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https://www.readbyqxmd.com/read/28431457/precision-medicine-and-pharmacogenetics-what-does-oncology-have-that-addiction-medicine-does-not
#1
Henry R Kranzler, Rachel V Smith, Robert Schnoll, Afaf Moustafa, Emma Greenstreet-Akman
BACKGROUND AND AIMS: Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#2
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431117/seeking-certainty-judicial-approaches-to-the-non-treatment-of-minimally-conscious-patients
#3
Richard Huxtable, Giles Birchley
A modest, but growing, body of case law is developing around the (non-)treatment of patients in the minimally conscious state. We sought to explore the approaches that the courts take to these decisions. Using the results of a qualitative analysis, we identify five key features of the rulings to date. First, the judges appear keen to frame the cases in such a way that these are rightly matters for judicial determination. Secondly, the judges appraise the types and forms of expertise that enter the courtroom, seeming to prefer the 'objective' and 'scientific', and particularly the views of the doctors...
April 18, 2017: Medical Law Review
https://www.readbyqxmd.com/read/28431057/quantitative-analysis-of-pkp2-and-neighbouring-genes-in-a-patient-with-arrhythmogenic-right-ventricular-cardiomyopathy-caused-by-heterozygous-pkp2-deletion
#4
Keiko Sonoda, Seiko Ohno, Sou Otuki, Koichi Kato, Nobue Yagihara, Hiroshi Watanabe, Takeru Makiyama, Tohru Minamino, Minoru Horie
Aims: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disease mainly caused by desmosome gene mutations. The genetic culprit, however, remains elusive in ∼50% of ARVC patients. One of the reasons for missing genetic abnormalities is the difficulty in detecting large deletions/duplications, which are called as copy number variation (CNV) by the Sanger sequencing method. This study aimed to identify CNVs in PKP2 and a part of other desmosome genes in ARVC patients. Methods and Results: The study cohort consisted of 71 ARVC probands who were diagnosed as definite or borderline cases based on 2010 Task Force Criteria...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430994/personhood-and-natural-kinds-why-cognitive-status-need-not-affect-moral-status
#5
Joseph Vukov
Lockean accounts of personhood propose that an individual is a person just in case that individual is characterized by some advanced cognitive capacity. On these accounts, human beings with severe cognitive impairment are not persons. Some accept this result-I do not. In this paper, I therefore advance and defend an account of personhood that secures personhood for human beings who are cognitively impaired. On the account for which I argue, an individual is a person just in case that individual belongs to a natural kind that is normally characterized by advanced cognitive capacities...
April 19, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28430920/rates-and-predictors-of-hospital-readmission-after-transcatheter-aortic-valve-implantation
#6
Anna Franzone, Thomas Pilgrim, Nicolas Arnold, Dik Heg, Bettina Langhammer, Raffaele Piccolo, Eva Roost, Fabien Praz, Lorenz Räber, Marco Valgimigli, Peter Wenaweser, Peter Jüni, Thierry Carrel, Stephan Windecker, Stefan Stortecky
Aims: To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and Results: Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive of hospital readmission within 1 year after TAVI with bootstrap analysis for internal validation. Of 868 patients alive at discharge, 221 (25.4%) were readmitted within 1 year...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430886/intrinsic-protein-disorder-reduces-small-scale-gene-duplicability
#7
Sanghita Banerjee, Felix Feyertag, David Alvarez-Ponce
Whereas the rate of gene duplication is relatively high, only certain duplications survive the filter of natural selection and can contribute to genome evolution. However, the reasons why certain genes can be retained after duplication whereas others cannot remain largely unknown. Many proteins contain intrinsically disordered regions (IDRs), whose structures fluctuate between alternative conformational states. Due to their high flexibility, IDRs often enable protein-protein interactions and are the target of post-translational modifications...
