Direct to consumer genetic testing provides ancestry and health risk information directly to consumers but has significant limitations. While it may promote health awareness, unexpected results can be stressful and consumers may make important medical decisions based on inaccurate or incomplete information from unregulated tests. The high rate of false positives seen in confirmatory testing suggests many consumers are receiving incorrect information from these tests. Regulatory bodies have concerns about oversight, accuracy, and inappropriate use of genetic data that could impact consumers.
Genetic Discrimination by Thalia EscobedoThaliae96
This powerpoint was part of the oral/visual component of the Advocacy Proposal, which was an important component, as it allowed me to talk about the social of genetic discrimination to my peers and propose my solution: The California Genetic Nondiscrimination Act of 2011.
The document discusses genome structure and genomics. It defines key terms like genome, repetitive DNA, and defines the major classes of repetitive DNA, which constitute around 45% of the human genome. It discusses how DNA denaturation and renaturation kinetics can be used to determine genome complexity and GC content. Cot analysis allows characterization of sequence complexity based on repetitiveness. Eukaryotic genomes have lower gene density and finding genes is more challenging compared to prokaryotes due to introns and other factors.
The document discusses transcriptomics and the relationship between transcriptome size and organism complexity. It questions how gene expression contributes to transcriptome size and what new studies reveal about size and complexity. Specifically, it notes that alternative splicing and RNA editing increase transcriptome size and complexity. It also discusses that the human genome is pervasively transcribed, with one stretch of DNA encoding many RNAs, including microRNAs, which control mRNA expression and are involved in development, gene regulation, and diseases like cancer.
Genome annotation, NGS sequence data, decoding sequence information, The genome contains all the biological information required to build and maintain any given living organism.
Synopsis
Introduction
Some Facts
Types of SNPs
SNPs act as gene markers
Methods of Detection
Techniques to detect SNPs
Allelic Specific Cleavage
Differential Hybridization
Single Base Extension or minisequencing
Alternate Methods for Detecting SNPs
Mass Spectrometry
Microchips
SIGNIFICANCE OF SNPs
HAPLOTYPE
ADVANTAGES
Are SNP data available to the public?
Some important SNP database Resources
CONCLUSION
References
Gene expression can be analyzed by determining mRNA levels and analyzing proteins. mRNA levels are usually determined by hybridizing probes to mRNA or cDNA, as in Northern blots which separate mRNA by size, or microarrays which analyze thousands of genes simultaneously. Protein analysis includes ELISA and Western blots to detect specific proteins, and proteomics uses techniques like gel electrophoresis and mass spectrometry to study the entire proteome.
This document discusses metabolic network analysis and summarizes information from the KEGG database. It describes searching metabolic terms on Google and Google Scholar, keywords used in metabolic network analysis, and basic concepts in metabolic network reconstruction. It also provides an overview of the KEGG PATHWAY, MEDICUS, Mapper, and Expression databases and tools for mapping gene expression data onto metabolic pathways. The document concludes by assigning a report task analyzing gene expression data mapped to pathways using KEGG Expression and KegArray.
In the protection of intellectual property world, patents are granted in many different countries and regions, each having slightly different legal conventions. A patent is similar to a real estate title in two ways.
Southern, Northern, and Western blotting are techniques to detect specific biomolecules separated by gel electrophoresis. Southern blotting detects DNA using DNA probes, Northern blotting detects RNA using RNA or DNA probes, and Western blotting detects proteins using antibodies. All three techniques involve transferring the separated biomolecules from a gel to a membrane, probing with a labeled detection molecule, washing unbound probes, and detecting signals.
This document discusses high-resolution views of the cancer genome using various technologies including DNA microarrays, comparative genomic hybridization, tiling arrays, next-generation sequencing, and DNAse-Seq. It describes how these technologies can be used to analyze gene expression, copy number variation, chromatin structure, and more to better understand cancer at the genomic level. Integrating data from all these sources presents challenges but may help improve individual health outcomes.
The document summarizes India's system of protecting geographical indications. It provides examples of famous Indian geographical indications like Darjeeling tea and Basmati rice. The Geographical Indications of Goods Act of 1999 established a registry system and definitions to register and protect geographical indications in India. Registered geographical indications receive protections from unauthorized use and can bring economic benefits by allowing products to sell at a premium price linked to their origin. The summary provides an overview of India's legislation establishing a system to promote and protect valuable geographical indications.
Role of bioinformatics in life sciences researchAnshika Bansal
1. The document discusses bioinformatics and summarizes some of its key applications and tools. It describes how bioinformatics merges biology and computer science to solve biological problems by applying computational tools to molecular data.
2. It provides examples of common bioinformatics tasks like retrieving sequences from databases, comparing sequences, analyzing genes and proteins, and viewing 3D structures.
3. The document lists several popular databases for nucleotide sequences, protein sequences, literature, and other biological data. It also introduces common bioinformatics tools for tasks like sequence alignment, translation, and structure analysis.
The document provides an overview of genomics and molecular profiling techniques. It discusses:
- The lab for bioinformatics and computational genomics which has 10 "genome hackers" and 42 scientists.
- An introduction to personalized medicine and biomarkers.
- First generation molecular profiling techniques like gene sequencing, microarrays, PCR.
- Next generation sequencing techniques like Roche 454, Illumina, SOLID which allow high throughput sequencing.
- Next generation applications like RNA sequencing, exome sequencing, epigenetic profiling.
- The role of bioinformatics in analyzing large genomic and molecular profiling data.
Genomics is the study of genomes and includes determining entire DNA sequences, genetic mapping, and studying intragenomic phenomena. It allows determining an ideal genotype. Genomics and bioinformatics provide benefits like improved crop productivity, stress tolerance, and nutritional quality. Proteomics studies proteins in cells. Bioinformatics handles large genomic and proteomic data using algorithms. Structural genomics constructs sequence data and maps genes. Functional genomics studies gene function. Comparative genomics compares sequences to find relationships.
This document provides an overview of patents and the patenting process in India. It discusses what constitutes an invention and outlines what is and is not patentable under Indian law. The document explains the patent application process in India, including requirements for drafting a patent specification and prosecution before the Indian Patent Office. It also summarizes the Patent Cooperation Treaty (PCT) process and Budapest Treaty for depositing microorganisms.
