Category Archives: Genetic medicine

Knowing your family history is the first preventative step any woman can take to avoid a diagnosis of ovarian cancer.

BY Dr. Gizelka David-West

As a gynecologic oncologist, this is an all too familiar conversation. Ovarian cancer is the fifth leading cause of cancer death in women, making it the deadliest of all gynecologic cancers with no screening tool. These facts are exactly why we advocate for preventative measures for ovarian cancer and the four other gynecologic cancers cervical, uterine, vaginal and vulvar.

Knowing your family history is the first preventative step any woman can take to avoid a diagnosis of ovarian cancer. Twenty to 25% of all cases of ovarian cancer are due to genetic mutations, with BRCA mutations accounting for about 16% of those cases and 5% being other mutations. Harboring a mutation in the BRCA 1 or BRCA2 gene increases a womans risk of developing ovarian cancer by 60% or 40%, respectively. With genetic testing and a confirmed mutation, we can prevent this disease with risk reducing surgeries that remove the fallopian tubes and ovaries, dramatically reducing this risk of cancer. Knowing your genetic profile can also help prevent recurrence of this deadly disease with targeted therapies that have been proven to prolong life without disease recurrence or progression.

Next up on the list of gynecologic cancers are three of the five, which fall into the category of HPV related cancers cervical, vulvar and vaginal cancers. With the development of the HPV vaccine, now available to women up to the age of 45, we can prevent these cancers and have the potential to eradicate them. Seems like a no brainer to call your local gynecologist and get vaccinated not only does the vaccine prevent these cancers, it prevents and can help treat the pre-cancer called dysplasia, which transforms into cancer of these organs if left untreated over time.

Finally, uterine cancer, a subset of which is endometrial cancer, is the most common of the gynecologic cancers. Although it is expected that 62,000 new cases of endometrial cancer will be diagnosed this year, it can potentially be prevented. A major risk factor for endometrial cancer is higher than normal estrogen stimulating the uterus this can come from our fat tissue and women who are overweight or obese, have a much higher risk of developing this cancer. Additionally, extra estrogen exposure can come from hormone replacement therapy, which some women may start using in the peri- and post-menopause phase of life. Genetics also play a role in uterine cancer and women with a confirmed diagnosis of Lynch Syndrome have up to a 60% risk of developing this cancer.

I focus my prevention strategies for endometrial cancer on encouraging my patients to maintain a normal range body mass index with regular healthy diet and exercise. If exploring hormone replacement therapy to use with caution the lowest doses for the shortest amount of time. And of course, genetic testing is recommended if strong personal or family history suggestive of Lynch Syndrome.

I hope this post has been informative and provides tools to help you share knowledge this month on preventing gynecologic cancers! To learn more about gynecologic cancers, genetics, clinical trials and survivorship, I encourage you to visit the Foundation for Womens Cancer website and share what you learn with your family, friends and colleagues.

Gizelka David-West, MD, is a practicing gynecologic oncologist, and attending and assistant professor at the Westchester Medical Center in Hawthorne, NY. David-West completed medical school at the University of Miami Miller School of Medicine; residency in obstetrics and gynecology at Mount Sinai School of Medicine; and a fellowship program in gynecologic oncology at New York University. She is also a member of the Society of Gynecologic Oncology (SGO) and on the communications committee for SGO and the Foundation for Womens Cancer. She is also the lead singer for the gynecologic cancer advocacy band N.E.D.

Read more:
What You Need to Know About Preventing Gynecologic Cancers - Curetoday.com

Photo Credit: Alamy Stock Photo

Baby boomers, the more than 75 million peoplein the U.S. born between 1944 and 1964,are starting to retire.As this generation ages and requires more advanced healthcare, the demand for healthcare occupationsis expected to grow at a breakneck pace.

According to the Bureau of Labor Statistics, between 2016 and 2026, the projected employment growth among healthcare jobs is 15.3 percent, far outpacing the national average of 7.4 percent. In fact, more than half of the top 20 fastest-growing occupations in the U.S. are related to healthcare. For example, home health aide positions are expected to increase 47.3 percent and personal care aide positions are expected to increase 38.6 percent by 2026. Fortunately for job seekers,not all healthcare-related occupations require a medical school degree. For individuals just starting out in their careers or looking to change industries, healthcare could be an excellent opportunity.

Interestingly, the growth in healthcare positions is not evenly distributed throughout the U.S. Among the largest U.S. states, Pennsylvania, Massachusetts, Ohio, and Michigan have disproportionately high concentrations of healthcare jobs. California, Texas, and Washington, on the other hand, have below average concentrations of these jobs.

