Insurance coverage leads to increased cancer
screening and diagnosis
After Medicare coverage expanded to include screening
for colon cancer, early diagnosis and treatment of the disease also increased,
according to a report by School of Medicine researchers in the December 20,
2006, issue of JAMA: The Journal of the American Medical Association.
Medicare reimbursement rules first changed in 1998 to
cover screening colonoscopies for older patients at risk for colon cancer.
Then, in 2001, coverage was expanded again to include all Medicare recipients.
A team led by Cary P. Gross, associate professor of medicine, found that
colonoscopies increased by 600 percent since the first Medicare change. A total
of 44,924 patients were diagnosed at an early stage during the study period, an
increase from 22.5 percent to 25.5 percent since 1998; after the second
coverage expansion, the percentage rose to 26.3 percent. "These data strongly
support initiatives to increase access to and use of screening colonoscopy,"
Gross said.
Nicotine dependence may be in the genes
The addictive power of tobacco has long been
recognized, but researchers are gradually zeroing in on genetic links to
nicotine dependence. Joel Gelernter ’79, professor of psychiatry, genetics, and
neurobiology, and colleagues recently linked several genetic regions to
nicotine dependence. Many of these regions have been targeted by other
researchers, but in a new finding reported in the January issue of Biological
Psychiatry, the
Gelernter team showed that a region of chromosome 5 that contains several genes
is strongly linked to nicotine dependence in African Americans. Gelernter now
wants to find the specific gene or genes that affect nicotine addiction.
Soldiers in Iraq battle a new, more elusive enemy
As if roadside bombs and suicide attacks weren't
enough, now American troops fighting in Iraq are facing another health threat: Acinetobacter
baumannii. More
than 240 wounded soldiers have been diagnosed with this antibiotic-resistant
strain of bacteria, which if unchecked can cause urinary tract infections,
pneumonia, meningitis, sepsis, and even death.
Michael Snyder, the Lewis B. Cullman Professor of
Molecular, Cellular, and Developmental Biology, and his colleagues have made a
significant contribution in the fight against A. baumannii. Using DNA sequencing technology,
Snyder's group found that 17 percent of the strain's genetic material
originated in other microorganisms and that it is through this foreign DNA that A. baumannii has
gained its durability. The findings were published in the March 1 issue of Genes
and Development. It
is believed that an understanding of these evolutionary adaptations will help
doctors develop antibiotics to treat the infections caused by this organism.
When the cure compounds the problem
It is common practice to give patients with heart or
lung problems, including premature babies, supplemental oxygen. But prolonged
high concentrations of oxygen can lead to hyperoxic acute lung injury (HALI),
in which extensive cell death causes the lung's capillaries to break down and
become leaky.
Jack A. Elias, the Waldemar Von Zedtwitz Professor
and chair of internal medicine, led a study to see if angiopoietin-2 (Ang2), a
protein known to destabilize blood vessels, might contribute to HALI. Elias's
team found high Ang2 levels and greater cell death in fluids and lung tissue
taken from mice, adult humans, and premature infants after exposure to high
oxygen levels. Mice that had been previously treated with RNA that suppressed
Ang2 had far less damage, and mice that lacked Ang2 lived much longer than
their counterparts. These findings, published in the November 5, 2006, issue of Nature Medicine, suggest that drugs designed to curb Ang2 could protect patients against HALI.
This study is an example of the "bench-to-bedside"
research that the Yale medical school has made a priority, because, while the
research was done on mice, researchers also established its relevance for human
patients with acute lung injury.
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