Whole Blood DNA Aberrant Methylation in Pancreatic Adenocarcinoma Shows Association with the Course of the Disease: A Pilot Study

Pancreatic tumors are usually diagnosed at an advanced stage in the progression of the disease, thus reducing the survival chances of the patients. Non-invasive early detection would greatly enhance therapy and survival rates. Toward this aim, we investigated in a pilot study the power of methylation changes in whole blood as predictive markers for the detection of pancreatic tumors. We investigated methylation levels at selected CpG sites in the CpG rich regions at the promoter regions of p16, RARbeta, TNFRSF10C, APC, ACIN1, DAPK1, 3OST2, BCL2 and CD44 in the blood of 30 pancreatic tumor patients and in the blood of 49 matching controls. In addition, we studied LINE-1 and Alu repeats using degenerate amplification approach as a surrogate marker for genome-wide methylation. The site-specific methylation measurements at selected CpG sites were done by the SIRPH method. Our results show that in the patient’s blood, tumor suppressor genes were slightly but significantly higher methylated at several CpG sites, while repeats were slightly less methylated compared to control blood. This was found to be significantly associated with higher risk for pancreatic ductal adenocarcinoma. Additionally, high methylation levels at TNFRSCF10C were associated with positive perineural spread of tumor cells, while higher methylation levels of TNFRSF10C and ACIN1 were significantly associated with shorter survival. This pilot study shows that methylation changes in blood could provide a promising method for early detection of pancreatic tumors. However, larger studies must be carried out to explore the clinical usefulness of a whole blood methylation based test for non-invasive early detection of pancreatic tumors

Potentials of e-health for implementation of Lithuanian health program

E-sveikatos koncepcija, atsiradusi XX a. pabaigoje suprantama kaip telekomunikacinių ir informacinių priemonių panaudojimas sveikatos priežiūroje. E-sveikatos pritaikymas galėtų praplėsti Lietuvos sveikatos programą įgyvendinimo galimybes. Lietuvos sveikatos programos uždavinių įgyvendinimas galėtų būtų vykdomas plėtojant telemediciną, e-mokymą, e-tyrinėjimus ir e-administravimą. Reikšminiai žodžiai: E-sveikata; Lietuvos sveikatos programa; Sveikatos informacinė sistema; Sveikatos priežiūros sistema; Telemedicina; Telemediciną; E-health; Health care system; Health information system; Lithuanian health program; TelemedicineThe concept of e-health is described as the daily use of telecommunications and information technologies in health care. It extends the possibilities for implementation of Lithuanian Health Program. The implementation of objectives of health program could be achieved by the development of telemedicine, e-learning, e-research, and e-administration. The use telemedicine could increase the quality and accessibility of health care system. The telemedicine can be used for online consultations, in-home monitoring of chronically ill by disease management programs, developing personal medical electronic record and online registration. E-learning gives opportunities for implementation of Health Program through development of informational websites about health and health promotion, organizing interactive courses how to prevent or solve current health problems, chat rooms for patient support ("self-care") groups and distance learning. E-rescarch expends possibilities for monitoring changes in health status of the population, development of health databases and participation in research. E-administration covers the use of information and communication technology for planning, implementation, funding, and assessment of disease control, quality, efficiency and effectiveness in service supply. It also includes epidemiological surveillance and control and administration of human and technical resources. Such implementation of telecommunications and information technologies in health care services will make them more effective and services will be more accessible. Individuals will be more empowered to take care of health. It will cause the increase of quality of life, which is one of the main goals of Lithuanian Health Program