Saturday, October 3, 2020

Identifying pathophysiological bases of disease in COVID-19

 Transl Med Commun 2020;5(1):15. doi: 10.1186/s41231-020-00067-w. Epub 2020 Sep 22.

Abstract

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that can affect lung physiology encompassing a wide spectrum of severities, ranging from asymptomatic and mild symptoms to severe and fatal cases; the latter including massive neutrophil infiltration, stroke and multiple organ failure. Despite many recents findings, a clear mechanistic description underlying symptomatology is lacking. In this article, we thoroughly review the available data involving risk factors, age, gender, comorbidities, symptoms of disease, cellular and molecular mechanisms and the details behind host/pathogen interaction that hints at the existence of different pathophysiological mechanisms of disease. There is clear evidence that, by targeting the angiotensin-converting enzyme II (ACE2) -its natural receptor-, SARS-CoV-2 would mainly affect the renin-angiotensin-aldosterone system (RAAS), whose imbalance triggers diverse symptomatology-associated pathological processes. Downstream actors of the RAAS cascade are identified, and their interaction with risk factors and comorbidities are presented, rationalizing why a specific subgroup of individuals that present already lower ACE2 levels is particularly more susceptible to severe forms of disease. Finally, the notion of endotype discovery in the context of COVID-19 is introduced. We hypothesize that COVID-19, and its associated spectrum of severities, is an umbrella term covering different pathophysiological mechanisms (endotypes). This approach should dramatically accelerate our understanding and treatment of disease(s), enabling further discovery of pathophysiological mechanisms and leading to the identification of specific groups of patients that may benefit from personalized treatments.

Friday, May 22, 2020

"Educational policymakers who praise online education for its efficiency mistake the point of education. Education is not meant to be efficient. It is meant to develop the minds and characters of young Americans—a process that takes time."

The Limitations of the Virtual Classroom



"Educational policymakers who praise online education for its efficiency mistake the point of education. Education is not meant to be efficient. It is meant to develop the minds and characters of young Americans—a process that takes time."

Ethics in the age of COVID-19

Ethics in the age of COVID-19

Thursday, May 21, 2020

Coronavirus Has Exposed the Burden of Mental Illness

Coronavirus Has Exposed the Burden of Mental Illness



"The reality of mental illness is that disasters and crisis seem to increase its severity, because much of what bubbles to the surface is underreported and untreated mental illness. We live in a country where one in five adults experience mental illness and one in 25 experience serious mental illness; however, the average delay between symptom onset and treatment initiation is 11 years. Those statistics do not begin to summarize the true extent of suffering that these individuals endure, but they do mean you most likely know someone who is struggling with mental illness. However, in 2018, only 40 percent of adults who experienced mental illness received treatment." 

"Deep reading has in large part informed our development as humans, in ways both physiological and cultural. And it is what ultimately allowed Americans to become 'We the People,'..."



The Erosion of Deep Literacy



"Deep reading has in large part informed our development as humans, in ways both physiological and cultural. And it is what ultimately allowed Americans to become 'We the People,' capable of self-government. If we are losing the capacity for deep reading, we must also be prepared to lose other, perhaps even more precious parts of what deep reading has helped to build."

Monday, May 18, 2020

Clinical trials and the COVID-19 pandemic

 2020 Jan-Apr;23(1):4-5. doi: 10.1967/s002449912014.

Clinical trials and the COVID-19 pandemic.

Author information

1
Former Consultant Medical Oncologist, Formerly, Lead Clinician of the Melanoma Unit, Imperial College at Charing Cross Hospital, London, U.K. sretsas@msn.com.

