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iPrevention; How to be a Disease Detective; Esophageal cancer: Are you at risk?; Growing bone?; Peri-implant mucositis and peri-implantitis

April 5, 2013
Editorial Director Maria Perno Goldie, RDH, MS, reports on several topics in the first of two scheduled issues of FOCUS this month. Included is discussion about a new Solve the Outbreak app for iPad users created by the Centers for Disease Control and Prevention, how to become a “Disease Detective” via a postgraduate program of service and on-the-job training offered by the Epidemic Intelligence Service, risks for developing esophageal cancer, using embryonic-like stem cells collected from adult cells to grow bone, and an understanding of peri-implant mucositis and peri-implantitis.
This first April issue of RDH eVillage FOCUS discusses Barrett’s Esophagus and esophageal cancer. The incidence of Barrett’s-related esophageal cancer is rising in women and African-Americans. The Fred Hutchinson Cancer Research Center is home to the Seattle Barrett’s Esophagus Program, a multidisciplinary effort conducted in collaboration with researchers at Brigham & Women’s College and the University of California at San Francisco. This research team has shown that a systematic approach to early cancer detection can boost five-year survival rates from about 15 percent to more than 80 percent. Other promising findings from the Seattle Barrett’s Esophagus Program suggest that modifiable lifestyle factors, from reducing obesity to quitting smoking, also may prevent progression of Barrett’s. It is hypothesized that aspirin and other NSAIDs may fight cancer by reducing chronic inflammation, which is a driving force behind the development of many cancers and other diseases, such as periodontal diseases. A study published in 2007 found that people with the most aggressive form of Barrett’s may benefit the most from preventive therapy with aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs, or NSAIDs.(1) Because this was a long-term observational study and not a clinical trial, the investigators cannot recommend NSAIDs for people with Barrett’s and they advise anyone who considers taking these medications to do so under the direction of a physician, as they can cause side effects such as gastrointestinal bleeding.
Another study showed that those who took statin drugs to lower their cholesterol had a 32 percent reduced risk of developing esophageal cancer.(2) Among a subgroup of Barrett’s patients with high-grade dysplasia, or cellular abnormality, those who took statins had a 59 percent reduced risk of esophageal cancer as compared to those who did not take such drugs. Those with high-grade dysplasia who took both statins and NSAIDs also had an 81 percent reduced risk of esophageal cancer as compared to patients who took neither.(2) Esophageal adenocarcinoma risk is significantly increased with increasing age and cigarette exposure.(3) Abdominal obesity, but not BMI, was associated with a modest increased risk. Continued follow-up of this and other cohorts is needed to precisely define these relationships so as to inform risk stratification and preventive interventions.
Another interesting bit of news comes from the Centers for Disease Control and Prevention (CDC). Here are two unrelated facts. The CDC wants to protect the public’s health, and roughly one in nine Americans has iPads. CDC has decided to relate them these facts, and make it fun at the same time!(4) The agency’s new “Solve the Outbreak” app turns prevention into a game, allowing users to choose their own health emergency and by correctly answering questions, rack up points and save lives in the process. According to its website, users start out as amateurs and earn badges by solving cases until they become “disease detectives.” Scores can be posted on Facebook and Twitter. Visit CDC on iTunes to download the app.(5)
Would you like to become a Disease Detective? The Epidemic Intelligence Service (EIS) is a unique 2-year post-graduate program of service and on-the-job training for health professionals interested in the practice of epidemiology. EIS officers comprise a vital element at the frontlines of public health conducting epidemiologic investigations, research, and surveillance, both domestically and internationally.(6) Formal instruction in epidemiology, biostatistics, public health ethics and law, evaluation of surveillance systems, and scientific writing supplement experiential training opportunities.

Another exciting bit of news … preparations have started for the first known human trial to use embryonic-like stem cells collected from adult cells to grow bone.(7) The cells technology, called VSEL stem cells, or very small embryonic-like stem cells, are derived from adults, not fetuses. This eliminates ethical arguments and potential side effects associated with using actual embryonic stem cells derived from a fetus.

Researchers from the University of Michigan School of Dentistry and New York-based NeoStem Inc. hypothesize that the VSEL stem cells, which imitate properties of embryonic stem cells, can provide a minimally invasive way to speed painful bone regeneration for dental patients and others with bone trauma. Within a year, researchers hope to begin recruiting roughly 50 patients who need a tooth extraction and a dental implant. Before extracting the tooth, U-M researchers harvest the patient's cells, and then NeoStem's VSEL technology is used to purify and isolate those VSEL stem cells from the patient's other cells. For more information, visit the website.(8)

And last, but not least, see the new report on Peri-Implant Mucositis and Peri-Implantitis. Enjoy the issue!!

1. Galipeau PC, Li X, Blount PL, Maley CC, Sanchez CA, et al.(2007) NSAIDs modulate CDKN2A, TP53, and DNA content risk for progression to esophageal adenocarcinoma. PLoS Med 4(2): e67. doi:10.1371/journal.pmed. 0040067.
2. Kantor ED, Onstad L, Blount PL, Reid BJ and Vaughan TL. Use of Statin Medications and Risk of Esophageal Adenocarcinoma in Persons with Barrett's Esophagus. Cancer Epidemiol Biomarkers Prev, March 2012, 21; 456.
3. Hardikar S, Onstad L, Blount PL, Odze RD, Reid BJ, et al. (2013) The Role of Tobacco, Alcohol, and Obesity in Neoplastic Progression to Esophageal Adenocarcinoma: A Prospective Study of Barrett's Esophagus. PLoS ONE 8(1): e52192. doi:10.1371/journal.pone.0052192.
4. http://www.cdc.gov/features/solvetheoutbreak/.
5. https://itunes.apple.com/us/app/solve-the-outbreak/id592485067?mt=8.
6. http://www.cdc.gov/EIS/downloads/EIS_FactSheet.pdf.
7. Newswise. Cells Culled From Adults May Grow Human Bone. http://www.newswise.com/articles/view/601132/?sc=dwhn.
8. http://www.neostem.com.


Maria Perno Goldie, RDH, MS

To read previous RDH eVillage FOCUS introductions by Maria Perno Goldie, go to introductions.

To read more about peri-implant mucositis and peri-implantitis, click here.