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Sample records for ambulatory-based standardized therapy

  1. Illinois Occupational Skill Standards: Occupational Therapy Cluster.

    Science.gov (United States)

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    This document, which is intended to serve as a guide for work force preparation program providers, details the Illinois occupational skill standards for programs preparing students for employment in jobs in occupational therapy. Agency partners involved in this project include: the Illinois State board of Education, Illinois Community College…

  2. Emerging Canadian QA standards for radiation therapy

    International Nuclear Information System (INIS)

    Full text: Canada operates a publicly funded health care system in which 70% of health care costs are paid by some level of government. Radiotherapy, indeed most cancer management, falls within the publicly funded realm of Canada's health care system. National legislation (the Canada Health Act) guarantees access to cancer services for all Canadians. However, the financial responsibility for these services is borne by the provinces. Most Canadian provinces manage the cancer management problem through central cancer agencies. In the past few decades, these provincial cancer agencies have formed the Canadian Association of Provincial Cancer Agencies (CAPCA). This association has adopted a broad mandate for cancer management in Canada (see www.capca.ca). Included in this mandate is the adoption of standards and guidelines for all aspects of cancer control. The complexity of radiation therapy has long underscored the need for cooperation at the international and national levels in defining programmes and standards. In recent decades formal quality assurance programme recommendations have emerged in the United States, Europe and Great Britain. When defining quality assurance programs, Canadian radiation treatment centres have referenced U.S. and other program standards since they have been available. Recently, under the leadership of the Canadian Association of Provincial Cancer Agencies (CAPCA), Canadian national quality assurance program recommendations are emerging. A CAPCA sponsored project to harmonize Canadian quality assurance processes has resulted in a draft document entitled 'Standards for Quality Assurance at Canadian Radiation Treatment Centres'. This document provides recommendations for the broad framework of radiation therapy quality assurance programs. In addition, detailed work is currently underway regarding equipment quality control procedures. This paper explores the historical and political landscape in which the quality assurance problem has

  3. Adjunct Methods of the Standard Diabetic Foot Ulceration Therapy

    Directory of Open Access Journals (Sweden)

    Dariusz Waniczek

    2013-01-01

    Full Text Available The outcome of management of diabetic foot ulceration (DFU is poor and insufficient. DFU therapy includes the standard management as debridement of the wound, revascularization procedures, off-loading of the ulcer and antibacterial actions, and supplementation of growth factors and cytokines, leading to stimulation of granulation, epidermization, and angiogenesis. The aim of the present review is to summarize the adjunct methods of the standard DFU therapy as hyperbaric oxygen therapy (HBOT, maggot therapy (MT, and platelet-rich plasma therapy (PRPT. The results of preclinical and clinical trials indicated that the methods may reduce time of therapy, short-term morbidity, and the risk of major amputation.

  4. Standard therapies versus novel therapies in Hodgkin lymphoma.

    Science.gov (United States)

    Gallamini, A; Di Raimondo, F; La Nasa, G; Romano, A; Borra, A; Greco, M

    2013-01-01

    The prognostic models in Hodgkin lymphoma (HL) such as the International Prognostic Score (IPS), retrospectively constructed in the last twenty years from different cohorts of patients treated with ABVD or ABVD-equivalent regimens have been shown a limited predictive value on treatment outcome when applied to a prospective cohort of patients. In the turn of millennium a new class of prognostic factors has emerged, aimed to test the chemosensitivity to treatment in a single patient-basis, such as the minimal residual disease (MRD) assessment with molecular biology, or interim PET/CT performed early during treatment. The main challenge in the management of both early and advanced-stage HL is to achieve a durable remission or cure while minimizing therapy toxicity. An adaptive therapy strategy based on interim PET results could distinguish high from low-risk patients: the former with a potential benefit from an intensify regimen, the latter in whom treatment could be de-escalated or abbreviated for minimizing long-term adverse effects. Conversely, chemosensitivity evaluation in early-stage HL has been the underpinning of de-escalation trials aimed at assessing the safety and the efficacy of omitting radiotherapy in interim PET-negative patients. Brentuximab Vedotin (BV) is a novel antibody-drug conjugate targeting CD30 linked to a potent synthetic antitubulin chemotherapeutic agent, monomethyl auristatin E (MME). BV showed an impressive activity against refractory/relapsed HL and now is being incorporated in a modified ABVD schedule in first-line treatment of HL, with promising efficacy and a low toxicity profile. This novel therapeutic strategy will tell us if traditional ABVD or BEACOPP chemotherapy could be abandoned for the brand-new targeted therapy. Despite the brilliant results of HL treatment, which proved able to achieve a long-term disease control in 80-90% of the patients, the search of new prognostic has continued over the last two decades and the progress

  5. A standardized method for beam design in neutron capture therapy

    International Nuclear Information System (INIS)

    A desirable end point for a given beam design for Neutron Capture Therapy (NCT) should be quantitative description of tumour control probability and normal tissue damage. Achieving this goal will ultimately rely on data from NCT human clinical trials. Traditional descriptions of beam designs have used a variety of assessment methods to quantify proposed or installed beam designs. These methods include measurement and calculation of open-quotes free fieldclose quotes parameters, such as neutron and gamma flux intensities and energy spectra, and figures-of-merit in tissue equivalent phantoms. The authors propose here a standardized method for beam design in NCT. This method would allow all proposed and existing NCT beam facilities to be compared equally. The traditional approach to determining a quantitative description of tumour control probability and normal tissue damage in NCT research may be described by the following path: Beam design → dosimetry → macroscopic effects → microscopic effects. Methods exist that allow neutron and gamma fluxes and energy dependence to be calculated and measured to good accuracy. By using this information and intermediate dosimetric quantities such as kerma factors for neutrons and gammas, macroscopic effect (absorbed dose) in geometries of tissue or tissue-equivalent materials can be calculated. After this stage, for NCT the data begins to become more sparse and in some areas ambiguous. Uncertainties in the Relative Biological Effectiveness (RBE) of some NCT dose components means that beam designs based on assumptions considered valid a few years ago may have to be reassessed. A standard method is therefore useful for comparing different NCT facilities

  6. Sequential Therapy or Standard Triple Therapy for Helicobacter pylori Infection: An Updated Systematic Review.

    Science.gov (United States)

    Feng, Li; Wen, Mao-Yao; Zhu, Yong-Jun; Men, Ruo-Ting; Yang, Li

    2016-01-01

    The effectiveness of standard triple therapy (STT) for the eradication of Helicobacter pylori has decreased recently. Sequential therapy (SQT) is a new regimen proposed to address this problem. The aim of this study was to compare the efficacy of SQT versus STT for H. pylori eradication. We searched The Cochrane Library, MEDLINE, Web of Science, and EMBASE databases up to July 2014. The risk ratios (RRs) of eradication rate were pooled, with a 95% confidence interval (CI). Thirty-six randomized clinical trials including a total of 10,316 patients met the inclusion criteria. The RR for eradication of H. pylori with SQT compared with STT was 1.14 (95% CI: 1.09-1.17), the eradication rates were 84.1% and 75.1%, respectively. There was significant heterogeneity between trial results (I = 73%; P eradication rates 80.9% vs. 40.7%), RR = 1.98 (95% CI: 1.33-2.94). There was no significant difference between groups in terms of the risk of adverse effects. In conclusion, SQT is more efficacious than STT (7 days and 10 days) in the eradication of HP, but the pooled rate seemed suboptimal. Further research is needed to develop more effective therapeutic approaches. Surveillance of resistance rates should be performed to guide treatment. PMID:25569598

  7. Efficacy of high-dose chemotherapy or standard salvage therapy in patients with recurrent medulloblastoma

    OpenAIRE

    Gururangan, Sridharan; Krauser, Jeanne; Watral, Melody A.; Driscoll, Tim; Larrier, Nicole; Reardon, David A.; Jeremy N Rich; Quinn, Jennifer A.; Vredenburgh, James J.; Desjardins, Annick; McLendon, Roger E; Fuchs, Herbert; Kurtzberg, Joanne; Friedman, Henry S.

    2008-01-01

    The efficacy of high-dose chemotherapy (HDC) or standard salvage therapy was evaluated in patients with recurrent medulloblastoma (MBL) using retrospective chart review of all patients with recurrent MBL treated at Duke University Medical Center between 1995 and 2005 and who had undergone HDC with or without radiotherapy (RT) or standard salvage therapy after relapse. A total of 30 patients were diagnosed with recurrent MBL after standard RT alone or chemotherapy with RT. Nineteen patients (7...

  8. Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

    OpenAIRE

    Gao, Xiao-Zhong; Qiao, Xiu-li; Song, Wen-chong; Wang, Xiao-Feng; Liu, Feng

    2010-01-01

    AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori) eradication in a randomized, double-blinded, comparative clinical trial in China.

  9. 78 FR 43889 - Synergizing Efforts in Standards Development for Cellular Therapies and Regenerative Medicine...

    Science.gov (United States)

    2013-07-22

    ... Therapies and Regenerative Medicine Products; Public Workshop AGENCY: Food and Drug Administration, HHS... Development for Cellular Therapies and Regenerative Medicine Products.'' The purpose of the public workshop is to bring together a broad range of stakeholders to discuss current and future standards...

  10. [Survey on antiemetic therapy in ambulatory cancer chemotherapy and medical economics for standardization].

    Science.gov (United States)

    Sato, Junya; Terui, Kazufumi; Souma, Akemi; Fujita, Shoko; Hayakari, Makoto

    2007-10-01

    A cancer chemotherapy unit was established to support therapy for outpatients with cancer in Hirosaki University Hospital. It is essential to standardize antiemetic therapy, since a wide variety of the therapy provided to the unit from the diagnosis and treatment departments were conventional and empirical. We surveyed the use conditions and compatibility of the therapy based on reliable guidelines, and then considered the medical economics for standardization. In moderate-grade emetogenic chemotherapy, 5-HT(3) receptor antagonists tended to be used frequently instead of the recommended steroids. From this survey, the standardization of the cost of 5-HT(3) receptor antagonists and the relatively inexpensive steroids used in cancer chemotherapy might reduce either the nausea or vomiting suffered by patients with cancer and their economic burden as well. PMID:17940380

  11. Evaluation of short wave therapy equipment based on brazilian standards

    Directory of Open Access Journals (Sweden)

    Cristiane Regina Gruber

    2006-01-01

    Full Text Available Short Wave Diathermy (SWD equipment is used in physiotherapy and applied therapeutically using radio frequency (RF radiation of 27.12 MHz. This article presents the results of a survey related to SWD, showing data about the equipment, conditions of use, visual inspection and analysis of accompanying documents, having as reference the requirements of the Brazilian standards NBR IEC 601-1 and NBR IEC 601-2-3. Electrical safety tests were also carried out for the equipment and the installation. The results showed that manufacturers do not completely follow the standards and there is a lack of knowledge of these standards by the physiotherapists. Electrical safety tests presented measured values of equipment leakage current within the limits of the standards, but installation presented fails. One can conclude that it is necessary a greater awareness by manufacturers and professionals regarding the standards including electrical safety in order to assure the correct use of SWD equipment.Equipamentos de diatermia por ondas curtas (DOC são utilizados em clínicas de fisioterapia e aplicados terapeuticamente, utilizando radiação de radiofreqüência (RF em 27,12 MHz. Este artigo apresenta os resultados de uma pesquisa diagnóstica para equipamentos de DOC mostrando dados relativos aos equipamentos, condições de uso, inspeção visual e análise dos documentos acompanhantes tendo como referência os requisitos descritos nas normas brasileiras NBR IEC 601-1 (geral e NBR IEC 601-2-3 (específica. Além disso, apresentam-se os resultados de testes de segurança elétrica efetuados nos equipamentos e nas instalações onde os mesmos são utilizados. Os resultados em geral mostraram que os fabricantes não seguem as normas para as especificações tanto do equipamento quanto do ambiente e dos documentos acompanhantes, e que há falta de conhecimento das normas por parte dos fisioterapeutas. Os testes de segurança elétrica envolvendo correntes de fuga

  12. [Diagnostic workup and therapy of infectious diarrhea. Current standards].

    Science.gov (United States)

    Stallmach, A; Hagel, S; Lohse, A W

    2015-12-01

    Infectious diarrhea is very common; its severity ranges from uncomplicated, self-limiting courses to potentially life-threatening disease. A rapid diagnostic workup providing detailed information on the suspected pathogen should be performed only in patients at risk, analyzing one single stool sample for Salmonella, Shigella, Campylobacter, and Norovirus. In the presence of risk factors, such as a history of antibiotic exposure within the last 3 months, testing for Clostridium difficile should be performed. Immunocompetent patients do not require specific antibiotic therapy. Exceptions exist in patients with severe comorbidities, immunodeficiency, fever/SIRS, and in patients with Shigella or C. difficile infection. Empirical antibiotic treatment should be considered in patients with fever and/or bloody diarrhea and in patients at risk. In patients with traveler's diarrhea, microbiological diagnosis is required only in patients with fever, bloody diarrhea, prolonged course of disease (more than 5 days), severe clinical course with hypotension or dehydration, and during outbreaks. In these patients one single fecal sample should be collected for stool cultures of Campylobacter, Shigella, and Salmonella, as well as microscopic examination for amoebiasis and Giardiasis. The main therapeutic measure for infectious diarrhea is sufficient oral rehydration. As in community-acquired diarrhea, azithromycin or ciprofloxacin are recommended-taking into account local antimicrobial resistance in the country of travel and possible side effects. PMID:26573083

  13. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    Science.gov (United States)

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P videogames were equally effective as traditional therapy for overall ROM gains and resulted in quicker recovery of motion with less pain experienced. Such videogames are a useful adjunct to therapy and should be considered as part of a holistic approach to rehabilitation within the hospital and at home after discharge in pediatric patients recovering from burn injury. PMID:26335108

  14. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    Science.gov (United States)

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P videogames were equally effective as traditional therapy for overall ROM gains and resulted in quicker recovery of motion with less pain experienced. Such videogames are a useful adjunct to therapy and should be considered as part of a holistic approach to rehabilitation within the hospital and at home after discharge in pediatric patients recovering from burn injury.

  15. Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxaci...

  16. Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report

    Directory of Open Access Journals (Sweden)

    Servadei Franco

    2010-04-01

    Full Text Available Abstract Background Management of glioblastoma multiforme (GBM has been difficult using standard therapy (radiation with temozolomide chemotherapy. The ketogenic diet is used commonly to treat refractory epilepsy in children and, when administered in restricted amounts, can also target energy metabolism in brain tumors. We report the case of a 65-year-old woman who presented with progressive memory loss, chronic headaches, nausea, and a right hemisphere multi-centric tumor seen with magnetic resonance imaging (MRI. Following incomplete surgical resection, the patient was diagnosed with glioblastoma multiforme expressing hypermethylation of the MGMT gene promoter. Methods Prior to initiation of the standard therapy, the patient conducted water-only therapeutic fasting and a restricted 4:1 (fat: carbohydrate + protein ketogenic diet that delivered about 600 kcal/day. The patient also received the restricted ketogenic diet concomitantly during the standard treatment period. The diet was supplemented with vitamins and minerals. Steroid medication (dexamethasone was removed during the course of the treatment. The patient was followed using MRI and positron emission tomography with fluoro-deoxy-glucose (FDG-PET. Results After two months treatment, the patient's body weight was reduced by about 20% and no discernable brain tumor tissue was detected using either FDG-PET or MRI imaging. Biomarker changes showed reduced levels of blood glucose and elevated levels of urinary ketones. MRI evidence of tumor recurrence was found 10 weeks after suspension of strict diet therapy. Conclusion This is the first report of confirmed GBM treated with standard therapy together with a restricted ketogenic diet. As rapid regression of GBM is rare in older patients following incomplete surgical resection and standard therapy alone, the response observed in this case could result in part from the action of the calorie restricted ketogenic diet. Further studies are needed

  17. [On the necessity of intellectual property rights involving standardization of acupuncture and moxibustion therapies].

    Science.gov (United States)

    Dong, Guo-Feng; Wu, Xiao-Dong; Han, Yan-Jing; Wang, Xin; Wang, Jun-Wen

    2014-08-01

    In the process of working out and implementing standardization of acupuncture-moxibustion (acu-moxi) therapy, the issue of intellectual property rights has been frequently involved. Whether is the standardization inevitably involved in intellectual property rights? A reasonable answer to this question is definitely of important realistic guiding value and significance for acu-moxi standardization work. For this reason, authors of the present paper sum up historical development of correlation between acu-moxi standardization and intellectual property rights, and fully analyze the related causes under the conditions of knowledge economy from 1) increasing protection of acu-moxi intellectual property rights, 2) intrinsic requirements for raising the standardization level of acu-moxi, 3) profits drive of the intellectual property rights owners, and 4) increasing impetuous international economic trade competition.

  18. Response rates of standard interferon therapy in chronic HCV patients of Khyber Pakhtunkhwa (KPK

    Directory of Open Access Journals (Sweden)

    Ahmad Bashir

    2012-01-01

    Full Text Available Abstract Background Interferon based therapy is used to eradicate the Hepatitis C Virus from the bodies of the infected individuals. HCV is highly prevalent in Khyber Pakhtunkhwa (KPK that is why it is important to determine the response of standard interferon based therapy in Chronic HCV patients of the region. Study design A total of 174 patients were selected for interferon based therapy. The patients were selected from four different regions of KPK. After confirmation of active HCV infection by Real Time PCR, standard interferon with ribavirn was given to patients for 6 months. After completion of therapy, end of treatment virologic response (ETR was calculated. Results Out of total 174 patients, 130 (74.71% showed ETR and 44 (25.28% did not show ETR. In district Bunir, out of 52 patients, 36 (69.23% showed ETR and 16 (30.79% did not show ETR. In district Mardan, out of the total 74 patients, 66 (89.18% were negative for HCV RNA and 8 (10.81% were resistant to therapy. In Peshawar, out of 22, 16 (60% were negative and 6 (40% were positive for HCV RNA at the end of 6 months therapy. In the Federally Administered Tribal Area (FATA, out of 18 only 10 (55.5% were negative and 8 (44.45% were positive for active HCV infection. Conclusion It is concluded that the response of antiviral therapy against HCV infection in chronic HCV patients of KPK province is 74.71%. The high response rate may be due to the prevalence of IFN-responsive HCV genotypes (2 and 3 in KPK.

  19. Development of job standards for clinical nutrition therapy for dyslipidemia patients.

    Science.gov (United States)

    Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min

    2015-04-01

    Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.

  20. Prospective trial in Saudi Arabia comparing the 14-day standard triple therapy with the 10-day sequential therapy for treatment of Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    Fahad Alsohaibani

    2015-01-01

    Full Text Available Background/Aims: Treatment success for Helicobacter pylori infection in Saudi Arabia is relatively unexplored. This prospective study compared the efficacy of sequential versus standard triple therapy in curing H. pylori infections. Patients and Methods: Eligible patients underwent upper endoscopy at a single center in Saudi Arabia from October 2011 to February 2014. Patients who tested positive for H. pylori infection were randomly assigned to sequential therapy or standard triple therapy. Sequential treatment: Esomeprazole (20 mg bid for 10 days, amoxicillin (1000 mg for 5 days, then clarithromycin 500 mg and tinidazole 500 mg; both bid for 5 days. Standard triple treatment: Esomeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1000 mg each bid for 14 days. After 6 weeks of treatment, patients were tested for cure using a validated urea breath test. Application of the E-test determined susceptibility of H. pylori to different antibiotics. Results: Of the 115 patients who received sequential therapy, 93 completed treatment. In the triple-therapy arm, 103 of 117 patients completed treatment. The eradication rate was 58/93 (62.3% with sequential therapy and 69/102 (67.6% with standard triple therapy, P = 0.44. Risk ratio was 0.92 (95% CI; 0.75–1.13, and number needed to treat was 19. Overall primary resistance: Metronidazole (48.5%, clarithromycin (23.3%, amoxicillin (14.8%, levofloxacin (11.1%, and tetracycline (2.3%. Mild adverse events occurred in 35 and 17 patients in the sequential and standard therapy groups, respectively. Conclusion: Sequential and standard triple therapies were similarly effective at eradicating H. pylori in two-thirds of Saudi patients. Metronidazole and clarithromycin resistance to H. pylori strains was common.

  1. Radioiodine therapy in patients with hyperthyroid disorder: standard versus dosimetric activity application.

    Science.gov (United States)

    Reinartz, P; Zimny, M; Schaefer, W; Mueller, B; Buell, U; Sabri, O

    2003-12-01

    Due to its high success rate and non-invasive character, an increasing demand for radioiodine therapy can be seen. This study was conducted to determine whether standardized 131I activities can be used to facilitate management of patients with hyperthyroid disorder or whether a pre-therapeutic radioiodine test is advisable to determine an adequate therapeutic activity. The therapeutic uptake of 218 patients with benign thyroid disorders were determined and compared with 24 h and 48 h test uptake measurements as well as with calculated standard uptake values. Since there is a linear relationship between iodine uptake and delivered radiation dose, the effect of the different therapeutic approaches on the latter parameter was analysed. Special care was taken to assess possible differences between the various thyroid disorders. A mean deviation between pre-therapeutic test uptake and actual therapeutic uptake of 14.7% was observed in contrast to one of 29.1% when using disease specific standard values per millilitre of thyroid tissue. Furthermore, the proportion of patients with large deviations of more than 40% increased drastically when using standard uptake values (with radioiodine test, 4.1%; with standard values, 18.8%). In conclusion, the dosimetric approach with a pre-therapeutic radioiodine test proved to be the most accurate therapeutic procedure. Both the 24 h and 48 h test uptake measurements gave analogous results and yielded a correlation coefficient of 0.91 when compared with the therapeutic uptake. While it may be tempting to use standard activities to facilitate patient management, the findings of this study confirm that, for precise therapy planning, a pre-therapeutic radioiodine test is advised. Since no significant difference could be found between the 24 h and 48 h test uptake values, an early measurement 24 h after administration of the test activity is recommended. PMID:14627852

  2. Targeting clinician concerns about exposure therapy: A pilot study comparing standard vs. enhanced training.

    Science.gov (United States)

    Farrell, Nicholas R; Kemp, Joshua J; Blakey, Shannon M; Meyer, Johanna M; Deacon, Brett J

    2016-10-01

    Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved training strategies are needed to minimize these concerns and improve exposure delivery. The present study compared the effectiveness of a standard (i.e., didactic) exposure therapy training model to an "enhanced" training paradigm encompassing strategies derived from social-cognitive theory on attitude change. Clinicians (N = 49) were assigned to one of the two training approaches. Relative to standard training, clinicians who received enhanced training showed: (a) significantly greater reductions in concerns about exposure from pre- to post-training, and (b) superior self-reported delivery of the treatment. Reduction in concerns during training mediated the effects of training condition on clinicians' self-reported exposure delivery. These findings underscore the importance of addressing clinician concerns about exposure therapy in training contexts. PMID:27567972

  3. Adding chiropractic to standard medical therapy for nonspecific low back pain

    DEFF Research Database (Denmark)

    Goertz, Christine M; Long, Cynthia R; Hondras, Maria;

    2013-01-01

    Study Design. Randomized controlled trial.Objective. To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military....... The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).Results. Mean Roland-Morris Disability Questionnaire scores decreased in both groups during...... personnel.Summary of Background Data. LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized...

  4. Compliance with technical standards for radiological protection at radiation therapy services in Sao Paulo State, Brazil

    International Nuclear Information System (INIS)

    Radiation therapy services provide essential therapeutic procedures for cancer, one of the main causes of population morbidity and mortality. Despite their importance in the health system and their potential risks due to the use of ionizing radiation, there are few studies on such services. We evaluated compliance with technical standards for radiological protection in radiation therapy services in Sao Paulo State, Brazil. Forty-nine services were studied in 2000 through interviews with technical staff. Typologies of performance profiles focusing on structure and process variables were constructed and services compared. Important differences were observed in the services' positions in the health care system, level of complexity, and geographic distribution, with better average performance in structural conditions but very inadequate performance in patient protection, indicating the need for more effective health surveillance. (author)

  5. Preliminary results of capecitabine metronomic chemotherapy in operable triple-negative breast cancer after standard adjuvant therapy – A single-arm phase II study

    Directory of Open Access Journals (Sweden)

    Hanan Shawky

    2014-12-01

    Conclusion: One year of capecitabine metronomic therapy preceded by standard adjuvant chemotherapy, is active and well-tolerated in TNBC patients previously treated with standard adjuvant chemotherapy.

  6. Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme

    International Nuclear Information System (INIS)

    Intensity-modulated radiation therapy (IMRT) affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM). Forty-two patients were treated with IMRT alone (72%) or as a boost (28%) after 3-dimensional conformal radiation therapy (3D-CRT). Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81%) had surgery, with gross tumor resection in 13 patients (36%); 22 patients (53%) received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Median survival was 8.7 months, with 37 patients (88%) deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized

  7. Levofloxacin-based first-line therapy versus standard first-line therapy for Helicobacter pylori eradication: meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Musthafa Chalikandy Peedikayil

    Full Text Available BACKGROUND: First-line levofloxacin-based treatments eradicate Helicobacter pylori with varying success. We examined the efficacy and safety of first-line levofloxacin-based treatment in comparison to standard first-line therapy for H pylori eradication. MATERIALS AND METHODS: We searched literature databases from Medline, EMBASE, and the Cochrane Register of Randomized Controlled Trials through March 2013 for randomized controlled trials comparing first-line levofloxacin and standard therapy. We included randomized controlled trials conducted only on naïve H pylori infected patients in adults. A systematic review was conducted. Meta-analysis was performed with Review Manager 5.2. Treatment effect was determined by relative risk with a random or fixed model by the Mantel-Haenszel method. RESULTS: Seven trials were identified with 888 patients receiving 7 days of first-line levofloxacin and 894 treated with standard therapy (Amoxicillin, Clarithromycin and proton pump inhibitor for 7 days. The overall crude eradication rate in the Levofloxacin group was 79.05% versus 81.4% in the standard group (risk ratio 0.97; 95% CI; 0.93, 1.02. The overall dropout was 46 (5.2% in the levofloxacin group and 52 (5.8% for standard therapy. The dizziness was more common among group who took Levofloxacin based treatment and taste disturbance was more common among group who took standard therapy. Meta-analysis of overall adverse events were similar between the two groups with a relative risk of 1.06 (95% CI 0.72, 1.57. CONCLUSION: Helicobacter pylori eradication with 7 days of Levofloxacin-based first line therapy was safe and equal compared to 7 days of standard first-line therapy.

  8. Effect of adding tyndallized probiotics to the World Health Organization standard therapy for acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Kesatrianita Mawarni Fanny

    2012-02-01

    Full Text Available Background Diarrhea is the major cause of morbidity and mortality in children. Probiotics can decrease the frequency and duration of diarrhea. There are two types of probiotics, live and tyndallized. Tyndallized probiotics have been sterilized, so they are unable to produce active metabolites, but may have an effect on human immunity. Objective To evaluate the effectiveness of supplementing WHO standard therapy with tyndallized probiotics in children with acute, watery diarrhea. Methods We performed a randomized, single-blind, controlled trial in children aged 3-60 months who were diagnosed with acute, watery diarrhea at Gunungsitoli General Hospital, Nias, North Sumatera. Subjects were collected by consecutive sampling by way of parent interviews. Results One hundred subjects with acute, watery diarrhea were divided into 2 groups of 50. One group was treated with only WHO standard therapy for acute, watery diarrhea. The other group was treated by WHO standard therapy with the addition of tyndallized probiotics. There were no significant differences in basic characteristics between the two groups. Diarrheal duration for the group receiving WHO standard therapy only was 3.95 ± 1.3 days, while that of the group receiving both WHO standard therapy and tyndallized probiotics was 4.6 ± 2.3 days (P > 0.05. Diarrheal frequency on the fifth day in the WHO standard therapy group was 1.90 ± 0.99 times per day, while that of the tyndallized probiotic group was 1.56 ± 0.67 times per day (P > 0.05. Conclusion There were no significant differences between WHO standard therapy alone and WHO standard therapy with the addition of tyndallized probiotics for decreasing the duration and frequency of diarrhea in children.[Paediatr Indones. 2012;52:91-4].

  9. Organisational standards for the delivery of intensity-modulated radiation therapy in Ontario.

    Science.gov (United States)

    Whitton, A; Warde, P; Sharpe, M; Oliver, T K; Bak, K; Leszczynski, K; Etheridge, S; Fleming, K; Gutierrez, E; Favell, L; Green, E

    2009-04-01

    By minimising the effect of irradiation on surrounding tissue, intensity-modulated radiation therapy (IMRT) can deliver higher, more effective doses to the targeted tumour site, minimising treatment-related morbidity and possibly improving cancer control and cure. A multidisciplinary IMRT Expert Panel was convened to develop the organisational standards for the delivery of IMRT. The systematic literature search used MEDLINE, EMBASE, the Cochrane Database, the National Guidelines Clearing House and the Health Technology Assessment Database. An environmental scan of unpublished literature used the Google search engine to review the websites of key organisations, cancer agencies/centres and vendor sites in Canada, the USA, Australia and Europe. In total, 22 relevant guidance documents were identified; 12 from the published literature and 10 from the environmental scan. Professional and organisational standards for the provision of IMRT were developed through the analysis of this evidence and the consensus opinion of the IMRT Expert Panel. The resulting standards address the following domains: planning of new IMRT programmes, practice setting requirements, tools, devices and equipment requirements; professional training requirements; role of personnel; and requirements for quality assurance and safety. Here the IMRT Expert Panel offers organisational and professional standards for the delivery of IMRT, with the intent of promoting innovation, improving access and enhancing patient care.

  10. The Future of Glioblastoma Therapy: Synergism of Standard of Care and Immunotherapy

    Directory of Open Access Journals (Sweden)

    Mira A. Patel

    2014-09-01

    Full Text Available The current standard of care for glioblastoma (GBM is maximal surgical resection with adjuvant radiotherapy and temozolomide (TMZ. As the 5-year survival with GBM remains at a dismal <10%, novel therapies are needed. Immunotherapies such as the dendritic cell (DC vaccine, heat shock protein vaccines, and epidermal growth factor receptor (EGFRvIII vaccines have shown encouraging results in clinical trials, and have demonstrated synergistic effects with conventional therapeutics resulting in ongoing phase III trials. Chemoradiation has been shown to have synergistic effects when used in combination with immunotherapy. Cytotoxic ionizing radiation is known to trigger pro-inflammatory signaling cascades and immune activation secondary to cell death, which can then be exploited by immunotherapies. The future of GBM therapeutics will involve finding the place for immunotherapy in the current treatment regimen with a focus on developing strategies. Here, we review current GBM therapy and the evidence for combination of immune checkpoint inhibitors, DC and peptide vaccines with the current standard of care.

  11. The Future of Glioblastoma Therapy: Synergism of Standard of Care and Immunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Mira A.; Kim, Jennifer E.; Ruzevick, Jacob [Department of Neurosurgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Phipps Building Rm 123, Baltimore, MD 21287 (United States); Li, Gordon [Department of Neurosurgery, Stanford University Medical Center, 1201 Welch Rd., P309 MSLS, Stanford, CA 94305 (United States); Lim, Michael, E-mail: mlim3@jhmi.edu [Department of Neurosurgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Phipps Building Rm 123, Baltimore, MD 21287 (United States)

    2014-09-29

    The current standard of care for glioblastoma (GBM) is maximal surgical resection with adjuvant radiotherapy and temozolomide (TMZ). As the 5-year survival with GBM remains at a dismal <10%, novel therapies are needed. Immunotherapies such as the dendritic cell (DC) vaccine, heat shock protein vaccines, and epidermal growth factor receptor (EGFRvIII) vaccines have shown encouraging results in clinical trials, and have demonstrated synergistic effects with conventional therapeutics resulting in ongoing phase III trials. Chemoradiation has been shown to have synergistic effects when used in combination with immunotherapy. Cytotoxic ionizing radiation is known to trigger pro-inflammatory signaling cascades and immune activation secondary to cell death, which can then be exploited by immunotherapies. The future of GBM therapeutics will involve finding the place for immunotherapy in the current treatment regimen with a focus on developing strategies. Here, we review current GBM therapy and the evidence for combination of immune checkpoint inhibitors, DC and peptide vaccines with the current standard of care.

  12. The Future of Glioblastoma Therapy: Synergism of Standard of Care and Immunotherapy

    International Nuclear Information System (INIS)

    The current standard of care for glioblastoma (GBM) is maximal surgical resection with adjuvant radiotherapy and temozolomide (TMZ). As the 5-year survival with GBM remains at a dismal <10%, novel therapies are needed. Immunotherapies such as the dendritic cell (DC) vaccine, heat shock protein vaccines, and epidermal growth factor receptor (EGFRvIII) vaccines have shown encouraging results in clinical trials, and have demonstrated synergistic effects with conventional therapeutics resulting in ongoing phase III trials. Chemoradiation has been shown to have synergistic effects when used in combination with immunotherapy. Cytotoxic ionizing radiation is known to trigger pro-inflammatory signaling cascades and immune activation secondary to cell death, which can then be exploited by immunotherapies. The future of GBM therapeutics will involve finding the place for immunotherapy in the current treatment regimen with a focus on developing strategies. Here, we review current GBM therapy and the evidence for combination of immune checkpoint inhibitors, DC and peptide vaccines with the current standard of care

  13. 42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Standards for Licensing Radiographers, Nuclear..., App. F Appendix F to Part 75—Standards for Licensing Radiographers, Nuclear Medicine Technologists... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2....

  14. Standard fractionation intensity modulated radiation therapy (IMRT of primary and recurrent glioblastoma multiforme

    Directory of Open Access Journals (Sweden)

    Fuller Clifton D

    2007-07-01

    Full Text Available Abstract Background Intensity-modulated radiation therapy (IMRT affords unparalleled capacity to deliver conformal radiation doses to tumors in the central nervous system. However, to date, there are few reported outcomes from using IMRT, either alone or as a boost technique, for standard fractionation radiotherapy for glioblastoma multiforme (GBM. Methods Forty-two patients were treated with IMRT alone (72% or as a boost (28% after 3-dimensional conformal radiation therapy (3D-CRT. Thirty-three patients with primary disease and 9 patients with recurrent tumors were included. Thirty-four patients (81% had surgery, with gross tumor resection in 13 patients (36%; 22 patients (53% received chemo-radiotherapy. The median total radiation dose for all patients was 60 Gy with a range from 30.6 to 74 Gy. Standard fractions of 1.8 Gy/day to 2.0 Gy/day were utilized. Results Median survival was 8.7 months, with 37 patients (88% deceased at last contact. Nonparametric analysis showed no survival difference in IMRT-boost vs. IMRT-only groups. Conclusion While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized.

  15. Role of standard test meal in initiation of insulin therapy in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Koprivica Branka

    2009-01-01

    Full Text Available Introduction Secondary monotherapy failure in diabetes mellitus type 2 occurs early in the course of disease. Choosing the optimal combination therapy depends on the primary pathogenic mechanism. Evaluation of the residual beta cell function is of primary importance in deciding whether insulin should be included in the combination therapy. Objective To investigate the influence of standard meal test and homeostasis model assessment (HOMA-B index, as markers of residual insulin secretion, on the efficacy of two different therapeutic strategies in secondary sulphonylurea (SU failure. Methods In the group of thirty subjects with diabetes type 2, metabolic syndrome and secondary SU failure, metformin (MET was added for the following six months. In the group of 30 subjects with diabetes type 2, secondary SU failure, with no metabolic syndrome, insulin (INS was added for the same period. During the six-month follow-up period, fasting, postprandial, mean daily blood glucose and glycosylated haemoglobin (HbA1C were evaluated. Fasting and meal stimulated C-peptide (CP and insulin levels were measured at the beginning; absolute and relative increase of CP (delta CP, delta CP%, and HOMA-B were calculated. Correlation between CP secretion and HOMA-B at the beginning and glycaemic control after six months of therapy were evaluated by using Pearson correlation coefficient. Results Glycaemic control after six months was significantly improved in both therapeutic combinations (p<0.01. However, target values were not met in either group. Stimulated CP levels correlated best with all the parameters of glycaemic control in the group SU+MET (r -0.479 to -0.791; p<0.01, and in the group SU+INS (r 0.382 to 0.635; p<0.01. HOMA-B correlated only with HbA1C in the SU+MET group (r=-0.382; p<0.05. Conclusion Clinical diagnosis of metabolic syndrome and evaluation of residual insulin secretion are necessary in choosing the best combination therapy in secondary SU failure

  16. Addition of multimodal therapy to standard management of steady state sickle cell disease.

    Science.gov (United States)

    Okpala, Iheanyi; Ezenwosu, Osita; Ikefuna, Anthony; Duru, Augustine; Chukwu, Barth; Madu, Anazoeze; Nwagha, Theresa; Ocheni, Sunday; Ibegbulam, Obike; Emodi, Ifeoma; Anike, Uche; Nonyelu, Charles; Anigbo, Chukwudi; Agu, Kingsley; Ajuba, Ifeoma; Chukwura, Awele; Ugwu, Ogechukwu; Ololo, Uche

    2013-01-01

    Most people on folic acid to boost erythropoiesis and prophylactic antimicrobials, the standard management of steady state sickle cell disease (SCD), have unacceptable numbers of crises. The objective of this study was to evaluate the effects of adding multimodal therapy with potassium thiocyanate and omega-3 fatty acids to the standard management of steady state SCD. Pre- and post-treatment numbers of crises and other disease indices were compared in 16 HbSS individuals on folic acid and paludrine after 12 months of adding eicosapentaenoic acid 15 mg/kg/day, docosahexaenoic acid 10 mg/kg/day, and potassium thiocyanate 1-2 mL/day, each milliliter of which contained 250 mg of thiocyanate and 100 micrograms of iodine to prevent hypothyroidism: a possible side-effect due to competitive inhibition of the transport of iodide into the thyroid gland by thiocyanate. Median number of crises reduced from 3/yr to 1/yr (P < 0.0001). There was no evidence of impaired thyroid function. Plasma level of tri-iodothyronine improved (P < 0.0001). Steady state full blood count and bilirubin level did not change significantly. The findings suggest that addition of potassium thiocyanate and eicosapentaenoic and docosahexaenoic acids to standard management of steady state SCD reduces the number of crises. This observation needs to be evaluated in larger studies.

  17. Advanced gastric cancer: Is there enough evidence to call second-line therapy standard?

    Institute of Scientific and Technical Information of China (English)

    Hendrik-Tobias Arkenau; Matilde Saggese; Charlotte Lemech

    2012-01-01

    Gastric cancer and cancer of the gastro-oesophageal junction (GOJ) are the 4th most common cancer diagnoses worldwide with regional differences in incidence rates.The treatment of gastric and GOJ cancers is complex and requires multimodality treatment including chemotherapy treatment,surgery,and radiotherapy.During the past decade considerable improvements were achieved by advanced surgical techniques,tailored chemotherapies/radiotherapy and technical innovations in clinical diagnostics.In patients with advanced or metastatic gastric/GOJ cancer systemic chemotherapy with fluoropyrimidine/platinum-based regimens (+/-human epidermal growth factor receptor-2 antibody) is the mainstay of treatment.Despite these improvements,the clinical outcome for patients with advanced or metastatic disease is generally poor with 5-year survival rates ranging between 5%-15%.These poor survival rates may to some extent be related that standard therapies beyond first-line therapies have never been defined.Considering that this patient population is often not fit enough to receive further treatments there is an increasing body of evidence from phase-2 studies that in fact second-line therapies may have a positive impact in terms of overall survival.Moreover two recently published phase-3 studies support the use of second-line chemotherapy.A South Korean study compared either,irinotecan or docetaxel with best supportive care and a German study compared irinotecan with best supportive care-both studies met their primary endpoint overall survival.In this "Field of Vision" article,we review these recently published phase-3 studies and put them into the context of clinical prognostic factors helping to guide treatment decisions in patients who most likely benefit.

  18. Low standard oral anticoagulation therapy for Chinese patients with St.Jude mechanical heart valves

    Institute of Scientific and Technical Information of China (English)

    孙晓刚; 胡盛寿; 祁国奇; 周玉燕

    2003-01-01

    Objective To study the efficacy of the low standard oral anticoagulation therapy following St Jude Medical (SJM) valve implantation for Chinese patients.Methods Totally 805 patients with a mean age of 42.70±11.09 years, enrolled into this study. Among them, 230 underwent aortic valve replacements (AVR), 381 mitral valve replacements (MVR), 189 double valve replacements (DVR) and 5 tricuspid valve replacememts (TVR). All patients received postoperative oral anticoagulation therapy based on a low standard of international normalized ratio (INR, 2.0-2.5). Of the 805 patients, 710 were followed up for 0.25-13 years (a median, 4.15 years). Results Postoperatively, 17 adverse events occurred. Operative mortality was 2.11%. The most frequent cause of operative mortality was a low cardiac output. During follow-up, there were 47 anticoagulant-induced hemorrhages [1.59%/patient-year (pt-yr)], 10 cases of thromboembolism (0.34%/pt-yr), and 3 mechanical valve thromboses (0.19%/pt-yr). There were 44 late deaths and the linearized late mortality rates were 0.51%pt-yr. Estimates of actuarial survival for all patients at 5 and 10 years was 97.45% (0.70%) and 77.96% (17.44%), respectively.Conclusions A low target INR range of 2.0-2.5 is preferable for Chinese patients so as to reduce the severe bleeding complications in those with conventionally higher levels of INR. The long-term results were satisfactory in terms of the numbers of those who suffered thrombosis, embolism and bleeding.

  19. Predicting the efficacy of trastuzumab-based therapy in breast cancer: current standards and future strategies.

    Science.gov (United States)

    Singer, Christian F; Köstler, Wolfgang J; Hudelist, Gernot

    2008-12-01

    Breast cancer is the most common female malignancy in many industrialized countries. Approximately one fourth of all women diagnosed with early breast cancer present with tumors that are characterized by erbB2 amplification. While the associated Her-2/neu receptor overexpression results in a high risk of relapse and poor prognosis, these tumors also represent a target for a selective monoclonal antibody therapy with trastuzumab (Herceptin). The combination of trastuzumab with chemotherapy has led to a considerable reduction of recurrences and to a significant reduction in breast cancer mortality both in the adjuvant and metastatic setting. Unfortunately, despite Her-2/neu overexpression, not all patients equally benefit from trastuzumab treatment, and almost all women with metastatic breast cancer eventually progress during antibody therapy. Moreover, trastuzumab is burdened with cardiotoxicity, thus increasing the risk of symptomatic congestive heart failure. In addition, the marginal costs for a 1 year therapy of trastuzumab-based therapy, which is currently considered to be the most effective treatment regimen in the adjuvant setting, may amount for up to US$ 40.000. Testing for erbB2 oncogene amplification by fluorescence in situ hybridization (FISH) and chromogenic in situ hybridization (CISH), respectively, and staining for Her-2/neu receptor overexpression by immunohistochemistry (IHC) represent the current standard for determining patient eligibility for trastuzumab-based therapy. However, while the negative predictive value of these assays for predicting the absence of benefit from trastuzumab-based therapy is sufficiently high, their positive predictive value remains insufficient, i.e. only a proportion of patients selected by these tests substantially benefit from trastuzumab-containing regimen. Accordingly, over the last years a number of biomarkers have been evaluated in their potential to predict response to trastuzumab-based therapies. These include

  20. Addition of Bevacizumab to Standard Radiation Therapy and Daily Temozolomide Is Associated With Minimal Toxicity in Newly Diagnosed Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Vredenburgh, James J., E-mail: vrede001@mc.duke.edu [Department of Medicine, Duke University Medical Center, Durham, NC (United States); Desjardins, Annick [Department of Neurology, Duke University Medical Center, Durham, NC (United States); Kirkpatrick, John P. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Reardon, David A. [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Department of Pediatrics, Duke University Medical Center, Durham, NC (United States); Peters, Katherine B. [Department of Neurology, Duke University Medical Center, Durham, NC (United States); Herndon, James E.; Marcello, Jennifer [Department of Cancer Center Biostatistics, Duke University Medical Center, Durham, NC (United States); Bailey, Leighann; Threatt, Stevie; Sampson, John; Friedman, Allan [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Friedman, Henry S. [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Department of Pediatrics, Duke University Medical Center, Durham, NC (United States)

    2012-01-01

    Purpose: To determine the safety of the addition of bevacizumab to standard radiation therapy and daily temozolomide for newly diagnosed glioblastoma multiforme (GBM). Methods and Materials: A total of 125 patients with newly diagnosed GBM were enrolled in the study, and received standard radiation therapy and daily temozolomide. All patients underwent a craniotomy and were at least 2 weeks postoperative. Radiation therapy was administered in 1.8-Gy fractions, with the clinical target volume for the primary course treated to a dose of 45 to 50.4 Gy, followed by a boost of 9 to 14.4 Gy, to a total dose of 59.4 Gy. Patients received temozolomide at 75 mg/m{sup 2} daily throughout the course of radiation therapy. Bevacizumab was given at 10 mg/kg intravenously every 14 days, beginning a minimum of 4 weeks postoperatively. Results: Of the 125 patients, 120 (96%) completed the protocol-specified radiation therapy. Five patients had to stop the protocol therapy, 2 patients with pulmonary emboli, and 1 patient each with a Grade 2 central nervous system hemorrhage, Grade 4 pancytopenia, and wound dehiscence requiring surgical intervention. All 5 patients ultimately finished the radiation therapy. After radiation therapy, 3 patients had progressive disease, 2 had severe fatigue and decreased performance status, 1 patient had a colonic perforation, and 1 had a rectal fissure; these 7 patients therefore did not proceed with the protocol-specified adjuvant temozolomide, bevacizumab, and irinotecan. However, 113 patients (90%) were able to continue on study. Conclusions: The addition of bevacizumab to standard radiation therapy and daily temozolomide was found to be associated with minimal toxicity in patients newly diagnosed with GBM.

  1. Addition of Bevacizumab to Standard Radiation Therapy and Daily Temozolomide Is Associated With Minimal Toxicity in Newly Diagnosed Glioblastoma Multiforme

    International Nuclear Information System (INIS)

    Purpose: To determine the safety of the addition of bevacizumab to standard radiation therapy and daily temozolomide for newly diagnosed glioblastoma multiforme (GBM). Methods and Materials: A total of 125 patients with newly diagnosed GBM were enrolled in the study, and received standard radiation therapy and daily temozolomide. All patients underwent a craniotomy and were at least 2 weeks postoperative. Radiation therapy was administered in 1.8-Gy fractions, with the clinical target volume for the primary course treated to a dose of 45 to 50.4 Gy, followed by a boost of 9 to 14.4 Gy, to a total dose of 59.4 Gy. Patients received temozolomide at 75 mg/m2 daily throughout the course of radiation therapy. Bevacizumab was given at 10 mg/kg intravenously every 14 days, beginning a minimum of 4 weeks postoperatively. Results: Of the 125 patients, 120 (96%) completed the protocol-specified radiation therapy. Five patients had to stop the protocol therapy, 2 patients with pulmonary emboli, and 1 patient each with a Grade 2 central nervous system hemorrhage, Grade 4 pancytopenia, and wound dehiscence requiring surgical intervention. All 5 patients ultimately finished the radiation therapy. After radiation therapy, 3 patients had progressive disease, 2 had severe fatigue and decreased performance status, 1 patient had a colonic perforation, and 1 had a rectal fissure; these 7 patients therefore did not proceed with the protocol-specified adjuvant temozolomide, bevacizumab, and irinotecan. However, 113 patients (90%) were able to continue on study. Conclusions: The addition of bevacizumab to standard radiation therapy and daily temozolomide was found to be associated with minimal toxicity in patients newly diagnosed with GBM.

  2. Comparing marginal structural models to standard methods for estimating treatment effects of antihypertensive combination therapy

    Directory of Open Access Journals (Sweden)

    Gerhard Tobias

    2012-08-01

    Full Text Available Abstract Background Due to time-dependent confounding by blood pressure and differential loss to follow-up, it is difficult to estimate the effectiveness of aggressive versus conventional antihypertensive combination therapies in non-randomized comparisons. Methods We utilized data from 22,576 hypertensive coronary artery disease patients, prospectively enrolled in the INternational VErapamil-Trandolapril STudy (INVEST. Our post-hoc analyses did not consider the randomized treatment strategies, but instead defined exposure time-dependently as aggressive treatment (≥3 concomitantly used antihypertensive medications versus conventional treatment (≤2 concomitantly used antihypertensive medications. Study outcome was defined as time to first serious cardiovascular event (non-fatal myocardial infarction, non-fatal stroke, or all-cause death. We compared hazard ratio (HR estimates for aggressive vs. conventional treatment from a Marginal Structural Cox Model (MSCM to estimates from a standard Cox model. Both models included exposure to antihypertensive treatment at each follow-up visit, demographics, and baseline cardiovascular risk factors, including blood pressure. The MSCM further adjusted for systolic blood pressure at each follow-up visit, through inverse probability of treatment weights. Results 2,269 (10.1% patients experienced a cardiovascular event over a total follow-up of 60,939 person-years. The HR for aggressive treatment estimated by the standard Cox model was 0.96 (95% confidence interval 0.87-1.07. The equivalent MSCM, which was able to account for changes in systolic blood pressure during follow-up, estimated a HR of 0.81 (95% CI 0.71-0.92. Conclusions Using a MSCM, aggressive treatment was associated with a lower risk for serious cardiovascular outcomes compared to conventional treatment. In contrast, a standard Cox model estimated similar risks for aggressive and conventional treatments. Trial registration Clinicaltrials

  3. Evolutionary cognitive therapy versus standard cognitive therapy for depression: a protocol for a blinded, randomized, superiority clinical trial

    OpenAIRE

    Giosan, Cezar; Cobeanu, Oana; Mogoase, Cristina; Muresan, Vlad; Malta, Loretta S.; WYKA, KATARZYNA; Szentagotai, Aurora

    2014-01-01

    Background Depression is estimated to become the leading cause of disease burden globally by 2030. Despite existing efficacious treatments (both medical and psychotherapeutic), a large proportion of patients do not respond to therapy. Recent insights from evolutionary psychology suggest that, in addition to targeting the proximal causes of depression (for example, targeting dysfunctional beliefs by cognitive behavioral therapy), the distal or evolutionary causes (for example, inclusive fitnes...

  4. How Well Do Randomized Controlled Trials Reflect Standard Care: A Comparison between Scientific Research Data and Standard Care Data in Patients with Intermittent Claudication undergoing Supervised Exercise Therapy

    Science.gov (United States)

    Mesters, E. P. E.; Nijhuis-van der Sanden, M. W. G.; Teijink, J. A. W.; de Bie, R. A.

    2016-01-01

    Objective The aim of the present study was to assess the degree and impact of patient selection of patients with intermittent claudication undergoing supervised exercise therapy in Randomized Controlled Trials (RCTs) by describing commonly used exclusion criteria, and by comparing baseline characteristics and treatment response measured as improvement in maximum walking distance of patients included in RCTs and patients treated in standard care. Methods We compared data from RCTs with unselected standard care data. First, we systematically reviewed RCTs that investigated the effect of supervised exercise therapy in patients with intermittent claudication. For each of the RCTs, we extracted and categorized the eligibility criteria and their justifications. To assess whether people in RCTs (n = 1,440) differed from patients treated in daily practice (n = 3,513), in terms of demographics, comorbidity and walking capacity, we assessed between group-differences using t-tests. To assess differences in treatment response, we compared walking distances at three and six months between groups using t-tests. Differences of ≥15% were set as a marker for a clinically relevant difference. Results All 20 included RCTs excluded large segments of patients with intermittent claudication. One-third of the RCTs eligibility criteria were justified. Despite, the numerous eligibility criteria, we found that baseline characteristics were largely comparable. A statistically significant and (borderline) clinically relevant difference in treatment response after three and six months between trial participants and standard care patients was found. Improvements in maximum walking distance after three and six months were significantly and clinically less in trial participants. Conclusions The finding that baseline characteristics of patients included in RCTs and patients treated in standard care were comparable, may indicate that RCT eligibility criteria are used implicitly by professionals

  5. How Well Do Randomized Controlled Trials Reflect Standard Care: A Comparison between Scientific Research Data and Standard Care Data in Patients with Intermittent Claudication undergoing Supervised Exercise Therapy.

