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Commentaries on each Volume’s Contribution to Medical Education by L.H. Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN – BioMedical e-Books e-Series: Multiple Volumes in Five e-Series

Series A: e-Books on Cardiovascular Diseases

 

• Cardiovascular Diseases, Volume One: Perspectives on Nitric Oxide in Disease Mechanisms.On com since 6/21/2013, 895 pages

http://www.amazon.com/dp/B00DINFFYC

 

Series A. Cardiovascular Diseases: Volume 1. Nitric Oxide

Commentary by L.H. Bernstein, MD, FCAP

This volume addresses the essential role of nitric oxide in vascular stress, which includes hypertension and atherosclerosis. Nitric oxide is only one of several substances that have a key role in vascular stress, but the role is large. It has three isoforms, each of which has a special place in organ system development. Nitric oxide has a specific role in oxidative stress that is generated by mitochondrial function, and it is essentially kept in equilibrium. When equilibrium is disrupted, there is a succession of events that leads to cell death and organ dysfunction. This volume elaborates on the consequences of nitric oxide in generalized vascular and in cardiac specific disease.

This book is a series of articles delineating the basic functioning of the NOS isoforms, their production widely by endothelial cells, and the effect of NITRIC OXIDE production by endothelial cells, by neutrophils and macrophages, the effect on intercellular adhesion, and the effect of circulatory shear and turbulence on NITRIC OXIDE production. The essential role of NITRIC OXIDE is seen widely in organ function and in disease development.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

This is the only book on the clinical implications of Nitric oxide on all human body biological systems that covers the biochemistry, the physiology and the pathophysiology representing the frontier of medical science in a clinical context.

 

• Cardiovascular Diseases, Volume Two: Cardiovascular Original Research: Cases in Methodology Design for Content Co-Curation. On com since 11/30/2015, 11039 KB

http://www.amazon.com/dp/B018Q5MCN8

 

Series A. Cardiovascular Diseases: Volume 2. Cardiovascular Original Research: Cases in Methodology Design for Content Co-Curation

Commentary by L.H. Bernstein, MD, FCAP

This volume addresses ORIGINAL Research via Content Curation by experts using critical thinking process & interpretation over open access networks, offering better organization and visibility of critical information useful for innovations in academic, clinical, and industrial research.

The main subject of this volume is an elaboration of the methodology for content curation of scientific and more specifically medical literature. It advances a five step process for the curation of the content.
The first evaluation is a review of the affordable care act and the cost of care for cardiovascular disease. The healthcare system needed changes because we have the most costly system, are endowed with advanced technology, and we have inexcusable outcomes in several domains of care, including, infant mortality, and prenatal care – but not in cardiology.

It goes on to consider the conditions that exist in the evolution of cardiovascular disease, among which are not all genetic, but more generally related to calcium signaling and metabolic events that arise during aging. These events have relevance to generalized vascular disease and to cerebral and renal vascular diseases. The material covered includes calcium homeostasis, vascular metabolism, lipid metabolism, conduction disturbances and cardiac dysrhythmias, myocardial infarction, and renal insufficiency.

Curation is an active filtering of the web’s and peer reviewed literature found by such means – immense amount of relevant and irrelevant content. In doing good curation, one does more than simply assign value by presentation of creative work in any category. Answers to specifically focused questions comes from the hard work of many in laboratory settings creatively establishing answers to definitive questions, each a part of the larger knowledge-base of reference.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

In this volume the power of co-curation is harnessed in the format of case studies in Interventional cardiology, Cardiac Medical Imaging and Cardiac Surgery. Unique focus on evolution of stent technology, hybrid operating rooms and outcomes of cardiac surgery compared with interventional cardiology: PCI (stenting) vs CABG (Open Heart Surgery). Primary care physicians in the community find the research findings very useful. The case studies contain material for Curriculum development.

 

Cardiovascular Diseases, Volume Three: Etiologies of Cardiovascular Diseases: Epigenetics, Genetics and Genomics. On Amazon.com since 11/29/2015, 12333 KB

http://www.amazon.com/dp/B018PNHJ84

 

Series A. Cardiovascular Diseases: Volume 3 –address the topics of Etiologies of CVD: Epigenetics, Genetics & Genomics

Commentary by L.H. Bernstein, MD, FCAP

These are matters of great interest and have made considerable progress in the last 30 years with respect to cause, risk and biomarkers, and therapies – both surgical and pharmacologic.

