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Stratified medicine

John D Pediani, Richard J Ward, Sara Marsango, Graeme Milligan
Spatial intensity distribution analysis (SpIDA) is a recently developed approach for determining quaternary structure information on fluorophore-labelled proteins of interest in situ. It can be applied to live or fixed cells and native tissue. Using confocal images, SpIDA generates fluorescence intensity histograms that are analysed by super-Poissonian distribution functions to obtain density and quantal brightness values of the fluorophore-labelled protein of interest. This allows both expression level and oligomerisation state of the protein to be determined...
October 9, 2017: Trends in Pharmacological Sciences
Daniele P Santos-Bezerra, Adriana Machado-Lima, Maria Beatriz Monteiro, Sharon N Admoni, Ricardo V Perez, Cleide G Machado, Maria Heloíza Shimizu, Ana M Cavaleiro, Karina Thieme, Márcia S Queiroz, Ubiratan F Machado, Daniel Giannella-Neto, Marisa Passarelli, Maria Lúcia Corrêa-Giannella
Quantitative polymerase chain reaction was employed to quantify expression of two genes coding for advanced glycation end-product receptors [RAGE ( AGER) and AGER1 ( DDOST)] and of the gene coding the deacetylase SIRT1 ( SIRT1) in peripheral blood mononuclear cells from type 1 diabetes patients without [Group A, n = 35; 28.5 (24-39) years old; median (interquartile interval)] or with at least one microvascular complication [Group B, n = 117; 34.5 (30-42) years old]; 31 healthy controls were also included. In a subgroup of 48 patients, daily advanced glycation end-products intake before blood collection was assessed...
October 1, 2017: Diabetes & Vascular Disease Research
Illana Gozes
This short review looks at Alzheimer's disease (AD) diagnosis through my own point of view, going from imaging through cerebrospinal fluid to blood proteins. Over the last couple of years, we have published two papers targeted at Alzheimer's diagnosis. In one paper, we took an approach of selecting a specific target, namely, activity-dependent neuroprotective protein (ADNP), and our results tightened the association of ADNP blood expression with intelligence. In another paper, we took an unbiased approach of analysis of all genes expressed in lymphoblastoid cells lines and discovered changes in expression of the regulator of G-protein signaling 2 (RGS2) as a potential AD predictor...
September 2017: EPMA Journal
Mathew N Nicholas, Stephanie K Li, Marlene Dytoc
Oral glucocorticoids are commonly used across every field of medicine; however, discontinuing them in patients can be challenging. The risk of acute adrenal crises secondary to glucocorticoid withdrawal can be fatal and arises from chronic suppression of the adrenal glands. Identifying risk factors for adrenal suppression in dermatological patients, such as doses greater than 5 to 7.5 mg of prednisone equivalent, duration of glucocorticoid use greater than 3 weeks, certain medications, and comorbidities, can help risk-stratify patients...
October 1, 2017: Journal of Cutaneous Medicine and Surgery
Marie-Odile Bernier, Neige Journy, Daphnee Villoing, Michele M Doody, Bruce H Alexander, Martha S Linet, Cari M Kitahara
Purpose To estimate the risk of cataract in a cohort of nuclear medicine (NM) radiologic technologists on the basis of their work histories and radiation protection practices. Materials and Methods In the years 2003-2005 and 2012-2013, 42 545 radiologic technologists from a U.S. prospective study completed questionnaires in which they provided information regarding their work histories and cataract histories. Cox proportional hazards models, stratified according to birth-year cohort (born before 1940 or born in 1940 or later) and adjusted for age, sex, and race, were used to estimate hazard ratios (HRs) for the risk of cataract in radiologic technologists according to NM work history practices according to decade...
October 11, 2017: Radiology
Bhawna Sharma, Rachael M Crist, Pavan P Adiseshaiah
Genomic analyses from patients with cancer have improved the understanding of the genetic elements that drive the disease, provided new targets for treating this relentless disease, and offered criteria for stratifying patient populations that will benefit most from treatments. In the last decade, several new targeted therapies have been approved by the FDA based on these omics findings, leading to significantly improved survival and quality of life for select patient populations. However, many of these precision medicines, e...
