paywalled: The Predictive Capacity of Personal Genome Sequencing - Science Translational Medicine

[Research Articles] The Predictive Capacity of Personal Genome Sequencing:

New DNA sequencing methods will soon make it possible to identify all germline variants in any individual at a reasonable cost. However, the ability of whole-genome sequencing to predict predisposition to common diseases in the general population is unknown. To estimate this predictive capacity, we use the concept of a "genometype." A specific genometype represents the genomes in the population conferring a specific level of genetic risk for a specified disease. Using this concept, we estimated the maximum capacity of whole-genome sequencing to identify individuals at clinically significant risk for 24 different diseases.

PLoS ONE: Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics

PLoS ONE: Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics

"The results of the survey questions showed that the vast majority of respondents agreed to prioritize patients with life threatening diseases and patients with acute diseases over all other patients. All criteria that described the patient's social engagement outside the family or socio-economic status (e.g., income, unemployment) were rejected as possible criteria for prioritization. A similar pattern could be observed in the discrete choice experiment: health status received the highest importance weight, whereas socio-economic status received a very low weight in terms of deciding which patient should be treated first. There is considerable agreement that those in need, i.e., the severely ill patient, should be treated first [1], [5]–[7]. Socio-economic status was not considered acceptable, but is a commonly practiced criterion in the daily routine of physicians [40], if not explicitly, at least implicitly so [41], [42]."


"In particular, medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria and lifestyles are rejected. Especially the DCE showed that health status and quality of life were the only attributes that respondents would ultimately likely include in a decision-making process about which patients to prioritize for care. Policy makers in Germany have been very reluctant to even discuss the topic; indeed, all ministers of health over the last decade or so have refused to even talk about this issue. The present study shows that the “voice of the patient” – reliably captured through the methods used here – can be encapsulated in statistical models and thus introduced into policy-making settings [15]. The methods and findings illustrated in this research can be used to 1) increase citizen participation in the political discussion concerning this substantive policy topic, 2) define the scope of policy actions within the realm of the feasible, and 3) frame communications between policy-setting bodies and the population."

paywalled: Diathermy-Induced Injury May Affect Detection of Occult Tubal Lesions at Risk-Reducing Salpingo-Oophorectomy

Diathermy: In the natural sciences, the term diathermy means "electrically induced heat" and is commonly used for muscle relaxation. It is also a method of heating tissue electromagnetically or ultrasonically for therapeutic purposes in medicine.

Diathermy-Induced Injury May Affect Detection of Occult Tuba... : International Journal of Gynecological Cancer

Background: Electrosurgery-induced tubal thermal injury obscures cellular detail and hampers histomorphological assessment for occult pathology.

Objective: 

The objectives of this study were to report on diathermy-related thermal injuries to the fallopian tube observed at RRSO and explore its potential impact on the detection of occult tubal epithelial lesions.

Design: 

This study was composed of high-risk women from breast and/or ovarian cancer families attending a tertiary high-risk familial gynecologic cancer clinic. This was a retrospective case-control analysis of high-risk women who underwent RRSO. Cases were all women detected to have occult lesions (tubal atypia/carcinoma in situ/cancer) between January 2005 and December 2010. Control subjects were all women with normal tubal/ovarian histology between August 2006 and December 2007.

Conclusions: This report highlights the potential impact of electrosurgical thermal injury on detection of occult tubal pathology following RRSO. It is important for surgeons to avoid thermal injury to the distal end of the tube.

Myriad RBM Announces the Launch of OncologyMAP® v. 2.0

Myriad RBM Announces the Launch of OncologyMAP® v. 2.0

Myriad Genetics (NASDAQ: MYGN) announced today that Myriad RBM, a wholly owned subsidiary of Myriad Genetics, has launched OncologyMAP® v. 2.0, a powerful research tool developed with funding and direction from the National Cancer Institute and the Cancer Prevention Research Institute of Texas. OncologyMAP® v. 2.0 is a comprehensive, cost-effective testing service that builds on the success of the original OncologyMAP® service by increasing the scope and diversity of biomarker analysis for drug re-tasking, indication expansion, and patient stratification studies and provides researchers with the ability to accelerate the pace of discovery, validation, and translation of cancer biomarkers into clinically useful tests......................

