Personalized Medicine

2016 ◽  
Author(s):  
Michael Snyder
Keyword(s):  
Family History ◽  
Personalized Medicine ◽  
Medical History ◽  
Personal Information ◽  
Vital Signs ◽  
Physical Exam ◽  
Practice Of Medicine ◽  
Laboratory Measures

What is personalized medicine? The practice of medicine has always been personal. Doctors use extensive personal information about a patient—including medical history, physical exam, vital signs, family history, laboratory measures, and imaging tests—to determine a patient’s risk for certain diseases and to make diagnoses....

What Goes Down, Might Come Up!

2020 ◽  
pp. 83-94
Author(s):  
Sharon E. Mace
Keyword(s):  
Weight Gain ◽  
Family History ◽  
Medical History ◽  
Diagnostic Testing ◽  
Physical Exam ◽  
Past Medical History ◽  
Bilious Vomiting ◽  
Underlying Illness ◽  
History Of ◽  
Comprehensive History

In infants, vomiting is usually benign, but it can also portend significant underlying illness or injury. It is important to remember that although vomiting is commonly from the gastrointestinal (GI) tract itself, it may also be due to more generalized, systemic disorders or injuries (non-GI causes). As with most pediatric complaints a comprehensive history and physical exam is critical to direct both diagnostic testing and management. Remember the past medical history in infants includes neonatal history, growth and developmental history (include weight gain), social and family history. A history of bilious vomiting in an infant should always raise concerns occurs with obstruction, therefore, bilious vomiting always warrants evaluation.

How Valid are Patient Reports of Family History of Illness?

1980 ◽  
Vol 19 (03) ◽  
pp. 162-164 ◽  
Author(s):  
Rachel Harris ◽  
W. Margaret ◽  
Kathleen Hunter
Keyword(s):  
Family History ◽  
Medical History ◽  
Cancer Patients ◽  
Cause Of Death ◽  
Death Certificate ◽  
Recall Rate ◽  
Patient Reports ◽  
Small Subgroup ◽  
History Of ◽  
Medical Histories

The recall rate of patients’ family medical histories was studied in 200 cancer and non-cancer patients. Data on age and cause of death for parents and grandparents were collected. Although most patients knew the age and cause of death of parents, less than half knew for grandparents. Cancer patients had significantly greater recall for maternally related relatives. A subsample of patients’ family medical histories was compared to death certificate data. Patients’ reports were found to be highly inaccurate. Since only a small subgroup could provide medical history data for grandparents, the generaliz-ability for history of family illness is questioned.

scholarly journals Retinal microvascular signs in COVID-19

2021 ◽  
pp. bjophthalmol-2020-318236
Author(s):  
Ralene Sim ◽  
Gemmy Cheung ◽  
Daniel Ting ◽  
Edmund Wong ◽  
Tien Yin Wong ◽  
...  
Keyword(s):  
Medical History ◽  
Vital Signs ◽  
Plexiform Layer ◽  
Nasopharyngeal Swab ◽  
Inner Plexiform Layer ◽  
Cross Sectional ◽  
Imaging Device ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Retinal Microvascular Signs

Background/aimsTo explore if retinal findings are associated with COVID-19 infection.MethodsIn this prospective cross-sectional study, we recruited participants positive for COVID-19 by nasopharyngeal swab, with no medical history. Subjects underwent retinal imaging with an automated imaging device (3D OCT-1 Maestro, Topcon, Tokyo, Japan) to obtain colour fundus photographs (CFP) and optical coherence tomographic (OCT) scans of the macula. Data on personal biodata, medical history and vital signs were collected from electronic medical records.Results108 patients were recruited. Mean age was 36.0±5.4 years. 41 (38.0%) had symptoms of acute respiratory infection (ARI) at presentation. Of 216 eyes, 25 (11.6%) had retinal signs—eight (3.7%) with microhaemorrhages, six (2.8%) with retinal vascular tortuosity and two (0.93%) with cotton wool spots (CWS). 11 eyes (5.1%) had hyper-reflective plaques in the ganglion cell-inner plexiform layer layer on OCT, of which two also had retinal signs visible on CFP (CWS and microhaemorrhage, respectively). There was no significant difference in the prevalence of retinal signs in symptomatic versus asymptomatic patients (12 (15.0%) vs 13 (9.6%), p=0.227). Patients with retinal signs were significantly more likely to have transiently elevated blood pressure than those without (p=0.03).ConclusionOne in nine had retinal microvascular signs on ocular imaging. These signs were observed even in asymptomatic patients with normal vital signs. These retinal microvascular signs may be related to underlying cardiovascular and thrombotic alternations associated with COVID-19 infection.

Chest wall mass: what lies beneath?