October 10, 2017: AAPS Journal
Rosalind Miller, Catherine Goodman
INTRODUCTION: Pharmacies and drug stores are frequently patients' first point of care in many low-income and middle-income countries, but their practice is often poor. Pharmacy retailing in India has traditionally been dominated by local, individually owned shops, but recent years have seen the growth of pharmacy chains. In theory, lower-powered profit incentives and self-regulation to preserve brand identity may lead to higher quality in chain stores. In practice, this has been little studied...
2017: BMJ Global Health
Sumera Rizvi, Shahid A Khan, Christopher L Hallemeier, Robin K Kelley, Gregory J Gores
Cholangiocarcinoma is a disease entity comprising diverse epithelial tumours with features of cholangiocyte differentiation: cholangiocarcinomas are categorized according to anatomical location as intrahepatic (iCCA), perihilar (pCCA), or distal (dCCA). Each subtype has a distinct epidemiology, biology, prognosis, and strategy for clinical management. The incidence of cholangiocarcinoma, particularly iCCA, has increased globally over the past few decades. Surgical resection remains the mainstay of potentially curative treatment for all three disease subtypes, whereas liver transplantation after neoadjuvant chemoradiation is restricted to a subset of patients with early stage pCCA...
October 10, 2017: Nature Reviews. Clinical Oncology
Edmée J M Schrijver, Oscar J de Vries, Peter M van de Ven, Pierre M Bet, Ad M Kamper, Sabine H A Diepeveen, Rob J van Marum, Astrid M van Strien, Sander Anten, Anne M Lagaay, Leo Boelaarts, Frank W Bloemers, Mark H H Kramer, Prabath W B Nanayakkara
Background: because the few randomised placebo-controlled trials investigating the potential role for prophylactic haloperidol in delirium prevention have focused on specific surgical populations, we investigated its efficacy and safety in acutely hospitalised older patients. Methods: this multi-centre, double-blind, stratified, block randomised, placebo-controlled trial was conducted at six Dutch hospitals. Patients age ≥70 years, acutely admitted through the emergency department for general medicine or surgical specialties and at risk for delirium were randomised (n = 245) to haloperidol or placebo 1 mg orally twice-daily (maximum of 14 doses) on top of standard nonpharmacological prevention strategies...
July 15, 2017: Age and Ageing
Leonieke J J van Mens, Marleen G H van de Sande, Dominique L P Baeten
PURPOSE OF REVIEW: The review presents the recent rapid expansion of therapeutical options in spondyloarthritis. Additionally, it focuses on the importance of additional questions raised by the growing therapeutic possibilities related to the optimal use of these drugs. RECENT FINDINGS: The emergence of new treatment options opens new avenues and opportunities for treating patients with nonresponse, contraindications, or intolerance for classic drugs. However, it becomes more relevant than ever to define not only drugs and treatment options but also treatment strategies...
October 4, 2017: Current Opinion in Rheumatology
Y-P Liu, L Li
Many studies have analyzed the association between between GSTT1 polymorphism and esophageal cancer, however, the results remained inconclusive. We therefore performed an updated meta-analysis based on Chinese individuals. PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure and Chinese Biology Medicine were searched up to December 2016. An OR with the corresponding 95% CI was used to assess the strength of the association. This meta-analysis included 12 studieswith 1246 cases and 1863 controls...
September 30, 2017: Cellular and Molecular Biology
Toshihiro Miyamoto, Yoshikane Kikushige, And Goichi Yoshimoto
Despite recent progress in diagnosis and leukemogenesis based on genomic landscapes in acute myelogenous leukemia (AML), advances in AML treatment lag behind. Over the past four decades, combination chemotherapy with anthracycline and cytarabine remains the standard induction therapy. Subsequent post-remission consolidation therapy stratifies patients into favorable-risk, intermediate-risk, and unfavorable-risk groups to assign post-remission therapies based on cytogenetic abnormalities and molecular mutations...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Antonino Di Pino, Sarah Mangiafico, Francesca Urbano, Roberto Scicali, Salvatore Scandura, Veronica D'Agate, Salvatore Piro, Corrado Tamburino, Francesco Purrello, Agata Maria Rabuazzo
Context: Prediabetes is associated with subclinical cardiac changes associated with heart failure development. Objective: We investigated diastolic function and its association with markers of glycation and inflammation related with cardiovascular disease in patients with prediabetes. We focused on individuals with prediabetes identified only by glycated hemoglobin A1c [HbA1c 5.7-6.4% who had normal fasting glucose (NFG) and normal glucose tolerance (NGT) after oral glucose tolerance test (OGTT)]...
