Medical Monday
Medical Monday – September 12, 2016
Medical Monday is a service of Project RACE for the multiracial community. We seek, gather, and list health articles of interest to interracial families and people of all races. We welcome health information from outside sources as long as the original source is cited.
1. Multiracial people in Kentucky are 30 percent more likely to have asthma, according to a new report from the Foundation for a Healthy Kentucky and the University of Kentucky released on Tuesday.
Source: WFPL
http://wfpl.org/report-stark-disparities-health-outcomes-race-kentucky/
2. Racial Disparities in Melanoma Survival – The majority of patients diagnosed with melanoma are white, but non-white patients have worse overall survival and are diagnosed at later stages. Greater melanoma awareness is needed in non-white populations.
Source: Practice Update
3. Study into black people’s health is launched- PhD student wants to understand why African Caribbeans are disproportionately affected by certain diseases
Source: The Voice
http://www.voice-online.co.uk/article/study-black-peoples-health-launched
If you have current medical news to contribute, please email it with the source and your contact information with MEDICAL NEWS SUBMISSION in the subject line to:
projectrace@projectrace.com
Medical MATTERS
(Reuters Health) – After a heart attack, black patients typically don’t live as long as whites – a racial difference that is starkest among the affluent – according to a new U.S. study.
Researchers evaluated data on more than 132,000 white heart attack patients and almost 9,000 black patients covered by Medicare, the government health program for the elderly and disabled. They used postal codes to assess income levels in patients’ communities.
After 17 years of follow-up, the overall survival rate was 7.4 percent for white patients and 5.7 percent for black patients, according to the results published in Circulation, the journal of the American Heart Association.
On average, across all ages, white patients in low-income areas lived longer after a heart attack – about 5.6 years compared with 5.4 years for black patients. But in high-income communities, the gap widened to a life expectancy of seven years for white people and 6.3 years for black individuals.
“We found that socioeconomic status did not explain the racial disparities in life expectancy after a heart attack,” lead study author Dr. Emily Bucholz of Boston Children’s Hospital said by email.
“Contrary to common belief, this suggests that improving socioeconomic standing may improve outcomes for black and white patients globally but is unlikely to eliminate racial disparities in health,” Bucholz added.
To see how race and class impact heart attack outcomes, Bucholz and colleagues reviewed health records collected from 1994 to 1996 for patients aged 65 to 90 years.
Just 6.3 percent of the patients were black, and only 6.8 percent lived in low-income communities, based on the typical household income in their postal codes.
Among white patients under 80, life expectancy was longest for patients in the most affluent neighborhoods and it got progressively shorter for middle-income and poor communities, the study found.
By contrast, life expectancy was similar for black patients residing in poor and middle-income communities across all ages. Only black patients under age 75 living in affluent areas had a survival advantage compared with their peers in less wealthy neighborhoods.
One shortcoming of the study is that it included a small proportion of black and poor patients, the authors acknowledge. It’s also possible that using postal codes to assess income may have led to some instances where income levels were inflated or underestimated, the authors note.
It’s possible that black patients living in affluent areas don’t fare as well as white patients because they don’t have the same amount of social support from their peers, said Dr. Joaquin Cigarroa, a cardiovascular medicine researcher at Oregon Health & Science University in Portland.
In poor neighborhoods, black patients may face additional challenges to surviving a heart attack, added Cigarroa, who wasn’t involved in the study.
“They more often live in low socioeconomic segments of our community that often have less access to health care resources and less access to stores with good nutrition,” Cigarroa said by email. “In addition, these segments of our community are often not ideally configured for promoting physical activity with parks, sidewalks, bike lanes, etc.”
The study findings highlight a need to improve outcomes among poor and black patients and suggest some differences in heart attack survival may come down to disparities in quality of care, said senior study author Dr. Harlan Krumholz of Yale University School of Medicine in New Haven, Connecticut.
