scholarly journals The Future of Parkinson’s Treatment – Personalised and Precision Medicine

2017 ◽  
Vol 12 (01) ◽  
pp. 15 ◽  
Author(s):  
Nataliya Titova ◽  
Peter Jenner ◽  
K Ray Chaudhuri ◽  
◽  
◽  
...  
Keyword(s):  
Personalised Medicine ◽  
Unmet Need ◽  
Treatment Strategies ◽  
Modern Concept ◽  
Motor Symptoms ◽  
Related Disorder ◽  
Surgical Manipulation ◽  
Future Therapy

The modern concept of Parkinson’s disease (PD) has changed and evolved and we consider Parkinson’s to be a multi-neurotransmitter dysfunction-related disorder with central and peripheral nervous system involvement. The clinical expression is thus a mixture of the outwardly evident motor symptoms and a range of ‘hidden’ non-motor symptoms. The complex underlying neuropathology of PD calls for a reassessment of the treatment strategies currently used. Treatment of PD is guideline-driven and in most cases based on a dopamine replacement strategy or surgical manipulation of brain dopaminergic pathways. Treatment of many non-dopaminergic non-motor and some motor symptoms, which have major effects on quality of life, continue to remain a key unmet need. Like in other chronic conditions such as rheumatology, the role of personalised medicine in PD needs to be increasingly considered. Personalised medicine for PD is not just a genetic approach to treatment but encompasses various strands of treatment. These include pharmacogenetic, pharmacological, as well as socio-demographic and lifestyle-related issues. Once these ‘enablers’ of personalised medicine are considered then satisfactory treatment for our patients with Parkinson’s can be achieved in an individualised manner. Future therapy for PD should move in that direction.

scholarly journals Treatment strategies for chemotherapy-induced peripheral neuropathy: potential role of exercise

2011 ◽  
Vol 4 (2) ◽  
pp. 117
Author(s):  
Karen Y. Wonders ◽  
Beverly S. Reigle ◽  
Daniel G. Drury
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Cancer Patients ◽  
Lifestyle Modification ◽  
Treatment Strategies ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Exercise Rehabilitation

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting effect of cancer therapy that often has negative implications on a patient’s quality of life. The pain associated with CIPN has long been recognized as one of the most difficult types of pain to treat. Historically, much effort has been made to explore pharmacological therapies aimed at reducing symptoms of CIPN. While many of these agents provide a modest relief in the symptoms of peripheral neuropathy, many have been shown to have additional negative side effects for cancer patients. Therefore, the authors suggest exercise rehabilitation as one lifestyle modification that may positively impact the lives of patients with CIPN. To our knowledge, there are currently no published clinical trials examining the role of exercise in preserving neurological function following chemotherapy. However, investigations using low-to-moderate intensity exercise as an intervention in patients with diabetic peripheral neuropathy and hereditary motor and sensory neuropathies have produced promising results. Given that cancer patients appear to tolerate exercise, it seems plausible that exercise rehabilitation could be used as an effective strategy to minimize CIPN-induced detriments to quality of life.

scholarly journals Is there a role for biomarkers in surveillance of pancreatic neuroendocrine neoplasms in Von Hippel-Lindau’s disease?

2021 ◽  
Author(s):  
Myrthe R Naber ◽  
Saya Ahmad ◽  
Annemarie A Verrijn Stuart ◽  
Rachel H Giles ◽  
Gerlof D Valk ◽  
...  
Keyword(s):  
Early Detection ◽  
Unmet Need ◽  
Neuroendocrine Neoplasms ◽  
Surveillance Program ◽  
Autosomal Dominant Disorder ◽  
Pancreatic Neuroendocrine Neoplasms ◽  
Von Hippel Lindau ◽  
Vhl Disease

Abstract Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder characterized by the development of multi-organ neoplasms. Among the manifestations of VHL are pancreatic neuroendocrine neoplasms (panNENs). In order to detect these lesions in a timely manner, patients are enrolled in a surveillance program, in accordance with the several existing VHL guidelines. However, these guidelines remain unclear about the role of biomarkers in diagnosing panNENs, despite the benefits a biomarker may offer regarding early detection of new lesions, thereby possibly limiting radiation exposure, and improving quality of life. The aim is to determine which biomarkers might be available in VHL patients and to assess what their clinical relevance in diagnosing panNENs in VHL patients is. We searched the databases of Pubmed/Medline, Embase and Web of Science to identify relevant articles. Seven studies assessing the diagnostic or prognostic value of biomarkers were included. The results from these studies were conflicting. Since no evident association between VHL-related panNENs and biomarkers was established in studies with larger study populations, currently biomarkers do not play a significant role in early detection or follow-up for panNENs in VHL patients. The absence of evidence underscores the need for specific research to address this unmet need.

scholarly journals Biomarkers in abnormal uterine bleeding†

2018 ◽  
Vol 101 (6) ◽  
pp. 1155-1166 ◽  
Author(s):  
Rohan Chodankar ◽  
Hilary O D Critchley
Keyword(s):  
Standard Treatment ◽  
Treatment Options ◽  
Unmet Need ◽  
Treatment Strategies ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Major Surgery ◽  
Clinical Area ◽  
Tailored Approach