Geographical Indications (GI)
Types of GI
Why GI needs to be protected?
Advantages of GI
How are GIs Protected?
WIPO and GI
GI in India
Registration process
GI in Tamil Nadu
The document discusses next generation sequencing (NGS) data analysis workflows and RNA sequencing data analysis. It provides an overview of primary, secondary, and tertiary analysis steps in NGS data analysis including quality control, mapping, assembly, and differential expression analysis. It also describes common file formats, tools for mapping, counting, and identifying differentially expressed genes from RNA-Seq data using either a reference genome or de novo assembly. Finally, it lists several pathways identified from comparative temporal analysis of differentially expressed genes.
The document discusses several applications of genomics and bioinformatics across various fields such as medicine, agriculture, microbiology, and more. It describes how genomic studies of humans and model organisms are providing insights into disease mechanisms and treatments. Applications in agriculture include developing crops with improved traits like insect or drought resistance. Microbial genomics is explored for uses like bioremediation, alternative energy, and industrial applications. Bioinformatics tools aid research through literature retrieval and comparative genomics studies.
Bioinformatics issues and challanges presentation at s p collegeSKUASTKashmir
This document provides an overview of bioinformatics and some key concepts:
- It discusses the exponential growth of biological data from technologies like PCR and microarrays, and how bioinformatics is needed to analyze this data.
- Bioinformatics is defined as integrating biology and computer science to collect, analyze, and interpret large amounts of molecular-level information. It uses databases and tools to study genomes, proteins, and biological processes.
- Major databases like GenBank, EMBL, and SwissProt store DNA, RNA, protein sequences and provide access to researchers. Tools like BLAST are used to search databases and analyze sequences.
- Benefits of bioinformatics include advances in medicine, agriculture, forensics
Take a look at the below link and then answer the below questions .docxssuserf9c51d
Take a look at the below link and then answer the below questions from each of their points of view:
Link: https://www.ted.com/talks/john_wilbanks_let_s_pool_our_medical_data/transcript?language=en
When you're getting medical treatment, or taking part in medical testing, privacy is important; strict laws limit what researchers can see and know about you. But what if your medical data could be used — anonymously — by anyone seeking to test a hypothesis? John Wilbanks wonders if the desire to protect our privacy is slowing research, and if opening up medical data could lead to a wave of health care innovation.
For this blog and tying all the topics covered in the class about the epistemology of knowledge, what is your opinion on this matter? Should we share or should we not share? To be or not to Be?
I want you to answer this from different points of view:
The Patient:
The Mother/Father/Son/Daughter/Husband/Wife/Partner/Friend who is trying to help:
The Doctor:
The Hospital Administrator:
The Researcher:
The Companies/Big Pharma:
The Government:
The Government Watchdogs making sure rules are enforced:
The Philanthropists:
He slammed the papers down on the table. "Doctor, I won't do it! I just saw on the news that the prostate blood test is useless at my age. It's milking the system." His face showed determination and defiance as his wife looked on in the corner. No amount of entreating could get him to budge on the subject. Forget the 10 years of my life I had sacrificed in the pursuit of medical knowledge, he had crowdsourced on Facebook information about the prostate specific antigen test; the difference is subtle, but I had gone to medical school and he had gone to Google. Posting information on their health and all their test results is a routine event for Friday Facebook users. Proclaiming quackery, he left my office determined never to return.
Patients want that aggregation of data. Appealing to their practical nature, the more data, the faster we get to a solution, and if it contributes to research and a better future, it can only be the right decision. Family and friends would likely agree, maintaining that in the best interest of the patient, posting data, even without the benefit of anonymity, is acceptable. As MIPS / MACRA move towards population management, more integrated metrics would be of great interest to the hospital administrator as well and allows for an understanding of which markets are likely to produce the best reimbursements by virtue of their higher baseline of health; not surprisingly, we know higher income demographics produce the most compliant patients with the best medical outcomes, which is why most hospitals now are closing shop in poor neighborhoods, despite their need, and opening up in upscale areas with not only an assured revenue stream of insured clients, but better access to medications for diabetes control, better access to nutrition which means faster and improved healing post-surgery, and lower l ...
Genetic Testing Reduces Specialty Drug SpendWellDyne
An award-winning WellDyneRx study, recognized by the Academy of Managed Care Pharmacy, found that pharmacogenomics screening saved self-funded employers 5 percent in specialty drug claim costs.
Cancer principles & practice of oncologySAMANTHA Lopez
This chapter provides an overview of cancer genetic counseling. Cancer genetic counseling is a communication process that assesses an individual's cancer risk based on their family history of cancer. The goals are to provide clients with an understanding of their risk, emotional support, and determine if cancers in the family could be due to a hereditary cancer syndrome. There are over 30 hereditary cancer syndromes that can be caused by mutations in different genes, so genetic testing for these syndromes can be complex. The chapter emphasizes that accurate cancer risk assessment and counseling requires specialized training.
Use of Genetic Databases to Advance Diagnostic Test DevelopmentEMMAIntl
In December 2018, the U.S. Food and Drug Administration formally recognized a public database that contains information about genes, genetic variants, and their relationship to disease. This blog discusses the motivation for creating such public databases and the implications for developers of genetic tests...
Humans are 99% similar to each other; but it is the 1% that is the cause of concern. This relatively small difference actually how a drug will effect our body. Pharmacogenomics is the study of how genes affect a person’s response to drugs. In order to prevent any unwanted reactions it has become necessary to consider one's genome while prescribing medicine. Thus pharmacogenomics is the starting point of personalized medicine.
LabSolutions offers molecular risk tests that analyze multiple genes associated with increased risk of certain diseases. The tests use next generation sequencing and other techniques to identify variants in these genes. While the tests do not diagnose conditions, positive results may inform medical management and be relevant for relatives. The report should be reviewed with a healthcare provider trained to interpret genetic results.
