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precision medication

George M Ibrahim, Alexander G Weil, Shaina Sedighim, Nathan B Schoen, Mirriam Mikhail, Priya Sharma, Magno R Guillen, Benjamin R Morgan, Simeon Wong, Iahn Cajigas, Walter J Jermakowicz, Carolina Sandoval-Garcia, Evan C Lewis, Aria Fallah, Nolan Altman, Santiago Medina, Esperanza Pacheco-Jacome, Prasanna Jayakar, Ann Hyslop, Ian Miller, John Ragheb, Sanjiv Bhatia, Byron Bernal
PURPOSE: Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) is an emerging minimally-invasive alternative to resective surgery for medically-intractable epilepsy. The precise lesioning effect produced by MRgLITT supplies opportunities to glean insights into epileptogenic regions and their interactions with functional brain networks. In this exploratory analysis, we sought to characterize associations between MRgLITT ablation zones and large-scale brain networks that portended seizure outcome using resting-state fMRI...
August 9, 2018: Seizure: the Journal of the British Epilepsy Association
Allen L Ho, Yagmur Muftuoglu, Arjun V Pendharkar, Eric S Sussman, Brenda E Porter, Casey H Halpern, Gerald A Grant
OBJECTIVE Stereoelectroencephalography (SEEG) has increased in popularity for localization of epileptogenic zones in drug-resistant epilepsy because safety, accuracy, and efficacy have been well established in both adult and pediatric populations. Development of robot-guidance technology has greatly enhanced the efficiency of this procedure, without sacrificing safety or precision. To date there have been very limited reports of the use of this new technology in children. The authors present their initial experience using the ROSA platform for robot-guided SEEG in a pediatric population...
August 17, 2018: Journal of Neurosurgery. Pediatrics
Kristen M Crosley
Deep brain stimulation (DBS) is a life-changing surgical treatment. More than 150,000 patients worldwide have been treated with DBS, primarily for Parkinson disease and medically refractory tremor and dystonia. However, the use of DBS has recently expanded beyond traditional movement disorders to include the treatment of obsessive compulsive disorder, epilepsy, and other neurological and psychological diseases. Considering this expanded use of DBS, it is essential to understand the role that each member of the multidisciplinary health care team plays and how to avoid possible complications during this procedure...
August 2018: AORN Journal
Gabrielle King, Kathryn D Baker, Madelyne A Bisby, Diana Chan, Caitlin S M Cowan, Anthea A Stylianakis, Kelsey S Zimmermann, Rick Richardson
There is a pressing need to improve treatments for anxiety. Although exposure-based therapy is currently the gold-standard treatment, many people either do not respond to this therapy or experience a relapse of symptoms after treatment has ceased. In recent years, there have been many novel pharmacological agents identified in preclinical research that have potential as adjuncts for exposure therapy, yet very few of these are regularly integrated into clinical practice. Unfortunately, the robust effects observed in the laboratory animal often do not translate to a clinical population...
August 16, 2018: Psychopharmacology
Joseph Connors, Rachel Aronov, Laura Malaga-Dieguez, Suzanne Vento, Laura Jane Pehrson, Ming Wu, Shailee Lala, Howard Trachtman
Interstitial nephritis (IN) is a relatively rare entity in children and adolescents that can be caused by a range of disorders including infection, medications, inflammatory bowel disease, and sarcoid. There is no proven therapy for this condition. We present 2 cases of biopsy-proven interstitial nephritis, of which 1 case was with granulomatous features that presented with unusual sonographic findings of discrete mass lesions in the kidney parenchyma bilaterally. Although a precise cause could not be identified in either case, 1 patient progressed to end-stage kidney disease (ESKD) and the other is in the early stages of treatment...
October 2018: Radiology Case Reports
Johannes Courtial, Tomáš Tyc, Jakub Bělín, Stephen Oxburgh, Gergely Ferenczi, Euan N Cowie, Chris D White
We present the theory of ray-optical transformation optics (RTO) with ideal thin lenses and show that ideal-thin-lens RTO devices are omnidirectional lenses. Key to designing such devices are two theorems, the loop-imaging theorem, and the edge-imaging theorem, which ensure that the interior physical space is distorted in the same way for all viewing directions. We discuss the possibility of realising such devices using lens holograms or Fresnel lenses, as both are in principle capable of changing the directions of rays incident from a specific point precisely like an ideal thin lens, thereby enabling macroscopic and broad-band RTO devices that work for at least one viewing position...
