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BMJ (Clinical Research Ed.) Jun 2021Regenerative medicine aspires to transform the future practice of medicine by providing curative, rather than palliative, treatments. Healing the central nervous system... (Review)
Review
Regenerative medicine aspires to transform the future practice of medicine by providing curative, rather than palliative, treatments. Healing the central nervous system (CNS) remains among regenerative medicine's most highly prized but formidable challenges. "Regenerative neurosurgery" provides access to the CNS or its surrounding structures to preserve or restore neurological function. Pioneering efforts over the past three decades have introduced cells, neurotrophins, and genes with putative regenerative capacity into the CNS to combat neurodegenerative, ischemic, and traumatic diseases. In this review we critically evaluate the rationale, paradigms, and translational progress of regenerative neurosurgery, harnessing access to the CNS to protect, rejuvenate, or replace cell types otherwise irreversibly compromised by neurological disease. We discuss the evidence surrounding fetal, somatic, and pluripotent stem cell derived implants to replace endogenous neuronal and glial cell types and provide trophic support. Neurotrophin based strategies via infusions and gene therapy highlight the motivation to preserve neuronal circuits, the complex fidelity of which cannot be readily recreated. We specifically highlight ongoing translational efforts in Parkinson's disease, amyotrophic lateral sclerosis, stroke, and spinal cord injury, using these to illustrate the principles, challenges, and opportunities of regenerative neurosurgery. Risks of associated procedures and novel neurosurgical trials are discussed, together with the ethical challenges they pose. After decades of efforts to develop and refine necessary tools and methodologies, regenerative neurosurgery is well positioned to advance treatments for refractory neurological diseases. Strategic multidisciplinary efforts will be critical to harness complementary technologies and maximize mechanistic feedback, accelerating iterative progress toward cures for neurological diseases.
Topics: Animals; Genetic Therapy; Humans; Nervous System Diseases; Neurosurgery; Regenerative Medicine; Stem Cell Transplantation
PubMed: 34162530
DOI: 10.1136/bmj.n955 -
Zhonghua Yi Xue Za Zhi Jan 2024With continuous breakthroughs in basic research and technological innovation in the field of biomedicine, we have a much deeper understanding of the nature of life and...
With continuous breakthroughs in basic research and technological innovation in the field of biomedicine, we have a much deeper understanding of the nature of life and disease pathogenesis. New medical technologies, medicines and medical instruments are emerging, which greatly promote diagnosis, treatment, prevention and healthy lifestyle. Focusing on international engagement together with the development needs of individual businesses is a major task for China's biomedical community in order to achieve high-quality outcomes. This paper emphasizes the need to further strengthen the cross-integration and development of medical science in China, realize the paradigm change of medical research, and promote the development and application of revolutionary medical technologies, diagnostics, drugs and medical devices. Eighteen frontier hot spots and common issues are highlighted for the field of biomedicine.
Topics: Biomedical Research; China; Medicine
PubMed: 38155093
DOI: 10.3760/cma.j.cn112137-20231221-01444 -
Theoretical Medicine and Bioethics Dec 2022Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative...
Medicine is increasingly subject to various forms of criticism. This paper focuses on dominant forms of criticism and offers a better account of their normative character. It is argued that together, these forms of criticism are comprehensive, raising questions about both medical science and medical practice. Furthermore, it is shown that these forms of criticism mainly rely on standards of evaluation that are assumed to be internal to medicine and converge on a broader question about the aim of medicine. Further work making medicine's internal norms explicit and determining the aim of medicine would not only help to clarify to what extent the criticism is justified, but also assist an informed deliberation about the future of medicine. To illustrate some of the general difficulties associated with such a task, the paper concludes by critically engaging Edmund Pellegrino's account of the aim of medicine as well as the Hastings Center's consensus report.
Topics: Humans; Philosophy, Medical; Medicine
PubMed: 36376739
DOI: 10.1007/s11017-022-09598-9 -
FP Essentials Jun 2021Various herbal medicines have been used around the world for more than 5,000 years. Herbal medicines, or herbal supplements, are defined as any products originating from...
Various herbal medicines have been used around the world for more than 5,000 years. Herbal medicines, or herbal supplements, are defined as any products originating from plants and used to preserve or recover health. In the United States, the popularity of herbal supplements has increased in the last several decades. Many physicians do not ask patients about herbal supplement use, and one-third of patients do not inform their physician about supplement use. However, physicians should ask, because although many supplements are considered low risk and safe, some have significant risks of adverse effects. For example, St John's wort () can have significant drug interactions with prescription or over-the-counter drugs. The effectiveness of herbal supplements in the management of specific conditions varies. For some conditions, there is robust clinical data supporting the use of specific herbal supplements, but for other conditions there is poor or insufficient data. The content and safety of herbal supplements are the purview of the Food and Drug Administration (FDA). However, the FDA primarily responds to after-the-fact reports of postmarketing safety concerns. When an herbal supplement-related adverse effect is suspected, patients or physicians should report it to the FDA via the MedWatch reporting system.
