Black and White adults' perspectives on the genetics of nicotine addiction susceptibility

Aims

Emerging research may soon lead to improved quit rates via genetically-tailored smoking cessation treatment. The purpose of this study was to explore individuals' beliefs and attitudes about genetic testing in this context, and how these may differ across racial groups.

Design

Two site qualitative study.

Methods

Eleven focus groups were conducted in 2007 with 51 Black and 55 White adult participants in Montgomery, AL and Baltimore, MD.

Measurements

Questions were asked about smoking as an addiction, the role of genetics in nicotine addiction susceptibility, and undergoing genetic testing to receive tailored smoking cessation treatment. Data were analyzed using content analysis.

Findings

Most participants believed that smoking was an addiction yet were unwilling to endorse the notion that genetics played a role in nicotine addiction susceptibility. However, 91% of White participants and 62% of Black participants indicated that they would likely take a genetic test that would match them to their optimal smoking cessation treatment. The primary potential benefit was a vague sense that additional knowledge about oneself would be of value. Primary barriers included disinterest and skepticism about the test, unwillingness to believe that genetics played a role in nicotine addiction or treatment response, and concerns about psychological consequences.

Conclusions

The majority of participants, particularly Black participants, did not believe that genetics played a significant role in nicotine addiction susceptibility but were willing to undergo genetic testing. Participants identified some benefit to tailoring smoking treatment by genotype. However, participants also expressed skepticism about the test and concerns about its consequences; these issues would need to be addressed in the clinical encounter.     

Knowledge, attitude, and practice of epilepsy in rural Sri Lanka.

Knowledge, attitude, and practice in relation to epilepsy in developing countries appears to be different from that in developed countries. This study was conducted to evaluate knowledge, attitudes, expectations, sociocultural aspects, patient characteristics, disease characteristics, pattern of drug therapy, and outcome of patients with epilepsy in rural Sri Lanka. Data were collected from 207 patients attending an epilepsy clinic. In general the study shows a positive trend in knowledge, expectations and attitude toward epilepsy. Social morbidity is reported from 53.6% indicating that public attitude towards epilepsy needs to be changed. Alternative modes of treatment have been tried by 45.9%, reflecting the cultural beliefs in the society. 75% are on monotherapy and carbamazepine is the most commonly used drug. Seizure control is excellent (no seizures during the preceding 6 months) in 33.8%. Side effects of antiepileptic drugs are reported by 76.3%. Various kinds of medical morbidity have been experienced by 32.9% of patients.     

Powered Endoscopic Endonasal Dacryocystorhinostomy with Mucosal Flaps and Trimming of Anterior End of Middle Turbinate

Endoscopic endonasal dacryocystorhinostomy (DCR), when compared to external techniques, has always had guarded acceptance primarily due to inconsistent success rates. The most common cause of surgical failure in endoscopic DCR is very high/very low mucosal incision, obstruction of neo-ostium by granulation tissue, infolding of flap or formation of synechiae between middle turbinate and the neo-ostium site post-operatively. Several techniques and modifications have been suggested by various authors over the years since the first introduction of endoscopic endonasal DCR. With the newer techniques and advancements, the success rates have become comparable or even higher than external DCR. The aim of our study was to determine the success of endoscopic endonasal DCR using the classical Wormald technique with a few modifications. A total of 37 cases of epiphora secondary to nasolacrimal duct obstruction were operated using endoscopic endonasal DCR technique. The surgical technique included classical Wormald principle of mucosal flap, removal of the overlying bone using Kerrisons punch & chisel-hammer followed by vertical incision on the sac. The medial wall of lacrimal sac was then trimmed using microdebrider, thus apposing it to the nasal mucosal flaps. The anterior end of middle turbinate was also trimmed prophylactically to prevent synechiae formation. The outcome and long term patency of the cases were evaluated. Of the 37 cases, 35 cases (94.6 %) had complete resolution of the epiphora at the end of 1 year follow up period. The two cases of failure were due to canaliculitis in one patient and extensive granulation around the neo-ostium in another. Thus the above method has very good success rate comparable to previous studies and very less chances of granulation tissue formation and blockage of neo-ostium by synechiae/flap infolding.     

