Heuristic Evaluation of Ehealth Interventions: Establishing Standards That Relate to the Therapeutic Process Perspective.

Science.gov (United States)

Baumel, Amit; Muench, Fred

2016-01-13

In recent years, the number of available eHealth interventions aimed at treating behavioral and mental health challenges has been growing. From the perspective of health care providers, there is a need for eHealth interventions to be evaluated prior to clinical trials and for the limited resources allocated to empirical research to be invested in the most promising products. Following a literature review, a gap was found in the availability of eHealth interventions evaluation principles related to the patient experience of the therapeutic process. This paper introduces principles and concepts for the evaluation of eHealth interventions developed as a first step in a process to outline general evaluation guidelines that relate to the clinical context from health care providers' perspective. Our approach was to conduct a review of literature that relates to the examination of eHealth interventions. We identified the literature that was most relevant to our study and used it to define guidelines that relate to the clinical context. We then compiled a list of heuristics we found to be useful for the evaluation of eHealth intervention products' suitability for empirical examination. Four heuristics were identified with respect to the therapeutic process: (1) the product's ease of use (ie, usability), (2) the eHealth intervention's compatibility with the clinical setting, (3) the presence of tools that make it easier for the user to engage in therapeutic activities, and (4) the provision of a feasible therapeutic pathway to growth. We then used this set of heuristics to conduct a detailed examination of MyFitnessPal. This line of work could help to set the bar higher for product developers and to inform health care providers about preferred eHealth intervention designs.

Internet addiction neuroscientific approaches and therapeutical interventions

CERN Document Server

Reuter, Martin

2015-01-01

This book combines a scholarly introduction with state-of-the-art research in the characterization of Internet addiction. It is intended for a broad audience including scientists, students and practitioners. The first part of the book contains an introduction to Internet addiction and their pathogenesis. The second part of the book is dedicated to an in-depth review of neuroscientific findings which cover studies using a variety of biological techniques including brain imaging and molecular genetics. The last part of the book will focus on therapeutic interventions for Internet addiction.

Meta-Analysis of Psychological Assessment as a Therapeutic Intervention

Science.gov (United States)

Poston, John M.; Hanson, William E.

2010-01-01

This study entails the use of meta-analytic techniques to calculate and analyze 18 independent and 52 nonindependent effect sizes across 17 published studies of psychological assessment as a therapeutic intervention. In this sample of studies, which involves 1,496 participants, a significant overall Cohen's d effect size of 0.423 (95% CI [0.321,…

Liver metastases: interventional therapeutic techniques and results, state of the art

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Vogl, T.J.; Mueller, P.K.; Mack, M.G.; Straub, R.; Engelmann, K. [Dept. of Radiology, Univ. of Frankfurt (Germany); Neuhaus, P. [Dept. of Surgery, Humboldt University of Berlin (Germany)

1999-05-01

The liver is the most common site of metastatic tumour deposits. Hepatic metastases are the major cause of morbidity and mortality in patients with gastrointestinal carcinomas and other malignant tumours. The rationale and results for interventional therapeutic techniques in the treatment of liver metastases are presented. For the treatment of patients with irresectable liver metastases, alternative local ablative therapeutic modalities have been developed. Technique and results of local interventional therapies are presented such as microwave-, radiofrequency (RF)- and ultrasound ablation, and laser-induced interstitial therapy (LITT), cryotherapy and local drug administration such as alcohol injection, endotumoral chemotherapy and regional chemoembolisation. In addition to cryotherapy, all ablative techniques can be performed percutaneously with low morbidity and mortality. Cryotherapy is an effective and precise technique for inducing tumour necrosis, but it is currently performed via laparotomy. Percutaneous local alcohol injection results in an inhomogeneous distribution in liver metastases with unreliable control rates. Local chemotherapeutic drug instillation and regional chemoembolisation produces relevant but non-reproducible lesions. Laser-induced interstitial thermotherapy (LITT) performed under MRI guidance results in precise and reproducible areas of induced necrosis with a local control of 94 %, and with an improved survival rate. Interventional therapeutic techniques of liver metastases do result in a remarkable local tumour control rate with improved survival results. (orig.) With 5 figs., 1 tab., 43 refs.

Weathering the storm: Improving therapeutic interventions for cytokine storm syndromes by targeting disease pathogenesis.

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Weaver, Lehn K; Behrens, Edward M

2017-03-01

Cytokine storm syndromes require rapid diagnosis and treatment to limit the morbidity and mortality caused by the hyperinflammatory state that characterizes these devastating conditions. Herein, we discuss the current knowledge that guides our therapeutic decision-making and personalization of treatment for patients with cytokine storm syndromes. Firstly, ICU-level supportive care is often required to stabilize patients with fulminant disease while additional diagnostic evaluations proceed to determine the underlying cause of cytokine storm. Pharmacologic interventions should be focused on removing the inciting trigger of inflammation and initiation of an individualized immunosuppressive regimen when immune activation is central to the underlying disease pathophysiology. Monitoring for a clinical response is required to ensure that changes in the therapeutic regimen can be made as clinically warranted. Escalation of immunosuppression may be required if patients respond poorly to the initial therapeutic interventions, while a slow wean of immunosuppression in patients who improve can limit medication-related toxicities. In certain scenarios, a decision must be made whether an individual patient requires hematopoietic cell transplantation to prevent recurrence of disease. Despite these interventions, significant morbidity and mortality remains for cytokine storm patients. Therefore, we use this review to propose a clinical schema to guide current and future attempts to design rational therapeutic interventions for patients suffering from these devastating conditions, which we believe speeds the diagnosis of disease, limits medication-related toxicities, and improves clinical outcomes by targeting the heterogeneous and dynamic mechanisms driving disease in each individual patient.

Does postural sway change in association with manual therapeutic interventions? A review of the literature

Directory of Open Access Journals (Sweden)

Ruhe Alexander

2013-02-01

Full Text Available Abstract Study design Literature Review Objectives The objective of this literature review was to determine if postural sway changes in association with manual therapeutic interventions and to investigate whether any changes occur in healthy individuals or in association with pain intensity. Summary of Background data Improving postural stability has been proposed as a goal of manual therapeutic interventions. So far, no literature review has addressed whether there is supportive evidence for this and if so, what factors may be associated or causative for observed sway alterations. Search methods Seven online databases (PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect and the Cochrane library were systematically searched followed by a manual search of the retrieved papers. Selection criteria Studies comparing postural sway derived from bipedal force plate measurements in association with a manual therapeutic intervention, ideally compared to a control group. Data collection and analysis Two reviewers independently screened titles and abstracts for relevance, conducted the data extraction and the risk of bias assessment which was conducted using the RTI item bank. A descriptive analysis was conducted as the heterogeneous study designs prevented pooling of data. Results Nine studies of varying methodological quality met the inclusion criteria. No direct comparison of data across the studies was possible. There was no evidence that manual interventions lead to a change in postural sway in healthy individuals regardless of the body regions addressed by the intervention. There was some indication that postural sway may change at follow-up measurements in pain sufferers; however, this may be due to variations in pain intensity rather than resulting from the intervention itself. Conclusions There is no conclusive scientific evidence that manual therapeutic interventions may exhibit any immediate or long-term effect on COP excursions. Any

The therapeutic alliance in internet interventions: A narrative review and suggestions for future research.

Science.gov (United States)

Berger, Thomas

2017-09-01

Research on Internet interventions has grown rapidly over the recent years and evidence is growing that Internet-based treatments often result in similar outcomes as conventional face-to-face psychotherapy. Yet there are still unanswered concerns such as whether a therapeutic alliance can be established over the Internet and whether the alliance is important in this new treatment format. A narrative review of studies formally assessing the therapeutic alliance in Internet interventions was conducted. It is the first review summarizing findings on the therapeutic alliance that (i) distinguishes between different forms of Internet interventions and (ii) does not restrict itself to specific Internet-based treatment formats such as guided self-help treatments, e-mail or videoconferencing therapies. Independent of communication modalities, diagnostic groups and amount of contact between clients and therapists, client-rated alliance scores were high, roughly equivalent to alliance ratings found in studies on face-to-face therapy. Mixed results were found regarding the therapist-rated alliance and alliance-outcome associations. The review points to the limitations of the available evidence and identifies unanswered questions. It is concluded that one of the major tasks for future research is to identify unique characteristics of the therapeutic alliance in the different treatment formats.

Therapeutic Intervention of Learning and Memory Decays by Salidroside Stimulation of Neurogenesis in Aging.

Science.gov (United States)

Jin, Huijuan; Pei, Lei; Shu, Xiaogang; Yang, Xin; Yan, Tianhua; Wu, Yan; Wei, Na; Yan, Honglin; Wang, Shan; Yao, Chengye; Liu, Dan; Tian, Qing; Wang, Lin; Lu, Youming

2016-03-01

Cognition in all mammals including human beings declines during aging. The cellular events responsible for this decay involve a reduction of neurogenesis in the dentate gyrus. Here, we show that treatment with a nature product from a traditional Chinese medicine, namely salidroside restores the capacity of the dentate gyrus to generate new neurons and intercepts learning and memory decays in mice during aging. We uncover that new neurons in aging mice have functional features of an adult granule neuron by forming excitatory synapses with their putative targeting neurons. Genetic inhibition of synaptic transmission from new neurons abolishes the therapeutic effects of salidroside in behavioral tests. We also identify that salidroside targets CREB transcription for the survival of new neurons in the dentate gyrus of old mice. Thus, salidroside is therapeutically effective against learning and memory decays via stimulation of CREB-dependent functional neurogenesis in aging.

IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH.

Science.gov (United States)

Page, Phil; Hoogenboom, Barb; Voight, Michael

2017-04-01

The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. 5.

Culture, context and therapeutic processes: delivering a parent-child intervention in a remote Aboriginal community.

Science.gov (United States)

Mares, Sarah; Robinson, Gary

2012-04-01

Little is written about the process of delivering mainstream, evidence-based therapeutic interventions for Aboriginal children and families in remote communities. Patterns of interaction between parents and children and expectations about parenting and professional roles and responsibilities vary across cultural contexts. This can be a challenging experience for professionals accustomed to work in urban settings. Language is only a part of cultural difference, and the outsider in a therapeutic group in an Aboriginal community is outside not only in language but also in access to community relationships and a place within those relationships. This paper uses examples from Let's Start, a therapeutic parent-child intervention to describe the impact of distance, culture and relationships in a remote Aboriginal community, on the therapeutic framework, group processes and relationships. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Program adaptation, evaluation and staff training and support need to take these factors into account to ensure cultural accessibility without loss of therapeutic fidelity and efficacy.

Neurotransmitter regulation of adult neurogenesis: putative therapeutic targets.

Science.gov (United States)

Vaidya, V A; Vadodaria, K C; Jha, S

2007-10-01

The evidence that new neuron addition takes place in the mammalian brain throughout adult life has dramatically altered our perspective of the potential for plasticity in the adult CNS. Although several recent reports suggest a latent neurogenic capacity in multiple brain regions, the two major neurogenic niches that retain the ability to generate substantial numbers of new neurons in adult life are the subventricular zone (SVZ) lining the lateral ventricles and the subgranular zone (SGZ) in the hippocampal formation. The discovery of adult neurogenesis has also unveiled a novel therapeutic target for the repair of damaged neuronal circuits. In this regard, understanding the endogenous mechanisms that regulate adult neurogenesis holds promise both for a deeper understanding of this form of structural plasticity, as well as the identification of pathways that can serve as therapeutic targets to manipulate adult neurogenesis. The purpose of the present review is to discuss the regulation of adult neurogenesis by neurotransmitters and to highlight the relevance of these endogenous regulators as targets to modulate adult neurogenesis in a clinical context.

Music and Music Intervention for Therapeutic Purposes in Patients with Ventilator Support; Gamelan Music Perspective

OpenAIRE

Suhartini Suhartini

2011-01-01

Background: Gamelan music is one of folk music for Javanese people. Several research studies testing the effects of music were conducted in Western countries. The music studies for therapeutic purposes used classical music commonly. Even in Indonesia, some researchers may use that music for therapeutic purposes. This concern article explains the perspective music and music intervention as therapeutic purposes, view with Javanese classical music.Objectives: To explore the evidence of music and...

The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review.

Science.gov (United States)

Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K Killeen, Therese; Merghati-Khoei, Effat

2015-07-01

In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, "pearl-growing" techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, "orgasm AND intervention". Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women' sexual problems such as FOD

A Video-Based Intervention on and Evaluation of Nursing Aides' Therapeutic Communication and Residents' Agitation During Mealtime in a Dementia Care Unit.

Science.gov (United States)

Levy-Storms, Lené; Harris, Lesley M; Chen, Xiao

2016-01-01

The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication. Additional analyses using specific CNAs' therapeutic communication behaviors indicated a significant negative association with refusals at post-test but not pretest. The findings suggest some communication mechanisms for how the intervention positively influenced residents' refusals.

Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis.

Science.gov (United States)

Tsang, Hector W H; Ching, S C; Tang, K H; Lam, H T; Law, Peggy Y Y; Wan, C N

2016-05-01

Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies. Copyright © 2016. Published by Elsevier B.V.

[Wide-spectrum clinical interventions in mental health: 'care' and 'subject supposed to know' in therapeutic assistance].

Science.gov (United States)

Estellita-Lins, Carlos; Oliveira, Verônica Miranda; Coutinho, Maria Fernanda

2009-01-01

This paper discusses the theme therapeutic assistance (TA), understood as homecare-based mental health intervention. We emphasize the importance of community interventions for dealing with psychic suffering, either through reading the symptoms based on visibility, or through a psychoanalytic approach mainly concerned with listening. Lacking an independent theoretical background to support this practice, therapeutic assistance makes use of theories coming from other related fields of knowledge. Therefore, we discuss the influence of psychoanalysis and its role among broad spectrum mental health practice through clinical interventions belonging to the field of TA, focusing on two long-range operative concepts: Lacan's subject supposed to know and Winnicott's care (or caring process). Both concepts guide the clinical action and provide answers to theoretical problems within the TA field. We conclude that TA meets some requirements of the classical management of transference by means of a complex care process developed in the daily life and environment of the patient, in which desire and subjectivity are necessarily recognized although no psychotherapic setting is intentionally settled. Therapeutic assistance performs the role of an advanced clinical sentinel in the field of community psychiatry and public health.

