BioMed Central Blog
The right to adequate pain treatment-new debate in BMC Medicine
In the developed world, we generally tend to take pain treatment and management for granted; if we’re in physical pain, someone will provide treatment to do something about it. It’s easy to lose sight of the fact that this is not neccessarily true across the globe. In a new debate published in BMC Medicine, Lohman and colleagues, from Human Rights Watch examine the issues related to access to adequate pain treatment, and why barriers to pain treatment can be tantamount to a violation of human rights.
Check out the full article: “Access to pain treatment as a human right”, and while you’re visiting BMC Medicine, why not sign up for article alerts, which will keep you up to date on the latest general medical and clinical research.
Posted by Robin Cassady-Cain at 10:00 Comments (0)
New method published in Genome Medicine improves complex disease risk prediction
A Method recently published in Genome Medicine suggests that inclusion of phenotypic and genotypic information from close relatives in a genetic risk prediction model can lead to improved estimates of an individual’s disease risk.
Douglas Ruderfer, Joshua Korn and Shaun Purcell, from Massachusetts General Hospital, The Broad Institute of Harvard and MIT, and Harvard Medical School have developed a liability threshold model which predicts an individual’s risk of developing a complex disease, using their own genotype as well as that of a close relative whose disease phenotype is known. “Family-based genetic risk prediction of multifactorial disease” is published in the January issue of Genome Medicine.
The authors say, ‘we do not ask “how well do SNPs predict disease compared to family history”, but rather, “how well do SNPs predict disease given a positive family history, and to what extent does including genotype data from the affected relatives help?”.’ They test their model on a simulated dataset for Crohn’s disease, a multifactorial trait, and show that estimates of disease risk are modestly improved by this method.
The presence of a complex disease in a family member may be a motivator for genetic testing. For many such diseases, the causal genetic variants will have a wide range of magnitudes, and the addition of a newly-discovered common variant with a small effect on disease risk will have a moderate effect on risk prediction. However, the cumulative value of these low-magnitude data can be informative. The improvement to disease risk prediction by this new model is also moderate, but genetic information from family members may be an important addition to genetic tests in the future. Of course, whether individuals then change their behaviour to reflect their predicted risk is another story …
Why not visit Genome Medicine’s new website for more research and reviews in this exciting field?
Rebecca Furlong
Assistant Editor, Genome Medicine
Posted by Rebecca Furlong at 10:55 Comments (0)
Inflammation hypothesis linked to Alzheimer's therapy
Alzheimer's disease is thought to affect 37 million people worldwide, and there is evidence to suggest that inflammation can contribute to Alzheimer's and exacerbate the course of the disease. A review published in Alzheimer's Research & Therapy discusses inflammatory reactions in Alzheimer’s, which are still considered to be downstream effects of the accumulated proteins believed to trigger disease – amyloid beta and tau.
But the more recent “inflammation hypothesis” suggests it may be possible to alter the immune system and direct it towards the clearance of these amyloid and tau proteins. Anti-inflammatory drugs and immunization against amyloid beta have been considered but initial clinical trials have shown mixed results.
Inflammation in Alzheimer's disease: relevance to pathogenesis and therapy
Elina Zotova, James AR Nicoll, Raj Kalaria, Clive Holmes, Delphine Boche
If it will be necessary to approach research from multiple directions to defeat this devastating condition, Zotova and colleagues suggest that addressing neuro-immune interactions involved throughout the disease course might help devise future therapeutic strategies.
Posted by Frances Mulvany at 15:03 Comments (0)
Gene signature for cancer cachexia - new research in Genome Medicine
An 83-gene signature for cachexia in cancer patients suggests that preclinical models do not accurately reflect the biological processes of this disease in humans, according to research recently published in Genome Medicine.
Cancer cachexia affects up to half of all cancer patients. It causes severe tissue wasting and weight loss which is resistant to increased nutritional intake, and can hasten cancer-related death. The molecular mechanisms behind this disease are poorly understood, and have mostly been examined biochemically or in preclinical models.
In their article “Using transcriptomics to identify and validate novel biomarkers of human skeletal muscle cancer cachexia”, Timmons and colleagues describe RNA profiling of muscle from cancer patients who were defined as either weight-stable or weight-losing since becoming ill. An 83-gene signature for weight loss was determined, which includes many genes not previously associated with this condition in humans or in animal models. The increased expression of genes such as CaMKII and TIE1 may lead to their use as novel molecular biomarkers of human cancer cachexia.
