Two Rare Clotting Genes Hike Heart Disease Risk
Some rare variant forms of genes that control blood clotting can increase the risk of heart disease, a British study finds.
The genes are not common enough and the risk they pose is not great enough to warrant screening for them now, said Dr. John Danesh, a professor of epidemiology and medicine at the University of Oxford, and lead author of a report in the Feb. 25 issue of The Lancet.
"But it is helpful to identify genetic variants that may be associated with increased risk," Danesh said. "This helps increase our understanding of the biological pathways that lead to heart disease. These findings could have implications for designing new therapies that target blood clotting pathways to help prevent heart disease."
There has been a back-and-forth controversy about the possible role of such genes in heart disease, Danesh said. "The whole purpose of this exercise was to try to pool the studies that have been reported and produced conflicting results, and clarify the evidence by pooling the data," he said.
Danesh and his colleges analyzed results of 191 studies that included 66,155 people with heart disease and 91,307 people with no heart trouble, looking for the incidence of seven variants of clotting genes that have been associated with increased risk in some studies. Most of the studies were done in Europe.
The analysis showed no significant association with increased risk for five of the genes. But there was a moderately increased risk for one variant of a gene for plasma protein V and one for the protein prothrombin. Both genetic variants increase the body's production of thrombin, an enzyme that encourages formation of blood clots.
The increased risk is not great, Danesh said. Persons who carry the variant genes have a 15 percent to 20 percent higher risk of developing heart disease than those who do not, the analysis showed. And the genetic variants aren't common, with about 3 percent of whites carrying the protein V version and 1 percent carrying the prothrombin version.
"They are not common enough or associated with enough risk to warrant screening for them," Danesh said. "In the future, if a number of weakly acting gene variants are identified, that might warrant screening. At the moment, the question is hypothetical."
Virus May Have Links to Prostate Cancer
A new virus has been identified in human prostate tumors, but the virus's link to prostate cancer is unclear and requires more research, researchers say.
"This is a virus that has never been seen in humans before. This is consistent with previous epidemiologic and genetic research that has suggested that prostate cancer may result from chronic inflammation, perhaps as a response to infection," researcher Dr. Eric Klein, head of urologic oncology at the Cleveland Clinic's Glickman Urologic Institute, said in a prepared statement.
The virus, which is closely related to viruses found in mice, has never before been detected in humans. Researchers at the University of California, San Francisco, and the Cleveland Clinic found it using the same DNA-hunting "virus chip" used three years ago to confirm the identity of the SARS virus.
The finding was reported Friday at an American Society of Clinical Oncology prostate symposium in San Francisco. A full report will be published in the journal PloS Pathogens.
The virus was found more often in human prostate tumors with two copies of the RNASEL gene mutations than in tumors with at least one normal copy of the gene. RNASEL is a gene that serves as an important defense against viruses. Scientists have previously speculated that a virus may be involved in some types of prostate cancer in men with mutated RNASEL genes.
Klein and his colleagues say the finding further validates the use of the virus chip to discover previously unknown viruses, and to learn more about viral causes of disease.
"The power of the virus chip resides in its ability to simultaneously screen for all viruses, without preconceptions or bias. In the case of these prostate tissues, no one would have suspected a virus of this class," UCSF researcher Joe DeRisi, who developed the chip, said in a prepared statement.
Deadly Strain of Bird Flu Found in India
A second state in India reported an outbreak of the H5N1 strain of bird flu on Saturday. The deadly virus was discovered earlier this month among chickens in the western state of Maharashtra, leading officials to slaughter more than half a million birds.
The latest outbreak is in the neighboring state of Gujarat, where at least two chickens have been found to be infected with the H5N1 strain.
The birds were discovered at a farm in the Utchal area of Gujarat, the region's administrator Vatsala Vasudev told The Associated Press.
No human cases of H5N1 have been reported in either state.
The H5N1 strain has spread from Asia to 10 European countries and Africa. At least 92 people have died of the disease.
Scientists fear the H5N1 strain could mutate into a form that is easily transmitted between humans, causing a pandemic. But the WHO says it remains difficult for humans to catch the virus.
