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Medical Breakthroughs

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https://www.readbyqxmd.com/read/28716338/changing-innovation-into-a-registered-product-from-concept-to-regulatory-approval
#1
Linda Rhodes
Innovation in animal health pharmaceuticals is important to address unmet and underserved medical needs, and often comes from products initially developed for human medicine. The purpose of the review is to help readers understand how breakthroughs from human biotechnology may be developed for use in veterinary medicine, while understanding the key drivers to success, the difficulties of regulatory approval, and the realistic risks and rewards of developing applications for animals. The types of human drugs which may be useful for veterinary applications are reviewed, including examples...
July 6, 2017: Theriogenology
https://www.readbyqxmd.com/read/28716109/clinical-characteristics-and-outcomes-of-pseudomonas-aeruginosa-bacteremia-in-febrile-neutropenic-children-and-adolescents-with-the-impact-of-antibiotic-resistance-a-retrospective-study
#2
Hyo Sup Kim, Bo Kyoung Park, Seong Koo Kim, Seung Beom Han, Jae Wook Lee, Dong-Gun Lee, Nack-Gyun Chung, Bin Cho, Dae Chul Jeong, Jin Han Kang
BACKGROUND: Although the proportion of Pseudomonas aeruginosa infections has reduced after the introduction of antibiotics with anti-pseudomonal effects, P. aeruginosa bacteremia still causes high mortality in immunocompromised patients. This study determined the clinical characteristics and outcomes of P. aeruginosa bacteremia and the antibiotic susceptibilities of strains isolated from febrile neutropenic patients. METHODS: Thirty-one febrile neutropenic children and adolescents with underlying hematologic/oncologic disorders diagnosed with P...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28711749/validation-of-the-korean-version-of-the-breakthrough-pain-assessment-tool-in-cancer-patients
#3
Jinyoung Shin, Sung Jung Cho, Jungkwon Lee, Youn Seon Choi
CONTEXT: Breakthrough cancer pain (BTcP) has not been properly evaluated and treated because there are relatively few available measurements. The breakthrough pain assessment tool (BAT) is currently recognized as a brief, multidimensional, and reliable measurement. OBJECTIVES: To validate the Korean version of the BAT (BAT-K) in adult cancer patients METHODS: We conducted a forward-backward translation and cross-cultural equivalence test. The psychometric properties with 120 cancer patients were assessed using factor analysis, reliability, and validity...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#4
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28695243/cns-metabolism-in-high-risk-drug-abuse-insights-gained-from-1-h-31-p-mrs-and-pet
#5
REVIEW
S Bodea
BACKGROUND: High-risk drug consumption is a matter of great concern for public health actors in industrialised countries. The latest trends show a market tendency towards diversification and increasing demand for high-purity synthetic drugs. While most consumers seek medical help after cannabis use, it is high-risk drugs like cocaine, heroin and amphetamines that account for most of the 1000 drug-related deaths that occur in Germany every year. PURPOSE: This article presents the most prominent in vivo cerebral metabolic information in cocaine, heroin and methamphetamine users provided by MRI spectroscopy and PET imaging...
July 10, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28690642/breakthrough-attacks-in-patients-with-hereditary-angioedema-receiving-long-term-prophylaxis-are-responsive-to-icatibant-findings-from-the-icatibant-outcome-survey
#6
Werner Aberer, Marcus Maurer, Laurence Bouillet, Andrea Zanichelli, Teresa Caballero, Hilary J Longhurst, Amandine Perrin, Irmgard Andresen
BACKGROUND: Patients with hereditary angioedema (HAE) due to C1-inhibitor deficiency (C1-INH-HAE) experience recurrent attacks of cutaneous or submucosal edema that may be frequent and severe; prophylactic treatments can be prescribed to prevent attacks. However, despite the use of long-term prophylaxis (LTP), breakthrough attacks are known to occur. We used data from the Icatibant Outcome Survey (IOS) to evaluate the characteristics of breakthrough attacks and the effectiveness of icatibant as a treatment option...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28685051/personalized-medicine-could-transform-healthcare
#7
Sunil Mathur, Joseph Sutton
Personalized medicine (PM) is about tailoring a treatment as individualized as the disease. The approach relies on identifying genetic, epigenomic, and clinical information that allows the breakthroughs in our understanding of how a person's unique genomic portfolio makes them vulnerable to certain diseases. PM approach is a complete extension of traditional approach (One-Size-Fits-All) to increasing our ability to predict which medical treatments will be safe and effective for individual patient, and which ones will not be, based on the patient's unique genetic profile...
July 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28684311/hippo-effector-yap-directly-regulates-the-expression-of-pd-l1-transcripts-in-egfr-tki-resistant-lung-adenocarcinoma
#8
Byung Soo Lee, Dong Il Park, Da Hye Lee, Jeong Eun Lee, Min-Kyung Yeo, Yeon Hee Park, Dae Sik Lim, Wonyoung Choi, Da Hye Lee, Geon Yoo, Han-Byul Kim, Dahyun Kang, Jae Young Moon, Sung Soo Jung, Ju Ock Kim, Hee Sun Park, Chaeuk Chung
Developments of EGFR-TKI and immunotherapy targeting the PD1/PD-L1 pathway are considered most important medical breakthroughs in lung cancer treatment. Nowadays, 3rd generation EGFR TKI is widely used for T790M positive 1st and 2nd EGFR-TKI resistant lung cancer patients. Immunotherapy is powerful option for lung cancer patients without drug targets and chemotherapy resistant patients. It also has changed the concept of conventional anti-cancer therapy in the point of regulating tumor microenvironment. There are many studies linking these two important pathways...
