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Stratified medicine

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https://www.readbyqxmd.com/read/29457840/population-pharmacokinetics-and-pharmacogenomics-of-apixaban-in-japanese-adult-patients-with-atrial-fibrillation
#1
Satoshi Ueshima, Daiki Hira, Yuuma Kimura, Ryo Fujii, Chiho Tomitsuka, Takuya Yamane, Yohei Tabuchi, Tomoya Ozawa, Hideki Itoh, Seiko Ohno, Minoru Horie, Tomohiro Terada, Toshiya Katsura
AIMS: This study aimed to analyse the effects of genetic polymorphisms in drug transporters and metabolising enzymes, and clinical laboratory data on the pharmacokinetic parameters of apixaban. METHODS: Data were collected from 81 Japanese patients with atrial fibrillation. Pharmacogenomic data were stratified by ABCB1, ABCG2, and CYP3A5 polymorphisms. The pharmacokinetic profile of apixaban was described by a one-compartment model with first-order absorption. Population pharmacokinetic analysis was conducted using non-linear mixed effect modelling (NONMEM™) program...
February 19, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29452422/asynchronous-and-pathological-windows-of-implantation-two-causes-of-recurrent-implantation-failure
#2
P Sebastian-Leon, N Garrido, J Remohí, A Pellicer, P Diaz-Gimeno
STUDY QUESTION: Is endometrial recurrent implantation failure (RIF) only a matter of an asynchronous (displaced) window of implantation (WOI), or could it also be a pathological (disrupted) WOI? SUMMARY ANSWER: Our predictive results demonstrate that both displaced and disrupted WOIs exist and can present independently or together in the same RIF patient. WHAT IS KNOWN ALREADY: Since 2002, many gene expression signatures associated with endometrial receptivity and RIF have been described...
February 14, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29450830/personalized-medicine-and-pay-for-performance-should-pharmaceutical-firms-be-fully-penalized-when-treatment-fails
#3
Fernando Antoñanzas, Roberto Rodríguez-Ibeas, Carmelo A Juárez-Castelló
In this article, we model the behavior of a pharmaceutical firm that has marketing authorization for a new therapy believed to be a candidate for personalized use in a subset of patients, but that lacks information as to why a response is seen only in some patients. We characterize the optimal outcome-based reimbursement policy a health authority should follow to encourage the pharmaceutical firm to undertake research and development activities to generate the information needed to effectively stratify patients...
February 15, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29443392/spatial-aspects-of-oncogenic-signaling-determine-response-to-combination-therapy-in-slice-explants-from-kras-driven-lung-tumors
#4
Katja Närhi, Ashwini S Nagaraj, Elina Parri, Riku Turkki, Petra W van Duijn, Annabrita Hemmes, Jenni Lahtela, Virva Uotinen, Mikko I Mäyränpää, Kaisa Salmenkivi, Jari Räsänen, Nina Linder, Jan Trapman, Antti Rannikko, Olli Kallioniemi, Taija Af Hällström, Johan Lundin, Wolfgang Sommergruber, Simon Anders, Emmy W Verschuren
A key question in precision medicine is how functional heterogeneity in solid tumors informs therapeutic sensitivity. We demonstrate that spatial characteristics of oncogenic signaling and therapy response can be modeled in precision-cut slices from Kras-driven non-small cell lung cancer (NSCLC) of varying histopathologies. Unexpectedly, profiling of in situ tumors demonstrates that signaling stratifies mostly according to histopathology, showing enhanced AKT and SRC activity in adenosquamous carcinoma (ASC), and MAPK activity in adenocarcinoma (AC)...
February 14, 2018: Journal of Pathology
https://www.readbyqxmd.com/read/29431136/how-patients-experiences-of-respiratory-tract-infections-affect-healthcare-seeking-and-antibiotic-use-insights-from-a-cross-sectional-survey-in-rural-anhui-china
#5
Mengjie Diao, Xingrong Shen, Jing Cheng, Jing Chai, Rui Feng, Panpan Zhang, Rongyao Zhou, Helen Lambert, Debin Wang
OBJECTIVE: To investigate the occurrence of reported respiratory tract infection (RTI) symptoms and their effects on use of self and professional care among patients in the community. DESIGN: A cross-sectional retrospective household survey. SETTING: 12 administrative villages from rural Anhui, China. PARTICIPANTS: 2160 rural adult residents aged ≥18 years registered as rural residents and actually living in the sampled villages when this study was conducted...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29427409/utilization-of-antiepileptic-medicines-in-swedish-children-and-adolescents-with-different-diagnoses
#6
Linnéa Karlsson Lind, Katarina Wide, Björn Wettermark, Mia von Euler
This study aimed to investigate the utilization of antiepileptic drugs (AEDs) in children and adolescents with epilepsy and other diagnoses in a nationwide population between 2007 and 2014. Data on dispensed prescriptions of AEDs were collected from the Swedish Prescribed Drug Register and linked to diagnosis data from the National Patient Register covering all in- and outpatient consultations from Swedish hospitals. Children aged 0-17 years who had received at least one prescription for AEDs were selected...
