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Constraint therapy

Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
Shringika Soni, Rakesh Kumar Ruhela, Bikash Medhi
Purpose: For the past few decades central nervous system disorders were considered as a major strike on human health and social system of developing countries. The natural therapeutic methods for CNS disorders limited for many patients. Moreover, nanotechnology-based drug delivery to the brain may an exciting and promising platform to overcome the problem of BBB crossing. In this review, first we focused on the role of the blood-brain barrier in drug delivery; and second, we summarized synthesis methods of nanomedicine and their role in different CNS disorder...
September 2016: Advanced Pharmaceutical Bulletin
Qie He, Junfeng Zhu, David Dingli, Jasmine Foo, Kevin Zox Leder
Over the past decade, several targeted therapies (e.g. imatinib, dasatinib, nilotinib) have been developed to treat Chronic Myeloid Leukemia (CML). Despite an initial response to therapy, drug resistance remains a problem for some CML patients. Recent studies have shown that resistance mutations that preexist treatment can be detected in a substantial number of patients, and that this may be associated with eventual treatment failure. One proposed method to extend treatment efficacy is to use a combination of multiple targeted therapies...
October 2016: PLoS Computational Biology
Thomas B Brunner, Ursula Nestle, Sonja Adebahr, Eleni Gkika, Rolf Wiehle, Dimos Baltas, Anca-Ligia Grosu
OBJECTIVE: Stereotactic radiotherapy near serial organs at risk (OAR) requires special caution. A novel intensity-modulated radiotherapy (IMRT) prescription concept termed simultaneous integrated protection (SIP) for quantifiable and comparable dose prescription to targets very close to OAR is described. MATERIALS AND METHODS: An intersection volume of a planning risk volume (PRV) with the total planning target volume (PTV) defined the protection volume (PTVSIP)...
October 18, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Henry Zakumumpa, Modupe Oladunni Taiwo, Alex Muganzi, Freddie Ssengooba
BACKGROUND: Human resources for health (HRH) constraints are a major barrier to the sustainability of antiretroviral therapy (ART) scale-up programs in Sub-Saharan Africa. Many prior approaches to HRH constraints have taken a top-down trend of generalized global strategies and policy guidelines. The objective of the study was to examine the human resources for health strategies adopted by front-line providers in Uganda to sustain ART delivery beyond the initial ART scale-up phase between 2004 and 2009...
October 19, 2016: Human Resources for Health
Peter Rijnbeek
Massive numbers of electronic health records are currently being collected globally, including structured data in the form of diagnoses, medications, laboratory test results, and unstructured data contained in clinical narratives. This opens unprecedented possibilities for research and ultimately patient care. However, actual use of these databases in a multi-center study is severely hampered by a variety of challenges, e.g., each database has a different database structure and uses different terminology systems...
September 2016: Journal of Hypertension
Sara Barbiero, Alexandra Rink, Fabrizio Matteucci, David Fedele, Fabiola Paiar, Francesco Pasqualetti, Michele Avanzo
PURPOSE: To report on single-fraction stereotactic body radiotherapy (RT) (SBRT) with flattening filter (FF)-free (FFF) volumetric modulated arc therapy (VMAT) for lung cancer and to compare dosimetric results with VMAT with FF. METHODS AND MATERIALS: Overall, 25 patients were treated with 6-MV FFF VMAT (Varian TrueBeam STx LINAC) to a prescribed dose of 24Gy in a single fraction. Treatment plans were recreated using FF VMAT. Dose-volume indices, monitor units (MU), and treatment times were compared between FFF and FF VMAT techniques...
October 14, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Xiaodong Zhang, Shasha Jing, Peiyi Gao, Jing Xue, Lu Su, Weiping Li, Lijie Ren, Qingmao Hu
Segmentation of infarcts at hyperacute stage is challenging as they exhibit substantial variability which may even be hard for experts to delineate manually. In this paper, a sparse representation based classification method is explored. For each patient, four volumetric data items including three volumes of diffusion weighted imaging and a computed asymmetry map are employed to extract patch features which are then fed to dictionary learning and classification based on sparse representation. Elastic net is adopted to replace the traditional L0-norm/L1-norm constraints on sparse representation to stabilize sparse code...