Abstract

"...but why think? Why not try the experiment?..." John Hunter (1728-1793), in a letter to Edward Jenner. August 2nd, 1775. When Galen of Pergamum (2nd c. A.D.), physician, philosopher and experimentalist, sought to ascertain the therapeutic properties of Theriac, an antidote of repute against poisons, he resorted to an experiment. Theriac or Theriaca was a compound drug, containing in some versions used in antiquity numerous components; Galen's own composition included over 70 ingredients! One of its uses was as an antidote against snakebites, a frequent peril for the Roman armies marching on in sandals. Galen spent most of his life in Rome and was elevated to Imperial Physician at the court of Marcus Aurelius, who apparently took daily doses of Theriac, which among other components included opium. Describing the experiment to his friend Pison, Galen wrote, "as I could not possibly conduct a trial on humans, I experimented on roosters" For his experiment, Galen, studied two groups of roosters, but he doesn't tell us how many animals he included in each category. Both groups were exposed to poisonous snakebites. All roosters who were fed with theriac prior to exposure to viper bites survived, whereas in the second group that had not received prophylactic Theriac, all roosters died. Not only is Galen's methodology remarkable, preceding the modern randomised trial by eighteen centuries, but more importantly, it is notable for his ethical stance at a time when sensitivities about human rights, prevalent in our times, were largely absent in societies of widespread slavery. For example, Mithridates VI (132-63 BC), the King of Pontus who is credited with the first use of Theriac, tested its efficacy on criminals and slaves. For his experiment Galen used the random allocation of treatment, today's prospective randomised clinical trial, implemented in the evaluation of novel therapies, widely used internationally, particularly in cancer research! This experimental method used for ascertaining the efficacy of new drugs became established after the second half of the 20th century and is now firmly entrenched as a research tool. On the other hand, the retrieval of information from observational studies or non-randomised series is considered scientifically inferior and is often dismissed or ignored as irrelevant or anecdotal. Such is the compulsion for the randomised study that in the midst of the COVID-19 pandemic, respected physicians and scientists appeared in the media hesitant to recommend the use of protective facial masks, as there was no evidence of benefit for their use from prospective randomised studies in the general population! Logic had no place in the argument! COVID-19, caused by the SARS-CoV-2 new corona virus, brought to the fore the randomised trial, as well as, the ethical dilemmas that surround the allocation of treatment at random, in the face of a devastating pandemic. Anthony Fauci, distinguished infectious diseases expert and an adviser to the President of the USA, at a recent briefing from the Situation Room of the White House, endorsed categorically and unreservedly the randomised trial for the evaluation of drugs potentially effective against SARS-CoV-2, in patients afflicted with COVID-19. A few days later on April 8th, 2020, Professor Sotiris Tsiodras, scientific advisor to the Greek Government for COVID-19 and an expert on infectious diseases, when asked by a journalist about chloroquine, he responded, "Antony Fauci is correct. Nevertheless, we give the drug to everyone, that is, not half of the patients will receive it, and the other half will not". If we accept that the randomised trial represents the unique, impregnable method of evaluating new treatments-several clinicians dispute this dogma. -the question arises how will treatments be allocated to patients? According to the Declaration of Helsinki participation of a subject in a clinical trial requires their explicit written consent. Will, a potentially hypoxic patient rapidly deteriorating, be able to understand what is being asked of them, and will that patient be in a position to provide consent? And if that patient refuses to be randomised, what are the options? Is it his/her right to request the active treatment that a fellow patient is receiving in the next bed? Although the Declaration of Helsinki allows the option of no treatment or even placebo, where no known treatment is available for a certain condition, such as COVID-19, it also emphasizes that "while the primary purpose of medical research is to generate new knowledge, this goal can never take precedence over the rights and interests of individual research subjects". Consider now the physicians and nurses on the first line of the battle against the pandemic; to the enormous pressures and risks that they experience daily, they may have to endure the added psychological burden of the randomised trial, knowing that half of their patients are receiving the promising drug, whilst the other half are denied the chance of potential benefit. When during the Medical Research Council's randomized trial of streptomycin, one senior physician contracted tuberculosis, the Medical Research Council obtained supplies for him outside the trial. In this brief instance of medical history, the equipoise, the scientific imperative, all arguments and other justifications for providing treatment at random, were thrown out of the window in favour of the human factor! Why is randomization necessary? Because-it is presumed-the process of randomising subjects, protects the study from the selective inclusion of patients with favourable characteristics, thus inadvertently allowing or facilitating a falsely favourable result for the drug or treatment under investigation. However, the process of randomising patients does not necessarily result in the randomisation of the characteristics of their disease. Exactly because of this, at the end of a randomised study, even if the prognostic variables are evenly represented and balanced in the strata, further confirmation of the result is sought with a statistical multifactorial analysis. Such multifactorial analyses can also be applied to a non-randomised group of patients engaged in the trial of a new drug. Since the middle of the 20th century a generation of physicians have been trained to dismiss, or are incapable of evaluating the validity of a treatment beyond the established etiquette of the randomised study. This, some have argued, constitutes intellectual indolence, it is not scientific robustness. Pandits foresee that the world will be different after the end of this pandemic. Perhaps human ingenuity will seek new investigative methods that will render the randomised clinical trial obsolete, both, on methodological and ethical grounds. Until then and even if we have to accept the scientific supremacy of the randomised study in the evaluation of novel therapies, the ethical considerations in the unprecedented circumstances of a relentless pandemic demand a more humane approach, befitting the beneficent precepts of the Hippocratic tradition.

