domingo, 1 de marzo de 2015

Molecular findings among patients referred for clinical whole-exome... - PubMed - NCBI

Molecular findings among patients referred for clinical whole-exome... - PubMed - NCBI



 2014 Nov 12;312(18):1870-9. doi: 10.1001/jama.2014.14601.

Molecular findings among patients referred for clinical whole-exome sequencing.

Abstract

IMPORTANCE:

Clinical whole-exome sequencing is increasingly used for diagnostic evaluation of patients with suspected genetic disorders.

OBJECTIVE:

To perform clinical whole-exome sequencing and report (1) the rate of molecular diagnosis among phenotypic groups, (2) the spectrum of genetic alterations contributing to disease, and (3) the prevalence of medically actionable incidental findings such as FBN1 mutations causing Marfan syndrome.

DESIGN, SETTING, AND PATIENTS:

Observational study of 2000 consecutive patients with clinical whole-exome sequencing analyzed between June 2012 and August 2014. Whole-exome sequencing tests were performed at a clinical genetics laboratory in the United States. Results were reported by clinical molecular geneticists certified by the American Board of Medical Genetics and Genomics. Tests were ordered by the patient's physician. The patients were primarily pediatric (1756 [88%]; mean age, 6 years; 888 females [44%], 1101 males [55%], and 11 fetuses [1% gender unknown]), demonstrating diverse clinical manifestations most often including nervous system dysfunction such as developmental delay.

MAIN OUTCOMES AND MEASURES:

Whole-exome sequencing diagnosis rate overall and by phenotypic category, mode of inheritance, spectrum of genetic events, and reporting of incidental findings.

RESULTS:

A molecular diagnosis was reported for 504 patients (25.2%) with 58% of the diagnostic mutations not previously reported. Molecular diagnosis rates for each phenotypic category were 143/526 (27.2%; 95% CI, 23.5%-31.2%) for the neurological group, 282/1147 (24.6%; 95% CI, 22.1%-27.2%) for the neurological plus other organ systems group, 30/83 (36.1%; 95% CI, 26.1%-47.5%) for the specific neurological group, and 49/244 (20.1%; 95% CI, 15.6%-25.8%) for the nonneurological group. The Mendelian disease patterns of the 527 molecular diagnoses included 280 (53.1%) autosomal dominant, 181 (34.3%) autosomal recessive (including 5 with uniparental disomy), 65 (12.3%) X-linked, and 1 (0.2%) mitochondrial. Of 504 patients with a molecular diagnosis, 23 (4.6%) had blended phenotypes resulting from 2 single gene defects. About 30% of the positive cases harbored mutations in disease genes reported since 2011. There were 95 medically actionable incidental findings in genes unrelated to the phenotype but with immediate implications for management in 92 patients (4.6%), including 59 patients (3%) with mutations in genes recommended for reporting by the American College of Medical Genetics and Genomics.

CONCLUSIONS AND RELEVANCE:

Whole-exome sequencing provided a potential molecular diagnosis for 25% of a large cohort of patients referred for evaluation of suspected genetic conditions, including detection of rare genetic events and new mutations contributing to disease. The yield of whole-exome sequencing may offer advantages over traditional molecular diagnostic approaches in certain patients.

PMID:
 
25326635
 
[PubMed - indexed for MEDLINE] 
PMCID:
 
PMC4326249
 
Free PMC Article

Welcome to NORD — National Organization for Rare Disorders

Welcome to NORD — National Organization for Rare Disorders

National Organization for Rare Disorders

World Rare Disease Day 2015

World Rare Disease Day 2015





World Rare Disease Day 2015

World Rare Disease Day is an annual observance held on the last day of February (February 28th or February 29th in a Leap Year) to raise awareness for rare diseases and improve access to treatments and medical representation for individuals with rare diseases and their families.
The 8th annual World Rare Disease Day will be held on Saturday, February 28, 2015. On this day, various activities take place in the United States, Europe, Russia, Japan and elsewhere around the world.

