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Early breast cancer may identify with urine test

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BERLIN — A new test that recognizes changes in cell metabolism system through urine tests may identify breast cancer early, researchers say.

According to the findings, published in the journal BMC Cancer, researchers at the University of Freiburg in Germany have developed a technique that involves determining the concentration of molecules that regulate cell metabolism which are often deregulated in cancer cells.

These molecules, referred to as microRNAs, enter into the urine over the blood. By deciding the structure of microRNAs in the urine, the researchers succeeded in setting up with 91 for percent accuracy whether a test subject was healthy or diseased.

The measurement was possible through the discovery of only four microRNAs.

If the effectiveness of the method is confirmed in further studies, it could serve later on as a method for checking the achievement of treatment and possibly also of making an early determination of breast cancer, researchers said.
Currently, researchers have made breast cancer diagnosis by mammography or ultrasound and confirmed it with tissue tests.

However, these methods have been subject to recurring criticism due to radiation exposure, erroneous results, and the fact that they involve an invasive intervention.

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In the study, Dr Elmar Stickeler, medical director of Senology at the Department of Obstetrics and Gynecology and head of the Breast Center at the Medical Center and his team measured the concentrations of nine microRNAs in the urine, short genetic sequences that regulate cell metabolism.

Four of the nine molecules exhibited significant differences in concentration between healthy and diseased test subjects.

“We discovered that the microRNA profile in the urine is modified in a characteristic way in the urine of test subjects with breast cancer,” said Stickeler.

“MicroRNAs should thus be suitable in principle for a breast cancer test,” Stickeler said.

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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