PubMed · 11625845
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M Nurnberg. 1995. [Not Available].. https://pubmed.ncbi.nlm.nih.gov/11625845/
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Measuring the impact of drug resistance is an important step in understanding the scope of the problem and formulating policies to limit the emergence and spread of resistant organisms. Studies have focused on measuring the increased costs, morbidity, and mortality in patients with infections due to resistant versus susceptible organisms. These have generally found that resistance worsens outcomes. By focusing only on infected patients, however, they may understate the impact of resistance. It is important to recognize that resistance also affects the treatment of individuals with nonresistant organisms. In areas with high rates of resistance, physicians and governments have changed empiric therapy for malaria, tuberculosis, acute respiratory infections, and other diseases, increasing overall treatment costs. In some instances, these costs may exceed those attributable to treatment failure.
Due to large genome projects more and more genetic information and more and more data about genetic background of various diseases can be obtained. By means of microarrays thousands to hundreds of thousands of molecular analysis can be performed at a time, rapidly, under identical conditions, hereby microarrays provide a solution to continuously increasing throughput demands from large genomic, pharmacogenetic and proteomic programmes. Microarrays offer unprecedented opportunities for qualitative and quantitative analysis of gene expression, understanding gene function and detection gene alterations, polimorphisms. Microarray expression profiles will define stages of different tumor types and new prognostic subgroups in cancer and other diseases. For individual patients, more precise diagnosis and risk assessment based on expression profiles are already achievable, leading to more accurate determination of prognosis and more individually tailored treatment. Microarrays will play an important role in diagnostics of infectious diseases and identification of novel diagnostic and therapeutic targets. Wide-spread application of microarrays in clinical practice is not typical today, but their production on an industrial scale and the increased information provided by microarrays should assure their entry into clinical practice as very powerful, sensitive, specific and rapid tools of diagnostics of various diseases.
In trying to decide what type of scientific paper I could prepare as a tribute to Jim Neel, I thought back over the discussions that we had over some 25 years. Sometimes these discussions were on specific topics such as how to extrapolate from mutation data in mice to those for humans following radiation or chemical exposures. On other occasions, our discussions were of a more philosophical nature, particularly on where the field of epidemiology might or needed to go. For example, what types of data are needed for assessing the public health impact of exposure to environmental agents. Perhaps because I enjoyed these discussions so much, I have chosen to take a look from a current perspective at the field of molecular epidemiology. Jim Neel would have loved to have entered into this discussion; he would have enhanced it in is own inimitable way.