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"Personalized medicine" disparities

Caren E Smith, Stephanie M Fullerton, Keith A Dookeran, Heather Hampel, Adrienne Tin, Nisa M Maruthur, Jonathan C Schisler, Jeffrey A Henderson, Katherine L Tucker, José M Ordovás
Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened...
August 1, 2016: Health Affairs
Assumpta C Nwaneri, Lucien McBeth, Terry D Hinds
Prostate cancer (PC) is one of the leading causes of mortality amongst elderly men in the USA and is second only to lung cancer. African Americans (AA) are at an increased risk of developing PC and are more likely to die from the disease in comparison to Caucasian Americans (CA). Chromosomal alterations or genetic differences between AA and CA may account for the variances observed in PC progression. Importantly, mutations in the androgen receptor (AR) or the epidermal growth factor receptor (EGFR) may contribute to the disparity...
July 22, 2016: Hormones & Cancer
Mohamad Farid, Joanne Ngeow
UNLABELLED: : Sarcomas are rare mesenchymal malignancies that demonstrate great clinical and biological heterogeneity. A variety of sarcomas develop in the context of well-defined heritable cancer predisposition syndromes, associations that are often overlooked, given the rarity and diversity of sarcomas and the equivalent relative infrequency of cancer genetic syndromes. This review describes in detail selected heritable cancer predisposition syndromes that are known to be associated with sarcomas...
August 2016: Oncologist
H Hansen, J Metzl
This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws...
June 2016: Journal of Bioethical Inquiry
Heidi M Tham, Sarah Hohl, Wade Copeland, Katherine J Briant, Leticia Márquez-Magaña, Beti Thompson
In a personalized medicine environment, it is necessary to have access to a range of biospecimens to establish optimal plans for disease diagnosis and treatment for individual patients. Cancer research is especially dependent on biospecimens for determining ideal personalized treatment for patients. Unfortunately, the vast majority of biospecimens are collected from non-Hispanic White individuals; thus, minority representation is lacking. This has negative implications for comprehensive cancer treatment. The Geographic Management of Cancer Health Disparities Program (GMaP) Region 6 implemented a series of biospecimen education seminars adapted from the Biospecimen and Biobanking module of an existing Cancer Education and Training Program...
April 26, 2016: Health Promotion Practice
Jingya Qiu, Jason H Moore, Christian Darabos
Genome-wide association studies (GWAS) have led to the discovery of over 200 single nucleotide polymorphisms (SNPs) associated with type 2 diabetes mellitus (T2DM). Additionally, East Asians develop T2DM at a higher rate, younger age, and lower body mass index than their European ancestry counterparts. The reason behind this occurrence remains elusive. With comprehensive searches through the National Human Genome Research Institute (NHGRI) GWAS catalog literature, we compiled a database of 2,800 ancestry-specific SNPs associated with T2DM and 70 other related traits...
May 2016: Genetic Epidemiology
Joni Strom Williams, Rebekah J Walker, Leonard E Egede
For decades, disparities in health have been well documented in the United States and regrettably, remain prevalent despite evidence and appeals for their elimination. Compared with the majority, racial and ethnic minorities continue to have poorer health status and health outcomes for most chronic conditions, including diabetes mellitus, cardiovascular disease, cancer and end-stage renal disease. Many factors, such as affordability, access and diversity in the healthcare system, influence care and outcomes, creating challenges that make the task of eliminating health disparities and achieving health equity daunting and elusive...
January 2016: American Journal of the Medical Sciences
Meghana V Kashyap, Michael Nolan, Marc Sprouse, Ranajit Chakraborty, Deanna Cross, Rhonda Roby, Jamboor K Vishwanatha
The Texas Center for Health Disparities, a National Institute on Minority Health and Health Disparities Center of Excellence, presents an annual conference to discuss prevention, awareness education, and ongoing research about health disparities both in Texas and among the national population. The 2014 Annual Texas Conference on Health Disparities brought together experts in research, patient care, and community outreach on the "Role of Genomics in Eliminating Health Disparities." Rapid advances in genomics and pharmacogenomics are leading the field of medicine to use genetics and genetic risk to build personalized or individualized medicine strategies...