How To Get Involved

Global Genes will hold a variety of awareness raising activities starting on World Rare Disease Day, February 28th and throughout the month of March. Please join patients, families, friends, caregivers, scientists, physicians, researchers, health care providers, policy experts and our team in 2015 to raise rare and genetic diseases awareness. Here are ways you can get involved!
Looking for ideas to plan your event?  Be sure to check out our Rare Disease Day planning webinar!
For more information, please contact Carrie Ostrea, Advocacy Director of Global Genes
WRDD RECAP-SURVEY-BUTTON-withborder
Wear That You Care - Blue Denim Genes Ribbon™Our popular campaign encouraging people to wear the Blue Denim Genes Ribbon™ and their favorite pair of jeans.Place your order today to receive your Blue Denim Genes Ribbon™ in time for Rare Disease Day!
Place your order today to receive your Blue Denim Genes Ribbon™ in time for Rare Disease Day!
plan-share-your-rare-disease-event
Find unique, creative, and fun ideas for rare disease day events you can host. Already have an event planned? Share it with our community!

Join Global Genes and Rare Disease Legislative Advocates (RDLA) for scheduled events February 23th – February 27, 2015.
Join our social media “rare disease day” campaign by changing your profile
and cover pictures to share how important rare disease awareness is to you!

Rare Disease Day USA | Alone we are Rare. Together we are Strong.

Rare Disease Day USA | Alone we are Rare. Together we are Strong.



NORD

Rare Disease Day | Office of Rare Diseases Research (ORDR-NCATS)

Rare Disease Day | Office of Rare Diseases Research (ORDR-NCATS)

National Center for Advancing Translational Sciences



On February 27, 2015, the National Institutes of Health (NIH) will celebrate the eighth annual Rare Disease Day with a day-long celebration and recognition of the various rare diseases research activities supported by NCATS’ Office of Rare Diseases Research, the NIH Clinical Center, other NIH Institutes and Centers; the Food and Drug Administration’s Office of Orphan Product Development; other Federal Government agencies; the National Organization for Rare Disorders; the Genetic Alliance; Global Genes; and Uplifting Athletes. Rare Disease Day at NIH will be held in the Masur Auditorium (Building 10) from 8:30 a.m. to 5:00 p.m. on Friday. Attendance is free and open to the public.
In addition to the various scheduled talks, there will be Clinical Center Tours and posters and exhibits from many groups relevant to the rare diseases research community displayed. In association with the Global Genes, we again encourage all attendees to wear their favorite pair of jeans.
About Rare Disease Day
Rare Disease Day was established to raise awareness with the public about rare diseases, the challenges encountered by those affected, the importance of research to develop diagnostics and treatments, and the impact of these diseases on patients' lives. The focus of Rare Disease Day 2010 was 'Patients and Researchers, Partners for Life!' and is aligned with ORDR's philosophy that researchers need to work closely with patients and patient advocacy groups to maximize chances for success. This philosophy has been put into practice in our very successful Rare Diseases Clinical Research Network.
There are about 7000 rare diseases identified in the United States. About 80 percent of rare diseases are genetic in origin and it is estimated that about half of all rare diseases affect children. Rare diseases can be chronic, progressive, debilitating, disabling, severe and life-threatening. Information is often scarce and research is usually insufficient. People affected face challenges such as delays in obtaining a diagnosis, misdiagnosis, psychological burden and lack of support services for the patient and family. The goals remain for rare disease patients to obtain the highest attainable standard of health and to be provided the resources required to overcome common obstacles in their lives.

Rare Disease Day is celebrated around the world to raise awareness among decision-makers as well as the general public regarding rare diseases and their impact on patients’ lives.  The NIH celebrates Rare Disease Day to:

  • Demonstrate and reiterate the NIH commitment to rare diseases research to help patients
  • Highlight rare diseases research, and the development of diagnostics and treatments, being funded and conducted across NIH
  • Initiate a mutually beneficial dialogue among public and private researchers, patients, patient advocates and policy makers
  • Exchange the latest rare diseases information with stakeholders to advance research and therapeutic efforts
  • Put a face on rare diseases by sharing stories of patients, their families and their communities
The first Rare Disease Day sponsored by EURORDIS was held in Europe on February 29, 2008. February 29th was chosen since it is a rare day and it is symbolic of rare diseases. 2009 was the first time that Rare Disease Day was observed in the U.S. In addition to 17 European countries participating in Rare Disease Day 2009, the United States was joined by Argentina, Australia, Canada, China, Colombia, and Taiwan in celebrating the first global Rare Disease Day. 
See Also: 
Past ORDR Rare Disease Day Events:  2014; 2013;  2012;  2011;  2010;  2009
National Organization for Rare Disorders (NORD)
The National Organization for Rare Disorders (NORD), a leading independent, non-profit organization committed to the identification, treatment, and cure of rare disorders, serves as the sponsor of Rare Disease Day in the United States, working with EURORDIS and other national sponsors around the world.  NORD hosts the official Rare Disease Day U.S. website, where it provides resources such as press kits, customizable press releases, official logos, videos and social media badges, and suggested activities with supporting materials for organizations, schools or universities, companies, and individuals.  The website lists events taking place across the U.S. for Rare Disease Day.  The public is invited to submit events to be listed.

