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Results for “personalized treatment”

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At least 19 recordsLinked to original sources
PubMed2004

Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment.

OBJECTIVE: Telepsychiatry is an increasingly common method of providing psychiatric care, but randomized trials of telepsychiatric treatment compared to in-person treatment have not been done. The primary objective of this study was to compare treatment outcomes of patients with depressive disorders treated remotely by means of telepsychiatry to outcomes of depressed patients treated in person. Secondary objectives were to determine if patients' rates of adherence to and satisfaction with treatment were as high with telepsychiatric as with in-person treatment and to compare costs of telepsychiatric treatment to costs of in-person treatment. METHOD: In this randomized, controlled trial, 119 depressed veterans referred for outpatient treatment were randomly assigned to either remote treatment by means of telepsychiatry or in-person treatment. Psychiatric treatment lasted 6 months and consisted of psychotropic medication, psychoeducation, and brief supportive counseling. Patients' treatment outcomes, satisfaction, and adherence and the costs of treatment were compared between the two conditions. RESULTS: Hamilton Depression Rating Scale and Beck Depression Inventory scores improved over the treatment period and did not differ between treatment groups. The two groups were equally adherent to appointments and medication treatment. No between-group differences in dropout rates or patients' ratings of satisfaction with treatment were found. Telepsychiatry was more expensive per treatment session, but this difference disappeared if the costs of psychiatrists' travel to remote clinics more than 22 miles away from the medical center were considered. Telepsychiatry did not increase the overall health care resource consumption of the patients during the study period. CONCLUSIONS: Remote treatment of depression by means of telepsychiatry and in-person treatment of depression have comparable outcomes and equivalent levels of patient adherence, patient satisfaction, and health care cost.

Delivery of Health Care↗
PubMed2002

Combined vascular targeted imaging and therapy: a paradigm for personalized treatment.

In order to be successful in personalizing treatment, methods for selecting patients as well as good surrogate biomarkers for monitoring the effects of treatment are required in addition to development of an efficacious targeted therapy. We have developed a polymerized nanoparticle platform technology that will allow us to put different targeting moieties on the surface of the particles in addition to loading the particles with different contrast and therapeutic agents. We have proven that these nanoparticles can be targeted to endothelial receptors and different payloads of contrast and therapeutic agents have been delivered to target cells with high target to background ratios. Using this combined vascular targeted imaging and therapy approach, we are optimistic that personalized treatment regimens can be developed for different disease processes such as cancer, inflammation, and ischemia.

Animals↗
PubMedDate not supplied

[Facial hemispasm: modern views on the etiology, pathogenesis and treatment. Personal experience with botulinum A toxin treatment].

The authors present current opinions on the etiology and strategies of treatment of hemifacial spasm. In the vast majority of patients it is caused by compression of facial nerve by redundant loops of vertebral and basilar arteries and their branches. It was confirmed by neuroradiology imaging techniques and during surgical interventions. In recent years a new, non-invasive method of treatment has gained a wide approval--the local injections of botulinum toxin A into contracting muscles is a highly effective (90%) and safe method of treatment. Our own material (10 patients, 22 sessions) confirms it as well.

Adult↗
PubMed2006

[An interactive and evolutive software program to personalize treatment schedule : implication on daily life: the Centre Léon Bérard experience].

The second plan against cancer, initiated by the French President in 2003, has introduced a two-step procedure to announce cancer to the patient. During initial visit, the doctor tells the patient about his disease. On the second visit, the doctor elaborates the treatment strategy and proposes an individualized treatment plan for each patient. The objective of this plan is to offer to patients and caregivers an accurate, precise and personalized treatment schedule. The Centre Léon Bérard (Regional Cancer Center) has implemented a computerized model to manage all different treatment schedules. We developed a software program based on two different steps. Firstly, standard treatment schedules are programmed for each type of disease. To offer a better view of the influence of treatment on daily life, we added information such as place of treatment (ambulatory, inpatient, outpatient) impact on well being (side effects, risk of aplasia...), future evaluations and medical acts (CT scan, MRI, lumbar puncture...) as well as actions the patient should take (blood cell count, to have eaten nothing...). Secondly, it tailors these standard treatments as well as all complementary information's to the specific needs of each patient, based on the medical information available in their computerized records. This personalized plan may be modified and adjusted at any time including therefore more and more real details and insights for each patient (delay of chemotherapy, dates of CT scan....). This would help patients and caregivers to better understand the different phases of the treatment and, thus, improve patient follow-up and information at every step of patient management. This tool is currently being tested at the Centre Léon Bérard.