No One is More Interested in Curing Your Cancer Than You « Dr. Robert A. Nagourney – Rational Therapeutics – Blog

No One is More Interested in Curing Your Cancer Than You « Dr. Robert A. Nagourney – Rational Therapeutics – Blog

No One is More Interested in Curing Your Cancer Than You

May 9, 2012 Leave a comment (Dr Robert A Nagourney blog)
 

A diagnosis of cancer thrusts a, heretofore, healthy individual into the strange and unfamiliar territory of medical oncology. Many of my patients describe this transition as “entering the cancer bubble.” Suddenly, you are on the inside and everyone on the outside is talking at you about what to do, where to go, whom to see, and what treatments to receive.
From the inside of the bubble however, all of this has a hollow ring as you ponder many options, few good and some, positively frightening. Unfortunately, few patients have the time to complete a MD, or PhD, between diagnosis and the initiation of treatment. Lacking the requisite expertise, they turn to the “authorities” for advice.

AHRQ Patient Safety Network - The Collection: Annotated links to patient safety literature, news, and other resources.

AHRQ Patient Safety Network - The Collection

The Collection

Annotated links to patient safety literature, news, and other resources.

Find items in The Collection by subject matter.

Approach to Improving Safety

Nurse Staffing Ratios

Culture of Safety

Quality Improvement Strategies

Human Factors Engineering

All Approaches to Improving Safety...

Clinical Area

Anesthesiology

Critical Care Nursing

Hospital Pharmacy

Pediatrics

All Clinical Areas...

Error Types

Cognitive Errors ("Mistakes")

Near Miss

Noncognitive Errors ("Slips & Lapses")

Epidemiology of Errors and Adverse Events

All Error Types...

Origin/Sponsor

Agency for Healthcare Research and Quality (AHRQ)

United States Federal Government

United Kingdom

State Governments and Agencies

All Origins/Sponsors...

Resource Type

Journal articles

Book/Report

Audiovisual

Legislation/Regulation

All Resource Types...

Safety Target

Look-Alike, Sound-Alike Drugs

Medication Errors/Preventable Adverse Drug Events

Nosocomial Infections

Wrong-Site Surgery

All Safety Targets...

Setting of Care

Hospitals

Operating Room

Ambulatory Care

Residential Facilities

All Settings of Care...

Target Audience

Nurses

Physicians

Health Care Executives and Administrators

Educators

All Target Audiences...

Produced for the Agency for Healthcare Research and Quality by a team of editors at the University of California, San Francisco with guidance from a prominent Editorial Board and Advisory Panel.

again! Pet food recalled after salmonella outbreak | Healthy Living - Yahoo! Shine

Pet food recalled after salmonella outbreak | Healthy Living - Yahoo! Shine

New roles for public health in cancer screening - CA: A Cancer Journal for Clinicians

New roles for public health in cancer screening - 2012 - CA: A Cancer Journal for Clinicians

paywalled: Why should I talk about emotion? Communication patterns associated with physician discussion of patient expressions of negative emotion in hospital admission encounters

Why should I talk about emotion? Communication patterns associated with physician discussion of patient expressions of negative emotion in hospital admission encounters

Objective 
To describe hospital-based physicians’ responses to patients’ verbal expressions of negative emotion and identify patterns of further communication associated with different responses.

Practice implications 
Providers should respond to expressions of negative emotion with statements that allow for or explicitly encourage further discussion of emotion.

paywalled: What Can We Learn About the Spiritual Needs of Palliative Care Patients From the Research Literature?

What Can We Learn About the Spiritual Needs of Palliative Care Patients From the Research Literature?

Context 
Spirituality is a distinctive subject within palliative care practice and literature, but research to date is relatively undeveloped in this field and studies often throw more light on conceptual and methodological issues than producing reliable data for clinical practice.

Objectives 
To determine what is known about the spiritual needs of palliative care patients from the evidence presented in published research.

Methods 
Specialist online databases were interrogated for primary empirical studies of patients with a chronic disease unresponsive to curative treatment. Studies that only used a proxy for the patient or reported expert opinion were excluded. Each study was critically appraised for quality and the strength of its evidence to determine if any data could be pooled.

Results 
Thirty-five studies were identified, equating to a total of 1374 patients.

VEGF induces ascites in ovarian cancer patients via increasing peritoneal permeability by downregulation of Claudin 5

VEGF induces ascites in ovarian cancer patients via increasing peritoneal permeability by downregulation of Claudin 5

Objective 
To evaluate the role of VEGF-dependent Claudin 5 production for the development of ascites via influencing endothelial permeability in peritoneal tissue of ovarian cancer patients.