Policies to reduce food insecurity: An ethical imperative

 2020 May 14;222:112943. doi: 10.1016/j.physbeh.2020.112943. [Epub ahead of print]

Policies to reduce food insecurity: An ethical imperative.

Author information

1
Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, U.S.. Electronic address: dpmiller@bu.edu.
2
Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, U.S.. Electronic address: mthomas7@bu.edu.

Abstract

A quarter of U.S. households receive food assistance, yet more than 11% still experience food insecurity annually. We argue that an expansion-oriented approach to food and nutrition assistance policy is an ethical imperative. Drawing on values from the Capability Approach and Social Empathy Model and supported by empirical evidence, we propose an ethical framework characterized by four principles that can be used to assess and inform the development of just food policies. We argue that policies should (1) embrace compassion, (2) create opportunity, (3) consider essential needs, and (4) promote knowledge and empathy. In an applied case, we evaluate current SNAP policy in terms of those principles and offer recommendations to promote justice in the design and implementation of SNAP and other food policies.

Friday, May 15, 2020

"You took an Oath!": Engaging Medical Students About the Importance of Oaths and Codes Through Film and Television

 2020 May 13. doi: 10.1007/s10730-020-09411-x. [Epub ahead of print]

"You took an Oath!": Engaging Medical Students About the Importance of Oaths and Codes Through Film and Television.

Author information

1
Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL, 60153, USA. kparsi@luc.edu.
2
Neiswanger Institute for Bioethics, Loyola University Chicago Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL, 60153, USA.

Abstract

In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress (Principles of biomedical ethics, 8th ed. Oxford University Press, Oxford, 2019). Yet, many issues that medical students will face (as students and as physicians) are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively used in ethics education of medical students. Oaths and codes can be engagingly taught using a range of techniques including visual narrative. Excerpts from television and film can be used to highlight challenging ethical dilemmas in a variety of settings, taking the learning from the theoretical to the more applied while offering context.

Moral in whose eyes? Cross-cultural differences in moral decision making and behaviour

 2020 May 6. doi: 10.1002/ijop.12681. [Epub ahead of print]

Moral in whose eyes? Cross-cultural differences in moral decision making and behaviour.

Seo M1Na J2Kim YH3.

Author information

1
Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
2
Department of Psychology, Sogang University, Seoul, Republic of Korea.
3
Department of Psychology, Yonsei University, Seoul, Republic of Korea.

Abstract

All people want to feel that they are morally adequate. People tend to evaluate their moral adequacy by judging their behaviour through their own eyes (first-person perspective) or the eyes of others (third-person perspective). People in all cultures use both perspectives, but there may be cultural variations in which perspective takes precedence. By conducting two studies, we explore the way people in face cultures are more likely to secure their moral self-regard through the eyes of others (vs. their own eyes), whereas the opposite is true in case of people from dignity cultures. Study 1 found that people from face culture (Korean participants) cheated to a lesser extent when others were invoked (vs. not invoked), but people from dignity culture (American participants) were not affected by this priming. Study 2 found that moral intentions were more strongly influenced by what participants perceived others to do in moral situations in face (vs. dignity) cultures. In contrast, moral intentions were found to be more strongly influenced by what they believed they should do in moral situations in dignity (vs. face) cultures.

"For the human lineage, footprint sites have been especially important in furthering scientists’ understanding of our own evolutionary journey."



Prehistoric Footprints Provide Rare Snapshot of Ancient Human Group Behavior



"For the human lineage, footprint sites have been especially important in furthering scientists’ understanding of our own evolutionary journey. The iconic 3.66-million-year-old paleontological site of Laetoli in Tanzania, for instance, provided some of the earliest definitive evidence of upright walking in our ancient ancestors."

