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NIHSeniorHealth: Taking Medicines – Personalized Medicines

Thursday, August 4th, 2016

Medicines: One Size Does Not Fit All

Studies have shown that bad reactions to properly prescribed medicines cause a number of hospitalizations each year. Researchers believe that many of these errors show that when it comes to taking medicines, "one size does not fit all."

For example, allergy medicines simply don't work for everyone who takes them. For some people, taking the standard dosage of a prescription pain reliever such as codeine offers no pain relief, and can even cause side effects that are uncomfortable or life-threatening.

As the body ages, fat and muscle content change, affecting how the body absorbs and processes drugs. Many other factors -- exercise habits, diet, and general state of health -- also influence how a person responds to medications.

Another key factor is heredity -- the genes we inherit from our parents and other ancestors. Genes can influence the way people respond to many types of medicines, such as Tylenol#3, which is acetaminophen plus codeine; antidepressants like Prozac, also called fluoxetine; and many blood pressure and asthma medicines.

Your genes determine the shape and function of your proteins. As drugs travel through the body, they interact with dozens of proteins.

Everyones genes are slightly different, so everyones proteins are different. Variations in some proteins can affect the way we respond to medicines. Such proteins include those that help the body absorb, metabolize, or eliminate drugs.

Many scientists around the country are conducting research to understand how genes affect the way people respond to medicines. This type of research is called pharmacogenomics.

Pharmacogenomics research aims to identify all the possible variations in genes that play a role in drug response. To identify which versions of a certain gene a person has, researchers examine DNA from that person. Researchers can obtain this DNA in an easy, painless and risk-free way using a cotton swab to collect mouth cells from inside the persons cheek. The scientists then isolate the DNA from the mouth cells.

Uncovering differences in people's genetic backgrounds will help doctors prescribe the right medicine in the right amount for each person, making medicines more safe and effective for everyone.

Scientists will also better understand the role that genes play in causing or contributing to diseases including cancer, heart disease, diabetes, depression, and many others. Research in pharmacogenomics will help scientists make future medicines as safe and effective as possible.

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Personalized medicine – Bio-Medicine – latest biology and …

Thursday, August 4th, 2016

Personalized medicine is the use of detailed information about a patient's genotype or level of gene expression and a patient's clinical data in order to select a medication, therapy or preventative measure that is particularly suited to that patient at the time of administration. The benefits of this approach are in its accuracy, efficacy, safety and speed. The term emerged in the late 1990s with progress in the Human Genome Project. Research findings over the past decade, or so, in biomedical research have unfolded a series of new, predictive sciences that share the appendage -omics (genomics, proteomics, metabolomics, cytomics). These are opening the possibility of a new approach to drug development as well as unleashing the potential of significantly more effective diagnosis, therapeutics, and patient care.

Traditional diagnosis focuses on the symptoms of a patient's illness whereas a personalized medicine approach can directly examine and analyse the genetic basis of a disease and stratify the total population into different sub-sets each with common, but unique, disease characteristics.

The pharmaceutical industry has worked on the basis of offering a therapy that is intended to suit the population at large based on what is known as the 'blockbuster drug model'. A blockbuster drug is a product capable of achieving sales of over $1 billion per annum. The pharmaceutical industry is facing severe difficulties across several spectrums with its blockbuster approach:

There are several stakeholders: the industry, the regulators, the payors, the patients and the general public

The pharmaceutical industry, in general, has been reluctant to the immediately embrace the potential of personalized medicine. It is believed that they are concerned that the emergence of personalized medicine will destroy the foundations of the mass-market blockbuster drug model because personalized therapeutics will cater for particular sub-sets of the general population.

Another reason for the scepticism of the pharmaceutical industry is the threat to existing products. Many blockbuster drugs, such as Lipitor, compare favorably with cheaper generic drugs only in a small percentage of patients. But since it is not known how to identify these, many physicians prescribe the expensive drug to all their patients. If a test could be devised to determine who actually benefits from the more expensive drug, all other patients could use the generic.

However, the technologies underpinning personalized medicine could enable the pharmaceutical industry to become more sure-footed. A more efficient drug development process, based on sound, robust genetic evidence could require less investment and, perhaps less elapsed time, to identify and develop new products as confidence deepens. Furthermore, the idea of a therapeutic being marketed on the basis of a companion theranostic test result could deepen and prolong consumer loyalty if sustainable benefits are evident.

The traditional diagnostics industry is mature and only achieving a growth rate of the order of 4% per annum. Its products are very cost sensitive and have a relatively short life cycle. The diagnostics industry has not been as successful as the pharmaceutical industry in attracting investment funding.

However, the advent of molecular diagnostic tests, or theranostics, opens new opportunities in a small but believed to be rapidly growing niche market. New relationships are likely to develop between industry partners committed to personalized medicine embracing the approach of successful, specialised pharmaceutical firms. Such has been the case with IBM. This corporation has made strategic partnerships with Mayo Clinic Medical Center and several other healthcare and testing centres. Its plan entails developing bioinformatics systems which will allow greater growth in tests that are available.

Still the major problem in growth of tests such as these is their clinical utility as well as reimbursement from third party payors.

The emergence of personalized medicine raises issues for those who pay for treatment. The unit cost is likely to he higher but it is argued that the total cost of a treatment cycle will be lower overall. Furthermore, the possibilities of the predicitive potential of personalized medicine ought to avert costly intensive care treatment when a disease is established.

The response of payers will be influenced by the nature of the relationship they have with those whom they are paying for. Is it a long-term relationship, which is the case with nationally funded medical care, or is it short term? New policies and procedures will be necessary.

Countries such as the United States are currently struggling with the burgeoning of healthcare expenditure. Perhaps personalized medicine is the cure. However, most US private insurers unlike the governmental system are not embracing this potential. Less than 5% of all private companies reimburse for genetic tests.

The Food and Drug Administration in the United States and their counterparts appear convinced that personalized medicine is going to make a profound impact on society and they are guiding this process.

Dr Andrew VonEschenbach, Director of the FDA recently gave a briefing to the Personalized Medicine Coalition at the National Press Club. He and the organization are truly committed to bring new testing and treatment to market which is molcularly based. His feeling is that the Molecular Metamorphosis is equivalent if not greater than the bacterial theory and its revolution of medicine.

Personalized medicine has the potential to revolutionize the practice of medicine, but despite significant scientific advances, very few genomics-based tests or treatments have reached consumers. Senator Barack Obama introduced the Genomics and Personalized Medicine Act to overcome the scientific barriers, adverse market pressures, and regulatory obstacles that have stood in the way of better medicine.[1] In addition, in the United States. The Secretary of Health and Human Services Mike Leavitt has made personalized medicine the top priority during his tenure. He has created a committee that is called the Secretary's Advisory Committee on Genetics Health and Society aka. SACGHS During the March meeting there was briefing re-affirming his commitment to this wonderful new phase of medical care.

One of the significant barriers to genetic testing is thought to be the fear of discrimination. Discirimination from an insurer or even worse and employer. This fear has been indicated in several polls, including the Harris Poll in 2002. For the last decade there has been some form of legislation which had been mired in the House of Representatives in the United States. The current bill is called the Genetic Information Nondiscrimination Act H.R. 493, S.358 aka GINA. It was passed in the House of Representatives 420-3 and appears to have major support in the Senate. This will legislation will break down a significant barrier to this technology

Patients will clearly be influenced by proven success as is the case with Herceptin and Gleevec. Theranostic tests are proving effective in other areas such as the identification of anti-retroviral drug for use with different strains of HIV.

At a recent meeting of the US Secretary's Advisory Committee on Genetics Health and Society it was revealed that a majority of the public supports the utilization of genetic testing, especially if this testing could be used to improve health outcomes.

Public education public confidence about the potential benefits of personalized medicine will be an important facet of its widespread acceptance. This includes about the research itself and the science underlying it; disease variations and the approach to prevention, treatment and care; and a deeper awareness of risks and benefits attaching to clinical trials.

The march toward personalized medicine is not driven, in some instances, on the basis of scientific hypothesis but through hypothesis generation sometimes starting with natural history. The key task is to find genes and gene variations that play a role in a disease. The first step is to associate the occurrence of a particualr gene variant with the incidence of a particular disease or disease predisposition - an association that can vary from one individual to another depending on many factors, including environmental circumstances. The outcome is the development of biomarkers which are stable and predictive. Today's biomarker is tomorrow's theranostic.

The infrastructure necessary includes molecular information -biological specimens derived from tissue, cells, or blood provided on the basis of informed donor consent and suitably annotated. Clinical information is also necessary based on patient medical records or clinical trial data.

A very high level of collaboration involving scientists and specialists from varying disciplines is required to integrate and make sense of all this information.

The Harvard Partners Center for Genetics and Genomics was founded in 2001 with the specific goal of accelerating the realization of personalized medicine. The Personal Genome Project was announced by George Church in 2006; it will publish full genome sequences and medical records of volunteers in order to enable research into personalized medicine.

Not only is personalized medicine tailoring the right drug, for the right person, at the right time but it also includes evaluating predisposition to disease sometimes decades in advance of its threatened onset.

Cancer genetics is a subspecialized field of genetics. This field initially dealt with the relatively small amount of inherited cancers. This amounted to about 5-10% of all cancers as estimated bt the National Institutes of Health.

Individuals diagnosed with familial breast, ovarian, colon cancer had been counseled in the past that they would receive standardized treatments and had limited options before their "condition" arrived. These options included removal of the organs that may give rise to cancer. Recent medical research indicates that medications, lifestyle changes and increased screening can mitigate some risk. An example is BRCA mutations where the carrier can have an increased lifetime risk of 85% for developing a breast cancer or up to 40% increased risk of getting ovarian cancer. Now medications such as tamoxifen are being shown to reduce incidence of disease.