Conclusion 
VEGF induces ascites in ovarian cancer patients. This instance happens due to increased peritoneal permeability, caused by downregulation of the tight junction protein Claudin 5 in the peritoneal endothelium.

paywalled - Outcomes of Primary Surgical Cytoreduction in Patients with BRCA-associated High-grade Serous Ovarian Carcinoma

 Outcomes of Primary Surgical Cytoreduction in Patients with BRCA-associated High-grade Serous Ovarian Carcinoma

Objective

BRCA-associated and sporadic ovarian cancers have different pathologic and clinical features. Our goal was to determine if BRCA mutation status is an independent predictor of residual tumor volume following primary surgical cytoreduction.

Highlights

► Differences in the biology of BRCA-associated and sporadic ovarian cancers do not result in differences in primary surgical outcomes.
► The improved survival of BRCA-associated ovarian cancers is not confounded by differences in primary surgical outcome.

(in research - genome) Integrated Analysis of Gene Expression and Tumor Nuclear Image Profiles Associated with Chemotherapy Response in Serous Ovarian Carcinoma

Integrated Analysis of Gene Expression and Tumor Nuclear Image Profiles Associated with Chemotherapy Response in Serous Ovarian Carcinoma
 

Background
Small sample sizes used in previous studies result in a lack of overlap between the reported gene signatures for prediction of chemotherapy response. Although morphologic features, especially tumor nuclear morphology, are important for cancer grading, little research has been reported on quantitatively correlating cellular morphology with chemotherapy response, especially in a large data set. In this study, we have used a large population of patients to identify molecular and morphologic signatures associated with chemotherapy response in serous ovarian carcinoma.

paywalled: Increased expression of OCIA domain containing 2 during stepwise progression of ovarian mucinous tumor - Pathology Intl

Increased expression of OCIA domain containing 2 during stepwise progression of ovarian mucinous tumor

Ovarian cancer immunoreactive antigen domain containing 2 (OCIAD2) has been reported to show cancer-specific expression in early invasive lung adenocarcinoma. OCIAD2 shows high homology with OCIAD1, which was originally immunoscreened from ascites of a patient with ovarian cancer and found to be a tumor-specific protein. Therefore, like OCIAD1, OCIAD2 is expected to show high immunoreactivity in ovarian tumors.

In this study, we examined the expression pattern of OCIAD2 in 117 ovarian mucinous tumors, and confirmed that it was more highly expressed in borderline tumor and carcinoma (51/74 cases, 69%) than in adenoma (6/43 cases, 14%). The immunoreactivity of OCIAD2 in borderline tumor and carcinoma was more specific than that of OCIAD1 (adenoma, 21/43 cases, 49%), and more sensitive than that of CEA (borderline tumor and carcinoma, 35/74 cases, 47%). Like OCIAD1, OCIAD2 is a cancer-related protein and its expression level increases during the course of malignant progression and is thought to be a very useful marker for evaluating the malignancy of ovarian mucinous tumors.

Fertility Q&A Ovarian Tissue Freezing

Fertility Q&A Ovarian Tissue Freezing:

An emerging method of fertility preservation offers hope for women with cancer.

By Karine Chung, MD, MSCE

If you are preparing to undergo cancer treatment, you may already be aware that cancer therapies—including chemotherapy and radiation—can cause infertility and premature menopause. If having children after completing your cancer treatment is important to you, you may have begun to consider options for fertility preservation. Because your chance of future successful pregnancies is best when fertility preservation procedures are performed before chemotherapy or radiation, the amount of time available to pursue these procedures is often limited and depends on when your cancer treatment is scheduled to start........

Complementary Therapies in Cancer Care

Complementary Therapies in Cancer Care:

An ongoing series highlighting complementary therapies
By Barrie R. Cassileth, MS, PhD

Complementary therapies are noninvasive, nonpharmacologic adjuncts to mainstream treatment.  They improve patients’ strength and control the physical and emotional symptoms associated with cancer and other serious illnesses. They provide self-help guidance to enhance body and soul at times when one feels vulnerable and life seems out of control.  Complementary therapies are used as adjuncts to mainstream care of cancer and other illnesses, not as substitutes. They improve physical and emotional function, and manage stress and symptoms of aging, regardless of health status.  Complementary therapies are rational, evidence-based practices delivered or taught by trained practitioners.  They include: mind-body practices such as meditation and self-hypnosis; massage therapies; nutritional counseling; physical fitness, including programs such as aerobic exercise, Chi Gong, tai chi, yoga and many other practices.
We begin this series with acupuncture, a two-to three-thousand-year-old practice known to relieve difficult, often otherwise untreatable symptoms and effect important improvements in physical function and well-being.......

