Textbook of Personalized Medicine - Second Edition [2015]

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cost, the need for a nearby cyclotron to produce radioisotopes with short half-lives.
Routine use for monitoring HBO therapy is not currently practical. It is extremely
sensitive in the early detection of a cerebrovascular disturbance and can delineate
the natural course of an episode that can lead to cerebral infarction. Evidence of
ischemia is clearly demonstrated by substantial reduction in CBF and elevated
CMR O2 and CMR glucose. The effect of a therapeutic intervention can be assessed
by demonstrating the complete or partial reversal of these physiological and bio-
chemical parameters.
SPECT is a useful tool for assessing the effect of HBO in neurological disorders.
It is based on principles similar to those of PET but the radioligands decay to emit
only a single photon. Advantages of SPECT over PET are:

1. It is more widely available and less costly than PET scan.


2. Any nuclear medicine facility with a gamma camera has the capability for this
   procedure.


3. There is a short waiting period for uptake of the isotope.


4. The procedure can be integrated with HBO sessions and a post-HBO scan can be
   done with the same injection as for the pre-HBO scan.


5. This scan documents the area of cerebral infarction as diminished uptake, and
   any improvement is easy to document by noting the increased uptake of the
   tracer.


6. Improvement in the scan can be correlated with clinical improvement.


7. SPECT performed within 24 h may be helpful in predicting outcome in clinical
   practice and in appropriately categorizing patients into subgroups for clinical
   trials.
   If neurologic defi cits improve transiently following a treatment and recur after
   the effects of HBO wear off and this phenomenon can be shown repeatedly, then it
   can be considered proof of the effi cacy of the treatment, particularly when it corre-
   lates with the improvement in SPECT scan.

Personalized Nutrition

Nutrition plays a crucial role in health as well as disease. Nutraceuticals are dietary
supplements such as vitamins, minerals and antioxidants, which can be used for
prevention and treatment of diseases. With advances in molecular biology, there is
a shift in focus from epidemiology and biochemistry to an understanding of how
nutrients act at molecular level. Advances in genomics have led to recognition of the
importance of genes in human nutrition. Genetic predisposition is an important fac-
tor in mortality linked to diet such as cardiovascular disease. Whereas traditional
nutrition research has dealt with providing nutrients to nourish populations, it nowa-
days focuses on improving health of individuals through diet. Modern nutritional
research is aiming at health promotion and disease prevention and on performance
improvement.

Personalized Nutrition