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Constraint therapy

Atallah Baydoun, Neha Vapiwala, Lee E Ponsky, Musaddiq Awan, Ali Kassaee, David Sutton, Tarun K Podder, Yuxia Zhang, Donald Dobbins, Raymond F Muzic, Bryan Traughber, Mitchell Machtay, Rodney Ellis
PURPOSE: We conducted this dosimetric analysis to evaluate the feasibility of a multi-center stereotactic body radiation therapy (SBRT) trial for renal cell carcinoma (RCC) using different SBRT platforms. MATERIALS/METHODS: The computed tomography (CT) simulation images of 10 patients with unilateral RCC previously treated on a Phase 1 trial at Institution 1 were anonymized and shared with Institution 2 after IRB approval. Treatment planning was generated through five different platforms aiming a total dose of 48 Gy in three fractions...
March 14, 2018: Journal of Applied Clinical Medical Physics
Laura M Scorr, Michael R Silver, John Hanfelt, Elaine Sperin, Alan Freeman, H A Jinnah, Stewart A Factor
Oromandibular dystonia (OMD) causes involuntary movements of masticatory and lingual muscles impairing eating, speaking, and swallowing. Treatment options are limited. The objective of this study was to determine the safety and efficacy of abobotulinumtoxinA (aboBoNTA) in OMD. A dose-finding study (phase 1) followed by a single session, prospective, single-blind trial (phase 2) was carried out. OMD subjects were evaluated at baseline, 6 and 12 weeks. Muscles injected were tailored to individual symptoms using EMG guidance, but the aboBoNTA dose for each muscle was pre-specified based on phase 1 results...
March 14, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Yoshikazu Maeda, Yoshitaka Sato, Hiroki Minami, Yutaka Yasukawa, Kazutaka Yamamoto, Hiroyasu Tamamura, Satoshi Shibata, Sayuri Bou, Makoto Sasaki, Yuji Tameshige, Kyo Kume, Hiroshi Ooto, Shigeru Kasahara, Yasuhiro Shimizu, Yusuke Saga, Akira Omoya, Makoto Saitou
PURPOSE: To evaluate the effectiveness of CT image-guided proton radiotherapy for prostate cancer by analyzing the positioning uncertainty and assessing daily dose change due to anatomical variations. MATERIALS AND METHODS: Patients with prostate cancer were treated by opposed lateral proton beams based on a passive scattering method using an in-room CT image-guided system. The system employs a single couch for both CT scanning and beam delivery. The patient was positioned by matching the boundary between the prostate and the rectum's anterior region identified in the CT images to the corresponding boundary in the simulator images after bone matching...
March 12, 2018: Medical Physics
Gitendra Uswatte, Edward Taub, Mary H Bowman, Adriana Delgado, Camille Bryson, David M Morris, Staci Mckay, Joydip Barman, Victor W Mark
PURPOSE: To evaluate the efficacy of an expanded form of Constraint-Induced Movement Therapy (eCIMT) that renders CIMT, originally designed for treating mild-to-moderate upper-extremity hemiparesis, suitable for treating severe hemiparesis. METHODS: Twenty-one adults ≥1 year after stroke with severe upper-extremity hemiparesis (with little or no capacity to make movements with the more-affected hand) were randomly assigned to eCIMT (n = 10), a placebo-control procedure (n = 4), or usual care (n = 7)...
2018: Restorative Neurology and Neuroscience
Maxwell Eyram Afari, Wajih Syed, Lana Tsao
Heart failure (HF), the cardiovascular epidemic of the twenty-first century, is associated with significant comorbidities and high mortality. The prevalence of HF is estimated around 6.5 million people and is expected to increase to 8 million by the year 2030. The associated costs to care for these patients continue to increase. Despite the advancement of pharmacologic therapy with significant improvement in morbidity and mortality, the 5-year survival for heart failure still stands at 61%. The challenges faced by HF patients include difficulty with lifestyle modifications, nonadherence to complex medical regimens, financial limitations, lack of access to medical care, and unfavorable side effects...
March 10, 2018: Heart Failure Reviews
Chia-Ming Chang, Yi-Hsin Lin, Abhishek Kumar Srivastava, Vladimir Grigorievich Chigrinov
Photobiomodulation or low-level light therapy (LLLT) has extensive applications based on light-induced effects in biological systems. Photobiomodulation remains controversial because of a poorly understood biochemical mechanism limited by the well-known biphasic dose response or Arndt-Schulz curve. The Arndt-Schulz curve states that an optimal dose of light is a key factor for realizing a therapeutic effect. In this report, we demonstrate a tunable optical system for photobiomodulation to aid physicians in overcoming the constraints of light due to biphasic dose response...