February 10, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29410461/in-silico-clinical-trials-for-pediatric-orphan-diseases
#7
A Carlier, A Vasilevich, M Marechal, J de Boer, L Geris
To date poor treatment options are available for patients with congenital pseudarthrosis of the tibia (CPT), a pediatric orphan disease. In this study we have performed an in silico clinical trial on 200 virtual subjects, generated from a previously established model of murine bone regeneration, to tackle the challenges associated with the small, pediatric patient population. Each virtual subject was simulated to receive no treatment and bone morphogenetic protein (BMP) treatment. We have shown that the degree of severity of CPT is significantly reduced with BMP treatment, although the effect is highly subject-specific...
February 6, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29406378/downward-trend-in-pediatric-resident-laryngoscopy-participation-in-picus
#8
Aayush Gabrani, Taiki Kojima, Ronald C Sanders, Asha Shenoi, Vicki Montgomery, Simon J Parsons, Sandeep Gangadharan, Sholeen Nett, Natalie Napolitano, Keiko Tarquinio, Dennis W Simon, Anthony Lee, Guillaume Emeriaud, Michelle Adu-Darko, John S Giuliano, Keith Meyer, Ana Lia Graciano, David A Turner, Conrad Krawiec, Adnan M Bakar, Lee A Polikoff, Margaret Parker, Ilana Harwayne-Gidansky, Benjamin Crulli, Paula Vanderford, Ryan K Breuer, Eleanor Gradidge, Aline Branca, Lily B Grater-Welt, David Tellez, Lisa V Wright, Matthew Pinto, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. DESIGN: Prospective cohort study. SETTING: Twenty-five PICUs at various children's hospitals across the United States. PATIENTS: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children)...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29405335/dielectrophoretic-analysis-of-treated-cancer-cells-for-rapid-assessment-of-treatment-efficacy
#9
Sina Mahabadi, Fatima H Labeed, Michael P Hughes
Whilst personalized medicine (where interventions are precisely tailored to a patient's genotype and phenotype, as well as the nature and state of the disease) is regarded as an optimal form of treatment, the time and cost associated with it means it remains inaccessible to the greater public. A simpler alternative, stratified medicine, identifies groups of patients who are likely to respond to a given treatment. This allows appropriate treatments to be selected at the start of therapy, avoiding the common "trial and error" approach of replacing a therapy only once it is demonstrated to be ineffective in the patient...
February 5, 2018: Electrophoresis
https://www.readbyqxmd.com/read/29403617/general-health-literacy-assessment-of-iranian-women-in-mashhad
#10
Lida Jarahi, Reza Asadi, Hamid Reza Hakimi
Background: In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. Aim: To assess women's health literacy and relative factors in Mashhad (Iran). Methods: Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this cross-sectional study by stratified sampling method...
November 2017: Electronic Physician
https://www.readbyqxmd.com/read/29402869/treatment-of-hypertension-in-renal-transplant-recipients-in-four-independent-cross-sectional-analyses
#11
Izabella Kuźmiuk-Glembin, Dorota Adrych, Leszek Tylicki, Zbigniew Heleniak, Hanna Garnier, Jakub Wiśniewski, Przemysław Rutkowski, Bolesław Rutkowski, Alicja Dębska-Ślizień
BACKGROUND/AIMS: This retrospective study analysed hypertension management and adherence to blood pressure (BP) targets among renal transplant recipients (RTRs) under specialized care in the Outpatient Transplantation Unit in the Department of Nephrology, Transplantology and Internal Medicine at Gdansk University Hospital. METHODS: Medical records of 101, 316, 639 and 818 RTRs diagnosed with hypertension, who received outpatient care in 2001, 2006, 2011 and 2014, respectively were analysed in four independent cross-sectional surveys...
January 24, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29400552/integrating-mammographic-breast-density-in-glandular-dose-calculation
#12
Moayyad E Suleiman, Patrick C Brennan, Ernest Ekpo, Peter Kench, Mark F McEntee
OBJECTIVE: This work proposes the use of mammographic breast density (MBD) to estimate actual glandular dose (AGD), and assesses how AGD compares to mean glandular dose (MGD) estimated using Dance et al. METHOD: HASH(0x5349550) METHODS: A retrospective sample of anonymised mammograms (52,405) was retrieved from a central database. Technical parameters and patient characteristics were exported from the Digital Imaging and Communication in Medicine (DICOM) header using third party software...
February 5, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29394965/frequency-of-macroprolactin-in-hyperprolactinemia
#13
Noreen Abbas Sherazi, Mirza Zain Baig, Aysha Habib Khan
OBJECTIVE: To determine the frequency of Macroprolactin (MaPRL) in patients with increased total prolactin and its clinical and financial impact. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Section of Clinical Chemistry, Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from March to May 2015. METHODOLOGY: Patients with high total prolactin were screened by polyethylene glycol (PEG) precipitation for determination of MaPRL...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29389748/clinical-trials-in-autism-spectrum-disorder-evidence-challenges-and-future-directions
#14
Evdokia Anagnostou
PURPOSE OF REVIEW: The purpose of this manuscript is to review the evidence generated by clinical trials of pharmaceuticals in autism spectrum disorder (ASD), describe challenges in the conduct of such trials, and discuss future directions RECENT FINDINGS: Clinical trials in ASD have produced several compounds to adequately support the pharmacological treatment of associated symptom domains: attention deficit hyperactivity disorder (methylphenidate, atomoxetine, and alpha agonists), irritability/aggression (risperidone and aripiprazole), sleep (melatonin), and weight gain associated with atypical antipsychotic use (metformin)...
