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In the absence of federal regulations governing genetic testing, consumers should get the advice of a genetic counselor or clinical geneticist before they have a genetic screening test, the group advises.

“Genetic tests can reveal life-changing information, both positive and negative, but misinterpreting test results can be dangerous,” Elizabeth Kearney, president of the NSGC, said in a society news release.

“The most important first step for consumers to understand when considering genetic testing is what can be learned from the test, and the impact the results could have on their lives and families,” she said. “Genetic testing should only be done through guidance of a genetic counselor or health care provider whose role is to protect the consumer, and assure they have appropriate testing and an accurate understanding of the results.”

The NSGC cautions that people who undergo genetic screening tests without the advice of a genetic counselor may:
Receive a series of test results but won’t get answers to their questions.
Get test results that cause alarm but won’t have anyone to talk to about their concerns.
Not know what action to take based on test results or may pay for information they already know.

The group also notes that genetic counselors should have specialized training in medical genetics and a master’s degree in their field.

SOURCE: National Society of Genetic Counselors.

Noting that pain and depression often occur at the same time, the current observation blends two competing schools of thought, in which some believe that pain is “all in the head” while others contend that pain is “all in the body.”

To see how pain and depression might intersect, the research team — led by the University of Oxford’s Dr. Chantal Berna — used brain imaging to conduct pain tests on healthy participants who were induced to feel sad.

A depressed mood appeared to affect brain nerve circuitry responsible for emotion, resulting in a stronger perception of pain, according to the report published in the June 1 issue of Biological Psychiatry.

“When the healthy people were made sad by negative thoughts and depressing music, we found that their brains processed pain more emotionally, which lead to them finding the pain more unpleasant,” Berna said in a news release from the journal’s publisher.

Berna’s team theorized that one’s ability to control the negative emotions linked to pain are short-circuited by depression, leading to a bigger punch when pain hits. In other words, depression may not only be a consequence of being in pain. It might actually exacerbate pain, making it worse than it would be for those in a positive frame of mind.

“Our research suggests depressed mood leads to maladaptive changes in brain function associated with pain, and that depressed mood itself could be a target for treatment by medicines or psychotherapy in this context,” Berna explained in the news release.

Following this line of research, the next step would be to study patients with chronic pain, because they often also suffer from depression, the researchers noted. The goal would be to find ways to more effectively treat the millions of people worldwide who experience chronic pain and depression, the authors explained.

Researchers analyzed biopsies from 131 men — 67 blacks and 64 whites — whose prostates were removed at the Durham Veterans Affairs Medical Center in North Carolina. The investigators found signs that the black men had more aggressive forms of prostate cancer.

The findings are scheduled to be released Wednesday at American Urological Association annual meeting in San Francisco.

“African-American men are more than twice as likely to develop prostate cancer, and these data show tumors may be more aggressive in this population,” Dr. Anthony Y. Smith, a spokesman for the association, said in a news release. “African-American men should be especially vigilant about their prostate health and talk with their physicians about prostate cancer testing starting at age 40.”

SOURCE: American Urological Association, news release.

“Many studies before have found some protective effect in the general population,” said Dr. Lu Qi, an assistant professor of nutrition at the Harvard School of Public Health and lead author of a report in the May 10 issue of Circulation. “Our study is the first in diabetic patients, and it provides direct evidence that whole grain, especially bran, reduces total mortality and cardiovascular mortality in diabetic patients.”

Bran is the hard, fiber-rich outer layer of grains such as wheat and oats. It is often removed when those grains are processed.

Though the report used data from the Nurses Health Study, which included only women, there is no reason to doubt that the same protective effect occurs in men, Qi said. He and his colleagues now are doing a similar analysis of data from a men-only study to prove that point.

The new report covered 7,822 women diagnosed with type 2 diabetes, the kind that generally develops in the adult years as the body loses its ability to metabolize blood sugar. The women answered questions about their diets every four years.

Over the 26 years covered by the study, the women in the top 20 percent for intake of whole grain, which includes bran and fiber, had a 35 percent lower risk for death from cardiovascular diseases such as heart attack and stroke and a 28 percent lower risk for death from all causes than women in the bottom 20 percent.

Medical organizations such as the American Heart Association and the American Diabetes Association have long recommended diets rich in whole-grain, high-fiber foods. “Our data strongly supports those recommendations,” Qi said. “We should recommend increased intake of whole grain for diabetic patients.”

The study results pointed mainly to bran intake as the protective factor. Women in the highest group for added bran had a 55 percent lower risk for death from all causes and a 64 percent lower risk for cardiovascular death than those who ate no added bran.