Because black patients have a greater burden of heart disease than white people, doctors may also need to focus more on prevention in this community, Krumholz said by email.
“Healthy heart habits may be even more important for African-Americans, for whom avoiding a heart attack is even more important given their worse outcomes after the event,” Krumholz said.
SOURCE: bit.ly/1q3uqj1 Circulation, online September 14, 2015.
Medical Matters
2:1 Rate at which African-Americans suffer sudden cardiac arrest compared with Caucasians.
Medical Monday
Illinois sperm bank wants judge to toss suit involving biracial child
DOWNERS GROVE, Ill. — A sperm bank in northeastern Illinois is seeking the dismissal of a lawsuit accusing it of mistakenly providing sperm from a black donor to a white Ohio woman, arguing that the baby was born healthy.
Lawyers representing Midwest Sperm Bank in Downers Grove say state law doesn’t allow for damages arising from the birth of a healthy child, the Chicago Tribune (http://trib.in/1PcxEcA ) reported.
Jennifer Cramblett became pregnant in December 2011 through artificial insemination using sperm donated by a black man instead of the white donor whom she and her partner selected. Cramblett learned of the mistake when she was five months into her pregnancy after calling Midwest Sperm Bank to reserve another sample from the same donor so her partner could have a child with a blood relation to the older sibling, she said.
The lawsuit filed last fall claims the mistake was made because the sperm bank keeps handwritten records, and an employee misread the donor numbers, giving Cramblett sperm from donor No. 330, instead of No. 380.
The sperm bank sent a partial refund check and an apology letter to Cramblett a month after she learned of the mistake, she said.
The couple’s daughter, who’s described in the lawsuit as “a beautiful, obviously mixed race, baby girl,” was born in August 2012.
Cramblett claims the sperm bank’s error caused her to live with “anxieties and uncertainty about her future and (her daughter’s) future,” because they lived in a predominantly white and intolerant town. Her lawsuit accuses the sperm bank of breach of warranty and “wrongful birth.”
Attorneys for the sperm bank argue in their motion for dismissal that wrongful birth doesn’t apply because the child wasn’t born with a hereditary or genetic disorder. They also claim the suit’s other allegation, breach of contract under the state’s so-called blood shield act, isn’t valid because the sperm wasn’t deficient or contaminated.
The case is due in court next week, but the sperm bank’s motion for dismissal isn’t expected to be argued until later this summer.
Medical Monday
Thyroid disease risk varies among blacks, Asians, whites
An analysis that included active military personnel finds that the rate of the thyroid disorder Graves disease is more common among blacks and Asian/Pacific Islanders compared with whites, according to a study in the April 16 issue of JAMA.
Donald S. A. McLeod, F.R.A.C.P., M.P.H., of the QIMR Berghofer Medical Research Institute, Queensland, Australia and colleagues studied all U.S. active duty military, ages 20 to 54 years, from January 1997 to December 2011 to determine the rate of Graves disease and Hashimoto thyroiditis (a progressive autoimmune disease of the thyroid gland) by race/ethnicity. Cases were identified from data in the Defense Medical Surveillance System, which maintains comprehensive records of inpatient and outpatient medical diagnoses among all active-duty military personnel. The relationship between Graves disease and race/ethnicity has previously not been known.
During the study period there were 1,378 cases of Graves disease in women and 1,388 cases in men and 758 cases of Hashimoto thyroiditis in women and 548 cases in men. Compared with whites, the incident rates for Graves disease was significantly higher among blacks and Asian/Pacific Islanders. In contrast, Hashimoto thyroiditis incidence was highest in whites and lowest in blacks and Asian/Pacific Islanders.
The authors write that the differences in incidence by race/ethnicity found in this study may be due to different environmental exposures, genetics, or a combination of both.