The exciting news is that cancer predisposition genes and families are being identified by genetic testing and research at a break neck pace. Because all cancers require a dysfunction in the DNA of cells that regulate growth, it would be foolhardy not to expect all cancers to have some heritable predisposition as well as environmental influence.

Personalized medicine aims to identify these families at risk for cancer, heart disease, diabetes, etc. Once identified by simple family history including a 3 generation pedigree or advanced genetic testing, the person could take preventative action. This might include changes in diet, cessation of toxic habits, earlier screening, exercise, prophylactic medications or surgery.

Two products, Herceptin supplied by Genentech and Gleevec supplied by Novartis,are prescribed on the basis of the outcome of a companion theranostic test. Herceptin treats a category of breast cancer in woman and the test helps identify those patients whose cancer cells express the protein HER2 making them eligible. Herceptin sales have grown from $30.5 million in 1998, its year of introduction, to $764 million in 2005. Gleevec treats chronic myeloid leukaemia (CML) arrived in 2004 and it is known as a targeted cancer drug. In addition because of new molecular testing for c-kit, tumors such as GIST GastroIntestinal Stromal Tumours a solid malignancy never associated with blood bourne cancer are also treated with this drug. It works by killing specific cells whereas chemotherapy can kill both deranged and healthy cells. Because of this ability to molecularly detect true disease causing mutation a whole new reclassification of cancer has begun. So has the unimagined use of several of these "targeted" drugs. Gleevec sales have exceeded $500 million.

There are several universities involved in translating the burgeoning science into use. The difficulty is that medical education in all countries does not provide adequate genetic instruction.

A small number of universities are currently developing a subspecialty in medicine that is known by several names including, molecular medicine, personalized medicine, or even prospective medicine. These include, Duke University in North Carolina USA, Harvard in Cambridge USA, The Mount Sinai Hospital in New York City. A medical school is currently being constructed in Arizona USA to teach the field of personalized medicine; this is a project of Arizona State University and a company called TGen.

Aside from academic universities, private programs such as Helix Health LLP in New York City provide genetics consultation to accomplish personalized medical care. Their mission is to educate and empower patients and physicians in this new paradigm of medicine.

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Medicine – Wikipedia, the free encyclopedia

Thursday, August 4th, 2016

Medicine (British English i; American English i) is the science and practice of the diagnosis, treatment, and prevention of disease.[1][2] The word medicine is derived from Latin medicus, meaning "a physician".[3][4] Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.[5]

Medicine has existed for thousands of years, during most of which it was an art (an area of skill and knowledge) frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism. In recent centuries, since the advent of modern science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science). While stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.

Prescientific forms of medicine are now known as traditional medicine and folk medicine. They remain commonly used with or instead of scientific medicine and are thus called alternative medicine. For example, evidence on the effectiveness of acupuncture is "variable and inconsistent" for any condition,[6] but is generally safe when done by an appropriately trained practitioner.[7] In contrast, treatments outside the bounds of safety and efficacy are termed quackery.

Medical availability and clinical practice varies across the world due to regional differences in culture and technology. Modern scientific medicine is highly developed in the Western world, while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners.[8] Even in the developed world however, evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm.[9]

In modern clinical practice, doctors personally assess patients in order to diagnose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins an interaction with an examination of the patient's medical history and medical record, followed by a medical interview[10] and a physical examination. Basic diagnostic medical devices (e.g. stethoscope, tongue depressor) are typically used. After examination for signs and interviewing for symptoms, the doctor may order medical tests (e.g. blood tests), take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions.[11] Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue.

The components of the medical interview[10] and encounter are:

The physical examination is the examination of the patient for medical signs of disease, which are objective and observable, in contrast to symptoms which are volunteered by the patient and not necessarily objectively observable.[12] The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia, diabetic ketoacidosis). Four actions are the basis of physical examination: inspection, palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order although auscultation occurs prior to percussion and palpation for abdominal assessments.[13]

The clinical examination involves the study of:

It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.

The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of "utilization review", such as prior authorization of tests, may place barriers on accessing expensive services.[14]

The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.

On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Contemporary medicine is in general conducted within health care systems. Legal, credentialing and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have significant impact on the way medical care is provided.

From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals and the Catholic Church today remains the largest non-government provider of medical services in the world.[15] Advanced industrial countries (with the exception of the United States)[16][17] and many developing countries provide medical services through a system of universal health care that aims to guarantee care for all through a single-payer health care system, or compulsory private or co-operative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.

Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those that can afford to pay for it or have self-insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.

Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice by patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for lack of openness,[18] new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.

Provision of medical care is classified into primary, secondary, and tertiary care categories.

Primary care medical services are provided by physicians, physician assistants, nurse practitioners, or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics, nursing homes, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes.

Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency rooms, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.

Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc.

Modern medical care also depends on information still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

In low-income countries, modern healthcare is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain.[19]

Working together as an interdisciplinary team, many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses, emergency medical technicians and paramedics, laboratory scientists, pharmacists, podiatrists, physiotherapists, respiratory therapists, speech therapists, occupational therapists, radiographers, dietitians, and bioengineers, surgeons, surgeon's assistant, surgical technologist.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry, while considered by some a separate discipline from medicine, is a medical field.

A patient admitted to the hospital is usually under the care of a specific team based on their main presenting problem, e.g., the Cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments.

Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in.

The main branches of medicine are:

In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which have its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments); the new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination.

Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing the examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA).

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery, ophthalmic surgery, cardiovascular surgery, colorectal surgery, neurosurgery, oral and maxillofacial surgery, oncologic surgery, orthopedic surgery, otolaryngology, plastic surgery, podiatric surgery, transplant surgery, trauma surgery, urology, vascular surgery, and pediatric surgery. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology, but are not considered surgical sub-specialties per se.

Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming.

Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied.[20] In North America, specialists in internal medicine are commonly called "internists." Elsewhere, especially in Commonwealth nations, such specialists are often called physicians.[21] These terms, internist or physician (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.

Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys.[22]

In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of Primary care.

There are many subspecialities (or subdisciplines) of internal medicine:

Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on Medical education and Physician for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the USA. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.

The followings are some major medical specialties that do not directly fit into any of the above-mentioned groups.

Some interdisciplinary sub-specialties of medicine include:

Medical education and training varies around the world. It typically involves entry level education at a university medical school, followed by a period of supervised practice or internship, and/or residency. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to the United States, must be completed in and delivered from a recognized university.

Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education. Medical practitioners upgrade their knowledge in various ways, including medical journals, seminars, conferences, and online programs.

In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.

In the European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC.

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:

Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.

Prehistoric medicine incorporated plants (herbalism), animal parts, and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian Medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine.

In Egypt, Imhotep (3rd millennium BC) is the first physician in history known by name. The oldest Egyptian medical text is the Kahun Gynaecological Papyrus from around 2000 BCE, which describes gynaecological diseases. The Edwin Smith Papyrus dating back to 1600 BCE is an early work on surgery, while the Ebers Papyrus dating back to 1500 BCE is akin to a textbook on medicine.[24]

In China, archaeological evidence of medicine in Chinese dates back to the Bronze Age Shang Dynasty, based on seeds for herbalism and tools presumed to have been used for surgery.[25] The Huangdi Neijing, the progenitor of Chinese medicine, is a medical text written beginning in the 2nd century BCE and compiled in the 3rd century.[26]

In India, the surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery.[27][dubious discuss][28][29] Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found.[30][31]

In Greece, the Greek physician Hippocrates, the "father of western medicine",[32][33] laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence".[34][35] The Greek physician Galen was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Early Middle Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

Most of our knowledge of ancient Hebrew medicine during the 1stmillenniumBC comes from the Torah, i.e.the Five Books of Moses, which contain various health related laws and rituals. The Hebrew contribution to the development of modern medicine started in the Byzantine Era, with the physician Asaph the Jew.[36]

After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the Persian polymath, Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine".[37] He wrote The Canon of Medicine, considered one of the most famous books in the history of medicine.[38] Others include Abulcasis,[39]Avenzoar,[40]Ibn al-Nafis,[41] and Averroes.[42]Rhazes[43] was one of the first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine.[44]Al-Risalah al-Dhahabiah by Ali al-Ridha, the eighth Imam of Shia Muslims, is revered as the most precious Islamic literature in the Science of Medicine.[45] The Islamic Bimaristan hospitals were an early example of public hospitals.[46][47]

In Europe, Charlemagne decreed that a hospital should be attached to each cathedral and monastery and the historian Geoffrey Blainey likened the activities of the Catholic Church in health care during the Middle Ages to an early version of a welfare state: "It conducted hospitals for the old and orphanages for the young; hospices for the sick of all ages; places for the lepers; and hostels or inns where pilgrims could buy a cheap bed and meal". It supplied food to the population during famine and distributed food to the poor. This welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates. The Benedictine order was noted for setting up hospitals and infirmaries in their monasteries, growing medical herbs and becoming the chief medical care givers of their districts, as at the great Abbey of Cluny. The Church also established a network of cathedral schools and universities where medicine was studied. The Schola Medica Salernitana in Salerno, looking to the learning of Greek and Arab physicians, grew to be the finest medical school in Medieval Europe.[48]

However, the fourteenth and fifteenth century Black Death devastated both the Middle East and Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East.[49] In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Vesalius improved upon or disproved some of the theories from the past. The main tomes used both by medicine students and expert physicians were Materia Medica and Pharmacopoeia.

Andreas Vesalius was the author of De humani corporis fabrica, an important book on human anatomy.[50] Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology.[51] Independently from Ibn al-Nafis, Michael Servetus rediscovered the pulmonary circulation, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris"[52] in 1546, and later published in the theological work for which he paid with his life in 1553. Later this was described by Renaldus Columbus and Andrea Cesalpino. Herman Boerhaave is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). Pierre Fauchard has been called "the father of modern dentistry".[53]

Veterinary medicine was, for the first time, truly separated from human medicine in 1761, when the French veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and other animals.

