A Mayo Clinic review of 47 studies found that 30-day readmissions can be reduced by almost 20 percent when specific efforts are taken to prevent them. Key among these are interventions to help patients deal with the work passed on to them at discharge.
‘Reducing early hospital readmissions is a policy priority aimed at improving quality of care and lowering costs,’ says Aaron Leppin, M.D., a research associate in Mayo Clinic
Inhibiting enzymes that cause changes in gene expression could decrease chemotherapy resistance in ovarian cancer patients, researchers at Georgia State University and the University of Georgia say.
Dr. Susanna Greer, associate professor of biology, and research partners at the University of Georgia have identified two enzymes that suppress proteins that are important for regulating cell survival and chemoresistance in ovarian cancer.
Ovarian cancer is one of the deadliest gynaecological cancers, with a 60 percent mortality rate and a five-year survival rate for less than 30 percent of women in the advanced stage of the disease. The high mortality rate is largely due to the development of resistance to chemotherapeutic drugs. Understanding the molecular and genetic mechanisms that drive the development of acquired chemoresistance can help improve therapeutic agents for ovarian cancer treatment.
‘Ovarian cancer is usually treated by surgery followed by chemotherapy,’ Greer said, ‘but because it’s typically found fairly late, ovarian cancer is often refractory to chemotherapy. You have tumours that initially respond to chemotherapy and then don’t. Ovarian cancer is the 8th most commonly diagnosed cancer in U.S. women, but due to its late diagnosis, causes more deaths than any other cancer of the female reproductive system.’
In a previous study, Greer found the expression of the protein RGS10, which regulates ovarian cancer cell growth and survival, is suppressed in ovarian cancer cells that are chemoresistant. The suppression was caused by two important mechanisms that silence genes and contribute to the progression of many cancers – DNA methylation, a biochemical process in which a methyl group is added to specific building blocks of DNA, and histone deacetylation, a process in which enzymes remove functional groups of atoms from proteins associated with DNA.
In their study, the researchers investigate the silencing of RGS10 expression in ovarian cancer cells by epigenetics, which is heritable changes in genes and gene expression that are not caused by changes in the DNA sequence, but rather by reversible and self-perpetuating mechanisms of DNA programming.
They identified two epigenetic regulators, HDAC1, a histone deacetylase, and DNMT1, a DNA methyl transferase. Decreasing the expression of HDAC1 and DNMT1 and blocking their activity significantly increased RGS10 expression and cell death. This also decreased the binding of HDAC1 to RGS10 in chemoresistant cells.
The research suggests that inhibiting HDAC1 and DNMT1 could be a novel therapeutic approach to overcoming chemoresistance in ovarian cancer.
EurekAlert
Scientists reported today the first human recipients of laboratory-grown vaginal organs. A research team led by Anthony Atala, M.D., director of Wake Forest Baptist Medical Center
As long as inexpensive statins, which lower cholesterol, are readily available and patients don
Using portable ultrasound as a first-line imaging study in kids with suspected appendicitis helps reduce emergency room length of stay and reduces the need for CT scans, according to a team of Mount Sinai researchers. Bedside ultrasound, often referred to as point-of-care ultrasonography, has a specificity of about 94%, meaning that it misses few cases, the Mt. Sinai researchers add.
Cancer patients could one day experience fewer side effects from chemotherapy following a discovery that opens the door for more targeted treatments.
Researchers have identified a possible way of treating tumours that would see doctors place harmless metal implants at the cancer site.
The discovery could make treatment more targeted than existing therapies, avoiding unwanted side effects, such as hair loss, tiredness and nausea. These occur when chemotherapy drugs carried in the blood kill healthy cells as well as cancer cells.
The scientists found that they could alter the chemical composition of commonly used chemotherapy drugs so that they only become active when they come into contact with a metal called palladium.