2018 ◽  
Vol 35 (10) ◽  
pp. 586-586
Author(s):  
Claire Elaine Richards ◽  
Ahmed Mamdouh Taha Mostafa ◽  
Amr Elmoheen
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Medical History ◽  
Chest Wall ◽  
Vital Signs ◽  
Cervical Lymphadenopathy ◽  
Anterior Chest Wall ◽  
List Type ◽  
History Of ◽  
Wall Mass ◽  
Chest Wall Mass

Clinical introductionA 24-year-old Filipino man attended the ED with a 1-month history of a discrete swelling over his upper anterior chest wall that was rapidly increasing in size and tenderness. He denied any other symptoms. His medical history was unremarkable.Examination revealed a tender, 7 cm × 6 cm mass over the upper part of the sternum (figure 1). The surface was smooth, it was immobile, non-compressible and the overlying skin was normothermic but mildly erythematous. Cervical lymphadenopathy was present. His vital signs were normal.Figure 1Chest wall mass.QuestionWhat is the most likely diagnosis?LipomaChondrosarcomaLymphomaMycobacterium tuberculosis (TB)

scholarly journals Personal Health Informatics. Editorial

2012 ◽  
Vol 21 (01) ◽  
pp. 2-3
Author(s):  
C. A. Kulikowski ◽  
A. Geissbuhler
Keyword(s):  
Health Informatics ◽  
Personal Information ◽  
Personal Health ◽  
Main Theme ◽  
Research Education ◽  
Main Research ◽  
Interdisciplinary Field ◽  
Practice Of Medicine ◽  
Challenges And Opportunities ◽  
Working Groups

SummaryTo provide an editorial introduction to the 2012 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2012 IMIA Yearbook.This 2012 issue of the IMIA Yearbook highlights important developments in personal health informatics, impacting the activities in research, education and practice in this interdisciplinary field.There has been steady progress towards introducing individualization or personalization into informatics systems by taking advantage of the increasing amounts of personal information that is relevant to medical decisions and application in clinical practice. At the same time, there are serious issues about the limits of existing systems being able to effectively personalize information within both practical and ethical constraints so critical to the practice of medicine. Recent literature bearing on these questions includes the selected papers published during the past 12 months, and articles reported by IMIA Working Groups on these topics.Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on the challenges and opportunities involved in personal health informatics.

Farewell to a Fallen Warrior

2001 ◽  
Vol 55 (1) ◽  
pp. 107-109
Author(s):  
Frank J. Richardson
Keyword(s):  
Bone Marrow ◽  
Heart Disease ◽  
Family History ◽  
Bone Marrow Transplant ◽  
Blood Test ◽  
Marrow Transplant ◽  
Physical Exam ◽  
Perfect Health ◽  
History Of ◽  
To Come

[In the Summer of 1999, Kemp Burleson had what he thought was going to be a rather routine annual physical exam. By his own estimate, at 37-years-old he was in perfect health. There was no warning of what was to come. At his wife's insistence, he asked for a blood test to determine if his cholesterol was elevated, as there was a family history of heart disease. Within days, the results were in. They were not good. It was not a cholesterol problem. He had leukemia and would need a bone marrow transplant to increase his odds for survival. In spite of the attempts to extend his life, he lived only several months following that initial diagnosis. The following is the eulogy that was inspired by our time together in the hospital.]

scholarly journals The effect of personal medical history and family history of cancer on the uptake of risk-reducing salpingo-oophorectomy

2015 ◽  
Vol 14 (4) ◽  
pp. 539-544 ◽  
Author(s):  
Jessica E. van der Aa ◽  
Jacob P. Hoogendam ◽  
Els S. F. Butter ◽  
Margreet G. E. M. Ausems ◽  
René H. M. Verheijen ◽  
...  
Keyword(s):  
Family History ◽  
Medical History ◽  
Family History Of Cancer ◽  
History Of ◽  
Risk Reducing ◽  
History Of Cancer

scholarly journals General versus Spinal Anesthesia During Caesarean Section; A Narrative Review

2019 ◽  
Author(s):  
Zahid Hussain Khan ◽  
Negar Eftekhar ◽  
Rafah Sabah Barrak
Keyword(s):  
Family History ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Comparative Study ◽  
General Anesthesia ◽  
Medical History ◽  
Spinal Anesthesia ◽  
Narrative Review ◽  
Included Patient

This research is a method review type, comparative study between the effects of General anesthesia versus those of spinal anesthesia during caesarean section on the newborns and the mother undergoing cesarean section. The variables considered in the study included patient family history, patient medical history, status of patient during pregnancy, age of patient, and emergency or planned cesarean. Both general and spinal methods of anesthesia had differing results in multiple aspects and effects both during and after the surgery. However, pros of spinal anesthesia topped those of general anesthesia and is therefore the more favorable method of anesthesia.

