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Evidence generating medicine

Junlong Wu, Hongkai Wang, Christopher J Ricketts, Youfeng Yang, Maria J Merino, Hailiang Zhang, Guohai Shi, Hualei Gan, W Marston Linehan, Yao Zhu, Dingwei Ye
BACKGROUND: An inherited susceptibility to renal cancers is associated with multiple predisposing genes, but most screening tests are limited to patients with a family history. Next-generation sequencing (NGS)-based multigene panels provide an efficient and adaptable tool for investigating pathogenic germline mutations on a larger scale. This study investigated the frequency of pathogenic germline mutations in renal cancer predisposition genes in patients with sporadic, early-onset disease...
December 12, 2018: Cancer
Yasamin Veziari, Saravana Kumar, Matthew Leach
BACKGROUND: As Complementary and Alternative medicine (CAM) grows in popularity, there is overt recognition for research evidence to inform clinical practice. While various strategies have been trialed to overcome the barriers to such progress, it is important to first understand the extent to which these barriers impact the conduct and application of CAM research. This study aimed to garner consensus and agreement among CAM researchers and practitioners in refining and validating a preliminary survey instrument for measuring these barriers...
December 14, 2018: BMC Complementary and Alternative Medicine
Xuanxuan Xiong, Bo Lu, Qingzhong Tian, Haiyan Zhang, Mingbo Wu, Hao Guo, Qianjin Zhang, Xiangcheng Li, Tian Zhou, Yun Wang
Cinobufagin is a cardiotoxic bufanolide steroid secreted by the Asiatic toad Bufo gargarizans. Cinobufagin is one of the active ingredients in the anticancer Chinese medicine called Chan Su, which was demonstrated to be an effective treatment for gastric cancer. Increasing evidence shows that inhibition of autophagy has a pro‑apoptotic effect on human gastric cancer cells. The aim of the present study was to investigate the relationship between cinobufagin, autophagy and apoptosis in gastric cancer. Autophagy was induced or inhibited in the human gastric cancer cell line SGC‑7901 by incubation in HBSS media or by treatment with 3‑methyladenine or ATG5 siRNA, respectively...
October 31, 2018: Oncology Reports
Lulu Yang, Chenhui Zhang, Wei Wang, Junqi Wang, Yuan Xiao, Wenli Lu, Xiaoyu Ma, Lifen Chen, Jihong Ni, Defen Wang, Jinxiu Shi, Zhiya Dong
BACKGROUND: Dwarfism is a common severe growth disorder, but the etiology is unclear in the majority of cases. Recombinant human growth hormone may be a treatment option, but it has limited efficacy. The currently known laboratory assays do not meet the precision requirements for clinical diagnosis. Here, we have constructed a targeted next-generation sequencing (NGS) panel of selected genes that are suspected to be associated with dwarfism for genetic screening. METHODS: Genetic screening of 91 children with short stature of unknown etiology was performed with the help of the NGS panel...
December 12, 2018: BMC Medical Genetics
Jean Marc Guilé, Laure Boissel, Stéphanie Alaux-Cantin, Sébastien Garny de La Rivière
Using the same Diagnostic and Statistical Manual of Mental Disorders, fifth version ( DSM-V ) criteria as in adults, borderline personality disorder (BPD) in adolescents is defined as a 1-year pattern of immature personality development with disturbances in at least five of the following domains: efforts to avoid abandonment, unstable interpersonal relationships, identity disturbance, impulsivity, suicidal and self-mutilating behaviors, affective instability, chronic feelings of emptiness, inappropriate intense anger, and stress-related paranoid ideation...
2018: Adolescent Health, Medicine and Therapeutics
Anshu Rajnish Sharma
Evidence-based historical accounts of critical events, which shaped nuclear medicine in India today, are presented in this article. There was parallel activity happening in the northern and western region of India in the early 60s. Radiation Medicine Center (RMC) at Mumbai inaugurated in September 1963 by Dr. Bhabha; and Institute of Nuclear Medicine and Allied Sciences, Delhi dedicated to the nation in February 1964. The isotope division of Bhabha Atomic Research Center endured as the backbone in the supply of indigenously produced medical radioisotopes in research reactors APSARA (1958) and CIRUS (1960)...
