News Briefs: Cancer Diagnosis; Brain Inflammation; Prostate Cancer
Cancer Among Conditions Most Likely to Be Misdiagnosed
Estimates suggest that more than 100,000 Americans die or are permanently disabled each year due to medical diagnoses that initially miss conditions or are wrong or delayed. A research team led from John Hopkins Armstrong Institute for Patient Safety and Quality has identified three major disease categories that account for nearly three-fourths of all serious harms from diagnostic errors. The findings, based on an analysis of a large repository of malpractice insurance claims, are described in a paper published in the July 11 online edition of the journal Diagnosis. Diagnostic errors leading to death or serious, permanent disability were associated with misdiagnosed cancers (37.8%), vascular events (22.8%) and infections (13.5%), categories that the research team calls the “big three.” According to the authors, the findings suggest that the most serious harms can be attributed to a surprisingly small number of conditions. The researchers state that it won’t be an easy or quick fix, but the insights provide a place to start. For example, researchers found that most of the diagnostic errors (71.2%) associated with the malpractice claims occurred in ambulatory settings, either in emergency departments, where missed infections and vascular events such as strokes were more of a concern, or outpatient clinics, where misdiagnoses were more likely to be cancer-related. The Society to Improve Diagnosis in Medicine and the Armstrong Institute Center for Diagnostic Excellence helped fund the study.
Reducing Brain Inflammation
Scientists discovered a novel mechanism and role in the brain for hyaluronic acid, a clear, gooey substance popularized by cosmetic and skin care products. Hyaluronic acid may be a key in how an immune signal moves from the bloodstream to the brain, activating the brain’s resident immune cells, the microglia. This new discovery could lead to novel opportunities to shut down brain inflammatory responses. Findings from this NIH funded study have important implications for better treatments for stroke, neurodegenerative diseases, as well as head injuries. Researchers demonstrated that inflammation can be abnormally amplified through endothelial cell and microglia crosstalk when the brain constantly receives inflammatory signals. The work identified hyaluronic acid as the key signal released by endothelial cells to stimulate microglia and promote oxidative damage. Ascorbyl palmitate, also known as vitamin C ester, was found to be quite effective in inhibiting microglia and reducing the production of inflammatory hyaluronic acid. This suggests that vitamin C ester may be useful in treating central nervous system inflammation, which can occur from head trauma or stroke, or as part of a systemic immune response. Inflammation within the central nervous system has been associated with chronic neurodegenerative diseases including Alzheimer’s disease, Parkinson’s disease and multiple sclerosis. The study appeared in Brain, Behavior and Immunity.
Noninvasive Urine Test Improves Detection of Aggressive Prostate Cancer
UCLA and the University of Toronto researchers identified a new biomarker in urine that can help detect aggressive prostate cancer, potentially saving hundreds of thousands of men each year from undergoing unnecessary surgeries and radiotherapy treatments. Prostate cancer can be easy to diagnose, but classifying patients into risk groups has been challenging. The researchers identified a biomarker using microRNA, which may give physicians insight into how far a tumor has spread and how to treat it. These small pieces of RNA are involved in prostate cancer development and progression; influence how men respond to treatment; and are detectable in urine, making this detection tool a promising noninvasive option. Researchers worked with 149 men to create and validate the biomarker to show that it works well and could be used to predict the likelihood of an aggressive prostate cancer. Participants in the study were evaluated for at least three years, allowing researchers to understand how their cancer changed over time. The biomarker was successful in identifying high-risk individuals and it achieved similar accuracy as invasive tissue-based tests. Funding sources included the Canadian Cancer Society and the National Cancer Institute’s Early Detection Research Network. The study was published in the Journal of the National Cancer Institute. Research is ongoing.
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