However, some candidates selected from the pre-clinical literature, such as FOXO1, showed no correlation with weight loss in this study. This suggests that some pathways do not play the same role in human cancer cachexia as previously indicated by animal and cell-based studies.
Check out the new Genome Medicine website for more exciting research and reviews!
Rebecca Furlong
Assistant Editor, Genome Medicine.
Posted by Rebecca Furlong at 14:32 Comments (0)
Disabilities associated with HIV infection are a real concern as they can make it difficult for HIV sufferers to participate fully in society. Disabilities can be physical, mental or involve sensory impairment and there is also evidence to show that people with existing disabilities are at a higher risk of contracting an HIV infection. Although these issues are of high importance, research in these areas has been sparse and so the series HIV/AIDS and Disability published by Journal of the International AIDS Society aims to raise awareness of these subjects and propose recommendations for the future.
In their introductory Editorial ‘Special theme on HIV and disability – a time for closer bonds’, Shirin Heidari
and Susan Kippax highlight the importance of continuing research and awareness into the problems encountered by HIV sufferers with disabilities and give an introduction to the various issues within this. The articles in the series cover a range of subjects including an article on how human rights law has treated disability and AIDS, in which the authors note some of the different ways in which national anti-discrimination laws have reflected the links between HIV and disability, and offer some recommendations for collaboration between HIV and disability rights advocates in advancing human rights at the international level. Another article looks at how to prevent and reduce factors affecting disability experiences and considers how extrinsic and intrinsic contextual factors may exacerbate or alleviate episodes of HIV-related disability and how these can offer a broader understanding of the disability experience and may suggest ways to prevent or reduce disability for adults living with HIV. To be informed when new articles are published within the HIV/AIDS and Disability thematic series please sign up for article alerts.
Posted by Genevieve Horne at 17:26 Comments (0)
Optimal design for questionnaires in clinical trials: science or art?
Questionnaires are a valuable tool for gathering outcome data from patients enrolled in clinical trials. In a review published this week in Trials Dr Phil Edwards considers recent developments in the field of questionnaire design that may help investigators minimize bias, improve data completeness and maximize precision in estimating the effect of treatments.
Review 
Questionnaires in clinical trials: guidelines for optimal design and administration
Phil Edwards
Trials 2010, 11:2 (11 January 2010)
[Abstract] [Provisional PDF]
Investigators often rely upon principles of questionnaire development that are based predominately on expert opinion rather than empirical evidence. In this review, Edwards discusses how the growing body of evidence on questionnaire design can be applied to the successful use of questionnaires in clinical practice and whether further research can make questionnaire design less of an art, and more of a science.
Posted by Victoria Thompson at 16:46 Comments (0)
Using Insulin-like growth factor genes to predict outcome in breast and lung cancer patients
As the era of personalised medicine and genomics evolves and the potential for better targeted treatments becomes a reality, the need to identify which individual treatments will benefit each individual patient is becoming imperative. One way to do this is to try and identify predictive gene signatures. This is what Rajski and colleagues have done in the article published this week in BMC Medicine; “IGF-I induced genes in stromal fibroblasts predict the clinical outcome of breast and lung cancer patients”, using cell lines to first develop the signature, and later validating their data in clinical patient samples.
In the accompanying commentary, Werner and Bruchim nicely outline the broader background to the article and explain the way in which Rajski and colleagues’ findings contribute not only to insulin-growth factor-targeted therapies for breast and lung cancer, but also more generally to the development of gene signatures for prediction of treatment response.
Why not visit the BMC Medicine webpage and check out the full story?
Posted by Robin Cassady-Cain at 10:36 Comments (0)
Proteomic effects of hormone therapies - new research in Genome Medicine
New research by Samir Hanash, Ross Prentice and colleagues, recently published in Genome Medicine, suggests that the different proteomic effects of estrogen-alone and estrogen plus progestin treatments may explain the distinctive clinical effects of each therapy.
