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Precision medicine stroke

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https://www.readbyqxmd.com/read/29912100/big-data-for-a-big-problem-precision-medicine-of-stroke-in-neurocritical-care
#1
David S Liebeskind
No abstract text is available yet for this article.
July 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29874173/induced-pluripotent-stem-cells-for-cardiovascular-disease-modeling-and-precision-medicine-a-scientific-statement-from-the-american-heart-association
#2
REVIEW
Kiran Musunuru, Farah Sheikh, Rajat M Gupta, Steven R Houser, Kevin O Maher, David J Milan, Andre Terzic, Joseph C Wu
Induced pluripotent stem cells (iPSCs) offer an unprece-dented opportunity to study human physiology and disease at the cellular level. They also have the potential to be leveraged in the practice of precision medicine, for example, personalized drug testing. This statement comprehensively describes the provenance of iPSC lines, their use for cardiovascular disease modeling, their use for precision medicine, and strategies through which to promote their wider use for biomedical applications. Human iPSCs exhibit properties that render them uniquely qualified as model systems for studying human diseases: they are of human origin, which means they carry human genomes; they are pluripotent, which means that in principle, they can be differentiated into any of the human body's somatic cell types; and they are stem cells, which means they can be expanded from a single cell into millions or even billions of cell progeny...
January 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29866706/interrogating-cortical-function-with-transcranial-magnetic-stimulation-insights-from-neurodegenerative-disease-and-stroke
#3
REVIEW
Smriti Agarwal, Giacomo Koch, Argye E Hillis, William Huynh, Nick S Ward, Steve Vucic, Matthew C Kiernan
Transcranial magnetic stimulation (TMS) is an accessible, non-invasive technique to study cortical function in vivo. TMS studies have provided important pathophysiological insights across a range of neurodegenerative disorders and enhanced our understanding of brain reorganisation after stroke. In neurodegenerative disease, TMS has provided novel insights into the function of cortical output cells and the related intracortical interneuronal networks. Characterisation of cortical hyperexcitability in amyotrophic lateral sclerosis and altered motor cortical function in frontotemporal dementia, demonstration of cholinergic deficits in Alzheimer's disease and Parkinson's disease are key examples where TMS has led to advances in understanding of disease pathophysiology and potential mechanisms of propagation, with the potential for diagnostic applications...
June 4, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29844141/interdisciplinary-models-for-research-and-clinical-endeavors-in-genomic-medicine-a-scientific-statement-from-the-american-heart-association
#4
REVIEW
Kiran Musunuru, Pankaj Arora, John P Cooke, Jane F Ferguson, Ray E Hershberger, Kathleen T Hickey, Jin-Moo Lee, João A C Lima, Joseph Loscalzo, Naveen L Pereira, Mark W Russell, Svati H Shah, Farah Sheikh, Thomas J Wang, Calum A MacRae
The completion of the Human Genome Project has unleashed a wealth of human genomics information, but it remains unclear how best to implement this information for the benefit of patients. The standard approach of biomedical research, with researchers pursuing advances in knowledge in the laboratory and, separately, clinicians translating research findings into the clinic as much as decades later, will need to give way to new interdisciplinary models for research in genomic medicine. These models should include scientists and clinicians actively working as teams to study patients and populations recruited in clinical settings and communities to make genomics discoveries-through the combined efforts of data scientists, clinical researchers, epidemiologists, and basic scientists-and to rapidly apply these discoveries in the clinic for the prediction, prevention, diagnosis, prognosis, and treatment of cardiovascular diseases and stroke...
June 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29778312/biomarker-signatures-of-sickle-cell-disease-severity
#5
Mengtian Du, Sarah Van Ness, Victor Gordeuk, Sayed M Nouraie, Sergei Nekhai, Mark Gladwin, Martin H Steinberg, Paola Sebastiani
Identifying sickle cell disease patients at high risk of complications could lead to personalized treatment and better prognosis but despite many advances prediction of the clinical course of these patients remains elusive. We propose a system-type approach to discover profiles of multiple, common biomarkers that correlate with morbidity and mortality in sickle cell disease. We used cluster analysis to discover 17 signatures of 17 common circulating biomarkers in 2320 participants of the Cooperative Study of Sickle Cell Disease, and evaluated the association of these signatures with risk for stroke, pain, leg ulceration, acute chest syndrome, avascular necrosis, seizure, death, and trend of fetal hemoglobin and hemolysis using longitudinally collected data...
