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2.
Medicine (Baltimore) ; 99(7): e19085, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32049811

RESUMEN

BACKGROUND: Myofascial pain syndrome (MPS) is commonly seen in clinical settings and negatively influences a patient's daily life. Recently, the application of extracorporeal shock wave therapy (ESWT) has been utilized as one of the treatment methods for MPS. The aim of this systematic review and meta-analysis was to summarize the current evidence for the short-term effect of ESWT on MPS of trapezius. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched from the database inception to March 2019. Two reviewers independently screened articles, evaluated methodological quality, and extracted data. The primary outcome was post-interventional pain intensity. RESULTS: Randomized controlled trials (RCTs) were conducted to determine whether ESWT was used as the main treatment on MPS. The 5 studies reviewed in this meta-analysis were evaluated for changes in pain intensity. Compared with other treatments, focused ESWT in MPS was more effective in reducing the scores of visual analog scale (VAS) (standardized mean difference [SMD] = -0.48, 95% CI -0.74 to -0.22). CONCLUSIONS: There is very low level evidence that focused ESWT is effective for short-term relief of neck pain in MPS. The limited sample size and poor quality of these studies highlight and support the need for large scale, good quality placebo controlled trials in this area.


Asunto(s)
Tratamiento con Ondas de Choque Extracorpóreas/métodos , Síndromes del Dolor Miofascial/terapia , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Medicina de Precisión , Ensayos Clínicos Controlados Aleatorios como Asunto , Músculos Superficiales de la Espalda , Resultado del Tratamiento
4.
Medicine (Baltimore) ; 99(3): e18784, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011474

RESUMEN

RATIONALE: Allograft-prosthetic composites (APCs) and proximal femoral replacement have been applied for reconstruction of severe segmental femoral bone loss in revision total hip arthroplasty. The outcomes are encouraging but the complication rate is relatively high. Considering the high complication rates and mixed results of APCs and megaprosthesis, we presented a case using personalized 3D printed Titanium sleeve-prosthetic composite for reconstruction of segmental bone defect. PATIENT CONCERNS: A 73-year-old woman presented to the emergency department on account of acute severe pain of the left hip without history of trauma. She had undergone a cemented total hip arthroplasty for osteonecrosis of femoral head at the left side in 2000. In 2013 she underwent a cemented revision total hip arthroplasty as a result of aseptic loosening of hip prosthesis. She denied obvious discomfort prior to this episode since the revision surgery in 2013. DIAGNOSIS: According to the clinical history, imaging and physical examination, we confirmed the diagnosis of severe segmental bone loss of proximal femur and fracture of prosthetic stem. The femoral bone defect was evaluated using the Paprosky classification system and rated as Type 3B, and the acetabular bone defect was rated as Type 2C. INTERVENTIONS: In this study, we present the first case of severe segmental bone loss of proximal femur in revision total hip arthroplasty that was successfully treated using personalized 3D printed Titanium sleeve-prosthetic composite OUTCOMES:: At the 2-year follow-up, the patient was symptom free with a Harris Hip Score of 91. Radiographs showed excellent osteointegration between the interface of sleeve-prosthetic composite and the host bone, with no signs of implant loosening or subsidence. LESSONS: Despite the absence of long term results of 3D printed Titanium sleeve-prosthetic composite reconstruction, the good clinical and radiological outcome at 2 years follow up implied its potential role for reconstruction of segmental femoral bone defect in revision THA.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Enfermedades Óseas/cirugía , Prótesis de Cadera , Medicina de Precisión , Impresión Tridimensional , Diseño de Prótesis/métodos , Anciano , Enfermedades Óseas/diagnóstico por imagen , Femenino , Fémur , Humanos , Medicina de Precisión/métodos , Falla de Prótesis , Reoperación , Titanio
6.
Rev Med Suisse ; 16(682): 354-356, 2020 Feb 19.
Artículo en Francés | MEDLINE | ID: mdl-32073769

RESUMEN

Children's food allergies are a significant public health burden in industrialized countries. Their prevalence is also increasing in developing countries, reflecting the impact of modern globalized food that challenges humanity to adapt to unprecedented allergenic stress. The understanding of the multiple mechanisms involved in the emergence of these allergies has greatly improved over the past two decades. On the therapeutic level, the eviction regime has shown its limitations and risks in growing individuals. Personalized nutrition represents a promising field of investigation in therapeutic innovations.


