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Causation in evidence based medicine

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https://www.readbyqxmd.com/read/28680464/-to-test-or-not-to-test-the-arguments-for-and-against-thrombophilia-testing-in-obstetrics
#1
REVIEW
Laura Ormesher, Louise E Simcox, Clare Tower, Ian A Greer
Clinicians increasingly investigate women for thrombophilias due to their associations with venous thromboembolism and placenta-mediated pregnancy complication. These associations, however, are modest and based largely on retrospective data from studies with heterogeneous classifications and populations, leading to discordance between evidence and guidelines. Current evidence suggests a contributory rather than causative role for thrombophilia in placenta-mediated pregnancy complication and venous thromboembolism...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28675654/bioinformatory-assisted-analysis-of-next-generation-sequencing-data-for-precision-medicine-in-pancreatic-cancer
#2
Linnéa Malgerud, Johan Lindberg, Valtteri Wirta, Maria Gustafsson-Liljefors, Masoud Karimi, Carlos Fernández Moro, Katrin Stecker, Alexander Picker, Carolin Huelsewig, Martin Stein, Regina Bohnert, Marco Del Chiaro, Stephan L Haas, Rainer L Heuchel, Johan Permert, Markus J Maeurer, Stephan Brock, Caroline S Verbeke, Lars Engstrand, David B Jackson, Henrik Grönberg, Johannes- Matthias Löhr
Pancreatic ductal adenocarcinoma (PDAC) is a tumor with an extremely poor prognosis, predominantly as a result of chemotherapy resistance and numerous somatic mutations. Consequently, PDAC is a prime candidate for the use of sequencing to identify causative mutations, facilitating subsequent administration of targeted therapy. In a feasibility study, we retrospectively assessed the therapeutic recommendations of a novel, evidence-based software that analyzes next-generation sequencing (NGS) data using a large panel of pharmacogenomic biomarkers for efficacy and toxicity...
July 4, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28560543/bone-and-soft-tissue-histology-a-new-approach-to-determine-characteristics-of-offending-instrument-in-sharp-force-injuries
#3
Tania Delabarde, Catherine Cannet, Jean Sébastien Raul, Annie Géraut, Marc Taccoen, Bertrand Ludes
This paper describes a new approach to determine characteristics of the implement used to inflict trauma which involves the histological analysis of exogenous particles. Based on Locard's principle "every contact leaves a trace," we decided to assess whether histological examination of bone and soft tissue around a penetrating injury (sharp force trauma) could provide evidence of the offending implement. Case reports and experimental studies have demonstrated the potential of cut mark features in bone to identify the causative implement and potentially assist in identifying the perpetrator...
May 30, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28536827/genetic-counselling-for-maternally-inherited-mitochondrial-disorders
#4
REVIEW
Joanna Poulton, Josef Finsterer, Patrick Yu-Wai-Man
The aim of this review was to provide an evidence-based approach to frequently asked questions relating to the risk of transmitting a maternally inherited mitochondrial disorder (MID). We do not address disorders linked with disturbed mitochondrial DNA (mtDNA) maintenance, causing mtDNA depletion or multiple mtDNA deletions, as these are autosomally inherited. The review addresses questions regarding prognosis, recurrence risks and the strategies available to prevent disease transmission. The clinical and genetic complexity of maternally inherited MIDs represent a major challenge for patients, their relatives and health professionals...
August 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28396090/executive-summary-of-imported-infectious-diseases-after-returning-from-foreign-travel-consensus-document-of-the-spanish-society-for-infectious-diseases-and-clinical-microbiology-seimc
#5
José Luis Pérez-Arellano, Miguel Górgolas-Hernández-Mora, Fernando Salvador, Cristina Carranza-Rodríguez, Germán Ramírez-Olivencia, Esteban Martín-Echeverría, Azucena Rodríguez-Guardado, Francesca Norman, Virginia Velasco-Tirado, Zuriñe Zubero-Sulibarría, Gerardo Rojo-Marcos, José Muñoz-Gutierrez, José Manuel Ramos-Rincón, M Paz Sánchez-Seco-Fariñas, María Velasco-Arribas, Moncef Belhassen-García, Mar Lago-Nuñez, Elías Cañas García-Otero, Rogelio López-Vélez
In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections...
April 7, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28206814/biomarkers-in-tumor-microenvironment-upregulation-of-fibroblast-activation-protein-%C3%AE-correlates-with-gastric-cancer-progression-and-poor-prognosis
#6
Mengmou Hu, Chengjia Qian, Ziwei Hu, Bojian Fei, Haibo Zhou
Gastric cancer is the third leading cause of cancer-related mortality worldwide. Recent evidence points to importance of cross talk between cancer cells and the surrounding stroma on gastric cancer progression. Tumor microenvironment biomarkers thus represent a new opportunity for diagnostics innovation. Reactive stromal fibroblasts selectively express the fibroblast activation protein alpha (FAP-α), a homodimeric integral membrane gelatinase that belongs to the serine protease family. We report here that FAP-α expression is significantly elevated in gastric cancer samples by more than fivefold (p < 0...