May 16, 2018: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29743322/protocol-for-a-randomised-controlled-trial-to-evaluate-the-effectiveness-of-the-care-for-stroke-intervention-in-india-a-smartphone-enabled-carer-supported-educational-intervention-for-management-of-disabilities-following-stroke
#6
K Sureshkumar, G V S Murthy, Hannah Kuper
INTRODUCTION: The rising prevalence of stroke and stroke-related disability witnessed globally over the past decades may cause an overwhelming demand for rehabilitation services. This situation is of concern for low-income and middle-income countries like India where the resources for rehabilitation are often limited. Recently, a smartphone-enabled carer-supported educational intervention for management of physical disabilities following stroke was developed in India. It was found to be feasible and acceptable, but evidence of effectiveness is lacking...
May 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29729639/method-development-and-application-for-multi-component-quantification-in-rats-after-oral-administration-of-longxuetongluo-capsule-by-uhplc-ms-ms
#7
Jing Sun, Huixia Huo, Yuelin Song, Jiao Zheng, Yunfang Zhao, Wenzhe Huang, Yonghua Wang, Jingbo Zhu, Pengfei Tu, Jun Li
Although wide applications towards ischemic stroke in clinic, the therapeutic materials of Longxuetongluo Capsule (LTC) that is composed of total phenolic extract of Chinese dragon's blood, are still largely unclear. Exposure pattern characterization of those drug-derived components in vivo, notably in circulation system has been recommended as a viable approach to disclose the effective components of a given herbal medicine. Herein, we aimed to develop a robust method being capable of multi-component quantification in either rat plasma or tissues following oral administration of LTC, and to clarify the kinetic profiles of 11 primary drug-derived phenolic derivatives...
April 22, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29686787/pattern-duration-of-stay-and-outcomes-of-medical-admissions-a-report-from-teaching-community-hospital-in-assir-region-saudi-arabia
#8
Mushabab A Al-Ghamdi, Aref A Bin Abdulhak
Background : Population-based studies are the gold standard to understand the burden of different diseases, plan health care policy and resource allocation, and provide an accurate estimate of disease several disease indices including mortality. However, population-based studies are difficult to undertake in a resource-limited situation where no robust data bases and disease registries are available. Therefore, hospital-based cohorts may be used to inform about the community health. Objectives: We sought to study the pattern of disease causing admission, hospital stay, and outcomes of medical admissions to King Abdullah Hospital in Bisha in order to inform clinicians, public health professionals, and policymakers about the current status of diseases within the community in Bisha...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29590102/common-%C3%AE-globin-variants-modify-hematologic-and-other-clinical-phenotypes-in-sickle-cell-trait-and-disease
#9
Laura M Raffield, Jacob C Ulirsch, Rakhi P Naik, Samuel Lessard, Robert E Handsaker, Deepti Jain, Hyun M Kang, Nathan Pankratz, Paul L Auer, Erik L Bao, Joshua D Smith, Leslie A Lange, Ethan M Lange, Yun Li, Timothy A Thornton, Bessie A Young, Goncalo R Abecasis, Cathy C Laurie, Deborah A Nickerson, Steven A McCarroll, Adolfo Correa, James G Wilson, Guillaume Lettre, Vijay G Sankaran, Alex P Reiner
Co-inheritance of α-thalassemia has a significant protective effect on the severity of complications of sickle cell disease (SCD), including stroke. However, little information exists on the association and interactions for the common African ancestral α-thalassemia mutation (-α3.7 deletion) and β-globin traits (HbS trait [SCT] and HbC trait) on important clinical phenotypes such as red blood cell parameters, anemia, and chronic kidney disease (CKD). In a community-based cohort of 2,916 African Americans from the Jackson Heart Study, we confirmed the expected associations between SCT, HbC trait, and the -α3...
