scholarly journals Searching for Clinically Relevant Biomarkers in Geriatric Oncology

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Theodora Katsila ◽  
George P. Patrinos ◽  
Dimitrios Kardamakis
Keyword(s):  
Decision Making ◽  
Ethical Issues ◽  
Unmet Need ◽  
Geriatric Oncology ◽  
Cost Effective ◽  
Multiple Organ ◽  
Health Concern ◽  
Policy Makers ◽  
Mortality And Morbidity ◽  
Organ Systems

Ageing, which is associated with a progressive decline and functional deterioration in multiple organ systems, is highly heterogeneous, both inter- and intraindividually. For this, tailored-made theranostics and optimum patient stratification become fundamental, when decision-making in elderly patients is considered. In particular, when cancer incidence and cancer-related mortality and morbidity are taken into account, elderly patient care is a public health concern. In this review, we focus on oncogeriatrics and highlight current opportunities and challenges with an emphasis on the unmet need of clinically relevant biomarkers in elderly cancer patients. We performed a literature search on PubMed and Scopus databases for articles published in English between 2000 and 2017 coupled to text mining and analysis. Considering the top insights, we derived from our literature analysis that information knowledge needs to turn into knowledge growth in oncogeriatrics towards clinically relevant biomarkers, cost-effective practices, updated educational schemes for health professionals (in particular, geriatricians and oncologists), and awareness of ethical issues. We conclude with an interdisciplinary call to omics, geriatricians, oncologists, informatics, and policy-makers communities that Big Data should be translated into decision-making in the clinic.

scholarly journals Attenuation of COVID-19-induced cytokine storm in a young male patient with severe respiratory and neurological symptoms

2021 ◽  
Author(s):  
Christian Muschitz ◽  
Anita Trummert ◽  
Theresa Berent ◽  
Norbert Laimer ◽  
Lukas Knoblich ◽  
...  
Keyword(s):  
Decision Making ◽  
Male Patient ◽  
Young Male ◽  
Standard Of Care ◽  
Multiple Organ ◽  
Cytokine Storm ◽  
Invasive Ventilation ◽  
Organ Systems ◽  
The Central Nervous System

SummarySevere acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), produces protean manifestations and causes indiscriminate havoc in multiple organ systems. This rapid and vast production of proinflammatory cytokines contributes to a condition termed cytokine storm. A 35-year-old, otherwise healthy, employed, male patient was tested positive for COVID-19. He was admitted to the hospital on disease day 10 due to retarded verbal reactions and progressive delirium. On account of these conditions and the need for noninvasive/invasive ventilation, a combination treatment with baricitinib and remdesivir in conjunction with standard of care was initiated. The cytokine storm was rapidly blocked, leading to a vast pulmonary recovery with retarded recovery of the central nervous system. We conclude that the rapid blockade of the COVID-19-induced cytokine storm should be considered of avail as a principle of careful decision-making for effective recovery.

Emerging targets for the diagnosis of Parkinson’s disease: examination of systemic biomarkers

2021 ◽  
Author(s):  
Lara Cheslow ◽  
Adam E Snook ◽  
Scott A Waldman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Neuronal Damage ◽  
Unmet Need ◽  
Multiple Organ ◽  
The Body ◽  
Organ Systems ◽  
Diagnostic Approaches ◽  
New Biomarkers

Parkinson’s disease (PD) is a highly prevalent and irreversible neurodegenerative disorder that is typically diagnosed in an advanced stage. Currently, there are no approved biomarkers that reliably identify PD patients before they have undergone extensive neuronal damage, eliminating the opportunity for future disease-modifying therapies to intervene in disease progression. This unmet need for diagnostic and therapeutic biomarkers has fueled PD research for decades, but these efforts have not yet yielded actionable results. Recently, studies exploring mechanisms underlying PD progression have offered insights into multisystemic contributions to pathology, challenging the classic perspective of PD as a disease isolated to the brain. This shift in understanding has opened the door to potential new biomarkers from multiple sites in the body. This review focuses on emerging candidates for PD biomarkers in the context of current diagnostic approaches and multiple organ systems that contribute to disease.