Source: Science Daily
Medical Monday
Genetic Mutations in White and Black Patients With Lung Cancer
TAKE-HOME MESSAGE
INTRODUCTION
Lung cancer is the leading cause of cancer-related deaths in the United States. The reasons for higher incidence and poorer survival rates among black compared to white lung cancer patients have not been defined. We hypothesized that differential incidence of somatic cancer gene mutations may be a contributing factor. Previous genomic studies of non-small cell lung cancer (NSCLC) have not adequately represented black patients.
METHODS
A MALDI-TOF mass-spectrometry approach was used to analyze tumor DNA for 214 coding mutations in 26 cancer genes previously identified in NSCLC. The samples included NSCLC from 335 white patients and 137 black patients. For 299 of these, normal matched DNA was available and analyzed. >RESULTS:: EGFR exon 19 deletions were only detected in female cases, with increased odds for black women compared to white women (odds ratio=3.914, 95% CI: 1.014-15.099, p=0.048). Beyond race, variations in mutation frequencies were seen by histology. DDR2 alterations, previously described as somatic mutations, were identified as constitutional variants.
CONCLUSIONS
This study is among the largest comparing somatic mutations in black and white patients. The results point to the molecular diversity of NSCLC and raise new questions as to the importance of inherited alleles. Genomic tumor testing will benefit both populations, although the mutation spectrum appears to vary by sex, race, and histology.
Source: Daily Practice
Medical Monday
Type 2 Diabetes Screening for Asian Americans
abstract
According to the U.S. Census Bureau, an Asian is a person with origins from the Far East (China, Japan, Korea, and Mongolia), Southeast Asia (Cambodia, Malaysia, the Philippine Islands, Thailand, Vietnam, Indonesia, Singapore, Laos, etc.), or the Indian subcontinent (India, Pakistan, Bangladesh, Bhutan, Sri Lanka, and Nepal); each region has several ethnicities, each with a unique culture, language, and history. In 2011, 18.2 million U.S. residents self-identified as Asian American, with more than two-thirds foreign-born. In 2012, Asian Americans were the nation’s fastest-growing racial or ethnic group, with a growth rate over four times that of the total U.S. population. International migration has contributed >60% of the growth rate in this population. Among Asian Americans, the Chinese population was the largest (4.0 million), followed by Filipinos (3.4 million), Asian Indians (3.2 million), Vietnamese (1.9 million), Koreans (1.7 million), and Japanese (1.3 million). Nearly three-fourths of all Asian Americans live in 10 states—California, New York, Texas, New Jersey, Hawaii, Illinois, Washington, Florida, Virginia, and Pennsylvania. By 2060, the Asian American population is projected to more than double to 34.4 million, with its share of the U.S. population climbing from 5.1 to 8.2% in the same period.
The Truth about DNA
Geneticists Just Discovered a Shocking Truth About Race in White People’s DNA
As it turns out, many white people may not be so “white” after all.
In fact, millions of Americans who consider themselves white actually have mixed-race roots. A study offers yet more evidence that race is no more than a social construct.
Our “hidden” African ancestries. Population genetics scientists from institutions including Harvard University analyzed DNA from thousands of Americans who described themselves as being part of a singular racial group. The results, published in the American Journal of Human Genetics, revealed that almost 4% of participants who identify as white have “hidden” African ancestry.
“For a generation, historians have been writing books about how race is culturally constructed,” said Claudio Saunt, a University of Georgia historian, commenting on the study. “This article uses another tool, DNA analysis, to get at the same question.”
The study: Thousands of customers of 23andMe, a genotyping company, submitted saliva samples for DNA analysis and answered questionnaires about their racial and ethnic identifications. One questionnaire asked participants about geographic ancestral origins while another asked about racial affiliation. Only customers who said they identified with a single racial or ethnic group were included.
The study included 150,000 white participants and several thousand Latinos and African-Americans. They collectively hailed from 48 states. Researchers used participants’ DNA samples to render their genetic profiles and compared the results to their self-reported ancestries.