April 19, 2017: DNA Research: An International Journal for Rapid Publication of Reports on Genes and Genomes
https://www.readbyqxmd.com/read/28430849/performance-and-symptom-validity-testing-as-a-function-of-medical-board-evaluation-in-u-s-military-service-members-with-a-history-of-mild-traumatic-brain-injury
#8
Patrick Armistead-Jehle, Wesley R Cole, Robert L Stegman
Objective: The study was designed to replicate and extend pervious findings demonstrating the high rates of invalid neuropsychological testing in military service members (SMs) with a history of mild traumatic brain injury (mTBI) assessed in the context of a medical evaluation board (MEB). Method: Two hundred thirty-one active duty SMs (61 of which were undergoing an MEB) underwent neuropsychological assessment. Performance validity (Word Memory Test) and symptom validity (MMPI-2-RF) test data were compared across those evaluated within disability (MEB) and clinical contexts...
April 20, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28430847/invited-commentary-bias-attenuation-and-identification-of-causal-effects-with-multiple-negative-controls
#9
Wang Miao, Eric Tchetgen Tchetgen
In this commentary, we describe several extensions to the interesting and important negative control exposure approach for partial confounding adjustment in time-series analysis proposed by Flanders et al. (Am J Epidemiol. 2012;000(0):000-000). Specifically, by leveraging the availability of exposure time series, we show that under certain additional fairly reasonable assumptions, one can incorporate both past and future exposures as multiple negative control exposures to further attenuate confounding bias...
April 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#10
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28430740/low-dose-computed-tomography-scans-with-automatic-exposure-control-for-patients-of-different-ages-undergoing-cardiac-pet-ct-and-spect-ct
#11
Ching-Ching Yang, Bang-Hung Yang, Chun-Yuan Tu, Tung-Hsin Wu, Shu-Hsin Liu
PURPOSE: This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). METHODS: One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult...
April 20, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28430735/sodium-tetradecyl-sulfate-a-review-of-clinical-uses
#12
Helena A Jenkinson, Kelly M Wilmas, Sirunya Silapunt
BACKGROUND: Sodium tetradecyl sulfate (STS) is Food and Drug Administration approved for treatment of varicose veins, but numerous other off-label applications have been reported. OBJECTIVE: To describe the clinical uses of STS, as well as efficacy and adverse effects. METHODS: Review of studies searchable on PubMed from 1938 to 2016 describing clinical uses of STS to determine efficacy and adverse effects associated with various applications...
April 19, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28430700/prescriber-compliance-with-liver-monitoring-guidelines-for-pazopanib-in-the-postapproval-setting-results-from-a-distributed-research-network
#13
Sumitra Shantakumar, Beth L Nordstrom, Susan A Hall, Luc Djousse, Myrthe P P van Herk-Sukel, Kathy H Fraeman, David R Gagnon, Karen Chagin, Jeanenne J Nelson
OBJECTIVES: Pazopanib received US Food and Drug Administration approval in 2009 for advanced renal cell carcinoma. During clinical development, liver chemistry abnormalities and adverse hepatic events were observed, leading to a boxed warning for hepatotoxicity and detailed label prescriber guidelines for liver monitoring. As part of postapproval regulatory commitments, a cohort study was conducted to assess prescriber compliance with liver monitoring guidelines. METHODS: Over a 4-year period, a distributed network approach was used across 3 databases: US Veterans Affairs Healthcare System, a US outpatient oncology community practice database, and the Dutch PHARMO Database Network...
April 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28430642/immunocompetent-mouse-allograft-models-for-development-of-therapies-to-target-breast-cancer-metastasis
#14
Yuan Yang, Howard H Yang, Ying Hu, Peter H Watson, Huaitian Liu, Thomas R Geiger, Miriam R Anver, Diana C Haines, Philip Martin, Jeffrey E Green, Maxwell P Lee, Kent W Hunter, Lalage M Wakefield
Effective drug development to combat metastatic disease in breast cancer would be aided by the availability of well-characterized preclinical animal models that (a) metastasize with high efficiency, (b) metastasize in a reasonable time-frame, (c) have an intact immune system, and (d) capture some of the heterogeneity of the human disease. To address these issues, we have assembled a panel of twelve mouse mammary cancer cell lines that can metastasize efficiently on implantation into syngeneic immunocompetent hosts...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430566/how-should-physicians-respond-when-patients-distrust-them-because-of-their-gender
#15
Monica Peek, Bernard Lo, Alicia Fernandez
There are many reasons why gender-concordant care benefits patients and is requested by them. For training hospitals, however, such requests present challenges as well as opportunities in providing patient-centered care. Responding to a case in which a female patient who is having a routine exam refuses care from a male medical student, we discuss ethical principles involved in gender-concordant care requests, when it is appropriate to question such requests, and a team-based approach to responding to them.