Asunto(s)
Hipersensibilidad a los Alimentos/terapia , Medicina de Precisión , Alérgenos/inmunología , Niño , Hipersensibilidad a los Alimentos/inmunología , Humanos , Prevalencia , Salud Pública
8.
Expert Rev Clin Pharmacol ; 13(2): 115-134, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31958027

RESUMEN

Introduction: Pharmacometabolomics is an emerging science pursuing the application of precision medicine. Combining both genetic and environmental factors, the so-called pharmacometabolomic approach guides patient selection and stratification in clinical trials and optimizes personalized drug dosage, improving efficacy and safety.Areas covered: This review illustrates the progressive introduction of pharmacometabolomics as an innovative solution for enhancing the discovery of novel drugs and improving research and development (R&D) productivity of the pharmaceutical industry. An extended analysis on published pharmacometabolomics studies both in animal models and humans includes results obtained in several areas such as hepatology, gastroenterology, nephrology, neuropsychiatry, oncology, drug addiction, embryonic cells, neonatology, and microbiomics.Expert opinion: a tailored, individualized therapy based on the optimization of pharmacokinetics and pharmacodynamics, the improvement of drug efficacy, and the abolition of drug toxicity and adverse drug reactions is a key issue in precision medicine. Genetics alone has become insufficient for deciphring intra- and inter-individual variations in drug-response, since they originate both from genetic and environmental factors, including human microbiota composition. The association between pharmacogenomics and pharmacometabolomics may be considered the new strategy for an in-deep knowledge on changes and alterations in human and microbial metabolic pathways due to the action of a drug.


Asunto(s)
Metabolómica/métodos , Preparaciones Farmacéuticas/administración & dosificación , Farmacogenética/métodos , Animales , Descubrimiento de Drogas/métodos , Industria Farmacéutica/métodos , Humanos , Preparaciones Farmacéuticas/metabolismo , Investigación Farmacéutica/métodos , Medicina de Precisión/métodos
12.
Crit Rev Oncol Hematol ; 146: 102863, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31935617

RESUMEN

Lung cancer is the most frequent cancer for males and third most frequent cancer for females. Targeted therapy drugs based on molecular alterations, such as angiogenesis inhibitors, epidermal growth factor receptor (EGFR) inhibitors, and anaplastic lymphoma kinase (ALK) inhibitors are important part of treatment of NSCLC. However, the quality of the available tumor biopsy and/or cytology material is sometimes not adequate to perform the necessary molecular testing, which has prompted the search for alternatives. This review examines the use of tumor-educated platelet (TEP) as a liquid biopsy in lung cancer patients. The development of sensitive and accurate techniques have made it possible to detect the specific genetic alterations for which targeted therapies are already available. Liquid biopsy offers opportunities to detect resistance mechanisms at an early stage. To conclude, tumor-educated platelet has the potential to be used as liquid biopsy for a variety of clinical and investigational applications.


Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma de Pulmón de Células no Pequeñas/patología , Ácidos Nucleicos Libres de Células/sangre , ADN de Neoplasias/sangre , ADN de Neoplasias/genética , Biopsia Líquida/métodos , Neoplasias Pulmonares/patología , Biomarcadores de Tumor/genética , Plaquetas/patología , Carcinoma de Pulmón de Células no Pequeñas/sangre , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/terapia , Ácidos Nucleicos Libres de Células/genética , Receptores ErbB/genética , Femenino , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/terapia , Masculino , Mutación , Medicina de Precisión , Inhibidores de Proteínas Quinasas/uso terapéutico
13.
Internist (Berl) ; 61(2): 170-174, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-31938815