Ethical issues in cardiac arrest and acute cardiac care: a European perspective

2021 ◽  
pp. 43-53
Author(s):  
Jean-Louis Vincent ◽  
Jacques Creteur
Keyword(s):  
Decision Making ◽  
Cardiac Arrest ◽  
Ethical Issues ◽  
Cardiac Care ◽  
Ethical Perspective ◽  
Mortality And Morbidity ◽  
Good Communication ◽  
Ethical Decisions ◽  
Artery Disease ◽  
Acute Cardiac Care

Acute cardiac syndromes are common and responsible for considerable mortality and morbidity. Decision making in such patients can be difficult clinically but can also be complex and challenging from an ethical perspective. This chapter reviews some of the ethical problems, including organ donation and withholding/withdrawing, that can occur in the acutely ill adult cardiac patient, starting with a brief look at the ethical principles that should guide our decision making: beneficence, non-maleficence, autonomy, and distributive justice. The role of advance directives and considerations related to family presence during cardiopulmonary resuscitation will also be discussed. With the increasing incidence and prevalence of coronary artery disease worldwide, the number of patients with cardiac arrest and requiring acute cardiac care is going to increase, and doctors will increasingly be faced with difficult ethical decisions associated with these patients. Open discussion and debate about these issues and good communication among patients, family members, and members of the health care team are essential to ensure that all patients receive the best possible end-of-life care.

scholarly journals Biologics in the Treatment of Lupus Erythematosus: A Critical Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Dominik Samotij ◽  
Adam Reich
Keyword(s):  
Clinical Trials ◽  
Lupus Erythematosus ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
Immunosuppressive Drugs ◽  
Multiple Organ ◽  
Biologic Agents ◽  
Drug Induced ◽  
Treatment Regimes ◽  
Organ Systems

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting multiple organ systems that runs an unpredictable course and may present with a wide variety of clinical manifestations. Advances in treatment over the last decades, such as use of corticosteroids and conventional immunosuppressive drugs, have improved life expectancy of SLE sufferers. Unfortunately, in many cases effective management of SLE is still related to severe drug-induced toxicity and contributes to organ function deterioration and infective complications, particularly among patients with refractory disease and/or lupus nephritis. Consequently, there is an unmet need for drugs with a better efficacy and safety profile. A range of different biologic agents have been proposed and subjected to clinical trials, particularly dedicated to this subset of patients whose disease is inadequately controlled by conventional treatment regimes. Unfortunately, most of these trials have given unsatisfactory results, with belimumab being the only targeted therapy approved for the treatment of SLE so far. Despite these pitfalls, several novel biologic agents targeting B cells, T cells, or cytokines are constantly being evaluated in clinical trials. It seems that they may enhance the therapeutic efficacy when combined with standard therapies. These efforts raise the hope that novel drugs for patients with refractory SLE may be available in the near future. This article reviews the current biological therapies being tested in the treatment of SLE.

Ethical issues in cardiac arrest and acute cardiac care: a European perspective

2017 ◽  
Author(s):  
Jean-Louis Vincent
Keyword(s):  
Decision Making ◽  
Cardiac Arrest ◽  
Ethical Issues ◽  
Health Care Team ◽  
Cardiac Care ◽  
Ethical Perspective ◽  
Mortality And Morbidity ◽  
Good Communication ◽  
Number Of Patients ◽  
Acute Cardiac Care

Acute cardiac syndromes are common and responsible for considerable mortality and morbidity. Decision making in such patients can be difficult clinically but can also be complex and challenging from an ethical perspective. This chapter reviews some of the ethical problems, including organ donation and withholding/withdrawing, that can occur in the acutely ill adult cardiac patient, starting with a brief look at the ethical principles that should guide our decision making: beneficence, non-maleficence, autonomy, and distributive justice. The role of advance directives and considerations related to family presence during cardiopulmonary resuscitation will also be discussed. With the increasing incidence and prevalence of coronary artery disease worldwide, the number of patients with cardiac arrest and requiring acute cardiac care is going to increase, and doctors will increasingly be faced with difficult ethical decisions associated with these patients. Open discussion and debate about these issues and good communication among patients, family members, and members of the health care team are essential to ensure that all patients receive the best possible end-of-life care.

scholarly journals Integrated Diabetic Clinic in a Rural Hospital of Nepal

2019 ◽  
Vol 2 (1) ◽  
pp. 77-78
Author(s):  
Niresh Thapa ◽  
Muna Maharjan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Cost Effective ◽  
Rural Setting ◽  
Health Concern ◽  
Public Health Concern ◽  
Mortality And Morbidity ◽  
Important Public Health ◽  
Diabetic Clinic

Diabetes is an important public health concern which is increasing rapidly in developing countries. It is challenging to prevent and manage diabetes in a rural setting. The Integrated Diabetic Clinic is comprehensive diabetes care under one roof. Its aim is to provide efficient accessible and affordable comprehensive care. It will make a huge difference in the management of diabetes. This clinic will play a major role in unifying different aspects of health care under one roof and offer the most comprehensive and cost-effective accessible health care to minimize mortality and morbidity associated with diabetes.

scholarly journals Decision-making under uncertainty in environmental health policy: new approaches

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Jacques Reis ◽  
Peter S. Spencer
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Environmental Health ◽  
Science Communication ◽  
Scientific Community ◽  
Ethical Issues ◽  
Scientific Uncertainty ◽  
Policy Makers ◽  
Complex Procedure

