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Person-centred health care and pain
Published in Stephen Buetow, Rethinking Pain in Person-Centred Health Care, 2020
One approach to personal care is personalized or precision medicine. Without entering debate5 about how these terms may differ, I suggest that, as a “new biomedical cosmology,”6 personalized medicine is an emerging, patient-centred approach to disease management. It promotes an individualist notion of the person of the patient by broadly applying advances in molecular medicine, genomics and bioinformatics to interventions tailored to individuals or at least small, specific subgroups. This application addresses a problem that has plagued evidence-based medicine as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals patients.”7
Introduction and Overview
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
At the same time that these medical physics techniques were exploding on the scene, our knowledge of the genome and biochemistry was undergoing a similar revolution. The result is molecular medicine – not a single field, but the synergy that results when all fields of medicine become informed by techniques resulting from our new understanding of genetics and molecular biology. Imaging technologies now can monitor the time course of body metabolism, explore the biology of specific receptors for brain chemicals or drugs, or map the response of different tumors to a program of chemotherapy for cancer to make sure each is responding and alternative therapies are not warranted.
Hypertension in Children and Adolescents
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Perinatal programming opens up new ways to understand the early-life origins of diseases such as HTN and diabetes, but also introduces relevant challenges in understanding the potential mechanisms involved. Making careful phenotypic observations and pairing them with molecular markers will need to be integrated into prospective studies. Newer tools of molecular medicine are increasingly available and have the potential to deepen our understanding of these intriguing associations.
Predictive biomarkers and personalized pharmacotherapy
Published in Expert Review of Molecular Diagnostics, 2022
Jan Trøst Jørgensen, Niels Westergaard
Inherent variability among patients significantly affects the outcomes of pharmacotherapy. Patients with apparently the same diagnosis often respond differently to the same pharmacological intervention, both with respect to efficacy and/or safety. Despite this knowledge, a large part of pharmacotherapy is still based on a ‘trial and error’ approach, which can have a severe negative impact on the patient [1]. The inability to predict which patients will respond to which drugs affects the efficacy and value of pharmacotherapy. However, the past 30 years of progress in molecular medicine has provided us with a better understanding of the underlying pathophysiology and mechanism of action of drugs, which is a prerequisite for making pharmacotherapy more predictable and efficient [2]. For some diseases and drugs, this understanding has led to the development of different types of predictive biomarkers, which can help to identify patients who are more likely to benefit from the drug in question and make pharmacotherapy more personalized.
The role of proteomics in defining autoimmunity
Published in Expert Review of Proteomics, 2021
Proteomics and sub-proteomics, with the latter corresponding to peptidomics, that is, the study of the set of peptides present in a cell, tissue, organism, or biological entity, have defined at the peptide molecular level a large part of (auto)antigens and biomarkers that characterize degenerative and infectious diseases. Today, immunoproteomics has revealed the potential to outline peptide platforms to be efficaciously used for the diagnostics and management of the disease that afflicts the human society. Such a till-now unthinkable clinical possibility is flanked by the additional enormous advantage of a new Molecular Medicine targeted to obtain healing without paying the price of adverse events. Indeed, to target a peptide means not only specificity but also absence of collateral effects, such as cross-reactivity and consequential autoimmunity.
Companion and complementary diagnostics: an important treatment decision tool in precision medicine
Published in Expert Review of Molecular Diagnostics, 2020
The advances in molecular medicine and especially molecular diagnostics have slowly enabled us to start to practice a more individualized pharmacotherapy. We have learnt, that most diseases are heterogeneous and, in order to achieve a more effective pharmacotherapy, drugs must be developed and prescribed accordingly. Consequently, over the last couple of decades we have seen that drugs, especially within oncology, are being developed for molecular defined subsets of patients and here, CDx takes up a central position [11]. However, as Dr. Edward Abrahams, President of Personalized Medicine Coalition, said in the interview with Dr. Edward Spofford for this special focus issue, conservatism in medicine might impact the development toward a more individualized pharmacotherapy. In the interview he says: ‘Medicine can be particularly conservative and does not change easily, even when the change we’re proposing – to understand the patient at the molecular level before prescribing a particular therapy – makes so much sense.’ [13]. Another challenge that we seem to face is the patient’s optimal access to CDx testing. This challenge call for an improved clinical diagnostic testing landscape in order to support a faster implementation of precision medicine [14].