Author Archives: Dr Justin Marley

Physical Forces in SNOMED CT®

lightning3

In this series of posts I am evaluating SNOMED CT® using the international browser.

SNOMED CT® includes codings for physical forces. These allow for the coding of forces associated with trauma and also documentation about the weather as examples of clinical utility. When combined with other codings this allows for a rich description of the context of clinical events.

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

APOE and Lipid Metabolism (Updated 21.2.17)

liver
In a previous post we looked at a review by Dose J, Huebbe P, Nebel A and Rimbach G titled  ‘APOE4 genotype and stress response – a mini review’. APOE4 is referenced as an upstream regulator of Tau and Amyloid pathology in Small and Duff’s Dual Pathway Hypothesis.
Given the suggested role of APOE4 in the above hypothesis, it is important to understand the role of the Apolipoprotein (APOE) in lipid metabolism.
In their paper, Dose et al note that there APOE plays a role in three key pathways for lipid metabolism.
(1) The exogenous pathway: In this pathway, APOE is incorporated into chylomicrons as they pass from the intestine into the systemic circulation. The APOE facilitates the uptake of cholesterol in the Liver.
(2) The endogenous pathway: In this pathway, APOE facilitates the transfer of cholesterol to the peripheral tissues.
(3) The reverse cholesterol pathway: In this pathway, APOE facilitates the transfer of cholesterol from the peripheral tissues to the liver.
This is a simplification of the more nuanced explanation provided by Dose et al.
Citation
Dose J, Huebbe P, Nebel A, Rimbach G. APOE genotype and stress response – a mini review. Lipids in Health and Disease. 2016;15:121. doi:10.1186/s12944-016-0288-2.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Generic Specifiers in SNOMED CT®

snowboarder_in_flight_tannheim_austria

Snowboarder by Sören (CC BY 2.0)

In this series of posts, I am assessing the SNOMED CT® terminology using the international browser.

SNOMED CT® codes for what I would refer to as more generic specifiers. These are difficult to summarise but a number of these reference other types of classification (e.g. criminal and civil proceedings).

Other specifiers include categories of sports, broad types of measurement scales and a range of techniques used in interventions.

Appendix A – Other Posts in the Series on Health Information Exchanges

A Literature Review of 40 years of SNOMED

Arizona Statewide Health Information Exchange

A History of The Health Information Exchange in Pennsylvania

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Creating a Health Information Exchange in Arizona

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

ICD-11 and SNOMED CT®

ICD-SNOMED-CT® Harmonisation

Physical Objects in SNOMED CT®

ICD-1 – Well…near enough

ICD-2

ICD-3

ICD-4

ICD-5

ICD-6

ICD-7

ICD-8

ICD-9

ICD-10

ICD-11

Körner Data and SNOMED: A Snapshot from 1988

Mapping ICD 9 (or 10) to SNOMED CT®

Over 1 Million Relationships: SNOMED CT ®

SNOMED CT® International Browser

SNOMED CT® Utilises the Brodmann Area Classification for Brain Regions

The Insular Cortex and SNOMED CT®

Administrative Statuses in SNOMED CT®

Environment Descriptors in SNOMED CT®

Event Descriptors in SNOMED CT®

What’s a Kinkajou got to do with 21st Century Medical Terminology?

Standardisation of Health Information Technology in New Zealand

Statisticians were Responsible for the Development of an International Classification of Diseases

Why Do We Need Electronic Record Systems to Talk to Each Other

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

2 Genes Associated with Longevity

DNA code analysis

Dose J, Huebbe P, Nebel A and Rimbach G have published an interesting review on APOE4 ‘APOE genotype and stress response – a mini review‘. APOE4 is referenced as an upstream regulator of Tau and Amyloid pathology in Small and Duff’s Dual Pathway Hypothesis.
In this review, Dose and colleagues note that there are two genes that are associated with longevity
(1) Apolipoprotein E (APOE4)
(2) Forkhead box O3 (FOXO3)
Citation
Dose J, Huebbe P, Nebel A, Rimbach G. APOE genotype and stress response – a mini review. Lipids in Health and Disease. 2016;15:121. doi:10.1186/s12944-016-0288-2.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Physical Objects in SNOMED CT®

belomorkanal

In this series of posts, I am assessing the SNOMED CT® terminology using the international browser. SNOMED CT® codes physical objects. Many of these are objects that you might find in a hospital or other clinical environment. Whilst many are clinical, some of the coded objects are administrative tools. There are also objects that may be involved in the events leading up to a clinical assessment. The broader description of concepts may be more straightforward to use in clinical practice but there are finer levels of detail for some objects.

