The potential of a placebo/nocebo effect in pharmacogenetics.

Pharmacogenetic testing holds great promise to improve health outcomes and reduce adverse drug responses through enhanced selection of therapeutic agents. Since drug responses can be manipulated by verbal suggestions, it is of particular interest to understand the potential impact of pharmacogenetic test results on drug response. Placebo and nocebo-like effects may be possible due to the suggestive nature of pharmacogenetic information that a drug will or will not likely lead to improved health outcomes. For example, pharmacogenetic testing could provide further reassurance to patients that a given drug will be effective and/or cause minimal side effects. However, pharmacogenetic information could adversely affect drug response through negative expectations that a drug will be less than optimally effective or cause an adverse response, known as a nocebo-like effect. Therefore, a patient's perceived value of testing, their understanding of the test results, and the manner in which they are communicated may influence therapeutic outcome. As such, physicians should consider the potential effect of pharmacogenetic test results on therapeutic outcome when communicating results to patients. Studies are needed to investigate the impact of pharmacogenetic information of therapeutic outcome.

Australian helminths in Australian rodents: an issue of biodiversity.

The Australian public as well as Australian funding bodies are generally unsympathetic to native murids, rats and mice, in spite of the fact that 36% have either become extinct or critically endangered since European settlement. The endemic Australian parasites of these rats and mice have been even less sympathetically regarded. Prior to 1958 very little work was carried out on the helminths of Australian rodents and little more is known today. Records are known from only 28% of the extant host species, comprising some 109 species of helminth identified at least to generic level. The rodents invaded Australia from the north, perhaps through New Guinea in at least two separate waves, 5-8 then about 1 million years ago. The parasites they brought with them have adapted and speciated and there has been some host switching between rodent groups and between rodents and the Australian marsupials. This is illustrated particularly in the Trichostrongyloidea. The origins of the rodents from Southeast Asia down the Indonesian island chain are reflected in the presence of the nematode genus Tikusnema in both Australia and Indonesia, and Cyclodontostomum purvisi across Southeast Asia and into New Guinea. Hydromys chrysogaster, the Australian water-rat, illustrates how the biogeographical influences of the host's distribution and lifestyle can affect its parasite fauna. Most of the research to date is merely indicative of where more data are needed. The links between Australian and New Guinean helminth fauna, as well as the links between rodent and marsupial hosts and their fauna, cannot be determined without further research.