    Directory of Open Access Journals (Sweden)

    S Dörenkamp

    Full Text Available The aim of the present study was to assess the degree and impact of patient selection of patients with intermittent claudication undergoing supervised exercise therapy in Randomized Controlled Trials (RCTs by describing commonly used exclusion criteria, and by comparing baseline characteristics and treatment response measured as improvement in maximum walking distance of patients included in RCTs and patients treated in standard care.We compared data from RCTs with unselected standard care data. First, we systematically reviewed RCTs that investigated the effect of supervised exercise therapy in patients with intermittent claudication. For each of the RCTs, we extracted and categorized the eligibility criteria and their justifications. To assess whether people in RCTs (n = 1,440 differed from patients treated in daily practice (n = 3,513, in terms of demographics, comorbidity and walking capacity, we assessed between group-differences using t-tests. To assess differences in treatment response, we compared walking distances at three and six months between groups using t-tests. Differences of ≥15% were set as a marker for a clinically relevant difference.All 20 included RCTs excluded large segments of patients with intermittent claudication. One-third of the RCTs eligibility criteria were justified. Despite, the numerous eligibility criteria, we found that baseline characteristics were largely comparable. A statistically significant and (borderline clinically relevant difference in treatment response after three and six months between trial participants and standard care patients was found. Improvements in maximum walking distance after three and six months were significantly and clinically less in trial participants.The finding that baseline characteristics of patients included in RCTs and patients treated in standard care were comparable, may indicate that RCT eligibility criteria are used implicitly by professionals when referring patients to

  6. Hypofractionated Versus Standard Radiation Therapy With or Without Temozolomide for Older Glioblastoma Patients

    Energy Technology Data Exchange (ETDEWEB)

    Arvold, Nils D. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Tanguturi, Shyam K. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Aizer, Ayal A. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Wen, Patrick Y.; Reardon, David A.; Lee, Eudocia Q.; Nayak, Lakshmi [Center for Neuro-Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Christianson, Laura W.; Horvath, Margaret C. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Dunn, Ian F.; Golby, Alexandra J.; Johnson, Mark D. [Department of Neurosurgery, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Claus, Elizabeth B. [Department of Neurosurgery, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); School of Public Health, Yale University, New Haven, Connecticut (United States); Chiocca, E. Antonio [Department of Neurosurgery, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Ligon, Keith L. [Department of Pathology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States); Alexander, Brian M., E-mail: bmalexander@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, Massachusetts (United States)

    2015-06-01

    Purpose: Older patients with newly diagnosed glioblastoma have poor outcomes, and optimal treatment is controversial. Hypofractionated radiation therapy (HRT) is frequently used but has not been compared to patients receiving standard fractionated radiation therapy (SRT) and temozolomide (TMZ). Methods and Materials: We conducted a retrospective analysis of patients ≥65 years of age who received radiation for the treatment of newly diagnosed glioblastoma from 1994 to 2013. The distribution of clinical covariates across various radiation regimens was analyzed for possible selection bias. Survival was calculated using the Kaplan-Meier method. Comparison of hypofractionated radiation (typically, 40 Gy/15 fractions) versus standard fractionation (typically, 60 Gy/30 fractions) in the setting of temozolomide was conducted using Cox regression and propensity score analysis. Results: Patients received SRT + TMZ (n=57), SRT (n=35), HRT + TMZ (n=34), or HRT (n=9). Patients receiving HRT were significantly older (median: 79 vs 69 years of age; P<.001) and had worse baseline performance status (P<.001) than those receiving SRT. On multivariate analysis, older age (adjusted hazard ratio [AHR]: 1.06; 95% confidence interval [CI]: 1.01-1.10, P=.01), lower Karnofsky performance status (AHR: 1.02; 95% CI: 1.01-1.03; P=.01), multifocal disease (AHR: 2.11; 95% CI: 1.23-3.61, P=.007), and radiation alone (vs SRT + TMZ; SRT: AHR: 1.72; 95% CI: 1.06-2.79; P=.03; HRT: AHR: 3.92; 95% CI: 1.44-10.60, P=.007) were associated with decreased overall survival. After propensity score adjustment, patients receiving HRT with TMZ had similar overall survival compared with those receiving SRT with TMZ (AHR: 1.10, 95% CI: 0.50-2.4, P=.82). Conclusions: With no randomized data demonstrating equivalence between HRT and SRT in the setting of TMZ for glioblastoma, significant selection bias exists in the implementation of HRT. Controlling for this bias, we observed similar overall

  7. MO-G-9A-01: Imaging Refresher for Standard of Care Radiation Therapy

    International Nuclear Information System (INIS)

    Imaging techniques and technology which were previously the domain of diagnostic medicine are becoming increasingly integrated and utilized in radiation therapy (RT) clinical practice. As such, there are a number of specific imaging topics that are highly applicable to modern radiation therapy physics. As imaging becomes more widely integrated into standard clinical radiation oncology practice, the impetus is on RT physicists to be informed and up-to-date on those imaging modalities relevant to the design and delivery of therapeutic radiation treatments. For example, knowing that, for a given situation, a fluid attenuated inversion recovery (FLAIR) image set is most likely what the physician would like to import and contour is helpful, but may not be sufficient to providing the best quality of care. Understanding the physics of how that pulse sequence works and why it is used could help assess its utility and determine if it is the optimal sequence for aiding in that specific clinical situation. It is thus important that clinical medical physicists be able to understand and explain the physics behind the imaging techniques used in all aspects of clinical radiation oncology practice. This session will provide the basic physics for a variety of imaging modalities for applications that are highly relevant to radiation oncology practice: computed tomography (CT) (including kV, MV, cone beam CT [CBCT], and 4DCT), positron emission tomography (PET)/CT, magnetic resonance imaging (MRI), and imaging specific to brachytherapy (including ultrasound and some brachytherapy specific topics in MR). For each unique modality, the image formation process will be reviewed, trade-offs between image quality and other factors (e.g. imaging time or radiation dose) will be clarified, and typically used cases for each modality will be introduced. The current and near-future uses of these modalities and techniques in radiation oncology clinical practice will also be discussed. Learning

  8. MO-G-9A-01: Imaging Refresher for Standard of Care Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Labby, Z [The University of Michigan Hospital ' Health Sys, Ann Arbor, MI (United States); Sensakovic, W [Florida Hospital, Orlando, FL (United States); Hipp, E [NYULMC Clinical Cancer Center, New York, NY (United States); Altman, M [Washington University School of Medicine, St. Louis, MO (United States)

    2014-06-15

    Imaging techniques and technology which were previously the domain of diagnostic medicine are becoming increasingly integrated and utilized in radiation therapy (RT) clinical practice. As such, there are a number of specific imaging topics that are highly applicable to modern radiation therapy physics. As imaging becomes more widely integrated into standard clinical radiation oncology practice, the impetus is on RT physicists to be informed and up-to-date on those imaging modalities relevant to the design and delivery of therapeutic radiation treatments. For example, knowing that, for a given situation, a fluid attenuated inversion recovery (FLAIR) image set is most likely what the physician would like to import and contour is helpful, but may not be sufficient to providing the best quality of care. Understanding the physics of how that pulse sequence works and why it is used could help assess its utility and determine if it is the optimal sequence for aiding in that specific clinical situation. It is thus important that clinical medical physicists be able to understand and explain the physics behind the imaging techniques used in all aspects of clinical radiation oncology practice. This session will provide the basic physics for a variety of imaging modalities for applications that are highly relevant to radiation oncology practice: computed tomography (CT) (including kV, MV, cone beam CT [CBCT], and 4DCT), positron emission tomography (PET)/CT, magnetic resonance imaging (MRI), and imaging specific to brachytherapy (including ultrasound and some brachytherapy specific topics in MR). For each unique modality, the image formation process will be reviewed, trade-offs between image quality and other factors (e.g. imaging time or radiation dose) will be clarified, and typically used cases for each modality will be introduced. The current and near-future uses of these modalities and techniques in radiation oncology clinical practice will also be discussed. Learning

  9. First-line eradication of Helicobacter pylori:Are the standard triple therapies obsolete? A different perspective

    Institute of Scientific and Technical Information of China (English)

    Gyrgy; Miklós; Buzás

    2010-01-01

    Studies concerning the eradication of Helicobacter pylori have resulted in a proliferation of meta-analyses. To date, there are 303 meta-analyses cited in PubMed, 113 dealing with the therapy of the infection. A chronological analysis of the results of meta-analyses performed between 1998 and 2010 shows that first-line standard triple therapies achieved eradication rates on an intention-to-treat basis of around 80%; prolonging treatment to 14, but not 10 d should improve the results. The proton pump inhibit...

  10. Xenograft assessment of predictive biomarkers for standard head and neck cancer therapies.

    Science.gov (United States)

    Stein, Andrew P; Swick, Adam D; Smith, Molly A; Blitzer, Grace C; Yang, Robert Z; Saha, Sandeep; Harari, Paul M; Lambert, Paul F; Liu, Cheng Z; Kimple, Randall J

    2015-05-01

    Head and neck squamous cell carcinoma (HNSCC) remains a challenging cancer to treat with overall 5-year survival on the order of 50-60%. Therefore, predictive biomarkers for this disease would be valuable to provide more effective and individualized therapeutic approaches for these patients. While prognostic biomarkers such as p16 expression correlate with outcome; to date, no predictive biomarkers have been clinically validated for HNSCC. We generated xenografts in immunocompromised mice from six established HNSCC cell lines and evaluated response to cisplatin, cetuximab, and radiation. Tissue microarrays were constructed from pre- and posttreatment tumor samples derived from each xenograft experiment. Quantitative immunohistochemistry was performed using a semiautomated imaging and analysis platform to determine the relative expression of five potential predictive biomarkers: epidermal growth factor receptor (EGFR), phospho-EGFR, phospho-Akt, phospho-ERK, and excision repair cross-complementation group 1 (ERCC1). Biomarker levels were compared between xenografts that were sensitive versus resistant to a specific therapy utilizing a two-sample t-test with equal standard deviations. Indeed the xenografts displayed heterogeneous responses to each treatment, and we linked a number of baseline biomarker levels to response. This included low ERCC1 being associated with cisplatin sensitivity, low phospho-Akt correlated with cetuximab sensitivity, and high total EGFR was related to radiation resistance. Overall, we developed a systematic approach to identifying predictive biomarkers and demonstrated several connections between biomarker levels and treatment response. Despite these promising initial results, this work requires additional preclinical validation, likely involving the use of patient-derived xenografts, prior to moving into the clinical realm for confirmation among patients with HNSCC.

  11. Everolimus treatment for patients with autoimmune hepatitis and poor response to standard therapy and drug alternatives in use

    DEFF Research Database (Denmark)

    Ytting, Henriette; Larsen, Fin Stolze

    2015-01-01

    here report the efficacy of everolimus treatment of patients with AIH. MATERIALS AND METHODS: Seven patients (six female, mean age 47 years, range 22-62 years) in whom disease control could not be achieved with standard therapy or the alternative drugs in use were included. RESULTS: Treatment......OBJECTIVE: Not all patients with autoimmune hepatitis (AIH) respond to standard medical therapy with corticosteroids and azathioprine. Such patients may develop end-stage liver disease with poor prognosis unless transplantation is considered. Alternatively, the introduction of new therapeutic...... with everolimus induced a clear reduction of transaminases within 2 weeks. After 3-5 months three patients had normal alanine aminotransferase (ALT) levels (10-45 IU) and four patients had ALT levels below 55 IU compared to a three- to fivefold elevated level prior to everolimus treatment. Sustained remission...

  12. Emotion-Abstraction Patterns and Cognitive Interventions in a Single Case of Standard Cognitive-Behavioral Therapy

    OpenAIRE

    Sassaroli, S; Brambilla, R; Colombo, R; Cislaghi, E.; Centorame, F; Favaretto, E; Fiore, F.; Veronese, G; Ruggiero, G

    2014-01-01

    Cognitive-behavioral therapy (CBT) assumes that therapeutic change de-pends mainly on change of cognitive content, while, from a theoretical viewpoint, other processes are excluded. This study aims to explore standard CBT interventions using a model of therapeutic change that includes both emotional and cognitive processes, i.e., the therapeutic cycle model (TCM; Mergenthaler, 1985; 1996), which describes the pro-cesses of therapeutic change in terms of cycles involving both emotional arousal...

  13. Robotic-based carbon ion therapy and patient positioning in 6 degrees of freedom: setup accuracy of two standard immobilization devices used in carbon ion therapy and IMRT

    Directory of Open Access Journals (Sweden)

    Jensen Alexandra D

    2012-03-01

    Full Text Available Abstract Purpose To investigate repositioning accuracy in particle radiotherapy in 6 degrees of freedom (DOF and intensity-modulated radiotherapy (IMRT, 3 DOF for two immobilization devices (Scotchcast masks vs thermoplastic head masks currently in use at our institution for fractionated radiation therapy in head and neck cancer patients. Methods and materials Position verifications in patients treated with carbon ion therapy and IMRT for head and neck malignancies were evaluated. Most patients received combined treatment regimen (IMRT plus carbon ion boost, immobilization was achieved with either Scotchcast or thermoplastic head masks. Position corrections in robotic-based carbon ion therapy allowing 6 DOF were compared to IMRT allowing corrections in 3 DOF for two standard immobilization devices. In total, 838 set-up controls of 38 patients were analyzed. Results Robotic-based position correction including correction of rotations was well tolerated and without discomfort. Standard deviations of translational components were between 0.5 and 0.8 mm for Scotchcast and 0.7 and 1.3 mm for thermoplastic masks in 6 DOF and 1.2 - 1.4 mm and 1.0 - 1.1 mm in 3 DOF respectively. Mean overall displacement vectors were between 2.1 mm (Scotchcast and 2.9 mm (thermoplastic masks in 6 DOF and 3.9 - 3.0 mm in 3 DOF respectively. Displacement vectors were lower when correction in 6 DOF was allowed as opposed to 3 DOF only, which was maintained at the traditional action level of > 3 mm for position correction in the pre-on-board imaging era. Conclusion Setup accuracy for both systems was within the expected range. Smaller shifts were required when 6 DOF were available for correction as opposed to 3 DOF. Where highest possible positioning accuracy is required, frequent image guidance is mandatory to achieve best possible plan delivery and maintenance of sharp gradients and optimal normal tissue sparing inherent in carbon ion therapy.

  14. Robotic-based carbon ion therapy and patient positioning in 6 degrees of freedom: setup accuracy of two standard immobilization devices used in carbon ion therapy and IMRT

    International Nuclear Information System (INIS)

    To investigate repositioning accuracy in particle radiotherapy in 6 degrees of freedom (DOF) and intensity-modulated radiotherapy (IMRT, 3 DOF) for two immobilization devices (Scotchcast masks vs thermoplastic head masks) currently in use at our institution for fractionated radiation therapy in head and neck cancer patients. Position verifications in patients treated with carbon ion therapy and IMRT for head and neck malignancies were evaluated. Most patients received combined treatment regimen (IMRT plus carbon ion boost), immobilization was achieved with either Scotchcast or thermoplastic head masks. Position corrections in robotic-based carbon ion therapy allowing 6 DOF were compared to IMRT allowing corrections in 3 DOF for two standard immobilization devices. In total, 838 set-up controls of 38 patients were analyzed. Robotic-based position correction including correction of rotations was well tolerated and without discomfort. Standard deviations of translational components were between 0.5 and 0.8 mm for Scotchcast and 0.7 and 1.3 mm for thermoplastic masks in 6 DOF and 1.2 - 1.4 mm and 1.0 - 1.1 mm in 3 DOF respectively. Mean overall displacement vectors were between 2.1 mm (Scotchcast) and 2.9 mm (thermoplastic masks) in 6 DOF and 3.9 - 3.0 mm in 3 DOF respectively. Displacement vectors were lower when correction in 6 DOF was allowed as opposed to 3 DOF only, which was maintained at the traditional action level of > 3 mm for position correction in the pre-on-board imaging era. Setup accuracy for both systems was within the expected range. Smaller shifts were required when 6 DOF were available for correction as opposed to 3 DOF. Where highest possible positioning accuracy is required, frequent image guidance is mandatory to achieve best possible plan delivery and maintenance of sharp gradients and optimal normal tissue sparing inherent in carbon ion therapy

  15. A Randomized Controlled Trial of Intravenous Magnesium Sulphate as an Adjunct to Standard Therapy in Acute Severe Asthma

    Directory of Open Access Journals (Sweden)

    Singh Anupam Kumar

    2008-12-01

    Full Text Available Though intravenous (IV Magnesium Sulphate (MgS04 has additive effect to beta-2 agonists, its additive benefit in face of combination therapy with beta-2-agonists and ipratropium (standard therapy of severe acute exacerbation of asthma remains unaddressed. The aim of this investigation was to evaluate the role of IV MgSO4 when used as an adjunct to standard therapy of severe exacerbations of asthma. Randomized, single blinded, placebo-controlled study was carried out in Emergency Department (ED. Patients aged 18-60 years presenting with acute asthma and FEV1 In group1 (controls, patients were nebulised with salbutamol and ipratropium thrice at 20 minutes interval and were given 2g IV MgSO4 at 30 minutes. In group2 patients were nebulised similarly, but were given IV normal saline at 30 minutes for blinding. FEV1 was evaluated at baseline and at 30 minutes intervals. The primary efficacy end point was FEV1%pred. at 120 mins and pooled discharge rate (derived from comparing proportion of groups attaining PEFR >60%pred. and relief in dyspnea at 30, 60, 90, 120 minutes. Both groups of 30 patients each, were matched with respect to demographic and pulmonary parameters (Baseline FEV1% :22.0+5.1% in group2 vs.22.07+5.2% in group1, p=0.87.At 120 minutes, there was a higher mean FEV1 %pred (62.84+4.73% vs. 56.7+4.5% and %improvement from baseline of (40.7+9.2%vs34.77+7.3%, in group 2 as compared to group1 (Mean Difference= 6.07%, C.I.1.87-10.62., pMagnesium sulfate as an adjunct to standard therapy in patients with severe exacerbation of asthma could cause improvement in pulmonary function and decrease in hospital admission.

  16. A review of standard pharmacological therapy for adult asthma – Steps 1 to 5.

    Science.gov (United States)

    Patel, Mitesh; Shaw, Dominick

    2015-05-01

    The aim of pharmacological therapy for asthma is to improve symptoms and lung function and minimize the risk of asthma attacks. The intensity of treatment is based on the level of asthma control and the potential risk of future deterioration. In the British asthma guidelines, treatments are divided into steps 1 to 5, with each step signifying a need for an increase in therapy in response to symptoms or to prevent exacerbations. Treatments comprise of inhaled or systemic medications. Inhaled therapy includes short-acting and long-acting medication to improve symptoms and inhaled corticosteroids that reduce airway inflammation. Systemic treatments include medications that act on specific biological pathways, such as the leukotriene or immunoglobulin E pathways, or systemic corticosteroids. In choosing a particular therapy, treatment benefits are balanced by the potential risks of medication-related adverse effects. This review will provide a practical guide to the key pharmacological therapies for adult asthma at steps 1 to 5 based on British guidelines and consider future options for new treatments.

  17. A question of ethics: selling autologous stem cell therapies flaunts professional standards.

    Science.gov (United States)

    Munsie, Megan; Hyun, Insoo

    2014-11-01

    The idea that the body's own stem cells could act as a repair kit for many conditions, including cardiac repair, underpins regenerative medicine. While progress is being made, with hundreds of clinical trials underway to evaluate possible autologous cell-based therapies, some patients and physicians are not prepared to wait and are pursuing treatments without evidence that the proposed treatments are effective, or even safe. This article explores the inherent tension between patients, practitioners and the need to regulate the development and commercialization of new cellular therapies--even when the cells come from the patient.

  18. De novo cataract development following a standard course of hyperbaric oxygen therapy.

    Science.gov (United States)

    Gesell, L B; Trott, A

    2007-01-01

    A 49 y/o female under went 48 hyperbaric oxygen (HBO2) treatments at 2.5 ATA (atmospheres absolute) (253 kPa) for 90 minutes for chronic refractory osteomyelitis of the sacrum and recurrent failure of a sacral myocutaneous flap. Prior to HBO2 therapy, formal ophthalmic exams revealed myopia but no evidence of cataract formation. Eight weeks following the completion of HBO2 therapy, on repeat ophthalmic exam, the patient was discovered to have worsening myopia. Changes of the crystalline lens, consistent with nuclear cataract development, were identified in each eye. Other common causes of cataract formation including diabetes, corticosteroid use, and excessive exposure to ultraviolet light, were excluded. While transient visual changes are known to occur during HBO2 therapy, cataract formation has only rarely been reported and only after prolonged courses of treatment (150 or more treatments). This case identifies the need to further investigate the ocular effects of HBO2 therapy, especially with regard to cataract development and progression.

  19. Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Borgi, Marta; Loliva, Dafne; Cerino, Stefania; Chiarotti, Flavia; Venerosi, Aldina; Bramini, Maria; Nonnis, Enrico; Marcelli, Marco; Vinti, Claudia; De Santis, Chiara; Bisacco, Francesca; Fagerlie, Monica; Frascarelli, Massimo; Cirulli, Francesca

    2016-01-01

    In this study the effectiveness of an equine-assisted therapy (EAT) in improving adaptive and executive functioning in children with autism spectrum disorder (ASD) was examined (children attending EAT, n = 15, control group n = 13; inclusion criteria: IQ > 70). Therapeutic sessions consisted in structured activities involving horses and…

  20. Neue Standards in der Therapie des fortgeschrittenen hepatozellulären Karzinoms

    Directory of Open Access Journals (Sweden)

    Altinbas M

    2010-01-01

    Full Text Available Der Hauptgrund des hepatozellulären Karzinoms (HCC ist die Leberzirrhose ( 80 %. Risikofaktoren für die Leberzirrhose sind die primär virale Hepatitis B oder C, Hämochromatose, alkoholische oder nichtalkoholische Lebererkrankung, Intoxikationen durch Aflatoxine und jede andere Ursache, die zur Leberzirrhose führt. Bei Patienten mit Leberzirrhose im Child-Aund -B-Stadium infolge einer viralen Hepatitis oder Alkoholzirrhose etc. sollten alle 6 Monate routinemäßige Vorsorgeuntersuchungen mittels Ultraschall durchgeführt werden (die Wertigkeit der α-Fetoprotein-Bestimmung ist umstritten. Der Einsatz bildgebender Verfahren wie Sonographie (Ultraschall [US], bei Schwierigkeiten die Spiral- Computertomographie (CT und Magnetresonanztomographie (MRT bei Patienten mit chronischen Lebererkrankungen gibt uns die Möglichkeit, häufig eine frühzeitige Diagnose der HCC zu stellen (die Leberzirrhose erschwert die bildgebende Diagnostik des HCC. Wenn eine Läsion bei diagnostizierten Leberzirrhotikern auftaucht, ist das ausreichend für die Diagnose des HCC ohne weitere Diagnostik, auch eine Biopsie ist nicht unbedingt erforderlich (NCCN-Guidelines. Die Wahl der Therapie (Resektion, Lebertransplantation, perkutane ablative Therapie, arterielle Chemoembolisation, systemische Therapie für das HCC richtet sich zum einen nach der Leberfunktion der Patienten und zum anderen nach dem Tumorstadium. Bei Diagnosestellung sind höchstens 20 % der hepatozellulären Karzinome kurativ resektabel, aus diesem Grund sind andere kurative Therapieoptionen sehr wichtig. Für die fortgeschrittenen Tumoren der Leber haben die neu entwickelten systemischen Therapien eine zunehmend große Bedeutung. Die zielgerichtete onkologische Therapie stellt eine gute Option für das HCC dar, weil diese besser verträglich ist. Hierbei soll das primäre Therapieziel die Verlängerung des progressionsfreien Überlebens und des Gesamtüberlebens bei guter Lebensqualität der Patienten

  1. Effect of r-TMS over standard therapy in decreasing muscle tone of spastic cerebral palsy patients.

    Science.gov (United States)

    Gupta, Meena; Lal Rajak, Bablu; Bhatia, Dinesh; Mukherjee, Arun

    2016-01-01

    Spastic cerebral palsy (CP) is the one of most common neurological disorders occurring due to damage to the immature brain or any other brain lesion at the time of birth. To aid in making the life of the CP patient meaningful, several interventions such as medical, surgical and rehabilitation have been employed to date. Besides these, recently repetitive Transcranial magnetic stimulation (r-TMS) is a new found approach which is being employed for treating various neurological and psychological conditions. The aim of this study was to observe the effects of r-TMS on muscle spasticity in CP patients by stimulating the motor cortex area of the brain, which is responsible for muscle movements. In this study, 20 subjects diagnosed with CP were recruited and 10 each were placed in two groups, namely the research group (RG) (mean age, height and weight were 7.99 (SD = 4.66) years, 116.7 (SD = 23.57) cm and 21.40 (SD = 10.95) kg, respectively) and the control group (CG) (mean age, height and weight were 8.41 (SD = 4.32) years, 107.9 (SD = 26.33) cm, 21.40 (SD = 12.63) kg, respectively). r-TMS frequencies of 5 Hz and 10 Hz were administered for 15 min daily to patients in RG followed by standard therapy (ST) of 1 h duration daily for 20 days. Moreover, the patients in the control group (CG) were given only standard therapy (ST) of 1 h duration for 20 days. Modified Ashworth Scale (MAS) was used as an outcome measure to determine the level of muscle spasticity. A pre- assessment of MAS score was performed on both RG and CG to determine the level of spasticity prior to starting therapy; and similarly post-assessment after 20 days was done to observe the changes post-therapy. Statistical analysis of pre vs post MAS scores showed that few muscles showed reduction in muscle tightness after administering only ST in the CG. On the contrary, the RG that underwent r-TMS therapy combined with ST showed a significant decrease (p < 0.05) in muscle tightness for all the

  2. [On the interrelationship between standardization and intellectual property rights of acu-moxibustion therapy].

    Science.gov (United States)

    Liu, Mai-lan; Chang, Xiao-rong; Yuan, Yi-qin

    2014-10-01

    Under the condition of knowledge economy, the acu-moxibustion standardization definitely involves intellectual property rights. Then, what is the relationship between the standardization and the intellectual property rights of acu-moxibustion? The authors of the present paper hold that it is not only exclusive, but also syncretic. If their relationship cannot be handled properly, their own respective development will be affected adversely. Therefore, a proper handling of the relationship between the two is of great practical significance. The present paper makes a comprehensive analysis about their interaction (mutual promotion and mutual inhibition), similarities (systemic composition, dynamic implementation course, standardization-rated order and ultimate targets) and differences (in properties, working components, secret requirement, effectiveness-time limitation, usage cost, etc).

  3. Development of transfer standard devices for ensuring the accurate calibration of ultrasonic physical therapy machines in clinical use

    International Nuclear Information System (INIS)

    Physical therapy ultrasound is widely applied to patients. However, many devices do not comply with the relevant standard stating that the actual power output shall be within ±20% of the device indication. Extreme cases have been reported: from delivering effectively no ultrasound or operating at maximum power at all powers indicated. This can potentially lead to patient injury as well as mistreatment. The present European (EC) project is an ongoing attempt to improve the quality of the treatment of patients being treated with ultrasonic physical-therapy. A Portable ultrasound Power Standard (PPS) is being developed and accurately calibrated. The PPS includes: Ultrasound transducers (including one exhibiting an unusual output) and a driver for the ultrasound transducers that has calibration and proficiency test functions. Also included with the PPS is a Cavitation Detector to determine the onset of cavitation occurring within the propagation medium. The PPS will be suitable for conducting in-the-field accreditation (proficiency testing and calibration). In order to be accredited it will be important to be able to show traceability of the calibration, the calibration process and qualification of testing staff. The clinical user will benefit from traceability because treatments will be performed more reliably

  4. Development of transfer standard devices for ensuring the accurate calibration of ultrasonic physical therapy machines in clinical use

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, R T [TNO Prevention and Health, Zernikedreef 9, 2333 CK Leiden (Netherlands); Richards, A [National Measurement Laboratory, CSIRO, Bradfield Rd, West Lindfield 2070, Sydney (Australia); Beissner, K [Physikalisch-Technische Bundesanstalt, PTB, Bundesallee 100, D-38116 Braunschweig (Germany); Zeqiri, B [National Physical Laboratory, NPL, Queens Road, Teddington, TW11 0LW (United Kingdom); Prout, G [National Measurement Laboratory, CSIRO, Bradfield Rd, West Lindfield 2070, Sydney (Australia); Cantrall, Ch [National Measurement Laboratory, CSIRO, Bradfield Rd, West Lindfield 2070, Sydney (Australia); Bezemer, R A [TNO Prevention and Health, Zernikedreef 9, 2333 CK Leiden (Netherlands); Koch, Ch [Physikalisch-Technische Bundesanstalt, PTB, Bundesallee 100, D-38116 Braunschweig, (Germany); Hodnett, M [National Physical Laboratory, NPL, Queens Road, Teddington, TW11 0LW (United Kingdom)

    2004-01-01

    Physical therapy ultrasound is widely applied to patients. However, many devices do not comply with the relevant standard stating that the actual power output shall be within {+-}20% of the device indication. Extreme cases have been reported: from delivering effectively no ultrasound or operating at maximum power at all powers indicated. This can potentially lead to patient injury as well as mistreatment. The present European (EC) project is an ongoing attempt to improve the quality of the treatment of patients being treated with ultrasonic physical-therapy. A Portable ultrasound Power Standard (PPS) is being developed and accurately calibrated. The PPS includes: Ultrasound transducers (including one exhibiting an unusual output) and a driver for the ultrasound transducers that has calibration and proficiency test functions. Also included with the PPS is a Cavitation Detector to determine the onset of cavitation occurring within the propagation medium. The PPS will be suitable for conducting in-the-field accreditation (proficiency testing and calibration). In order to be accredited it will be important to be able to show traceability of the calibration, the calibration process and qualification of testing staff. The clinical user will benefit from traceability because treatments will be performed more reliably.

  5. Generation of CAR T Cells for Adoptive Therapy in the Context of Glioblastoma Standard of Care

    Science.gov (United States)

    Riccione, Katherine; Suryadevara, Carter M.; Snyder, David; Cui, Xiuyu; Sampson, John H.; Sanchez-Perez, Luis

    2016-01-01

    Adoptive T cell immunotherapy offers a promising strategy for specifically targeting and eliminating malignant gliomas. T cells can be engineered ex vivo to express chimeric antigen receptors specific for glioma antigens (CAR T cells). The expansion and function of adoptively transferred CAR T cells can be potentiated by the lymphodepletive and tumoricidal effects of standard of care chemotherapy and radiotherapy. We describe a method for generating CAR T cells targeting EGFRvIII, a glioma-specific antigen, and evaluating their efficacy when combined with a murine model of glioblastoma standard of care. T cells are engineered by transduction with a retroviral vector containing the anti-EGFRvIII CAR gene. Tumor-bearing animals are subjected to host conditioning by a course of temozolomide and whole brain irradiation at dose regimens designed to model clinical standard of care. CAR T cells are then delivered intravenously to primed hosts. This method can be used to evaluate the antitumor efficacy of CAR T cells in the context of standard of care. PMID:25741761

  6. Action Inquiry Into the Use of Standardized Evaluation Tools for Music Therapy

    Directory of Open Access Journals (Sweden)

    Kate Williams

    2006-07-01

    Full Text Available Sing & Grow is an early intervention music therapy project that provides community group music therapy programs to families with young children who encounter risk factors that may impact on parenting and optimal child development. A variety of evaluation tools were devised and used over the first 3 years of the project. Upon the subsequent funding and expansion of the project at the end of this period, it was necessary to find, test and devise more rigorous, valid and reliable measures to withstand the scrutiny of researchers, and to combat the concerns and criticisms associated with the previous methods of data collection. An action inquiry project was therefore undertaken with two groups of project participants to trial the use of the Parenting Stress Index and Depression, Anxiety and Stress Scales, both recommended by leading psychologists. Key findings that will be discussed include the friction between the deficit-focussed nature of many psychometric tools and the strengths-based approach taken in service delivery, the level of difficulty in terms of literacy and comprehension for vulnerable respondents, and the lack of one tool with the ability to comprehensively measure all aspects of a broad scoping program.

  7. [The value of telemedicine in 2011 : standard care in heart failure therapy?].

    Science.gov (United States)

    Zugck, C; Cebola, R; Taeger, T; Franke, J

    2011-10-01

    Heart failure represents a significant clinical and health economic problem. The implementation of new therapeutic strategies favorably affecting the course of the disease remains insufficient in day to day practice. Thus, the use telemedicine offers a central service and information instrument, such that optimized therapy can be achieved by consistent patient surveillance. Predefined vital parameters are automatically transmitted to the telemedicine center; if individually predefined limits are exceeded, therapeutic means are immediately initiated. The service is available to patients 24 h/day throughout the year in case cardio-pulmonary symptoms are experienced. This patient-oriented use of technology should not replace the physician-patient relationship, but improves and supports the participation and self-management of patients. PMID:21912909

  8. Phd study of reliability and validity: One step closer to a standardized music therapy assessment model

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl

    The paper will present a phd study concerning reliability and validity of music therapy assessment model “Assessment of Parenting Competences” (APC) in the area of families with emotionally neglected children. This study had a multiple strategy design with a philosophical base of critical realism...... and pragmatism. The fixed design for this study was a between and within groups design in testing the APCs reliability and validity. The two different groups were parents with neglected children and parents with non-neglected children. The flexible design had a multiple case study strategy specifically...... of the theoretical understanding of the clientgroup. Furthermore, a short describtion of the specific assessment protocol and analysis procedures of APC will be a part of the presentation. The phd study sought to explore how to develop measures of parenting competences in looking at autonomy relationship...

  9. Neuropsychological Outcome of Children Treated for Standard Risk Medulloblastoma in the PNET4 European Randomized Controlled Trial of Hyperfractionated Versus Standard Radiation Therapy and Maintenance Chemotherapy

    International Nuclear Information System (INIS)

    Purpose: In the European HIT-SIOP PNET4 randomized controlled trial, children with standard risk medulloblastoma were allocated to hyperfractionated radiation therapy (HFRT arm, including a partially focused boost) or standard radiation therapy (STRT arm), followed, in both arms, by maintenance chemotherapy. Event-free survival was similar in both arms. Previous work showed that the HFRT arm was associated with worse growth and better questionnaire-based executive function, especially in children <8 years of age at diagnosis. Therefore, the aim of this study was to compare performance-based cognitive outcomes between treatment arms. Methods and Materials: Neuropsychological data were collected prospectively in 137 patients. Using the Wechsler Intelligence Scales, Kaufman Assessment Battery for Children, and Raven's Progressive Matrices, we estimated full-scale intelligence quotient (FSIQ) and, when available, verbal IQ (VIQ), performance IQ (PIQ), working memory index (WMI), and processing speed index (PSI). Results: Among the 137 participants (HFRT arm n=71, STRT arm n=66, 63.5% males), mean (±SD) ages at diagnosis and assessment respectively were 9.3 (±3.2) years of age (40.8% < 8 years of age at diagnosis) and 14.6 (±4.3) years of age. Mean (±SD) FSIQ was 88 (±19), and mean intergroup difference was 3.88 (95% confidence interval: −2.66 to 10.42, P=.24). No significant differences were found in children >8 years of age at diagnosis. In children <8 years of age at diagnosis, a marginally significant trend toward higher VIQ was found in those treated in the HFRT arm; a similar trend was found for PSI but not for PIQ, WMI, or FSIQ (mean intergroup differences were: 12.02 for VIQ [95% CI: 2.37-21.67; P=.02]; 3.77 for PIQ [95% CI: −5.19 to 12.74; P>.10]; 5.20 for WMI [95% CI: −2.07 to 12.47; P>.10]; 10.90 for PSI [95% CI: −1.54 to 23.36; P=.08]; and 5.28 for FSIQ [95% CI: −4.23 to 14.79; P>.10]). Conclusions: HFRT was associated with

  10. Neuropsychological Outcome of Children Treated for Standard Risk Medulloblastoma in the PNET4 European Randomized Controlled Trial of Hyperfractionated Versus Standard Radiation Therapy and Maintenance Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Câmara-Costa, Hugo, E-mail: hugocamaracosta@gmail.com [National Institute of Health and Medical Research, INSERM U1178, Paris (France); Resch, Anika [University Medical Center Hamburg-Eppendorf, Hamburg (Germany); Kieffer, Virginie [Saint Maurice Hospitals, Saint Maurice (France); Lalande, Clémence [Institut Gustave Roussy, Villejuif (France); Poggi, Geraldina [Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco (Italy); Kennedy, Colin; Bull, Kim [University of Southampton, Faculty of Medicine, Southampton (United Kingdom); Calaminus, Gabriele [Paediatric Oncology, University of Muenster, Muenster (Germany); Grill, Jacques [Institut Gustave Roussy, Villejuif (France); Doz, François [Institut Curie and University Paris Descartes, Sorbonne Paris Cité, Paris (France); Rutkowski, Stefan [University Medical Center Hamburg-Eppendorf, Hamburg (Germany); Massimino, Maura [Fondazione IRCCS, Istituto Nazionale Tumori, Milan (Italy); Kortmann, Rolf-Dieter [Department of Radiation Therapy, University of Leipzig, Leipzig (Germany); Lannering, Birgitta [Paediatric Oncology, University of Gothenburg, Gothenburg (Sweden); Dellatolas, Georges [National Institute of Health and Medical Research, INSERM U1178, Paris (France); Chevignard, Mathilde [Rehabilitation Department for Children With Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, and Sorbonne Universités, UPMC Universités Paris, INSERM CNRS, Paris (France)

    2015-08-01

    Purpose: In the European HIT-SIOP PNET4 randomized controlled trial, children with standard risk medulloblastoma were allocated to hyperfractionated radiation therapy (HFRT arm, including a partially focused boost) or standard radiation therapy (STRT arm), followed, in both arms, by maintenance chemotherapy. Event-free survival was similar in both arms. Previous work showed that the HFRT arm was associated with worse growth and better questionnaire-based executive function, especially in children <8 years of age at diagnosis. Therefore, the aim of this study was to compare performance-based cognitive outcomes between treatment arms. Methods and Materials: Neuropsychological data were collected prospectively in 137 patients. Using the Wechsler Intelligence Scales, Kaufman Assessment Battery for Children, and Raven's Progressive Matrices, we estimated full-scale intelligence quotient (FSIQ) and, when available, verbal IQ (VIQ), performance IQ (PIQ), working memory index (WMI), and processing speed index (PSI). Results: Among the 137 participants (HFRT arm n=71, STRT arm n=66, 63.5% males), mean (±SD) ages at diagnosis and assessment respectively were 9.3 (±3.2) years of age (40.8% < 8 years of age at diagnosis) and 14.6 (±4.3) years of age. Mean (±SD) FSIQ was 88 (±19), and mean intergroup difference was 3.88 (95% confidence interval: −2.66 to 10.42, P=.24). No significant differences were found in children >8 years of age at diagnosis. In children <8 years of age at diagnosis, a marginally significant trend toward higher VIQ was found in those treated in the HFRT arm; a similar trend was found for PSI but not for PIQ, WMI, or FSIQ (mean intergroup differences were: 12.02 for VIQ [95% CI: 2.37-21.67; P=.02]; 3.77 for PIQ [95% CI: −5.19 to 12.74; P>.10]; 5.20 for WMI [95% CI: −2.07 to 12.47; P>.10]; 10.90 for PSI [95% CI: −1.54 to 23.36; P=.08]; and 5.28 for FSIQ [95% CI: −4.23 to 14.79; P>.10]). Conclusions: HFRT was associated with

  11. SU-E-P-22: AAPM Task Group 263 Tackling Standardization of Nomenclature for Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Matuszak, M; Feng, M [University of Michigan, Ann Arbor, MI (United States); Moran, J [Univ Michigan Medical Center, Ann Arbor, MI (United States); Xiao, Y [Thomas Jefferson University, Philadelphia, PA (United States); Mayo, C; Miller, R [Mayo Clinic, Rochester, MN (United States); Bosch, W [Washington Univ, Saint Louis, MO (United States); Popple, R [Univ Alabama Birmingham, Birmingham, AL (United States); Marks, L [UNC School of Medicine, Chapel Hill, NC (United States); Wu, Q [Duke University Medical Center, Durham, NC (United States); Molineu, A; Martel, M [UT MD Anderson Cancer Center, Houston, TX (United States); Yock, T [Massachusetts General Hospital, Boston, MA (United States); McNutt, T [Johns Hopkins University, Severna Park, MD (United States); Brown, N [Baptist Medical Center, Jacksonville, FL (United States); Purdie, T [Princess Margaret Hospital, Toronto, ON (Canada); Yorke, E [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Santanam, L [Washington University School of Medicine, St.louis, MO (United States); Gabriel, P [University of Pennsylvania, Philadelphia, PA (United States); Michalski, J [Washington University, Saint Louis, MO (United States); and others

    2015-06-15

    Purpose: There is growing recognition of need for increased clarity and consistency in the nomenclatures used for body and organ structures, DVH metrics, toxicity, dose and volume units, etc. Standardization has multiple benefits; e.g. facilitating data collection for clinical trials, enabling the pooling of data between institutions, making transfers (i.e. hand-offs) between centers safer, and enabling vendors to define “default” settings. Towards this goal, the American Association of Physicists in Medicine (AAPM) formed a task group (TG263) in July of 2014, operating under the Work Group on Clinical Trials to develop consensus statements. Guiding principles derived from the investigation and example nomenclatures will be presented for public feedback. Methods: We formed a multi-institutional and multi-vendor collaborative group of 39 physicists, physicians and others involved in clinical use and electronic transfer of information. Members include individuals from IROC, NRG, IHE-RO, DICOM WG-7, ASTRO and EORTC groups with overlapping interests to maximize the quality of the consensus and increase the likelihood of adoption. Surveys of group and NRG members were used to define current nomenclatures and requirements. Technical requirements of vendor systems and the proposed DICOM standards were examined. Results: There is a marked degree of inter and intra institutional variation in current approaches, resulting from inter-vendor differences in capabilities, clinic specific conceptualizations and inconsistencies. Using a consensus approach, the group defined optimal formats for the naming of targets and normal structures. A formal objective assessment of 13 existing clinically-used software packages show that all had capabilities to accommodate these recommended nomenclatures. Conclusions: A multi-stakeholder effort is making significant steps forward in developing a standard nomenclature that will work across platforms. Our current working list includes > 550

  12. Do novel oral anticoagulants do better than standard therapy in the treatment of deep vein thrombosis?

    Science.gov (United States)

    Brodmann, M

    2013-08-01

    The focus of DVT treatment is the prevention of recurrence and thrombus migration by treatment with anticoagulants. The aim is to improve outcomes by reducing clot burden and by preventing thrombus propagation, in order to prevent PE and the development of long-term complication. Actually, initial therapy is parenteral anticoagulation, mainly with low molecular weight heparin followed by a vitamin K antagonist (VKA) for triggered and idiopathic DVT. The long term treatment suggestion with a VKA is for sure the most challenging therapeutic scenario, showing all the disadvantages of VKA especially in the onset phase when therapeutic levels of VKA are difficult to achieve. The difference between VKAs and NOACs is the fact, that NOACs target a specific factor in the coagulation cascade. At time now two pathways have been chosen for treatment options, the direct inhibition of active sites of thrombin and factor Xa. Routine monitoring is not required and the drugs can be administered in fixed doses, which should increase patient adherence to long term treatment. At time now, four novel anticoagulants are called to be options for DVT treatment. Rivaroxaban, apixaban and edoxaban are direct FXa inhibitors, whereas dabigtran etexilate is a direct thrombin inhibitor. PMID:23681109

  13. Characterization and comparison of "Standard" and "Young" tumor infiltrating lymphocytes for adoptive cell therapy at a Danish Translational Research Institution

    DEFF Research Database (Denmark)

    Donia, Marco; Junker, Niels; Ellebaek, Eva;

    2012-01-01

    Adoptive cell therapy (ACT) with ex vivo expanded tumor infiltrating lymphocytes (TILs) in combination with IL-2 is an effective treatment for patients with metastatic melanoma. Modified protocols of cell expansion may allow treatment of most enrolled patients and improve the efficacy of adoptively...... transferred cells. The aim of this study was to establish and validate the novel "Young TIL" method at our institution and perform a head-to-head comparison of clinical grade products generated with this protocol opposed to the conventional "Standard TIL", that we are currently using in a pilot ACT trial for...... melanoma patients. Our results confirm that "Young TILs" display an earlier differentiation state, with higher CD27 and lower CD56 expression. In addition, CD8(+) TILs expressing CD27 had longer telomeres compared to the CD27(-) . A recently described subset of NK cells, endowed with a high expression of...

  14. Water for haemodialysis and related therapies: recent standards and emerging issues.

    Science.gov (United States)

    Hoenich, Nicholas A; Levin, Robert; Ronco, Claudio

    2010-01-01

    Dialysis is a well-established and widely used procedure. For a number of years, the focus has been on ensuring that water used in the preparation of dialysis fluid meets the required chemical and microbiological quality and complies with national or international standards which have recently been updated. Continued vigilance is required, in particular when new chemicals such as silver-stabilized hydrogen peroxide and chlorine dioxide are used to prevent growth of Legionella bacteria in hospital water systems, since residues are harmful to patients receiving dialysis. To achieve the required quality, large volumes of water are processed, and a substantial portion is sent to waste via the municipal sewer systems with little attempt to reuse such water on site. In view of concern about global warming and climate change, there is a need to adopt a more environmentally conscious attitude requiring dialysis providers to focus on this aspect of water usage. PMID:20093808

  15. Breast cancer therapy for BRCA1 carriers: moving towards platinum standard?

    Directory of Open Access Journals (Sweden)

    Imyanitov Evgeny N

    2009-04-01

    Full Text Available Abstract Recently Byrski et al. reported the first-ever breast cancer (BC study, which specifically selected BRCA1-carriers for the neoadjuvant treatment and used monotherapy by cisplatin instead of conventional schemes. Although the TNM staging of the recruited patients was apparently more favorable than in most of published neoadjuvant trials, the results of Byrski et al. clearly outperform any historical data. Indeed, 9 of 10 BRCA1-associated BC demonstrated complete pathological response to the cisplatin treatment, i.e. these women have good chances to be ultimately cured from the cancer disease. High sensitivity of BRCA1-related tumors to platinating agents has been discussed for years, but it took almost a decade to translate convincing laboratory findings into first clinical observations. With increasing stratification of tumor disease entities for molecular subtypes and rapidly growing armamentarium of cancer drugs, it is getting technically and ethically impossible to subject all promising treatment options to the large randomized prospective clinical trials. Therefore, alternative approaches for initial drugs evaluation are highly required, and one of the choices is to extract maximum benefit from already available collections of biological material and medical charts. For example, many thousands of BC patients around the world have already been subjected to second- or third-line therapy with platinum agents, but the association between BRCA status and response to the treatment has not been systematically evaluated in these women. While potential biases of retrospective studies are widely acknowledged, it is frequently ignored that the use of archival collections may provide preliminary answers for long-standing questions within days instead of years. However, even elegantly-designed, small-sized, hypothesis-generating retrospective studies may require multicenter efforts and somewhat cumbersome logistics, that may explain the

  16. Managing and predicting low response to standard in vitro fertilization therapy: a review of the options.

    Science.gov (United States)

    Karande, Visjhvanath C

    2003-01-01

    Low responders remain a difficult group of patients to manage in an in vitro fertilization (IVF) program. Such patients have low peak estradiol concentrations (strategies that have been utilized to manage low responders because the definition of a low responder varies widely. Also, very few large prospective randomized trials have compared different protocols. Two stimulation protocols involving varying doses of leuprorelin and high doses of gonadotropins appear to be the most promising. The early gonadotropin-releasing hormone (GnRH) agonist cessation protocol involves routine pituitary desensitization with luteal phase start of leuprorelin 0.5 mg for 10-14 days. With the onset of gonadotropin treatment, there is cessation of leuprorelin. The 'microdose flare' protocol utilizes oral contraceptive priming followed by diluted doses of leuprorelin 50 microg given twice daily. Two days later, stimulation is started by adding high doses of gonadotropins. The microdoses of leuprorelin and the high doses of gonadotropins are then continued until the day of chorionic gonadotropin administration. Patients who do not respond to these protocols or those with severely diminished ovarian reserve are candidates for donor oocytes. The role of GnRH antagonists and the in vitro maturation of oocytes are potentially exciting strategies that are still being investigated. Ultrasound measurements of ovarian volume, baseline antral follicle counts, and Doppler measurement of ovarian stromal blood flow now make it possible to predict low response to IVF therapy. Low response can be expected if the smaller ovary has a volume <3 cm3, or the mean ovarian diameter in the two longest planes is <20 mm. Antral follicle counts of < or = 3 in each ovary are also associated with low response. Data on ovarian stromal blood flow are still unclear, but an ovarian peak systolic velocity of <10 cm/sec is associated with low response. If low response is anticipated based on baseline ultrasound scan, a

  17. Neurobehavioral radiation mitigation to standard brain cancer therapy regimens by Mn(III) n-butoxyethylpyridylporphyrin-based redox modifier.

    Science.gov (United States)

    Weitzel, Douglas H; Tovmasyan, Artak; Ashcraft, Kathleen A; Boico, Alina; Birer, Samuel R; Roy Choudhury, Kingshuk; Herndon, James; Rodriguiz, Ramona M; Wetsel, William C; Peters, Katherine B; Spasojevic, Ivan; Batinic-Haberle, Ines; Dewhirst, Mark W

    2016-06-01

    Combinations of radiotherapy (RT) and chemotherapy have shown efficacy toward brain tumors. However, therapy-induced oxidative stress can damage normal brain tissue, resulting in both progressive neurocognitive loss and diminished quality of life. We have recently shown that MnTnBuOE-2-PyP(5+) (Mn(III)meso-tetrakis(N-n-butoxyethylpyridinium -2-yl)porphyrin) rescued RT-induced white matter damage in cranially-irradiated mice. Radiotherapy is not used in isolation for treatment of brain tumors; temozolomide is the standard-of-care for adult glioblastoma, whereas cisplatin is often used for treatment of pediatric brain tumors. Therefore, we evaluated the brain radiation mitigation ability of MnTnBuOE-2-PyP(5+) after either temozolomide or cisplatin was used singly or in combination with 10 Gy RT. MnTnBuOE-2-PyP(5+) accumulated in brains at low nanomolar levels. Histological and neurobehavioral testing showed a drastic decrease (1) of axon density in the corpus callosum and (2) rotorod and running wheel performance in the RT only treatment group, respectively. MnTnBuOE-2-PyP(5+) completely rescued this phenotype in irradiated animals. In the temozolomide groups, temozolomide/ RT treatment resulted in further decreased rotorod responses over RT alone. Again, MnTnBuOE-2-PyP(5+) treatment rescued the negative effects of both temozolomide ± RT on rotorod performance. While the cisplatin-treated groups did not give similar results as the temozolomide groups, inclusion of MnTnBuOE-2-PyP(5+) did not negatively affect rotorod performance. Additionally, MnTnBuOE-2-PyP(5+) sensitized glioblastomas to either RT ± temozolomide in flank tumor models. Mice treated with both MnTnBuOE-2-PyP(5+) and radio-/chemo-therapy herein demonstrated brain radiation mitigation. MnTnBuOE-2-PyP(5+) may well serve as a normal tissue radio-/chemo-mitigator adjuvant therapy to standard brain cancer treatment regimens. Environ. Mol. Mutagen. 57:372-381, 2016. © 2016 Wiley Periodicals, Inc

  18. RITUXIMAB TREATMENT EFFICACY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS REFRACTORY TO STANDARD THERAPY IN THE LONG-TERM FOLLOW-UP

    OpenAIRE

    M. E. Tsanyan; S K Soloviev; A. V. Torgashina; E N Aleksandrova; S G Radenska-Lopovok; E. V. Nikolaeva; E L Nasonov

    2014-01-01

    Objective. To evaluate the efficacy and safety of rituximab (RTM) treatment in the long-term follow-up of patients with systemic lupus erythematosus (SLE) refractory to standard therapy. Material and methods. RTM therapy was prescribed to 97 SLE patients with high disease activity and insufficient effica- cy of using high doses of glucocorticoids (GC) and cytostatics. The median follow-up time (25th; 75th percentiles) was 18 [12; 36] months. The most common clinical manifestations of SLE incl...

  19. The Sleep Or Mood Novel Adjunctive therapy (SOMNA) trial: a study protocol for a randomised controlled trial evaluating an internet-delivered cognitive behavioural therapy program for insomnia on outcomes of standard treatment for depression in men

    OpenAIRE

    Cockayne, Nicole L; Christensen, Helen M; Griffiths, Kathleen M; Naismith, Sharon L.; Hickie, Ian B.; Thorndike, Frances P.; Ritterband, Lee M.; Glozier, Nick S

    2015-01-01

    Background Insomnia is a significant risk factor for depression onset, can result in more disabling depressive illness, and is a common residual symptom following treatment cessation that can increase the risk of relapse. Internet-based cognitive behavioural therapy for insomnia has demonstrated efficacy and acceptability to men who are less likely than women to seek help in standard care. We aim to evaluate whether internet delivered cognitive behavioural therapy for insomnia as an adjunct t...

  20. Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device (TheraBite®) with standard physical therapy exercise

    NARCIS (Netherlands)

    S. Kraaijenga; L. van der Molen; H. van Tinteren; F. Hilgers; L. Smeele

    2014-01-01

    Aims: To compare in a randomized controlled clinical trial (RCT) the application of the TheraBite® (TB) Jaw Motion Rehabilitation System with a standard physical therapy (PT) exercise regimen for the treatment of myogenic temporomandibular disorder (TMD). Methodology: Myogenic TMD patients were rand

  1. A proposal to the technical standard for "Marital and Sex Therapy"%《婚姻与性治疗》技术标准建议书

    Institute of Scientific and Technical Information of China (English)

    胡佩诚; 甄宏丽; 陶林

    2013-01-01

    目的:提出一套婚姻与性治疗的技术标准.方法:采用文献回顾、专家咨询、临床实践等一系列方法.结果:推出一套完整的技术操作标准,供讨论参考.结论:婚姻与性治疗是一套可行的有效的在性科学领域中的治疗方法.%Objectives:To propose a technical standard for marital and sex therapy.Method:We make the proposal based on literature review,expert consultation and clinical practice.Results:A series of technical standards for marital and sex therapy were proposed for peer evaluation and reference.Conclusion:Marital and sex therapy is an effective treatment in sexuality sciences.

  2. Difficulties and Perspectives of Immunomodulatory Therapy with Mistletoe Lectins and Standardized Mistletoe Extracts in Evidence-Based Medicine

    Directory of Open Access Journals (Sweden)

    Tibor Hajtó

    2011-01-01

    Full Text Available Viscum album preparations are aqueous mistletoe plant extracts used in complementary and alternative medicine as immunomodulators in cancer therapy. However, evidence of immunological efficacy of mistletoe extracts (MEs used in clinical trials is often lacking. Mechanisms involved in anti-tumor properties of ME and mistletoe lectins (MLs modify both innate and adaptive immune systems, according to animal model experiments. In the background of these effects, a selective binding of ML on CD75 ganglioside receptors of interleukin 12 (IL-12-producing macrophages or dendritic cells can play an important role. Immunological effects of ME correlate with their lectin activity, showing a bell-shaped dose-response curve of efficacy. Therefore, a correct determination of MLs for the standardization of commercial ME is essential. However, plant MLs exhibit heterogeneity, which most likely results from post-translational processing. In addition, amino acid analysis of ML has revealed numerous conservative substitutions along their amino acid sequence. Consequently, ML research needs new perspectives, and the advantages and disadvantages of purified and biologically better defined ML preparations are also discussed in this article.