Case Management↗
PubMed2026

Two-sample Mendelian randomization study of gut microbiota and inflammatory proteins: Predictive, preventive, and personalized treatment for migraine.

The human gut microbiota is increasingly recognized as a significant factor in the pathogenesis of migraine, potentially via inflammatory pathways. Identifying specific human gut microbiota components associated with migraines, along with the investigation of particular inflammatory proteins, is essential for advancing primary prediction, targeted prevention, and personalized treatment strategies for migraines. We conducted a two-sample Mendelian randomization study using publicly available summary statistics from genome-wide association studies. Data for 473 human gut microbiota taxa were obtained from the Finnish national health survey conducted by the National Institute for Health and Welfare study (FINRISK, n = 5959 European participants). Genome-wide association study data (https://www.ebi.ac.uk/gwas/) for 91 circulating inflammatory proteins were obtained from 14,824 participants across 11 cohorts using the Olink Target 96 Inflammation panel. Migraine outcome data were obtained from the FinnGen R12 release, with cases defined using ICD-10 code G43. All genome-wide association study analyses were adjusted for sex, age, genotyping batch, and 10 genetic principal components to control population stratification (genomic inflation factors: 1.00–1.05). Inverse variance-weighted Mendelian randomization was the primary analysis method, with Mendelian randomization-Egger, weighted median, and mode-based methods as sensitivity analyses. Two-step Mendelian randomization mediation analysis quantified the proportion of the effects of human gut microbiota on migraine that are mediated through inflammatory proteins. Thirty-seven bacterial genera were found to be associated with migraine using the inverse variance-weighted method. Of these, 18 genera exhibited a negative association, while 19 genera demonstrated a positive association with migraine risk. Additionally, eight inflammatory proteins were found to increase the risk of migraine. Among human gut microbiota, four were observed to reduce inflammatory protein levels, whereas another four were associated with increased inflammatory protein levels. Additionally, five gut microbiota were identified to influence migraine through inflammatory proteins in both Mendelian randomization analyses. Specifically, Actinobacteria, Brachyspiraceae, CAG-269 sp001915995, and Paraglaciecola were found to affect migraine outcomes via inflammatory proteins, with mediation proportions of 12%, 19%, 15.5%, and 6.7%, respectively. Lawsonibacter sp002161175 was identified to influence migraine risk through Oncostatin-M and SLAM, with mediation proportions of 15.6% and 11.3%, respectively. Our study elucidated the role of specific human gut microbiota alterations in the pathogenesis of migraine and highlighted the mediating effects of inflammatory proteins. Targeting these particular human gut microbiota alterations offers a promising strategy for predictive, preventive, and personalized medicine in migraine management, resulting in substantial clinical advancements.

causality↗
PubMed1997

[Results of periumbilical approach to hypertrophic pyloric stenosis treatment. Personal experience].

BACKGROUND: Ramstedt's pyloromyotomy is the universally accepted treatment for hypertrophic pyloric stenosis. It could be performed through different surgical approaches: Robertson muscle splitting incision, transverse right transrectal incision, median longitudinal incision laparoscopic approach and circumumbilical incision. METHODS: This latter technique was successfully personally utilized for the treatment of 33 consecutive patients; 29 patient were male and 4 female, age ranged from 15 to 52 days (median value 32.6 days), previously full term, normal weighing newborns. In all patients but one, the large pyloric mass bulged through the incision and the Ramstedt's pyloromyotomy was performed as usual. In one case, the pyloromyotomy has been done through the incision by holding the large pylorus firmly beneath the abdominal wall. The operative time has been quite similar to that obtained with the transverse right incision. The mean hospitalization period has been of four days. RESULTS: No operative or postoperative complications were observed. Particularly, despite no antibiotics were used, no wounds infections occurred. CONCLUSIONS: The esthetic result was satisfying in all cases after one month follow-up.