The new study did not look at the reason why whole grains and bran were protective, but previous research has found lower levels of inflammatory biomarkers associated with them, Qi said. Whole grains appear to reduce inflammation and improve the function of the endothelium, the thin layer of cells that line the interior of blood vessels and play an important role in regulating blood pressure.

“We do recommend that, when people with diabetes choose a grain product, they should choose a whole-grain product,” said Stephanie Dunbar, a dietician who is director of clinical affairs at the American Diabetes Association. “It should be brown rice instead of white rice, whole-wheat bread rather than white bread.”

People with diabetes are also advised to limit their intake of carbohydrates, which means that “their best choices are low-fat dairy products, fruits and starchy vegetables,” Dunbar said. “If choosing a grain product, they should choose a whole-grain, which has more fiber and all of those good things.”

SOURCES: Lu Qi, M.D., Ph.D., assistant professor, medicine, Harvard Medical School, and assistant professor, nutrition, Harvard School of Public Health, Boston; Stephanie Dunbar, M.P.H., R.D., director, clinical affairs, American Diabetes Association, Alexandria, Va.;

Researchers led by Amy L. Byers of the University of California at San Francisco analyzed a survey of 2,575 people aged 55 and older.

Five percent said they’d had a mood disorder — such as depression or bipolar disorder — within the past year. Twelve percent reported anxiety disorders such as panic disorder, generalized anxiety disorder and post-traumatic stress disorder, and 3 percent said they had both mood and anxiety disorders.

The oldest people in the study, those aged 85 and older, were the least likely to report having the conditions.

In general, women had around double the rate of the disorders as men did.

“Given the rapid aging of the U.S. population, the potential public health burden of late-life mental health disorders will likely grow as well,” the researchers wrote. They stressed the importance of “continued epidemiologic monitoring of the mental health status” of older Americans, from the youngest in that age group to the oldest.

The study appears online in the Archives of General Psychiatry.

Only two of the three phases of research required for new drug treatments have been completed, however. At this point, it’s not clear whether the treatment will go on to receive federal approval.

The hormone treatment, called MDV3100, is being tested as a treatment for a disease known as castration-resistant prostate cancer, according to a report on the research, published online April 14 in The Lancet.

Prostate tumors need testosterone to grow. One treatment involves castration, possibly with additional drug treatment, to combat the body’s processing of testosterone.

Though the treatment kills some cancer cells, others remain alive but dormant, the researchers explained in a news release from the journal. And these cells can re-grow and survive without as much testosterone, thus becoming castration-resistant, they said.

For their study, Dr. Howard Scher of Memorial Sloan-Kettering Cancer Center in New York City and his colleagues tested the MDV3100 hormone treatment in 140 men in the United States with castration-resistant prostate cancer. The researchers gave varying doses, from 30 to 600 milligrams a day, to the men to find the maximum tolerable dose, which they determined to be 240 milligrams.

“We recorded encouraging anti-tumor activity with MDV3100 in patients with castration-resistant prostate cancer,” both before and after chemotherapy, the researchers wrote in their report.

The researchers have begun a third phase of testing in which they will compare the hormone treatment to a placebo to see if it helps men with advanced prostate cancer live longer.

SOURCE: The Lancet, news releas.

The U.S. Food and Drug Administration today announced the approval of the Esteem – an implanted hearing system used to treat moderate to severe sensorineural hearing loss, a type of permanent hearing loss.

Sensorineural hearing loss is usually caused by genetic factors or damage to the inner ear resulting from noise, viral infections, or aging. The results are reductions in perception of sounds and in the ability to understand speech.

This differs from conductive hearing loss, which occurs when sound waves cannot transmit well through the outer or middle ear or both. Medical or surgical treatment can often restore hearing in people with a conductive hearing loss, which can be caused by earwax, fluid in the middle ear space, or a punctured eardrum.

The Esteem system consists of external testing and programming instruments and three implantable components: a sound processor, sensor, and driver. The sensor senses vibrations from the eardrum and middle ear bones and converts these mechanical vibrations into electrical signals, which are then sent to the sound processor, which amplifies and filters the signal to compensate for the individual patient’s hearing loss. The driver converts the enhanced electrical signal back to vibrations, which are then transmitted into the inner ear where they are perceived as sound.

“The approval of Esteem provides patients with an option to alleviate their hearing loss by using a device with no readily visible external components,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health.

