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    2234 results match your criteria Annual Review of Medicine[Journal]

    1 OF 45

    Basket Studies: Redefining Clinical Trials in the Era of Genome-Driven Oncology.
    Annu Rev Med 2017 Nov 8. Epub 2017 Nov 8.
    Early Drug Development Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; email: , ,
    Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncology care. "Basket studies," or histology-agnostic clinical trials in genomically selected patients, represent one important research tool to continue making progress in this field. Read More

    Innate Immunity and Neurodegeneration.
    Annu Rev Med 2017 Nov 6. Epub 2017 Nov 6.
    Institute of Innate Immunity, University Hospitals Bonn, Bonn 53127, Germany; email:
    The innate immune system plays diverse roles in health and disease. It represents the first line of defense against infection and is involved in tissue repair, wound healing, and clearance of apoptotic cells and cellular debris. Excessive or nonresolving innate immune activation can lead to systemic or local inflammatory complications and cause or contribute to the development of inflammatory diseases. Read More

    Targeting RAGE Signaling in Inflammatory Disease.
    Annu Rev Med 2017 Nov 6. Epub 2017 Nov 6.
    University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida 33136, USA.
    The receptor for advanced glycation end-products (RAGE) is a multiligand pattern recognition receptor implicated in diverse chronic inflammatory states. RAGE binds and mediates the cellular response to a range of damage-associated molecular pattern molecules (DAMPs) including AGEs, HMGB1, S100s, and DNA. RAGE can also act as an innate immune sensor of microbial pathogen-associated molecular pattern molecules (PAMPs) including bacterial endotoxin, respiratory viruses, and microbial DNA. Read More

    Novel Latency Reversal Agents for HIV-1 Cure.
    Annu Rev Med 2017 Nov 3. Epub 2017 Nov 3.
    Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah 84112; email:
    Antiretroviral therapy (ART) has rendered HIV-1 infection a treatable illness; however, ART is not curative owing to the persistence of replication-competent, latent proviruses in long-lived restingTcells. Strategies that target these latently infected cells and allow immune recognition and clearance of this reservoir will be necessary to eradicate HIV-1 in infected individuals. This review describes current pharmacologic approaches to reactivate the latent reservoir so that infected cells can be recognized and targeted, with the ultimate goal of achieving an HIV-1 cure. Read More

    Molecular and Genomic Determinants of Response to Immune Checkpoint Inhibition in Cancer.
    Annu Rev Med 2017 Nov 3. Epub 2017 Nov 3.
    Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02215, USA; email:
    Molecularly targeted therapy and immunotherapy have dramatically changed the landscape of available treatment options for patients with advanced cancer. Improved understanding of the molecular and genomic features of cancers over the last decade has led to the development of successful targeted therapies and the field of precision cancer medicine. As a result of these advances, patients whose tumors harbor select molecular alterations are eligible for treatment with targeted therapies active against the unique molecular aberration. Read More

    PCSK9 Inhibitors: Mechanisms of Action, Metabolic Effects, and Clinical Outcomes.
    Annu Rev Med 2017 Nov 2. Epub 2017 Nov 2.
    Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado 80045; email: ,
    Atherosclerotic cardiovascular disease (ASCVD) is associated with significant morbidity and mortality worldwide. Increased serum levels of lowdensity lipoprotein cholesterol (LDL-C) are an independent risk factor for ASCVD, and clinical trial data have shown that lowering LDL-C generally reduces cardiovascular risk. Until recently, 3-hydroxy-3-methylglutarylcoenzyme A (HMG-CoA) reductase inhibitors (statins) have been the main therapy for lowering LDL-C. Read More

    Use and Misuse of Opioids in Chronic Pain.
    Annu Rev Med 2017 Oct 13. Epub 2017 Oct 13.
    Treatment Research Institute, Philadelphia, Pennsylvania 19106; email:
    The prescribing of opioid analgesics for pain management-particularly for management of chronic noncancer pain (CNCP)-has increased more than fourfold in the United States since the mid-1990s. Yet there is mounting evidence that opioids have only limited effectiveness in the management of CNCP, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths. These concerns have led to critical revisiting and modification of prior pain management practices (e. Read More