January 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28119081/neuroprotective-effect-and-mechanism-of-daucosterol-palmitate-in-ameliorating-learning-and-memory-impairment-in-a-rat-model-of-alzheimer-s-disease
#7
Zhi-Hong Ji, Zhong-Qi Xu, Hong Zhao, Xin-Yu Yu
Alzheimer's disease (AD) is an age-related neurodegenerative disorder characterized by progressive memory decline and cognitive impairment. Amyloid beta (Aβ) has been proposed as the causative role for the pathogenesis of AD. Accumulating evidence demonstrates that Aβ neurotoxicity is mediated by glutamate excitotoxicity. Daucosterol palmitate (DSP), a plant steroid with anti-glutamate excitotoxicity effect, was isolated from the anti-aging traditional Chinese medicinal herb Alpinia oxyphylla Miq. in our previous study...
March 2017: Steroids
https://www.readbyqxmd.com/read/28115076/cognitive-bias-and-the-creation-and-translation-of-evidence-into-clinical-practice
#8
REVIEW
Donald A Molony
The optimal translation of evidence into the clinical practice of nephrology follows validated evidence-based medicine (EBM) principles. Most importantly, the evidence-based medicine practitioner requires that the evidence, as much as possible, addresses in an unbiased manner clinical questions of importance to patients and reflects the truth. In this chapter, we evaluate how cognitive biases that affect medical decision making might systematically bias the overall management of patients with kidney disease and, thus, distort the observations about disease causation, prognosis, diagnosis, and management that are derived from analysis of administrative databases or electronic medical records of health care systems...
November 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28092685/precision-oncology-for-acute-myeloid-leukemia-using-a-knowledge-bank-approach
#9
Moritz Gerstung, Elli Papaemmanuil, Inigo Martincorena, Lars Bullinger, Verena I Gaidzik, Peter Paschka, Michael Heuser, Felicitas Thol, Niccolo Bolli, Peter Ganly, Arnold Ganser, Ultan McDermott, Konstanze Döhner, Richard F Schlenk, Hartmut Döhner, Peter J Campbell
Underpinning the vision of precision medicine is the concept that causative mutations in a patient's cancer drive its biology and, by extension, its clinical features and treatment response. However, considerable between-patient heterogeneity in driver mutations complicates evidence-based personalization of cancer care. Here, by reanalyzing data from 1,540 patients with acute myeloid leukemia (AML), we explore how large knowledge banks of matched genomic-clinical data can support clinical decision-making. Inclusive, multistage statistical models accurately predicted likelihoods of remission, relapse and mortality, which were validated using data from independent patients in The Cancer Genome Atlas...
March 2017: Nature Genetics
https://www.readbyqxmd.com/read/27754286/br-07-1-development-of-the-cell-microarray-for-high-throughput-analysis-of-gut-microbiota
#10
Seong-Tshool Hong
The human intestine contains a massive and complex microbial community called gut microbiota. A typical human carries 100 trillion microbes in his/her body which is 10 times greater than the number of their host cells, i.e. whole number of human cells. A combined microbial genome constituting gut microbiota is well excess our own human genome. The microbial composition of gut microbiotata and its role on diseases became a booming area of research, presenting a new paradigm of opportunities for modern medicines...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27681809/microbiota-is-a-primary-cause-of-pathogenesis-of-chronic-wounds
#11
R Wolcott, N Sanford, R Gabrilska, J L Oates, J E Wilkinson, K P Rumbaugh
OBJECTIVE: Diverse microorganisms present on the surface of chronic wounds have been established to constitute wound microbiota. The aims of this study were to quantify the viability of wound microbiota, classify dispersal of viable microbes from the wound, and determine if human wound microbiota can produce a chronic wound in an animal model. METHOD: Wound microbiotas as units (multiple microbial species acting as one infectious agent) were obtained from well-defined human chronic wounds and seeded onto mouse surgical excision wounds to produce chronically infected wounds that closely resembled the chronic wounds observed in the original hosts...
October 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27671725/evidence-based-toxicology
#12
Sebastian Hoffmann, Thomas Hartung, Martin Stephens
Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27643284/br-07-1-development-of-the-cell-microarray-for-high-throughput-analysis-of-gut-microbiota
#13
Seong-Tshool Hong
The human intestine contains a massive and complex microbial community called gut microbiota. A typical human carries 100 trillion microbes in his/her body which is 10 times greater than the number of their host cells, i.e. whole number of human cells. A combined microbial genome constituting gut microbiota is well excess our own human genome. The microbial composition of gut microbiotata and its role on diseases became a booming area of research, presenting a new paradigm of opportunities for modern medicines...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27632829/the-effectiveness-of-nonoperative-rehabilitation-programs-for-athletes-diagnosed-with-osteitis-pubis
#14
REVIEW
Scott W Cheatham, Morey J Kolber, Kathryn Kumagai Shimamura
Clinical Scenario: The differential diagnosis of groin pain can be very challenging due to the many causative pathologies. Osteitis pubis is a pathology that is becoming more recognized in athletes who participate in sports such as soccer, ice hockey, rugby, and football. Conservative nonoperative treatment is often prescribed first before surgical intervention. Of particular interest are the outcomes of nonoperative rehabilitation programs and their effectiveness to return athletes to preinjury levels of participation...
