CARDIOLOGY - Criterium Inc. | Globe Newsletter | Sept 2012
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AUGUST 2019    A Monthly Review of Articles of Interest for the Clinical Community

..This Month's Clinical Focus:  UROLOGY..

 
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  Children's National study identifies potential pupillary biomarker for pediatric BBD

Pilot study published in Journal of Pediatric Urology - could improve diagnosis and intervention 

Researchers have discovered a potential biomarker in the pupillary response of some pediatric patients with Bowel and Bladder Dysfunction (BBD) that could improve the speed and accuracy of diagnosis and treatment, according to a study from Children's National Health System published in the Journal of Pediatric Urology.
 
BBD describes a range of lower urinary tract symptoms accompanied by conditions such as enuresis (bedwetting), urgency and urinary retention, and constipation. While these symptoms represent 40% of all pediatric urology visits, BBD is considered an underdiagnosed pediatric illness. The cause of BBD may be physical, such as problems with the involuntary nerves that control the urinary tract, or it may be a behavioral health issue such as anxiety.
 
Kids eye-2408020_1920 by virginia332 at Pixabay FREE LIC CC00

Pediatric anesthesiologist Julia Finkel, M.D., who serves as director of Research and Development for Pain Medicine at the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National, led this pilot study to explore whether BBD could be detected from a patient's pupillary light reflex response. Using pupillometry, Dr. Finkel and her team recorded and analyzed the pupillary responses of 28 patients with BBD, ages 7 21, from the Wetting, Infections and Stooling Help (WISH) clinic at Children's National. The study included baseline static and dynamic pupillometry assessments obtained from each patient before and after voiding. Pupillary measurements were also taken after five minutes of lying down and again after five minutes of standing.
 
In reviewing the patient's graphed data, the researchers noted a distinct "notch" shape repeated in the pupillary response graph of 11 of the 28 patients with BBD symptoms. In those 11 patients, the graph notch seems to indicate a brief, repeat constriction of the patient's pupil before returning to its resting size. Considering that bowel and bladder functions are controlled in part by the autonomic nervous system, researchers surmised that the notch on the graph reflects a disturbance in the regulation of the autonomic nervous system of those 11 patients, which would indicate a physiological cause for their BBD, either alone or in combination with a behavioral cause.
 
"To our knowledge, this unique pupillary signature has not been previously seen or described in other patient populations and we have not seen it in any of our other studies," says Dr. Finkel. "It may represent a distinctive and readily-identifiable physiologic marker of disease."
 
SOURCE: Children's National Health System via PRNewswire
 

Clinical Validation Study for ClarityDX Prostate

 
A novel liquid biopsy platform for the early diagnosis of clinically significant prostate cancer

The study will be carried out with blood to be sampled from 2,800 men with elevated PSA levels. Patient recruitment will be managed by the Alberta Prostate Cancer Research Initiative (APCaRI) and will start in Alberta at Calgary's Prostate Cancer Centre (PCC) and Edmonton's Northern Alberta Urology Centre (NAUC). Recruitment of men from the Yukon Territories will follow.
 
Blood Tubes laboratory-3827736_1920 by Belova59 atPixabay FREE LIC CC00

Previously, a 415-patient prospective clinical study established the validity of this novel liquid biopsy platform and determined it to be 40% more specific than the standard prostate cancer blood screen test, PSA. Nanostics also very recently completed an intensive 2,000 sample stability study with the liquid biopsy blood test to determine the optimal collection and transportation conditions.
 
This new clinical validation study is part of the process towards meeting FDA and Health Canada requirements for an in vitro diagnostic test, which will allow Nanostics proprietary ClarityDX Prostate test to be provided to patients. The study will be conducted in partnership with DynaLIFE Medical Labs, an award-winning company which provides clinical services for over 2 million patients in its facility in Edmonton, as well as APCaRI at the University of Alberta. The co-principal investigators of this study are Dr. Eric Hyndman (PCC) and Dr. Adrian Fairey (NAUC), both notable urologists and prostate cancer researchers. Funding for the clinical study comes in part from the Motorcycle Ride for Dad, Alberta Cancer Foundation, Alberta Innovates-ASBIRI program and the University Hospital Foundation Kaye Fund.
 
The potential impact of the ClarityDX Prostate test is considerable; implementation could eliminate up to 600,000 unnecessary biopsies, 24,000 hospitalizations and up to 50% of unnecessary treatments for prostate cancer in North America. Beyond an estimated cost savings to the healthcare system of more than $1.4B per year, this will have a dramatic impact on the healthcare experience and quality of life for men.
 
SOURCE: Nanostics http://www.nanosticsdx.com/ via PRNewswire

Image credits: Childs Eye by virginia332; Lab Tubes by Bellova59 both at PixaBay.com Free Lic CC0

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