  3. Quality of Survival and Growth in Children and Young Adults in the PNET4 European Controlled Trial of Hyperfractionated Versus Conventional Radiation Therapy for Standard-Risk Medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Colin, E-mail: crk1@soton.ac.uk [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Bull, Kim [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Chevignard, Mathilde [Hôpitaux de Saint Maurice, Saint Maurice (France); Neurophysiology, University of Pierre et Marie-Curie Paris 6, Paris (France); Culliford, David [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Dörr, Helmuth G. [Kinder- und Jugendklinik der Universität Erlangen, Erlangen (Germany); Doz, François [Institut Curie and University Paris Descartes, Sorbonne Paris Cité (France); Kortmann, Rolf-Dieter [Department of Radiation Therapy, University of Leipzig, Leipzig (Germany); Lannering, Birgitta [Department of Pediatrics, The Sahlgren Academy, University of Gothenburg, Gothenburg (Sweden); Massimino, Maura [Fondazione Istituto di Ricovero e Cura a Carattere Scientifico IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Navajas Gutiérrez, Aurora [Hospital Universitario Cruces, Baracaldo-Vizcaya (Spain); Rutkowski, Stefan [University Medical Center Hamburg-Eppendorf, Hamburg (Germany); Spoudeas, Helen A. [Center for Pediatric Endocrinology, University College London, London (United Kingdom); Calaminus, Gabriele [Pediatric Oncology, University of Muenster, Muenster (Germany)

    2014-02-01

    Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.

  4. Quality of Survival and Growth in Children and Young Adults in the PNET4 European Controlled Trial of Hyperfractionated Versus Conventional Radiation Therapy for Standard-Risk Medulloblastoma

    International Nuclear Information System (INIS)

    Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life

  5. Small laser spot versus standard laser spot photodynamic therapy for idiopathic choroidal neovascularization: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-xin; TAO Yong

    2012-01-01

    Backcround Idiopathic choroidal neovascularization (ICNV) affects young patients and thus may have a significant impact on vision and life quality over a patient's lifespan.This study was designed to compare the visual outcome and retinal pigment epithelium (RPE) damage after photodynamic therapy (PDT) with small laser spot and PDT with standard laser spot for idiopathic choroidal neovascularization (ICNV).Methods This was a randomized controlled study.Fifty-two patients with ICNV were enrolled and randomly divided into a study group (small laser spot PDT,n=27) and a control group (standard laser spot PDT,n=25).Best corrected visual acuity (BCVA),optic coherence tomography (OCT) and fluorescein angiography (FA) findings were the main measurements.The patients were followed up 1 week,1,3,6,9 months and 1 year after PDT.Results BCVA improvement was statistically significantly higher in the study group than the control group at 6-month ((25.53±15.01) letters vs.(14.71±11.66) letters,P=0.025) and 9-month follow-ups ((27.53±17.78) letters vs.(15.59±12.21) letters,P=0.039).At 3-and 6-month follow-ups,the quadrants of RPE damage between the two groups varied significantly (P <0.001 and P=0.023,respectively).In each follow-up,the number of cases with decreased or unchanged leakage of choroidal neovascularization by FA and reduced subretinal fluid by OCT did not vary significantly between the two groups.Ten cases (37.0%) in the study group and eight cases (32.0%) in the control group suffered from recurrent CNV (P=0.703).Conclusions Better visual improvements,less RPE damage,a similar recurrent rate of CNV and change of subretinal fluid were observed in the small laser spot PDT group than in the standard laser spot PDT group for ICNV.

  6. RITUXIMAB TREATMENT EFFICACY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS REFRACTORY TO STANDARD THERAPY IN THE LONG-TERM FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    M. E. Tsanyan

    2014-01-01

    Full Text Available Objective. To evaluate the efficacy and safety of rituximab (RTM treatment in the long-term follow-up of patients with systemic lupus erythematosus (SLE refractory to standard therapy. Material and methods. RTM therapy was prescribed to 97 SLE patients with high disease activity and insufficient effica- cy of using high doses of glucocorticoids (GC and cytostatics. The median follow-up time (25th; 75th percentiles was 18 [12; 36] months. The most common clinical manifestations of SLE included nephritis (62%, skin lesion (33%, and lesion of the nervous system (22.7%. The clinical assessment of the SLE activity was carried out using the SLEDAI-2K activity index. In assessing the therapy efficacy, the following concepts were used: the partial response (PR, complete response (CR, and flare. Flare was classified as moderate (MF and severe (SF using the SLE flare index (SFI. Results. Immediately after RTM therapy, depletion of B-cells was determined in 78% of the patients with SLE. During the 6-year follow-up, the effect of RTM therapy was achieved in 84% of the patients after repeated courses of RTM (CR – 56%, PR – 28%. In total, flares were observed in 24 (24.7% patients; the median interval from RTM administration to flare was 12 [12; 24] months. In the long-term follow-up, the decline in the SLEDAI-2K index, normalization of laboratory test values, and the decrease in the daily GC dose were noted. Most patients tolerated well both the first and repeated courses of RTM therapy. Conclusion. According to the results of the long-term follow-up, RTM therapy is a highly effective method to treat SLE patients with the ineffectiveness of previously conducted standard therapy with GC and cytostatics. Good tolerance of RTM treatment has been noted; no increase in risk of infectious complications or adverse reactions has been found. 

  7. Achieving a Spiritual Therapy Standard for Drug Dependency in Malaysia, from an Islamic Perspective: Brief Review Article.

    Science.gov (United States)

    Seghatoleslam, Tahereh; Habil, Hussain; Hatim, Ahmad; Rashid, Rusdi; Ardakan, Abolfazl; Esmaeili Motlaq, Farid

    2015-01-01

    Religion is one of the protective factors that facilities positive outcomes by preventing individuals from engaging in addictive substance. A recent study has confirmed that religion inhibits drug addiction. The concept of psychospiritual therapy was to introduce drug addiction. Therefore, of the various methods of psychotherapy, the usage of Taqwa (piety) emerged as an applicable method of Islamic spiritual therapy. This study was conducted in Malaysia as a Muslim country and focuses on Islamic recommendations and its relation to spiritual therapy.

  8. Total skin electron therapy treatment verification: Monte Carlo simulation and beam characteristics of large non-standard electron fields

    Energy Technology Data Exchange (ETDEWEB)

    Pavon, Ester Carrasco [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Sanchez-Doblado, Francisco [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Leal, Antonio [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Capote, Roberto [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Lagares, Juan Ignacio [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Perucha, Maria [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain); Arrans, Rafael [Dpto Fisiologia Medica y Biofisica, Facultad de Medicina, Universidad de Sevilla, Avda Sanchez Pizjuan, 4, E-41009, Sevilla (Spain)

    2003-09-07

    Total skin electron therapy (TSET) is a complex technique which requires non-standard measurements and dosimetric procedures. This paper investigates an essential first step towards TSET Monte Carlo (MC) verification. The non-standard 6 MeV 40 x 40 cm{sup 2} electron beam at a source to surface distance (SSD) of 100 cm as well as its horizontal projection behind a polymethylmethacrylate (PMMA) screen to SSD = 380 cm were evaluated. The EGS4 OMEGA-BEAM code package running on a Linux home made 47 PCs cluster was used for the MC simulations. Percentage depth-dose curves and profiles were calculated and measured experimentally for the 40 x 40 cm{sup 2} field at both SSD = 100 cm and patient surface SSD = 380 cm. The output factor (OF) between the reference 40 x 40 cm{sup 2} open field and its horizontal projection as TSET beam at SSD = 380 cm was also measured for comparison with MC results. The accuracy of the simulated beam was validated by the good agreement to within 2% between measured relative dose distributions, including the beam characteristic parameters (R{sub 50}, R{sub 80}, R{sub 100}, R{sub p}, E{sub 0}) and the MC calculated results. The energy spectrum, fluence and angular distribution at different stages of the beam (at SSD = 100 cm, at SSD = 364.2 cm, behind the PMMA beam spoiler screen and at treatment surface SSD = 380 cm) were derived from MC simulations. Results showed a final decrease in mean energy of almost 56% from the exit window to the treatment surface. A broader angular distribution (FWHM of the angular distribution increased from 13deg at SSD 100 cm to more than 30deg at the treatment surface) was fully attributable to the PMMA beam spoiler screen. OF calculations and measurements agreed to less than 1%. The effect of changing the electron energy cut-off from 0.7 MeV to 0.521 MeV and air density fluctuations in the bunker which could affect the MC results were shown to have a negligible impact on the beam fluence distributions. Results

  9. [Corrective effects of electromagnetic radiation in a millimeter wavelength range on the parameters of oxidative stress after standard anti-helicobacterial therapy in patients with ulcer disease].

    Science.gov (United States)

    Ivanishkina, E V; Podoprigorova, V G

    2012-01-01

    We assessed the possibilities of correction of oxidative stress parameters in the serum and gastroduodenal mucosa using electromagnetic radiation in a millimeter wavelength range in 127 patients with gastric and duodenal ulcer after eradication therapy. Control group included 230 healthy subjects. Parameter of lipid oxidation by free radicals were measured by direct methods (hemiluminescence and EPR-spectroscopy). The results show that standard eradication therapy does not influence parameters of oxidative stress. More pronounced effect of electromagnetic radiation in a millimeter wavelength range may be due to the correction of prooxidant-antioxidant and antioxidant disbalance. This observation provides pathogenetic substantiation for the inclusion of this physical method in modern therapeutic modalities.

  10. RT-PCR standardization and bone mineralization after low-level laser therapy on adult osteoblast cells

    Science.gov (United States)

    do Bomfim, Fernando R. C.; Sella, Valéria R. G.; Zanaga, Jéssica Q.; Pereira, Nayara S.; Nouailhetas, Viviane L. A.; Plapler, Hélio

    2014-03-01

    Purpose: Osteoblasts are capable to produce different compounds directly connected to bone mineralization process. This study aims to standardize the reverse transcriptase polymerase chain reaction (RT-PCR) for adult osteoblasts to observe the effect of low level laser therapy on bone mineralization. Methods: Five-millimeter long fragments obtained from the mead femoral region of male Wistar rats were assigned into group A (n=10, laser) and group B (n=10, no laser), submitted to mechanic and enzymatic digestion. After 7 days, cultures of group A were irradiated daily on a single spot with a GaInAs laser, λ=808nm, 200mW/cm2, 2J/cm2, bean diameter of 0,02mm, 5 seconds for 6 days. Group B was manipulated but received no laser irradiation. After 13 days the cells were trypsinized for 15 minute and stabilized with RNA later® for RNA extraction with Trizol®. cDNA synthesis used 10μg of RNA and M-MLV® enzyme. PCR was accomplished using the β-actin gene as a control. Another aliquot was fixed for Hematoxylin-Eosin and Von Kossa staining to visualize bone mineralization areas. Results: Under UV light we observed clearly the amplification of β-actin gene around 400bp. HE and Von Kossa staining showed osteoblast clusters, a higher number of bone cells and well defined mineralization areas in group A. Conclusion: The cell culture, RNA extraction and RT-PCR method for adult osteoblasts was effective, allowing to use these methods for bone mineralization studies. Laser improved bone mineralization and further studies are needed involving osteogenesis, calcium release mechanisms and calcium related channels.

  11. Achieving a Spiritual Therapy Standard for Drug Dependency in Malaysia, from an Islamic Perspective: Brief Review Article

    Science.gov (United States)

    SEGHATOLESLAM, Tahereh; HABIL, Hussain; HATIM, Ahmad; RASHID, Rusdi; ARDAKAN, Abolfazl; ESMAEILI MOTLAQ, Farid

    2015-01-01

    Abstract Religion is one of the protective factors that facilities positive outcomes by preventing individuals from engaging in addictive substance. A recent study has confirmed that religion inhibits drug addiction. The concept of psychospiritual therapy was to introduce drug addiction. Therefore, of the various methods of psychotherapy, the usage of Taqwa (piety) emerged as an applicable method of Islamic spiritual therapy. This study was conducted in Malaysia as a Muslim country and focuses on Islamic recommendations and its relation to spiritual therapy. PMID:26060772

  12. Achieving a Spiritual Therapy Standard for Drug Dependency in Malaysia, from an Islamic Perspective: Brief Review Article.

    Directory of Open Access Journals (Sweden)

    Tahereh Seghatoleslam

    2015-01-01

    Full Text Available Religion is one of the protective factors that facilities positive outcomes by preventing individuals from engaging in addictive substance. A recent study has confirmed that religion inhibits drug addiction. The concept of psychospiritual therapy was to introduce drug addiction. Therefore, of the various methods of psychotherapy, the usage of Taqwa (piety emerged as an applicable method of Islamic spiritual therapy. This study was conducted in Malaysia as a Muslim country and focuses on Islamic recommendations and its relation to spiritual therapy.

  13. Effectiveness, safety, and standard of service delivery: A patient-based survey at a pancha karma therapy unit in a secondary care Ayurvedic hospital

    Directory of Open Access Journals (Sweden)

    Sanjeev Rastogi

    2011-01-01

    Full Text Available Pancha karma is a modality of treatments commonly used in Ayurvedic hospitals. It has elaborate textual reference of its usage in various clinical conditions forming the basis of its extensive use in Ayurvedic clinical practice. Unfortunately, despite its unquestionable popularity and usage among Ayurvedic physicians and patients, it has not been evaluated rigorously on scientific parameters to identify its effectiveness, safety, and procedural standards. Considering the patient′s opinion as an important determinant in this perspective, this study aims at identifying the patient′s (actual recipients of pancha karma therapy perception toward the effectiveness, safety, and standard of service delivery concerning pancha karma through a structured survey at a pre-identified pancha karma therapy unit in a secondary care Ayurvedic hospital. Majority of the survey respondents considered these therapies as safe and effective (88%. Ninety-four percent respondents have expressed their satisfaction to the standard of services provided to them at the pancha karma unit of the hospital concerned.

  14. Triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication: A comparative three-armed randomized clinical trial

    Institute of Scientific and Technical Information of China (English)

    Seyed Amir Mirbagheri; Mehrdad Hasibi; Mehdi Abouzari; Armin Rashidi

    2006-01-01

    AIM: To compare the effectiveness of triple, standard quadruple and ampicillin-sulbactam-based quadruple therapies for H pylori eradication in a comparative threearmed randomized clinical trial. METHODS: A total of 360 H pylori-positive patients suffering from dyspepsia and aging 24-79 years with a median age of 42 years were enrolled in the study and randomly allocated into the following three groups: group A (n = 120) received a standard 1-wk triple therapy (20mg omeprazole b.I.d., 1000 mg amoxicillin b.I.d., 500 mg clarithromycin b.I.d.); group B (n = 120) received a 10-d standard quadruple therapy (20 mg omeprazole b.I.d., 1000 mg amoxicillin b.I.d., 240 mg colloidal bismuth subcitrate b.I.d., and 500 mg metronidazole b.I.d.); group C (n = 120) received the new protocol, I.e. 375 mg sultamicillin (225 mg ampicillin plus 150 mg sulbactam) b.I.d. (before breakfast and dinner), instead of amoxicillin in the standard quadruple therapy for the same duration. Chi-square test with the consideration of P < 0.05 as significant was used to compare the eradication rates by intention-to-treat and per-protocol analyses in the three groups. RESULTS: The per-protocol eradication rate was 91.81% (101 patients from a total of 110) in group A, 85.84% (97patients from a total of 113) in group B, and 92.85% (104 patients from a total of 112) in group C. The intentionto-treat eradication rate was 84.17% in group A, 80.83% in group B, and 86.67% in group C. The new protocol yielded the highest eradication rates by both per-protocol and intention-to-treat analyses followed by the standard triple and quadruple regimens, respectively. However, the differences were not statistically significant between the three groups. CONCLUSION: The results of this study provide further support for the equivalence of triple and quadruple therapies in terms of effectiveness, compliance and sideeffect profile when administered as first-line treatmentfor Hpylori infection. Moreover, the new protocol

  15. Evaluation of the Effects of Photodynamic Therapy Alone and Combined with Standard Antifungal Therapy on Planktonic Cells and Biofilms of Fusarium spp. and Exophiala spp.

    Science.gov (United States)

    Gao, Lujuan; Jiang, Shaojie; Sun, Yi; Deng, Meiqi; Wu, Qingzhi; Li, Ming; Zeng, Tongxiang

    2016-01-01

    Infections of Fusarium spp. and Exophiala spp. are often chronic, recalcitrant, resulting in significant morbidity, causing discomfort, disfigurement, social isolation. Systemic disseminations happen in compromised patients, which are often refractory to available antifungal therapies and thereby lead to death. The antimicrobial photodynamic therapy (aPDT) has been demonstrated to effectively inactivate multiple pathogenic fungi and is considered as a promising alternative treatment for mycoses. In the present study, we applied methylene blue (8, 16, and 32 μg/ml) as a photosensitizing agent and light emitting diode (635 ± 10 nm, 12 and 24 J/cm2), and evaluated the effects of photodynamic inactivation on five strains of Fusarium spp. and five strains of Exophiala spp., as well as photodynamic effects on in vitro susceptibility to itraconazole, voriconazole, posaconazole and amphotericin B, both planktonic and biofilm forms. Photodynamic therapy was efficient in reducing the growth of all strains tested, exhibiting colony forming unit-reductions of up to 6.4 log10 and 5.6 log10 against planktonic cultures and biofilms, respectively. However, biofilms were less sensitive since the irradiation time was twice longer than that of planktonic cultures. Notably, the photodynamic effects against Fusarium strains with high minimal inhibitory concentration (MIC) values of ≥16, 4-8, 4-8, and 2-4 μg/ml for itraconazole, voriconazole, posaconazole and amphotericin B, respectively, were comparable or even superior to Exophiala spp., despite Exophiala spp. showed relatively better antifungal susceptibility profile. MIC ranges against planktonic cells of both species were up to 64 times lower after aPDT treatment. Biofilms of both species showed high sessile MIC50 (SMIC50) and SMIC80 of ≥16 μg/ml for all azoles tested and variable susceptibilities to amphotericin B, with SMIC ranging between 1 and 16 μg/ml. Biofilms subjected to aPDT exhibited a distinct reduction in SMIC

  16. Estimation of the standardized risk difference and ratio in a competing risks framework: application to injection drug use and progression to AIDS after initiation of antiretroviral therapy.

    Science.gov (United States)

    Cole, Stephen R; Lau, Bryan; Eron, Joseph J; Brookhart, M Alan; Kitahata, Mari M; Martin, Jeffrey N; Mathews, William C; Mugavero, Michael J

    2015-02-15

    There are few published examples of absolute risk estimated from epidemiologic data subject to censoring and competing risks with adjustment for multiple confounders. We present an example estimating the effect of injection drug use on 6-year risk of acquired immunodeficiency syndrome (AIDS) after initiation of combination antiretroviral therapy between 1998 and 2012 in an 8-site US cohort study with death before AIDS as a competing risk. We estimate the risk standardized to the total study sample by combining inverse probability weights with the cumulative incidence function; estimates of precision are obtained by bootstrap. In 7,182 patients (83% male, 33% African American, median age of 38 years), we observed 6-year standardized AIDS risks of 16.75% among 1,143 injection drug users and 12.08% among 6,039 nonusers, yielding a standardized risk difference of 4.68 (95% confidence interval: 1.27, 8.08) and a standardized risk ratio of 1.39 (95% confidence interval: 1.12, 1.72). Results may be sensitive to the assumptions of exposure-version irrelevance, no measurement bias, and no unmeasured confounding. These limitations suggest that results be replicated with refined measurements of injection drug use. Nevertheless, estimating the standardized risk difference and ratio is straightforward, and injection drug use appears to increase the risk of AIDS. PMID:24966220

  17. A PROSPECTIVE RANDOMIZED TRIAL OF VACUUM-ASSISTED CLOSURE VERSUS STANDARD THERAPY OF CHRONIC NON-HEALING WOUNDS

    Directory of Open Access Journals (Sweden)

    Raghupathy

    2016-06-01

    Full Text Available BACKGROUND The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. The optimum level of negative pressure appears to be around 125 mmHg below ambient and there is evidence that this is most effective if applied in a cyclical fashion of five minutes on and two minutes off. It is believed that the negative pressure assists with removal of interstitial fluid, decreasing localised oedema and increasing blood flow. This in turn decreases tissue bacterial levels. Additionally, mechanical deformation of cells is thought to result in protein and matrix molecule synthesis, which increases the rate of cell proliferation. Despite the significant costs involved, the technique is said to compare favourably in financial terms with conventional treatments in the management of difficult to heal wounds. METHODS VAC therapy using facilities available in government. RESULTS Study group of 20 members with 98-100% graft uptake for most used VAC therapy of 1 to 2 settings. CONCLUSION Negative-Pressure Wound Therapy (NPWT is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds and enhance healing of second and third degree burns. The therapy involves the controlled application of subatmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. The use of this technique in wound management increased dramatically over the 1990s and 2000s and a large number of studies have been published examining NPWT. NPWT appears to be useful for diabetic wound and management of the open abdomen (Laparotomy, but further research is required for other wound types, always superior to normal saline dressing.

  18. Study of Standardized Anticoagulant Therapy in Patient with Atrial Fibrillation%房颤患者规范化抗凝治疗现状调研

    Institute of Scientific and Technical Information of China (English)

    Lydie-Edwige Biye; 葛卫红; 于锋

    2011-01-01

    Objective: To understand current the state of standardized anticoagulant therapy in patient with atrial fibrillation and analyze the factors that affect standard anticoagulant therapy, and at the same time, to make progress by the foundation of corresponding countermeasures. Methods:Diagnosed nonvalvular atrial fibrillation patients were history inspected for a period of 12 months (January-December 2010) in Nanjing Drum Tower Hospital Cardiovascular Department, CHADS2 scheme method was used to stratify atrial fibrillation patient and assess their risk of bleeding, the standardized anticoagulant therapy conditions were evaluated according to ACC/AHA/ESC (American College of Cardiology/American Heart Association/ European Society of Cardiology) atrial fibrillation treatment guidelines. Results: A total of 200 patients were enrolled, 39 (19.5%) patient were on warfarin anticoagulant therapy, among which 18 (46%)had international normalized ratio (INR) in therapeutic range (2.0~3.0). According to the CHADS2 scheme,143 patients were divided into the high risk group, in which only 31 were on warfarin anticoagulant treatment. Conclusion: The percentage of standard anticoagulant treatment in patients with atrial fibrillation is very low (40%), still more, the percentage of high risk patients using warfarin standard anticoagulant treatment was even low 22%. Further investigation and understanding of the causes of this phenomenon will help intervene effectively and improve the standard of anticoagulant therapy in patient with atrial fibrillation.%目的:了解心房颤动患者规范化抗凝治疗现状,分析影响规范化抗凝治疗的因素,同时为进一步提出相应的对策打下基础.方法:查阅2010年1~12月份南京鼓楼医院心内科明确诊断患有非瓣膜性心房颤动的患者病历,采用CHADS风险评分法对这些患者进行出血风险评估,根据ACC/AHA/ESC心房颤动治疗指南评价其规范化抗凝

  19. Negative pressure wound therapy versus standard wound care in chronic diabetic foot wounds: study protocol for a randomized controlled trial

    OpenAIRE

    Seidel, Dörthe; Mathes, Tim; Lefering, Rolf; Storck, Martin; Lawall, Holger; Neugebauer, Edmund A. M.

    2014-01-01

    Background In August 2010, the Federal Joint Committee (G-BA) decided that negative pressure wound therapy (NPWT) would not be reimbursable in German ambulatory care. This decision was based on reports from the Institute for Quality and Efficiency in Health Care (IQWiG), which concluded that there is no convincing evidence in favor of NPWT. The aim of this diabetic foot study (DiaFu study) is to evaluate whether the clinical, safety and economic results of NPWT are superior to the results of ...

  20. Raising the standard: changes to the Australian Code of Good Manufacturing Practice (cGMP) for human blood and blood components, human tissues and human cellular therapy products.

    Science.gov (United States)

    Wright, Craig; Velickovic, Zlatibor; Brown, Ross; Larsen, Stephen; Macpherson, Janet L; Gibson, John; Rasko, John E J

    2014-04-01

    In Australia, manufacture of blood, tissues and biologicals must comply with the federal laws and meet the requirements of the Therapeutic Goods Administration (TGA) Manufacturing Principles as outlined in the current Code of Good Manufacturing Practice (cGMP). The Therapeutic Goods Order (TGO) No. 88 was announced concurrently with the new cGMP, as a new standard for therapeutic goods. This order constitutes a minimum standard for human blood, tissues and cellular therapeutic goods aimed at minimising the risk of infectious disease transmission. The order sets out specific requirements relating to donor selection, donor testing and minimisation of infectious disease transmission from collection and manufacture of these products. The Therapeutic Goods Manufacturing Principles Determination No. 1 of 2013 references the human blood and blood components, human tissues and human cellular therapy products 2013 (2013 cGMP). The name change for the 2013 cGMP has allowed a broadening of the scope of products to include human cellular therapy products. It is difficult to directly compare versions of the code as deletion of some clauses has not changed the requirements to be met, as they are found elsewhere amongst the various guidelines provided. Many sections that were specific for blood and blood components are now less prescriptive and apply to a wider range of cellular therapies, but the general overall intent remains the same. Use of 'should' throughout the document instead of 'must' allows flexibility for alternative processes, but these systems will still require justification by relevant logical argument and validation data to be acceptable to TGA. The cGMP has seemingly evolved so that specific issues identified at audit over the last decade have now been formalised in the new version. There is a notable risk management approach applied to most areas that refer to process justification and decision making. These requirements commenced on 31 May 2013 and a 12 month

  1. Effects of adding intravenous nicorandil to standard therapy on cardiac sympathetic nerve activity and myocyte dysfunction in patients with acute decompensated heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji; Funada, Ryuichi; Takama, Noriaki; Koitabashi, Norimichi; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Suzuki, Yasuyuki; Matsumoto, Naoya [Nihon University School of Medicine, Department of Cardiology, Tokyo (Japan); Sato, Yuichi [Health Park Clinic, Department of Imaging, Takasaki, Gunma (Japan)

    2015-04-01

    Nicorandil, an adenosine triphosphate-sensitive potassium channel opener, improves cardiac sympathetic nerve activity (CSNA) in ischemic heart disease or chronic heart failure. However, its effects on CSNA and myocyte dysfunction in acute heart failure (AHF) remain unclear. We investigated the effects of adding intravenous nicorandil to standard therapy on CSNA and myocyte dysfunction in AHF. We selected 70 patients with mild to moderate nonischemic AHF who were treated with standard conventional therapy soon after admission. Thirty-five patients were assigned to additionally receive intravenous nicorandil (4-12 mg/h; group A), whereas the remaining patients continued their current drug regimen (group B). Delayed total defect score (TDS), delayed heart to mediastinum count (H/M) ratio, and washout rate (WR) were determined by {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy within 3 days of admission and 4 weeks later. High sensitivity troponin T (hs-TnT) level was also measured at the same time points. After treatment, MIBG scintigraphic parameters significantly improved in both groups. However, the extent of the changes in these parameters in group A significantly exceeded the extent of the changes in group B [TDS -11.3 ± 4.3 in group A vs -4.0 ± 6.0 in group B (p < 0.01); H/M ratio 0.31 ± 0.16 vs 0.14 ± 0.16 (p < 0.01); WR -13.8 ± 7.8 % vs -6.1 ± 8.9 % (p < 0.01)]. The hs-TnT level decreased significantly from 0.052 ± 0.043 to 0.041 ± 0.033 ng/ml (p < 0.05) in group A, but showed no significant change in group B. Moreover, in both groups, no relationships between the extent of changes in MIBG parameters and hs-TnT level were observed. Adding intravenous nicorandil to standard therapy provides additional benefits for CSNA and myocyte dysfunction over conventional therapy alone in AHF patients. Furthermore, the mechanisms of improvement in CSNA and myocyte dysfunction after nicorandil treatment in AHF patients were distinct. (orig.)

  2. A 12 Week, Open Label, Phase I/IIa Study Using Apatone® for the Treatment of Prostate Cancer Patients Who Have Failed Standard Therapy

    Directory of Open Access Journals (Sweden)

    Basir Tareen, Jack L. Summers, James M. Jamison, Deborah R. Neal, Karen McGuire, Lowell Gerson, Ananias Diokno

    2008-01-01

    Full Text Available Purpose: To evaluate the safety and efficacy of oral Apatone® (Vitamin C and Vitamin K3 administration in the treatment of prostate cancer in patients who failed standard therapy. Materials and Methods: Seventeen patients with 2 successive rises in PSA after failure of standard local therapy were treated with (5,000 mg of VC and 50 mg of VK3 each day for a period of 12 weeks. Prostate Specific Antigen (PSA levels, PSA velocity (PSAV and PSA doubling times (PSADT were calculated before and during treatment at 6 week intervals. Following the initial 12 week trial, 15 of 17 patients opted to continue treatment for an additional period ranging from 6 to 24 months. PSA values were followed for these patients. Results: At the conclusion of the 12 week treatment period, PSAV decreased and PSADT increased in 13 of 17 patients (p ≤ 0.05. There were no dose-limiting adverse effects. Of the 15 patients who continued on Apatone after 12 weeks, only 1 death occurred after 14 months of treatment. Conclusion: Apatone showed promise in delaying biochemical progression in this group of end stage prostate cancer patients.

  3. Evaluation of different normalization procedures for the calculation of the standardized uptake value in therapy response monitoring studies

    NARCIS (Netherlands)

    Vriens, Dennis; de Geus-Oei, Lioe-Fee; van Laarhoven, Hanneke W; Timmer-Bonte, Johanna N H; Krabbe, Paul F M; Visser, Eric P; Oyen, Wim J G

    2009-01-01

    OBJECTIVES: The aim of this prospective study was to assess the influence of different normalization procedures on relative changes in standardized uptake values (SUV) of F-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for the assessment of chemotherapy response in patients with

  4. 42 CFR Appendix E to Part 75 - Standards for Accreditation of Educational Programs for Radiation Therapy Technologists

    Science.gov (United States)

    2010-10-01

    ... clinical education center is used, each must meet the standards of a major cancer management center. 3. When didactic preparation and supervised clinical education are not provided in the same institution... accredited institution and each clinical education center, clearly defining the responsibilities...

  5. Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy.

    Science.gov (United States)

    Robinson, Yohan; Olerud, Claes

    2012-05-01

    After more than two decades the treatment effect of cement augmentation of osteoporotic vertebral compression fractures (VCF) has now been questioned by two blinded randomised placebo-controlled trials. Thus many practitioners are uncertain on the recommendation for cement augmentation techniques in elderly patients with osteoporotic VCF. This systematic review analyses randomised controlled trials on vertebroplasty and kyphoplasty to provide an overview on the current evidence. From an electronic database research 8 studies could be identified meeting our inclusion criteria of osteoporotic VCF in elderly (age>60 years), treatment with vertebroplasty or kyphoplasty, controlled with placebo or standard medical therapy, quality of life, function, or pain as primary parameter, and randomisation. Only two studies were properly blinded using a sham-operation as control. The other studies were using a non-surgical treatment control group. Further possible bias may be caused by manufacturer involvement in financing of three published RCT. There is level Ib evidence that vertebroplasty is no better than placebo, which is conflicting with the available level IIb evidence that there is a positive short-term effect of cement augmentation compared to standard medical therapy with regard to QoL, function and pain. Kyphoplasty is not superior to vertebroplasty with regard to pain, but with regard to VCF reduction (evidence level IIb). Kyphoplasty is probably not cost-effective (evidence level IIb), and vertebroplasty has not more than short-term cost-effectiveness (evidence level IV). Vertebroplasty and kyphoplasty cannot be recommended as standard treatment for osteoporotic VCF. Ongoing sham-controlled trials may provide further evidence in this regard.

  6. Evaluation of different normalization procedures for the calculation of the standardized uptake value in therapy response monitoring studies.

    OpenAIRE

    Vriens, D.; Geus-Oei, L.F. de; Laarhoven, H.W.M. van; Timmer-Bonte, J.N.H.; Krabbe, P.F.M.; Visser, E.P.; Oyen, W.J.G.

    2009-01-01

    OBJECTIVES: The aim of this prospective study was to assess the influence of different normalization procedures on relative changes in standardized uptake values (SUV) of F-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for the assessment of chemotherapy response in patients with colorectal carcinoma (CRC) and nonsmall cell lung carcinoma (NSCLC). METHODS: In 97 patients with CRC (n = 48) and NSCLC (n = 49), FDG-PET was performed before and during the course of chemotherapy...

  7. Dosimetry standards

    International Nuclear Information System (INIS)

    The following leaflets are contained in this folder concerning the National Physical Laboratory's measurement services available in relation to dosimetry standards: Primary standards of X-ray exposure and X-ray irradiation facilities, X-ray dosimetry at therapy levels, Protection-level X-ray calibrations, Therapy-level gamma-ray facility, Fricke dosemeter reference service, Low-dose-rate gamma-ray facility, Penetrameter and kV meter calibration, Measurement services for radiation processing, Dichromate dosemeter reference service, Electron linear accelerator. (U.K.)

  8. Estimation of a Self-Consistent Set of Radiobiological Parameters From Hypofractionated Versus Standard Radiation Therapy of Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pedicini, Piernicola, E-mail: ppiern@libero.it [Service of Medical Physics, Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture (Italy); Strigari, Lidia [Laboratory of Medical Physics and Expert Systems, Istituto Nazionale Tumori Regina Elena, Rome (Italy); Benassi, Marcello [Service of Medical Physics, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (Italy)

    2013-04-01

    Purpose: To determine a self-consistent set of radiobiological parameters in prostate cancer. Methods and Materials: A method to estimate intrinsic radiosensitivity (α), fractionation sensitivity (α/β), repopulation doubling time, number of clonogens, and kick-off time for accelerated repopulation of prostate cancer has been developed. Based on the generalized linear-quadratic model and without assuming the isoeffective hypothesis, the potential applications of the method were investigated using the clinical outcome of biochemical relapse-free survival recently reviewed in the literature. The strengths and limitations of the method, regarding the fitted parameters and 95% confidence intervals (CIs), are also discussed. Results: Our best estimate of α/β is 2.96 Gy (95% CI 2.41-3.53 Gy). The corresponding α value is 0.16 Gy{sup −1} (95% CI 0.14-0.18 Gy{sup −1}), which is compatible with a realistic number of clonogens: 6.5 × 10{sup 6} (95% CI 1.5 × 10{sup 6}-2.1 × 10{sup 7}). The estimated cell doubling time is 5.1 days (95% CI 4.2-7.2 days), very low if compared with that reported in the literature. This corresponds to the dose required to offset the repopulation occurring in 1 day of 0.52 Gy/d (95% CI 0.32-0.68 Gy/d). However, a long kick-off time of 31 days (95% CI 22-41 days) from the start of radiation therapy was found. Conclusion: The proposed analytic/graphic method has allowed the fitting of clinical data, providing a self-consistent set of radiobiological parameters for prostate cancer. With our analysis we confirm a low value for α/β with a correspondingly high value of intrinsic radiosensitivity, a realistic average number of clonogens, a long kick-off time for accelerated repopulation, and a surprisingly fast repopulation that suggests the involvement of subpopulations of specifically tumorigenic stem cells during continuing radiation therapy.

  9. Occurrence of HSV-1-induced pneumonitis in patients under standard immunosuppressive therapy for rheumatic, vasculitic, and connective tissue disease

    Directory of Open Access Journals (Sweden)

    Ihrler Stephan

    2009-05-01

    Full Text Available Abstract Background Herpes simplex virus type-1 (HSV-1 has been described to cause respiratory tract infections in critically ill patients or in individuals that are immunocompromised. It is a continuing matter of debate under which circumstances HSV-1 is a relevant pathogen for pneumonitis. While its role during critical illness has been investigated by prospective interventional studies, comparatively little systematic data is available on the role of HSV-1 for pneumonitis in outpatients with autoimmune disease under a maintenance regimen of immunosuppression. Methods We retrospectively reviewed the charts of ~1400 patients with rheumatoid arthritis, vasculitis, and systemic lupus erythematosus (SLE that were followed at the outpatient clinic of a German University hospital during the years 2000–2007. Episodes of admission to a ward resulting in the diagnosis of pneumonia/pneumonitis were identified, and the type of pneumonia and clinical features retrospectively studied. Results 63 patients with rheumatoid arthritis, vasculitis, or SLE were admitted to a ward and diagnosed to have pneumonia/pneumonitis. Using bronchoscopy a total of 6 cases of pulmonary infection associated with HSV-1 in the lower respiratory tract were identified. Among those, 2 cases suggested a causative role of HSV-1 as the sole agent causing pneumonitis that proved clinically responsive to antiviral treatment. In the remaining 4 cases HSV-1 appeared as a bystander of bacterial infection. Maintenance therapy with leflunomide, which inhibits HSV-1 assembly in vitro, was associated with a milder course of pneumonitis in one patient. Detection of HSV-1 was associated with stronger immunosuppressive regimens and vasculitic disease. Conclusion The present study analyzed the frequency and hallmarks of cases of HSV-1 associated pneumonitis that occurred in a comparatively large cohort of patients with rheumatologic autoimmune diseases. In an area of controversy, this study

  10. Patients' preference for integrating homeopathy (PPIH) within the standard therapy settings in West Bengal, India: The part 1 (PPIH-1) study.

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Arya, Jogendra Singh; Choubey, Gurudev; Ghosh, Aloke; Das, Kaushik Deb; Ganguly, Subhasish; Dey, Samit; Saha, Sangita; Singh, Rakesh; Bhattacharyya, Kajal; Ghosh, Shubhamoy; Ali, Sk Swaif

    2016-07-01

    There is lack of studies assessing the preference of Indian patients for integration of homeopathy into standard therapy settings. The objectives of this study were to examine the knowledge, attitudes, and practice of homeopathy among Indian patients already availing homeopathy treatment and its integration into mainstream healthcare. A cross-sectional survey was conducted among adult patients attending the out-patients of the four government homeopathic hospitals in West Bengal, India. A self-administered 24-items questionnaire in local vernacular Bengali was developed and administered to the patients. A total of 1352 patients' responses were included in the current analysis. 40% patients thought that homeopathic medicines can be used along with standard therapy. 32.5% thought that homeopathic medicines might cause side effects, while only 13.3% believed that those might interact with other medications. Patients' knowledge ranged between 25.1 and 76.5% regarding regulations of practicing and safety of homeopathic medicine in India and abroad; while positive attitude towards the same ranged between 25.4 and 88.5%. 88.6% of the patients had favorable attitude toward integrated services. 68.2% of the patients used homeopathic medicines in any acute or chronic illness for themselves and 76.6% for their children. Preference for integrated services was significantly associated with better knowledge (P = 0.002), positive attitudes toward safety and regulations (P < 0.0001), and integration (P < 0.0001), but not with the level of practice (P = 0.515). A favorable attitude toward integrating homeopathy into conventional healthcare settings was obtained among the patients attending the homeopathic hospitals in West Bengal, India. PMID:27419087

  11. Treatment of subcutaneous abdominal wound healing impairment after surgery without fascial dehiscence by vacuum assisted closure™ (SAWHI-V.A.C.®-study) versus standard conventional wound therapy: study protocol for a randomized controlled trial

    OpenAIRE

    Seidel, Dörthe; Lefering, Rolf; Neugebauer, Edmund AM

    2013-01-01

    Background A decision of the Federal Joint Committee Germany in 2008 stated that negative pressure wound therapy is not accepted as a standard therapy for full reimbursement by the health insurance companies in Germany. This decision is based on the final report of the Institute for Quality and Efficiency in Health Care in 2006, which demonstrated through systematic reviews and meta-analysis of previous study projects, that an insufficient state of evidence regarding the use of negative press...

  12. Hypothesizing the body’s genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy

    Directory of Open Access Journals (Sweden)

    Sara Nora Ross

    2013-11-01

    Full Text Available We aim for this contribution to operate bi-directionally, both as a bedside to bench reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Some of the key hypotheses are: (1 Correctly-directed system efforts may reverse a system’s heretofore misdirected efforts, restoring healthier neurophysiology. (2 The enhanced information processing accompanying good posture is an essential initial condition. (3 Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4 Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5 Dynamics create necessary and evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems’ dynamics, which appear to trigger health-fostering self-reorganizing processes in the presence of catalytic initial

  13. Identification of early and distinct glioblastoma response patterns treated by boron neutron capture therapy not predicted by standard radiographic assessment using functional diffusion map

    International Nuclear Information System (INIS)

    Radiologic response of brain tumors is traditionally assessed according to the Macdonald criteria 10 weeks from the start of therapy. Because glioblastoma (GB) responds in days rather than weeks after boron neutron capture therapy (BNCT) that is a form of tumor-selective particle radiation, it is inconvenient to use the Macdonald criteria to assess the therapeutic efficacy of BNCT by gadolinium-magnetic resonance imaging (Gd-MRI). Our study assessed the utility of functional diffusion map (fDM) for evaluating response patterns in GB treated by BNCT. The fDM is an image assessment using time-dependent changes of apparent diffusion coefficient (ADC) in tumors on a voxel-by-voxel approach. Other than time-dependent changes of ADC, fDM can automatically assess minimum/maximum ADC, Response Evaluation Criteria In Solid Tumors (RECIST), and the volume of enhanced lesions on Gd-MRI over time. We assessed 17 GB patients treated by BNCT using fDM. Additionally, in order to verify our results, we performed a histopathological examination using F98 rat glioma models. Only the volume of tumor with decreased ADC by fDM at 2 days after BNCT was a good predictor for GB patients treated by BNCT (P value = 0.022 by log-rank test and 0.033 by wilcoxon test). In a histopathological examination, brain sections of F98 rat glioma models treated by BNCT showed cell swelling of both the nuclei and the cytoplasm compared with untreated rat glioma models. The fDM could identify response patterns in BNCT-treated GB earlier than a standard radiographic assessment. Early detection of treatment failure can allow a change or supplementation before tumor progression and might lead to an improvement of GB patients’ prognosis

  14. QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFUL TRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED LESCOL XL (FLUVASTATIN ADDED TO STANDARD THERAPY. RESULTS OF THE LESQOL OPEN-LABEL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2010-01-01

    Full Text Available Aim. The main aim of the present study was to evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who were prescribed fluvastatin extended release in addition to standard treatment.Material and methods. This was a national prospective multicenter observational study. Patients with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatin extended release (Lescol Forte, Novartis 80 mg QD were included in the present observation. The following efficacy and safety parameters were evaluated: quality of life evaluated with SF-36 scale before and during treatment; hypolipidemic efficacy, compliance to therapy; adverse events and serious adverse events. Observation period was 6 months in all patients and 12 months in some patients at the discretion of the investigator.Results. 524 patients (79% men and 21% women completed the 6 months observation period and 116 patients were followed up for 12 months. Significant increase of all measures of SF-36 scales, physical and mental health was observed in 6 and 12 months of fluvastatin extended release treatment. Total and low density lipoprotein cholesterol reduction was 30.5% and 54.9% respectively, p<0.01, in 6 months and 34.2% and 34.3% respectively in 12 months of treatment, p<0.01. High density lipoprotein cholesterol was significantly increased by 22.5% in 12 months of treatment, p<0.01. There were very few adverse events and laboratory changes during the course of treatment.Conclusion. LESQOL study showed significant increase in quality of life and good hypolipidemic efficacy as well as good tolerability of fluvastatin extended release in patients after coronary angioplasty.

  15. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

    International Nuclear Information System (INIS)

    Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

  16. Is standard breast-conserving therapy (BCT in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

    Directory of Open Access Journals (Sweden)

    Eilf Kirsten

    2010-11-01

    Full Text Available Abstract Background Breast conserving therapy (BCT is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed. Methods Toxicity was measured in 109 patients at initiation (t1, during radiotherapy (t2-t7, and 6 weeks after treatment completion (t8 using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5 based on CTC (Common Toxicity Criteria -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: 60 years. Results Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7, and dropped to 0.23 (t8. Univariate analyses revealed slightly higher toxicity in older (> 60 years versus young patients ( 60 years patients (p = 0.039. Toxicity differences in all other scales were not significant. Between older (> 60 years and midaged patients (50-60 years no significant differences in toxicity were found. This was also true for the comparison between young ( Conclusion The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women.

  17. Bowel sparing in pediatric cranio-spinal radiotherapy: a comparison of combined electron and photon and helical TomoTherapy techniques to a standard photon method

    Energy Technology Data Exchange (ETDEWEB)

    Harron, Elizabeth, E-mail: elizabeth.harron@nuh.nhs.uk [Regional Medical Physics Department, Freeman Hospital, Freeman Road, Newcastle upon Tyne (United Kingdom); Lewis, Joanne [Northern Centre for Cancer Care, Freeman Hospital, Freeman Road, Newcastle upon Tyne (United Kingdom)

    2012-07-01

    The aim of this study was to compare the dose to organs at risk (OARs) from different craniospinal radiotherapy treatment approaches available at the Northern Centre for Cancer Care (NCCC), with a particular emphasis on sparing the bowel. Method: Treatment plans were produced for a pediatric medulloblastoma patient with inflammatory bowel disease using 3D conformal 6-MV photons (3DCP), combined 3D 6-MV photons and 18-MeV electrons (3DPE), and helical photon TomoTherapy (HT). The 3DPE plan was a modification of the standard 3DCP technique, using electrons to treat the spine inferior to the level of the diaphragm. The plans were compared in terms of the dose-volume data to OARs and the nontumor integral dose. Results: The 3DPE plan was found to give the lowest dose to the bowel and the lowest nontumor integral dose of the 3 techniques. However, the coverage of the spine planning target volume (PTV) was least homogeneous using this technique, with only 74.6% of the PTV covered by 95% of the prescribed dose. HT was able to achieve the best coverage of the PTVs (99.0% of the whole-brain PTV and 93.1% of the spine PTV received 95% of the prescribed dose), but delivered a significantly higher integral dose. HT was able to spare the heart, thyroid, and eyes better than the linac-based techniques, but other OARs received a higher dose. Conclusions: Use of electrons was the best method for reducing the dose to the bowel and the integral dose, at the expense of compromised spine PTV coverage. For some patients, HT may be a viable method of improving dose homogeneity and reducing selected OAR doses.

  18. Is standard breast-conserving therapy (BCT) in elderly breast cancer patients justified? A prospective measurement of acute toxicity according CTC-classification

    International Nuclear Information System (INIS)

    Breast conserving therapy (BCT) is an accepted treatment for early-stage breast cancer. This study aimed to measure prospectively acute radiation-related toxicity and to create a comprehensive data base for long-term temporal analyses of 3D conformal adjuvant radiotherapy. The specific aspect of age has been neglected by traditional research. Therefore, the impact of age on acute BCT toxicity should be also specifically adressed. Toxicity was measured in 109 patients at initiation (t1), during radiotherapy (t2-t7), and 6 weeks after treatment completion (t8) using a new topographic module. Organ systems were recorded in 15 scales and scored according to symptom intensity (grade 0-5) based on CTC (Common Toxicity Criteria) -classification. Radiotherapy was virtually CT-based planned and applied with 6-MeV-photons. Mean total dose was 60.1 Gy. Patients were stratified by age in 3 Groups: <50, 50-60, and >60 years. Registered toxicity was generally low. Mean overall-grade climbed from 0.29-0.40 (t1-t7), and dropped to 0.23 (t8). Univariate analyses revealed slightly higher toxicity in older (> 60 years) versus young patients (< 50 years) in 2 scales only: breast-symmetry (p = 0.033), and arm function (p = 0.007). However, in the scale 'appetite' toxicity was higher in younger (< 50 years) versus older (> 60 years) patients (p = 0.039). Toxicity differences in all other scales were not significant. Between older (> 60 years) and midaged patients (50-60 years) no significant differences in toxicity were found. This was also true for the comparison between young (< 50 years) versus midaged patient groups (50-60 years). The treatment concept of BCT for breast cancer is generally well tolerated. The toxicity-measurement with the new topographic module is feasible. Not modified standard treatment for BC should be performed in elderly women

  19. Quality assurance standards drive improvements in the profile of radiation therapy departments participating in trials of the EORTC Radiation Oncology Group

    International Nuclear Information System (INIS)

    Background and purpose: The Facility Questionnaire (FQ) of the European Organisation for Research and Treatment of Cancer Radiation Oncology Group (EORTC-ROG) evaluates the human, technical and organizational resources at each EORTC member institution. The purpose of this study is to use the FQ database to assess the improvement of radiation therapy (RT) structures and resources within the EORTC compared to the previous surveys performed by our group. Material and methods: We report the content of the current FQ database, completed online by 156 EORTC candidate member institutions from 22 countries between February 2011 and February 2013. Results are compared to FQ-published data from 1992 and 2007. Results: The average number of patients per year per EORTC institution is 2381 (range 350–12,000) an 18.2% increase compared to the 2007 figures. From 2007 to 2013 the average number of radiation oncologists, physicists and radiation technologists per EORTC institution has increased by 27% (from 8.5 to 10.8), 41% (from 5.2 to 7.4) and 38% (from 26.1 to 36.1) respectively. Consequently the number of patients per year per radiation oncologist has decreased from 258 to 243, for physicists from 426 to 354 and for radiation technologists from 107 to 86. One hundred and forty-six (94%) and 101 (65%) institutions can now deliver IMRT and SBRT, compared to 77 (79%) and 53 (54%) in 2007. Conclusions: The standards set by the EORTC-ROG are met by a continually improving number of institutions, helping to safeguard use of advanced technologies in EORTC-ROG clinical trials

  20. Bowel sparing in pediatric cranio-spinal radiotherapy: a comparison of combined electron and photon and helical TomoTherapy techniques to a standard photon method

    International Nuclear Information System (INIS)

    The aim of this study was to compare the dose to organs at risk (OARs) from different craniospinal radiotherapy treatment approaches available at the Northern Centre for Cancer Care (NCCC), with a particular emphasis on sparing the bowel. Method: Treatment plans were produced for a pediatric medulloblastoma patient with inflammatory bowel disease using 3D conformal 6-MV photons (3DCP), combined 3D 6-MV photons and 18-MeV electrons (3DPE), and helical photon TomoTherapy (HT). The 3DPE plan was a modification of the standard 3DCP technique, using electrons to treat the spine inferior to the level of the diaphragm. The plans were compared in terms of the dose-volume data to OARs and the nontumor integral dose. Results: The 3DPE plan was found to give the lowest dose to the bowel and the lowest nontumor integral dose of the 3 techniques. However, the coverage of the spine planning target volume (PTV) was least homogeneous using this technique, with only 74.6% of the PTV covered by 95% of the prescribed dose. HT was able to achieve the best coverage of the PTVs (99.0% of the whole-brain PTV and 93.1% of the spine PTV received 95% of the prescribed dose), but delivered a significantly higher integral dose. HT was able to spare the heart, thyroid, and eyes better than the linac-based techniques, but other OARs received a higher dose. Conclusions: Use of electrons was the best method for reducing the dose to the bowel and the integral dose, at the expense of compromised spine PTV coverage. For some patients, HT may be a viable method of improving dose homogeneity and reducing selected OAR doses.

  1. Imatinib in combination with hydroxyurea versus hydroxyurea alone as oral therapy in patients with progressive pretreated glioblastoma resistant to standard dose temozolomide

    DEFF Research Database (Denmark)

    Dresemann, G.; Weller, M.; Ostenfeld-Rosenthal, Ann Maria;

    2010-01-01

    A randomized, multicenter, open-label, phase 3 study of patients with progressive, recurrent glioblastoma multiforme (GBM) for whom front-line therapy had failed was conducted. This study was designed to determine whether combination therapy with imatinib and hydroxyurea (HU) has superior antitum...

  2. 灌注负压与标准负压创面治疗的疗效比较%The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy

    Institute of Scientific and Technical Information of China (English)

    范伟锋; 区健毅; 陈衍尧; 李锦塘; 朱秋贤; 叶家键

    2015-01-01

    Objective: To evaluate the impact of negative-pressure wound therapy with instillation (NPWTi) compared with standard NPWT. Methods: A total of 142 patients with wound infection were enrolled between 2010 and 2014. Patients were divided into three groups: NPWT group, NPWTi with 6 min dwell time and 20 min dwell time group. The clinical differences among three groups were compared. Results: One hundred forty-two patients (NPWT, n=74; NPWTi, 6-minute dwell time, n=34; and NPWTi, 20-minute dwell time, n=34) were included in the analysis. Number of operative visits was significantly lower for the 6- minute and 20-minute dwell time groups [(2.4 ± 0.9) and (2.6 ± 0.9), respectively] compared with the no-instillation group (P≤0.05). Hospital stay was significantly shorter for the 20-minute dwell time group (11.4 ± 5.1) days compared with the no-instillation group (14.92 ± 9.23) days (P≤0.05). Time to final surgical procedure was significantly shorter for the 6- minute and 20-minute dwell time groups (7.8 ± 5.2 and 7.5 ± 3.1 days, respectively) compared with the no-instillation group (9.23 ± 5.2) days (P<0.05). Percentage of wounds closed before discharge and culture improvement for gram-positive bacteria was significantly higher for the 6-minute dwell time group compared with the no-instillation group (94% vs. 62%, and 90% vs. 63%, P<0.05, respectively). Conclusion: Negative-pressure wound therapy with instillation (6-minute or 20-minute dwell time) is more beneficial than standard negative-pressure wound therapy for the adjunctive treatment of acutely and chronically infected wounds that require hospital admission.%目的:探讨灌注式负压创面治疗与标准负压创面治疗的疗效比较情况。方法:回顾性分析2010年2月-2014年7月因伤口感染就诊于我院的142例患者。详细记录患者的病史及基线等资料,将患者分为灌注式负压治疗组和标准负压治疗组,其中灌注式负压分为6min 和20min 两组

  3. Intravenous Tigecycline Facilitates Cure of Severe Clostridium difficile Infection (CDI) After Failure of Standard Therapy: A Case Report and Literature Review of Tigecycline Use in CDI

    Science.gov (United States)

    Navalkele, Bhagyashri D.; Lerner, Stephen A.

