Digital health: trends, opportunities and challenges in medical devices, pharma and bio-technology

CSI Transactions on ICT, Journal Year: 2023, Volume and Issue: 11(1), P. 11 - 30

Published: April 1, 2023

Language: Английский

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Challenges in ARDS Definition, Management, and Identification of Effective Personalized Therapies

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(4), P. 1381 - 1381

Published: Feb. 9, 2023

Over the last decade, management of acute respiratory distress syndrome (ARDS) has made considerable progress both regarding supportive and pharmacologic therapies. Lung protective mechanical ventilation is cornerstone ARDS management. Current recommendations on in include use low tidal volume (VT) 4–6 mL/kg predicted body weight, plateau pressure (PPLAT) < 30 cmH2O, driving (∆P) 14 cmH2O. Moreover, positive end-expiratory should be individualized. Recently, variables such as power transpulmonary seem promising for limiting ventilator-induced lung injury optimizing ventilator settings. Rescue therapies recruitment maneuvers, vasodilators, prone positioning, extracorporeal membrane oxygenation, carbon dioxide removal have been considered patients with severe ARDS. Regarding pharmacotherapies, despite more than 50 years research, no effective treatment yet found. However, identification sub-phenotypes revealed that some failed to provide benefits when considering all can show beneficial effects these were stratified into specific sub-populations; example, those hyperinflammation/hypoinflammation. The aim this narrative review an overview current advances from pharmacological treatments, including personalized therapy.

Language: Английский

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Review of Personalized Medicine and Pharmacogenomics of Anti-Cancer Compounds and Natural Products

Genes, Journal Year: 2024, Volume and Issue: 15(4), P. 468 - 468

Published: April 8, 2024

In recent years, the FDA has approved numerous anti-cancer drugs that are mutation-based for clinical use. These have improved precision of treatment and reduced adverse effects side effects. Personalized therapy is a prominent hot topic current medicine also represents future direction development. With continuous advancements in gene sequencing high-throughput screening, research development strategies personalized developed rapidly. This review elaborates strategies, which include artificial intelligence, multi-omics analysis, chemical proteomics, computation-aided drug design. technologies rely on molecular classification diseases, global signaling network within organisms, new models all targets, significantly support medicine. Meanwhile, we summarize drugs, such as lorlatinib, osimertinib, other natural products, deliver therapeutic based genetic mutations. highlights potential challenges interpreting mutations combining while providing ideas pharmacogenomics cancer study.

Language: Английский

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Cardiopulmonary Exercise Testing in Heart Failure

Journal of Cardiovascular Development and Disease, Journal Year: 2024, Volume and Issue: 11(3), P. 70 - 70

Published: Feb. 20, 2024

Cardiopulmonary exercise testing (CPET) provides important information for the assessment and management of patients with heart failure. This measures respiratory cardiac responses to allows measurement oxygen uptake (V˙O2) max relationship between minute ventilation (V˙E) carbon dioxide excretion (V˙CO2). These two parameters help classify into categories that predict prognosis, a V˙O2 < 14 mL/kg/min V˙E/V˙CO2 slope >35 have poor prognosis. has been used in drug trials determine complex physiologic medications, such as angiotensin-converting enzyme inhibitors. For example, study enalapril demonstrated peak was 14.6 ± 1.6 on placebo 15.8 2.0 after 15 days treatment. The slopes were 43 8 39 7 enalapril. Chronic failure reduced physical activity measured by cardiopulmonary are associated increases BNP, several studies rehabilitation is reductions BNP V˙O2. Therefore, measurements can benefits provide indirect estimates changes In addition, microRNAs status skeletal muscle during rehabilitation. However, CPET requires complicated technology, simpler methods measure could clinicians manage their patients. Recent advances technology led development portable equipment, which be various routine activities, walking upstairs, sweeping floor, making bed, better understanding patient’s current symptoms. Finally, smart watches about cardiorespiratory system, identify unexpected clinical problems, monitor response organized use these devices contribute certain aspects patients’ care, monitoring treatment atrial fibrillation. review article comprehensive overview discusses principles, methods, applications, prognostic implications.

Language: Английский

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A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Feb. 24, 2025

Acute respiratory distress syndrome (ARDS) is a severe complication of critical illness, characterized by bilateral lung infiltrates and hypoxemia. Its clinical pathophysiological heterogeneity poses challenges for both diagnosis treatment. This review outlines the evolution ARDS definitions, discusses underlying pathophysiology ARDS, examines implications its heterogeneity. Traditional definitions required invasive mechanical ventilation relied on arterial blood gas measurements to calculate PaO2/FiO2 ratio. Recent updates have expanded these criteria include patients receiving noninvasive support, such as high-flow nasal oxygen, adoption SpO2/FiO2 ratio an alternative While changes broaden diagnostic criteria, they also introduce additional complexity. heterogeneity—driven varying etiologies, subphenotypes, biological mechanisms—highlights limitations uniform management approach. Emerging evidence highlights presence distinct each defined unique molecular characteristics, offering pathway more precise therapeutic targeting. Advances in omics technologies—encompassing genomics, proteomics, metabolomics—are paving way precision-medicine approaches with potential revolutionize tailoring interventions individual patient profiles. paradigm shift from broad categories precise, subphenotype-driven care holds promise redefining landscape treatment and, ultimately, improving outcomes this complex, multifaceted syndrome.