At the local level, the technology hubs of San Jose, Seattle, and San Francisco have some of the lowest concentrations of healthcareprofessionals while Southern metros like Greenville and Charlottesville have higher concentrations. Wages for healthcare positions also tend to be highest in the Northeast and the West Coast, and lowest in the South. For example, median annual wages range from $88,630 in California to $52,530 in Mississippi.

While the highest-paying jobs among healthcare practitioners do require going to medical school, there are still many high-paying jobs that dont require a medical degree. For instance, the median annual wage for healthcare practitioners and related occupations in the U.S. is $66,440, compared to the overall median annual wage of $38,640 for all occupations.These positions not only benefit society, but they are also in high demand and well compensated.

To find which healthcare jobs have the highest salaries without requiring a medical degree, tutoring firm HeyTutoranalyzed data from the U.S. Bureau of Labor Statistics Occupational Employment Statistics and Employment Projections surveys. Its researchers looked only at healthcare practitioners and technical occupations requiring a masters degree or less. These 10 in-demand jobs all make over $75,000 per year.

Working in collaboration with a dentist, dental hygienistsassist patients by cleaning teeth, taking x-rays, and assessing oral health for signs of diseases such as gingivitis. In addition to having at least an associates degree, all dental hygienists must be licensed to practice. Half of dental hygienists work part-time, so this could be a good career path for a parent or caregiver. Dental hygienists have the highest total employment on this list.

Nuclear medicine technologistssupport physicians by preparing and administering radioactive chemicals to patients in order to diagnose health issues or provide treatment. For example, certain diagnostic tests like PET scans require the patient to ingest radioactive drugs to detect abnormalities like tumors. For some patients, radioactive drugs can be used for treatment instead of surgery. Even though nuclear medicine technologists have the lowest projected employment growth on this list, it is still higher than the projected growth rate for all occupations.

Speech-language pathologistsassistchildren and adults who struggle with speech or swallowing disorders. This occupation involves creating custom treatment plans for patients, which might include strengthening throat muscles, teaching vocabulary, or coaching patients on how to make sounds. Speech-language pathologists usually work in schools or hospitals.

One of the biggest determinants of health risks is family medical history. Genetic counselors analyze an individuals family medical history to analyze therisk of different genetic disorders and birth defects that could be inherited. Genetic counselors can assess risks for individuals ofany age, from infancy through adulthood. Genetic counselors have the lowest total employment on this list.

Radiation therapistswork in hospitals and other healthcare facilities to administer radiation treatments used toshrinkcancerous tumors. They must take precautions to ensure that only the desired area of treatment is targeted for the radiation, without affecting the rest of the body. Radiation therapists must have an associates degree, and some states require a license or certification exam.

Occupational therapists provide therapeutic services to ill or injured patients of all ages by integrating everyday activities into a holistic treatment plan. For example, occupational therapists might teach a patient with cerebral palsy how to get dressed or a child who struggles with fine motor skills how to hold a pencil. Occupational therapists might recommend special equipment like wheelchairs, identify improvements that can be made to the home or workplace, or teach new skills that all help improve quality of life for their patients.

Nurse midwivesare part of a subset known as advanced practice registered nurses (APRNs). Nurse midwives assist women in reproductive health by performing gynecological exams, offering prenatal care, and delivering babies. As with most of the other professions on this list, nurse midwives consult with physicians frequently to coordinate patients treatment.

Another type of APRN, nurse practitionershave many of the same responsibilities as a physician and can serve as a primary care provider. Nurse practitioners often focus on a specific age group, such as pediatric orgeriatric health. Nurse practitioners perform medical examinations, administer treatment, and counsel patients on health and wellness. Projected employment growth is 36.1 percent, significantly higher than the projected growth rate of 7.4 percentfor all occupations.

Physician assistants(PAs) work in a variety of healthcare settings to examine patients, diagnose illnesses, prescribe medication, and interpret diagnostic tests. PAs work under the supervision of a physician, but the amount of supervision required varies in each state. PAs must obtain a masters degree and a license in order to practice. Physician assistants have the highest projected employment growth on this list.

The third type of advanced practice nurse, nurse anesthetists are trained to provide anesthesia and pain management to patients undergoing surgery. The nurse anesthetist also stays with the patient for the duration of the procedure to check vitals and adjust the anesthesia if needed. Nurse anesthetists must earn a masters degree, a license, and a certification in order to practice. In addition, certified registered nurse anesthetists (CRNAs) must take a Continued Professional Certification (CPC) Program every 4 years in order to remain active.