    2016-01-01

    Standard treatment for severe Clostridium difficile infection (CDI) is oral vancomycin with metronidazole. After failure of this standard regimen, treatment becomes challenging. A young woman treated for septic shock developed CDI. Standard treatment failed and she was ineligible for fecal transplant. Addition of tigecycline to her regimen resulted in cure. PMID:27419166

  4. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Niewald, Marcus, E-mail: marcus.niewald@uks.eu [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany); Seegenschmiedt, M. Heinrich [Radiotherapy Center, Hamburg (Germany); Micke, Oliver [Franziskus Hospital, Bielefeld (Germany); Graeber, Stefan [Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar (Germany); Muecke, Ralf [Lippe Hospital, Lemgo (Germany); Schaefer, Vera; Scheid, Christine; Fleckenstein, Jochen; Licht, Norbert; Ruebe, Christian [Department of Radiation Oncology, Saarland University Medical Center, Homburg/Saar (Germany)

    2012-11-15

    Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey. The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.

  5. 10 Años innovando en el tratamiento de la infección tuberculosa latente: comparación entre pautas estándar y pautas cortas en tratamiento directamente observado 10 years of innovation in the treatment of latent tuberculosis infection: a comparison between standard and short course therapies in directly observed therapy

    Directory of Open Access Journals (Sweden)

    G. López

    2011-06-01

    cortas 96 (23,41% pacientes, por los siguientes motivos (36 por abandono voluntario, 54 por reacciones adversas, 1 por libertad o traslado, 3 por causa desconocida, 1 por brote psicótico en enfermo psiquiátrico y 1 por hepatitis aguda no filiada. Se aprecian diferencias significativas en las tasas de finalización del TIT al comparar la pauta estándar 9H y las pautas cortas. Se observa una mayor probabilidad de finalización, estadísticamente significativa, con las pautas cortas: p: 0,006; Odds Ratio: 1.56 (LC95%: 1.14-2.12. Este diferencia en la finalización se debe a que la pauta 9H presenta un mayor número de abandonos voluntarios sin motivo aparente (p: 0.002; OR: 2.03 [1.30-3.15] y un mayor número de abandonos por conducción a otro centro o libertad (pObjectives: The main aim of the study is to compare the acceptance, adherence, tolerance and safety of short course therapies in comparison to a standard 9 month treatment for latent tuberculosis infection (LTBI in directly observed therapy (DOT and contrast this with previous results from a standard therapy in patient self-administered treatment. Materials and methods: Retrospective longitudinal study carried out at a medium sized prison. Period of inclusion covers 10 years, from January 2000 to December 2009. The Centers for Disease Control and Prevention (CDC inclusion and exclusion criteria were used, as well as the ones included in the Program for Tuberculosis Prevention and Control in the Prison Environment. 4 LTBI therapies according to the preference of the patient and possible interactions with other treatments were utilised. Therapy I consisted of isoniazid (H in doses of 300 mg/day for 9 months (9H, therapy II with rifampicin for 2 months, twice a week, (2R2Z2 therapy III with rifampicin and isoniazid for 3 months (3RH and therapy IV with rifampicin for four months (4R. Treatment was administered under strict DOT conditions by nursing staff. Results: 902 patients were included, of which 810 accepted

  6. A pilot study exploring quality of life experienced by patients undergoing negative-pressure wound therapy as part of their wound care treatment compared to patients receiving standard wound care.

    Science.gov (United States)

    Ousey, Karen J; Milne, Jeanette; Cook, Leanne; Stephenson, John; Gillibrand, Warren

    2014-08-01

    The use of negative pressure wound therapy (NPWT) has been widely documented as a technique to help heal complex wounds. This article presents the findings of a preliminary study which aimed to explore quality of life (QoL) experienced by patients undergoing NPWT as part of their wound care treatment in comparison to that of patients with a wound using traditional (standard) wound care therapies. A quasi-experimental study was undertaken, with patients treated in wound care/vascular clinics with chronic/acute wounds. QoL impact was measured using the Cardiff Wound Impact Schedule and administered post-consent at timed intervals. Our results identified that there were no real differences in QoL scores recorded by patients over the 12-week period. Although there was no overall interaction between the therapies used for wound healing, NPWT did have an effect on social life: during the first 2 weeks of the application of therapy, patients in the NPWT group reported an increase in the social life domain. The authors conclude that true QoL can only be elicited if an accurate baseline is established or if data is collected over a long enough period to allow comparison of scores over time.

  7. Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy.

    NARCIS (Netherlands)

    Bekkering, G.E.; Tulder, M.W. van; Hendriks, E.J.M.; Koopmanschap, M.A.; Knol, D.L.; Bouter, L.M.; Oostendorp, R.A.B.

    2005-01-01

    BACKGROUND AND PURPOSE: An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. SUBJE

  8. Imatinib in combination with hydroxyurea versus hydroxyurea alone as oral therapy in patients with progressive pretreated glioblastoma resistant to standard dose temozolomide.

    Science.gov (United States)

    Dresemann, Gregor; Weller, Michael; Rosenthal, Mark A; Wedding, Ulrich; Wagner, Wolfgang; Engel, Erik; Heinrich, Bernhard; Mayer-Steinacker, Regine; Karup-Hansen, Anders; Fluge, Oystein; Nowak, Anna; Mehdorn, Maximilian; Schleyer, Eberhard; Krex, Dietmar; Olver, Ian N; Steinbach, Joachim P; Hosius, Christian; Sieder, Christian; Sorenson, Greg; Parker, Richard; Nikolova, Zariana

    2010-02-01

    A randomized, multicenter, open-label, phase 3 study of patients with progressive, recurrent glioblastoma multiforme (GBM) for whom front-line therapy had failed was conducted. This study was designed to determine whether combination therapy with imatinib and hydroxyurea (HU) has superior antitumor activity compared with HU monotherapy in the treatment of recurrent GBM. The target population consisted of patients with confirmed recurrent GBM and an Eastern Cooperative Oncology Group performance status of 0-2 who had completed previous treatment comprising surgical resection, irradiation therapy, and first-line chemotherapy (preferably temozolomide (TMZ) containing regimen) and who have progressed despite treatment. If first-line chemotherapy did not contain TMZ, a second completed chemotherapy was acceptable. The primary efficacy parameter was progression-free survival (PFS). The primary comparison of combination therapy versus monotherapy for PFS was not significant (adjusted P = 0.56). The hazard ratio (HR) (adjusted HR = 0.93) was not clinically relevant. The median PFS for the combination arm was low at 6 weeks and similar to the median PFS in the monotherapy arm (6 weeks). The 6-month PFS for the two treatment groups was very similar (5% in the combination arm vs. 7% in the monotherapy arm). No clinically meaningful differences were found between the two treatment arms, and the primary study end point was not met. Among the patients receiving imatinib, no adverse events were reported that were either previously unknown or unexpected as a consequence of the disease.

  9. A randomized controlled trial of single-class maintenance therapy with abacavir/lamivudine/zidovudine after standard triple antiretroviral induction therapy : final 96-week results from the FREE study

    NARCIS (Netherlands)

    Sprenger, H. G.; Langebeek, N.; Mulder, P. G. H.; ten Napel, C. H. H.; Vriesendorp, R.; Hoepelman, A. I. M.; Legrand, J. C.; Koopmans, P. P.; Bravenboer, B.; ten Kate, R. W.; Groeneveld, P. H. P.; Bierman, W. F. W.; van der Werf, T. S.; Gisolf, E. H.; Richter, C.

    2015-01-01

    ObjectivesThe aim of the study was to test the antiviral efficacy of a triple nucleoside reverse transcriptase inhibitor (NRTI) regimen, with potential beneficial metabolic effects, as maintenance therapy after induction with dual NRTIs and a boosted protease inhibitor (PI). MethodsAn open-label, no

  10. Intensity modulated radiation therapy for head and neck cancer: The standard; Radiotherapie avec modulation d'intensite pour les cancers de la tete et du cou: le standard

    Energy Technology Data Exchange (ETDEWEB)

    Maingon, P.; Crehange, G.; Chamois, J.; Khoury, C.; Truc, G. [Departement de radiotherapie, centre Georges-Francois-Leclerc, 1, rue du Pr-Marion, 21079 Dijon cedex (France)

    2011-10-15

    Combined radical radiation therapy for head and neck carcinoma should be planned with intensity modulated beams to provide a rapid answer to patients' requirements in terms of quality of treatment. The most frequent late toxicity of radiation therapy is xerostomia, which may be prevented by using this technique able to significantly spare salivary glands irradiation. Selection of indications is a very important step. The objective of sparing salivary functions, strongly associated with optimization criteria of quality of life should be considered as a main objective in irradiation of head and neck tumours. The various possibilities offered by this technique allowing to boost a target volume included in prophylactically irradiated regions could offer the possibility to escalate the dose in selected patients. The feasibility of this process is currently validated in prospective studies. Finally, routine implementation of intensity modulated radiation therapy should be performed with strong and robust quality assurance procedures, ensuring that the expected benefit could be increased with the current developments by using rotational techniques. (authors)

  11. Compliance with technical standards for radiological protection at radiation therapy services in Sao Paulo State, Brazil; Analise de conformidades as normas tecnicas de protecao radiologica dos servicos de radioterapia no Estado de Sao Paulo, Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Eduardo, Maria Bernadete de Paula [Secretaria de Estado da Saude de Sao Paulo, SP (Brazil). Centro de Vigilancia Epidemiologica; Novaes, Hillegonda Maria Dutilh [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina]. E-mail: mbpeduardo@uol.com.br

    2004-07-01

    Radiation therapy services provide essential therapeutic procedures for cancer, one of the main causes of population morbidity and mortality. Despite their importance in the health system and their potential risks due to the use of ionizing radiation, there are few studies on such services. We evaluated compliance with technical standards for radiological protection in radiation therapy services in Sao Paulo State, Brazil. Forty-nine services were studied in 2000 through interviews with technical staff. Typologies of performance profiles focusing on structure and process variables were constructed and services compared. Important differences were observed in the services' positions in the health care system, level of complexity, and geographic distribution, with better average performance in structural conditions but very inadequate performance in patient protection, indicating the need for more effective health surveillance. (author)

  12. [18F]FDG-PET Standard Uptake Value as a Metabolic Predictor of Bone Marrow Response to Radiation: Impact on Acute and Late Hematological Toxicity in Cervical Cancer Patients Treated With Chemoradiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To quantify the relationship between bone marrow (BM) response to radiation and radiation dose by using 18F-labeled fluorodeoxyglucose positron emission tomography [18F]FDG-PET standard uptake values (SUV) and to correlate these findings with hematological toxicity (HT) in cervical cancer (CC) patients treated with chemoradiation therapy (CRT). Methods and Materials: Seventeen women with a diagnosis of CC were treated with standard doses of CRT. All patients underwent pre- and post-therapy [18F]FDG-PET/computed tomography (CT). Hemograms were obtained before and during treatment and 3 months after treatment and at last follow-up. Pelvic bone was autosegmented as total bone marrow (BMTOT). Active bone marrow (BMACT) was contoured based on SUV greater than the mean SUV of BMTOT. The volumes (V) of each region receiving 10, 20, 30, and 40 Gy (V10, V20, V30, and V40, respectively) were calculated. Metabolic volume histograms and voxel SUV map response graphs were created. Relative changes in SUV before and after therapy were calculated by separating SUV voxels into radiation therapy dose ranges of 5 Gy. The relationships among SUV decrease, radiation dose, and HT were investigated using multiple regression models. Results: Mean relative pre-post-therapy SUV reductions in BMTOT and BMACT were 27% and 38%, respectively. BMACT volume was significantly reduced after treatment (from 651.5 to 231.6 cm3, respectively; P<.0001). BMACT V30 was significantly correlated with a reduction in BMACT SUV (R2, 0.14; P<.001). The reduction in BMACT SUV significantly correlated with reduction in white blood cells (WBCs) at 3 months post-treatment (R2, 0.27; P=.04) and at last follow-up (R2, 0.25; P=.04). Different dosimetric parameters of BMTOT and BMACT correlated with long-term hematological outcome. Conclusions: The volumes of BMTOT and BMACT that are exposed to even relatively low doses of radiation are associated with a decrease in WBC counts following CRT. The loss in

  13. [{sup 18}F]FDG-PET Standard Uptake Value as a Metabolic Predictor of Bone Marrow Response to Radiation: Impact on Acute and Late Hematological Toxicity in Cervical Cancer Patients Treated With Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Elicin, Olgun [Department of Radiation Oncology, Lausanne University Hospital, Lausanne (Switzerland); Callaway, Sharon [Velocity Medical Solutions, Atlanta, Georgia (United States); Prior, John O. [Department of Nuclear Medicine, Lausanne University Hospital, Lausanne (Switzerland); Bourhis, Jean [Department of Radiation Oncology, Lausanne University Hospital, Lausanne (Switzerland); Ozsahin, Mahmut, E-mail: mahmut.ozsahin@chuv.ch [Department of Radiation Oncology, Lausanne University Hospital, Lausanne (Switzerland); Herrera, Fernanda G., E-mail: fernanda.herrera@chuv.ch [Department of Radiation Oncology, Lausanne University Hospital, Lausanne (Switzerland)

    2014-12-01

    Purpose: To quantify the relationship between bone marrow (BM) response to radiation and radiation dose by using {sup 18}F-labeled fluorodeoxyglucose positron emission tomography [{sup 18}F]FDG-PET standard uptake values (SUV) and to correlate these findings with hematological toxicity (HT) in cervical cancer (CC) patients treated with chemoradiation therapy (CRT). Methods and Materials: Seventeen women with a diagnosis of CC were treated with standard doses of CRT. All patients underwent pre- and post-therapy [{sup 18}F]FDG-PET/computed tomography (CT). Hemograms were obtained before and during treatment and 3 months after treatment and at last follow-up. Pelvic bone was autosegmented as total bone marrow (BM{sub TOT}). Active bone marrow (BM{sub ACT}) was contoured based on SUV greater than the mean SUV of BM{sub TOT}. The volumes (V) of each region receiving 10, 20, 30, and 40 Gy (V{sub 10}, V{sub 20}, V{sub 30}, and V{sub 40}, respectively) were calculated. Metabolic volume histograms and voxel SUV map response graphs were created. Relative changes in SUV before and after therapy were calculated by separating SUV voxels into radiation therapy dose ranges of 5 Gy. The relationships among SUV decrease, radiation dose, and HT were investigated using multiple regression models. Results: Mean relative pre-post-therapy SUV reductions in BM{sub TOT} and BM{sub ACT} were 27% and 38%, respectively. BM{sub ACT} volume was significantly reduced after treatment (from 651.5 to 231.6 cm{sup 3}, respectively; P<.0001). BM{sub ACT} V{sub 30} was significantly correlated with a reduction in BM{sub ACT} SUV (R{sup 2}, 0.14; P<.001). The reduction in BM{sub ACT} SUV significantly correlated with reduction in white blood cells (WBCs) at 3 months post-treatment (R{sup 2}, 0.27; P=.04) and at last follow-up (R{sup 2}, 0.25; P=.04). Different dosimetric parameters of BM{sub TOT} and BM{sub ACT} correlated with long-term hematological outcome. Conclusions: The volumes of BM

  14. 项目管理在推进静脉治疗新规范中的应用效果%Application effects of project management in boosting the new standard of intravenous therapy

    Institute of Scientific and Technical Information of China (English)

    秦月兰; 周金艳; 刘艳辉; 邹颢宇; 屈梅香

    2016-01-01

    Objective To investigate application effects of project management in boosting the operation standard of intravenous therapy nursing technique. Methods The team of project management was established. After the ward rounding in the whole hospital, ten key points were listed for improvement. The idea of project management was applied in intravenous therapy, and then the second ward rounding in the whole hospital was carried out. Finally, the results of the second ward rounding were analyzed, summarized and compared to the results before the appliance of project management. Results After the appliance of project management, for the nurses, they all increased compared with before the implementation of project management in the awareness rate of core contents, the accuracy of check methods, the coincidence rate of selecting therapy equipment, the rate of reaching the standard of disinfection, the compliance rate of the sanitation of hands, the implement rate of the observation of intravenous therapy, the qualified rate of changing blood transfusion apparatus and additional device, the accuracy of maintaining the central vena catheterization and the qualified rate of the usage of remaining needles, except the incidence rate of adverse events of intravenous therapy ( decreased compared to the rate before the appliance of project management) (P <0. 05). Conclusions The appliance of project management philosophy in the operation standard of intravenous therapy nursing technique improves the quality and safety of intravenous therapy in the whole hospital. Its appliance has vitality in the fields of hospitals and nursing.%目的 探讨项目管理在推进执行静脉治疗护理技术操作规范中的应用效果.方法 成立项目管理团队,进行全院查房,列出亟待改进的十大关键点,将项目管理理念运用于静脉治疗后,再次进行全院查房,将结果 与实施前进行比较分析、总结.结果 项目管理实施后护士核心

  15. A review of continuous vs intermittent androgen deprivation therapy: Redefining the gold standard in the treatment of advanced prostate cancer. Myths, facts and new data on a perpetual dispute

    Directory of Open Access Journals (Sweden)

    Zisis Kratiras

    2014-01-01

    Full Text Available Objectives: To review the literature and present new data of continuous androgen deprivation therapy (ADT vs intermittent androgen deprivation (IAD as therapies for prostate cancer in terms of survival and quality of life and clarify practical issues in the use of IAD. Materials and Methods: We conducted a systematic search on Medline and Embase databases using “prostatic neoplasm” and “intermittent androgen deprivation” as search terms. We reviewed meta-analyses, randomised controlled trials, reviews, clinical trials and practise guidelines written in English from 2000 and onwards until 01/04/2013. Ten randomized controlled trials were identified. Seven of them published extensive data and results randomizing 4675 patients to IAD versus CAD. Data from the other three randomized trials were limited. Results: Over the last years studies confirmed that IAD is an effective alternative approach to hormonal deprivation providing simultaneously several potential benefits in terms of quality of life and cost effectiveness. Thus, in patients with non metastatic, advanced prostate cancer IAD could be used as standard treatment, while in metastatic prostate cancer IAD role still remains ambiguous. Conclusions: Nowadays, revaluation of the gold standard of ADT in advanced prostate cancer appears essential. Recent data established that IAD should no longer be considered as investigational, since its effectiveness has been proven, especially in patients suffering from non-metastatic advanced prostate cancer.

  16. Symptom-triggered benzodiazepine therapy for alcohol withdrawal syndrome in the emergency department: a comparison with the standard fixed dose benzodiazepine regimen.

    LENUS (Irish Health Repository)

    Cassidy, Eugene M

    2012-10-01

    The aim of the study was to compare symptom-triggered and standard benzodiazepine regimens for the treatment of alcohol withdrawal syndrome in an emergency department clinical decision unit. The authors found that the symptom-triggered approach reduced cumulative benzodiazepine dose and length of stay.

  17. Examination standards and radiological evaluation of targeted therapy for gastrointestinal stromal tumors%胃肠道间质瘤靶向治疗的影像学评价与检查规范

    Institute of Scientific and Technical Information of China (English)

    张晓鹏

    2013-01-01

    Conventional morphological evaluation criteria cannot objectively reflect the histopathological changes of gastrointestinal stromal tumor (GIST) to targeted therapy,and therefore it is unable to adapt to the requirements of the development of personalized medicine.The emerging of Choi and subsequent joint criteria of computed tomography diagnosis provides new methods for the evaluation of the histopathological changes of GIST to targeted therapy.Positron emission tomography (PET)-standardized uptake value (SUV) and apparent diffusion coefficient (ADC) on diffusion-weighted magnetic resonance imaging (MRI) can reflect the histopathological changes of GIST to targeted therapy in the early stage through functional imaging,and provide new potential biomarkers for evaluating the efficacy.Standardized radiological examination and evaluation process are conducive to launch the personalized treatment of GIST.%传统形态学标准难以准确反映胃肠道间质瘤(GIST)靶向治疗后的病理组织学改变,已无法满足个体化诊断治疗时代对影像学评价手段的需求.Choi标准及后续多个CT检查联合标准的出现,为客观反映GIST靶向治疗后的组织学改变提供了新的标准.PET-标准摄取值和MRI扩散加权成像表观扩散系数值的变化,可从功能成像角度反映GIST靶向治疗后的早期组织学改变,为其疗效评价提供新的有潜力指标.制订并遵循规范的影像学检查及评价流程,有利于GIST个体化诊断治疗的开展.

  18. FRAGMATIC: A randomised phase III clinical trial investigating the effect of fragmin® added to standard therapy in patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Macbeth Fergus R

    2009-10-01

    Full Text Available Abstract Background Venous thromboembolism (VTE occurs when blood clots in the leg, pelvic or other deep vein (deep vein thrombosis with or without transport of the thrombus into the pulmonary arterial circulation (pulmonary embolus. VTE is common in patients with cancer and is increased by surgery, chemotherapy, radiotherapy and disease progression. Low molecular weight heparin (LMWH is routinely used to treat VTE and some evidence suggests that LMWH may also have an anticancer effect, by reduction in the incidence of metastases. The FRAGMATIC trial will assess the effect of adding dalteparin (FRAGMIN, a type of LMWH, to standard treatment for patients with lung cancer. Methods/Design The study design is a randomised multicentre phase III trial comparing standard treatment and standard treatment plus daily LMWH for 24 weeks in patients with lung cancer. Patients eligible for this study must have histopathological or cytological diagnosis of primary bronchial carcinoma (small cell or non-small cell within 6 weeks of randomisation, be 18 or older, and must be willing and able to self-administer 5000 IU dalteparin by daily subcutaneous injection or have it administered to themselves or by a carer for 24 weeks. A total of 2200 patients will be recruited from all over the UK over a 3 year period and followed up for a minimum of 1 year after randomisation. Patients will be randomised to one of the two treatment groups in a 1:1 ratio, standard treatment or standard treatment plus dalteparin. The primary outcome measure of the trial is overall survival. The secondary outcome measures include venous thrombotic event (VTE free survival, serious adverse events (SAEs, metastasis-free survival, toxicity, quality of life (QoL, levels of breathlessness, anxiety and depression, cost effectiveness and cost utility. Trial registration Current Controlled Trials ISRCTN80812769

  19. Development of Legislation and Standardization of Acupuncture Therapy in the United States of America%美国针灸立法及标准化研究现状

    Institute of Scientific and Technical Information of China (English)

    王守东; 侯酉娟; 孟凡红; 陈淑娟; 王焱垚; 姜帆; 丁铭

    2012-01-01

    In the present article, the authors summarized the state of acupuncture therapy in the United States of America from 1) history and current state. 2) legislation and its contents, management system and introduction of health insurance system, and 3) standardization. Acupuncture therapy, as a complementary or alternative therapy, has been widely supported and approved by majority of states in the USA. The authors hold that due to differences between the oriental and western cultures and difficulties of Chinese medicine in quantitative and qualitative studies, the legislation on acupuncture therapy for approval of the A-merican Parliament needs paying more efforts.%本文简要回顾针灸在美国的传入历史和发展现状,重点介绍美国联邦政府和各州政府针灸立法概况、主要内容、立法特点和管理体制,了解和掌握美国针灸立法及针具规范化及操作安全性规范及执业规范等相关针灸标准化现状,研究并分析针灸在美国获得民众及官方认可的深层次原因,以及当前仍需解决的重要问题,并提出针对性意见和建议,以期为推动针灸在美国及全球的发展,并为中医的国际化战略提供有益借鉴,同时为本国学者及管理者进行针灸立法及标准化的建立提供参考.

  20. Proton Therapy

    Science.gov (United States)

    Oelfke, Uwe

    Proton therapy is one of the most rapidly developing new treatment technologies in radiation oncology. This treatment approach has — after roughly 40 years of technical developments — reached a mature state that allows a widespread clinical application. We therefore review the basic physical and radio-biological properties of proton beams. The main physical aspect is the elemental dose distribution arising from an infinitely narrow proton pencil beam. This includes the physics of proton stopping powers and the concept of CSDA range. Furthermore, the process of multiple Coulomb scattering is discussed for the lateral dose distribution. Next, the basic terms for the description of radio-biological properties of proton beams like LET and RBE are briefly introduced. Finally, the main concepts of modern proton dose delivery concepts are introduced before the standard method of inverse treatment planning for hadron therapy is presented.

  1. Study of Standardized Anticoagulant Therapy in Elderly Patient with Atrial Fibrillation%CHADS2评分法规范老年非瓣膜性房颤治疗研究

    Institute of Scientific and Technical Information of China (English)

    孙荣艳; 范正俊; 冯云萍; 浩一竹

    2015-01-01

    Objective:To understand current the state of standardized anticoagulant therapy.In elderly patient with atrial fibrillation and analyze the factors that affect standard anticoagulant therapy,and at the same time,to make progress by the foundation of corresponding countermeasures.Method:Diagnosed nonvalvular atrial fibrillation elderly patients were history inspected for a period of 12 months(from January 2013 to December 2013)in 1st Hospital Cardiovascular Department,CHADS2 scheme method was used to stratify atrial fibrillation elderly patient and assess their risk of bleeding,the standardized anticoagulant therapy conditions were evaluated according to atrial fibrillation treatment guidelines.Result:A total of 161 patients were enrolled.According to the CHADS2 scheme,106 patients were divided into the high risk group,in which only 21 were on warfarin anticoagulant treatment.Among which 11(42.3%) had international normalized ratio(INR)in therapeutic range(2.0-3.0).Conclusion:The percentage of standard anticoagulant treatment in elderly patients with atrial fibrillation is very low(38.4%),still more,the percentage of high risk patients using warfarin standard anticoagulant treatment is even low 19.8%.Further investigation and understanding of the causes of this phenomenon will help intervene effectively and improve the standard of anticoagulant therapy in patient with atrial fibrillation.%目的:了解老年非瓣膜性心房颤动患者规范化抗凝治疗现状,分析影响规范化抗凝治疗的因素。方法:调取2013年1-12月份曲靖市第一人民医院住院诊断为非瓣膜性心房颤动的老年患者病历,采用CHADS2评分法评价其规范化抗凝情况。结果:共入选患者161例。按照CHADS2评分法将入组患者分组,其中评分≥1患者151例中,进行规范华法林抗凝治疗的仅26例,抗凝结果11例INR在目标范围内,达到华法林抗凝目标INR值的为42.3%。结论:老年非瓣膜性心房颤

  2. Comparison between spousal donor transplantation treated with anti-thymocyte globulin induction therapy and, living related donor transplantation treated with standard immunosuppression

    Directory of Open Access Journals (Sweden)

    Erkan Demir

    2014-01-01

    Full Text Available The worldwide shortage of organs available for transplantation has led to the use of living-unrelated kidney donors. In this context, spouses represent an important source of organ donors. We compared the allograft outcomes of spousal donor transplantation (SDT with anti-thymocyte globulin (ATG induction therapy and living related donor transplantation (LRDT with triple immonosuppression and basiliximab, in addition. Among the 335 living and deceased donor kidney transplantations performed between April 2001 and June 2010, there were 274 living donor kidney transplantations including 34 SDT and 240 LRDT. The minimum follow-up period was 36 months. All recipients of SDT received ATG (1.5 mg/kg induction therapy, which was stopped five to seven days after surgery. Maintenance immunosuppression included tacrolimus (TAC, mycophenolate mofetil (MMF and prednisolone. LRDT recipients received triple immunosuppressive protocol consisting of cyclosporine or TAC, MMF and prednisolone, in addition to basiliximab. There was a significant difference between the two groups in recipient age, while pre-operative duration on dialysis, recipient sex and donor age and sex were not significantly different. There was also a significant difference between the two groups in the number of human leukocyte antigen (HLA mismatches. The 1-, 3- and 5-year graft survival rates of SDT were 94.1%, 88.2% and 79.4%, respectively, and the frequency of acute rejection episodes was 5.8% (two cases. The 1-, 3- and 5-year graft survival rates of LRDT were 95.8%, 91.6% and 83.3%, respectively, with the frequency of acute rejection being 16.2%. The graft survival rates of SDT were as good as LRDT, while the acute rejection rates in SDT were lower than in LRDT, although the difference was not statistically different (P = 0.13.

  3. Comparison between spousal donor transplantation treated with anti-thymocyte globulin induction therapy and, living related donor transplantation treated with standard immunosuppression.

    Science.gov (United States)

    Demir, Erkan; Paydas, Saime; Erken, Ugur

    2014-05-01

    The worldwide shortage of organs available for transplantation has led to the use of living-unrelated kidney donors. In this context, spouses represent an important source of organ donors. We compared the allograft outcomes of spousal donor transplantation (SDT) with anti-thymocyte globulin (ATG) induction therapy and living related donor transplantation (LRDT) with triple immonosuppression and basiliximab, in addition. Among the 335 living and deceased donor kidney transplantations performed between April 2001 and June 2010, there were 274 living donor kidney transplantations including 34 SDT and 240 LRDT. The minimum follow-up period was 36 months. All recipients of SDT received ATG (1.5 mg/kg) induction therapy, which was stopped five to seven days after surgery. Maintenance immunosuppression included tacrolimus (TAC), mycophenolate mofetil (MMF) and prednisolone. LRDT recipients received triple immunosuppressive protocol consisting of cyclosporine or TAC, MMF and prednisolone, in addition to basiliximab. There was a significant difference between the two groups in recipient age, while pre-operative duration on dialysis, recipient sex and donor age and sex were not significantly different. There was also a significant difference between the two groups in the number of human leukocyte antigen (HLA) mismatches. The 1-, 3- and 5-year graft survival rates of SDT were 94.1%, 88.2% and 79.4%, respectively, and the frequency of acute rejection episodes was 5.8% (two cases). The 1-, 3- and 5-year graft survival rates of LRDT were 95.8%, 91.6% and 83.3%, respectively, with the frequency of acute rejection being 16.2%. The graft survival rates of SDT were as good as LRDT, while the acute rejection rates in SDT were lower than in LRDT, although the difference was not statistically different (P = 0.13).

  4. Anecdotal therapies.

    Science.gov (United States)

    Millikan, L E

    1999-01-01

    Traditionally, many advances in medicine have been serendipitous. Are serendipitous and anecdotal synonymous? Many of our materia medica today relate to initial probes and anecdotal reports that matured to full investigation and therapeutic indications. The recent situation regarding Skin Cap is one that highlights the downside of this scenario. Several drugs in the US continue usage largely related to anecdotal indications, and anecdotal extension of legend indications is a standard for American Dermatology. The situation with systemic drugs, such as Trental, zinc preparations, imidazoles for extended indications, lysine and melatonin, all will be discussed. Topical preparations such as skin cap, cantharone, Vioform, all also are included in this category. It is important to place this topic in perspective in regards to geographic variation and therapeutic need. Many diseases lacking specific therapy are important targets for anecdotal therapy, and this will foster continued approaches in this area. The growing standardization of medicine and pharmaceutical regulation, threatens the anecdotal approach, but it provides still an important link to the future for some forms of therapy in diseases that are difficult to treat. Traditionally, the anecdote has been the first step in the therapeutic chain. Withering discovery of the benefits of the common fox glove in dropsy, was followed by many other anecdotes arriving via folk-medicine in the New World. This approach of utilizing folk medicine has now reached new heights, with very active searches by major pharmaceutical companies throughout the third world for remedies that may have potential. Couched with this is the history of anecdotal "snake-oil" remedies, that clearly had no benefit to anyone except the huckster marketing same. The excesses in this area of unproven and false therapies, led to the gradual organization of therapeutic trials and the Food and Drug Administration in the US as we know it today. The

  5. Development and implementation of a music/activity therapy intake assessment for psychiatric patients. Part I: initial standardization procedures on data from university students.

    Science.gov (United States)

    Braswell, C; Brooks, D M; Decuir, A; Humphrey, T; Jacobs, K W; Sutton, K

    1983-01-01

    The stimulus for the Music/Activity Therapy Intake Assessment was a recent publication by the Joint Commission on Accreditation of Hospitals requiring for activity services, "assessment of the patient's needs, interests, life experiences, capacities, and deficiencies" (1981, p. 126). The Assessment was written in the spring of 1982 and contains four sections: Activity Preference, Organizational involvement, Attitude Survey, and Post-Interview Observations. The purpose of the present study was to investigate the psychometric properties of the Attitude Survey. The Attitude Survey was administered to 214 university students enrolled in three areas of study: human science, performance, and liberal arts. Results show that each of the three scales in the Survey is internally consistent (.63 to .74), that each scale measures a single large dimension, and that two of the three scales significantly discriminate between groups of students (p less than .05). The authors conclude that the Attitude Survey possesses adequate psychometric properties to justify its continued use as part of the Music/Activity Intake Assessment. PMID:10262389

  6. Preoperative [{sup 18}F]-fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes may aid in selecting patients with oral cavity squamous cell carcinoma for salvage therapy after relapse

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Chun-Ta; Huang, Shiang-Fu; Chen, I. How [Chang Gung Memorial Hospital and Chang Gung Univ., Dept. of Otorhinolaryngology, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Dept. of Head and Neck Surgery, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang, Joseph Tung-Chieh [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Radiation Oncology, Taoyuan, Taiwan (China); Wang, Hung-Ming [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Hema-Oncology, Taoyuan, Taiwan (China); Ng, Shu-Hang [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Diagnostic Radiology, Taoyuan, Taiwan (China); Hsueh, Chuen; Lee, Li-Yu. [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Pathology, Taoyuan, Taiwan (China); Lin, Chih-Hung [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Plastic and Reconstructive Surgery, Taoyuan, Taiwan (China); Cheng, Ann-Joy [Chang Gung Memorial Hospital and Chang Gung Univ., Head and Neck Oncology Group, Cancer Center, Taoyuan, Taiwan (China); Chang Gung Memorial Hospital and Chang Gung Univ., Medical Biotechnology, Biostatistics Consulting Center/Dept. of Public Health, Taoyuan, Taiwan (China); Yen, Tzu-Chen [Chang Gung Memorial Hospital and Chang Gung Univ., Taoyuan, Taiwan (China)

    2009-11-15

    Relapse of tumours in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a dismal outcome. In this prospective study, we sought to investigate the clinical significance of the preoperative maximal standardized uptake value (SUVmax) at the neck lymph nodes in selecting patients with OSCC for salvage therapy after relapse. Between 2002 and 2007, 108 patients with early relapse of OSCC (n=75) or late relapse of OSCC (n=33) were identified. Salvage therapy was performed in 47 patients. All patients underwent 2-deoxy-2[{sup 18}F]-fluoro-d-glucose positron emission tomography during the 2 weeks before surgery and neck dissection. All patients were followed for 12 months or more after surgery or until death. The optimal cut-off value for the neck lymph node SUVmax (SUVnodal-max) was selected according to the 5-year disease-specific survival (DSS) rate. Independent risk factors were identified by Cox regression analysis. The mean follow-up for all patients was 20.3 months (41.1 months for surviving patients). In the early relapse group, several prognostic factors were identified in univariate and multivariate analyses, including a SUVnodal-max value of {>=}4.2. A scoring system based on univariate analysis was formulated. Patients with a score of 0 had a better 5-year DSS than those with scores of 1 or higher (58% vs. 5%, p=0.0003). In patients with late relapse, a SUVnodal-max value of {>=}4.2 had the highest prognostic value for predicting the 5-year DSS (45% vs. 0%, p=0.0005). Among patients with relapsed OSCC, the SUVnodal-max value may aid in selecting patients for salvage therapy. (orig.)

  7. Twice-weekly pegylated interferon-α-2a and ribavirin results in superior viral kinetics in HIV/hepatitis C virus co-infected patients compared to standard therapy

    Science.gov (United States)

    Murphy, Alison A.; Herrmann, Eva; Osinusi, Anu O.; Wu, Lynn; Sachau, William; Lempicki, Richard A.; Yang, Jun; Chung, Tei L.; Wood, Brad J.; Haagmans, Bart L.; Kottilil, Shyam; Polis, Michael A.

    2014-01-01

    Background Hepatitis C virus (HCV)/HIV co-infected patients have more rapid progression of liver fibrosis and only modest cure rates (sustained virologic responses, SVRs) when compared to HCV monoinfected patients. Method We compared the virologic responses of either twice-weekly peginterferon-α-2a 180 µg/week (for 4 weeks, followed by weekly dosing) or weekly peginterferon-α-2a 180 µg/week, and weight-based ribavirin (1–1.2 g/day), among HIV/HCV co-infected genotype-1 individuals. Results Patients receiving the investigational dosing had lower levels of HCV RNA at all time points after initiation of therapy. More patients on this arm achieved clinically relevant early virological responses at weeks 1, 2, 4, 12, and 24. The enhanced early virologic response observed with the investigational arm was associated with a higher induction of interferon-stimulated genes. This early double dose regimen also resulted in a rapid normalization of liver enzymes. Twice-weekly peginterferon-α-2a was associated with more frequent early virological responses with similar safety profiles when compared with standard therapy. Conclusion Our results, when confirmed in larger randomized clinical trials, may provide a novel therapeutic approach to improve SVR among HIV/HCV co-infected patients, especially African–American patients. PMID:21593619

  8. Successful and Safe Long-Term Standard Antiviral Therapy in a Patient with “Explosive” Immune Response in Course of HCV-Related Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Paolo Conca

    2015-06-01

    Full Text Available Hepatitis C virus (HCV has been recognized to be both a hepato- and lymphotropic virus. HCV lymphotropism represents an essential detail in the pathogenesis of virus-related autoimmune and lymphoproliferative disorders, ranging from clonal expansion of B-cells with organ and non-organ-specific autoantibody production up to overt non-Hodgkin’s lymphoma along a continuous step-by-step model of B-cell lymphomagenesis, where the intermediated mixed cryoglobulinemia could be considered as a stage of suppressible antigen-driven lymphoproliferation. The HCV long-lasting extrahepatic replicative state generates an abnormal systemic immunological response, including rheumatoid factor (RF and cryo- and non-cryoprecipitable immune complexes, as well as clinical manifestations, comprising dermatitis, polyarthralgias and arthritis, pulmonary disease, aplastic anemia, glomerulonephritis and vasculitis. The mechanism of these extra-hepatic disorders is thought of as linked to immune complex disease, but their pathogenesis is poorly clarified. Immune-suppressive treatment could induce high-level hepatitis C viremia and impair hepatic disease. We report a female patient, whose chronic HCV-related liver cirrhosis with associated explosive, but oligosymptomatic lymphoproliferative immune response, i.e., RF beyond three thousand times the upper of normal range (unr, type II cryoglobulinemia with cryocrit 40% and monoclonal gammopathy IgM-k, has been successfully and safely treated by long-lasting (sixty-six months combined antiviral therapy (pegylated interferon alfa and ribavirin, at moderate and tapering dose regimen, prolonged for nearly 24 months after the first viral suppression. At the last follow-up (fifty-one months, the patient was showing very-long term antiviral response, progressive decline of secondary immune activation and absence of significant side-effects. Further research is required to fully verify the real impact on therapeutic choice/regimen.

  9. Accelerators for Cancer Therapy

    Science.gov (United States)

    Lennox, Arlene J.

    2000-05-30

    The vast majority of radiation treatments for cancerous tumors are given using electron linacs that provide both electrons and photons at several energies. Design and construction of these linacs are based on mature technology that is rapidly becoming more and more standardized and sophisticated. The use of hadrons such as neutrons, protons, alphas, or carbon, oxygen and neon ions is relatively new. Accelerators for hadron therapy are far from standardized, but the use of hadron therapy as an alternative to conventional radiation has led to significant improvements and refinements in conventional treatment techniques. This paper presents the rationale for radiation therapy, describes the accelerators used in conventional and hadron therapy, and outlines the issues that must still be resolved in the emerging field of hadron therapy.

  10. 非糖尿病专科患者使用胰岛素泵治疗的规范化管理%Non-diabetic Patients Using Insulin Pump Therapy Specialist Standardized Management

    Institute of Scientific and Technical Information of China (English)

    杨事欣; 崔英杰; 李淑芬; 汪珠; 王明亮; 王艳丽

    2015-01-01

    Objective Non-diabetic patients using insulin pump therapy specialist standardized management were discussed. Methods In our hospital 152 cases of non-diabetic specialist using an insulin pump to control blood sugar in patients with clinical data. Results Fasting blood glucose level of the patient, 2h postprandial blood glucose level HbA1c was significantly lower than before treatment (P<0.05), None of the patients due to the infusion of error cause serious consequences. Conclusion The implementation of the non-specialist diabetes patients using insulin pump therapy standardized management, can improve blood sugar, can be extended.%目的:对非糖尿病专科患者使用胰岛素泵治疗的规范化管理进行探讨。方法选择我院非糖尿病专科收治的152例使用胰岛素泵控制血糖患者的临床资料。结果患者的空腹血糖值、餐后2 h 血糖值以及糖化血红蛋白数值明显低于治疗前(P <0.05);无一例患者由于输注错误导致出现严重后果。结论对非糖尿病专科使用胰岛素泵治疗的患者实施规范化管理,能够有效改善患者血糖。

  11. Photodynamic therapy as adjunctive therapy for morpheaform basal cell carcinoma.

    Science.gov (United States)

    Torres, T; Fernandes, I; Costa, V; Selores, M

    2011-01-01

    The authors decided to evaluate the possible use of methyl-aminolevulinate photodynamic therapy (MAL-PDT) as adjunctive therapy for morpheaform basal cell carcinoma prior to standard surgical excision in order to reduce tumor size and volume and to facilitate surgical treatment. It was observed that MAL-PDT may be an option as an adjunctive therapy prior to standard surgical excision of morpheaform basal cell carcinoma, leading to less invasive surgery.

  12. Photodynamic therapy as adjunctive therapy for morpheaform basal cell carcinoma

    OpenAIRE

    Torres, T.; I. Fernandes; Costa, V.; Selores, M

    2011-01-01

    The authors decided to evaluate the possible use of methyl-aminolevulinate photodynamic therapy (MAL-PDT) as adjunctive therapy for morpheaform basal cell carcinoma prior to standard surgical excision in order to reduce tumor size and volume and to facilitate surgical treatment. It was observed that MAL-PDT may be an option as an adjunctive therapy prior to standard surgical excision of morpheaform basal cell carcinoma, leading to less invasive surgery.

  13. Standardized Index of Shape (SIS): a quantitative DCE-MRI parameter to discriminate responders by non-responders after neoadjuvant therapy in LARC

    Energy Technology Data Exchange (ETDEWEB)

    Petrillo, Antonella; Fusco, Roberta; Petrillo, Mario; Granata, Vincenza [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy). Div. of Radiology; Sansone, Mario [Naples Univ. ' ' Federico II' ' (Italy). Dept. of Biomedical, Electronics and Telecommunications Engineering; Avallone, Antonio [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy). Div. of Gastrointestinal Medical Oncology; Delrio, Paolo [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy). Div. of Gastrointestinal surgical Oncology; Pecori, Biagio [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy). Div. of Radiotherapy; Tatangelo, Fabiana [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy). Div. of Diagnostic Pathology; Ciliberto, Gennaro [Istituto Nazionale Tumori Fondazione Giovanni Pascale - IRCCS, Naples (Italy)

    2015-07-15

    To investigate the potential of DCE-MRI to discriminate responders from non-responders after neoadjuvant chemo-radiotherapy (CRT) for locally advanced rectal cancer (LARC). We investigated several shape parameters for the time-intensity curve (TIC) in order to identify the best combination of parameters between two linear parameter classifiers. Seventy-four consecutive patients with LARC were enrolled in a prospective study approved by our ethics committee. Each patient gave written informed consent. After surgery, pathological TNM and tumour regression grade (TRG) were estimated. DCE-MRI semi-quantitative analysis (sqMRI) was performed to identify the best parameter or parameter combination to discriminate responders from non-responders in response monitoring to CRT. Percentage changes of TIC shape descriptors from the baseline to the presurgical scan were assessed and correlated with TRG. Receiver operating characteristic analysis and linear classifier were applied. Forty-six patients (62.2 %) were classified as responders, while 28 subjects (37.8 %) were considered as non-responders. sqMRI reached a sensitivity of 93.5 % and a specificity of 82.1 % combining the percentage change in Maximum Signal Difference (ΔMSD) and Wash-out Slope (ΔWOS), the Standardized Index of Shape (SIS). SIS obtains the best result in discriminating responders from non-responders after CRT in LARC, with a cut-off value of -3.0 %. (orig.)

  14. Healing results in dependence on the administered nominal standard dose in carcinoma of the oral cavity treated by combined surgical and radiological therapy

    International Nuclear Information System (INIS)

    Between 1972 and 1980, a homogenous group of 116 patients with squamous cell carcinomas in the oral cavity and the oropharynx underwent a combined surgical and radiological treatment. 36 out of them were submitted to a preoperative short-term irradiation with postoperative dose completion, the other 80 patients were only irradiated after the operation. The nominal standard dose (NSD) was calculated for all patients. The group submitted to preoperative short-term irradiation, having the same conditions apart from that, showed considerably less recurrences (13.9%) than the patients irradiated only after the operation (33.7%). Due to the shorter overall treatment period, higher average NSD values have been obtained in case of preoperative short-term irradiation. The authors discuss to what extent the better treatment results of pre- and postoperative irradiation are due to the devitalization effect or to the higher NSD values. The results show, however, that the fractionation scheme should be taken into special consideration in order to optimize the biologic radiation effect in the treatment of carcinomas of the oral cavity. (orig.)

  15. Is the alpha-beta ratio of prostate cancer really low? A prospective, non-randomized trial comparing standard and hyperfractionated conformal radiation therapy

    International Nuclear Information System (INIS)

    Background and purpose: The objectives of the current study were to compare genito-urinary (GU) and gastro-intestinal (GI) toxicities as well as biochemical control (bRFS) in prostate cancer, utilizing conventional (2.0 Gy daily) (STD) or hyperfractionated (HFX) conformal irradiation (CRT). HFX (1.2 Gy BID) was chosen as a radiobiological method to try to reduce long term sequelae without compromising local control. Patients and methods: Three-hundred-and-seventy consecutive patients (pts) entered this prospective, non-randomized trial in the period January 1993-January 2003; 209 were treated with STD and 161 with HFX CRT. All were evaluable for acute toxicity analysis, 179 (STD) and 151 pts (HFX) being evaluable for late sequelae and bRFS analyses. Pt characteristics were not statistically different in the two groups. CRT consisted of a 4-field technique for prostate and/or pelvic nodes and a 5-field boost with rectal shielding. Median doses were 74 and 79.2 Gy for STD and HFX patients respectively, the latter dose being isoeffective for tumour control assuming α/β=10 (EQD2=73.9 Gy). Median follow-up was 29.4 months (25.2 mos for STD; 37.7 mos for HFX; P<0.01). The two regimens were compared in terms of acute and late GU and GI toxicities and 5-year bRFS by univariate and multivariate analyses. Results: Acute grade≥2 GU toxicity was higher in the STD group (48.6% versus 37.3% in HFX, P=0.03), while no significant difference was found for acute GI toxicity. Late grade≥2 GU and GI toxicities were lower in the HFX group (5-year actuarial rate: GU: 10.1% versus 20.3%, P=0.05; GI: 6.0% versus 10.6%, P=0.18). Five-year bRFS were 70% (±13.8%, 95% CI) and 82.6% (±7.2%) for STD and HFX, respectively (P=0.44); a trend favouring HFX was found in the subgroup of pts who did not receive hormonal therapy (5-year bRFS: 85.9%±12.4% versus 63.9%±23.8%, P=0.15). Multivariate analysis revealed only risk groups and age statistically related to bRFS but not fractionation

  16. Novel 3D ultrasound image-based biomarkers based on a feature selection from a 2D standardized vessel wall thickness map: a tool for sensitive assessment of therapies for carotid atherosclerosis

    International Nuclear Information System (INIS)

    With the advent of new therapies and management strategies for carotid atherosclerosis, there is a parallel need for measurement tools or biomarkers to evaluate the efficacy of these new strategies. 3D ultrasound has been shown to provide reproducible measurements of plaque area/volume and vessel wall volume. However, since carotid atherosclerosis is a focal disease that predominantly occurs at bifurcations, biomarkers based on local plaque change may be more sensitive than global volumetric measurements in demonstrating efficacy of new therapies. The ultimate goal of this paper is to develop a biomarker that is based on the local distribution of vessel-wall-plus-plaque thickness change (VWT-Change) that has occurred during the course of a clinical study. To allow comparison between different treatment groups, the VWT-Change distribution of each subject must first be mapped to a standardized domain. In this study, we developed a technique to map the 3D VWT-Change distribution to a 2D standardized template. We then applied a feature selection technique to identify regions on the 2D standardized map on which subjects in different treatment groups exhibit greater difference in VWT-Change. The proposed algorithm was applied to analyse the VWT-Change of 20 subjects in a placebo-controlled study of the effect of atorvastatin (Lipitor). The average VWT-Change for each subject was computed (i) over all points in the 2D map and (ii) over feature points only. For the average computed over all points, 97 subjects per group would be required to detect an effect size of 25% that of atorvastatin in a six-month study. The sample size is reduced to 25 subjects if the average were computed over feature points only. The introduction of this sensitive quantification technique for carotid atherosclerosis progression/regression would allow many proof-of-principle studies to be performed before a more costly and longer study involving a larger population is held to confirm the treatment

  17. Novel 3D ultrasound image-based biomarkers based on a feature selection from a 2D standardized vessel wall thickness map: a tool for sensitive assessment of therapies for carotid atherosclerosis

    Science.gov (United States)

    Chiu, Bernard; Li, Bing; Chow, Tommy W. S.

    2013-09-01

    With the advent of new therapies and management strategies for carotid atherosclerosis, there is a parallel need for measurement tools or biomarkers to evaluate the efficacy of these new strategies. 3D ultrasound has been shown to provide reproducible measurements of plaque area/volume and vessel wall volume. However, since carotid atherosclerosis is a focal disease that predominantly occurs at bifurcations, biomarkers based on local plaque change may be more sensitive than global volumetric measurements in demonstrating efficacy of new therapies. The ultimate goal of this paper is to develop a biomarker that is based on the local distribution of vessel-wall-plus-plaque thickness change (VWT-Change) that has occurred during the course of a clinical study. To allow comparison between different treatment groups, the VWT-Change distribution of each subject must first be mapped to a standardized domain. In this study, we developed a technique to map the 3D VWT-Change distribution to a 2D standardized template. We then applied a feature selection technique to identify regions on the 2D standardized map on which subjects in different treatment groups exhibit greater difference in VWT-Change. The proposed algorithm was applied to analyse the VWT-Change of 20 subjects in a placebo-controlled study of the effect of atorvastatin (Lipitor). The average VWT-Change for each subject was computed (i) over all points in the 2D map and (ii) over feature points only. For the average computed over all points, 97 subjects per group would be required to detect an effect size of 25% that of atorvastatin in a six-month study. The sample size is reduced to 25 subjects if the average were computed over feature points only. The introduction of this sensitive quantification technique for carotid atherosclerosis progression/regression would allow many proof-of-principle studies to be performed before a more costly and longer study involving a larger population is held to confirm the treatment

  18. Proton Therapy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Proton Therapy Proton therapy delivers radiation to tumor tissue ... feel during and after the procedure? What is proton therapy and how is it used? Protons are ...

  19. Oxygen Therapy

    Science.gov (United States)

    Oxygen therapy is a treatment that provides you with extra oxygen. Oxygen is a gas that your body ... machine in your home. A different kind of oxygen therapy is called hyperbaric oxygen therapy. It uses oxygen ...

  20. Clinical analysis on the patients with gastrointestinal cancer after surgery treated with standardized sequential enteral parenteral nutrition support therapy and parenteral nutrition support therapy%胃肠道恶性肿瘤手术后进行规范化序贯肠内肠外营养支持疗法与肠外营养支持的临床分析

    Institute of Scientific and Technical Information of China (English)

    翟丽; 刘敏; 王娟; 周少飞; 温成泉

    2013-01-01

    Objective To observe and compare the effect of cellular immunologic function and nutritional status on patients with gastrointestinal cancer after surgery treated with standardized sequential enteral parenteral nutrition support therapy and parenteral nutrition support therapy. Method 78 cases of patients with gastrointestinal cancer after surgery were randomly divided into control group(40cases)and observation group(38cases). The control group was treated with parenteral nutrition support and the observation group was treated with standardized sequential enteral parenteral nutritional support therapy.The therapeutic effect of the two groups including the complications caused by surgery, the hospital stay, the nutrition index one week after operation, the recovery of gastrointestinal and the influence on immunologic function were compared and evaluated. Results The treatment effect of observation group is better than those of the conrol group. The postoperative recovery time and hospital stay in the observation group was signiifcantly shorter than those of the control group(P<0.05). The postoperative prealbumin, albumin and body weight of the observation group patients were signiifcantly higher than those of the control group.The CD3+and CD4+increased signiifcantly in observation group(P < 0.05)compared with the control group. Conclusions Standardized sequential enteral parenteral nutrition support therapy after gastrointestinal operation can effectively improve the nutrition status accelerate the recovery of gastrointestinal and immune function shorten the hospital stay and promote the recovery of the patients with gastrointestinal cancer .%目的:比较规范化序贯肠内肠外营养支持疗法和仅采用肠外营养支持对消化道肿瘤患者术后营养状况及免疫功能的影响。方法将78例行手术治疗的消化道肿瘤患者随机分为对照组(40例)和观察组(38例),给予对照组患者肠外营养支持,给予观察组

  1. Population Health and Occupational Therapy.

    Science.gov (United States)

    Braveman, Brent

    2016-01-01

    Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function.

