Value-based Medicine and Gene Therapy

2021 ◽  
Vol 61 (3) ◽  
pp. 195-215
Author(s):  
Gary C. Brown ◽  
Melissa M. Brown
Keyword(s):  
2021 ◽  
pp. 78-112
Author(s):  
Jennifer Hochschild

Chapter 4 examines two of the cells in the basic framework: “Enthusiasm” about the benefits of using the science of genetic inheritance, and “Skepticism” about the risks of using the science of genetic inheritance. For each viewpoint, this chapter explores arenas within medical and scientific research (including gene therapy, the search for Covid-19 vaccines, and gene editing), criminal justice (including forensic DNA databases, rapid DNA testing, and exoneration), and biogeographical ancestry (including racial and ethnic ancestry testing, race-based medicine, and deep ancestry). Chapter 4 provides evidence to support both excitement about the benefits of genomic science and concern about its risks and costs.


2014 ◽  
Vol 33 (1) ◽  
pp. 8-21 ◽  
Author(s):  
Sonja Pavlović ◽  
Branka Zukić ◽  
Maja Stojiljković Petrović

Summary Nowadays, genetics and genomics are fully integrated into medical practice. Personalized medicine, also called genome-based medicine, uses the knowledge of the genetic basis of disease to individualize treatment for each patient. A number of genetic variants, molecular genetic markers, are already in use in medical practice for the diagnosis, prognosis and follow-up of diseases (monogenic hereditary disorders, fusion genes and rearrangements in pediatric and adult leukemia) and presymptomatic risk assessment (BRCA 1/2 for breast cancer). Additionally, the application of pharmacogenomics in clinical practice has significantly contributed to the individualization of therapy in accordance with the patient’s genotype and gene expression profile. Genetic testing for several pharmacogenomic markers (TPMT, UGT1A1, CYP2C9, VKORC1) is mandatory or recommended prior to the initiation of therapy. The most important achievement of genome-based medicine is molecular-targeted therapy, tailored to the genetic profile of a disease. Testing for gene variants in cancer (BCR-ABL, PML/RARa, RAS, BCL-2) is part of the recommended evaluation for different cancers, in order to achieve better management of the disease. The ultimate goal of medical science is to develop gene therapy which will fight or prevent a disease by targeting the disease causing genetic defect. Gene therapy technology is rapidly developing, and has already been used with success. Although medicine has always been essentially »personal« to each patient, personalized medicine today uses modern technology and knowledge in the field of molecular genetics and genomics, enabling a level of personalization which leads to significant improvement in health care.


2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.


2001 ◽  
Vol 120 (5) ◽  
pp. A349-A349
Author(s):  
J TSENG ◽  
F FARNEBO ◽  
O KISKER ◽  
C BECKER ◽  
C KUO ◽  
...  

2005 ◽  
Vol 173 (4S) ◽  
pp. 300-300
Author(s):  
Sreedhar Sagi ◽  
Lutz Trojan ◽  
Peter Aiken ◽  
Maurice S. Michel ◽  
Thomas Knoll

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