Posts Tagged ‘boston’

Provider, parental assumptions on teen sex yield ‘missed opportunities’ for HPV vaccine

Researchers at Boston University School of Medicine (BUSM) conducted hundreds of interviews to offer new insights into this frequent — and often controversial — clinic room conversation. Their findings and recommendations will appear in the September 2014 issue of Pediatrics.

Specifically researchers found that vaccination rates could be traced to personal biases and communication styles of providers. Providers who believed a child was at low risk for sexual activity — an assessment, they admitted, not always accurate — were more likely to delay administration. Often, this deferred decision was never readdressed. Those with high vaccination rates approached HPV vaccines as a routine part of the age 11 vaccine bundle, unequivocally recommended it to parents, and framed the conversation as one about cancer prevention.

“Emphasis on cancer prevention and concurrent administration with other routine childhood vaccines has the potential to dramatically reduce missed opportunities occurring among well- intentioned providers and parents,” explained lead author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at Boston Medical Center.

The researchers interviewed 124 parents and 37 health-care providers at four clinics between September 2012 and August 2013. Parents and providers were asked to discuss their reasons why their HPV vaccine eligible girls did or did not ultimately receive the vaccine. Remarkably, the most common parental reason (44 percent) was that their child was never offered the vaccine. Other common reasons included the perception that the vaccination was optional instead of recommended or being told by their provider that it was unnecessary prior to sexual debut. Among those that declined the vaccine, the rationale often involved safety concerns and a belief that their daughters were too young to need it.

source : http://www.sciencedaily.com/releases/2014/08/140818012326.htm

Researchers identify a mechanism that stops progression of abnormal cells into cancer

Although the link between abnormal cells and tumor suppressor pathways — like that mediated by the well known p53 gene — has been firmly established, the critical steps in between are not well understood. According to the authors, whose work appears in Cell, this work completes at least one of the missing links.

Normal human cells contain 23 pairs of chromosomes, but this number doubles to 46 pairs as a cell prepares to divide. At the end of a normal cell division cycle, these chromosomes evenly divide to produce two identical cells with 23 pairs of chromosomes each. Sometimes, however, errors occur during division and cells fail to divide properly, resulting in giant cells with double the number of chromosomes, known as a tetraploid cells. Normally, p53 dependent pathways stop these tetraploid cells from proliferating. This response is critical because those tetraploid cells that escape detection can facilitate cancer development: Recent studies suggest that as many as 40% of all solid tumors have passed through a tetraploid stage at some point during their development. Thus, there has been great interest in understanding how a cell “knows” it has a tetraploid complement of chromosomes and is in need of tumor suppression.

Using a technique known as genome-wide screening, the scientists systematically depleted every human gene from tetraploid cells in order to discover which ones were important to prevent proliferation. They found that when one specific gene, LATS2, was eliminated, the arrested tetraploid cells resumed proliferation, thus demonstrating that LATS2 was an upstream gene responsible for halting abnormal cell division. The LATS2 gene is known to activate the Hippo tumor suppressor pathway, which is the same pathway our bodies use to ensure our vital organs don’t grow out of control. Now, the authors demonstrate that the Hippo pathway also represents the underlying pathway that prevents tetraploid cells from proliferating and causing tumors. “Although more studies are needed to further clarify this critical pathway, this work may help guide the development of new therapies that specifically target tumor cells with abnormal numbers of chromosomes, while sparing the normal healthy cells from which they originated,” explained corresponding author Neil J. Ganem, PhD, Assistant Professor of Pharmacology and Medicine in the Shamim and Ashraf Dahod Breast Cancer Research Laboratories at BUSM.

source : http://www.sciencedaily.com/releases/2014/08/140814124453.htm

Patient navigation may aid in breast cancer treatment in high-risk populations

Using data from a previously published, multi-center study funded by the National Cancer Institute, researchers aimed to identify the possible benefits of assigning patient navigators to women recently diagnosed with breast cancer. According to the results, women were more likely to start recommended treatment when assisted by one of these trained specialists. For example, they were more likely to start hormonal therapy, which is considered the gold standard in treatment for certain types of breast cancer.

Naomi Ko, MD, MPH, instructor of medicine in the Section of Hematology Oncology at Boston University School of Medicine and a practicing breast oncologist at Boston Medical Center, stresses the need for further investigation. “This study gave us a glimpse of the potential benefit of patient navigation but there’s a lot more research to be done. At this point we still need to understand how or why patient navigation works. Understanding where patient navigation is most beneficial in cancer care, in order to help the neediest patients, is a rich topic for future research,” said Ko.

Navigators are experts in helping patients overcome the numerous obstacles they face, including monetary difficulties, transportation issues, educational and even language barriers, and have become an integral part of the cancer care model. It has been known that minority and high risk patients, or those who may benefit most from these navigators, often have worse outcomes after diagnosed with cancer.

source : http://www.sciencedaily.com/releases/2014/08/140804123218.htm