Trochlear pain is frequently overlooked as published data regarding the clinical characteristic and current treatment are limited. The aim of this study is to evaluate this information from our experiences with trochlear pain. Medical records of 43 patients with trochlear pain from HRH Princess Maha Chakri Sirindhorn Medical Center between November 2010 and April 2017 were reviewed. Most patients were female (88%), with a median age of 51 years. Common characteristic symptoms of trochlear pain were acute, episodic, dull or pressure-like, periorbital pain, often radiating to the forehead, and aggravated by eye movements, especially reading. The causes of trochlear pain were idiopathic or primary trochlear headache (n = 33, 77%) and trochleitis (n = 10, 23%). Treatments included oral NSAIDs or dexamethasone injection into the trochlear region. At a median follow-up of 11 months (range 0-64), 67% of the patients reported complete remission using oral medication. Local steroid injection is useful in non-responding patients to oral therapy with an overall remission of 86%. Successful treatment outcome was achieved in most patients.
BackgroundOne particularly promising component of personalized medicine in cancer treatment is targeted therapy, which aims to maximize therapeutic efficacy while minimizing toxicity. However, the number of approved targeted agents remains limited. Expression microarray data for different types of cancer are resources to identify genes that were upregulated. The genes are candidate targets for cancer-targeting agents for future anticancer research and targeted treatments.Methods and findingsThe gene expression profiles of 48 types of cancer from 2,141 microarrays reported in the Gene Expression Omnibus were analyzed. These data were organized into 78 experimental groups, on which we performed comprehensive analyses using two-tailed Student’s t-tests with significance set at P < 0.01 to identify genes that were upregulated compared with normal cells in each cancer type. The resulting list of significantly upregulated genes was cross-referenced with three categories of protein inhibitor targets, categorized by inhibitor type (‘Targets of US Food and Drug Administration (FDA)-approved anticancer drugs’, ‘Targets of FDA-approved nonantineoplastic drugs’, or ‘Targets of non-FDA-approved chemical agents’). Of the 78 experimental groups studied, 57 (73%) represent cancers that are currently treated with FDA-approved targeted treatment agents. However, the target genes for the indicated therapies are upregulated in only 33 of these groups (57%). Nevertheless, the mRNA expression of the genes targeted by FDA-approved treatment agents is increased in every experimental group, including all of the cancers without FDA-approved targeted treatments. Moreover, many targets of protein inhibitors that have been approved by the FDA as therapies for nonneoplastic diseases, such as 3-hydroxy-3-methylglutaryl-CoA reductase and cyclooxygenase-2 and the targets of many non-FDA-approved chemical agents, such as cyclin-dependent kinase 1 and DNA-dependent protein kinase, are also overexpressed in many types of cancer.ConclusionThis research demonstrates a clinical correlation between bioinformatics data and currently approved treatments and suggests novel uses for known protein inhibitors in future antineoplastic research and targeted therapies.
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