    Refinement of the Affordable Care Act: A Progressive Perspective.
    Annu Rev Med 2017 Oct 13. Epub 2017 Oct 13.
    Division of General Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida 33136; email: ,
    The Affordable Care Act (ACA) was the most significant expansion of health coverage since Medicare and Medicaid were enacted. The law resulted in approximately 13-20 million uninsured persons gaining coverage. Despite these gains, the ACA has numerous shortcomings. Read More

    Evidence for Genetic Risk Contributing to Long-Term Adverse Treatment Effects in Childhood Cancer Survivors.
    Annu Rev Med 2017 Oct 13. Epub 2017 Oct 13.
    University of Alabama, Birmingham, Alabama 35233, USA; email:
    Survivors of childhood cancer are at increased risk for therapy-related morbidities and mortality. Although the demographic and clinical factors predicting the risk for long-term effects of cancer therapy are well known, the impact of genetic risk for specific late effects is less clearly defined. Here, we review the extant literature and recent research describing genetic modifiers to risk for the more common late effects of childhood cancer therapy. Read More

    New-Generation High-Potency and Designer Antibodies: Role in HIV-1 Treatment.
    Annu Rev Med 2017 Oct 13. Epub 2017 Oct 13.
    Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892; email: ,
    Broadly neutralizing antibodies (bNAbs) have been evaluated as promising agents in the fight against infectious diseases. HIV-1-specific bNAbs, in particular, have been tested in both preventive and therapeutic modalities. Multiple bNAbs have been isolated, characterized, and assessed in vitro and in vivo, but no single antibody appears to possess the breadth and potency that may be needed if it is to be used in the treatment of HIV-1 infection. Read More

    New Concepts in the Treatment of Malignant Pleural Mesothelioma.
    Annu Rev Med 2017 Oct 13. Epub 2017 Oct 13.
    Division of General Thoracic Surgery, Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
    Malignant pleural mesothelioma (MPM) is a highly aggressive and generally incurable cancer. Current anti-MPM chemotherapy-based treatments are only marginally effective, and long-term survival remains an unmet goal. Nonetheless, in selected cases, personalized surgery-based multimodality treatments (MMT) have been shown to significantly extend survival. Read More

    Lymphedema: Pathogenesis and Novel Therapies.
    Annu Rev Med 2017 Sep 6. Epub 2017 Sep 6.
    Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065; email: , , ,
    Lymphedema affects up to 1 in 6 patients who undergo treatment for a solid tumor in the United States. Its prevalence has increased as more effective oncologic therapies have improved patient survival, but there remains no definitive cure. Recent research has elucidated new details in the pathogenesis of the disease and has demonstrated that it is fundamentally an immunologic progress that ultimately results in inflammation, fibroadipose deposition, impaired lymphangiogenesis, and dysfunctional lymphatic pumping. Read More

    Zika, Chikungunya, and Other Emerging Vector-Borne Viral Diseases.
    Annu Rev Med 2017 Aug 28. Epub 2017 Aug 28.
    Institut Pasteur, Biology of Infection Unit, INSERM Unité 1117, 75006 Paris, France; email: ,
    Arthropod-borne viruses (arboviruses) have a long history of emerging to infect humans, but during recent decades, they have been spreading more widely and affecting larger populations. This is due to several factors, including increased air travel and uncontrolled mosquito vector populations. Emergence can involve simple spillover from enzootic (wildlife) cycles, as in the case of West Nile virus accompanying geographic expansion into the Americas; secondary amplification in domesticated animals, as seen with Japanese encephalitis, Venezuelan equine encephalitis, and Rift Valley fever viruses; and urbanization, in which humans become the amplification hosts and peridomestic mosquitoes, mainly Aedes aegypti, mediate human-to-human transmission. Read More

    Circulating Tumor DNA: Measurement and Clinical Utility.
    Annu Rev Med 2017 Aug 28. Epub 2017 Aug 28.
    Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland 21287; email:
    Circulating tumor DNA (ctDNA) is a component of the "naked" DNA found in blood. It can be isolated from plasma and represents combined genetic material from the primary tumor and metastases. Quantitative and qualitative information about a cancer, including mutations, can be derived using digital polymerase chain reaction and other technologies. Read More