March 2018: PLoS Genetics
https://www.readbyqxmd.com/read/29472380/spontaneous-coronary-artery-dissection-current-state-of-the-science-a-scientific-statement-from-the-american-heart-association
#10
REVIEW
Sharonne N Hayes, Esther S H Kim, Jacqueline Saw, David Adlam, Cynthia Arslanian-Engoren, Katherine E Economy, Santhi K Ganesh, Rajiv Gulati, Mark E Lindsay, Jennifer H Mieres, Sahar Naderi, Svati Shah, David E Thaler, Marysia S Tweet, Malissa J Wood
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction...
May 8, 2018: Circulation
https://www.readbyqxmd.com/read/29464356/weighing-the-anti-ischemic-benefits-and-bleeding-risks-from-aspirin-therapy-a-rational-approach
#11
REVIEW
Sagar Dugani, Jeffrey M Ames, JoAnn E Manson, Samia Mora
PURPOSE OF REVIEW: The role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention...
February 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29459990/-acute-treatment-and-secondary-prophylaxis-of-ischemic-stroke-an-excellent-example-for-personalized-medicine
#12
R Wachter, K Gröschel
About a quarter of a million people in Germany suffer a stroke every year. Stroke is the most dreaded cardiovascular disease, even before myocardial infarction and heart failure. In the last two to three years, significant progress has been made in acute treatment, secondary prophylaxis in patients with patent foramen ovale, and the interdisciplinary evaluation of atrial fibrillation as the cause of the stroke. These new findings allow for more precise treatment.
March 2018: Der Internist
https://www.readbyqxmd.com/read/29283026/restoring-motor-functions-after-stroke-multiple-approaches-and-opportunities
#13
Estelle Raffin, Friedhelm C Hummel
More than 1.5 million people suffer a stroke in Europe per year and more than 70% of stroke survivors experience limited functional recovery of their upper limb, resulting in diminished quality of life. Therefore, interventions to address upper-limb impairment are a priority for stroke survivors and clinicians. While a significant body of evidence supports the use of conventional treatments, such as intensive motor training or constraint-induced movement therapy, the limited and heterogeneous improvements they allow are, for most patients, usually not sufficient to return to full autonomy...
November 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
https://www.readbyqxmd.com/read/29280924/metabolomics-and-precision-medicine-in-trauma-the-state-of-the-field
#14
Sudha P Jayaraman, Rahul J Anand, Jonathan H DeAntonio, Martin Mangino, Michel B Aboutanos, Vigneshwar Kasirajan, Rao Ivatury, Alex B Valadka, Olena Glushakova, Ronald L Hayes, Lorin M Bachmann, Gretchen M Brophy, Daniel Contaifer, Urszula O Warncke, Donald F Brophy, Dayanjan S Wijesinghe
Trauma is a major problem in the United States. Mortality from trauma is the number one cause of death under the age of 45 in the US and is the third leading cause of death for all age groups. There are nearly 200,000 deaths per year due to trauma in the US at a cost of over $671 billion in combined health care costs and lost productivity. Unsurprisingly, trauma accounts for about 30% of all life-years lost in the US. Due to immense development of trauma systems, a large majority of trauma patients survive the injury but then go on to die from complications arising from the injury...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29237706/patient-characteristics-resource-use-and-outcomes-associated-with-general-internal-medicine-hospital-care-the-general-medicine-inpatient-initiative-gemini-retrospective-cohort-study
#15
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Peter Cram, Irfan A Dhalla, Stephen W Hwang, Andreas Laupacis, Muhammad M Mamdani, Steven Shadowitz, Ross Upshur, Robert J Reid, Fahad Razak
BACKGROUND: The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. METHODS: This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29170312/15-a-clinical-decision-tool-for-prescribing-anti-platelet-medication-for-patients-with-suspected-acute-coronary-syndrome-pam
#16
Charles Reynard, Rick Body
