Vessel-Targeting Nanoclovers Enable Noninvasive Delivery of Magnetic Hyperthermia-Chemotherapy Combination for Brain Cancer Treatment.

Despite being promising, the clinical application of magnetic hyperthermia for brain cancer treatment is limited by the requirement of highly invasive intracranial injections. To overcome this limitation, here we report the development of gallic acid-coated magnetic nanoclovers (GA-MNCs), which allow not only for noninvasive delivery of magnetic hyperthermia but also for targeted delivery of systemic chemotherapy to brain tumors. GA-MNCs are composed of clover-shaped MNCs in the core, which can induce magnetic heat in high efficiency, and polymerized GA on the shell, which enables tumor vessel-targeting. We demonstrate that intravenous administration of GA-MNCs following alternating magnetic field exposure effectively inhibited brain cancer development and preferentially disrupted tumor vasculature, making it possible to efficiently deliver systemic chemotherapy for further improved efficacy. Due to the noninvasive nature and high efficiency in killing tumor cells and enhancing systemic drug delivery, GA-MNCs have the potential to be translated for improved treatment of brain cancer.

The Patient-Centered Approach: A Review of the Literature and Its Application for Acoustic Neuromas.

Patient-centered care is defined as "care that is consistent with and respects the values, needs, and wishes of patients" and is best achieved when clinicians involve patients and their support system in health care discussions and decisions. While this approach has been well established and supported in more general medical specialties, such as primary care, that may encompass a more holistic approach, it has rarely been described in surgical disciplines. Acoustic neuromas (ANs) can be unique among other skull base and intracranial pathologies, in that the management of these tumors can vary from patient to patient depending on various factors. Moreover, typical options, including observation, radiation, and surgery, may often have equipoise for some patients and their tumors. Therefore, a patient-centered approach, strongly guided by the expertise of experienced skull base surgeons, may likely be the most appropriate type of care for patients with ANs. Herein, we review the documented use of patient-centered care in other aspects of medicine, propose the benefits of this approach for patients with ANs, and provide ways this can be better implemented in practice.

Gastric bypass: a risk factor for neural tube defects? Case report.

Gastric bypass surgery has become a safe and acceptable surgical weight loss treatment for individuals who suffer from morbid obesity. Patients who undergo this procedure are subject to vitamin deficiencies due to an iatrogenic malabsorptive state. Folate, a vitamin known for its role in the prevention of neural tube defects (NTDs), can be part of the deficiency spectrum resulting from this procedure. The authors describe the case of a woman who was nonadherent to multivitamin treatment after undergoing gastric bypass surgery. Her lack of understanding and appreciation of the relationship between gastric bypass surgery, folate deficiency, and NTDs may have contributed to her noncompliance with daily multivitamin consumption. As a result, her potential problems with folate absorption could have contributed to her subsequently giving birth to a child with a myelomeningocele. Thus, patient awareness and counseling along with aggressive vitamin supplementation among this particular population may help prevent the occurrence of NTDs after gastric bypass surgery.