A bivariate genome-wide approach to metabolic syndrome: STAMPEED consortium

OBJECTIVE The metabolic syndrome (MetS) is defined as concomitant disorders of lipid and glucose metabolism, central obesity, and high blood pressure, with an increased risk of type 2 diabetes and cardiovascular disease. This study tests whether common genetic variants with pleiotropic effects account for some of the correlated architecture among five metabolic phenotypes that define MetS. RESEARCH DESIGN AND METHODS Seven studies of the STAMPEED consortium, comprising 22,161 participants of European ancestry, underwent genome-wide association analyses of metabolic traits using a panel of ～2.5 million imputed single nucleotide polymorphisms (SNPs). Phenotypes were defined by the National Cholesterol Education Program (NCEP) criteria for MetS in pairwise combinations. Individuals exceeding the NCEP thresholds for both traits of a pair were considered affected. RESULTS Twenty-nine common variants were associated with MetS or a pair of traits. Variants in the genes LPL, CETP, APOA5 (and its cluster), GCKR (and its cluster), LIPC, TRIB1, LOC100128354/MTNR1B, ABCB11, and LOC100129150 were further tested for their association with individual qualitative and quantitative traits. None of the 16 top SNPs (one per gene) associated simultaneously with more than two individual traits. Of them 11 variants showed nominal associations with MetS per se. The effects of 16 top SNPs on the quantitative traits were relatively small, together explaining from ～9% of the variance in triglycerides, 5.8% of high-density lipoprotein cholesterol, 3.6% of fasting glucose, and 1.4% of systolic blood pressure. CONCLUSIONS Qualitative and quantitative pleiotropic tests on pairs of traits indicate that a small portion of the covariation in these traits can be explained by the reported common genetic variants.     

Effectiveness of cognitive behavior therapy for patients with heart failure and depression: A systematic review protocol

The objective of this review is to determine the effectiveness of cognitive behavior therapy for patients with heart failure and depression, aged ≥18 years, in institutionalized healthcare settings. More specifically, the review aims to identify which cognitive behavior therapy strategy/strategies, including the method of delivery, is the most effective for the management of depression in hospitalized patients with heart failure. The review question is as follows: Is cognitive behavior therapy effective in reducing symptoms of depression in patients with heart failure? This systematic review will be conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness evidence. This review only includes randomized controlled trials assessing the effectiveness of cognitive behavior therapy as a treatment for depression in adults (aged ≥18 years) with heart failure, compared with usual care, which might include medications.     

The Landscape of microRNA Targeting in Prostate Cancer Defined by AGO-PAR-CLIP

MicroRNA (miRNA) deregulation in prostate cancer (PCa) contributes to PCa initiation and metastatic progression. To comprehensively define the cancer-associated changes in miRNA targeting and function in commonly studied models of PCa, we performed photoactivatable ribonucleoside-enhanced cross-linking immunoprecipitation of the Argonaute protein in a panel of PCa cell lines modeling different stages of PCa progression. Using this comprehensive catalogue of miRNA targets, we analyzed miRNA targeting on known drivers of PCa and examined tissue-specific and stage-specific pathway targeting by miRNAs. We found that androgen receptor is the most frequently targeted PCa oncogene and that miR-148a targets the largest number of known PCa drivers. Globally, tissue-specific and stage-specific changes in miRNA targeting are driven by homeostatic response to active oncogenic pathways. Our findings indicate that, even in advanced PCa, the miRNA pool adapts to regulate continuing alterations in the cancer genome to balance oncogenic molecular changes. These findings are important because they are the first to globally characterize miRNA changes in PCa and demonstrate how the miRNA target spectrum responds to staged tumorigenesis.     

The genotypes and virulence attributes of C. albicans isolates from oral leukoplakia

Background There is a debate as to whether some types of oral leucoplakias (OL) are caused by Candida species, and whether they contribute to the malignant transformation, associated with a minority of such lesions. As no detailed population analysis of yeast isolates from OL is available, we evaluated the virulence attributes, and genotypes of 35 C. albicans from OL, and compared their genotypes with 18 oral isolates from healthy individuals.Material and Methods The virulence traits evaluated were esterase, phospholipase, proteinase, haemolysin and coagulase production, and phenotypic switching activity, and yeast adherence and biofilm formation. DNA from OL and control yeasts were evaluated for A, B or C genotype status.Results Phospholipase, proteinase, and coagulase activity and biofilm formation was observed in 80%, 66%, 97 % and 77 % of the isolates, respectively. Phenotypic switching was detected in 8.6%, while heamolytic, and esterase activity and adherence were noted in all isolates.Conclusions The genotype A was predominant amongst both the OL and control groups. Due to the small sample size of our study a larger investigation to define the role of candidal virulent attributes in the pathogenicity of OL is warranted, and the current data should serve as a basis until then. Key words:C. albicans, oral cavity, leukoplakia, virulence factors, genotyping.