Language: Английский

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Glucocorticoid therapy for acute respiratory distress syndrome: Current concepts

Journal of Intensive Medicine, Journal Year: 2024, Volume and Issue: 4(4), P. 417 - 432

Published: April 1, 2024

Acute respiratory distress syndrome (ARDS), a fatal critical disease, is induced by various insults. ARDS represents major global public health burden, and the management of continues to challenge healthcare systems globally, especially during pandemic coronavirus disease 2019 (COVID-19). There remains no confirmed specific pharmacotherapy for ARDS, despite advances in understanding its pathophysiology. Debate about potential role glucocorticoids (GCs) as promising clinical therapy. Questions regarding GC agent, dose, duration patients with need be answered, because substantial variations administration regimens across studies. heterogeneity likely affects therapeutic actions exogenous GCs. This review includes progress determining mechanisms action applications COVID-19 pandemic.

Language: Английский

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Integrative proteomic profiling of lung tissues and blood in acute respiratory distress syndrome

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: May 1, 2023

Introduction Acute respiratory distress syndrome and acute lung injury (ARDS/ALI) still lack a recognized diagnostic test pharmacologic treatments that target the underlying pathology. Methods To explore sensitive non-invasive biomarkers associated with pathological changes in of direct ARDS/ALI, we performed an integrative proteomic analysis blood samples from lipopolysaccharide (LPS)-induced ARDS mice COVID-19-related patients. The common differentially expressed proteins (DEPs) were identified based on combined serum model. clinical value DEPs was validated plasma proteomics cases ARDS. Results We 368 504 LPS-induced mice. Gene ontology (GO) classification Kyoto Encyclopedia Genes Genomes (KEGG) showed these tissues primarily enriched pathways, including IL-17 B cell receptor signaling response to stimuli. In contrast, mostly involved metabolic pathways cellular processes. Through network protein-protein interactions (PPI), diverse clusters samples. further 50 commonly upregulated 10 downregulated Internal validation parallel-reacted monitor (PRM) external Expression Omnibus (GEO) datasets confirmed DEPs. then patients six (HP, LTA4H, S100A9, SAA1, SAA2, SERPINA3) good prognostic value. Discussion These can be viewed as could potentially serve targets for early detection treatment especially hyperinflammatory subphenotype.

Language: Английский

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Increased pro-SFTPB in HDL promotes the pro-inflammatory transition of HDL and represents a sign of poor prognosis in ARDS patients

Journal of Translational Medicine, Journal Year: 2025, Volume and Issue: 23(1)

Published: Jan. 16, 2025

Language: Английский

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Genetic Determinants of the Acute Respiratory Distress Syndrome

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(11), P. 3713 - 3713

Published: May 27, 2023

Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition that arises from multiple causes, including sepsis, pneumonia, trauma, and severe coronavirus disease 2019 (COVID-19). Given the heterogeneity of causes lack specific therapeutic options, it crucial to understand genetic molecular mechanisms underlie this condition. The identification risks pharmacogenetic loci, which are involved in determining drug responses, could help enhance early patient diagnosis, assist risk stratification patients, reveal novel targets for pharmacological interventions, possibilities repositioning. Here, we highlight basis importance most common approaches understanding pathogenesis ARDS its critical triggers. We summarize findings screening variation via genome-wide association studies analyses based on other approaches, such as polygenic scores, multi-trait analyses, or Mendelian randomization studies. also provide an overview results rare using Next-Generation Sequencing techniques their links with inborn errors immunity. Lastly, discuss overlap between COVID-19 by causes.

Language: Английский

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Anti-inflammatory therapies for acute respiratory distress syndrome

Expert Opinion on Investigational Drugs, Journal Year: 2023, Volume and Issue: 32(12), P. 1143 - 1155

Published: Nov. 24, 2023

Introduction Treatments for the acute respiratory distress syndrome (ARDS) are mainly supportive, and ventilatory management represents a key approach in these patients. Despite progress pharmacotherapy, anti-inflammatory strategies treatment of ARDS have shown controversial results. Positive outcomes with pharmacologic nonpharmacologic treatments been found two different biological subphenotypes ARDS, suggesting that, personalized medicine approach, pharmacotherapy can be effective.

Language: Английский

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