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900.

The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austria, doctors Rudolf Virchow, Wilhelm Conrad Rntgen, Karl Landsteiner and Otto Loewi made notable contributions. In the United Kingdom, Alexander Fleming, Joseph Lister, Francis Crick and Florence Nightingale are considered important. Spanish doctor Santiago Ramn y Cajal is considered the father of modern neuroscience.

From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet.

In the United States, William Williams Keen, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasabur), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca) and others did significant work. Russian Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids.[54]Pharmacology developed in part from herbalism and some drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc.).[55]Vaccines were discovered by Edward Jenner and Louis Pasteur.

The first antibiotic was arsphenamine (Salvarsan) discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by German chemists originally from azo dyes.

Pharmacology has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by modern global information science, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.[56]

Traditional medicine (also known as indigenous or folk medicine) comprises knowledge systems that developed over generations within various societies before the era of modern medicine. The World Health Organization (WHO) defines traditional medicine as "the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness."[57]

In some Asian and African countries, up to 80% of the population relies on traditional medicine for their primary health care needs. When adopted outside of its traditional culture, traditional medicine is often called alternative medicine.[57] Practices known as traditional medicines include Ayurveda, Siddha medicine, Unani, ancient Iranian medicine, Irani, Islamic medicine, traditional Chinese medicine, traditional Korean medicine, acupuncture, Muti, If, and traditional African medicine.

The WHO notes however that "inappropriate use of traditional medicines or practices can have negative or dangerous effects" and that "further research is needed to ascertain the efficacy and safety" of several of the practices and medicinal plants used by traditional medicine systems.[57] The line between alternative medicine and quackery is a contentious subject.

Traditional medicine may include formalized aspects of folk medicine, that is to say longstanding remedies passed on and practised by lay people. Folk medicine consists of the healing practices and ideas of body physiology and health preservation known to some in a culture, transmitted informally as general knowledge, and practiced or applied by anyone in the culture having prior experience.[58] Folk medicine may also be referred to as traditional medicine, alternative medicine, indigenous medicine, or natural medicine. These terms are often considered interchangeable, even though some authors may prefer one or the other because of certain overtones they may be willing to highlight. In fact, out of these terms perhaps only indigenous medicine and traditional medicine have the same meaning folk medicine, while the others should be understood rather in a modern or modernized context.[59]

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University of Maryland School of Medicine

Thursday, August 4th, 2016

SOMnews, the official monthly newsletter of the University of Maryland School of Medicine, features stories about the outstanding achievements of our faculty staff and students.

Part of SOMnews, The Buzz is a self reported publication highlighting important grants and contracts, journal publications and awards by our faculty.

Delivered by E. Albert Reece, MD, PhD, MBA, Vice President for Medical Affairs at the University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean of the University of Maryland School of Medicine, the theme of this years State of the School address was Undaunted in Purpose, Resilient in Execution.

A joint effort of the School of Medicine and the UM Medical System, the Annual Report highlights our economic impact to the state and the people behind the numbers.

The University of Maryland Medicine Bulletin, America's oldest medical alumni magazine, is sponsored by the Medical Alumni Association, and the University of Maryland School of Medicine.

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Personalized medicine: The way forward? – Medical News Today

Thursday, August 4th, 2016

Everyone is different. Research suggests that humans have somewhere between 99 and 99.9 percent in common with each other. The remaining 1 percent can make a big difference when it comes to health, whether it is resistance or susceptibility to disease, or treatment.

Being different, our bodies react differently to treatment.

Variations in chemical and genetic composition mean that one person's response to a therapy will not necessarily be the same as the next.

As developments in the fields of genetics and technology advance, the conventional, one-size-fits-all approach to medicine starts to look outdated.

Instead, we are seeing a growing range of strategies that take into consideration the quirks of the individual.

This article will look at some of the strategies already available to help healthcare professionals meet individual patient needs, in the multifaceted field of personalized medicine.

Research suggests that around 50 percent of patients with depression do not respond to first-line antidepressants. What can explain this, and how can it be solved?

Current treatment is often a case of trial and error. A patient may take one medication after another, often for 12 weeks or more each time, while symptoms remain the same, or worsen.

A team from King's College London in the United Kingdom recently announced a blood test that can predict with accuracy and reliability whether an individual patient will respond to common antidepressants.

This, they say, "could herald a new era of personalized treatment for patients with depression."

High levels of blood inflammation have been linked to a lower response to antidepressants, so the team designed a test to distinguish levels of blood inflammation.

It evaluates the levels of two biomarkers: macrophage migration inhibitory factor (MIF) and interleukin (IL)-1.

Results showed that none of the patients with levels of MIF and IL-1 above a certain threshold responded to conventional antidepressants, while with inflammation levels below this threshold did tend to respond. The findings indicate that patients with higher levels of inflammation should use a combination of antidepressants from the early stages to stop their condition from getting worse.

The two biomarkers affect a number of brain mechanisms involved in depression, including the birth of new brain cells, connections between them, and the death of brain cells as a result of oxidative stress, related to the processing of free radicals.

Depression can result when chemical signaling is disrupted, and the function of the brain's protective mechanisms is reduced.

"The identification of biomarkers that predict treatment response is crucial in reducing the social and economic burden of depression, and improving quality of life of patients."

Prof. Carmine Pariante, King's College London

Getting the right medication from the start would enhance the well-being of patients, and it would also save on healthcare costs, in terms of time and money.

In 2012, the United States Food and Drug Administration (FDA) approved a new treatment for cystic fibrosis (CF), a serious, genetic condition that affects the respiratory and digestive systems. The drug is ivacaftor, known by the trade name of Kalydeco.

People with CF have a fault in the flow of salt and water on the surface of the lungs. It leads to a buildup of sticky mucus that can be life-threatening.

In 4 percent of patients with CF, this problem comes from a mutation in the gene G551D, which regulates the transport of salt and water in the body.

Ivacaftor can help around 1,200 people in the U.S., but more significantly, it is the first therapy to target the underlying cause of CF rather than the symptoms.

Genomic science enabled scientists to pinpoint the root of the problem, to develop a repair strategy, and to establish which patients it might benefit.

Cancer treatment is well suited to a genomic and individual approach.

In 1979, scientists discovered the most commonly mutated gene in human cancer: TP53, or p53. The BRCA1 gene mutation was discovered in 1994, and BRCA2 in 1995.

Targeted therapy for women with ovarian cancer caused by BRCA1 and BRCA2 are already in use. Targeted therapies aim to attack the tumor without harming healthy cells. The drugs work on DNA repair pathways that are blocked in women with mutations in BRCA1 and BRCA2.

In 2011, the Wall Street Journal published an infographic indicating what percentage of different cancers were likely to stem from genetic mutations that could be targeted by specific drugs. The figures ranged from 21 percent of people with cancers relating to the head or neck to 73 percent of melanoma cases.

Jen Trowbridge, researching how genomics affects cancer at the Jackson Laboratory in Bar Harbor, Maine, foresees that instead of telling a person that they have brain cancer or lung cancer, doctors will be saying, "you have cancer that's caused by this mutation, and we have a drug that targets that mutation."

People's genetic makeup affects their future health and longevity. Genetic information can help scientists to predict what diseases people are likely to get, and how their bodies are likely to react.

Fast facts about BRCA1

Learn more about breast cancer.

In April 2016, scientists from the Scripps Translational Science Institute (STSI) found that in a group of over 1,400 healthy 80-105-year-olds, there was a "higher-than-normal presence of genetic variants offering protection from cognitive decline."

In particular, they found an absence of the coding variant for COL25A1, a gene that has been associated with the development of Alzheimer's disease.

Gene-editing techniques, such as "CRISPR," that modify DNA by "snipping" it, could prevent the onset of age-related diseases such as Alzheimer's in later years.

Women with a family history of breast cancer can undergo screening for BRCA1 and BRCA2 mutations to decide whether to take preventive action, such as a mastectomy, to minimize the risk of developing breast or ovarian cancer in future.

Recent research has suggested that women with the BRCA1 mutation should consider having children earlier, because the fault may affect the number of eggs in the ovaries.

Jen Trowbridge puts it this way: "Conventional medicine continues to treat the symptoms, but genetic scientists are now working to get right to the roots of diseases, the 'birth of a cancer,' starting from cell one."

Advances in biotechnology also contribute to personalized medicine.

New imaging technology means that assessments of a patient's condition and needs can be ever more precise.

The data gathered can lead to tailor-made devices, and even regenerative medicine.

One example is the personalized tinnitus masker, with custom-tailored audio signals that can be configured to meet the needs of the individual patient.

Mobile health (mHealth) solutions include interconnected, wearable medical devices that feed back to the doctor a person's heart rhythms and other vital data, enabling remote monitoring, and any appropriate tweaking of treatment.

3-D printing and regenerative medicine have already provided patients with replacement body parts, including bone and a windpipe.

A CT scan assesses patient needs, computer-aided design plans the structure, and 3-D printing creates the final product. A device that is implanted surgically can then dissolve over time, as the body naturally replaces it with human tissue.

Researchers in the U.K. recently created the prototype of a 3-D-printed bone scaffold. The device would allow tissue to grow around it and new human bone to develop, as the artificial bone dissolves.

The device would match the patient's exact size and shape, and its porous nature would allow blood flow and cell growth to occur.

In 2013, physicians at the University of Michigan and Akron Children's Hospital created a bioresorbable airway splint to treat a critically ill infant. The child's airway walls were so weak that breathing or coughing could cause them to collapse. The device provided a placeholder for cells to grow naturally around it, as the body healed itself.

An FDA report describes this as "a glimpse into a future where truly individualized, anatomically specific devices may become a standard part of patient care."

Until now, diseases have been treated with a relatively narrow range of therapies. Randomized controlled trials have been the most reliable guarantee of safety and efficacy.If the majority of people respond to a treatment in tests, it is considered successful.