The data used in this analysis is from the U.S. Bureau of Labor Statistics Occupational Employment Statistics and Employment Projections surveys. To find the highest-paying healthcare occupations that dont require a professional degree, only Healthcare Practitioners and Technical Occupationswere considered. Occupations requiring a professional degree were filtered out. The remaining occupations were ordered by their median annual wage for 2018 (rounded to the nearest thousand). Median annual wages and total employment are for 2018; whereas, the projected employment growth is for 2016-2026. Wage data cover non-farm wage and salary workers and does not cover the self-employed, owners and partners in unincorporated firms, or household workers.

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The Highest-Paying Healthcare Jobs That Don't Require a Medical School Degree - KMVU Fox 26 Medford

MedicalResearch.com Interview with:

Dr Ranjit Manchanda MD, MRCOG, PhDProfessor & Consultant Gynaecological OncologistNHS Innovation Accelerator (NIA) FellowIntegrated Academic Training Programme DirectorLondon Specialty School of Obstetrics & Gynaecology, Health Education EnglandCancer Research UK, Barts Centre | Queen Mary University of LondonDepartment of Gynaecological Oncology | Barts Health NHS Trust, Royal London HospitalLondon

MedicalResearch.com: What is the background for this study?

Response: Current national and international guidelines recommend genetic-testing (for BRCA genes) in women with breast cancer (BC) who fulfil recognised/established clinical criteria which are based on a history of cancer in the patient and family. However 50% of BRCA carriers do not fulfil these criteria. Thus the current family-history or clinical-criteria based approach misses half the people at risk. Additionally only 20%-30% of patients eligible tend to get referred for and access BRCA testing. Newer genes like PALB2 which cause breast cancer have been identified and can also be tested for.

Knowing a patients mutation status (carrier identification) can have a number of benefits. After unilateral breast cancer, mutations carriers can choose contralateral prophylactic-mastectomy (CPM) or preventative mastectomy of the second breast to reduce their risk of developing contralateral breast cancer. Additionally they can opt for surgical prevention for ovarian-cancer (OC). Cancer affected carriers may become eligible for novel drugs (like poly-adenosine-diphosphate-ribose-polymerase (PARP) inhibitors) and other precision-medicine based novel drug therapies through clinical trials. A major advantage of genetic-testing is enabling testing relatives of breast cancer mutation carriers, to identify unaffected relatives carrying mutations who can benefit from early diagnosis and cancer prevention.

Testing everyone instead of being restricted by family history will identify many more mutation carriers and their family members who can benefit from precision prevention. A large proportion of these cancers are preventable in known unaffected mutations carriers.

MedicalResearch.com: What are the main findings?

Response: In our study we compare two strategies of genetic testing in women with breast cancer.

Strategy-1: All women with breast cancer undergo BRCA1/BRCA2/PALB2 testing (multi gene testing).

Strategy-2: This is current practice where only those women who fulfil current family-history based clinical-criteria undergo BRCA-testing.

For the first time we show that moving to a strategy for multigene testing for all women with breast cancer diagnosed annually (irrespective of family history or any criteria) can prevent an additional 1142 breast cancer and 959 ovarian cancer cases and 633 (breast/ovarian cancer) deaths in the UK; and prevent 5,478 breast cancer and 4,275 ovarian cancer cases and 2,406 (breast/ovarian cancer) deaths in the USA.

We have performed a comprehensive cost-effectiveness analysis and show that this new strategy would remain well below UK/NICE (National Institute of Health & Care Excellence) and US cost-effectiveness thresholds which are 20,000-30,000/QALY (quality adjusted life year) and $100,000/QALY respectively. The incremental cost-effectiveness ratios are 10,464/QALY (from a payer-perspective) or 7,216/QALY (from a societal-perspective) in the UK or $65,661/QALY (form a payer-perspective) or $61,618/QALY (from a societal-perspective) in USA women.

MedicalResearch.com: What should readers take away from your report?

Response: Our findings support changing current policy to expand genetic-testing to multigene testing (BRCA1, BRCA2 and PALB2 mutations) for all women with breast cancer. This approach will save many more lives and is cost-effective.

A similar approach has recently been implemented for ovarian cancer over the last few years and now we need to do it in breast cancer too.

Oncologists, surgeons and clinical nurse-specialists may need to provide pre-test counselling and genetic-testing, with genetic-services focusing on post-test counselling and support for women found to carry gene mutations. Such a model has been implemented in ovarian cancer pathways. There are other models too which have been successfully used to deliver genetic testing and counselling in ovarian cancer and can be extrapolated or explored for breast cancer. Implementation will need to be accompanied by a process of training and education for relevant clinicians/health professionals involved in the breast cancer care pathway so that they can understand the implications for management.