March 9, 2018: Scientific Reports
Jie Wei, Ming Chao
PURPOSE: We presented a feasibility study to extract the diaphragm motion from the inferior contrast cone beam computed tomography (CBCT) projection images using a constrained linear regression optimization algorithm. METHODS: The shape of the diaphragm was fitted by a parabolic function which was initialized by five manually placed points on the diaphragm contour of a pre-selected projection. A constrained linear regression model by exploiting the spatial, algebraic, and temporal constraints of the diaphragm, approximated by a parabola, was employed to estimate the parameters...
February 2018: Physica Medica: PM
Siiri E Iismaa, Xenia Kaidonis, Amy M Nicks, Nikolay Bogush, Kazu Kikuchi, Nawazish Naqvi, Richard P Harvey, Ahsan Husain, Robert M Graham
Stimulating regeneration of complex tissues and organs after injury to effect complete structural and functional repair, is an attractive therapeutic option that would revolutionize clinical medicine. Compared to many metazoan phyla that show extraordinary regenerative capacity, which in some instances persists throughout life, regeneration in mammalians, particularly humans, is limited or absent. Here we consider recent insights in the elucidation of molecular mechanisms of regeneration that have come from studies of tissue homeostasis and injury repair in mammalian tissues that span the spectrum from little or no self-renewal, to those showing active cell turnover throughout life...
2018: NPJ Regenerative Medicine
Ruggero Ruggieri, Stefania Naccarato, Rosario Mazzola, Francesco Ricchetti, Stefanie Corradini, Alba Fiorentino, Filippo Alongi
BACKGROUND: Linac-based stereotactic radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) of multiple brain lesions using volumetric modulated arc therapy (VMAT) is typically performed by a multiple-isocenter approach, i.e. one isocenter per lesion, which is time-demanding for the need of independent setup verifications of each isocenter. Here, we present our initial experience with a new dedicated mono-isocenter technique with multiple non-coplanar arcs (HyperArc™, Varian Inc...
March 5, 2018: Radiation Oncology
Lennart Åström, Erik Grusell, Fredrik Sandin, Ingela Turesson, Lars Holmberg
BACKGROUND: High-dose-rate brachytherapy (HDR-BT) has optimal prerequisites in radiotherapy of prostate cancer (PC) with a conformal dose distribution and high doses per fraction giving a biological dose escalation. We report the outcome after HDR-BT and external beam radiotherapy (EBRT) after 20 years of experience. MATERIAL AND METHODS: The study includes 623 patients, median age of 66 years, treated from 1995 to 2008 and a median follow up of 11 years (range 2-266 months)...
February 26, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Peter Ziegenhein, Cornelis Ph Kamerling, Martin F Fast, Uwe Oelfke
In this work we describe an ultra-fast, low-latency implementation of the energy/mass transfer (EMT) mapping method to accumulate dose on deforming geometries such as lung using the central processing unit (CPU). It enables the computation of the actually delivered dose for intensity-modulated radiation therapy on 4D image data in real-time at 25 Hz. In order to accumulate the delivered dose onto a reference phase a pre-calculated deformable vector field is used. The aim of this study is to present an online dose accumulation technique that can be carried out in less than 40 ms to accommodate the machine log update rate of our research linac...
February 26, 2018: Scientific Reports
A Ranger, A Dunlop, K Hutchinson, H Convery, M K Maclennan, H Chantler, N Twyman, C Rose, D McQuaid, R A Amos, C Griffin, N M deSouza, E Donovan, E Harris, C E Coles, A Kirby
AIMS: Radiotherapy target volumes in early breast cancer treatment increasingly include the internal mammary chain (IMC). In order to maximise survival benefits of IMC radiotherapy, doses to the heart and lung should be minimised. This dosimetry study compared the ability of three-dimensional conformal radiotherapy, arc therapy and proton beam therapy (PBT) techniques with and without breath-hold to achieve target volume constraints while minimising dose to organs at risk (OARs). MATERIALS AND METHODS: In 14 patients' datasets, seven IMC radiotherapy techniques were compared: wide tangent (WT) three-dimensional conformal radiotherapy, volumetric-modulated arc therapy (VMAT) and PBT, each in voluntary deep inspiratory breath-hold (vDIBH) and free breathing (FB), and tomotherapy in FB only...
