A recent international study proved that physicians can diagnose Parkinson’s disease (PD) by testing a patient’s spinal fluid. If this diagnostic method is widely adopted, physicians may be able to diagnose PD earlier and better monitor disease progression.
Key Points At age 74, Paul Lyman sold his Cessna 182 airplane after deciding to seek treatment for his essential tremor symptoms. Last April, he traveled 400 miles to have focused ultrasound treatment at the University of Utah. Learn how the treatment changed his life and got him back in the cockpit. In the fall of 2021, 74-year-old pilot, Paul Lyman, sold his Cessna 182 airplane after deciding to seek treatment for his essential tremor symptoms. After hearing about focused ultrasound from a friend, Paul traveled 400 miles from his home in Montana to be treated at the University of Utah Medical Center in April 2022. Within the last year, the pilot returned to the sky. In this patient profile, Paul describes living with ET, discovering focused ultrasound, being evaluated and treated at the University of Utah Medical Center, and how his life has changed. When did you first notice your symptoms of ET?The symptoms appeared over a long period of time. I was about 45 years old when I noticed a very slight shake in my right hand. But a lot of older people get shakes. I did not pay too much attention to it, because it was not debilitating, and I was able to do my job. It was just a shake that did not interrupt my lifestyle—until it did. When were you diagnosed, and does anyone else in your family have ET?I was diagnosed with ET in my late 50s or early 60s. ET does run in families. Neither my parents nor siblings have had tremors, but two of my three kids have symptoms. My second daughter (age 36) is starting to complain about it, and my son (age 33) has also noticed some symptoms. It does not interfere with their lifestyle or job performance, but they notice it. When did you know you needed to seek treatment?In my mid-sixties, the shaking became more pronounced. I gradually retrained myself to use my left hand to lift a fork or hold a cup of coffee or a glass of wine. I flyfish and used to enjoy fishing and tying flies as a hobby, but I had to stop tying flies. I was an electrical contractor by trade, and I noticed that I could no longer solder fine circuits or things like that. The symptoms seemed to progress more rapidly during the last 10 years than they did in the preceding 20 years. Did having ET affect your ability to fly your airplane?I never felt unsafe while flying with ET but cannot explain why. Airplanes have a lot of small dials, buttons, and instruments to push, and when there is turbulence, it is not easy to operate the controls. I did not have any issues with dialing on radio frequencies, pushing the right buttons to transponder, or anything like that. When I got out of the airplane, I had tremors again. I do not have an explanation for that other than maybe it was the need for total concentration. In late 2021, I decided to sell my airplane, because I wanted to pursue focused ultrasound as a treatment option, and I did not know how the Federal Aviation Administration (FAA)-designated Aviation Medical Examiner (AME) would view the procedure when reviewing my pilot medical certificate. I contacted the Aircraft Owners and Pilots Association Pilot Protection Services (PPS), and PPS confirmed that the FAA AMEs evaluate all medical procedures on a case-by-case basis for denial of or special issuance of a medical certificate. The AME would review my health certificate after the procedure, and I had no idea how the FAA would respond. That uncertainty was my motivation for selling the plane. How did having ET affect your quality of life?I learned how to live with ET, but it was not comfortable, and it wore on me. But I never really shut myself off from people. For example, I play golf with the same guys twice a week. It would take forever to tee up the ball. But the guys were good and never mentioned it. How did you hear about focused ultrasound as a treatment for ET?I have a neighbor in Arizona, where we spend the winter months. He also had ET (with symptoms worse than mine) and started looking into treatment options. He told me about focused ultrasound before it was even approved by the Food and Drug Administration (FDA) or Medicare. He was contemplating getting treated with focused ultrasound, and I was intrigued because I knew I would eventually seek treatment. As it turned out, I got treated first and now he is preparing to also get focused ultrasound at the University of Utah Medical Center. What did your doctor say about focused ultrasound?When I told my family physician, an internal medicine specialist, about focused ultrasound for ET, she had not heard of it and thought I was talking about deep brain stimulation (DBS). After I sent her some information on focused ultrasound, she cautioned me that she had heard rumors about speech, balance, and gate problems after being treated with focused ultrasound. I learned that the University of Utah provided focused ultrasound for ET and that it was the closest center to us in Montana, so I contacted the neurology department there and then told Dr. Johnston about it. When she gave me the referral, she asked if I really wanted to try focused ultrasound. I did. Describe your initial evaluation at the University of Utah.My wife and I drove 400 miles from Montana, spent the night in Salt Lake City, and had the appointment with the neurologist. He explained the differences between DBS and focused ultrasound. He then had a meeting with the entire team to review my case and the options for my treatment. Then, the neurology department nurse and focused ultrasound program coordinator, Heather Wisner, RN, called me to explain that the process involved five appointments for five different pre-procedure evaluations, which were physical therapy, CT scan, MRI, psychology, and neurosurgery. We flew up ...
Key Points A new clinical trial has begun in the UK investigating histotripsy for the treatment of primary kidney tumors. HistoSonics’ Edison platform uses histotripsy to noninvasively and mechanically destroy tissue. The trial is named after the late Charles Cain, PhD, co-inventor of histotripsy and co-founder of HistoSonics. The first patient has been treated in a new clinical trial investigating the HistoSonics’ Edison platform for the treatment of kidney tumors. Edison is a sonic beam therapy system that uses histotripsy to noninvasively and mechanically destroy tissue. The new Phase I trial will assess the safety and feasibility of using histotripsy to target primary solid renal tumors in 20 participants at multiple sites throughout the UK. It is named the CAIN trial after the late Charles Cain, PhD, former Chair of Biomedical Engineering at the University of Michigan, co-inventor of histotripsy, and co-founder of HistoSonics, who passed away in March 2020. The first procedure was performed in Leeds, UK, by Professor Tze Min Wah, Senior Consultant Radiologist and Clinical Lead for Interventional Oncology Program at Leeds Teaching Hospitals NHS Trust, UK. Professor Tze Min Wah commented in the release, “I was delighted to lead the clinical team in carrying out this world’s first kidney tumor treatment using histotripsy, and [it was] a real privilege to have the trust of the patient and their family in translating this innovative technology into our clinic. The CAIN Trial represents a significant milestone for treatment of solid renal tumors with histotripsy as a needle-less technology and is a paradigm shift from this point onward.” The company also has an FDA-approved Investigational Device Exemption (IDE) trial in the US to evaluate the safety and efficacy of histotripsy in destroying targeted kidney tissue, called the #HOPE4KIDNEY trial, which is expected to begin enrollment later this year. “This first treatment is a significant milestone for the company as it represents expansion into our second active clinical application (after liver) and supports our mission to deliver histotripsy to patients who may potentially benefit from its unique capabilities,” said Mike Blue, President, and CEO of HistoSonics. Learn More About the Trial Read HistoSonics’ Press Release This trial has garnered media coverage from Aunt Minnie and Mass Device.
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