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BIOL1080 > Evidence Based Medecine > Flashcards

Evidence Based Medecine Flashcards

1
Q

Systems biology

A

The systematic study of complex interactions in biological systems/ looking at the whole puzzle rather than one piece

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2
Q

Goal of systems biology

A

To better understand the whole process that happens in a biological system, opposite of usual reductionist approach

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3
Q

How does systems biology study biological systems

A

By perturbing/disturbing them either biologically, genetically or chemically and monitoring the gene and informational pathway responses and ultimately formulating the mathematical models that describe the structure of the system and it’s response to individual perturbations

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4
Q

Emergent properties

A

Properties of an entire system or organism that are not necessarily evident/obvious from just looking at individual components
“The whole is greater than the sum of its parts”
Ex personalities neuron

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5
Q

Levels of systems biology

A

Genes, proteins, tissues, organs and organ systems

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6
Q

Purpose of systems biology

A

Predict outcomes and responses in a living system (uses bioinformatics)

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7
Q

Bioinformatics

A

Complex mathematical modelling used to predict outcomes and responses
Field that develops tools to understand data

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8
Q

Omics

A

Looks at both genome and other components

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9
Q

Geneomics

A

Study of an organisms complete set of DNA

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10
Q

Prenomics

A

Study of all the set of proteins produced within a biological unit (organ, organism, organ system)

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11
Q

Metabolics

A

Study of metabolism within a givin unit(cell, tissue, organ, organism)

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12
Q

Reduction vs integration

A

Systems biology is abt putting together rather than taking apart, integration rather than reduction

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13
Q

Isolated models

A

Molecules, cells, organs or tissue
Reduction
Exquisite control over experimental conditions
Can explain mechanisms

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14
Q

Integrated models

A

Whole body or organism approach
Less control over variables
Viewed as less
More important

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15
Q

Biological concepts of health from the systems biology perspective of the adult human

A
  1. Each adult human can be considered as a unique biological system
  2. The adult human biological system has a control and communication network (CCN) that coordinates our functions (networking)
  3. The CCN controls and processes information flow in the adult human
  4. The CCN is the focal point of health in the adult human
  5. Aging and disease are processes which represent compromised functions/structure of the CCN
  6. Systems biology is an integrated approach to health disease and aging and should enhance medical and healthcare practice
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16
Q

Emergent property

A

A collection or complex system has but which the individual members do not have

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17
Q

7 characteristics of life

A
  1. Responsiveness to environment
  2. Growth and change
  3. Ability to reproduce
  4. Have a metabolism and breath
  5. Maintain homeostasis
  6. Be made of cells
  7. Pass traits to offspring
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18
Q

Robert Sapolsky

A

Neurologist and primatologist
Explores long term health impacts of stress

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19
Q

Components of the CCN

A

(Which all interact)
- the central nervous system
- the peripheral nervous system
- the endocrine system
- support and defence system

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20
Q

Properties of the CCN

A

1.Controls and coordinates the function of all physiological systems and individual organs including itself
2. It’s always on
3. It is distributed throughout the entire body
4. Each component of the network has multiple functions
5. Information flow is chemical based via cell to cell connection

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21
Q

Inputs of health disease and aging

A

The CCN is the integrator of inputs of health disease and aging
genetics, 🧬
environment ☀️
lifestyle 🏋️

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22
Q

Seven dimensions of human health

A

Spiritual
Physical
Mental
Emotional
Environmental
Social
Occupational

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23
Q

Examples of diseases resulting from diminished/abnormal function of CCN

A

Diabetes, atherosclerosis
Cancer, autoimmune diseases
Depression, ADHD
Have primary portion of CCN affected

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24
Q

Examples of reduced function CCN with aging

A

Impaired memory, Alzheimer’s, (central nervous system)
Diminishes touch sensitivity (peripheral)
Impaired wound healing (support and defence)

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25
Q

P4 Medecine

A

Personalized, predictive, preventative, participatory
Informed by each person’s unique, genetic and genomic & environmental information

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26
Q

Research in medecine and healthcare

A

-experimental models in health research
- human studies, basic experimental designs (non clinical, clinical)
-evidence based medecine
- new dimensions in medecine and healthccare

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27
Q

Types of models for human medical and health research

A

A- simulations with math models/computer (in silico)
B- in vitro (in glass) and ex vitro (out of the living) models
C- Animal models
D- Human participants

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28
Q

Purpose of in vitro and exvitro research

A

-allows for more controlled experimental conditions (isolating something without system)
- Understanding fundamental mechanisms

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29
Q

Examples of in vitro and ex vitro research

A

Isolated and beating heart, culturing cells, growing skin, transformed cancer cells

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30
Q

Nematodes and fruit flies

A

Animal models for research
Both used extensively to study genetics

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31
Q

C. Elegans

A

Nematode (40% genetic homology to human)
Easy to study
Cheap
Short life cycle
Self fertilizers
Can be frozen, thawed and remain viable
Transparent. Facilitates study of cell differentiation

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32
Q

Research examples c elegans

A

Embryonic metabolism
Using fluorescent light to follow digestion of a nutrient, synthesis of proteins, cholesterol etc.