Personalized Medicine: Current and Future Perspectives Personalized Medicin...MedicineAndHealth
The document discusses personalized medicine, including its definitions, current state, and future perspectives. It provides examples of personalized medicine like warfarin dosing and breast cancer risk assessment. It outlines key issues for stakeholders like payers, providers, developers, government, and consumers regarding pharmacogenomics testing, costs, access, and emerging ethical and policy concerns around privacy, informed consent, and potential for discrimination.
What Your Saliva Reveals About You: Direct-to-Consumer Genetic TestsEMMAIntl
Direct-to-consumer (DTC) tests, such as those marketed by 23andMe, are changing the classic paradigm of health professionals ordering and interpreting genetic testing for a patient. In this article, we provide an overview of the DTC landscape and regulatory pathways...
Possible Solution for Managing the Worlds Personal Genetic Data - DNA Guide, ...DNA Compass
World DNA Day and Genome Day, Dalian China 2011
"Possible Solution for Managing the Worlds Genetic Data" given by Alice Rathjen, Founder & President DNA Guide, Inc.
Proposes genetic tests be given a rating for quality of science, medical utility and viewing risk so as to facilitate the flow of genetic information in a responsible manner from the lab to the physician and patient. Explains how technology combined with public policy could enable both privacy and personalized medicine to thrive. Advocates individual ownership over personal genetic data and suggests the genome as a data format could provide the foundation for digital human rights.
tags: DNA, genetic testing, privacy, personalized medicine, FDA regulation
Global Medical Cures™ | Genetic Testing Handbook
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Genetic testing identifies changes in chromosomes, genes, or proteins. There are several types of genetic tests, including newborn screening, diagnostic testing, carrier testing, prenatal testing, preimplantation testing, predictive/presymptomatic testing, and forensic testing. Genetic tests are performed on samples like blood or tissue and require informed consent. Results can provide health information but also have limitations since not all genetic causes are understood.
The document discusses integrating genomic testing and remote cancer advisory services to improve cancer diagnosis and treatment in developing countries. It outlines several barriers to international patients accessing these services, including lack of knowledge, high costs, language barriers, and difficulty interpreting genomic test results. An integrated service is proposed that would provide genomic testing, remote advisory support from major US cancer centers, and diagnostic decision support to address these barriers. This could help minimize diagnostic errors and improve outcomes for patients in developing countries.
This document discusses different methods for drug safety surveillance, including passive and active surveillance. Passive surveillance involves voluntary reporting of adverse drug reactions by healthcare professionals, while active surveillance proactively collects data through methods like monitoring sentinel sites. Other discussed methods include spontaneous reporting, case series, stimulated reporting, medicine event monitoring, registries, cross-sectional studies, case-control studies, cohort studies, and targeted clinical investigations. Large databases and targeted studies can provide important safety information collected through various surveillance techniques.
Direct To Consumer Genomics and the Future of HealthcareRyan Squire
Richard Sharp, Ph.D., Director of Bioethics Research at the Cleveland Clinic presents on direct-to-consumer genomics and the future of health care.
Dr. Sharp received his training in philosophy and medical ethics at Michigan State University.
Prior to joining the Cleveland Clinic in 2007, Dr. Sharp taught bioethics at Baylor College of Medicine and the National Institute of Environmental Health Sciences, one of the National Institutes of Health (NIH), where he directed the Program in Environmental Health Policy and Ethics.
His research examines the promotion of informed patient decision-making in clinical research, particularly research that involves genetic analyses.
2018 Genetic Testing Assessment: These slides discuss issues associated with genetic testing interpretation. All who order genetic testing should be familiar with these recent publications.
At least one in every 20 adults who seeks medical care in a U.S. emergency room or community health clinic may walk away with the wrong diagnosis, according to a new analysis that estimates that 12 million Americans a year could be affected by such errors.
Experts have often downplayed the scope of diagnostic errors not because they were unaware of the problem, but “because they were afraid to open up a can of worms they couldn't close.
Post marketing studies of drug effects must then generally include at least 10,000 exposed persons in a cohort study, or enroll diseased patients from a population of equivalent size for a case–control study. A study of this size would be 95% certain of observing at least one case of any adverse effect that occurs with an incidence of 3 per 10 000 or greater (see Chapter 3). However, studies this large are expensive and difficult to perform. Yet, these studies often need to be conducted quickly, to address acute and serious regulatory, commercial, and/or public health crises. For all of these reasons, the past two decades have seen a growing use of computerized databases containing medical care data, so called “automated databases,” as potential data sources for pharmacoepidemiology studies.
Patient safety has always been the industry’s focus during clinical trials. However, a recent spate of well-publicized patient safety issues have increased public scrutiny and the biotechnology, pharmaceutical and CRO industries' desire to improve study quality, resulting in larger, longer, more expensive trials. In this Q&A, James T. Gourzis, M.D., Ph.D., discusses issues affecting patient safety, including factors that have launched safety to the forefront; what to look for in evaluating CRO excellence; unique oncology considerations and the ramifications of the rare toxicity; optimizing the Data Monitoring Committee; budget decisions that affect patient safety and the evolution/future of FDA requirements.
There are only around 500 geneticists and 2,400 genetic counselors in the U.S. to help integrate genomic medicine into patient care. DNA Direct aims to address this shortage and other barriers through technology solutions that provide education, decision support, and expert guidance to patients, providers, payors, and medical centers. Their programs have shown success in improving patient compliance with genetic screening and understanding of test results.
The document discusses diagnostic error in healthcare. It begins by noting that inaccurate diagnoses, incorrect treatments, and lack of diagnoses contribute to unnecessary costs, inefficiency, and patient dissatisfaction. Improving diagnostic accuracy can help achieve quality, control costs, and increase patient satisfaction. The document then discusses:
- The high incidence of diagnostic errors, which result in tens of thousands of deaths per year and enormous financial tolls.
- Evidence that diagnostic errors commonly cause patient harm and occur across primary care, inpatient, and outpatient settings.
- An innovative solution of independent virtual second opinions to address diagnostic errors by improving accuracy and ensuring appropriate treatment.