Volume 3 is a comprehensive review of recent Original Research on Cardiovascular Diseases: Causes, Risks and Management and related opportunities for Targeted Therapy. It is a rich source of research literature on the genomic influences in cardiovascular disease etiologies. These have variable influence on the etiologies of atherosclerosis, microvascular disease, plaque formation. However, the context is multivariable and includes the environment, dietary factors, level of emotional stress, sleep habits, and the daily activities of living for affected individuals.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

Volume 3 covers Epigenetics, Genetics & Genomics of Cardiovascular Diseases. In one volume a comprehensive exposition of ALL the etiologies for heart disease are analyzed for the cause, the risk, the biomarkers, the determinant vs the life style and diet controllable factors in disease evolution. This is the first book to cover comprehensively Epigenetics consequences.

This volume is used by a Medical School in Philadelphia for curriculum development purposes.

 

• Cardiovascular Diseases, Volume Four: Regenerative and Translational Medicine: The Therapeutics Promise for Cardiovascular Diseases. On comsince 12/26/2015, 11668 KB

http://www.amazon.com/dp/B019UM909A

 

Series A. Cardiovascular Diseases: Volume 4 Regenerative and Translational Medicine: The Therapeutics Promise for Cardiovascular Diseases

Commentary by L.H. Bernstein, MD, FCAP

Volume 4 is largely concerned with cardiovascular diseases, Translational Medicine (TM) and post TM as it concerns Regenerative & Pesonalized Medicine (R&PM) in the context of translational medicine and remodeling concepts leading to electric signal conduction, congestive heart failure and myocardial hypertrophy. It further considers protein targets that have been undruggable because of structural features as future pharmaceutical targets. It also discusses tight junctions and ion transport, critical for conduction and excitation contraction coupling. It extends the discussion to cardiomyocyte specific kinases and its role in oxidation related atrial fibrillation. Other PMs are S-nitrosylation and deacetylation, and signaling with oxidative stress that are disrupted in cardiac disease.

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

The curation methodology enables the authors/curators to develop one volume that covers the state of science on Regenerative (Stem Cell Implantation) and Translational Medicine (from animal studies to first in Man, clinical trials) with a focus on the Therapeutics Promise for Cardiovascular Diseases. This volume provides latest material for coving these two fields in the classroom. The electronic Table of Contents of the book can serve as a course layout. This book edifies PCP in the community about the frontiers of clinical trials and innovations on Regenerative (Stem Cell Implantation)

 

• Volume Five: Pharmacological Agents in Treatment of Cardiovascular Diseases

Work-in-Progress

https://pharmaceuticalintelligence.com/biomed-e-books/series-a-e-books-on-cardiovascular-diseases/volume-five-pharmaco-therapies-for-cvd/

 

• Volume Six: Interventional Cardiology and Cardiac Surgery for Disease Diagnosis and Guidance of Treatment

Work-in-Progress

https://pharmaceuticalintelligence.com/biomed-e-books/series-a-e-books-on-cardiovascular-diseases/volume-six-interventional-cardiology-and-cardiac-surgery/

 

 

Series B: Frontiers in Genomics Research

 

• VOLUME 1: Genomics Orientations for Personalized Medicine. On comsince 11/23/2015, 11724 KB

http://www.amazon.com/dp/B018DHBUO6

 

Commentary by L.H. Bernstein, MD, FCAP

What is the Future for Genomics in Clinical Medicine?

Author: Larry H Bernstein, MD, FCAP

 

Series B: Frontiers in Genomics Research

 

Series B, VOLUME 1: Genomics Orientations for Personalized Medicine

Commentary on Volume’s Contribution to Medical Education by Larry H. Bernstein, MD, FCAP

After the completion of the HGP in 2003, the work was ripe for accelerated discovery, and we have seen new issues in the years since the human genome project (HGP) and ENCODE, and more recently, the 2004 International HapMap project, and 2005 GWAS.  This is because there is a now a confluence of circumstances relating to the practice of medicine, the education of physicians, the communication between physician and patients changing from what is referred to “god handing down an edict” to evidence-based medicine.  This is also complicated at a time that we have a national state-by-state implementation of a remodeled Medicare and Medicaid plan based on the program already successful in Massachusetts.

In the reorganization, there will be more regional hospital, academic and clinic consolidations, and even possible statewide organizations, movement of patients from inpatient beds sooner with a high skill level of outpatient support, greater concentration of physician staffs aligned to PHO type arrangements, and a need to fill PCP gaps with qualified Advanced Nurse Providers.

