Target treatment

Figure 32.1 Targeted treatment solutions. Reproduced with permission from Threshold of Innovation (2005). IBM Business Consulting Services [1]. See color plate.

Studies of chemokine processing linked to HIV infection have provided several potential therapeutic targets. Treatment of HIV/AIDS patients with HAART includes... 

Tab. 23.1. Desired outcomes of targeted treatments to various regions of the gut.

Steam (or hot air) injection requires the placement of injection wells outside the contaminated area and extractions near the center of the targeted treatment area. 

Empiric therapy has value during initial investigation, where a specific diagnosis cannot be made or where a specific diagnosis is made but targeted treatment is not available. 

The technology developer, Atomic Energy of Canada Limited (AECL), has compiled cost estimates (in 1994 U.S. dollars) for the CHEMIC process based on treatment of a simulated waste solution contaminated with metals (cadmium and lead at feed concentrations from 1 to 5 mg/liter) and strontium-90 [from 1000 to 2000 becquerel per liter (Bq/liter)]. The target treatment level is <0.014 mg/liter lead, <0.02 mg/liter cadmium, and <10 Bq/liter strontium-90. See Table 1 for estimates associated with this cost analysis. The AECL analysis indicated that costs of the CHEMIC process compared favorably with the estimated costs for treatment using reverse osmosis or fixed-bed ion exchange. 

In targeted treatment, pharmacotherapy is only used when prodromal symptoms become manifest, in the few days or weeks preceding a recurrence. Such nonspecific symptoms may include ... 

A targeted treatment strategy uses these symptoms as cues to restart drug therapy, thus avoiding continual antipsychotic exposure. One important problem with this approach is that the organ needed to do the monitoring (i.e., the brain) is the organ that is dysfunctional. 

Based on the published abstract of their work, we multiplied the 23% who did not relapse with maintenance medication times the assumed 121 in each arm of the trial, averaged the 63% and 45% for the two nonmedication strategies, and then multiplied this mean (i.e., 53.5%) by the 242 in these two arms of the trial. The results indicated that 25% of continuously medicated patients relapsed, in contrast to 50% in the targeted treatment groups, a highly statistically significant difference. 

Fawcett J. Targeting treatment in patients with mixed symptoms of anxiety and depression. J Clin Psychiatry 1990 51[Suppl 11] 40-43. 

Apart from academic organizations, the NCI (National Cancer Institute) and FDA (Food and Drug Administration) have initiated a collaboration to focus on using proteomic technologies to develop more targeted treatments and more reliable diagnostic kits for early detection of cancer. In mid-2001, researchers analyzed a series of tumor cells from different patients and came up with a roster of proteins present in cancer cells. These are distinct molecules not found in normal cells. In early 2002, scientists involved in this program reported that it is possible to compare... 

Semisynthetic Maytansine Analogues for the Targeted Treatment of Cancer. J Med Chem 49 4392... 

Abou-Jawde R, Choueiri T, Alemany C, Mekhail T. An overview of targeted treatments in cancer. Clin Ther. 2003 25 2121-2137. 

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