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Stratified medicine

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https://www.readbyqxmd.com/read/28106607/individualized-venous-thromboembolism-risk-stratification-using-the-2005-caprini-score-to-identify-the-benefits-and-harms-of-chemoprophylaxis-in-surgical-patients-a-meta-analysis
#1
Christopher J Pannucci, Lukasz Swistun, John K MacDonald, Peter K Henke, Benjamin S Brooke
OBJECTIVE: We performed a meta-analysis to investigate benefits and harms of chemoprophylaxis among surgical patients individually risk stratified for venous thromboembolism (VTE) using Caprini scores. SUMMARY OF BACKGROUND DATA: Individualized VTE risk stratification may identify high risk surgical patients who benefit from peri-operative chemoprophylaxis. METHODS: MEDLINE, EMBASE, and the Cochrane Library (CENTRAL) databases were queried...
January 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28100276/realising-stratified-psychiatry-using-multidimensional-signatures-and-trajectories
#2
Dan W Joyce, Angie A Kehagia, Derek K Tracy, Jessica Proctor, Sukhwinder S Shergill
BACKGROUND: Stratified or personalised medicine targets treatments for groups of individuals with a disorder based on individual heterogeneity and shared factors that influence the likelihood of response. Psychiatry has traditionally defined diagnoses by constellations of co-occurring signs and symptoms that are assigned a categorical label (e.g. schizophrenia). Trial methodology in psychiatry has evaluated interventions targeted at these categorical entities, with diagnoses being equated to disorders...
January 18, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28096287/prediction-models-for-exacerbations-in-patients-with-copd
#3
REVIEW
Beniamino Guerra, Violeta Gaveikaite, Camilla Bianchi, Milo A Puhan
Personalised medicine aims to tailor medical decisions to the individual patient. A possible approach is to stratify patients according to the risk of adverse outcomes such as exacerbations in chronic obstructive pulmonary disease (COPD). Risk-stratified approaches are particularly attractive for drugs like inhaled corticosteroids or phosphodiesterase-4 inhibitors that reduce exacerbations but are associated with harms. However, it is currently not clear which models are best to predict exacerbations in patients with COPD...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28087565/perturbation-of-retinoid-homeostasis-increases-malformation-risk-in-embryos-exposed-to-pregestational-diabetes
#4
Leo M Y Lee, Maran B W Leung, Rachel C Y Kwok, Yun-Chung Leung, Chi-Chiu Wang, Peter J McCaffery, Andrew J Copp, Alisa S W Shum
Pregestational diabetes is highly associated with increased risk of birth defects. However, factors that can increase or reduce expressivity and penetrance of malformations in diabetic pregnancies remain poorly identified. All-trans retinoic acid (RA) plays crucial roles in embryogenesis. Here, we find that Cyp26a1, which encodes a key enzyme for catabolic inactivation of RA required for tight control of local RA concentrations, is significantly down-regulated in embryos of diabetic mice. Embryonic tissues expressing Cyp26a1 show reduced efficiency of RA clearance...
January 13, 2017: Diabetes
https://www.readbyqxmd.com/read/28077904/regadenoson-in-myocardial-perfusion-study-first-institutional-experiences-in-bosnia-and-herzegovina
#5
Nermina Beslic, Renata Milardovic, Amera Sadija, Sejla Ceric, Zeljka Raic
INTRODUCTION: Myocardial perfusion imaging (MPI) is widely used in the evaluation of known and suspected coronary artery disease (CAD). Imaging of heart in stress and rest enables the comparison of myocardial uptake of radiotracer in proportion to the needs and coronary flow, which is used for detection of perfusion defects. Exercise stress and pharmacologic agents are used for the stressing purpose. Novel pharmacologic stressor regadenoson is A2A selective adenosine agonist, which selectively binds to the adenosine receptors in coronary arteries causing coronary dilatation...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28075351/circulating-nucleosomes-and-nucleosome-modifications-as-biomarkers-in-cancer
#6
REVIEW
Peter McAnena, James A L Brown, Michael J Kerin
Traditionally the stratification of many cancers involves combining tumour and clinicopathological features (e.g., patient age; tumour size, grade, receptor status and location) to inform treatment options and predict recurrence risk and survival. However, current biomarkers often require invasive excision of the tumour for profiling, do not allow monitoring of the response to treatment and stratify patients into broad heterogeneous groups leading to inconsistent treatment responses. Here we explore and describe the benefits of using circulating biomarkers (nucleosomes and/or modifications to nucleosomes) as a non-invasive method for detecting cancer and monitoring response to treatment...