    Refinement of the Affordable Care Act.
    Annu Rev Med 2017 Aug 25. Epub 2017 Aug 25.
    Baker Institute for Public Policy and Rice University, Houston, Texas 77251; email:
    Regardless of what legislation the federal government adopts to address health insurance coverage for nonelderly Americans, private insurance will likely play a major role. This article begins by listing some of the major reasons critics dislike the Affordable Care Act, then discusses the validity of these concerns from an economics perspective. Criticisms of the ACA include the increased role of government in healthcare, the ACA's implicit income redistribution, and concern about high and rising insurance premiums. Read More

    Understanding Peripartum Cardiomyopathy.
    Annu Rev Med 2017 Aug 16. Epub 2017 Aug 16.
    Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA 19014; email:
    Peripartum cardiomyopathy (PPCM) is the unexplained loss of maternal cardiac systolic function in the period surrounding parturition. PPCM affects women worldwide and is a leading cause of maternal mortality. The cause of PPCM has remained elusive until recently. Read More

    Atrial Fibrillation Ablation.
    Annu Rev Med 2017 Aug 14. Epub 2017 Aug 14.
    Michigan Medicine, University of Michigan, Ann Arbor, MI 48109; email:
    The prevalence of atrial fibrillation (AF) has risen significantly over the past two decades. Catheter ablation is an increasingly utilized treatment strategy and has evolved significantly over the same time period. Successful ablation improves patient symptoms, reduces stroke risk, and can preserve or improve cardiac function. Read More

    Lysosomal Proteins as a Therapeutic Target in Neurodegeneration.
    Annu Rev Med 2017 Jan;68:445-458
    Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611-4296; email: ,
    Several proteins that are mutated in lysosomal storage diseases are linked to neurodegenerative disease. This review focuses on some of these lysosomal enzymes and transporters, as well as current therapies that have emerged from the lysosomal storage disease field. Given the deeper genetic understanding of lysosomal defects in neurodegeneration, we explore why some of these orphan disease drug candidates are also attractive targets in subpopulations of individuals with neurodegenerative disease. Read More

    Mechanisms and New Strategies for Primary Sjögren's Syndrome.
    Annu Rev Med 2017 Jan;68:331-343
    Department of Physiology, School of Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece; email:
    Primary Sjögren's syndrome (SS) is a common chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands, mainly salivary and lacrimal, resulting in oral and ocular dryness, although virtually any organ system can be affected. SS-related systemic manifestations are classified as either related to the presence of periepithelial infiltrates in exocrine and parenchymal organs or resulting from immunocomplex deposition due to B cell hyperactivity with increased risk for B cell lymphoma development. Activation of both innate and adaptive immune pathways contributes to disease pathogenesis, with prominent interferon (IFN) signatures identified in both peripheral blood and affected salivary gland tissues. Read More

    Update on Alzheimer's Disease Therapy and Prevention Strategies.
    Annu Rev Med 2017 Jan;68:413-430
    Laboratory of Chemical Biology and Signal Transduction, The Rockefeller University, New York, NY 10065; email:
    Alzheimer's disease (AD) is the primary cause of age-related dementia. Effective strategies to prevent and treat AD remain elusive despite major efforts to understand its basic biology and clinical pathophysiology. Significant investments in therapeutic drug discovery programs over the past two decades have yielded some important insights but no blockbuster drugs to alter the course of disease. Read More

    Therapeutics Targeting Drivers of Thoracic Aortic Aneurysms and Acute Aortic Dissections: Insights from Predisposing Genes and Mouse Models.
    Annu Rev Med 2017 Jan;68:51-67
    Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029.
    Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling. Read More

    Controversies in the Treatment of Ductal Carcinoma in Situ.
    Annu Rev Med 2017 Jan;68:197-211
    Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065; email:
    Ductal carcinoma in situ (DCIS) accounts for 20% of all newly diagnosed breast cancers. Mastectomy was once the gold standard for the treatment of DCIS; however, breast-conserving surgery (BCS) has been adopted as the treatment of choice for patients with small, screen-detected lesions. Both adjuvant radiation and hormonal therapy following BCS have been demonstrated in randomized trials to reduce the risk of both invasive and DCIS recurrence, but neither affects survival. Read More