July 3, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28682859/multidisciplinary-interventions-and-continuous-quality-improvement-to-reduce-unplanned-extubation-in-adult-intensive-care-units-a-15-year-experience
#9
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Chung-Han Ho, Chin-Ming Chen, Willy Chou
We conduct a retrospective study of patients with unplanned extubation (UE) in adult intensive care units (ICU) at a medical center. In 2001, a multidisciplinary team of intensivists, senior residents, nurses, and respiratory therapists was established at Chi Mei Medical Center. The improvement interventions, implemented between 2001 and 2015, were organized around 8 key areas: standardizing procedures, improving communication skills, revising sedation and weaning protocols, changing strategies for restraints, establishing a task force for identifying and managing high-risk patients, using new quality-improvement models as breakthrough series and team resource management, using the strategy of accountability without assigning blame, and changing a new method to secure endotracheal tube...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28679666/anticipating-the-emergence-of-infectious-diseases
#10
Tobias S Brett, John M Drake, Pejman Rohani
In spite of medical breakthroughs, the emergence of pathogens continues to pose threats to both human and animal populations. We present candidate approaches for anticipating disease emergence prior to large-scale outbreaks. Through use of ideas from the theories of dynamical systems and stochastic processes we develop approaches which are not specific to a particular disease system or model, but instead have general applicability. The indicators of disease emergence detailed in this paper can be classified into two parallel approaches: a set of early-warning signals based around the theory of critical slowing down and a likelihood-based approach...
July 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28674714/genexpert-technology-a-breakthrough-for-the-diagnosis-of-tuberculous-pericarditis-and-pleuritis-in-less-than-2-hours
#11
Muhammad Saeed, Mobeen Ahmad, Shagufta Iram, Saba Riaz, Mehwish Akhtar, Maleeha Aslam
OBJECTIVES: To evaluate the diagnostic validity of GeneXpert for the detection of Mycobacterium tuberculosis (MTB) in pericardial and pleural effusions samples. METHODS: A cross sectional study was conducted at the Mycobacteriology Laboratory, Allama Iqbal Medical College, Lahore, Pakistan. A total of 286 (158 pleural and 128 pericardial fluids) samples were received from tuberculosis (TB) suspects between January 2014 and August 2016. Every sample was processed for Ziehl-Neelsen (Zn) smear, Lowenstein Jensen (LJ) culture, GeneXpert MTB/RIF assay according to standard protocols...
July 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28674056/clinical-features-of-breakthrough-acinetobacter-bacteremia-during-carbapenem-therapy-a-multicenter-study
#12
Yi-Tzu Lee, Yung-Chih Wang, Shu-Chen Kuo, Chung-Ting Chen, Chang-Pan Liu, Yuag-Meng Liu, Te-Li Chen, Ya-Sung Yang
Breakthrough Acinetobacter bacteremia during carbapenem therapy is not uncommon and creates therapeutic dilemmas for clinicians. This study was conducted to evaluate the clinical and microbiological characteristics of breakthrough Acinetobacter bacteremia during carbapenem therapy and to assess the efficacy of various antimicrobial therapies. We analyzed 100 adults who developed breakthrough Acinetobacter bacteremia during carbapenem therapy at 4 medical centers over a 6-year period. Their 30-day mortality rate was 57...
July 3, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28673652/innovation-best-practices-in-the-medical-device-industry
#13
Partha P Ray, Joseph F Amaral, Piet Hinoul
Advances in patient care often germinate from keen clinical insights and a needs-based approach to innovation. Although there is an important role for incremental improvements to existing solutions, transformational innovation is what truly drives real shifts in clinical outcomes and subsequently patient satisfaction, market access, and economic value. A good example of this is the evolution of the coronary stent market. The best innovation programs are focused on unmet needs rather than solutions, call for a careful articulation of the specific problems to be solved, involve a deep dive within a clinical area, and seek to prioritize research and development investments into areas where the greatest impact can be expected...
June 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28673279/pharmacogenetic-evaluation-to-assess-breakthrough-psychosis-with-aripiprazole-long-acting-injection-a-case-report
#14
Seenae Eum, Mark E Schneiderhan, Jacob T Brown, Adam M Lee, Jeffrey R Bishop
BACKGROUND: Given the complex nature of symptom presentation and medication regimens, psychiatric clinics may benefit from additional tools to personalize treatments. Utilizing pharmacogenetic information may be helpful in assessing unique responses to therapy. We report herein a case of wearing-off phenomena during treatment with aripiprazole long-acting injectable (LAI) and a proof of concept strategy of how pharmacogenetic information may be used to assess possible genetic factors and also hypothesize potential mechanisms for further study...