But no treatment is 100 percent successful, because everyone is different.

Genome sequencing and advancing technology are shifting the perspective on healthcare, bringing tailor-made treatment further within reach.

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Icahn School of Medicine at Mount Sinai – New York City …

Thursday, August 4th, 2016

Select Ambulatory Programs Anatomy and Functional Morphology Anesthesiology Anesthesiology, Cardiothoracic Anesthesia Anesthesiology, Pain Management Anesthesiology, Pediatric Anesthesia Biomathematical Sciences Cardiothoracic Surgery Cardiovascular Surgery Center for Comparative Medicine and Surgery Dentistry Dentistry, Oral and Maxillofacial Surgery Dermatology Developmental and Regenerative Biology Emergency Medicine Experimental Therapeutics Institute Family Medicine & Community Health Genetics and Genomic Sciences Geriatrics and Palliative Medicine Geriatrics and Palliative Medicine, Experimental Diabetes and Aging Icahn School of Medicine at Mount Sinai Inpatient Adult Psychiatry Medical Education Medicine Medicine, Cardiology Medicine, Clinical Geriatrics Medicine, Clinical Immunology Medicine, Endocrinology, Diabetes and Bone Disease Medicine, Gastroenterology Medicine, General Internal Medicine Medicine, Hematology and Medical Oncology Medicine, Hospital Medicine Medicine, Infectious Diseases Medicine, Liver Diseases Medicine, Nephrology Medicine, Pulmonary, Critical Care and Sleep Medicine Medicine, Rheumatology Metabolic, Endocrine and Minimally Invasive Surgery Microbiology Mount Sinai Beth Israel Mount Sinai Health System Mount Sinai Roosevelt Mount Sinai St. Luke's Neurology Neurology, Headache Neurology, Movement Disorders Neurology, Neuromuscular Diseases Neurology, Vestibular/Ocular Neuroscience Neurosurgery Obstetrics, Gynecology and Reproductive Science Oncological Sciences Ophthalmology Orthopaedics Orthopaedics, Foot and Ankle Service Orthopaedics, Spine Division Orthopaedics, Sports Medicine Service Otolaryngology Outpatient Adult Psychiatry Pathology Pathology, Dermatopathology Pediatrics Pediatrics, Adolescent Medicine Pediatrics, Allergy and Immunology Pediatrics, Ambulatory Care Pediatrics, Behavioral Pediatrics Pediatrics, Cardiology Pediatrics, Child Life Pediatrics, Endocrinology - Adrenal Steroid Disorders Pediatrics, Endocrinology and Diabetes Pediatrics, Gastroenterology Pediatrics, General Pediatrics Pediatrics, Hematology/Oncology Pediatrics, Hepatology Pediatrics, Infectious Diseases Pediatrics, Mount Sinai Pediatrics Pediatrics, Nephrology Pediatrics, Neurology Pediatrics, Newborn Medicine Pediatrics, Pediatric Critical Care Medicine Pediatrics, Pediatrics Associates Pediatrics, Pulmonary and Critical Care Pediatrics, Rheumatology Pharmacological Sciences Population Health Science and Policy Preventive Medicine Preventive Medicine, Preventive Medicine Preventive Medicine, Social Work and Behavioral Science Psychiatry Psychiatry, Alcohol and Substance Abuse Psychiatry, Child and Adolescent Psychiatry Psychiatry, Health Services Research Psychiatry, Imaging Psychiatry, Mood and Personality Disorders Psychiatry, Neuropsychology Psychiatry, Schizophrenia Radiation Oncology Radiology Radiology, Oncology Rehabilitation Medicine Surgery Surgery, Colo-Rectal Surgery Surgery, Pediatric Surgery Surgery, Plastic Surgery Surgery, Surgical Oncology Surgery, Vascular Surgery Surgical Intensive Care Unit Thoracic Surgery Urology

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Clinical Pharmacology & Therapeutics – Wiley Online Library

Thursday, August 4th, 2016

CPT welcomes original articles in the emerging areas of translational, predictive and personalized medicine; new therapeutic modalities including gene and cell therapies; pharmacogenomics, proteomics and metabolomics; bioinformation and applied systems biology complementing areas of pharmacokinetics and pharmacodynamics, human investigation and clinical trials, pharmacovigilance, pharmacoepidemiology, and population pharmacology.

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for deadlines and further information.

Listen here.

This episode features Bernard Vrijens of WestRock Healthcare discussing quantifying the influence of adherence and dose individualization. Read his Commentary which published in the April issue here.

FIND MORE CLINPHARMPOD EPISODES HERE

This Annual Issue highlights the translation of molecular insights into novel management paradigms in pulmonary hypertension; inflammatory bowel disease; asthma, and viral infections, emerging nucleic acid-based technologies that are poised to transform human therapeutics. Plus, the evolution of fundamental clinical pharmacology platforms that optimize the efficiency of bench to bedside translation of therapeutic discoveries across the continuum of development, regulation, and utilization.

Read these outstanding contributions in the January issue

Enjoy FREE access to key collections of articles from CPT selected by the Editor-in-Chief.

Read the virtual issues:

CPIC Guidelines & Updates - from the Clinical Pharmacogenetics Implementation Consortium (CPIC)

Clinical Trials

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Perelman School of Medicine at the University of Pennsylvania

Thursday, August 4th, 2016

Codependence of Cell Nucleus Proteins Key to Understanding Fatty Liver Disease

26 Jul 2016A new appreciation for the interplay between two cell nucleus proteins that lead both intertwined and separate lives is helping researchers better understand fatty liver disease, according to a new study by researchers at the Perelman School of Medicine at the University of Pennsylvania. Read more

25 Jul 2016In the era of precision medicine, targeting the mutations driving cancer growth, rather than the tumor site itself, continues to be a successful approach for some patients. In the latest example, researchers from Penn Medicine and other institutions found that treating metastatic thyroid cancer... Read more

20 Jul 2016Regina Cunningham, PhD, RN, FAAN, AOCN, has been named Senior Vice President and Chief Nursing Executive for the University of Pennsylvania Health System, beginning July 1. Read more

20 Jul 2016HIV researchers at the Perelman School of Medicine at the University of Pennsylvania and The Wistar Institute will co-lead a five-year, $23 million grant from the National Institutes of Health, as part of the second iteration of the Martin Delaney Collaboratory: Towards an HIV-1 Cure program, that... Read more

19 Jul 2016Prior work by a team of Penn Medicine researchers found that sex-specific changes in cerebral blood flow (CBF) begin at puberty. The team's newest research shows that higher blood flow in emotional brain regions such as the amygdala is associated with higher levels of anxiety and mood symptoms in... Read more

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Center for Personalized Medicine | Roswell Park Cancer …

Tuesday, October 20th, 2015

TheCenter for Personalized Medicine (CPM)is helping doctorsdeliver the best possible patient care by developing laboratory testing solutions that accurately, quickly and deeply inform cliniciansof the latest treatment and careoptions based on their patients'unique tumor profiles.

The CPM brings together a multidisciplinary expert teamin the areas of oncology, pathology, laboratory and information technology, bioinformatics, medical informaticsand health care delivery to perform cutting edge research and createthe highest quality, evidence-based genomic tests available using advanced molecular diagnostic technologies. The team is developing a comprehensive OmniSeq Programto implement personalized genomic medicine in routine cancer care.

This is the future of medicine, not just in oncology but across all diseases. Candace Johnson, PhD, President & CEO of RPCI

In cancer, personalized medicine uses advanced laboratory technologies to detect alterations in tumor DNA to match a patient to the treatments that will work best for their specific tumor, help avoid unnecessary treatment, find out how well treatment is working over time or make a prognosis.

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Personalized medicine – ScienceDaily

Friday, October 9th, 2015

Currently, much of medical practice is based on "standards of care" that are determined by averaging responses across large cohorts.

The theory has been that everyone should get the same care based on clinical trials.

Personalized Medicine is the concept that managing a patient's health should be based on the individual patient's specific characteristics, including age, gender, height/weight, diet, environment, etc.

Potential applications of personalized medicine Personalized medicine aims to identify individuals at risk for common diseases such as cancer, heart disease, and diabetes.

The simple family history has long been used by physicians to identify individuals at increased risk and to advise preventive measures such as lifestyle modifications (changes in diet, cessation of toxic habits, increased exercise) earlier screening, or even prophylactic medications or surgery.

Scientific advancements offer the potential to define an individual's risk based on their genetic make-up.

Fields of Translational Research termed "-omics" (genomics, proteomics, and metabolomics) study the contribution of genes, proteins, and metabolic pathways to human physiology and variations of these pathways that can lead to disease susceptibility.

It is hoped that these fields will enable new approaches to diagnosis, drug development, and individualized therapy.

Pharmacogenetics Pharmacogenetics (also termed pharmacogenomics) is the field of study that examines the impact of genetic variation on the response to medications.

This approach is aimed at tailoring drug therapy at a dosage that is most appropriate for an individual patient, with the potential benefits of increasing the efficacy and safety of medications.

Gene-centered research may also speed the development of novel therapeutics.

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Welcome to the Indiana Institute for Personalized Medicine

Wednesday, October 7th, 2015

Dr. Lang Li, Associate Director of the IIPM, namedDirector ofIU Center for Computational Biology and Bioinformatics. Read more...

IIPM Member Dr. Janet Carpenter named Indiana University Distinguished Professor.Read more...

Posted on August 12, 2014 IIPM Member receives Conquer Cancer Foundation grant Dr. Costantine Albany, IIPM member, has received a Conquer Cancer Foundation grant. Read more...

