Researchers at Memorial Sloan-Kettering Cancer Center (MSKCC) have shown for the first time that a tendency to develop some blood disorders may be inherited. Their research, published online in Nature Genetics, identifies a common genetic sequence abnormality that enhances the likelihood of acquiring a mutation in a gene linked to certain blood diseases.

The investigators carried out a genome-wide study to identify inherited DNA sequence changes that frequently occur in patients with myeloproliferative neoplasms, in which several types of blood cells are excessively produced in the bone marrow. They found that an inherited alteration in the gene for JAK2 - a protein with enzymatic activity that is linked to the abnormal production of blood cells - is more common in patients with these disorders. Importantly, patients who inherited this JAK2 alteration were predisposed to acquiring another JAK2 mutation on the same DNA strand. According to the research, these mutations do not arise randomly, but are specifically determined by the DNA sequence.

More than half of patients afflicted with myeloproliferative neoplasms - which affect an estimated 140,000 people in the US - carry the JAK2 mutation and suffer from the overproduction of red blood cells, platelets, or fibrous connective tissue. According to the authors, understanding the underlying inherited sequence partly explains the predisposition for acquiring mutations in certain disease-specific genes and may help explain why some individuals are at higher risk in developing the disease.

Female migrants from Asia have become "highly vulnerable" to HIV during the global financial crisis, according to a United Nations Development Programme report released in Manila, the Philippines, on Tuesday, AFP/Nasdaq.com reports. According to the report, the economic crisis has resulted in widespread job cuts and the "situation of migrant workers is under threat." It added, "When demand for labor wanes, those in the weakest bargaining position, usually temporary migrant workers and particularly the undocumented, will accept almost any conditions to hold on to their jobs."

Between 70% and 80% of migrant workers from Sri Lanka and the Philippines to Arab states are women, and 60% of female migrants from Bangladesh were employed in the region between 1991 and 2007, according to the report. It added that these women now face harsh conditions. Many are heavily indebted when they leave their home countries, and others experience sexual abuse by their employers or are kidnapped by human traffickers. "Conditions are expected to become harsher for even the employed migrant workers as they try to hang on to their jobs," UNDP country representative Renaud Meyer said, adding that undocumented workers are among the most vulnerable and might "accept almost any circumstances to hold on to their jobs." Meyer said, "Worst still, during the present turmoil, desperation for work may lead to migration under unsafe conditions, sexual exploitation and increased vulnerability to HIV infections" (AFP/Nasdaq.com, 3/10).

Prasada Rao, regional director for UNAIDS, said that although "migration itself is not a risk factor to HIV infection, the conditions under which some workers migrate and their living conditions in the host countries make them highly vulnerable to HIV." Ajay Chhibber, UNDP regional director for Asia and the Pacific, said that migrants found to be HIV-positive often face deportation and that they are unable to find work and experience discrimination once they return to their home countries (AP/MSNBC.com, 3/10).

According to AFP/Nasdaq.com, although some countries require HIV/AIDS education for migrants prior to departure, many workers do not receive such education. For example, 96% of Bangladeshi domestic workers in the Middle East said that they did not receive HIV/AIDS orientation before departure. "While half of them have heard of HIV through the media or from co-workers, none had in-depth knowledge of HIV prevention" and safer-sex methods, the report said, adding that the combination of recruitment fees and low wages can force female migrants into "debt traps, which in turn, could lead to sexual exploitation." In addition, workers who "flee abusive working conditions are immediately rendered illegal by host countries, exposing them to greater risk of abuse, including sexual exploitation and increased vulnerability to HIV," the study said. It was based on more than 600 interviews with migrant workers from Bangladesh, Pakistan, the Philippines and Sri Lanka, which supply workers to countries such as Bahrain, Lebanon and the United Arab Emirates

Young patients with heart disease are smoking more and twice as many suffer from diabetes compared to 12 years ago. Heart disease prevention in routine clinical practice is inadequate, with only a third of patients being referred to and joining prevention and rehabilitation programmes, whilst doctors are prescribing more and more drugs. Yet lifestyle programmes should be the backbone of preventive care. Saving people's lives from acute heart attacks is not sufficient, and an urgent investment in prevention is needed to address the lifestyle causes of heart disease. These are the conclusions of an Article published in this week's edition of The Lancet. The Article is one of four cardiology papers published in this edition, ahead of the American College of Cardiology meeting at the end of March.

Heart disease is preventable, yet it is the biggest killer in Europe causing 2 million deaths every year. The first (1995-96) and second (1999-2000) EUROASPIRE (European Action on Secondary and primary Prevention by Intervention to Reduce Events) surveys showed that in coronary patients cardiovascular risk factors such as smoking, high blood pressure, and high cholesterol were poorly managed in people with heart disease in Europe. Indeed, despite clear national and international guidelines on the best ways to prevent heart disease, they reported a widening gap between what is recommended and the results achieved in clinical practice.

In this study, Professor David Wood from Imperial College London, UK, and colleagues report the third (2006-7) EUROASPIRE survey outcomes*, examining more than a decade of heart disease prevention practices in 22 countries in Europe.

