The Role of Intrathecal Pumps in Nonmalignant Pain.

Intrathecal pumps deliver analgesic medication directly into the central nervous system. In patients with chronic nonmalignant pain, intrathecal therapy using morphine or ziconotide has been shown to be an effective option when traditional noninvasive methods do not provide adequate relief. There has been increasing use of intrathecal drug administration in the management of patients with nonmalignant pain in recent years given the advances in technology and research on the topic. However, due to its invasive nature, intrathecal pumps remain the last option among patients with chronic pain.

Cell-Free DNA in Dermatology Research.

In various diseases, particularly cancer, cell-free DNA (cfDNA) has been widely studied as a marker of disease prognosis or to facilitate the detection of therapeutic targets. In dermatology, most studies have focused on melanoma; other skin diseases such as vascular malformations and psoriasis have also been examined. Genetic alterations unique to the tissue of origin such as sequence variations, copy number alterations, chromosomal rearrangements, differential DNA methylation patterns, and fragmentation patterns can be identified in circulation providing information on patient disease status. These alterations can be detected either by PCR-based methods or next-generation sequencing depending on the target of interest. In this article, we discuss the origins of cfDNA, the most common methods of detection, current studies assessing cfDNA as a biomarker, and cfDNA's potential clinical applications in melanoma and other skin diseases. In addition, we provide important factors to consider during blood processing and DNA extraction as well as limitations for each assay.