The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

Directory of Open Access Journals (Sweden)

Zahra Salmani

2015-07-01

Full Text Available Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90% related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well

The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

Science.gov (United States)

Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K.Killeen, Therese; Merghati-Khoei, Effat

2015-01-01

Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols

Therapeutic interventions in the Netherlands and Belgium in support of people with profound intellectual and multiple disabilities

NARCIS (Netherlands)

Vlaskamp, Carla; Nakken, Han

For several reasons, people with profound and multiple disabilities may be offered a variety of therapeutic interventions. Thus far, researchers have shown a limited interest in providing an empirical base for these interventions. Research is needed on the theoretical rationale (if any), the

Multispectral therapeutic endoscopy imaging and intervention

Science.gov (United States)

Bala, John L.; Schwaitzberg, Steven D.

2007-02-01

With the debut of antibiotic drug therapy, and as a result of its ease of use and general success in treating infection, drugs have become the treatment of choice for most bacterial infections. However, the advent of multiple, very aggressive drug-resistant bacteria, an increasing population which cannot tolerate drugs, and the high cost of drug therapy suggest that a new modality for treating infections is needed. The complex interplay of clonal spread, persistence, transfer of resistance elements and cell-to-cell interaction all contribute to the difficulty in developing drugs to treat new antibiotic-resistant bacterial strains. A dynamic non-drug system, using extant pulsed ultraviolet lightwave technology to kill infection, is being developed to destroy pathogens. This paper theorizes that the shock effect of pulsed xenon's high energy ultraviolet pulses at wavelengths between 250-270nm separates the bacteria's DNA bands, and, subsequently, destroys them. Preliminary laboratory tests have demonstrated the ability of the technology to destroy Staphylococcus aureus, Pseudomonas aeruginosa Escherichia coli, Helicobacter pylori, Acinetobacter baumannii, Klebsiella punemonia, Bacillus subtillis, and Aspergillus fumigates at penetration depths of greater than 3mm in fluids with 100% effectiveness in less than five seconds of exposure to pulsed xenon lightwaves. Micro Invasive Technology, Inc is developing .pulsed xenon therapeutic catheters and endoscopic instruments for internal antimicrobial eradication and topographical devices for prophylactic wound, burn and surgical entrance/exit site sterilization. Pulsed Xenon light sources have a broad optical spectrum (190-1200nm), and can generate light pulses with sufficient energy for combined imaging and therapeutic intervention by multiplexing a fiber optic pathway into the body. In addition, Pulsed Xenon has proven ability to activate photo reactive dyes; share endoscopic lightguides with lasers while, simultaneously

Patient-Specific Tailored Intervention Improves INR Time in Therapeutic Range and INR Variability in Heart Failure Patients.

Science.gov (United States)

Gotsman, Israel; Ezra, Orly; Hirsh Raccah, Bruria; Admon, Dan; Lotan, Chaim; Dekeyser Ganz, Freda

2017-08-01

Many patients with heart failure need anticoagulants, including warfarin. Good control is particularly challenging in heart failure patients, with range, thereby increasing the risk of complications. This study aimed to evaluate the effect of a patient-specific tailored intervention on anticoagulation control in patients with heart failure. Patients with heart failure taking warfarin therapy (n = 145) were randomized to either standard care or a 1-time intervention assessing potential risk factors for lability of INR, in which they received patient-specific instructions. Time in therapeutic range (TTR) using Rosendaal's linear model was assessed 3 months before and after the intervention. The patient-tailored intervention significantly increased anticoagulation control. The median TTR levels before intervention were suboptimal in the interventional and control groups (53% vs 45%, P = .14). After intervention the median TTR increased significantly in the interventional group compared with the control group (80% [interquartile range, 62%-93%] vs 44% [29%-61%], P <.0001). The intervention resulted in a significant improvement in the interventional group before versus after intervention (53% vs 80%, P <.0001) but not in the control group (45% vs 44%, P = .95). The percentage of patients with a TTR ≥60%, considered therapeutic, was substantially higher in the interventional group: 79% versus 25% (P <.0001). The INR variability (standard deviation of each patient's INR measurements) decreased significantly in the interventional group, from 0.53 to 0.32 (P <.0001) after intervention but not in the control group. Patient-specific tailored intervention significantly improves anticoagulation therapy in patients with heart failure. Copyright © 2017 Elsevier Inc. All rights reserved.

Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

NARCIS (Netherlands)

Miranda, DR; deRijk, A; Schaufeli, W

Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

The approach of cancer related fatigue in rehabilitation medicine: Part II – Therapeutic interventions

Directory of Open Access Journals (Sweden)

Salca Amalia

2015-09-01

Full Text Available Starting with patient’ diagnose and continuing throughout the treatment and thereafter, cancer-related fatigue (CRF is a distressing and disabling symptom, highly prevalent across the cancer continuum2. This is a review article mainly focusing on the rehabilitation objectives and interventions in CRF, and implementation issues, according to the report of an NCCN member institution4. Implementation is the most problematic, considering the large number of patients to whom it is addressed to and the variety of pathologies within this group of patients. The onset of CRF is difficult to establish, because of the limitations of reporting this symptom4, but it is a valuable predictor in prognosis. The main interventions in rehabilitation applicable to these patients are discussed in correlation to the objectives of each phase of therapeutic management in cancer: pre-operatory, before, during or after radio and/or chemotherapy Conclusion: Rehabilitation interventions should be applied to all patients diagnosed with cancer, according to their phase of oncologic treatment and the objectives. This should be practiced as preventive measure, but as a therapeutic one to, considering the high incidence of CFR before diagnose.

The mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization

International Nuclear Information System (INIS)

Li Weiduo; Yang Jianyong; Zhuang Wenquan; Chen Wei; Li Heping

2002-01-01

Objective: To explore the mid-to-long term therapeutic efficacy of Graves' disease after interventional embolization. Methods: Twenty-five patients of Graves' disease treated with interventional embolization were followed up for 24-57 months. T 3 and T 4 were monitored at pre-operation, six months, 12 months, 2, 3 and 4 years after operation, respectively. Other references included pulse, thyroid size, and vessel's murmur. Results: Twenty-two patients completely relieved from the hyperthyroidism during the follow-up. Only one patient suffered from recurrence. Other two patients were still on maintaining dosage of antithyroid drug therapy. No hypothyroidism or hypoparathyroidism was found during this term. Conclusion: Mid-to-long term follow-up showed satisfactory efficacy of interventional therapy, offering another alternative for treatment of refractory Graves' disease

Therapeutic Effects of Horseback Riding Interventions: A Systematic Review and Meta-analysis.

Science.gov (United States)

Stergiou, Alexandra; Tzoufi, Meropi; Ntzani, Evangelia; Varvarousis, Dimitrios; Beris, Alexandros; Ploumis, Avraam

2017-10-01

Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life. In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool. Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs. Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.

Amplification of tumor inducing putative cancer stem cells (CSCs) by vitamin A/retinol from mammary tumors

Energy Technology Data Exchange (ETDEWEB)

Sharma, Rohit B. [Department of Microbiology and Molecular Genetics, University of Pittsburgh, PA 15261 (United States); Wang, Qingde [Department of Surgery, University of Pittsburgh, PA 15261 (United States); Khillan, Jaspal S., E-mail: khillan@pitt.edu [Department of Microbiology and Molecular Genetics, University of Pittsburgh, PA 15261 (United States)

2013-07-12

Highlights: •Vitamin A supports self renewal of putative CSCs from mammary tumors. •These cells exhibit impaired retinol metabolism into retinoic acid. •CSCs from mammary tumors differentiate into mammary specific cell lineages. •The cells express mammary stem cell specific CD29 and CD49f markers. •Putative CSCs form highly metastatic tumors in NOD SCID mouse. -- Abstract: Solid tumors contain a rare population of cancer stem cells (CSCs) that are responsible for relapse and metastasis. The existence of CSC however, remains highly controversial issue. Here we present the evidence for putative CSCs from mammary tumors amplified by vitamin A/retinol signaling. The cells exhibit mammary stem cell specific CD29{sup hi}/CD49f{sup hi}/CD24{sup hi} markers, resistance to radiation and chemo therapeutic agents and form highly metastatic tumors in NOD/SCID mice. The cells exhibit indefinite self renewal as cell lines. Furthermore, the cells exhibit impaired retinol metabolism and do not express enzymes that metabolize retinol into retinoic acid. Vitamin A/retinol also amplified putative CSCs from breast cancer cell lines that form highly aggressive tumors in NOD SCID mice. The studies suggest that high purity putative CSCs can be isolated from solid tumors to establish patient specific cell lines for personalized therapeutics for pre-clinical translational applications. Characterization of CSCs will allow understanding of basic cellular and molecular pathways that are deregulated, mechanisms of tumor metastasis and evasion of therapies that has direct clinical relevance.

Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments.

Science.gov (United States)

Sandoval, Julio; Gomez-Arroyo, Jose; Gaspar, Jorge; Pulido-Zamudio, Tomas

2015-10-01

Despite significant advances in pharmacological treatments, pulmonary arterial hypertension remains an incurable disease with an unreasonably high morbidity and mortality. Although specific pharmacotherapies have shifted the survival curves of patients and improved exercise endurance as well as quality of life, it is also true that these pharmacological interventions are not always accessible (particularly in developing countries) and, perhaps most importantly, not all patients respond similarly to these drugs. Furthermore, many patients will continue to deteriorate and will eventually require an additional, non-pharmacological, intervention. In this review we analyze the role of atrial septostomy and Potts anastomosis in the management of patients with pulmonary arterial hypertension, we summarize the current worldwide clinical experience (case reports and case series), and discuss why these interventional/surgical strategies might have a therapeutic role beyond that of a "bridge" to transplantation. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Fibroblast growth factor receptor (FGFR) alterations in squamous differentiated bladder cancer: a putative therapeutic target for a small subgroup.

Science.gov (United States)

Baldia, Philipp H; Maurer, Angela; Heide, Timon; Rose, Michael; Stoehr, Robert; Hartmann, Arndt; Williams, Sarah V; Knowles, Margaret A; Knuechel, Ruth; Gaisa, Nadine T

2016-11-01

Although drugable fibroblast growth factor receptor (FGFR) alterations in squamous cell carcinomas (SCC) of various entities are well known, little is known about FGFR modifications in squamous differentiated bladder cancer. Therefore, our study evaluated FGFR1-3 alterations as a putative therapeutic target in this subgroup. We analyzed 73 squamous differentiated bladder cancers (n = 10 pT2, n = 55 pT3, n = 8 pT4) for FGFR1-3 protein expression, FGFR1-3 copy number variations, FGFR3 chromosomal rearrangements (fluorescence in situ hybridization (FISH)) and FGFR3 mutations (SNapShot analysis). Only single cases displayed enhanced protein expression, most frequently FGFR3 overexpression (9.4% (6/64)). FISH showed no amplifications of FGFR1, 2 or 3. Break apart events were only slightly above the cut off in 12.1% (8/66) of cases and no FGFR3-TACC3 rearrangements could be proven by qPCR. FGFR3 mutations (p.S249C) were found in 8.5% (6/71) of tumors and were significantly associated with FGFR3 protein overexpression (p bladder cancer (n = 85), which revealed reduced overall expression of FGFR1 and FGFR2 in tumors compared to normal tissue, while expression of FGFR3 remained high. In the TCGA "squamous-like" subtype FGFR3 mutations were found in 4.9% and correlated with high FGFR3 RNA expression. Mutations of FGFR1 and FGFR2 were less frequent (2.4% and 1.2%). Hence, our comprehensive study provides novel insights into a subgroup of squamous differentiated bladder tumors that hold clues for novel therapeutic regimens and may benefit from FGFR3-targeted therapies.

Evaluation of scoring models for identifying the need for therapeutic intervention of upper gastrointestinal bleeding: A new prediction score model for Japanese patients.

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Iino, Chikara; Mikami, Tatsuya; Igarashi, Takasato; Aihara, Tomoyuki; Ishii, Kentaro; Sakamoto, Jyuichi; Tono, Hiroshi; Fukuda, Shinsaku

2016-11-01

Multiple scoring systems have been developed to predict outcomes in patients with upper gastrointestinal bleeding. We determined how well these and a newly established scoring model predict the need for therapeutic intervention, excluding transfusion, in Japanese patients with upper gastrointestinal bleeding. We reviewed data from 212 consecutive patients with upper gastrointestinal bleeding. Patients requiring endoscopic intervention, operation, or interventional radiology were allocated to the therapeutic intervention group. Firstly, we compared areas under the curve for the Glasgow-Blatchford, Clinical Rockall, and AIMS65 scores. Secondly, the scores and factors likely associated with upper gastrointestinal bleeding were analyzed with a logistic regression analysis to form a new scoring model. Thirdly, the new model and the existing model were investigated to evaluate their usefulness. Therapeutic intervention was required in 109 patients (51.4%). The Glasgow-Blatchford score was superior to both the Clinical Rockall and AIMS65 scores for predicting therapeutic intervention need (area under the curve, 0.75 [95% confidence interval, 0.69-0.81] vs 0.53 [0.46-0.61] and 0.52 [0.44-0.60], respectively). Multivariate logistic regression analysis retained seven significant predictors in the model: systolic blood pressure upper gastrointestinal bleeding. © 2016 Japan Gastroenterological Endoscopy Society.

The Putative Son's Attractiveness Alters the Perceived Attractiveness of the Putative Father.

