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Stratified medicine

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https://www.readbyqxmd.com/read/29242522/amyloid-%C3%AE-and-tau-complexity-towards-improved-biomarkers-and-targeted-therapies
#1
REVIEW
Juan Carlos Polanco, Chuanzhou Li, Liviu-Gabriel Bodea, Ramon Martinez-Marmol, Frederic A Meunier, Jürgen Götz
Most neurodegenerative diseases are proteinopathies, which are characterized by the aggregation of misfolded proteins. Although many proteins have an intrinsic propensity to aggregate, particularly when cellular clearance systems start to fail in the context of ageing, only a few form fibrillar aggregates. In Alzheimer disease, the peptide amyloid-β (Aβ) and the protein tau aggregate to form plaques and tangles, respectively, which comprise the histopathological hallmarks of this disease. This Review discusses the complexity of Aβ biogenesis, trafficking, post-translational modifications and aggregation states...
December 15, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/29242403/does-pet-reconstruction-method-affect-deauville-scoring-in-lymphoma-patients
#2
Blandine Enilorac, Charline Lasnon, Cathy Nganoa, Christophe Fruchart, Anne Claire Gac, Gandhi Damaj, Nicolas Aide
Background: When scoring 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) with the Deauville scale (DS), the quantification of tumor and reference organs limits the problem of optical misinterpretation. Compared to conventional reconstruction algorithms, point spread function (PSF) modeling significantly increases standardized uptake values (SUVs) in tumors but only moderately in the liver, which could affect the DS. We investigated whether the choice of the reconstruction algorithm affects the DS and whether discordances affect the capability of FDG PET to stratify lymphoma patients...
December 14, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29234875/chronic-disease-list-conditions-in-patients-with-rheumatoid-arthritis-in-the-private-healthcare-sector-of-south-africa
#3
Nericke Olivier, Johanita Burger, Rianda Joubert, Martie Lubbe, Adele Naudé, Marike Cockeran
INTRODUCTION: Little is known about the burden of rheumatoid arthritis (RA) in South Africa. The aim of this study was to establish the prevalence of RA and coexisting chronic disease list (CDL) conditions in the private health sector of South Africa. METHODS: A retrospective, cross-sectional analysis was performed on medicine claims data from 1 January 2014 to 31 December 2014 to establish the prevalence of RA. The cohort of RA patients was then divided into those with and those without CDL conditions, to determine the number and type of CDL conditions per patient, stratified by age group and gender...
December 12, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29228059/does-access-to-clinical-study-reports-from-the-european-medicines-agency-reduce-reporting-biases-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-on-the-effect-of-erythropoiesis-stimulating-agents-in-cancer-patients
#4
Eliane Rohner, Michael Grabik, Thomy Tonia, Peter Jüni, Frank Pétavy, Francesco Pignatti, Julia Bohlius
Since 2010, the European Medicines Agency (EMA) has provided access to clinical study reports (CSRs). We requested CSRs for randomized controlled trials (RCTs) of erythropoiesis-stimulating agents (ESAs) in cancer patients from EMA and identified RCT publications with literature searches. We assessed CSR availability and completeness, the impact of unreported and unpublished data obtained from CSRs on the effects of ESAs on quality of life (QoL) of cancer patients, and discrepancies between data reported in the public domain and in CSRs...
2017: PloS One
https://www.readbyqxmd.com/read/29226811/evidence-based-therapy-and-its-association-with-workforce-detachment-after-first-hospitalization-for-heart-failure
#5
Rasmus Rørth, Emil L Fosbøl, Ulrik M Mogensen, Kristian Kragholm, Pardeep S Jhund, Mark C Petrie, Morten Schou, Gunnar H Gislason, John J V McMurray, Christian Torp-Pedersen, Lars Køber, Søren L Kristensen
OBJECTIVES: This study investigated the association between the use of evidence-based medicine (EBM) for heart failure (HF) and risk of workforce detachment. BACKGROUND: The ability to work can be a marker of functional capacity and quality of life. METHODS: We examined a nationwide cohort of patients in the workforce 1 year after first hospitalization for HF. EBM was defined as treatment with β-blockers and renin angiotensin system inhibitors...
November 27, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29224672/sle-redefined-on-the-basis-of-molecular-pathways
#6
REVIEW
Guillermo Barturen, Marta E Alarcón-Riquelme
The implementation of precision medicine requires the recruiting of patients in statistically enough numbers, the possibility of obtaining enough materials, and the integration of data from various platforms, which are all real limitations. These types of studies have been performed extensively in cancer but barely on systemic lupus erythematosus (SLE) or other rheumatic diseases. To consider the practical use of the information obtained from such studies, we have to take into account the best biological fluid to use, the ease to perform the analysis in clinical practice, and its relevance to clinical practice...