FDA Approves New Silicone Gel-Filled Breast Implant

FDA Approves New Silicone Gel-Filled Breast Implant:

The U.S. Food and Drug Administration (FDA) has approved a silicone gel-filled breast implant manufactured by Sientra Inc for breast augmentation in women at least 22 years old and breast reconstruction in women of any age.

As a condition of approval, the company is required to conduct post-approval studies to assess long-term safety and effectiveness outcomes as well as the risks of rare disease outcomes.
Silicone gel-filled breast implants are implanted under breast tissue or chest muscle for breast augmentation or reconstruction. They have a silicone outer shell that is filled with silicone gel and come in different sizes.

Breast reconstruction may refer to a primary reconstruction to replace breast tissue that has been removed or revision surgery to correct the result of a primary reconstruction surgery.

The FDA based its approval of Sientra’s implant on 3 years of clinical data from 1,788 participants. Complications and outcomes reflected those found in previous studies of other breast implants and included tightening of the area around the implant (capsular contracture), reoperation, implant removal, an uneven appearance (asymmetry), and infection.
Sientra’s post-approval studies will include:

• An additional 7 years of follow-up of the 1,788 clinical trial participants in their pre-market study
• A 10-year study of 4,782 women receiving Sientra silicone gel-filled breast implants to collect information on long-term local complications such as capsular contracture, as well as less common disease outcomes, such as rheumatoid arthritis and breast and lung cancer
• Five case-control studies that will evaluate the association between Sientra’s silicone gel-filled breast implants and five rare diseases: rare connective tissue disease, neurological disease, brain cancer, cervical/vulvar cancer, and lymphoma.

With the addition of Sientra’s approval, there are now three FDA-approved silicone gel-filled breast implants on the market in the U.S.
Silicone gel implants have generated a fair amount of controversy regarding their safety because of the question as to whether they can trigger certain connective tissue and autoimmune diseases. In 1992, the FDA restricted the use of silicone implants in order to evaluate whether they were indeed associated with autoimmune conditions. Clinical trials have continued and the data continues to indicate that the implants are safe.
It’s important to remember that breast implants are not lifetime devices and long-term monitoring is imperative.
Reference:
FDA approves new silicone gel-filled breast implant [FDA News Release]. U.S. Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm295437.htm”>http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm295437.htm

Rexahn Pharmaceuticals Submits Archexin Phase II Protocol for Ovarian Cancer to FDA - News

Rexahn Pharmaceuticals Submits Archexin Phase II Protocol for Ovarian Cancer to FDA

May 08, 2012 08:03 AM Eastern Daylight Time 

ROCKVILLE, Md.--(EON: Enhanced Online News)--Rexahn Pharmaceuticals, Inc. (NYSE Amex: RNN), a clinical stage pharmaceutical company developing and commercializing potential best in class oncology and CNS therapeutics, today announced that it has submitted a Phase II protocol for the clinical study of Archexin^® as a treatment of ovarian cancer to the U.S. Food and Drug Administration (FDA).

“Treatment options are limited for patients who are stricken with ovarian cancer, therefore we look forward to investigating Archexin as a potential combination treatment for this disease.”

The Phase II study will assess the safety and efficacy of Archexin when used in combination with both carboplatin and paclitaxel as a second-line therapy in subjects who are platinum-sensitive following their first relapse. The study will be conducted at multiple centers in the United States, and subjects will be randomized to receive either carboplatin/paclitaxel or carboplatin/paclitaxel/Archexin. Various measures of clinical benefit will be assessed

University of Arizona wins NIH Grant to on Diagnosis of Ovarian Cancer by Confocal Microendoscopy - Optical Coherence Tomography News

University of Arizona wins NIH Grant to on Diagnosis of Ovarian Cancer by Confocal Microendoscopy - Optical Coherence Tomography News