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Prokop, Pavol

2015-08-01

A body of literature has investigated female mate choice in the pre-mating context (pre-mating sexual selection). Humans, however, are long-living mammals forming pair-bonds which sequentially produce offspring. Post-mating evaluations of a partner's attractiveness may thus significantly influence the reproductive success of men and women. I tested herein the theory that the attractiveness of putative sons provides extra information about the genetic quality of fathers, thereby influencing fathers' attractiveness across three studies. As predicted, facially attractive boys were more frequently attributed to attractive putative fathers and vice versa (Study 1). Furthermore, priming with an attractive putative son increased the attractiveness of the putative father with the reverse being true for unattractive putative sons. When putative fathers were presented as stepfathers, the effect of the boy's attractiveness on the stepfather's attractiveness was lower and less consistent (Study 2). This suggests that the presence of an attractive boy has the strongest effect on the perceived attractiveness of putative fathers rather than on non-fathers. The generalized effect of priming with beautiful non-human objects also exists, but its effect is much weaker compared with the effects of putative biological sons (Study 3). Overall, this study highlighted the importance of post-mating sexual selection in humans and suggests that the heritable attractive traits of men are also evaluated by females after mating and/or may be used by females in mate poaching.

Evidence mapping based on systematic reviews of therapeutic interventions for gastrointestinal stromal tumors (GIST

Directory of Open Access Journals (Sweden)

Mónica Ballesteros

2017-09-01

Full Text Available Abstract Background Gastrointestinal Stromal Tumours (GISTs are the most common mesenchymal tumours. Currently, different pharmacological and surgical options are used to treat localised and metastatic GISTs, although this research field is broad and the body of evidence is scattered and expanding. Our objectives are to identify, describe and organise the current available evidence for GIST through an evidence mapping approach. Methods We followed the methodology of Global Evidence Mapping (GEM. We searched Pubmed, EMBASE, The Cochrane Library and Epistemonikos in order to identify systematic reviews (SRs with or without meta-analyses published between 1990 and March 2016. Two authors assessed eligibility and extracted data. Methodological quality of the included systematic reviews was assessed using AMSTAR. We organised the results according to identified PICO questions and presented the evidence map in tables and a bubble plot. Results A total of 17 SRs met eligibility criteria. These reviews included 66 individual studies, of which three quarters were either observational or uncontrolled clinical trials. Overall, the quality of the included SRs was moderate or high. In total, we extracted 14 PICO questions from them and the corresponding results mostly favoured the intervention arm. Conclusions The most common type of study used to evaluate therapeutic interventions in GIST sarcomas has been non-experimental studies. However, the majority of the interventions are reported as beneficial or probably beneficial by the respective authors of SRs. The evidence mapping is a useful and reliable methodology to identify and present the existing evidence about therapeutic interventions.

The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental study.

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Soyez, Veerle; De Leon, George; Broekaert, Eric; Rosseel, Yves

2006-07-01

Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable 'significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). Participation in the social network intervention was associated

Evaluation of a modified contingency management intervention for consistent attendance in therapeutic workplace participants.

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Wong, Conrad J; Dillon, Erin M; Sylvest, Christine; Silverman, Kenneth

2004-06-11

In a therapeutic workplace business, drug abuse patients are hired as data entry operators and paid to perform data entry work contingent upon documented drug abstinence. Reliable attendance has been difficult to maintain despite the opportunity for operators to earn a living wage, 6 h per day, 5 days per week. A within-subject reversal design experiment evaluated a contingency management intervention that allowed for flexibility regarding when operators could arrive to work, yet maintained a contingency for reliable workplace attendance. Results from a within-subject reversal design experiment demonstrated the contingency management intervention to be effective in increasing the frequency of completed work shifts in four of five operators. Repeated measures ANOVA and Tukey's post-hoc tests of grouped data showed that the contingency management intervention significantly (P workplace participants.

Multifactorial causal model of brain (dis)organization and therapeutic intervention: Application to Alzheimer's disease.

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Iturria-Medina, Yasser; Carbonell, Félix M; Sotero, Roberto C; Chouinard-Decorte, Francois; Evans, Alan C

2017-05-15

Generative models focused on multifactorial causal mechanisms in brain disorders are scarce and generally based on limited data. Despite the biological importance of the multiple interacting processes, their effects remain poorly characterized from an integrative analytic perspective. Here, we propose a spatiotemporal multifactorial causal model (MCM) of brain (dis)organization and therapeutic intervention that accounts for local causal interactions, effects propagation via physical brain networks, cognitive alterations, and identification of optimum therapeutic interventions. In this article, we focus on describing the model and applying it at the population-based level for studying late onset Alzheimer's disease (LOAD). By interrelating six different neuroimaging modalities and cognitive measurements, this model accurately predicts spatiotemporal alterations in brain amyloid-β (Aβ) burden, glucose metabolism, vascular flow, resting state functional activity, structural properties, and cognitive integrity. The results suggest that a vascular dysregulation may be the most-likely initial pathologic event leading to LOAD. Nevertheless, they also suggest that LOAD it is not caused by a unique dominant biological factor (e.g. vascular or Aβ) but by the complex interplay among multiple relevant direct interactions. Furthermore, using theoretical control analysis of the identified population-based multifactorial causal network, we show the crucial advantage of using combinatorial over single-target treatments, explain why one-target Aβ based therapies might fail to improve clinical outcomes, and propose an efficiency ranking of possible LOAD interventions. Although still requiring further validation at the individual level, this work presents the first analytic framework for dynamic multifactorial brain (dis)organization that may explain both the pathologic evolution of progressive neurological disorders and operationalize the influence of multiple interventional

Effectiveness of a Therapeutic Summer Camp for Children with ADHD: Phase I Clinical Intervention Trial

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Hantson, Julie; Wang, Pan Pan; Grizenko-Vida, Michael; Ter-Stepanian, Marina; Harvey, William; Joober, Ridha; Grizenko, Natalie

2012-01-01

Objective: The objective of this study was to evaluate the effectiveness of a 2-week therapeutic summer day camp for children with ADHD, which included a social skills training program and parent psychoeducation and training program. This was an open-label, nonrandomized Phase I Clinical Intervention Trial. Method: Parents completed the Weiss…

VenomKB, a new knowledge base for facilitating the validation of putative venom therapies.

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Romano, Joseph D; Tatonetti, Nicholas P

2015-11-24

Animal venoms have been used for therapeutic purposes since the dawn of recorded history. Only a small fraction, however, have been tested for pharmaceutical utility. Modern computational methods enable the systematic exploration of novel therapeutic uses for venom compounds. Unfortunately, there is currently no comprehensive resource describing the clinical effects of venoms to support this computational analysis. We present VenomKB, a new publicly accessible knowledge base and website that aims to act as a repository for emerging and putative venom therapies. Presently, it consists of three database tables: (1) Manually curated records of putative venom therapies supported by scientific literature, (2) automatically parsed MEDLINE articles describing compounds that may be venom derived, and their effects on the human body, and (3) automatically retrieved records from the new Semantic Medline resource that describe the effects of venom compounds on mammalian anatomy. Data from VenomKB may be selectively retrieved in a variety of popular data formats, are open-source, and will be continually updated as venom therapies become better understood.

In vitro disintegration of goat brain cystatin fibrils using conventional and gemini surfactants: Putative therapeutic intervention in amyloidoses.

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Bhat, Waseem Feeroze; Bhat, Imtiyaz Ahmad; Bhat, Sheraz Ahmad; Bano, Bilqees

2016-12-01

Many protein misfolding diseases in mammalian system are characterised by the accumulation of protein aggregates in amyloid fibrillar forms. Several therapeutic approaches include reduction in the production of the amyloidogenic form of proteins, increase in the clearance rate of misfolded or aggregated proteins, and direct inhibition of the self-assembly process have been explained. One of the possible remedial treatments for such disorders may be to identify molecules which are capable of either preventing formation of fibrils or disintegrating the formed fibrils. In this work, we have studied the effect of conventional surfactants; sodium dodecylsulphate (SDS), cetyl trimethylammonium bromide (CTAB) and dicationic gemini (16-4-16) surfactant on the disintegration of the goat brain cystatin (GBC) fibrils above their critical micelle concentrations (CMC) using ThT fluorescence, CD, TEM, Congo red and turbidity approaches. The results obtained are significant and showing the best disintegrating potency on GBC fibrils with gemini surfactant. The outcome from this work will aid in the development and/or design of potential inhibitory agents against amyloid deposits associated with amyloid diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

International children's continence society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children

NARCIS (Netherlands)

Rawashdeh, Y. F.; Austin, P.; Siggaard, C.; Bauer, S. B.; Franco, I.; de Jong, T. P.; Jorgensen, T. M.

2012-01-01

Purpose We present a consensus view of members of the International Children's Continence Society on the therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Material and Methods Discussions were held by a group of pediatric urologists and gastroenterologists

The Leptospiral Antigen Lp49 is a Two-Domain Protein with Putative Protein Binding Function

Energy Technology Data Exchange (ETDEWEB)

Oliveira Giuseppe,P.; Oliveira Neves, F.; Nascimento, A.; Gomes Guimaraes, B.

2008-01-01

Pathogenic Leptospira is the etiological agent of leptospirosis, a life-threatening disease that affects populations worldwide. Currently available vaccines have limited effectiveness and therapeutic interventions are complicated by the difficulty in making an early diagnosis of leptospirosis. The genome of Leptospira interrogans was recently sequenced and comparative genomic analysis contributed to the identification of surface antigens, potential candidates for development of new vaccines and serodiagnosis. Lp49 is a membrane-associated protein recognized by antibodies present in sera from early and convalescent phases of leptospirosis patients. Its crystal structure was determined by single-wavelength anomalous diffraction using selenomethionine-labelled crystals and refined at 2.0 Angstroms resolution. Lp49 is composed of two domains and belongs to the all-beta-proteins class. The N-terminal domain folds in an immunoglobulin-like beta-sandwich structure, whereas the C-terminal domain presents a seven-bladed beta-propeller fold. Structural analysis of Lp49 indicates putative protein-protein binding sites, suggesting a role in Leptospira-host interaction. This is the first crystal structure of a leptospiral antigen described to date.

Inventory of Novel Animal Models Addressing Etiology of Preeclampsia in the Development of New Therapeutic/Intervention Opportunities.

Science.gov (United States)

Erlandsson, Lena; Nääv, Åsa; Hennessy, Annemarie; Vaiman, Daniel; Gram, Magnus; Åkerström, Bo; Hansson, Stefan R

2016-03-01

Preeclampsia is a pregnancy-related disease afflicting 3-7% of pregnancies worldwide and leads to maternal and infant morbidity and mortality. The disease is of placental origin and is commonly described as a disease of two stages. A variety of preeclampsia animal models have been proposed, but all of them have limitations in fully recapitulating the human disease. Based on the research question at hand, different or multiple models might be suitable. Multiple animal models in combination with in vitro or ex vivo studies on human placenta together offer a synergistic platform to further our understanding of the etiology of preeclampsia and potential therapeutic interventions. The described animal models of preeclampsia divide into four categories (i) spontaneous, (ii) surgically induced, (iii) pharmacologically/substance induced, and (iv) transgenic. This review aims at providing an inventory of novel models addressing etiology of the disease and or therapeutic/intervention opportunities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

International Children's Continence Society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children.

Science.gov (United States)

Rawashdeh, Y F; Austin, P; Siggaard, C; Bauer, S B; Franco, I; de Jong, T P; Jorgensen, T M

2012-06-01

We present a consensus view of members of the International Children's Continence Society on the therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Discussions were held by a group of pediatric urologists and gastroenterologists appointed by the board. The following draft review document was open to all the ICCS members via the ICCS web site. Feedback was considered by the core authors and by agreement, amendments were made as necessary. The final document is not a systematic literature review. It includes relevant research when available as well as expert opinion on the current understanding of therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Guidelines on pharmalogical and surgical intervention are presented. First the multiple modalities for intervention that do not involve surgical reconstruction are summarized concerning pharmacological agents, medical devices, and neuromodulation. The non-surgical intervention is promoted before undertaking major surgery. Indicators for non-surgical treatments depend on issues related to intravesical pressure, upper urinary tract status, prevalence of urinary tract infections, and the degree of incontinence. The optimal age for treatment of incontinence is also addressed. This is followed by a survey of specific treatments such as anticholinergics, botulinum-A toxin, antibiotics, and catheters. Neuromodulation of the bladder via intravesical electrical stimulation, sacral nerve stimulation, transcutaneous stimulation, and biofeedback is scrutinized. Then follows surgical intervention, which should be tailored to each individual, based on careful consideration of urodynamic findings, medical history, age, and presence of other disability. Treatments mentioned are: urethral dilation, vesicostomy, bladder, augmentation, fascial sling, artificial urinary sphincters, and bladder neck reconstruction and are summarized with regards to success rates

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

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Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions

Efficacy and safety of a multifactor intervention to improve therapeutic adherence in patients with chronic obstructive pulmonary disease (COPD: protocol for the ICEPOC study

Directory of Open Access Journals (Sweden)

Prados-Torres Daniel

2011-02-01

Full Text Available Abstract Background Low therapeutic adherence to medication is very common. Clinical effectiveness is related to dose rate and route of administration and so poor therapeutic adherence can reduce the clinical benefit of treatment. The therapeutic adherence of patients with chronic obstructive pulmonary disease (COPD is extremely poor according to most studies. The research about COPD adherence has mainly focussed on quantifying its effect, and few studies have researched factors that affect non-adherence. Our study will evaluate the effectiveness of a multifactor intervention to improve the therapeutic adherence of COPD patients. Methods/Design A randomized controlled clinical trial with 140 COPD diagnosed patients selected by a non-probabilistic method of sampling. Subjects will be randomly allocated into two groups, using the block randomization technique. Every patient in each group will be visited four times during the year of the study. Intervention: Motivational aspects related to adherence (beliefs and behaviour: group and individual interviews; cognitive aspects: information about illness; skills: inhaled technique training. Reinforcement of the cognitive-emotional aspects and inhaled technique training will be carried out in all visits of the intervention group. Discussion Adherence to a prescribed treatment involves a behavioural change. Cognitive, emotional and motivational aspects influence this change and so we consider the best intervention procedure to improve adherence would be a cognitive and emotional strategy which could be applied in daily clinical practice. Our hypothesis is that the application of a multifactor intervention (COPD information, dose reminders and reinforcing audiovisual material, motivational aspects and inhalation technique training to COPD patients taking inhaled treatment will give a 25% increase in the number of patients showing therapeutic adherence in this group compared to the control group. We will

Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions.

