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https://www.readbyqxmd.com/read/29604225/bedside-reasoning-on-causes-and-mechanisms-of-diseases-in-the-era-of-precision-medicine-a-timeless-story
#1
REVIEW
D Lipsker
This is a short reflection about bedside reasoning in clinical medicine, emphasizing the importance of distinguishing between causes and mechanisms of diseases. All complex/sporadic diseases result from interactions between a genetic predisposition and environmental factors. The main disease mechanisms resulting in clinical signs involve inflammation, insult of vessels or nerves, pharmacological or hormonal dysfunction, altered metabolism and overload, tumoral proliferations, intrinsic dysfunction, malformation and traumatism...
March 31, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29536661/bacteriophage-lambda-the-path-from-biology-to-theranostic-agent
#2
REVIEW
Carlos E Catalano
Viral particles provide an attractive platform for the engineering of semisynthetic therapeutic nanoparticles. They can be modified both genetically and chemically in a defined manner to alter their surface characteristics, for targeting specific cell types, to improve their pharmacokinetic features and to attenuate (or enhance) their antigenicity. These advantages derive from a detailed understanding of virus biology, gleaned from decades of fundamental genetic, biochemical, and structural studies that have provided mechanistic insight into virus assembly pathways...
March 13, 2018: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/29531460/quantitative-and-noninvasive-assessment-of-chronic-liver-diseases-using-two-dimensional-shear-wave-elastography
#3
REVIEW
Li-Ting Xie, Chun-Hong Yan, Qi-Yu Zhao, Meng-Na He, Tian-An Jiang
Two-dimensional shear wave elastography (2D-SWE) is a rapid, simple and novel noninvasive method that has been proposed for assessing hepatic fibrosis in patients with chronic liver diseases (CLDs) based on measurements of liver stiffness. 2D-SWE can be performed easily at the bedside or in an outpatient clinic and yields immediate results with good reproducibility. Furthermore, 2D-SWE was an efficient method for evaluating liver fibrosis in small to moderately sized clinical trials. However, the quality criteria for the staging of liver fibrosis are not yet well defined...
March 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29475003/neuropathic-pain-models-caused-by-damage-to-central-or-peripheral-nervous-system
#4
REVIEW
Anil Kumar, Harshpreet Kaur, Arti Singh
Neuropathic Pain (NP) is a painful condition which is a direct consequence of a lesion or disease affecting the somatosensory system with symptoms like allodynia, hyperalgesia. It has complex pathogenesis as it involves several molecular signaling pathways, thus numerous reliable animal models are crucial to understand the underlying mechanism of NP and formulate effective management therapy. Some models like spinal cord injury, chronic constriction injury, spinal nerve ligation, chemotherapy induced peripheral neuropathy, diabetes-induced NP and many more are discussed...
April 2018: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29421626/molecular-simulation-aspects-of-amyloid-peptides-at-membrane-interface
#5
REVIEW
Yonglan Liu, Baiping Ren, Yanxian Zhang, Yan Sun, Yung Chang, Guizhao Liang, Lijian Xu, Jie Zheng
The interactions of amyloid peptides with cell membranes play an important role in maintaining the integrity and functionality of cell membrane. A thorough molecular-level understanding of the structure, dynamics, and interactions between amyloid peptides and cell membranes is critical to amyloid aggregation and toxicity mechanisms for the bench-to-bedside applications. Here we review the most recent computational studies of amyloid peptides at model cell membranes. Different mechanisms of action of amyloid peptides on/in cell membranes, targeted by different computational techniques at different lengthscales and timescales, are rationally discussed...
February 6, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29277304/the-association-between-pulsatile-portal-flow-and-acute-kidney-injury-after-cardiac-surgery-a-retrospective-cohort-study
#6
William Beaubien-Souligny, Roberto Eljaiek, Annik Fortier, Yoan Lamarche, Mark Liszkowski, Josée Bouchard, André Y Denault
OBJECTIVE: Venous congestion is a possible mechanism leading to acute kidney injury (AKI) following cardiac surgery. Portal vein flow pulsatility is an echographic marker of cardiogenic portal hypertension and might identify clinically significant organ congestion. This exploratory study aims to assess if the presence of portal flow pulsatility measured by transthoracic echography in the postsurgical intensive care unit is associated with AKI after cardiac surgery. DESIGN: Retrospective cohort study...
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29241812/exploiting-the-therapeutic-potential-of-ready-to-use-drugs-repurposing-antibiotics-against-amyloid-aggregation-in-neurodegenerative-diseases
#7
REVIEW
Sergio B Socias, Florencia González-Lizárraga, Cesar L Avila, Cecilia Vera, Leonardo Acuña, Julia E Sepulveda-Diaz, Elaine Del-Bel, Rita Raisman-Vozari, Rosana N Chehin
Neurodegenerative diseases are chronic and progressive disorders that affect specific regions of the brain, causing gradual disability and suffering that results in a complete inability of patients to perform daily functions. Amyloid aggregation of specific proteins is the most common biological event that is responsible for neuronal death and neurodegeneration in various neurodegenerative diseases. Therapeutic agents capable of interfering with the abnormal aggregation are required, but traditional drug discovery has fallen short...
