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.
Low GI diet beneficial for gestational diabetes
Gestational diabetes mellitus (GDM) occurs in some women when they have high levels of glucose in their blood during pregnancy. Diet and exercise changes are recommended for these women to reduce the risk of developing metabolic syndrome and type 2 diabetes. New research has been carried out in Malaysia to assess the impact of lowering dietary glycemic index (GI) – a measure of how quickly carbohydrates are broken down into glucose – on fasting blood glucose (FBG) levels and body composition. After one year, post-GDM women who received low GI diet advice had greater reductions in FBG and triglyceride levels than those given conventional dietary recommendations. The authors conclude that low GI diet education should be added to lifestyle interventions for reducing the risk of type 2 diabetes in post-GDM women.
Ghani et al. Nutrition & Diabetes
Defining the optimal lipid measurement to monitor CVD
One of the most commonly used tests to monitor cardiovascular disease (CVD) development is a blood measure of lipid levels. These tests – measuring fats such as high- and low-density lipoprotein (HDL and LDL) cholesterol, triglycerides, apolipoproteins and total cholesterol – are carried out regularly in the clinic, but there is controversy surrounding which lipid test is the most appropriate indicator of CVD risk. In a longitudinal analysis of various lipid measurements over five years, researchers in Australia have now shown that non-HDL cholesterol measures and HDL:LDL ratios are superior to total cholesterol levels for predicting coronary events, suggesting that these measures should be used to predict cardiovascular risk and guide clinical decision making.
Glasziou et al. BMJ Open
Reducing mother-to-child transmission of HIV
Most HIV infections in children occur as a result of mother-to-child transmission (MTCT) during pregnancy, birth or breastfeeding. MTCT can be greatly reduced through antenatal HIV testing and treatment with antiretroviral therapy. New evidence from a systematic review and meta-analysis shows that women living in areas where HIV infection is common are at high risk of acquiring HIV infection during pregnancy and after birth, and those who become infected during pregnancy are more likely to pass the infection onto their children than those with chronic HIV infection. These findings emphasize the importance of repeat HIV testing and prompt treatment in pregnant women, as well as counselling pregnant women about how to prevent HIV infection.
Drake et al. PLOS Medicine
Targeting microRNAs in melanoma
Melanoma is the deadliest form of skin cancer, and mutations in two specific genes – BRAF and NRAS – occur in around 70 percent of patients with melanoma. Many cancer-causing genes are regulated by small RNA molecules called microRNAs. Now, research using cells from patients with melanoma has revealed that a specific microRNA, miR-146a, is present at higher levels in melanoma cells than non-cancer cells, and that this microRNA becomes more active as the disease progresses. Importantly, drugs blocking miR-146a production reduced growth and proliferation of melanoma cells, indicating that therapies targeting this molecule could represent a promising approach for treating melanoma.
Forloni et al. eLife
Can video interventions increase physical activity?
Over half of the population in Australia does not meet physical activity guidelines. While web-based interventions to increase activity have the potential to reach many people, there are issues with participant drop-out. In an attempt to address this problem, a trial has been carried out to assess the effectiveness of computer-tailored video advice versus text-delivered guidance. Participants were randomly assigned to receive one of the two types of feedback; those in the video group paid greater attention to the advice and remained focused on the screen for longer. These findings suggest that delivering health advice through video may be an effective strategy to improve engagement in activity interventions.
Alley et al. Frontiers in Public Health
Gene signature for TB
A 251-gene expression signature that can detect tuberculosis (TB) infection has been identified by researchers in the US and South Africa. The signature, which was identified through analysis of gene expression data in blood samples taken from patients infected with TB, can detect infection in the presence and absence of HIV, and can distinguish active from latent TB infection. Expression levels of the gene signature also decreased with increasing length of treatment, suggesting that the signature could be used in the clinic to detect disease and monitor response to treatment.
Dawany et al. PLOS One
Blood cell ratio predicts chemotherapy response in pancreatic cancer
Pancreatic cancer is very difficult to detect in its early stages, meaning that many patients are diagnosed too late for curative surgery. Chemotherapy is commonly used to treat advanced pancreatic cancer (APC), but the long-term effectiveness varies considerably between patients, and it is therefore important to identify those who are likely to benefit from treatment. A retrospective analysis of medical records now suggests that a ratio of different white blood cells – the neutrophil-to-lymphocyte ratio (NLR) – can be used to predict chemotherapy outcome in APC patients. After adjusting for potentially confounding factors, elevated pre-treatment NLR remained associated with poor survival in those receiving chemotherapy, suggesting that measuring NLR could be used to predict which patients are likely to benefit from chemotherapy, so that other treatments can be considered for those unlikely to benefit.
Xue et al. Cancer Medicine
Written by Claire Barnard, Senior Editor for BMC Medicine.