News
Pentagon suspends work with toxins at defense labs. It can’t have been an announcement the U.S. Army really wanted to make, but the people have a right to know—so in a briefing held last month, a Pentagon spokesperson revealed that more live anthrax was unintentionally shipped to more research labs than had been previously revealed. According to the latest information released by the Department of Defense, Dugway Proving Ground in Utah shipped live anthrax spores to labs in all 50 states and at least nine foreign countries. A total of 194 labs are known to have received the live bacteria, and that number is expected to rise as more samples are tested.
It was also revealed that contaminated material was found outside of a containment area at Dugway, although still within an enclosed lab dedicated to the purpose of containment. The Army ordered a suspension of all activity at the Utah site and an immediate review of procedures at the nine Defense Department laboratories that handle dangerous agents and toxins. An investigation is also ongoing into how the live anthrax could have been unwittingly sent across the country and world. There is no reason to suspect foul play, but a review of procedures and whether they were properly followed certainly seems to be in order.
Genomics/Genetics
Gene may predict severity of post-traumatic stress disorder. Scientists have found a gene that appears to predict more severe post-traumatic stress disorder (PTSD) symptoms as well as a thinner cortex in regions of the brain critical for regulating strong emotions and coping with stressful experiences. The study, appearing online in the journal Molecular Psychiatry, is believed to be the first to show that the spindle and kinetochore-associated complex subunit 2 (SKA2) gene may play a role in the development of PTSD.
PTSD is prevalent among veterans. Eleven to 20 percent of veterans who served in Operations Iraqi Freedom and Enduring Freedom have experienced PTSD in a given year. Studies suggest that warzone trauma, PTSD symptoms, and other post-deployment mental health problems put veterans at heightened risk for suicide.
The researchers performed MRI brain scans and collected blood samples from 200 veterans returning from the recent conflicts in Iraq and Afghanistan. They looked at whether a chemical change (methylation) in the function of the SKA2 gene measured in blood predicted the thickness of brain cortex (a measure of neuronal health) and psychological symptoms, specifically PTSD and depression.
Cancer
Genetic testing all women for breast cancer might not be worth the cost. Women who are carriers of mutated BRCA genes are known to have a significantly higher risk for developing breast and ovarian cancers than those who are not. But a new study by UCLA researchers questions the value of screening for the genetic mutations in the general population—including those who do not have cancer or have no family history of the disease—because of the high cost. The researchers found that compared with universal screening, other diagnostic tools remain more efficient and might be more cost-effective.
A viewpoint piece, published in JAMA Oncology, was authored by Patricia Ganz, MD, and Elisa Long, PhD. They concluded the BRCA genetic test that is most widely used today, which sells for about $4,000, is too expensive to warrant universal screening, given how rare BRCA mutations are in women.
Long and Ganz calculated that for every 10,000 women screened, BRCA screening could avert four cases of breast cancer and two cases of ovarian cancer more than family history-based testing. But the BRCA screening would only extend patients’ life by an average of two days. For 99.75 percent of women screened, a negative genetic test offers no increase in life expectancy, nor would it eliminate the need for regular mammograms, and it could provide false reassurance that a woman is not at risk for breast cancer.
Infectious Diseases
Liver damage from hepatitis C is more widespread than thought. Severe liver damage may be four times more common among Americans with the liver infection hepatitis C than has been previously believed, a new study suggests. Analyzing nearly 9,800 patients with hepatitis C, researchers learned that using a biopsy alone to reveal liver cirrhosis—indicating scarring in the organ—is likely to significantly underestimate its prevalence.
“We thought it would be important to provide the healthcare community with some estimate as to the severity of liver disease among patients with hepatitis C because it’s a question that comes up very frequently: Just how sick is this community?” says study author Dr. Stuart Gordon, director of hepatology at Henry Ford Hospital in Detroit, MI.
For the study, Gordon and his team analyzed records from 9,783 hepatitis C patients cared for at four large U.S. healthcare systems. The records indicated that 29 percent of the patients had evidence of liver damage, or cirrhosis. But medical records didn’t indicate the cirrhosis in 62 percent of these patients, the study found.
Blood Banking
Canadian hospital uses an inexpensive drug to save blood and money during hip and knee replacements. Using an inexpensive drug for every hip or knee replacement since 2013 has helped St. Michael’s Hospital in Toronto, Ontario, to reduce its number of red blood cell transfusions performed during these surgeries by more than 40 percent without negatively affecting patients, according to new research. The drug tranexamic acid, known as TXA, prevents excessive blood loss during surgeries.
TXA had been shown to be effective in orthopedic, trauma, and cardiac patients, but less than half of eligible patients at St. Michael’s received this drug because of a previous province-wide shortage. The drug was given only to patients at high risk of requiring a blood transfusion.
The TXA shortage ended in early 2013, and, in October 2013, St. Michael’s anesthesiologists started giving TXA to every eligible patient undergoing hip or knee replacement. A total of 402 patients received the drug.
“We wanted to optimize TXA’s use in patients undergoing hip or knee replacements because these procedures often result in high blood loss and frequently require transfusions,” says Greg Hare, MD, an anesthesiologist at St. Michael’s. “The drug costs about $10 per patient, while the average cost of transfusing one unit of blood is $1,200.”
Making TXA use mandatory for eligible patients undergoing hip or knee replacement reduced the hospital’s transfusion rate for those surgeries from 8.8 percent to 5.2 percent.