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Baumel, Amit; Faber, Keren; Mathur, Nandita; Kane, John M; Muench, Fred

2017-03-21

Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects. As a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims). A total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary

Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

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Heather S. Smallwood

2017-05-01

Full Text Available Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1 and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention.

Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

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Smallwood, Heather S.; Duan, Susu; Morfouace, Marie; Rezinciuc, Svetlana; Shulkin, Barry L.; Shelat, Anang; Zink, Erika E.; Milasta, Sandra; Bajracharya, Resha; Oluwaseum, Ajayi J.; Roussel, Martine F.; Green, Douglas R.; Pasa-Tolic, Ljiljana; Thomas, Paul G.

2017-05-01

Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1 and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention.

Hepatology may have problems with putative surrogate outcome measures

DEFF Research Database (Denmark)

Gluud, Christian; Brok, Jesper; Gong, Yan

2007-01-01

A surrogate outcome measure is a laboratory measurement, a physical sign, or another intermediate substitute that is able to predict an intervention's effect on a clinically meaningful outcome. A clinical outcome detects how a patient feels, functions, or survives. Surrogate outcome measures occur...... faster or more often, are cheaper, and/or are less invasively achieved than the clinical outcome. In practice, validation is surprisingly often overlooked, especially if a biologic plausible rationale is proposed. Surrogate outcomes must be validated before use. The first step in validation...... predicts the intervention's effect on the clinical outcome. In hepatology a number of putative surrogate outcomes are used both in clinical research and in clinical practice without having been properly validated. Sustained virological response to interferons and ribavirin in patients with chronic...

Unresolved Questions Concerning the Effectiveness of Psychological Assessment as a Therapeutic Intervention: Comment on Poston and Hanson (2010)

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Lilienfeld, Scott O.; Garb, Howard N.; Wood, James M.

2011-01-01

In a recent article in this journal, Poston and Hanson (2010) reported a meta-analysis of 17 studies on the use of psychological assessment as a therapeutic intervention (PATI) and concluded that "psychological assessment procedures--when combined with personalized, collaborative, and highly involving test feedback--have positive, clinically…

Exploring the feasibility of a therapeutic music video intervention in adolescents and young adults during stem-cell transplantation.

Science.gov (United States)

Burns, Debra S; Robb, Sheri L; Haase, Joan E

2009-01-01

The purpose of this study was to explore the feasibility and preliminary efficacy of a therapeutic music video (TMV) intervention for adolescents and young adults (AYAs) undergoing stem-cell transplantation (SCT). Twelve AYAs (aged 11-24 years) were randomized to the TMV or an audio-book protocol. The TMV was designed to diminish symptom distress and improve coping, derived meaning, resilience, and quality of life by supporting AYAs in exploring thoughts and feelings. Six sessions with a board-certified music therapist were held twice a week for 3 weeks. The Adolescent Resilience Model guided the selection of a large, comprehensive battery of outcome measures. Major data collections occurred before admission, after intervention, and at 100 days after transplantation. Participants completed a brief set of measures at presession/postsessions 2, 4, and 6. Rates of consent, session completion, and questionnaire completion supported feasibility. Immediate follow-up measures suggest positive trends in the TMV group for hope, spirituality, confidence/mastery, and self-transcendence. Positive trends at 100 days include MOS, symptoms distress, defensive coping, spirituality, and self-transcendence. Therapeutic music video participants also demonstrated gains in quality of life. The TMV intervention may buffer the immediate after-effects of the stem-cell transplantation experience, and a larger study is warranted.

Combining Radiation Epidemiology With Molecular Biology-Changing From Health Risk Estimates to Therapeutic Intervention.

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Abend, Michael; Port, Matthias

2016-08-01

The authors herein summarize six presentations dedicated to the key session "molecular radiation epidemiology" of the ConRad meeting 2015. These presentations were chosen in order to highlight the promise when combining conventional radiation epidemiology with molecular biology. Conventional radiation epidemiology uses dose estimates for risk predictions on health. However, combined with molecular biology, dose-dependent bioindicators of effect hold the promise to improve clinical diagnostics and to provide target molecules for potential therapeutic intervention. One out of the six presentations exemplified the use of radiation-induced molecular changes as biomarkers of exposure by measuring stabile chromosomal translocations. The remaining five presentations focused on molecular changes used as bioindicators of the effect. These bioindicators of the effect could be used for diagnostic purposes on colon cancers (genomic instability), thyroid cancer (CLIP2), or head and neck squamous cell cancers. Therapeutic implications of gene expression changes were examined in Chernobyl thyroid cancer victims and Mayak workers.

The Role of Therapeutic Drugs on Acquired Mitochondrial Toxicity.

Science.gov (United States)

Morén, Constanza; Juárez-Flores, Diana Luz; Cardellach, Francesc; Garrabou, Glòria

2016-01-01

Certain therapeutic drugs used in medical practice may trigger mitochondrial toxicity leading to a wide range of clinical symptoms including deafness, neuropathy, myopathy, hyperlactatemia, lactic acidosis, pancreatitis and lipodystrophy, among others, which could even compromise the life of the patient. The aim of this work is to review the potential mitochondrial toxicity derived from drugs used in health care, including anesthetics, antiepileptics, neuroleptics, antidepressants, antivirals, antibiotics, antifungals, antimalarics, antineoplastics, antidiabetics, hypolipemiants, antiarrhythmics, anti-inflammatories and nitric oxide. We herein have reviewed data from experimental and clinical studies to document the molecular mitochondrial basis, potential biomarkers and putative clinical symptoms associated to secondary effects of drugs. One hundred and forty-five articles were selected and the information was organized by means of the primary target to which pharmacologic drugs were directed. Adverse toxic events were classified depending on the mitochondrial offtarget effect and whether they had been demonstrated in the experimental or clinical setting. Since treatment of acquired mitochondriopathies remains supportive and therapeutic interventions cannot be avoided, information of molecular and clinical consequences of toxic exposure becomes fundamental to assess riskbenefit imbalance of treatment prescription. Additionally, there is a crucial need to develop less mitochondrial toxic compounds, novel biomarkers to follow up mitochondrial toxicity (or implement those already proposed) and new approaches to prevent or revert unintended mitochondrial damage.

The utilisation of storytelling as a therapeutic intervention by educational psychologists to address behavioural challenges relating to grief of adolescent clients

OpenAIRE

2014-01-01

M.Ed. (Educational Psychology) Storytelling as a therapeutic intervention entails the narrating of events by externalising emotions, thoughts and responses to life-changing events such as loss and grief. This creates the opportunity for clients to engage with psychologists by projecting various beliefs and challenges, such as grief, through a range of therapeutic modalities. This study conducts an inquiry into the ways in which storytelling can be utilised by educational psychologists with...

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

Directory of Open Access Journals (Sweden)

Aoun-Bacha Zeina

2008-06-01

Full Text Available Abstract Background This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA patients. Methods Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS. Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16 and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression. Results The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic admissions. Patient mean(SD age was 65.8(12.3 years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release. The mean(SD APACHE II score at hospital admission was 14.9(6.0 and ICU mean duration of stay was 11.2(15.4 days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14, (p = 0.024, APACHE II 1.11(0.11, (p = 0.05 and duration of mechanical ventilation 1.07(0.07, (p = 0.046. Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58 (p = 0.007, GCS at hospital admission: -6.83(1.08, (p = 0.001, and duration of hospital stay -0.38(0.14, (p = 0.40. Conclusion To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?

A therapeutic workplace for the long-term treatment of drug addiction and unemployment: eight-year outcomes of a social business intervention.

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Aklin, Will M; Wong, Conrad J; Hampton, Jacqueline; Svikis, Dace S; Stitzer, Maxine L; Bigelow, George E; Silverman, Kenneth

2014-01-01

This study evaluated the long-term effects of a therapeutic workplace social business on drug abstinence and employment. Pregnant and postpartum women (N = 40) enrolled in methadone treatment were randomly assigned to a therapeutic workplace or usual care control group. Therapeutic workplace participants could work weekdays in training and then as employees of a social business, but were required to provide drug-free urine samples to work and maintain maximum pay. Three-year outcomes were reported previously. This paper reports 4- to 8-year outcomes. During year 4 when the business was open, therapeutic workplace participants provided significantly more cocaine- and opiate-negative urine samples than controls; reported more days employed, higher employment income, and less money spent on drugs. During the 3 years after the business closed, therapeutic workplace participants only reported higher income than controls. A therapeutic workplace social business can maintain long-term abstinence and employment, but additional intervention may be required to sustain effects. Copyright © 2014 Elsevier Inc. All rights reserved.

A Therapeutic Workplace for the Long-Term Treatment of Drug Addiction and Unemployment: Eight-Year Outcomes of a Social Business Intervention

Science.gov (United States)

Aklin, Will M.; Wong, Conrad J.; Hampton, Jacqueline; Svikis, Dace S.; Stitzer, Maxine L.; Bigelow, George E.; Silverman, Kenneth

2014-01-01

This study evaluated the long-term effects of a Therapeutic Workplace social business on drug abstinence and employment. Pregnant and postpartum women (N=40) enrolled in methadone treatment were randomly assigned to a Therapeutic Workplace or Usual Care Control group. Therapeutic Workplace participants could work weekdays in training and then as employees of a social business, but were required to provide drug-free urine samples to work and maintain maximum pay. Three-year outcomes were reported previously. This paper reports 4- to 8- year outcomes. During year 4 when the business was open, Therapeutic Workplace participants provided significantly more cocaine- and opiate-negative urine samples than controls; reported more days employed, higher employment income, and less money spent on drugs. During the 3 years after the business closed, Therapeutic Workplace participants only reported higher income than controls. A Therapeutic Workplace social business can maintain long-term abstinence and employment, but additional intervention may be required to sustain effects. PMID:25124257

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders.

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Afra, Pegah; Bruggers, Carol S; Sweney, Matthew; Fagatele, Lilly; Alavi, Fareeha; Greenwald, Michael; Huntsman, Merodean; Nguyen, Khanhly; Jones, Jeremiah K; Shantz, David; Bulaj, Grzegorz

2018-01-01

Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination

Oxidative stress in cancer and fibrosis: Opportunity for therapeutic intervention with antioxidant compounds, enzymes, and nanoparticles

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Jingga Morry

2017-04-01

Full Text Available Oxidative stress, mainly contributed by reactive oxygen species (ROS, has been implicated in pathogenesis of several diseases. We review two primary examples; fibrosis and cancer. In fibrosis, ROS promote activation and proliferation of fibroblasts and myofibroblasts, activating TGF-β pathway in an autocrine manner. In cancer, ROS account for its genomic instability, resistance to apoptosis, proliferation, and angiogenesis. Importantly, ROS trigger cancer cell invasion through invadopodia formation as well as extravasation into a distant metastasis site. Use of antioxidant supplements, enzymes, and inhibitors for ROS-generating NADPH oxidases (NOX is a logical therapeutic intervention for fibrosis and cancer. We review such attempts, progress, and challenges. Lastly, we review how nanoparticles with inherent antioxidant activity can also be a promising therapeutic option, considering their additional feature as a delivery platform for drugs, genes, and imaging agents.

Tool to assess causality of direct and indirect adverse events associated with therapeutic interventions.

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Zorzela, Liliane; Mior, Silvano; Boon, Heather; Gross, Anita; Yager, Jeromy; Carter, Rose; Vohra, Sunita

2018-03-01

To develop and test a tool to assess the causality of direct and indirect adverse events associated with therapeutic interventions. The intervention was one or more drugs and/or natural health products, a device, or practice (professional delivering the intervention). Through the assessment of causality of adverse events, we can learn about factors contributing to the harm and consider what modification may prevent its reoccurrence. Existing scales (WHO-UMC, Naranjo and Horn) were adapted to develop a tool (algorithm and table) to evaluate cases of serious harmful events reported through a national surveillance study. We also incorporated a novel approach that assesses indirect harm (caused by the delay in diagnosis/treatment) and the health provider delivering the intervention (practice). The tool was tested, revised and then implemented to assess all reported cases of serious events resulting from use of complementary therapies. The use of complementary therapies was the trigger to report the event. Each case was evaluated by two assessors, out of a panel of five, representing different health care professionals. The tool was used in assessment of eight serious adverse events. Each event was independently evaluated by two assessors. The algorithm facilitated assessment of a serious direct or indirect harm. Assessors agreed in the final score on seven of eight cases (weighted kappa coefficient of 0.75). A tool to support the assessment of causality of adverse events was developed and tested. We propose a novel method to assess direct and indirect harms related to product(s), device(s), practice or a combination of the previous. Further research will probably help evaluate this approach across different settings and interventions.

[Patients' intervention in a therapeutic education program dedicated to systemic lupus: definitions, setting and benefits].

