10 reasons how biomedical sciences apply to the clinical case updated 2023

A PowerPoint presentation of a critical appraisal I did, which I will attach. My presentation needs to be 30 minutes long. CATEGORY COMMENTS* Points Preparation and Quality of Presentation Presentation of the significant details of the clinical case Spoke clearly and

emphasized important points. Adequate pace of delivery within required presentation length (~30 min) Professionalism of presentation slides

(i.e. no typos, grammatically correct, consistency and clarity formatting) Answered and handled all questions appropriately in a confident manner. 0-10 points PICO Question Background search was conducted thoroughly and prior learning was reviewed and applied in developing the

PICO question. All PICO components are clearly defined, correctly written, and in the correct order. The PICO question is appropriately derived from the case and reflects a clinically relevant question. 0-10 points Background on Topic/Biomedical Able to

thoroughly explain the events that occur at the physiological, and/or biochemical, cellular and molecular levels of the biomedical topic relevant to the case

Demonstrates a thorough understanding of how biomedical sciences/case topic apply to the clinical case

Demonstrates knowledge of pathology/disease implication on oral health and dental treatment ___0-15 points Search and References Description of the Key steps in the

search strategy were completed; 1) key words and or MeSH terms were relevant to the PICO 2) PubMed or other EB search engines were used, 3) article retrieved from a peer-

reviewed journal 4) article is of appropriate level of evidence and relevant to the PICO 5) References listed and formatted appropriately. 0-5 points

Basic Biomedical Sciences Research

Basic biomedical research, which addresses mechanisms that underlie the formation and function of living organisms, ranging from the study of single molecules to complex integrated functions of humans, contributes profoundly to our knowledge of how disease, trauma, or genetic defects alter normal physiological and behavioral processes.

Recent advances in molecular biology techniques and characterization of the human genome, as well as the genomes of an increasing number of model organisms, have provided basic biomedical researchers with the tools to elucidate molecular-, cellular-, and systems-level processes at an unprecedented depth and rate.

Thus basic biomedical research affects clinical research and vice versa. Biomedical researchers supply many of the new ideas that can be translated into potential therapies and subsequently tested in clinical studies, while clinical researchers may suggest novel mechanisms of disease that can then be tested in basic studies using animal models.

The tools also now exist to rapidly apply insights gained from model organisms to human health and disease. For example, gene mutations known to contribute to human disease can be investigated in model organisms, whose underlying characteristics lend them to rapid assessment. Resulting treatment strategies can then be tested in mammalian species prior to the design of human clinical trials.

These and other mutually supportive systems suggest that such interactions between basic biomedical and clinical researchers not only will continue but will grow as the two domains keep expanding. But the two corresponding workforces will likely remain, for the most part, distinct.

Similarly, there is a symbiosis between basic biomedical and behavioral and social sciences research )

and an obvious overlap at the interface of neuroscience, physiological psychology, and behavior.

The boundary between these areas is likely to remain indistinct as genetic and environmental influences that affect brain formation and function are better understood. Consequently, such investigations will impact the study of higher cognitive functions, motivation, and other areas traditionally studied by behavioral and social scientists.

Basic biomedical research will therefore undoubtedly continue to play a central role in the discovery of novel mechanisms underlying human disease and in the elucidation of those suggested by clinical studies. As an example, although a number of genes that contribute to disorders such as Huntington’s, Parkinson’s, and Alzheimer’s disease have been

identified, the development of successful therapies will require an understanding of the role that the proteins encoded by these genes play in normal cellular processes. Similarly, realizing the potential of stem cell–based therapies for a number of disorders will require characterization of the signals that cause stem cells to differentiate into specific cell types.

Thus a workforce trained in basic biomedical research will be needed to apply current knowledge and that gained in the future toward the improvement of human health. Since such research will be carried out not only in academic institutions but increasingly in

industry as well, the workforce must be sufficient to supply basic biomedical researchers for large pharmaceutical companies as well as smaller biotech and bioengineering firms, thereby contributing to the economy as well as human health.

Pathology: The Clinical Description of Human Disease

Pathology (from the Greek word pathology, meaning the study of suffering) refers to the specialty of medical science concerned with the cause, development, structural/functional changes, and natural history associated with diseases.

Disease refers to a definable deviation from a normal phenotype (observable characteristics due to genome and environment), evident via patient complaints (symptoms), and/or the measurements of a careful observer (signs). The cause of the disease is referred to as its etiology (from the Greek word meaning the study of cause). One disease entity can have more than one etiology, and one etiology can lead to more than one disease.

Each disease entity develops through a series of mechanistic chemical and cellular steps. This stepwise process of disease development is referred to as its pathogenesis (from the Greek word meaning generation of suffering). Pathogenesis can refer to the changes in the structure or function of an organism at the gross/clinical level, and it can refer to the stepwise molecular abnormalities leading to changes in cellular and tissue function.

The presentation of a disease to a clinician is in the form of a human patient with variably specific complaints (symptoms), to which the examining physicians can add diagnostic sensitivity and specificity by making observations (screening for signs of diseases). These phenotypic (measurable characteristic) abnormalities reflect the interaction of the genotype (cytogenetic and nucleic acid sequence/expression) of the patient and his/her environment. Patient workup uses present illness history with reference to past medical

history, review of other organ systems for other abnormalities, review of family history, physical examination, radiographic studies, clinical laboratory studies (for example, peripheral blood or CSF specimens), and anatomic pathology laboratory studies (for example, tissue biopsy or pleural fluid cytology specimens). As you will see from other chapters in this book, the ability to rapidly and inexpensively screen for chromosomal translocations, copy number variation, genetic variation, and abundance of mRNA and miRNA is adding substantial molecular correlative information to the workup of diseases.

The differential diagnosis represents the set of possible diagnoses that could account for symptoms and signs associated with the condition of the patient.

The conclusion of the workup generally results in a specific diagnosis which meets a set of diagnostic criteria, and which explains the patient’s symptoms and phenotypic abnormalities. Obviously, arrival at the correct diagnosis is a function of the examining physician and pathologist (fund of knowledge, experience, alertness), the prevalence of the disease in question in the particular patient (age, race, sex, site), and the sensitivity/specificity of the screening tests used (physical exam, vital signs, blood solutes, tissue stains, genetic assays).

The pathologic diagnosis represents the best estimate currently possible of the disease entity affecting the patient, and is the basis for downstream follow-up and treatment decisions. The diagnosis implies a natural history (course of disease, including chronicity, functional impairment, survival) that most patients with this disease are expected to follow. Be aware that not all patients with a given disease will naturally follow the same disease course, so differences in patient outcome do not necessarily correspond to incorrect diagnosis.

Variables that independently correlate with clinical outcome differences are called independent prognostic variables, and are routinely assessed in an effort to predict the natural history of the disease in the patient. It is also important to note that medical therapies for specific diseases do not always work. Variables that independently correlate with (predict) responses to therapy are called independent predictive variables.

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References

1 .Rehabilitation and Therapy: Biomedical sciences contribute to developing and refining rehabilitation techniques, physical therapy protocols, and assistive technologies for

2 .Pathophysiology: Biomedical sciences provide understanding of the underlying mechanisms and pathophysiology of diseases, enabling clinicians to comprehend disease processes and guide treatment decisions.

3 . Disease Diagnosis: Biomedical sciences provide knowledge and tools for accurate diagnosis of diseases through techniques such as laboratory tests, imaging technologies, and molecular diagnostics. (Reference: Kumar, V., Abbas, A. K., Aster, J. C., & Robbins, S. L. (2021). Robbins Basic Pathology (11th ed.). Elsevier.)