Slides faod - the other mitochondrial energy diseases - vockleymitoaction
Jerry Vockley is the director of the Center for Rare Disease Therapy at the University of Pittsburgh. The center conducts research on novel therapies for inborn errors of fatty acid oxidation using a personalized medicine approach. Some key points from the document:
- The center is researching therapies for rare genetic diseases including anaplerotic therapy and use of medium chain triglycerides.
- Clinical trials have shown that triheptanoin reduces events in fatty acid oxidation disorders and improves cardiac function.
- Other potential therapies discussed include transcriptional activators, antioxidants, chaperones, and gene therapy approaches.
- Collaborations with pharmaceutical companies are exploring drug development approaches for disorders like VLC
This document provides resources for those affected by mitochondrial disease. It summarizes the types of support that may be helpful, including health care needs, emotional support, basic needs, and community services. Mary Castro Summers is introduced as someone passionate about sharing community resource information and connecting families supporting loved ones with special health care needs. Her experience includes working with organizations that assist families impacted by mitochondrial disease.
Primary Mitochondrial Disease and Secondary Mitochondrial Dysfunctionmitoaction
This document summarizes a presentation by Dr. Richard E. Frye on mitochondrial dysfunction in neurodevelopmental disorders and autism. The presentation covers:
- Evidence that mitochondrial dysfunction is involved in many diseases and now believed to be important in autism based on studies showing abnormalities in electron transport chain complexes in autistic children.
- Further studies demonstrating differences in mitochondrial reserve capacity between autistic children and controls, and associations with environmental exposures like air pollution.
- Research into mechanisms of dysfunction including effects of the gut microbiome, genes, and potential treatments like mitochondrial cocktails.
This document provides background information on mitochondria and mitochondrial diseases, and discusses supplementation strategies. It describes how mitochondria produce energy in cells and how damage can accumulate over time. Available therapies include supplements like CoQ10, riboflavin, L-carnitine, folinic acid, L-arginine, NAC, and other vitamins/antioxidants. Side effects and considerations for dosing and monitoring are reviewed to safely utilize supplementation for mitochondrial diseases.
Three sentences summarizing the key points:
1) Infection can be detrimental for patients with mitochondrial disease as it increases their metabolic demands and immune responses can further damage mitochondria.
2) Some patients with mitochondrial disease may have immune dysfunction, shown by recurrent infections, hypogammaglobulinemia, poor vaccine responses, and impaired clearance of viruses.
3) The NIH MINI study aims to characterize immune function and risks of infection in mitochondrial disease patients through longitudinal monitoring to help mitigate health risks.
The document discusses how infection can be detrimental for patients with mitochondrial disease due to the increased energy demands and potential immune dysfunction. It outlines how the immune system may be compromised in mitochondrial disease based on clinical observations of increased infections and poor vaccine responses in some patients. Animal studies show that mitochondrial dysfunction within immune cells can impair their function and response to infection.
MitoAction Mobile is a mobile app that allows patients with mitochondrial disease to create and track care plans, share tasks and symptoms with their care team, and view symptom history. The app provides secure messaging with doctors and nurses and full reporting of medical information to help coordinate care. MitoAction Mobile aims to revolutionize mitochondrial disease management through comprehensive care planning and communication tools available on patients' mobile devices.
-What are Standards of Care and why does the Mito community need such standards?
-Review the MMS's Standards of Care for Mitochondrial Disease and how they were developed.
-Outline upcoming MMS projects.
This document summarizes Leigh syndrome, a rare neurological disorder caused by defects in mitochondrial energy production. It describes Dr. Denis Leigh's original 1951 case report that defined the syndrome. Over time, MRI and genetic testing allowed diagnosis of different mitochondrial disorders collectively termed Leigh syndrome. Current understanding is that Leigh syndrome has various genetic causes but commonly involves symmetrical brain lesions and early developmental regression. No effective treatments exist but research continues into therapies like idebenone, sodium pyruvate, and rapamycin.
This document discusses when an alternative diagnosis to mitochondrial disease should be considered. It notes that while mitochondrial diseases affect 1 in 4,000 people, the symptoms can overlap with other genetic disorders. It provides examples of "red flags" where alternative diagnoses may be more likely, such as predominantly seizure disorders, developmental delays with dysmorphic features but no other system involvement, or isolated myopathies. It emphasizes the importance of fully evaluating for other causes before concluding a mitochondrial diagnosis and considering genomic testing to reach the correct diagnosis when atypical features are present. Reaching the accurate diagnosis is critical for treatment and family planning.
What you should know about genetic testing for mitochondrial disordersmitoaction
Amanda Balog, CGC, Senior Genetic Counselor, Mitochondrial and Metabolic Genetics, of GeneDx discusses: "What You Should Know About Genetic Testing for Mitochondrial Disorders."
Richard Frye, MD, PhD, FAAP, FAAN, CPI, will discuss:
*The enteric (gut) microbiome has an important influence on health and disease states in humans.
* The enteric microbiome influences the human host using chemical mediators, some of which can directly affect mitochondrial function
* Short chain fatty acids produced by gut bacteria not only modulate mitochondrial function and cellular regulatory pathways, but can also be used as mitochondrial fuels.
This document discusses mitochondrial replacement therapy (MRT) as a potential treatment for mitochondrial diseases caused by mutations in mitochondrial DNA. It provides background on mitochondrial genetics and diseases. MRT aims to prevent transmission of mitochondrial mutations by transferring nuclear DNA from a patient's egg to a donor egg with healthy mitochondria, using techniques like spindle transfer. The document outlines research progress, including the first reported birth from MRT. It notes MRT is approved in the UK but still under study in the US. It also describes inclusion criteria for research participation and acknowledges collaborators supporting MRT research efforts.
Mitochondria and MitoQ – A research updatemitoaction
Greg Macpherson presented an update on research related to mitochondria and MitoQ. Some key points include:
- MitoQ was discovered at Otago University in New Zealand and is a mitochondria-targeted antioxidant.
- Over 200,000 patient months of experience and availability in over 100 countries.
- Research has included over 50 million USD invested and 200+ published papers involving 70+ disease models.
- Clinical trials have shown benefits for conditions such as fibromyalgia, chronic fatigue syndrome, and type 2 diabetes.