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Hervier, B; Magar, Y; Allab, F; Richard, K; Neves, Y; Danjou, S; Amoura, Z; Ayçaguer, S

2015-10-01

Though recommended, participation of patients with specific expertise in therapeutic education programs (TEP) is rare. This work reports the experience of a national reference centre for rare systemic diseases. Involvement of "expert patients" (EP) has been planned from the development of a TEP dedicated to systemic lupus: patients' roles and required expertise have been defined and linked to the pedagogical tools. Such patients have been recruited during individual interviews and called to participate to specific pedagogical training. EP intervention have been evaluated by questionnaire to EP and health care providers. Three EP's functions have been identified: sharing experiences, giving "tips and tricks" and promoting dialogue. EP's interventions has been organised into a hierarchy (from sharing to co-animation). Among 298 patients enrolled in the TEP, 25 (8.4%) have been identified as possible EP. Eight of them (32%) benefited from a specific training of 12 hours. Among these patients, two (25%) regularly participate to the education sessions. For EP as well as for health care providers, EP's intervention seems beneficial (visual scale scores of 7.5 and 9.5, respectively). Though difficult to organise, EP's intervention in TEP dedicated to rare systemic diseases seems useful and would earn to be increase. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Brain aging and therapeutic interventions

DEFF Research Database (Denmark)

This book brings together most up-to-date information on different aspects of brain aging and on the strategies for intervention and therapy of age-related brain disorders. It includes 18 chapters by leading researchers, and each chapter is a comprehensive and critical review of the topic...

Are MAO-A deficiency states in the general population and in putative high-risk populations highly uncommon?

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Murphy, D L; Sims, K; Eisenhofer, G; Greenberg, B D; George, T; Berlin, F; Zametkin, A; Ernst, M; Breakefield, X O

1998-01-01

Lack of monoamine oxidase A (MAO-A) due to either Xp chromosomal deletions or alterations in the coding sequence of the gene for this enzyme are associated with marked changes in monoamine metabolism and appear to be associated with variable cognitive deficits and behavioral changes in humans and in transgenic mice. In mice, some of the most marked behavioral changes are ameliorated by pharmacologically-induced reductions in serotonin synthesis during early development, raising the question of possible therapeutic interventions in humans with MAO deficiency states. At the present time, only one multi-generational family and a few other individuals with marked MAO-A deficiency states have been identified and studied in detail. Although MAO deficiency states associated with Xp chromosomal deletions were identified by distinct symptoms (including blindness in infancy) produced by the contiguous Norrie disease gene, the primarily behavioral phenotype of individuals with the MAO mutation is less obvious. This paper reports a sequential research design and preliminary results from screening several hundred volunteers in the general population and from putative high-risk groups for possible MAO deficiency states. These preliminary results suggest that marked MAO deficiency states are very rare.

Inhibiting DNA Polymerases as a Therapeutic Intervention against Cancer

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Anthony J. Berdis

2017-11-01

Full Text Available Inhibiting DNA synthesis is an important therapeutic strategy that is widely used to treat a number of hyperproliferative diseases including viral infections, autoimmune disorders, and cancer. This chapter describes two major categories of therapeutic agents used to inhibit DNA synthesis. The first category includes purine and pyrmidine nucleoside analogs that directly inhibit DNA polymerase activity. The second category includes DNA damaging agents including cisplatin and chlorambucil that modify the composition and structure of the nucleic acid substrate to indirectly inhibit DNA synthesis. Special emphasis is placed on describing the molecular mechanisms of these inhibitory effects against chromosomal and mitochondrial DNA polymerases. Discussions are also provided on the mechanisms associated with resistance to these therapeutic agents. A primary focus is toward understanding the roles of specialized DNA polymerases that by-pass DNA lesions produced by DNA damaging agents. Finally, a section is provided that describes emerging areas in developing new therapeutic strategies targeting specialized DNA polymerases.

Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

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Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn

2017-06-01

The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.

The Multitheoretical List of Therapeutic Interventions - 30 items (MULTI-30).

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Solomonov, Nili; McCarthy, Kevin S; Gorman, Bernard S; Barber, Jacques P

2018-01-16

To develop a brief version of the Multitheoretical List of Therapeutic Interventions (MULTI-60) in order to decrease completion time burden by approximately half, while maintaining content coverage. Study 1 aimed to select 30 items. Study 2 aimed to examine the reliability and internal consistency of the MULTI-30. Study 3 aimed to validate the MULTI-30 and ensure content coverage. In Study 1, the sample included 186 therapist and 255 patient MULTI ratings, and 164 ratings of sessions coded by trained observers. Internal consistency (Chronbach's alpha and McDonald's omega) was calculated and confirmatory factor analysis was conducted. Psychotherapy experts rated content relevance. Study 2 included a sample of 644 patient and 522 therapist ratings, and 793 codings of psychotherapy sessions. In Study 3, the sample included 33 codings of sessions. A series of regression analyses was conducted to examine replication of previously published findings using the MULTI-30. The MULTI-30 was found valid, reliable, and internally consistent across 2564 ratings examined across the three studies presented. The MULTI-30 a brief and reliable process measure. Future studies are required for further validation.

Assessing Therapeutic Alliance in the Context of mHealth Interventions for Mental Health Problems: Development of the Mobile Agnew Relationship Measure (mARM) Questionnaire.

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Berry, Katherine; Salter, Amy; Morris, Rohan; James, Susannah; Bucci, Sandra

2018-04-19

Digital health interventions in the form of smartphone apps aim to improve mental health and enable people access to support as and when needed without having to face the stigma they may experience in accessing services. If we are to evaluate mobile health (mHealth) apps and advance scientific understanding, we also need tools to help us understand in what ways mHealth interventions are effective or not. The concept of therapeutic alliance, a measure of the quality of the relationship between a health care provider and a service user, is a key factor in explaining the effects of mental health interventions. The Agnew Relationship Measure (ARM) is a well-validated measure of therapeutic alliance in face-to-face therapy. This study presented the first attempt to (1) explore service users' views of the concept of relationship within mHealth mental health interventions and (2) adapt a well-validated face-to-face measure of therapeutic alliance, the Agnew Relationship Measure (ARM), for use with mHealth interventions. In stage 1, we interviewed 9 mental health service users about the concept of therapeutic alliance in the context of a digital health intervention and derived key themes from interview transcripts using thematic analysis. In stage 2, we used rating scales and open-ended questions to elicit views from 14 service users and 10 mental health staff about the content and face validity of the scale, which replaced the word "therapist" with the word "app." In stage 3, we used the findings from stages 1 and 2 to adapt the measure with the support of a decision-making algorithm about which items to drop, retain, or adapt. Findings suggested that service users do identify relationship concepts when thinking about mHealth interventions, including forming a bond with an app and the ability to be open with an app. However, there were key differences between relationships with health professionals and relationships with apps. For example, apps were not as tailored and

Radioresistant head and neck squamous cell carcinoma cells: Intracellular signaling, putative biomarkers for tumor recurrences and possible therapeutic targets

International Nuclear Information System (INIS)

Skvortsov, Sergej; Jimenez, Connie R.; Knol, Jaco C.; Eichberger, Paul; Schiestl, Bernhard; Debbage, Paul; Skvortsova, Ira; Lukas, Peter

2011-01-01

Purpose: Treatment of local and distant head and neck cancer recurrences after radiotherapy remains an unsolved problem. In order to identify potential targets for use in effective therapy of recurrent tumors, we have investigated protein patterns in radioresistant (FaDu-IRR and SCC25-IRR, “IRR cells”) as compared to parental (FaDu and SCC25) head and neck carcinoma cells. Methods and materials: Radiation resistant IRR cells were derived from parental cells after repeated exposure to ionizing radiation 10 times every two weeks at a single dose of 10 Gy, resulting in a total dose of 100 Gy. Protein profiling in parental and IRR cells was carried out using two-dimensional differential gel electrophoresis (2D-DIGE) followed by MALDI-TOF/TOF mass spectrometry. Cell viability, cell migration assays and Western blot analysis were used to confirm results obtained using the proteome approach. Results: Forty-five proteins that were similarly modulated in FaDu-IRR and SCC25-IRR cells compared to parental cells were selected to analyze their common targets. It was found that these either up- or down-regulated proteins are closely related to the enhancement of cell migration which is regulated by Rac1 protein. Further investigations confirmed that Rac1 is up-regulated in IRR cells, and inhibiting its action reduces the migratory abilities of these cells. Additionally, the Rac1 inhibitor exerts cytostatic effects in HNSCC cells, mostly in migratory cells. Conclusions: Based on these results, we conclude that radioresistant HNSCC cells possess enhanced metastatic abilities that are regulated by a network of migration-related proteins. Rac1 protein may be considered as a putative biomarker of HNSCC radiation resistance, and as a potential therapeutic target for treating local and distant HNSCC recurrences.

Therapist self-disclosure and the therapeutic alliance in the treatment of eating problems.

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Simonds, Laura M; Spokes, Naomi

2017-01-01

Evidence is mixed regarding the potential utility of therapist self-disclosure. The current study modelled relationships between perceived helpfulness of therapist self-disclosures, therapeutic alliance, patient non-disclosure, and shame in participants (n = 120; 95% women) with a history of eating problems. Serial multiple mediator analyses provided support for a putative model connecting the perceived helpfulness of therapist self-disclosures with current eating disorder symptom severity through therapeutic alliance, patient self-disclosure, and shame. The analyses presented provide support for the contention that therapist self-disclosure, if perceived as helpful, might strengthen the therapeutic alliance. A strong therapeutic alliance, in turn, has the potential to promote patient disclosure and reduce shame and eating problems.

Measuring the Developing Therapeutic Relationship Between Pregnant Women and Community Health Workers Over the Course of the Pregnancy in a Study Intervention.

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Lichtveld, Maureen Y; Shankar, Arti; Mundorf, Chris; Hassan, Anna; Drury, Stacy

2016-12-01

The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR) is a frequently-administered tool for measuring therapeutic relationships between clinicians and patients. This manuscript tested the STAR's psychometric properties within a community health worker (CHW)-led intervention study involving pregnant and postpartum women. Women (n = 141) enrolled in the study completed the 12-item participant STAR survey (STAR-P) at two time points over the course of pregnancy and at two time points after delivery. The factor structure of the STAR-P proved to be unstable with this population. However, a revised 9-item STAR-P revealed a two-factor model of positive and negative interactions, and demonstrated strong internal consistency at postpartum time points. The revised STAR-P shows strong psychometric properties, and is suitable for use to evaluate the relationship developed between CHWs and pregnant and postpartum women in an intervention program.

Regulating Critical Period Plasticity: Insight from the Visual System to Fear Circuitry for Therapeutic Interventions

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Elisa M. Nabel

2013-11-01

Full Text Available Early temporary windows of heightened brain plasticity called critical periods developmentally sculpt neural circuits and contribute to adult behavior. Regulatory mechanisms of visual cortex development –the preeminent model of experience-dependent critical period plasticity- actively limit adult plasticity and have proved fruitful therapeutic targets to reopen plasticity and rewire faulty visual system connections later in life. Interestingly, these molecular mechanisms have been implicated in the regulation of plasticity in other functions beyond vision. Applying mechanistic understandings of critical period plasticity in the visual cortex to fear circuitry may provide a conceptual framework for developing novel therapeutic tools to mitigate aberrant fear responses in post traumatic stress disorder. In this review, we turn to the model of experience-dependent visual plasticity to provide novel insights for the mechanisms regulating plasticity in the fear system. Fear circuitry, particularly fear memory erasure, also undergoes age-related changes in experience-dependent plasticity. We consider the contributions of molecular brakes that halt visual critical period plasticity to circuitry underlying fear memory erasure. A major molecular brake in the visual cortex, perineuronal net formation, recently has been identified in the development of fear systems that are resilient to fear memory erasure. The roles of other molecular brakes, myelin-related Nogo receptor signaling and Lynx family proteins– endogenous inhibitors for nicotinic acetylcholine receptor, are explored in the context of fear memory plasticity. Such fear plasticity regulators, including epigenetic effects, provide promising targets for therapeutic interventions.

Therapeutic intervention at cellular quality control systems in Alzheimer's and Parkinson's diseases.

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Arduino, Daniela M; Esteves, A Raquel; Silva, Diana F F; Martins-Branco, Diogo; Santos, Daniel; Pimentel, Diana F Gomes; Cardoso, Sandra M

2011-01-01

Cellular homeostasis relies on quality control systems so that damaged biologic structures are either repaired or degraded and entirely replaced by newly formed proteins or even organelles. The clearance of dysfunctional cellular structures in long-lived postmitotic cells, like neurons, is essential to eliminate, per example, defective mitochondria, lipofuscin-loaded lysosomes and oxidized proteins. Short-lived proteins are degraded mainly by proteases and proteasomes whether most long-lived proteins and all organelles are digested by autophagy in the lysosomes. Recently, it an interplay was established between the ubiquitin-proteasome system and macroautophagy, so that both degradative mechanisms compensate for each other. In this article we describe each of these clearance systems and their contribution to neuronal quality control. We will highlight some of the findings that provide evidence for the dysfunction of these systems in Alzheimer's and Parkinson's diseases. Ultimately, we provide an outline on potential therapeutic interventions based on the modulation of cellular degradative systems.

The effects of therapeutic touch on pain.

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Monroe, Carolyn Magdalen

2009-06-01

To better understand how Therapeutic Touch can be used in today's health care arena, this integrative literature review will examine current research that will help answer the question, Does Therapeutic Touch reduce pain? An extensive search was conducted of the online databases MEDLINE, CINAHL, Cochrane Library, EMBASE, PsychLIT, and PubMed to retrieve research articles published from 1997 to 2007. Seven studies that were conducted between 1997 and 2004 were found and only five of the seven were included as pertinent evidence to answer the question. All of the research that was reviewed to answer whether Therapeutic Touch could significantly reduce pain revealed a majority of statistically significant positive results for implementing this intervention. Because there are no identified risks to Therapeutic Touch as a pain relief measure, it is safe to recommend despite the limitations of current research. Therapeutic Touch should be considered among the many possible nursing interventions for the treatment of pain.

Humor: A Therapeutic Intervention for Child Counseling

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Berg, Rachelle G.; Parr, Gerald; Bradley, Loretta J.; Berry, Jeremy J.

