Disadvantaged women at greater risk of heart disease
Women from low socio-economic backgrounds are 25% more likely to suffer a heart attack than disadvantaged men, a study from the George Institute for Global Health has found. The researchers reviewed 116 studies involving data from 22 million people from North America, Europe, Asia and Australasia. The review showed that lower socio-economic status, compared to higher, was associated with a higher risk of cardiovascular disease for both sexes, but women from more disadvantaged backgrounds were relatively more likely to suffer from coronary heart disease than men from similar backgrounds. There was no difference in risk found for stroke, however. The effects of levels of education, income, job type and postcode on the risk of cardiovascular disease were assessed in the study, which was published in the Journal of Epidemiology and Community Health. Comparisons between men and women were made. “The results demonstrated a need for tailored interventions for women to address the gender gap and deliver the best possible care,” the authors wrote. The George Institute has produced a policy paper called Women’s health: a new global agenda, which also highlighted the need for a gendered approach to the collection and use of health data.
Mobile phones could detect cancer
A portable mobile phone-based device for the detection of cancer-related mutations in DNA has been showcased in a study published in Nature Communications. The device enables diagnosis at the site of sampling, which could cut costs and time, and can detect unique DNA sequences, including cancer-specific mutations. Molecular diagnostic tests are often conducted at centralised laboratories, which can cause a delay in obtaining the results, particularly if the patient is in a remote or inaccessible location. Swedish researchers designed a 3D-printed light-weight optomechanical attachment that is integrated with the existing camera module of a mobile phone and allows in-field diagnosis. The authors said they have shown that “a cost-effective and compact multimodal microscope integrated on a mobile phone can be used for (i) targeted DNA sequencing and (ii) in situ point mutation analysis that allow integrating molecular analysis with tumour tissue morphology.” The device was shown to detect cancer-specific DNA sequences using probes labelled with a fluorescent compound; a match generates a fluorescent signal that the phone’s camera can detect. Although the device presented does not allow for detection of new mutations, it offers a cost-effective approach to molecular diagnosis that might be applicable to resource-limited or geographically isolated settings. This technology has potential applications outside of cancer diagnosis, such as pathogen detection. By reducing time and cost, mobile phone-based diagnostic devices can bring detailed molecular information directly to the researcher in the field.
One-third of asthma sufferers might be misdiagnosed
Canadian research published in JAMA has found that among adults with a previous physician diagnosis of asthma, a current diagnosis could not be established in about one-third of patients who were not using daily asthma medications or had weaned off medications. The authors speculated that the failure to confirm the diagnosis could be because of spontaneous remission or initial misdiagnosis. They conducted a study that included 701 adults who reported a history of physician-diagnosed asthma established within the previous 5 years. All participants were assessed with home peak flow and symptom monitoring, spirometry and bronchial challenge tests, and those participants using daily asthma medications had their medications gradually tapered off over four study visits. Participants in whom a diagnosis of current asthma was ultimately ruled out were followed up clinically with repeated bronchial challenge tests over 1 year. Of 701 participants, 613 completed the study and could be conclusively evaluated for a diagnosis of current asthma, which was ruled out in 203 of 613 study participants (33%). “Two phenomena may account for failure to ultimately confirm current asthma in 33.1% of the study cohort: (1) spontaneous remission of previously active asthma; and (2) misdiagnosis of asthma in the community,” the authors wrote. “At least 24 of 203 participants (11.8%) in whom current asthma was ruled out … presumably experienced spontaneous remission of their asthma at some time between their initial community diagnosis and entry into the study.” Twelve participants (2%) were found to have serious cardiorespiratory conditions that had been previously misdiagnosed as asthma in the community. After an additional 12 months of follow-up, 181 participants (30%) continued to exhibit no clinical or laboratory evidence of asthma. Participants in whom current asthma was ruled out, compared with those in whom it was confirmed, were less likely to have undergone testing for airflow limitation in the community at the time of initial diagnosis (44% vs 56%, respectively). More than 90% of participants in whom asthma was ruled out had asthma medications safely stopped for an additional 1-year period.
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