March 2018: Progress in Neurobiology
https://www.readbyqxmd.com/read/29160706/synthesis-and-characterization-of-ultralow-fouling-poly-n-acryloyl-glycinamide-brushes
#8
Fengyu Yang, Yonglan Liu, Yanxian Zhang, Baiping Ren, Jianxiong Xu, Jie Zheng
The rational design of biomaterials with antifouling properties still remains a challenge, although this is important for many bench-to-bedside applications for biomedical implants, drug delivery carriers, and marine coatings. Herein, we synthesized and characterized poly(N-acryloylglycinamide) (polyNAGA) and then grafted poly(NAGA) onto Au substrate to form polymer brushes with well-controlled film stability, wettability, and thickness using surface-initiated atom transfer radical polymerization (SI-ATRP)...
December 12, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/29074905/antimicrobial-resistance-and-antimicrobial-stewardship-programmes-benefiting-the-patient-or-the-population
#9
(no author information available yet)
'...bedside rationing of antimicrobials is 'fair and ethically sound' even if it doesn't promote the short-term best medical interest of the individual patients'.
October 27, 2017: British Dental Journal
https://www.readbyqxmd.com/read/29058876/synthetic-xylosides-probing-the-glycosaminoglycan-biosynthetic-machinery-for-biomedical-applications
#10
Jie Shi Chua, Balagurunathan Kuberan
Glycosaminoglycans (GAGs) are polysaccharides ubiquitously found on cell surfaces and in the extracellular matrix (ECM). They regulate numerous cellular signaling events involved in many developmental and pathophysiological processes. GAGs are composed of complex sequences of repeating disaccharide units, each of which can carry many different modifications. The tremendous structural variations account for their ability to bind many proteins and thus, for their numerous functions. Although the sequence of GAG biosynthetic events and the enzymes involved mostly were deduced a decade ago, the emergence of tissue or cell specific GAGs from a nontemplate driven process remains an enigma...
October 23, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/29044002/irrational-antibiotic-prescribing-practice-among-children-in-critical-care-of-tertiary-hospitals
#11
Mirza Tasawer Baig, Ali Akbar Sial, Ambreen Huma, Maryam Ahmed, Uzma Shahid, Nayel Syed
This study assessed the prescribing pattern of irrational use of antibiotic among children under age of 12 years in public and private sector hospitals in Pakistan. The prospective clinical evaluation of drug utilization pattern of antimicrobials from Patient Bedside File (PBF) of in-patients and Culture Sensitivity Test (CST) reports were evaluated to determine the antibiotic resistance. Two indicators recorded to assess antibiotic prescribing were; dose of prescribed antibiotic (low-dose, rational and high -dose) and Indication (valid or invalid)...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28984698/relative-importance-assigned-to-health-care-rationing-principles-at-the-bedside-evidence-from-a-portuguese-and-bulgarian-survey
#12
Micaela Moreira Pinho, Ana Pinto Borges
Activity was undertaken to develop a Prioritization Scoring Index for Portugal and Bulgaria that weights the importance given to ethical rationing principles that should guide decisions at the bedside. Data from two random samples of 355 Portuguese and 298 Bulgarian members of the public were collected from an online questionnaire. Questions asked about the level of importance given to specific issues related to patient's prioritization criteria. Responses were analyzed quantitatively with the SPSS. In the process of selecting the patient to treat, Portuguese and Bulgarian respondents seem unanimous in giving greater importance to (i) the treatment outcomes, (ii) the severity of illness, (iii) children, and (iv) patients' fragility...
October 2017: Health Care Manager
https://www.readbyqxmd.com/read/28968360/general-approach-to-peripheral-nerve-disorders
#13
James A Russell
PURPOSE OF REVIEW: This article provides a conceptual framework for the evaluation of patients with suspected polyneuropathy to enhance the clinician's ability to localize and confirm peripheral nervous system pathology and, when possible, identify an etiologic diagnosis through use of rational clinical and judicious testing strategies. RECENT FINDINGS: Although these strategies are largely time-honored, recent insights pertaining to the pathophysiology of certain immune-mediated neuropathies and to evolving genetic testing strategies may modify the way that select causes of neuropathy are conceptualized, evaluated, and managed...
