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Personalized medicine

Michel Tchuenche, Vibhuti Haté, Dacia McPherson, Eurica Palmer, Ananthy Thambinayagam, Dayanund Loykissoonlal, Emmanuel Njeuhmeli, Steven Forsythe
In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC) program on the basis of compelling evidence that circumcision reduces men's risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income). Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies...
2016: PloS One
Arno K Kumagai, Brittani Jackson, Saleem Razack
Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Evan K Perrault
No studies have assessed prospective patients' opinions regarding physician introductory videos despite their increasing prevalence. Therefore, a within-subjects experiment randomly exposed participants to five physician video biographies featuring primarily either personal or professional information. Participants' attitudes were measured. They also selected the physician they would want to visit. Participants chose physicians with whom they perceived the greatest similarity, and indicated greater ease choosing physicians when exposed to biographies containing personal information...
October 26, 2016: Health Marketing Quarterly
Yu-Ming Shen, Lien D Le, Rory Wilson, Ulrich Mansmann
BACKGROUND: Biomarkers providing evidence for patient-treatment interaction are key in the development and practice of personalized medicine. Knowledge that a patient with a specific feature - as demonstrated through a biomarker - would have an advantage under a given treatment vs. a competing treatment can aid immensely in medical decision-making. Statistical strategies to establish evidence of continuous biomarkers are complex and their formal results are thus not easy to communicate...
October 26, 2016: Methods of Information in Medicine
Ioline D Henter, Rafael T de Sousa, Philip W Gold, Andre R Brunoni, Carlos A Zarate, Rodrigo Machado-Vieira
Real-world effectiveness trials suggest that antidepressant efficacy is limited in many patients with mood disorders, underscoring the urgent need for novel therapeutics to treat these disorders. Areas Covered: Here, we review the clinical evidence supporting the use of novel modulators for the treatment of mood disorders, including specific glutamate modulators such as: 1) high-trapping glutamatergic modulators; 2) subunit (NR2B)-specific N-methyl-D-aspartate (NMDA) receptor antagonists; 3) NMDA receptor glycine-site partial agonists; and 4) metabotropic glutamate receptor (mGluR) modulators...
October 26, 2016: Expert Review of Clinical Pharmacology
Tim Lustberg, Johan van Soest, Arthur Jochems, Timo Deist, Yvonka van Wijk, Sean Walsh, Philippe Lambin, Andre Dekker
Data collected and generated by radiation oncology can be classified by the 4Vs of Big Data (Volume, Variety, Velocity, and Veracity) because it is spread across different care providers and not easily shared due to patient privacy protection. The magnitude of the 4Vs is substantial in oncology, especially due to imaging modalities and unclear data definitions. To create useful models ideally all data of all care providers is understood and learned from, however this presents challenges in the guise of poor data quality, patient privacy concerns, geographical spread, interoperability, and the large volume...
October 26, 2016: British Journal of Radiology
Fabienne Hartmann-Fritsch, Daniela Marino, Ernst Reichmann
BACKGROUND: The treatment of severe full-thickness skin defects represents a significant and common clinical problem worldwide. A bio-engineered autologous skin substitute would significantly reduce the problems observed with today's gold standard. METHODS: Within 15 years of research, the Tissue Biology Research Unit of the University Children's Hospital Zurich has developed autologous tissue-engineered skin grafts based on collagen type I hydrogels. Those products are considered as advanced therapy medicinal products (ATMPs) and are routinely produced for clinical trials in a clean room facility following the guidelines for good manufacturing practice (GMP)...
September 2016: Transfusion Medicine and Hemotherapy
Susanna Wallerstedt
Medical and scientific assessments as the basis for prioritization and resource allocation for new drug treatment - experiences from five years of systematic workIn this study, the process for introduction of new drug treatment in Region Västra Götaland (second largest region in Sweden encompassing 1.6 million inhabitants, 17% of all inhabitants in Sweden) is described. A working group, consisting of persons with relevant expertise and declared conflicts of interest, contributes with medical and scientific assessments as the basis for prioritization and resource allocation...
October 18, 2016: Läkartidningen
J S Yu, A Y Xue, E E Redei, N Bagheri
Major depressive disorder (MDD) is a critical cause of morbidity and disability with an economic cost of hundreds of billions of dollars each year, necessitating more effective treatment strategies and novel approaches to translational research. A notable barrier in addressing this public health threat involves reliable identification of the disorder, as many affected individuals remain undiagnosed or misdiagnosed. An objective blood-based diagnostic test using transcript levels of a panel of markers would provide an invaluable tool for MDD as the infrastructure-including equipment, trained personnel, billing, and governmental approval-for similar tests is well established in clinics worldwide...
October 25, 2016: Translational Psychiatry
Dana B Mukamel, Alpesh Amin, David L Weimer, Heather Ladd, Joseph Sharit, Ran Schwarzkopf, Dara H Sorkin
OBJECTIVE: To test whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. DATA SOURCES/SETTING: Primary data collected in the Departments of Medicine and Surgery at a University Medical Center between March 2014 and August 2015. STUDY DESIGN: A randomized controlled trial in which patients in the intervention group were given NHCPlus...
October 24, 2016: Health Services Research
Jason Kwah, Jennifer Weintraub, Robert Fallar, Jonathan Ripp
BACKGROUND : Burnout is a common issue in internal medicine residents, and its impact on medical errors and professionalism is an important subject of investigation. OBJECTIVE : To evaluate differences in medical errors and professionalism in internal medicine residents with and without burnout. METHODS : A single institution observational cohort study was conducted between June 2011 and July 2012. Burnout was measured using the Maslach Burnout Inventory to generate subscores for the following 3 domains: emotional exhaustion, depersonalization, and sense of personal accomplishment...