RESUMEN

Cholangiocellular carcinoma (CCA) is one of the primary liver tumors and overall represents a rare malignancy; however, in recent years the incidence, particularly of intrahepatic CCA (iCCA) has increased worldwide. Due to the high mortality, CCAs cause a significant proportion of cancer-related deaths also in Germany. Because the diagnosis is often made in advanced stages of the disease, in many cases a surgical approach with curative intention is not possible. For locally advanced or metastatic CCA the combination of gemcitabine and cisplatin currently remains the only approved systemic treatment. As the average survival time is only approximately 12 months even under first-line treatment with gemcitabine/cisplatin, research is focused on developing new molecularly targeted and immunological treatment options. Various studies are currently being carried out to investigate approval options for targeted treatment, which could be considered for genetically altered tumors, e.g. in fibroblast growth factor receptor (FGFR) fusion and isocitrate dehydrogenase (IDH) mutations. Additionally, initial clinical data on immune checkpoint inhibitors are available for CCA. Due to the complex selection and partially limited applicability of current treatment options in patients with CCA, an early collaboration with a gastroenterology and oncology center with the possibility of supervision by a tumor board consisting of gastroenterological oncologists, surgeons, radiologists and radio-oncologists or in advanced stages by a molecular tumor board is essential.


Asunto(s)
Neoplasias de los Conductos Biliares , Conductos Biliares Intrahepáticos , Colangiocarcinoma , Neoplasias de los Conductos Biliares/genética , Neoplasias de los Conductos Biliares/terapia , Colangiocarcinoma/genética , Colangiocarcinoma/terapia , Alemania , Humanos , Terapia Molecular Dirigida , Medicina de Precisión
14.
Eur J Epidemiol ; 35(1): 5-10, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31993883

RESUMEN

To review the highest impact studies published from the UK Biobank and assess their contributions to "precision medicine." We reviewed 140 of 689 studies published between 2008 and May 2019 from the UK Biobank deemed to be high impact by citations, alternative metric data, or publication in a high impact journal. We classified studies according to whether they (1) were largely methods papers, (2) largely replicated prior findings or associations, (3) generated novel findings or associations, (4) developed risk prediction models that did not yield clinically significant improvements in risk estimation over prior models or (5) developed models that produced significant improvements in individualized risk assessment, targeted screening, or targeted treatment. This final category represents "precision medicine." We classified 15 articles as category 1, 33 as category 2, 85 as category 3, six as category 4, and one as category 5. In this assessment of the first 7 years of the UK Biobank and first 4 years of genetic data availability, the majority of high impact UK Biobank studies either replicated known associations or generated novel associations without clinically relevant improvements in risk prediction, screening, or treatment. This information may be useful for designers of other cohort studies in terms of input to design and follow-up to facilitate precision medicine research.


Asunto(s)
Bancos de Muestras Biológicas , Factor de Impacto de la Revista , Publicaciones Periódicas como Asunto , Medicina de Precisión , Edición , Humanos , Reino Unido
15.
Cancer Sci ; 111(3): 774-782, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31955490

RESUMEN

The SWI/SNF chromatin remodeling complex is composed of approximately 15 subunits, and approximately 20% of all cancers carry mutations in the genes encoding these subunits. Most of the genetic alterations in these genes are loss-of-function mutations. The identification of vulnerability based on synthetic lethality in cancers with SWI/SNF chromatin remodeling complex deficiency contributes to precision medicine. The SWI/SNF chromatin remodeling complex is involved in transcription, DNA repair, DNA replication, and chromosomal segregation. Cancers with deficiency in the SWI/SNF chromatin remodeling complex show increased vulnerability derived from the loss of these functions. Synthetic lethal targets have been identified based on vulnerabilities in the functions of the SWI/SNF chromatin remodeling complex. In this review article, we propose a precision medicine strategy using chemotherapeutic methods, such as molecular targeted therapy and immunotherapy, based on harnessing synthetic lethality in cancers with deficiency in the SWI/SNF chromatin remodeling complex.


Asunto(s)
Ensamble y Desensamble de Cromatina/genética , Cromatina/genética , Neoplasias/genética , Humanos , Inmunoterapia/métodos , Terapia Molecular Dirigida/métodos , Medicina de Precisión/métodos
16.
Crit Rev Oncol Hematol ; 147: 102881, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31991224

RESUMEN

Individuals do not react to radiation in a homogeneous manner. Recent radiogenomic research has proven that individual polymorphisms can correlate with treatment response most likely due to variation in the ability to recognise and repair DNA breaks. The difference in radiosensitivity between genders has been well documented, yet most radiotherapeutic guidelines are based solely on population averages rather than demographic subgroups such as age, race and gender. This paper is a review of the burgeoning literature available on the differences in efficacy and outcome of radiotherapy between genders. The work examines the effect of radiation on gender both from a tumour control as well as normal tissue toxicity perspective. While the literature reporting such findings is limited, the results show a small but significant difference in response to radiotherapy between sexes. Prospective and retrospective studies for evaluating these gender-specific differences are encouraged as a next step in personalised medicine.