June 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29207572/fixed-and-adaptive-parallel-subgroup-specific-design-for-survival-outcomes-power-and-sample-size
#7
Miranta Antoniou, Andrea L Jorgensen, Ruwanthi Kolamunnage-Dona
Biomarker-guided clinical trial designs, which focus on testing the effectiveness of a biomarker-guided approach to treatment in improving patient health, have drawn considerable attention in the era of stratified medicine with many different designs being proposed in the literature. However, planning such trials to ensure they have sufficient power to test the relevant hypotheses can be challenging and the literature often lacks guidance in this regard. In this study, we focus on the parallel subgroup-specific design, which allows the evaluation of separate treatment effects in the biomarker-positive subgroup and biomarker-negative subgroup simultaneously...
December 4, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29205435/relative-efficiency-of-precision-medicine-designs-for-clinical-trials-with-predictive-biomarkers
#8
Weichung Joe Shih, Yong Lin
Prospective randomized clinical trials addressing biomarkers are time consuming and costly, but are necessary for regulatory agencies to approve new therapies with predictive biomarkers. For this reason, recently, there have been many discussions and proposals of various trial designs and comparisons of their efficiency in the literature. We compare statistical efficiencies between the marker-stratified design and the marker-based precision medicine design regarding testing/estimating 4 hypotheses/parameters of clinical interest, namely, treatment effects in each marker-positive and marker-negative cohorts, marker-by-treatment interaction, and the marker's clinical utility...
December 4, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29202320/screening-itself-for-disseminated-intravascular-coagulation-may-reduce-mortality-in-sepsis-a-nationwide-multicenter-registry-in-japan
#9
Yutaka Umemura, Kazuma Yamakawa, Mineji Hayakawa, Toshimitsu Hamasaki, Satoshi Fujimi
OBJECTIVES: Screening of patients with sepsis for disseminated intravascular coagulation (DIC) has been recommended in several guidelines. However, DIC screening is still not widely accepted as an essential component of sepsis management, partly because of a lack of evidence that DIC screening has an effect on mortality. We investigated whether DIC screening was associated with a survival benefit in patients with sepsis. DESIGN: Post hoc analysis of a nationwide multicenter retrospective cohort study...
November 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29198996/the-relationship-of-health-literacy-to-diabetes-status-differs-by-sex-in-older-adults
#10
Michael Quartuccio, Eleanor M Simonsick, Susan Langan, Tamara Harris, Rebecca L Sudore, Roland Thorpe, Caterina Rosano, Felicia Hill-Briggs, Sherita Golden, Rita R Kalyani
OBJECTIVE: Lower health literacy is associated with higher rates of mortality and chronic disease. It remains unclear whether health literacy is associated with diabetes and/or hyperglycemia in older adults, and if this relationship differs by sex. RESEARCH DESIGN AND METHODS: We performed a cross-sectional analysis of 2510 older adults in the Health, Aging and Body Composition (Health ABC) Study who had both a Rapid Estimate of Adult Literacy in Medicine (REALM) measurement and diabetes status available...
October 28, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29197305/internal-medicine-hospitalists-perceived-barriers-and-recommendations-for-optimizing-secondary-prevention-of-osteoporotic-hip-fractures
#11
Eng Keong Tan, Kah Poh Loh, Sarah L Goff
OBJECTIVES: Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. METHODS: In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center...
December 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29196046/prehospital-antibiotics-in-the-ambulance-for-sepsis-a-multicentre-open-label-randomised-trial
#12
Nadia Alam, Erick Oskam, Patricia M Stassen, Pieternel van Exter, Peter M van de Ven, Harm R Haak, Frits Holleman, Arthur van Zanten, Hien van Leeuwen-Nguyen, Victor Bon, Bart A M Duineveld, Rishi S Nannan Panday, Mark H H Kramer, Prabath W B Nanayakkara
BACKGROUND: Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also benefit from timely prehospital care. METHODS: After training EMS personnel in recognising sepsis, we did a randomised controlled open-label trial in ten large regional ambulance services serving 34 secondary and tertiary care hospitals in the Netherlands...
November 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29192598/personalized-medicine-pharmacogenomic-and-companion-biomarker
#13
Hana Manceau, Kawthar Amrani, Katell Peoc'h
The aim of this review is to provide a brief overview of personalized medicine, pharmacogenetics and companion tests. Personalized or stratified medicine is a new paradigm in the management of patients, aimed at better taking into account inter-individual variability. The response to drugs' intake varies considerably, depending on the transport and metabolism of the drugs, the target and the pathophysiological characteristics of the organism. Each stage is very variable and can be modified by endogenous factors (pathophysiology, age, sex, genetics…) or exogenous (environmental: taking other medicines, food, tobacco, alcohol…)...
December 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29189341/normative-data-set-of-sway-balance-mobile-assessment-in-pediatric-athletes
#14
Stevi L Anderson, Dustin Gatens, Colette Glatts, Stephen A Russo
OBJECTIVE: To examine and describe normative values for an objective, mobile measure of postural stability commonly used in concussion assessments, SWAY Balance (SWAY Medical, Tulsa, Oklahoma). DESIGN: Retrospective analysis of baseline balance assessments in a healthy pediatric population. SETTING: Baseline assessments completed by certified athletic trainers at an outpatient concussion center or sports medicine offices in Philadelphia, PA and surrounding suburban Pennsylvania and New Jersey or during an athletic trainer's baseline assessment of collegiate athletes at a National Collegiate Athletic Association (NCAA) Division-II University in Fort Lauderdale, FL...