Posted on July 25, 2013 Educational Conference on Personalized Medicine and Pharmacogenomics "Pharmacogenomics in Clinical PracticeWhat you need to know" Thursday, September 5, 2013 from 8:30am 3:00pm The Indiana Institute of Personalized Medicine is offering a didactic and case-study oriented educational conference focusing on pharmacogenomics and its application in clinical practice.The IIPM, led by Dr. Flockhart and a select group of clinicians and pharmacogenomic experts, will conduct a CME and ACPE qualified program addressing the use of pharmacogenomics in clinical practice. The program will be held at the IU Health Neuroscience Center Auditorium at 355 West 16th Street Indianapolis IN 46202. Read more...

To assist with the recognition of these medications, Dr. Malaz A. Boustani and an interdisciplinary team developed the Anticholinergic Cognitive Burden (ACB) list as a practical tool that identifies the severity of anticholinergic effects on cognition of both prescription and over-the-counter medications. Read more...

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Personalized Medicine News — ScienceDaily

Thursday, September 10th, 2015

Sustained Remission of Multiple Myeloma After Personalized Cellular Therapy Sep. 9, 2015 A multiple myeloma patient whose cancer had stopped responding after nine different treatment regimens experienced a complete remission after receiving an investigational personalized cellular ... read more Design of 'Japonica Array' Sep. 2, 2015 Scientists have successfully developed the Japonica Array which is the first ever SNP array optimized for Japanese population.The aim of development of Japonica Array is not only to facilitate the ... read more Lupus: A Disease With Many Faces Sep. 1, 2015 Lupus is an autoimmune disease with so many different symptoms that it is often difficult to diagnose and to treat. Despite huge medical advances over the last few years, lupus is incurable. Modern, ... read more 21-Gene Recurrence Score and Receipt of Chemotherapy in Patients With Breast Cancer Aug. 27, 2015 Use of the 21-gene recurrence test score was associated with lower chemotherapy use in high-risk patients and greater use of chemotherapy in low-risk patients compared with not using the test among a ... read more Young Black Women Have a Higher Frequency of BRCA Mutations Than Previously Reported Aug. 25, 2015 Researchers recently conducted the largest U.S. based study of BRCA mutation frequency in young black women diagnosed with breast cancer at or below age 50 and discovered they have a much higher BRCA ... read more Genomic Testing Triggers a Diabetes Diagnosis Revolution Aug. 17, 2015 Over a 10 year period, the time that babies receive genetic testing after being diagnosed with diabetes has fallen from over four years to under two months. Pinpointing the exact genetic causes of ... read more MicroRNA Markers for Madhumeha Aug. 14, 2015 Researchers have shown the biomarker role of certain circulatory microRNAs characteristic of Asian Indian phenotype in patients with type 2 ... read more Better Way to Personalize Bladder Cancer Treatments Aug. 13, 2015 A new way to personalize treatments for aggressive bladder cancer has been developed by researchers. In early proof-of-concept research, the team took bladder tumors from individual patients, ... read more New Computational Method Predicts Genes Likely to Be Causal in Disease Aug. 10, 2015 A new computational method improves the detection of genes that are likely to be causal for complex diseases and biological traits. The method, PrediXcan, estimates gene expression levels across the ... read more Statistical Technique Helps Cancer Researchers Understand Tumor Makeup, Personalize Care Aug. 9, 2015 A new statistical method for analyzing next-generation sequencing data helps researchers study the genome of various organisms such as human tumors and could help bring about personalized cancer ... read more Enthusiasm for Personalized Medicine Is Premature, Prominent Public Health Scholars Argue Aug. 5, 2015 The increasing national focus on personalized or 'precision' medicine is misguided, distracting from broader investments to reduce health inequities and address the social factors that ... read more People With Type 2 Diabetes Benefit from Blood Glucose Self-Monitoring, Study Shows Aug. 5, 2015 People with type 2 diabetes can lower their blood sugar if they follow a personalized blood glucose monitoring schedule, even if they dont use insulin, according to a new ... read more New Cancer Marker Identified; Possible Therapeutic Target for Breast Cancer July 31, 2015 Basal-like breast cancer (BLBC) is an aggressive form of breast cancer and is often referred to as "triple negative," which means it is not responsive to the common medical therapeutics. ... read more Targeted Therapy Shows Effectiveness Against a Subtype of the Brain Tumor Medulloblastoma July 29, 2015 A subset of medulloblastoma tumors briefly stopped growing or disappeared entirely during treatment with vismodegib, researchers report after a trial with both adults and ... read more New Tool Uses 'Drug Spillover' to Match Cancer Patients With Treatments July 28, 2015 A new article describes a new tool that improves the ability to match drugs to disease: the Kinase Addiction Ranker predicts what genetics are truly driving the cancer in any population of cells and ... read more Race, Institutional Factors Play an Important Role in Pharmacogenomic Trial Participation July 28, 2015 The participation rate of patients in pharmacogenomic trials has been the focus of recent study. The research has concluded that there are a number of factors at the patient, physician, institution ... read more Clinical Validation for LOXO-101 Against TRK Fusion Cancer July 27, 2015 The first imaging studies of TRK fusion cancer conducted post-treatment have confirmed that stage IV patient's tumors had substantially regressed. With four months of treatment, additional CT ... read more 'Major Player' in Skin Cancer Genes Identified July 27, 2015 A subgroup of genetic mutations that are present in a significant number of melanoma skin cancer cases has been defined by a multidisciplinary team of researchers. Their findings shed light on an ... read more July 23, 2015 Adolescent idiopathic scoliosis -- a condition featuring curvature of the spine -- affects tens of millions of children worldwide, but does not have a known cause. Now, scientists have discovered a ... read more First Genetic Test Developed to Predict Tumor Sensitivity to Radiation Therapy July 23, 2015 Advances have been made in cancer care with the development of the first test that analyzes the sensitivity of tumors to radiation therapy. Researchers discovered that colon cancer metastases have ... read more

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Personalized Medicine Conferences | Europe | Worldwide …

Saturday, September 5th, 2015

OMICS Internationalinvites all the participants across the globe to attend 3rd International Conference on Predictive, Preventive and Personalized Medicine & Molecular Diagnostics during September 01-03, 2015 Valencia, Spain.

Personalized Medicine 2015scientific program paves a way to gather visionaries through the research talks and presentations and put forward many thought provoking strategies in Personalized Medicine.

OMICS Internationalis devotedly involved in conducting International conferences 2014-2015 Europe, across USA (Baltimore, Chicago, Las Vegas, Philadelphia, and San Antonio) and almost all other parts of the world

Personalized Medicine 2015 will serve as an impulse for the advancement of molecular analysis by connecting scientists all across the world at conferences and exhibitions that would create an environment conducive for information exchange, generation of new ideas and acceleration of applications. Personalized Medicine promises many medical innovations, and has the potential to change the way treatments are discovered and used.

Personalized Medicine is referred as individualized therapy which means the prescription of specific treatments and therapeutics. Biomarker is a biological characteristic which can be molecular, anatomic, physiologic and chemical change drug development research which turns biomarkers into companion diagnostics. Personalized medicine therapeutics and companion diagnostic market have huge opportunities for growth in healthcare and will improve therapeutic effectiveness and reduce the severity of adverse effects approach to drug therapies. Personalized cancer medicine is self-made samples of translating cancer genetics into medical. Genomic medicine can contribute to personalized medicine Genomics by revealing genomic variations; have an effect on health, sickness and drug response.

Please, submit your abstract according to our format as early as possible and take advantage of early bird registration. All abstracts will be reviewed by the OCM/Review Panel.

As the hardest problem with science can only be solved by the Opencollaboration with Scientifc Community, Series of Conferences are Organized by Omics International Confereses, for more details have a glance atConference Series

Track 1:Current Focus on Personalized Medicine

Personalized medicine is an emerging practice of medicine that uses an individual's genetic profile to guide decisions made in regard to the prevention, diagnosis, and treatment of disease. Knowledge of a patient's genetic profile can help doctors select the proper medication or therapy and administer it using the proper dose or regimen. Used for the treatment asPersonalized cancer medicine,Diabetes- related disease: risk assessment & management,Personalized medicine: New strategies and economic implications,Implications of personalized medicine in treatment of HIV,Applications of personalized medicine in rare diseases,Translational Medicine.

Track 2:Clinical aspects of Personalized Medicine in Human, Animal models

Personalized medicine is based on intraspecies differences. It is axiomatic that small differences in genetic make-up can result in dramatic differences in response to drugs or disease andSocietal impact of personalized medicine. To express this in more general terms: in any given complex system, small changes in initial conditions can result in dramatically different outcomes. Despite human variability and intraspecies variation in other species, nonhuman species are still the primary model for ascertaining data forPersonalized medicine health improvement in Human.We call this practice into question and conclude that human-based research should be the primary means for obtaining data about human diseases and responses to drugs.Strategies in the development and application of personalized medicinewas developed for the accurate results inPersonalized medicine health improvement in Human and Animal Models.

Track 3:Genetics of Ebola Outbreak

Sequence analysis of Ebola virus Genomeis the second through the sixth genes of the Ebola virus (EBO) genome indicates that it is organized similarly to rhabdoviruses and paramyxoviruses and is virtually the same as Marburg virus (MBG). Scientists usedgenomic sequencing technologiesto identify the origin and track transmission of the Ebola virus in the current outbreak in Africa.

Track 4:Molecular Diagnostics and Therapeutics

Molecular diagnosticsis a technique used to analyzebiological markersin thegenomeandproteome,realizing the value of personalized medicinethe individual'sgenetic codeand how their cells express their genes asproteins, by applyingmolecular biologytomedical testing. The technique is used to diagnose and monitor disease, detect risk, and decide which therapies will work best for individual patients.Therapeutics and diagnosticsare useful in a range of medical specialisms, includinginfectious disease,oncology,human leukocyte antigentyping (which investigates and predictsimmune function),coagulation, and pharmacogenomicsthe genetic prediction of which drugs will work best and even leads totranslational research.