All of this is happening now.  This is a realignment to meet the needs of the Payor (Fed, HMO, Big Insurance), with tighter margins per stay and critical decisions about capital needs and depreciation, at the same time, required to meet a higher risk of performance standard.  Eric topol refers to the need to education of this generation of physicians in Personalized Medicine.  But that has never been so easy for those advanced in their careers, and even bright new entries into the profession are faced with productivity guidelines.  It is an assignment that will be a new challenge for the Pathology profession, just as the student lab was long ago replaced by the laboratory, with microbiology, blood bank, hematology, chemistry and immunology, to which was added molecular testing.  It will be a very challenging undertaking compared to past experience, and it will be a very big adjunct to microscopy, while imaging technology, in the hands of radiology, is undergoing a parallel transformation.

We derive the following major points from what has been presented in this work:

Genomics will become a key component integrated into patient-care, preventive-medicine, and what is going to become a standard of practice for personalized medicine, or individualized-care of a patient defined by individuality, culture, and personal goals for treatment outcomes.  A personal goal may be a likely or unlikely point of view in the eye of the observer:

• Let me live with my illness, but relieve my pain
• Give me a realistic time to prepare for dying so I can tie up loose ends
• A cure would be a gift if there adverse effects are minimal

The expanded view of this expectation resides in a more accepting view of what lies ahead and of what is behind.  The choice before us lacked clarity in the past.  The view was limited, and might still be for some with an unfulfilled life, whether imposed or chosen.

The medical requirement that supercedes all others is:

1. Clinical medicine context … clinically guided
2. physician/patient relationship  … not a consumer relationship
3. First do no harm… directly related to priority for care
4. must know significance … disease recessive traits ..
5. can we offer anything?

common complex diseases…

1. both genetic & environmental factors
2. not inherited in predictable ways
3. gene-gene interactions
4. variants usually account for a small amount of risk

examples where both clinical assessment and genomic personalized medicine are expected to realize potential real concordance are:

1. macular degeneration
2. alzheimer’s disease
3. colon cancer

The increased benefit to the pathology-diagnostic imaging -surgical-oncology team is seen as

1. tailoring treatment though genomic guidance:
2. microscopic doesn’t dictate treatment
3. determine choice of treatment
4. drug reactions may be avoided

Medical Gutenberg

Eric Topol refers to the “Medical Gutenberg” in a recent lecture in the Medscape series “Creative Destruction of Medicine”.  He says ” If we go back to the 1400s and the printing press invented by Johannes Gutenberg, you know how transformative that invention was. The high priests were no longer the only ones who could read; the ability to read books was unleashed to the public. Many years, many centuries have passed since those times, but here in the 21st century we’re getting consumers — the public — to read medical stuff.”  He goes on that “now we’re moving from information asymmetry to information parity. This really sets up a unique experience, but it won’t [happen] for all consumers because they’re not all going to want to learn to read and get into this [medical information]. But who has the most vested interest in one’s health if it isn’t that individual, that patient?”
That’s Medical Gutenberg. That’s the opportunity that lies ahead with digital medicine — shifting that information and data to the patient requiring the guidance, knowledge, and experience from physicians.

A Tale of Two Nominal Super-Drugs.

A Success Story?  Perhaps too early to know.  New York Times reported on March 19 , 2013 that Amgen, had met the primary goal of a Phase 3 clinical trial in patients with advanced melanoma, with 16 percent of the patients in the trial who had the treatment, called talimogene laherparepvec, or TVEC, experienced a significant shrinkage of their tumors that lasted at least six months compared with only 2 percent of the patients in a control group.  TVEC is a herpes simplex virus modified in such a way that it replicates in fast-growing cancer cells but not healthy ones, and it also contains an implanted gene for GM-CSF (colony stimulating factor), a protein that stimulates the immune system.  When the the replicating viruses cause the cell to burst, freeing the virus and the GM-CSF in the presence of tumor components, it elicits a systemic immune response that can kill cancer cells throughout the body.  Recall that this is a late-stage response, and a long term disease free survival is not determined.

A Failure.  {Marker for NSCLC Chemo Response Doesn’t Hold Up. by Crystal Phend, MedPage Today, March 20, 2013}  A DNA repair biomarker thought to predict benefit from platinum-based chemotherapy in non-small cell lung cancer (NSCLC) doesn’t actually do that good a job.  The problem is both technical and due to the inability of the assay to distinguish the key form of the protein for DNA repair. The ERCC1 protein expression level didn’t predict a boost in overall survival (OS) from adjuvant cisplatin (Platinol)-based chemotherapy compared with observation alone in two clinical trials (P=0.23 for interaction). There was no effect seen in the ERCC1-negative group, which was the basis for proposing the protein as a predictive biomarker.