Costs of testing are falling and technological advances can now deliver large volume high throughput genetic testing. All this provides huge new opportunities for cancer prevention and changes in the way we deliver cancer genetic testing in health care. This approach can ensure that more women can take preventative action to minimise their future cancer risk through prevention or early diagnosis options.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: What is needed is development and evaluation of implementation models and pathways to deliver this. Newer context specific delivery models will be needed for implementing this approach.

We are interested in evaluating and undertaking analysis in other countries too and also in the development and evaluation of context specific implementation pathways for unselected testing at breast cancer diagnosis including in low and middle income countries.

Disclosures these are listed in the paper. Please see paper.

I have received research funding from The Eve Appeal and Cancer Research UK into population testing and from Barts & the London Charity and Rosetree Charity outside this work, as well as an honorarium for grant review from Israel National Institute for Health Policy Research and honorarium for advisory board meeting for MSD and Astrazeneca. My work is supported through a NHS Innovation Accelerator Fellowship.

Disclosures from other co-authors-

Dr Buist and Dr Bowels- Grants from NCI. Dr Evans- Honorarium from Astrazeneca and grants from Manchester National Institute of Health Research Biomedical Research Centre. Dr Eccles- Grants from Cancer Research UK. Dr Cuzick and Dr Brentnall- Grants from Cancer Research UK.

Citation:

Sun L, Brentnall A, Patel S, et al. A Cost-effectiveness Analysis of Multigene Testing for All Patients With Breast Cancer.JAMA Oncol.Published online October 03, 2019. doi:10.1001/jamaoncol.2019.3323

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Oct 4, 2019 @ 1:48 pm

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Study Finds Multigene Testing For All Women With Breast Cancer Can Save Lives and Money - MedicalResearch.com

Genetic medicine is the integration and application of genomic technologies allows biomedical researchers and clinicians to collect data from large study population and to understand disease and genetic bases of drug response. It includes genome structure, functional genomics, epigenomics, genome scale population genomics, systems analysis, pharmacogenomics and proteomics. The Division of Genetic Medicine provides an academic environment enabling researchers to explore new relationships between disease susceptibility and human genetics. The Division of Genetic Medicine was established to host both research and clinical research programs focused on the genetic basis of health and disease. Equipped with state-of-the-art research tools and facilities, our faculty members are advancing knowledge of the common genetic determinants of cancer, congenital neuropathies, and heart disease.

Related Journals of Genetic Medicine

Cellular & Molecular Medicine, Translational Biomedicine, Biochemistry & Molecular Biology Journal, Cellular & Molecular Medicine, Electronic Journal of Biology, Molecular Enzymology and Drug Targets, Journal of Applied Genetics, Journal of Medical Genetics, Genetics in Medicine, Journal of Anti-Aging Medicine, Reproductive Medicine and Biology, Romanian journal of internal medicine

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Genetic Medicine | List of High Impact Articles | PPts ...

Faye Flam is a Bloomberg Opinion columnist. She has written for the Economist, the New York Times, the Washington Post, Psychology Today, Science and other publications. She has a degree in geophysics from the California Institute of Technology.

Weve had plenty of time to ponder the medical ethics.

Source: Hulton Archive, via Getty Images

Source: Hulton Archive, via Getty Images

The news that scientists may have finally used gene therapy to cure the bubble boy immune disorder, SCID-X1, came as a surprise not because it happened so fast, but because it took so long that it had begun to seem impossible.

Scientists were talking about revolutionizing medicine with gene therapy back in the 1980s, and the first child with a different form of the disease, called SCID-ADA, was given gene therapy in 1992. By 2000, doctors were treating the first kids with SCID-X1. But there were problems. Some of them developed leukemia.

Theres a belief that became pervasive in the 1990s that medicine is moving so fast that ethics cant keep up. Science stories in the news would refer toBrave New World or Frankensteins monster. But now that were living in that long-imagined future, it looks like science isnt keeping pace with the hype, which over the years has included promises of cures tied to the human genome project, the expectation that gene therapy would be commonplace, and even the weird belief that cloning would replace sex as the preferred method of human reproduction.

Things havent quite panned out that way. To better understand why, I talked with Jonathan Kimmelman, a medical ethicist at McGill University in Canada, and an expert in human experimentation. He said that despite all the hype, medical technology doesnt leap forward with every new idea the way other kinds of tech can. The ethics of human research slows things down.

Not that medical ethics is easy. The challenge for ethicists, and for society, is to judge research decisions based on what the scientists knew at the time, not the outcome. Unethical researchers might get lucky, and good ones might get very unlucky. By those standards, he said, the researchers who accidentally caused some SCID patients to get leukemia were still taking an ethically acceptable risk, given the scale of the potential benefits, but researchers at the University of Pennsylvania whose experiment killed an 18-year-old subject were not.