January 8, 2017: Cancers
https://www.readbyqxmd.com/read/28067704/intravenous-ketamine-infusions-for-neuropathic-pain-management-a-promising-therapy-in-need-of-optimization
#7
Dermot P Maher, Lucy Chen, Jianren Mao
Intravenous ketamine infusions have been used extensively to treat often-intractable neuropathic pain conditions. Because there are many widely divergent ketamine infusion protocols described in the literature, the variation in these protocols presents a challenge for direct comparison of one protocol with another and in discerning an optimal protocol. Careful examination of the published literature suggests that ketamine infusions can be useful to treat neuropathic pain and that certain characteristics of ketamine infusions may be associated with better clinical outcomes...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28065816/development-of-customized-fetal-growth-charts-in-twins
#8
Tullio Ghi, Federico Prefumo, Anna Fichera, Mariano Lanna, Enrico Periti, Nicola Persico, Elsa Viora, Giuseppe Rizzo
BACKGROUND: Twin gestations are at significantly higher risk of fetal growth restriction in comparison with singletons. Using fetal biometric charts customized for obstetrical and parental characteristics may facilitate accurate assessment of fetal growth. OBJECTIVE(S): To construct reference charts for gestation of fetal biometric parameters stratified by chorionicity and customized for obstetrical and parental characteristics. STUDY DESIGN: Fetal biometric measurements obtained from serial ultrasound examinations in uncomplicated twin pregnancies delivering after 36 weeks of gestation were collected by 19 Italian fetal medicine units under the auspices of the Società Italiana di Ecografia Ostetrica e Ginecologica...
January 5, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28051967/introducing-a-novel-applicant-ranking-tool-to-predict-future-resident-performance-a-pilot-study
#9
Sarah N Bowe, Erik K Weitzel, William N Hannah, Brian M Fitzgerald, Gregory P Kraus, Christopher J Nagy, Stephen A Harrison
The purposes of this study are to (1) introduce our novel Applicant Ranking Tool that aligns with the Accreditation Council for Graduate Medical Education competencies and (2) share our preliminary results comparing applicant rank to current performance. After a thorough literature review and multiple roundtable discussions, an Applicant Ranking Tool was created. Feasibility, satisfaction, and critiques were discussed via open feedback session. Inter-rater reliability was assessed using weighted kappa statistic (κ) and Kendall coefficient of concordance (W)...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28049673/dental-students-reflections-on-quality-of-periodontal-care-in-dental-school-clinics
#10
Sangeetha Chandrasekaran, Charles Powell, Laurice De la Rosa, Anuj Mittal, Lonnie Johnson
The aim of this study was to analyze dental students' descriptions of and reflections on the periodontal care they provided for their patients in dental school clinics. All students enrolled in the final year of the DDS program in 2011-14 at the University of Colorado School of Dental Medicine were required to complete a self-assessment of the periodontal care they provided for patients. Assessments from 263 students were compiled and qualitatively analyzed. The key reasons given for not providing good care were identified and then stratified as student/school-dependent or patient-dependent factors...
January 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/28041596/clinical-settings-in-knee-osteoarthritis-pathophysiology-guides-treatment
#11
REVIEW
Gabriel Herrero-Beaumont, Jorge A Roman-Blas, Olivier Bruyère, Cyrus Cooper, John Kanis, Stefania Maggi, René Rizzoli, Jean-Yves Reginster
Osteoarthritis (OA) is the most common chronic joint disorder and its prevalence increases rapidly during midlife. Complex interactions of genetic alterations, sex hormone deficit, and aging with mechanical factors and systemic inflammation-associated metabolic syndrome lead to joint damage. Thus, the expression of a clinical phenotype in the early stages of OA relies on the main underlying pathway and predominant joint tissue involved at a given time. Moreover, OA often coexists with other morbidities in the same patient, which in turn condition the OA process...
February 2017: Maturitas
https://www.readbyqxmd.com/read/28040667/multivariate-linear-regression-modelling-of-lung-weight-in-24-056-swedish-medico-legal-autopsy-cases
#12
T Gustafsson, A Eriksson, C J Wingren
Heavy combined lung weight at autopsy is a non-specific autopsy finding associated with certain causes of death such as intoxication. There is however no clear definition of what constitutes "heavy" lung weight. Different reference values have been suggested but previous studies have been limited by small select populations and only univariate regression has been attempted. The aim of this study was to create a model to estimate lung weight from decedent parameters. We identified all cases >18 years age autopsied at the Swedish National Board of Forensic Medicine from 2000 through 2013, excluding cases with a post-mortem interval >5 days as well as cases with extreme values, totalling 24,056 cases...
December 12, 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28040277/microparticles-and-their-role-in-coronary-artery-disease
#13
REVIEW
Sudheer Koganti, Despina Eleftheriou, Paul A Brogan, Tushar Kotecha, Ying Hong, Roby D Rakhit
Despite significant advances in prevention, medical and interventional management, coronary artery disease (CAD) remains the leading cause of death worldwide. Although the number of people being diagnosed with CAD has plateaued in the western world, it is projected to increase significantly in the developing world reaching epidemic proportions, particularly in South Asia. To better stratify the risk of developing and suffering a cardiovascular event due to CAD, not only plasma biomarkers relating to disease burden but also disease activity in CAD are needed; this will allow targeting of appropriate management to high-risk patients for acute events...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28034454/comprehensive-genomic-sequencing-and-the-molecular-profiles-of-clinically-advanced-breast-cancer
#14
Jeffrey S Ross, Laurie M Gay
Targeting specific mutations that have arisen within a tumour is a promising means of increasing the efficacy of treatments, and breast cancer is no exception to this new paradigm of personalised medicine. Traditional DNA sequencing methods used to characterise clinical cancer specimens and impact treatment decisions are highly sensitive, but are often limited in their scope to known mutational hot spots. Next-generation sequencing (NGS) technologies can also test for these well-known hot spots, as well as identifying insertions and deletions, copy number changes such as ERBB2 (HER2) gene amplification, and a wide array of fusion or rearrangement events...