Indonesia raised its death toll to 20 on Saturday. A senior health ministry official said tests confirm that a 27-year-old woman who died Monday in capital Jakarta succumbed to H5N1.
Medicare May Limit Drug Plan Offerings
The Bush administration is looking at ways to simplify the new Medicare prescription drug benefit, but initial proposals are unlikely to win over the program's critics.
In a 39-page draft memorandum to insurers, employers and others administering the drug benefit, the Centers for Medicare and Medicaid Services asked for advice on how to simplify the program in 2007.
The agency proposed limiting to two the number of drug plans a company can offer per region. Many insurers now offer three, and since there are often more than a dozen insurers per region, consumers often have more than 40 choices.
The agency also said it expects that an insurer's two plans must have meaningful differences to make comparisons easier.
The recommendations appear to be a direct response to concerns that some older and disabled people are confused by the vast array of options.
Ron Pollack, executive director of the activist group Families USA, said the plans can't generate enough enrollment to generate bargaining clout with drug manufacturers. Slightly reducing the number of plans won't change that scenario, he said, nor will it make the program easier to understand.
"When you have such a huge number of companies providing this coverage and no effort to standardize benefits it creates chaos," Pollack said.
Rep. Pete Stark, D-Calif., a frequent critic of the program, gave the Medicare-Medicaid agency credit for seeking to simplify the plan, but he did so while also chiding the administration.
"It is too bad this recognition comes 2 1/2 years after passage of the law, and two months into implementation," Stark said.
The administration said competition from insurers is lowering the cost of the program. In early February, it said premiums will average about $25 a month, as opposed to the $37 projected when the program was approved. It now estimates the program will cost about $678 billion over 10 years rather than about $730 billion estimated originally.
"We're seeing the cost of drugs come down in a rapid way because of an organized, competitive marketplace," Health and Human Services Secretary Mike Leavitt said earlier this month.
A spokesman for the Medicare-Medicaid agency, Gary Karr, said the draft memorandum should not be viewed as a sign the administration is backing away from the view that all the choices are a good thing for the elderly and disabled.
"It's simply asking for comment," Karr said. "Earlier, there were predictions we would not have enough plans. That's clearly not the case now. The question is will it still be of service to beneficiaries if you had fewer. Again, it's not a commitment."
About 42 million people are eligible to enroll in a private plan that is designed to subsidize some of their prescription drug expenses. Most of the larger insurers give beneficiaries more than one option.
For example, one company will offer a plan that charges consumers less, but the trade-off can be a more limited choice of drugs. Another plan will offer more drug coverage but the customer will have to pay higher premiums.
The range of plans available vary by region. In Alaska, there are 11 insurers offering 27 drug plans. In Pennsylvania, there are 23 insurers offering 52 plans.
Beneficiaries also can choose from more comprehensive medical coverage, called Medicare Advantage, which operates like an HMO. Most beneficiaries can choose from more than a dozen Medicare Advantage plans.
Food Fact:
Tater gallery.
A surprisingly small serving of sweet potatoes meets your entire daily needs for vitamin E. Most vitamin E-rich foods, such as vegetable oils, nuts and avocados, contain a hefty dose of fat, but just 2/3 cup of sweet potatoes provides 100% of your daily vitamin E needs, and it's virtually fat-free. A medium sweet potato has just 118 calories, and its orange-hued flesh is rich in cancer-fighting beta carotene. Sweet potatoes also contain vitamin B6, potassium, iron and fiber -- pop one in the microwave for a great late afternoon snack.
Fitness Tip of the day:
Mirror, mirror...
Ever wonder why health clubs have all those mirrors? No, it's not for vanity's sake! The mirrors are there to assure you're maintaining proper form when exercising. You're not being a narcissist when you position yourself in front of the mirror; pay careful attention to see you're doing the exercise right. If you are uncertain as to how to perform an exercise, don't hesitate to ask for help.
FAQ of the day:
Why do food labels say "Less than" for some nutrients?
Eating too much of certain nutrients -- total fat, saturated fat, cholesterol and sodium -- may increase your risk of developing heart disease, so their Daily Value is given as an upper limit not to be exceeded, rather than an amount you should try to achieve. There's no problem if you exceed the Daily Value for fiber, vitamin A, vitamin C, iron or calcium.
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