October 2016: Journal of Graduate Medical Education
Francesca Mertan, Baris Turkbey
Imaging has played an important role in the administration of personalized medicine. From diagnosing diseases to guiding therapies, imaging has become an all-encompassing modality. With respect to prostate cancer, personalized management of the disease has been transformed by imaging. Specifically, multiparametric magnetic resonance imaging has emerged as a vital player in the detection, characterization, and localization of the disease thus making the incorporation of imaging in personalized prostate cancer management integral...
October 21, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Gabrielle Bertier, Jian Carrot-Zhang, Vassilis Ragoussis, Yann Joly
Precision medicine (PM) can be defined as a predictive, preventive, personalized, and participatory healthcare service delivery model. Recent developments in molecular biology and information technology make PM a reality today through the use of massive amounts of genetic, 'omics', clinical, environmental, and lifestyle data. With cancer being one of the most prominent public health threats in developed countries, both the research community and governments have been investing significant time, money, and efforts in precision cancer medicine (PCM)...
October 24, 2016: Genome Medicine
Stephen L Kopecky, Douglas C Bauer, Martha Gulati, Jeri W Nieves, Andrea J Singer, Peter P Toth, James A Underberg, Taylor C Wallace, Connie M Weaver
Description: Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for persons who do not consume adequate calcium from their diet as a standard strategy for the prevention of osteoporosis and related fractures. Whether calcium with or without vitamin D supplementation is beneficial or detrimental to vascular health is not known. Methods: The National Osteoporosis Foundation and American Society for Preventive Cardiology convened an expert panel to evaluate the effects of dietary and supplemental calcium on cardiovascular disease based on the existing peer-reviewed scientific literature...
October 25, 2016: Annals of Internal Medicine
Christopher R Friese, Yun Li, Irina Bondarenko, Timothy P Hofer, Kevin C Ward, Ann S Hamilton, Dennis Deapen, Allison W Kurian, Steven J Katz
BACKGROUND: The 21-gene recurrence score (RS) assay stratifies early-stage, estrogen receptor-positive breast cancer by recurrence risk. Few studies have examined the ways in which physicians use the RS to recommend adjuvant systemic chemotherapy or patients' experiences with testing and decision making. METHODS: This study surveyed 3880 women treated for breast cancer in 2013-2014; they were identified from the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results registries (response rate, 71%)...
October 24, 2016: Cancer
Y Liu, Z-X Zhang
OBJECTIVE: Precision medicine is a personalized disease prevention and treatment program combining modern genetic technology, molecular imaging techniques, and biological information with patients' living environment and clinical data, for accurate classification and diagnosis of diseases. CASE REPORT: Our study presents the case of a 7-year-old female patient with clinical manifestations of growth hormone (GH) deficiency. After treatment with recombinant human GH for 2 years, the patient showed a reduced growth rate...
October 2016: European Review for Medical and Pharmacological Sciences
Paolo Capogrosso, Eugenio Ventimiglia, Marco Moschini, Luca Boeri, Elena Farina, Nadia Finocchio, Giorgio Gandaglia, Nicola Fossati, Alberto Briganti, Franscesco Montorsi, Andrea Salonia
BACKGROUND: Controversial results have shown a significant association with either low or high total testosterone (tT) levels and high risk prostate cancer (PCa). We tested the relationship between circulating tT and grade group 5 (G5) PCa at radical prostatectomy (RP) in patients with preoperative low- to intermediate-risk disease. METHODS: Serum sex hormones were assessed the day before RP in a cohort of 846 patients with low- to intermediate-risk PCa. Patients were segregated using the new 5-tiered Gleason grade groups...
October 24, 2016: Prostate
Ilyas Singeç, Anton Simeonov
Pluripotent stem cell research has made extraordinary progress over the last decade. The robustness of nuclear reprogramming of somatic cells into induced pluripotent stem cells (iPSCs) has created entirely novel opportunities for drug discovery and personalized regenerative medicine. Patient- and disease-specific iPSCs can be expanded indefinitely and differentiated into relevant cell types of different organ systems. As the utilization of iPSCs is becoming a key enabling technology across various scientific disciplines, there are still important challenges that need to be addressed...
2016: Drug Target Review
Alexey Kamenskiy, Andreas Seas, Paul Deegan, William Poulson, Eric Anttila, Sylvie Sim, Anastasia Desyatova, Jason MacTaggart
Femoropopliteal artery (FPA) mechanics play a paramount role in pathophysiology and the artery's response to therapeutic interventions, but data on FPA mechanical properties are scarce. Our goal was to characterize human FPAs over a wide population to derive a constitutive description of FPA aging to be used for computational modeling. Fresh human FPA specimens ([Formula: see text]) were obtained from [Formula: see text] predominantly male (80 %) donors 54±15 years old (range 13-82 years). Morphometric characteristics including radius, wall thickness, opening angle, and longitudinal pre-stretch were recorded...
October 22, 2016: Biomechanics and Modeling in Mechanobiology
Stefanie Mache, Lisa Baresi, Monika Bernburg, Karin Vitzthum, David Groneberg
BACKGROUND: Dealing with work-related stress is highly prevalent for employees in Gynecology Medicine. Junior physicians, in particular, have to face high working demands and challenges while starting their medical career after graduation. Job resources (i.e., social support) and personal resources (coping skills) might reduce job strain. The evidence for supportive and effective mental health interventions for clinicians is limited. Offering psychosocial skill training for entrants in Gynecology Medicine is expected to be highly beneficial...
October 22, 2016: Archives of Gynecology and Obstetrics
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