Hormone replacement therapy (HRT) acts as an artificial boost to women’s hormone levels, providing short-term relief from symptoms of the menopause. However, the Women’s Health Initiative trials found that postmenopausal HRT may be associated with some adverse conditions, such as venous thromboembolism and stroke, as well as with positives like reduced risk of fracture. Estrogen plus progestin therapy seems to have more unfavorable effects than estrogen-alone, but the biological basis for this clinical outcome is not well understood.
Samir Hanash and colleagues previously reported that one year of estrogen treatment had a profound effect on the serum proteome, including proteins involved in blood clotting, bone formation, and inflammation pathways. Their new study, "Postmenopausal estrogen and progestin effects on the serum proteome" published in Genome Medicine, shows that taking estrogen plus progestin for one year has a similarly acute effect. While the majority of pathways identified were shared between the two therapies, several promising proteins were identified which may begin to explain some of the different clinical effects. For example, the authors note that progestin may have a distinct impact on the insulin growth factor pathway and on circulating levels of extracellular matrix proteins, which have roles in tumorigenesis and tumor invasion respectively, and are relevant to the possible association of estrogen plus progestin HRT with breast cancer.
This is an exciting glimpse into the kind of understanding that proteomic analysis can provide about human health and disease. However, the authors caution that only one type of estrogen and progestin were tested and different formulations may have other effects. Their results hint that the different ways of administering the same drug (oral vs. injection, for example) may also have differing effects on the proteome, and ultimately, on disease risk.
Genome Medicine is getting a makeover! What do you think of our new look?
Rebecca Furlong
Assistant Editor, Genome Medicine
Posted by Rebecca Furlong at 16:58 Comments (0)
Assessing the effects of social marketing on physical activity behaviors
International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) has recently published its first thematic series of articles presenting research on how mass communication and social marketing affect levels of physical activity within a population.
With rising trends in obesity and the associated health problems, exacerbated by a lack of physical activity, governments are increasingly keen to address these issues by encouraging us to get active.
The series, ParticipACTION: Baseline research on the resurgence of Canada's physical activity social marketing leader, focuses on ParticipACTION, a not-for-profit organization dedicated to inspiring and supporting active living and sport participation for Canadians. Edited by Adrian Bauman and Mark Tremblay, the articles address a range of aspects including an assessment of the effect of a mass media campaign designed to inform parents of the risks associated with inactivity for children and youths.
What are your thoughts on this type of program? Are government initiatives such as this a viable way to improve public health?
Sally Robertson
Senior Assistant Editor
Posted by Alison Cobb at 10:34 Comments (0)
Traumatic brain injury – a new approach to data standardisation
Traumatic brain injury (TBI) is a serious but variable disease, leading to difficulties analysing related studies. In a commentary published in Critical Care, Dr Andrew Maas, University Hospital Antwerp, Brussels, describes how pooling data from several sources can provide a cost-efficient way of comparing cases of TBI.
The IMPACT (International Mission on Prognosis and Clinical Trial Design in TBI) project incorporated individual patient data from a variety of study designs and has lead to increased understanding of differences in the way trauma centres deal with TBI.
But key to sharing of results is standardisation of data collection and coding, and this work by the IMPACT study group has contributed to a broader US initiative – the National Institute of Neurological Disorders & Stroke (NINDS) Common Data Elements – that will soon be releasing its draft recommendations and templates.
To read all commentaries and reviews, non-subscribers to Critical Care can register for a free 30-day trial.
Surayya Johar
In-house Editor, Critical Care
Posted by Iain Hrynaszkiewicz at 14:46 Comments (0)
Multiple sclerosis-new Minireview in BMC Medicine
If you’re like me, you probably know at least one person affected by multiple sclerosis, an autoimmune demyelinating disease of the central nervous system that strikes during young adulthood. Like many other neurological diseases, the deterioration that results from multiple sclerosis is tragic, and the development of more effective treatment is a very active area of research.
How effective are the current treatments? What is understood about how these treatments work to modify advancement of multiple 
sclerosis pathology? What are the current treatments in drug trials, and what is needed in the future to achieve truly effective treatment for different subsets of patients? These are the main issues that Spain, Cameron and Bourdette from the Oregon Health and Science University address in their minireview “Recent Developments in Multiple Sclerosis Therapeutics” published this week in BMC Medicine.
Why not visit the BMC Medicine homepage to find out more about this, and other developments in general medical and clinical research?
