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Quality Data Made Accessible To Clinical Teams
NHS clinical teams will have access to data showing their performance against a set of more than 200 indicators of high quality care in the NHS in one place. It is the next phase in the drive to help NHS professionals improve the quality of care they deliver to patients, and will also support providers and commissioners of NHS services.

Number Of Black Organ Donors Increases In Michigan, Many Blacks Still Reluctant To Donate Organs
Although the number of blacks who are registered as organ donors in Michigan has increased in the last 15 years, many are still reluctant to be organ donors, the Detroit News reports. According to Remonia Chapman, director of Gift of Life Michigan"s minority organ tissue transplant education program, many blacks are hesitant to participate with the organ donor registry because they have inadequate access to health care.Chapman said that increased awareness and education about organ donation and the diseases that lead to the need for donated organs, as well as partnerships with minority donors, black ministers and community groups, have encouraged more blacks to be organ donors. In the last 15 years, the percentage of black Michigan residents who are registered organ donors has increased from 10.8% to 21%, with overall minority registration at 24%. Chapman noted that about 41.3% of people on Michigan"s transplant waiting list and about 46% of people in need of a kidney are minorities.According to the News, minority donors are the best matches for minority organ recipients because the genetic profiles of the donor and recipient will have more similarities. Chapman added that the best matches for kidney recipients are donors from the recipient"s family or from the recipient"s ethnic group if a family donor is not available (Stolarz, Detroit News, 5/19).
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Evidence Challenges Effectiveness Of Embryo Screening For Older Women
There is growing evidence that a procedure for identifying chromosomal abnormalities in embryos prior to in vitro fertilization is ineffective at helping older women become pregnant, the Wall Street Journal reports. The procedure -- known as pre-implantation genetic screening, or PGS -- is performed in dozen of U.S. fertility clinics and sometimes marketed to older women as a way to increase the odds of a healthy live birth. PGS involves extracting a single cell from a six-cell embryo and inspecting it for chromosomal abnormalities known as aneuploidies; unaffected embryos can then be implanted through IVF. Women older than age 35 have a higher risk of aneuploidies, in which embryos have fewer or more than the usual number of 23 pairs of chromosomes. Aneuploidies can trigger early miscarriage or certain genetics conditions, such as Down syndrome. Most medical experts agree that embryo screening is capable of significantly reducing the risk of Down syndrome and other serious chromosome-related illnesses. However, evidence from several studies increasingly suggests that the procedure does not increase older women"s chances of healthy live births. The American Society for Reproductive Medicine released an initial opinion about PGS in 2007, saying that available evidence does not support the use of embryo screening to increase live birth rates in older women. Andrew La Barbera, scientific director of the society, said, "Since that time, there have been several more trials that have reached the same conclusion." Another shortcoming is that most clinics can only test for fewer than half of the 23 chromosomes, meaning that many defects can go undetected. However, medical experts say that the use of PGS has increased in the two years since ASRM issued its recommendations. According to the Journal, PGS can add more than $2,000 to the roughly $10,000 cost of one IVF cycle. Very few health insurers cover PGS, though some pay for IVF. Some experts contend that studies showing a lack of clinical benefit from PGS do not use more efficient biopsy techniques that can prevent damage to the embryo. Santiago Munne, scientific director for Reprogenetics, said that the treatment is "effective." In a 2007 study, Munne and colleagues used PGS to reduce the rate at which patients miscarried. However, the chances of a woman getting pregnant largely were unchanged, which the authors said could be attributed to the small number of study participants (Naik, Wall Street Journal, 6/1).
Nutrition