Female↗
PubMed2001

[Osteomyelitis of the spine and its surgical treatment--personal experience].

PURPOSE OF THE STUDY: Evaluation of surgical treatment of osteomyelitis of the spine, determination of efficient diagnostic and therapeutic criteria. MATERIAL: The examined group comprised in total 27 patients. No selection was made, all patients who were operated on and treated at the Department of the authors were followed gradually as they were admitted at the Department. METHODS: Evaluation was based on the monitoring of the clinical condition of patients including laboratory tests. Evaluated was also the achievement of vertebral body fusion three months after the surgery. The surgical procedure always contained a radical debridement of inflammatory focus, a massive autogenous cancellous bone grafting mixed with Gentamycin foam, either separately or in combination with instrumentation. Approach to the inflammatory focus was in 9 cases transforaminal posterior, in 2 cases transforaminal combined with transversectomy, in 2 cases transforaminal combined with laminectomy, in 4 cases transthoracic, in 1 case transabdominal, in 7 cases retroperitoneal and once percutaneous technique was used. RESULTS: All patients operated on healed without complications. Local pain and temperature subsided rapidly (in terms of days). Also objective inflammatory criteria returned to normal (in terms of weeks). Seven patients show improved neurological status. X-ray examination 3 months after the surgery always shows consolidation and ingrowth of cancellous bone grafts without local relapse or loss of correction. DISCUSSION: The numbers of patients of the authors' group correspond with the numbers of patients presented in literature. There is also agreement with other authors that a modern treatment of spinal osteomyelitis should include a radical debridement of the focus combined with instrumentation, neurological decompression and application of cancellous bone grafts completed by local antibiotics. As compared to other authors who present a prevalence of abscess the histological examination of our cases shows predominantly inflammatory granuloma. CONCLUSION: Radical surgical treatment of spinal osteomyelitis including debridement, cancellous bone grafting, internal fixation (instrumentation) and decompression together with a general treatment and orthotic management seems to be an efficient way of the treatment of this serious disease.

Adolescent↗
PubMed2026

Establishment and Characterization of Patient-Derived Xenograft Organoids for Personalized Treatment of Castration-Resistant Prostate Cancer.

BACKGROUND: Basic research on castration-resistant prostate cancer (CRPC) is limited by the lack of clinically relevant models. This study aimed to establish patient-derived xenografts (PDX) and PDX-derived organoids from clinical CRPC specimens to develop a bidirectional experimental platform for in vivo xenografts and ex vivo organoids. METHODS: We established a new PDX library (KUCaP PDX series) using CRPC clinical specimens and derived prostate cancer organoids. Comprehensive biological characterization of clinical specimens, PDXs, PDX-derived organoids, and organoid-derived xenografts (ODXs) was performed to confirm the preservation of the original tumor features. Using our PDX library, we conducted genetic engineering and drug testing to explore novel therapeutic approaches. RESULTS: PDX-derived organoids were successfully established from all eight KUCaP PDX lines (100%). Four of the eight lines (50%) were maintained during the long-term culture experiments for over ten passages. Key features observed in the original clinical specimens, including genetic alterations and castration responsiveness, were maintained across the PDX, PDX-derived organoid, and ODX models. RNA sequencing revealed that transcriptomic profiles were consistently maintained across clinical specimens, PDXs, PDX-derived organoids, and ODXs. One PDX and organoid (KUCaP19) which exhibited a high homologous recombination deficiency (HRD) score, without any pathogenic homologous recombination repair (HRR) gene alterations, showed sensitivity to a poly ADP-ribose polymerase (PARP) inhibitor. In contrast, KUCaP12, which had no HRR alterations and a low HRD score, did not respond to PARP inhibition. CONCLUSIONS: We developed the KUCaP library as a novel experimental platform for CRPC research by integrating clinical specimens with PDX, organoid, and ODX models along with their genomic and transcriptomic data. These models largely retained the genetic profiles and responses to castration observed in the original tumors. The bidirectional use of personalized PDX and organoids will facilitate the elucidation of the molecular mechanisms of CRPC.