Researchers hope that by implanting small devices coated with palladium into patients
Concerted effort is needed to reverse the ongoing rise in pertussis cases and deaths, especially among children and young people, according to the article by Emily Peake. ‘This effort begins with nurses and nurse practitioners and other primary care providers who educate patients and the public,’ they write. ‘The battle of pertussis is winnable through education, awareness, and vaccination.’
Caused by infection with Bordetella pertussis bacteria, pertussis has been increasing in recent years. In the United States, average annual pertussis cases increased from less than 3,000 cases per year during the 1980s to 48,000 in 2012, including 20 deaths. Worldwide, there are an estimated 50 million cases of pertussis and 300,000 deaths. Pertussis is a major cause of death in infants worldwide.
Why is pertussis on the rise? ‘Ambivalence toward precautionary childhood vaccinations’ is a key reason, along with the lack of well-child visits and appropriate boosters. The arrival of non-vaccinated immigrants may also be linked to new clusters of pertussis outbreaks, according to Peake and McGuire. They write, ‘Nurses should educate patients and the public that follow-up booster vaccinations at all ages are critical to maintain immunity to pertussis and other vaccine-preventable diseases.’
Issues including vaccine availability and cost, literacy and language barriers, and lack of information all contribute to the lack of recommended vaccinations. Fear of vaccination and religious objections also play a role. Most states allow exemptions from vaccination based on religious reasons, and there’s evidence that even non-religious parents are using these exemptions to avoid vaccinating their children.
Nurses should reassure parents that that recommended vaccines are safe. Current diphtheria-tetanus-pertussis vaccines do not contain the mercury-containing preservative thimerosal. Adverse events occur in only a small fraction of vaccinated children, and most of these are mild local reactions.
‘Practitioners must build a trusting relationship with patients and reinforce the need for vaccinations through face-to-face contact, engaging parents to discuss concerns, and provide evidence-based research to guide recommendations and reassure patients of the safety of vaccines,’ Peake and McGuire write. Waiting rooms provide a good opportunity to present videos and other educational materials.
The World Health Organization is working to increase the percentage of infants who receive at least three doses of pertussis vaccine to 90 percent or higher, especially in developing countries. The authors discuss some international efforts to fight pertussis and other vaccine-preventable diseases, such as the United Nations Foundation’s
Closer to home, partnerships should be formed with service organisations, food banks, churches, hospitals and schools. ‘These groups can help identify those most likely not to be vaccinated and help them find free or low cost immunisations,’ the authors write. ‘Faith community nurses are in an ideal role to create and lead these partnerships.’
Nurses can also advocate for policies aimed at making universal vaccinations available for adolescents and adults. Peake and McGuire conclude, ‘By using our resources and uniting, a global battle will be waged and won against pertussis and the children of tomorrow can breathe easier for a lifetime.’
EurekAlert
Several medications can help people with alcohol use disorders maintain abstinence or reduce drinking, according to research from the University of North Carolina at Chapel Hill.
The work provides additional options for clinicians to effectively address this global concern.
Although alcohol use disorders are associated with many health problems, including cancers, stroke and depression, fewer than one-third of people with the disorders receive any treatment and less than 10 percent receive medications to help reduce alcohol consumption.
‘There are many studies that have tried to show whether certain medications can help with alcohol use disorders, but it is a lot of information to digest and many providers do not know what works or doesn
Astrocytomas are the most common malignant brain tumours. While most patients
Wearing a fitness tracker on your wrist or clipped to your belt is so 2013.
Engineers at the University of Illinois at Urbana-Champaign and Northwestern University have demonstrated thin, soft stick-on patches that stretch and move with the skin and incorporate commercial, off-the-shelf chip-based electronics for sophisticated wireless health monitoring.
The patches stick to the skin like a temporary tattoo and incorporate a unique microfluidic construction with wires folded like origami to allow the patch to bend and flex without being constrained by the rigid electronics components. The patches could be used for everyday health tracking
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