In that 1999 case, Jesse Gelsinger died from an experimental gene therapy aimed at curing a different genetic disorder one less life-threatening than SCID. His immune system mounted a deadly reaction to the virus used to insert the gene into his cells a deactivated cold virus called an adenovirus.

In retrospect, there were problems with that trial financial conflicts of interest, worrisome signs in animal studies that were ignored, and some irregularities in the way the human subjects were treated, said Kimmelman, who has written a book about the case. After the death, lots of people claimed to have seen these problems, but, sadly, none of them took the initiative to blow the whistle.

SCID gene therapy trials progressed more carefully, even though the disease was claiming lives with each passing year. A defective gene prevents the bone marrow from creating working immune cells, so kids with the disease have essentially no immune system. This came to public attention in the 1970s, when doctors found a way to keep the famous bubble boy, David Vetter, alive until the age of 12 by sealing him into a sterile plastic enclosure.

Gene therapy seemed like a promising solution. Doctors knew which genes were damaged, and they knew that they need to get working copies into the patients bone marrow.

But theres another layer of precision needed: It can matter where newly introduced genes get incorporated into the persons chromosomes. Viruses cant be programmed to put them in any specific place. Scientists knew, said Kimmelman, that getting the working versions of these genes into the wrong places might trigger leukemia. They thought it was very unlikely, but realized only after the fact that the viruses tended to preferentially place the genes in locations where they increased risk. In 2002, the SCID-X1 trial was stopped after the disease affected four children.

Over the years, scientists have examined other, safer vectors, and, counterintuitively, found that for SCID-X1, their best bet was a deactivated human immunodeficiency virus (HIV). These latest experiments, done in St. Judes Childrens Research Hospital in Memphis and published in the New England Journal of Medicine, took steps to prevent leukemia. Its still early, but the researchers say that so far the results look promising.

A similar standard should apply to the claimed gene-edited babies allegedly born in China late last year. The ethics has to be judged on the risks that were taken at the time, not the outcome, which may never be known given the secrecy surrounding the research. The babies - twin girls - were essentially human guinea pigs. The only disease involved was the fathers HIV-positive status, but there are safe ways to make sure a fathers virus isnt passed to his offspring.

The risks of this are still relatively unknown, and the fact that the SCID researchers misjudged the risk of giving their subjects leukemia should serve as a warning. Once again, in the case of the Crispr babies, the ethical principles were there, but they were broken maybe by a rogue scientist but possibly by one whose experiments were known and fundedby the Chinese government. Kimmelman points out that people have been debating the ethics of genetic engineering on unborn children since the 1970s, soon after the debut of genetic engineering.

In the medical community, there was almost universal agreement that the experiment was unethical because the twin girls were subject to unnecessary risk. The main problem with genetic technology isnt the need to prevent the birth ofFrankensteins monster, but to follow the ethical principles that Hippocrates wrote about more than 2,000 years ago. The needs of patients have to come first, even if it slows down the pace of progress.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:Faye Flam at fflam1@bloomberg.net

To contact the editor responsible for this story:Philip Gray at philipgray@bloomberg.net

Before it's here, it's on the Bloomberg Terminal.

Originally posted here:
Genetic Medicine Isn't Moving Faster Than the Speed of ...

Masters in Genetics Counseling The curriculum consists of 40 semester hours: 22 semester hours of didactic course work and 7 semester hours of research. Additionally, there are four 8-week clinical rotations, one 3-week laboratory rotation and one 6-week summer clinical rotation required of all students, which provide an additional 11 credit hours.

MS/MA in Genetic Counseling and Bioethics The Departments of Genetics & Genome Sciences and Bioethics offer a dual degree program between the Masters in Genetic Counseling and the Masters in Bioethics Programs. The dual degree program provides a comprehensive curriculum integrating foundational principles of genetics and ethics.

Faculty Leadership Read about the Genetic Counseling Training Program's Leadership.

How to Apply Interested in Applying? Read about how to apply to Case Western Reserve University's Masters of Genetic Counseling.

The Genetic Counseling Training Program offers two degrees: a Master of Science degree in Genetic Counseling or a Masters in Genetic Counseling and Bioethics (dual degree program).

