TOP MEDICAL NEWS 13/July/2022

Here are the top medical stories for today:

Genetic Testing May Benefit Patients With Depression, Finds JAMA Study

A new study by U.S. Department of Veterans Affairs found that pharmacogenomic testing can help providers avoid prescribing antidepressant medications that may have undesirable outcomes.

Pharmacogenomics is the study of how genes affect the body's response to drugs.

The researchers also found that the patients who underwent genetic testing had more positive outcomes, compared with patients in usual care. Over 24 weeks of treatment, the group with genetic testing had in a drop in depression symptoms with a peak effect at 12 weeks. Each patient in the study had major depressive disorder. Symptoms of that health condition include insomnia, loss of appetite, feelings of sadness and depression, and thoughts of dying by suicide.

Reference: "Effect of pharmacogenomic testing for drug-gene interactions on medication selection and remission of symptoms in major depressive disorder: the PRIME Care randomized clinical trial." Journal of the American Medical Association, DOI: 10.1001/jama.2022.

Spirituality linked with better health outcomes

Spirituality should be incorporated into care for both serious illness and overall health, according to a study led by researchers at Harvard.

This study represents the most rigorous and comprehensive systematic analysis of the modern day literature regarding health and spirituality to date, said researchers. These findings indicate that attention to spirituality in serious illness and in health should be a vital part of future whole person- centered care, and the results should stimulate more national discussion and progress on how spirituality can be incorporated into this type of value-sensitive care.

Reference: "Spirituality in Serious Illness and Health" JAMA DOI:10.1001/jama.2022.11086.

Challenges for current thinking about autosomal dominant polycystic kidney disease

Recent research published in JASN uncovers an over-looked mechanism that likely contributes to this condition. The findings provide a better understanding of ADPKD and may lead to new strategies to treat it. Research indicates that the polycystin-2 protein in cells' endoplasmic reticulum is important for maintaining kidney health, and its lack can contribute to autosomal dominant polycystic kidney disease.

Loss of PC1 and PC2 in cilia is believed central to the pathogenesis of cyst formation that's a hallmark of Autosomal dominant polycystic kidney disease. PC1 and PC2 can be expressed in other locations, however, and it's unclear if these forms of the proteins are also important for preventing Autosomal dominant polycystic kidney disease.

Reference: "Study results challenge current thinking about autosomal dominant polycystic kidney disease"; AMERICAN SOCIETY OF NEPHROLOGY, Journal of the American Society of Nephrology DOI:10.1681/ASN.2022010053.

Maternal mortality is no longer falling in the UK, maternal age, obesity and C-section the main reasons

New research from Scotland published in Anaesthesia (a journal of the Association of Anaesthetists) shows the increased risk of severe maternal sickness/complications (morbidity) is associated with a range of risk factors including increasing maternal age and levels of obesity, and also previous Caesarean section.

Even though maternal mortality is no longer reducing (although the UK rate is low by international standards), nor is it going up and the authors believe a possible explanation for this is that UK maternity services are continually adapting to meet the needs of this increasingly complex pregnant population.

Reference: "Increasing maternal age, obesity and Caesarean section rates could be reasons why maternal mortality is no longer falling in the UK"; AAGBI, Anaesthesia.