Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.3.1.21 (CPT)
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Disease-onset time (DOT) and disease trajectory concepts were applied to derive an Alzheimer's disease (AD) progression population model using the clinical dementia rating scale-sum of boxes (CDR-SOB) from the AD neuroimaging initiative (ADNI) database. The model enabled the estimation of a DOT and a disease trajectory for each patient. The model also allowed distinguishing fast and slow-progressing subpopulations according to the functional assessment questionnaire, normalized hippocampal volume, and CDR-SOB score at study entry. On the basis of these prognostic factors, 81% of the mild cognitive impairment (MCI) subjects could correctly be assigned to slow or fast progressers, and 77% of MCI to AD conversions could be predicted whereas the model described correctly 84% of the conversions. Finally, synchronization of the biomarker-time profiles on estimated individual DOT virtually expanded the population observation period from 3 to 8 years. DOT-disease trajectory model is a powerful approach that could be applied to many progressive diseases.CPT: Pharmacometrics & Systems Pharmacology (2013) 2, e78; doi:10.1038/psp.2013.54; advance online publication 2 October 2013.
CPT Pharmacometrics Syst Pharmacol 2013 Oct 02
PMID:Modeling Alzheimer's Disease Progression Using Disease Onset Time and Disease Trajectory Concepts Applied to CDR-SOB Scores From ADNI. 2408 49

The revolution in scientific innovation, driven by the engines of enabling technologies, is increasingly capable of deconstructing complex disease processes for the express purpose of reconstructing patient-specific solutions. These revelations in biological mechanisms provide the pressure points of opportunity for radical discovery and development to advance modern health care. Principles of mechanism-based discovery and their translation into therapeutic algorithms will, however, be challenged in the near term by emerging global public health crises that currently have no immediate solutions: chronic diseases, obesity, antibiotic-resistant infections, dementia, depression. The threat of these pandemics (multiplied in an increasingly aging population), the global burden of disease they represent, and their worldwide assault on human capital underscore the importance of continued and accelerated investments in science-propelled practice advancement, converting new knowledge into delivery of tangible health solutions. In that context, this annual issue of CPT on therapeutics innovations highlights remarkable recent successes in the discovery-development paradigm translating molecular innovations into diagnostic and therapeutic realities that transform the management of disease, impacting global health.
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PMID:Molecular insights provide the critical path to disease mitigation. 2435 48

Purpose: Vision loss has been associated with negative health outcomes, but population-level data on vision loss are lacking, and there are limited data on low vision-associated outcomes among women, minorities, and older age groups. The objective of this study was to determine the prevalence of vision loss in a nationally representative sample of older US adults and examine its association with hip fracture, depression, anxiety, and dementia. Methods: Cross-sectional analysis of Medicare claims data from 2014. Blindness and low vision, hip fracture, depression, anxiety, and dementia were identified using Chronic Condition Warehouse indicator variables based on ICD-9 and CPT codes. Multivariable logistic regression models were built to examine whether sociodemographic factors were associated with vision loss and to determine the relationships between vision loss and hip fracture and neuropsychiatric outcomes. Results: The prevalence of low vision in the Medicare population was 994/100,000 and increased significantly with age, Black (1,854/100,000) or Hispanic (2,862/100,000) race/ethnicity, female gender (1,181/100,000), and Medicaid eligibility (2,975/100,000). After adjusting for relevant comorbidities, low vision was significantly associated with hip fracture (adjusted odds ratio [AOR] 2.54, 95% CI: 2.52-2.57), depression (AOR 3.99, 95% CI: 3.97-4.01), anxiety (AOR 2.93, 95% CI: 2.91-2.95), and dementia (AOR 3.91, 95% CI: 3.88-3.93). Conclusion: Blindness and low vision are common in older Americans, especially among racial and ethnic minorities and lower income individuals, and associated with hip fracture, depression, anxiety, and dementia. The prevention and treatment of vision loss may reduce health disparities and negative health outcomes in the aging population.
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PMID:Blindness and Visual Impairment in the Medicare Population: Disparities and Association with Hip Fracture and Neuropsychiatric Outcomes. 3106 38