2016: Computational and Mathematical Methods in Medicine
R J Cassidy, X Yang, T Liu, M Thomas, S G Nour, A B Jani
PURPOSE: Sexual dysfunction after radiotherapy for prostate cancer remains an important late adverse toxicity. The neurovascular bundles (NVB) that lie posterolaterally to the prostate are typically spared during prostatectomy, but in traditional radiotherapy planning they are not contoured as an organ-at-risk with dose constraints. Our goal was to determine the dosimetric feasibility of "NVB-sparing" prostate radiotherapy while still delivering adequate dose to the prostate. METHODS: Twenty-five consecutive patients with prostate cancer (with no extraprostatic disease on pelvic magnetic resonance imaging [MRI]) who that were treated with external beam radiotherapy, with the same primary planning target volume margins, to a dose of 79...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Marcus Sonier, William Chu, Nafisha Lalani, Darby Erler, Patrick Cheung, Renee Korol
To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jaroslaw T Hepel, Kara Lynne Leonard, Howard Safran, Thomas Ng, Angela Taber, Humera Khurshid, Ariel Birnbaum, David E Wazer, Thomas DiPetrillo
PURPOSE: Stereotactic body radiation therapy (SBRT) boost to primary and nodal disease after chemoradiation has potential to improve outcomes for advanced non-small cell lung cancer (NSCLC). A dose escalation study was initiated to evaluate the maximum tolerated dose (MTD). METHODS AND MATERIALS: Eligible patients received chemoradiation to a dose of 50.4 Gy in 28 fractions and had primary and nodal volumes appropriate for SBRT boost (<120 cc and <60 cc, respectively)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Lauren Henke, Rojano Kashani, Deshan Yang, Tianyu Zhao, Olga Green, Lindsey Olsen, Vivian Rodriguez, H Omar Wooten, H Harold Li, Yanle Hu, Jeffrey Bradley, Clifford Robinson, Parag Parikh, Jeff Michalski, Sasa Mutic, Jeffrey R Olsen
PURPOSE: To characterize potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. METHODS AND MATERIALS: Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR image guided RT system. The SBRT plans were created on the basis of tumor/organ at risk (OAR) anatomy at initial computed tomography simulation (PI), and simulated adaptive plans were created on the basis of observed MR image set tumor/OAR "anatomy of the day" (PA)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Jacob A Miller, Elizabeth E Bennett, Roy Xiao, Rupesh Kotecha, Samuel T Chao, Michael A Vogelbaum, Gene H Barnett, Lilyana Angelov, Erin S Murphy, Jennifer S Yu, Manmeet S Ahluwalia, John H Suh, Alireza M Mohammadi
BACKGROUND: The primary dose-limiting toxicity of stereotactic radiosurgery (SRS) is radiation necrosis (RN), which occurs after approximately 5% to 10% of treatments. This adverse event may worsen neurologic deficits, increase the frequency and cost of imaging, and necessitate prolonged treatment with steroids or antiangiogenic agents. Previous investigations have primarily identified lesion size and dosimetric constraints as risk factors for RN in small populations. We hypothesized that disease histology, receptor status, and mutational status are associated with RN...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Suresh Rana, ChihYao Cheng, Li Zhao, SungYong Park, Gary Larson, Carlos Vargas, Megan Dunn, Yuanshui Zheng
INTRODUCTION: The purpose of this study was to evaluate the dosimetric and radiobiological impact of intensity modulated proton therapy (IMPT) and RapidArc planning for high-risk prostate cancer with seminal vesicles. METHODS: Ten high-risk prostate cancer cases were included in this retrospective study. For each case, IMPT plans were generated using multiple field optimisation (MFO) technique (two fields) with XiO treatment planning system (TPS), whereas RapidArc plans were generated using double-arc technique (two full arcs) with Eclipse TPS...
