A new study has determined how often people should get screened for gastric or stomach cancer in high-risk regions of the world. The findings could help reduce deaths from gastric cancer, which is the second most common cause of cancer-related mortality.

Although the incidence of gastric cancer has decreased substantially in the western part of the world, the disease is still common in areas such as Eastern Asia, including Korea, Japan, and China.

Gastric cancer patients’ prognosis strongly depends on the stage of the disease, or how advanced it is, at the time of diagnosis. In other words, early detection and treatment can save lives.

Gastric cancer screening is often done by upper endoscopy

A new study by University of North Carolina School of Medicine researchers found that 31 percent of children identified as at risk for autism spectrum disorders (ASD) at 12 months received a confirmed diagnosis of ASD by age 3 years.
In addition, 85 percent of the children found to be at risk for ASD based on results from the First Year Inventory (FYI), a 63-item questionnaire filled out by their parents, had some other developmental disability or concern by age three, said Grace Baranek, PhD, senior author of the study and an autism researcher with the Program for Early Autism, Research, Leadership and Service (PEARLS) in the Department of Allied Health Sciences at the UNC School of Medicine.
‘These results indicate that an overwhelming majority of children who screen positive on the FYI indeed experience some delay in development by age three that may warrant early intervention,’ she said.
Lead author of the study, Lauren Turner-Brown, PhD, also a researcher with PEARLS and the Carolina Institute for Developmental Disabilities said, ‘Identification of children at risk for ASD at 12 months could provide a substantial number of children and their families with access to intervention services months or years before they would otherwise receive a traditional diagnosis.’
The First Year Inventory was developed by Grace Baranek, PhD, Linda Watson, EdD, Elizabeth Crais, PhD and J. Steven Reznick, PhD, who are all researchers with PEARLS. All are also co-authors of the study with Turner-Brown, published online ahead of print.
In the study, parents of 699 children who had completed the FYI when their child was 12 months old completed additional screening questionnaires when their child reached age 3. In addition, children who were found to be at risk for ASD based on these measures were invited for in-person diagnostic evaluations.
‘These findings are encouraging and suggest promise in the approach of using parent report of infant behaviours as a tool for identifying 12-month-olds who are at risk for an eventual diagnosis of ASD,’ Turner-Brown said. University of North Carolina Health Care

Included in the 2012 International Antiviral Society-USA panel recommendations for human immunodeficiency virus (HIV) patient care is that all adult patients, regardless of CD4 cell count, should be offered antiretroviral therapy (ART), according to an article. Other new recommendations include changes in therapeutic options and modifications in the timing and choice of ART for patients with an opportunistic illness such as tuberculosis.
Melanie A. Thompson, M.D., of the AIDS Research Consortium of Atlanta, presented the findings of the article at a JAMA media briefing at the International AIDS Conference.
‘Since the first antiretroviral drug was approved 25 years ago, improvements in the potency, tolerability, simplicity, and availability of ART have resulted in dramatically reduced numbers of opportunistic diseases and deaths where ART is accessible,’ according to background information in the article. ‘New trial data and drug regimens that have become available in the last 2 years warrant an update to guidelines for ART in HIV-infected adults in resource-rich settings.’
Dr. Thompson and colleagues with the International Antiviral Society-USA panel conducted a review of the medical literature to identify relevant evidence published since the last report (2010), as well as data that had been published or presented in abstract form at scientific conferences in the past 2 years. The revised guidelines reflect new data regarding recommendations of when to initiate ART, new options for initial and subsequent therapy, ART management in the setting of special conditions, new approaches to monitoring treatment success and quality, and managing antiretroviral failure.
Among the primary recommendations of the panel are that treatment is recommended for all adults with HIV infection. The researchers found that there is no CD4 cell count threshold at which starting therapy is contraindicated, but the strength of the recommendation and the quality of the evidence supporting initiation of therapy increase as the CD4 cell count decreases and when certain concurrent conditions are present. Patients should be monitored for their CD4 cell count, and also HIV-1 RNA levels, ART adherence, HIV drug resistance, and quality-of-care indicators.
Initial regimens that are recommended include 2 nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine or abacavir/lamivudine) plus a non-nucleoside reverse transcriptase inhibitor (efavirenz), a ritonavir-boosted protease inhibitor (atazanavir or darunavir), or an integrase strand transfer inhibitor (raltegravir). ‘The aim of therapy continues to be maximal, lifelong, and continuous suppression of HIV replication to prevent emergence of resistance, facilitate optimal immune recovery, and improve health’ the authors write. Alternatives in each class are recommended for patients with or at risk of certain concurrent conditions, including cardiovascular disease, reduced kidney function, or tuberculosis.
The primary reasons for switching regimens include virologic, immunologic, or clinical failure and drug toxicity or intolerance. Switching regimens in virologically suppressed patients to reduce toxicity, improve adherence and tolerability, and avoid drug interactions can be done by switching 1 or more agents in the regimen. ‘Confirmed treatment failure should be addressed promptly and multiple factors considered,’ the researchers write.
‘Although it is crucial to intensify efforts to find a cure for persons who are already infected and an effective vaccine for those who are not, many of the tools needed to control the HIV/AIDS pandemic are already at hand. Critical components of the tool kit to eradicate AIDS include expanded HIV testing, increased focus on engagement in HIV care, early and persistent access to ART, and attention to improving ART adherence. These must occur in the context of strategies to address social determinants of health, including the elimination of stigma and discrimination,’ the authors conclude. EurekAlert