Why is that significant surprise?  The inability of the assay to distinguish the key form of the protein for DNA repair, the group reported in the March 21 issue of the NEJM.  The antibodies do not have adequate discrimination for therapeutic decision making regarding cisplatin-containing treatment in patients with NSCLC, which requires the specific detection of the unique functional isoform of ERCC1 — ERCC1-202.  There are three other isoforms of ERCC1 (excision repair cross-complementation group 1) protein that aren’t critical in fighting the cytotoxic effect of platinum chemotherapy.

So here we have it.  It’s not yet, far from the worst of times, but equity barriers remain for a time.  The science is critical important, and the implementation of good science can reap huge benefits in time.

New Recommendations for Genetic Reporting
GENNewsHighlights  Mar 22, 2013

Finally, there is now emerging a standard of care for providing and reporting of genetic information. The American College of Medical Genetics and Genomics (ACMG) released landmark recommendations on the handling of incidental findings in clinical genome and exome sequencing.This was published within days of completion of this work.  It is only the beginning of a process expected to go through many revisions.

http://www.genengnews.com/gen-news-highlights/new-recommendations-for-genetic-reporting/81248136/

A minimum list of genetic conditions, genes, and variants that laboratories performing clinical sequencing should seek and report to the physicians that ordered the testing—regardless of the original reasons for which the test was ordered.

In assembling this list, the Working Group prioritized the disclosure of disorders where:

• Preventative measures and treatments exist
• Patients might not experience symptoms for a long period of time
• The genetic mutations are well recognized and known to have a strong link of causation

Examples of diseases recommended for disclosure include rare hereditary cancers and rare heart diseases that could result in sudden cardiac death.

According to Robert C. Green, MD, medical genecist at Brigham and Women’s Hospital, Harvard, laboratories are looking for guidance on how and what should be communicated to clinicians when results are analyzed. These recommendations will allow a small percentage of families to learn unexpected but potentially life-saving information about an illness they may have never suspected they were at risk for.”  The Working Group did not recommend giving patients the choice of whether or not their physician would receive results from the list of recommended incidental findings. This makes sense in the realization that the actual strength of the finding is uncertain.   The Working group also recommended that adult-onset conditions on the list be reported, perhaps with the expectation of life-style modification for prevention.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

This volume covers in 21 chapters all the material representing the Frontier of Science in Genomics Orientations for Personalized Medicine. There is no one domain in Medical Education more in need for contents for teaching Medical students than GENOMICS and how this fields applies to Personalized Medicine and Precision Medicine. This volume represents a response for that need in Medical Education.

 

 

VOLUME 2: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS & BioInformatics, Simulations and the Genome Ontology

Work-in-Progress

https://pharmaceuticalintelligence.com/biomed-e-books/genomics-orientations-for-personalized-medicine/volume-two-genomics-methodologies-ngs-bioinformatics-simulations-and-the-genome-ontology/

 

Series C: e-Books on Cancer & Oncology

 

• Volume 1: Cancer Biology & Genomics for Disease Diagnosis. On comsince 8/11/2015, 13744 KB

http://www.amazon.com/dp/B013RVYR2K

 

Series C, Volume 1: Cancer Biology and Genomics for Disease Diagnosis, 2015.

 Commentary by L.H. Bernstein, MD, FCAP

This book elaborates the worldwide prevalence of cancer as a leading disease. It defines cancer and it discusses the cancer metastasis process. This is essential for medical students and for those undergraduates who have a premedical curriculum with intent on a medical career. In the first chapter there are some interesting presentations about cancer prevention, and a discussion about cancer genetics by James Watson. The genome has been a dominant theme in cancer research for decades following the elucidation of the genetic code and the RNA mediated translation of the code in protein synthesis by the rough endoplasmic reticulum. It discusses melanoma and prostate cancer, which are different. It also considers the role of diet in cancer.

The metabolic pathways that drive cancer is an ongoing investigation. Cancer was first identified in leukemia by Rudolph Virchow, and the discovery of Hodgkin’s lymphoma by Dorothy Hodgkin was another landmark. Chapter 2 begins with differences between cancers, and the tendency for rapid growth and proliferation. There is also a presentation on the mole rat, free of cancer, and of the zebrafish. The work of Otto Warburg in 1924 was monumental. Warburg elucidated the dependence of cancer cells on anaerobic glycolysis and considered cancer to be a fundamental disruption of oxidative metabolism. This work was in part subsumed by the discovery of the genetic code, leading to an emphasis on cancer genetics. However, there has been a resurgence of research on the metabolic events that characterize the Warburg effect.
Furthermore, it poses the question of differences in cancer cell growth, and there is discussion of the stem cell.