Asunto(s)
Neoplasias/radioterapia , Medicina de Precisión , Radioterapia/efectos adversos , Femenino , Humanos , Masculino , Tolerancia a Radiación , Factores Sexuales , Resultado del Tratamiento
17.
Br J Nurs ; 29(1): 62-63, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917944

RESUMEN

Emeritus Professor Alan Glasper, from the University of Southampton, discusses processes for ensuring that all patients have an up-to-date personalised care plan that details all their care needs during admission to hospital.


Asunto(s)
Planificación de Atención al Paciente/organización & administración , Medicina de Precisión/métodos , Medicina de Precisión/enfermería , Humanos , Medicina Estatal , Reino Unido
18.
Zhonghua Wai Ke Za Zhi ; 58(1): 31-36, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31902167

RESUMEN

Metabolic reprogramming has been identified as a hallmark of cancer. Liver is an essential hub in the body for the metabolism of three major nutrients including glucose, lipids and amino acids. Hepatocellular carcinoma(HCC) usually presents a variety of changes in characteristic metabolism, such as increased aerobic glycolysis, enhanced de novo lipid synthesis, glutamine depletion, and oxidative metabolism imbalance, which can provide energy and bio-macromolecular raw materials for rapidly growing and proliferating tumor cells. The process of tumor metabolic reprogramming is regulated by multiple factors, such as alterations in metabolic enzyme activity, abnormal gene expression, and signaling pathway disturbance. Advances in high-throughout metabolomics technology have provided a powerful platform for discovering the novel biomarkers and metabolic targets of HCC. Therefore, in-depth study of the metabolic characteristics and regulatory mechanisms of HCC is critical for the development of novel antimetabolites.


Asunto(s)
Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/metabolismo , Metabolómica , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/terapia , Glucólisis , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Medicina de Precisión
19.
Zhonghua Wai Ke Za Zhi ; 58(1): 37-41, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31902168

RESUMEN

Pancreatic cancer is the most lethal malignancy with an overall 5-year survival rate less than 9%, mainly due to late diagnosis and lack of effective therapeutic options.In the last decade, post-operative survival has been enhanced with advent of neoadjuvant therapy and combined adjuvant therapy.Furthermore, the information gained from the omics data, including next generation sequencing data, hasn't yet begun to affect treatment of pancreatic cancer patients.However, in terms of precision medicine, pancreatic cancer has always lagged behind other tumors.Therefore, combined with practical experience, summary of the latest development and research progress of precise medical treatment of pancreatic cancer, especially from the fields of molecular biology and experimental models, is of critical importance. Further development of precise medicine for pancreatic cancer based on platforms using PDX and organoid model would promisingly help in effective improvement of clinical treatment.


Asunto(s)
Neoplasias Pancreáticas/terapia , Medicina de Precisión , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Terapia Neoadyuvante
20.
Zhonghua Wai Ke Za Zhi ; 58(1): 52-56, 2020 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-31902171

RESUMEN

Recently, with the development and widespread application of total mesorectal excision and neoadjuvant chemoradiotherapy, the long-term overall survival and disease-free survival of patients with middle & low rectal cancer have been greatly improved. Moreover, there are also researches in minimally invasive techniques, such as laparoscopy and robotic surgical system in the radical rectal surgery, as well as the combination of tumor molecular targeting markers and gene sequencing technology. Nowadays, the treatment of rectal cancer has entered a new era of individualized precise medicine. However, there are still some controversies in lateral lymph node dissection. The criteria of diagnosis and treatment, neoadjuvant therapy, indications of lateral lymph node dissection, the area of dissection and neuroprotection are still unsatisfactory. It is necessary to explore the personalized treatment strategies of lateral lymph node dissection in the precise medical era.


Asunto(s)
Escisión del Ganglio Linfático/métodos , Neoplasias del Recto/patología , Terapia Combinada , Humanos , Metástasis Linfática , Pelvis/patología , Pelvis/cirugía , Medicina de Precisión , Neoplasias del Recto/cirugía
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