There’s a link between racial identity and geography. The frequency with which self-identified white participants had African ancestry varied significantly by region. And ancestry patterns appeared to mirror major population shifts tied to historical events in American history.
For example, researchers found white people with African ancestry at much higher rates in southern states. As much as 12% of self-described European Americans from South Carolina and Louisiana had African ancestry. And in other parts of the South, it was about 1 in 10. Researchers estimated that this interracial mixing, which geneticists call “admixture,” started about six generations ago (roughly 180 years) — before African-Americans migrated to the northern states.
Oklahoma, the study revealed, has the highest proportion of self-identified African-Americans with Native American genes. Oklahoma also happens to be where Native Americans and African-Americans first crossed paths, so to speak, when Native Americans walked the Trail of Tears in the 1830s after being forced out of the South.
How people describe themselves, it increasingly seems, has less to do with genetic makeup than the influence of social norms.
“Many Americans claim ancestry they don’t have or don’t claim ancestry that they do,” said Saunt. “In my own state of Georgia, for example, where I teach Native American history, numerous students tell me they have Cherokee ancestry, but in fact whites from Georgia have less indigenous ancestry than whites from just about any other state.”
The study is not without controversy: Personal genotyping companies like 23andMe have come under fire for cherry-picking the genes they analyze (millions out of billions) for participants’ DNA profiles. But, 23andMe codes for genes that are pretty well-established in tracing ancestry, according to a company representative.
And while there’s potentially bias in studying only 23andMe customers, both study authors and other experts in the field said it would be hard for a single research institution, or even a government agency, to perform a study of this magnitude and complexity.
“We needed many, many people,” said lead study author Kasia Bryc, “so it wasn’t possible just a short time ago. 23andMe was the first source that could offer this kind of data.”
Overall, and perhaps most importantly, the findings speak to the thorny relationship between biology and identity.
“Individuals who self-identify as white will respond in diverse ways to genetic testing showing that they have recent African ancestry,” said Saunt. “Some will embrace the findings, and others will deny them, even in the face of the evidence. The insistence on racial purity is part of a long American tradition. Even before DNA analysis, families repudiated relatives they knew were theirs. That tradition is waning, but it is, unfortunately, far from extinguished.”
Source: ScienceMic
Medical Monday
New forensic tool detects ethnicity and gender in single hair
A cutting-edge technique to identify human hair could one day be helping to catch criminals according to a new study from researchers in Canada.
The tool produces results faster than current DNA analysis techniques used in law enforcement, and in early tests showed a 100% success rate at identifying gender and ethnicity.
The new tool is the work of Diane Beauchemin, a professor in the department of chemistry at Queen’s University in Kingston, Ontario, and MSc student Lily Huang. They describe their proof of concept study in the Journal of Analytical Atomic Spectrometry.
Prof. Beauchemin says her first “foray into forensic chemistry was developing a method of identifying paint that could help solve hit and run cases.” Applying a similar approach to hair analysis was Ms. Huang’s idea, she adds, so they started working on it last year.
Blood samples recovered at a crime scene are often used to identify gender and ethnicity, but blood deteriorates quickly and is prone to contamination.
However, hair is very stable. The reason it is a promising avenue for forensics is because of the unique mix of elements it contains, which varies according to diet, ethnicity, gender the environment and working conditions. They get into the hair from sweat secretions.
The team found they could identify gender from the elements magnesium, sulfur, strontium and zinc. And to discriminate ethnicity they used lithium, molybdenum, sulfur, strontium, chromium, potassium, nickel, zinc and lead.
The process takes just 85 seconds to complete. First they grind up the hair sample, burn it (using a method called electrothermal vaporization), and then analyze the vapor it produces (using inductively coupled plasma optical emission spectrometry).
Current forensic methods used to analyze hair are time-consuming and use corrosive solvents and reagents, Prof. Beauchemin told Chemistry World.
