Captured by Forbes
Lately there’s been a lot of talk about personalized medicine. There’s a bold idea going around that people should take control of their own healthcare and manage the flood of new data stemming from a whole bunch of new technologies, including, but hardly limited to, personal genomes, biomarkers, wireless sensors, and iPhone ECGs.
It is unclear how much any of this is ready for prime time in actual medical practice. Although the science and technology advance every day, and there is no question that these will one day play an important role in medical care, there are still very few actual instances where personalized medicine has been shown to benefit patients, and no reason to think that widespread application in the general population would result in significant benefits.
But let’s assume for the moment that the technology does work and can benefit people. Does that mean most people would benefit if they took a more active role in obtaining this information (for example, by ordering a personal genome from 23andme.com), and then interpreting and acting upon the information?
Posted in 2013, P4 Medicine, P4 Medicine Update, Personalized Medicine
Tagged biomarkers, doctor, medical care, medical practice, patients, personal genomes, personalized medicine, technology
Captured by American Academy of Ophthalmologists
A new study finds that certain changes in blood vessels in the eye’s retina can be an early warning that a person is at increased risk forglaucoma, an eye disease that slowly robs people of their peripheral vision. Using diagnostic photos and other data from the Australian Blue Mountains Eye Study, the researchers showed that patients who had abnormally narrow retinal arteries when the study began were also those who were most likely to have glaucoma at its 10-year end point. If confirmed by future research, this finding could give ophthalmologists a new way to identify and treat those who are most vulnerable to vision loss from glaucoma. The study was recently published online byOphthalmology, the journal of the American Academy of Ophthalmology.
Open-angle glaucoma (OAG), the most common form of the disease, affects nearly three million people in the U.S[i] and 60 million worldwide.[ii] Vision loss occurs when glaucoma damages the optic nerve, the part of the eye that transmits images from the retina to the brain. Unfortunately, because glaucoma does not have symptoms, many people don’t know they have the disease until a good portion of their sight has been lost. Early detection is critical to treating glaucoma in time to preserve vision.
The findings of the new study, led by Paul Mitchell, M.D., PhD, of the Centre for Vision Research, University of Sydney, supports the concept that abnormal narrowing of retinal blood vessels is an important factor in the earliest stages of OAG. Tracking nearly 2,500 participants, the study found that the OAG risk at the 10-year mark was about four times higher in patients whose retinal arteries had been narrowest when the study began, compared with those who had had the widest arteries.
Posted in 2013, P4 Medicine Update, Personalized, Predictive, Preventive
Tagged AAO, American Academy of Ophthalmologists, blood vessles, eye, glaucoma, open-angle glaucoma, peripheral vision, retina, symptoms, vision loss
Captured by Johns Hopkins
Johns Hopkins researchers have developed a new way of looking at standard MRI scans that more accurately measures damage to the blood-brain barrier in stroke victims, a process they hope will lead to safer, more individualized treatment of blood clots in the brain and better outcomes.
The blood-brain barrier is a unique shielding of blood vessels that limits the passage of molecules from the blood stream into the brain. Without it, the brain is open to infection, inflammation and hemorrhage. Ischemic stroke patients are at risk of bleeding into the brain when there is damage to the barrier. By more accurately identifying areas of damage, the researchers, in a report published in the journal PLOS ONE, say they hope to use their new tool to predict and reduce the risk of complications from clot-dissolving drugs used to treat this kind of stroke.
“A better characterization of blood-brain barrier damage opens the door to new approaches to treating stroke patients,” says study leader Richard Leigh, M.D., an assistant professor of neurology and radiology at the Johns Hopkins University School of Medicine. “We want to help patients, but we need to make sure our treatments don’t make things worse.”
In an ischemic stroke, a blood clot is stuck in a vessel, cutting off blood flow to a portion of the brain, which will begin to die the longer the clot remains. When patients come to the hospital within three-to-four hours of suffering an ischemic stroke, doctors quickly move to give them the intravenous clot-busting drug tPA, hoping that it will dissolve the clot without causing additional damage.
Posted in 2013, P4 Medicine Update, Personalized, Predictive, Preventive
Tagged blood clots, blood-brain barrier, brain, hemorrhage, infection, ischemic stroke, MRI, outcomes, patients, Stroke, treatment
Captured by University of Michigan Health System
For some people with diabetes, there may be such a thing as too much care.
Traditional treatment to reduce risks of heart disease among patients with diabetes has focused on lowering all patients’ blood cholesterol to a specific, standard level. But this practice may prompt the over-use of high-dose medications for patients who don’t need them, according to new research from the VA Ann Arbor Healthcare System (VAAAHS) and the University of Michigan Health System.
The study encourages a more individualized approach to treatment that adjusts treatment according to the patient in order to improve the quality of care. The findings appear in Circulation: Cardiovascular Quality and Outcomes.
Authors also suggest that blanket goals routinely used to lower heart attack risks may unnecessarily expose some patients to potential adverse side effects of high-dose medications. Researchers also note that when these standard goals are used to assess whether a health provider delivered high quality care, they may encourage overly aggressive treatment.
Captured by Johns Hopkins Medicine
Scientists at the Johns Hopkins Kimmel Cancer Center have combined the ability to detect cancer DNA in the blood with genome sequencing technology in a test that could be used to screen for cancers, monitor cancer patients for recurrence and find residual cancer left after surgery.
“This approach uses the power of genome sequencing to detect circulating tumor DNA in the blood, providing a sensitive method that can be used to detect and monitor cancers,” says Victor Velculescu, M.D., Ph.D., professor of oncology and co-director of the Cancer Biology Program at Johns Hopkins.
A report describing the new approach appears in the Nov. 28 issue of Science Translational Medicine. To develop the test, the scientists took blood samples from late-stage colorectal and breast cancer patients and healthy individuals and looked for DNA that had been shed into the blood.
The investigators applied whole-genome sequencing technology to DNA found in blood samples, allowing them to compare sequences from cancer patients with those from healthy people. The scientists then looked for telltale signs of cancer in the DNA: dramatic rearrangements of the chromosomes or changes in chromosome number that occur only in cancer cells.
Posted in 2013, Genome Sequencing, P4 Medicine Update, Personalized, Predictive, Preventive
Tagged blood tests, cancer, detection, gene sequencing, Johns Hopkins, whole genome sequencing