Track 5:Biomarkers

In medicine, abiomarkerand molecular markersare the measurableindicatorof the severity or presence of some disease state. More generally abiomarkeris anything that can be used as an indicator of a particular disease state or some otherphysiologicalstate of an organismDrug-Diagnostic Co-Development. In the current era of stratified medicine and biomarker-driven therapies, the focus has shifted from predictions based on the traditional anatomic staging systems to guide the choice of treatment for an individual patient to an integrated approach using the genetic makeup of the tumor and the genotype of the patient. Genomics and other "omics technologies have largely contributed to the identification and the development of biomarkers likeStratification biomarkers in personalised medicine. The recent surge in high-throughput sequencing of cancer genomes has supported an expanding molecular classification of cancer. These studies have identified putative predictive biomarkers signifying aberrant oncogene pathway activation and may provide a rationale for matching patients with molecularly targeted therapies in clinical trials. Here, we discuss some of the challenges of adapting these data for rare cancers or molecular subsets of certain cancers, which will require aligning the availability of investigational agents, rapid turnaround of clinical grade sequencing, molecular eligibility and reconsideringPersonalizing clinical trials with biomarkersdesign and end points.

Track 6:Nanotechnology and Biotechnology

Nanotechnology("nanotech") is the manipulation of matter on anatomic,molecular, and supramolecularscale. The earliest, widespread description of nanotechnologyreferred to the particular technological goal of precisely manipulating atoms and molecules for fabrication of macroscale products, also now referred to asmolecular nanotechnology. Applications of pharmaceutical nanotools,Cell based therapy,Molecular mechanismsare the techniques and tool in nano technology and biotechnology.

The human metabolome is best understood by analogy to the human genome, i.e., where the human genome is the set of all genes in a human being, the human metabolome is the set of all metabolites in a human being well understood by Role of Metabolics, Bioinformatics, Biosensorsin Personalized Medicine.

Track 7:Predictive Medicine in Pharmaceutical Analysis

Predictive medicineis a field ofmedicinethat entails predicting the probability ofdiseaseand instituting preventive measures in order to either prevent the disease altogether or significantly decrease its impact upon the patient (such as by preventingmortalityor limitingmorbidity).Techniques and assaysincludeNewborn screening,Diagnostic testing,Medical bioinformatics,Prenatal testing,Carrier testing,Preconception testing. Newborn screeningis apublic healthprogram designed to screen infants shortly after birth for a list of conditions that are treatable, but not clinically evident in the newborn period.Prenatal testing: Prenatal testing is used to look for diseases and conditions in a fetus orembryobefore it is born. This type of testing is offered for couples who have an increased risk of having a baby with a genetic or chromosomal disorder. Screening can determine the sex of the fetus.Prenatal testingcan help a couple decide whether toabortthe pregnancy. Like diagnostic testing,prenatal testingcan be noninvasive or invasive. Non-invasive techniques include examinations of the woman's womb throughor maternal serum screens. These non-invasive techniques can evaluate risk of a condition, but cannot determine with certainty if the fetus has a condition.

Track 8:Preventive Medicine

Preventive Medicine is practiced by all physicians to keep their patients healthy. It is also a unique medical specialty recognized by the American Board of Medical Specialties (ABMS). Preventive Medicinefocuses on the health of individuals, communities, and defined populations. It is also used for the treatment forobesity, blindness. TheEpidemiologyDivisionapplies research methods to understand the patterns and causes of health and disease in the populationandto translate this knowledge into programs designed to prevent disease. The division has a long history of involvement in NIH-sponsored multi-site, longitudinal cohort studies, and its faculty oversees many investigator-initiated, NIH-sponsored research projects and trials. Public trust invaccinesis a key to the success of immunization programs worldwide in the era of preventive medicine.

Track 9:Health Care Medicine and P4 Medicine

P4 Medicineis a plan to radically improve the quality of human life via biotechnology. P4 Medicine is a term coined by biologist Leroy Hood, and is short for "Predictive, Preventive, Personalized, andParticipatory Medicine." The premise of P4 Medicine is that, over the next 20 years, medical practice will be revolutionized by biotechnology, to manage a person's health, instead of manage a patient's disease.Internal medicineorgeneralmedicine(in Commonwealth nations) is themedicalspecialty dealing with the prevention, diagnosis, and treatment of adult diseases.Emergency medicineis amedicalspecialty involving care for adult and pediatric patients with acute illnesses or injuries that require immediatemedicalattention.

Track 10:Lifestyle Medicine

Lifestyle Medicine (LM) is the use of lifestyle interventions in the treatment andmanagement of disease. LM is becoming the preferred modality for not only the prevention but thetreatment of most chronic diseases, including Type-2 Diabetes, Coronary Heart Disease, Hypertension, Obesity, Insulin Resistance Syndrome, Osteoporosis, cancer prevention Alsoinclude Aerobic & Resistance exercises for patients with diabetes,Sleep and disease prevention, Intrinsic motivation and health behavior adherence.

Track 11:Genomics

Genomicsis a discipline ingeneticsthat appliesrecombinant DNA,DNA sequencingmethods, andbioinformaticsto sequence, assemble, and analyze the function and structure ofgenomes. Advances in genomics have triggered a revolution in discovery-based research to understand even the most complex biological systems such as the brain. The field includes efforts to determine the entireDNA sequenceandhuman genome varivationof organisms and fine-scalegenetic mapping. The field also includes studies of intragenomic phenomena such as other interactions betweenlociand within thegenome and metagenomics.Comparative genomicsis an exciting new field of biological research in which thegenomesequences of different species human, mouse and a wide variety of other organisms from yeast to chimpanzees are compared.

Track 12:Cancer Immunology & Oncology

Personalized medicine can be used to learn about a person's genetic makeup and to unravel thebiology of their tumor. Using this information, doctors hope to identify prevention, screening, andtreatment strategiesthat may be more effective and cause fewer side effects than would be expected with standard treatments. By performing more genetic tests and analysis, doctors may customize treatment to each patient's needs. Creating a personalized cancer screening and treatment plan includes: Determining the chances that a person will develop cancer and selectingscreening strategiesto lower the risk, Matching patients with treatments that are more likely to be effective and cause fewer side effects,Predicting the risk of recurrence(return of cancer).

Personalized medicine can be used to learn about a person's genetic makeup and to unravel the biology of their tumor. Using this information, doctors hope to identify prevention, screening, and treatment strategies that may be more effective and cause fewer side effects than would be expected with standard treatments. By performing more genetic tests and analysis, doctors may customize treatment to each patient's needs. Creating aPersonalized Cancer Medicineand treatment plan includes: Determining the chances that a person will develop cancer and selecting screeningstrategies to lower therisk, Matching patients with treatments that are more likely to be effectiveand cause fewer side effects, Predicting the risk of recurrence(return of cancer).

Personalized medicine is an evolving field of medicine in which treatments are tailored to the individual patient.Personalized Diagnosticsare medical devices that help doctors decide which treatments to offer patients and which dosage to give, tailored specifically to the patient, says Elizabeth A. Mansfield, Ph.D., Deputy Office Director for Personalized Medicine in FDAs Office of In Vitro Diagnostics and Radiological Health. The companion diagnostic is essential to the safe and effective use of the drug.

Personalized Medicine Diabetesis the use of information about the genetic makeup of a person with diabetes to tailor strategies for preventing, detecting, treating, or monitoring their diabetes. The practice of PMFD involves four processes. First is the identification of genes and biomarkers for diabetes as well as for obesity. Second, is allocation of resources to prevent or detect the diabetes and/or obesity phenotype in high-risk individuals, whose risk is based on their genotype. Third is selection of individualized therapies for affected individuals. Fourth is measurement of circulating biomarkers of diabetes to monitor the response to prevention or therapy.

Personalized Medicine World Conferencewill serve as an impulse for the advancement of molecular analysis by connecting scientists all across the world at conferences and exhibitions that would create an environment conducive for information exchange, generation of new ideas and acceleration of applications.Personalized Medicine Conferencepromises many medical innovations, and has the potential to change the way treatments are discovered and used.

Cancer chemotherapy is in evolution from non-specific cytotoxic drugs that damage both tumour and normal cells to more specific agents and immunotherapy approaches. Targeted agents are directed at unique molecular features of cancer cells, and immunotherapeutics modulate the tumour immune response; both approaches aim to produce greater effectiveness with less toxicity. The development and use of such agents in biomarker-defined populations enables a morePersonalized Medicine Oncologytreatment than previously possible and has the potential to reduce the cost of cancer care.

The term "personalized medicine" is often described as providing "the right patient with the right drug at the right dose at the right time." More broadly,personalized medicine(also known asprecision medicine)may be thought of as the tailoring of medical treatment to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up. International expertise Gathering onPersonalized Medicine World Congress.

Personalized medicine will shift medical practices upstream from the reactive treatment of disease, to proactive healthcare management including screening, early treatment, and prevention, and will alter the roles of both physician and patient. Personalized medicine requires a systems approach to implementation. But in a healthcare economy that is highly decentralized and market driven, it is incumbent upon the stakeholders themselves to advocate for a consistent set of policies and legislation that pave the way for the adoption of personalized medicine. To address this need, thePersonalized Medicine Coalition(PMC) was formed as a nonprofit umbrella organization of pharmaceutical, biotechnology, diagnostic, and information technology companies, healthcare providers and payers, patient advocacy groups, industry policy organizations, major academic institutions, and government agencies.

Pharmacogenomics is part of a field called personalized medicine, also called individualized or precision medicine, that aims to customize health care, with decisions and treatments tailored to each individual patient in every way possible.Although genomic testing is still a relatively new development in drug treatment, this field is expanding. Currently, more than 100 drugs have label information regardingPersonalized Medicine Pharmacogenomicsbiomarkers some measurable or identifiable segment of genetic information that can be used to direct the use of a drug.

