Evolving Role and Translation of Radiomics and Radiogenomics in Adult and Pediatric Neuro-Oncology.

Exponential technologic advancements in imaging, high-performance computing, and artificial intelligence, in addition to increasing access to vast amounts of diverse data, have revolutionized the role of imaging in medicine. Radiomics is defined as a high-throughput feature-extraction method that unlocks microscale quantitative data hidden within standard-of-care medical imaging. Radiogenomics is defined as the linkage between imaging and genomics information. Multiple radiomics and radiogenomics studies performed on conventional and advanced neuro-oncology image modalities show that they have the potential to differentiate pseudoprogression from true progression, classify tumor subgroups, and predict recurrence, survival, and mutation status with high accuracy. In this article, we outline the technical steps involved in radiomics and radiogenomics analyses with the use of artificial intelligence methods and review current applications in adult and pediatric neuro-oncology.

Plasma lipids and blood glucose in infants of toxemic mothers.

Maternal and cord blood of 34 toxemic and 27 non-toxemic mothers and their infants were studied for lipids and glucose. All the lipid fractions in cord blood were significantly lower (P less than .001) than that of the mother in all groups due to relative impermeability of the placenta. AFD infants of toxemic mothers had significantly higher (P less than .001) value of FFA and triglyceride as compared with AFD infants of non-toxemic mothers. However SFD infants of toxemic mothers had higher FFA only when compared with that of non-toxemic mother. This is possibly due to sympathetic stimulation related to placental insufficiency with hypoxia and hypoglycemia that lead to mobilisation of adipose tissue into FFA and glycerol in fetus. Plasma phospholipid, cholesterol, HDLC, LDLC of infants of toxemic mothers were significantly lower (P less than .001), more so in SFD infants, possibly due to impaired liver function. 53% of infants of toxemic mothers also had hyperbilirubinemia. Cord blood glucose in toxemic group was significantly lower (P less than .05) than AFD infants of non-toxemic group.

Advances in management of meconium aspiration syndrome.

Meconium Aspiration Syndrome (MAS) is a leading cause of respiratory distress in the newborn. Antenatal diagnosis of meconium stained amniotic fluid and fetal distress is important to reduce morbidity and mortality in the neonates. Amnioinfusion of saline and tracheal suctioning of meconium are preventive interventions. Babies with MAS who continue to have respiratory distress need to be put on conventional ventilators. Increasing hypoxia, hypercarbia and barotrauma warrants changing to high frequency oscillatory ventilation. Pulmonary hypertension is an important complication which should be promptly recognized. Nitric oxide therapy used with high frequency ventilation has improved the outcome of babies with severe MAS and pulmonary hypertension. Some of these babies who continue to worsen clinically need to be put on ECMO circuit. Surfactant infusion in babies with MAS has been shown to improve gas exchange, resolve pulmonary hypertension and decrease oxygenation index. Total and partial liquid ventilation with perflurocarbon improves oxygenation, increases lung expansion and increases pulmonary blood flow in model studies of animals with MAS. Surfactant infusion and liquid ventilation are newer promising modes of therapeutic interventions in babies with severe MAS.

Perinatal morbidity and mortality in cesarean section.

PIP: The study purpose was to assess the incidence and indications of cesarean section; the effect of anesthesia, maternal and fetal factors on the morbidity and mortality of newborn infants; and to compare the morbidity and mortality patterns of infants delivered by cesarean section with that of infants delivered by the normal vaginal route. The morbidity and mortality pattern of 200 consecutive normally delivered infants were compared with that of 265 infants delivered by cesarean section. The incidence of morbidity in emergency cesarean section, planned section and normal vaginal delivery was 54.6%, 20.4%, and 12%, respectively. Higher incidence in emergency section was primarily because of asphyxia, intracranial stress, dysmaturity, transient tachypnea, prematurity and infection. Mortality was 7.5% in emergency section, 2.2% in planned section and 4% in normal delivery. Most of the stillbirth and neonatal deaths were because of gross asphyxia, prolonged labor due to cephalopelvic disproportion and uterine dysfunction, fetal distress, and abnormal presentation. Associated factors adversely influencing the morbidity and mortality included maternal age below 20 years and above 30 years, height below 510 centimeters, grand multiparity, low socioeconomic class, poor antenatal care, fetal distress, general anesthesia, prematurity and birth weight below 2 kilograms.^ieng

Development of diclofenac sodium-loaded alginate-PVP K 30 microbeads using central composite design.

BACKGROUND AND THE PURPOSE OF THE STUDY: Diclofenac sodium is a non-steroidal anti-inflammatory agent with a short biological half-life (1-2 hr) and requires multiple dosing. This research was carried out to develop and optimize diclofenac sodium loaded alginate-PVP K 30 microbeads to eliminate the need for multiple dosing and adverse effects. METHODS: Diclofenac sodium loaded alginate-PVP K 30 microbeads were prepared by ionotropic gelation. Particle size, drug release, swelling, FTIR and SEM analyses were performed. RESULTS: Optimized microbeads showed particle size of 0.589±0.054 to 0.620±0.067 mm, and drug entrapment efficiency of 97.88±2.86 to 98.60±3.55%. The in vitro drug release from microbeads was sustained over 10 hrs and followed controlled-release pattern. FTIR analysis indicated the possibility of intermolecular hydrogen bonding interactions, i.e., -OH…O=C in microbeads. CONCLUSION: Microbeads for oral controlled delivery of diclofenac sodium were successfully developed by ionotropic gelation.