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Editorial, Opinion Piece Discuss Issues Related To Routine HIV Testing
A recent directive to streamline the HIV testing consent process in Massachusetts as well as consent forms "no longer hav[ing] to accompany test specimens to the lab," are bringing "the state closer to a CDC recommendation that clinicians provide HIV screening on an opt-out basis," according to a Boston Globe editorial. "The opt-out provision is at the heart" of legislation sponsored by state Sen. Patricia Jehlen (D) that would end the state"s requirement of written consent for HIV testing "and instead have healthcare providers inform patients verbally that the test is planned but that they can decline it," the editorial states, adding, "The Jehlen bill would help destigmatize HIV testing itself" (7/6).

Health And Safety Executive Warns Of Dangers In Failing To Maintain Plant Equipment After Driver's Death, UK
The Health and Safety Executive has warned of the danger of not maintaining plant equipment after the death of a telescopic forklift truck driver, who was crushed between the descending arm and side of his vehicle.
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Low Prevalence Of HPV Infection May Be Tied To Poor Prognosis For Blacks With Head And Neck Cancer
Researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer have found that head and neck cancer patients who test positive for the human papillomavirus (HPV) have much better survival rates than patients who don"t have the virus, according to a new study in the journal Cancer Prevention Research. The researchers also discovered that blacks in the study had a very low rate of HPV infection, and consequently worse survival, which may explain why African-American patients traditionally have had a poor prognosis for head and neck cancer.
Public Health

Critical Marker Of Response To Gemcitabine In Pancreatic Cancer Identified By Jefferson Researchers

A protein related to aggressive cancers can actually improve the efficacy of gemcitabine at treating pancreatic cancer, according to a Priority Report in Cancer Research, published by researchers at Thomas Jefferson University. The protein, called Hu antigen R (HuR), is a stress response protein found in the cytoplasm of pancreatic tumor cells. In certain experimental settings, pancreatic cancer cells that overexpressed HuR were up to 30-fold more sensitive to gemcitabine (Gemzar), according to Jonathan Brody, Ph.D., assistant professor of Surgery at Jefferson Medical College of Thomas Jefferson University. In a clinical correlate study that included 32 resected pancreatic cancer patients who received gemcitabine, patients who had low cytoplasmic HuR levels had a 7-fold increased mortality risk compared to patients with high levels. This was after adjustment for other variables including age, sex, radiation therapy and other chemotherapy use. "This marker appears to tell us upfront whether a patient will respond to treatment with gemcitabine, which is the routine treatment for pancreatic cancer," said Dr. Brody, who is the senior author of the study. "Of course, larger and comprehensive prospective studies need to be performed, but we now have a real clue about how to make this treatment better. Finding a mechanism that regulates gemcitabine"s metabolism in pancreatic cancer cells is the real novel and exciting aspect of these findings." Dr. Brody and colleagues found that in pancreatic cancer, HuR helps to regulate an enzyme called deoxycytidine kinase (dCK), which is responsible for metabolizing and activating gemcitabine. As with most chemotherapy drugs, gemcitabine causes cell stress and activates the HuR stress proteins. In turn, the high levels of HuR stimulate the production of more dCK, thus making gemcitabine more efficient, according to Dr. Brody. "Normally, patients higher HuR cytoplasmic levels have a worse prognosis, since HuR expression is associated with advanced malignancies," Dr. Brody said. "However, in our study, they did better than patients with low HuR levels when they were treated with gemcitabine. We think it"s because they already have high HuR levels at the time of treatment, which may be a response to the tumor cell environment." According to Dr. Brody, research is underway to find a way to activate HuR in patients with a low expression. Other goals include expanding these findings to a larger pancreatic cancer population, and to other tumors that may be treated with gemcitabine, including breast, ovarian and certain lung cancers. They also want to determine if other chemotherapeutic agents engage this intriguing and manipulative pathway. Notes: Co-authors of the paper include Charles J. Yeo, M.D., Samuel D. Gross Professor and chairman of the department of Surgery, and Agnieszka Witkiewicz, M.D., assistant professor of Pathology, Anatomy and Cell Biology. Drs. Brody, Yeo and Witkiewicz are co-directors of the Jefferson Pancreas, Biliary and Related Cancer Center. Other study collaborators include Dr. Myriam Gorospe from the National Institute on Aging (NIH) and Dr. Judith Keen from the University of Medicine and Dentistry of New Jersey. Emily Shafer Thomas Jefferson University


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