- Mouse and human research has demonstrated reductions in oxidative stress, inflammation, and markers of disease from conditions such as liver fibrosis when taking MitoQ.
- Future research
Day-to-Day Management of Mitochondrial Diseasemitoaction
MitoAction provides support for individuals and families affected by mitochondrial disease. Their vision is to create a worldwide community for mitochondrial disease patients. Mitochondrial disease is caused by failures of the mitochondria, which act as the cell's powerhouse. Symptoms can vary widely and affect multiple body systems. Management of mitochondrial disease focuses on treating symptoms, managing energy levels, addressing nutritional needs, and preventing triggers. Comprehensive care involves monitoring for complications and coordinating with multiple medical specialists.
Exercise and nutrition in Mitochondrial Diseasemitoaction
Mark Tarnopolsky, MD, PhD, FRCP,
Depts. of Pediatrics (Neuromuscular + Neurometabolic Disease) and Medicine (Cell Biology/Metabolism, Neurology and Rehabilitation), McMaster University, Hamilton, CANADA
Diagnostic Testing for Mitochondrial Diseasemitoaction
Review traditional diagnostic pathways
Discuss newer testing that has become available in recent years
Review new approaches to attempt to shorten time to diagnosis and increase precision
How to Build Your Mitochondrial Medical Homemitoaction
The document provides guidance on how to build a "medical home" for patients with mitochondrial disease by establishing a primary care physician to coordinate care across various specialists. It emphasizes finding a "quarterback" for the healthcare team and providing that physician with resources on mitochondrial disease. The medical home model aims to improve outcomes through coordinated, patient-centered care rather than a previous fee-for-service model.
The document discusses planning for summer programs for students with disabilities, noting that most students experience regression over the summer without continued services and support. It outlines factors for IEP teams to consider when determining if extended year services are needed, such as demonstrated regression or difficulty relearning skills. The document also provides guidance on reviewing a child's health plan, evaluating proposed summer programs, and participating in IEP meetings to ensure a child's needs are met.
The impact of CD160 deficiency on alloreactive CD8 T cell responses and allog...MARIALUISADELROGONZL
CD160 is a member of the immunoglobulin superfamily with a pattern of expression
mainly restricted to cytotoxic cells. To assess the functional relevance of the HVEM/
CD160 signaling pathway in allogeneic cytotoxic responses, exon 2 of the CD160
gene was targeted by CRISPR/Cas9 to generate CD160 deficient mice. Next, we
evaluated the impact of CD160 deficiency in the course of an alloreactive
response. To that aim, parental donor WT (wild-type) or CD160 KO (knock-out) T
cells were adoptively transferred into non-irradiated semiallogeneic F1 recipients,
in which donor alloreactive CD160 KO CD4 T cells and CD8 T cells clonally
expanded less vigorously than in WT T cell counterparts. This differential proliferative
response rate at the early phase of T cell expansion influenced the course of CD8 T
cell differentiation and the composition of the effector T cell pool that led to a significant
decreased of the memory precursor effector cells (MPECs) / short-lived effector
cells (SLECs) ratio in CD160 KO CD8 T cells compared to WT CD8 T cells. Despite
these differences in T cell proliferation and differentiation, allogeneic MHC class I
mismatched (bm1) skin allograft survival in CD160 KO recipients was comparable
to that of WT recipients. However, the administration of CTLA-4.Ig showed an
enhanced survival trend of bm1 skin allografts in CD160 KO with respect to WT recipients.
Finally, CD160 deficient NK cells were as proficient as CD160 WT NK cells in
rejecting allogeneic cellular allografts or MHC class I deficient tumor cells. CD160
may represent a CD28 alternative costimulatory molecule for the modulation of
allogeneic CD8 T cell responses either in combination with costimulation blockade
or by direct targeting of alloreactive CD8 T cells that upregulate CD160 expression
in response to alloantigen stimulation
STRATEGIES FOR RATIONALISING/REDUCING CAESAREAN SECTION RATE BY USE OF "SION ...Niranjan Chavan
The journey to reduce/rationalise the C-section rate started in June 2023 and it’s an ongoing study been carried out at #SionHospital #LTMMC Mumbai.
It’s going to revolutionise the journey of motherhood for safer, predictable maternal and fetal outcome.
The SION model is a structured and networked approach to promoting vaginal deliveries.
By integrating education, support, policy implementation, and continuous improvement, it aims to enhance maternity care and reduce unnecessary C-sections through collaborative efforts among healthcare providers and patients.
Encouraging trials of labor after previous C-sections (TOLAC) and fostering a multidisciplinary team approach in maternity care are crucial.
Regular training for healthcare providers and establishing supportive hospital policies further promote vaginal births.
Principles of Cleaning
Nonsurgical root canal treatment is a predictable method of retaining a tooth that otherwise would require extraction. Success of root canal treatment in a tooth with a vital pulp is higher than that of a tooth that is necrotic with periradicular pathosis. The difference is the persistent irritation of necrotic tissue remnants, and the inability to remove the microorganisms and their by-products. The most significant factors affecting this process are tooth anatomy and morphology, and the instruments and irrigants available for treatment. Instruments must contact and plane the canal walls to debride the canal.
Morphologic factors such as lateral and accessory canals, canal curvatures, canal wall irregularities, fins, cul-de-sacs, and isthmuses make total debridement virtually impossible. Therefore the goal of cleaning not total elimination of the irritants but it is to reduce the irritants.
Currently there are no reliable methods to assess cleaning. The presence of clean dentinal shavings, the color of the irrigant, and canal enlargement three file sizes beyond the first instrument to bind have been used to assess the adequacy; however, these do not correlate well with debridement. Obtaining glassy smooth walls is a preferred indicator. The properly prepared canals should feel smooth in all dimensions when the tip of a small file is pushed against the canal walls. This indicates that files have had contact and planed all accessible canal walls thereby maximizing debridement (recognizing that total debridement usually does not occur).
Principles of Shaping
The purpose of shaping is to
1) facilitate cleaning and
2) provide space for placing the obturating materials.
