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https://www.readbyqxmd.com/read/28944582/myopenia-and-precision-p4-medicine
#1
EDITORIAL
John E Morley, Stefan D Anker
Precision (P4) medicine represents a new medical paradigm that focuses on Personalized, Predictive, Preventive and Participatory approaches. The P4 paradigm is particularly appropriate for moving the care of persons with myopenia forward. Muscular dystrophies are clearly a set of genetically different diseases where genomics are the basis of diagnosis, and genetic modulation via DNA, oligonucleotides and clustered regularly interspaced short palendronic repeats hold great potential for a cure. The utility of personalized genomics for sarcopenia coupled with utilizing a predictive approach for the diagnosis with early preventive strategies is a key to improving sarcopenic outcomes...
September 24, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28944288/the-wisdom-study-breaking-the-deadlock-in-the-breast-cancer-screening-debate
#2
REVIEW
Laura J Esserman
There are few medical issues that have generated as much controversy as screening for breast cancer. In science, controversy often stimulates innovation; however, the intensely divisive debate over mammographic screening has had the opposite effect and has stifled progress. The same two questions-whether it is better to screen annually or bi-annually, and whether women are best served by beginning screening at 40 or some later age-have been debated for 20 years, based on data generated three to four decades ago...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28944281/adenovirus-mediated-gene-delivery-potential-applications-for-gene-and-cell-based-therapies-in-the-new-era-of-personalized-medicine
#3
Cody S Lee, Elliot S Bishop, Ruyi Zhang, Xinyi Yu, Evan M Farina, Shujuan Yan, Chen Zhao, Zongyue Zheng, Yi Shu, Xingye Wu, Jiayan Lei, Yasha Li, Wenwen Zhang, Chao Yang, Ke Wu, Ying Wu, Sherwin Ho, Aravind Athiviraham, Michael J Lee, Jennifer Moriatis Wolf, Russell R Reid, Tong-Chuan He
With rapid advances in understanding molecular pathogenesis of human diseases in the era of genome sciences and systems biology, it is anticipated that increasing numbers of therapeutic genes or targets will become available for targeted therapies. Despite numerous setbacks, efficacious gene and/or cell-based therapies still hold the great promise to revolutionize the clinical management of human diseases. It is wildly recognized that poor gene delivery is the limiting factor for most in vivo gene therapies...
June 2017: Genes & Diseases
https://www.readbyqxmd.com/read/28943682/residual-weighted-learning-for-estimating-individualized-treatment-rules
#4
Xin Zhou, Nicole Mayer-Hamblett, Umer Khan, Michael R Kosorok
Personalized medicine has received increasing attention among statisticians, computer scientists, and clinical practitioners. A major component of personalized medicine is the estimation of individualized treatment rules (ITRs). Recently, Zhao et al. (2012) proposed outcome weighted learning (OWL) to construct ITRs that directly optimize the clinical outcome. Although OWL opens the door to introducing machine learning techniques to optimal treatment regimes, it still has some problems in performance. (1) The estimated ITR of OWL is affected by a simple shift of the outcome...
2017: Journal of the American Statistical Association
https://www.readbyqxmd.com/read/28942762/clinical-use-of-a-home-sleep-apnea-test-an-american-academy-of-sleep-medicine-position-statement
#5
Ilene M Rosen, Douglas B Kirsch, Ronald D Chervin, Kelly A Carden, Kannan Ramar, R Nisha Aurora, David A Kristo, Raman K Malhotra, Jennifer L Martin, Eric J Olson, Carol L Rosen, James A Rowley
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. It is the position of the American Academy of Sleep Medicine (AASM) that only a physician can diagnose medical conditions such as OSA and primary snoring. Throughout this statement, the term "physician" refers to a medical provider who is licensed to practice medicine. A home sleep apnea test (HSAT) is an alternative to polysomnography for the diagnosis of OSA in uncomplicated adults presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA...
September 20, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28942731/factors-influencing-trainee-doctor-emigration-in-a-high-income-country-a-mixed-methods-study
#6
Nicholas Clarke, Sophie Crowe, Niamh Humphries, Ronan Conroy, Simon O'Hare, Paul Kavanagh, Ruairi Brugha
BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. METHODS: Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey...
September 25, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28941996/fistula-recurrence-pregnancy-and-childbirth-following-successful-closure-of-female-genital-fistula-in-guinea-a-longitudinal-study
#7
Alexandre Delamou, Therese Delvaux, Alison M El Ayadi, Vandana Tripathi, Bienvenu S Camara, Abdoul H Beavogui, Lauri Romanzi, Bethany Cole, Patrice Bouedouno, Moustapha Diallo, Thierno H Barry, Mandian Camara, Kindy Diallo, Alain Leveque, Wei-Hong Zhang, Vincent De Brouwere
BACKGROUND: Female genital fistula is a devastating maternal complication of delivery in developing countries. We sought to analyse the incidence and proportion of fistula recurrence, residual urinary incontinence, and pregnancy after successful fistula closure in Guinea, and describe the delivery-associated maternal and child health outcomes. METHODS: We did a longitudinal study in women discharged with a closed fistula from three repair hospitals supported by EngenderHealth in Guinea...