BACKGROUND: The benefit of antiplatelet medication in confirmed acute coronary syndrome (ACS) is well established. In the Emergency Department (ED) diagnostic uncertainty may lead to over-treatment, with consequent risks (e.g., bleeding), or under-treatment, compromising clinical outcomes. Clinicians must subjectively balance the anticipated risks and benefits with their perceived probability of ACS in order to decide whether to prescribe these medications. We aimed to construct a clinical model to optimise and personalise recommendations for anti-platelet prescription in this context...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29114077/the-ubiquitin-e3-ligase-traf6-exacerbates-ischemic-stroke-by-ubiquitinating-and-activating-rac1
#17
Tao Li, Juan-Juan Qin, Xia Yang, Yan-Xiao Ji, Fangliang Guo, Wen-Lin Cheng, Xiaolin Wu, Fu-Han Gong, Ying Hong, Xue-Yong Zhu, Jun Gong, Zhihua Wang, Zan Huang, Zhi-Gang She, Hongliang Li
Stroke is one of the leading causes of morbidity and mortality worldwide. Inflammation, oxidative stress, apoptosis, and excitotoxicity contribute to neuronal death during ischemic stroke; however, the mechanisms underlying these complicated pathophysiological processes remain to be fully elucidated. Here, we found that the expression of tumor necrosis factor receptor-associated factor 6 (TRAF6) was markedly increased after cerebral ischemia/reperfusion (I/R) in mice. TRAF6 ablation in male mice decreased the infarct volume and neurological deficit scores, and decreased pro-inflammatory signaling, oxidative stress and neuronal death after cerebral I/R, whereas transgenic overexpression of TRAF6 in male mice exhibited opposite effects...
November 7, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29105736/stroke-identification-by-criteria-based-dispatch-a-register-based-study
#18
E N Ellensen, H Naess, T Wisborg, S Hunskaar, E Zakariassen
BACKGROUND: Rapid and precise dispatch of resources is a key element in pre-hospital emergency medicine. Emergency medical communication centres (EMCCs) dispatch resources based on protocols and guidelines, balancing the acute need of the individual and the resource allocation of the pre-hospital emergency medical system. The aim of this study was to determine the validity of stroke identification by the Norwegian dispatch guidelines. METHOD AND MATERIAL: This was a register-based study where patients suspected for stroke were compared to those with the final diagnosis of stroke as an indicator group for the guideline validation...
January 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29103068/antiplatelet-therapy-for-secondary-prevention-of-vascular-disease-complications
#19
REVIEW
Rahul R Goli, Mayur M Contractor, Ashwin Nathan, Sony Tuteja, Taisei Kobayashi, Jay Giri
PURPOSE OF REVIEW: Platelets are activated upon interaction with injured vascular endothelium to form a primary hemostatic plug. Pathogenic thrombosis driven by platelet aggregation can occur in the setting of vascular disease leading to ischemic events. The use of antiplatelet agents has become a mainstay for prevention of the secondary complications of vascular disease. This review summarizes seminal and recent literature related to this area. RECENT FINDINGS: Aspirin is a cornerstone of antiplatelet therapy for coronary artery disease and cerebrovascular disease for prevention of myocardial infarction, stroke, and vascular death...
November 4, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29060181/a-new-hand-function-assessment-method-using-an-infrared-imaging-device
#20
Qinag Fang, Xudong Gu
Many post-stroke patients suffer various degrees of hand function and fine motor skills impairment. Both passive and active hand rehabilitation training are beneficial in improving strength and dexterity of hands. However, hand rehabilitation programs should be prescribed, based on an accurate assessment of hand function. Here we propose a novel method for hand function assessment that can accurately measure multiple joint angles of a hand simultaneously using a portable infrared imaging device. Different from the traditional assessment methods that are often based on clinicians' subjective observation and ordinal charts, this method provides an accurate, fast and objective evaluation using infrared imaging sensors...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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