How Much Are We Spending To Prevent One COVID-19 Death — Millions, Billions, Trillions? Nobody Knows

How Much Are We Spending To Prevent One COVID-19 Death — Millions, Billions, Trillions? Nobody Knows


“The only U.S.-based academic study empirically linking lockdowns to lower deaths is a recent economics paper identifying California’s lockdown as the reason for its lower death rate. The problem with this paper is that the authors find that the lockdown began to reduce California’s deaths just five days after being implemented. The effect is too early to derive from the supposed cause.”
The massively intrusive and costly government lockdowns are looking more and more like the most expensive and least effective regulations ever imposed in this nation’s history. 
Will anyone be held responsible for the calamity, or will we just go on pretending it was worth it?

"Yet, sometimes, a reviewer, carried away by their own enthusiasm for the subject, will end up producing a piece that says more about them than it does about the book."

A Radical Proposal: Book reviews should review books

Give us more judgement, more opinions[,] and more criticism

"Yet, sometimes, a reviewer, carried away by their own enthusiasm for the subject, will end up producing a piece that says more about them than it does about the book. Then, I think, it becomes the responsibility of a conscientious literary editor to return to their writer and, however distinguished and successful they are, to suggest, gently, that it would be a useful public service to the reader to indicate whether the book in front of them for review is worth purchasing."

Tuesday, April 21, 2020

Can we craft a theory in which space and time aren’t assumed to exist?

Can we craft a theory in which space and time aren’t assumed to exist?

In some versions of quantum gravity, time itself condenses into existence.



According to Oriti, the field of quantum gravity now needs more radical ideas to push itself forward. That's because something new is needed to bring the ideas around LQG, which has been developed at the microscopic scale, up to the scale of the Universe as a whole. Over the past decade or so, he has led research in the direction of Group Field Theory (GFT) condensate cosmology, which proposes that the Universe as we know it came about through a kind of hydrodynamic condensation process.
“One can think of this process in GFT condensate cosmology as being analogous to steam,” he says. “Steam is a phase in which the entities which constitute all of space—or atoms of space as we call them—can find themselves condensing into water, which is our analogy for space-time.”
According to this version of LQG, once this transition takes place—at the beginning of the Universe for example—then the familiar constructs of space and time are born. Awkwardly, even speaking of a 'transition' or 'beginning' implicitly assumes the notion of time, or a process happening over time. In the context of these ideas, we must learn to forget that.

Coronavirus is causing a mental health crisis. Here’s how to fight it.

Coronavirus is causing a mental health crisis. Here’s how to fight it.

Covid-19 patients and those caring for them could be especially at risk for anxiety, depression, and other conditions.

"Even under more normal circumstances, prolonged loneliness can contribute to depression and anxiety, as well as to physical health problems. One 2016 study, for example, found that being lonely was associated with an increased risk of stroke and heart disease. Today, the ordinary risks of loneliness could be magnified by the stress of living during a pandemic. For people who are social distancing right now, “there is a high risk that they’re going to become more anxious, much more depressed, and it’s going to have longer-term effects,” Rima Styra, an associate professor of psychiatry at the University of Toronto, told Vox.
Overall, a lot of people around the world are experiencing a dip in mental well-being. Factors from “looming severe shortages of resources” to the “imposition of unfamiliar public health measures that infringe on personal freedoms” are likely to increase emotional distress during this time, psychiatry professors Betty Pfefferbaum and Carol S. North wrote in a paper published this week in the New England Journal of Medicine."

"The metaphors of neuroscience – computers, coding, wiring diagrams and so on – are inevitably partial. That is the nature of metaphors..."

Why your brain is not a computer


"The metaphors of neuroscience – computers, coding, wiring diagrams and so on – are inevitably partial. That is the nature of metaphors, which have been intensely studied by philosophers of science and by scientists, as they seem to be so central to the way scientists think. But metaphors are also rich and allow insight and discovery. There will come a point when the understanding they allow will be outweighed by the limits they impose, but in the case of computational and representational metaphors of the brain, there is no agreement that such a moment has arrived. From a historical point of view, the very fact that this debate is taking place suggests that we may indeed be approaching the end of the computational metaphor. What is not clear, however, is what would replace it."

Sunday, March 8, 2020

"Technology alters the human condition; it also gives it expression."