Topics: Dietary Supplements; Drug Interactions; Humans; Hypericum; Integrative Medicine; Phytotherapy; Plants, Medicinal; United States
PubMed: 34128628
DOI: No ID Found -
Journal of Ethnopharmacology Jan 2019This "geographic and thematic" issue of the Journal of Ethnopharmacology focuses on the traditional medicines in trade in Asia on the 30th anniversary of the 1988...
This "geographic and thematic" issue of the Journal of Ethnopharmacology focuses on the traditional medicines in trade in Asia on the 30th anniversary of the 1988 Chiang-Mai Declaration, an output of an historic meeting organized by WHO, IUCN and WWF. The emphasis on the Asian countries that represent the highest volume and value of medicinal plants trade in the world is deliberate. Not only because of the scale and speed of changes in traditional medicines trade in Asia, but also to highlight the conservation and sustainable use issues being faced today. In 1988, few studies had been done on the informal sector trade or on medicinal plant value-chains and even fewer studies on cross-border trade in medicinal plants or fungi. At that time, e-commerce in Traditional and Complementary Medicine (T&CM), so common today, did not even exist. And no comparitive, repeat studies of traditional medicines markets had been done at all. Thirty years later, this special issue illustrates how the traditional medicines trade has grown and changed. Links between medicinal plant conservation, scarcity and price on one hand and quality, safety and adulteration on the other are better understood. E-commerce in T&CM has grown exponentially, due to 51% of the world's population having internet access by 2017. Yet despite global policy goals for conservation and sustainable use, the challenges facing medicinal plants conservation are greater than ever before. Consequently, the need for co-operation between the health-care and conservation sectors recognised in 1988 is even greater today. And this is recognised in WHO's 2014-2023 strategy for traditional medicines, which identifies the need to raise awareness about issues of biodiversity and conservation as an important strategic action (WHO, 2013). This Special Issue is a small contribution towards that goal.
Topics: Asia; Commerce; Conservation of Natural Resources; Medicine, Traditional; Plants, Medicinal
PubMed: 30326261
DOI: 10.1016/j.jep.2018.10.006 -
Klinicka Onkologie : Casopis Ceske a... 2021Implementation of information and communication technologies in healthcare is a highly relevant topic nowadays. The speed of todays technological progress often exceeds... (Review)
Review
BACKGROUND
Implementation of information and communication technologies in healthcare is a highly relevant topic nowadays. The speed of todays technological progress often exceeds our ability to adapt to changes. The possibilities for integrating eHealth into healthcare are enormous. Nevertheless, implementation of this pillar of contemporary healthcare is in its very beginnings in the Czech Republic, especially in oncology.
PURPOSE
The article offers a systematic classification and definition of the benefits of eHealth with regard to the practical use by healthcare professionals, focusing mainly on the oncological practice in the Czech and global healthcare systems. The aim of the article is to provide relevant information about current challenges and solutions in eHealth programs in the Czech Republic to healthcare professionals.
CONCLUSION
Effective employment of e-Health in medical practice consists in the integration of the entire community of healthcare professionals, modern technologies and relevant parts of the political and economic system.
Topics: Czech Republic; Health Personnel; Humans; Medical Oncology; Telemedicine
PubMed: 34702043
DOI: 10.48095/ccko2021366 -
Current Pharmaceutical Design 20183D printed pharmaceutical products are revolutionizing the pharmaceutical industry as a prospective mean to achieve a personalized method of treatments acquired to the... (Review)
Review
BACKGROUND
3D printed pharmaceutical products are revolutionizing the pharmaceutical industry as a prospective mean to achieve a personalized method of treatments acquired to the specially designed need of each patient. It will depend upon age, weight, concomitants, pharmacogenetics and pharmacokinetic profile of the patient and thus transforming the current pharmaceutical market as a potential alternative to conventional medicine. 3D printing technology is getting more consideration in new medicine formulation development as a modern and better alternative to control many challenges associated with conventional medicinal products. There are many advantages of 3D printed medicines which create tremendous opportunities for improving the acceptance, accuracy and effectiveness of these medicines. In 2015, United State Food and Drug Administration has approved the first 3D printed tablet (Spritam®) and had shown the emerging importance of this technology.
METHODS
This review article summarizes as how in-depth knowledge of drugs and their manufacturing processes can assist to manage different strategies for various 3D printing methods. The principal goal of this review is to provide a brief introduction about the present techniques employed in tech -medicine evolution from conventional to a novel drug delivery system.
RESULTS
It is evidenced that through its unparalleled advantages of high-throughput, versatility, automation, precise spatial control and fabrication of hierarchical structures, the implementation of 3D printing for the expansion and delivery of controlled drugs acts as a pivotal role.