2009-01-01

Counselors utilize many strategies, techniques, and tools when building a therapeutic alliance or addressing children's issues. Due to the serious nature of discussing problems or perhaps because of the fear of seeming insensitive, counselors often overlook humor as a means to enhance therapy. Whether deliberate or spontaneous, humor can add…

Alternative Therapeutic Intervention for Individuals with Rett Syndrome

Directory of Open Access Journals (Sweden)

Meir Lotan

2007-01-01

Full Text Available The individual with Rett syndrome (RS displays an array of challenging difficulties in all areas of daily living. Since there is no cure for the disorder at this moment, parents of the individual with Rett search for different interventional modalities that will improve the condition and quality of life for their child. During the last few years, many individuals with RS have experienced different kinds of interventions. This paper presents these methods with relevant case stories for others to share the possibilities. This paper reviews the following interventions: animal-assisted therapy, such as dolphin therapy and dog-assisted therapy; auditory integration training; hyperbaric chamber; manual therapy, such as acupuncture/acupressure, aromatherapy, craniosacral therapy, Mayo facial release, Treager massage, chiropractor, and Reiki; mental modification techniques, such as Lovas and cognitive rehabilitation; motoric interventions, such as advanced biomechanical rehabilitation, patterning/Doman-DeLacato approach, and yoga. The present paper is not a recommendation for any of the above-mentioned techniques, but merely a review of different interventions available for the inquisitive parent of the individual with RS.

Therapeutic education among adults with type 2 diabetes: effects of a three-day intervention on perceived competence, self-management behaviours and glycaemic control.

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Trouilloud, David; Regnier, Jennifer

2013-06-01

The purpose of this study was to evaluate the impact of a three-day therapeutic education programme on perceived competence, self-management behaviours (i.e. physical activity, diet and medication) and glycaemic control among adults with type 2 diabetes. A total of 120 participants were included in this randomized, wait list control group trial. The results confirm that therapeutic education may be a powerful healthcare intervention to improve lifestyle and health status of people with type 2 diabetes. We observed that the education programme used in this study generated positive changes in glycaemic control and adherence to physical activity and diet after three months follow-up. Furthermore, the intervention positively impacted participants' perceived competence towards physical activity and diet. The latter finding is of particular importance, given that perceived competence has been found to be involved in long-term adherence to self-management behaviours.

Comparative proteomics of cerebrospinal fluid reveals a predictive model for differential diagnosis of pneumococcal, meningococcal, and enteroviral meningitis, and novel putative therapeutic targets

Science.gov (United States)

2015-01-01

Background Meningitis is the inflammation of the meninges in response to infection or chemical agents. While aseptic meningitis, most frequently caused by enteroviruses, is usually benign with a self-limiting course, bacterial meningitis remains associated with high morbidity and mortality rates, despite advances in antimicrobial therapy and intensive care. Fast and accurate differential diagnosis is crucial for assertive choice of the appropriate therapeutic approach for each form of meningitis. Methods We used 2D-PAGE and mass spectrometry to identify the cerebrospinal fluid proteome specifically related to the host response to pneumococcal, meningococcal, and enteroviral meningitis. The disease-specific proteome signatures were inspected by pathway analysis. Results Unique cerebrospinal fluid proteome signatures were found to the three aetiological forms of meningitis investigated, and a qualitative predictive model with four protein markers was developed for the differential diagnosis of these diseases. Nevertheless, pathway analysis of the disease-specific proteomes unveiled that Kallikrein-kinin system may play a crucial role in the pathophysiological mechanisms leading to brain damage in bacterial meningitis. Proteins taking part in this cellular process are proposed as putative targets to novel adjunctive therapies. Conclusions Comparative proteomics of cerebrospinal fluid disclosed candidate biomarkers, which were combined in a qualitative and sequential predictive model with potential to improve the differential diagnosis of pneumococcal, meningococcal and enteroviral meningitis. Moreover, we present the first evidence of the possible implication of Kallikrein-kinin system in the pathophysiology of bacterial meningitis. PMID:26040285

Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures

Science.gov (United States)

Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O

2012-01-01

Objective The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. Methods We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. Results The mean MSD and DAP were respectively 389 mGy and 65 Gy cm−2 for CAs, and 916 mGy and 69 Gy cm−2 for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Conclusion Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions. PMID:22457404

The Therapeutic Efficacy of Domestic Violence Victim Interventions.

Science.gov (United States)

Hackett, Shannon; McWhirter, Paula T; Lesher, Susan

2016-04-01

A meta-analysis on domestic violence interventions was conducted to determine overall effectiveness of mental health programs involving women and children in joint treatment. These interventions were further analyzed to determine whether outcomes are differentially affected based on the outcome measure employed. To date, no meta-analyses have been published on domestic violence victim intervention efficacy. The 17 investigations that met study criteria yielded findings indicating that domestic violence interventions have a large effect size (d = .812), which decreases to a medium effect size when compared to control groups (d = .518). Effect sizes were assessed to determine whether treatment differed according to the focus of the outcome measure employed: (a) external stress (behavioral problems, aggression, or alcohol use); (b) psychological adjustment (depression, anxiety, or happiness); (c) self-concept (self-esteem, perceived competence, or internal locus of control); (d) social adjustment (popularity, loneliness, or cooperativeness); (e) family relations (mother-child relations, affection, or quality of interaction); and (f) maltreatment events (reoccurrence of violence, return to partner). Results reveal that domestic violence interventions across all outcome categories yield effects in the medium to large range for both internalized and externalized symptomatology. Implications for greater awareness and support for domestic violence treatment and programming are discussed. © The Author(s) 2015.

Therapeutic Intervention for the Physically Handicapped

Science.gov (United States)

Spillios, James; Janzen, Henry L.

1978-01-01

The need for training counselors specifically for intervention with the physically handicapped is the major focus of this article. Definitions of disabilities, rehabilitation and emotional factors are stressed as important variables in physical and psychotherapeutic treatment. The authors review some of the psychological aspects in counseling the…

Therapeutic Intervention for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Systematic Review and Meta-Analysis

Science.gov (United States)

Kuriyama, Akira; Whelan, Julia S.; Jackson, Jeffrey L.; Dimitrakoff, Jordan D.

2012-01-01

Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). Methods We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity. Results Mepartricin, percutaneous tibial nerve stimulation (PTNS), and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT) resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions. Conclusion Results from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and researchers must

Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Jeffrey M Cohen

Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI. METHODS: We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity. RESULTS: Mepartricin, percutaneous tibial nerve stimulation (PTNS, and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions. CONCLUSION: Results from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and

Therapeutic risk management of the suicidal patient: safety planning.

Science.gov (United States)

Matarazzo, Bridget B; Homaifar, Beeta Y; Wortzel, Hal S

2014-05-01

This column is the fourth in a series describing a model for therapeutic risk management of the suicidal patient. Previous columns presented an overview of the therapeutic risk management model, provided recommendations for how to augment risk assessment using structured assessments, and discussed the importance of risk stratification in terms of both severity and temporality. This final column in the series discusses the safety planning intervention as a critical component of therapeutic risk management of suicide risk. We first present concerns related to the relatively common practice of using no-suicide contracts to manage risk. We then present the safety planning intervention as an alternative approach and provide recommendations for how to use this innovative strategy to therapeutically mitigate risk in the suicidal patient.

Reactor-produced therapeutic radioisotopes

International Nuclear Information System (INIS)

Knapp, F.F. Jr.

2002-01-01

The significant worldwide increase in therapeutic radioisotope applications in nuclear medicine, oncology and interventional cardiology requires the dependable production of sufficient levels of radioisotopes for these applications (Reba, 2000; J. Nucl. Med., 1998; Nuclear News, 1999; Adelstein and Manning, 1994). The issues associated with both accelerator- and reactor-production of therapeutic radioisotopes is important. Clinical applications of therapeutic radioisotopes include the use of both sealed sources and unsealed radiopharmaceutical sources. Targeted radiopharmaceutical agents include those for cancer therapy and palliation of bone pain from metastatic disease, ablation of bone marrow prior to stem cell transplantation, treatment modalities for mono and oligo- and polyarthritis, for cancer therapy (including brachytherapy) and for the inhibition of the hyperplastic response following coronary angioplasty and other interventional procedures (For example, see Volkert and Hoffman, 1999). Sealed sources involve the use of radiolabeled devices for cancer therapy (brachytherapy) and also for the inhibition of the hyperplasia which is often encountered after angioplasty, especially with the exponential increase in the use of coronary stents and stents for the peripheral vasculature and other anatomical applications. Since neutron-rich radioisotopes often decay by beta decay or decay to beta-emitting daughter radioisotopes which serve as the basis for radionuclide generator systems, reactors are expected to play an increasingly important role for the production of a large variety of therapeutic radioisotopes required for these and other developing therapeutic applications. Because of the importance of the availability of reactor-produced radioisotopes for these applications, an understanding of the contribution of neutron spectra for radioisotope production and determination of those cross sections which have not yet been established is important. This

Secreted Frizzled-related protein 2 as a target in antifibrotic therapeutic intervention.

Science.gov (United States)

Mastri, Michalis; Shah, Zaeem; Hsieh, Karin; Wang, Xiaowen; Wooldridge, Bailey; Martin, Sean; Suzuki, Gen; Lee, Techung

2014-03-15

Progressive fibrosis is a pathological hallmark of many chronic diseases responsible for organ failure. Although there is currently no therapy on the market that specifically targets fibrosis, the dynamic fibrogenic process is known to be regulated by multiple soluble mediators that may be therapeutically intervened. The failing hamster heart exhibits marked fibrosis and increased expression of secreted Frizzled-related protein 2 (sFRP2) amenable to reversal by mesenchymal stem cell (MSC) therapy. Given the previous demonstration that sFRP2-null mice subjected to myocardial infarction exhibited reduced fibrosis and improved function, we tested whether antibody-based sFRP2 blockade might counteract the fibrogenic pathway and repair cardiac injury. Cardiomyopathic hamsters were injected intraperitoneally twice a week each with 20 μg of sFRP2 antibody. Echocardiography, histology, and biochemical analyses were performed after 1 mo. sFRP2 antibody increased left ventricular ejection fraction from 40 ± 1.2 to 49 ± 6.5%, whereas saline and IgG control exhibited a further decline to 37 ± 0.9 and 31 ± 3.2%, respectively. Functional improvement is associated with a ∼ 50% reduction in myocardial fibrosis, ∼ 65% decrease in apoptosis, and ∼ 75% increase in wall thickness. Consistent with attenuated fibrosis, both MSC therapy and sFRP2 antibody administration significantly increased the activity of myocardial matrix metalloproteinase-2. Gene expression analysis of the hamster heart and cultured fibroblasts identified Axin2 as a downstream target, the expression of which was activated by sFRP2 but inhibited by therapeutic intervention. sFRP2 blockade also increased myocardial levels of VEGF and hepatocyte growth factor (HGF) along with increased angiogenesis. These findings highlight the pathogenic effect of dysregulated sFRP2, which may be specifically targeted for antifibrotic therapy.

Putative therapeutic targets for symptom subtypes of adult ADHD: D4 receptor agonism and COMT inhibition improve attention and response inhibition in a novel translational animal model.

Science.gov (United States)

Tomlinson, Anneka; Grayson, Ben; Marsh, Samuel; Hayward, Andrew; Marshall, Kay M; Neill, Joanna C

2015-04-01

Prefrontal cortical dopamine plays an important role in cognitive control, specifically in attention and response inhibition; the core deficits in ADHD. We have previously shown that methylphenidate and atomoxetine differentially improve these deficits dependent on baseline performance. The present study extends this work to investigate the effects of putative therapeutic targets in our model. A selective dopamine D4 receptor agonist (A-412997) and the catechol-O-methyl-transferase (COMT) inhibitor; tolcapone, were investigated in the combined subtype of adult ADHD (ADHD-C). Adult female rats were trained to criterion in the 5C-CPT (5-Choice Continuous Performance Task) and then separated into subgroups according to baseline levels of sustained attention, vigilance, and response disinhibition. The subgroups included: high-attentive (HA) and low-attentive with high response disinhibition (ADHD-C). The ADHD-C subgroup was selected to represent the combined subtype of adult ADHD. Effects of tolcapone (3.0, 10.0, 15.0mg/kg) and A-412997 (0.1, 0.3, 1.0µmol/kg) were tested by increasing the variable inter-trial-interval (ITI) duration in the 5C-CPT. Tolcapone (15mg/kg) significantly increased sustained attention, vigilance and response inhibition in ADHD-C animals, and impaired attention in HA animals. A-412997 (1.0µmol/kg) significantly increased vigilance and response inhibition in ADHD-C animals only, with no effect in HA animals. This is the first study to use the translational 5C-CPT to model the adult ADHD-C subtype in rats and to study new targets in this model. Both tolcapone and A-412997 increased vigilance and response inhibition in the ADHD-C subgroup. D4 and COMT are emerging as important potential therapeutic targets in adult ADHD that warrant further investigation. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review.

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Campagnolo, N; Johnston, S; Collatz, A; Staines, D; Marshall-Gradisnik, S

2017-06-01

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterised by unexplained fatigue for at least 6 months accompanied by a diverse but consistent set of symptoms. Diet modification and nutritional supplements could be used to improve patient outcomes, such fatigue and quality of life. We reviewed and discussed the evidence for nutritional interventions that may assist in alleviating symptoms of CFS/ME. Medline, Cinahl and Scopus were systematically searched from 1994 to May 2016. All studies on nutrition intervention were included where CFS/ME patients modified their diet or supplemented their habitual diet on patient-centred outcomes (fatigue, quality of life, physical activity and/or psychological wellbeing). Seventeen studies were included that meet the inclusion criteria. Of these, 14 different interventions were investigated on study outcomes. Many studies did not show therapeutic benefit on CFS/ME. Improvements in fatigue were observed for nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10. This review identified insufficient evidence for the use of nutritional supplements and elimination or modified diets to relieve CFS/ME symptoms. Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used, and studies not reporting dietary intake method. Further research is warranted in homogeneous CFS/ME populations. © 2017 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV - EUS-guided interventions

DEFF Research Database (Denmark)

Jenssen, C; Hocke, M; Fusaroli, P

2016-01-01

The fourth part of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describes general aspects of endoscopic ultrasound-guided diagnostic and therapeutic interventions and assesses the evidence for endoscopic ultrasound-gu...