The Ancients’ Tech Anxiety 


On the shallowness of reading mythology as sci-fi


"With respect to inventiveness of robot-like beings, the Greeks displaced some of this wonder to the divine realm. But the inventive Hephaestus, at least, is surely the most human of the all-too-human gods: lame, short, ugly. Mayor endorses the idea that, as scholar Jessica Riskin put it, “mythology blurs the distinction between technology and divine power.” The ancient stories, then, suggest that technology involves a godlike creativity, yet is often used for the satisfaction of our more bestial desires. Daedalus’ wings are a means to and an expression of human freedom, but they empower also the ingrained rashness of youth. Technology alters the human condition; it also gives it expression."

How #coronavirus is upending corporate America

How coronavirus is upending corporate America



"The $10 billion biotech Moderna developed a potential coronavirus vaccine in record time, Andrew Dunn reports. Andrew sat down with Stephane Bancel, the company's CEO, to talk about the company's hopes of pioneering a new way of developing vaccines."

Saturday, March 7, 2020

Increased expression of plasminogen activator inhibitor-1 (PAI-1) is associated with depression and depressive phenotype in C57Bl/6J mice

 2019 Dec;237(12):3419-3430. doi: 10.1007/s00221-019-05682-0. Epub 2019 Nov 16.

Increased expression of plasminogen activator inhibitor-1 (PAI-1) is associated with depression and depressive phenotype in C57Bl/6J mice.

Author information

1
Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, 75708, USA.
2
Department of Pathology, The University of Mississippi Medical Center, Jackson, MS, USA.
3
Department of Epidemiology and Biostatistics, School of Rural and Community Health, The University of Texas Health Science Center at Tyler, Tyler, TX, 75708, USA.
4
Department of Behavioral Health, Child and Adolescent Psychiatry, The University of Texas Health Science Center at Tyler, 11937 US Highway 271, Tyler, TX, 75708, USA. Richard.Idell@uthct.edu.

Abstract

Plasminogen activator inhibitor 1 (PAI-1), which is elevated in numerous disease states, has been implicated as a stress-related protein involved in the pathogenesis of depression. We measured PAI-1 in the plasma of healthy and depressed individuals and assessed plasminogen activator (PA) expression and regulation by PAI-1 in cultured normal human astrocytes (NHA). Elevated plasma PAI-1 levels were found in depressed patients. Brain tissues from depressed individuals also showed stronger expression of hippocampal PAI-1 by confocal imaging in comparison to healthy individuals. Using a lipopolysaccharide-induced inflammatory model of depression in mice, we measured PAI-1 in murine plasma and brain, by ELISA and immunohistochemistry, respectively. Similar elevations were seen in plasma but not in brain homogenates of mice exposed to LPS. We further correlated the findings with depressive behavior. Ex vivo experiments with NHA treated with proinflammatory cytokines implicated in the pathogenesis of depression showed increased PAI-1 expression. Furthermore, these studies suggest that urokinase-type plasminogen activator may serve as an astrocyte PA reservoir, able to promote cleavage of brain-derived neurotrophic factor (BDNF) during stress or inflammation. In summary, our findings confirm that derangements of PAI-1 variably occur in the brain in association with the depressive phenotype. These derangements may impede the availability of active, mature (m)BDNF and thereby promote a depressive phenotype.

'Your Bills Don’t Get Sick': Workers Say #Coronavirus Prevention Isn’t Easy

'Your Bills Don’t Get Sick': Workers Say Coronavirus Prevention Isn’t Easy



"Uber, Lyft, Doordash and other delivery companies have advised drivers or delivery workers to stay safe — and to stay home if they aren’t feeling well. But advocates argue that creates a difficult choice for many workers."

The morality of evolution and a return to subjectivity

 2020 Feb 17. doi: 10.1057/s11231-020-09231-5. [Epub ahead of print]

The morality of evolution and a return to subjectivity.

Author information

1
, 975A Heritage Village, Southbury, CT, 06488, USA. mariorendon7@gmail.com.