Chapter 3 is a significant work on the genetics of cancers. There is a discussion of DNA and the types of cancer, and of JUNK DNA, and the elucidation of complexity in cancer. Then there is the issue of intratumor heterogeneity. Several gastrointestinal types include hepatocellular, pancreas, gastric and salivary, and then breast cancer is discussed. Chapter 4, concerned with epigenetic as well as genetic factors in cancer cell development. Chapter 5 is the metabolism of cancer, which returns to the importance of mitochondria and energy metabolism. It also gives attention to a role of nitric oxide. Chapter 4 elaborates on gastrointestinal (colon and pancreas) and breast cancer, genetics, the BRCA mutations, and tumor progression.

Part 2, Chapters 5 and 6 are concerned with the introduction of specific drugs for cancer cell types. These include breast, gastric, colorectal, kidney, prostate, ovarian, melanoma and leukemia. Chapter 7 elaborates on targeted therapy for specific types of cancer using genomics to identify cell types. This is currently important in developing a personalized medicine.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

Each chapter covers another aspect of the molecular biology of cancers and carcinogenesis. The basic science is presented for Health professionals in training, while it covers all the aspects of life sciences applicable for clinical education: dysfunctional processes and pathophysiological outcomes.

 

• Volume 2: Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery(Series C Book 2). On com since 5/18/2017, 5408 pages

http://www.amazon.com/dp/B071VQ6YYK

 

Series C, Volume 2. Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery

Commentary by L.H. Bernstein, MD, FCAP

This e-Book is a comprehensive review and interpretation of recent Original Research on Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery written by Experts, Authors, Writers. The results of Frontier Original Research are gaining value added for the e-Reader by the Methodology of Curation. It may be of special value to both pre-medical undergraduates and medical students, and would be of even greater interest to those who are in an internship in oncology. This is an outstanding follow up on Volume 1, which deals with the basic science that underlies our current knowledge of cancers and carcinogenesis. Volume 2 presents the options available and under development for modalities of therapy.

The first chapter echoes vol 1 in that it is concerned largely with the basic mechanism of cancer evolution, which includes such content as cell growth and regulation, genomics and epigenome, siRNA, and CRISPR/Cas9, which is content that is rapidly expanding, immunity and epigenetic expression.

The second chapter is a detailed consideration of the Warburg effect and the relationship of the glycolytic reliance of the cancer cell to impaired mitochondrial oxidative phosphorylation. It also describes the isocitrate dehydrogenase isoenzyme that is associated with malignancy. There is also the phenomenon that the level of oxidative impairment is related to the rate of proliferation. Finally, it introduces the mechanism of autophagy, the cell death pathway. The impairment of the cancer metabolic identity impairs autophagy, which is related to the term cancer cell “immortality”. It goes on to introduce the concept of personalized medicine based on the fact that cancer cell types have specific identities and development histories. The remaining content gives a thorough examination of specific cancer types.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

This e-Book is the ONLY multidisciplinary comprehensive review and interpretation of recent FIVE Original Research areas on Cancer Therapies:

(1) Metabolic,

(2) Genomics,

(3) Interventional,

(4) Immunotherapy and

(5) Nanotechnology in Therapy Delivery

From a Medical Education perspective, the contents in Volume 1 and Volume 2 is organized for teaching the Frontier of Science on Cancer: Volume 1: the basic science and Volume 2: the Frontier in Oncological Therapeutic Options.

Nowhere is to be found content interpretation as the ones covered in the following two original 360 degrees curations:

• Warburg Effect Revisited – 2

Writer and Curator: Larry H. Bernstein, MD, FCAP

https://pharmaceuticalintelligence.com/2015/03/30/warburg-effect-revisited-2/

·       Immune-Oncology Molecules In Development & Articles on Topic in @pharmaceuticalintelligence.com

Curators: Stephen J Williams, PhD and Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2016/01/11/articles-on-immune-oncology-molecules-in-development-pharmaceuticalintelligence-com/

 

Series D: e-Books on BioMedicine – Metabolomics, Immunology, Infectious Diseases

• Metabolomics

VOLUME 1: Metabolic Genomics and Pharmaceutics. On Amazon.com since 7/21/2015, 13927 KB

http://www.amazon.com/dp/B012BB0ZF0

 

• The Immune System, Stress Signaling, Infectious Diseases and Therapeutic Implications