Advances in human genome research are opening the door to a new paradigm for practicing medicine that promises to transform healthcare. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual's molecular profile, will impact the way drugs are developed and medicine is practiced. The traditional linear process of drug discovery and development will be replaced by an integrated and heuristic approach. In addition,Personalized Medicine Patient Carewill be revolutionized through the use of novel molecular predisposition, screening, diagnostic, prognostic, pharmacogenomic and monitoring markers. Although numerous challenges will need to be met to make personalized medicine a reality, with time, this approach will replace the traditional trial-and-error practice of medicine.

Personalized lifestyle medicine is a newly developed term that refers to an approach to medicine in which an individual's health metrics from point-of-care diagnostics are used to develop lifestyle medicine-oriented therapeutic strategies for improving individual health outcomes in managing chronic disease.Personalized lifestyle medicinecan provide solutions to chronic health problems by harnessing innovative and evolving technologies based on recent discoveries in genomics, epigenetics, systems biology, life and behavioral sciences, and diagnostics and clinical medicine.

The US market for personalized medicines is predicted to grow at the compounded annual growth rate of 9.5% during 2010 to 2015. This growth in future is expected to be driven by different factors like cost savings on treatments, early diagnosis of disease, drug safety, patient compliance, and optimization of therapies. Currently, America dominates the market for personalized medicine; however, advancement in technology and developments in the field of DNA is expected to establishPersonalized Medicine Marketin UK, France, India, China, and Japan.

Rapid advances in technology have made it feasible to identify a persons unique genome. One person differs from another by millions of variations in the genome, and many of these variations affect susceptibility to disease and response to treatments.Greater understanding of individual genomes is allowing scientists and clinicians to begin to personalize" medicine. ThePersonalized Genomic Medicinerevolution will yield more effective medicines with fewer adverse side effects and lead to longer, healthier lives and lower health care costs. The personalized medicine industry in the United States already generates $286 billion per year in revenues and is growing by 11 percent annually, according to PricewaterhouseCoopers.Research at JAX Genomic Medicine will contribute to personalized medicine by revealing how genomic variations affect health, disease and drug response.

The globalPersonalized Medicine Industrywas valued at USD 1,007.88 billion in 2014 and is expected to reach USD 2,452.50 billion in 2022, growing at a CAGR of 11.8% over the forecast period. Key drivers of the market include growing development of next generation sequencing, whole genome technology, companion diagnostics and growing number of retail clinics.

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Enthusiasm for personalized medicine is premature …

Sunday, August 9th, 2015

August 5, 2015

The increasing national focus on personalized or 'precision' medicine is misguided, distracting from broader investments to reduce health inequities and address the social factors that affect population health, two leading public health scholars argue in the New England Journal of Medicine.

"There is now broad consensus that health differences between groups and within groups are not driven by clinical care, but by social-structural factors that shape our lives," write Sandro Galea, MD, DrPH, dean of the Boston University School of Public Health, and Ronald Bayer, PhD, professor of Sociomedical Sciences and co-director of the Center for the History and Ethics of Public Health at Columbia University's Mailman School of Public Health. "Yet seemingly willfully blind to this evidence, the United States continues to spend its health dollars overwhelmingly on clinical care.

"It is therefore not surprising that even as we far outpace all other countries in spending on health, we have poorer health indicators than many countries, some of them far less wealthy than ours."

Bayer and Galea say that while investments in precision medicine may ultimately "open new vistas of science" and make contributions to "a narrow set of conditions that are primarily genetically determined," enthusiasm about the promise of this research is premature. Leaders of the National Institutes of Health (NIH) have praised President Barack Obama's recent initiative to devote $215 million to personalized medicine, an emerging practice of medicine that uses an individual's genetic profile to guide decisions in regard to the diagnosis and treatment of disease.

"Without minimizing the possible gains to clinical care from greater realization of precision medicine's promise, we worry that an unstinting focus on precision medicine by trusted spokespeople for health is a mistakeand a distraction from the goal of producing a healthier population," they write.

Arguing that clinical intervention will not remedy pressing health problems that arise from environmental conditions and inequities in income and resources, they cite a 2013 report by the National Research Council and the Institute of Medicine that found Americans fared worse in terms of heart disease, birth outcomes, life expectancy and other indicators than their counterparts in other high-income countries. The report concluded that "decades of research have documented that health is determined by far more than health care."

They call for greater public investments in "broad, cross-sectional efforts" to minimize the socioeconomic and racial disparities in the U.S. that contribute to poor health.

Bayer and Galea say the NIH's most recent Estimates of Funding for Various Research, Condition and Disease Categories report shows that total support for research areas including the words 'gene,' 'genome' or 'genetic' was about 50 percent higher than funding for areas including the word 'prevention.' And investment in public health infrastructure, including local health departments, lags substantially behind that of other high-income countries.

In explaining why they felt compelled to speak out, Galea and Bayer said they are wary that that specialized medicine will push larger public health initiatives aside.

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Personalized Medicine and Cancer Companion Diagnostics

Wednesday, August 5th, 2015

Companion Diagnostics are the Key to Personalized Medicine for Cancer

Personalized medicine -- also known as targeted medicine or precision medicine -- is a rapidly-evolving area of healthcare in which treatment for a medical condition such as cancer is tailored to the individual patient and his or her biology. There should be no one-size-fits-all approach to medicine. The goal of personalized medicine is to prescribe the right medicine to the right patient at the right time and avoid the trial-and-error treatment paradigm.

If, for example, a woman has ovarian cancer caused by a genetic mutation, personalized medicine may enable her to be treated with a chemotherapy shown to be effective in individuals with that specific mutation.1

Companion diagnostics are the medical tests that make personalized medicine possible. Designed to be paired with a specific drug, companion diagnostics help healthcare professionals determine which patients could be helped by that drug and which patients would not benefit, or could even be harmed.

Unlike other laboratory developed tests, companion diagnostic tests are reviewed and approved by the U.S. Food and Drug Administration (FDA), which is the gold standard for ensuring safety, effectiveness and quality. FDA approval gives physicians confidence they are receiving the highest quality test result on a consistent basis.

BRACAnalysis CDx is an FDA-approved companion diagnostic that helps to identify women with advanced ovarian cancer with germline BRCA1/2 mutations who have completed three or more lines of chemotherapy and might benefit from treatment with Lynparza (olaparib).

Myriad myChoice HRD is a tumor tissue test that measures deficiencies in the DNA-repair mechanism of cancer cells and may help identify more of the cancer patients who are most likely to benefit from certain types of DNA-damaging chemotherapy agents.

Personalized medicine is the future of healthcare, not just for cancer, but for disease in general. Companion diagnostics will be critical tools that all physicians will need in their toolbox as healthcare moves forward. In addition to cancer, companion diagnostics hold promise in the treatment of other chronic diseases such as rheumatoid arthritis, other autoimmune disorders and diabetes.

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Pharmacogenomic Testing Services | Personalized Medicine …

Saturday, August 1st, 2015

Welcome to DNA Stat. We specialize in personalized medicine services, specifically in the pain management and pharmacogenomics arena. We take pride in both our research and unsurpassed customer service, providing clients with genetic & pharmacogenomics testing which is the fastest growing field in the medical industry today.

Pain management and pharmacogenomics is vitally important as we progress into the 21st century as it is a realization and acknowledgement that one size does not fit all when it comes to medications. What might work for one individual flawlessly could mean an adverse reaction and a trip to the emergency room for another. Genetic Testing is the tool used to determine the difference before the medication is ingested. In this way, we are spearheading and defining personalized medicine services and enabling people to recover and maintain their illnesses and conditions worry-free. By eliminating the guess work, patients can recover more fully and quicker than ever before.

We know that the medical industry can be daunting to most people. Fortunately, the genetic & pharmacogenomics testing at DNA Stat comes down to a simple Buccal swab of the cheek. No needles involved, no fear, no blood no problem. Within three weeks, the patients doctor will have in his or her hands a Pharm D Report which is the roadmap to prescribing better medications and better treatments for their patient. DNA Stat, the leader in genetic& pharmacogenomics testing, is changing the way the world sees medicine one patient at a time.

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Personalized Medicine, Targeted Therapeutics and Companion …

Sunday, June 28th, 2015

NEW YORK, June 23, 2015 /PRNewswire/ --

This is a comprehensive account of the market size, segmentation, key players, SWOT analysis, influential technologies, and business and economic environments. The report is supported by over 270 tables & figures over 254 pages. The personalized medicine (global) market is presented as follows:

By Company (e.g., 23andMe, AFFYMETRIX, ATOSSA GENETICS, NODALITY, deCode /Amgen, CELERA, MYRIAD) By Geography (US, UK, EU) By Segment (Targeted therapeutics, Companion Diagnostics, Esoteric tests, Esoteric lab services) By Sub-market (Companion diagnostics & therapeutic, nutrition & wellness, medical technology, pharmacogenomics, consumer genomics)

A wealth of financial data & business strategy information is provided including:

Company financials, sales & revenue figures Business Model Strategies for Diagnostic, Pharmaceutical and Biotechnology Companies Business Model Strategies for Providers. Provider Systems and Academic Medical Centres Business Model Strategies for Payers & Governments Private and Public Funding and Personalized Medicine Reimbursement Revisions to Current Payment Systems and intellectual property How to Gain Market Penetration in the EU Cost-effectiveness and Business Value of Personalized Medicine Consumer genomics and POC market Therapeutics and Companion Diagnostics (e.g., BRAC Analysis, Oncotype Dx , KRAS Mutations) Comprehensive account of company product portfolios & kits

SWOT, Economic & Regulatory Environment specifics include:

Key strengths, weaknesses and threats influencing leading player position within the market Technologies driving the market (e.g., New-Generation Sequencing Technologies, Ultra-High Throughput Sequencing) Top fastest growing market segments and emerging opportunities Top pharmaceutical companies within the IPM by market share and revenue Comprehensive product portfolios, R&D activity and pipeline therapeutics M&A activity and future strategies of top personalized medicine pharmacos Personalized Medicine Regulation (USA, UK, Germany, France, Spain, Italy) CE-marked Personalized Medicine/Diagnostic Tests FDA Advances in Personalized Medicine Regulation

This report highlights a number of significant pharmacos and gives details of their operations, products, financials and business strategy.