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430558/lower-esophageal-sphincter-augmentation-for-gastroesophageal-reflux-disease-the-safety-of-a-modern-implant
#16
C Daniel Smith, Robert A Ganz, John C Lipham, Reginald C Bell, David W Rattner
INTRODUCTION: Use of the magnetic sphincter augmentation device (MSAD) for gastroesophageal reflux disease (GERD) is increasing. As this innovative treatment for GERD gains widespread use and adoption, an assessment of its safety since U.S. market introduction is presented. METHODS: Events were collected from the Manufacturer and User Facility Device Experience (MAUDE) database, which reports events submitted to the Food and Drug Administration (FDA) of suspected device-associated deaths, serious injuries, and malfunctions...
April 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28430427/performance-of-the-amoeba-water-model-in-the-vicinity-of-qm-solutes-a-diagnosis-using-energy-decomposition-analysis
#17
Yuezhi Mao, Yihan Shao, Jacek Dziedzic, Chris-Kriton Skylaris, Teresa Head-Gordon, Martin Head-Gordon
The importance of incorporating solvent polarization effects into the modeling of solvation processes has been well-recognized, and therefore a new generation of hybrid quantum mechanics/molecular mechanics (QM/MM) approaches that accounts for this effect is desirable. We present a fully self-consistent, mutually polarizable QM/MM scheme using the AMOEBA force field, in which the total energy of the system is variationally minimized with respect to both the QM electronic density and the MM induced dipoles. This QM/AMOEBA model is implemented through the Q-Chem/LibEFP code interface and then applied to the evaluation of solute-solvent interaction energies for various systems ranging from the water dimer to neutral and ionic solutes (NH3, NH4(+) , CN(-)) surrounded by increasing numbers of water molecules (up to 100)...
April 21, 2017: Journal of Chemical Theory and Computation
https://www.readbyqxmd.com/read/28430422/gauging-donor-acceptor-properties-and-redox-stability-of-chelating-click-derived-triazoles-and-triazolylidenes-a-case-study-with-rhenium-i-complexes
#18
Lisa Suntrup, Sinja Klenk, Johannes Klein, Sebastian Sobottka, Biprajit Sarkar
Bidentate ligands containing at least one triazole or triazolylidene (mesoionic carbene, MIC) unit are extremely popular in contemporary chemistry. One reason for their popularity is the similarities as well as differences in the donor/acceptor properties that these ligands display in comparison to their pyridine or other N-heterocyclic carbene counterparts. We present here seven rhenium(I) carbonyl complexes where the bidentate ligands contain combinations of pyridine/triazole/triazolylidene. These are the first examples of rhenium(I) complexes with bidentate 1,2,3-triazol-5-ylidene-containing ligands...
April 21, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28430377/exploring-why-young-people-with-type%C3%A2-1-diabetes-decline-structured-education-with-a-view-to-overcoming-barriers
#19
V E Coates, G Horigan, M Davies, M T Davies
AIMS: To identify factors that influence lack of engagement of young adults with Type 1 diabetes (aged 13-21 years) with structured diabetes education (SDE) to inform and broaden the reach of future SDE. METHODS: A quantitative, cross-sectional survey was undertaken of 227 young people with Type 1 diabetes drawn from 11 health trusts across Northern Ireland and England, deemed to be representative of the wider population. Participants were asked to complete a questionnaire exploring non-attendance, along with the Diabetes Care Profile, the Diabetes Empowerment Scale (Short Form), the Diabetes Knowledge Test and the 12-item General Health Questionnaire...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28430317/treatment-of-central-venous-in-stent-restenosis-with-repeat-stent-deployment-in-hemodialysis-patients
#20
James Ronald, Bradley Davis, Carlos J Guevara, Waleska M Pabon-Ramos, Tony P Smith, Charles Y Kim
PURPOSE: To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. MATERIALS AND METHODS: A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group)...
April 20, 2017: Journal of Vascular Access
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