2015: Journal of Carcinogenesis
Diana Lynn Woods, Janet C Mentes, Mary Cadogan, Linda R Phillips
Unique drug responses that may result in adverse events are among the ethnocultural differences described by the Agency for Healthcare Research and Quality. These differences, often attributed to a lack of adherence on the part of the older adult, may be linked to genetic variations that influence drug responses in different ethnic groups. The paucity of research coupled with a lack of knowledge among health care providers compound the problem, contributing to further disparities, especially in this era of personalized medicine and pharmacogenomics...
September 23, 2015: Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society
Christopher S Lathan
Lung cancer is the leading cause of cancer related mortality in the US, and while treatment disparities by race and class have been well described in the literature, the impact of social determinates of health, and specific characteristics of the treatment centers have been less well characterized. As the treatment of lung cancer relies more upon a precision and personalized medicine approach, where patients obtain treatment has an impact on outcomes and could be a major factor in treatment disparities. The purpose of this manuscript is to discuss the manner in which lung cancer care can be impacted by poor access to high quality treatment centers, and how the built environment can be a mitigating factor in the pursuit of treatment equity...
August 2015: Translational Lung Cancer Research
Paula S Ramos, Andrew M Shedlock, Carl D Langefeld
Human genetic diversity is the result of population genetic forces. This genetic variation influences disease risk and contributes to health disparities. Autoimmune diseases (ADs) are a family of complex heterogeneous disorders with similar underlying mechanisms characterized by immune responses against self. Collectively, ADs are common, exhibit gender and ethnic disparities, and increasing incidence. As natural selection is an important influence on human genetic variation, and immune function genes are enriched for signals of positive selection, it is thought that the prevalence of AD risk alleles seen in different population is partially the result of differing selective pressures (for example, due to pathogens)...
November 2015: Journal of Human Genetics
Vural Özdemir
Vural Özdemir began his career as a medical doctor in Turkey in 1990, as a scientist at the Faculty of Medicine, University of Toronto (ON, Canada), where he obtained his MSc and PhD in clinical pharmacology (1998), and subsequently completed a 4-year postdoctoral fellowship in personalized medicine with the late Werner Kalow, a founding pioneer in the field of pharmacogenetics. Özdemir contributed to the conception and development of the repeated drug administration (RDA) method as a novel way of measuring pharmacological heritability, pharmacogenetics of psychiatric drugs and studying the clinical role of CYP2D6 genetic variations for endogenous neurotransmitter metabolism in the human brain...
2014: Personalized Medicine
Arti Hurria, Hy Muss
The true face of breast cancer is more commonly that of an older woman. The rapid aging of the US population is contributing to an increasing number of breast cancer cases in older adults today, as well as an increase in the number of breast cancer survivors who carry the long-term side effects of breast cancer treatment. The number one problem facing older women with breast cancer today is that they are not receiving the same benefits from treatment advances as younger women. This disparity in outcomes highlights the great need for studies that specially include older women with breast cancer in order to guide informed decisions regarding the most efficacious treatment options...
2015: Advances in Experimental Medicine and Biology
Steven N Hart, Raymond M Moore, Michael T Zimmermann, Gavin R Oliver, Jan B Egan, Alan H Bryce, Jean-Pierre A Kocher
Objective. Bringing together genomics, transcriptomics, proteomics, and other -omics technologies is an important step towards developing highly personalized medicine. However, instrumentation has advances far beyond expectations and now we are able to generate data faster than it can be interpreted. Materials and Methods. We have developed PANDA (Pathway AND Annotation) Explorer, a visualization tool that integrates gene-level annotation in the context of biological pathways to help interpret complex data from disparate sources...
2015: PeerJ
Gustavo Vilchez, Jing Dai, Navleen Gill, Moraima Lagos, Ray Bahado-Singh, Robert J Sokol
OBJECTIVE: The recommendation for elective induction of labor (IOL) is to await ≥ 39 weeks. Studies show earlier maturity of Blacks compared to Whites. The objective was to examine the effect of the Black race on the risk of intrapartum and neonatal complications after IOL. METHODS: Black women with non-indicated IOL at 37-42 weeks were selected from the CDC-Birth Cohorts 2007-2010. Congenital anomalies, hypertension/diabetes, low-birth weight, breech presentation, previous cesarean and premature rupture of membranes were excluded...