VOLUME 2: Infectious Diseases and Therapeutics

VOLUME 3: The Immune System and Therapeutics

(Series D: BioMedicine & Immunology) Kindle Edition. On Amazon.com since September 4, 2017, 3747 pages

https://www.amazon.com/dp/B075CXHY1B

Commentary by L.H. Bernstein, MD, FCAP

Series D consists of 3 volumes which contributes to our understanding of metabolism, infectious disease mechanisms, and the immune response. This is essential for our grasping the potential for drug development based on targeting the immune response, and for targeting specific infectious organisms based on interference with essential metabolic pathways. This is of great value for the pre-medical and medical student as well as for postgraduate physicians. Infectious diseases are common worldwide, considering bacterial and viral pathogens. The bacteria have the capability of developing resistance. The viruses have the capability of developing immune resistance to varying degrees, most notable being influenza. This leads to the following alternatives being to block essential pathways of microbial metabolism, which may be followed by a metabolic bypass that constitutes drug resistance. The three volumes are as follows: Metabolic Genomics & Pharmaceutics; Infectious Diseases and Therapeutics; The Immune System and Therapeutics.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

Metabolomics and Microbiome represent the Frontier discoveries between Metabolism, Genomics and Human Immune system. We pioneered in 2015 the publication of the first book on that subject matter containing contents for Medical Education.

Volume 2:

Infectious Diseases contains the disease mechanism of Bacterial Infection, Viral Infection, Fungal Infection and Allergy-related Infections. The Therapeutics for each type of infection covers the FDA Approved Drugs for Infections and Infectious Diseases: Bacterial Infection, Viral Infection, Fungal Infection and Allergy-related Infections, 1995 – 2016. Thus, this book becomes a Handbook of therapeutic options per Pathogen classification type. It lands as contents for teaching and curriculum development in this critical domain of PUBLIC HEALTH.

Volume 3:

Immune system and Immune response consists of clinical perspectives on the basic science of Immunology. Without the clinician interpretation of this complex body of knowledge the contents would have been left in the domains of basic Biological Sciences: Bacteriology, Virology, Parasitology and Allergy. The Therapeutics explanation coupled with Immune Response types is the roseta stone for Treatment of the immune system, where a failure to identify the treatment may lead to life threatening conditions and failure of the immune system by succumbing the host to pathogen persistence and its survival leading to host’s death. We have included a chapter dedicated to immunotherapy in Cancer. The contents for teaching and curriculum development in this critical domain provide explanations for adoption of Precision Medicine paradigm for advancement of patient-centered medicine.

 

Series E: Patient-Centered Medicine – LINKS to e-Books & Cover Pages for Volumes 1,2,3,4

 

• Volume 1: The VOICES of Patients, Hospitals CEOs, Health Care Providers, Caregivers and Families: Personal Experience with Critical Care and Invasive Medical Procedures. On com since 10/16/2017, 826 pages

https://www.amazon.com/dp/B076HGB6MZ

 

Commentary by L.H. Bernstein, MD, FCAP – Book Co-Editor and contributor of articles on Cancer as a Patient and Physician

This volume is divided into three parts: perceptions of care, the voice of cancer survivors, and the voice of open heart surgery survivors.  This is quite difficult because of variation in patients’ ages, outlooks, chronicity and type of condition, and adverse effects of treatments.  The best that we can do is look at a small number of narratives.

Perceptions of care are determined by a number of important factors that are dependent on the individual and on the physician, and on the treatment conditions.  The individual factors include, but are not limited to patient social status, linguistic factors, cognitive skills and level of education, and communication skills of the care providers.  The facilities can be a factor not easily ranked, although that is always a matter for debate.  The voices of cancer survivors are presented for both cancer and cardiovascular surgery.  These are quite variable and are highly dependent on the specialty treatment organization.

This volume of contributions has focused on the patient’s response to treatment, the expected response to pharmacotherapy, immunotherapy, and radiation therapy.  The discussion also entails the difficulties in going beyond diagnosis to a grasp of long term survival.  In examining the patient perspective, the patient and the physician have to be in concert with realistic expectations of toxicities, exacerbations, and the possibility of a decline into cachexia.

Individual experiences with cancer, heart disease, and debilitation

It is true in medicine and healthcare that the patient comes first. This calls for a respect for the patient’s best concerns. In the United States (USA), this might be an unusual statement given the great diversity we have as a people.  Nevertheless, integration of communities takes time, economic disparities separate individuals and communities within communities, and there are religious and cultural values that divide one person from another. In this respect, families matter, and families may be divided.

There is a range of individual, social and chronic conditions that engage all of us.  On the one hand there is the end of life experience.  We grow old, but how do we grow old?  In the case of cancer, we see that it inflicts pain and suffering at any age.  The death of a child is experienced by the parents.  Cancer requires some combination of surgery, postoperative chemo- or immunotherapy with local radiation. The chance of recurrence is not small, so the question is always when and how it will be reasserted.

