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Precision medicine stroke

Amy Geard, Gift D Pule, David Chelo, Valentina Josiane Ngo Bitoungui, Ambroise Wonkam
Sickle cell disease (SCD) vastly impacts the African continent and is associated with cardiovascular diseases. Stroke, kidney disease, and pulmonary hypertension are considered as proxies of severity in SCD with several genomic loci implicated in their heritability. The present expert review examined the current data on epidemiology and genetic risk factors of stroke, pulmonary hypertension, and kidney disease associated with SCD, as indexed in PubMed(®) and Google Scholar(®). Studies collectively show that stroke and kidney disease each affect ∼10% of SCD patients, with pulmonary hypertension displaying a higher prevalence of 30% among adults with SCD...
October 2016: Omics: a Journal of Integrative Biology
Etheresia Pretorius
The latest statistics from the 2016 heart disease and stroke statistics update shows that cardiovascular disease is the leading global cause of death, currently accounting for more than 17.3 million deaths per year. Type II diabetes is also on the rise with out-of-control numbers. To address these pandemics, we need to treat patients using an individualized patient care approach, but simultaneously gather data to support the precision medicine initiative. Last year the NIH announced the precision medicine initiative to generate novel knowledge regarding diseases, with a near-term focus on cancers, followed by a longer-term aim, applicable to a whole range of health applications and diseases...
October 6, 2016: Current Pharmaceutical Design
Anna Dominiczak
Human primary or essential hypertension is a complex, polygenic trait with some 50% contribution from genes and environment. Richard Lifton and colleagues provided elegant dissection of several rare Mendelian forms of hypertension, exemplified by the glucocorticoid remediable aldosteronism and Liddle's syndrome. These discoveries illustrate that a single gene mutation can explain the entire pathogenesis of severe, early onset hypertension as well as dictating the best treatment.The dissection of the much more common polygenic hypertension has proven much more difficult...
September 2016: Journal of Hypertension
David S Liebeskind
No abstract text is available yet for this article.
August 8, 2016: Trends in Cardiovascular Medicine
Saeed Mehrabi, Yanshan Wang, Donna Ihrke, Hongfang Liu
In the era of precision medicine, accurately identifying familial conditions is crucial for providing target treatment. However, it is challenging to identify familial conditions without detailed family history information. In this work, we studied the documentation of family history of premature cardiovascular disease and hypercholesterolemia. The information on patients' family history of stroke within the Patient-provided information (PPI) forms was compared with the information gathered by clinicians in clinical notes...
2016: AMIA Summits on Translational Science Proceedings
Shih-Pin Chen, Cenk Ayata
PURPOSE OF REVIEW: Spreading depression (SD) is a wave of simultaneous and near-complete depolarization of virtually all cells in brain tissue associated with a transient "depression" of all spontaneous or evoked electrical activity in the brain. SD is widely accepted as the pathophysiological event underlying migraine aura and may play a role in headache pathogenesis in secondary headache disorders such as ischemic stroke, subarachnoid or intracerebral hemorrhage, traumatic brain injury, and epilepsy...
July 2016: Current Pain and Headache Reports
Sara K Rostanski, Randolph S Marshall
No abstract text is available yet for this article.
July 1, 2016: JAMA Neurology
Colleen M Hanley, Peter R Kowey
No abstract text is available yet for this article.
July 2016: Journal of Cardiovascular Electrophysiology
F S Schreiber, I Becker, P Deckert, H Elsbernd, C Isensee
OBJECTIVES: There is minimal information on malnutrition in neurologic-psychiatric patients compared to internal and trauma-surgical patients. The aim of the present study was to explore if there is a correlation of these different disease groups with the nutritional assessment and biochemical markers. DESIGN: Cross - sectional study. SETTING AND PARTICIPANTS: The study was done in a department of geriatric medicine with subspecialisation in neurologic diseases and stroke unit...
April 2016: Journal of Nutrition, Health & Aging
Yuya Masuda, Kazuhiko Matsuno, Chikara Shimizu
In recent years, thrombotic disease, including myocardial infarction and ischemic stroke, has rapidly increased in Japan. To treat and prevent thromboembolism, warfarin has been commonly prescribed for a long period as an oral anticoagulant. However, it is difficult to define an appropriate warfarin dose because of large inter-individual variability in dose requirements and the narrow therapeutic range. Recent pharmacogenomic (PGx) studies have shown that several single nucleotide polymorphisms (SNPs) in CYP2C9 (warfarin metabolic enzyme) and VKORC1 (warfarin target enzyme) are responsible for an individual's warfarin sensitivity...
November 2015: Rinsho Byori. the Japanese Journal of Clinical Pathology
David Della-Morte, Francesca Pacifici, Tatjana Rundek
PURPOSE OF REVIEW: Cerebrovascular disease (CeVD) remains a major cause of death and a leading cause of disability worldwide. CeVD is a complex and multifactorial disease caused by the interaction of vascular risk factors, environment, and genetic factors. In the present article, we discussed genetic susceptibility to CeVD, with particular emphasis on genetic studies of the associations between lipid traits and CeVD. RECENT FINDINGS: Several animal and clinical studies clearly defined genetic predisposition to atherosclerosis and CeVD, and particularly to ischemic stroke...