2016: Journal of Maternal-fetal & Neonatal Medicine
Osman A Gani, Balmukund Thakkar, Dilip Narayanan, Kazi A Alam, Peter Kyomuhendo, Ulli Rothweiler, Veronica Tello-Franco, Richard A Engh
In just over two decades, structure based protein kinase inhibitor discovery has grown from trial and error approaches, using individual target structures, to structure and data driven approaches that may aim to optimize inhibition properties across several targets. This is increasingly enabled by the growing availability of potent compounds and kinome-wide binding data. Assessing the prospects for adapting known compounds to new therapeutic uses is thus a key priority for current drug discovery efforts. Tools that can successfully link the diverse information regarding target sequence, structure, and ligand binding properties now accompany a transformation of protein kinase inhibitor research, away from single, block-buster drug models, and toward "personalized medicine" with niche applications and highly specialized research groups...
October 2015: Biochimica et Biophysica Acta
Yohann Foucher, Aurélie Meurette, Pascal Daguin, Angélique Bonnaud-Antignac, Jean-Benoît Hardouin, Sabrina Chailan, Karine Neau, Emmanuelle Papuchon, Sandra Gaboriau, Christophe Legendre, Emmanuel Morélon, Philippe Tessier, Magali Giral
BACKGROUND: Numerous well-established clinical parameters are taken into consideration for the follow-up adaptation of kidney transplant recipients, but there are important disparities between countries, centres and clinicians. Therefore, novel scoring systems have been developed, for instance the Kidney Transplant Failure Score (KTFS) which aims to stratify patients according to their risk of return to dialysis. We hypothesize that the efficiency of the follow-up after one year post-transplantation can be improved by adapting it to the risk of graft failure defined by the KTFS estimation...
2015: BMC Nephrology
Kyle B Brothers, Mark A Rothstein
As research focused on personalized medicine has developed over the past decade, bioethics scholars have contemplated the ethical, legal and social implications of this type of research. In the next decade, there will be a need to broaden the focus of this work as personalized medicine moves into clinical settings. We consider two broad issues that will grow in importance and urgency. First, we analyze the consequences of the significant increase in health information that will be brought about by personalized medicine...
2015: Personalized Medicine
Elizabeth S Chen, Elizabeth W Carter, Tamara J Winden, Indra Neil Sarkar, Yan Wang, Genevieve B Melton
OBJECTIVE: To integrate data elements from multiple sources for informing comprehensive and standardized collection of family health history (FHH). MATERIALS AND METHODS: Three types of sources were analyzed to identify data elements associated with the collection of FHH. First, clinical notes from multiple resources were annotated for FHH information. Second, questions and responses for family members in patient-facing FHH tools were examined. Lastly, elements defined in FHH-related specifications were extracted for several standards development and related organizations...
April 2015: Journal of the American Medical Informatics Association: JAMIA
Joanne Armstrong, Michele Toscano, Nancy Kotchko, Sue Friedman, Marc D Schwartz, Katherine S Virgo, Kristian Lynch, James E Andrews, Claudia X Aguado Loi, Joseph E Bauer, Carolina Casares, Rachel Threet Teten, Matthew R Kondoff, Ashley D Molina, Mehrnaz Abdollahian, Lana Brand, Gregory S Walker, Rebecca Sutphen
Research to date regarding identification and management of hereditary breast and ovarian cancer syndrome (HBOC) in the U.S. has been confined primarily to academic center-based studies with limited patient engagement. To begin to understand and address the current gaps and disparities in delivery of services for the appropriate identification and optimal risk management of individuals with HBOC, we designed and have initiated the American BRCA Outcomes and Utilization of Testing (ABOUT) Study. ABOUT relies on a collaborative patient advocacy, academic and industry partnership to recruit and engage U...
February 2015: Journal of Genetic Counseling
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