Open Reading Frame brings together a selection of recent publication highlights from elsewhere in the open access ecosystem. This week we take a look at the past few weeks in medicine.
Pain and everyday function in elderly patients
When elderly patients are discharged from hospital, it is important to consider factors that may affect prognosis, so that post-hospital treatment can be planned accordingly. Now, research has been carried out in Australia to assess whether self-reported pain affects physical performance in older people following discharge from inpatient rehabilitation. The authors showed that in around a fifth of patients, pain interferes with daily activities, and chronic pain is associated with impaired physical performance. These findings suggest that self-reported pain should be taken into account in this patient group, and managing pain could contribute towards improvements in everyday function and quality of life
Pereira et al. Clinical Interventions in Aging
CHD risk: an additive effect of lifestyle and genes
Both lifestyle factors and genetic predisposition are known to affect the risk of developing coronary heart disease (CHD). Now, a new study from the European Prospective Investigation into Cancer and nutrition (EPIC) cohort has revealed potential interactions between genetic and environmental factors that contribute to CHD risk. The authors investigated the effect of conventional risk factors (ConvRFs) such as smoking, physical activity and overweight, as well as an additive gene risk score (GRS), in a Greek population. The joint presence of a higher GRS and more ConvRFs was found to be associated with increased risk of CHD compared with a lower GRS and lower risk ConvRFs, suggesting that genetic and environmental risk factors have an additive effect on CHD risk. The authors conclude that this additive effect may be consequential to inform CHD prevention strategies, as lifestyle advice can be targeted towards those with a genetic CHD predisposition.
Yiannakouris et al. BMJ Open
Exploring cell hijack in pancreatic cancer: a potential therapeutic target?
Pancreatic stellate cells are usually involved in beneficial tissue repair, but new research suggests they also contribute to the growth and spread of pancreatic cancer. These cells are usually activated by the protein fibroblast growth factor (FGF) binding to a cell surface receptor. However, in donated pancreatic cancer tissue, researchers showed that FGF travels directly to the nucleus of stellate cells, causing them to divide and communicate with the cancer cells. In an organ model of pancreatic cancer, the study also showed that blocking FGF receptors in stellate cells reduces their ability to proliferate and invade other tissues. These results suggest that the ‘cell hijack’ method of cancer invasion, previously seen in breast cancer, could contribute to pancreatic cancer spread, and targeting FGF receptors in stellate cells could be a promising approach to prevent cancer progression.
Coleman et al. EMBO Molecular Medicine
Refining age-targeted malaria interventions
The burden of disease from malaria has decreased in recent years, owing to increasingly effective treatments and vector control measures. It is important to understand the age distribution of malaria infection so that interventions can be targeted to the right people in order to further decrease the burden of disease. A mathematical modeling study suggests that 60 percent of malaria cases occur in children under five in areas of high transmission, whereas in low transmission areas, approximately 20 percent of cases occur in under fives. These results indicate that the focus of interventions in young children should be informed by area-specific transmission rates, and age-targeted prevention and treatment strategies should be refined between countries.
Griffin et al. Nature Communications
Predicting treatment response in lung cancer
Choosing the most appropriate second line therapy in non-small cell lung cancer is challenging, and two of the most commonly used options are tyrosine kinase inhibitors (TKIs) and chemotherapy. Identifying which patients are likely to respond to a particular therapy will help tailor the right treatment to the right patient. A recent study analyzed patient records to identify factors associated with response to two TKIs, gefitinib and erlotinib. The researchers found that younger age, current smoking and presence of abdominal metastases are associated with progression, but only abdominal metastasis remained significantly associated after adjustment for confounding factors. Further work is needed to establish whether abdominal metastases are predictive of TKI resistance, but these preliminary results suggest that chemotherapy may be a better treatment option in these patients.
Rozensztajn et al. Cancer Medicine
Reduced incidence of H.pylori and gastrointestinal bleeding in Malaysia
The incidence of peptic ulcer disease – or stomach ulcers – is decreasing in Asia, largely as a result of reduced Helicobacter pylori infection rates. Peptic ulcers are a common cause of gastrointestinal (GI) bleeding, and a study has been carried out in Malaysia to assess the impact of reduced H.pylori incidence on GI bleeding. The results revealed that GI bleeding is relatively rare in the general population, but occurs most commonly in the elderly. Therefore, a low incidence of H.pylori infection may not reduce GI bleeding in the elderly, and it is important to monitor other potential causes that can be targeted for treatment in older people.
Lee et al. PeerJ
Written by Claire Barnard, Senior Editor for BMC Medicine.