    Catastrophic Antiphospholipid Syndrome: Candidate Therapies for a Potentially Lethal Disease.
    Annu Rev Med 2017 Jan;68:287-296
    Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY 10021.
    Catastrophic antiphospholipid syndrome (CAPS) is a potentially lethal disease that presents with rapidly progressive multiple organ thromboses. Anticoagulation, corticosteroids, intravenous immunoglobulin, and plasma exchange are the most commonly used treatments for CAPS patients. However, the high mortality despite these medications necessitates new treatment strategies. Read More

    Lymphangioleiomyomatosis: A Monogenic Model of Malignancy.
    Annu Rev Med 2017 Jan;68:69-83
    Department of Internal Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio 45267; email:
    Lymphangioleiomyomatosis (LAM) is a rare, low-grade, metastasizing neoplasm that arises from an unknown source, spreads via the lymphatics, and targets the lungs. All pulmonary structures become infiltrated with benign-appearing spindle and epithelioid cells (LAM cells) that express smooth-muscle and melanocyte-lineage markers, harbor mTOR-activating mutations in tuberous sclerosis complex (TSC) genes, and recruit abundant stromal cells. Elaboration of lymphangiogenic growth factors and matrix remodeling enzymes by LAM cells enables their access to lymphatic channels and likely drives the cystic lung remodeling that often culminates in respiratory failure. Read More

    Transcatheter Aortic Valve Replacement: State of the Art and Future Directions.
    Annu Rev Med 2017 Jan 14;68:15-28. Epub 2016 Nov 14.
    Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905; email:
    Transcatheter aortic valve replacement (TAVR) is a transformational and rapidly evolving treatment for patients with aortic stenosis who require valve replacement. Novel technological advancements have made this percutaneous minimally invasive therapy a first-line treatment for many patients at extreme risk for conventional cardiac surgery. New devices and improvements in existing devices have reduced procedural complications, and scientific trials are investigating the role of TAVR in lower-risk aortic stenosis populations, in patients with aortic regurgitation, and in patients with bicuspid aortic valve disease. Read More

    Mechanisms and Medicines for Remyelination.
    Annu Rev Med 2017 Jan 17;68:431-443. Epub 2016 Nov 17.
    Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195; email:
    Demyelination of central nervous system axons, associated with traumatic injury and demyelinating diseases such as multiple sclerosis, causes impaired neural transmission and ultimately axon degeneration. Consequently, extensive research has focused on signaling systems that promote myelinating activity of oligodendrocytes or promote production of new oligodendrocytes from oligodendrocyte progenitor cells. Many receptor systems, notably including growth factor receptors and G protein-coupled receptors, control myelination. Read More

    CAR T Cell Therapy for Solid Tumors.
    Annu Rev Med 2017 Jan 17;68:139-152. Epub 2016 Nov 17.
    Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; email:
    The field of cancer immunotherapy has been re-energized by the application of chimeric antigen receptor (CAR) T cell therapy in cancers. These CAR T cells are engineered to express synthetic receptors that redirect polyclonal T cells to surface antigens for subsequent tumor elimination. Many CARs are designed with elements that augment T cell persistence and activity. Read More

    Ebola: Anatomy of an Epidemic.
    Annu Rev Med 2017 Jan 21;68:359-370. Epub 2016 Oct 21.
    Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30333; email: , , ,
    As of the end of March 2016, the West Africa epidemic of Ebola virus disease (Ebola) had resulted in a total of 28,646 cases, 11,323 of them fatal, reported to the World Health Organization. Guinea, Liberia, and Sierra Leone were most heavily affected, but Ebola cases were exported to several other African and European countries as well as the United States, with limited further transmission, including to healthcare workers. We review the descriptive epidemiology of the outbreak, novel aspects and insights concerning the unprecedented response, scientific observations, and public health implications. Read More

    Antimalarial Drugs as Immune Modulators: New Mechanisms for Old Drugs.
    Annu Rev Med 2017 Jan 21;68:317-330. Epub 2016 Oct 21.
    Division of Rheumatology, Department of Medicine, University of Washington, Seattle, Washington 98195; email
    The best known of the naturally occurring antimalarial compounds are quinine, extracted from cinchona bark, and artemisinin (qinghao), extracted from Artemisia annua in China. These and other derivatives are now chemically synthesized and remain the mainstay of therapy to treat malaria. The beneficial effects of several of the antimalarial drugs (AMDs) on clinical features of autoimmune disorders were discovered by chance during World War II. Read More