Appendix A – Other Posts in the Series on Health Information Exchanges

A Literature Review of 40 years of SNOMED

Arizona Statewide Health Information Exchange

A History of The Health Information Exchange in Pennsylvania

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Creating a Health Information Exchange in Arizona

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

ICD-11 and SNOMED CT®

ICD-SNOMED-CT® Harmonisation

ICD-1 – Well…near enough

ICD-2

ICD-3

ICD-4

ICD-5

ICD-6

ICD-7

ICD-8

ICD-9

ICD-10

ICD-11

Körner Data and SNOMED: A Snapshot from 1988

Mapping ICD 9 (or 10) to SNOMED CT®

Over 1 Million Relationships: SNOMED CT ®

SNOMED CT® International Browser

SNOMED CT® Utilises the Brodmann Area Classification for Brain Regions

The Insular Cortex and SNOMED CT®

Administrative Statuses in SNOMED CT®

Environment Descriptors in SNOMED CT®

Event Descriptors in SNOMED CT®

What’s a Kinkajou got to do with 21st Century Medical Terminology?

Standardisation of Health Information Technology in New Zealand

Statisticians were Responsible for the Development of an International Classification of Diseases

Why Do We Need Electronic Record Systems to Talk to Each Other

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Hypotheses About Alzheimer’s Disease: Summary of Posts to Date

Stylised Diagram of the Hippocampus - Frank Gaillard
Diagram showing Hippocampus, an area affected by Alzheimer’s Disease (credits Appendix A)

We’ve looked at a number of hypotheses about Alzheimer’s Disease and the finer details of some of these hypotheses. I’ll present an overview of the posts to date to help the readers orientate themselves. There was a previous summary but this current piece includes references to more recent posts to bring the summary up-to-date.

This video by the NIA provides an overview of the Amyloid and Tau pathologies described in Alzheimer’s Disease.

There was a discussion of the main hypothesis relating to Alzheimer’s Disease – the Amyloid Cascade hypothesis.We also looked at the Icelandic mutation which is thought to have protective qualities.

We looked at alternatives to the Amyloid Cascade hypothesis in this post. There was a discussion of the PART hypothesis which was driven by histopathological findings. There was also a look at Small and Duff’s Dual Pathway hypothesis (DPH) for Alzheimer’s Disease which focused on explaining the findings in late-onset Alzheimer’s Type Dementia. The hypothesis states that in addition to the Amyloid cascade which leads to Tau pathology there are upstream regulators that influence both pathologies.

In the DPH, special mention is made of three upstream regulators – APOE4, the Retromer protein-sorting complex and GSK. There was a focus on the Retromer protein-sorting complex in the first instance. The relationship of Retromers to the Endosome was discussed in this post. There was also a broader look at the Endomembrane system.

There was then a closer look at a component of the Retromer complex that was specifically mentioned in the DPH – VPs35. VPS35 was investigated in relation to Alzheimer’s Disease in a study published in 1995 by Small, one of the authors of the DPH. However much of the subsequent research into VPS35 has been related to Parkinson’s Disease and there has also been discussion of VPS35 more broadly in neurodegeneration.

We looked at Glycogen Synthase Kinase 3 another of the upstream regulators mentioned in the DPH.

glycogenesis

Glycogenesis by Mark Cicade (CC-BY-SA-4.0)

We saw in a review by Beurel and colleagues that there were two lines of evidence that focused interest on GSK3 in the research community investigating Alzheimer’s Disease and other aspects of the relationship in this post. We also looked at what Small and Duff had written about this relationship in their 2008 paper.

We also looked at lipid metabolism to gain a better understanding of the context of the APOE4 link in Alzheimer’s Disease. The Wellcome Trust created the video below which can be found on their YouTube channel. This provides a broad overview of lipid metabolism.

Appendix A – Credits

Picture by FG Designs. Creative Commons License.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Event Descriptors in SNOMED CT®

stretcher

In this series of posts I am looking at SNOMED CT® using the international browser. SNOMED CT® uses event descriptors. There are 117 events that I could identify including an extended period of being weightless. The event descriptors can be combined with the environment descriptors.

I thought there looks to be some overlap with the V, Y and Z codes in ICD-10 and again it will be interesting to see how this develops with the ICD-11/SNOMED CT® harmonisation.

Appendix A – Other Posts in the Series on Health Information Exchanges

A Literature Review of 40 years of SNOMED

Arizona Statewide Health Information Exchange

A History of The Health Information Exchange in Pennsylvania

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Creating a Health Information Exchange in Arizona

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

ICD-11 and SNOMED CT®

ICD-SNOMED-CT® Harmonisation

ICD-1 – Well…near enough

ICD-2

ICD-3

ICD-4

ICD-5

ICD-6

ICD-7

ICD-8

ICD-9

ICD-10

ICD-11

Körner Data and SNOMED: A Snapshot from 1988

Mapping ICD 9 (or 10) to SNOMED CT®

Over 1 Million Relationships: SNOMED CT ®

SNOMED CT® International Browser

SNOMED CT® Utilises the Brodmann Area Classification for Brain Regions

The Insular Cortex and SNOMED CT®

Administrative Statuses in SNOMED CT®

Environment Descriptors in SNOMED CT®

Metadata in SNOMED CT®

What’s a Kinkajou got to do with 21st Century Medical Terminology?

Standardisation of Health Information Technology in New Zealand

Statisticians were Responsible for the Development of an International Classification of Diseases

Why Do We Need Electronic Record Systems to Talk to Each Other

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.