CONCLUSION
3D printing technology has an extraordinary ability to provide elasticity in the manufacturing and designing of composite products that can be utilized in programmable and personalized medicine. Personalized medicine helps in improving drug safety and minimizes side effects such as toxicity to individual human being which is associated with unsuitable drug dose.
Topics: Drug Delivery Systems; Drug Liberation; Humans; Pharmaceutical Preparations; Precision Medicine; Printing, Three-Dimensional; Technology, Pharmaceutical
PubMed: 30727872
DOI: 10.2174/1381612825666190206195808 -
Cytotherapy May 2021The Standards Coordinating Body for Gene, Cell, and Regenerative Medicines and Cell-Based Drug Discovery (SCB) supports the development and commercialization of... (Review)
Review
The Standards Coordinating Body for Gene, Cell, and Regenerative Medicines and Cell-Based Drug Discovery (SCB) supports the development and commercialization of regenerative medicine products by identifying and addressing industry-wide challenges through standards. Through extensive stakeholder engagement, the implementation of rapid microbial testing methods (RMTMs) was identified as a high-priority need that must be addressed to facilitate more timely release of products. Since 2017, SCB has coordinated efforts to develop standards for this area through surveys, weekly meetings, workshops, leadership in working groups and participation in standards development organizations. This article describes the results of these efforts and discusses the current landscape of RMTMs for regenerative medicine products. Based on discussions with stakeholders across the field, an overview of traditional culture-based methods and limitations, alternative microbial testing technologies and current challenges, fit-for-purpose rapid microbial testing and case studies, risk-based strategies for selection of novel rapid microbial test methods and ongoing standards efforts for rapid microbial testing are captured here. To this end, SCB is facilitating several initiatives to address challenges associated with rapid microbial testing for regenerative medicine products. Two documentary standards are under development: an International Organization for Standardization standard to provide the framework for a risk-based approach to selecting fit-for-purpose assays primarily intended for cell and gene therapy products and an ASTM standard guide focused on sampling methods for microbial testing methods in tissue-engineered medical products. Working with the National Institute of Standards and Technology, SCB expects to facilitate the process of developing publicly available microbial materials for inter-laboratory testing. These studies will help collect the data necessary to facilitate validation of novel rapid methods. Finally, SCB has been working to increase awareness of, dialog about and participation in efforts to develop standards in the regenerative medicine field.
Topics: Biological Assay; Reference Standards; Regenerative Medicine; Tissue Engineering
PubMed: 33775524
DOI: 10.1016/j.jcyt.2020.07.006 -
Journal of the American Medical... Jul 2016Precision medicine approaches disease treatment and prevention by taking patients' individual variability in genes, environment, and lifestyle into account. Although the...
Precision medicine approaches disease treatment and prevention by taking patients' individual variability in genes, environment, and lifestyle into account. Although the ideas underlying precision medicine are not new, opportunities for its more widespread use in practice have been enhanced by the development of large-scale databases, new methods for categorizing and representing patients, and computational tools for analyzing large datasets. New research methods may create uncertainty for both healthcare professionals and patients. In such situations, frameworks that address ethical, legal, and social challenges can be instrumental for facilitating trust between patients and providers, but must protect patients while not stifling progress or overburdening healthcare professionals. In this perspective, we outline several ethical, legal, and social issues related to the Precision Medicine Initiative's proposed changes to current institutions, values, and frameworks. This piece is not an exhaustive overview, but is intended to highlight areas meriting further study and action, so that precision medicine's goal of facilitating systematic learning and research at the point of care does not overshadow healthcare's goal of providing care to patients.
Topics: Confidentiality; Health Personnel; Humans; Informed Consent; Patient Participation; Precision Medicine
PubMed: 26977101
DOI: 10.1093/jamia/ocv215 -
Drug Discovery Today Dec 2015The stratified medicine companion diagnostic (CDx) cut-off decision integrates scientific, clinical, ethical, and commercial considerations, and determines its value to... (Review)
Review
The stratified medicine companion diagnostic (CDx) cut-off decision integrates scientific, clinical, ethical, and commercial considerations, and determines its value to developers, providers, payers, and patients. Competition already sharpens these issues in oncology, and might soon do the same for emerging stratified medicines in autoimmune, cardiovascular, neurodegenerative, respiratory, and other conditions. Of 53 oncology targets with a launched therapeutic, 44 have competing therapeutics. Only 12 of 141 Phase III candidates addressing new targets face no competition. CDx choices might alter competitive positions and reimbursement. Under current diagnostic incentives, payers see novel stratified medicines that improve public health and increase costs, but do not observe companion diagnostics for legacy treatments that would reduce costs. It would be in the interests of payers to rediscover their heritage of direct investment in diagnostic development.
Topics: Drug Industry; Humans; Molecular Diagnostic Techniques; Motivation; Precision Medicine; Public Health
PubMed: 26542060
DOI: 10.1016/j.drudis.2015.10.017