The main objective of shaping is to maintain or develop a continuously tapering funnel from the canal orifice to the apex. This decreases procedural errors when cleaning and enlarging apically. The degree of enlargement is often dictated by the method of obturation. For lateral compaction of gutta percha the canal should be enlarged sufficiently to permit placement of the spreader to within 1-2 millimeters of the corrected working length. There is a correlation between the depth of spreader penetration and the apical seal.5 For warm vertical compaction techniques the coronal enlargement must permit the placement of the pluggers to within 3 to 5 mm of the corrected working length.6
As dentin is removed from the canal walls the root is weakened.7 The degree of shaping is determined by the preoperative root dimension, the obturation technique, and the restorative treatment plan. Narrow thin roots such as the mandibular incisors cannot be enlarged to the same degree as more bulky roots such as the maxillary central incisors. Post placement is also a determining factor in the amount of coronal dentin removal.
Definition of mental health nursing, terminology, classification of mental disorder, ICD-10, Indian Classification, Personality development, defense mechanism, etiology of bio psychosocial factors,
Heart Valves and Heart Sounds -Congenital & valvular heart disease.pdfMedicoseAcademics
This presentation, authored by Dr. Faiza, Assistant Professor of Physiology at CIMS Multan, delivers an in-depth analysis of heart valves, heart sounds, valvular heart diseases, and congenital heart defects. It begins by distinguishing between normal and abnormal heart sounds, elucidating the timing and causes of the four heart sounds—S1, S2, S3, and S4—and their clinical significance. Detailed explanations are provided on the auscultation sounds that define conditions such as mitral stenosis, mitral insufficiency, aortic stenosis, and aortic insufficiency, with a focus on how these pathological changes affect cardiac mechanics and blood pressure.
The presentation delves into abnormal heart sounds, known as murmurs, categorizing them by their causes, which include valvular lesions, rheumatic fever, aging, congenital heart diseases, viral infections during pregnancy, and hereditary factors. It explores the various types of murmurs, their timing within the cardiac cycle, and their association with specific valvular heart diseases such as stenosis and regurgitation. The intricate relationship between systolic and diastolic murmurs and conditions like anemia and ventricular septal defects is also highlighted.
Further, the presentation covers the pathophysiology of congenital heart diseases, offering a comprehensive review of conditions such as Tetralogy of Fallot and Patent Ductus Arteriosus. It explains the mechanisms of these diseases, their impact on cardiac function, and the clinical manifestations observed in affected individuals. The physiological adjustments of the circulatory system during exercise in patients with valvular lesions are discussed, emphasizing the reduced cardiac reserve and the risk of acute pulmonary edema.
Special attention is given to the compensatory mechanisms of the heart in response to valvular diseases, including the development of concentric and eccentric hypertrophy, increased venous return, and the eventual progression to heart failure. The presentation also examines rheumatic valvular lesions, aging-related aortic stenosis, and the specific challenges posed by these conditions, such as reduced stroke volume and increased metabolic demand.
This thorough exploration of heart sounds, valvular diseases, and congenital defects is designed to enhance understanding and clinical acumen, making it a valuable resource for medical students, healthcare professionals, and educators in the field of cardiology and physiology.
an huge problem we are facing about the anaemia , we slight our contribution to aware with one of its class , with detailed description. it is usefull for health , medicine , pharmacy , nursing.
As a leading rheumatologist in Chandigarh, Dr. Aseem specializes in the diagnosis and management of a wide range of rheumatic conditions, including but not limited to:
Rheumatoid Arthritis: An autoimmune disorder that causes chronic inflammation of the joints.
Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage.
Lupus: A systemic autoimmune disease that can affect the skin, joints, kidneys, and other organs.
Ankylosing Spondylitis: A type of arthritis that primarily affects the spine, causing pain and stiffness.
Gout: A form of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in the joints.
Psoriatic Arthritis: A type of arthritis that affects some people with psoriasis.
Vasculitis: An inflammation of the blood vessels that can cause a variety of symptoms.
Sjogren’s Syndrome: An autoimmune disorder characterized by dry eyes and mouth.
Accurate diagnosis is crucial for effective treatment. Dr. Aseem Goyal utilizes advanced diagnostic techniques to identify the underlying causes of rheumatic conditions. Our state-of-the-art facility is equipped with the latest technology to provide comprehensive diagnostic services, including:
Blood Tests: To check for markers of inflammation and autoimmune activity.
Imaging Studies: Such as X-rays, MRI, and ultrasound to assess joint and soft tissue damage.
Joint Fluid Analysis: To examine the fluid in the joints for signs of inflammation or infection.
Biopsy: In certain cases, a small tissue sample may be taken for further examination.
Treatment Approaches
Dr. Aseem Goyal adopts a holistic and patient-centered approach to treatment. Depending on the specific condition and its severity, treatment options may include:
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce inflammation and relieve pain.
Disease-Modifying Antirheumatic Drugs (DMARDs): To slow the progression of rheumatic diseases.
Biologic Agents: Targeted therapies that block specific pathways in the immune system.
Corticosteroids: To control severe inflammation quickly.
Staphysagria is often indicated for individuals who have a tendency to suppress emotions and suffer from the effects of suppressed anger, grief or indignation. They may exhibit a tendency to have a fragile or sensitive disposition. Staphysagria individuals often have a craving for solitude and a desire for sympathy.
Subcutaneous nodules in rheumatic diseases Ahmed Yehia Assistant Professor of internal Medicine, Immunology, rheumatology and allergy
How to use subcutaneous nodules as a clue for diagnosis by completing the puzzle
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
Lymphoma Made Easy , New Teaching LecturesMiadAlsulami
This lecture was presented today as part of our local Saudi Fellowship program. After three years of direct interaction with trainees and hematologists, I have started to develop an understanding of what needs to be covered. This lecture might serve as a roadmap for approaching and reporting lymphoma cases.