Method is robust and can be used universally
Ms. Huang says the method is “very robust and can be used universally. One of our samples even included dyed hair and the test was 100% accurate. The test was able to distinguish East Asians, Caucasians and South Asians.”
Current forensic methods used to analyze hair are time-consuming and use corrosive solvents and reagents.
The team is already talking to law enforcement agencies about the next step in using the new method.
And the researchers are also planning to develop the method so it can pinpoint exactly where in the world a hair sample is from, as well as add more ethnicities and age to the repertoire.
To extend the repertoire of variables the method can identify means measuring more elements, but Prof. Beauchemin says this would not take more time, because their detection is simultaneous.
In 2010, Medical News Today learned how researchers are working on a method of forensic identification using hand bacteria. The method uses the fact that when we handle objects we leave behind bacterial communities that are uniquely identifiable.
Source: Medical News Today
Medical Monday
DNA TESTING
All his life, Neil Schwartzman searched for his biological family. He was adopted in 1960 at 10 days old, and he never knew where he came from. At first, he looked for answers by going to social services in his hometown of Montreal, Quebec, and trying to access adoption records. “There was nothing in the file,” he said. “Everything I did ended up being a dead end.” As he approached middle age, in 2008, he had just about given up. That’s when he heard about the direct-to-consumer genetic testing service 23andMe.
Unlike previous inquiries about his origins, this one occurred at the molecular level. He spit in a tube and sent it off to 23andMe’s California headquarters for analysis. For about $100, they sent back information about his genealogy (biological relatives), ancestry (lineage and geographic origins), and — this was before a 2013 Food and Drug Administration crackdown — his health, including genetic predispositions for various diseases and behavioral traits. Schwartzman said he didn’t expect much from his foray into personal DNA testing. He just signed up “as a last-ditch effort to try to get some medical information for myself.”
In early May 2011, several years after enrolling, he was pleasantly surprised: an email arrived from another anonymous 23andMe user saying she thought Schwartzman might be a half-brother.
The 23andMe website prompted him with a question about whether he wanted to find out more about the nature of their DNA relationship. He consented. Soon, he said, “We began to realize that my mother had a baby that she never disclosed to anyone.” That baby was Schwartzman. “The whole thing was swept under the rug until — fast forward 50, 51 years ahead — and there I am.”
Because of this “technological magic,” as Schwartzman put it, he was reunited with his family with more ease than any other search he had undertaken. He was able to fulfill that deep, universal longing we all have to understand our origins.
“It was nice to finally share this commonality with the rest of the world. It was very emotionally satisfying.”
Within a few weeks, he flew to California to meet his older sister, Jolie Pearl. They had their first meeting in a crowded restaurant in San Francisco’s theater district. They were the first ones at the restaurant, and they talked until the place closed. During that same visit, on an emotional day he will never forget, he was reunited with his biological mother in Oakland, California. On the way there, he asked his sister what kind of flower his mom would like. They decided on a potted orchid.
His mother, who was already confused with dementia, gave Schwartzman a book, “a random gift she pulled up at last minute,” he said. “It certainly wasn’t a typical reunion you see on TV, where the music swells up and everyone is carried away on gossamer wings.” Still, he said, “It was the welcome completion of a quest I had had for 50 years. It confirmed that I wasn’t placed on the earth by aliens, that I had a mother.”
The reunion went well enough that the family met again, once in California and once in Montreal. “It was nice to finally share this commonality with the rest of the world,” Schwartzman said. “It was very emotionally satisfying.”
At the time, Schwartzman and Pearl were the poster children for 23andMe’s “DNA relatives” program. Their story — and a picture of them staring at each other at a fork in a railway track — is still featured on the company web page about adoptees. They were, it seemed, among the many now finding family and having joyful reunions as a result of personal genetic testing. “It was the start of a relationship,” 23andMe writes of Schwartzman’s discovery. Then, Schwartzman hailed 23andMe as “an example of the miracle of modern science.” Pearl called the reunion “the best thing.”
