51 research outputs found
A new polygenic score for refractive error improves detection of children at risk of high myopia but not the prediction of those at risk of myopic macular degeneration
Background
High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ −6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER.
Methods
The PGS was derived from genome-wide association studies in participants of UK Biobank, CREAM Consortium, and Genetic Epidemiology Research on Adult Health and Aging. MMD severity was quantified by a deep learning algorithm. Prediction of HM was quantified as the area under the receiver operating curve (AUROC). Prediction of severe MMD was assessed by logistic regression.
Findings
In independent samples of European, African, South Asian and East Asian ancestry, the PGS explained 19% (95% confidence interval 17–21%), 2% (1–3%), 8% (7–10%) and 6% (3–9%) of the variation in SER, respectively. The AUROC for HM in these samples was 0.78 (0.75–0.81), 0.58 (0.53–0.64), 0.71 (0.69–0.74) and 0.67 (0.62–0.72), respectively. The PGS was not associated with the risk of MMD after accounting for SER: OR = 1.07 (0.92–1.24).
Interpretation
Performance of the PGS approached the level required for clinical utility in Europeans but not in other ancestries. A PGS for refractive error was not predictive of MMD risk once SER was accounted fo
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Diagnosis and assessment of microbial infections with host and microbial MicroRNA profiles
Multiple breakpoint method for measuring effect of antibiotics on endocarditis strains of streptococci.
Improving Compliance with Helicobacter Pylori Eradication Therapy: When and How?
Compliance with therapy is the single most important factor in
Helicobacter pylori (H. pylori) eradication. Poorer levels
of compliance with therapy are associated with significantly lower levels of
eradication. Numerous factors can contribute to achieving good levels of
compliance. These include the complexity and duration of treatment. It is also
important that the physician is motivated to ensure eradication is confirmed and
the patient is sufficiently informed to empower him or her to achieve high
levels of compliance. Compliance is also contingent on medication regimes that
are simple, safe, tolerable and efficacious. The opportunity to improve
compliance exists at every point of contact between the patient and the medical
services. Experts and opinion leaders in the field can play a role by ensuring
that physicians are educated and motivated enough to encourage and support
compliance with H. pylori eradication therapy. Both patients
and physicians need to be aware of the importance of the bacterium in causing
disease. The importance of the doctor—patient relationship is
paramount. Pragmatic strategies that may be of assistance may come in the form
of polypills, combined Blister Packs, adjuvant therapies and modified release
compounds. Colleagues such as pharmacists and nurse specialists can also play an
important role and should be actively engaged. Structured aftercare and follow
up offers the best chance for ensuring compliance and subsequent eradication of
the H. pylori pathogen
Efficacy of high dose intravenous heparin for treatment of left ventricular thrombi with high embolic risk
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