Biomedical Engineering Reference
In-Depth Information
fast data output. Technologies to analyse features such as detection of mutant
genes and transcripts, interacting sets of molecules including complexes of nucleic
acids and proteins, as well as variants introduced by chemical modifications of
specific nucleic acids or proteins also remain to be developed. Today positron-
emission tomography (PET) or PET-MR images already provide the possibility for
a quantitative analysis of the localisation of certain active substances in the body.
The new integrated PET-MR scanners allow the integration of complex, multi-
parametrical, multi-resolution data for 3D reconstructions. The new developments
in detection techniques and algorithms will improve both resolution and sensitivity
by an order of magnitude or more. X-ray tomography provides volumetric infor-
mation about the body or a particular organ. When used in conjunction with the
injection of a contrast agent and with an appropriate data analysis, it enables, for
example, efficient cardiovascular, pulmonary, and tumor imaging [
28
-
30
].
An issue that is gaining increasing importance is the multitude of micro-
organisms interacting with the human body. New publications [
31
,
32
] show that
the metabiome—the microbes living in our intestines—has much more influence
on human health than expected. In a few years time we will have access to
knowledge regarding how the microbiome interacts with the human body and
triggers or influences health status or certain diseases. The study of the microbi-
ome (the identification of the specific micro-organisms and their composition in
the intestines) was very demanding in the past because these microbes prefer
anaerobic conditions, and it was very difficult if not impossible to cultivate the
specific intestinal microbes in the lab for characterization. The fast and cheap next
generation sequencing techniques now open up the possibility to study these mi-
crobiomes via metagenomics approaches to characterize the composition of the
population in a given environment and with an appropriate time resolution. To
transfer metagenomic approaches into clinical practice new approaches in auto-
mated data assembly and annotation are needed.
One essential prerequisite to implement personalized medicine via a patient
model is the use of electronic health records (EHR) of patients. Today, in most
European countries we face the situation that the patient data are distributed and
fragmented, and most of this information is only available on paper. Finland,
Sweden, and Scotland as well as regions such as northern Italy have already
implemented EHR for their citizens, and more countries will follow. The EHR will
be the information core where all the data from a patient is collected and will
constitute the interface between patient and health professionals. In particular, the
monitoring of risk patients or patients with chronic diseases via sensors and
imaging needs a central repository connected to an alert system and to to clini-
cians. With higher mobility of citizens, EHRs are necessary to ensure patient data
can be accessed and updated independently from various locations and times.
Given this perspective of future personalized medicine it is important that plat-
forms implemented in different countries work according to standards and allow
interoperability between systems. The consent of the citizens in a society on legal
and ethical issues connected to an EHR are of crucial importance for the set-up of
EHRs, and one of the main questions will be related to the safe storage of the data