  2. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same w

  3. Accounting standards

    NARCIS (Netherlands)

    B. Stellinga

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed companie

  4. Influence of multileaf collimator leaf width on volumetric modulated arc therapy plans evaluated on AAPM standard phantom%应用AAPM标准模体评估MLC宽度对VMAT计划的影响

    Institute of Scientific and Technical Information of China (English)

    黄娜; 王培; 张德康; 唐斌; 黎杰; 王先良; 吴凡; 秦远; 康盛伟

    2016-01-01

    目的:使用AAPM119报告标准模体和标准靶区设计双弧VMAT计划,依照AAPM119报告剂量目标要求比较Agility和MLCi2两种叶片剂量参数。方法利用AAPM119报告中Cshape、Head and Neck、Prostate和Multitarget标准靶区勾画结构,按照AAPM计划目标要求,首先采用医科达Agility MLC进行计划设计,在计划设计参数不变情况下仅更换为医科达MLCi2进行计划优化和剂量计算。以AAPM119报告目标剂量为标准,分析两种MLC叶片在4种靶区勾画结构下的靶区和OAR剂量体积参数的差异。结果依照AAPM119号报告所达到的平均剂量标准,Cshape、Head and Neck和Multitarget 靶区结构采用Agility制作的放疗计划剂量指标多优于采用MLCi2制作的放疗计划, Prostate靶区结构采用MLCi2制作的放疗计划剂量指标优于采用Agility制作的放疗计划。结论在靶区勾画结构、计划设计人员、计划设计参数和评价标准全部相同下,对严苛剂量限值目标医科达Agility比医科达MLCi2能更好达到剂量目标要求。%Objective To develop double-arc volumetric modulated arc therapy ( VMAT) plans using standard phantom and standard target volume in AAPM119 report, and to investigate the dosimetric parameters of Agility and MLCi2 leafs according to the requirements for target dose in AAPM119 report. Methods The Cshape, Head and Neck, Prostate, and Multitarget structures for standard target volume delineation in AAPM119 report were used.The Elekta Agility multi-leaf collimator was used to develop plans, and then with other parameters remaining unchanged, Elekta MLCi2 was used for plan optimization and dose calculation.The target dose in AAPM119 report was used as the standard to analyze the differences in target volume and dose-volume parameters of organs at risk between the four structures for target volume delineation.Results According to the mean dose in AAPM119 report, in the Cshape, Head and Neck, and

  5. Radiation Therapy

    Science.gov (United States)

    ... therapy. At this time, you will have a physical exam , talk about your medical history , and maybe have imaging tests . Your doctor or nurse will discuss external beam radiation therapy, its benefits and side effects, and ways you can care ...

  6. Massage therapy research review.

    Science.gov (United States)

    Field, Tiffany

    2016-08-01

    In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research. PMID:27502797

  7. Therapy Services.

    Science.gov (United States)

    Austin Independent School District, TX.

    Reviewed are the goals and activities of the therapy services in the Austin Early Childhood Special Education Program. Specific sections detail activities for speech therapy (such as diagnostic assessment, habilitation, consultation, and reporting procedures), occupational therapy (including identification and assessment, and services to children,…

  8. Bicalutamide as immediate therapy either alone or as adjuvant to standard care of patients with localized or locally advanced prostate cancer: first analysis of the early prostate cancer program

    DEFF Research Database (Denmark)

    See, William A; Wirth, Manfred P; McLeod, David G;

    2002-01-01

    We determine the efficacy and tolerability of bicalutamide as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with clinically localized or locally advanced prostate cancer.......We determine the efficacy and tolerability of bicalutamide as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with clinically localized or locally advanced prostate cancer....

  9. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  10. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  11. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  12. [Intravenous and subcutaneous immunoglobulin therapy].

    Science.gov (United States)

    Thon, Vojtěch

    2013-07-01

    Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The -anti-IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG. PMID:23964967

  13. Training Standardization

    International Nuclear Information System (INIS)

    The article describes the benefits of and required process and recommendations for implementing the standardization of training in the nuclear power industry in the United States and abroad. Current Information and Communication Technologies (ICT) enable training standardization in the nuclear power industry. The delivery of training through the Internet, Intranet and video over IP will facilitate this standardization and bring multiple benefits to the nuclear power industry worldwide. As the amount of available qualified and experienced professionals decreases because of retirements and fewer nuclear engineering institutions, standardized training will help increase the number of available professionals in the industry. Technology will make it possible to use the experience of retired professionals who may be interested in working part-time from a remote location. Well-planned standardized training will prevent a fragmented approach among utilities, and it will save the industry considerable resources in the long run. It will also ensure cost-effective and safe nuclear power plant operation

  14. Variation in Patient Profiles and Outcomes in US and Non-US Subgroups of the Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX Trial

    Science.gov (United States)

    Vaduganathan, Muthiah; Harrington, Robert A.; Stone, Gregg W.; Steg, Ph. Gabriel; Gibson, C. Michael; Hamm, Christian W.; Price, Matthew J.; Prats, Jayne; Deliargyris, Efthymios N.; Mahaffey, Kenneth W.; White, Harvey D.

    2016-01-01

    Background— The Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX trial demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention compared with clopidogrel. Methods and Results— We analyzed all patients included in the modified intention-to-treat analysis in US (n=4097; 37.4%) and non-US subgroups (n=6845; 62.6%). The US cohort was older, had a higher burden of cardiovascular risk factors, and had more frequently undergone prior cardiovascular procedures. US patients more frequently underwent percutaneous coronary intervention for stable angina (77.9% versus 46.2%). Almost all US patients (99.1%) received clopidogrel loading doses of 600 mg, whereas 40.5% of non-US patients received 300 mg. Bivalirudin was more frequently used in US patients (56.7% versus 2.9%). At 48 hours, rates of the primary composite end point were comparable in the US and non-US cohorts (5.5% versus 5.2%; P=0.53). Cangrelor reduced rates of the primary composite end point compared with clopidogrel in US (4.5% versus 6.4%; odds ratio 0.70 [95% confidence interval 0.53–0.92]) and in non-US patients (4.8% versus 5.6%; odds ratio 0.85 [95% confidence interval 0.69–1.05]; interaction P=0.26). Similarly, rates of the key secondary end point, stent thrombosis, were reduced by cangrelor in both regions. Rates of Global Use of Strategies to Open Occluded Arteries (GUSTO)–defined severe bleeding were low and not significantly increased by cangrelor in either region. Conclusions— Despite broad differences in clinical profiles and indications for percutaneous coronary intervention by region in a large global cardiovascular clinical trial, cangrelor consistently reduced rates of ischemic end points compared with clopidogrel without an excess in severe bleeding in both the US and non-US subgroups. Clinical Trial Registration— URL: http

  15. Bicalutamide as immediate therapy either alone or as adjuvant to standard care of patients with localized or locally advanced prostate cancer: first analysis of the early prostate cancer program

    DEFF Research Database (Denmark)

    See, William A; Wirth, Manfred P; McLeod, David G;

    2002-01-01

    We determine the efficacy and tolerability of bicalutamide as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with clinically localized or locally advanced prostate cancer....

  16. A randomised comparison of bicalutamide ('Casodex') 150 mg versus placebo as immediate therapy either alone or as adjuvant to standard care for early non-metastatic prostate cancer. First report from the Scandinavian Prostatic Cancer Group Study No. 6

    DEFF Research Database (Denmark)

    Iversen, P; Tammela, T L J; Vaage, S;

    2002-01-01

    To assess the efficacy and tolerability of bicalutamide 150 mg ('Casodex'(1)) as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with early (T1b-T4, any N, M0) prostate cancer.......To assess the efficacy and tolerability of bicalutamide 150 mg ('Casodex'(1)) as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with early (T1b-T4, any N, M0) prostate cancer....

  17. EOS standards

    Energy Technology Data Exchange (ETDEWEB)

    Greeff, Carl W [Los Alamos National Laboratory

    2011-01-12

    An approach to creating accurate EOS for pressure standards is described. Applications to Cu, Au, and Ta are shown. Extension of the method to high compressions using DFT is illustrated. Comparisons with modern functionals show promise.

  18. Proton therapy

    International Nuclear Information System (INIS)

    Proton therapy has become a subject of considerable interest in the radiation oncology community and it is expected that there will be a substantial growth in proton treatment facilities during the next decade. I was asked to write a historical review of proton therapy based on my personal experiences, which have all occurred in the United States, so therefore I have a somewhat parochial point of view. Space requirements did not permit me to mention all of the existing proton therapy facilities or the names of all of those who have contributed to proton therapy. (review)

  19. (Terminology standardization)

    Energy Technology Data Exchange (ETDEWEB)

    Strehlow, R.A.

    1990-10-19

    Terminological requirements in information management was but one of the principal themes of the 2nd Congress on Terminology and Knowledge Engineering. The traveler represented the American Society for Testing and Materials' Committee on Terminology, of which he is the Chair. The traveler's invited workshop emphasized terminology standardization requirements in databases of material properties as well as practical terminology standardizing methods. The congress included six workshops in addition to approximately 82 lectures and papers from terminologists, artificial intelligence practitioners, and subject specialists from 18 countries. There were approximately 292 registrants from 33 countries who participated in the congress. The congress topics were broad. Examples were the increasing use of International Standards Organization (ISO) Standards in legislated systems such as the USSR Automated Data Bank of Standardized Terminology, the enhanced Physics Training Program based on terminology standardization in Physics in the Chinese province of Inner Mongolia, and the technical concept dictionary being developed at the Japan Electronic Dictionary Research Institute, which is considered to be the key to advanced artificial intelligence applications. The more usual roles of terminology work in the areas of machine translation. indexing protocols, knowledge theory, and data transfer in several subject specialties were also addressed, along with numerous special language terminology areas.

  20. Sweat Therapy.

    Science.gov (United States)

    Colmant, Stephen A.; Merta, Rod J.

    2000-01-01

    A study combined group sweating and group counseling. Four adolescent boys with disruptive behavior disorders participated in 12 sweat therapy sessions. They reported the sessions useful for sharing personal concerns and receiving assistance with problem solving. Three boys showed improvement in self-esteem. Advantages of sweat therapy over other…

  1. Gene therapy.

    OpenAIRE

    Mota Biosca, Anna

    1992-01-01

    Applications of gene therapy have been evaluated in virtually every oral tissue, and many of these have proved successful at least in animal models. While gene therapy will not be used routinely in the next decade, practitioners of oral medicine should be aware of the potential of this novel type of treatment that doubtless will benefit many patients with oral diseases.

  2. Medical nutrition therapy planning

    Directory of Open Access Journals (Sweden)

    Torović Ljilja

    2010-01-01

    Full Text Available Introduction. Diet has vital, preventive and therapeutic functions. Medical nutrition therapy is a part of the Standardized Nutrition Care Process integrated in health care systems. Material and methods. An overview of the Nutrition Care Process model and the application of nutrition guidelines based on literature, reports, documents and programmes of international health, food and physical activity authorities was done. Results. The Nutrition Care Process model requires registered dieticians, standardized terminology as well as nutrition diagnosis categorization. It consists of four distinct, but interrelated and connected steps: (a nutrition assessment, (b nutrition diagnosis, (c nutrition intervention, and (d nutrition monitoring and evaluation. An individual approach is essential for successful medical nutrition therapy. Nutrition guidelines facilitate the process of understanding and application of medical nutrition therapy. Conclusion. The Nutrition Care process provides dietetic professionals information on high-quality client nutrition care. The success of medical nutrition therapy rests not only upon the advice of the dietician, but also upon the client’s compliance.

  3. Frequency standards

    CERN Document Server

    Riehle, Fritz

    2006-01-01

    Of all measurement units, frequency is the one that may be determined with the highest degree of accuracy. It equally allows precise measurements of other physical and technical quantities, whenever they can be measured in terms of frequency.This volume covers the central methods and techniques relevant for frequency standards developed in physics, electronics, quantum electronics, and statistics. After a review of the basic principles, the book looks at the realisation of commonly used components. It then continues with the description and characterisation of important frequency standards

  4. Medical nutrition therapy planning

    OpenAIRE

    Torović Ljilja; Grujičić Maja; Pavlović-Trajković Ljiljana; Jovičić Jelena; Novaković Budimka; Balać Dragana

    2010-01-01

    Introduction. Diet has vital, preventive and therapeutic functions. Medical nutrition therapy is a part of the Standardized Nutrition Care Process integrated in health care systems. Material and methods. An overview of the Nutrition Care Process model and the application of nutrition guidelines based on literature, reports, documents and programmes of international health, food and physical activity authorities was done. Results. The Nutrition Care Process model requires registered diet...

  5. Virtual reality exposure therapy

    OpenAIRE

    Rothbaum, BO; Hodges, L; Kooper, R

    1997-01-01

    It has been proposed that virtual reality (VR) exposure may be an alternative to standard in vivo exposure. Virtual reality integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer- generated virtual environment. Virtual reality exposure is potentially an efficient and cost-effective treatment of anxiety disorders. VR exposure therapy reduced the fear of heights in the first control...

  6. Pharmacoeconomics of Surfactant Therapy

    OpenAIRE

    Barbarello-Andrews, Liza; Marsh, Wallace

    2006-01-01

    Surfactant therapy has become an integral part of the standard of care for treating premature infants with respiratory distress syndrome (RDS). Institutions that routinely treat this patient population have to select a surfactant based upon clinical and pharmacoeconomic considerations. Pharmacoeconomic studies have established the cost-effectiveness of individual agents based on a variety of factors, including length of hospitalization, mortality odds ratio, and other direct medical costs. Th...

  7. A new look at anti-Helicobacter pylori therapy

    Institute of Scientific and Technical Information of China (English)

    Seng-Kee Chuah; Feng-Woei Tsay; Ping-I Hsu; Deng-Chyang Wu

    2011-01-01

    With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H .pylori)infection. Novel first-line anti-H. pylorii therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy. This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects. The best second-line therapy for patients who fail to eradicate H. pylori with first-line therapies containing clarithromycin, amoxicillin and metronidazole is unclear. However, a levofloxacin-based triple therapy is an accepted rescue treatment. Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test. Nonetheless, an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H. pylorii infection if antimicrobial sensitivity data are unavailable.

  8. Current therapy for Parkinson's disease

    OpenAIRE

    A. V. Obukhova

    2014-01-01

    The main goal of therapy for Parkinson's disease (PD) is to correct dopamine deficiency in the nigrostriatal system. Levodopa preparations and dopamine receptor agonists (DRAs) that are prescribed with regards to patient age and disease severity are mainly used now. Notwithstanding the fact that levodopa preparations are the gold standard of therapy, their long-term use gives rise to complications as motor fluctuations and drug-induced dyskinesias. The currently available DRAs are the drugs o...

  9. Physical Therapy and Occupational Therapy in Progeria

    Science.gov (United States)

    Physical Therapy and Occupational Therapy in Progeria Information for Families and Caretakers from The Progeria Research Foundation Written ... accelerated aging in children. Children with Progeria need Physical Therapy (PT) and Occupational Therapy (OT) as often as ...

  10. Could New 'Talk Therapy' Cut Cost of Treating Depression?

    Science.gov (United States)

    ... Could New 'Talk Therapy' Cut Cost of Treating Depression? Behavioral activation would be more accessible than currently ... gold-standard treatment -- cognitive behavioral therapy -- for treating depression in adults, a new study suggests. The researchers ...

  11. Oxygen Therapy

    Science.gov (United States)

    Oxygen therapy is a treatment that provides you with extra oxygen. Oxygen is a gas that your body needs to function. Normally, your lungs absorb oxygen from the air you breathe. But some conditions ...

  12. Oxygen Therapy

    Science.gov (United States)

    ... therapy works, it helps to understand how your respiratory system works. This system is a group of organs and tissues that help you breathe. The respiratory system includes the airways and lungs. The airways carry ...

  13. Oxygen therapy as an additional component of cytostatic treatment for recurrent cervical cancer

    OpenAIRE

    R. F. Savkova; L. E. Rotobelskaya; L. F. Yudina; M. A. Gerashchenko; A. S. Dzasokhov

    2012-01-01

    The data obtained by the authors suggest that the efficiency of standard cytostatic therapy for recurrent cervical cancer in combination with chemotherapy and oxygen therapy has increased and the tolerance of cytostatic treatment during oxygen therapy improved.

  14. Feasibility and efficacy of an isocaloric high-protein vs. standard diet on insulin requirement, body weight and metabolic parameters in patients with type 2 diabetes on insulin therapy

    DEFF Research Database (Denmark)

    Luger, M; Holstein, B; Schindler, K;

    2013-01-01

    To determine the feasibility and efficacy of a high-protein diet compared with a standard diet aiming for weight maintenance in insulin treated type-2 diabetic patients on insulin requirement, body weight and metabolic parameters over 12 weeks.......To determine the feasibility and efficacy of a high-protein diet compared with a standard diet aiming for weight maintenance in insulin treated type-2 diabetic patients on insulin requirement, body weight and metabolic parameters over 12 weeks....

  15. Khan's the physics of radiation therapy

    CERN Document Server

    Khan, Faiz M

    2014-01-01

    Expand your understanding of the physics and practical clinical applications of advanced radiation therapy technologies with Khan's The Physics of Radiation Therapy, 5th edition, the book that set the standard in the field. This classic full-color text helps the entire radiation therapy team-radiation oncologists, medical physicists, dosimetrists, and radiation therapists-develop a thorough understanding of 3D conformal radiotherapy (3D-CRT), stereotactic radiosurgery (SRS), high dose-rate remote afterloaders (HDR), intensity modulated radiation therapy (IMRT), image-guided radiation therapy (

  16. Maintenance Therapy in IBD

    Science.gov (United States)

    ... Help Center Home > Resources > Maintenance Therapy Go Back Maintenance Therapy Email Print + Share The term "maintenance therapy" ... are referred to as "maintenance therapies." Why is Maintenance Therapy Needed in IBD? Both Crohn's disease and ...

  17. Standard deviations

    CERN Document Server

    Smith, Gary

    2015-01-01

    Did you know that having a messy room will make you racist? Or that human beings possess the ability to postpone death until after important ceremonial occasions? Or that people live three to five years longer if they have positive initials, like ACE? All of these ‘facts' have been argued with a straight face by researchers and backed up with reams of data and convincing statistics.As Nobel Prize-winning economist Ronald Coase once cynically observed, ‘If you torture data long enough, it will confess.' Lying with statistics is a time-honoured con. In Standard Deviations, ec

  18. Family therapy

    Directory of Open Access Journals (Sweden)

    Shaikh Altamash

    2013-01-01

    Full Text Available Another major force not letting us succeed in the treatment of diabetes remains right inside the patients home, their family members. Hence, it is important to know the perception of the close family members about this simple and strong tool in diabetes, ′insulin′. The drug is nearing its century, it has not fully being accepted gracefully even in todays electronic savvy society. So, we need to strongly discover the reason for its non-acceptance, while trials are out inventing new drugs. One vital thing that can change this attitude is increasing the understanding of this drug, insulin in depth to close people around the patient, the ′family′. Underestimating family′s perception about disease and treatment for diabetes is detrimental to both diseased and the doctor. This consists of a biopsychosocial model; biological, psychological and social factors. Family forms the most important part of it. The strategies in family therapy include psychodynamic, structural, strategic, and cognitive-behavioral component. Diabetes has and will continue to rise, so will be the treatment options. From the clinicians side its to fix fasting first but from patients its fix family first. Family therapy demonstrates the importance of insulin initiation and maintenance in insulin naive patients, and continuation for others. The specific needs of such patients and their impact on family life are met with family therapy. Who needs family therapy? Benefits of family therapy and a case based approach is covered.

  19. Promise and Pitfalls of Heavy-Particle Therapy

    OpenAIRE

    Mitin, Timur; Zietman, Anthony L

    2014-01-01

    Proton beam therapy, the most common form of heavy-particle radiation therapy, is not a new invention, but it has gained considerable public attention because of the high cost of installing and operating the rapidly increasing number of treatment centers. This article reviews the physical properties of proton beam therapy and focuses on the up-to-date clinical evidence comparing proton beam therapy with the more standard and widely available radiation therapy treatment alternatives. In a cost...

  20. Art Therapy

    DEFF Research Database (Denmark)

    Skov, Vibeke; Pedersen, Inge Nygaard

    2014-01-01

    Abstract Based on a Jungian approach, this article will introduce an integrative model to therapeutic change using art therapy methods as practical tools, with the aim of improving quality of life and in the prevention of depression. In a research study involving six participants, painting, clay...... work and drumming were used together with imagination and personal dialogues linked to the artwork. These art therapy processes attempted to combine the participant’s experience of inner and outer reality. The effect of gaining more knowledge about their inner reality using dreams and symbols......, was that participants gained a new understanding about their personal life. In addition, some participants were able to continue to use art therapy experiences as selfdevelopmental tools after the research study terminated. Jung’s description of the interactive relationship between the two living parts of the psyche...

  1. Truth therapy/lie therapy.

    Science.gov (United States)

    Langs, R

    In this paper an attempt is made to conceptualize a basic dimension of various psychotherapeutic treatment modalities, especially psychoanalysis and psychoanalytically oriented psychotherapy. The central variable under consideration is the extent to which each endeavors to approach the truth within both patient and therapist as it exists dynamically in terms of their spiraling unconscious communicative interaction. That treatment modality which takes into account every possible dimension of such truths is termed truth therapy. Treatment modalities that make no attempt to arrive at these truths or that deliberately or inadvertently falsify their nature are termed lie or barrier therapies. Extensive consideration is given to truth therapy and the truth system on which it is based. The basis for the need for lie therapies is explored, and lie systems, which may arise from either patient or therapist, or both, are identified. A classification of common types of lie patients and lie therapists (and their main techniques) is offered. The implications of this delineation for our understanding of the dynamic therapies are discussed, and a number of new clinical issues arising from this perspective are addressed.

  2. What Is Music Therapy?

    Science.gov (United States)

    American Music Therapy Association Home Contact News Help/FAQ Members Only Login About Music Therapy & AMTA What is Music Therapy? Definition and Quotes ... is Music Therapy? Print Email Share What is Music Therapy What is Music Therapy? Music Therapy is the ...

  3. Neoadjuvant Therapy in Pancreatic Cancer: Review Article

    OpenAIRE

    Moritz Pross; Wellner, Ulrich F.; Kim C Honselmann; Carlo Jung; Steffen Deichmann; Tobias Keck; Dirk Bausch

    2015-01-01

    We performed a literature review for neoadjuvant therapy in pancreatic cancer. We divided the results into resectable disease and local advanced pancreatic cancer. Results Neoadjuvant therapy in pancreatic cancer is safe. But currently no standard guidelines exist in neoadjuvant approaches on pancreatic cancer. For local advanced pancreatic cancer the available data tends to show a positive effect on survival rates for neoadjuvant approaches.

  4. Pet Therapy.

    Science.gov (United States)

    Kavanagh, Kim

    1994-01-01

    This resource guide presents information on a variety of ways that animals can be used as a therapeutic modality with people having disabilities. Aspects addressed include: pet ownership and selection criteria; dogs (including service dogs, hearing/signal dogs, seeing leader dogs, and social/specialty dogs); horseriding for both therapy and fun;…

  5. Behaviour therapy for obesity treatment considering approved drug therapy

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2008-05-01

    Full Text Available Introduction: Obesity is a worldwide health problem whose prevalence is on the increase. Many obesity-associated diseases require intensive medical treatment and are the cause of a large proportion of health-related expenditures in Germany. Treatment of obesity includes nutritional, exercise and behaviour therapy, usually in combination. The goal of behaviour therapy for obesity is to bring about a long-term alteration in the eating and exercise habits of overweight and obese individuals. Under certain circumstances, drug treatment may be indicated. Objectives: What is the effectiveness of behaviour therapy for obesity considering approved drugs reduce weight under medical, economic, ethical-social and legal aspects? Methods: A systematic review was conducted using relevant electronic literature databases. Publications chosen according to predefined criteria are evaluated by approved methodical standards of the evidence-based medicine systematically and qualitatively. Results: In total 18 studies, included one HTA and one meta-analysis could be identified according to the predefined inclusion criteria. Three studies compare behaviour therapy to other therapy forms (advice or instruction on nutritional changes, physical activity or a combination of the two, six studies evaluate different forms of behaviour therapy, four studies and four studies compare behaviour therapies mediated by Internet or telephone. Three studies could be identified examining the effect of the combination of behaviour and drug therapy. Furthermore one HTA and one meta-analysis could be included in the evaluation. The behaviour therapy in comparison with other therapy forms reveals a higher effectiveness. In comparison of the different therapeutic approaches of the behaviour therapy intensive behaviour therapy forms and group therapy show a higher effectiveness. Studies related to behaviour therapy based on media support demonstrate a weight reduction both through the

  6. Hadron therapy

    International Nuclear Information System (INIS)

    Full text: Historically discoveries and technological advances in radiation and accelerator physics have been rapidly applied in the healing arts. X rays, discovered by Roentgen in 1895, and radioisotopes, discovered by Becquerel in 1896, were both applied to the treatment of cancer by the first year of the twentieth century. By the time that Chadwick discovered the neutron in 1932 radiotherapy was a well-established modality for the treatment of cancer. The potential use of neutrons in radiotherapy was immediately recognized by L.H. Gray (a recent Ph.D. graduate from the Cavendish laboratories in Cambridge). He built a neutron generator for radiobiology research at Mount Vernon Hospital in London, it's design was based on a similar device built at Cambridge by Mark Oliphant. In parallel with these developments Earnest Lawrence, in collaboration with his brother John Lawrence, a physician, were also studying the radiobiology of neutrons. They obtained some funding from the US National Cancer Institute to construct a 60'' cyclotron for neutron radiation therapy. These clinical trials, started in 1938, were the first application of heavy particles for cancer therapy. Immediately after the second World War advances in accelerator technology lead to the building of the first synchrocyclotrons, which produced proton beams with ranges approaching 30 cm in water. At the Harvard synchrocyclotron Robert R. Wilson realized that proton beams might have considerable advantages over other radiation beams in the treatment of deep-seated tumors. This advantage derives from the increase in stopping power at the end of the proton range, first observed by W.H.Bragg at the University of Adelaide; a phenomenon now known as the Bragg peak. Conventional X-ray beams are exponentially attenuated by matter and, hence, delivering large radiation doses to tumors at depth while not causing excessive damage to the overlying normal tissues can be problematical. The Bragg peak and the well

  7. Overall Response Rate, Progression-Free Survival, and Overall Survival With Targeted and Standard Therapies in Advanced Non–Small-Cell Lung Cancer: US Food and Drug Administration Trial-Level and Patient-Level Analyses

    Science.gov (United States)

    Blumenthal, Gideon M.; Karuri, Stella W.; Zhang, Hui; Zhang, Lijun; Khozin, Sean; Kazandjian, Dickran; Tang, Shenghui; Sridhara, Rajeshwari; Keegan, Patricia; Pazdur, Richard

    2015-01-01

    Purpose To conduct analyses exploring trial-level and patient-level associations between overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) in advanced non–small-cell lung cancer (NSCLC) trials. Methods We identified 14 trials (N = 12,567) submitted to US Food and Drug Administration since 2003 of treatments for advanced NSCLC. Only randomized, active-controlled trials with more than 150 patients were included. Associations between trial-level PFS hazard ratio (HR), OS HR, and ORR odds ratio were analyzed using a weighted linear regression model. Patient-level responder analyses comparing PFS and OS between patients with and without an objective response were performed using pooled data from all studies. Results In the trial-level analysis, the association between PFS and ORR was strong (R2 = 0.89; 95% CI, 0.80 to 0.98). There was no association between OS and ORR (R2 = 0.09; 95% CI, 0 to 0.33) and OS and PFS (R2 = 0.08; 95% CI, 0 to 0.31). In the patient-level responder analyses, patients who achieved a response had better PFS and OS compared with nonresponders (PFS: HR, 0.40; 95% CI, 0.38 to 0.42; OS: HR, 0.40; 95% CI, 0.38 to 0.43). Conclusion On a trial level, there is a strong association between ORR and PFS. An association between ORR and OS and between PFS and OS was not established, possibly because of cross-over and longer survival after progression in the targeted therapy and first-line trials. The patient-level analysis showed that responders have a better PFS and OS compared with nonresponders. A therapy in advanced NSCLC with a large magnitude of effect on ORR may have a large PFS effect. PMID:25667291

  8. Particle therapy

    Energy Technology Data Exchange (ETDEWEB)

    Raju, M.R.

    1993-09-01

    Particle therapy has a long history. The experimentation with particles for their therapeutic application got started soon after they were produced in the laboratory. Physicists played a major role in proposing the potential applications in radiotherapy as well as in the development of particle therapy. A brief review of the current status of particle radiotherapy with some historical perspective is presented and specific contributions made by physicists will be pointed out wherever appropriate. The rationale of using particles in cancer treatment is to reduce the treatment volume to the target volume by using precise dose distributions in three dimensions by using particles such as protons and to improve the differential effects on tumors compared to normal tissues by using high-LET radiations such as neutrons. Pions and heavy ions combine the above two characteristics.

  9. Radioiodine therapy

    International Nuclear Information System (INIS)

    For over 40 years now, radioiodine (131I) has remained one of the most useful radionuclide for diagnosis and therapy in Nuclear Medicine. The wide application of radioiodine in the study of the thyroid gland and in the management of its disorders has been most rewarding. The medical literature is replete with reports of its efficacy, failures, and complications, but most of these studies have been conducted among Caucasian persons and in relatively affluent societies. Very few reports are available from the less developed and economically depressed areas of the world where thyroid disorders abound or and are even endemic. This chapter is an attempt to highlight the use of radioactive iodine therapy in the developing countries, particularly those in the Asian region

  10. Music Therapy

    DEFF Research Database (Denmark)

    Trondalen, Gro; Bonde, Lars Ole

    2012-01-01

    Music therapy (MT) is most commonly defined as an intervention where “the therapist helps the client to promote health, using music experiences and the relationships developing through them” (Bruscia 1998). Also other definitions of MT agree that a therapeutic relationship is important for a music...... intervention to be considered MT. Other interventions that “use music for health-related goals, but in ways that do not qualify as music therapy” (Gold 2009), may be described as music medicine, or simply as music listening. In this text we elaborate on an overview chapter covering some of the different major...... music therapy orientations/models (Guided Imagery and Music, Nordoff-Robbins, Psychoanalytic, Cognitive-behavioral etc), their theoretical foundations and their practical approaches to health and wellbeing or ‘health musicking’. The relational context – the interplay of (expressive as well as receptive...

  11. Music Therapy

    DEFF Research Database (Denmark)

    Sanfi, Ilan

    2012-01-01

    may cause detrimental long-term effects. Three studies have examined the effect of music therapy procedural support (MTPS) under needle procedures. Consequently, this study aims at examining the effects of MTPS in an RCT. Moreover, the study addresses clinical aspects of the applied MT intervention...... and provides research-based clinical tools. Methods 41 children (1 to 10 years) were enrolled and underwent a single PIVA procedure. The children were randomly assigned to either an MT or a comparable control group receiving PIVA. In addition, the music therapy (MT) group received individualised MTPS (i.......e. music alternate engagement) before, during, and after PIVA. The intervention was performed by a trained music therapist and comprised preferred songs, improvised songs/music, and instrument playing. The study was carried out in accordance with the rules in force regarding research ethics and clinical MT...

  12. Music therapy

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    alternate with clear and lucid mental states. These states are important as it is here that it is possible to meet the person’s psychosocial needs. Ketil Normann’s conceps of periods of lucidity are presented and connected to clinical music therapy practice and how it is possible to use music in order...... as a consequence of person-centred care. Umeå University Medical Dissertations. New Series. Ridder, H.M. (2005). Music therapy as a way to enhance lucidity in persons with dementia in advanced stages. In: Esch, A.; Frohne-Hagemann, I.; Laqua, M.; Schirmer, H.; Seitz, E. (Eds.) Jahrbuch Musicktherapie. Forschung......Neurodegenerative diseases and dementia might be followed by symptoms of confusion. In this paper a view on dementia is presented where the person is not described as “demented” and in a permanent state of non-lucidity and confusion, but is described as a person where periods of confusion might...

  13. Antiproton therapy

    CERN Document Server

    Knudsen, Helge V; Bassler, Niels; Alsner, Jan; Beyer, Gerd-Jürgen; DeMarco, John J; Doser, Michael; Hajdukovic, Dragan; Hartley, Oliver; Iwamoto, Keisuke S; Jäkel, Oliver; Kovacevic, Sandra; Møller, Søren Pape; Overgaard, Jens; Petersen, Jørgen B; Ratib, Osman; Solberg, Timothy D; Vranjes, Sanja; Wouters, Bradly G

    2008-01-01

    Radiotherapy is one of the most important means we have for the treatment of localised tumours. It is therefore essential to optimize the technique, and a lot of effort goes into this endeavour. Since the proposal by Wilson in 1946 [R.R. Wilson, Radiology use of fast protons, Radiology 47 (1946) 487.] that proton beams might be better than photon beams at inactivating cancer cells, hadron therapy has been developed in parallel with photon therapy and a substantial knowledge has been gained on the effects of pions, protons and heavy ions (mostly carbon ions). Here we discuss the recent measurements by the CERN ACE collaboration of the biological effects of antiprotons, and argue that these particles very likely are the optimal agents for radiotherapy.

  14. Gene therapy

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005147 CNHK200-hA-a gene-viral therapeutic system and its antitumor effect on lung cancer. WANG Wei-guo(王伟国),et al. Viral & Gene Ther Center, Eastern Hepatobilli Surg Instit 2nd Milit Univ, Shanghai 200438. Chin J Oncol,2005:27(2):69-72. Objective: To develop a novel vector system, which combines the advantages of the gene therapy,

  15. A Systematic Review of Randomized Controlled Studies of Art Therapy

    Science.gov (United States)

    Maujean, Annick; Pepping, Christopher A.; Kendall, Elizabeth

    2014-01-01

    This review article examines current knowledge about the efficacy of art therapy based on the findings of 8 randomized controlled trials (RCTs) conducted with adult populations from 2008-2013 that met a high standard of rigor. Of these studies, all but one reported beneficial effects of art therapy. Review findings suggest that art therapy may…

  16. The effectiveness of exercise therapy for ankylosing spondylitis: a review.

    Science.gov (United States)

    Wang, Ching-Yi; Chiang, Pin-Yen; Lee, Hong-Shen; Wei, James Cheng-Chung

    2009-09-01

    Exercise therapy is an important component of current standard therapy for patients with ankylosing spondylitis. The purpose of this review is to provide important guidelines when prescribing exercises by reviewing articles evaluating the effectives and usefulness of exercise therapy in patients with ankylosing spondylosis.

  17. Renal Replacement Therapy.

    Science.gov (United States)

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients' clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the "Tower of Babel" of critical care nephrology. PMID:26918174

  18. 下肢深静脉血栓形成介入治疗规范的专家共识%The consensus among Chinese interventional experts on the standard of interventional therapy for deep venous thrombosis of lower extremity

    Institute of Scientific and Technical Information of China (English)

    中华医学会放射学分会介入学组

    2011-01-01

    This paper aims to introduce the indications and contraindications of catheter-directed thrombolysis, percutaneous mechanical thrombectomy, balloon angioplasty and stent implantation for deep venous thromhosis of lower extremity, and also aims to summarize and to illustrate the manipulating procedure, the points for attention, the perioperative complications and preventions in performing different kind of interventional technique. Great importance is attached to the interventional therapy for both acute and subacute deep venous thrombosis of lower extremity in order to effectively reduce the occurrence of post-thrombosis syndrome. (J Intervent Radiol, 2011 , 20 : 505-510)%提出经导管溶栓治疗、机械性血栓消除术、球囊血管成形术及支架植入术治疗下肢深静脉血栓形成的适应证和禁忌证,对各种介入技术的操作步骤、注意事项、围手术期处理和并发症防治进行归纳和说明.强调重视急性期和亚急性期DVT的介入治疗,以减少血栓形成后综合征的发生率.

  19. Music Therapy: A Career in Music Therapy

    Science.gov (United States)

    About Music Therapy & Music Therapy Training M usic therapy is a healthcare profession that uses music to help individuals of all ages improve physical, ... grateful I chose a career as rewarding as music therapy. I love what I do each day!” Where ...

  20. An analysis of the curative effect of saccharomyces boulardii combined with a standard triple therapy in the treatment of 55 cases of helicobacter pylori-induced peptic ulcer%布拉酵母菌联合标准三联疗法治疗幽门螺杆菌消化性溃疡55例效果分析

    Institute of Scientific and Technical Information of China (English)

    朱路平; 肖飞

    2014-01-01

    目的:分析布拉酵母菌联合标准三联疗法治疗幽门螺杆菌消化性溃疡的临床疗效和安全性。方法随机将109例确诊幽门螺杆菌消化性溃疡进行分组,对照组54例予标准三联疗法治疗,实验组55例予布拉氏酵母菌联合标准三联疗法治疗,观察两组溃疡愈合效果、幽门螺杆菌清除率和不良反应情况。结果实验组溃疡愈合总有效率92.73%明显高于对照组79.63%(P0.05)。结论布拉氏酵母菌联合标准三联疗法能够通过快速恢复幽门螺杆菌消化性溃疡患者肠道菌群的动态平衡、抑制幽门螺杆菌在胃黏膜上皮定值和成长等作用提高幽门螺杆菌清除率。%Objective To analyze the clinical effect and safety of saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer. Methods A total of 109 patients who were diagnosed as helicobacter pylori-induced peptic ulcer were randomly assigned to control group and experimental group. The control group of 54 patients received a standard triple therapy, and the experimental group of 55 patients received saccharomyces boulardii combined with a standard triple therapy. Ulcer recovery, clearance rate of helicobacter pylori and adverse events were observed between the two groups. Results The total effective rate of ulcer recovery in the ex-perimental group was 92.73%, significantly higher than that of 79.63%in the control group(P<0.05); The clearance rate of helicobacter pylori in the experimental group was 90.91%, significantly higher than that of 75.93% in the control group (P<0.05); The incidence of adverse events in the experimental group was 12.73%, and P value was over 0.05 compared to that of 11.11% in the control group. Conclusion The saccharomyces boulardii combined with a standard triple therapy in the treatment of helicobacter pylori-induced peptic ulcer has a significantly effect, and is able to en-hance the

  1. Clinical Comparison of Sequential Scheme and Standard Triple Therapy in Treatment of Initial Patients with Infection of Helicobacter Pylori%序贯方案和标准三联方案治疗初始幽门螺旋菌感染患者的临床比较

    Institute of Scientific and Technical Information of China (English)

    张磊

    2015-01-01

    Objective To study the clinical effect of sequential scheme and standard triple therapy in treatment of initial patients with infection of Helicobacter pylori. Methods From 2012 March to 2014 September were treuted 106 cases who meet the re-quirements of initial Helicobacter in our hospital were divided into two groups. The control group took the triple therapy, observa-tion group adopted sequential therapy, comparison of two clinical symptom score, Hp eradication rate and the incidence of adverse reactions. Results The observation group after treatment, review the symptom scores were significantly lower than those in control group (P0.05). Conclusion Sequential scheme of Hp eradication rate, low recurrence rate, it has clinical value.%目的:比较序贯方案和标准三联方案治疗初始幽门螺旋菌感染临床疗效。方法以该院于2012年3月-2014年9月共收治106例符合要求初始幽门螺旋菌感染患者进行研究,分为两组。对照组采取三联疗法,观察组采取序贯疗法,比较两组临床症状评分、Hp根除率及不良反应发生率。结果观察组治疗结束、复查时的症状评分均显著低于对照组(P0.05)。结论序贯方案Hp根除率高,复发率低,有临床推广价值。

  2. Neoadjuvant therapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Rachit; D; Shah; Anthony; D; Cassano; James; P; Neifeld

    2014-01-01

    Esophageal cancer is increasing in incidence more than any other visceral malignancy in North America. Adenocarcinoma has become the most common cell type. Surgery remains the primary treatment modality for locoregional disease. Overall survival with surgery alone has been dismal, with metastatic disease the primary mode of treatment failure after an R0 surgical resection. Cure rates with chemotherapy or radiation therapy alone have been disappointing as well. For these reasons, over the last decade multi-modality treatment has gained increasing acceptance as the standard of care. This review examines the present data and role of neoadjuvant treatment using chemotherapy and radiation therapy followed by surgery for the treatment of esophageal cancer.

  3. Quadruple H therapy for vasospasm

    Directory of Open Access Journals (Sweden)

    Walid M

    2009-01-01

    Full Text Available Triple H therapy has been enthusiastically used to increase cerebral blood flow in cases of vasospasm. Nevertheless, the oxygen-carrying capacity of the blood is lowered with this treatment. This side effect can theoretically be partially corrected using hyperbaric oxygen therapy (HBO which appears to be the missing ring in the above therapeutic regimen. We conducted a review of of the available evidence regarding the beneficial effects of HBO in preventing postoperative ischemic complications due to vasospasm after surgery on ruptured cerebral aneurysms and the rationale for including HBO into the standards of care of these difficult patients.

  4. Therapy of Multiple Myeloma

    Institute of Scientific and Technical Information of China (English)

    H.Goldschmidt; F.W.Cremer; 等

    2002-01-01

    Multiple Myeloma(MM)is characterised by the accumulation of malignanat plasma cells in the bone marrow producing a monocolonal immungoglobulin.The standard conventiona therapy in the combination of melphalan and prednisone resulting in a response rate of 40%-60% and in a median survival time of approximately 3 years.In order to improve the therapeutic efficacy va rious combination regimens have been tested.Most randomized trials have frailed to show a significant improvement in survival time when combination chemotherapy is used instead of melphalan with or without prednisone.The benefit of maintenance therapy with interferon-alpha has been demonstrated.The toxicity of interferon-alpha,which may reduce the quality of life,should be considered.Recently,myeloma-treatment has been modified.High-dose chemotherapy accompaniced by hematopoietic stem-cell support via autologous transplant is recommended up to the age of 65-70 years.First results from a French study comparing single versus double autologous transplantaiton have shown a benefit in terms of event-free survival for the sequential approach.Vaccinations as an adoptive immuntherapy to treat minimal residual dsease are umder way.The mortality rate of allogeneic transplantation of hemaatopoietic stem cells has been reduced in the last 5 years.The use of reduced conditioning regimens or the partial depletion of T cells in peripheral blood stem cell transplants in an effort to decrease transplant related mortality are promising approaches.Thalidomide and its derivates are a new class of agents with independent anti-tumour activity in MM.Encouraging results with this antiangiogenic therapy in phase Ⅱ trials have been reported.Supportive therapies,such as the treatment of anaemia with erythropoietin,the management of renal failure and the use of bisphosphonates,improve the life quality of MM patients.

  5. Investigation and Analysis on the Standardized Anticoagulant Therapy with Warfarin in the Patients with Atrial Fibrillation in a Grade 3 Hospital%某三甲医院心房颤动患者华法林规范化抗凝治疗现状调查分析

    Institute of Scientific and Technical Information of China (English)

    郑必龙; 刘俊

    2016-01-01

    目的:了解心房颤动患者抗凝治疗现状,为心房颤动规范化抗凝治疗提供参考。方法:选取皖南医学院弋矶山医院2013年1月~2014年12月非瓣膜性心房颤动患者200例,采用CHA2DS2-VASc和HAS-BLED评分系统对纳入人群进行血栓危险分层和出血风险评估,并依据《2010年欧洲心脏病学会(ESC)心房颤动治疗指南》评价其规范化抗凝情况。结果:CHA2DS2-VASc和HAS-BLED评分分别为(2.73±2.10)分和(1.57±1.13)分。183例(91.5%)患者接受抗血栓治疗,使用华法林抗凝治疗的有74例(37%),而血栓高危组125例患者中,接受华法林抗凝治疗50例(40%)。华法林抗凝治疗时间(5.78±4.73) d,累积给药剂量为(19.46±18.19) mg,55例(74.32%)患者出院前监测国际标准化比值(INR),INR达标率为30.9%。结论:心房颤动以华法林抗凝治疗现状不容乐观,应采取有效的干预措施,提高心房颤动患者抗凝治疗规范化程度。%Objective: To investigate the current state of anticoagulant therapy with warfarin in the pa-tients with atrial fibrillation in order to provide references on the standardized anticoagulant therapy. Meth-ods: A total of 200 patients diagnosed non-valvular atrial fibrillation were inspected from January 2013 to December 2014 in the Yijishan Hospital of Wannan Medical College. CHA2DS2-VASc and HAS-BLED scheme methods were used to assess the risk of thrombosis and hemorrhage in the patients and the stan-dardized anticoagulant therapy conditions were evaluated according to the 2010 update of the ESC (Euro-pean Society of Cardiology) guidelines for the management of atrial fibrillation. Results: The scores of CHA2DS2-VASc and HAS-BLED scheme were (2.73±2.10) points and (1.57±1.13) points,respectively. A-mong the 200 patients, 183 patients (91.5%) received antithrombosis therapy and 74 patients (37%) were on warfarin anticoagulant therapy. In the

  6. Stereotactic Body Radiotherapy and Ablative Therapies for Lung Cancer.

    Science.gov (United States)

    Abbas, Ghulam; Danish, Adnan; Krasna, Mark J

    2016-07-01

    The treatment paradigm for early stage lung cancer and oligometastatic disease to the lung is rapidly changing. Ablative therapies, especially stereotactic body radiation therapy, are challenging the surgical gold standard and have the potential to be the standard for operable patients with early stage lung cancer who are high risk due to co- morbidities. The most commonly used ablative modalities include stereotactic body radiation therapy, microwave ablation, and radiofrequency ablation.

  7. Pemphigus vulgaris and laser therapy: Crucial role of dentists

    OpenAIRE

    Pavlić Verica; Vujić-Aleksić Vesna; Zubović Nina; Veselinović Valentina

    2014-01-01

    Introduction. Pemphigus vulgaris is a relatively rare, chronic, autoimmune vesiculobullous disorder characterized by formation of intraepithelial vesiculae and/or bullae in the skin and mucous membrane. Systemic steroids are considered to be the standard first-line therapy for pemphigus vulgaris. However, for patients unresponsive to standard therapy, the new treatment modalities are being sought. Low-level laser therapy has been accepted as an alternative ...

  8. The Financial Therapy Association: A Brief History

    Directory of Open Access Journals (Sweden)

    Sonya Britt

    2010-10-01

    Full Text Available The purpose of this brief review is to provide a historical context for the conceptualization, development, and launch of the Financial Therapy Association (FTA. The FTA membership base consists of practicing financial planners, financial counselors, psychologists, marriage and family therapists, social workers, financial coaches, psychotherapists, and researchers from these and other disciplines. From the outset, the Association’s purpose has encompassed five goals:To promote a vision of financial therapy, which is the study of cognitive, emotional, behavioral, relational, economic, and integrative aspects of financial health.To provide a forum for researchers, practitioners, the media, and policy makers to share research and practice methods and models of financial therapy.To promote methods of training for those involved in financial therapy.To inform policy and practice management standards as these relate to financial therapy.To stimulate and disseminate clinical, experimental, and survey research on financial therapy.

  9. Photodynamic therapy in endodontics: a literature review.

    Science.gov (United States)

    Trindade, Alessandra Cesar; De Figueiredo, José Antônio Poli; Steier, Liviu; Weber, João Batista Blessmann

    2015-03-01

    Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics. PMID:25719896

  10. [Outlook: Future therapy of renal cell carcinoma].

    Science.gov (United States)

    Bergmann, Lothar; Miller, Kurt

    2010-01-01

    Targeted therapies have fundamentally altered the therapy of metastatic renal cell carcinoma (mRCC). Sunitinib today is an internationally recommended reference standard in first-line therapy; other drugs such as Temsirolimus, Everolimus, Bevacizumab (in combination with Interferon-alpha) and Sorafenib are part of the therapeutic arsenal. Practitioners thus have now more and better therapeutic options at hand, leading to a significantly improved prognosis for mRCC patients. Numerous ongoing research activities aim at the improvement of the benefits of the new compounds in the metastatic situation or application earlier in the course of the disease. Key aspects of future development in RCC are the optimization of the current therapy options by developing new targeted therapies, the search for the best combinations and sequences including the role of nephrectomy and the assessment in the adjuvant or neo-adjuvant setting. The following contribution provides an overview of ongoing studies, thus giving insight into the future therapy of RCC. PMID:20164673

  11. Instant standard concept for data standards development

    OpenAIRE

    Folmer, Erwin; Kulcsor, Istvan Zsolt; Roes, Jasper

    2013-01-01

    This paper presents the current results of an ongoing research about a new data standards development concept. The concept is called Instant Standard referring to the pressure that is generated by shrinking the length of the standardization process. Based on this concept it is estimated that the development time is reduced by over 50% while maintaining an appropriate quality level for achieving interoperability in practice. The Instant Standard concept for development of data standards is des...

  12. [EFFICACY OF STANDARD TWO-YEAR COMPREHENSIVE THERAPY TO ACHIEVE TARGET BLOOD PRESSURE AND REGRESSION DEGREES OF REMODELING OF THE LEFT VENTRICULAR HYPERTROPHY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION WITH COMORBID HYPERTENSION].

    Science.gov (United States)

    Denesiuk, E V

    2015-01-01

    The study involved 23 men after acute myocardial infarction (AMI) with comorbid arterial hypertension (AH). Mean age of patients was 56.7 years. Recurrent myocardial infarction was determined in 38.4%, cardiac failure I-III functional classes--100% of the cases. All patients underwent clinical examination, electrocardiography and echocardiography, blood lipid profile. Standard comprehensive treatment for two years included an perindopril 5-10 mg/day, beta-blocker bisoprolol--5-10 mg/day, antisclerotic drug atorvastatin--20 mg/day and aspirin--75 mg/day. The patients after treatment was determined by a gradual increase towards the target of AT at 3, 6 and 12 to 24 months. Concentric left ventricular hypertrophy (LVH) before treatment was determined in 47.8%, eccentric--in 52.2% of patients. In the study of degrees of LVH I (initial) the extent to treatment was determined by 4.3%, II (moderate)--26.1%, III (large)--at 69.6%, indicating the development of cardiac remodeling. After the treatment was determined by marked reduction III (large) degree and transfer it in the II (moderate) and I (small) degree of left ventricular hypertrophy due to more or less pronounced changes remodeling left ventricular. The obtained data allow a more detailed and adequately assess the structural and functional outcome variables and determine the regression of myocardial hypertrophy in the background to achieve target blood pressure, which is important in practical cardiology.

  13. [EFFICACY OF STANDARD TWO-YEAR COMPREHENSIVE THERAPY TO ACHIEVE TARGET BLOOD PRESSURE AND REGRESSION DEGREES OF REMODELING OF THE LEFT VENTRICULAR HYPERTROPHY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION WITH COMORBID HYPERTENSION].

    Science.gov (United States)

    Denesiuk, E V

    2015-01-01

    The study involved 23 men after acute myocardial infarction (AMI) with comorbid arterial hypertension (AH). Mean age of patients was 56.7 years. Recurrent myocardial infarction was determined in 38.4%, cardiac failure I-III functional classes--100% of the cases. All patients underwent clinical examination, electrocardiography and echocardiography, blood lipid profile. Standard comprehensive treatment for two years included an perindopril 5-10 mg/day, beta-blocker bisoprolol--5-10 mg/day, antisclerotic drug atorvastatin--20 mg/day and aspirin--75 mg/day. The patients after treatment was determined by a gradual increase towards the target of AT at 3, 6 and 12 to 24 months. Concentric left ventricular hypertrophy (LVH) before treatment was determined in 47.8%, eccentric--in 52.2% of patients. In the study of degrees of LVH I (initial) the extent to treatment was determined by 4.3%, II (moderate)--26.1%, III (large)--at 69.6%, indicating the development of cardiac remodeling. After the treatment was determined by marked reduction III (large) degree and transfer it in the II (moderate) and I (small) degree of left ventricular hypertrophy due to more or less pronounced changes remodeling left ventricular. The obtained data allow a more detailed and adequately assess the structural and functional outcome variables and determine the regression of myocardial hypertrophy in the background to achieve target blood pressure, which is important in practical cardiology. PMID:27491146

  14. Short Term Efficacy of Ten-day Standard Sequential Therapy Combined With Dental Scaling on Helicobacter Pylori ;Eradication in Patients With Chronic Atrophic Gastritis%序贯疗法联合口腔洁治对慢性萎缩性胃炎患者胃幽门螺杆菌根除的近期疗效研究

    Institute of Scientific and Technical Information of China (English)

    孙佩玉

    2015-01-01

    Objective To investigate the efficacy of ten-day standard sequential therapy combined with dental scaling therapy on helicobacter pylori( Hp)in patients with chronic atrophic gastritis. Methods A total of 132 patients with chronic atrophic gastritis and positive Hp in both stomach and oral cavity were enrolled from Gastroenterology Department of the First Hospital of Jiaxing from January,2013 to January,2014 and were randomly assigned into observation group(n =62)and control group( n =70 ) . The observation group received ten -day standard sequential therapy combined with dental scaling therapy. The control group received ten-day standard sequential therapy only. Before treatment,one month and 3 months after treatment,two groups were compared by gastric Hp eradication rate,oral Hp positive rate and scores of pathological mechanism and symptoms. Results One month after treatment,two groups were significantly different in gastric Hp eradication rate and oral Hp positive rate(P﹤0. 05). Before treatment,two groups were not significantly different in scores of pathological mechanism and symptoms(P﹥0. 05);One month after treatment,significant differences occurred between two groups(P﹤0. 05). Three months after treatment,two groups were significantly different in gastric Hp eradication rate and oral Hp positive rate ( P ﹤0. 05 ). Conclusion Ten-day standard sequential therapy combined with dental scaling therapy has better Hp eradication effect and safety on patients with chronic atrophic gastritis.%目的:探讨序贯疗法联合口腔洁治对慢性萎缩性胃炎患者胃幽门螺杆菌( Hp)根除的近期疗效。方法将2013年1月—2014年1月在我院消化科门诊就诊的慢性萎缩性胃炎且胃、口腔Hp阳性患者132例作为研究对象,采用随机数字表法分为治疗组62例和对照组70例。治疗组给予10 d序贯疗法和口腔洁治法,对照组单纯给予10 d序贯疗法。比较两组治疗前、治疗后1

  15. Adjuvant therapies for colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The management of colon and rectal cancer has changed dramatically over the last 25 years. The use of adjuvant therapies has become standard practice in locally advanced (stage Ⅲ and selected stage Ⅱ) colorectal cancer. Improved surgical techniques, chemotherapeutics and radiotherapy are resulting in higher cure rates and the development of agents targeting proliferative and angiogenic pathways offer further promise. Here we explore risk factors for local and distant recurrence after resection of colon and rectal cancer, and the role of adjuvant treatments. Discussion will focus on the evidence base for adjuvant therapies utilised in colorectal cancer, and the treatment of sub-groups such as the elderly and stage Ⅱ disease. The role of adjuvant radiotherapy in rectal cancer in reduction of recurrence will be explored and the role and optimal methods for surveillance post-curative resection with or without adjuvant therapy will also be addressed.

