Personalized medicine considers race, genetics, and environment
By Bhawani Jain
We all have different genetics and backgrounds, so why should we all receive identical medical treatment for a diagnosis or condition?
Today, personalized medicine is on the rise, with treatments tailored to a patient’s unique characteristics, racial and genetic differences, as well as environmental conditions that may impact the quality of their care.
For instance, an estimated 45% of individuals of East Asian descent carry the Aldehyde Dehydrogenase 2 mutation (ALDH2*2). Patients with this mutation have a lowered ability to metabolize nitroglycerin to nitric oxide. Because nitroglycerin is used to prevent and treat angina and heart attacks (among other uses), patients with the mutation may need significantly more nitroglycerin to achieve therapeutic results. Pharmacists need to be conscious of this genetic mutation, and the populations it commonly impacts, when speaking with, screening and filling prescriptions for patients.
High quality patient care requires interprofessional care teams to respectfully discuss race with patients when clinically relevant. As trusted medication experts, hospital and community pharmacists can now tailor drug therapies to suit each patient’s unique individual needs but that must involve open and evidence-based discussions to achieve desired results.
Wildly floored “science” behind mental-health apps
By Nick Keppler
The pandemic has taken a toll on the mental health of countless people. To make matters worse, necessary stay-at-home measures hampered access to care. In the gap, some of us have turned to mental-health apps for solace, with many making claims and promises in areas stretching from cognitive behavioral therapy to guided meditation. But a new study published in PLOS Digital Health finds often apps are not backed by the rigorous evidence their claims require, and they also don’t seem to work all that well. The meta-review examined 145 studies on phone-based mental-health interventions. Generally, the apps were more effective than no treatment at all, but their usefulness waned when they were compared to other treatments options or interventions. This was true whether the apps were targeting anxiety, stress, feelings of depression, tobacco or alcohol addiction, or general well-being. One study published in the journal Anxiety and Depression in 2017 found that among 52 apps offered for anxiety, two-thirds did not have any healthcare professionals involved in their development. Worse yet, less than four percent were rigorously tested as research is often done by those employed by the company selling the app.
She was missing a chunk of her brain. It didn’t matter
By Grace Browne
A woman who has chosen to go by the initials EG, is missing her left temporal lobe, a part of the brain thought to be involved in language processing. The cause was likely a stroke that happened when she was a baby, and today there is only cerebro-spinal fluid in that area of her brain.
Surprisingly, however, missing a large chunk of her brain has had little effect on EG’s life. She now has a graduate degree, has enjoyed an impressive career, and speaks Russian.
The first paper based on EG’s brain was recently published in the medical journal Neuropsychologia. Evelina Fedorenko, a cognitive neuroscientist at MIT working with the patient, found that her left frontal cortex is perfectly capable of supporting high-level cognitive functions.
Infact, it was concluded that, in the absence of a left temporal lobe, the task of language processing seemed to simply shift over to EG’s right hemisphere.
Just how remarkably little effect the uniqueness of EG’s brain has on her day-to-day life showed how researchers sheerly expendable big chunks of brain can be. These findings point to the wonderful reality that if the brain is damaged, it will often find a way to rewire itself.