The Master of Science degree in Genetic Counseling is a two-year academic program comprised of didactic coursework, laboratory exposure, research experience and extensive clinical training. The program, directed by Anne L. Matthews, RN, PhD, is an integral component of the teaching and research programs in the Department of Genetics and Genome Sciences at CWRU under the leadership of Dr. Anthony Wynshaw-Boris, MD/PhD, chairman of the department. Program leadership also includes Rebecca Darrah, MA, MS, PhD, Associate Director; and the program's medical director, Anna Mitchell, MD, PhD Associate Professor in the Department of Genetics and Genome Sciences and Medical Director of the Center for Human Genetics, University Hospitals Cleveland Medical Center; and Michelle Merrill, MS, LCGC, Director for Clinical Training and genetic counselor at the Center for Human Genetics, University Hospitals Cleveland Medical Center. The dual degree program in Genetic Counseling and Bioethics is co-directed by Drs. Matthews and Aaron Goldenberg, PhD, Associate Professor of Bioethics and Genetics & Genome Sciences.

The Program is accredited by the Accreditation Council for Genetic Counseling (ACGC) and graduates of the program are eligible to apply for Active Candidate Status and sit for the American Board of Genetic Counseling certification examination. We are extremely proud of our 98.7% pass rate for graduates who sat for the ABGC examination.

The mission and overall objective of the Genetic Counseling Training Program is to prepare students with the appropriate knowledge and experiences to function as competent and empathetic genetic counselors in a wide range of settings and roles. With unprecedented advances in our understanding of the genetic and molecular control of gene expression and development, and in our ability to apply this knowledge clinically, the Program strives to train students who can interface between patients, clinicians, and molecular and human geneticists. Students gain insightful and multifaceted skills that will enable them to be effective genetic counselors, aware of the many new technical advances and often-difficult ethical, legal and social issues that have surfaced in the light of the Human Genome Project. Graduates of the Program will be prepared to work in a variety of settings including both adult and pediatric genetics clinics, specialty clinics such as cancer genetics, cardiovascular genetics. and metabolic clinics, and prenatal diagnosis clinics, as well as in areas of research or commercial genetics laboratories relevant to genetic counseling and human genetics.

A unique aspect of the Genetic Counseling Training Program that it is housed within Case Western Reserve's Department of Genetics and Genome Sciences that is internationally known for both its clinical expertise and cutting edge research in molecular genetics, model organisms and human genetics. Thus, the Department of Genetics and Genome Sciences at CWRU provides an interface between human and medical genetics with basic genetics and provides an exciting atmosphere in which to learn and develop professionally. The direct access to both clinical resources and advanced technologies in human and model organisms affords students with an unparalleled environment for achievement.

The Graduate Program in Genetics in the Department of Genetics and Genome Sciences provides an interactive and collaborative environment for both pre (genetic counseling and PhD students) - and post-doctoral trainees to come together in a collegial atmosphere. By fostering interactions between pre- and post-doctoral trainees in genetic counseling, medical genetics, and basic research at an early stage of their careers, it is anticipated that graduates will be well-rounded professionals with an understanding of the importance of both clinical and basic research endeavors. Moreover, such resources as the Department of Biomedical Ethics, the Center for Genetic Research, Ethics and Law, the Mandel School of Applied Social Sciences, and the Law-Medicine Center provide for an enriched learning experience for students.

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Masters in Genetic Counseling - genetics.case.edu

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Even though cancers may be found in the same part of the body and look similar under the microscope, we now understand that they can be quite different. That difference often appears in how that tumor type responds to therapy. Increasingly, that variation in response to treatment can reflect the changes that are found in the DNA of the tumor. Thats why Moffitt Cancer Center looks at every patients cancer as unique. We start with a precise diagnosis that tries to identify the specific DNA alternations in the tumor and then create an individualized treatment plan that has the best chance of beating your cancer. Our team approach ensures a full range of specialists are collaborating to look at your cancer from every perspective.

The ultimate goal of personalized medicine at Moffitt is to create and share new, targeted treatments that will improve outcomes, cure disease, extend survivorship and improve quality of life for patients regardless of where they live. This is accomplished through existing clinical programs as well as ongoing research into how best to develop the right diagnosis and treatment plan for each individual.

Our efforts include:

DeBartolo Family Personalized Medicine InstituteThe DeBartolo Family Personalized Medicine Institute provides the hub for personalized care and research at Moffitt. Created by a generous donation from the DeBartolo Family Foundation, the DFPMI was created in 2012 to revolutionize the discovery, delivery and effectiveness of cancer care on an international scale.

Department of Individualized Cancer ManagementThe Department of Individualized Cancer Management includes five high impact and clinically oriented departments under the leadership of Dr. Howard McLeod: Adolescent & Young Adult, Gene Home, Genetic Risk Assessment Service, Personalized Cancer Medicine and the Senior Adult Oncology Program. The Personalized Cancer Medicine department is comprised of the Personalized Medicine Clinical Service (PMCS) and Clinical Genomics Action Committee (CGAC). PMCS and CGAC were developed as pathways for direct clinical translation of results from genomic testing. PMCS provides consultation and interpretation of the tumor genetic sequencing results for Moffitt patients and serves as a resource to Moffitt Physicians for input and advice regarding personalized medicine. CGAC serves as Moffitts unique molecular tumor board and includes a diverse team with expertise from various disciplines. Dr. McLeod, a renowned expert on the role of genetics on the individuals response to cancer therapies, is the Medical Director for the DeBartolo Family Personalized Medicine Institute.