Analysis of Hydraulic Flood Control Structure at Putat Boro River

OpenAIRE

Ruzziyatno, Ruhban

2015-01-01

Putat Boro River is one of the main drainage systems of Surakarta city which drains into Bengawan Solo river. The primary problem when flood occur is the higher water level of Bengawan Solo than Boro River and then backwater occur and inundates Putat Boro River. The objective of the study is to obtain operational method of Putat Boro River floodgate to control both inflows and outflows not only during flood but also normal condition. It also aims to know the Putat Boro rivers floodgate op...

Gardening as a therapeutic intervention in mental health.

Science.gov (United States)

Page, Mathew

This article describes why one low-secure unit chose to initiate a horticultural therapy project and organise it as a 'workers' cooperative'. The therapeutic benefits of gardening are explored, particularly focusing on the social benefits. The article also discusses the issue of hope, which is an intrinsic requirement in gardening.

Twenty putative palmitoyl-acyl transferase genes with distinct ...

African Journals Online (AJOL)

There are 20 genes containing DHHC domain predicted to encode putative palmitoyltransferase in Arabidopsis thaliana genome. However, little is known about their characteristics such as genetic relationship and expression profile. Here, we present an overview of the putative PAT genes in A. thaliana focusing on their ...

The therapeutic relationship after psychiatric admission.

LENUS (Irish Health Repository)

Roche, Eric

2014-03-01

The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

Therapeutical Intervention, Relaxation, Mental Images, and Spirituality (RIME for Spiritual Pain in Terminal Patients. A Training Program

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Ana Catarina de Araújo Elias

2006-01-01

Full Text Available Therapeutic intervention involving the technique of Relaxation, Mental Images, and Spirituality (RIME can foster the redefinition of spiritual pain in terminal patients. A training course was developed to instruct health care professionals in its use, and the results were followed up by evaluating reactions of professionals to its use in intervention with patients. Six subjects (a nurse, a doctor, three psychologists, and an alternative therapist, all skilled in palliative care, were invited to take part in the experience. They worked with 11 terminal patients in public hospitals of the cities of Campinas, Piracicaba, and São Paulo, located in Brazil. The theoretical basis for the study involves action research and phenomenology, and the results were analyzed using both qualitative and quantitative methods. The analysis of the experience of the professionals revealed 5 categories and 15 subcategories. The analysis of the nature of spiritual pain revealed 6 categories and 11 subcategories. The administration of RIME revealed statistically significant differences (p < 0.0001, i.e., patients reported a greater level of well-being at the end than at the beginning of sessions, which suggests that RIME led to the redefinition of spiritual pain for these terminal patients. The training program proposed has shown itself to be effective in preparing health care professionals for the use of RIME intervention.

Lower Extremity Injury Patterns in Elite Ballet Dancers: Ultrasound/MRI Imaging Features and an Institutional Overview of Therapeutic Ultrasound Guided Percutaneous Interventions.

Science.gov (United States)

Rehmani, Razia; Endo, Yoshimi; Bauman, Phillip; Hamilton, William; Potter, Hollis; Adler, Ronald

2015-10-01

Altered biomechanics from repetitive microtrauma, such as long practice hours in en pointe (tip of the toes) or demi pointe (balls of the feet) predispose ballet dancers to a multitude of musculoskeletal pathologies particularly in the lower extremities. Both ultrasound and magnetic resonance imaging (MRI) are radiation-sparing modalities which can be used to confidently evaluate these injuries, with ultrasound (US) offering the added utility of therapeutic intervention at the same time in experienced hands. The purposes of this paper were: (1) to illustrate the US and MRI features of lower extremity injury patterns in ballet dancers, focusing on pathologies commonly encountered at a single orthopedic hospital; (2) to present complementary roles of both ultrasound and MRI in the evaluation of these injuries whenever possible; (3) to review and present our institutional approach towards therapeutic ultrasound-guided interventions by presenting explicit cases. Online searches were performed using the search criteria of "ballet biomechanics" and "ballet injuries." The results were then further narrowed down by limiting articles published in the past 15 years, modality (US and MRI), anatomical region (foot and ankle, hip and knee) and to major radiology, orthopedics, and sports medicine journals. Performing ballet poses major stress to lower extremities and predisposes dancer to several musculoskeletal injuries. These can be adequately evaluated by both US and MRI. US is useful for evaluating superficial structures such as soft tissues, tendons, and ligaments, particularly in the foot and ankle. MRI provides superior resolution of deeper structures such as joints, bone marrow, and cartilage. In addition, US can be used as a therapeutic tool for providing quick symptomatic improvement in these athletes for who "time is money". Performing ballet may cause major stress to the lower extremities, predominantly affecting the foot and ankle, followed by the knee and hip. US

Testing the Effectiveness of Therapeutic Showering in Labor.

Science.gov (United States)

Stark, Mary Ann

: Therapeutic showering is a holistic nursing intervention that is often available and supports physiologic labor. The purpose of this study was to compare the effectiveness of therapeutic showering with usual care during active labor. Research questions were as follows: Are there significant differences between women who showered 30 minutes during active labor and those who received usual labor care in anxiety, tension, relaxation, pain, discomfort, and coping? Is there a difference in use of obstetric interventions between groups? A convenience sample of healthy low-risk women in active labor was recruited (N = 32). A pretest posttest control group repeated-measures design was used. Participants were randomized to treatment group (n = 17), who showered for 30 minutes, or to control group (n = 14) who received usual labor care. Women evaluated pain, discomfort, anxiety, tension, coping, and relaxation at enrollment, again 15 minutes after entering the shower or receiving usual care, then again 30 minutes after entering the shower or receiving usual care. Chart reviews after delivery recorded obstetric interventions. The showering group had statistically significant decreases in pain, discomfort, anxiety and tension, and significant increase in relaxation. There were no differences in use of obstetric interventions. Therapeutic showering was effective in reducing pain, discomfort, anxiety, and tension while improving relaxation and supporting labor in this sample.

Pediatric interventional radiology: vascular interventions

International Nuclear Information System (INIS)

Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

2016-01-01

Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. (author)

Modulation of Lipid Droplet Metabolism—A Potential Target for Therapeutic Intervention in Flaviviridae Infections

Directory of Open Access Journals (Sweden)

Jingshu Zhang

2017-11-01

Full Text Available Lipid droplets (LDs are endoplasmic reticulum (ER-related dynamic organelles that store and regulate fatty acids and neutral lipids. They play a central role in cellular energy storage, lipid metabolism and cellular homeostasis. It has become evident that viruses have co-evolved in order to exploit host lipid metabolic pathways. This is especially characteristic of the Flaviviridae family, including hepatitis C virus (HCV and several flaviviruses. Devoid of an appropriate lipid biosynthetic machinery of their own, these single-strand positive-sense RNA viruses can induce dramatic changes in host metabolic pathways to establish a favorable environment for viral multiplication and acquire essential components to facilitate their assembly and traffic. Here we have reviewed the current knowledge on the intracellular life cycle of those from the Flaviviridae family, with particular emphasis on HCV and dengue virus (DENV, and their association with the biosynthesis and metabolism of LDs, with the aim to identify potential antiviral targets for development of novel therapeutic interventions.

Diagnostic and therapeutic peroral cholangioscopy

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Jong Ho Moon

2012-01-01

Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

Therapeutic touch and post-Hurricane Hugo stress.

Science.gov (United States)

Olson, M; Sneed, N; Bonadonna, R; Ratliff, J; Dias, J

1992-06-01

This repeated-session design sought to answer questions about the effectiveness of therapeutic touch in reduction of stress for 23 individuals following a natural disaster. In addition, methodological issues related to the average length of time for a therapeutic-touch treatment and a method of documenting the nonverbal interaction between subject and toucher were investigated. Findings indicate that stressed people report themselves to be less stressed following therapeutic touch (p = .05). Time of therapeutic-touch intervention varied significantly between the touchers, with a range of 6.8 to 20 minutes. Qualitative data examining the interaction of toucher and subject raised a number of questions that require further study.

Interventions designed to improve therapeutic communications between black and minority ethnic people and professionals working in psychiatric services: a systematic review of the evidence for their effectiveness.

Science.gov (United States)

Bhui, Kamaldeep; Aslam, Rabbea'h W; Palinski, Andrea; McCabe, Rose; Johnson, Mark R D; Weich, Scott; Singh, Swaran Preet; Knapp, Martin; Ardino, Vittoria; Szczepura, Ala

2015-04-01

Black and minority ethnic (BME) people using psychiatric services are at greater risk of non-engagement, dropout from care and not receiving evidence-based interventions than white British people. To identify effective interventions designed to improve therapeutic communications (TCs) for BME patients using psychiatric services in the UK, to identify gaps in the research literature and to recommend future research. Black African, black Caribbean, black British, white British, Pakistani and Bangladeshi patients in psychiatric services in the UK, or recruited from the community to enter psychiatric care. Some studies from the USA included Hispanic, Latino, Chinese, Vietnamese, Cambodian and African American people. Any that improve TCs between BME patients and staff in psychiatric services. The published literature, 'grey' literature, an expert survey, and patients' and carers' perspectives on the evidence base. Databases were searched from their inception to 4 February 2013. Databases included MEDLINE, Applied Social Sciences Index and Abstracts, The Cochrane Library, Social Science Citation Index, Allied and Complementary Medicine Database, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, EMBASE, The Campbell Collaboration and ProQuest for dissertations. Studies were included if they reported evaluation data about interventions designed to improve therapeutic outcomes by improving communication between BME patients and psychiatric professionals. Qualitative studies and reports in the grey literature were included only if they gave a critical evaluative statement. Two members of the team selected studies against pre-established criteria and any differences were resolved by consensus or by a third reviewer, if necessary. Data were extracted independently by two people and summarised in tables by specific study designs. Studies were subjected to a narrative synthesis that included a thematic analysis contrasting populations, countries and the

Update of green tea interactions with cardiovascular drugs and putative mechanisms

Directory of Open Access Journals (Sweden)

José Pablo Werba

2018-04-01

Full Text Available Many patients treated with cardiovascular (CV drugs drink green tea (GT, either as a cultural tradition or persuaded of its putative beneficial effects for health. Yet, GT may affect the pharmacokinetics and pharmacodynamics of CV compounds. Novel GT-CV drug interactions were reported for rosuvastatin, sildenafil and tacrolimus. Putative mechanisms involve inhibitory effects of GT catechins at the intestinal level on influx transporters OATP1A2 or OATP2B1 for rosuvastatin, on CYP3A for sildenafil and on both CYP3A and the efflux transporter p-glycoprotein for tacrolimus. These interactions, which add to those previously described with simvastatin, nadolol and warfarin, might lead, in some cases, to reduced drug efficacy or risk of drug toxicity. Oddly, available data on GT interaction with CV compounds with a narrow therapeutic index, such as warfarin and tacrolimus, derive from single case reports. Conversely, GT interactions with simvastatin, rosuvastatin, nadolol and sildenafil were documented through pharmacokinetic studies. In these, the effect of GT or GT derivatives on drug exposure was mild to moderate, but a high inter-individual variability was observed. Further investigations, including studies on the effect of the dose and the time of GT intake are necessary to understand more in depth the clinical relevance of GT-CV drug interactions. Keywords: Cardiovascular drugs, Green tea, Herb–drug interactions

Beyond the therapeutic shackles of the monoamines: New mechanisms in bipolar disorder biology.

Science.gov (United States)

Data-Franco, João; Singh, Ajeet; Popovic, Dina; Ashton, Melanie; Berk, Michael; Vieta, Eduard; Figueira, M L; Dean, Olivia M

2017-01-04

Multiple novel biological mechanisms putatively involved in the etiology of bipolar disorders are being explored. These include oxidative stress, altered glutamatergic neurotransmission, mitochondrial dysfunction, inflammation, cell signaling, apoptosis and impaired neurogenesis. Important clinical translational potential exists for such mechanisms to help underpin development of novel therapeutics - much needed given limitations of current therapies. These new mechanisms also help improve our understanding of how current therapeutics might exert their effects. Lithium, for example, appears to have antioxidant, immunomodulatory, signaling, anti-apoptotic and neuroprotective properties. Similar properties have been attributed to other mood stabilizers such as valproate, lamotrigine, and quetiapine. Perhaps of greatest translational value has been the recognition of such mechanisms leading to the emergence of novel therapeutics for bipolar disorders. These include the antioxidant N-acetylcysteine, the anti-inflammatory celecoxib, and ketamine - with effects on the glutamatergic system and microglial inhibition. We review these novel mechanisms and emerging therapeutics, and comment on next steps in this space. Copyright © 2016 Elsevier Inc. All rights reserved.

Targeting activator protein 1 signaling pathway by bioactive natural agents: Possible therapeutic strategy for cancer prevention and intervention.

Science.gov (United States)

Tewari, Devesh; Nabavi, Seyed Fazel; Nabavi, Seyed Mohammad; Sureda, Antoni; Farooqi, Ammad Ahmad; Atanasov, Atanas G; Vacca, Rosa Anna; Sethi, Gautam; Bishayee, Anupam

2018-02-01

Activator protein 1 (AP-1) is a key transcription factor in the control of several cellular processes responsible for cell survival proliferation and differentiation. Dysfunctional AP-1 expression and activity are involved in several severe diseases, especially inflammatory disorders and cancer. Therefore, targeting AP-1 has recently emerged as an attractive therapeutic strategy for cancer prevention and therapy. This review summarizes our current understanding of AP-1 biology and function as well as explores and discusses several natural bioactive compounds modulating AP-1-associated signaling pathways for cancer prevention and intervention. Current limitations, challenges, and future directions of research are also critically discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using data sources beyond PubMed has a modest impact on the results of systematic reviews of therapeutic interventions.