The system is designed to alleviate the effects of hearing loss in patients ages 18 years and older. Other criteria for the device include: stable bilateral sensorineural hearing loss, a normally functioning Eustachian tube, and normal middle ear anatomy. A patient’s ability to understand speech using Esteem should be similar to that of conventional hearing aids.

In a multicenter clinical study of Esteem versus pre-implant hearing aids, 93 percent of Esteem recipients scored equal to or better than their pre-implant hearing aids on a speech intelligibility test. Seven percent scored less than with their pre-implant hearing aids, and 56 percent scored better than with their pre-implant hearing aids.

Seven percent of participants experienced facial paralysis, and 42 percent experienced taste disturbance, both of which are results of the surgical procedure necessary to implant the device. The majority of these adverse events resolved during the one-year study period.

As a condition of FDA approval, Esteem manufacturer, Envoy Medical Corporation of St. Paul, Minn., must conduct two post-approval studies. In one study, Envoy must continue to follow-up on 61 subjects from the original study for five years to study safety and effectiveness. Another study of 120 newly enrolled subjects will include an evaluation of the incidence of facial paralysis at one month after implantation, and evaluate the effectiveness of Esteem five years after implantation.

Researchers assessed fitness, cognitive function and brain structural changes in 21 women with relapsing-remitting multiple sclerosis (MS).

Patients who were classified as being highly fit performed much better on cognitive function tests than less-fit patients. MRI scans also showed that higher levels of fitness were associated with greater volume of gray matter, which is linked to vital brain processing skills, and less damage in parts of the brain where MS-related deterioration occurs.

“We found that aerobic fitness has a protective effect on parts of the brain that are most affected by multiple sclerosis,” study lead author Ruchika Shaurya Prakash, an assistant professor of psychology at Ohio State University, said in a news release. “As a result, these fitter patients actually show better performance on tasks that measure processing speed.”

The researchers also found that fitter MS patients showed less deterioration of brain white matter, which are fibers that connect gray matter areas.

The study findings were released online in advance of publication in an upcoming print issue of the journal Brain Research.

Previous research has shown that exercise promotes production of proteins called nerve growth factors, which play an important role in the growth and maintenance of neurons in the brain.

“Our hypothesis is that aerobic exercise enhances these nerve growth factors in MS patients, which increases the volume of the gray matter and increases the integrity of the white matter. As a result, there is an improvement in cognitive function,” Prakash said.

“For a long time, MS patients were told not to exercise because there was a fear it could exacerbate their symptoms. But we’re finding that if MS patients exercise in a controlled setting, it can actually help them with their cognitive function,” she added.

SOURCE: Ohio State University, news release.

The molecules, or antigens, appear to trigger powerful immune responses in patients that help protect them from falling ill in subsequent infections.

Led by Freya Fowkes at the Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia, researchers plowed through 33 previous studies which analyzed people who had suffered from malaria in the past but were now immune.

What they found was that two antigens — MSP-3 and MSP-119 — triggered particularly powerful antibodies in patients, which protected them from falling ill subsequently with malaria by 54 and 18 percent, respectively.

“People in malaria endemic areas develop natural immunity to malaria, what (these studies) have done is go into these communities and see what antigens (the people) have immunity to and see if we can use these antigens to make vaccines,” Fowkes told Reuters ahead of the publication of the team’s findings.

“We’ve reviewed all the literature that looks at surface antigens … results suggest that response to the two (antigens) were most indicative of protection against clinical disease. There may be other antigens out there that may be protective but they have just not been well studied.”

The study was published in the latest issue of PLoS Medicine on Wednesday.

ELUSIVE VACCINE

The malaria parasite multiplies by invading red blood cells in its victims.

“The parasite uses different antigens to attach to the different molecules on the surface of red blood cells … once inside the red blood cells the parasite rapidly divides and multiplies, and red blood cells burst and release even more (parasites) that infect even more red blood cells,” Fowkes said.

“You can get hundreds of thousands of infected red blood cells in a person.”

A malaria vaccine has been difficult to make because the parasite is very diverse with many antigens on its surface.

“With measles, you get just one measles infection and you are immune for life,” Fowkes said.

“With malaria, you need multiple infections to develop long term immunity to disease. The actual parasite itself is very diverse with lots of different antigens on the surface … and it takes a while to develop enough immunity to all the different antigens to give long term protection against malaria.”

“Some molecules will be more effective at stimulating an immune response than others. We have to prioritize the antigens and also look at others in making a vaccine.”

(Reporting by Tan Ee Lyn; Editing by Raju Gopalakrishnan)