An Autoclavable Steerable Cannula Manual Deployment Device: Design and Accuracy Analysis.

An Autoclavable Steerable Cannula Manual Deployment Device: Design and Accuracy Analysis.

J Med Device. 2012 Dec; 6(4): 410071-410077
Burgner J, Swaney PJ, Bruns TL, Clark MS, Rucker DC, Burdette EC, Webster RJ

Accessing a specific, predefined location identified in medical images is a common interventional task for biopsies and drug or therapy delivery. While conventional surgical needles provide little steerability, concentric tube continuum devices enable steering through curved trajectories. These devices are usually developed as robotic systems. However, manual actuation of concentric tube devices is particularly useful for initial transfer into the clinic since the Food and Drug Administration (FDA) and Institutional Review Board (IRB) approval process of manually operated devices is simple compared to their motorized counterparts. In this paper, we present a manual actuation device for the deployment of steerable cannulas. The design focuses on compactness, modularity, usability, and sterilizability. Further, the kinematic mapping from joint space to Cartesian space is detailed for an example concentric tube device. Assessment of the device’s accuracy was performed in free space, as well as in an image-guided surgery setting, using tracked 2D ultrasound. HubMed – drug

Biomarkers in systemic lupus erythematosus: challenges and prospects for the future.

Ther Adv Musculoskelet Dis. 2013 Aug; 5(4): 210-33
Liu CC, Kao AH, Manzi S, Ahearn JM

The search for lupus biomarkers to diagnose, monitor, stratify, and predict individual response to therapy is currently more intense than ever before. This effort is essential for several reasons. First, epidemic overdiagnosis and underdiagnosis of lupus, even by certified rheumatologists, leads to errors in therapy with concomitant side effects which may be more serious than the disease itself. Second, identification of lupus flares remains as much an art as it is a science. Third, the capacity to stratify patients so as to predict those who will develop specific patterns of organ involvement is not currently possible but would potentially lead to preventive therapeutic strategies. Fourth, only one new drug for the treatment of lupus has been approved by the US Food and Drug Administration in over 50 years. A major obstacle in this pipeline is the dearth of biomarkers available to prove a patient has responded to an experimental therapeutic intervention. This review will summarize the challenges faced in the discovery and validation of lupus biomarkers, the most promising lupus biomarkers identified to date, and the promise of future directions. HubMed – drug

Pleuropulmonary and lymph node progression after docetaxel – benefits from treatment with cabazitaxel in metastatic prostate cancer.

Case Rep Oncol. 2013 May; 6(2): 391-6
Huerta AS, Santos ER, Campos GB, Coloma CS, Gómez ON

To date, there are no guidelines for a rational and more favourable sequence of treatment after docetaxel. Two drugs (cabazitaxel and abiraterone) have recently been approved as second-line treatment after docetaxel failure in metastatic castration-resistant prostate cancer (mCRPC), but there are no studies comparing abiraterone versus cabazitaxel. The most suitable drug is chosen based on the physician’s opinion and the patient’s characteristics. In patients with a good performance status who are able to receive either treatment, it would be convenient to begin with cabazitaxel and to reserve abiraterone in case there is a worsening of the general status, in consideration of abiraterone’s more favourable toxicity profile.We describe the case of a 74-year-old male with mCRPC who presented with an interesting and uncommon tumour dissemination (pleuropulmonary) occurring after the first standard treatment with docetaxel. Intravenous treatment with cabazitaxel 25 mg/m(2) and oral prednisone 10 mg continuously was initiated. The patient received a total of 8 cycles of chemotherapy. A reduction of mediastinal adenopathies and infrarenal para-aortic stable bone involvement and an absence of pleural effusion were observed. No relevant toxicity was noted. Since February 2012, a progressive PSA increase without clinical deterioration has been noted.The selection criteria for second- and third-line systemic treatment and the excellent response obtained with cabazitaxel in an unusual disease setting are described. The results confirm the long duration and quality of response of cabazitaxel treatment. Further therapeutic options in this group of patients are suggested. HubMed – drug