September 20, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28941640/nanoparticle-impact-on-innate-immune-cell-pattern-recognition-receptors-and-inflammasomes-activation
#8
REVIEW
Ana Luísa Silva, Carina Peres, João Conniot, Ana I Matos, Liane Moura, Bárbara Carreira, Vanessa Sainz, Anna Scomparin, Ronit Satchi-Fainaro, Véronique Préat, Helena F Florindo
Nanotechnology-based strategies can dramatically impact the treatment, prevention and diagnosis of a wide range of diseases. Despite the unprecedented success achieved with the use of nanomaterials to address unmet biomedical needs and their particular suitability for the effective application of a personalized medicine, the clinical translation of those nanoparticulate systems has still been impaired by the limited understanding on their interaction with complex biological systems. As a result, unexpected effects due to unpredicted interactions at biomaterial and biological interfaces have been underlying the biosafety concerns raised by the use of nanomaterials...
September 20, 2017: Seminars in Immunology
https://www.readbyqxmd.com/read/28941536/rationale-for-adjunctive-therapies-for-pediatric-sepsis-induced-multiple-organ-failure
#9
REVIEW
Bradley S Podd, Dennis W Simon, Santiago Lopez, Andrew Nowalk, Rajesh Aneja, Joseph A Carcillo
Adjunctive therapies have been proposed for use in at least 5 inflammation pathobiology phenotypes in pediatric sepsis-induced multiple organ failure. This article discusses host-pathogen interaction prototypes to facilitate understanding of the rationale for personalized therapy in these phenotypes. The article discusses the literature on adjunctive antiinflammatory and immune modulation therapies that, in addition to traditional organ support and infection source control, might be part of a personalized precision medicine approach to the reversal of each of these inflammatory pathobiology phenotypes...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28941240/dynamic-changes-in-brain-mesenchymal-perivascular-cells-associate-with-multiple-sclerosis-disease-duration-active-inflammation-and-demyelination
#10
Ellen Iacobaeus, Rachael V Sugars, Anton Törnqvist Andrén, Jessica J Alm, Hong Qian, Janek Frantzen, Jia Newcombe, Kanar Alkass, Henrik Druid, Matteo Bottai, Matias Röyttä, Katarina Le Blanc
Vascular changes, including blood brain barrier destabilization, are common pathological features in multiple sclerosis (MS) lesions. Blood vessels within adult organs are reported to harbor mesenchymal stromal cells (MSCs) with phenotypical and functional characteristics similar to pericytes. We performed an immunohistochemical study of MSCs/pericytes in brain tissue from MS and healthy persons. Post-mortem brain tissue from patients with early progressive MS (EPMS), late stage progressive MS (LPMS), and healthy persons were analyzed for the MSC and pericyte markers CD146, platelet-derived growth factor receptor beta (PDGFRβ), CD73, CD271, alpha-smooth muscle actin, and Ki67...
September 23, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28940226/the-effect-of-leprotic-infection-on-the-risk-of-death-in-medieval-rural-denmark
#11
K Saige Kelmelis, Michael Holton Price, Jim Wood
INTRODUCTION: Paleopathological studies of leprosy in Danish skeletal collections show that many individuals suffered from this stigmatized disease during the Middle Ages. This study examines the risk of death associated with leprotic infection in individuals from the Danish rural cemetery of Øm Kloster (AD 1172-1536). Specifically, we modeled the influence of leprotic infection on age-specific mortality accounting also for sex and social status (lay person / monastic). MATERIALS AND METHODS: The sample consisted of 311 adult individuals from the Øm Kloster skeletal collection housed at the Institute of Forensic Medicine, University of Southern Denmark (ADBOU)...
September 22, 2017: American Journal of Physical Anthropology
https://www.readbyqxmd.com/read/28939999/our-genes-our-selves-hereditary-breast-cancer-and-biological-citizenship-in-norway
#12
Pål Møller, Eivind Hovig
The concept 'hereditary breast cancer' is commonly used to delineate a group of people genetically at risk for breast cancer-all of whom also having risk for other cancers. People carrying pathogenic variants of the BRCA1 and BRCA2 genes are often referred to as those having predisposition for 'hereditary breast cancer'. The two genes, however, are when altered, associated with different risks for and dying from breast cancer. The main risk for dying for carriers of both genes is from ovarian cancer. These biological facts are of philosophical interest, because they are the facts underlying the public debate on BRCA1/2 genetic testing as a model for the discussion of how to implement genetic knowledge and technologies in personalized medicine...