October 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28955226/tamoxifen-from-failed-contraceptive-pill-to-best-selling-breast-cancer-medicine-a-case-study-in-pharmaceutical-innovation
#14
Viviane M Quirke
Today, tamoxifen is one of the world's best-selling hormonal breast cancer drugs. However, it was not always so. Compound ICI 46,474 (as it was first known) was synthesized in 1962 within a project to develop a contraceptive pill in the pharmaceutical laboratories of ICI (now part of AstraZeneca). Although designed to act as an anti-estrogen, the compound stimulated, rather than suppressed ovulation in women. This, and the fact that it could not be patented in the USA, its largest potential market, meant that ICI nearly stopped the project...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28735000/application-of-pharmacometrics-and-quantitative-systems-pharmacology-to-cancer-therapy-the-example-of-luminal-a-breast-cancer
#15
REVIEW
Brett Fleisher, Ashley N Brown, Sihem Ait-Oudhia
Breast cancer (BC) is the most common cancer in women, and the second most frequent cause of cancer-related deaths in women worldwide. It is a heterogeneous disease composed of multiple subtypes with distinct morphologies and clinical implications. Quantitative systems pharmacology (QSP) is an emerging discipline bridging systems biology with pharmacokinetics (PK) and pharmacodynamics (PD) leveraging the systematic understanding of drugs' efficacy and toxicity. Despite numerous challenges in applying computational methodologies for QSP and mechanism-based PK/PD models to biological, physiological, and pharmacological data, bridging these disciplines has the potential to enhance our understanding of complex disease systems such as BC...
July 19, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28610537/overcoming-multiple-myeloma-drug-resistance-in-the-era-of-cancer-omics
#16
Matthew Ho Zhi Guang, Amanda McCann, Giada Bianchi, Li Zhang, Paul Dowling, Despina Bazou, Peter O'Gorman, Kenneth C Anderson
Multiple myeloma (MM) is among the most compelling examples of cancer in which research has markedly improved the length and quality of lives of those afflicted. Research efforts have led to 18 newly approved treatments over the last 12 years, including seven in 2015. However, despite significant improvement in overall survival, MM remains incurable as most patients inevitably, yet unpredictably, develop refractory disease. Recent advances in high-throughput 'omics' techniques afford us an unprecedented opportunity to (1) understand drug resistance at the genomic, transcriptomic, and proteomic level; (2) discover novel diagnostic, prognostic, and therapeutic biomarkers; (3) develop novel therapeutic targets and rational drug combinations; and (4) optimize risk-adapted strategies to circumvent drug resistance, thus bringing us closer to a cure for MM...
March 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28416241/circulating-tumor-dna-from-bench-to-bedside
#17
Joline S J Lim, Filip Janku, Timothy A Yap
In the era of personalized medicine, tumor sampling is paramount to enable the assessment of actionable molecular aberrations to help rationalize and guide treatment decisions. Longitudinal tracking of such aberrations may also be helpful to detect emerging drug resistance and to allow for timely modifications to ongoing therapies to improve patient outcomes. Nevertheless, tumor tissue sampling involves an invasive procedure with potential risks to patients and involves logistical challenges. As such, other less invasive and safer methods such as blood sampling for molecular profiling has been gaining traction...
May 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28301693/the-clue
#18
Tyler Tate
As I stood outside of Carlos's room, I felt caught on the horns of a dilemma. It seemed impossible to truly "be there" for Carlos without sacrificing my other intern duties. This tension pervaded much of my residency training, as I often found myself spending more time completing chart notes, answering pages, and giving sign out than I did at the bedside with my patients. I knew I had a duty to "do my job"-I could not let my team down. But what about my duty to Carlos, a duty to act on my intuition and try to "get to the bottom" of his illness, if that was even possible? And what about my thirteen other patients? Wasn't I was their doctor as well? I have spent countless hours studying the ethical frameworks for medical rationing...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28298480/antimicrobial-stewardship-programmes-bedside-rationing-by-another-name
#19
Simon Oczkowski
Antimicrobial therapy is a cornerstone of therapy in critically ill patients; however, the wide use of antibiotics has resulted in increased antimicrobial resistance and outbreaks of resistant disease. To counter this, many hospitals have instituted antimicrobial stewardship programmes as a way to reduce the inappropriate use of antibiotics. However, uptake of antimicrobial stewardship programmes has been variable, as many clinicians fear that they may put individual patients at risk of treatment failure. In this paper, I argue that antimicrobial stewardship programmes are indeed a form of bedside rationing, and explore the risks and benefits of such programmes for individual patients in the intensive care unit, and the critically ill population in general...
March 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28225697/who-should-ration
#20
Philip M Rosoff
A principal component of physician decision making is judging what interventions are clinically appropriate. Due to the inexorable and steady increase of health care costs in the US, physicians are constantly being urged to exercise judicious financial stewardship with due regard for the financial implications of what they prescribe. When applied on a case-by-case basis, this otherwise reasonable approach can lead to either inadvertent or overt and arbitrary restriction of interventions for some patients rather than others on the basis of clinically irrelevant characteristics such as ethnicity, gender, age, or skin color...
February 1, 2017: AMA Journal of Ethics
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