February 23, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Sabino De Placido, Ciro Gallo, Michelino De Laurentiis, Giancarlo Bisagni, Grazia Arpino, Maria Giuseppa Sarobba, Ferdinando Riccardi, Antonio Russo, Lucia Del Mastro, Alessio Aligi Cogoni, Francesco Cognetti, Stefania Gori, Jennifer Foglietta, Antonio Frassoldati, Domenico Amoroso, Lucio Laudadio, Luca Moscetti, Filippo Montemurro, Claudio Verusio, Antonio Bernardo, Vito Lorusso, Adriano Gravina, Gabriella Moretti, Rossella Lauria, Antonella Lai, Carmen Mocerino, Sergio Rizzo, Francesco Nuzzo, Paolo Carlini, Francesco Perrone
BACKGROUND: Uncertainty exists about the optimal schedule of adjuvant treatment of breast cancer with aromatase inhibitors and, to our knowledge, no trial has directly compared the three aromatase inhibitors anastrozole, exemestane, and letrozole. We investigated the schedule and type of aromatase inhibitors to be used as adjuvant treatment for hormone receptor-positive early breast cancer. METHODS: FATA-GIM3 is a multicentre, open-label, randomised, phase 3 trial of six different treatments in postmenopausal women with hormone receptor-positive early breast cancer...
February 23, 2018: Lancet Oncology
Cassandra Stambaugh
PURPOSE: To determine clinically relevant pass/question/fail criteria for gamma analysis of intensity modulated radiation therapy quality assurance (IMRT QA) plans, identify which plans should be further analyzed with dose-volume histogram (DVH) metrics, and create a workflow for performing that DVH-based analysis. METHODS: Eleven plans, five prostate and six head/neck, were selected to represent known good plans based on their high passing rate using conventional IMRT QA criteria...
February 26, 2018: Medical Physics
Suzanne C Wilkens, Jonathan Lans, Claudia A Bargon, David Ring, Neal C Chen
BACKGROUND: Prior research documents that greater psychologic distress (anxiety/depression) and less effective coping strategies (catastrophic thinking, kinesophobia) are associated with greater pain intensity and greater limitations. Recognition and acknowledgment of verbal and nonverbal indicators of psychologic factors might raise opportunities for improved psychologic health. There is evidence that specific patient words and phrases indicate greater catastrophic thinking. This study tested proposed nonverbal indicators (such as flexion of the wrist during attempted finger flexion or extension of uninjured fingers as the stiff and painful finger is flexed) for their association with catastrophic thinking...
February 14, 2018: Clinical Orthopaedics and related Research
Gunhild Mo Hansen, Susanne Wulff Svendsen, Iris Brunner, Jørgen Feldbæk Nielsen
Background Several predictors have been associated with upper extremity (UE) recovery after stroke, but characteristics that predict shoulder function after constraint-induced movement therapy (CIMT) have not yet been identified. Objectives To identify predictors associated with satisfactory shoulder function in patients with reduced shoulder function at admission to CIMT. Methods One hundred and seventy five patients were treated using CIMT while in a specialized inpatient hospital. Satisfactory shoulder function was defined according to the functional ability scale of the Wolf Motor Function test...
February 23, 2018: Topics in Stroke Rehabilitation
Jeanne C Watson
An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach...
February 21, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Seán Walsh, Erik Roelofs, Peter Kuess, Yvonka van Wijk, Ben Vanneste, Andre Dekker, Philippe Lambin, Bleddyn Jones, Dietmar Georg, Frank Verhaegen
We present a methodology which can be utilized to select proton or photon radiotherapy in prostate cancer patients. Four state-of-the-art competing treatment modalities were compared (by way of an in silico trial) for a cohort of 25 prostate cancer patients, with and without correction strategies for prostate displacements. Metrics measured from clinical image guidance systems were used. Three correction strategies were investigated; no-correction, extended-no-action-limit, and online-correction. Clinical efficacy was estimated via radiobiological models incorporating robustness (how probable a given treatment plan was delivered) and stability (the consistency between the probable best and worst delivered treatments at the 95% confidence limit)...
February 18, 2018: Cancers
Philippe Lachapelle, Meina Li, Jo Douglass, Alastair Stewart
The transforming growth factor (TGF)-β cytokines play a central role in development and progression of chronic respiratory diseases. TGF-β overexpression in chronic inflammation, remodeling, fibrotic process and susceptibility to viral infection is established in the most prevalent chronic respiratory diseases including asthma, COPD, lung cancer and idiopathic pulmonary fibrosis. Despite the overwhelming burden of respiratory diseases in the world, new pharmacological therapies have been limited in impact...
February 17, 2018: Pharmacology & Therapeutics
Teresa H Evering
PURPOSE OF REVIEW: The HIV-1 envelope gene (env) has been an intense focus of investigation in the search for genetic determinants of viral entry and persistence in the central nervous system (CNS). RECENT FINDINGS: Molecular signatures of CNS-derived HIV-1 env reflect the immune characteristics and cellular constraints of the CNS compartment. Although more readily found in those with advanced HIV-1 and HIV-associated neurocognitive disorders (HAND), molecular signatures distinguishing CNS-derived quasispecies can be identified early in HIV-1 infection, in the presence or absence of combination antiretroviral therapy (cART), and are dynamic...
February 19, 2018: Current HIV/AIDS Reports
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