September 22, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28939582/a-randomised-controlled-trial-of-an-intervention-delivered-by-app-instant-messaging-to-increase-the-acceptability-of-effective-contraception-among-young-people-in-tajikistan-study-protocol
#13
Ona McCarthy, Baptiste Leurent, Phil Edwards, Ravshan Tokhirov, Caroline Free
INTRODUCTION: Women in lower income countries experience unintended pregnancies at a higher rate compared with women in higher income countries. Unintended pregnancy is associated with numerous poorer health outcomes for both women and their children. In Tajikistan, an estimated 26% of married individuals aged 15-24 years have an unmet need for contraception. The strong cultural value placed on childbearing and oppositional attitudes towards contraception are major barriers to contraceptive uptake in the country...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28939411/high-prevalence-of-severe-asthma-in-a-large-random-population-study
#14
Roxana Mincheva, Linda Ekerljung, Apostolos Bossios, Bo Lundbäck, Jan Lötvall
BACKGROUND: The prevalence of asthma severity is not well described at a population level. OBJECTIVE: To determine the prevalence of phenotypic signs of asthma severity among individuals with asthma in a general population, and to describe risk factors for asthma severity. METHODS: Epidemiological study conducted between 2008 and 2012 (West Sweden Asthma Study). A postal questionnaire was sent to random population (N = 30,000) in West Sweden, with 18,087 responses...
September 19, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28939373/emerging-models-of-interprofessional-collaboration-in-cancer-care
#15
REVIEW
Teresa Knoop, Debra Wujcik
OBJECTIVES: To present emerging models for oncology health professionals to consider when coordinating cancer care among professionals, beginning as early as initial professional education and training and continuing along the cancer continuum to include cancer treatment and psychosocial support. DATA SOURCES: Journal articles indexed on the National Library of Medicine database and personal communications with oncology colleagues. CONCLUSION: Interprofessional collaboration is becoming increasingly important in the specialty of oncology...
September 19, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28939108/differential-response-to-doxorubicin-in-breast-cancer-subtypes-simulated-by-a-microfluidic-tumor-model
#16
Altug Ozcelikkale, Kyeonggon Shin, Victoria Noe-Kim, Bennett D Elzey, Zizheng Dong, Jian-Ting Zhang, Kwangmeyung Kim, Ick Chan Kwon, Kinam Park, Bumsoo Han
Successful drug delivery and overcoming drug resistance are the primary clinical challenges for management and treatment of cancer. The ability to rapidly screen drugs and delivery systems within physiologically relevant environments is critically important; yet is currently limited due to lack of appropriate tumor models. To address this problem, we developed the Tumor-microenvironment-on-chip (T-MOC), a new microfluidic tumor model simulating the interstitial flow, plasma clearance, and transport of the drug within the tumor...
September 19, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28938895/-it-is-good-to-take-her-early-to-the-doctor-mothers-understanding-of-childhood-pneumonia-symptoms-and-health-care-seeking-in-kilimanjaro-region-tanzania
#17
Florida Muro, Judith Meta, Jenny Renju, Adiel Mushi, Hilda Mbakilwa, Raimos Olomi, Hugh Reyburn, Helena Hildenwall
BACKGROUND: Pneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers' illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania...
September 22, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28938884/do-virtual-patients-prepare-medical-students-for-the-real-world-development-and-application-of-a-framework-to-compare-a-virtual-patient-collection-with-population-data
#18
M Urresti-Gundlach, D Tolks, C Kiessling, M Wagner-Menghin, A Härtl, I Hege
BACKGROUND: An important aspect of virtual patients (VPs), which are interactive computer-based patient scenarios, is authenticity. This includes design aspects, but also how a VP collection represents a patient population and how a patient is presented in a VP scenario. Therefore, our aim was to analyze VP scenarios integrated into the combined internal medicine and surgery curriculum at the University of Munich (LMU) and compare the results with data from the population in Germany. METHOD: We developed a coding framework with four main categories: patient data, patient representation, diagnoses, and setting...
September 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28937058/epidemiology-of-human-leukocyte-antigens-among-omani-population
#19
Issa Al Salmi, Abdul Massiah Metry, Faisal Al Ismaili, Alan Hola, Faissal Shaheen, Hana Fakhoury, Suad Hannawi
Oman is located on the Southeastern coast of the Arabian Peninsula, and its population has high levels of consanguinity. Human leukocytic antigen (HLA) typing analysis in human population holds unexploited potential for elucidating the genetic causes of human disease and possibly leads to personalized medicine. This is a retrospective, descriptive study evaluating HLA frequencies of Omani individuals who underwent workup for kidney transplantation at the Royal Hospital (RH) from 2005 to 2016. Data on 870 subjects were collected from the Oman kidney transplant registry at RH as well from electronic medical record system...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936750/person-centered-care-and-personalized-medicine-irreconcilable-opposites-or-potential-companions
#20
Leila El-Alti, Lars Sandman, Christian Munthe
In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined or if they conflict at fundamental or pragmatic levels...
September 21, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
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