Findings showed a continuing and widening gap between the guidelines and patients' lifestyles in terms of stopping smoking, and reducing obesity and diabetes, and at the same time substantial increases in doctors prescribing of all of the major classes of cardioprotective drugs.

The authors report that over 12 years there has been no reduction in the proportion of patients with heart disease who smoke (20.3% in EUROASPIRE I, 21.2% in II, and 18.2% in III), but there has been a large increase in the proportion of younger female smokers. In addition, there has been a substantial increase in obesity and diabetes. In 1995-96, 25% of patients were obese and 17.4% had diabetes, this rose to 38% and 28% in 2006-7.

Further, despite large increases in the use of all classes of blood pressure lowering drugs, blood pressure management showed no improvement. Three out of five patients in all three surveys had raised blood pressure, and almost half of all patients remained above the recommended lipid targets. However, the number of patients with raised cholesterol has more than halved.

According to the authors, the results show how even when faced with a life-threatening disease it is difficult for people to change their behaviour. It is even harder when they don't have the professional support from a multidisciplinary team of nurses, dieticians, physiotherapists and doctors providing comprehensive prevention and rehabilitation programmes. They also point out that simply prescribing more cardioprotective drugs is clearly not enough and drug treatments need to be combined with professional lifestyle intervention.

They conclude by calling for comprehensive lifestyle programmes to be an integral part of health-care provision and health insurance plans for all patients with heart disease.

In an accompanying Comment, Mette Brekke and Bjørn Gjelsvik from The University of Oslo in Norway, say that the results give three messages: "First, to help patients with coronary heart disease achieve a healthy lifestyle should be mandatory and have high priority for doctors and health authorities. Second, therapeutic targets…[such as blood pressure and lipid targets] are too ambitious and might take focus away from important lifestyle issues. Finally…political action is needed to reverse the negative trends of obesity and sedentary habits, ranging from fighting against the fast food and sugar industries to safe bicycle paths and healthy school meals."

Pregnant women suffering from asthma run a greater risk of giving birth prematurely if they suspend their asthma treatments. According to a Université de Montréal study, published in Respiratory Medicine, the probability of suffering from hypertension during pregnancy also increases for women who interrupt their asthma treatment.

"Many pregnant women cease taking their asthma medication to protect the health of their child," says Faranak Firoozi, a researcher at the Université de Montréal's Department of Pharmacy. "However, they don't know that unchecked asthma can cause greater harm to the child than the medication."

According to Firoozi, there is no correlation between taking asthma medication, such as Pulmicort or Ventolin, and any congenital birth defect. In their study, Firoozi and colleagues debunk the myth that fetal gender has an affect on maternal asthma.

"Contrary to what some researchers have said, there is no difference between male and female hormones and how they impact bronchial sensitivity, which would in turn accentuate asthma symptoms when a woman carries a girl. This is good news," says Firoozi.

Firoozi used data collected by the Régie de l'assurance maladie, the Ministère de la santé et des services sociaux and the Institut de la statistique du Québec, on 13,000 pregnant women who consulted a physician for asthma between 1990 and 2002. The researcher analyzed the medication used by these women and their rate of hospitalization following their visit to the ER.

"Yes, asthma can have an important impact on pregnancy," says Firoozi. "Asthmatic women must be closely followed during pregnancy given the risks they pose to their own health and the health of their child. But the sex of the fetus has nothing to do with the asthmatic condition of pregnant women.

Human problems rarely occur in a vacuum, but persist as part of ongoing social interaction in which causes and effects are interwoven. One person's behavior can set the stage for what another does. A new study in the journal Family Process reveals that smoking can promote emotional connection for couples when both partners smoke. Health-compromising behaviors, such as smoking or weight gain, may sometimes persist because they preserve stability in a vital close relationship.

Researchers led by Michael J. Rohrbaugh and Varda Shoham of the University of Arizona had 25 couples discuss a health-related disagreement before and during a period of actual smoking, then use joysticks to rate how they had felt from moment to moment (from very positive to very negative) while watching themselves on video. One partner in each couple smoked despite having a heart or lung problem, and in some couples the other partner was a smoker as well.

The joy-stick ratings of partners in dual-smoker couples became more positive and more synchronous contingent upon lighting up - as if they were dancing to the same emotional tune. In single-smoker couples, however, both partners (smokers and non-smokers alike) report decreased positive emotions and less affective synchrony.

While most people think of health-compromising habits like smoking as a purely individual matter of motivation or addiction, this study shows that social factors beyond the smoker are important as well.

Having a partner who also smokes makes a huge difference in how smoking fits the couple's relationship (e.g. as an irritant or an ally), which in turn has implications for helping one or both partners quit.

"Looking beyond the patient can help to predict health outcomes, and relational processes are an important focus for intervention," the authors conclude. "Although prevailing conceptualizations cast nicotine addiction almost exclusively as an 'individual problem,' (findings such as ours) add credence to alternative, more contextual avenues of intervention."