The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform
Deepak Gopal Shewade - One of the best experts on this subject based on the ideXlab platform.
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Metabolomics: A Tool Ahead for Understanding Molecular Mechanisms of Drugs and Diseases
Indian Journal of Clinical Biochemistry, 2015Co-Authors: Neel Jayesh Shah, Srinivasamurthy Sureshkumar, Deepak Gopal ShewadeAbstract:To refer to metabolomics as a new field is injustice to ancient doctors who used ants to diagnose the patients of diabetes having glycosuria. Measuring the levels of molecules in biological fluids believing them to be the representatives of biochemical pathways of carbohydrates, fats, proteins, nucleic acids or xenobiotic metabolism and deciphering meaningful data from it is what can be called as metabolomics, just as high glucose in urine suggests diabetes mellitus. Genomics, epigenetics, proteomics, transcriptomics finally converge to metabolomics, which are the signatures of mechanisms of bodily processes which is why understanding this science can have many applications. Just as a heap of stones does not make a house, having data of metabolite levels does not make it a science. Analyzing this data would help us in constructing biochemical pathways and their interactions. Analyzing the changes caused by a Drug in the metabolite levels would help us in deriving the mechanisms by which the Drug acts. Comparing metabolite levels in diseased with non-diseased, good-responders with poor-responders to a particular Drug can help in identifying new markers of a disease or response to a Drug respectively. Also, metabolite levels of an endogenous substrate can tell us the status of a person’s metabolizing enzymes and help in Drug Dose Titration. Generating hypothesis by identifying the new molecular markers and testing their utility in clinics seems to be the most promising approach in future. This review narrates the modes of quantifying and identifying metabolome, its proposed applications in diagnosis, monitoring and understanding the diseases and Drug responses. We also intend to identify hindrances in using metabolomics in clinical studies or experiments.
Michele Degregorio - One of the best experts on this subject based on the ideXlab platform.
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Abstract P211: Effect of Quality Improvement Discharge Tool in Heart Failure
Circulation-cardiovascular Quality and Outcomes, 2011Co-Authors: Abhijeet Basoor, Tarek Saleh, John F. Cotant, Kirit Patel, Benjamin Diaczok, Mina Todorov, Abdul Halabi, Nitin Doshi, Michele DegregorioAbstract:Background: Approximately 33% to 40% of older adults with heart failure are re-hospitalized within three months of discharge. The 6 month readmission rate is as high as 50%. Studies have shown that upward Titration of ACE I, ARB and beta-blockers after discharge resulted in reduced hospital re-admission rates, improved functional capacity and quality of life. In our quality improvement project two groups of patients admitted with primary diagnoses of CHF were studied. A discharge checklist was developed for the second group and its effect on Dose Titration and readmissions was studied. Methods: For the first group, all patients readmitted within 3 months for CHF from April 1, 2007 to December 31, 2007 were identified. The primary end point was the difference in dosage of ACE I/ARB and B- blockers between discharge and readmission. For the second group a CHF discharge checklist was used randomly in patients admitted with primary diagnoses of CHF from August 2008 to October 2009. Checklist included documentation regarding Dose Titration, relevant counselling, education and follow up instructions. Results: The first group had 127 readmissions for CHF within 3 months of discharge. The second had 48 patients in which CHF discharge checklist was used. The characteristics of two populations is shown in the Table. Second group readmissions for CHF were decreased after using the checklist from 68% (15/22) to 36% (8/22, p = 0.3). Compared to prior to using the checklist, the total number of readmissions within 6 months of discharge were reduced significantly from 25 to 9 (p = 0.04). Up Titration of diuretics in the hospital was associated with decreased readmissions (p=0.07, 4/14 vs 0/8). Conclusion: The use of CHF discharge checklist significantly improves Dose Titration of heart failure medications and decreases the total number of readmissions due to CHF. Furthermore among Drug Dose Titration, up Titration of diuretics tend to decrease CHF readmissions.
Neel Jayesh Shah - One of the best experts on this subject based on the ideXlab platform.