July 3, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28654446/sepsis-in-obstetrics-pathophysiology-and-diagnostic-definitions
#15
Sheryl E Parfitt, Mary L Bogat, Sandra L Hering, Cheryl Roth
In spite of many medical breakthroughs, sepsis continues to be challenging to identify, treat, and successfully resolve, including among the obstetric population. Sepsis is the result of an overactive, complex inflammatory response that is not completely understood. Currently there are no nationally agreed-upon criteria for systemic inflammatory response syndrome or sepsis in pregnant or peripartum women, as the physiologic changes of pregnancy have not been taken into consideration.This article is the first in a series of three that discuss the importance of sepsis and septic shock in pregnancy...
July 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28651747/the-rise-of-artificial-intelligence-and-the-uncertain-future-for-physicians
#16
EDITORIAL
C Krittanawong
Physicians in everyday clinical practice are under pressure to innovate faster than ever because of the rapid, exponential growth in healthcare data. "Big data" refers to extremely large data sets that cannot be analyzed or interpreted using traditional data processing methods. In fact, big data itself is meaningless, but processing it offers the promise of unlocking novel insights and accelerating breakthroughs in medicine-which in turn has the potential to transform current clinical practice [1]. Physicians can analyze big data, but at present it requires a large amount of time and sophisticated analytic tools such as supercomputers...
June 23, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28638289/diagnosis-and-treatment-of-hereditary-hemorrhagic-telangiectasia
#17
REVIEW
Cameron Grigg, Daniel Anderson, James Earnshaw
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disorder known for its debilitating symptoms. More than 90% of patients with HHT experience epistaxis, and they average up to 18 bleeds per month. We review the current literature on the pathophysiology, clinical presentation, and management of HHT. METHODS: We searched MEDLINE, EMBASE, and PubMed and identified 19 articles published since 2000 with current information on HHT. RESULTS: HHT is a disease more commonly associated with significant morbidity rather than mortality...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28600477/targeting-the-wnt-pathway-and-cancer-stem-cells-with-anti-progastrin-humanized-antibodies-a-major-breakthrough-for-k-ras-mutated-colorectal-cancer-treatment
#18
Alexandre Prieur, Monica Cappellini, Guillaume Habif, Marie-Paule Lefranc, Thibault Mazard, Eric Morency, Jean-Marc Pascussi, Maud Flaceliere, Nathalie Cahuzac, Berengere Vire, Benjamin Dubuc, Amandine Durochat, Pierre Liaud, Jérémy Ollier, Caroline Pfeiffer, Sophie Poupeau, Véronique Saywell, Chris Planque, Eric Assenat, Frédéric Bibeau, Jean-François Bourgaux, Pascal Pujol, Alain Sézeur, Marc Ychou, Dominique Joubert
<p>Patients with metastatic colorectal cancer (CRC) suffer from disease relapse mainly due to cancer stem cells (CSC). Interestingly, they have an increased level of blood progastrin, a tumor-promoting peptide essential for the self-renewal of colon CSCs, which is also a direct b-catenin/Tcf4 target gene. In this study we aimed to develop a novel targeted therapy to neutralize secreted progastrin in order to inhibit Wnt signaling, CSCs and reduce relapses.</p> Experimental Design: <p>Antibodies (monoclonal and humanized) directed against progastrin were produced and selected for target specificity and affinity...
June 9, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28599011/medicine-performing-arts-and-science-dancing-to-the-same-tune
#19
EDITORIAL
Bronwen J Ackermann
A substantial period of time has been spent developing rigorous quantitative scientific approaches to inform medical practice (evidence-based practice). While this process has been important for many medical breakthroughs, and continues to play a critical role in medical and scientific research, it was felt to cause a medical shift away from the individual patient, as practitioners focussed more on the method of practice than the person themselves. However, following this period when a preponderance of attention was paid to quantitative studies, the tide has now turned back to integrating this knowledge with the clinical skills and expertise of medical practitioners...
June 2017: Medical Problems of Performing Artists
https://www.readbyqxmd.com/read/28591112/the-promise-of-organ-and-tissue-preservation-to-transform-medicine
#20
Sebastian Giwa, Jedediah K Lewis, Luis Alvarez, Robert Langer, Alvin E Roth, George M Church, James F Markmann, David H Sachs, Anil Chandraker, Jason A Wertheim, Martine Rothblatt, Edward S Boyden, Elling Eidbo, W P Andrew Lee, Bohdan Pomahac, Gerald Brandacher, David M Weinstock, Gloria Elliott, David Nelson, Jason P Acker, Korkut Uygun, Boris Schmalz, Brad P Weegman, Alessandro Tocchio, Greg M Fahy, Kenneth B Storey, Boris Rubinsky, John Bischof, Janet A W Elliott, Teresa K Woodruff, G John Morris, Utkan Demirci, Kelvin G M Brockbank, Erik J Woods, Robert N Ben, John G Baust, Dayong Gao, Barry Fuller, Yoed Rabin, David C Kravitz, Michael J Taylor, Mehmet Toner
The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities...
June 7, 2017: Nature Biotechnology
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