As part of Rare Disease Day, NORD helps to organize state-wide awareness events across the U.S.  The events take place at State Houses and are intended to inform and educate legislators on the challenges and needs of rare disease patients.  There is growing interest in this area, with 30 State House events planned for 2015. Rare disease patients and others in the rare disease community are invited to share their personal stories and photos through the Rare Disease Day Handprints Across America™ campaign.  All submissions will be featured on the Rare Disease Day U.S. website and on social media.  Follow Rare Disease Day on Facebook and Twitter and join the conversation using the hashtags #RDD2015 and #RareDiseaseDay.

For more information, visit http://rarediseaseday.us/.


Global Genes 
hopeGlobal Genes is a leading rare and genetic disease patient advocacy organization led by Team RARE (Rare advocacy, Awareness, Research, Education) and promotes the needs of the rare and genetic disease community under a unifying symbol of hope – the Blue Denim Genes RibbonTM.
What began as a grassroots movement in 2009 to use the simple concept of "jeans and genes" to increase awareness for rare and genetic disorders has grown to over 400 global organizations. Their mission is centered on increasing rare disease awareness, public and physician education, building community through social media and supporting research initiatives to find treatments and cures for rare and genetic diseases.
Global Genes organizes a Wear That You CareTM awareness campaign on World Rare Disease Day where supporters wear the Genes RibbonTM and their favorite pair of jeans to show support for people fighting rare and genetic diseases. They encourage patients and family advocates to share their stories through social media via creative photo campaigns and blog articles. In 2013, the organization will launch a Twitter campaign with the hashtags #careaboutrare and #wearthatyoucare.
For more information on how to receive Blue Denim Genes RibbonsTM and how to participate in the Wear That You CareTM campaign, visit http://globalgenes.org/world-rare-disease-day/.

Rare Disease Day: Genomics and Public Health - February 24, 2015

Genomics|Features|Rare Diseases

Genomics & Health Impact Update with DNA in background



Rare Diseases



BioEdge: the latest news and articles about bioethics

BioEdge: the latest news and articles about bioethics

Bioedge



Michael Cook
Editor
BioEdge











Hi there,
Even writing a short column like this one is a tough job. Those who agree with you expect more gold when the lode is nearly exhausted; those who disagree with you demand minute documentation; those who are merely curious will not return if the punctuation is sloppy. There’s a deadline and it has to be posted quickly. It can make you quite dyspeptic.
Which perhaps explains a post written by the incoming associate editor of the Journal of Medical Ethics, Brian D. Earp. An Oxford theologian, Nigel Biggars, argues in the JME that there is a place for religion in bioethics and medicine. (See below.) Fiddlesticks, says Earp. “Some people will feel a shiver go down their spines—and not only the non-religious.”
I thought for a moment that he must have been referring to the intersection of religion and cardiology documented in The Discovery And Conquest Of Mexico, by Bernal Diaz. (A fabulous read, by the way.)
"The dismal drum of Huichilobos sounded again, accompanied by conches, horns, and trumpet-like instruments. It was a terrifying sound, and when we looked at the tall cue [temple-pyramid] from which it came we saw our comrades who had been captured in Cortés defeat being dragged up the steps to be sacrificed. …Then after they had danced the papas [Aztec priests] laid them down on their backs on some narrow stones of sacrifice and, cutting open their chests, drew out their palpitating hearts which they offered to the idols before them."
But no, Earp was referring to Christianity, whose distinctive contribution to medicine, apparently, is to deny women life-saving abortions. It’s odd that he ignored the Good Samaritan ethic which gave rise to the modern hospital system and the well-documented origin of bioethics in Catholic medical ethics. And, as Biggar points out, notions of human dignity and a preferential option for the poor are grounded in Christian ethics.
If we are looking for a philosophy to animate good medical care, we could do worse than Christianity, quite a bit worse. I think that the jury is still out on whether religion-less, secular medical ethics has really been a big improvement. 






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BioEdge: the latest news and articles about bioethics