Robin Cassady-Cain,
In House Editor, BMC Medicine
Posted by Robin Cassady-Cain at 17:46 Comments (0)
Working together to benefit patients: meeting the challenge
Can we achieve true collaboration between the National Health Service (NHS), academia, industry and consumers? UK government directives have prescribed this activity but in a commentary published this week in Trials, authors Adams and de Lima argue that these groups are yet to fully embrace the challenges of truly working together.
Commentary
When worlds collide
Clive E Adams, Mauricio S de Lima
Trials 2009, 10:108 (27 November 2009)
[Abstract] [Provisional PDF]
Adams and de Lima suggest that, while clinicians may see research as an academic exercise with limited relevance to clinical practice, industry players are likely to expect a level of inefficiency from the NHS. Furthermore, academics may be discouraged from accepting industry funding due to concerns over conflict of interest. As a result the benefits to patients from relevant research, as well as their potential involvement, may be limited.
Although changes must be made to ensure that the challenges of collaborative working can be met, the authors believe that this cultural shift represents a unique opportunity for industry, academia and the NHS to work together to allow patients the benefit of world-leading research with relevant clinical outcomes.
Victoria Thompson
Assistant Journal Development Editor
Posted by Iain Hrynaszkiewicz at 14:43 Comments (0)
New Co-Editor-in-Chief for Journal of the International AIDS Society
We are delighted to welcome Dr Papa Salif Sow, Professor of Infectious Diseases from the University of Dakar in Senegal, as the new Co-Editor-in-Chief for Journal of the International AIDS Society (JIAS). Dr Sow has served as Head of the Department of Infectious Diseases since 2002 and is also the President of the African Network of AIDS Physicians in Africa and Coordinator of the Regional Centre for Research and Training at Fann Hospital, Dakar, Senegal. Dr Sow’s extensive experience in raising awareness and medical help for HIV/AIDS sufferers in Africa will greatly help to raise the profile of the journal and ensure that JIAS continues to publish high-quality articles on important aspects of AIDS research from all areas of the world. You can keep up to date with the latest articles by signing up for email article alerts.
We would like to take this opportunity to thank Dr Elly Katabira who is stepping down as Co-Editor-in-Chief of JIAS. His contribution to the journal over the last few years is highly valued and we are pleased to have his ongoing support as a member of the Editorial Board.
Posted by Genevieve Horne at 16:57 Comments (1)
Getting into a rhythm – What are the most effective atrial fibrillation treatment methods?
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia affecting about 1% of the general population. Treatments such as rate controlling therapy and anticoagulants are commonly used to stabilise heart rhythm and prevent complications that may arise from AF. But, how effective are the current range of treatments for AF and does the time of intervention impact on the eventual outcome of this prevalent condition?
In BMC Medicine this week, Paulus Kirchhof dicusses the range of treatments available to AF sufferers and the reasons why these 
treatments do not improve outcomes.
Kirchhof suggests that initiating treatment at an earlier stage may be beneficial for the millions of people afflicted by AF and argues that early diagnosis via the use of newer screening technologies, together with the development and delivery of safer rhythm control interventions are needed to improve outcomes in people with AF.
You, or someone you know, is likely to experience AF, so why not check out the full commentary here.
Mick Aulakh
Assistant Editor, BMC Medicine
Posted by Robin Cassady-Cain at 11:24 Comments (0)
Migraine—Are more effective treatments in sight?
Migraine is a largely inherited neurological disorder leading to a combination of symptoms including headache, visual and aural effects. As any long-time migraine sufferer will tell you, migraine pain is debilitating, and the current treatments are not always very effective. How well do we really understand the mechanism of migraine, and what treatments are available? Are there better treatments coming in the near future? How can we maximise the therapeutic effect of existing treatment?
These are just a few of the questions that Peter Goadsby and Till Springer address in their minireview “Migraine pathogenesis and state of pharmacological treatment options” in BMC Medicine this month. If you suffer from migraine, or see patients with migraine in your day to day practice, how do you feel about progress in this area?
If you’re interested in research, reviews or opinion articles covering topics of medical interest, article alerts are a great way to keep informed of developments in medical research!
Posted by Robin Cassady-Cain at 17:27 Comments (0)