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn J...rightmanforbloodline
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
TEST BANK Physical Examination and Health Assessment 9th Edition by Carolyn Jarvis, All Chapters 1 - 32 Full Complete.pdf
2024 07 12 Do you share my autistic traits_ - Google Sheets.pdfCarriePoppy
I made this spreadsheet when I was waiting for my autism assessment. It helped me determine that I probably have autism. When I did get tested, they (UCLA) told me I do, indeed, have Type 1 autism. You can use this spreadsheet to compare your experience to mine. I am a white woman, AFAB. My diagnosis is Type 1 autism with a pragmatic language deficit.
this presentation is all about vital force . this is the useful information for the students of homeopathy streamhyddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddddjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjvgggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggg .
Hemodialysis: Chapter 10, AVF and AVG - Complications (Diagnosis and Manageme...NephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/akgMSyA06Qg
- Video recording of this lecture in Arabic language: https://youtu.be/HAR3QLj0Q5A
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Introduction to Dental Implant for undergraduate studentShamsuddin Mahmud
Introduction to Dental Implant
Dr Shamsuddin Mahmud
Assistant Professor, Department of Prosthodontics
Nortth East Medical College (Dental Unit)
Definition of Dental Implant
A prosthetic device
made of alloplastic material(s)
implanted into the oral tissues beneath the mucosal and/or periosteal layer and
on or within the bone
to provide retention and support for a fixed or removable dental prosthesis.
Classification of Dental Implant
According to placement within the tissue
Blade/Plate form implant
According to Material Used
A) METALLIC IMPLANTS
Commercially pure Titanium
Cobalt chromium molybdenum
Titanium aluminum vanadium
Stainless steel
B) NON-METALLIC IMPLANT
Zirconium
Ceramic
Carbon
According to the ability of implant to stimulate bone formation
A) Bio active
Hydroxyapatite
Tri Calcium Phosphate
B) Bio inert
Metals
Parts of Dental Implant
Implant fixture
Implant mount
Cover screw
Gingival former/healing screw/healing abutment/permucosal extension
Impression post/impression transfer abutment
Implant analogue
Abutment
Fixation screw
Implant Fixture
Implant Mount
Connected to the fixture
Function: used to carry implant from its vital to the prepared osteotomy site either by hand or with a ratchet/ handpiece adaption
Cover Screw
component that is used to cover the implant connection during the submerged healing of the implant
Function: preserves the patency of the connection by preventing any soft tissue ingrowth in the connection
Gingival former/ Healing Abutment/ Healing screw
Screw/ abutment used to create the soft tissue emergence profile around the implant.
Time of placement:
During 1st surgery – One step surgery
After Osseointegration – Two step/stage surgery
Gingival former/ Healing Abutment/ Healing screw
Placed in the site 2-3 weeks for soft tissue healing
Function:
Create gingival emergence profile
Formation of biological width
Impression post/impression transfer abutment
component that is used to trans- fer the implant Hex position and orientation from the mouth to the working cast.
Types
Closed tray
Open tray
Implant analogue/
component which has a different body but its platform and connection are exactly similar to the implant. The analogue is used to replicate the implant platform and connection in the laboratory mode.
Abutment
Abutments
Advantages of Dental Implant Retained Prosthesis
Maintain bone height and width by preventing bone resorption
Maintain facial esthetics
Improve masticatory performance
Improve stability and retention of prosthesis
More esthetics
Increase survival times of prostheses
There is no need to alter adjacent teeth
Improve psychological health
Disadvantages of Dental Implant Retained Prosthesis
Very expensive.
Cannot be used in medically compromised patients who cannot undergo surgery.
Longer duration of treatment
Requires a lot of patient co-operation because of repeated recall visits are essential
INDICATION OF DENTAL IMPLANT
Dental implants can successfully restore all
2. What is DTC Testing?
Direct to Consumer (DTC) genetic tests are advertised and sold directly to the
public.
Offers information that many include ancestry, risks of developing certain
conditions, carrier status for some autosomal recessive diseases, predicted
drug response, and non-disease phenotypic traits such as eye color.
DTC tests are not diagnostic and offers risk information for only a limited set
of conditions.
3. Who offers DTC Testing?
Family Tree DNA
My Heritage
23andMe
Ancestry
Mayo Clinic GeneGuide
Color
4. DTC Power
DTC testing may promote awareness of genetic diseases.
It may provide you with personalized information about your health, disease
risk, and other traits.
This testing may allow consumers to take a more proactive role in their
health care.
Offers a means for people to learn about their ancestral origins.
It does not require approval from an insurance company or a healthcare
provider.
Results are available relatively quickly.
Your data is added to a large database that may be used to further medical
research. Depending on the company, the database may represent up to
several million participants.
5. DTC Limitations
Unexpected information that you receive about your health, family relationships,
or ancestry may be stressful or upsetting. For example, one may learn of non-
paternity or that they are adopted.
People may make important decisions about disease treatment or prevention
based on inaccurate, incomplete or misunderstood information from their tests
results.
There is currently little oversight or regulation of testing companies.
Unproven or invalid tests can be misleading. There may not be enough scientific
evidence to link a particular genetic variation with a given disease or trait.
Genetic privacy may be compromised if testing companies use your genetic
information in an unauthorized way or if your data is stolen. For example, the
company may sell your data to corporations, research groups or may work with law
enforcement.
The results of genetic testing may impact your ability to obtain life, disability or
long-term care insurance.
6. DTC Limitations cont…
In the US, the FDA restricts DTC testing companies from offering products that
function as diagnostic tests.
In April 2017 FDA authorized 23andMe to market genetic HEALTH RISK tests for 10
specific multifactorial conditions (Parkinson disease, Alzheimer disease, celiac
disease, alpha-1-antitrypsin, early-onset primary dystonia, factor XI deficiency,
Gaucher type I, glucose-6-phosphate dehydrogenase def’y, hereditary
hemochromatosis, hereditary thrombophilia.
The risk assessment of these 10 diseases is based on the presence or absence of a
limited list of genetic variants in the sample, which are statistically higher in
affected vs healthy cohorts but not necessarily causal of the conditions because
additional environmental and lifestyle factors affect risk.
None of the genes associated with these conditions are comprehensively
sequenced or analyzed in DTC tests NOR do the tests include all of the genes that
have been associated with these conditions.
7. Example of DTC Gene Risk Analysis
23andMe’s genetic health risk test for Parkinson disease reports on
just ONE variant in each of two genes, LRRK2 and GBA, linked to this
disorder.