Total Cancer CareMoffitt Cancer Center's Total Cancer Care initiative is an ambitious research partnership between patients, doctors and researchers to improve all aspects of cancer prevention and care. Patients participate by donating information and tissue. Researchers use the information to learn about all issues related to cancer and how care can be improved. Physicians use the information to better educate and care for patients.

Clinical PathwaysMoffitts clinical pathways are a model for providing evidence-based, consensus-driven, cost-effective cancer care. Each of the 51 disease-specific pathways that Moffitt has developed offers a detailed road map for physicians to provide state-of-the-art cancer care. The pathways demonstrate how to integrate evidence-based medicine with available technology to standardize, benchmark, measure and improve cancer care.

Molecular Diagnostics LaboratoryThe Morsani Molecular Diagnostics Laboratory is revolutionizing cancer diagnostics by using the most advanced genetic testing tools available to improve the precision in the patient care we provide. Studies show as many as 30 percent of initial cancer diagnoses are revised to indicate a different type of cancer. This lab seeks to reduce that number by developing clinical biomarkers that can help identify the right drug for a particular patient or determine if a specific clinical trial is a good match for a patient with a certain tumor gene mutation.

ORIENThe Oncology Research Information Exchange Network (ORIEN) is a unique research partnership among North Americas top cancer centers that recognizes collaboration and access to data as the key to cancer discovery. Through ORIEN, founders Moffitt and The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus leverage multiple data sources and match patients to targeted treatments. Partners have access to one of the worlds largest clinically annotated cancer tissue repositories and data from more than 100,000 patients who have consented to the donation for research.

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Personalized Medicine | Moffitt

At Montefiore, our approach to genetic testing and research demonstrates a unique recognition of the increasing importance of this field. We are one of the only institutions worldwide to have placed our Division of Reproductive Genetics within our Obstetrics & Gynecology Department, rather than within pediatrics, which allows our patients to receive highly specialized care before and during all stages of their pregnancies.

With our ever-growing knowledge of genetics, our approach to prenatal care and overall healthcare for women incorporates a new range of interventions and treatments. We are expanding the field further with ongoing research and patient care, and by training the next generation of experts through Montefiore's affiliation with the Albert Einstein College of Medicine.

Our doctors are among only a few nationally who have a specialty in medical genetics coupled with a foundation in gynecology. Women can expect comprehensive care that addresses all aspects of their own health and prenatal needs.

When a pregnant woman receives an ultrasound at Montefiore, we apply our expertise in genetics to look for Down Syndrome and other syndromes and birth defects, whether related to chromosomes or single genes. We continually expand our expertise by performing more than 1,500 amniocenteses annually. Our doctors have published many papers on topics related to unusual ultrasounds.

Montefiore's range of experts and well-coordinated services offer patients complete care without the stress of traveling between multiple sites. Such centralized treatment is especially important because of the emotional and physical stress of dealing with a serious problem. After managing women's care for more than 30 years, we have ample experience synchronizing treatments between departments such as Gynecology, Obstetrics, Pathology and Psychiatry.

We are also expanding our work on the link between genetics and infertility, including male infertility. Those seeking infertility treatments, such as in vitro fertilization, can talk to our expert geneticists about the latest advancements in the field in genetic counseling.

And because we work closely with our colleagues in pediatrics, our patients can be confident that they will receive informed, caring treatment through every stage of pregnancy and childbirth.

We are also committed to expanding our expertise in the field of cancer genetics specific to women, including testing for:

As we gain a greater understanding of the genes that predispose people to specific cancers, we are able to save lives by using a complete family history and genetic testing to identify patients who may be at risk.

Women can now receive therapies to treat and prevent cancer earlier than ever before. Montefiore's leadership in the field is evident in the increasing number of patients who are referred to us by doctors at other medical centers in the region because of our state-of-the-art care.

Please print and fill out the Genetics Questionnaire before your appointment with the geneticist or genetic counselor because it will be helpful for us. If you have medical records or family records, please bring them with you to your appointment.

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Genetic Counseling - Bronx - Westchester - New York ...

