Search

Background: The objective was to examine the short‐term risk and predictors of anaemia following initiation of combination antiretroviral therapy (cART) in HIV‐infected patients from the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian‐Pacific, and Caribbean and Central and South America regions of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) collaboration. Methods: Anaemia was defined as haemoglobin of < 10 g/dL. Patients were included if they started cART with three or more drugs, had prior haemoglobin of > = 10 g/dL, and had one or more follow‐up haemoglobin tests. Factors associated with anaemia up to 12 months were examined using Cox proportional hazards models and stratified by IeDEA region. Results: Between 1998 and 2008, 19,947 patients initiated cART with baseline and follow‐up haemoglobin tests (7358, 7289, 2853, 471, 1550 and 426 in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian‐Pacific, and Caribbean and Central and South America regions, respectively). At initiation, anaemia was found in 45% of Western Africa patients, 29% of Eastern Africa patients, 21% of Southern Africa patients, 36% of Central Africa patients, 15% of patients in Asian‐Pacific and 14% of patients in Caribbean and Central and South America. Among patients with haemoglobin of > = 10 g/dL at baseline (13,445), the risks of anaemia were 18.2, 6.6, 9.7, 22.9, 11.8 and 19.5 per 100 person‐years in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian, and Caribbean and Central and South America regions, respectively. Factors associated with anaemia were female sex, low baseline haemoglobin level, low baseline CD4 count, more advanced disease stage, and initial cART containing zidovudine. Conclusions: In data from 34 cohorts of HIV‐infected patients from sub‐Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin monitoring was recommended in patients at risk of developing anaemia following cART initiation., Background According to World Health Organization (WHO) estimations [1], access to combination antiretroviral treatment (cART) has improved dramatically in low‐ and middle‐income countries with limited resources. At the end of [...]

Genomic medicine is poised to offer a broad array of new genome-scale screening tests which might lead to a phenomenon in which multiple abnormal genomic findings are discovered, analogous to the 'incidentalomas' that are often discovered in radiological studies. Several steps that could be taken to help avoid these substantive risks to the practice of genomically personalized medicine are presented.

The highest priority new initiative resulting from the 1985–86 National Library of Medicine Long Range Planning exercise initiated by NLM Director Dr. Donald A.B. Lindberg was the creation of new information resources and services related to molecular biology and genetics, termed "biotechnology information". Beginning with existing NLM resources and research projects associated with molecular data, and with Lindberg's enthusiastic support, the institution launched a Congressionally-mandated Center that has become an essential part of 21st century biomedical science. [ABSTRACT FROM AUTHOR]

From 1992 to 1995 Donald A.B. Lindberg M.D. served concurrently as the founding director of the National Coordination Office (NCO) for High Performance Computing and Communications (HPCC) and NLM director. The NCO and its successors coordinate the Presidential-level multi-agency HPCC research and development (R&D) program called for in the High-Performance Computing Act of 1991. All large Federal science and technology R&D and applications agencies, including those involved in medical research and health care, participate in the now-30-year-old program. Lindberg's HPCC efforts built on his pioneering work in developing and applying advances in computing and networking to meet the needs of the medical research and health care communities. As part of NLM's participation in HPCC, Lindberg promoted R&D and demonstrations in telemedicine, including testbeds, medical data privacy, medical decision-making, and health education. That telemedicine technologies were ready to meet demand during the COVID-19 pandemic is testament to Lindberg's visionary leadership. [ABSTRACT FROM AUTHOR]

It is increasingly important to design local biomedical databases with attention to naming and classification standards. In some cases, common nomenclature will not be suitable, having been designed for another purpose, but much will be useful. Development of standard nomenclature is a social responsibility in the electronic biomedical community. (MSE)

Abstract Introduction The eMERGE (electronic MEdical Records and GEnomics) Network is an NHGRI-supported consortium of five institutions to explore the utility of DNA repositories coupled to Electronic Medical Record (EMR) systems for advancing discovery in genome science. eMERGE also includes a special emphasis on the ethical, legal and social issues related to these endeavors. Organization The five sites are supported by an Administrative Coordinating Center. Setting of network goals is initiated by working groups: (1) Genomics, (2) Informatics, and (3) Consent & Community Consultation, which also includes active participation by investigators outside the eMERGE funded sites, and (4) Return of Results Oversight Committee. The Steering Committee, comprised of site PIs and representatives and NHGRI staff, meet three times per year, once per year with the External Scientific Panel. Current progress The primary site-specific phenotypes for which samples have undergone genome-wide association study (GWAS) genotyping are cataract and HDL, dementia, electrocardiographic QRS duration, peripheral arterial disease, and type 2 diabetes. A GWAS is also being undertaken for resistant hypertension in ≈2,000 additional samples identified across the network sites, to be added to data available for samples already genotyped. Funded by ARRA supplements, secondary phenotypes have been added at all sites to leverage the genotyping data, and hypothyroidism is being analyzed as a cross-network phenotype. Results are being posted in dbGaP. Other key eMERGE activities include evaluation of the issues associated with cross-site deployment of common algorithms to identify cases and controls in EMRs, data privacy of genomic and clinically-derived data, developing approaches for large-scale meta-analysis of GWAS data across five sites, and a community consultation and consent initiative at each site. Future activities Plans are underway to expand the network in diversity of populations and incorporation of GWAS findings into clinical care. Summary By combining advanced clinical informatics, genome science, and community consultation, eMERGE represents a first step in the development of data-driven approaches to incorporate genomic information into routine healthcare delivery.

Hewlett-Packard Corporation grant enabled Harvard Medical School to begin using computer technology in medical educational applications. Hardware and software selection, integration into the curriculum, teaching the use of computers, cost, successful applications, knowledge base access, simulations, video and graphics teaching programs, and clinical case book are discussed. (MLW)

The evolution from classical genetics to biotechnology, an area of research involving key macromolecules in living cells, is chronicled and the current state of biotechnology is described, noting related advances in computing and clinical medicine. (MSE)