norman Ramirez, Department of Orthopaedics, La Concepci??n Hospital, San German, Puerto Rico; Simon Carlo, Department of Molecular Medicine, La Concepci??n Hospital, San German, Puerto Rico and Department of Genetics, San Juan Bautista School of Medicine, Caguas, Puerto Rico; Jose Torres, Department of Biochemistry, Ponce School of Medicine, Ponce, Puerto Rico; John Emans, Department of Orthopaedic Surgery, Children's Hospital Boston; and Peter Turnpenny, Clinical Genetics Department, Royal Devon and Exeter Hospital, Exeter, United Kingdom.
The Stowers Institute Molecular Biology Facility supports investigators in their research endeavors by providing high-quality services, participation in collaborative projects, and access to state-of-the-art technology. Learn more about their work at www.stowers-institute/Public/CoreFacilities.asp#mobio.
Dr. Pourqui?© also is an investigator with the Howard Hughes Medical Institute and a Professor in the Department of Anatomy & Cell Biology at the University of Kansas School of Medicine. Learn more about his work at stowers-institute/labs/PourquieLab.asp.
About the Stowers Institute
Housed in a 600,000 square-foot state-of-the-art facility on a 10-acre campus in the heart of Kansas City, Missouri, the Stowers Institute for Medical Research conducts basic research on fundamental processes of cellular life. Through its commitment to collaborative research and the use of cutting-edge technology, the Institute seeks more effective means of preventing, treating, and curing disease. The Institute was founded by Jim and Virginia Stowers, two cancer survivors who have created combined endowments of $2 billion in support of basic research of the highest quality.
Source: Marie Jennings
Stowers Institute for Medical Research
The discovery was published on the Web site of the American Journal of Human Genetics.
Working with samples from 31 patients at Boston Children's Hospital with various congenital vertebral defects, the team sequenced five genes thought to be involved in the malformations. In a patient of Puerto Rican descent, the team discovered a mutation in the MESP2 gene - a mutation that completely disrupted the function of the gene.
The affected patient had Spondylothoracic Dysostosis, also known as Jarcho-Levin Syndrome. Spondylothoracic Dysostosis is a rare genetic disorder characterized by distinctive malformations of the vertebrae and ribs, respiratory problems, and other abnormalities. Infants born with Spondylothoracic Dysostosis have short necks, limited neck motion, and are short in stature. Spondylothoracic Dysostosis is prevalent in the Puerto Rican population.
Sequencing of samples from additional Spondylothoracic Dysostosis patients of Puerto Rican descent demonstrated the same mutation in the MESP2 gene.
"Spondylothoracic Dysostosis was first characterized in the Puerto Rican population 70 years ago," said Dr. Staehling-Hampton, co-equal first author on the paper, "but the gene mutation causing the condition was not isolated until now. The MESP2 mutation can be detected by a simple assay, so identification of this mutation will allow people who have a family history of Spondylothoracic Dysostosis to determine if they carry the mutation and whether they are at risk of passing the disorder on to future generations."
"After working for many years to study spinal formation in chicks and mice, it is rewarding to expand our investigation to clinical applications," said Dr. Pourqui?©, senior author on the publication. "We will continue to work with colleagues to collect more samples from patients with congenital vertebral abnormalities and sequence more genes to look for causative mutations. Additionally, we will sequence MESP2 in a larger collection of DNA samples from Puerto Rico to determine the carrier frequency of this MESP2 mutation in the general Puerto Rican population."
Kym Delventhal, a Laboratory Manager in the Stowers Institute's Molecular Biology Facility, also contributed to this publication.
Additional contributing authors include Alberto Cornier, Department of Molecular Medicine, La Concepci??n Hospital, San German, Puerto Rico and Department of Biochemistry, Ponce School of Medicine, Ponce, Puerto Rico; Yumiko Saga, Division of Mammalian Development, National Institute of Genetics, Mishima, Japan; Jean-Francois Caubet, Department of Orthopaedic Surgery, Children's Hospital Boston; Nobuo Sasaki, Division of Mammalian Development, National Institute of Genetics, Mishima, Japan; Sian Ellard, Department of Molecular Genetics, Royal Devon and Exeter Hospital, Exeter, United Kingdom; Elizabeth Young, Department of Molecular Genetics, Royal Devon and Exeter Hospital, Exeter, United Kingdom; Norman Ramirez, Department of Orthopaedics, La Concepci??n Hospital, San German, Puerto Rico; Simon Carlo, Department of Molecular Medicine, La Concepci??n Hospital, San German, Puerto Rico and Department of Genetics, San Juan Bautista School of Medicine, Caguas, Puerto Rico; Jose Torres, Department of Biochemistry, Ponce School of Medicine, Ponce, Puerto Rico; John Emans, Department of Orthopaedic Surgery, Children's Hospital Boston; and Peter Turnpenny, Clinical Genetics Department, Royal Devon and Exeter Hospital, Exeter, United Kingdom.
The Stowers Institute Molecular Biology Facility supports investigators in their research endeavors by providing high-quality services, participation in collaborative projects, and access to state-of-the-art technology. Learn more about their work at www.stowers-institute/Public/CoreFacilities.asp#mobio.
Dr. Pourqui?© also is an investigator with the Howard Hughes Medical Institute and a Professor in the Department of Anatomy & Cell Biology at the University of Kansas School of Medicine. Learn more about his work at stowers-institute/labs/PourquieLab.asp.