    Biosimilars: The US Regulatory Framework.
    Annu Rev Med 2017 Jan 28;68:243-254. Epub 2016 Oct 28.
    US Food and Drug Administration, Silver Spring, Maryland 20993; email: , ,
    With the passage of the Biologics Price Competition and Innovation Act of 2009, the US Food and Drug Administration established an abbreviated pathway for developing and licensing biosimilar and interchangeable biological products. The regulatory framework and the technical requirements of the US biosimilars program involve a stepwise approach that relies heavily on analytical methods to demonstrate through a "totality of the evidence" that a proposed product is biosimilar to its reference product. By integrating analytical, pharmacological, and clinical data, each of which has limitations, a high level of confidence can be reached regarding clinical performance. Read More

    Next-Generation Sequencing and Result Interpretation in Clinical Oncology: Challenges of Personalized Cancer Therapy.
    Annu Rev Med 2017 Jan 2;68:113-125. Epub 2016 Nov 2.
    Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy.
    The tools of next-generation sequencing (NGS) technology, such as targeted sequencing of candidate cancer genes and whole-exome and -genome sequencing, coupled with encouraging clinical results based on the use of targeted therapeutics and biomarker-guided clinical trials, are fueling further technological advancements of NGS technology. However, NGS data interpretation is associated with challenges that must be overcome to promote the techniques' effective integration into clinical oncology practice. Specifically, sequencing of a patient's tumor often yields 30-65 somatic variants, but most of these variants are "passenger" mutations that are phenotypically neutral and thus not targetable. Read More

    The Type I Interferonopathies.
    Annu Rev Med 2017 Jan 2;68:297-315. Epub 2016 Nov 2.
    Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; email:
    Type I interferons (IFNs) play a central role in the immune defense against viral infections. Type I IFN activation is induced by pattern-recognition receptors of the innate immune system that sense pathogen-derived nucleic acids. Cellular responses to type I IFN signaling are orchestrated by a complex network of regulatory pathways that involve both the innate and adaptive immune system. Read More

    Obstructive Sleep Apnea: Update and Future.
    Annu Rev Med 2017 Jan 5;68:99-112. Epub 2016 Oct 5.
    Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104.
    Obstructive sleep apnea (OSA) is a worldwide disease whose prevalence is increasing as obesity rates increase. The link between obesity and OSA is likely to be the deposition of fat in the tongue, compromising upper airway size. The role of obesity varies in different ethnic groups, with Chinese being particularly sensitive to increases in weight. Read More

    Tissue Engineering: Toward a New Era of Medicine.
    Annu Rev Med 2017 Jan 30;68:29-40. Epub 2016 Sep 30.
    Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157; email: ,
    The goal of tissue engineering is to mitigate the critical shortage of donor organs via in vitro fabrication of functional biological structures. Tissue engineering is one of the most prominent examples of interdisciplinary fields, where scientists with different backgrounds work together to boost the quality of life by addressing critical health issues. Many different fields, such as developmental and molecular biology, as well as technologies, such as micro- and nanotechnologies and additive manufacturing, have been integral for advancing the field of tissue engineering. Read More

    Nonalcoholic Steatohepatitis.
    Annu Rev Med 2017 Jan 5;68:85-98. Epub 2016 Oct 5.
    Division of Gastroenterology, School of Medicine, Duke University, Durham, North Carolina 27710; email:
    Nonalcoholic steatohepatitis (NASH) has become a major cause of cirrhosis and liver-related deaths worldwide. NASH is strongly associated with obesity and the metabolic syndrome, conditions that cause lipid accumulation in hepatocytes (hepatic steatosis). It is not well understood why some, but not other, individuals with hepatic steatosis develop NASH. Read More

    Noninvasive Prenatal DNA Testing: The Vanguard of Genomic Medicine.
    Annu Rev Med 2017 Jan 10;68:459-472. Epub 2016 Oct 10.
    Mother Infant Research Institute, Tufts Medical Center, Boston, Massachusetts 02111; email:
    Noninvasive prenatal DNA testing is the vanguard of genomic medicine. In only four years, this screening test has revolutionized prenatal care globally and opened up new prospects for personalized medicine for the fetus. There are widespread implications for increasing the scope of human genetic variation that can be detected before birth, and for discovering more about maternofetal and placental biology. Read More