April 2016: Current Opinion in Lipidology
Iva Sorta-Bilajac Turina, Helena Glibotić Kresina, Svjetlana Gašparović Babić, Suzana Janković, Sandro Kresina, Morana Brkljačić
This paper analyses the current situation in the Croatian health-care system, with special emphasis on the (dis)organization of palliative care within the public health, more precisely gerontology context. Namely, population world-wide is getting older, that is both a statistical and an everyday-medical fact. Today we consider citizens after the age of 65 as the elderly, with a tendency to move the age-limit to 75 years. Croatia on the matter swiftly follows global trends, while literature points to the fact that an increase in the elderly population dictates the need for an organized system of palliative care and hospice building...
June 2015: Collegium Antropologicum
Sulette de Villiers, Albe Swanepoel, Janette Bester, Etheresia Pretorius
Central to the pathogenesis of ischaemic stroke are the normally protective processes of platelet adhesion and activation. Experimental evidence has shown that the ligand-receptor interactions in ischaemic stroke represent a thrombo-inflammatory cascade, which presents research opportunities into new treatment. However, as anti-platelet drugs have the potential to cause severe side effects in ischaemic stroke patients (as well as other vascular disease patients), it is important to carefully monitor the risk of bleeding and risk of thrombus in patients receiving treatment...
May 2, 2016: Journal of Atherosclerosis and Thrombosis
Joosup Kim, Amanda G Thrift, Mark R Nelson, Christopher F Bladin, Dominique A Cadilhac
There are many recommended pharmacological and non-pharmacological therapies for the prevention of stroke, and an ongoing challenge is to improve their uptake. Personalized medicine is seen as a possible solution to this challenge. Although the use of genetic information to guide health care could be considered as the apex of personalized medicine, genetics is not yet routinely used to guide prevention of stroke. Currently personalized aspects of prevention of stroke include tailoring interventions based on global risk, the utilization of individualized management plans within a model of organized care, and patient education...
2015: Vascular Health and Risk Management
David S Liebeskind
BACKGROUND: Precision medicine in cerebrovascular disorders may be greatly advanced by the use of innovative interventional and imaging-intensive registries. Registries have remained subsidiary to randomized controlled trials, yet vast opportunities exist to leverage big data in stroke. SUMMARY: This overview builds upon the rationale for innovative, imaging-intensive interventional registries as a pivotal step in realizing precision medicine for several cerebrovascular disorders...
October 2015: Interventional Neurology
Albe C Swanepoel, Etheresia Pretorius
Stroke is one of the most debilitating thrombotic diseases, and world-wide it is estimated that by, 2030, 23 million people will be affected. Except for the impact on the individual families, the world economy is also affected adversely. Although the medical treatment and knowledge of stroke are both increasing and well-researched, we still do not see a decrease in stroke prevalence. Currently various diagnostic tests are employed to determine the specific type of ischemic stroke as classified by the TOAST criteria...
December 2015: Thrombosis Research
B M Ansari, V Zochios, F Falter, A A Klein
Accurate assessment of intravascular fluid status and measurement of fluid responsiveness have become increasingly important in peri-operative medicine and critical care. The objectives of this systematic review and narrative synthesis were to discuss current controversies surrounding fluid responsiveness and describe the merits and limitations of the major cardiac output monitors in clinical use today in terms of usefulness in measuring fluid responsiveness. We searched the MEDLINE and EMBASE databases (2002-2015); inclusion criteria included comparison with an established reference standard such as pulmonary artery catheter, transthoracic echocardiography and transoesophageal echocardiography...
January 2016: Anaesthesia
Athanase Benetos, Patrick Rossignol, Antonio Cherubini, Laure Joly, Tomasz Grodzicki, Chakravarthi Rajkumar, Timo E Strandberg, Mirko Petrovic
IMPORTANCE: Hypertension treatment is beneficial for most hypertensive patients. The benefits for patients who are very old and frail, especially those taking numerous medications, are less certain. OBJECTIVE: To provide recommendations for the evaluation and treatment of hypertension among patients aged 80 years and older. EVIDENCE ACQUISITION: MEDLINE, PubMed Central, and the Cochrane Database of Systematic Reviews were searched from inception through April 2015, with an emphasis on 2010-2015...
July 14, 2015: JAMA: the Journal of the American Medical Association
Nandu Goswami, Joyce Evans, Stefan Schneider, Melanie von der Wiesche, Edwin Mulder, Andreas Rössler, Helmut Hinghofer-Szalkay, Andrew P Blaber
AIMS: Exposure to artificial gravity (AG) at different G loads and durations on human centrifuges has been shown to improve orthostatic tolerance in men. However, the effects on women and of an individual-specific AG training protocol on tolerance are not known. METHODS: We examined the effects of 90 minutes of AG vs. 90 minutes of supine rest on the orthostatic tolerance limit (OTL), using head up tilt and lower body negative pressure until presyncope of 7 men and 5 women...
2015: PloS One
Hafsa Ahmad, Kiran Khandelwal, Sheeba Saji Samuel, Shivangi Tripathi, Kalyan Mitra, Rajender Singh Sangwan, Rakesh Shukla, Anil Kumar Dwivedi
Withania somnifera Dunal is an Indian medicinal plant with significant pharmacological properties, such as adaptogenic, anti-inflammatory, anti-oxidant, anti-platelet, anti-hypertensive, hypoglycemic and hypolipidemic effects. Several chemotypes of W. somnifera include NMITLI-101, NMITLI-118 and NMITLI-128. The present work elaborates the optimization and development of a liposomal delivery system for efficient delivery of NMITLI118RT+ [a standardized ethanolic extract of a new chemotype of W. somnifera Dunal (NMITLI-118) roots] against cerebral stroke in rats...
May 28, 2015: Drug Delivery
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