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Metabolomics: A Tool Ahead for Understanding Molecular Mechanisms of Drugs and Diseases
Indian Journal of Clinical Biochemistry, 2015Co-Authors: Neel Jayesh Shah, Srinivasamurthy Sureshkumar, Deepak Gopal ShewadeAbstract:To refer to metabolomics as a new field is injustice to ancient doctors who used ants to diagnose the patients of diabetes having glycosuria. Measuring the levels of molecules in biological fluids believing them to be the representatives of biochemical pathways of carbohydrates, fats, proteins, nucleic acids or xenobiotic metabolism and deciphering meaningful data from it is what can be called as metabolomics, just as high glucose in urine suggests diabetes mellitus. Genomics, epigenetics, proteomics, transcriptomics finally converge to metabolomics, which are the signatures of mechanisms of bodily processes which is why understanding this science can have many applications. Just as a heap of stones does not make a house, having data of metabolite levels does not make it a science. Analyzing this data would help us in constructing biochemical pathways and their interactions. Analyzing the changes caused by a Drug in the metabolite levels would help us in deriving the mechanisms by which the Drug acts. Comparing metabolite levels in diseased with non-diseased, good-responders with poor-responders to a particular Drug can help in identifying new markers of a disease or response to a Drug respectively. Also, metabolite levels of an endogenous substrate can tell us the status of a person’s metabolizing enzymes and help in Drug Dose Titration. Generating hypothesis by identifying the new molecular markers and testing their utility in clinics seems to be the most promising approach in future. This review narrates the modes of quantifying and identifying metabolome, its proposed applications in diagnosis, monitoring and understanding the diseases and Drug responses. We also intend to identify hindrances in using metabolomics in clinical studies or experiments.
Qing-yuan Zhang - One of the best experts on this subject based on the ideXlab platform.
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Managing Pain in Patients With Cancer: The Chinese Good Pain Management Experience
American Society of Clinical Oncology, 2017Co-Authors: Jie-jun Wang, Yu-guang Huang, Kun Wang, He-long Zhang, Li Zhang, Qing-yuan ZhangAbstract:Purpose: The number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer. Methods: We describe procedures for the selection, implementation, and assessment procedures for model cancer wards. We analyzed published results in areas of staff training and patient education, pain management in practice, analgesic Drugs administration, and patient follow-up and satisfaction. Results: Pain management training enabled medical staff to accurately assess the level of pain and to provide effective pain relief through timely dispensation of medication. Patients with good knowledge of treatment of pain were able to overcome their aversion to opioid Drugs and cooperate with nursing staff on pain assessment to achieve effective Drug Dose Titration. Consumption of strong opioid Drugs increased significantly; however, there was no change for weaker opioids. Higher pain remission rates were achieved for patients with moderate-to-severe pain levels. Proper patient follow-up after discharge enabled improved outcomes to be maintained. Conclusion: The GPM program has instituted a consistent and high standard of care for pain management at cancer wards and improved the quality of life for patients with cancer
Srinivasamurthy Sureshkumar - One of the best experts on this subject based on the ideXlab platform.
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Metabolomics: A Tool Ahead for Understanding Molecular Mechanisms of Drugs and Diseases
Indian Journal of Clinical Biochemistry, 2015Co-Authors: Neel Jayesh Shah, Srinivasamurthy Sureshkumar, Deepak Gopal ShewadeAbstract:To refer to metabolomics as a new field is injustice to ancient doctors who used ants to diagnose the patients of diabetes having glycosuria. Measuring the levels of molecules in biological fluids believing them to be the representatives of biochemical pathways of carbohydrates, fats, proteins, nucleic acids or xenobiotic metabolism and deciphering meaningful data from it is what can be called as metabolomics, just as high glucose in urine suggests diabetes mellitus. Genomics, epigenetics, proteomics, transcriptomics finally converge to metabolomics, which are the signatures of mechanisms of bodily processes which is why understanding this science can have many applications. Just as a heap of stones does not make a house, having data of metabolite levels does not make it a science. Analyzing this data would help us in constructing biochemical pathways and their interactions. Analyzing the changes caused by a Drug in the metabolite levels would help us in deriving the mechanisms by which the Drug acts. Comparing metabolite levels in diseased with non-diseased, good-responders with poor-responders to a particular Drug can help in identifying new markers of a disease or response to a Drug respectively. Also, metabolite levels of an endogenous substrate can tell us the status of a person’s metabolizing enzymes and help in Drug Dose Titration. Generating hypothesis by identifying the new molecular markers and testing their utility in clinics seems to be the most promising approach in future. This review narrates the modes of quantifying and identifying metabolome, its proposed applications in diagnosis, monitoring and understanding the diseases and Drug responses. We also intend to identify hindrances in using metabolomics in clinical studies or experiments.