  16. [Radiation therapy of pancreatic cancer].

    Science.gov (United States)

    Huguet, F; Mornex, F; Orthuon, A

    2016-09-01

    Currently, the use of radiation therapy for patients with pancreatic cancer is subject to discussion. In adjuvant setting, the standard treatment is 6 months of chemotherapy with gemcitabine and capecitabine. Chemoradiation (CRT) may improve the survival of patients with incompletely resected tumors (R1). This should be confirmed by a prospective trial. Neoadjuvant CRT is a promising treatment especially for patients with borderline resectable tumors. For patients with locally advanced tumors, there is no a standard. An induction chemotherapy followed by CRT for non-progressive patients reduces the rate of local relapse. Whereas in the first trials of CRT large fields were used, the treated volumes have been reduced to improve tolerance. Tumor movements induced by breathing should be taken in account. Intensity modulated radiation therapy allows a reduction of doses to the organs at risk. Whereas widely used, this technique is not recommended. PMID:27523418

  17. Laser Therapy in Ethnic Populations

    OpenAIRE

    Cole, Patrick D.; Hatef, Daniel A.; Kaufman, Yoav; Pozner, Jason N.

    2009-01-01

    Today, laser therapy is standard treatment for a wide variety of dermatologic complaints. From skin rejuvenation to the management of complex vascular malformations, laser treatment has proved to be an effective, innovative solution to once-challenging dilemmas. However, laser application in those with darker complexions remains a topic of great concern. Although contemporary devices may use longer-wavelength lasers and cooling devices to isolate target tissues within patients with high level...

  18. 男男性行为人群HIV感染者CD+4T随访检测与抗病毒治疗状况及影响因素分析%Status and correlates of standardized follow-up CD+4T counting and antiretroviral therapy among HIV-positive men who have sex with men

    Institute of Scientific and Technical Information of China (English)

    汪敏; 张洪波; 王君; 佘敏; 宋丹丹; 曹臻; 董振鑫; 浩浩; 沙迦

    2012-01-01

    Objective To know the status and correlates of standardized follow-up CDJT counting and antiretroviral therapy among a sample of HIV-positive men who have sex with men ( MSM). Methods A total of 200 HIV-positive MSM were recruited in Shanghai using snowball sampling. Data were collected with a self-administered questionnaire including sociodemographic, HIV/AIDS-related knowledge, CD4T counting and antiretroviral therapy in the time. Results Of 200 HIV-positive MSM participants, 190 were qualified for standardized follow-up CDJT counting and/or antiretroviral therapy and 78.4% of them reported receiving standardized follow-up CDJT counting and/or antiretroviral therapy (SCAT). The results from multiple Logistic regression analysis showed that who had less than 7 score of knowledge related HIV/AIDS were more likely to report non-SCAT( Ofl = 4.78, 90%C/:1.52-15.02). Participants ever sought for psychological counseling or financial help in past year were more likely to report non-SCAT than those who didn't (0/{=2.28, 90%C/;l. 18-4.38). Participants who didn' t consider HIV-status of sexual partners were less likely to report non-SCAT ( OR = 0.38, 90% CI-.0. 19-0.76). Comparing with those disclosure of positive HIV status to somebody else during 10 days , who disclosure of positive HIV status after 10 days were more likely to report non-SCAT(0fl=4.22, 90% C/: 1.70-10.47). Conclusions This survey revealed that there were some HIV-positive MSM who didn't access the service of standardized follow-up CD4T counting and antiretroviral therapy. Reinforcing education of antiretroviral therapy and improving health service will be needed.%目的 了解男男性行为人群(men who have sex with men,MSM) HIV感染者中艾滋病规范检测或治疗状况,探讨影响艾滋病规范检测或治疗的因素.方法 采用滚雪球的方法在上海市招募200名HIV阳性的MSM进行问卷调查,问卷内容包括规范服务状况与艾滋病相关危险行为等.结果 应该接

  19. [The application of total quality management (TQM) in quality management of radiation therapy].

    Science.gov (United States)

    Jiang, Rui-yao; Fu, Shen; Li, Bin

    2009-03-01

    The strategies and methods of the total quality management (TQM) need to applied in quality management of radiation therapy. We should improve the level of quality control and quality assurance in radiation therapy. By establishing quality control system in radiation therapy, standardization of radiation therapy workflow, strengthening quality control of devices and physical technique and paying attention to safety protection and staff training.

  20. A Comparison of Aphasia Therapy Outcomes before and after a Very Early Rehabilitation Programme Following Stroke

    Science.gov (United States)

    Godecke, Erin; Ciccone, Natalie A.; Granger, Andrew S.; Rai, Tapan; West, Deborah; Cream, Angela; Cartwright, Jade; Hankey, Graeme J.

    2014-01-01

    Background: Very early aphasia rehabilitation studies have shown mixed results. Differences in therapy intensity and therapy type contribute significantly to the equivocal results. Aims: To compare a standardized, prescribed very early aphasia therapy regimen with a historical usual care control group at therapy completion (4-5 weeks post-stroke)…

  1. Pyloric stenosis associated Crohn’s disease responding to adalimumab therapy

    Institute of Scientific and Technical Information of China (English)

    Sameer; Gaggar; John; Scott; Nicholas; Thompson

    2012-01-01

    Gastroduodenal Crohn’s disease (CD) is rare and the response to standard medical therapy is often poor. Anti-tumor necrosis factor therapy has revolutionised the treatment of CD. We present a patient with pyloric stenosis associated with CD which improved with Adalimumab therapy. We recommend considering antitumor necrosis factor therapy in symptomatic gastroduodenal CD.

  2. Vocal therapy with larynx compression after partial laryngectomy

    Directory of Open Access Journals (Sweden)

    Mumović Gordana M.

    2011-01-01

    Full Text Available The aim of the study was to establish the effects of the vocal therapy by manual compression of the larynx on dysphonia due to a partial laryngectomy and compare them with the effects of the standard vocal therapy. The prospective study included 66 patients submitted to any partial laryngectomy type. The patients were randomly classified into two groups: Group I (33 receiving the standard vocal therapy, and Group II (33 submitted to larynx compression vocal therapy. The 6-week vocal treatment was performed. The treatment effects were evaluated by subjective and objective voice analysis methods. The subjective and objective acoustic voice analysis revealed a significant influence (p<0.05 of either of the two vocal therapy modes on initial dysphonia. The larynx compression vocal therapy had better effects on the acoustic parameters: habitual fundamental frequency, mean fundamental frequency, standard deviation of fundamental frequency, maximal fundamental frequency, harmonics-to-noise ratio, and signal-to-noise ratio.

  3. Radioactive Iodine (Radioiodine) Therapy

    Science.gov (United States)

    ... lymph nodes and other parts of the body. Radioactive iodine therapy improves the survival rate of patients with papillary ... and benefits of RAI therapy with your doctor. Radioactive iodine therapy cannot be used to treat anaplastic (undifferentiated) and ...

  4. External Beam Therapy (EBT)

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z External Beam Therapy (EBT) External beam therapy (EBT) is a ... follow-up should I expect? What is external beam therapy and how is it used? External beam ...

  5. Laser therapy for cancer

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000905.htm Laser therapy for cancer To use the sharing features ... Lasers are also used on the skin. How Laser Therapy is Used Laser therapy can be used ...

  6. Occupational Therapy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Occupational Therapy KidsHealth > For Parents > Occupational Therapy Print A A ... for some kids. continue Kids Who Might Need Occupational Therapy According to the AOTA, kids with these medical ...

  7. American Music Therapy Association

    Science.gov (United States)

    American Music Therapy Association Home Contact News Help/FAQ Members Only Login Quick Links Facts About Music Therapy Qualifications ... with AMTA Sponsor AMTA Events Social Networking Support Music Therapy When you shop at AmazonSmile, Amazon will ...

  8. Instant standard concept for data standards development

    NARCIS (Netherlands)

    Folmer, E.; Kulcsar, I.Z.; Roes, J.

    2013-01-01

    This paper presents the current results of an ongoing research about a new data standards development concept. The concept is called Instant Standard referring to the pressure that is generated by shrinking the length of the standardization process. Based on this concept it is estimated that the dev

  9. Effects of Music Therapy on Drug Therapy of Adult Psychiatric Outpatients: A Pilot Randomized Controlled Study

    Science.gov (United States)

    Degli Stefani, Mario; Biasutti, Michele

    2016-01-01

    Objective: Framed in the patients’ engagement perspective, the current study aims to determine the effects of group music therapy in addition to drug care in comparison with drug care in addition to other non-expressive group activities in the treatment of psychiatric outpatients. Method: Participants (n = 27) with ICD-10 diagnoses of F20 (schizophrenia), F25 (schizoaffective disorders), F31 (bipolar affective disorder), F32 (depressive episode), and F60 (specific personality disorders) were randomized to receive group music therapy plus standard care (48 weekly sessions of 2 h) or standard care only. The clinical measures included dosages of neuroleptics, benzodiazepines, mood stabilizers, and antidepressants. Results: The participants who received group music therapy demonstrated greater improvement in drug dosage with respect to neuroleptics than those who did not receive group music therapy. Antidepressants had an increment for both groups that was significant only for the control group. Benzodiazepines and mood stabilizers did not show any significant change in either group. Conclusion: Group music therapy combined with standard drug care was effective for controlling neuroleptic drug dosages in adult psychiatric outpatients who received group music therapy. We discussed the likely applications of group music therapy in psychiatry and the possible contribution of music therapy in improving the psychopathological condition of adult outpatients. In addition, the implications for the patient-centered perspective were also discussed. PMID:27774073

  10. Prostate Focused Ultrasound Therapy.

    Science.gov (United States)

    Chapelon, Jean-Yves; Rouvière, Olivier; Crouzet, Sébastien; Gelet, Albert

    2016-01-01

    The tremendous progress in engineering and computing power coupled with ultrasound transducer technology and imaging modalities over the past 20 years have encouraged a revival of clinical interest in ultrasound therapy, mainly in High-Intensity Focused Ultrasound (HIFU). So far, the most extensive results from HIFU obtained in urology involve transrectal prostate ablation, which appears to be an effective therapeutic alternative for patients with malignant prostate tumors. Prostate cancer (PCa) is one of the most frequently diagnosed cancers in men. Several treatment options with different therapeutic approaches exist, including HIFU for localized PCa that has been in use for over 15 years. Since the early 2000s, two systems have been marketed for this application, and other devices are currently in clinical trials. HIFU treatment can be used either alone or in combination with (before- or after-) external beam radiotherapy (EBRT) (before or after HIFU) and can be repeated multiple times. HIFU treatment is performed under real-time monitoring with ultrasound or guided by MRI. Two indications are validated today: Primary care treatment and EBRT failure. The results of HIFU for primary care treatment are similar to standard conformal EBRT, even though no randomized comparative studies have been performed and no 10-year follow up data is yet available for HIFU. Salvage HIFU after EBRT failure is increasing with oncological outcomes, similar to those achieved with surgery but with the advantage of fewer adverse effects. HIFU is an evolving technology perfectly adapted for focal treatment. Thus, HIFU focal therapy is another pathway that must be explored when considering the accuracy and reliability for PCa mapping techniques. HIFU would be particularly suited for such a therapy since it is clear that HIFU outcomes and toxicity are relative to the volume of prostate treated. PMID:26486330

  11. Individual Music Therapy for Agitation in Dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Stige, Brynjulf; Qvale, Liv Gunnhild;

    2013-01-01

    methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. Method: In a crossover trial, 42 participants......Objectives: Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been...... with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. Results: Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at −6...

  12. Update on Hypercortisolism Therapy.

    Science.gov (United States)

    Arnaldi, Giorgio; Trementino, Laura

    2016-01-01

    Treating Cushing's syndrome is very challenging and should be tailored to the patient. Surgery is considered the gold standard treatment for both pituitary adrenocorticotropic hormone (ACTH)-secreting adenomas, ectopic ACTH-secreting tumors and adrenal tumors, as the chance to be successful is high, especially for adrenal tumors, when performed in specialized centers by expert surgeons. Pituitary radiotherapy represents a second-line treatment in patients not cured with surgery, or when medical treatment is not suitable/efficacious, although the rate of cure is largely variable and achieved only in the long term, and is associated with the risk of developing secondary hypopituitarism. Several drugs, acting at the pituitary, adrenal or peripheral tissue level, are available. Medical treatment is indicated as second-line therapy for patients unsuccessfully treated with pituitary surgery, or in those awaiting radiotherapy to become effective, or prior to adrenalectomy, and as the first-line approach to prepare patients for surgery, especially those with severe comorbidities, or in those not suitable/refusing surgery. The success rate of medical therapy is variable, depending on the cause and severity of hypercortisolism, and is often associated with important side effects. PMID:27210582

  13. Music therapy CD creation for initial pediatric radiation therapy: a mixed methods analysis.

    Science.gov (United States)

    Barry, Philippa; O'Callaghan, Clare; Wheeler, Greg; Grocke, Denise

    2010-01-01

    A mixed methods research design was used to investigate the effects of a music therapy CD (MTCD) creation intervention on pediatric oncology patients' distress and coping during their first radiation therapy treatment. The music therapy method involved children creating a music CD using interactive computer-based music software, which was "remixed" by the music therapist-researcher to extend the musical material. Eleven pediatric radiation therapy outpatients aged 6 to 13 years were randomly assigned to either an experimental group, in which they could create a music CD prior to their initial treatment to listen to during radiation therapy, or to a standard care group. Quantitative and qualitative analyses generated multiple perceptions from the pediatric patients, parents, radiation therapy staff, and music therapist-researcher. Ratings of distress during initial radiation therapy treatment were low for all children. The comparison between the two groups found that 67% of the children in the standard care group used social withdrawal as a coping strategy, compared to 0% of the children in the music therapy group; this trend approached significance (p = 0.076). MTCD creation was a fun, engaging, and developmentally appropriate intervention for pediatric patients, which offered a positive experience and aided their use of effective coping strategies to meet the demands of their initial radiation therapy treatment.

  14. Adenoviral Vectors for Hemophilia Gene Therapy

    Science.gov (United States)

    Brunetti-Pierri, N; Ng, Philip

    2013-01-01

    Hemophilia is an inherited blood clotting disorder resulting from deficiency of blood coagulation factors. Current standard of care for hemophilia patients is frequent intravenous infusions of the missing coagulation factor. Gene therapy for hemophilia involves the introduction of a normal copy of the deficient coagulation factor gene thereby potentially offering a definitive cure for the bleeding disorder. A variety of approaches have been pursued for hemophilia gene therapy and this review article focuses on those that use adenoviral vectors. PMID:24883229

  15. Increased survival in men with metastatic prostate cancer receiving chemo and hormone therapy

    Science.gov (United States)

    Men with hormone-sensitive metastatic prostate cancer who received the chemotherapy drug docetaxel given at the start of standard hormone therapy lived longer than patients who received hormone therapy alone, according to early results from a NIH-supporte

  16. Music as a therapy: role in psychiatry.

    Science.gov (United States)

    Solanki, Madhusudan Singh; Zafar, Mehnaz; Rastogi, Rajesh

    2013-06-01

    Music is popularly believed to usher in bliss and serenity, and healing is considered its natural quality. It has an emotionally charging charisma of its own, that we all as listeners might have experienced at times. Music has been there with mankind since the beginning of history, but where does it stand as a therapy? Is there any evidence base? How this therapy came into being and how it has evolved, and what the old and current research says about its role in psychiatric disorders. This review tries to explore these questions and arrives at a conclusion that music certainly promises more than just entertainment, and evidence so far suggests music therapy can be beneficial in the treatment of psychiatric disorders, as a cost effective noninvasive adjunct to standard therapy in a variety of settings and patient groups, yet more validated scientific research is still required to establish it as a sole quantified therapy.

  17. Ozone Therapy in Treatment of Female Infertility

    Directory of Open Access Journals (Sweden)

    Maradi A. Burduli

    2015-03-01

    Full Text Available Ozone therapy and physiotherapy have been successfully used in obstetric practice. The paper summarizes the results of studies on the use of ozone therapy in the postoperative rehabilitation of gynecological patients operated on for female infertility of various origins. Biomechanisms systemic impact methods of ozone therapy on the human body to meet the requirements of the tactics of the impact on the etiopathogenic mechanisms of chronic inflammatory diseases of the pelvic organs and their complications. It is advisable to wider use of ozone therapy in the complex treatment standards gynecological patients. Postoperative rehabilitation, including ozone therapy, can have a significant impact on the clinical course of gynecological and extragenital pathology, pregnancy rate and its outcomes.

  18. Standards help enterprises

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Standardization in modern times began from the Industrial Revolution. Various industrial sectors, for which about 300 standardization technical commissions have been established, make up the key fields of China's standardization.

  19. Standards in education

    OpenAIRE

    Darko Zupanc

    2005-01-01

    Modern educational systems are based on standards. Systems in countries all over the world differ and have different tradition, so different terms are used for similar concepts. In education, standards should have a similar role as in physics, where they are empirical and measurable. Two types of standards can be defined: content or curriculum standards and performance standards, with the latter being essential. Setting educational goals or content standards is the first step in the construct...

  20. Physical Therapy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Physical Therapy KidsHealth > For Parents > Physical Therapy Print A A ... Finding a Physical Therapist en español Terapia física Physical Therapy Basics Doctors often recommend physical therapy (PT) for ...

  1. Family Play Therapy.

    Science.gov (United States)

    Ariel, Shlomo

    This paper examines a case study of family play therapy in Israel. The unique contributions of play therapy are evaluated including the therapy's accessibility to young children, its richness and flexibility, its exposure of covert patterns, its wealth of therapeutic means, and its therapeutic economy. The systematization of the therapy attempts…

  2. Marriage or Family Therapy.

    Science.gov (United States)

    Haley, Jay

    1984-01-01

    Reviews the differences between family therapy and marriage counseling in terms of professional organization, theory, and practice. Suggests that training in marriage therapy does not appear adequate for family therapy. The goal of the therapy field should be more consensus in theory and a single profession of therapists. (JAC)

  3. Review of exposure therapy: A gold standard for PTSD treatment

    Directory of Open Access Journals (Sweden)

    Sheila A. M. Rauch, PhD

    2012-06-01

    Full Text Available Prolonged exposure (PE is an effective first-line treatment for posttraumatic stress disorder (PTSD, regardless of the type of trauma, for Veterans and military personnel. Extensive research and clinical practice guidelines from various organizations support this conclusion. PE is effective in reducing PTSD symptoms and has also demonstrated efficacy in reducing comorbid issues such as anger, guilt, negative health perceptions, and depression. PE has demonstrated efficacy in diagnostically complex populations and survivors of single- and multiple-incident traumas. The PE protocol includes four main therapeutic components (i.e., psychoeducation, in vivo exposure, imaginal exposure, and emotional processing. In light of PE’s efficacy, the Veterans Health Administration designed and supported a PE training program for mental health professionals that has trained over 1,300 providers. Research examining the mechanisms involved in PE and working to improve its acceptability, efficacy, and efficiency is underway with promising results.

  4. Creating standards: Creating illusions?

    DEFF Research Database (Denmark)

    Linneberg, Mai Skjøtt

    written standards may open up for the creation of illusions. These are created when written standards' content is not in accordance with the perception standard adopters and standard users have of the specific practice phenomenon's content. This general theoretical argument is exemplified by the specific...

  5. Arizona Academic Standards: Kindergarten

    Science.gov (United States)

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains Arizona public schools' academic standards for kindergarten. The contents of this document include the following: (1) The Arts Standard 2006--Kindergarten; (2) Comprehensive Health Education/Physical Activity Standards 1997--Readiness (Kindergarten); (3) Foreign and Native Language Standards 1997--Readiness…

  6. Photometric Standards for Non-Standard Filters

    Science.gov (United States)

    Hoot, John E.

    2015-05-01

    The AAVSO, professional collaborators, and research consortiums are increasingly requesting that photometric observations be submitted after they have been transformed onto 'standard' photometric systems. This greatly reduces the burden on the principal investigators in managing and merging data from many disparate contributors, but discourages many potential contributors who are unaware that their present equipment can make a valuable contribution. Many potential observers, amateurs, students and instructors are confused over what filters are required and what standards are best. This paper focuses on the best standards and observation methods for observers with one shot color cameras and those possessing monochrome CCD cameras with LRGB filter sets, the two most common configurations used in amateur and educational observatories. This paper examines which current standards best match common equipment and present effective ways for amateurs and students to reduce data to standard systems with common tools and a minimum of mathematical rigor.

  7. Standardization and the European Standards Organisations

    Directory of Open Access Journals (Sweden)

    Marta Orviska

    2014-01-01

    Full Text Available Standardization is a relatively neglected aspect of the EU regulatory process and yet it is fundamental to that process and arguably has recently been the key vehicle in making the single market an economic reality. Yet the key standardization bodies in the EU, the ESOs, are scarcely known to the public and seldom discussed in the literature. In this article we redress this imbalance, arguing that standardization and integration are closely related concepts. We also argue that the ESOs have developed a degree of autonomy in expanding the boundaries of standardization and even in developing their own links with the rest of the world. Recent proposals put forward by the European Commission can be seen as an attempt to reduce that autonomy. These proposals emphasize the speed of, and stakeholder involvement in, standards production, which we further suggest are somewhat conflicting aims.

  8. Eradication of H pylori infection in a rural population:One-day quadruple therapy versus 7-day triple therapy

    Institute of Scientific and Technical Information of China (English)

    Lian Zhang; Wei-Cheng You; Lin Shen; Jun-Ling Ma; Kai-Feng Pan; Wei-Dong Liu; Jie Li; Shu-Dong Xiao; San-Ren Lin; Meinhard Classen

    2006-01-01

    AIM: To compare the one-day quadruple therapy with a standard 7-d triple therapy for H pylori eradication in a rural population of China.METHODS: A total of 396 patients with 13C-urea breath test positive for H pylori were assigned into two groups:239 patients received one-day quadruple therapy (amoxicillin 2000 mg qid; metronidazole 500 mg qid; bismuth citrate 900 mg qid and lansoprazole 60 mg once daily)and 157 patients received 7-d standard triple therapy (amoxicillin 1000 mg bid; clarithromycin 500 mg bid and lansoprazole 30 mg bid). All the patients underwent a 13C-UBT to assess the eradication of H pylori infection six weeks after treatment.RESULTS: Two hundred and twenty-nine patients completed the one-day therapy (95.8%) and 148patients completed the 7-d therapy (94.2%). The oneday therapy eradicated H pylori infection in 64 patients (27.95%). In contrast, 103 patients (69.59%) were H pylori negative after the 7-d therapy (P < 0.01).CONCLUSION: This pilot study suggests there is no beneficial effect of the one-day therapy in treatment of H pylori infection compared with the 7-d standard therapy.

  9. The Dynamics of Standardization

    DEFF Research Database (Denmark)

    Brunsson, Nils; Rasche, Andreas; Seidl, David

    2012-01-01

    This paper suggests that when the phenomenon of standards and standardization is examined from the perspective of organization studies, three aspects stand out: the standardization of organizations, standardization by organizations and standardization as (a form of) organization. Following a...... comprehensive overview of existing research in these three areas, we argue that the dynamic aspects of standardization are under-represented in the scholarly discourse. Furthermore, we identify the main types of tension associated with standardization and the dynamics they generate in each of those three areas......, and show that, while standards and standardization are typically associated with stability and sameness, they are essentially a dynamic phenomenon. The paper highlights the contributions of this special issue to the topic of standards as a dynamic phenomenon in organization studies and makes...

  10. ACOUSTICAL STANDARDS NEWS.

    Science.gov (United States)

    Stremmel, Neil; Struck, Christopher J

    2016-07-01

    American National Standards (ANSI Standards) developed by Accredited Standards Committees S1, S2, S3, S3/SC 1, and S12 in the areas of acoustics, mechanical vibration and shock, bioacoustics, animal bioacoustics, and noise, respectively, are published by the Acoustical Society of America (ASA). In addition to these standards, ASA publishes a catalog of Acoustical American National Standards. To receive a copy of the latest Standards catalog, please contact Neil Stremmel.Comments are welcomed on all material in Acoustical Standards News.This Acoustical Standards News section in JASA, as well as the National Catalog of Acoustical Standards and other information on the Standards Program of the Acoustical Society of America, are available via the ASA home page: http://acousticalsociety.org. PMID:27475185

  11. Current work on dosimetry standards in Japan

    International Nuclear Information System (INIS)

    Basic concepts on standardization of radiation dosimetry are reviewed. The present situation regarding primary standards in the Electrotechnical Laboratory, the primary standard dosimetry laboratory in Japan, is presented, considering the following; (i) Established dosimetric standards of exposure for soft and medium-energy X-rays and gamma rays. This section includes methods of their standardization, and discusses accuracies of instruments operating as environmental-level, protection-level, inspection-level, therapy-level, and processing-level measuring systems. The results of international comparisons between ETL and other, foreign primary standard dosimetry laboratories are presented; (ii) Other established radiation standards related to derivation of radiation absorbed dose. These primary standards include those for the neutron emission rates, thermal and fast neutron flux densities, energy fluences for high-energy photons and electrons, and activities of several kinds of radioactive material. The accuracies and results of international comparisons relating to them are also presented; (iii) Research being carried out at ETL. The current status of the dissemination of radiation standards is presented considering in particular: (i) The calibration services available at ETL, the categories of these services, energy and dose rate ranges, methods, accuracies, etc.; (ii) The calibration services available in certain other organizations considered as SSDLs in Japan, the categories of such work, methods, accuracies etc.; (iii) Present endeavours towards establishing a systematic and effective dissemination system (a so-called Traceability System) in Japan

  12. Analysis of influencing factors of drug antihypertensive therapy management and blood pressure standard in com-munity hypertension management cases%社区高血压管理病人药物降压治疗管理及血压达标的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    董婷; 刘素珍; 李继平

    2016-01-01

    Objective:To probe into the situation of drug antihypertensive therapy and blood pressure standard of hypertension patients participating in a community managements in Chengdu and its influencing factors.Meth-ods:A total of 664 cases of patients in two communities in Chengdu received the questionnaire about general conditions,drug treatment and its management behavior,blood pressure control and so on.Results:The pa-tients’drug treatment rate was 97.7%;most of the patients received the combined antihypertensive with multi drugs.The patients’standard rate of blood pressure control was 68.1%;there was statistically significant differ-ences in standard rate of blood pressure control among patients with different ages,or genders,course of dis-ease,tobacco and alcohol habits,the number of complications,special clinics,blood glucose,blood lipids,treat-ment of management score(P <0.05),in which the prescribed medication,remembering medication,older than 65 years old,normal blood lipid,kind numbers of complications were the influencing factors of blood pressure standard(P <0.05 ).Conclusion:The drug treatment rate of patients participating in community management was higher,and most of them followed the recommended scheme,their standard rate of blood pressure was higher,and their compliance was better and could help patients control blood pressure.%[目的]探讨参与成都某社区管理的高血压病人药物降压治疗和血压达标情况及其影响因素。[方法]对成都市两社区664例病人的一般情况、药物治疗及其管理行为和血压控制情况等进行问卷调查。[结果]病人药物治疗率为97.7%;大多数病人采用多药联合降压。病人血压控制达标率为68.1%;不同年龄、性别、病程、烟酒嗜好、并发症种数、特殊门诊、血糖、血脂、治疗管理总分等病人的血压控制达标率差异有统计学意义(P <0.05),其中遵医嘱服药、记得服药、年龄≥65岁、血脂达标、

  13. Rationale for the tinnitus retraining therapy trial

    Directory of Open Access Journals (Sweden)

    Craig Formby

    2013-01-01

    Full Text Available The Tinnitus Retraining Therapy Trial (TRTT is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1 directive counseling and sound therapy using conventional sound generators; (2 directive counseling and placebo sound generators; or (3 standard of care as administered in the military. Study centers include a Study Chair′s Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant′s life.

  14. Hepatocellular carcinoma : Dutch guideline for surveillance, diagnosis and therapy

    NARCIS (Netherlands)

    Eskens, F. A. L. M.; van Erpecum, K. J.; de Jong, K. P.; van Delden, O. M.; Klumpen, H. J.; Verhoef, C.; Jansen, P. L. M.; van den Bosch, M. A. A. J.; Romero, A. Mendez; Verheij, J.; Bloemena, E.; de Man, R. A.

    2014-01-01

    Hepatocellular carcinoma (HCC) is rare in the Netherlands, even though the incidence has increased quite sharply in recent years. Standard treatment options consist of surgery, orthotopic liver transplantation, radiofrequency ablation, transarterial chemoembolisation (TACE) and systemic therapy with

  15. Adjuvant Therapy of Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Chakra P Chaulagain

    2011-07-01

    Full Text Available There is no clear consensus on what type of adjuvant therapy should be used for patients with pancreatic cancer. Chemoradiation is the favored treatment modality by many in the United States while gemcitabine based chemotherapy is favored in Europe. Both of these approaches have been shown by large prospective, randomized trials to improve disease free intervals and in some studies overall survival. This year at the American Society of Clinical Oncology (ASCO Gastrointestinal Cancer Symposium, the randomized phase III study presented by Uesaka et al. from Japan (Abstract #145 represents a newer paradigm of oral adjuvant S-1 chemotherapy in place of the traditional standard of care intravenous gemcitabine in terms of prolonging patients’ survival. Another study by Fan et al. (Abstract #269 examined the value of targeted therapy using erlotinib with adjuvant chemoradiation and chemotherapy. We present the summary of these two studies and discuss the potential impact on our clinical practice on this highly lethal cancer.

  16. Fractionated radiation therapy after Strandqvist

    International Nuclear Information System (INIS)

    Models for predicting the total dose required to produce tolerable normal-tissue damage in radiation therapy are becoming less empirical, more realistic, and more specific for different tissue reactions. The progression is described from the 'cube root law', through STRANDQVIST'S well known graph to NSD, TDF and CRE and more recently to biologically based time factors and linear-quadratic dose-response curves. New applications of the recent approach are reviewed together with their implications for non-standard fractionation in radiation therapy. It is concluded that accelerated fractionation is an important method to be investigated, as well as hyperfractionation; and that more data are required about the proliferation rates of clonogenic cells in human tumours. (orig.)

  17. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Birke-Sorensen, Hanne; Kruse, Marie;

    formation (52%) compared to standard care. The reduction in wound dehiscence was not statistically significant. The numbers needed to treat were 3 (seroma), 17 (dehiscence), and 25 (infection). Methodical heterogeneity across studies led to downgrading quality of evidence to moderate for infection......Aim: Postoperative wound complications make many surgical procedures unnecessarily complex, particularly in high-risk patients. Negative Pressure Wound Therapy is well recognized in the management of open wounds. In recent years, it has been introduced as well in the management of closed surgical...... incisions to reduce postoperative wound complications, though the evidence base to support this intervention is limited. The aim of this study was to assess if Negative Pressure Wound Therapy (NPWT) reduces postoperative complications when applied on closed surgical incisions. Method: A systematic review...

  18. Review of Tumor Dormancy Therapy Using Traditional Oriental Herbal Medicine

    OpenAIRE

    Lee Jong-Ho; Koung Fan-Pei; Cho Chong-Kwan; Lee Yeon-Weol; Yoo Hwa-Seung

    2013-01-01

    Objective: Standard cancer therapy prolongs survival, but can be detrimental to the quality of life, compromise the immune system, and leave residual disease that can cause recurrence years or decades in the future. Tumor dormancy therapy is a novel therapeutic approach that may improve these shortcomings, promote quality of life, and prolong survival. The aim of this study was to analyze studies on dormancy therapy, especially studies using traditional Oriental herbal medicine, so as to eval...

  19. Standardisation in standards

    International Nuclear Information System (INIS)

    The following observations are offered by one who has served on national and international standards-writing committees and standards review committees. Service on working groups consists of either updating previous standards or developing new standards. The process of writing either type of document proceeds along similar lines. The first order of business is to recognise the need for developing or updating a standard and to identify the potential user community. It is also necessary to ensure that there is a required number of members willing to do the writing. A justification is required as to why a new standard should be developed, and this is written as a new work item proposal or a project initiation notification system form. This document must be filed officially and approved, and a search is then undertaken to ensure that the proposed new standard will not duplicate a standard that has already been published or is underway in another standards organisation. (author)

  20. Standards in education

    Directory of Open Access Journals (Sweden)

    Darko Zupanc

    2005-12-01

    Full Text Available Modern educational systems are based on standards. Systems in countries all over the world differ and have different tradition, so different terms are used for similar concepts. In education, standards should have a similar role as in physics, where they are empirical and measurable. Two types of standards can be defined: content or curriculum standards and performance standards, with the latter being essential. Setting educational goals or content standards is the first step in the construction of knowledge measurement procedures. In Slovenia, the traditional term 'performance objective' or 'instructional objective' can be used instead of the term 'content standards'. For each school subject on different levels in Slovenian educational system, performance standards have to be set in the future, if educational system is to be based on standards.

  1. Rational Emotive Behavior Therapy after Ellis: Predictions for the Future.

    Science.gov (United States)

    Weinrach, Stephen G.; Ellis, Albert; DiGiuseppe, Raymond; Bernard, Michael E.; Dryden, Windy; Kassinove, Howard; Morris, G. Barry; Vernon, Ann; Wolfe, Janet

    1995-01-01

    Nine members of the institute for Rational-Emotive Therapy's (REBT) International Training Standards and Review Committee predicted the status of REBT 25 to 50 years after the death of Albert Ellis. Will REBT continue to exist in its own right or be incorporated into newer forms of cognitive behavior therapy? (EMK)

  2. Nuclear standardization development study

    International Nuclear Information System (INIS)

    Nuclear industry is the important part of national security and national economic development is key area of national new energy supported by government. nuclear standardization is the important force for nuclear industry development, is the fundamental guarantee of nuclear safe production, is the valuable means of China's nuclear industry technology to the world market. Now nuclear standardization faces to the new development opportunity, nuclear standardization should implement strategy in standard system building, foreign standard research, company standard building, and talented people building to meet the requirement of nuclear industry development. (author)

  3. Music Therapy and Music Therapy Research. Response

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2002-01-01

    This response to Keynote by Prof. Even Ruud (N)"Music Education and Music Therapy seeks to define these two areas with specific focus on tools and methods for analysis of music as these methods are developed in music therapy. This includes that the music therapist, the music and the client create...

  4. MGMT Methylation Status: The Advent of Stratified Therapy in Glioblastoma?

    OpenAIRE

    Peter Hau; Roger Stupp; Hegi, Monika E.

    2007-01-01

    Glioblastomas are the most malignant gliomas with median survival times of only 15 months despite modern therapies. All standard treatments are palliative. Pathogenetic factors are diverse, hence, stratified treatment plans are warranted considering the molecular heterogeneity among these tumors. However, most patients are treated with "one fits all" standard therapies, many of them with minor response and major toxicities. The integration of clinical and molecular information, now becoming a...

  5. Innovative Approaches to Plasminogen Activator Therapy

    Science.gov (United States)

    Haber, Edgar; Quertermous, Thomas; Matsueda, Gary R.; Runge, Marschall S.

    1989-01-01

    Plasminogen activator therapy for acute myocardial infarction has become standard medical practice. Bleeding complications, however, limit the utility of the currently available agents. This article reviews how the tools of molecular biology and protein engineering are being used to develop safer and more effective plasminogen activators.

  6. Radioactivity of peat mud used in therapy.

    Science.gov (United States)

    Karpińska, Maria; Mnich, Krystian; Kapała, Jacek; Bielawska, Agnieszka; Kulesza, Grzegorz; Mnich, Stanisław

    2016-02-01

    The aim of the study was to determine the contents of natural and artificial isotopes in peat mud and to estimate the radiation dose absorbed via skin in patients during standard peat mud treatment. The analysis included 37 samples collected from 8 spas in Poland. The measurements of isotope concentration activity were conducted with the use of gamma spectrometry methods. The skin dose in a standard peat mud bath therapy is approximately 300 nSv. The effective dose of such therapy is considered to be 22 nSv. The doses absorbed during peat mud therapy are 5 orders of magnitude lower than effective annual dose absorbed from the natural radiation background by a statistical Pole (3.5 mSv). Neither therapeutic nor harmful effect is probable in case of such a small dose of ionising radiation. PMID:26675542

  7. Radioactivity of peat mud used in therapy.

    Science.gov (United States)

    Karpińska, Maria; Mnich, Krystian; Kapała, Jacek; Bielawska, Agnieszka; Kulesza, Grzegorz; Mnich, Stanisław

    2016-02-01

    The aim of the study was to determine the contents of natural and artificial isotopes in peat mud and to estimate the radiation dose absorbed via skin in patients during standard peat mud treatment. The analysis included 37 samples collected from 8 spas in Poland. The measurements of isotope concentration activity were conducted with the use of gamma spectrometry methods. The skin dose in a standard peat mud bath therapy is approximately 300 nSv. The effective dose of such therapy is considered to be 22 nSv. The doses absorbed during peat mud therapy are 5 orders of magnitude lower than effective annual dose absorbed from the natural radiation background by a statistical Pole (3.5 mSv). Neither therapeutic nor harmful effect is probable in case of such a small dose of ionising radiation.

  8. Modern radiation therapy for extranodal lymphomas

    DEFF Research Database (Denmark)

    Yahalom, Joachim; Illidge, Tim; Specht, Lena;

    2015-01-01

    Extranodal lymphomas (ENLs) comprise about a third of all non-Hodgkin lymphomas (NHL). Radiation therapy (RT) is frequently used as either primary therapy (particularly for indolent ENL), consolidation after systemic therapy, salvage treatment, or palliation. The wide range of presentations of ENL...... there is a lack of guidelines for the use of RT in the management of ENL. This report presents an effort by the International Lymphoma Radiation Oncology Group (ILROG) to harmonize and standardize the principles of treatment of ENL, and to address the technical challenges of simulation, volume definition...... and treatment planning for the most frequently involved organs. Specifically, detailed recommendations for RT volumes are provided. We have applied the same modern principles of involved site radiation therapy as previously developed and published as guidelines for Hodgkin lymphoma and nodal NHL. We have...

  9. The Environmental Impact on Occupational Therapy Interventions.

    Science.gov (United States)

    Skubik-Peplaski, Camille Louise; Howell, Dana; Hunter, Elizabeth

    2016-01-01

    The purpose of this study was to investigate how the environment influenced the intervention choices occupational therapists made for patients recovering from a stroke in an inpatient rehabilitation hospital. Three occupational therapists were observed providing intervention for six patients over a 16-month period. Treatment spaces included a therapy gym, gym with kitchen combination, and a home-like space. Furniture was added to the therapy gym to be more home-like midway through the study. Observations included therapist selection of treatment location and interventions, and observational data of the environment and interactions among therapists and patients. This study found that inpatient rehabilitation environments did influence interventions. The occupational therapists provided therapy in the standard therapy gym environment most often, whether it was enhanced to be more home-like or not, and predominately used preparatory methods.

  10. Genes and Gene Therapy

    Science.gov (United States)

    ... correctly, a child can have a genetic disorder. Gene therapy is an experimental technique that uses genes to ... or prevent disease. The most common form of gene therapy involves inserting a normal gene to replace an ...

  11. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  12. Adlerian Marriage Therapy.

    Science.gov (United States)

    Carlson, Jon; Dinkmeyer, Don, Sr.

    1987-01-01

    Describes the assumptions, processes, and techniques used in Alderian marriage therapy. Describes purpose of therapy as assessing current beliefs and behaviors while educating the couple in new procedures that can help the couple establish new goals. (Author/ABL)

  13. Therapy and Counseling

    Science.gov (United States)

    ... feelings and behavior. Behavior therapy is sometimes called behavior modification therapy. This kind of treatment focuses on changing unwanted or unhealthy behaviors and replacing them with healthy ones. This treatment ...

  14. Virtual particle therapy centre

    CERN Multimedia

    2015-01-01

    Particle therapy is an advanced technique of cancer radiation therapy, using protons or other ions to target the cancerous mass. This advanced technique requires a multi-disciplinary team working in a specialised centre. 3D animation: Nymus3D

  15. Hyperbaric oxygen therapy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002375.htm Hyperbaric oxygen therapy To use the sharing features on this page, please enable JavaScript. Hyperbaric oxygen therapy uses a special pressure chamber to increase ...

  16. Watermarking as a traceability standard.

    Science.gov (United States)

    Coatrieux, Gouenou; Quantin, Catherine; Allaert, François-André

    2012-01-01

    The exponential increase in the number of electronic document exchanges in healthcare has considerably increased the risk of document drop-out or address errors. It may therefore be important to know to whom the information belongs and who produced it. This becomes a major concern when the document has been involved in processes leading to the choice of therapy and eventually in cases where patients seek damages for medical malpractice. Watermarking, which is the embedding of security elements, such as a digital signature, within a document, can help to ensure that a digital document is reliable. However, at the same time, questions arise about the validity of watermarking-based evidence. In this paper, beyond the technical aspects, we discuss the worldwide legal acceptability of watermarking and the need for its recognition as a standard according to technical characteristics that the CEN and ISO need to agree on.

  17. Agent Standards Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation of the work herein proposed is the development of standards for software autonomous agents. These standards are essential to achieve software...

  18. Standards and standpoints

    DEFF Research Database (Denmark)

    Nissen, Morten

    2016-01-01

    This article argues that critique is a necessary component in any study of standards, just as it is implied in the concept of standard itself. From this follows the relevance of reflexively situating our research in relation to the cultural-historical development of standards and standardization....... The argument takes off from two different conceptualizations of standards in the literature. On the one hand, standards as immanent to practices (the “Neo-Aristotelian” approach), and on the other hand, standards as imposed to regulate practices (the “neo-pragmatist” and “governmentality” approaches......). It is suggested that this opposition can be superseded by articulating the former alternative, not as an essentialism of “practice,” but as the reflexive assumption of standpoint. Some intricacies of the articulation of standpoint are then discussed, concluding in a proposed dialectics of standard and standpoint....

  19. Catalytic Functions of Standards

    NARCIS (Netherlands)

    K. Blind (Knut)

    2009-01-01

    textabstractThe three different areas and the examples have illustrated several catalytic functions of standards for innovation. First, the standardisation process reduces the time to market of inventions, research results and innovative technologies. Second, standards themselves promote the diffusi

  20. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Vinter, Christina Anne; Bille, Camilla;

    Background: Obese women undergoing caesarean section are at increased risk of surgical wound complications, which may lead to delayed recovery, pain, reduced quality of life, and increased health care cost. The aim of this study is to evaluate the effect of incisional Negative Pressure Wound...... the therapy will be left in situ for five days. In the control group the dressing will be left in situ for at least 24 hours as standard procedure. Follow-up is 30 days. Results: The study is on going. The first 179 participants are about to be analysed. Overall we expect to find a 50% reduction of wound...

  1. The proposed Sticks Standard

    OpenAIRE

    Trimberger, Stephen

    1980-01-01

    This is version 1.0 of the Sticks Standard. Software has been written to interface this standard to plotters, a graphic Sticks editor, a Stick compactor and several simulators. The Standard appears adequate to describe cells for chip assemblers as well as Stick diagram editing and compaction systems. However, this version of the Sticks Standard cannot efficiently describe large chips because it lacks an array facility. This deficiency will be corrected in the next release of the Sticks ...

  2. Combined tumor therapy

    International Nuclear Information System (INIS)

    This comprehensive survey of current methods and achievements first takes a look at the two basic therapies, devoting a chapter each to the surgery and radiotherapy of tumors. The principal subjects of the book, however, are the systemic, adjuvant therapy, biological therapies, hyperthermia and various other therapies (as e.g. treatment with ozone, oxygen, or homeopathic means), and psychotherapy. (MG) With 54 figs., 86 tabs

  3. A case of standardization?

    DEFF Research Database (Denmark)

    Rod, Morten Hulvej; Høybye, Mette Terp

    2015-01-01

    Guidelines are increasingly used in an effort to standardize and systematize health practices at the local level and to promote evidence-based practice. The implementation of guidelines frequently faces problems, however, and standardization processes may in general have other outcomes than the o...... describe this process as a case of epistemic standardization....

  4. Questioning the Standard

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Dairy quality standards trigger further controversy China’s dairy industry is once again being scrutinized as suspicions abound that major dairy enterprises played a hand in manipulating and lowering quality standards to save costs.The new standards released in March 2010 set the maximum safety limit for bacteria in raw milk at 2 million cells per milliliter, four times

  5. Collaboration Between Multistakeholder Standards

    DEFF Research Database (Denmark)

    Rasche, Andreas; Maclean, Camilla

    responsibility is unlikely to support a great variety of partly competing and overlapping standards. Increased collaboration between these standards would enhance both their impact and their adoption by firms. This report examines the nature, benefits, and shortcomings of existing multistakeholder standards...

  6. Automotive Technology Skill Standards

    Science.gov (United States)

    Garrett, Tom; Asay, Don; Evans, Richard; Barbie, Bill; Herdener, John; Teague, Todd; Allen, Scott; Benshoof, James

    2009-01-01

    The standards in this document are for Automotive Technology programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school automotive program. Minimally, the student will complete a three-year program to achieve all standards. Although these exit-level standards are designed…

  7. Methylprednisolone pulse therapy in severe acute asthma.

    Science.gov (United States)

    Pedersen, B K; Laursen, L C; Lervang, H H; Stjernebjerg, T; Weeke, B

    1987-02-01

    In a group comparative double blind pilot study six asthmatic patients with an acute exacerbation of their disease were randomly treated with either methylprednisolone pulse therapy (MPPT) (1000 mg daily for 3 days) (n = 2) followed by placebo tablets, or standard doses of methylprednisolone (MP) (50 mg daily gradually decreased to zero over 3 weeks) (n = 4). The results showed that the effect of MPPT did not differ from that of standard doses of MP. MPPT has, however, the potential of being preferable to standard treatment with MP, because of easy administration and optimal patient compliance. PMID:3296841

  8. Venous Thromboembolism Anticoagulation Therapy

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2009-01-01

    @@ VTE of the main treatment for anticoagulant thera-py, anticoagulant therapy drug of choice for low molecu-lar weight heparin (LMWH) for the overwhelming major-ity of clinicians agree that long-term oral anticoagulant therapy is still Vit. K antagonist (mainly warfarin).

  9. Musings on Adventure Therapy.

    Science.gov (United States)

    Alvarez, Antonio G.; Stauffer, Gary A.

    2001-01-01

    Critiques various definitions of adventure therapy, then suggests that adventure therapy is any intentional, facilitated use of adventure tools and techniques to guide personal change toward desired therapeutic goals. Reflects on the nature of adventure therapy through a discussion of the application of this definition and its implications for…

  10. Behavior Therapy of Impotence

    Science.gov (United States)

    Dengrove, Edward

    1971-01-01

    Behavior therapy approaches to the treatment of male sexual impotence, specifically premature ejaculation and erective impotence, are discussed. Included in the behavioral therapies are systematic desensitization, active graded therapy, assertive techniques, sexual responses, operant approaches and others. Often marriage counseling is also…

  11. Aquatic Therapy for Children

    Science.gov (United States)

    Kucher, Greta; Moore, Kelsey; Rodia, Rachel; Moser, Christy Szczech

    2015-01-01

    Aquatic therapy has long been highlighted in the literature as a potentially powerful therapeutic intervention. This review will highlight basic definitions of aquatic therapy, review salient research, and identify specific diagnoses that may benefit from aquatic therapy. Online resources, blogs, and books that occupational therapists may find…

  12. Therapy of pancreatic cancer

    International Nuclear Information System (INIS)

    Pancreatic cancer remains one of the most difficult diseases to cure. Japan pancreas society guidelines for management of pancreatic cancer indicate therapeutic algorithm according to the clinical stage. For locally limited pancreatic cancer (cStage I, II, III in Japanese classification system), surgical resection is recommended, however prognosis is still poor. Major randomized controlled trials of resected pancreatic cancer indicates that adjuvant chemotherapy is superior to observation and gemcitabine is superior to 5-fluorouracil (FU). For locally advanced resectable pancreatic cancer (cStage IVa in Japanese classification system (JCS)), we perform neoadjuvant chemoradiotherapy. Phase I study established a recommended dose of 800 mg gemcitabine and radiation dose of 36 Gy. For locally advanced nonresectable pancreatic cancer (cStage IVa in JCS), chemoradiotherapy followed by chemotherapy is recommended. Although pancreatic cancer is chemotherapy resistant tumor, systemic chemotherapy is recommended for metastatic pancreatic cancer (cStage IVb in JCS). Single-agent gemcitabine is the standard first line agent for the treatment of advanced pancreatic cancer. Meta-analysis of chemotherapy showed possibility of survival benefit of gemcitabine combination chemotherapy over gemcitabine alone. We hope gemcitabine combination chemotherapy or molecular targeted therapy will improve prognosis of pancreatic cancer in the future. (author)

  13. Information Security Standards

    Directory of Open Access Journals (Sweden)

    Dan Constantin Tofan

    2011-09-01

    Full Text Available The use of standards is unanimously accepted and gives the possibility of comparing a personal security system with a given frame of reference adopted at an international level. A good example is the ISO 9000 set of standards regarding the quality management system, which is a common reference regardless of the industry in which a certain company activates. Just like quality control standards for other industrial processes such as manufacturing and customer service, information security standards demonstrate in a methodical and certifiable manner that an organization conforms to industry best practices and procedures. This article offers a review of the world’s most used information security standards.

  14. Business Standardization & Market Economy

    Institute of Scientific and Technical Information of China (English)

    Li Shiyuan

    2007-01-01

    The introduction of the market economy in China requires a renewed understanding of the theory and practice of business standardization. Built on the basic principles of standardization and the market economics, this paper seeks to define the role and status of standardization in the market economy, its aims and priorities. It then describes the deployment of standardization in market competition. Lastly, it explores into the possible transformations of concepts, functions and associated personnel of enterprise standardization in order to keep abreast of the evolving market economy.

  15. Standardization in Beijing Opera

    Institute of Scientific and Technical Information of China (English)

    Liu Zhiyang

    2012-01-01

    Beijing Opera is the treasure of Chinese traditional dramatic arts.More than 200 years of artistic practice is the process that makes it mature and standardized.Although it is not described by standardized academic terminologies,all the performances of 'Chang (Singing)','Nian(Speaking)','Zuo (Acting)' and 'Da (Fighting)' have been following standardization requirement which is called "Chengshi (pattem)" in professional language or "Fan'er" in jargou,literally meaning a standard pattern.The pattern is the an technology format which is refined and summarized in accordance with the beautify principles from natural forms of things in life and then standardized to be the commonly adhered.

  16. 117 Standards Admitted in Civil Administration Standardization Plan

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ The Ministry of Civil Administration has finalized its Standardization Plan 2007. According to this plan, the Ministry will see that 117 standards, including 8 compulsory national standards, 83 recommended national standards, and 26 professional standards, are prepared by June 2008.

  17. Music Therapy for Seniors

    OpenAIRE

    SLUNEČKOVÁ, Petra

    2014-01-01

    This bachelor thesis deals with the use of music therapy in the lives of seniors. The target of this thesis is to map the possibilities of using music therapy ways with seniors and to recommend a suitable music therapy resources on the basis of the research and evaluation of obtained dates. The theoretical part describes the term "the music therapy", e.g. concept, definition, types and forms, the development of music therapy, the history, methods and techniques. This age group is defined in t...

  18. Scoring and Standard Setting with Standardized Patients.

    Science.gov (United States)

    Norcini, John J.; And Others

    1993-01-01

    The continuous method of scoring a performance test composed of standardized patients was compared with a derivative method that assigned each of the 131 examinees (medical residents) a dichotomous score, and use of Angoff's method with these scoring methods was studied. Both methods produce reasonable means and distributions of scores. (SLD)

  19. Individualized therapies in colorectal cancer: KRAS as a marker for response to EGFR-targeted therapy

    Directory of Open Access Journals (Sweden)

    Li Kuiyuan

    2009-04-01

    Full Text Available Abstract Individualized therapies that are tailored to a patient's genetic composition will be of tremendous value for treatment of cancer. Recently, Kirsten ras (KRAS status has emerged as a predictor of response to epidermal growth factor receptor (EGFR targeted therapies. In this article, we will discuss targeted therapies for colorectal cancers (CRC based on EGFR signaling pathway and review published data about the potential usefulness of KRAS as a biological marker for response to these therapies. Results from relevant studies published since 2005 and unpublished results presented at national meetings were retrieved and summarized. These studies reflected response (or lack of response to EGFR-targeted therapies in patients with metastatic CRC as a function of KRAS status. It has become clear that patients with colorectal cancer whose tumor has an activating mutation in KRAS do not respond to monoclonal antibody therapies targeting EGFR. It should now become a standard practice that any patients being considered for EGFR targeted therapies have their tumors tested for KRAS status and only those with wild-type KRAS being offered such therapies.