May 11, 2016: Journal of Medical Radiation Sciences
Urszula Ledzewicz, Heinz Schaettler
We review results about the structure of administration of chemotherapeutic anti-cancer treatment that we have obtained from an analysis of minimally parameterized mathematical models using methods of optimal control. This is a branch of continuous-time optimization that studies the minimization of a performance criterion imposed on an underlying dynamical system subject to constraints. The scheduling of anti-cancer treatments has all the features of such a problem: treatments are administered in time and the interactions of the drugs with the tumor and its microenvironment determine the efficacy of therapy...
2016: Advances in Experimental Medicine and Biology
Judith Pérez-Velázquez, Jana L Gevertz, Aleksandra Karolak, Katarzyna A Rejniak
A tumor vasculature that is functionally abnormal results in irregular gradients of metabolites and drugs within the tumor tissue. Recently, significant efforts have been committed to experimentally examine how cellular response to anti-cancer treatments varies based on the environment in which the cells are grown. In vitro studies point to specific conditions in which tumor cells can remain dormant and survive the treatment. In vivo results suggest that cells can escape the effects of drug therapy in tissue regions that are poorly penetrated by the drugs...
2016: Advances in Experimental Medicine and Biology
Carmen Burtea, Sophie Laurent, Tuba Sanli, Deborah Fanfone, Aude Devalckeneer, Sébastien Sauvage, Marie-Claire Beckers, Sandrine Rorive, Isabelle Salmon, Luce Vander Elst, Bernard R Lauwerys, Robert N Muller
BACKGROUND: Interleukin-7 receptor alpha (IL-7Rα) represents a biomarker with potential applications in rheumatoid arthritis (RA) diagnosis and therapy. We have therefore searched by phage display potential IL-7Rα specific peptides with the primary goal being to develop in vivo molecular imaging tools. METHODS: IL-7Rα-targeted peptides were searched within a disulfide-constrained combinatorial phage displayed library of random linear heptapeptides. The apparent dissociation constant (Kd) and half maximal inhibition constant (IC50) were estimated for phage clones and synthesized peptides by ELISA...
October 12, 2016: Arthritis Research & Therapy
Amit Lakhanpal, Ernest Brahn
Biologics as therapeutic interventions for human disease represent both a distinctly modern novelty and an echo of ancient, or at least old, medical practice. The similarity lies in the sense that in both the synthetic effort occurs in living organisms (an extract of a plant, animal tissue, or a cell culture) while the difference is apparent in the bioengineering required in modern methods and the corresponding flexibility to customize the therapeutic product. Although the concept of looking to living systems as a source of medically useful compounds either for research or for actual patient care has never vanished, the development of biochemistry and advances in medicinal chemistry made production by total synthesis the standard for a safe, reliable, and commercial drug production at sufficient scale...
October 6, 2016: Clinical Rheumatology
Milly Buwenge, Savino Cilla, Alessandra Guido, Lucia Giaccherini, Gabriella Macchia, Francesco Deodato, Silvia Cammelli, Francesco Cellini, Gian C Mattiucci, Vincenzo Valentini, Markus Stock, Alessio G Morganti
AIM: Aim of this study was to perform a planning feasibility analysis of a 3-level dose prescription using an IMRT-SIB technique. BACKGROUND: Radiation therapy of locally advanced pancreatic cancer should administer a minimum dose to the duodenum and a very high dose to the vascular infiltration areas to improve the possibility of a radical resection. MATERIALS AND METHODS: Fifteen patients with pancreatic head adenocarcinoma and vascular involvement were included...
November 2016: Reports of Practical Oncology and Radiotherapy
Richard G Parker, Amaya Perez-Brumer, Jonathan Garcia, Kelly Gavigan, Ana Ramirez, Jack Milnor, Veriano Terto
INTRODUCTION: Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings. METHODS: Between January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention...
2016: Journal of the International AIDS Society
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