Viruses cannot replicate by themselves. Instead, they rely on the host for almost all their replicative functions. Similarly, many viruses are unable to cause damage without the host immune system. ...Because of this, two strategies can often ameliorate disease — antivirals, which block replication, and antiinflammatories, which can limit the damage induced by infection. In the lung, this latter strategy is exemplified by the treatment of
Pneumocystis jiroveci
, in which treatment with glucocorticoids reduces the severity of disease and the risk of death.
1,2
However, because blocking inflammatory pathways raises the possibility of diminishing the host response and increasing replication of . . .
In the past 10 years, the number of tools available to treat cancer has increased, as has our understanding of what makes some cancers tick. The standard old-time cancer treatments were largely ...predicated on attacking DNA, an approach fueled by the belief that tumor cells divide more rapidly than normal cells. However, with the notable exception of Burkitt's lymphoma, only a small percentage of tumor cells in a patient are dividing at any given time. As we have learned more about DNA repair mechanisms and epigenetic alterations in cancers, DNA remains a viable target for new cancer therapies, but DNA . . .
This article considers the growing recognition of precision medicine by clinicians, patients, the pharmaceutical industry, and policymakers and summarizes how this rapidly accelerating field will ...leave a major imprint on the practice of medicine.
The growing recognition of precision medicine by clinicians, health systems, and the pharmaceutical industry, as well as by patients and policymakers,
1
reflects the emergence of a field that is accelerating rapidly and will leave a major imprint on the practice of medicine. In this article, we summarize the forces accelerating precision medicine, the challenges to its implementation, and the implications for clinical practice.
What Is Precision Medicine?
The terms precision, personalized, and individualized medicine are often used interchangeably. Many physicians contend that they have always practiced individualized and personalized medicine. We agree and, for this reason, prefer the term precision . . .
Updated to include the newest drugs and those currently in development, this Fifth Edition is a comprehensive reference on the preclinical and clinical pharmacology of anticancer agents. Organized by ...drug class, the book provides the latest information on all drugs and biological agents-their mechanisms of action, interactions with other agents, toxicities, side effects, and mechanisms of resistance. The authors explain the rationale for use of drugs in specific schedules and combinations and offer guidelines for dose adjustment in particular situations. This edition's introduction includes timely information on general strategies for drug usage, the science of drug discovery and development, economic and regulatory aspects of cancer drug development, and principles of pharmacokinetics. Eight new chapters have been added and more than twenty have been significantly revised. A companion website includes the fully searchable text and an image bank.
The Covid-19 epidemic continues to rage, especially in countries that have been unable or unwilling to institute strong public health measures. A return to normality has increasingly come to rely on ...the success of vaccines to prevent disease and, we hope, limit further spread of infection. However, this hope has been tempered by several unknowns. No existing vaccines have been shown to be effective against infection with any betacoronavirus, the family that includes SARS-CoV-2, which causes Covid-19. SARS, caused by another betacoronavirus, ended on its own before serious efforts at vaccine development were undertaken, and the rather small number of . . .
The introduction of “personalized medicine” has spurred major changes in oncology, but success has been spread unevenly across the spectrum of solid tumors. Although prognoses for adenocarcinoma of ...the lung and melanoma have been profoundly altered, other diseases, such as colon cancer and ovarian cancer, have lagged behind owing to differences in genetics and biology. One of the earliest classes of targeted therapies in ovarian cancer has been the PARP (polyadenosine diphosphate–ribose polymerase) inhibitors.
1-3
In this issue of the
Journal
, investigators report the results of three randomized trials of three different PARP inhibitors for maintenance therapy in patients with ovarian . . .
Screening asymptomatic patients for cancer is based on a simple premise: cancers that are detected early before they produce symptoms should be easier to cure than those that progress to become ...clinically detectable. In practice, tools have been developed to realize the detection of clinically undetectable cancers, but the effect of their application on overall survival has been enormously challenging to demonstrate. Several factors contribute to the difficulty in proving the value of cancer screening. First, any test will have false negatives, in which case a patient’s cancer goes undetected. Second, tests for cancer are quite often falsely positive because . . .
Data Sharing Longo, Dan L; Drazen, Jeffrey M
The New England journal of medicine,
01/2016, Letnik:
374, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The aerial view of the concept of data sharing is beautiful. What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are ...lying there, previously unseen? The potential for leveraging existing results for even more benefit pays appropriate increased tribute to the patients who put themselves at risk to generate the data. The moral imperative to honor their collective sacrifice is the trump card that takes this trick.
However, many of us who have actually conducted clinical research, managed clinical studies and data collection and analysis, and curated data sets have . . .
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