23andMe Affymetrix Astex Pharmaceuticals Atossa Genetics CuraGen Celera Corporation (Quest Diagnostics) Celldex Therapeutics deCode Genetics (Amgen) Illumina Genelex Myriad Nodality Qiagen What you will gain:

An in-depth understanding of the global personalized medicine market and it's environment Current market facts, figures and product lines of key players in the industry Emerging trends in key markets such as the US, UK, Germany and France Knowledge of how the personalized medicine market will integrate into the global healthcare market Technical insights into new generation sequencing technologies and ultra-high throughput sequencing Updates on bioinformatics, high throughput systems, genetic analysis kits, companion diagnostics and future technologies FDA approved pharmacogenetic tests and recognized biomarkers Information on key government and regulatory policies Strategies on how to adapt and restructure current business models to this industry

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The Promise of Personalized Medicine – Vanderbilt Magazine

Saturday, June 27th, 2015

Empowered by genetic information, Vanderbilt aims to reinvent health care. by Bill Snyder and Dagny Stuart

The iconic Norman Rockwell painting of a family doctor checking the heart of a young patients doll may seem quaint, but its far from old-fashioned. On the contrary, personalized medicine is bringing the family doctor back and the family nurse, and the family pharmacist, and a whole team of family health care providers. Only this time, they will be empowered by 21st-century tools like genomics, informatics and high-tech imaging.

Ailments will be diagnosed more quickly and accuratelyor prevented before they can occur. By selecting drugs that match each patients unique genetic readout or by tweaking molecular pathways instead of blasting away like a shotgun, treatments will be more effective and will have fewer side effects.

After having gone through a period where blockbuster drugs and massive screening were the norm, we are actually moving back to a place where were trying to tailor care to the individual, says Dr. Jeff Balser, Vanderbilt Universitys vice chancellor for health affairs and dean of the School of Medicine.

I try to think of this as not getting more high-tech and therefore more distant from the patient, Balser says. But through technology were becoming more familiar with our patients as individuals and, along with that, always remembering to be personableNorman Rockwell with a DNA sequencer.

In 2010 Vanderbilt University Medical Center launched two major personalized medicine initiatives to advance cancer treatment and to individualize and improve drug therapy. Already this approach is showing promise.

Patients scheduled for cardiac or orthopedic procedures are being tested in advance for genetic variations that can affect their response to common blood thinners. Based on the test results, their doctors may adjust the dose or order a different drug entirely.

Similarly, by reading the genetic fingerprints of tumors removed from patients with certain forms of cancer, doctors can choose targeted drugs that are most likely to work.

Using genetic information to guide drug therapy is just the beginning. In the near future, genomicsthe science of reading and interpreting the DNA sequencewill help Vanderbilt physicians select the best tests and procedures for their patients. Eventually, genetics will help guide efforts to prevent disease and maintain good health.

Personalized medicine is more than genetics, of course. Social, family and behavioral factors, as well as environmental and economic circumstances, also have a profound impact on health. Those things are just as important in tailoring care to the individual as their genetic background, says Balser. Its almost like genomic medicine is what were using to learn how to individualize medicine, but then we can apply it to a broader set of data and circumstances.

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Conquering Cancer: Personalized Medicine Is the Future …

Saturday, June 20th, 2015

Personalization is threaded into the social fabric of America. Innovation is rooted in customizing and personalizing even the smallest parts of our lives, stemming from technology and retail to travel, media and wellness. The future continues to promise even smarter applications where personalization fits, but what about our health? Enter, precision medicine -- this new era of personalized medicine has arrived to healthcare and the possibilities in treating cancer unimaginable just a few years ago, are closer than ever. Imagine a world where your treatment was tailored to you, taking into consideration every cell and gene throughout your individual genetic profile, using that data to specifically design a treatment to fight the exact cancer you have? Sound too good to be true? Think again. The future is here, and the healthcare industry is preparing for massive disruption but for once disruption couldn't have come at a better time.

The Road to Personalized Medicine for Cancer Treatment

For decades, physicians had the same approach for all patients with the same type of cancer, be it breast, lung, liver or prostate cancer, the same way, even through they were aware drug treatments may work on some and fail in others. This is not to say all cancers are treated the same, but the basic approach and process is used when it comes to diagnosing, staging, and recurrence. As significant advances in research progressed over the course of the last 30 years, the medical community created standards of care and treatment when it came to diseases like diabetes, heart disease, and even cancer. However, treating cancer cannot be classified with a standard approach. What we're learning more and more comes down to the individual. Each person is as unique on the inside as they are on the outside. Therefore, why wouldn't we treat their cancer using an individual approach?

For the last 20 years, cancer cells have outsmarted us by protecting themselves, building a wall, not allowing the immune system to identify and kill them. Current treatments are not aimed at stopping cells from spreading and have almost no selective capacity to distinguish between cancer cells and healthy cells. We've basically poisoned the body to kill cancer using chemotherapy and even radiation. But advancements in research has led to a number of potential targeted therapies designed to fight cancer, among them one approach is gaining more and more support -- immunotherapy. This type of targeted therapy teaches our own immune system to fight cancer cells and spare healthy ones. By injecting bacteria inside cancer cells and putting them back into the body, the immune system can learn to recognize and kill them. Think of your T cells as guided missiles aimed at killing the bad cancer cells versus a bomb that kills every cell in its path such as chemotherapy. But an approach we could've never foreseen 10 years ago is right around the corner, leading a transition not just from the diagnosis and treatment of these cancers but much more emphasis on prediction and prevention.

Welcome to the world of precision medicine also deemed "personalized medicine," where each patient is treated individually based on their genetic makeup and the specific genetic mutations present in their body. The National Institutes of Health defines precision medicine as an emerging approach for disease treatment and prevention that integrates an individual's variability in genes, environment and lifestyle. To take it even further, precision health may be the new approach to medicine, rooted in prevention and prediction of various diseases while also maintaining overall health and quality of life.

In my field, which is prostate cancer, we talk a lot about an individual patient's risk factors such as family history, which is a huge proponent of the disease and how aggressive it is. While oftentimes surgery is the first line of defense, the right way to treat prostate cancer and any cancer is through individualized care. Recently at the 110th Annual Scientific Meeting of the American Urological Association, a significant study was presented which showed a combined assessment of genetic bio markers and the genetic profile for a patient would lead to better methods for diagnosing, treating and measuring the likelihood of the disease recurring. The breakthrough here is the role genetic testing plays in cancer, throughout the entire process, from diagnosis to recurrence. We can gather more information about the patient at each step of the way.

Precision Medicine Meets Individualized Care

I've always spoken about the importance of individualized care, especially when it comes to diagnosing and treating cancer. Innovations in genomic testing are leading this emerging era of cancer therapy -- analyzing a group of genes and their activity, which can influence how a cancerous tumor is likely to grow and respond to treatment. This type of diagnostic testing analyzes and detects very specific abnormalities in the tumor cells in a patient's individual cancer. Unlocking the mysteries of genetics holds the promise of finding more customized cures with drugs that attack genetic mutations or repair genetic defects based on the individual patient. Advances in genetic sequencing has increased the likelihood of detecting mutations driving tumor growth and even specific cells inside the tumor. This is the future of treating and diagnosing cancer, integrated with the promise of precision medicine.

Is this revolutionizing everything we know about cancer, from prevention and diagnosis to treatment and recurrence? I would say yes. We've always identified cancer based on the organ it originates in such as the prostate, colon or liver, grouping these together as if they grow the same. What we know now is just because it's deemed "prostate cancer" doesn't mean all prostate cancers develop or progress in the same way. Testing the genetics of an individual patient has opened up an entire new conversation in oncology leading us to define within the cancer what actually drives its development and progression.

The Precision Medicine Initiative

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How An Integrated Data Approach will Impact Personalized …

Friday, June 12th, 2015

Leveraging Tissue Data and Analysis

By extracting and analyzing all the relevant data from tissue samples, and correlating that to genomic and other data in order to get a clear picture of what is happening inside a patient, several areas of diagnostic and drug discovery and development are impacted:

Evaluating combination therapies

With combination therapies, the diagnosisin terms of which drugs will be effective in combinationbecomes very complicated. Looking at tissue data in conjunction with the other patient data available enables researchers to combine many different molecules to understand which one tells the right storyin other words, which combination of those molecules demonstrate patterns that predict drug response, and thus which combination is the right one for a target group of patients.

Gaining insight into biological processes driving disease

In the past, the industry usually took a bottom up approach where a molecule or protein was considered first, and then researchers thought upward in terms of how that biological molecule could help a patient. This paradigm is changing and pathological data is now being used to drive biological research. By looking at tissue in a structured, statistical, and analytical way in addition to the molecules and pathways, new discoveries can be made, which ultimately triggers more purposeful research.

Identifying novel tissue diagnostics with prognostic or predictive value

Historically, researchers searching for biomarkers would stain certain proteins in the tissue, such as with immunohistochemistry (IHC), which they would then investigate with the naked eye. Much of this investigation is being automated now, however. Machines can identify more objects and more precise measurements in tissue than the human eye, and this approach is being used to identify biomarkers and develop diagnostics that could not previously be found.

The use of an integrated data approach to drug discovery and development has been slow to get off the ground, but the need and possibilities for a big data approach is growing. This is changing, however. Technologies are emerging that can collect, correlate, and structure a significant volume and multiple kinds of dataincluding genetic, tissue, clinical outcomes and other kinds of patient datain a meaningful way, giving researchers the ability to see the bigger picture and make discoveries that couldnt previously be found.

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