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33
Q

Drospholia Melangaster

A

Fruit fly with 65% genetic homology to human

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34
Q

Why would drispholia melangaster be used in neuropharmacy research

A

Life cycle and development are very sensitive to environmental conditions
Can be Used in neuropharmacy research to study the effects of drugs and alcohol

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35
Q

Laboratory rats

A

Animal models
Very social and intelligent
Often used to study lifestyle effects on metabolism (diets, exercise, drugs)
Tend to take a more severe approach than with humans ex 50% fat diets, 10hrs/week except code
Not good model for human infant nutrition and metabolism

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36
Q

Laboratory mice

A

Many different strains
Used to study lifestyle effects on metabolism, results may differ from rats
Can’t assume one model = another

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37
Q

Why are mice a popular animal model for research?

A

Due to ease of applying recombinant DNA technology (knockout a gene, overexpress a gene)
Can test importance of a single protein

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38
Q

Why can’t we assume rats = mice

A

Results may differ

Takes longer to make a mouse insulin resistant on a high fat diet than rats
Muscle metabolism can differ(less impairments of glucose uptake with mice with high fat diet vs rats
Mitochondria adapt less robustly with exercise in mice vs rats

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39
Q

Laboratory swine

A

animal models
Piglets are the Best primative models for human infant development and metabolism
Used to study organ transplant (xenografts)

40
Q

Laboratory primates

A

Closest model you will get to represent the human BUT
Ethics? Cost?
Very little primate research in Canada more in USA

41
Q

TYPE of research done on laboratory primates

A

Human pathologies (AIDS etc) drug abuse
Transplantation

42
Q

Basic experimental design of humans and healthcare research

A

Non-clinical studies (non intervention)
Clinical studies (intervention)

43
Q

Non clinical studies

A

No intervention
No medicinal / lifestyle treatment given
Cannot predict or prove cause and effect of a medicinal substance
Only predicts associations/correlations

44
Q

What are most common type of non clinical study

A

Epidemiological (diseases)

45
Q

Clinical studies

A

Intervention
Any investigation involving participants that evaluates the effects of one or more health related interventional health outcomes
A medicinal or lifestyle treatment and or control substance and placebo are given

46
Q

What are the gold standard for human healthcare research

A

Double-blind, placebo controlled clinical trials

47
Q

Who reviews research for human clinical trials

A

Institutional ethics review boards

48
Q

Tests performed to test a new drug’s safety

A
  1. Preclinical
  2. Phase I clinical trial
  3. Phase II clinal trial
  4. Phase III clinical trial
  5. After approval
49
Q

Preclinical

A

Animal studies before testing on human

50
Q

Phase I clinical trial

A

Is the drug safe for humans? Small group of people (10s)

51
Q

Phase II clinical trial

A

Does the drug work for its intended purpose? Uses larger group (100s)
Check safety, figure out dose

52
Q

Phase III clinical trial

A

How does the drug compare to other available treatments? Even larger group (1000s)

53
Q

After approval

A

Ongoing assessment of long term use, benefits and risks

54
Q

Cochrane reviews

A

A database of systemic reviews and meta-analyses which summarize and interpret results of medical research

55
Q

RCTs

A

Randomized controlled trials
Gold standard of human medicine research
Interventions
Should be blinded

56
Q

Lowest to highest relevance to clinical setting types of research

A

Insilico research (lowest)
In vitro
Animal model
Case control studies (no intervention)
Cohort survey studies
Randomized control trials
Critically appraised papers
“. “. Topics
Systematic reviews

57
Q

Evidence based medicine outcome

A

Takes into account
Patient values
Clinical data
Research evidence
To formulate the optimal decision

58
Q

New dimensions in medical and healthcare practice

A

A. Evolutionary medecine
B. Integrative medecine
C. Collective medicine
D. Enhancement medicine

59
Q

Evolutionary medicine

A

Aka Darwinian medicine
The application of modern evolutionary theory to understanding healthcare and disease

60
Q

Examples of evolutionary medecine

A

Paleo diet- is our modern diet unhealthy?
We get little physical activity- is this a sign we’re injured and need to slow down our metabolism
We all have fight or flight response but what if it’s always on

61
Q

Integrative medicine

A

Treats the whole person, including all aspects of lifestyle, not just the symptoms
Holistic medecine
Emphasizes therapeutic relationship between practitioner and patient, is informed by evidence and makes use of all appropriate therapies
Ex acupuncture, aromatherapy

62
Q

Collective medicine

A

Recognises human and animal health and mental health are inextricably linked

63
Q

One health

A

Term applied to connections among the health of humans animals and the environment

64
Q

Enhancement medicine

A

Botox, liposuction, fertility drugs, laser vision, steroids

65
Q

Nootropics

A

Type of enhancement medicine (Brain enhancers)
Dopaminergenics
Cholinergic stimulants
Natural compounds (omega 3s?)