November 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Yang He, Fu Peng, Cao Deng, Liang Xiong, Zi-Yan Huang, Ruo-Qi Zhang, Meng-Jia Liu, Cheng Peng
The Lamiales order presents highly varied genome sizes and highly specialized life strategies. Patchouli, Pogostemon cablin (Blanco) Benth. from the Lamiales, has been widely cultivated in tropical and subtropical areas of Asia owing to high demand for its essential oil. Here, we generated ~681 Gb genomic sequences (~355X coverage) for the patchouli, and the assembled genome is ~1.91 Gb and with 110,850 predicted protein-coding genes. Analyses showed clear evidence of whole-genome octuplication (WGO) since the pan-eudicots γ triplication, which is a recent and exclusive polyploidization event and occurred at ~6...
December 11, 2018: Scientific Data
Laurie P Whitsel, John Wilbanks, Mark D Huffman, Jennifer L Hall
This paper focuses on the significant role of government in promoting precision medicine and public health and the potential intersection with healthy living (HL) and population health. Recent research has highlighted the interplay between genes, environments and different exposures individuals and populations experience over a lifetime. These interactions between longitudinal behaviors, epigenetics, and expression of the human genome have the potential to transform health and well-being, even within a single generation...
December 7, 2018: Progress in Cardiovascular Diseases
Prashant Mahajan, Timothy Visclosky, Sanjeev Bhoi, Sagar Galwankar, Nathan Kuppermann, Robert Neumar
Despite the fact that emergency care can impact health of populations, the global epidemiology of emergencies in children and adults is unknown and substantial variation exists in emergency infrastructure among different nations, especially among the low and middle income countries. Various research networks which are etiology specific or subspecialty specific, including emergency care based networks have positively impacted the health of populations. However, emergency departments (ED) in low and middle income counties are underrepresented in most international networks...
November 23, 2018: American Journal of Emergency Medicine
Ulf Näslund, Nawi Ng, Anna Lundgren, Eva Fhärm, Christer Grönlund, Helene Johansson, Bernt Lindahl, Bertil Lindahl, Kristina Lindvall, Stefan K Nilsson, Maria Nordin, Steven Nordin, Emma Nyman, Joacim Rocklöv, Davide Vanoli, Lars Weinehall, Patrik Wennberg, Per Wester, Margareta Norberg
BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention. METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden...
December 3, 2018: Lancet
(no author information available yet)
Objective: To obtain baseline data of pediatricians' clinical use of antibacterial agents in children in China, and provide evidence for the follow-up of guidelines for the diagnosis and treatment of children's clinical medications and the development of rational drug management measures and norms. Methods: A multi-center cross-sectional study was designed to conduct a network electronic questionnaire survey of doctors with child prescription rights in hospitals of all provinces, municipalities and autonomous regions across the country through cluster sampling to understand the current status of antibacterial drugs use in 2016...
December 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Héléna A Gaspar, Christopher Hübel, Gerome Breen
Summary: Results from hundreds of genome-wide association studies (GWAS) are now freely available and offer a catalogue of the association between phenotypes across medicine with variants in the genome. With the aim of using this data to better understand therapeutic mechanisms, we have developed Drug Targetor, a web interface that allows the generation and exploration of drug-target networks of hundreds of phenotypes using GWAS data. Drug Targetor networks consist of drug and target nodes ordered by genetic association and connected by drug-target or drug-gene relationship...
December 4, 2018: Bioinformatics
Simone Gambazza
An attempt to distinguish science from folklore in medical practice was made in 1991, when a new paradigm called evidence-based medicine (EBM) officially appeared. Although this approach was meant to avoid clinical entropy, it might constitute a barrier for contemporary health enhancement, generating results that could be selectively chosen or obtained through misapplication of frequent statistics. At worst, only few health professions can take advantage from this supposed demarcation criterion, lacking the infrastructure and institutional support to carry on research and thus offering a risky disservice to patients...