January 31, 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29383324/a-predictive-algorithm-to-detect-opioid-use-disorder-what-is-the-utility-in-a-primary-care-setting
#15
Chee Lee, Maneesh Sharma, Svetlana Kantorovich, Ashley Brenton
Purpose: The purpose of this study was to determine the clinical utility of an algorithm-based decision tool designed to assess risk associated with opioid use in the primary care setting. Methods: A prospective, longitudinal study was conducted to assess the utility of precision medicine testing in 1822 patients across 18 family medicine/primary care clinics in the United States. Using the profile, patients were categorized into low, moderate, and high risk for opioid use...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29383057/fantastic-learning-moments-and-where-to-find-them
#16
Alexander Y Sheng, Ryan Sullivan, Kara Kleber, Patricia M Mitchell, James H Liu, Jolion McGreevy, Kerry McCabe, Annemieke Atema, Jeffrey I Schneider
Introduction: Experiential learning is crucial for the development of all learners. Literature exploring how and where experiential learning happens in the modern clinical learning environment is sparse. We created a novel, web-based educational tool called "Learning Moment" (LM) to foster experiential learning among our learners. We used data captured by LM as a research database to determine where learning experiences were occuring within our emergency department (ED). We hypothesized that these moments would occur more frequently at the physician workstations as opposed to the bedside...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29382306/quality-medicines-in-maternal-health-results-of-oxytocin-misoprostol-magnesium-sulfate-and-calcium-gluconate-quality-audits
#17
Chimezie Anyakora, Yetunde Oni, Uchenna Ezedinachi, Adebola Adekoya, Ibrahim Ali, Charles Nwachukwu, Charles Esimone, Victor Abiola, Jude Nwokike
BACKGROUND: The high level of maternal mortality and morbidity as a result of complications due to childbirth is unacceptable. The impact of quality medicines in the management of these complications cannot be overemphasized. Most of those medicines are sensitive to environmental conditions and must be handled properly. In this study, the quality of oxytocin injection, misoprostol tablets, magnesium sulfate, and calcium gluconate injections was assessed across the six geopolitical zones of Nigeria...
January 30, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29373991/ethnomycological-knowledge-in-three-communities-in-amealco-qu%C3%A3-retaro-m%C3%A3-xico
#18
Daniel Robles-García, Humberto Suzán-Azpiri, Adriana Montoya-Esquivel, Jesús García-Jiménez, Edgardo Ulises Esquivel-Naranjo, Elhadi Yahia, Fidel Landeros-Jaime
BACKGROUND: Fungi have multiple uses in temperate areas of México, but an important decrease in the traditional knowledge of uses and customs of mushrooms becomes a fundamental issue for fungi conservation. However, only few studies quantify the traditional ethnomycological knowledge in México, and this study is the first quantitative report for Querétaro, a central state with both Otomí and Mestizo communities and a high fungi diversity. METHODS: The present study was conducted registering traditional knowledge on the use and consumption of mushrooms in three Hñähñu (Otomí) communities (Tesquedó, Xajay, and Tenasdá) in Amealco de Bonfil, Querétaro, México, between August 2013 and November 2014...
January 26, 2018: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/29373209/automated-radiology-pathology-module-correlation-using-a-novel-report-matching-algorithm-by-organ-system
#19
Bari Dane, Ankur Doshi, Soterios Gfytopoulos, Priya Bhattacharji, Michael Recht, William Moore
OBJECTIVES AND RATIONALE: Radiology-pathology correlation is time-consuming and is not feasible in most clinical settings, with the notable exception of breast imaging. The purpose of this study was to determine if an automated radiology-pathology report pairing system could accurately match radiology and pathology reports, thus creating a feedback loop allowing for more frequent and timely radiology-pathology correlation. METHODS: An experienced radiologist created a matching matrix of radiology and pathology reports...
January 17, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29369358/the-association-between-weight-gain-during-pregnancy-and-intertwin-delivery-weight-discordance-using-2011-2015-birth-registration-data-from-the-usa
#20
Yanni Xiao, Minxue Shen, Shujuan Ma, Xuan Tao, Shi Wu Wen, Hongzhuan Tan
OBJECTIVE: To assess the effect of weight gain during pregnancy on intertwin delivery weight discordance. METHODS: In the present retrospective cohort study using twin delivery records, data were extracted from the 2011-2015 USA birth registration dataset created by the Centers for Disease Control and Prevention. The outcome variable was delivery weight discordance. The nonlinear association of weight gain during pregnancy with delivery weight discordance was examined using a generalized additive model, adjusting for potential confounders...
January 25, 2018: International Journal of Gynaecology and Obstetrics
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