November 16, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29185887/stratified-or-personalised-medicine-in-the-treatment-of-psoriasis
#15
Peter Cm van de Kerkhof
No abstract text is available yet for this article.
December 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29174310/gefitinib-versus-vinorelbine-plus-cisplatin-as-adjuvant-treatment-for-stage-ii-iiia-n1-n2-egfr-mutant-nsclc-adjuvant-ctong1104-a-randomised-open-label-phase-3-study
#16
Wen-Zhao Zhong, Qun Wang, Wei-Min Mao, Song-Tao Xu, Lin Wu, Yi Shen, Yong-Yu Liu, Chun Chen, Ying Cheng, Lin Xu, Jun Wang, Ke Fei, Xiao-Fei Li, Jian Li, Cheng Huang, Zhi-Dong Liu, Shun Xu, Ke-Neng Chen, Shi-Dong Xu, Lun-Xu Liu, Ping Yu, Bu-Hai Wang, Hai-Tao Ma, Hong-Hong Yan, Xue-Ning Yang, Qing Zhou, Yi-Long Wu
BACKGROUND: Cisplatin-based adjuvant chemotherapy is the standard of care for patients with resected stage II-IIIA non-small-cell lung cancer (NSCLC). RADIANT and SELECT trial data suggest patients with EGFR-mutant stage IB-IIIA resected NSCLC could benefit from adjuvant EGFR tyrosine kinase inhibitor treatment. We aimed to compare the efficacy of adjuvant gefitinib versus vinorelbine plus cisplatin in patients with completely resected EGFR-mutant stage II-IIIA (N1-N2) NSCLC. METHODS: We did a randomised, open-label, phase 3 trial at 27 centres in China...
November 21, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29172765/interdependent-career-types-and-divergent-standpoints-on-the-use-of-advanced-technology-in-medicine
#17
Daniel A Menchik
This paper uses the case of the uneven use of a robotic technology to explain how physicians with similar training come to engage in different medical practices. I develop a conceptual framework in which their decisions to use advanced technologies are informed by "interdependent career types," a concept that incorporates features of the professional social context of physicians' work and the expertise they use, and reflects how medicine distributes expertise via formal and informal referral structures. I draw on data regarding specialized physicians' differentiated use of this technology over five years as well as interviews with those who continue to use the technology and those who have abandoned it...
December 2017: Journal of Health and Social Behavior
https://www.readbyqxmd.com/read/29170406/an-extracellular-matrix-related-prognostic-and-predictive-indicator-for-early-stage-non-small-cell-lung-cancer
#18
Su Bin Lim, Swee Jin Tan, Wan-Teck Lim, Chwee Teck Lim
The prognosis and prediction of adjuvant chemotherapy (ACT) response in early-stage non-small cell lung cancer (NSCLC) patients remain poor in this era of personalized medicine. We hypothesize that extracellular matrix (ECM)-associated components could be potential markers for better diagnosis and prognosis due to their differential expression in 1,943 primary NSCLC tumors as compared to 303 normal lung tissues. Here we develop a 29-gene ECM-related prognostic and predictive indicator (EPPI). We validate a robust performance of the EPPI risk scoring system in multiple independent data sets, comprising a total of 2,071 early-stage NSCLC tumors...
November 23, 2017: Nature Communications
https://www.readbyqxmd.com/read/29165605/patient-reported-outcome-measures-in-neurosurgery-a-review-of-the-current-literature
#19
Prajwal Ghimire, Harutomo Hasegawa, Nida Kalyal, Victoria Hurwitz, Keyoumars Ashkan
BACKGROUND: Patient-reported outcome measures (PROMs) play an important role in the evaluation of health outcomes, quality of life, and satisfaction, and have been successfully utilized in many areas of clinical medicine and surgical practice. The prevalence of PROMs in neurosurgery is not known. OBJECTIVE: To review the PROMs that have been utilized in the published neurosurgery literature to date. METHODS: Articles were searched in MEDLINE, EMBASE, HMIC Health Management Information Consortium, PsycARTICLES, and PsycINFO using search terms related to neurosurgery and PROMs, published from 1806 to August 2016...
November 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29160923/pregnancy-weight-gain-by-gestational-age-and-stillbirth-a-population-based-cohort-study
#20
Kari Johansson, Jennifer A Hutcheon, Lisa M Bodnar, Sven Cnattingius, Olof Stephansson
OBJECTIVE: To study the association between total and early pregnancy (<22 completed weeks) weight gain and risk of stillbirth, stratified by early-pregnancy body mass index (BMI). DESIGN: Population-based cohort study. SETTING: Stockholm-Gotland Region, Sweden. POPULATION: Pregnant women with singleton births (n=160,560). METHODS: Pregnancy weight gain was standardized into gestational age-specific z-scores...
November 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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