    Management of Systemic Lupus Erythematosus During Pregnancy.
    Annu Rev Med 2017 Jan 21;68:271-285. Epub 2016 Sep 21.
    Hospital for Special Surgery, Weill Cornell Medicine, New York, NY 10021; email:
    Reproductive issues including contraception, fertility, and pregnancy are important components of the comprehensive care of women with systemic lupus erythematosus (SLE). SLE pregnancies are complicated due to risk for maternal disease exacerbation and potential for fetal and neonatal complications. Pre-pregnancy assessment is important to identify patients with severe disease-related damage who should avoid pregnancy, counsel patients to conceive when disease has been stable and inactive on appropriate medications, and assess relevant risk factors including renal disease, antiphospholipid antibody, and anti-Ro/SS-A and anti-La/SS-B antibodies. Read More

    Cardiac Pacing and Defibrillation Devices: Cost and Effectiveness.
    Annu Rev Med 2017 Jan 21;68:1-13. Epub 2016 Sep 21.
    Medicine Service Line, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104.
    Implantable cardiac pacing and defibrillation devices are effective and commonly used therapies for patients with cardiac rhythm disorders. Because device implantation is not easily reversible, as well as the high healthcare costs inherent in device use, a clear understanding of the clinical benefits relative to costs is essential for both appropriate clinical use and rational policy making. Cardiac implantable electronic devices (CIEDs) have been among the best-investigated therapies in medicine; these devices have been the topic of numerous clinical and economic evaluations during the past 30 years. Read More

    Neprilysin Inhibitors: Emerging Therapy for Heart Failure.
    Annu Rev Med 2017 Jan 21;68:41-49. Epub 2016 Sep 21.
    Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; email: , ,
    Biologically active natriuretic peptides (NPs) are an integral part of cardiac homeostasis as they help to maintain sodium and fluid balance. When homeostasis is perturbed by neurohormonal activation in heart failure, levels of NPs rise in response. Neprilysin (NEP) is a naturally occuring enzyme that breaks down NPs. Read More

    Highly Effective New Treatments for Psoriasis Target the IL-23/Type 17 T Cell Autoimmune Axis.
    Annu Rev Med 2017 Jan 23;68:255-269. Epub 2016 Sep 23.
    Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY 10065; email: ,
    Psoriasis vulgaris, affecting the skin, is one of the most common organ-specific autoimmune diseases in humans. Until recently, psoriasis was treated by agents or approaches discovered largely through serendipity. Many of the available drugs were inherently quite toxic when used as continuous treatment for many years in this chronic disease. Read More

    Oral Combination Therapies for Hepatitis C Virus Infection: Successes, Challenges, and Unmet Needs.
    Annu Rev Med 2017 Jan 23;68:345-358. Epub 2016 Sep 23.
    Duke University School of Medicine and Duke Clinical Research Institute, Durham, North Carolina 27715; email:
    The current standard of care for the treatment of hepatitis C virus (HCV) consists of interferon-free direct-acting antiviral (DAA) regimens, including combinations of DAAs and fixed-dose combination pills. DAAs for HCV are likely to be heralded as one of medicine's greatest advancements. Viral eradication rates are pushing 100% for many HCV-infected populations, including patients with HIV/HCV coinfection, decompensated cirrhosis, liver and kidney transplants, and end-stage liver disease. Read More

    Resection of Liver Metastases in Colorectal Cancer in the Era of Expanding Systemic Therapy.
    Annu Rev Med 2017 Jan 28;68:183-196. Epub 2016 Sep 28.
    North Western Hepatobiliary Unit, Aintree University Hospital, Liverpool L9 7AL, United Kingdom; email:
    About 25% of patients with colorectal cancer develop liver metastases after resection of the primary tumor, and surgical resection of the metastases offers the only opportunity for long-term survival. However, only 20% of patients present with resectable disease. Deciding which patients should be offered surgery, and which should receive additional treatment in the form of perioperative chemotherapy, is complex. Read More