Abstract Abnormal uterine bleeding (AUB) is an extremely common problem and represents a clinical area of unmet need. It has clinical implications and a high cost for the healthcare system. The PALM-COEIN acronym proposed by FIGO may be used as a foundation of care; it improves the understanding of the causes of AUB, and in doing so facilitates effective history taking, examination, investigations, and management. Heavy menstrual bleeding, a subset of AUB, is a subjective diagnosis and should be managed in the context of improving the woman's quality of life. Available evidence suggests that there is poor satisfaction with standard treatment options often resulting in women opting for major surgery such as hysterectomy. Such women would benefit from a tailored approach, both for diagnosis and treatment, highlighting the deficiency of biomarkers in this area. This article focuses on the causes of AUB as per the PALM-COEIN acronym, the researched biomarkers in this area, and the potential pathogenetic mechanisms. In the future, these approaches may improve our understanding of AUB, thereby enabling us to direct women to most suitable current treatments and tailor investigative and treatment strategies to ensure best outcomes, in keeping with the principles of personalized or precision medicine.

scholarly journals Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy (‘4P medicine’)

2017 ◽  
Vol 72 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Matthias Orth ◽  
Maria Averina ◽  
Stylianos Chatzipanagiotou ◽  
Gilbert Faure ◽  
Alexander Haushofer ◽  
...  
Keyword(s):  
Patient Autonomy ◽  
Personalised Medicine ◽  
Laboratory Medicine ◽  
The European Union ◽  
Medical Specialists ◽  
Laboratory Results ◽  
Training Programmes ◽  
The Right

The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.

Rehabilitation management of the lower extremity in HIV disease

1995 ◽  
Vol 85 (7) ◽  
pp. 394-402 ◽  
Author(s):  
MA McReynolds
Keyword(s):  
Lower Extremity ◽  
Treatment Strategies ◽  
Gait Pattern ◽  
Hiv Disease ◽  
Peripheral Neuropathies ◽  
Skin Ulcers ◽  
Immunodeficiency Virus ◽  
And Function

The sequelae of human immunodeficiency virus (HIV) disease include a host of devastating conditions involving the lower extremity. These include rheumatologic dysfunction, Kaposi's sarcoma, peripheral neuropathies, and skin ulcers. Pain, weakness, and loss of range of motion caused by these conditions can lead to changes in gait pattern, loss of mobility and function, and limited quality of life. The role of the rehabilitation specialist in the care and treatment of HIV disease as it affects the lower extremity, and the treatment strategies, precautions, and suggestions will be discussed.

scholarly journals Music and dance in chronic lung disease

Breathe ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Keir Philip ◽  
Adam Lewis ◽  
Nicholas S. Hopkinson
Keyword(s):  
Chronic Disease ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Personalised Medicine ◽  
Evidence Base ◽  
Self Management ◽  
Music Making ◽  
Arts In Health

Arts in Health interventions show potential to improve the quality of life of people with chronic lung disease. Listening to music, making music, and dance have accepted and established roles in the lives of people without chronic disease. However, their potential utility in chronic disease management is infrequently considered by medical professionals. The aim of this review is to examine the use of music and dance in the treatment and self-management of chronic lung disease. Although the evidence base is currently limited, existing research suggests a range of biopsychosocial benefits. As personalised medicine and social prescribing become more prominent, further research is required to establish the role of arts interventions in chronic lung disease.

scholarly journals The Role of Alpha Defensins in Patients with Ankylosing Spondylitis

2020 ◽  
Author(s):  
Pelin Oktayoglu ◽  
Nuriye Mete ◽  
Mehmet Caglayan
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Elevated Serum ◽  
Treatment Strategies ◽  
Disease Activity Index ◽  
Pathogenetic Mechanisms

Abstract Objectives Defensins are a family of antimicrobial peptides. Elevated levels of human neutrophil peptides (HNP 1–3) are seen in blood samples of patients with inflammatory bowel disease (IBD) and in many rheumatic diseases. It has been suggested that they may play a significant role in the progression and pathogenesis of these diseases. Therefore, we aimed to investigate the levels of HNP 1–3 in sera of patients with ankylosing spondylitis (AS) and its association with disease activity and other clinical features of AS. Methods A total of 36 patients, who met the Modified New York Criteria for AS, and 50 healthy controls (HCs) were included in this study. The Bath AS Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) were used to assess disease activity. The Bath AS Radiology Index (BASRI) was used to assess radiological damage. Spinal and hip measurements were determined by the Bath AS Metrology Index (BASMI). An AS Quality of Life (ASQoL) questionnaire was administered to assess the disease-related quality of life. Serum HNP 1–3 levels were determined using the ELISA kit. Results Mean serum HNP 1–3 levels were significantly higher in patients with AS (287.01±201.307 vs. 152.09±43.75 pg/ml) compared with HCs (p=0.001). HNP 1–3 levels did not correlate with BASDAI (p=0.519), ASDAS-CRP (p=0.424), BASRI (p=0.280), BASMI (p=0.168), ASQoL (p=0.307), ESR (p=0.706) and CRP (p=0.157) values. Conclusion Elevated serum levels of HNP 1–3 may play an important role in the pathogenetic mechanisms of AS. This result may give us an opportunity to develop new treatment strategies considering the role of these peptides in the pathogenetic mechanisms of AS.