The situation with heart disease is not quite the same.  We might like to just be lost in the night, but we don’t have choices.  We are also faced with combined chronic systemic conditions, and the heart, kidneys, brain, and lungs are fed by a vascular system.  Consequently, it raises the likelihood of multisystem failure.  In this situation the possibilities are unclear. The patient with end stage renal disease may go on dialysis in clinic or terminally at home.

The situation is most impressive at the patient end of the process.  I still remember a woman of color who had experienced emotional distress and ended several marriages in divorce before she entered the “metropolitan” hospital in my medical school years and was found to have a sudden increase in blood pressure related to a rare adrenaline secreting adenoma of the Organ of Zuckerkandl.  She had no visitors during her hospital experience.  That was also a time when schizophrenia was not understood, and it also brought shame to a family.

Then there are myths to dispel. When a young woman got pregnant, it was a personal and a family crisis.  This is still a situation today that has been highlighted by a juncture disclosed in a presidential contestant interview about whether an abortion, considered a moral issue by the church, is punishable.  It also was stated that it would necessitate a return of “back-alley” abortions.  It reminded me of the autopsy I performed as a resident on a woman who had pyelonephritis leading to end stage kidney disease.  I am a triplet with a sister two years older than myself, and I only learned late in life that my mother had had an aborted pregnancy to alleviate the strain it would place on the family, my father earning a meager living.  There is no easy way to conclude this than to say that to the patient, medicine is highly personal.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

Case studies is a method used in Medical Schools for decades. This Volume is very unique by the following aspects: (1) Primary method of data collection was REAL TIME INTERVIEWS conducted by a professional Medical Writer with several stackholders in health care:

Patients, Hospitals CEOs, Health Care Providers, Caregivers and Families.

This volume is the first in a four-volumes e-Series on Patient-Centered Medicine. There are narratives by Patients and there are accounts by Health Care Providers. This volume is unique in the body of existing literature on the subject matter, in the exposition effort to incorporate in tandem, the VOICES of Patients on their Personal Experience with Critical Care and Invasive Medical Procedures. We provide the Personal views of Hospitals CEOs, Health Care Providers, Caregivers and Families in conjunction with the voices of the Patients.

This Volume represents PRIMARY RESEARCH attained by two methodologies:

One, Personal Interviews conducted by the volume Co-Editor, Gail S. Thornton, with Patients and their families facing the diagnosis of a serious medical (not Terminal) illness requiring a major surgery.  Ms. Thornton conducted interviews with Hospitals CEOs and other leaders of several Health Care Providers in the US and in other countries.

The other, Personal Accounts and Testimonies of Patients are written by themselves. Some are MDs diagnosed with Cancer, had undergone invasive surgeries as an organ excision, some underwent Open Heart Surgery.

This Volume is AUTHENTIC as has been told by Patients, Hospitals CEOs, Health Care Providers, Caregivers and Families, therefore it represents outstanding Teaching material for Medical Students in training.

This volume is used by a Medical School in Philadelphia for curriculum development in Patient-center Medicine.

 

• Volume 2: Medical Scientific Discoveries for the 21st Century & Interviews with Scientific Leaders. On com since 12/9/2017, 2862 pages

https://www.amazon.com/dp/B078313281

 

• Volume 3: Milestones in Physiology: Discoveries in Medicine, Genomics and Therapeutics. On com since 12/27/2015, 11125 KB

http://www.amazon.com/dp/B019VH97LU

 

Commentary on Volumes 2 & 3 by L.H. Bernstein, MD, FCAP

Volumes 2 & 3 are of special interest to high school and college students who major in chemistry, molecular biology, or pre-medical studies as well as medical students and postgraduate physicians.

Volume 2 begins the first chapter with a very engaging history of great medical discoveries in much of the 20^th century. It traces the discoveries with an emergence of infectious disease followed by endocrinology, including diabetes and pancreatic insulin, and the neuroendocrine axis. As the century develops there are new questions and new solutions, but answers lead to new questions. A large body of Nobel Prize discoveries is laid out and a historical map emerges that connects discoveries in a discovery family. An example of this is the identification of the virus that causes influenza by Opie which is a trigger for the search for the genetic code by Pauling and by Watson. The discovery of the nucleotide sequence of DNA produces a mechanism and the x-ray crystallographic picture. DNA leads to RNA. RNA leads to protein synthesis. The physiology is accompanied by the structure of the cell, which again leads to many related functions.
In addition, there is ever more complexity in the discovery of special types of RNA, such as, inhibiting RNA and silencing RNA. In addition, the discovery of the mechanism of protein synthesis leads to a distinction between the smooth and rough endoplasmic reticulum, after which the cell death mechanism is realized. This has new implications for repair mechanisms and for degenerative diseases as well as for cardiac and vascular response to nitrosative and oxidative stress (Inflammatory and oxidative and nitrosative stress pathways underpinning chronic fatigue, somatization and psychosomatic symptoms), atherosclerosis, and diabetes mellitus. In addition, there is a significant coverage of the expanding knowledge of pharmacology and therapeutics, including nanotechnology, and translational medicine.