    Toward an Effective Ebola Virus Vaccine.
    Annu Rev Med 2017 Jan 28;68:371-386. Epub 2016 Sep 28.
    Department of Microbiology and Immunology, Sidney Kimmel Medical College,Thomas Jefferson University, Philadelphia, Pennsylvania 19107; email:
    Long-term control of viral outbreaks requires the use of vaccines to impart acquired resistance and ensuing protection. In the wake of an epidemic, established immunity against a particular disease can limit spread and significantly decrease mortality. Creation of a safe and efficacious vaccine against Ebola virus (EBOV) has proven elusive so far, but various inventive strategies are now being employed to counteract the threat of outbreaks caused by EBOV and related filoviruses. Read More

    Esophageal Adenocarcinoma: Screening, Surveillance, and Management.
    Annu Rev Med 2017 Jan 31;68:213-227. Epub 2016 Aug 31.
    Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas 77030; email: ,
    Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Read More

    Precision Medicine in Myelodysplastic Syndromes and Leukemias: Lessons from Sequential Mutations.
    Annu Rev Med 2017 Jan 7;68:127-137. Epub 2016 Sep 7.
    Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195; email:
    Precision medicine can be simply defined as the identification of personalized treatment that matches patient-specific clinical and genomic characteristics. Since the completion of the Human Genome Project in 2003, significant advances have been made in our understanding of the genetic makeup of diseases, especially cancers. The identification of somatic mutations that can drive cancer has led to the development of therapies that specifically target the abnormal proteins derived from these mutations. Read More

    The End of Nihilism: Systemic Therapy of Advanced Non-Small Cell Lung Cancer.
    Annu Rev Med 2017 Jan 7;68:153-168. Epub 2016 Sep 7.
    Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Deerfield Beach, Florida 33442; email:
    Lung cancer is the leading cause of cancer death in the United States and many other parts of the world. Non-small cell lung cancer (NSCLC) comprises 85-90% of lung cancers. Historically, the expected survival of patients with advanced disease has been estimated in months. Read More

    Management of Rectal Cancer Without Radical Resection.
    Annu Rev Med 2017 Jan 9;68:169-182. Epub 2016 Sep 9.
    Radiology, The Netherlands Cancer Institute, 1066CX Amsterdam, The Netherlands; email:
    The basis of the current treatment of rectal cancer is a radical total mesorectal excision of the rectum, and although this provides excellent oncological control, it is associated with morbidity and functional problems in cancer survivors. Organ-preservation alternatives are local excision alone for very early tumors, chemoradiation followed by either local excision of a small tumor remnant or, when there is a complete clinical response, a nonoperative watch-and-wait approach. The functional advantage of these alternatives is clear, but there is some concern about the oncological risk. Read More

    Why Are There So Many Mastectomies in the United States?
    Annu Rev Med 2017 Jan 26;68:229-241. Epub 2016 Aug 26.
    Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065; email:
    Breast-conserving therapy (BCT) and mastectomy result in equivalent long-term survival. Locoregional recurrence rates after BCT have decreased over time and are now similar to those after mastectomy. Contralateral breast cancer rates are declining as well owing to the widespread use of adjuvant systemic therapy. Read More

    Middle East Respiratory Syndrome: Emergence of a Pathogenic Human Coronavirus.
    Annu Rev Med 2017 Jan 26;68:387-399. Epub 2016 Aug 26.
    Department of Microbiology, University of Iowa, Iowa City, Iowa 52242; email:
    In 2012, a zoonotic coronavirus was identified as the causative agent of Middle East respiratory syndrome and was named MERS coronavirus (MERS-CoV). As of August 11, 2016, the virus has infected 1,791 patients, with a mortality rate of 35.6%. Read More

    Gene Editing: A New Tool for Viral Disease.
    Annu Rev Med 2017 Jan 26;68:401-411. Epub 2016 Aug 26.
    Department of Molecular Genetics and Microbiology and Center for Virology, Duke University Medical Center, Durham, North Carolina 27710; email: ,
    The emergence of the CRISPR/Cas system of antiviral adaptive immunity in bacteria as a facile system for gene editing in mammalian cells may well lead to gene editing becoming a novel treatment for a range of human diseases, especially those caused by deleterious germline mutations. Another potential target for gene editing are DNA viruses that cause chronic pathogenic diseases that cannot be cured by using currently available drugs. We review the current state of this field and discuss the potential advantages and problems with using a gene editing approach as a treatment for diseases caused by DNA viruses. Read More

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