"Liquid" Biopsy - Blood Test for cancer

As cells divide and die, they release some of their DNA into the bloodstream. Only in recent years have we had equipment sensitive enough to detect this - hence we can detect many prenatal diseases in a baby through a blood test from the mother.

Cancer cells grow and turn over quickly, so it makes sense that they would also release DNA. But can we detect this accurately? Since medicine has discovered many of the mutations involved in cancers, specially the common ones, searching the blood for these should predict recurrence or even a new cancer.

Cohen JD et al. in Science 2018 Feb 23 developed a test for both DNA acid and protein remnants shed by early cancers of the ovary, liver, stomach, pancreas, esophagus, colon, lung, and breast. The test was used in 1005 patients already diagnosed with these cancers, The test was 63% accurate, it only missed about 2% (although higher in breast cancer) and had a false positive in less than 1%.

Clearly not ready for prime time, this is a substantial step towards blood tests for recurrence and even screening.

Virus Producing Insulin?

Viruses are tiny DNA containing packages that use our body's metabolism and cells to help produce more. They are sometimes not even considered alive, as they do not have any mobility and cannot reproduce without the host. In some ways they are higher on the evolutionary scale since they had to develop after we did!

But scientists recently discovered some unusual properties of viral proteins that suggest a possible symbiotic relationship. In Proc Natl Acad Sci U S A 2018 Mar 6, researchers discovered that members of a relatively innocuous family of viruses, members of the Iridoviridae family, often present without symptoms in our intestines, have the ability to produce hormones that closely resemble human insulin and insulin-like growth factors (IGFs). These hormones are biologically active!

Perhaps our intestinal microbiotome (bacteria in the intestine) should now include viruses. The more we know, the more complex it gets. We have studied the DNA of less than 2% of known human viruses!

New Hope for MS - Stem Cells

MS, or Multiple Sclerosis, is often a relapsing disease that can lead to severe disability and death. Most current treatments offer some minimal help or delay in progression, but are often poorly effective.

Now researchers, in a preliminary study, http://www.sth.nhs.uk/news/news?action=view&newsID=1035, have published early promising results.

They split a group of 110 patients who were having relapses despite best medical therapy into 2 groups of 55, and gave one group a type of stem cell transplant. The transplant gorup had 1 relapse, versus 39 in the other.

This is probably the most dramatic treatment we have seen in MS, and if the 5 year study shows continued good results may be the new normal treatment for MS!

Gun Laws - "When Will We Ever Learn"

Unfortunately many of the politicians in our current government like to only believe the scientific evidence they like; no matter how clear the studies are.

So for those of us who believe in science and not lobbyists, a recent study was quite clear about gun laws and deaths from those weapons.

In JAMA Intern Med 2018 Mar 5, researchers found that states with the strictest laws had 50% less gun related homicides and suicides. Interestingly, proximity to a state with lax gun laws resulted in only a 25% decrease.

In Australia, which regulated automatic weapons following a massacre in 1996, the evidence is even stronger. Prior to 1996 there were 13 killings of 4 or more people in the 18 years previous. Since the new law - none. And gun related homicides dropped by over 50% to record low rates.

As Bob Dylan once said, "when will we ever learn?"

Simple Treatments for Nausea and Acid Reflux?

Colon Cancer Screening And Bacteria in Gut causing Cancer

It is thought that colon cancer begins, in most instances, by a benign polyp that slowly changes over many years, thus the recommendation for a colonoscopy every 10 years after age 50. Fro those with a strong family history, or certain other conditions, and earlier or more frequent schedule is advised.

However, a colonoscopy reimburses the physician well, and even more when a polyp is found or removed. This can be subjective, though many hospitals now require photos. I still recall many years ago when I was on the quality control committee of my hospital when we questioned a physician about his too frequent procedures. When we required him to take photos of his "lesions" and set a 6 month followup, we discovered that he no longer did colonoscopies at our facility!

In a recent study on the possible overuse of colonoscopies (J Gen Intern Med 2015 Mar 30:277) Boston researchers used medical record data to examine this issue in 1429 patients who had first screening colonoscopies during a 10-year period (2000–2010). Guidelines recommend repeat colonoscopy at 10 years after a colonoscopy with no polyps, 5 years after detecting low-risk findings,and 3 years after detecting higher-risk polyps. They found that about 30% with negative findings and 50% with low risk polyps had premature repeat colonoscopies. And this does not include those with possible questionable polyps. So be careful and discuss a premature repeat with your physician.

In another study, which correlates with many recent findings, (Bullman S et al. Science 2017 Dec 15), investigators found that from more than 500 cases of colon cancer a fusobacterial DNA (DNA from a specific bacteria)was found in nearly 50% of primary tumors. They found that this same bacterial DNA seemed to also induce tumors in mice. And treating these mice with an antibiotic against this germ decreased tumor size.

It is possible that at least some of human colon cancer may be related to a specific bacteria. Stay tuned for possible screening and treatment.. 

How addictive is Social Media

It appears to be common sense these days, when looking at everyone on their devices, to conclude social media is addictive.

In a recent study, PLoS One 2017 Dec 14., researchers determined that greater attention to Facebook is associated with depression, anxiety, narcissism, and stress in university students.

The researchers found that the incidence of Facebook addiction, as well as these other symptoms, increased in a group of Facebook users by a factor of 15 to about 1 in 10 "addicted". And these users had more psychological symptoms above.

We should all limit our use of devices and social media. This trend is not good for anyone.