August 1, 2017: Journal of Clinical Endocrinology and Metabolism
Daniel N A Ankrah, Margaret Lartey, Aukje K Mantel-Teeuwisse, Hubert G M Leufkens
BACKGROUND: There is limited information on patterns of treatment change among new initiators of highly active antiretroviral therapy (HAART) in the regions most affected by HIV/AIDS. This makes it difficult to identify the determinants of treatment change. In this retrospective cohort study, we examined treatment change patterns over a five-year period among initiators of HAART. METHODS: De-identified data were obtained from the Fevers' Unit Database at the Korle-Bu Teaching Hospital...
October 2, 2017: BMC Infectious Diseases
S Müller, G Menciotti, M Borgarelli
OBJECTIVES: To determine feasibility and repeatability of measuring the anatomic regurgitant orifice area (AROA) using real-time three-dimensional transthoracic echocardiography (RT3DE) in dogs with myxomatous mitral valve disease (MMVD), and to investigate differences in the AROA of dogs with different disease severity and in different American College of Veterinary Internal Medicine (ACVIM) stages. ANIMALS: Sixty privately-owned dogs diagnosed with MMVD. METHODS: The echocardiographic database of our institution was retrospectively searched for dogs diagnosed with MMVD and RT3DE data set acquisition...
September 27, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Flavia R Greiffo, Oliver Eickelberg, Isis E Fernandez
Fibrotic lung diseases involve subject-environment interactions, together with dysregulated homeostatic processes, impaired DNA repair and distorted immune functions. Systems medicine-based approaches are used to analyse diseases in a holistic manner, by integrating systems biology platforms along with clinical parameters, for the purpose of understanding disease origin, progression, exacerbation and remission.Interstitial lung diseases (ILDs) refer to a heterogeneous group of complex fibrotic diseases. The increase of systems medicine-based approaches in the understanding of ILDs provides exceptional advantages by improving diagnostics, unravelling phenotypical differences, and stratifying patient populations by predictable outcomes and personalised treatments...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
Nicole Higgins, Paul C Fitzgerald, Dominique van Dyk, Robert A Dyer, Natalie Rodriguez, Robert J McCarthy, Cynthia A Wong
BACKGROUND: Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. METHODS: This study was a randomized double-blind clinical trial...
September 25, 2017: Anesthesia and Analgesia
Qiuli Fu, Zhe Mo, Danni Lyu, Lifang Zhang, Zhenwei Qin, Qiaomei Tang, Houfa Yin, Peiwei Xu, Lizhi Wu, Xiaoming Lou, Zhijian Chen, Ke Yao
BACKGROUND: Conjunctivitis, one of the most common ocular surface diseases, can be caused by many factors. OBJECTIVES: The objective of this study was to investigate the potential association between conjunctivitis and air pollutants. MATERIALS AND METHODS: Data of 9737 outpatient visits for conjunctivitis from July 1, 2014 to June 30, 2016 were obtained from the Eye Center of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China...
September 22, 2017: Environmental Pollution
Juan Iovanna, Nelson Dusetti
Accumulation of genetic mutations drives the development of pancreatic ductal adenocarcinoma (PDAC). Contrary to what it is expected, however, genetic analyses, no matter how precise or detailed, do not allow the identification of patient groups with different clinical outcomes or the selection of specific treatments. In fact, clinical outcome and sensitivity to treatments are associated with a given phenotype and are therefore associated at a transcriptomic level. In practical terms, therefore, the most appropriate readout for phenotypically stratifying PDACs should be transcriptomic and not genetic analysis...
September 22, 2017: Cancer Letters
Louise E Bartlett, Nicole Pratt, Elizabeth E Roughead
AIM: To compare persistence in people who initiate the combination of amlodipine and statin as a fixed dose combination (FDC) or separate pill combination (SePC), and assess the impact of prior medicine exposure on this outcome. METHOD: Prescription dispensing data from a national administrative dataset were used to identify patients initiating FDCs or SePCs of amlodipine and statin between April and September 2013. Each cohort was stratified according to dispensing of calcium channel blockers (CCB) or statins in the prior 12 months...
September 25, 2017: Current Medical Research and Opinion
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