Male↗
PubMedDate not supplied

[Pancreatic pseudocysts: endoscopic treatment. Personal experience].

Pseudocyst is a complication of acute and chronic pancreatitis. Today endoscopic drainage is reported as being the treatment of choice for these complications. Endoscopic drainage was performed in 15 patients with a pseudocyst bulging into stomach or duodenal lumen as detected by CT and endoscopic examination. All 15 cases treated from January 1991 to December 2001 (11 men, 4 women; median age: 55.7 years [range: 33-81] were successfully drained. The mean hospital stay was 4.8 days. No mortality or major complications were observed and the compliance was very good. The procedure is safe and we believe that endoscopic drainage should be the procedure of choice for pseudocysts which bulge into the gastrointestinal lumen.

Adult↗
PubMed1991

[Breast cancer. Treatment. Personal experience].

The follow up of 92 cases of patients with cancer of the breast is presented. They were treated initially with surgery, and afterwards with a variety of adjuvant treatments. They were seen from July of 1983 to September of 1990. Of these cases, 35 belonged to premenopausal patients (Table No. 1) and 57 to postmenopausal patients (Table No. 2). Among the premenopausals, 15/35 (60%) had a positive axillary dissection while 14/35 (40%) had a negative one. Among the premenopausal females, 15/21 (71%) had a T1-2 tumor, and 6/21 (28.5%) had a locally advanced, T3 tumor. All the premenopausal patients with a positive axilla received postoperative chemotherapy. Of 21 patients, 10/21 (47.6%) recurred. Among the premenopausal females with negative axillary nodes, all 14 had a localized T1-2 tumor. Only 7 of those received adjuvant chemotherapy. Only one of the 5 patients who recurred had received chemotherapy. The 25-30 years old subgroup was particularly interesting. A total of 10 patients (10.8%) (Table No. 3) were seen. (Table No. 3). The results do not seem to indicate this is a subgroup with a specially adverse prognosis. Among the postmenopausal females (Table No. 2), 41/57 (71.9%) had positive axillary nodes while 16/57 (28%) had negative nodes. Of 41 postmenopausal females with positive axillary nodes, 36 (87.8%) had a T1-2 tumor and over 5/41 (12.2%) had a locally advanced tumor. Among the postmenopausal females with positive axillary nodes, 31/41 (75.6%) received chemotherapy. Of these, 18 out of 41 (44%) recurred. Of the 16 patients with negative axillary nodes, only one received chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Benign thyroid nodule: what is the treatment? Personal experience].

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in the Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobe-isthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSIONS: Therefore our experience has carried us to consider the lobectomy which treatment of choice for all those benign thyroid diseases with solitary nodule.

Humans↗
PubMed2001

[Personal treatment of congenital penile curvature].

Severe type I congenital curvature of the penis is characterised by an almost transparent hypoplasia uretra. Treatment consists of resecetion of the dysplasic urethra and its replacement by tubular grafts of preputial or extragenital skin or of the vesical or buccal mucous membrane. We present our experience of four patient with type I congenital curvature of the penis which we treated with a simple surgical technique consisting of leaving the over-lying skin attached to the hypoplasia urethra and resecting the remaining fibrotic tissue which is connected to and retracts the skin and the cavernous bodies. We performed plastic surgery of the dorsal surface of the tunica albuginea to achieve correct penis hardening and finalized the surgery with reconstruction of the ventral surface of the penis by spreading out the dorsal prepuce or by using a pediculated graft of surplus preputial skin.

Humans↗