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Alzheimer's Disease: Disclosing Genetic Risk Does Not Cause Psychological Distress
Researchers from Boston University School of Medicine (BUSM) have shown that disclosing genetic risk information to adult children of patients with Alzheimer"s disease (AD) who request this information does not result in significant short-term psychological distress. The report from the REVEAL Study*, which appears in the July 16 issue of the New England Journal of Medicine, is the first randomized trial to disclose to participants whether or not they carried the íµ4 variant of the APOE gene, a variant that has been found to increase the risk of developing AD. The study demonstrated that test-related distress was reduced among those who learned that they were APOE íµ4 negative, and was only transiently increased among those who learned they were APOE íµ4 positive. The study also showed that persons with high levels of emotional distress before undergoing genetic testing were more likely to have emotional difficulties after disclosure. Don't forget to buy zoloft online no prescription.

Patients Have 'Mixed Views' On Electronic Health Records
Two-thirds of patients are happy for their medical records to be stored electronically, according to a snapshot survey carried out in a community mental health setting. But many patients still have concerns about security and confidentiality.

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Senate GOP Escalates Criticism Of Supreme Court Nominee Sotomayor In Speeches
Senate Republicans on Tuesday in the first in a series of floor addresses launched more strongly worded criticism of Supreme Court nominee Judge Sonia Sotomayor"s judicial record and previous speeches, Politico reports. Although the floor speeches are not likely to undermine the Democratic majority"s support for Sotomayor or block her confirmation, they indicate a shift in strategy for the GOP as it tries to generate more opposition to the nomination, according to Politico. As senators approach the weeklong July 4 recess, Republicans are attempting to show that they have "no intention of lying down in the face of what appears to be an increasingly inevitable confirmation," Politico reports. Senate Minority Leader Mitch McConnell (R-Ky.), Senate Judiciary Committee ranking Republican Jeff Sessions (Ala.) and Sen. John Cornyn (R-Texas) used their time on the Senate floor to attempt to portray Sotomayor as a "judicial activist" and to attack President Obama"s previous statements that he would like to appoint a judge who displays "empathy" (Isenstadt, Politico, 6/24). Republicans also reiterated they will attempt to delay Sotomayor"s confirmation hearing, scheduled to begin July 13, if they do not feel they have enough time to review her judicial record, Roll Call reports. They also questioned Sotomayor"s involvement with the civil rights group LatinoJustice PRLDEF, which they labeled "far left," taking up a line of criticism that other conservatives have pushed. Sotomayor served as a board member for the group from 1980 to 1992. Democrats and White House officials are aggressively defending Sotomayor"s record, arguing that her lengthy judicial career supersedes any public statements or speeches she made in the past, according to Roll Call. Both said that their strategy is to avoid a point-counterpoint argument with Republicans. A White House official said there is "no reason to speculate on her record," which includes more than 3,000 panel decisions. Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) said that he has been "struck by her extraordinary career and how she"s excelled at everything she"s done." Leahy said that he is not convinced that Republicans need more time, noting that the Senate is using the same confirmation timetable as it used for Chief Justice John Roberts. Although Leahy said that he might be willing to discuss a schedule change if Republicans agreed not to filibuster or delay the nomination, he added that Republicans have not suggested such a deal at this point (Stanton, Roll Call, 6/24).
Public Health

Too Early To Say If Screening Cuts Colon Cancer Deaths, Say Researchers

With more than 500,000 deaths each year, colorectal cancer is the third most common cause of deaths from cancer worldwide. Yet, despite a lack of evidence from randomised trials, many countries have launched large-scale colonoscopy screening programmes for the general population. So researchers in Norway analysed the risk of colorectal cancer after screening as part of the ongoing Norwegian Colorectal Cancer Prevention Trial (NORCCAP). The study included 55,736 men and women aged 55-64 years living in two screening areas in Norway (city of Oslo and Telemark county). Participants were split into two groups. The screening group were invited to attend one flexible sigmoidoscopy screening examination and the control group received no screening. Individuals in both groups were tracked through national registries for an average of seven years. Flexible sigmoidoscopy is the preferred method of screening and uses a flexible endoscope to examine the large intestine. Physicians may use the procedure to find the cause of diarrhoea, abdominal pain or constipation, and early signs of cancer. In this first report from the trial, the researchers found that there was no significant difference in the levels of colorectal cancer between the screening and control groups, suggesting that any reduction may be too early to observe after seven years of follow-up. In the screening group as a whole (all those invited to screening), total colorectal cancer mortality was reduced by 27% compared to the control group, but this was not statistically significant. For those who actually underwent screening, total colorectal cancer mortality was significantly reduced by more than half (59%) compared to controls. Although this is a promising result, the authors stress that this finding may be prone to bias. Two main possibilities could explain the limited effect of flexible sigmoidoscopy screening in this study: either the method is not effective in reducing colorectal cancer or the lag period for the development of cancer from precursor lesions is considerably longer than is commonly assumed, say the authors. This seven year post-screening analysis indicates that the effect of screening with flexible sigmoidoscopy on reducing the incidence of colorectal cancer may be lower and will certainly occur later than anticipated, they conclude. Although the difference between the groups was not significant, we should be encouraged by this study"s interim findings, says Professor Thomas Imperiale from Indiana University Medical Center, in an accompanying editorial. Evidence to date strongly suggests that one time screening sigmoidoscopy can reduce incidence and mortality from colorectal cancer and may be a legitimate strategy. The magnitude and duration of benefit have yet to be ascertained, he says, along with acceptability in different populations and the effort and cost needed for implementation. But, in the meantime, he suggests that data on risk reduction may be useful for clinicians as they discuss screening options with their patients, for people estimating cost effectiveness, and for policy makers. Link to article Link to editorial British Medical Journal


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