Abstract Decision-making in environmental health policy is a complex procedure even in well-known conditions. Thus, in the case of uncertainty, decision-making becomes a hurdle race. We address scientific uncertainty, methods to reduce uncertainty, biomedical doubt and science communication, and the role of stakeholders, activists, lobbies and media that together influence policy decisions. We also consider the major responsibility and role of the medico-scientific community in this process. This community can and should teach the principle of scientific uncertainty to all stakeholders, advise policy-makers and underline the ethical issues, considering that our brains are not only the deposit of our humanity but also the route to environmental health and societal harmony.

scholarly journals CHD associated with syndromic diagnoses: peri-operative risk factors and early outcomes

2015 ◽  
Vol 26 (1) ◽  
pp. 30-52 ◽  
Author(s):  
Benjamin J. Landis ◽  
David S. Cooper ◽  
Robert B. Hinton
Keyword(s):  
Expectant Management ◽  
Multiple Organ ◽  
Deletion Syndrome ◽  
Cardiovascular Risks ◽  
Genetic Syndrome ◽  
Operative Morbidity ◽  
Mortality And Morbidity ◽  
Improved Outcomes ◽  
Organ Systems ◽  
Operative Evaluation

AbstractCHD is frequently associated with a genetic syndrome. These syndromes often present specific cardiovascular and non-cardiovascular co-morbidities that confer significant peri-operative risks affecting multiple organ systems. Although surgical outcomes have improved over time, these co-morbidities continue to contribute substantially to poor peri-operative mortality and morbidity outcomes. Peri-operative morbidity may have long-standing ramifications on neurodevelopment and overall health. Recognising the cardiovascular and non-cardiovascular risks associated with specific syndromic diagnoses will facilitate expectant management, early detection of clinical problems, and improved outcomes – for example, the development of syndrome-based protocols for peri-operative evaluation and prophylactic actions may improve outcomes for the more frequently encountered syndromes such as 22q11 deletion syndrome.

Ethical issues in cardiac arrest and acute cardiac care: a European perspective

2018 ◽  
Author(s):  
Jean-Louis Vincent
Keyword(s):  
Decision Making ◽  
Cardiac Arrest ◽  
Ethical Issues ◽  
Health Care Team ◽  
Cardiac Care ◽  
Ethical Perspective ◽  
Mortality And Morbidity ◽  
Good Communication ◽  
Number Of Patients ◽  
Acute Cardiac Care

Acute cardiac syndromes are common and responsible for considerable mortality and morbidity. Decision making in such patients can be difficult clinically but can also be complex and challenging from an ethical perspective. This chapter reviews some of the ethical problems, including organ donation and withholding/withdrawing, that can occur in the acutely ill adult cardiac patient, starting with a brief look at the ethical principles that should guide our decision making: beneficence, non-maleficence, autonomy, and distributive justice. The role of advance directives and considerations related to family presence during cardiopulmonary resuscitation will also be discussed. With the increasing incidence and prevalence of coronary artery disease worldwide, the number of patients with cardiac arrest and requiring acute cardiac care is going to increase, and doctors will increasingly be faced with difficult ethical decisions associated with these patients. Open discussion and debate about these issues and good communication among patients, family members, and members of the health care team are essential to ensure that all patients receive the best possible end-of-life care.

Cardiovascular physiology teaching: computer simulations vs. animal demonstrations.

1994 ◽  
Vol 266 (6) ◽  
pp. S36 ◽  
Author(s):  
R W Samsel ◽  
G A Schmidt ◽  
J B Hall ◽  
L D Wood ◽  
S G Shroff ◽  
...  
Keyword(s):  
Conceptual Knowledge ◽  
Animal Studies ◽  
Computer Software ◽  
Cost Effective ◽  
Multiple Organ ◽  
Cardiovascular Physiology ◽  
Laboratory Observation ◽  
Organ Systems ◽  
Laboratory Tool

The roots of physiology lie in laboratory observation, and physiology courses continue to rely on laboratory observation to provide students with practical information to correlate with their developing base of conceptual knowledge. To this end, animal laboratories provide a functioning example of interactions among organ systems and a source of data for student analysis. However, there are continuing objections to using animals for teaching, and animal labs are costly in time and effort. As an alternative laboratory tool, computer software can simulate the operation of multiple organ systems: responses to interventions illustrate intrinsic organ behavior and integrated systems physiology. Advantages of software over animal studies include alteration of variables that are not easily changed in vivo, repeated interventions, and cost-effective hands-on student access. Nevertheless, simulations miss intangible aspects of experimental physiology, and results depend critically on the assumptions of the model. We used both computer and animal demonstrations in teaching cardiovascular physiology to first-year medical students. The students rated both highly, but the computer-based session received a higher rating. We believe that both forms of teaching have educational merit. At the introductory level, the computer appears to provide an effective alternative.

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