66
Q

Trajectory

A

Growth, development and aging
(Years, decades)

67
Q

Rhythms

A

Maintenance/repair, other processes
(Days weeks months)

68
Q

Homeostasis or balance (time)

A

Maintenance of steady state
(Seconds minutes, hours)

69
Q

Energy and information flow (time)

A

Action potentials, enzymatic reactions
(Milliseconds, microseconds)

70
Q

Lifespan

A

How long we live

71
Q

Healthspan

A

How long we live healthily, independent lifestyle

72
Q

Average lifespan factors

A

Weight, build, exercise, stress, sleep, education level, blood, total cholesterol, blood pressure, smoking, age of parents/grandparents

73
Q

Bio markers

A

Things to measure objectively
Then we can track aging/disease process
Indicates the biological state of an organism

74
Q

Sarcopenia

A

Age related muscle mass loss
Up to 1% after age 40

75
Q

Requirements of a bio marker

A

Reflect the normal healthy function or disease process or predict the risk of future development of disease
Have a predictable range across an identifiable category of individuals or must be routinely monitored over time within each individual
Have methods available for accurate and precise measurement

76
Q

How to use bio markers to diagnose?

A

Most markers have normal ranges and if patients value is too high or low it can be used to assess a risk for a disease or diagnose one
When you are outside of a reference range

77
Q

Chronobiology

A

The study of timescales and cycles in biology
Branch of biology concerned with natural physical rhythms

78
Q

The 3 Biological rhythms

A

Ultradian
Circadian
Infradian

79
Q

Ultradian rhythm

A

Less than 24 hours
Ex. Appetite ghrelin, cortisol

80
Q

Circadian

A

24 hour biological rhythm
Ex. Sleep, cortisol lowest at midnight, peak in the morning

81
Q

Infradian rhythm

A

Biological rhythm
More than 24 hours
Ex. Menstrul cycle

82
Q

Diurnal variation/circadian rhythms

A

Based on 24 hour cycle
Involved in all phsiological processes
Controlled by peripheral clocks that are governed by a master or central clock
Controls gene expression, regulation of enzyme activities, neural function, hormone secretion

83
Q

What do circadian rhythms coordinate

A

Sleep, nutrient supply, activity patterns. With metabolic patterns required at different stages of the day

84
Q

Disruption of circadian rhythms outcomes

A

Leads to a wide spectrum of health problems and premature aging
Elevated inflammatory cytokines
Gastrointestinal function
Obesity
Metabolic syndrome

85
Q

When is wound healing fastest and why

A

In the morning because our cells evolved to be able to heal wounds more effectively at the biological time they are most likely to occur

86
Q

Suprachiasmatic nucleus

A

The master or central clock which keeps time based on light signals from the retina
Nearly every cell in the body has a subsidiary (peripheral) clock that coordinates its metabolism with the rest of the body (slave to central clock)

87
Q

What controls the molecular clock

A

Not very understood
Entrained by light and dark cycles
Still intact in most blind individuals
Chemical signals involved are not clear (prob melatonin)

88
Q

Health implications of f disruptions of circadian rhythms

A

Shift workers tend to experience a greater incidence of
Heart attacks
Obesity, diabetes, cardiovascular complications
Cancer
Alzheimer’s disease

89
Q

Late chronotypes risks

A

Night owls
More likely to suffer from mental stress than smokers

90
Q

Examples of circadian rhythm relevant to health

A
  1. Heart attack risk is greater mid morning no clear answer yet
    (Could be protein Klf15) affect the K+ efflux in heart or caffeine, stress, combination of factors
  2. There is a two centimetre diurnal/daily variation in height
91
Q

Limitation of using height as a bio marker for osteoporosis

A

It varies
Timing of measurements need to be standardized
Needs to be measured over time in each Individual
Doesn’t change much during disease
Can’t directly predict the disease state

92
Q

What is best bio marker for osteoporosis

A

DEXA
Dual energy X-ray absorptionometry determines bone mineral density as a more definite approach

93
Q

When we need calcium for our non bone tissues where do we get it

A

We obtain it from dissolution of the minerals in bone

94
Q

When we have excess calcium in the blood stream where does it go

A

we deposit calcium in the bone
Bone acts as a buffer for calcium levels

95
Q

Age of peak bone mass

A

20-30

96
Q

When we measure bone density with dexa what are we estimating

A

The amount of x-ray absorbing dense material, hydroxyapatite that is packed in the extracellular space of the bone

97
Q

Hydroappetite

A

The amount of x-ray absorbing dense material that is packed in the extracellular space of the bone

BIOL1080 (3 decks)

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