Yeast 'DNA Damage Sensor' Provides Chemotherapy Resistance Clue

Cancer Research UK scientists have been part of an international collaboration that has revealed the structure of a protein found in simple yeast cells and shown how it flags up damaged DNA for repair. The results of their study are published in Nature*. The finding may provide clues as to how some cancer cells become resistant to certain chemotherapy drugs. Researchers based at Cancer Research UK"s Paterson Institute for Cancer Research at the University of Manchester, worked with other US and UK collaborators to investigate a recently discovered DNA "damage sensing" protein family. The collaboration used a technique called X-ray crystallography to show in yeast cells how the family called alkyltransferase-like proteins (ATLs) - originally discovered by Paterson scientists*** - can detect the DNA damage caused by some anti-cancer drugs, and alert the cell"s DNA repair machinery. They also found ATLs in organisms as diverse as sea anemones and microscopic organisms - so it"s likely that a similar protein plays the same kind of "damage sensor" role in humans. Some anti-cancer drugs kill tumour cells by damaging their DNA. But sometimes the treatment fails because tumour cells can repair this DNA damage - and reverse the effects of the drug. This latest study suggests that that ATL proteins might contribute to this drug resistance. Their new work shows how the yeast ATL protein binds to DNA and "flips" out the damaged DNA bases, flagging them up for repair. The scientists already knew that the ATL in yeast cells protect them from being destroyed by the kind of damage caused by anticancer agents. When the gene for the ATL protein was deactivated in yeast cells, the yeast cells became very sensitive to these drugs. The study of the DNA repair processes in cells is an area of intense activity. A better understanding of them will help scientists find ways to block DNA repair which could lead to the development of more effective cancer treatments. A number of clinical trials based on this concept are being carried out at the moment. Doctor Geoff Margison, Cancer Research UK scientist and study co-author, said: "We have found out how this family of proteins can begin the repair of certain types of DNA damage. "Now the hunt is on to see if similar processes exist in humans. If so, they may tell us why some tumours do not respond to certain chemotherapy drugs and they will provide important new targets for future drug development." Dr Helen George, Cancer Research UK"s head of science information, said: "Our research over several decades has contributed to our understanding of repair kits in cells and these latest results are an exciting step forward. Many chemotherapy drugs work by damaging the DNA in cancer cells which destroys them. But cells can be incredibly resilient and fight back to repair their damage. "This research reveals for the first time exactly how a key repair protein can detect the damage caused by some types of chemotherapy and initiate the DNA repair process. If this process occurs in humans, this may provide new leads for treating cancer." Notes *Alkylated DNA damage flipping bridges base and nucleotide excision repair. Nature. Julie Tubbs et al. ** X-ray crystallography This technique is used to determine molecular structures by finding out the order in which atoms are arranged within a crystal. X-rays are beamed onto a crystallised form of the molecule of interest and are scattered in different directions. By following the direction in which the x-rays are scattered it is possible to produce a 3-D structure of the location of the atoms in the crystal and from this determine the 3-D structure of the molecules. ***In 2003-2007 they first reported and then characterised the fission yeast ATL protein and reported that inactivation of the gene (called Atl1) in S.pombe made them very sensitive to DNA damaging agents. Margison GP, Povey AC, Kaina B, Santibanez Koref MF. Variability and regulation of O6-alkylguanine-DNA alkyltransferase. Carcinogenesis. 24: 625-635. (2003) Pearson SJ, Ferguson J, Santibanez-Koref M, Margison GP. Inhibition of O6-methylguanine-DNA methyltransferase by an alkyltransferase-like protein from Escherichia coli. Nucleic Acids Res. 33: 3837-3844 (2005) Pearson, S.J., Wharton, S.J., Watson, A.J., Begum. G., Butt, A., Glynn, N., Shibata, T., Williams, D.M. Santibanez-Koref, M.F., Margison, G.P. A novel DNA damage recognition protein in S. pombe. Nucleic Acids Res. 34: 2347-2354 (2006) Margison, G.P., Butt, A., Pearson, S.J., Wharton, S.J., Watson, A.J., Marriott, A., Caetano, C.M., Hollins, J.J., Rukazenkova, N., Begum, G. and Santibanez-Koref, M.F. Alkyltransferase-like proteins. DNA Repair 8; 1222-1228 (2007). About Cancer Research UK - Together with its partners and supporters, Cancer Research UK"s vision is to beat cancer. - Cancer Research UK carries out world-class research to improve understanding of the disease and find out how to prevent, diagnose and treat different kinds of cancer. - Cancer Research UK ensures that its findings are used to improve the lives of all cancer patients. - Cancer Research UK helps people to understand cancer, the progress that is being made and the choices each person can make. - Cancer Research UK works in partnership with others to achieve the greatest impact in the global fight against cancer. Cancer Research UK


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