December 26, 2016: Pathology
https://www.readbyqxmd.com/read/28028721/prevalence-and-determinants-of-traditional-complementary-and-alternative-medicine-provider-use-among-adults-from-32-countries
#15
Karl Peltzer, Supa Pengpid
OBJECTIVE: To estimate recent prevalence data (2011-2013) on traditional, complementary and alternative medicine (TCAM) provider use and sociodemographic and health related correlates in nationally representative population samples from 32 countries from all world regions. METHODS: This secondary analysis was based on the International Social Survey Program (ISSP), 2011-2013, Health and Health Care Module. In a cross-sectional population-based survey (N=52,801), simple or multi-stage stratified random sampling was used, resulting in representative samples of the adult population of respective countries...
December 27, 2016: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28025609/indications-for-tonsillectomy-stratified-by-the-level-of-evidence
#16
REVIEW
Jochen P Windfuhr
Background: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of evidence-based medicine. Material and methods: A systematic Medline research was performed using the key word of "tonsillectomy" in combination with different filters such as "systematic reviews", "meta-analysis", "English", "German", and "from 1984/01/01 to 2015/05/31"...
2016: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/28013197/achieving-consensus-on-minimum-data-items-including-core-outcome-domains-for-a-longitudinal-observational-cohort-study-in-rheumatoid-arthritis
#17
Elena Nikiphorou, Sarah L Mackie, John Kirwan, Martin Boers, John Isaacs, Ann W Morgan, Adam Young
OBJECTIVES: To obtain consensus on the minimum data items for an observational cohort study in RA in the UK and to make available the process for similar studies and other rheumatic conditions. METHODS: Individuals with a diverse range of expertise and backgrounds were invited to participate in a process of proposing a minimum core dataset (MCD) for research studies, commissioned by Arthritis Research UK as part of the larger INBANK project. The group included patients and representatives from clinical and academic rheumatology, outcomes science, stratified medicine, health economics, and national professional and academic bodies/committees...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28007364/factor-eight-inhibitor-bypassing-agent-feiba-for-reversal-of-target-specific-oral-anticoagulants-in-life-threatening-intracranial-bleeding
#18
Gordon Mao, Lauren King, Sarah Young, Richard Kaplan
INTRODUCTION: As increasing number of patients present to emergency departments with life threatening hemorrhages, particularly intracranial hemorrhage on anticoagulation physicians must be cognizant of the limitations of the available reversal options. Based upon the available literature, our institution formulated a reversal algorithm for patients with life-threatening bleeding on factor Xa inhibitors by administering factor eight inhibitor bypassing agent (FEIBA) 20 units/kg. METHODS: A retrospective chart review was performed to include all patients who received FEIBA per institutional protocol...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28005253/diverging-conclusions-from-the-same-meta-analysis-in-drug-safety-source-of-data-primary-versus-secondary-takes-a-toll
#19
Guillermo Prada-Ramallal, Bahi Takkouche, Adolfo Figueiras
INTRODUCTION: Meta-analyses of observational studies represent an important tool for assessing efficacy and safety in the pharmacoepidemiologic field. The data from the individual studies are either primary (i.e., collected through interviews or self-administered questionnaires) or secondary (i.e., collected from databases that were established for other purposes). So far, the origin of the data (primary vs. secondary) has not been systematically assessed as a source of heterogeneity in pharmacoepidemiologic meta-analyses...
December 22, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28003130/ethnopharmacological-survey-of-medicinal-plants-used-in-daraa-tafilalet-region-province-of-errachidia-morocco
#20
Mohamed Eddouks, Mohammed Ajebli, Morad Hebi
ETHNOPHARMACOLOGICAL RELEVANCE: We carried out an ethnobotanical survey in Tafilalet region. This region is classified by the UNESCO as a reserve of biosphere and represents an important area with important knowledge of traditional medicine, especially the use of medicinal plants for human healthcare. Furthermore, the geographic location of this region makes this site a diverse and interesting resource of herbal biodiversity. THE AIM OF THE STUDY: The study aimed to collect information about medicinal plants used in Tafilalet region as well as the indigenous knowledge related to the use of this natural resource in healthcare by the local population in order to preserve and protect this invaluable inheritance from loss and overlook...
December 18, 2016: Journal of Ethnopharmacology
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