July 9, 2018: Optics Express
Juliane Lippert, Silke Appenzeller, Raimunde Liang, Silviu Sbiera, Stefan Kircher, Barbara Altieri, Indrajit Nanda, Isabel Weigand, Andrea Gehrig, Sonja Steinhauer, Renzo J M Riemens, Andreas Rosenwald, Clemens R Müller, Matthias Kroiss, Simone Rost, Martin Fassnacht, Cristina L Ronchi
Context: Adrenocortical carcinoma (ACC) has a heterogeneous prognosis and current medical therapies have limited efficacy in its advanced stages. Genome-wide multi-omics-studies identified molecular patterns associated with clinical outcome. Objective: Here, we aimed at identifying a molecular signature useful for both personalized prognostic stratification and druggable targets, using methods applicable in clinical routine. Design: 117 tumor samples from 107 ACC patients were analyzed...
August 2, 2018: Journal of Clinical Endocrinology and Metabolism
Lee S Cohen, Lina Góez-Mogollón, Alexandra Z Sosinsky, Gina M Savella, Adele C Viguera, David Chitayat, Sonia Hernández-Díaz, Marlene P Freeman
OBJECTIVE: Second-generation antipsychotics are commonly prescribed to reproductive-age women for the treatment of a spectrum of psychiatric disorders. Quetiapine is the most commonly prescribed medication in this class, and therefore a better understanding of its reproductive safety profile is critical. The goal of this study was to determine the risk of major malformations among infants exposed to quetiapine during pregnancy compared with a group of infants whose mothers had a history of psychiatric morbidity but who did not use a second-generation antipsychotic during pregnancy...
August 16, 2018: American Journal of Psychiatry
Tomohiro Kajikawa, Noriyuki Kadoya, Kengo Ito, Yoshiki Takayama, Takahito Chiba, Seiji Tomori, Ken Takeda, Keiichi Jingu
The quality of radiotherapy has greatly improved due to the high precision achieved by intensity-modulated radiation therapy (IMRT). Studies have been conducted to increase the quality of planning and reduce the costs associated with planning through automated planning method; however, few studies have used the deep learning method for optimization of planning. The purpose of this study was to propose an automated method based on a convolutional neural network (CNN) for predicting the dosimetric eligibility of patients with prostate cancer undergoing IMRT...
August 14, 2018: Radiological Physics and Technology
Amritha Gourisankar, Sarah A Eisenstein, Nicholas T Trapp, Jonathan M Koller, Meghan C Campbell, Mwiza Ushe, Joel S Perlmutter, Tamara Hershey, Kevin J Black
The anatomical connections of the subthalamic nucleus (STN) have driven hypotheses about its functional anatomy, including the hypothesis that the precise anatomical location of STN deep brain stimulation (DBS) contributes to the variability of motor and non-motor responses across patients with Parkinson's disease (PD). We previously tested the hypothesis using a three-dimensional (3D) statistical method to interpret the acute effects of unilateral DBS at each patient's clinically optimized DBS settings and active contact...
July 2018: Royal Society Open Science
Patricia A Carney, George C Mejicano, Tracy Bumsted, Mark Quirk
BACKGROUND: Medical education is a dynamic process that will continuously evolve to respond to changes in the foundations of medicine, the clinical practice of medicine and in health systems science. PURPOSE: In this paper, we review how assessing learning in such a dynamic environment requires comprehensive flexible and adaptable methodological approaches designed to assess knowledge attainment and transfer, clinical skills/competency development, and ethical/professional behavior...
August 14, 2018: Medical Teacher
Zixuan Yuan, Liang Zhao, Yafei Zhang, Shun Li, Bomin Pan, Lei Hua, Zhen Wang, Chengkun Ye, Jun Lu, Rutong Yu, Hongmei Liu
PURPOSE: GOLPH3 has been shown to be involved in glioma proliferation. In this study, we aimed to demonstrate that GOLPH3 can serve as a target for glioma gene therapy. METHODS: During the experiment, cationic liposomes with angiopep-2 (A2-CL) were used to deliver siGOLPH3 crossing the blood-brain barrier and reaching the glioma. RESULTS: At the cellular level, the A2-CL/siGOLPH3 could silence GOLPH3 and then effectively inhibited the proliferation of cells...
August 13, 2018: Journal of Neuro-oncology
Emma Maria Dunne, Ian Mark Fraser, Mitchell Liu
Stereotactic body radiation therapy (SBRT) also referred to as stereotactic ablative radiotherapy (SABR), is a technique which has emerged over the past two decades due to improvements in radiation technology. Unlike conventional external beam radiotherapy (cEBRT) which traditionally delivers radiation in small doses [approximately 2 Gray (Gy) per fraction] over several weeks, SBRT, typically delivered in one to eight fractions, is a technique whereby potentially ablative doses of radiotherapy (usually 7.5-20 Gy per fraction) can be delivered with steeper dose gradients and sub millimetre precision, minimising risk to surrounding normal tissues...