Volume 3 continues where Volume 2 left off. It traces the development of clinical chemistry and methods of biological discovery. It begins with a history of infectious diseases, and the therapeutic tie is to immunology, which are both of cellular and antibody nature. A science of immunology developed first with the production of antibodies and the discovery of antisera, which is related to both transfusion reaction and vaccination. It continues further into specific proteins, such as oxygen binding hemoglobins and myoglobin, and this is the path to proteomics. Proteomics considers the structure of protein, protein aggregation, and misfolded protein, such as prion. This leads to a new concept of protein-protein and protein-lipid interactions. The chapter also covers genomics and epigenomics. All of this has been central to the development of modern pharmaceuticals.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

Medical discoveries covered in Volume 2 and Breakthroughs in Physiology are covered in Volume 3. Development of Companion Diagnostics and newly emerging tools for Lab Tests and evidence-based diagnosis are presented. The historical perspectives provided are vital for Medical student development of a longitudinal horizon understanding of the key trajectories that have led to and are leading innovations and progress in Medicine. All Life Sciences students and Historians of Medicine and of Life Sciences, will benefit greatly from a Clinician’s and Pathologist’s perspectives as developed in Volume 2 and 3.

 

• Volume 4: Medical 3D BioPrinting – The Revolution in Medicine, Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices. On com since 12/30/2017, 1005 pages

https://www.amazon.com/dp/B078QVDV2W

 

Series E, Volume 4: Medical 3D BioPrinting – The Revolution in Medicine

Commentary by L.H. Bernstein, MD, FCAP

This volume is focused only on the emerging field of 3D medical discovery and its impact on teaching physicians and surgeons, surgical procedures and on potential pharmaceutical applications. It is resident in medical devices and applications at the micro- and the macro- scale. The chapters that follow provide insight into how this development will fuel new drug development, diagnostics, and joint or tissue replacement. This would have applications in joint replacement, burn and trauma surgery, and even possibly cancer treatment.

The potential implications of Nanoscribe’s Photonic Professional GT point to much more important developments then micro-replicated artifacts and figures. This printing technology is being used to develop advanced medical practices that will help with previously difficult processes such as delivering drugs via micro-robots, targeting specific cancer cells, and even assisting in difficult eye operations.

We have covered a broad range of topics in medicine, surgical repair, anatomical presentation and teaching, diagnostics, and even pharmaceutical development. In order to achieve this level of progress the dependence of 2D visualization had to be supplanted by 3D images, even at the molecular level. Examples of this at the macro level are organ replacement, tissue grafts, and introduction of organoids. Examples of this at the micro level are MEMS and sensors in their design, prototyping and manufacturing. In addition, there is an impact on drug development and targeting, nanotechnology, and in drug delivery, and organ transplants (heart, kidney).

The previous series of articles showed a remarkable development of techniques involving tissue and organ remodeling or replacement, a new scale of pharma engineering, an increasing load of FDA approved bioengineering products, the development of biological glue, the application of DNA to polymer engineering, and a new scale of funding for bioengineering. This is the beginning and the continuation of a new age of medical bioengineering.

 

Commentary on Volume’s Contribution to Medical Education by Aviva Lev-Ari, PhD, RN

While reading this book title few times, Medical 3D BioPrinting – The Revolution in Medicine, Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices, one realizes that we are facing in 2018, the 4^th Revolution in Medicine and in Medical Education. The Gray’s Anatomy ATLAS

https://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3Dstripbooks&field-keywords=Gray%27s+Anatomy

is been replace in EVERY Medical School with 3D Printed Anatomical models – the teaching of Anatomy has been revolutionized FOREVER. In Academic Hospital, in Operating Rooms, prior to heart, kidney, lung, liver, and every other organ the CT scan is translated into a 3D Printed Organ for the surgeon to examine the anatomy before the surgery. Tissue repairs for burns, injury, plastic surgery – all are using hydrogels and synthetic materials produced by 3D Printing. 

To teach medical students about the Medical 3D BioPrinting – The Revolution in Medicine, one needs a book curated by Clinicians, Scientists and Engineers, https://www.amazon.com/dp/B078QVDV2W

Is our solution in publishing the FIRST book on the topic that covers ENGINEERING aspects, Biomaterials and Medicine applications for development of new Biologics and of New Medical Devices using the 3D BioPrinting technology.