There are additional known pathogenic variants in these two genes
They do not report out on other genes known to be linked to Parkinson
disease such as SNCA and PARK2/PARKIN.
The consumer is not provided with a comprehensive genetic risk
assessment.
In contrast, diagnostic tests are comprehensive with analysis of the
full coding sequences of all genes associated with that disease and the
results are used by the provider to guide disease management or
surveillance.
8. Raw Data Analysis
Although the FDA prohibits most DTC companies from offering diagnostic
genetic tests, some companies provide their raw genotyping data if
requested.
Patients can access interpretation services for their raw genotyping data
through fee-for-service third party companies.
A study in 2017 reviewing third party companies found they operate by
querying publicly available databases, despite reports that the majority of
classifications in some of these databases is incorrect resulting in, for
example, the interpretation of single nucleotide polymorphisms as pathogenic
when they may be VUS, likely benign variants, and benign polymorphisms. In
addition, these companies are providing information to the consumer with the
assumption that these variants in the raw data they are interpreting are
actually true abnormalities in the first place and not false positives. Badalato et
al. Eur J Hum Genet 2017;25:1189-1194
9. 23andme Statement on Testing Clinical
Utility
They made the following statement regarding the clinical
utility of their DTC testing:
“The test is not intended to tell you anything about your current state of
health, or to be used to make medical decisions, including whether or
not you should take a medication, how much of a medication you should
take, or determine any treatment… These carrier reports are not
intended to tell you anything about your risk for developing a disease in
the future, the health of your fetus, or your newborn child’s risk of
developing a particular disease later in life.”
10. Ambry Genetics DTC Testing Study – Tandy-
Connor, et al; Genetics in Medicine;2018;20(12):1515-1521
Analyzed variants previously identified by DTC testing and raw data analysis
in 49 patients between January 2014 and December 2016.
91.8% of patients were female; 73.5% unaffected by disease; 53.1% aged 30-
49 years.
In 44.9% of cases, single-site analysis was ordered to confirm DTC raw data
findings; 87.8% was testing of cancer genes,8.2% in CF genes, and 2% each in
connective tissue disorders and Familial Mediterranean Fever genes.
Overall, 60% of the variants were confirmed while 40% were false positives,
the latter most commonly found in the breast cancer BRCA1/2 genes.
Misclassification of variants by the third party interpretation service, some of
which were variants found in the general population at frequencies too high
to be associated with disease (one BRCA2 gene variant is found in about 25%
of the general population).
11. Lessons Learned
Alarmingly high false positive rate
High incidence of discrepant classification/misinterpretation of variants
coming from DTC companies and/or third-party interpretation services.
It is critical that clinical confirmatory testing be performed on any variants
reported in the raw data provided by a DTC company prior to any changes in
medical management to confirm the presence of that variant in the individual
as well as an accurate classification.
Many DTC genetic tests do not include comprehensive gene analysis.
Genetic testing needs to be interpreted by a qualified health-care
professional in the context of several other factors to include personal and
family medical history.
12. My Biggest Concern
The Ambry study data was generated on 49
patients whose providers knew enough to
refer for additional testing. How many
people are out there with false positive data
making poor decisions for themselves and
their families based on inaccurate
information?
13. American Society of Human Genetics
Statement on DTC Testing
“Because of the fragmented regulatory environment for genetic testing in general,
there is concern that the quality of the tests offered DTC may be inadequate. For a
test to be of good quality, the laboratory performing it must be able to obtain the
correct answer reliably, meaning that it detects a particular genetic variant when it is
present and does not detect the variant when it is absent. A test’s accuracy is
referred to as “analytic validity”. Further, there must be adequate scientific evidence
to support the correlation between the genetic variant and a particular health
condition or risk – the so-called clinical validity.”
“Claims made regarding DTC genetic tests may is some cases be exaggerated or
unsupported by scientific evidence. Exaggerated or unsupported claims may lead
consumers to get tested inappropriately or to have false expectations regarding the
benefits of testing. Further, consumers may make unwarranted, and even
irrevocable, decisions on the basis of test results and associated information, such as
the decision to terminate a pregnancy, to forgo needed treatment, or to pursue
unproven therapies.”
14. American College of Medical Genetics
Comment on DTC Testing
“Due to the complexities of genetic testing and
counseling, the self-ordering of genetic tests by
patients over the telephone or the Internet, and
their use of genetic “home testing” kits, is
potentially harmful. Potential harms include
inappropriate test utilization, misinterpretation of
test results, lack of necessary follow-up, and other
adverse consequences.”
15. NIH Concerns for DTC Testing
Statement from the National Institutes of Health (NIH):
“DTC genetic testing may promote awareness of genetic diseases, allow
consumers to take a more proactive role in their health care, and offer a means for
people to learn abut their ancestral origins.” However, “consumers are vulnerable
to being misled by the results of unproven or invalid tests” and “may make
important decisions about treatment or prevention based on inaccurate, incomplete
or misunderstood information about their health.”
16. Federal Concerns for DTC Testing
On November 28, 2017, Senator Chuck Shumer called on the Federal Trade Commission
(FTC) to regulate consumer DNA testing
Schumer cautions that these test kits put consumer privacy at risk because DNA firms could
potentially sell personal and genetic information. Now Schumer is calling on the Federal Trade
Commission to investigate and ensure that the privacy policies are clear, transparent, and fair
to consumers, according to a statement released by Schumer’s office.
“When it comes to protecting consumers’ privacy from at-home DNA test kit services, the
federal government is behind,” Schumer said. “Besides, putting your most personal genetic
information in the hands of third parties for their exclusive use raises a lot of concerns, from the
potential for discrimination by employers all the way to health insurance. That's why I am asking
the Federal Trade Commission to take a serious look at this relatively new kind of service and
ensure that these companies have clear, fair privacy policies and standards for all kinds of at-
home DNA test kits. We don't want to impede research but we also don't want to empower
those looking to make a fast buck or an unfair judgement off your genetic information. We can
find the right balance here, and we must.” Ref Mobihealth News