Optical Coherence Tomography News (18 hours ago) Gynecology 

The University of Arizona received a $276,708 2012 NIH grant to study diagnosis of Ovarian Cancer by Confocal Microendoscopy. The principal Investigator is Arthur Gmitro. This grant is part of a multi-year project that started in 2005 and ends in 2014. Below is a summary of the work.
The objective of this research is to further develop and clinically validate a real-time multispectral confocal microendoscope for in vivo diagnosis of ovarian cancer. The confocal microendoscope is a new type of instrument for visualizing tissue at the cellular level and has shown great promise for performing optical biopsy. Confocal microendoscopy has the potential to provide a physician with an immediate evaluation of tissue and to survey a much greater area of tissue, reducing the sampling error of traditional tissue extraction biopsy. A confocal microlaparoscope system was constructed and tested in vivo in humans during the prior funding period. A specific aim of this work is to now validate the system and show that it can be used to detect cancer of the ovary during a laparoscopic procedure. Additional objectives of the work are to expand the use of the instrument to the detection of peritoneal implants of ovarian cancer throughout the abdominal cavity and to develop and test a system capable of imaging inside the fallopian tubes. Further technical development is aimed at improving the confocal imaging performance and adding optical coherence tomography as a complimentary imaging modality. The new instrument will incorporate the two imaging modalities into a single compact probe with seamless and rapid switching between modes of operation. In addition to the technology development and clinical translation, another aim of the project is to develop and test targeted contrast agents that provide safer and more effective in vivo identification of ovarian cancer

paywalled: Is there any association between retroperitoneal lymphadenectomy and survival benefit in advanced stage epithelial ovarian carcinoma patients?

Is there any association between retroperitoneal lymphadenectomy and survival benefit in advanced stage epithelial ovarian carcinoma patients? 

Abstract

Aim:  The effect of systematic retroperitoneal lymphadenectomy (SRL) remains controversial in patients with advanced epithelial ovarian cancer (aEOC) who are optimally debulked.

Conclusion:  Our data suggest that aEOC patients with optimal cytoreduction who underwent SRL did not show a significant improvement in survival irrespective of each histological type.

paywalled: Physical Activity, Biomarkers, and Disease Outcomes in Cancer Survivors: A Systematic Review

Physical Activity, Biomarkers, and Disease Outcomes in Cancer Survivors: A Systematic Review:

Background
Cancer survivors often seek information about how lifestyle factors, such as physical activity, may influence their prognosis. We systematically reviewed studies that examined relationships between physical activity and mortality (cancer-specific and all-cause) and/or cancer biomarkers.

Methods
We identified 45 articles published from January 1950 to August 2011 through MEDLINE database searches that were related to physical activity, cancer survival, and biomarkers potentially relevant to cancer survival. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement to guide this review. Study characteristics, mortality outcomes, and biomarker-relevant and subgroup results were abstracted for each article that met the inclusion criteria (ie, research articles that included participants with a cancer diagnosis, mortality outcomes, and an assessment of physical activity).

Results
There was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality. There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers. Randomized controlled trials of exercise that included biomarker endpoints suggest that exercise may result in beneficial changes in the circulating level of insulin, insulin-related pathways, inflammation, and, possibly, immunity; however, the evidence is still preliminary.

Conclusions
Future research directions identified include the need for more observational studies on additional types of cancer with larger sample sizes; the need to examine whether the association between physical activity and mortality varies by tumor, clinical, or risk factor characteristics; and the need for research on the biological mechanisms involved in the association between physical activity and survival after a cancer diagnosis. Future randomized controlled trials of exercise with biomarker and cancer-specific disease endpoints, such as recurrence, new primary cancers, and cancer-specific mortality in cancer survivors, are warranted.

May 7th: The connection between genes and colon cancer (Lynch Syndrome/FAP) - MD Anderson Cancer Center - audio/ iTunes

The connection between genes and colon cancer - MD Anderson Cancer Center

Cancer Newsline - 05/07/2012

About 20% of colon cancer cases are related to a strong family history of colon cancer. Eduardo Vilar-Sanchez, M.D., Ph.D., Assistant Professor in the Department of Clinical Cancer Prevention at The University of Texas MD Anderson Cancer Center, focuses his discussion on the main types of genetic colon cancers including hereditary nonpolyposis colorectal cancer syndrome or HNPCC (also called Lynch syndrome) and familial adenomatous polyposis (FAP).

• Listen to The connection between genes and colon cancer
• Download The onnection between genes and colon cancer on iTunes

paywalled: Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis

Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis.

Abstract

Obesity is associated with poor survival after breast cancer diagnosis in individual studies and meta-analyses. Evidence regarding associations of obesity with breast cancer-specific survival (BCSS) and overall survival (OS) in relation to hormone receptor status, or BCSS in relation to menopausal status has not been evaluated in a previous meta-analysis. ............ These findings led us to conclude that there is no evidence showing that the association of obesity with breast cancer outcome differs by hormone receptor or menopausal status. This has implications for studies of weight loss interventions in the adjuvant BC setting.

Drug Data Shouldn’t Be Secret - NYTimes.com

Drug Data Shouldn’t Be Secret - NYTimes.com

"We should not have to wait for patients to be hurt by the medications they take, as recently happened with the diabetes drug Avandia, before reviewing this wealth of data."