scholarly journals Update on the Role of Neuropeptide Y and Other Related Factors in Breast Cancer and Osteoporosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Shu-ting Lin ◽  
Yi-zhong Li ◽  
Xiao-qi Sun ◽  
Qian-qian Chen ◽  
Shun-fa Huang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neuropeptide Y ◽  
Treatment Strategies ◽  
Nuclear Factor Κb ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Osteogenic Response ◽  
The Relationship

Breast cancer and osteoporosis are common diseases that affect the survival and quality of life in postmenopausal women. Women with breast cancer are more likely to develop osteoporosis than women without breast cancer due to certain factors that can affect both diseases simultaneously. For instance, estrogen and the receptor activator of nuclear factor-κB ligand (RANKL) play important roles in the occurrence and development of these two diseases. Moreover, chemotherapy and hormone therapy administered to breast cancer patients also increase the incidence of osteoporosis, and in recent years, neuropeptide Y (NPY) has also been found to impact breast cancer and osteoporosis.Y1 and Y5 receptors are highly expressed in breast cancer, and Y1 and Y2 receptors affect osteogenic response, thus potentially highlighting a potential new direction for treatment strategies. In this paper, the relationship between breast cancer and osteoporosis, the influence of NPY on both diseases, and the recent progress in the research and treatment of these diseases are reviewed.

scholarly journals Dissecting the role of EYS in retinal degeneration: clinical and molecular aspects and its implications for future therapy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ana B. Garcia-Delgado ◽  
Lourdes Valdes-Sanchez ◽  
Maria Jose Morillo-Sanchez ◽  
Beatriz Ponte-Zuñiga ◽  
Francisco J. Diaz-Corrales ◽  
...  
Keyword(s):  
Autosomal Recessive ◽  
Personalised Medicine ◽  
Therapeutic Approaches ◽  
Cell Therapies ◽  
Cellular Localisation ◽  
Clinical Presentations ◽  
Technical Advances ◽  
Molecular Aspects ◽  
Future Therapy

AbstractMutations in the EYS gene are one of the major causes of autosomal recessive retinitis pigmentosa. EYS-retinopathy presents a severe clinical phenotype, and patients currently have no therapeutic options. The progress in personalised medicine and gene and cell therapies hold promise for treating this degenerative disease. However, lack of understanding and incomplete comprehension of disease's mechanism and the role of EYS in the healthy retina are critical limitations for the translation of current technical advances into real therapeutic possibilities. This review recapitulates the present knowledge about EYS-retinopathies, their clinical presentations and proposed genotype–phenotype correlations. Molecular details of the gene and the protein, mainly based on animal model data, are analysed. The proposed cellular localisation and roles of this large multi-domain protein are detailed. Future therapeutic approaches for EYS-retinopathies are discussed.

scholarly journals Rheumatoid cachexia: the underappreciated role of myoblast, macrophage and fibroblast interplay in the skeletal muscle niche

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
T. Ollewagen ◽  
K. H. Myburgh ◽  
M. van de Vyver ◽  
C. Smith
Keyword(s):  
Dynamic Control ◽  
Treatment Strategies ◽  
Macrophage Phenotype ◽  
Cellular Environment ◽  
Rheumatoid Cachexia ◽  
Inflammatory State ◽  
Role Players ◽  
Cell Niche

AbstractAlthough rheumatoid arthritis affects 1% of the global population, the role of rheumatoid cachexia, which occurs in up to a third of patients, is relatively neglected as research focus, despite its significant contribution to decreased quality of life in patients. A better understanding of the cellular and molecular processes involved in rheumatoid cachexia, as well as its potential treatment, is dependent on elucidation of the intricate interactions of the cells involved, such as myoblasts, fibroblasts and macrophages. Persistent RA-associated inflammation results in a relative depletion of the capacity for regeneration and repair in the satellite cell niche. The repair that does proceed is suboptimal due to dysregulated communication from the other cellular role players in this multi-cellular environment. This includes the incomplete switch in macrophage phenotype resulting in a lingering pro-inflammatory state within the tissues, as well as fibroblast-associated dysregulation of the dynamic control of the extracellular matrix. Additional to this endogenous dysregulation, some treatment strategies for RA may exacerbate muscle wasting and no multi-cell investigation has been done in this context. This review summarizes the most recent literature characterising clinical RA cachexia and links these features to the roles of and complex communication between multiple cellular contributors in the muscle niche, highlighting the importance of a targeted approach to therapeutic intervention.

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