From the reviews:

"A compilation of genetic tests and related information . This book would be of great interest to molecular genetics fellows, pathology/laboratory medicine residents or fellows, practicing pathologists, and oncologists. It would also be of interest to anyone in the healthcare professions . I also recommend it to practitioners looking for a comprehensive and concise, state-of-the-art book on clinically useful molecular/genetic tests. It is a great study guide during training and would be a great review book in preparation for specialty board certification exams." (Valerie L. Ng, Doodys Review Service, July, 2008)

"This book provides a comprehensive review of the various molecular genetic tests that are currently being conducted at research and clinical laboratories. This textbook is robust and would be useful in an advanced genetics course ase part of a clinical-based diagnosic genetics-based graduate program; genetic training postdoctoral program, or molecular genetic pathology post-MD fellowship training program. In addition, some of the chapters in this book could be incorporated into existing advanced cytogenetic courses or upper-level molecular biology courses.

In summary, Molecular Genetic Pathology is a comprehensive review guide that looks at the various theories and methodologies of how molecular genetic testing is beingperformed." (Reviewed by Peter Hu, Molecular Genetic Technology Program, The University of Texas M.D. Anderson Cancer Center, Houston, Texas)

"The book features chapters written by experts in all aspects of molecular pathology . this is a timely and useful book, principally because of its comprehensiveness. Readers seeking an introduction to molecular diagnostics will probably find it thin on background explanations and overwhelming in detail. for trainees and laboratory workers in the field who need a quick summary of available techniques and diagnostic markers, it should prove to be a valuable and convenient resource." (Jeffrey Sklar, The New England Journal of Medicine, Vol. 360 (20), May, 2009)

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Molecular Genetic Pathology: 9781588299741: Medicine ...

Directions to CHDD from Main Information Desk at UWMCThe Patient Information Desk on the main (3rd Floor) of UWMC has detailed directions and a map to CHDD and may be able to provide an escort. From the Information Desk take the Pacific Elevators to the 1st Floor of the hospital. Walk through the Plaza Caf and exit the back glass doors of the hospital. CHDD is the four story brick building directly across the street. Check in at the reception desk on the main (2nd Floor) of CHDD.

Access the lot from 15th Avenue N.E. Stop at gate house 6 to obtain a parking permit.

Look for CHDD- designated or UWMC disability parking stalls. Walk out of S1 at the east end and enter CHDD Clinic building. Patients can be dropped off at the CHDD entrance from which vehicles can return to S1 for parking. A cash payment of $15.00 is required upon entry. Please leave the permit on your dashboard. A partial discount voucher will be given at appointment check-in for patients or family members.

CHDD Parking Brochure (PDF)

Disability ParkingFor All CHDD patients and families with mobility parking needs, the closest parking is in the S1 Garage. Please request a disability placard at the gate house. A cash payment of $15.00 is required upon entry. Please leave the permit on your dashboard. A partial discount voucher will be given at appointment check-in for patients or family members. Valet parking is available at the main entrance of the Medical Center; wheelchairs and escort services are available from the Information Desk.

Valet ParkingValet parking service for patients and their visitors is located in front of the Medical Center, near the main entrance. Allow extra time if you choose to use valet parking.

From valet service, walk east to the main entrance of UWMC. The Information Desk has detailed directions and a map to CHDD and may be able to provide an escort.Triangle Parking GarageThe Triangle Parking Garage is located on N.E. Pacific Place, across the street from UW Medical Center. From Montlake Blvd., turn left onto N.E. Pacific Street and right onto N.E. Pacific Place. The Triangle Garage has a height restriction of 6 8. Allow extra time if you choose to use the Triangle Parking Garage.From the Triangle Garage, take the pedestrian tunnel to the front entrance of the UWMC. The Information Desk has detailed directions and a map to CHDD and may be able to provide an escort.

Surgery Pavilion Parking GarageThe Surgery Pavilion Parking Garage is accessed off of N.E. Pacific Street next to the Emergency Room entrance. The Surgery Pavilion has a height restriction of 9 6 on Level P1. Levels P2 & P3 (2nd & 3rd floor) have a height restriction of 6 7. Allow extra time if you choose to use the Surgery Pavilion Parking Garage.

From the Surgery Pavilion Parking Garage, take the elevator to the third floor. Walk across the pedestrian overpass to the main hospital building lobby. The Information Desk has detailed directions and a map to CHDD and may be able to provide an escort.Payment Rates for parking in S-1, Valet, Triangle, Surgery Pavilion:Patients parking in S-1 will need to pay $15 up front which will be partially reimbursed with validation upon exiting the parking lot (see rates for parking in link above). Credit/Debit cards will be reimbursed on the card, while patients paying cash will be given a cash reimbursement.

Getting to UW Medical Center

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Genetic Medicine Clinic at UW Medical Center | UW Medicine