December 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/27544582/detection-of-hereditary-bisalbuminemia-in-bottlenose-dolphins-tursiops-truncatus-montagu-1821-comparison-between-capillary-zone-and-agarose-gel-electrophoresis
#15
Claudia Gili, Federico Bonsembiante, Renzo Bonanni, Alessia Giordano, Sabina Ledda, Giorgia Beffagna, Saverio Paltrinieri, Matteo Sommer, Maria Elena Gelain
BACKGROUND: Hereditary bisalbuminemia is a relatively rare anomaly characterized by the occurrence of two albumin fractions on serum protein separation by electrophoresis. In human medicine, it is usually revealed by chance, is not been clearly associated with a specific disease and the causative genetic alteration is a point mutation of human serum albumin gene inherited in an autosomal codominant pattern. This type of alteration is well recognizable by capillary zone electrophoresis (CZE), whilst agarose gel electrophoresis (AGE) not always produces a clear separation of albumin fractions...
August 20, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/27441534/risk-factors-of-thyroid-pathology-formation-in-outpatient-pregnant-population
#16
N Morchiladze, B Tkeshelashvili, D Gagua, T Gagua
Several medical - biological and social - hygienic factors have been found to account for the definite increase in the incidence of thyroid gland disorders in reproductive age and pregnant women. Aim of our study was to identify the risk factors for development of thyroid gland pathology in outpatient pregnant women. Observational study - "case - control" study has been conducted at the base of David Gagua Hospital Ltd. Main (study) group involved 292 pregnant patients with established thyroid pathology. Control group included 58 conditionally healthy pregnant participants without any demonstrated thyroid pathology...
June 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27052648/cns-infections-in-patients-with-hematological-disorders-including-allogeneic-stem-cell-transplantation-guidelines-of-the-infectious-diseases-working-party-agiho-of-the-german-society-of-hematology-and-medical-oncology-dgho
#17
M Schmidt-Hieber, G Silling, E Schalk, W Heinz, J Panse, O Penack, M Christopeit, D Buchheidt, U Meyding-Lamadé, S Hähnel, H H Wolf, M Ruhnke, S Schwartz, G Maschmeyer
Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients...
July 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/26821064/dysregulated-mitochondrial-and-chloroplast-bioenergetics-from-a-translational-medical-perspective-review
#18
REVIEW
George B Stefano, Richard M Kream
Mitochondria and chloroplasts represent endosymbiotic models of complex organelle development, driven by intense evolutionary pressure to provide exponentially enhanced ATP-dependent energy production functionally linked to cellular respiration and photosynthesis. Within the realm of translational medicine, it has become compellingly evident that mitochondrial dysfunction, resulting in compromised cellular bioenergetics, represents a key causative factor in the etiology and persistence of major diseases afflicting human populations...
March 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/26778324/encouragement-to-increase-the-use-of-psychosocial-skills-in-the-diagnosis-and-therapy-of-patients-with-functional-dysphonia
#19
REVIEW
Jürg Kollbrunner, Eberhard Seifert
Clinicians believe that psychosocial factors play a causal role in the etiology of many forms of functional dysphonia (FD). But for decades, all attempts to confirm such causation have failed. This paper aims to show the logic of this failure, to discuss the possibilities of employing psychology in therapy nonetheless, and to encourage clinicians to use their psychosocial knowledge and skills. The failure to confirm psychic and social factors as causal in the etiology of FD is basically a consequence of a principal shortcoming of evidence-based medicine (EBM)...
January 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/26614812/evidence-based-causation-in-toxicology-a-10-year-retrospective
#20
REVIEW
R C James, J K Britt, N C Halmes, P S Guzelian
We introduced Evidence-based Toxicology (EBT) in 2005 to address the disparities that exist between the various Weight-of-Evidence (WOE) methods typically applied in the regulatory hazard decision-making arena and urged toxicologists to adopt the evidence-based guidelines long-utilized in medicine (i.e., Evidence-Based Medicine or EBM). This review of the activities leading to the adoption of evidence-based methods and EBT during the last decade demonstrates how fundamental concepts that form EBT, such as the use of systematic reviews to capture and consider all available information, are improving toxicological evaluations performed by various groups and agencies...
December 2015: Human & Experimental Toxicology
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