  20. Aroma therapy and medfly SIT

    Energy Technology Data Exchange (ETDEWEB)

    Shelly, Todd E., E-mail: todd.e.shelly@aphis.usda.go [U.S. Department of Agriculture (USDA-APHIS), HI (United States). Animal and Plant Health Inspection

    2006-07-01

    A summary of the main findings of the research program on the biological competence of mass-reared, sterile males of the Mediterranean fruit fly (med fly), Ceratitis capitata (Wied.) and the development and implementation of the sterile insect technique (SIT) against this pest is presented. The potential application of aroma therapy to improve the mating success of sterile med fly males is studied. The report assumes a loosely chronological framework as it documents progression along two experimental scales: the number of males simultaneously exposed to ginger root oil, starting with small groups of 25 males and ending with rooms with nearly 200 million males; the experimental arena used to test the effects of aroma therapy, progressing from standard field-cages to large field enclosures to the open field. In addition, brief comments are offered regarding the potential negative effects of GRO exposure, the mechanisms underlying GRO-mediated improvement in male mating success, and the financial costs of GRO aroma therapy. (MAC)

  1. Aroma therapy and medfly SIT

    International Nuclear Information System (INIS)

    A summary of the main findings of the research program on the biological competence of mass-reared, sterile males of the Mediterranean fruit fly (med fly), Ceratitis capitata (Wied.) and the development and implementation of the sterile insect technique (SIT) against this pest is presented. The potential application of aroma therapy to improve the mating success of sterile med fly males is studied. The report assumes a loosely chronological framework as it documents progression along two experimental scales: the number of males simultaneously exposed to ginger root oil, starting with small groups of 25 males and ending with rooms with nearly 200 million males; the experimental arena used to test the effects of aroma therapy, progressing from standard field-cages to large field enclosures to the open field. In addition, brief comments are offered regarding the potential negative effects of GRO exposure, the mechanisms underlying GRO-mediated improvement in male mating success, and the financial costs of GRO aroma therapy. (MAC)

  2. Meta analysis of CHA2DS2-VASc contributing to standardization management of the prophylactic anticoagulation therapy of TE and/or stroke in AF patients%CHA2DS2-VASc评分有助于房颤脑卒中和(或)血栓栓塞预防性抗凝治疗的规范化Meta分析

    Institute of Scientific and Technical Information of China (English)

    朱文根; 熊琴梅; 洪葵

    2015-01-01

    Objective:To perform a systematic review and meta-analysis of the predictive abilities of CHA2DS2-VASc in stroke and systemic thromboembolism (TE) risk stratification of atrial fibrilltion (AF) patients with and without anticoagulation therapy.Method:The data were systematically retrieved by searching the Cochrane Library,PubMed and Embase databases to identify relevant cohort studies published in English reporting the diagnostic performance between CHADS2 and CHA2DS2-VASc.Review Manager 5.2 software were used to perform the statistical analyses.The risk ratios (RRs) with the 95% CI were presented and pooled for comparative analysis of the occurrence of TE and/or stroke between CHA2DS2-VASc<2 and CHA2DS2-VASc≥2,also considering the presence or absence of anticoagulation therapy.Result:Twelve cohort studies were identified in the analysis.Of these included studies,7 of the included studies reported TE outcomes,and 5 studies included a record of stroke events.With regard to the occurrence of outcomes individually,patients with CHA2 DS2-VASc scores ≥2 showed a greater risk for stroke (RR 5.31,CI:3.69~7.62;P<0.01) and TE (RR 5.94,CI:5.48~6.43;P<0.01) (Pdiff=0.55),regardless of the presence or absence of anticoagulation therapy (RR 5.43,CI:4.92~6.00;P<0.01 and RR 5.92,CI:5.26~6.67;P<0.01,respectively) (Pdiff =0.57).The average ratio of endpoint events in the low-risk group of CHA2DS2-VASc was less than CHADS2 (0.54% vs 1.40%,P<0.05).The average proportion of the high-risk group of CHA2DS2-VASc was greater than CHADS2 (81.0% vs 46.0%,P<0.05).Conclusion:Our results showed better diagnostic performance for CHA2DS2-VASc over CHADS2 for the distribution of greater numbers of patients and a greater incidence of endpoints events into the high-risk stratification,as well as the identification of patients with atrial fibrillation who are at substantial risk of endpoint events with or without optimal anticoagulant therapy.It indicates that the

  3. Decitabine as Maintenance Therapy After Standard Therapy in Treating Patients With Previously Untreated Acute Myeloid Leukemia

    Science.gov (United States)

    2016-07-19

    Acute Myeloid Leukemia With Myelodysplasia-Related Changes; Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With t(16;16)(p13.1;q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); RUNX1-RUNX1T1; Adult Acute Myeloid Leukemia With t(9;11)(p22;q23); MLLT3-MLL; Untreated Adult Acute Myeloid Leukemia

  4. Androgen Deprivation Therapy and Secondary Hormone Therapy in the Management of Hormone-sensitive and Castration-resistant Prostate Cancer.

    Science.gov (United States)

    Saad, Fred; Fizazi, Karim

    2015-11-01

    Androgen deprivation therapy (ADT) is the standard of care for patients with metastatic prostate cancer (mPC). However, nearly all patients with mPC progress to castration-resistant PC (CRPC). Arrays of treatments, including secondary hormonal therapies, are available for the treatment of mPC and CRPC, which show efficacy when administered with ADT. Continuation of ADT is recommended for CRPC treatment as therapies are added. New secondary hormonal therapies include abiraterone, targeting the CYP17 enzyme family, and enzalutamide, an androgen receptor inhibitor with heightened binding specificity. The optimal decision-making process for CRPC treatment option remains unclear, pending further research and experience. PMID:26282624

  5. Standards der Globalisierung

    OpenAIRE

    Botzem, Sebastian

    2010-01-01

    Accounting standards are frequently understood to be little more than formalized rules for the preparation of financial statements. However, despite the apparent a-political nature standards are contested and show relevant distributional effects. In times of economic globalization, setting accounting standards is increasingly organized beyond the nation state. A private not-for-profit organization has emerged over 35 years which dominates accounting regulation today. This dissertation analyze...

  6. Study on application of standardized diet design in diet therapy for type 2 diabetes patients with obese%标准化饮食设计在2型糖尿病肥胖病人饮食治疗中的应用研究

    Institute of Scientific and Technical Information of China (English)

    胡鹏; 李敏; 于晓霞

    2012-01-01

    [目的]研究标准化饮食设计在2型糖尿病肥胖病人饮食治疗中的作用.[方法]将36例2型糖尿病肥胖病人随机分为两组,给予饮食教育与治疗,低糖组以进糖类占总热量的30%为主的食物,低脂肪组以进食糖类占总热量的55%、脂肪占总热量的30%为主的食物.观察两组入院时、出院后3个月和6个月病人的体重指数;观察两组入院时、出院后6个月糖化血红蛋白、血脂的变化;并于第6个月给予动态血糖监测,观察两组病人24 h血糖平均值、三餐餐后血糖峰值及出现峰值的时间、每日谷值的变化.[结果]低糖组6个月后体重低于低脂肪组(P<0.01);低糖组三餐餐后血糖峰值比低脂肪组明显降低(P<0.01),且达到峰值时间明显延长(P<0.01),每日谷值明显上升(P<0.01);6个月后低糖组与低脂肪组血脂指标比较差异无统计学意义(P>0.05).[结论]低糖饮食能更好地控制2型糖尿病肥胖病人的血糖波动和体重,并在短期内不会影响病人的血脂.%Objective: To probe into the effect of the standardized diet design in diet therapy for obese patients with type 2 diabetes. Methods; A total of 36 cases of type 2 diabetes patients with obese were randomly divided into two groups,dietary education and therapy was given to both group cases, low - carbohydrate group patients had the food in which carbohydrates accounted for 30% of the total calories,low - fat group patients were given food in which carbohydrate accounted for more than 55% of total calories and the fat accounted for less 30% of the total calories. Then the patient's body mass index in two groups was observed respectively at admission, 3 months, 6 months after discharge; changes of glycosylated hemoglobin and blood lipid of two groups were observed at admission and 6 months after discharge; and the continuous glucose monitoring was placed in sixth months so as to observe the 24 h average blood sugar

  7. Flight Standards Automation System

    Data.gov (United States)

    Department of Transportation — FAVSIS supports Flight Standards Service (AFS) by maintaining their information on entities such as air carriers, air agencies, designated airmen, and check airmen....

  8. Standard NIM instrumentation system

    CERN Document Server

    1990-01-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID- 20893 (Rev 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice.

  9. Standardization: colorfull or dull?

    Science.gov (United States)

    van Nes, Floris L.

    2003-01-01

    After mentioning the necessity of standardization in general, this paper explains how human factors, or ergonomics standardization by ISO and the deployment of information technology were linked. Visual display standardization is the main topic; the present as well as the future situation in this field are treated, mainly from an ISO viewpoint. Some observations are made about the necessary and interesting co-operation between physicists and psychologists, of different nationality, who both may be employed by either private enterprise or governmental institutions, in determining visual display requirements. The display standard that is to succeed the present ISO standards in this area: ISO 9241-3, -7, -8 and ISO 13406-1, -2, will have a scope that is not restricted to office tasks. This means a large extension of the contexts for which display requirements have to be investigated and specified especially if mobile use of displays, under outdoor lighting conditions, is included. The new standard will be structured in such a way that it is better accessible than the present ones for different categories of standards users. The subject color in the new standard is elaborated here. A number of questions are asked as to which requirements on color rendering should be made, taking new research results into account, and how far the new standard should go in making recommendations to the display user.

  10. Standard NIM instrumentation system

    Energy Technology Data Exchange (ETDEWEB)

    1990-05-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev. 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice.

  11. Standard NIM instrumentation system

    International Nuclear Information System (INIS)

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev. 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice

  12. International hearing protector standardization

    DEFF Research Database (Denmark)

    Poulsen, Torben

    2002-01-01

    Hearing protectors shall fulfill some minimum requirements to their performance. As hearing protector manufacturers sell the products all over the world, the testing and certification of hearing protectors has become an international issue. The ISO working group WG17 under the headlines Acoustics......, Noise, produce hearing protector standards to be used at an international level. The presentation will cover the ongoing work in WG17, including the revision of existing standards (ISO 4869-1, ISO 4869-3), upcoming new standards (ISO 4869-7) and the plans and status for future standards (performance in...

  13. The postmodern turn in group therapy.

    Science.gov (United States)

    O'Leary, J V

    2001-10-01

    The postmodern critique, often referred to as social constructionism, has influenced nearly all disciplines, including recently the domain of psychology--and most particularly psychoanalysis. This article presents an exposition of the "postmodern turn," including some historical perspective, a description of its theoretical elements as related to psychological practice, as well as standard objections to its theories. This author believes that many of the concepts inherent to a social constructionist approach are compelling for theory and practice in group therapy. Clinical case studies are cited in describing how postmodern theories present a natural fit for group therapy. Furthermore, specific implications of this model are delineated for the arduous task of leading groups.

  14. Music therapy with disorders of consciousness

    DEFF Research Database (Denmark)

    Magee, Wendy L.; O'Kelly, Julian

    Music therapy is a clinical healthcare discipline that draws its evidence base from a number of theoretical frameworks, including psychology and music neuroscience to improve the health and well-being in individuals from varied clinical populations. Working with individuals across the lifespan...... is to present the latest developments in music therapy intervention and measurement with people with disorders of consciousness stemming from acquired profound brain injury. We will share a standardized clinical protocol and examine recent research findings that illustrate the benefits of music-based methods...

  15. Therapy of the burnout syndrome [Therapie des Burnout-Syndroms

    Directory of Open Access Journals (Sweden)

    Korczak, Dieter

    2012-06-01

    Full Text Available [english] The prevalence, diagnostics and therapy of the burnout syndrome are increasingly discussed in the public. The unclear definition and diagnics of the burnout syndrome are scientifically criticized. There are several therapies with unclear evidence for the treatment of burnout in existence.The health technology assessment (HTA report deals with the question of usage and efficacy of different burnout therapies.For the years 2006 to 2011, a systematic literature research was done in 31 electronic databases (e.g. EMBASE, MEDLINE, PsycINFO. Important inclusion criteria are burnout, therapeutic intervention and treatment outcome.17 studies meet the inclusion criteria and are regarded for the HTA report. The studies are very heterogeneous (sample size, type of intervention, measuring method, level of evidence. Due to their study design (e.g. four reviews, eight randomized controlled trials the studies have a comparable high evidence: three times 1A, five times 1B, one time 2A, two times 2B and six times 4. 13 of the 17 studies are dealing with the efficacy of psychotherapy and psychosocial interventions for the reduction of burnout (partly in combination with other techniques. Cognitive behaviour therapy leads to the improvement of emotional exhaustion in the majority of the studies. The evidence is inconsistent for the efficacy of stress management and music therapy. Two studies regarding the efficacy of Qigong therapy do not deliver a distinct result. One study proves the efficacy of roots of Rhodiola rosea (evidence level 1B. Physical therapy is only in one study separately examined and does not show a better result than standard therapy.Despite the number of studies with high evidence the results for the efficacy of burnout therapies are preliminary and do have only limited reach. The authors of the studies complain about the low number of skilled studies for the therapy of burnout. Furthermore, they point to the insufficient evaluation of

  16. Algorithms for optimizing drug therapy

    Directory of Open Access Journals (Sweden)

    Martin Lene

    2004-07-01

    based on one of these three models could be constructed regarding all but one of the studied disorders. The single exception was depression, where reliable relationships between patient characteristics, drug classes and outcome of therapy remain to be defined. Conclusion Algorithms for optimizing drug therapy can, with presumably rare exceptions, be developed for any disorder, using standard Internet programming methods.

  17. Music therapy for end-of-life care: an updated systematic review

    OpenAIRE

    McConnell, Tracey; Scott, David; Porter, Sam

    2016-01-01

    Background: Music therapy during palliative and end-of-life care is well established and positive benefits for patients have been reported. Aim: Assess the effectiveness of music therapy versus standard care alone or standard care in combination with other therapies for improving psychological, physiological and social outcomes among adult patients in any palliative care setting. Data sources: In order to update an existing Cochrane systematic review, we searched MEDLINE, CINAHL, EMBASE, Psyc...

  18. Acceptance and Commitment Therapy versus Cognitive Therapy for the Treatment of Comorbid Eating Pathology

    Science.gov (United States)

    Juarascio, Adrienne S.; Forman, Evan M.; Herbert, James D.

    2010-01-01

    Previous research has indicated that although eating pathology is prevalent in college populations, both CBT and non-CBT-based therapies achieve only limited effectiveness. The current study examined several questions related to the treatment of eating pathology within the context of a larger randomized controlled trial that compared standard CBT…

  19. Music therapy improvisation

    OpenAIRE

    Mira Kuzma

    2001-01-01

    In this article, the technique of music therapy – music therapy improvisation is introduced. In this form of music therapy the improvising partners share meaning through the improvisation: the improvisation is not an end in itself: it portrays meaning that is personal, complex and can be shared with the partner. The therapeutic work, then, is meeting and matching the client's music in order to give the client an experience of "being known", being responded through sounds a...

  20. Hormone therapy in acne

    OpenAIRE

    Chembolli Lakshmi

    2013-01-01

    Underlying hormone imbalances may render acne unresponsive to conventional therapy. Relevant investigations followed by initiation of hormonal therapy in combination with regular anti-acne therapy may be necessary if signs of hyperandrogenism are present. In addition to other factors, androgen-stimulated sebum production plays an important role in the pathophysiology of acne in women. Sebum production is also regulated by other hormones, including estrogens, growth hormone, insulin, insulin-l...

  1. Psychodynamic Music Therapy

    OpenAIRE

    Jinah Kim

    2016-01-01

    This paper introduces and explores the basic principles of psychodynamic approaches in music therapy. Music is used as a means to explore both conscious and unconscious issues as well as the internal world of the individuals involved in music therapy. However, the focus of therapy is on therapeutic relationship, especially the dynamics of transference and counter-transference between the client and the music therapist. Musical experiences, such as music listening, songs, and improvisation, ca...

  2. Journal of Proton Therapy

    OpenAIRE

    Editorial Office

    2015-01-01

    Journal of Proton Therapy (JPT) is an international open access, peer-reviewed journal, which publishes original research, technical reports, reviews, case reports, editorials, and other materials on proton therapy with focus on radiation oncology, medical physics, medical dosimetry, and radiation therapy.No article processing/submission feeNo publication feePeer-review completion within 3-6 weeksImmediate publication after the completion of final author proofreadDOI assignment for each publi...

  3. Writing Music Therapy

    OpenAIRE

    Mary Helena Rykov

    2011-01-01

    Communicating about music therapy is problematic because discursive language fails to convey the nonverbal, embodied essence of experience. I explore the emergence of this problem in the music therapy literature. I discuss the scholarship of phenomenological writing. I provide examples of nondiscursive music therapy writing. I introduce the genre of poetic inquiry.

    Poetry is the most musical form of language. Poetry and music, linked throughout history, share many ...

  4. Principles of gene therapy

    OpenAIRE

    Mammen Biju; Ramakrishnan T; Sudhakar Uma; Vijayalakshmi

    2007-01-01

    Genes are specific sequences of bases that encode instructions to make proteins. When genes are altered so that encoded proteins are unable to carry out their normal functions, genetic disorders can result. Gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. This article reviews the fundamentals in gene therapy and its various modes of administration with an insight into the role of gene therapy in Periodontics an...

  5. Cochlear Gene Therapy

    OpenAIRE

    Lustig, Lawrence R.; Akil, Omar

    2012-01-01

    The purpose of this review is to highlight recent advances in cochlear gene therapy over the past several years. Cochlear gene therapy has undergone tremendous advances over the past decade. Beginning with some groundbreaking work in 2005 documenting hair cell regeneration using virallymediated delivery of the mouse atonal 1 gene, gene therapy is now being explored as a possible treatment for a variety of causes of hearing loss.

  6. Unproven (questionable) cancer therapies.

    OpenAIRE

    Brigden, M L

    1995-01-01

    More than half of all cancer patients use some form of alternative treatment during the course of their illness. Alternative therapies are often started early in patients' illness, and their use is frequently not acknowledged to health care professionals. Some alternative therapies are harmful, and their promoters may be fraudulent. Persons who try alternative cancer therapies may not be poorly educated but may ultimately abandon conventional treatment. Recent attention has focused on aspects...

  7. Pain in photodynamic therapy

    OpenAIRE

    Mircea Tampa; Maria Isabela Sârbu; Mădălina-Irina Mitran; Cristina-Iulia Mitran; Adrian Dumitru; Vasile Benea; Simona-Roxana Georgescu

    2016-01-01

    Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect...

  8. Nuclear medicine therapy

    CERN Document Server

    Eary, Janet F

    2013-01-01

    One in three of the 30 million Americans who are hospitalized are diagnosed or treated with nuclear medicine techniques. This text provides a succinct overview and detailed set of procedures and considerations for patient therapy with unsealed radioactivity sources.  Serving as a complete literature reference for therapy with radiopharmaceuticals currently utilized in practice, this source covers the role of the physician in radionuclide therapy, and essential procedures and protocols required by health care personnel.

  9. How many standards?

    DEFF Research Database (Denmark)

    Maegaard, Marie

    2009-01-01

    Discussions of standardisation and standard languages has a long history in linguistics. Tore Kristiansen has contributed to these discussions in various ways, and in this chapter I will focus on his claim that young Danes operate with two standards, one for the media and one for the school. This...

  10. State Skill Standards: Photography

    Science.gov (United States)

    Howell, Frederick; Reed, Loretta; Jensen, Capra; Robison, Gary; Taylor, Susan; Pavesich, Christine

    2007-01-01

    The Department of Education has undertaken an ambitious effort to develop statewide skill standards for all content areas in career and technical education. The standards in this document are for photography programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school program.…

  11. Soviet Standardization of Russian.

    Science.gov (United States)

    Benson, Morton

    1961-01-01

    After a brief history of influences on the standardization of Russian since the Revolution, the descriptive and normalizing role of specific reference works of grammar, phonetics, vocabulary, and morphology is discussed. Concluding remarks point out a problem caused by a lack of coordination of standardization efforts and the mounting demands for…

  12. Workflow automation architecture standard

    Energy Technology Data Exchange (ETDEWEB)

    Moshofsky, R.P.; Rohen, W.T. [Boeing Computer Services Co., Richland, WA (United States)

    1994-11-14

    This document presents an architectural standard for application of workflow automation technology. The standard includes a functional architecture, process for developing an automated workflow system for a work group, functional and collateral specifications for workflow automation, and results of a proof of concept prototype.

  13. Standards Supporters Firing Back

    Science.gov (United States)

    Ujifusa, Andrew

    2013-01-01

    Supporters of the Common Core State Standards are moving to confront increasingly high-profile opposition to the standards at the state and national levels by rallying the private sector and initiating coordinated public relations and advertising campaigns as schools continue implementation. In states such as Michigan and Tennessee, where…

  14. Standardizing visual display quality

    NARCIS (Netherlands)

    Besuijen, Ko; Spenkelink, Gerd P.J.

    1998-01-01

    The current ISO 9241–3 standard for visual display quality and the proposed user performance tests are reviewed. The standard is found to be more engineering than ergonomic and problems with system configuration, software applications, display settings, user behaviour, wear and physical environment

  15. The Genomic Standards Consortium

    DEFF Research Database (Denmark)

    Field, Dawn; Amaral-Zettler, Linda; Cochrane, Guy;

    2011-01-01

    Standards Consortium (GSC), an open-membership organization that drives community-based standardization activities, Here we provide a short history of the GSC, provide an overview of its range of current activities, and make a call for the scientific community to join forces to improve the quality...

  16. Academic Standards in Alabama

    Science.gov (United States)

    A+ Education Partnership, 2014

    2014-01-01

    Education policymakers and educators in Alabama are committed to improving the state's public education system to ensure that students gain the knowledge and skills they need to graduate from high school ready for real life. The state is on the path to implementing higher academic standards--the College and Career Ready Standards--which lay a…

  17. [CAS General Standards 2012

    Science.gov (United States)

    Council for the Advancement of Standards in Higher Education, 2011

    2011-01-01

    The mission of the Council for the Advancement of Standards in Higher Education (CAS) is to promote the improvement of programs and services to enhance the quality of student learning and development. CAS is a consortium of professional associations who work collaboratively to develop and promulgate standards and guidelines and to encourage…

  18. State Skill Standards: Metalworking

    Science.gov (United States)

    Pointer, Mike; Naylor, Randy; Warden, John; Senek, Gene; Shirley, Charles; Lefcourt, Lew; Munson, Justin; Johnson, Art

    2005-01-01

    The Department of Education has undertaken an ambitious effort to develop statewide occupational skill standards. The standards in this document are for metalworking programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school program. The writing team determined that any…

  19. [Nutritional therapy of gout].

    Science.gov (United States)

    Nickolai, Beate; Kiss, Caroline

    2016-01-01

    Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid. PMID:27008448

  20. [Nutritional therapy of gout].

    Science.gov (United States)

    Nickolai, Beate; Kiss, Caroline

    2016-01-01

    Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid.

  1. Medical Art Therapy

    Directory of Open Access Journals (Sweden)

    Birgul Aydin

    2012-03-01

    Full Text Available Art therapy is a form of expressive therapy that uses art materials. Art therapy combines traditional psychotherapeutic theories and techniques with an understanding of the psychological aspects of the creative process, especially the affective properties of the different art materials. Medical art therapy has been defined as the clinical application of art expression and imagery with individuals who are physically ill, experiencing physical trauma or undergoing invasive or aggressive medical procedures such as surgery or chemotherapy and is considered as a form of complementary or integrative medicine. Several studies have shown that patients with physical illness benefit from medical art therapy in different aspects. Unlike other therapies, art therapy can take the patients away from their illness for a while by means of creative activities during sessions, can make them forget the illness or lost abilities. Art therapy leads to re-experiencing normality and personal power even with short creative activity sessions. In this article definition, influence and necessity of medical art therapy are briefly reviewed.

  2. Postmodernism and Music Therapy

    Directory of Open Access Journals (Sweden)

    Eugenia Hernandez-Ruiz

    2005-11-01

    Full Text Available The present essay is a short and probably superficial analysis of music therapy and music therapy research. I have to say that by no means do I consider myself an expert or even experienced enough to provide "critiques" about any area of music therapy. This work is a revised version of a term paper presented at the University of Kansas in 2002, and is just the result of my interest in some recent trends of thoughts (e.g. social constructionism, and their impact, if any, on music therapy. I believe in dialogue as a means to forward knowledge, and so I dare to share this work with colleagues.

  3. Neutron Therapy Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Neutron Therapy Facility provides a moderate intensity, broad energy spectrum neutron beam that can be used for short term irradiations for radiobiology (cells)...

  4. Principles of gene therapy

    Directory of Open Access Journals (Sweden)

    Mammen Biju

    2007-01-01

    Full Text Available Genes are specific sequences of bases that encode instructions to make proteins. When genes are altered so that encoded proteins are unable to carry out their normal functions, genetic disorders can result. Gene therapy is designed to introduce genetic material into cells to compensate for abnormal genes or to make a beneficial protein. This article reviews the fundamentals in gene therapy and its various modes of administration with an insight into the role of gene therapy in Periodontics and future percepts and the technical and ethical issues of using gene therapy.

  5. Music Therapy with Adolescents

    Directory of Open Access Journals (Sweden)

    Jukko Tervo

    2005-03-01

    Full Text Available The therapeutic community described in this paper was situated at the University of Oulu Central Hospital Department of Psychiatry, Finland, during the years 1979-1989. The ward consisted of eight beds, four for boys and four for girls. The basic emphasis in the treatment was laid on psychoanalytic psychotherapy and music and art therapies suitable for the stage of adolescent development. Adolescent community therapy (psychoanalytic psychotherapy, music therapy, art therapy, special school etc. creates an environment which supports individual growth of the adolescent and youth culture. This, in turn, simultaneously supports psychotherapy.

  6. [Morita therapy over history].

    Science.gov (United States)

    Usa, Shinichi

    2003-01-01

    At Sansei Hospital in Kyoto we performed Morita Therapy not only for Japanese clients but also foreign clients from several countries, like Germany, Switzerland, U.S.A., China, Korea, India and Indonesia. We could treat those foreign clients using Morita Therapy with good success although they came from various cultural backgrounds. One of the characteristic Approaches of Morita Therapy was that it avoided the conceptualization of self-consciousness and self image as a subjective fiction established by abstract and logical thinking. Secondary Morita Therapy moves clients to deal with activities in real life. These 2 approaches help clients not to be involved in symptom development or fixation mechanisms and break through self-centeredness. At the first stage of Morita Therapy, namely in the bed rest period clients can experience his psychic state as if he were a just born baby. The founder of Gestalt Therapy, Frederick S. Perls experienced by himself Morita Therapy. During bed rest therapy he behaved as if he were a baby. This behavior came out not from conscious abstract and logical thinking but from spontaneous "pre-conscious" state of mind. Morita called this "Jun-na-kokoro" (Pure mind). Morita knew that neurotic symptoms come out from those abstract and logical thinking which could lead to fixation of symptoms so that therapy principle might be the de-centralization of self and the pure mind experience which is found in our daily life and also in daily life of foreign people from various cultural backgrounds. PMID:12875225

  7. Standardization of engineering documentation

    International Nuclear Information System (INIS)

    Many interrelated activities involving a number of organizational units comprise the process for the design and construction of a nuclear steam supply steam (NSSS). In the application of a standard NSSS design, many activities are duplicated from project to project and form a standard process for the engineering. This standard process in turn lends itself to a system for standardizing the engineering documentation associated with a particular design application. For these varied activities to be carried out successfully, a strong network of communication is required not only within each design organization but also externally among the various participants: the owner, the NSSS supplier, the architect-engineer, the construction agency, equipment suppliers, and others. This paper discusses, from the viewpoint of a NSSS supplier's engineering organization, the role of standard engineering documents in the design process and communication network

  8. Evaluating Living Standard Indicators

    Directory of Open Access Journals (Sweden)

    Birčiaková Naďa

    2015-09-01

    Full Text Available This paper deals with the evaluation of selected available indicators of living standards, divided into three groups, namely economic, environmental, and social. We have selected six countries of the European Union for analysis: Bulgaria, the Czech Republic, Hungary, Luxembourg, France, and Great Britain. The aim of this paper is to evaluate indicators measuring living standards and suggest the most important factors which should be included in the final measurement. We have tried to determine what factors influence each indicator and what factors affect living standards. We have chosen regression analysis as our main method. From the study of factors, we can deduce their impact on living standards, and thus the value of indicators of living standards. Indicators with a high degree of reliability include the following factors: size and density of population, health care and spending on education. Emissions of carbon dioxide in the atmosphere also have a certain lower degree of reliability.

  9. Flow cytometry data standards

    Directory of Open Access Journals (Sweden)

    Kollmann Tobias R

    2011-03-01

    Full Text Available Abstract Background Flow cytometry is a widely used analytical technique for examining microscopic particles, such as cells. The Flow Cytometry Standard (FCS was developed in 1984 for storing flow data and it is supported by all instrument and third party software vendors. However, FCS does not capture the full scope of flow cytometry (FCM-related data and metadata, and data standards have recently been developed to address this shortcoming. Findings The Data Standards Task Force (DSTF of the International Society for the Advancement of Cytometry (ISAC has developed several data standards to complement the raw data encoded in FCS files. Efforts started with the Minimum Information about a Flow Cytometry Experiment, a minimal data reporting standard of details necessary to include when publishing FCM experiments to facilitate third party understanding. MIFlowCyt is now being recommended to authors by publishers as part of manuscript submission, and manuscripts are being checked by reviewers and editors for compliance. Gating-ML was then introduced to capture gating descriptions - an essential part of FCM data analysis describing the selection of cell populations of interest. The Classification Results File Format was developed to accommodate results of the gating process, mostly within the context of automated clustering. Additionally, the Archival Cytometry Standard bundles data with all the other components describing experiments. Here, we introduce these recent standards and provide the very first example of how they can be used to report FCM data including analysis and results in a standardized, computationally exchangeable form. Conclusions Reporting standards and open file formats are essential for scientific collaboration and independent validation. The recently developed FCM data standards are now being incorporated into third party software tools and data repositories, which will ultimately facilitate understanding and data reuse.

  10. Therapy with radionuclides. Radionuklid-Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Hotze, A.L. (Bonn Univ. (Germany). Klinik fuer Nuklearmedizin)

    1992-12-01

    Radioiodine therapy of benign and malignant thyroid diseases is a well-established procedure in Nuclear Medicine. However, the therapeutic use of radioisotopes in other diseases is relatively unknown among our refering physicians. The therapeutic effects of intraarticular (rheumatoid arthritis) and intracavitary (pleural and peritoneal carcinosis) applications yields good results. The radiophosphorus therapy in polycythemia vera rubra has always to be considered as an alternative to chemotherapy. The use of analgetics may be reduced by pain therapy of bone metastasis by injection of bone-seeking beta emitters like Rh-186 HEDP. Other procedures like therapeutic application of meta-iodo-benzylguanidine in neuroblastoma and malignant pheochromocytoma resulted in at least remissions of the disease. Radioimmunotherapy needs further evaluation before it can be recommended as a routine procedure. (orig.).

  11. Risk factors for local recurrence after breast-conserving therapy

    International Nuclear Information System (INIS)

    Breast-conserving therapy has been widely accepted as a standard treatment for early breast cancer both in Western countries and in Japan. In Western countries, many studies have investigated the risk factors for local recurrence after breast-conserving therapy (BCT), but few such studies have been done in Japan. To determine the risk factors for local recurrence in 399 breast cancer patients (stage I and II, n=396; stage III, n=3) who had undergone BCT with or without postoperative radiation therapy, we evaluated their clinicopathological features by univariate and multivariate analyses. The patients were treated at Osaka National Hospital between February 1988 and December 1997. Univariate analysis showed that a young age (≤45 years; P=0.0005) was a significant risk factor for local recurrence, while radiation therapy (P=0.0058) and adjuvant endocrine therapy (P=0.0041) significantly reduced the risk of local recurrence. In patients with BCT, without radiation therapy a positive surgical margin significantly increased the risk of local recurrence (P=0.0470). Multivariate analysis showed that a young age (P=0.0285) was a significant independent risk factor for local recurrence, while radiation therapy (P=0.0457) significantly decreased recurrence. In patients with a negative surgical margin, radiation therapy (P=0.0158) and adjuvant endocrine therapy (P=0.0421) significantly reduced the relative risk of local recurrence, to 0.160 and 0.366, respectively. In patients with a positive surgical margin, radiation therapy marginally significantly (P=0.0756) reduced the relative risk of local recurrence, to 0.181, and adjuvant endocrine therapy significantly (P=0.0119) reduced the risk, to 0.076. Young age and lack of radiation therapy or adjuvant endocrine therapy were risk factors for local recurrence in breast cancer patients treated with breast conserving therapy, with surgical margin status also being a possible risk factor. (author)

  12. Cognitive Behavioral Therapy and Motivational Enhancement Therapy.

    Science.gov (United States)

    Wu, Sarah S; Schoenfelder, Erin; Hsiao, Ray Chih-Jui

    2016-10-01

    Although cognitive behavioral therapy (CBT) is widely recognized as the preferred treatment of psychiatric disorders, less is known about the application of CBT to substance use disorders, particularly in adolescence. This article discusses how CBT conceptualizes substance use and how it is implemented as a treatment of adolescent substance abuse. The article draws on several manuals for CBT that implement it as a standalone treatment or in combination with motivational enhancement therapies. Also reviewed are several studies that examined the efficacy of CBT. Finally, the implications are discussed. Numerous starting resources are provided to help a clinician implement CBT.

  13. 76 FR 75782 - Revising Standards Referenced in the Acetylene Standard

    Science.gov (United States)

    2011-12-05

    ... organizations (``SDO standards'') (69 FR 68283). A SDO standard referenced in OSHA's Acetylene Standard (29 CFR... of the Compressed Gas Association standard, CGA G-1-2003, in the Acetylene Standard. See 74 FR 40442... appropriate, revoke references to outdated national SDO standards in OSHA rules (see, e.g., 69 FR 68283, 70......

  14. 76 FR 75840 - Revising Standards Referenced in the Acetylene Standard

    Science.gov (United States)

    2011-12-05

    ... language from outdated standards published by standards developing organizations (``SDO standards'') (69 FR... Association standard, CGA G-1-2003, in the Acetylene Standard. See 74 FR 40442 and 74 FR 40450, respectively... outdated standard; and impose no significant new compliance costs on employers (69 FR 68283, 68285).......

  15. How we make cell therapy in Italy.

    Science.gov (United States)

    Montemurro, Tiziana; Viganò, Mariele; Budelli, Silvia; Montelatici, Elisa; Lavazza, Cristiana; Marino, Luigi; Parazzi, Valentina; Lazzari, Lorenza; Giordano, Rosaria

    2015-01-01

    In the 21st century scenario, new therapeutic tools are needed to take up the social and medical challenge posed by the more and more frequent degenerative disorders and by the aging of population. The recent category of advanced therapy medicinal products has been created to comprise cellular, gene therapy, and tissue engineered products, as a new class of drugs. Their manufacture requires the same pharmaceutical framework as for conventional drugs and this means that industrial, large-scale manufacturing process has to be adapted to the peculiar characteristics of cell-containing products. Our hospital took up the challenge of this new path in the early 2000s; and herein we describe the approach we followed to set up a pharmaceutical-grade facility in a public hospital context, with the aim to share the solutions we found to make cell therapy compliant with the requirements for the production and the quality control of a high-standard medicinal product. PMID:26316716

  16. Maintenance Therapy for NSCLC: Consensus and Controversy

    Institute of Scientific and Technical Information of China (English)

    Shun Lu; Yong-feng Yu

    2011-01-01

    Nowadays,advanced non-small cell lung cancer (NSCLC) is still an incurable disease.However,recent researches on maintenance therapy have led to considerable progress.Recently,pemetrexed and erlotinib have been approved for maintenance chemotherapy by both the U.S.Food and Drug Administration and European Medicines Agency.However,there are not adequate data to support the maintenance therapy as the standard treatment for advanced NSCLC and there has been no conclusive predictor of who will get benefit from maintenance chemotherapy and what type of maintenance,continuation or switch,is preferred.This article reviews the main studies on maintenance therapy of advanced NSCLC and discusses the results available to date.

  17. Photodynamic therapy, new drugs, new lasers

    International Nuclear Information System (INIS)

    In the mid-1970's Dougherty and co-workers reintroduced hematoporphyrin derivative (HpD) as tumor localizer and photosensitizer for the detection and treatment of neoplastic disease. The efforts of this group led to the introduction of the combination of HpD and lasers for the treatment of a number of human neoplasms. During the late 1970's and throughout most of the 1980's efforts were made to determine the active component in the mixture of porphyrins which comprise HpO. The standard light source used in HpD was the argon-dye laser. Recently new photosensitizers for photodynamic therapy have been introduced. These newer photosensitizers are pure and not mixtures and are associated with less side effects than HpD. Concomitant with the development of new photosensitizers has been the development of new laser systems for photodynamic therapy. In this paper current developments in new drugs and new lasers for photodynamic therapy are presented

  18. Androgen deprivation therapy-associated vasomotor symptoms

    Institute of Scientific and Technical Information of China (English)

    Jason M Jones; Manish Kohli; Charles L Loprinzi

    2012-01-01

    Androgen deprivation therapy (ADT) is widely used as standard therapy in the treatment of locally advanced and metastatic prostate cancer.While efficacious,ADT is associated with multiple side effects,including decreased libido,erectile dysfunction,diabetes,loss of muscle tone and altered body composition,osteoporosis,lipid changes,memory loss,gynecomastia and hot flashes.The breadth of literature for the treatment of hot flashes is much smaller in men than that in women.While hormonal therapy of hot flashes has been shown to be effective,multiple non-hormonal medications and treatment methods have also been developed.This article reviews current options for the treatment of hot flashes in patients taking ADT.

  19. Wireless installation standard

    International Nuclear Information System (INIS)

    This is divided six parts which are radio regulation law on securing of radio resource, use of radio resource, protection of radio resource, radio regulation enforcement ordinance with securing, distribution and assignment of radio regulation, radio regulation enforcement regulation on utility of radio resource and technical qualification examination, a wireless installation regulation of technique standard and safety facility standard, radio regulation such as certification regulation of information communicative machines and regulation of radio station on compliance of signal security, radio equipment in radio station, standard frequency station and emergency communication.

  20. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

  1. Gene therapy for thyroid cancer

    International Nuclear Information System (INIS)

    Gene therapy for thyroid cancer include immunotherapy, suicide gene therapy, tumor suppressor replacement, 131I therapy by sodium/iodide symporter and antisense therapy and so on. Gene therapy has wide perspectives, but there are many problems need to be solved for clinical application

  2. [Dance/Movement Therapy.

    Science.gov (United States)

    Fenichel, Emily, Ed.

    1994-01-01

    This newsletter theme issue focuses on dance, play, and movement therapy for infants and toddlers with disabilities. Individual articles are: "Join My Dance: The Unique Movement Style of Each Infant and Toddler Can Invite Communication, Expression and Intervention" (Suzi Tortora); "Dynamic Play Therapy: An Integrated Expressive Arts Approach to…

  3. What Is Wilderness Therapy?

    Science.gov (United States)

    Russell, Keith C.

    2001-01-01

    Based on the literature and recent research, an integrated, consistent definition of wilderness therapy is presented to differentiate it from other outdoor adventure programs and guide program design and research efforts. Trends in the outdoor industry are explored that suggest that wilderness therapy programs are searching for recognition by…

  4. Therapy of Lies

    Science.gov (United States)

    Price, Sean

    2012-01-01

    Conversion therapy comes in many forms, ranging from informal chats with counselors to aggressive physical coercion, but all are based on the belief that a gay male or a lesbian can be changed "back" to heterosexual behavior. It is not just alarmed parents who turn to this therapy. Many LGBT individuals seek out such treatment in an effort to…

  5. Antiproton Cancer Therapy

    DEFF Research Database (Denmark)

    Bassler, Niels

    An essential part in cancer radiotherapy, is to direct a sufficiently high dose towards the tumour, without damaging the surrounding tissue. Different techniques such as intensity modulated radiation therapy and proton therapy have been developed, in order to reduce the dose to the normal tissue...

  6. Pediatric Music Therapy.

    Science.gov (United States)

    Lathom-Radocy, Wanda B.

    This book on music therapy includes relevant medical, psychological, and developmental information to help service providers, particularly music therapists, and parents to understand children with disabilities. The first two chapters describe the process of assessment and delineation of goals in music therapy that leads to the design of the music…

  7. Boganmeldelse - Music Therapy Research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2006-01-01

    . Alligevel følger her en anbefaling af bogen: for musikterapeuter er det en bog, man ikke kommer uden om. Music Therapy Research, på dansk Musikterapiforskning, er en gennemrevideret, ja faktisk nyudgivelse, af bogen Music Therapy Research: Quantitative and Qualitative Perspectives, som udkom i 1995. Også...

  8. Poetry Therapy: A Bibliography.

    Science.gov (United States)

    Weinstock, Donald J., Comp.

    The 84 entries contained in this bibliography are arranged under three headings: poetry therapy, bibliotherapy, and relevant related items. Representing books, educational journals, popular magazines, and research studies, the titles span a variety of topics, including the following: poetry therapy in psychiatric nursing, poetry programs in mental…

  9. Massage Therapy Research

    Science.gov (United States)

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2007-01-01

    Massage therapy has been notably effective in preventing prematurity, enhancing growth of infants, increasing attentiveness, decreasing depression and aggression, alleviating motor problems, reducing pain, and enhancing immune function. This review covers massage therapy research from the last decade, as an update to the American Psychologist 1998…

  10. Technical standards in nuclear area

    International Nuclear Information System (INIS)

    The technical standardization in nuclear area is discussed. Also, the competence of CNEN in standardization pursuit is analysed. Moreover, the process of working up of technical standards is explained; in addition, some kinds of technical standards are discussed. (author)

  11. Neuropathic pain therapy: from bench to bedside.

    Science.gov (United States)

    Backonja, Miroslav Misha

    2012-07-01

    Neuropathic pain is a result of complex interactions between peripheral and central mechanisms with multiple potential therapeutic targets. However, the complexity of these mechanisms and relative youth of translational pain research, which is in its infancy, have prevented translation of successful basic bench research to human therapy. Most of the clinically available neuropathic pain treatments are borrowed from other therapeutic areas, such as antidepressants and antiepileptics, or involve application of older therapy, such as opioids. Exceptions are ziconotide, tapentadol, and the high-concentration capsaicin patch. Similar to all other analgesic agents, these provide only partial pain relief in subsets of patients. The standard of care for patients with chronic neuropathic pain is multimodal and multidisciplinary. For most patients to achieve and maintain satisfactory pain relief a combination of therapeutic agents is necessary, providing the empiric basis for rational polypharmacy, which has become a standard approach as well. PMID:23117951

  12. Advanced metrology for cancer therapy. Proceedings

    International Nuclear Information System (INIS)

    Physical treatments play a central role in cancer therapy. Metrology is reasonably well-established for only some of these techniques: several modern forms of treatment (IMRT, hadron therapy, HITU, brachytherapy) suffer from the limited support of traceable metrology which restricts the success of these techniques. The European Union recognised this deficit and identified metrology for health as one of the first four Targeted Programmes in the framework of the European Metrology Research Programme (EMRP), running from 2008 to 2011. The programme included two EMRP projects which address metrology for cancer therapy: - project T2.J06 deals with brachytherapy - project T2.J07 deals with external beam cancer therapy using ionising radiation and highintensity ultrasound Primary measurement standards applicable to modern treatment conditions are being developed under both projects, together with measurement techniques which are meant as a basis of future protocols for dosimetry, treatment planning and monitoring. This three-day scientific conference provides a platform for the presentation of current developments in clinical measurement techniques for cancer therapy, together with the achievements of these projects, under the headings: - Primary and secondary standards of absorbed dose to water for IMRT and brachytherapy - 3D dose distributions and treatment planning for IMRT and brachytherapy - Hadron therapy (protons and carbon ions) - High Intensity Therapeutic Ultrasound (HITU) The aim of the conference is to provide a forum for the exchange of information and expertise in the community of medical physicists and metrologists at the European level. The conference programme includes 4 keynote talks by invited speakers as well as 59 proffered papers and posters.

  13. Music therapy improvisation

    Directory of Open Access Journals (Sweden)

    Mira Kuzma

    2001-09-01

    Full Text Available In this article, the technique of music therapy – music therapy improvisation is introduced. In this form of music therapy the improvising partners share meaning through the improvisation: the improvisation is not an end in itself: it portrays meaning that is personal, complex and can be shared with the partner. The therapeutic work, then, is meeting and matching the client's music in order to give the client an experience of "being known", being responded through sounds and being able to express things and communicate meaningfully. Rather than the client playing music, the therapy is about developing the engagement through sustained, joint improvisations. In music therapy, music and emotion share fundamental features: one may represent the other, i.e., we hear the music not as music but as dynamic emotional states. The concept of dynamic structure explains why music makes therapeutic sense.

  14. Medical therapy in acromegaly.

    LENUS (Irish Health Repository)

    Sherlock, Mark

    2011-05-01

    Acromegaly is a rare disease characterized by excess secretion of growth hormone (GH) and increased circulating insulin-like growth factor 1 (IGF-1) concentrations. The disease is associated with increased morbidity and premature mortality, but these effects can be reduced if GH levels are decreased to <2.5 μg\\/l and IGF-1 levels are normalized. Therapy for acromegaly is targeted at decreasing GH and IGF-1 levels, ameliorating patients\\' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, radiotherapy and medical therapies, such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant. Medical therapy is currently most widely used as secondary treatment for persistent or recurrent acromegaly following noncurative surgery, although it is increasingly used as primary therapy. This Review provides an overview of current and future pharmacological therapies for patients with acromegaly.

  15. Proton therapy physics

    CERN Document Server

    2012-01-01

    Proton Therapy Physics goes beyond current books on proton therapy to provide an in-depth overview of the physics aspects of this radiation therapy modality, eliminating the need to dig through information scattered in the medical physics literature. After tracing the history of proton therapy, the book summarizes the atomic and nuclear physics background necessary for understanding proton interactions with tissue. It describes the physics of proton accelerators, the parameters of clinical proton beams, and the mechanisms to generate a conformal dose distribution in a patient. The text then covers detector systems and measuring techniques for reference dosimetry, outlines basic quality assurance and commissioning guidelines, and gives examples of Monte Carlo simulations in proton therapy. The book moves on to discussions of treatment planning for single- and multiple-field uniform doses, dose calculation concepts and algorithms, and precision and uncertainties for nonmoving and moving targets. It also exami...

  16. Music therapy in dementia

    DEFF Research Database (Denmark)

    McDermott, Orii; Crellin, Nadia; Ridder, Hanne Mette Ochsner;

    2013-01-01

    Objective Recent reviews on music therapy for people with dementia have been limited to attempting to evaluate whether it is effective, but there is a need for a critical assessment of the literature to provide insight into the possible mechanisms of actions of music therapy. This systematic review......, five studies investigated hormonal and physiological changes, and five studies focused on social and relational aspects of music therapy. The musical interventions in the studies were diverse, but singing featured as an important medium for change. Conclusions Evidence for short-term improvement...... in mood and reduction in behavioural disturbance was consistent, but there were no high-quality longitudinal studies that demonstrated long-term benefits of music therapy. Future music therapy studies need to define a theoretical model, include better-focused outcome measures, and discuss how the findings...

  17. Pain in photodynamic therapy

    Directory of Open Access Journals (Sweden)

    Mircea Tampa

    2016-04-01

    Full Text Available Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect of photodynamic therapy and it is the most important factor affecting the patient's adherence to treatment. The aim of this article is to look over the most recent medical studies regarding pain in PDT, with emphasis on the factors affecting the occurrence of pain and the most recent strategies for controlling photodynamic therapy- related pain.

  18. Therapy of unspecific tinnitus without organic cause

    Directory of Open Access Journals (Sweden)

    Seiler, Gerda

    2006-08-01

    ] is the best evaluated procedure. The number of therapies which treat tinnitus is exceptionally high and makes clear, that the search for "the" tinnitus therapy is still going on. According to the current knowledge tinnitus genesis is multifactorial and therefore there can’t be any standard therapy for tinnitus. The following seven categories can be distinguished: Ad 1: Machine-aided acoustic therapies: From many studies regarding machine-aided acoustic therapy of tinnitus only two showed an evidence degree that allows scientifically correct statements about the effectiveness of these procedures. Selectively significant improvements could be shown in the comparison with a placebo (apparatus switched off a superiority of tinnitus-maskers. Ad 2: Electrostimulation: In an application study of electro-stimulation the results were not evaluated statistically, but it was described descriptively that a successful medical treatment can be expected in about 50% of the cases. Ad 3: Psychological therapy procedures: Hypnosis did not show positive effectiveness. With regard to biofeedback it can be concluded that this method can be effective in individual cases, however regarded as unreliable from missing reproducibility. Neurobiofeedback could prove that it had a positive therapeutic effect. From eight controlled studies to relaxation techniques and cognitive behaviour therapy four studies showed a therapeutic effectiveness and four failed. Combined therapies proved generally to be more effective than individual types. The behaviour medical psychotherapy could show a positive therapy effect. In a study with cognitive therapy and relaxation (three groups, a passive relaxation, an active relaxation and a cognitive therapy short-term successes could be stated (for one month, however, the parameters of success returned on the initial value after four months. Also only coincidental and short-term successes could be achieved with cognitive behaviour therapy training, autogenic

  19. Striving for "Standard Economy"

    Institute of Scientific and Technical Information of China (English)

    Li Huailin

    2006-01-01

    @@ Promotion of the "standard economy" itself is an integral part of upgrading the quality of China's economic development, transforming economic growth mode and responding to foreign trade barriers as well as a key strategy for improving foreign trade level.

  20. Speech processing standards

    Science.gov (United States)

    Ince, A. Nejat

    1990-05-01

    Speech processing standards are given for 64, 32, 16 kb/s and lower rate speech and more generally, speech-band signals which are or will be promulgated by CCITT and NATO. The International Telegraph and Telephone Consultative Committee (CCITT) of the International body which deals, among other things, with speech processing within the context of ISDN. Within NATO there are also bodies promulgating standards which make interoperability, possible without complex and expensive interfaces. Some of the applications for low-bit rate voice and the related work undertaken by CCITT Study Groups which are responsible for developing standards in terms of encoding algorithms, codec design objectives as well as standards on the assessment of speech quality, are highlighted.

  1. FDA Recognized Consensus Standards

    Data.gov (United States)

    U.S. Department of Health & Human Services — This database consists of those national and international standards recognized by FDA which manufacturers can declare conformity to and is part of the information...

  2. Crew Transportation Operations Standards

    Science.gov (United States)

    Mango, Edward J.; Pearson, Don J. (Compiler)

    2013-01-01

    The Crew Transportation Operations Standards contains descriptions of ground and flight operations processes and specifications and the criteria which will be used to evaluate the acceptability of Commercial Providers' proposed processes and specifications.

  3. Ozone Standard Reference Photometer

    Data.gov (United States)

    Federal Laboratory Consortium — The Standard Reference Photometer (SRP) Program began in the early 1980s as collaboration between NIST and the U.S. Environmental Protection Agency (EPA) to design,...

  4. International standards in metallurgy

    Institute of Scientific and Technical Information of China (English)

    Fomina; O.; N.

    2005-01-01

    The existence of incompatible standards in many technical fields represents a technical barrier to international cooperation between enterprises in different countries in the manufacture of high technology products.……

  5. FREIGHT CONTAINER LIFTING STANDARD

    Energy Technology Data Exchange (ETDEWEB)

    POWERS DJ; SCOTT MA; MACKEY TC

    2010-01-13

    This standard details the correct methods of lifting and handling Series 1 freight containers following ISO-3874 and ISO-1496. The changes within RPP-40736 will allow better reading comprehension, as well as correcting editorial errors.

  6. AKRO: Standard Prices

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Standard prices are generated for cost recovery programs in the Individual Fishing Quota (IFQ) halibut and sablefish, BSAI Rationalized crab, and Central Gulf of...

  7. Islam, Standards, and Technoscience

    DEFF Research Database (Denmark)

    Fischer, Johan

    Halal (literally, "permissible" or "lawful") production, trade, and standards have become essential to state-regulated Islam and to companies in contemporary Malaysia and Singapore, giving these two countries a special position in the rapidly expanding global market for halal products: in these n......Halal (literally, "permissible" or "lawful") production, trade, and standards have become essential to state-regulated Islam and to companies in contemporary Malaysia and Singapore, giving these two countries a special position in the rapidly expanding global market for halal products......" that frames everyday halal consumption, Fischer provides a multisited ethnography of the overlapping technologies and techniques of production, trade, and standards that together warrant a product as "halal," and thereby help to format the market. Exploring global halal in networks, training, laboratories......, activism, companies, shops and restaurants, this book will be an essential resource to scholars and students of social science interested in the global interface zones between religion, standards, and technoscience....

  8. Fiber optics standard dictionary

    CERN Document Server

    Weik, Martin H

    1997-01-01

    Fiber Optics Vocabulary Development In 1979, the National Communications System published Technical InfonnationBulle­ tin TB 79-1, Vocabulary for Fiber Optics and Lightwave Communications, written by this author. Based on a draft prepared by this author, the National Communications System published Federal Standard FED-STD-1037, Glossary of Telecommunications Terms, in 1980 with no fiber optics tenns. In 1981, the first edition of this dictionary was published under the title Fiber Optics and Lightwave Communications Standard Dictionary. In 1982, the then National Bureau of Standards, now the National Institute of Standards and Technology, published NBS Handbook 140, Optical Waveguide Communications Glossary, which was also published by the General Services Admin­ istration as PB82-166257 under the same title. Also in 1982, Dynamic Systems, Inc. , Fiberoptic Sensor Technology Handbook, co-authored and edited by published the this author, with an extensive Fiberoptic Sensors Glossary. In 1989, the handbook w...

  9. Standards Implementation of MSW

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ With the development of society and economy, the living standard of people is raised, the issue on disposal of refuse is becoming more and more serious, and urban garbage has caused wide public concerns.

  10. DOE technical standards list. Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listing of current DOE technical standards, non-Government standards that have been adopted by DOE, other Government documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  11. Standard software for CAMAC

    International Nuclear Information System (INIS)

    The NIM Committee (National Instrumentation Methods Committee) of the U.S. Department of Energy and the ESONE Committee of European Laboratories have jointly specified standard software for use with CAMAC. Three general approaches were followed: the definition of a language called IML for use in CAMAC systems, the definition of a standard set of subroutine calls, and real-time extensions to the BASIC language. This paper summarizes the results of these efforts. 1 table

  12. Food Safety & Standards

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ An increasing number of people have realized that food safety is an important issue for public health. It not only concerns public health and safety, but also has direct influence on national economic progress and social development. The development and implementation of food safety standards play a vital role in protecting public health, as well as in standardizing and facilitating the sound development of food production and business.