July 2018: Annals of Translational Medicine
Robert Goodspeed, Xiang Yan, Jean Hardy, V G Vinod Vydiswaran, Veronica J Berrocal, Philippa Clarke, Daniel M Romero, Iris N Gomez-Lopez, Tiffany Veinot
BACKGROUND: Mobile devices are increasingly used to collect location-based information from individuals about their physical activities, dietary intake, environmental exposures, and mental well-being. Such research, which typically uses wearable devices or mobile phones to track location, benefits from the growing availability of fine-grained data regarding human mobility. However, little is known about the comparative geospatial accuracy of such devices. OBJECTIVE: In this study, we compared the data quality of location information collected from two mobile devices that determine location in different ways-a global positioning system (GPS) watch and a mobile phone with Google's Location History feature enabled...
August 13, 2018: JMIR MHealth and UHealth
Max C Ramírez-Soto, Elsa G Aguilar-Ancori, Andrés Tirado-Sánchez, Alexandro Bonifaz
Ecological determinants of sporotrichosis etiological agents remain poorly understood. For this reason, we performed explorations using local climate estimates to determine the temperature and humidity ranges of the environment where clinically relevant Sporothrix species occur and to identify what plant species are associated with them, using data collected from the published literature. We performed a literature search to identify all publications on environmental isolations of medically relevant species of Sporothrix in the PubMed, SCOPUS, and EMBASE databases...
August 12, 2018: Journal of Fungi (Basel, Switzerland)
İsmail Harmankaya, Nevzat Serdar Ugras, Tamer Sekmenli, Fatih Demir, Yavuz Köksal
Simultaneous calcified fibrous pseudotumor (CFT) and Castleman disease (CD) is an extremely rare association. CD is an uncommon lymphoproliferative disease that can arise in various sites of the body, while CFT is a rare type of benign fibrous lesion that frequently affects children and young adults, occurring as solitary or multiple lesions throughout the human body. Both entities are rare and exhibit typical and diverse histomorphological features. We report the case of a 15-year-old female patient, who, at the age of 13 had a biopsy performed at an external medical center; however, after 4 months the lesion had regrown...
July 2018: Autopsy & Case Reports
Luis Aliaga, Georgette Fatoul, Emilio Guirao, Alejandro Peña, Javier Rodríguez-Granger, Fernando Cobo
Nocardia paucivorans brain abscesses are unusual in humans. Sixteen cases of this infection have been reported in the world medical literature. There is precise clinical information available from nine patients. All of these patients recovered or were cured from their brain disease with long-term antimicrobial treatment. Surgical drainage was performed in four patients.
2018: IDCases
Jean-Louis Pujol, Benoît Roch, Camille N Pujol, Catherine Goze
Small cell lung cancer accounts for 14% of all lung cancers. It remains a major challenge for oncology as the progresses made in the past three decades are modest. After a rapid overview of current knowledge regarding somatic genomic alterations, this state-of-art addresses pathways to improve small-cell lung cancer outcome such as the targeting of DNA damage repair mechanisms firstly anti-PARPs, inhibitory molecules of EZH2, derepression of the NOTCH pathway, rovalbituzumab-tesirine, inhibition of serine/threonine Aurora A kinase, temozolomide and its dependence on methylation of the MGMT promoter...
August 9, 2018: Bulletin du Cancer
Frank Alifui-Segbaya, Jasper Bowman, Alan R White, Sony Varma, Graham J Lieschke, Roy George
The paucity of information on the biological risks of photopolymers in additive manufacturing or three-dimensional printing (3DP) is a major challenge for the uptake of the technology in the construction of medical devices in dentistry. In this paper, the biocompatibility of additively manufactured methacrylates are evaluated using the innovative zebrafish (Danio rerio) embryo model. Data obtained confirmed gradations of toxicity primarily influenced by ethanol treatment, exposure scenarios, and extraction vehicles...
August 9, 2018: Acta Biomaterialia
Yasuyuki Shiraishi, Shun Kohsaka, Toshiyuki Nagai, Ayumi Goda, Atsushi Mizuno, Yuji Nagatomo, Yasumori Sujino, Ryoma Fukuoka, Mitsuaki Sawano, Takashi Kohno, Keiichi Fukuda, Toshihisa Anzai, Ramin Shadman, Todd Dardas, Wayne C Levy, Tsutomu Yoshikawa
BACKGROUND: Precise risk stratification in heart failure (HF) patients enables clinicians to tailor the intensity of their management. The Seattle Heart Failure Model (SHFM), which uses conventional clinical variables for its prediction, is widely used. We aimed to externally validate SHFM in Japanese HF patients with a recent episode of acute decompensation requiring hospital admission. METHODS: SHFM was applied to 2470 HF patients registered in the West Tokyo Heart Failure (WET-HF) and National cerebral and cardiovascular center acute decompensated heart failure (NaDEF) databases between 2006 and 2016...
August 9, 2018: Journal of Cardiac Failure
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