University of Michigan heart researchers are shedding light on a new method for steadying an abnormal heart rhythm.
Irregular heart rhythms, or arrhythmias, set the stage for a common, debilitating disorder called atrial fibrillation that puts adults as young as age 40 at risk for fatigue, fainting, cardiac arrest, and even death.
Medications can help, but doctors also use catheter ablation in which electrical impulses are delivered to a region of the heart to disrupt the arrhythmia.
However, half of patients require more than one ablation to see results. In a laboratory study, the U-M used photodynamic therapy, a technique long used in cancer research, to disrupt the specific cells causing the arrhythmia.
The study suggests cell-specific cardiac ablation could help patients avoid complications, and get closer to an arrhythmia-free life without having to undergo repeat hospital visits.
Chemists in the U-M Department of Chemistry and electrophysiologists at the U-M Center for Arrhythmia Research collaborated on the study that will require further examination before it is available in the hospital setting.
‘This cell-selective therapy may represent an innovative concept to overcome some of the current limitations of cardiac ablation,’ says lead study author Uma Mahesh Avula, M.D., research fellow at the U-M Center for Arrhythmia Research.
The heart consists of different types of cells such as myocytes, fibroblast, adiopocytes and purkinje fibres, which are all needed for normal cardiac activity.
The new study is the first of its kind to use photodynamic therapy and nanotechnology to ablate only the cardiac myocytes responsible for arrhythmias. In current ablative techniques, all cardiac cells receive ablative energy, which can lead to complications such as puncturing the heart muscle, bleeding or stroke.
‘Current ablation techniques are severely limited by its non-specific nature of cellular damage. Besides this lack of cellular discrimination markedly increases the required energy amounts and prolongs procedure times, all of which reduces overall ablation results,’ Avula says.
Catheter ablation has emerged as an important treatment option that requires careful assessment, planning and execution for optimal success rates. Advances over the past 20 years have made the treatment safer, but it remains highly complex.
‘Approaches that could simplify and shorten the procedure may contribute to more patients being treated,’ Avula says.
Rather than radiofrequency energy, the most common type used in cardiac ablation, the U-M team introduces the use of PDT in cardiac electrophysiology to target specific cell types. Targeted PDT, which was pioneered in the labs of study senior author U-M chemist and engineer Raoul Kopelman, Ph.D., is extensively used in cancer research for selectively killing cancerous cells.
The disruption induced by PDT is confined to cells that have been photosensitised, while adjacent non-photosensitised cells are unaffected. The U-M has applied for a patent for this technology.
‘We think this approach will decrease the extent of unwanted cell injury, inflammation, and ablation-related tissue damage, and pave a way for the development of more effective therapies for cardiac arrhythmias,’ says study senior author J

Thanks to tiny microneedles, eye doctors may soon have a better way to treat diseases such as macular degeneration that affect tissues in the back of the eye. That could be important as the population ages and develops more eye-related illnesses