scholarly journals SAT-571 Rare Case of Tocilizumab-Induced Severe Hypertriglyceridemia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ankur Modi ◽  
Beth Scholz ◽  
David Wenkert
Keyword(s):  
Rheumatoid Arthritis ◽  
Family History ◽  
Meta Analysis ◽  
Adverse Event Reporting System ◽  
Vital Signs ◽  
Hepatic Clearance ◽  
Atherogenic Index ◽  
Favorable Effect ◽  
Lipoprotein A ◽  
Her Family

Abstract Tocilizumab (TCZ) is a monoclonal antibody against the IL-6receptor used in the treatment of rheumatoid arthritis (RA). Hypertriglyceridemia is a rare side effect of TCZ, occurring in<1% of cases (1). A 37 year-old woman presented with abdominal pain, nausea and diarrhea. Her past medical history included RA and dyslipidemia; she had no history of diabetes, hypothyroidism, renal disease, alcoholism or recent medication changes. Following failure of other immunosuppressant agents, IV TCZ was initiated. After two and a half years, TCZ formulation was changed to subcutaneous injections for convenience about 6 weeks prior to presentation. Family history included mother with dyslipidemia. Her vital signs were normal on admission with labs remarkable for lipase of 332 and triglycerides (TG) of 5680. Her TG 2months prior to initiating subcutaneous tocilizumab therapy was 1373. CT abdomen demonstrated findings of acute pancreatitis (AP). She was subsequently admitted to the ICU and started on an insulin drip, fibrate, statin and fish oil along with supportive care. TCZ was held. Because her TGs remained severely elevated, she was transferred to our facility for plasmapheresis with subsequent improvement of the same to 768 after two treatments. TCZ was considered the probable etiology of her hypertriglyceridemia with subsequent AP after ruling out other secondary causes. Hereditary hypertriglyceridemia, given her family history, likely contributed to her chronically elevated TG’s. TCZ has been reported to increase TG levels mainly through an increase in VLDL-TG content. TCZ was found to reduce hepatic LDLr expression thus reducing hepatic clearance of TGs and LPL mediated lipolysis of TG-rich lipoproteins (2). Despite the association of TCZ with increased lipid levels, it has a favorable impact on lipid metabolism via improved functionality of HDL-C and no impact in the atherogenic index; patients also experience a favorable response to statin treatment (3). In observational studies, TCZ shows a favorable effect on myocardial infarction compared to other biologic agents for RA, attributed partly to a decrease in lipoprotein(a) levels. Nonetheless, it should be used in caution in those with high cardiovascular risk, especially dyslipidemia (4). 1. Flaig T, Douros A. Tocilizumab-induced pancreatitis:case report and review of data from the FDA Adverse Event Reporting System. Journal of Clinical Pharmacy and Therapeutics 2016, 41:718-721. 2. Strang A, Bisoendial R. Atherosclerosis 229(2013):174-181. 3. Garcıa-Gomez C, Martın-Martınez M. Lipoprotein(a) concentrations in rheumatoid arthritis on biologic therapy:Results from the CARdiovascular inrheuMAtology study project. Journal of Clinical Lipidology (2017) 11:749-756. 4. CastagnéB, Viprey M. Cardiovascular safety of tocilizumab: A systematic review and network meta-analysis. PLoS ONE 14(8):e0220178.

scholarly journals Unnecessary Chest Tube for a Hemodialytic Patient with Multiple Trauma: A Case Report

2021 ◽  
Author(s):  
Vahid Reisi-Vanani ◽  
Hooman Esfahani
Keyword(s):  
Multiple Trauma ◽  
Chest Tube ◽  
Vital Signs ◽  
Physical Exam ◽  
Respiratory Sounds ◽  
Mortality And Morbidity ◽  
Radiologic Findings ◽  
Skin Fold ◽  
Chest Deformity ◽  
Threatening Condition

Abstract Background Pneumothorax (PTX) is a life-threatening condition that overdiagnosis could result in increases in mortality and morbidity of patients, this overdiagnosis would be increased if physicians do not manage the patient classically and do not pay attention to the physical exam and history of the patient. Case presentation: A-71-year old man was admitted to the emergency department due to multiple trauma. His vital signs were stable and in examination, there were two lacerations on his scalp with venous bleeding source and galea transaction; there were also some abrasions all over his body including his thorax. In the physical exam, there was no sucking lesion, decreases in respiratory sounds in auscultation or chest deformity but he had little right hemithorax rib tenderness. In more evaluations, there was a suspected visceral line of pleura in his CXR and no plural sliding movement was seen in E-FAST by the operator. Due to the inconsistency in physical exam and radiologic findings we decided to take a chest CT-scan before the insertion of the chest tube that indicated no PTX for him and the suspected visceral line in CXR was skin fold of a permacath for hemodialysis. Conclusions Several conditions could mimic findings of PTX in CXR that every physician should know and pay attention to them besides special attention to the history taking and physical examination to reduce the mortality and morbidity of patients.

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