Open Reading Frame brings together a selection of recent publication highlights from elsewhere in the open access ecosystem. This week we take a look at the past few weeks in medicine.
Pharmacist-led care for diabetic patients?
As the incidence of type 2 diabetes increases, it is necessary for more healthcare professionals to be involved in the care of these patients. Pharmacists see type 2 diabetes patients more frequently than physicians and are in a good position to identify those with poorly controlled diabetes. New research has investigated the effects of pharmacist-led prescribing on glycemic control in these patients, and found similar results to physician-led prescribing. These findings provide further support for the important role of pharmacists in caring for type 2 diabetes patients, and indicate that pharmacist-led prescribing is a feasible strategy to improve glycemic control in these patients.
Al Hamarneh et al. BMJ Open
Dengue shock syndrome: understanding its pathogenesis
Dengue is one of the most common viral infections transmitted by mosquitoes. Pathogenesis can vary from fever to dengue shock syndrome (DSS), where dangerously low blood pressure causes circulatory collapse. Deaths resulting from dengue infection occur mainly in patients with DSS, and it is important to understand why some patients develop this severe complication. Researchers have collated the evidence in a systematic review and meta-analysis, finding that people who were younger in age, female, showed neurological involvement, vomiting and abdominal pain, along with a number of other factors, are more likely to develop DSS. These results improve understanding of why some patients develop a more severe course of infection, and should help physicians target specific interventions to those at greatest risk of developing DSS.
Huy et al. PLOS Neglected Tropical Diseases
Blood pressure drug could fight cancer
New research suggests that losartan, a common drug used to treat high blood pressure, could help treat cancer and improve life expectancy. In mouse models of breast and pancreatic cancer, losartan was found to increase blood flow to tumors, which in turn increases the delivery of oxygen. The researchers also showed that losartan improves chemotherapy drug delivery into tumors and reduces hypoxia. Taken together, these results suggest that blood pressure drugs could be given together with chemotherapy to tackle cancer. The researchers plan to extend these results into patients with inoperable pancreatic cancer as soon as possible, and are currently recruiting trial participants.
Chauhan et al. Nature Communications
What are the barriers to successful treatment of HIV and hepatitis co-infection?
In patients infected with HIV, liver disease occurring as a result of hepatitis co-infection is one of the main causes of non-AIDS mortality. Curative treatment for hepatitis C virus (HCV) infection is now available, but uptake rates remain low in some areas and it is essential to improve access to HCV treatment for HIV positive individuals. New research in Canada has explored HCV treatment uptake rates across different medical centers, in order to identify which factors are associated with success in starting patients on treatment. The study showed that healthcare providers have broadly differing opinions on what determines treatment eligibility – from history of reinfection to psychiatric comorbidities – suggesting that provider-related treatment barriers are as important as patient-related barriers. These results suggest that programs designed to improve uptake should target physicians as well as patients, and updated guidelines to treat HIV-HCV co-infection are required.
Young et al. CMAJ Open
Cognitive-behavioral strategies: an effective approach for distress in COPD?
Dyspnea, or shortness of breath, is a distressing symptom of chronic obstructive pulmonary disease (COPD), and is one of the main reasons for referral to pulmonary rehabilitation. Now, researchers have provided evidence for the effectiveness of cognitive-behavioral strategies to treat dyspnea in a review of COPD studies. The authors conclude that while these results highlight the potential benefits of behavioral treatment strategies, further randomized controlled trials are needed before such interventions can be recommended in clinical practice guidelines.
Norweg and Collins. International Journal of Chronic Obstructive Pulmonary Disease
Targeting miRNAs in type 2 diabetes
In type 2 diabetes, insulin secretion from pancreatic β cells is impaired, and regulators of the genes involved in this process are being explored as possible targets for therapy. Research carried out in a pancreatic β cell line has investigated whether miRNA-184, a regulator of genes encoding glutamate proteins, is involved in insulin secretion. The researchers found that overexpressing miRNA-184 inhibits insulin secretion, suggesting that this miRNA could be explored further as a therapeutic target in type 2 diabetes patients.
Morita et al. PeerJ
Blood loss during surgery predicts colorectal cancer recurrence
The liver is the most common location for secondary tumors in metastatic colorectal cancer (CRC), and survival rates have increased in recent years with the improvement of surgical techniques for liver resection. It is important to identify factors predicting clinical outcome in metastatic CRC patients, and a review of patient records in China has shown that the amount of blood loss occurring during liver resection can predict long-term survival and recurrence rates. These findings highlight the importance of selecting appropriate patients for surgery, and suggest that surgeons should take further precautions to minimize blood loss.
Jiang et al. PLOS One
Written by Claire Barnard, Senior Editor for BMC Medicine.