About the Stowers Institute
Housed in a 600,000 square-foot state-of-the-art facility on a 10-acre campus in the heart of Kansas City, Missouri, the Stowers Institute for Medical Research conducts basic research on fundamental processes of cellular life. Through its commitment to collaborative research and the use of cutting-edge technology, the Institute seeks more effective means of preventing, treating, and curing disease. The Institute was founded by Jim and Virginia Stowers, two cancer survivors who have created combined endowments of $2 billion in support of basic research of the highest quality.
Source: Marie Jennings
Stowers Institute for Medical Research
суббота, 5 ноября 2011 г.
Injectable Bulking Agent Improves Symptoms Of Faecal Incontinence
Injection of a bulking agent into the anal canal improves symptoms of faecal incontinence more than does a sham (placebo) treatment. The authors say this is the first time such a randomised trial comparing active and sham treatments has proven efficacy, and that the treatment is safe. The authors of the Article are Dr Wilhelm Graf, Department of
Surgery, Akademiska sjukhuset, Uppsala, Sweden, and colleagues.
The prevalence of faecal incontinence is the same in men and women and ranges from around 3% in individuals aged 20-30 years to around 15% in those older than 70 years. The cause of faecal incontinence is multifactorial and not completely understood. Two recognised types of clinical incontinence exist: passive incontinence and urge incontinence. Passive incontinence (ie, leakage without notice) is related to low anal resting pressure and internal sphincter deficiency. Urge incontinence (ie, inability to withstand an urge to defecate) is often attributed to an insufficiency in external sphincter tone and activity.
While injection of a bulking agent in the anal canal is increasingly used to treat for faecal incontinence, efficacy has not been shown in a controlled trial. In this study the authors aimed to assess the efficacy of injection of dextranomer in stabilised hyaluronic acid (NASHA Dx) for treatment of faecal incontinence.
206 patients aged 18 to 75 years from the USA and Europe were randomly assigned to receive 4 injections of 1 ml of NASHA Dx in the anal canal (136 patients) or sham treatment (the same injections but no substance injected). The researchers found that, after six months, just over half (52%) patients who received NASHA Dx had a 50% or more reduction in the number of incontinence episodes, compared with less than a third (31%) who received sham treatment. There were 128 treatment-related adverse events reported in the treatment group, and 29 in the sham group. These included transient injection-site bleeding (7 in treatment group, 12 in sham) and pain (6 in treatment group, 1 in sham) Two adverse events in the treatment group were serious (1 rectal abscess and 1 prostatic abscess).
The authors conclude: "The treatment might also be used as a treatment before more invasive techniques or as an additional or adjuvant treatment if other treatments do not give adequate symptomatic relief. This treatment is easy to apply and safe. A refinement of selection criteria for patients, optimum injected dose, ideal site of injection, and long-term results might further increase the acceptance of this minimally invasive treatment."
In a linked Comment, Dr Christine Norton, Bucks New University and Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK, says that more detailed information is needed before the study could be replicated. She points to several important data not included, such as of the type of incontinence suffered (urge, passive or both), anal pressures, ultrasound appearance, or sensation, which might give clues about the mechanism of action.
Asking whether or not the study should change clinical practice, she concludes: "Maybe, but until we ask patients what they think, we cannot be sure whether a statistically significant result will actually change people's lives."
Link to Article and Comment
Source
The Lancet
Surgery, Akademiska sjukhuset, Uppsala, Sweden, and colleagues.
The prevalence of faecal incontinence is the same in men and women and ranges from around 3% in individuals aged 20-30 years to around 15% in those older than 70 years. The cause of faecal incontinence is multifactorial and not completely understood. Two recognised types of clinical incontinence exist: passive incontinence and urge incontinence. Passive incontinence (ie, leakage without notice) is related to low anal resting pressure and internal sphincter deficiency. Urge incontinence (ie, inability to withstand an urge to defecate) is often attributed to an insufficiency in external sphincter tone and activity.
While injection of a bulking agent in the anal canal is increasingly used to treat for faecal incontinence, efficacy has not been shown in a controlled trial. In this study the authors aimed to assess the efficacy of injection of dextranomer in stabilised hyaluronic acid (NASHA Dx) for treatment of faecal incontinence.
206 patients aged 18 to 75 years from the USA and Europe were randomly assigned to receive 4 injections of 1 ml of NASHA Dx in the anal canal (136 patients) or sham treatment (the same injections but no substance injected). The researchers found that, after six months, just over half (52%) patients who received NASHA Dx had a 50% or more reduction in the number of incontinence episodes, compared with less than a third (31%) who received sham treatment. There were 128 treatment-related adverse events reported in the treatment group, and 29 in the sham group. These included transient injection-site bleeding (7 in treatment group, 12 in sham) and pain (6 in treatment group, 1 in sham) Two adverse events in the treatment group were serious (1 rectal abscess and 1 prostatic abscess).
The authors conclude: "The treatment might also be used as a treatment before more invasive techniques or as an additional or adjuvant treatment if other treatments do not give adequate symptomatic relief. This treatment is easy to apply and safe. A refinement of selection criteria for patients, optimum injected dose, ideal site of injection, and long-term results might further increase the acceptance of this minimally invasive treatment."
In a linked Comment, Dr Christine Norton, Bucks New University and Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK, says that more detailed information is needed before the study could be replicated. She points to several important data not included, such as of the type of incontinence suffered (urge, passive or both), anal pressures, ultrasound appearance, or sensation, which might give clues about the mechanism of action.
Asking whether or not the study should change clinical practice, she concludes: "Maybe, but until we ask patients what they think, we cannot be sure whether a statistically significant result will actually change people's lives."
Link to Article and Comment
Source
The Lancet
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