  13. Evidence Standards and Litigation

    DEFF Research Database (Denmark)

    Guerra, Alice; Luppi, Barbara; Parisi, Francesco

    In litigation models, the parties’ probability to succeed in a lawsuit hinge upon two main factors: the merits of the parties’ claims and their litigation efforts (Katz, 1988; Hirshleifer, 1989; Farmer and Pecorino, 1999). In this paper we extend this framework to consider an important procedural...... for low-merit cases when standards are set high. This provides a valuable key for understanding the sorting effect of evidence standards and their role as a policy instrument in civil litigation....

  14. The Gold Standard Programme

    DEFF Research Database (Denmark)

    Neumann, Tim; Rasmussen, Mette; Ghith, Nermin;

    2013-01-01

    To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.......To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates....

  15. Standard Model Theory

    OpenAIRE

    Hollik, W.

    2015-01-01

    In this conference report a summary is given on the theoretical work that has contributed to provide accurate theoretical predictions for testing the standard model in present and future experiments. Precision calculations for the vector boson masses, for the Z resonance, W pair production, and for the g-2 of the muon are reviewed and the theoretical situation for the Higgs sector is summarized. The status of the standard model is discussed in the light of the recent high and low energy data....

  16. Integrated therapy for HIV and tuberculosis

    OpenAIRE

    Manosuthi, Weerawat; Wiboonchutikul, Surasak; Sungkanuparph, Somnuek

    2016-01-01

    Tuberculosis (TB) has been the most common opportunistic infection and cause of mortality among HIV-infected patients, especially in resource-limited countries. Clinical manifestations of TB vary and depend on the degree of immunodeficiency. Sputum microscopy and culture with drug-susceptibility testing are recommended as a standard method for diagnosing active TB. TB-related mortality in HIV-infected patients is high especially during the first few months of treatment. Integrated therapy of ...

  17. Supportive therapy in medical therapy of head and neck tumors [

    Directory of Open Access Journals (Sweden)

    Link, Hartmut

    2012-12-01

    Full Text Available [english] Fever during neutropenia may be a symptom of severe life threatening infection, which must be treated immediately with antibiotics. If signs of infection persist, therapy must be modified. Diagnostic measures should not delay treatment. If the risk of febrile neutropenia after chemotherapy is ≥20%, then prophylactic therapy with G-CSF is standard of care. After protocols with a risk of febrile neutropenia of 10–20%, G-CSF is necessary, in patients older than 65 years or with severe comorbidity, open wounds, reduced general condition. Anemia in cancer patients must be diagnosed carefully, even preoperatively. Transfusions of red blood cells are indicated in Hb levels below 7–8 g/dl. Erythropoies stimulating agents (ESA are recommended after chemotherapy only when hemoglobin levels are below 11 g/dl. The Hb-level must not be increased above 12 g/dl. Anemia with functional iron deficiency (transferrin saturation <20% should be treated with intravenous iron, as oral iron is ineffective being not absorbed. Nausea or emesis following chemotherapy can be classified as minimal, low, moderate and high. The antiemetic prophylaxis should be escalated accordingly. In chemotherapy with low emetogenic potential steroids are sufficient, in the moderate level 5-HT3 receptor antagonists (setrons are added, and in the highest level Aprepitant as third drug.

  18. ISO radiation sterilization standards

    International Nuclear Information System (INIS)

    This presentation provides an overview of the current status of the ISO radiation sterilization standards. The ISO standards are voluntary standards which detail both the validation and routine control of the sterilization process. ISO 11137 was approved in 1994 and published in 1995. When reviewing the standard you will note that less than 20% of the standard is devoted to requirements and the remainder is guidance on how to comply with the requirements. Future standards developments in radiation sterilization are being focused on providing additional guidance. The guidance that is currently provided in informative annexes of ISO 11137 includes: device/packaging materials, dose setting methods, and dosimeters and dose measurement, currently, there are four Technical Reports being developed to provide additional guidance: 1. AAMI Draft TIR, 'Radiation Sterilization Material Qualification' 2. ISO TR 13409-1996, 'Sterilization of health care products - Radiation sterilization - Substantiation of 25 kGy as a sterilization dose for small or infrequent production batches' 3. ISO Draft TR, 'Sterilization of health care products - Radiation sterilization Selection of a sterilization dose for a single production batch' 4. ISO Draft TR, 'Sterilization of health care products - Radiation sterilization-Product Families, Plans for Sampling and Frequency of Dose Audits'

  19. Standardization Practices of Gree

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    1.The great importance attached by the company's executives is a strong guarantee for leap-forward development of standardization.To give play to the strategic role of standards in supporting the long-term and sustainable development of the enterprise,the company's management has attached great importance to the standardization work and provided strong capital support and guarantee of resources in standardization.Continuously improve the requirements of corporate technical standards and reliability quality control means,develop core technologies with independent intellectual property rights,continuously achieve major breakthroughs in key technologies and successfully apply to the company's products to help the enterprises maintain rapid and steady development in the market of household electrical appliances with extremely intense competition,achieve remarkable economic and social benefits for the company,and provide strong support for leap-forward development of standardization work.The company has successively and independently developed a series of highend products and technologies which are intemationally advanced.So far,the company has 10 innovations included in the national science and technology programs.

  20. 75 FR 50880 - TRICARE: Non-Physician Referrals for Physical Therapy, Occupational Therapy, and Speech Therapy

    Science.gov (United States)

    2010-08-18

    ..., Occupational Therapy, and Speech Therapy AGENCY: Office of the Secretary, Department of Defense. ACTION: Final... engage in referrals of beneficiaries to the Military Health System for physical therapy, occupational..., occupational therapy, and speech therapy without having the patient see a physician. This rule will...

  1. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    This Department of Energy (DOE) technical standards list (TSL) has been prepared by the Office of Nuclear Safety Policy and Standards (EH-31) on the basis of currently available technical information. Periodic updates of this TSL will be issued as additional information is received on standardization documents being issued, adopted, or canceled by DOE. This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listings of current DOE technical standards, non-Government standards that have been adopted by DOE, other standards-related documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  2. How Does Oxygen Therapy Work?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Does Oxygen Therapy Work? Oxygen therapy provides you with extra ... be delivered to your lungs in several ways. Oxygen Therapy Systems Oxygen is supplied in three forms: ...

  3. Standardized beam bouquets for lung IMRT planning

    Science.gov (United States)

    Yuan, Lulin; Wu, Q. Jackie; Yin, Fangfang; Li, Ying; Sheng, Yang; Kelsey, Christopher R.; Ge, Yaorong

    2015-02-01

    The selection of the incident angles of the treatment beams is a critical component of intensity modulated radiation therapy (IMRT) planning for lung cancer due to significant variations in tumor location, tumor size and patient anatomy. We investigate the feasibility of establishing a small set of standardized beam bouquets for planning. The set of beam bouquets were determined by learning the beam configuration features from 60 clinical lung IMRT plans designed by experienced planners. A k-medoids cluster analysis method was used to classify the beam configurations in the dataset. The appropriate number of clusters was determined by maximizing the value of average silhouette width of the classification. Once the number of clusters had been determined, the beam arrangements in each medoid of the clusters were designated as the standardized beam bouquet for the cluster. This standardized bouquet set was used to re-plan 20 cases randomly selected from the clinical database. The dosimetric quality of the plans using the beam bouquets was evaluated against the corresponding clinical plans by a paired t-test. The classification with six clusters has the largest average silhouette width value and hence would best represent the beam bouquet patterns in the dataset. The results shows that plans generated with a small number of standardized bouquets (e.g. 6) have comparable quality to that of clinical plans. These standardized beam configuration bouquets will potentially help improve plan efficiency and facilitate automated planning.

  4. Standardized beam bouquets for lung IMRT planning

    International Nuclear Information System (INIS)

    The selection of the incident angles of the treatment beams is a critical component of intensity modulated radiation therapy (IMRT) planning for lung cancer due to significant variations in tumor location, tumor size and patient anatomy. We investigate the feasibility of establishing a small set of standardized beam bouquets for planning. The set of beam bouquets were determined by learning the beam configuration features from 60 clinical lung IMRT plans designed by experienced planners. A k-medoids cluster analysis method was used to classify the beam configurations in the dataset. The appropriate number of clusters was determined by maximizing the value of average silhouette width of the classification. Once the number of clusters had been determined, the beam arrangements in each medoid of the clusters were designated as the standardized beam bouquet for the cluster. This standardized bouquet set was used to re-plan 20 cases randomly selected from the clinical database. The dosimetric quality of the plans using the beam bouquets was evaluated against the corresponding clinical plans by a paired t-test. The classification with six clusters has the largest average silhouette width value and hence would best represent the beam bouquet patterns in the dataset. The results shows that plans generated with a small number of standardized bouquets (e.g. 6) have comparable quality to that of clinical plans. These standardized beam configuration bouquets will potentially help improve plan efficiency and facilitate automated planning. (paper)

  5. Descriptive analysis of YouTube music therapy videos.

    Science.gov (United States)

    Gooding, Lori F; Gregory, Dianne

    2011-01-01

    The purpose of this study was to conduct a descriptive analysis of music therapy-related videos on YouTube. Preliminary searches using the keywords music therapy, music therapy session, and "music therapy session" resulted in listings of 5000, 767, and 59 videos respectively. The narrowed down listing of 59 videos was divided between two investigators and reviewed in order to determine their relationship to actual music therapy practice. A total of 32 videos were determined to be depictions of music therapy sessions. These videos were analyzed using a 16-item investigator-created rubric that examined both video specific information and therapy specific information. Results of the analysis indicated that audio and visual quality was adequate, while narrative descriptions and identification information were ineffective in the majority of the videos. The top 5 videos (based on the highest number of viewings in the sample) were selected for further analysis in order to investigate demonstration of the Professional Level of Practice Competencies set forth in the American Music Therapy Association (AMTA) Professional Competencies (AMTA, 2008). Four of the five videos met basic competency criteria, with the quality of the fifth video precluding evaluation of content. Of particular interest is the fact that none of the videos included credentialing information. Results of this study suggest the need to consider ways to ensure accurate dissemination of music therapy-related information in the YouTube environment, ethical standards when posting music therapy session videos, and the possibility of creating AMTA standards for posting music therapy related video.

  6. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana

    the rate of surgical wound infection and wound exudate post-caesarean and that wound infection had a negative impact on quality of life one month after surgery. Alongside the clinical trial, a trial-based cost-effectiveness analysis demonstrated that the treatment is cost-effective in a high......Women with a pre-gestational body mass index (BMI) above 30 kg/m2 giving birth by caesarean section are at high risk of surgical wound infection compared with women with a BMI below 30 kg/m2. Incisional Negative Pressure Wound Therapy (iNPWT) is one strategy to reduce the rate of surgical wound...... infection. However, the treatment is relatively costly compared to standard postoperative dressings and thus it was important to consider the rationale for using iNPWT before introducing the treatment in a clinical setting. This thesis assesses the current evidence of whether iNPWT reduces post...

  7. Gene Therapy of Cancerous Diseases

    OpenAIRE

    Valenčáková, A.; Dziaková, A.; Hatalová, E.

    2015-01-01

    Gene therapy of cancerous diseases provides new means of curing patients with oncologic illnesses. There are several approaches in treating cancer by gene therapy. Most commonly used methods are: cancer immunogene therapy, suicide gene therapy, application of tumor-suppressor genes, antiangiogenic therapy, mesenchymal stem cells used as vectors, gene directed enzyme/prodrug therapy and bacteria used as anti-cancer agents. Cancer gene immunotherapy uses several immunologic agents for the purp...

  8. [Novelties in the diagnostics and therapy of hairy cell leukemia].

    Science.gov (United States)

    Sári, Eszter; Rajnai, Hajnalka; Dénes, Kitti; Bödör, Csaba; Csomor, Judit; Körösmezey, Gábor; Tárkányi, Ilona; Eid, Hanna; Nagy, Zsolt; Demeter, Judit

    2016-06-01

    Differential diagnosis of hairy cell leukemia (HCL) and related disorders (hairy cell leukemia variant and splenic marginal zone lymphoma) is of utmost importance since the treatment and prognosis of these lymphomas differ. Since 2011 diagnosis of hairy cell leukemia has been easier because of discovery of the disease defining somatic mutation BRAF V600E mutation, which has been also known as driver mutation in malignant melanoma. The presence of this mutation enabled targeted molecular therapy in HCL as well. As first line therapy purine nucleoside analogues are the gold standard, but refractory/relapsed patient are candidates for targeted BRAF-inhibitor therapy. This manuscript serves as guidance in making diagnosis and standard treatment of HCL, and summarizes newest data about molecular therapy, including our single center experience collected from 75 patients. PMID:27275640

  9. How we make cell therapy in Italy

    Directory of Open Access Journals (Sweden)

    Montemurro T

    2015-08-01

    Full Text Available Tiziana Montemurro, Mariele Viganò, Silvia Budelli, Elisa Montelatici, Cristiana Lavazza, Luigi Marino, Valentina Parazzi, Lorenza Lazzari, Rosaria GiordanoCell Factory, Unit of Cell Therapy and Cryobiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, ItalyAbstract: In the 21st century scenario, new therapeutic tools are needed to take up the social and medical challenge posed by the more and more frequent degenerative disorders and by the aging of population. The recent category of advanced therapy medicinal products has been created to comprise cellular, gene therapy, and tissue engineered products, as a new class of drugs. Their manufacture requires the same pharmaceutical framework as for conventional drugs and this means that industrial, large-scale manufacturing process has to be adapted to the peculiar characteristics of cell-containing products. Our hospital took up the challenge of this new path in the early 2000s; and herein we describe the approach we followed to set up a pharmaceutical-grade facility in a public hospital context, with the aim to share the solutions we found to make cell therapy compliant with the requirements for the production and the quality control of a high-standard medicinal product.Keywords: advanced therapy medicinal product, good manufacturing practices, stem cells

  10. Particle therapy and treatment of cancer.

    Science.gov (United States)

    Halperin, Edward C

    2006-08-01

    The desire of radiation oncologists and medical physicists to maximise the radiation dose to the tumour while minimising that to healthy tissues has led to attempts to improve the dose distributions and biological effects achievable with photons and electrons. Protons, neutrons, pions, boron-neutron capture therapy, and charged-nuclei therapy (with argon, carbon, helium [alpha particles], neon, nitrogen, and silicon) have been assessed for their physical, biological, and clinical effects. In the 90 years since protons and neutrons were discovered, investigations of particle therapy for cancer have helped to elucidate many fundamental radiobiological ideas, such as linear energy transfer, relative biological effectiveness, oxygen effect, and oxygen enhancement. Particle therapy has contributed to our understanding of medical ethics when neutron therapy became intertwined with the debate over standards of informed consent in radiation experiments in humans during the cold war era. Particle teletherapy and brachytherapy continue to show promise in some clinical situations. In the future, the insights of molecular biology might clarify the ideal particles for clinical situations.

  11. Desmoid-Type Fibromatosis: Evolving Treatment Standards.

    Science.gov (United States)

    Fiore, Marco; MacNeill, Andrea; Gronchi, Alessandro; Colombo, Chiara

    2016-10-01

    Desmoid-type fibromatosis is a rare nonmetastasizing neoplasm with variable behavior. Recent discoveries into the biology of this disease hold promise for identifying prognostic and predictive features and novel therapeutic targets. Surgery has been the historical standard of care but carries considerable drawbacks in terms of high local recurrence rates and poor functional outcomes. Improved understanding of the natural history of desmoid-type fibromatosis has resulted in a paradigm shift toward nonoperative management. Effective medical treatment options include nonsteroidal antiinflammatory drugs, hormone therapy, cytotoxic chemotherapy, and targeted agents. A treatment algorithm has been proposed with the objective of optimizing treatment.

  12. Targeted Therapies for Kidney Cancer

    Science.gov (United States)

    ... for kidney cancer Targeted therapies for kidney cancer Biologic therapy (immunotherapy) for kidney cancer Chemotherapy for kidney cancer Pain control for kidney cancer Treatment choices by stage for ...

  13. Radiation therapy physics

    CERN Document Server

    Hendee, William R; Hendee, Eric G

    2013-01-01

    The Third Edition of Radiation Therapy Physics addresses in concise fashion the fundamental diagnostic radiologic physics principles as well as their clinical implications. Along with coverage of the concepts and applications for the radiation treatment of cancer patients, the authors have included reviews of the most up-to-date instrumentation and critical historical links. The text includes coverage of imaging in therapy planning and surveillance, calibration protocols, and precision radiation therapy, as well as discussion of relevant regulation and compliance activities. It contains an upd

  14. Medical Therapy of Acromegaly

    Directory of Open Access Journals (Sweden)

    U. Plöckinger

    2012-01-01

    Full Text Available This paper outlines the present status of medical therapy of acromegaly. Indications for permanent postoperative treatment, postirradiation treamtent to bridge the interval until remission as well as primary medical therapy are elaborated. Therapeutic efficacy of the different available drugs—somatostatin receptor ligands (SRLs, dopamine agonists, and the GH antagonist Pegvisomant—is discussed, as are the indications for and efficacy of their respective combinations. Information on their mechanism of action, and some pharmakokinetic data are included. Special emphasis is given to the difficulties to define remission criteria of acromegaly due to technical assay problems. An algorithm for medical therapy in acromegaly is provided.

  15. Drug therapies in dermatology.

    Science.gov (United States)

    Aslam, Arif; Griffiths, Christopher E M

    2014-02-01

    This article explores the current and emerging therapies for skin disease, with a particular focus on chronic plaque psoriasis and metastatic malignant melanoma. We discuss the current biological therapies used for psoriasis and those on the horizon, including small molecules and biosimilars. We also summarise the recent advances in the use of novel therapeutic agents in other dermatological diseases and outline the promise of translational research and stratified medicine approaches in dermatology. Better matching of patients with therapies is anticipated to have a major effect on both clinical practice and the development of new drugs and diagnostics. PMID:24532745

  16. Vitamin therapy in schizophrenia.

    Science.gov (United States)

    Hoffer, Leonard John

    2008-01-01

    Schizophrenia is a devastating and poorly understood disease for which the only accepted therapy is nonspecific antipsychotic and anti-seizure medication. This article summarizes the evidence that certain vitamin deficiencies likely worsen the symptoms of schizophrenia, and the evidence that large doses of certain vitamins could improve the core metabolic abnormalities that predispose some people to develop it; it recounts the history of a controversial vitamin-based therapy for schizophrenia called orthomolecular psychiatry; and it concludes by advocating a process for discovering promising new schizophrenia therapies that involves small, carefully conducted clinical trials of nutrient combinations in appropriately selected patients. PMID:18587164

  17. Collaboration in experiential therapy.

    Science.gov (United States)

    Berdondini, Lucia; Elliott, Robert; Shearer, Joan

    2012-02-01

    We offer a view of the nature and role of client-therapist collaboration in experiential psychotherapy, focusing on Gestalt and emotion-focused therapy (EFT). We distinguish between the necessary condition of mutual trust (the emotional bond between client and therapist) and effective collaboration (regarding the goals and tasks of therapy). Using a case study of experiential therapy for social anxiety, we illustrate how the development of collaboration can be both complex and pivotal for therapeutic success, and how it can involve client and therapist encountering one another through taking risks by openly and nonjudgementally disclosing difficult experiences in order to enrich and advance the work. PMID:23616296

  18. Complications of cancer therapy

    International Nuclear Information System (INIS)

    The purpose of this chapter is to review systematically the toxicity of contemporary chemotherapy and irradiation on normal tissues of growing children. Whenever possible, the separate toxicity of chemotherapy, irradiation, and combination therapy is addressed. However, it is not always possible to quantitate specifically such reactions in the face of multiple drug therapy, which may enhance radiation injury or reactivate prior radiation injury. Prior detailed reviews have provided important sources of information concerning radiation injury for this more general discussion. The information provided will assist both the clinician and the radiologist in the recognition of early and late complications of therapy in pediatric oncology

  19. Feminist music therapy pedagogy

    DEFF Research Database (Denmark)

    Hahna, Nicole; Swantes, Melody

    2011-01-01

    ) participatory learning, (b) validation of personal experience/development of confidence, (c) political/social activism, and (d) critical thinking/ open-mindedness. The results revealed that 46% (n = 32) of participants identified as feminist music therapists and 67% (n = 46) of participants identified as using......This study surveyed 188 music therapy educators regarding their views and use of feminist pedagogy and feminist music therapy. The purpose of this study was two-fold: (a) to determine how many music therapy educators used feminist pedagogy and (b) to determine if there was a relationship between...

  20. Electroconvulsive therapy revisited.

    Science.gov (United States)

    Atkinson, S D; Smith, C; Smith, E M; Miller, J M

    1991-05-01

    Electroconvulsive therapy (ECT) remains an extremely valuable tool in the treatment of certain psychiatric disorders. Despite the sensationalism of the past decade, ECT is the treatment of choice in severe depression that is unresponsive to other therapies or in patients who are overtly suicidal. In addition, ECT is particularly valuable in the elderly population, who are at risk for serious complications from the side effects associated with drug therapy. This report describes a case of recurrent depression in which ECT was successfully used. PMID:2072186

  1. Consequences of Accounting Standards

    Institute of Scientific and Technical Information of China (English)

    Cai Mingyue

    2009-01-01

    The first part of this article consists in attempting to highlight the importance of concerning about the economic consequences and introducing the foundation of economic consequence theory, proposing that the accounting standard is not only a kind of technical standard, it also has the economic consequences, so it becomes the object which all quarters special interest group gambles to get latent profit. After general characterization of the economic consequences in the second part, the article gives a description of the influences the change of accounting standards bring to the government, the ordinary investors and creditors, the auditors, and the enterprise, establishing a framework that how those groups react as the economic consequences in the third part. The fourth section compare technical theory and accounting standards theory, links the basic norms of accounting such as conservatism, relevance and reliability to the methods of escaping the harm of economic consequences, then proposes some specific methods in the formuhtion of accounting standard. Finally, the article utilizes the methods to settle the problems appearing in Chinese market.

  2. GISB: Efficiency through standardization

    International Nuclear Information System (INIS)

    For those who participated in the numerous day-long development sessions held in the dim, stale basement auditorium of the Department of Energy, the ida that the Gas Industry standards Board (GISB) would be producing standards anytime soon seemed a distant dream. However, the hazy vision of just over a year ago has now become a reality. As summer turns to fall and young gas schedulers throughout this country dream of the gridiron, GISB will have already issued a model electronic-trading partner agreement and 12 standards for capacity-release transactions, as well as three standards for nomination-related transactions. Under the steady hand of Executive directors Rae McQuade and a board of director that looks like a Who's Who of the gas industry, GISB has developed into a organization that will directly influence how gas is purchased, transported, and accounted and paid for in the 21st century. The paper describes the background of the organization, standards that have been released, and issues still to be addressed

  3. [MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) AND THE "THIRD WAVE" OF COGNITIVE-BEHAVIORAL THERAPIES (CBT)].

    Science.gov (United States)

    Garay, Cristian Javier; Korman, Guido Pablo; Keegan, Eduardo Gustavo

    2015-01-01

    The paper presents the reasons that led to the incorporation of mindfulness as part of a cognitive therapy approach to the prevention of relapse of recurrent depressive disorders. It describes the context in which models focused on the contents of cognition gave way to models focused on cognitive processes. We highlight the problems encountered by the standard cognitive model when trying to account for the cognitive vulnerability of individuals who, having experienced a depressive episode, are in remission. We briefly describe the theoretical foundations of Mindfulness-Based Cognitive Therapy and its therapeutic approach.

  4. Treating Women Drug Abusers: Action Therapy and Trauma Assessment

    OpenAIRE

    Uhler, Ann S.; Parker, Olga V.

    2002-01-01

    The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors ...

  5. Adjuvant Therapy of Colon Cancer: Current Status and Future Developments

    OpenAIRE

    Morse, Michael A.

    2005-01-01

    Options for the adjuvant therapy of resected stage III colon cancer have expanded beyond the previously well-accepted standard of 5-fluorouracil (5-FU) combined with leucovorin. The Xeloda in Adjuvant Colon Cancer Therapy (X-ACT) study confirmed that capecitabine (Xeloda) is at least as effective and is less toxic than a bolus 5-FU and leucovorin regimen for patients with stage III colon cancer. This study, in addition to National Surgical Adjuvant Breast and Bowel Project (NSABP) C-06, which...

  6. Pneumothorax following thoracic radiation therapy for Hodgkin's disease

    International Nuclear Information System (INIS)

    Radiation therapy alone to the nodal drainage sites above the diaphragm, namely a ''mantle'' field, is often standard treatment for early stage Hodgkin's disease and may be used in combination with chemotherapy in more advanced disease. Localised pneumonitis and fibrosis are recognised treatment related sequelae; however, other pulmonary complications, including pneumothorax, have been described. Two cases of spontaneous pneumothorax following mantle radiation therapy are presented. (author)

  7. HYPOLIPIDEMIC THERAPY IN PATIENTS AFTER HEART TRANSPLANTATION: STATINS

    Directory of Open Access Journals (Sweden)

    A. О. Shevchenko

    2016-01-01

    Full Text Available Statins should be used as a part of standard therapy in patients after heart transplantation. The effectiveness of statins is associated not only with their hypolipidemic action, but also with their immunomodulatory and antineoplastic properties. Statin therapy initiated early after heart transplantation improves the shortand long-term prognosis and outcomes, leading to a reduction in the incidence of cardiac allograft vasculopathy, acute rejection, and cancer. 

  8. Gene Therapy for Muscular Dystrophy: Moving the Field Forward

    OpenAIRE

    Al-Zaidy, Samiah; Rodino-Klapac, Louise; Mendell, Jerry R.

    2014-01-01

    Gene therapy for the muscular dystrophies has evolved as a promising treatment for this progressive group of disorders. While corticosteroids and/or supportive treatments remain standard of care for Duchenne muscular dystrophy (DMD), loss of ambulation, respiratory failure and compromised cardiac function is the inevitable outcome. Recent developments in genetically mediated therapies have allowed for personalized treatments that strategically target individual muscular dystrophy subtypes bas...

  9. [Hyperbaric therapy and diving medicine - hyperbaric therapy part 2: adjuvant therapy].

    Science.gov (United States)

    Tetzlaff, Kay; Jüttner, Björn

    2015-10-01

    Hyperbaric oxygen therapy (HBOT), i. e. breathing pure oxygen at elevated ambient pressure, remains the gold standard of care in treating air or gas embolism and decompression illness. Guidelines are less clear on the value of HBOT in acute management of carbon monoxide (CO) poisoning or clostridial necrosis. To evaluate the evidence of clinical efficacy of HBOT we performed a systematic literature review. Part 1 assesses acute indications such as air or gas embolism, decompression sickness, CO-poisoning, clostridialmyonecrosis, necrotizing problem wounds, acute traumatic wounds and arterial retinal occlusion. Part 2 discusses further uses of HBOT as adjuvant treatment and highlights problems in assessing the value of HBOT using evidence-based medicine criteria. PMID:26510108

  10. Chinese Consensus on Combination Therapy of Chronic Hepatitis B

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    In May 2011,editorial boards of Chinese Journal of Experimental and Clinical Infectious Diseases (Electronic Edition),Chinese Journal of Liver Diseases (Electronic Edition) and Infection International (Electronic Edition) organized an expert committee to form an expert consensus on antiviral combination therapy of chronic hepatitis B (CHB).The consensus publication promoted and standardized the combination therapy concept of chronic hepatitis B.Clinical evidence of combination therapy for CHB is incomplete.The concept of combination therapy is gradually extended,from combination of antiviral drugs plus antiviral drugs,to antiviral drugs plus hepatoprotective drugs,and antiviral drugs plus immunomodulatory drugs.Therefore,editorial boards once again asked experts to analyze the new clinical evidence,and form the expert consensus on combination therapy of chronic hepatitis B.The formulation of this consensus is according to the principles of evidence-based medicine.Large number of clinical studies of combination therapy is still in progress.This consensus can not fully answer all the problems encountered in the combination therapy of CHB.With the progress of clinical practice of antiviral therapy,and the accumulation of evidence in combination therapy,the expert committee will update the consensus timely.

  11. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob;

    2014-01-01

    OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...

  12. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

  13. Ethics, standards, and TQM.

    Science.gov (United States)

    Botticelli, M G

    1995-04-01

    The most important ethical issue for our profession is the responsibility to assure the care delivered by our colleagues and ourselves meets a self-imposed standard of excellence. There is anecdotal and experimental evidence that we have not fulfilled this obligation. Peer review has proven, for a number of reasons, to be ineffective; however, improvements in the epidemiologic sciences should provide better standards and total quality management (TQM) might prove to be of value in monitoring, comparing and improving the decisions made by physicians. Its promise lies in its emphasis on statistical analysis, its focus on systematic rather than human error, and its use of outcomes as standards. These methods, however, should not diminish our other professional responsibilities: Altruism, peer review, and in Hippocrates' words "to prescribe regimens for the good of our patients-and never do harm to anyone."

  14. Standards and quality

    CERN Document Server

    El-Tawil, Anwar

    2015-01-01

    The book brings together a number of subjects of prime importance for any practicing engineer and, students of engineering. The book explains the concepts and functions of voluntary standards, mandatory technical regulations, conformity assessment (testing and measurement of products), certification, quality and quality management systems as well as other management systems such as environmental, social responsibility and food safety management systems.The book also gives a comprehensive description of the role of metrology systems that underpin conformity assessment. A description is given of typical national systems of standards, quality and metrology and how they relate directly or through regional structures to international systems. The book also covers the relation between standards and trade and explains the context and stipulations of the Technical Barriers to Trade Agreement of the World Trade Organization (WTO).

  15. Fasteners 5 basic standards

    CERN Document Server

    2011-01-01

    This 3rd edition of DIN Handbook 193 contains 38 fundamental standards on fasteners, covering such areas as countersinks and counterbores, widths across flats, thread run-outs and thread undercuts, bolt and screw ends, stud ends and tapped holes for compression couplings, driving features, tolerances for screw threads and nomenclature. New to this compilation are DIN 34824 dealing with 12 point sockets for bolts and screws and DIN EN ISO 15065 which reflects current practice in Europe with regard to countersinks for countersunk head screws. Also included for the first time is DIN EN ISO 225 "Fasteners - Bolts, screws, studs and nuts - Symbols and descriptions of dimensions" which, together with DIN ISO 1891, now also incorporates terminology in Chinese, Japanese and Swedish. Four standards have been revised for this edition, among them DIN 918 Supplement 3 which provides information on the current status of European standardization relating to fasteners. DIN Handbook 193 is one of a series of six handbooks on...

  16. Automated Standard Hazard Tool

    Science.gov (United States)

    Stebler, Shane

    2014-01-01

    The current system used to generate standard hazard reports is considered cumbersome and iterative. This study defines a structure for this system's process in a clear, algorithmic way so that standard hazard reports and basic hazard analysis may be completed using a centralized, web-based computer application. To accomplish this task, a test server is used to host a prototype of the tool during development. The prototype is configured to easily integrate into NASA's current server systems with minimal alteration. Additionally, the tool is easily updated and provides NASA with a system that may grow to accommodate future requirements and possibly, different applications. Results of this project's success are outlined in positive, subjective reviews complete by payload providers and NASA Safety and Mission Assurance personnel. Ideally, this prototype will increase interest in the concept of standard hazard automation and lead to the full-scale production of a user-ready application.

  17. Beyond the standard model

    International Nuclear Information System (INIS)

    The standard model of particle interactions is a complete and relatively simple theoretical framework which describes all the observed fundamental forces. It consists of quantum chromodynamics (QCD) and of the electro-weak theory of Glashow, Salam and Weinberg. The former is the theory of colored quarks and gluons, which underlies the observed phenomena of strong interactions, the latter leads to a unified description of electromagnetism and of weak interactions. The inclusion of the classical Einstein theory of gravity completes the set of established basic knowledge. The standard model is in agreement with essentially all of the experimental information which is very rich by now. The recent discovery of the charged and neutral intermediate vector bosons of weak interactions at the expected masses has closed a really important chapter of particle physics. Never before the prediction of new particles was so neat and quantitatively precise. Yet the experimental proof of the standard model is not completed. For example, the hints of experimental evidence for the top quark at a mass ∼ 40 GeV have not yet been firmly established. The Higgs sector of the theory has not been tested at all. Beyond the realm of pure QED, even remaining within the electro-weak sector, the level of quantitative precision in testing the standard model does not exceed 5% or so. Furthermore, the standard model does not look as the ultimate theory. To a closer inspection a large class of fundamental questions emerges and one finds that a host of crucial problems are left open by the standard model

  18. Standardization Historical Overview

    Institute of Scientific and Technical Information of China (English)

    Wang Ping

    2008-01-01

    @@ 1. Indroduction Standardization germinated in ancient times, and began to develop from the beginning of the in-dustrial revolution, and took off in the later years of the 19th Century. It has been closely connected with the development of science and technology, as well as industry and trade throughout human histo-ry. Standardization now plays an important role in nearly every aspect of human life, in different sec-tors of industry and society. It has had a great im-pact on our lives.

  19. Coordinate Standard Measurement Development

    Energy Technology Data Exchange (ETDEWEB)

    Hanshaw, R.A.

    2000-02-18

    A Shelton Precision Interferometer Base, which is used for calibration of coordinate standards, was improved through hardware replacement, software geometry error correction, and reduction of vibration effects. Substantial increases in resolution and reliability, as well as reduction in sampling time, were achieved through hardware replacement; vibration effects were reduced substantially through modification of the machine component dampening and software routines; and the majority of the machine's geometry error was corrected through software geometry error correction. Because of these modifications, the uncertainty of coordinate standards calibrated on this device has been reduced dramatically.

  20. Conference: STANDARD MODEL @ LHC

    CERN Multimedia

    2012-01-01

    HCØ institute Universitetsparken 5 DK-2100 Copenhagen Ø Denmark Room: Auditorium 2 STANDARD MODEL @ LHC Niels Bohr International Academy and Discovery Center 10-13 April 2012 This four day meeting will bring together both experimental and theoretical aspects of Standard Model phenomenology at the LHC. The very latest results from the LHC experiments will be under discussion. Topics covered will be split into the following categories:     * QCD (Hard,Soft & PDFs)     * Vector Boson production     * Higgs searches     * Top Quark Physics     * Flavour physics

  1. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

  2. Radiation Therapy (For Parents)

    Science.gov (United States)

    ... be some permanent changes to the color and elasticity of the skin. How can you help? Dress ... to Home and School Cancer Center Cancer Basics Types of Cancer Teens Get Radiation Therapy Chemotherapy Dealing ...

  3. External Radiation Therapy

    Medline Plus

    Full Text Available ... frequently used is radiation therapy. Gunnar Zagars, M.D.: There are different forms of radiation for prostate ... typical treatment takes seven weeks. Gunnar Zagars, M.D.: A patient comes in every day, Monday to ...

  4. Targeted therapies for cancer

    Science.gov (United States)

    ... to be untrue. Possible side effects from targeted therapies include: Diarrhea Liver problems Skin problems such as rash, dry skin, and nail changes Problems with blood clotting and wound healing High blood pressure As with any treatment, you ...

  5. Targeted Thrombolytic Therapy

    Institute of Scientific and Technical Information of China (English)

    胡豫

    2004-01-01

    @@ Venous and arterial thrombosis are closely related to many severe diseases, especially to cardiovascular and cerebrovasular disorders. Thrombolytic therapy has been proven to be an effective method to treat such disease, which decreased the mortality and morbidity greatly.

  6. [Physiotherapy as manual therapy].

    Science.gov (United States)

    Torstensen, T A; Nielsen, L L; Jensen, R; Reginiussen, T; Wiesener, T; Kirkesola, G; Mengshoel, A M

    1999-05-30

    Manual therapy includes methods where the therapist's hands are used to stretch, mobilize or manipulate the spinal column, paravertebral structures or extremity joints. The aims of these methods are to relieve pain and improve function. In Norway only specially qualified physiotherapists and chiropractors are authorized to perform manipulation of joints (high velocity thrust techniques). To become a qualified manual therapist in Norway one must have a minimum of two years of clinical practice as physiotherapist followed by two year full time postgraduate training in manual therapy (a total of six years). Historically the Norwegian manual therapy system was developed in the 1950s by physiotherapists and medical doctors in England (James Cyriax and James Mennell) and Norway. As a result doctors allowed physiotherapists to use manipulation as a treatment method of both spinal and peripheral joints. In 1957 the Norwegian health authorities introduced reimbursement for manual therapy performed by physiotherapists.

  7. Drug therapy smartens up

    Science.gov (United States)

    Martin, Christian

    2015-11-01

    The submission of the first 'smart pill' for market approval, combined with progress in the European nanomedicine landscape, illustrates the positive outlook for drug therapy and health monitoring, explains Christian Martin.

  8. External Radiation Therapy

    Medline Plus

    Full Text Available ... the treatment that is frequently used is radiation therapy. Gunnar Zagars, M.D.: There are different forms of radiation for prostate cancer. They really boil down to two different types. ...

  9. Home Oxygen Therapy

    Science.gov (United States)

    ... Oxygen Therapy Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition Exercise Coming Of Age Older Adults Allergy ... oxygen is so cold it can hurt your skin. Keep a fire extinguisher close by, and let ...

  10. Interactional Gestalt Therapy.

    Science.gov (United States)

    Warehime, Robert G.

    1981-01-01

    Group gestalt therapy in which the leader facilitates the development of helping capacity in group members is described. The general characteristics of this approach are discussed and ground rules concerning leader and member behaviors are suggested. (RC)

  11. Occupational therapy evaluation

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Wæhrens, Eva Ejlersen

    2014-01-01

    Background: The Occupational Therapy Intervention Process Model (OTIPM) serves to guide occupational therapists in their professional reasoning. The OTIPM prescribes evaluation of task performance based on both self-report and observation. Although this approach seems ideal, many clinicians raise...

  12. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  13. Photodynamic therapy in dermatology

    Directory of Open Access Journals (Sweden)

    Nayak Chitra

    2005-01-01

    Full Text Available Photodynamic therapy is a new modality of therapy being used for the diagnosis and treatment of many tumors. It is now being increasingly used for skin tumors and other dermatological disorders. With its range of application it is certainly the therapy of the future. Its mechanism of action is by the Type II photo-oxidative reaction. The variables are the photosensitizer, the tissue oxygenation and the light source. It has been used to treat various disorders including Bowen′s disease, actinic keratoses, squamous cell carcinomas, basal cell carcinomas, and mycosis fungoides. The side-effects are fortunately mild and transient. Newer photosensitisers like methyl aminolevulinate hold a lot of promise for better therapy.

  14. [Maintenance therapy for advanced non-small-cell lung cancer].

    Science.gov (United States)

    Saruwatari, Koichi; Yoh, Kiyotaka

    2014-08-01

    Maintenance therapy is a new treatment strategy for advanced non-small-cell lung cancer(NSCLC), and it consists of switch maintenance and continuation maintenance.Switch maintenance is the introduction of a different drug, not included as part of the induction therapy, immediately after completion of 4 cycles of first-line platinum-based chemotherapy.Continuation maintenance is a continuation of at least one of the drugs used in the induction therapy in the absence of disease progression.Several phase III trials have reported survival benefits with continuation maintenance of pemetrexed and switch maintenance of pemetrexed or erlotinib.Therefore, maintenance therapy has become a part of the standard first-line treatment for advanced NSCLC.However, further research is needed to elucidate the selection criteria of patients who may benefit the most from maintenance therapy. PMID:25132023

  15. Proton beam therapy

    OpenAIRE

    Levin, W P; Kooy, H; Loeffler, J S; T. F. DeLaney

    2005-01-01

    Conventional radiation therapy directs photons (X-rays) and electrons at tumours with the intent of eradicating the neoplastic tissue while preserving adjacent normal tissue. Radiation-induced damage to healthy tissue and second malignancies are always a concern, however, when administering radiation. Proton beam radiotherapy, one form of charged particle therapy, allows for excellent dose distributions, with the added benefit of no exit dose. These characteristics make this form of radiother...

  16. Nanomedicine and cancer therapies

    CERN Document Server

    Sebastian, Mathew; Elias, Eldho

    2012-01-01

    Introduction Nanotechnological-Based Systems for CancerIn vivo Spectroscopy for Detection and Treatment of GBM with NPt® ImplantationNanobiotechnology for Antibacterial Therapy and DiagnosisChitosan NanoparticlesSynthesis and Biomedical Application of Silver NanoparticlesRecent Advances in Cancer Therapy Using PhytochemicalsMitochondrial Dysfunction and Cancer: Modulation by Palladium-Lipoic Acid ComplexUnity of Mind and Body: The Concept of Life Purpose DominantThuja Occidentalis and Breast Cancer ChemopreventionAntioxidants and Com

  17. Who needs pharmacologic therapy?

    Directory of Open Access Journals (Sweden)

    Christopher Porterfield; Rohit Malhotra

    2014-06-01

    Full Text Available Treatment of atrial fibrillation has evolved significantly in the last ten years, with ablation becoming a far more common form of treatment for this most common of arrhythmias. However, while ablation has become more common, certain populations derive continued benefit from the use of pharmacologic therapy for treatment. We review the use of pharmacologic therapy and novel considerations for treatment of atrial fibrillation.

  18. Intraoperative Stem Cell Therapy

    OpenAIRE

    Coelho, Mónica Beato; Cabral, Joaquim M. S.; Karp, Jeffrey M.

    2012-01-01

    Stem cells hold significant promise for regeneration of tissue defects and disease-modifying therapies. Although numerous promising stem cell approaches are advancing in clinical trials, intraoperative stem cell therapies offer more immediate hope by integrating an autologous cell source with a well-established surgical intervention in a single procedure. Herein, the major developments in intraoperative stem cell approaches, from in vivo models to clinical studies, are reviewed, and the poten...

  19. Antisense Therapy in Neurology

    OpenAIRE

    Lee, Joshua J.A.; Toshifumi Yokota

    2013-01-01

    Antisense therapy is an approach to fighting diseases using short DNA-like molecules called antisense oligonucleotides. Recently, antisense therapy has emerged as an exciting and promising strategy for the treatment of various neurodegenerative and neuromuscular disorders. Previous and ongoing pre-clinical and clinical trials have provided encouraging early results. Spinal muscular atrophy (SMA), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), Duchenne muscular dystrophy (DMD)...

  20. Yoga therapy for Schizophrenia

    OpenAIRE

    N Gangadhar Bangalore; Shivarama Varambally

    2012-01-01

    Schizophrenia is one of the most severe mental disorders. Despite significant advances in pharmacotherapy, treatment remains sub-optimal, with many patients having persisting deficits, especially in cognitive and social functioning. Yoga as a therapy has proven to be effective as a sole or additional intervention in psychiatric disorders such as depression and anxiety. Recently, there has been significant interest in the application of yoga therapy in psychosis and schizophrenia. To review a)...

  1. YOGA THERAPY AND DISABILITY

    OpenAIRE

    Belia Méndez Rial

    2015-01-01

    Yoga is a useful supportive intervention for a broad range of pain-associated diseases. It is often recommended as therapy for a variety of medical conditions and it is rising popularity as therapy (Verrastro, 2014). Yoga is a system of movement and breathing exercises meant to foster mind-body connection. It creates inner, physical and emotional balance through the use of postures, called asanas, combined with breathing techniques or pranayama (Posadzki et al, 2011). Benefits are found in di...

  2. Practical procedures: oxygen therapy.

    Science.gov (United States)

    Olive, Sandra

    Knowing when to start patients on oxygen therapy can save lives, but ongoing assessment and evaluation must be carried out to ensure the treatment is safe and effective. This article outlines when oxygen therapy should be used and the procedures to follow. It also describes the delivery methods applicable to different patient groups, along with the appropriate target saturation ranges, and details relevant nurse competencies.

  3. Acupuncture in Treating Dry Mouth Caused By Radiation Therapy in Patients With Head and Neck Cancer | Division of Cancer Prevention

    Science.gov (United States)

    RATIONALE: Acupuncture may help relieve dry mouth caused by radiation therapy. PURPOSE: This randomized phase III trial is studying to see how well one set of acupuncture points work in comparison to a different set of acupuncture points or standard therapy in treating dry mouth caused by radiation therapy in patients with head and neck cancer. |

  4. Cognitive behavioural therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Churchill, Rachel; Moore, Theresa Hm; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Furukawa, Toshi A; Lewis, Glyn; Hunot, Vivien

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all CBT approaches compared with all other psychological therapy approaches for acute depressionTo examine the effectiveness and acceptability of different CBT approaches (cognitive therapy, rational emotive behaviour therapy, problem-solving therapy, self-control therapy and Coping with Depression course) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all CBT approaches compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, third wave CBT) for acute depression.

  5. Humanistic therapies versus other psychological therapies for depression.

    Science.gov (United States)

    Churchill, Rachel; Davies, Philippa; Caldwell, Deborah; Moore, Theresa Hm; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all humanistic therapies compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different humanistic therapy models (person-centred, gestalt, process-experiential, transactional analysis, existential and non-directive therapies) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all humanistic therapies compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. PMID:25278809

  6. Concept Analysis: Music Therapy.

    Science.gov (United States)

    Murrock, Carolyn J; Bekhet, Abir K

    2016-01-01

    Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant's concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007-2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant's concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed. PMID:27024999

  7. Psychodynamic Music Therapy

    Directory of Open Access Journals (Sweden)

    Jinah Kim

    2016-07-01

    Full Text Available This paper introduces and explores the basic principles of psychodynamic approaches in music therapy. Music is used as a means to explore both conscious and unconscious issues as well as the internal world of the individuals involved in music therapy. However, the focus of therapy is on therapeutic relationship, especially the dynamics of transference and counter-transference between the client and the music therapist. Musical experiences, such as music listening, songs, and improvisation, can be used to facilitate the therapeutic processes, and to achieve individualized therapeutic goals. When clinically appropriate, verbal processing might play as crucial a role as the musical processing. Practitioners of psychodynamic approaches often strive to gain meaning and in-depth understandings from therapeutic experiences, and the approach is therefore suitable for individuals who are ready to work through their personal issues within a therapeutic relationship. Various approaches and techniques have been developed in psychotherapy as well as in music therapy. Perhaps the only commonality in these approaches is that psychodynamic thinking informs the direction of the therapy and therapeutic processes. Clinical vignettes will be introduced within the article to highlight a triadic dynamic—the client, the music therapist, and the music—in order to illustrate the core aspects of psychodynamic music therapy.

  8. Cellular therapy in Tuberculosis

    Directory of Open Access Journals (Sweden)

    Shreemanta K. Parida

    2015-03-01

    Full Text Available Cellular therapy now offer promise of potential adjunct therapeutic options for treatment of drug-resistant tuberculosis (TB. We review here the role of Mesenchymal stromal cells, (MSCs, as well as other immune effector cells in the therapy of infectious diseases with a focus on TB. MSCs represent a population of tissue-resident non-hematopoietic adult progenitor cells which home into injured tissues increase the proliferative potential of broncho-alveolar stem cells and restore lung epithelium. MSCs have been shown to be immune-modulatory and anti-inflammatory mediated via cell-cell contacts as well as soluble factors. We discuss the functional profile of MSCs and their potential use for adjunct cellular therapy of multi-drug resistant TB, with the aim of limiting tissue damage, and to convert unproductive inflammatory responses into effective anti-pathogen directed immune responses. Adjunct cellular therapy could potentially offer salvage therapy options for patients with drug-resistant TB, increase clinically relevant anti-M.tuberculosis directed immune responses and possibly shorten the duration of anti-TB therapy.

  9. Fertility and cancer therapy

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, L.C.

    1979-05-01

    With increased survival of increasing numbers of cancer patients as a result of therapy, the consequences, early and late, of the therapies must be realized. It is the treating physician's duty to preserve as much reproductive potential as possible for patients, consistent with adequate care. With radiotherapy this means shielding the gonads as much as possible, optimal but not excessive doses and fields, oophoropexy, or sperm collection and storage prior to irradiation. With chemotherapy it means the shortest exposure to drugs consistent with best treatment and prior to therapy the collection and storage of sperm where facilities are available. At present this is still an experimental procedure. Artificial insemination for a couple when the male has received cancer therapy is another alternative. Finally, it is the responsibility of physicians caring for patients with neoplasms to be knowledgeable about these and all other effects of therapy so that patients may be counseled appropriately and understand the implications of therapy for their life.

  10. Concept Analysis: Music Therapy.

    Science.gov (United States)

    Murrock, Carolyn J; Bekhet, Abir K

    2016-01-01

    Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant's concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007-2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant's concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed.

  11. Department of Energy Standards Index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This TSL, intended for use in selecting and using DOE technical standards and other Government and non-Government standards, provides listing of current and inactive DOE technical standards, non-Government standards adopted by DOE, other Government documents in which DOE has a recorded interest, and cancelled DOE technical standards.

  12. Comparison of sequential and 7-, 10-, 14-d triple therapy for Helicobacter pylori infection

    Institute of Scientific and Technical Information of China (English)

    Hyuk Soon Choi; Hoon Jai Chun; Sang Hoon Park; Bora Keum; Yeon Seok Seo; Yong Sik Kim; Yoon-Tae Jeen

    2012-01-01

    AIM:To compare the effectiveness of sequential therapy for Helicobacter pylori (H.pylori) infection with that of triple therapy of varying durations.METHODS:The 460 patients enrolled in this study had H.pylori-associated gastritis or a gastric or duodenal ulcer.After screening,H.pylori-infected patients were randomly assigned to receive either conventional triple therapy for 7,10 or 14 d,or a new 10-d sequential therapy.Each of the 4 treatment groups included 115 patients.The outcomes of eradication therapy were assessed 4 wk after treatment by the urea breath test and histology.RESULTS:The overall eradication rate was 81.0%,and eradication rates were 75.7% for 7-d conventional triple therapy,81.9% for 10-d conventional triple therapy,84.4% for 14-d conventional triple therapy,and 82.0% for 10-d sequential therapy.Neither intention-to-treat analysis nor per protocol analysis showed significant differences in eradication rates using sequential therapy or the standard triple therapy (P =0.416 and P =0.405,respectively).CONCLUSION:There are no significant differences between 10-d sequential eradication therapy for H.pylori and any duration of standard triple treatment in Korean patients.

  13. The Current Status of Physical Therapy in China

    Institute of Scientific and Technical Information of China (English)

    Alice Jones; Margot A Skinner

    2013-01-01

    The current health system in China has evolved by embracing both traditional Chinese medicine and Western medicine.China is the only country in the world where the number of doctors is larger than the number of nurses but education programmes for other health professions like physical therapy have been slow to develop.In the case of physical therapy it was not until China won the bid for the Olympic Games that permission to establish the first physical therapy programme was granted.Since then China has undergone a period of rapid economic growth enabling many people to have a higher standard of living and improved health,but at the same time the country is faced with massive urbanization,industrialization,increasing environmental health threats,increased health disparities and an aging population.With the support of the Chinese Association of Rehabilitation Medicine,an increased investment by the Government in public health and rehabilitation and engagement of international education experts,entry-level education programmes for physical therapy have started to develop and there are now nine which are modeled,at least to some extent,on the World Confederation for Physical Therapy's international guidelines.The paper explores the development of physical therapy education in China and discusses possible options for the way forward so that as the demand for physical therapy to service 1.4 billion people grows,the profession is prepared and the standards expected of the entry-level physical therapist will not be compromised.

  14. Standardized Curriculum for Cosmetology.

    Science.gov (United States)

    Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

    Standardized curricula are provided for two courses for the secondary vocational education program in Mississippi: cosmetology I and II. The 18 units in cosmetology I are as follows: introduction to cosmetology; Vocational Industrial Clubs of America; the look you like; bacteriology; sterilization and sanitation; hair and disorders; draping,…

  15. Setting the Standard

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The country’s self-developed document format standard faces a difficult decision and possible extinction as it goes up against mighty Microsoft Since Microsoft’s Office Open Extensible Markup Language (OOXML)document format was accepted as an international stan- dard by the International Organization for

  16. Standards and Interoperability

    Institute of Scientific and Technical Information of China (English)

    Stephen McGibbon

    2006-01-01

    @@ I am sure that there will be much discussion at the upcoming Baltic IT&T 2005 conference about standards and interoperability, and so I thought I would try to contribute to the debate with this, the first of four articles that I will write for this journal over the coming months.

  17. On Standard Ideals

    Institute of Scientific and Technical Information of China (English)

    Zhi De YU

    2003-01-01

    In the paper, we study a class of standard ideals which are more general than the m-primarystandard ideals discussed in [2]. We will prove an important equality concerning I-weak sequences; thusa generalization of the equality of [2] is established.

  18. Setting Environmental Standards

    Science.gov (United States)

    Fishbein, Gershon

    1975-01-01

    Recent court decisions have pointed out the complexities involved in setting environmental standards. Environmental health is composed of multiple causative agents, most of which work over long periods of time. This makes the cause-and-effect relationship between health statistics and environmental contaminant exposures difficult to prove in…

  19. Beyond the standard model

    International Nuclear Information System (INIS)

    These lecture notes are intended as a pedagogical introduction to several popular extensions of the standard model of strong and electroweak interactions. The topics include the Higgs sector, the left-right symmetric model, grand unification and supersymmetry. Phenomenological consequences and search procedures are emphasized. (author) figs., tabs., 18 refs

  20. Standardization of Sign Languages

    Science.gov (United States)

    Adam, Robert

    2015-01-01

    Over the years attempts have been made to standardize sign languages. This form of language planning has been tackled by a variety of agents, most notably teachers of Deaf students, social workers, government agencies, and occasionally groups of Deaf people themselves. Their efforts have most often involved the development of sign language books…