2018: Journal of Allied Health
Habib Haybar, Saeid Shahrabi, Hadi Rezaeeyan, Reza Shirzad, Najmaldin Saki
Endothelial cells (ECs) are the innermost layer of blood vessels that play important roles in homeostasis and vascular function. However, recent evidence suggests that the onset of inflammation and the production of reactive oxygen species impair the function of ECs and are a main factor in the development of cardiovascular disease (CVD). In this study, we investigated the effects of inflammatory markers, oxidative stress, and treatment on ECs in CVD patients. This review article is based on the material obtained from PubMed up to 2018...
December 1, 2018: Cardiovascular Toxicology
Thomas M Polasek, Craig R Rayner, Richard W Peck, Andrew Rowland, Holly Kimko, Amin Rostami-Hodjegan
Model-informed precision dosing (MIPD) is biosimulation in healthcare to predict the drug dose for a given patient based on their individual characteristics that is most likely to improve efficacy and/or lower toxicity compared with traditional dosing. Despite widespread use of biosimulation in drug development, MIPD has not been adopted beyond academic-hospital centers. A reason for this is that MIPD requires more supporting evidence in the language that everyday doctors understand-evidence-based medicine...
November 30, 2018: Clinical Pharmacology in Drug Development
Sherin Jose Chockattu, Deepak Byathnal Suryakant, Sophia Thakur
Magnetic resonance imaging (MRI) is an advanced diagnostic tool used in both medicine and dentistry. Since it functions based on a strong uniform static magnetic field and radiofrequency pulses, it is advantageous over imaging techniques that rely on ionizing radiation. Unfortunately, the magnetic field and radiofrequency pulses generated within the magnetic resonance imager interact unfavorably with dental materials that have magnetic properties. This leads to unwanted effects such as artifact formation, heat generation, and mechanical displacement...
November 2018: Restorative Dentistry & Endodontics
Bao-Yong Lai, Ning Liang, Hui-Juan Cao, Guo-Yan Yang, Li-Yan Jia, Rui-Xue Hu, Chun-Li Lu, Nan-Qi Zhao, Sai-Nan Fang, Xue-Han Liu, Ya-Jing Zhang, Yu-Tong Fei, Da-Rong Wu, Jian-Ping Liu
OBJECTIVE: To evaluate the benefits and harms of pediatric Tui Na as a non-pharmaceutical Chinese medicine therapy for acute diarrhea in children under 5 years of age. DESIGN: Systematic review and meta-analysis of randomized clinical trials. METHODS: We searched seven major English and Chinese databases from their inception to January 2018 for randomized clinical trials (RCTs) comparing pediatric Tui Na therapy with conventional medicine (montmorillonite/diosmectite or probiotics used alone or in combination)...
December 2018: Complementary Therapies in Medicine
Carole A Federico, Taiji Wang, Adélaïde Doussau, Jeffrey S Mogil, Dean Fergusson, Jonathan Kimmelman
Importance: After a drug receives regulatory approval, researchers often pursue small, underpowered trials, called exploratory trials, aimed at testing additional indications. If favorable early findings from exploratory trials are not promptly followed by confirmatory trials, then physicians, patients, and payers can be left uncertain about a drug's clinical value (clinical agnosticism). Such findings may encourage the off-label use of ineffective drugs. Objective: To characterize the relationship between exploratory and confirmatory postapproval trials for the blockbuster drug, pregabalin (Lyrica)...
November 26, 2018: JAMA Internal Medicine
Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher
INTRODUCTION: Acute ischemic stroke is a leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA. OBJECTIVE: This review evaluates literature and utility of tenecteplase for treatment of acute ischemic stroke...
November 15, 2018: American Journal of Emergency Medicine
Benedikt E Maissenhaelter, Ashley L Woolmore, Peter M Schlag
Background: In recent years there has been an increasing, partially also critical interest in understanding the potential benefits of generating real-world evidence (RWE) in medicine. Objectives: The benefits and limitations of RWE in the context of randomized controlled trials (RCTs) are described along with a view on how they may complement each other as partners in the generation of evidence for clinical oncology. Moreover, challenges and success factors in building an effective RWE network of cooperating cancer centers are analyzed and discussed...
2018: Der Onkologe: Organ der Deutschen Krebsgesellschaft E.V
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