Abstract

Today societies display, almost uniformly, an aggressive demeanor that can hardly be covered by diplomacy; they are always prepared for war. The prophecy is repeatedly fulfilled and today we are engaged in protracted wars while fearing universal destruction. This basic attitude irremediably corrupts our consciousness and blemishes our self. The biological underpinnings of how we got to this point, psychologically, and the historical sublimations involved are explored here. The result, today, is that we live using a minimum of our human capacity at the huge cost in crucial energetic waste, while nature has started to protest. The self-feeding destructive mechanism is inordinate objectification, at the expense of our unique subjective power. Evolutionarily designed for balanced self-regulation-the sublimation of a dual instinctual disposition backed up by a dimorphic body and brain-nature warns us we have detoured from the moral blueprint and, were we to continue it will be at our own risk. We need to review our moral theories and return to our critical pre-patriarchal subjectivity, which was resourceful, dually-fed, balanced, and discriminating. That subjectivity is now largely replaced by pre-emptive, ideological cognitive modules and stereotypes that block intelligent dialogue and appear to be already modeled on a false Utopia of artificial intelligences.

"...virtually all of the increase in current smoking prevalence in Minnesota is associated with the e-cig tax and the associated decrease in successful quits."

The Impact of E-Cig Taxes on Smoking Rates: Evidence From Minnesota


"Specifically, the 95 percent e-cig tax in Minnesota, the first such tax increase in the nation, led to a decrease in cigarette smoking cessation by about 1.14 percentage points -- approximately a 5 percent increase in relative smoking participation. In fact, virtually all of the increase in current smoking prevalence in Minnesota is associated with the e-cig tax and the associated decrease in successful quits."

The Inconvenient Truth about Your “Authentic” Self

The Inconvenient Truth about Your “Authentic” Self

To actually feel authentic, you might have to betray your true nature

"But authenticity is a slippery thing. Although most people would define authenticity as acting in accordance with your idiosyncratic set of values and qualities, research has shown that people feel most authentic when they conform to a particular set of socially approved qualities, such as being extroverted, emotionally stable, conscientious, intellectual and agreeable.
This is the paradox of authenticity: In order to reap the many of the benefits of feeling authentic, you may have to betray your true nature."



#Coronavirus - Are there two strains and is one more deadly? ("...One is not more deadly than the other.")

Coronavirus: Are there two strains and is one more deadly?

"But the differences between the two identified strains are tiny. In fact, they can’t really be considered to be separate “strains”, says Jones. And many of the genetic differences won’t affect the production of proteins, and so won’t change the way the virus works, or the symptoms it causes, he says. One is not more deadly than the other."

Read more: https://www.newscientist.com/article/2236544-coronavirus-are-there-two-strains-and-is-one-more-deadly/#ixzz6FqEN8KVB

Amid growing #coronavirus cases, another number increasing: recoveries

Amid growing coronavirus cases, another number increasing: recoveries

At least 15 coronavirus patients in the U.S. are said to have recovered.
Isolation does not mean a patient is particularly dangerous. The measure is put into place simply to prevent spread of the virus in the community.
"That's why these seemingly drastic measures are being taken," Safdar, the medical director of infection control and prevention at UW Health in Madison, Wisconsin, told NBC News. "If you're a positive COVID-19 case, you stay in isolation until testing shows that you are negative."

Update on emerging biomarkers in lung cancer

 2019 Jan;11(Suppl 1):S81-S88. doi: 10.21037/jtd.2019.01.46.

Update on emerging biomarkers in lung cancer.

Author information

1
Houston Methodist Hospital, Cancer Center, Houston, Texas, USA.
2
Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
3
Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA.

Abstract

There has been considerable progress made in identifying oncogenic driver mutations in advanced lung cancer. The recognition that lung cancer is actually an umbrella classification that is comprised of multiple molecular subgroups has had a profound impact on how medical oncologists make treatment decisions. These mutations are clinically important as available targeted therapies can achieve significant responses and prolonged disease control. This review will summarize the current guidelines for biomarker testing and available therapeutic agents.

Testing for coronavirus is expanded to patients who have a doctor’s order, CDC says

Testing for coronavirus is expanded to patients who have a doctor’s order, CDC says


Experts have questioned whether the United States can meet the likely surge in testing demand that will follow the change in guidelines.
Two kinds of coronavirus tests in the United States have FDA emergency use authorizations and are in use nationwide.
One kind is the CDC test kits that are distributed to public health laboratories across the country, and another test has been designed and used by New York state.
At least 163 coronavirus cases have been reported across 16 states, most of them in California and Washington states.