Biomarker linked with heart disease
In a study published online by JAMA Cardiology, Elizabeth Selvin, of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues examined the association of six-year change in high-sensitivity cardiac troponin T with incident coronary heart disease, heart failure and all-cause mortality. High-sensitivity cardiac troponin T (hs-ctnt), a protein that can be measured via a blood test, is a biomarker of cardiovascular risk and could be approved in the United States for clinical use soon. Cardiac troponin is critical to the clinical diagnosis of heart attack, particularly among symptomatic persons with chest pain. However, little is known about the implications of changes in hs-ctnt levels over time. This analysis included 8,838 participants from the Atherosclerosis Risk in Communities Study who were initially free of coronary heart disease (CHD) and heart failure (HF) and who had hs-ctnt measured twice, 6 years apart. Of the participants (average age, 56 years; 59 percent female; 21 percent black), there were 1,157 CHD events, 965 HF events, and 1,813 deaths overall. Incident detectable hs-ctnt (baseline, <0.005 ng/ml; follow-up, ? 0.005 ng/ml) was independently associated with subsequent CHD, HF and death relative to an hs-cTnT level less than 0.005 ng/ml at both visits. Individuals with the most marked hs-ctnt increases (e.g. baseline, < 0.005 ng/ml; follow-up, ? 0.014 ng/ml) had significantly increased risks for CHD, HF and death. In persons with decreasing hs-ctnt levels (e.g., 6-year reductions >50 percent from baseline), there was also evidence suggestive of lower risk for outcomes compared with persons with stable or increasing concentrations.
A bleeding heart tells on heart failure
The amount a heart 'bleeds' following a heart attack can predict the severity of future heart failure, according to research presented at the British Cardiovascular Conference, in Manchester. Bleeding, or bruising in the heart, affects over 40 percent of people who suffer from a heart attack. The researchers have now found that this injury is associated with a higher risk of developing heart failure in the months following a heart attack. There are 188,000 hospital episodes attributed to heart attack in the U.K. each year: that's one around every three minutes. But although around seven out of 10 people now survive a heart attack, many are left with heart failure. The British Heart Foundation-funded study found that bleeding was linked to a 2.6 times greater risk of adverse remodelling, where the heart muscle changes shape, which is a precursor to heart failure. It is also linked to a six times greater risk of either death or heart failure following a heart attack. The researchers also validated a test for use at the time of heart attack treatment to rule-in or rule-out heart muscle bleeding, and the likelihood of survival free of heart failure. This information would be useful to doctors to identify patients who are at risk of adverse outcome for more intensive treatment. The findings will pave the way to find new treatments to prevent bleeding following a heart attack and the subsequent onset of heart failure. MRI imaging, a non-invasive scan, can be used after a heart attack to monitor heart muscle bleeding, which happens in phases. The first phase is in the 12 hours following a heart attack, and the second takes place within two to three days. This provides a window of opportunity to introduce treatments to prevent the second phase of bleeding, which could reduce or prevent the later onset of heart failure.
Screening for syphilis recommended for persons at increased risk of infection
The U.S. Preventive Services Task Force (USPSTF) has found convincing evidence that screening for syphilis infection in asymptomatic, nonpregnant persons at increased risk for infection provides substantial benefit. The report appears in the June 7 issue of JAMA. This is an A recommendation, indicating that the USPSTF recommends the screening and that there is high certainty that the net benefit is substantial. The number of cases of primary and secondary syphilis have been increasing since 2000. In 2014, approximately 20,000 cases of syphilis were reported in the U.S. Left untreated, syphilis can progress to late-stage disease in about 15 percent of persons who are infected. Late-stage syphilis can lead to development of inflammatory lesions throughout the body, which can lead to cardiovascular or organ dysfunction. Syphilis infection also increases the risk for acquiring or transmitting human immunodeficiency virus (HIV) infection. To update its 2004 recommendation on screening for syphilis infection in nonpregnant adults, the USPSTF reviewed the evidence on screening for syphilis infection in asymptomatic, nonpregnant adults and adolescents, including patients coinfected with other sexually transmitted infections (such as HIV). Screening for syphilis in pregnant women was updated in a separate recommendation statement in 2009 (A recommendation). The USPSTF found convincing evidence that treatment with antibiotics can lead to substantial health benefits in nonpregnant persons who are at increased risk for syphilis infection by curing syphilis infection, preventing manifestations of late-stage disease, and preventing sexual transmission to others. The USPSTF found no direct evidence on the harms of screening for syphilis in nonpregnant persons who are at increased risk for infection. Potential harms of screening include false-positive results that require clinical evaluation, unnecessary anxiety to the patient, and the potential stigma of having a sexually transmitted infection. The harms of antibiotic treatment are well established, and the magnitude of these harms is no greater than small. The USPSTF concludes with high certainty that the net benefit of screening for syphilis infection in nonpregnant persons who are at increased risk for infection is substantial. Accurate screening tests are available to identify syphilis infection in populations at increased risk. Effective treatment with antibiotics can prevent progression to late-stage disease, with small associated harms, providing an overall substantial health benefit.
Cancer imaging in high definition
UPM researchers are involved in a European network to develop an endoscopic scanner for early detection of certain types of cancers that have a high mortality rate today. Endo TOFPET-US project aims to develop a generation of medical scanners specifically designed for the examination of certain organs. Endo TOFPET-US is an international consortium which is technically led by CERN and uses the latest advances on detectors of high energy physics to enhance the quality of nuclear medical images, particularly the images known as Positron Emission Tomography (PET). Researchers from Biomedical Image Technologies (BIT) at Universidad Politécnica de Madrid (UPM) are involved in the project through the Picosec educational project and have collaborated in the design and implementation of both the electronics and data acquisition system of the developed sensor. This work was carried out along with the lab of Experimental High Energy Physics and Associated Instrumentation in Portugal (LIP) that gave as a result the spin-off company Petsys Electronics SA of Portugal. This electronics will help obtain high-definition images that will allow us to early detect cancers. An example is the case of pancreatic cancer that has a mortality rate up to 90 percent nowadays. The latest innovations in detectors for high energy physics carried out in CERN are exceeding the speed limit when detecting elementary particles. PET medical imaging is one application of this technology and consists in a technique that detects pairs of gamma rays emitted indirectly by a positron-emitting and which is used in medical scanners for cancer diagnosis. As part of the Seventh Framework Program, the European Union funded the international collaboration known as EndoTOFPET-US in which various multidisciplinary groups joined forces to develop the first endoscopic PET scanner for specific organs. Besides, in order to boost the future of research in Europe, this consortium trained a group of young researchers who participated in the development of the scanner within the Picosec program. BIT researchers from School of Telecommunications Engineering at UPM took part of this project and have actively participated in the design and implementation of the electronics and the data acquisition system of the detector with the collaboration of Petsys Electronics SA. In spite of the latest advances in cancer detection and diagnosis, some types of cancers are detected in advanced stages due to their morphology and location. Improving an early detection of the different types of cancers is essential to increase the survival rates of this disease. The project includes two trends in medical imaging: detectors for examination of certain organs and a multimodal imaging technique, all this in order to provide data about the cancer that is not available so far.