Science.gov (United States)

Halladay, Christopher W; Trikalinos, Thomas A; Schmid, Ian T; Schmid, Christopher H; Dahabreh, Issa J

2015-09-01

Searching multiple sources when conducting systematic reviews is considered good practice. We aimed to investigate the impact of using sources beyond PubMed in systematic reviews of therapeutic interventions. We randomly selected 50 Cochrane reviews that searched the PubMed (or MEDLINE) and EMBASE databases and included a meta-analysis of ≥10 studies. We checked whether each eligible record in each review (n = 2,700) was retrievable in PubMed and EMBASE. For the first-listed meta-analysis of ≥10 studies in each review, we examined whether excluding studies not found in PubMed affected results. A median of one record per review was indexed in EMBASE but not in PubMed; a median of four records per review was not indexed in PubMed or EMBASE. Meta-analyses included a median of 13.5 studies; a median of zero studies per meta-analysis was indexed in EMBASE but not in PubMed; a median of one study per meta-analysis was not indexed in PubMed or EMBASE. Meta-analysis using only PubMed-indexed vs. all available studies led to a different conclusion in a single case (on the basis of conventional criteria for statistical significance). In meta-regression analyses, effects in PubMed- vs. non-PubMed-indexed studies were statistically significantly different in a single data set. For systematic reviews of the effects of therapeutic interventions, gains from searching sources beyond PubMed, and from searching EMBASE in particular are modest. Copyright © 2015 Elsevier Inc. All rights reserved.

Results from Therapeutic Touch Interventions in the Newborn: A Systematic Literature Review

Directory of Open Access Journals (Sweden)

Ana Cristina Ramos

2016-04-01

Full Text Available Therapeutic Touch (TT is a contemporary approach to several ancestral healing practices. As one of the oldest vibrational therapies still in use, it is expected to act on the balancing of the human being’s energy field, by the laying hands on. The hands are, therefore, vehicles of comfort, affection, support and healing. This article illustrates a systematic review of the literature (RSL, on the effects of TT in the newborn. Objective: To know the effect of TT in the newborn. Methods: We carried the research on the Online Knowledge Library platform (Biblioteca do Conhecimento Online/B-On by researching on the available electronic databases. The articles which addressed the TT as an intervention in the newborn were included. From the 237 articles found, eight ones were selected according to the inclusion criteria previously established. Results: All studies demonstrated benefits of applying TT, such as calming effect after nursing procedures, because it reduces pain, reduces the motor activity, decreases the level of cortisol, facilitates feeding, suction/ swallowing and thus increases weight, stabilizes vital signs, promotes rest, improves interaction with the environment and saves energy for growth and healing. Conclusions: The practice of TT in the newborn can contribute to his well-being, bringing him physical, psychological and spiritual benefits.

Conflicts in the therapeutic field

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Antonino Aprea

2012-06-01

Full Text Available How the analytical knowledge that compare human consciousness with that, even more disturbing, moving behind his fifth can be said to be “for peace”? It can be - and this will be the contribution of the proposal - the same tortuous and enigmatic of therapeutic practice, with its hesitations and his impulses, to outline a path crossing and overcoming the conflict? May, finally, peace, in the sense of feasibility of intra-and interpersonal dialectic instead of tearing and hostileconfrontation with oneself and with the other, to be a reference in some crucial pivot of ethical therapeutic work? To these questions the intervention seeks to answer retracing some of the highlights of almost three years of therapeutic work with a young woman and her family.

Interventional neuroradiology

International Nuclear Information System (INIS)

Mehta, B.A.; Quint, D.J.; Sanders, W.P.; Patel, S.C.; Boulos, R.S.; Burke, T.H.

1987-01-01

This presentation reviews the authors' angiographic approach to interventional cases and demonstrates examples of procedures we have performed including preoperative embolizations (dural, arteriovenous malformations, meningioma, juvenile angiofibroma, gliosarcoma, glomus tympanicum, hemangiopericytoma, and spinal hemangioma), therapeutic interventions (balloon occlusion of cavernous-carotid and vertebral fistulas, intracranial and extracranial aneurysms, and angioplasty of vertebral, external carotid, and subclavian arteries), and pain management (alcohol injection of spine metastases). Potential and actual complications are reviewed

Implications for Therapeutic Intervention

Directory of Open Access Journals (Sweden)

A. L. Hof

2001-01-01

Full Text Available Patients with an upper motor neurone syndrome (CP suffer from many disabling primary symptoms: spasms, weakness, and loss of dexterity. These primary ‘neurogenic’ symptoms often lead to secondary disabilities, muscle contractures, and tertiary effects, bone deformations. A common symptom of CP is hypertonia, with. the consequence that the involved muscles remain in an excessively shortened length for most of the time. As a normal reaction of the muscle tissue, the number of sarcomeres is reduced and the muscle fibers shorten permanently: a contracture develops. A possible second type of contracture is that normal muscle lengthening along with bone growth is affected. Current treatments for the secondary effects include (1 reduction of muscle force, (2lengthening of the muscle fibers by serial plaster casts, and (3surgical lengthening of tendons or aponeurosis. The choice of treatment depends on the cause of the functional deficit. Bone tissue also adapts itself to abnormal forces, especially in the growth period. The hypertonias or contractures of CP so may give rise to bone malformations that interfere with function (e.g. femur endorotation or may reduce the action of muscles by changing the lever arm (e.g. ankle varus. Although prevention should always be preferred, a timely surgical intervention cannot always be avoided. The differences in treatment for the various groups require and justify an extensive laboratory investigation, including EMG recordings in gait, measurement of passive elastic properties, and long-term observation of the hypertonia.

Brain science and illness beliefs: an unexpected explanation of the healing power of therapeutic conversations and the family interventions that matter.

Science.gov (United States)

Wright, Lorraine M

2015-05-01

Paradigm families and paradigm practice moments have shown me that therapeutic conversations between nurses and families can profoundly and positively change illness beliefs in family members and nurses and contribute to healing from serious illness. The integration of brain science into nursing practice offers further understanding of the importance of illness beliefs and the role they may play in helping individual and family healing. Brain science offers explanations that connect how certain family nursing interventions that soften suffering and challenge constraining illness beliefs may result in changes in brain structure and functioning. New illness beliefs may result in new neural pathways in the brain, and therefore, possibilities for a new way of being in relationship with illness and in relationship with others can also develop. Newly acquired practice skills and interventions that have emerged from an understanding of brain science plus the reemphasis of other interventions utilized in the Illness Beliefs Model are offered to enhance our care of families suffering with illness. © The Author(s) 2015.

Integrating School-Based and Therapeutic Conflict Management Models at School.

Science.gov (United States)

D'Oosterlinck, Franky; Broekaert, Eric

2003-01-01

Explores the possibility of integrating school-based and therapeutic conflict management models, comparing two management models: a school-based conflict management program, "Teaching Students To Be Peacemakers"; and a therapeutic conflict management program, "Life Space Crisis Intervention." The paper concludes that integration might be possible…

Use of informed consent with therapeutic paradox.

Science.gov (United States)

Farkas, M M

1992-01-01

Debate persists in the literature and among clinicians about the ethical appropriateness of paradoxical interventions. It has been suggested that informed consent with therapeutic paradox would alleviate ethical concerns of deception, manipulation, harm to the client, and withholding of information from the client in therapy. The purpose of this study was to explore health care consumer reactions to the benefits and risks of therapeutic paradox as stated in a consent for treatment form. The study explored the responses of 32 medical patients to a hypothetical consent for treatment form for therapeutic paradox. Data were collected in a brief semistructured interview after subjects read the hypothetical consent form. Utilizing a case study, the investigator then offered an example of a successful paradoxical intervention and additional subject comments were solicited. Content analysis of the responses was made. Health care consumers had mixed responses to the consent form. While the consent form served as an obstacle for some consumers, many were willing to sign the consent form and accept treatment even though they had internal reservations and questions. Appropriateness of the consent form format is discussed.

A putative hybrid swarm within Oonopsis foliosa (Asteraceae: Astereae)

Science.gov (United States)

Hughes, J.F.; Brown, G.K.

2004-01-01

Oo??nopsis foliosa var. foliosa and var. monocephala are endemic to short-grass steppe of southeastern Colorado and until recently were considered geographically disjunct. The only known qualitative feature separating these 2 varieties is floral head type; var. foliosa has radiate heads, whereas var. monocephala heads are discoid. Sympatry between these varieties is restricted to a small area in which a range of parental types and intermediate head morphologies is observed. We used distribution mapping, morphometric analyses, chromosome cytology, and pollen stainability to characterize the sympatric zone. Morphometrics confirms that the only discrete difference between var. foliosa and var. monocephala is radiate versus discoid heads, respectively. The outer florets of putative hybrid individuals ranged from conspicuously elongated yet radially symmetric disc-floret corollas, to elongated radially asymmetric bilabiate- or deeply cleft corollas, to stunted ray florets with appendages remnant of corolla lobes. Chromosome cytology of pollen mother cells from both putative parental varieties and a series of intermediate morphological types collected at the sympatric zone reveal evidence of translocation heterozygosity. Pollen stainability shows no significant differences in viability between the parental varieties and putative hybrids. The restricted distribution of putative hybrids to a narrow zone of sympatry between the parental types and the presence of meiotic chromosome-pairing anomalies in these intermediate plants are consistent with a hybrid origin. The high stainability of putative-hybrid pollen adds to a growing body of evidence that hybrids are not universally unfit.

A systematic review of psychoneuroimmunology-based interventions.

Science.gov (United States)

Moraes, Lucam J; Miranda, Márcia B; Loures, Liliany F; Mainieri, Alessandra G; Mármora, Cláudia Helena C

2018-07-01

Psychoneuroimmunology-based interventions are used to attenuated disease progression and/or side effects of pharmacological treatment. This systematic review evaluates the different therapeutic and/or clinical psychoneuroimmunology-based interventions associated to both psychological, neuroendocrine and immunological variables. The review was conducted for all English, Portuguese and Spanish language articles published between 2005 and 2015. Independent investigators analyzed 42 studies concerning human psychoneuroimmunology-based interventions. Decreased levels of cortisol, epinephrine and norepinephrine (stress-related hormones) were associated to interventions like yoga, meditation, tai chi, acupuncture, mindfulness, religious/spiritual practices, cognitive behavior therapy, coping and physical exercises. Moreover, those interventions were also associated to reductions in inflammatory processes and levels of pro-inflammatory cytokines in cancer, HIV, depression, anxiety, wound healing, sleep disorder, cardiovascular diseases and fibromyalgia. Despite the associations between PNI variables and clinical/therapeutic interventions, only one study evidenced significant effects on a disease progression.

Therapeutic doll play in the treatment of a severely impaired psychiatric inpatient: dramatic clinical improvements with a nontraditional nursing intervention.

Science.gov (United States)

Birnbaum, Shira; Hanchuk, Hilary; Nelson, Marjorie

2015-05-01

Interest has grown in the use of doll therapy, particularly in geropsychiatric and dementia care settings. In a long-term state psychiatric hospital, a dollhouse-play activity was implemented in an effort to engage an acutely disturbed, middle-aged woman undergoing medication trials and whose symptoms had been refractory to conventional treatments. A schedule of nondirective dollhouse-play activities was implemented over an 8-week period. Measures of behavioral change were tracked. Dramatic clinical improvements were seen, including significant reductions in verbal and physical aggression, use of as-needed medications, and need for close one-to-one monitoring. Improvements were seen prior to achievement of therapeutic drug levels. The patient was successfully discharged from the hospital. Doll play has recently been associated with clinical benefits in the care of patients with dementia and has long been deployed in childhood mental health treatment. The current findings suggest doll play may have applications as a time-limited intervention in the treatment of major psychiatric disorders in adults and warrants consideration when achieving therapeutic alliance has proven particularly challenging. Copyright 2015, SLACK Incorporated.

Music-based therapeutic interventions for people with dementia

NARCIS (Netherlands)

Steen, J.T. van der; Soest-Poortvliet, M.C. van; Wouden, J.C. van der; Bruinsma, M.S.; Scholten, R.J.; Vink, A.C.

2017-01-01

BACKGROUND: Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research

Pursuing prosody interventions.

Science.gov (United States)

Hargrove, Patricia M

2013-08-01

This paper provides an overview of evidence-based prosodic intervention strategies to facilitate clinicians' inclusion of prosody in their therapeutic planning and to encourage researchers' interest in prosody as an area of specialization. Four current evidence-based prosodic interventions are reviewed and answers to some important clinical questions are proposed. Additionally, the future direction of prosodic intervention research is discussed in recommendations about issues that are of concern to clinicians. The paper ends with a call for participation in an online collaboration at the Clinical Prosody blog at clinicalprosody.wordpress.com.

Systematic review of universal and targeted workplace interventions for depression.

Science.gov (United States)

Wan Mohd Yunus, Wan Mohd Azam; Musiat, Peter; Brown, June S L

2018-01-01

Depression is increasingly being recognised as a significant mental health problem in the workplace contributing to productivity loss and economic burden to organisations. This paper reviews recently published randomised controlled trials (RCTs) of universal and targeted interventions to reduce depression in the workplace. Studies were identified through searches of EMBASE, MEDLINE/PubMed, PsycINFO, PsycARTICLES Full Text, and Global Health and Social Policy and Practice databases. Studies were included if they included an RCT of a workplace intervention for employees targeting depression as the primary outcome. Twenty-two published RCTs investigating interventions utilising various therapeutic approaches were identified. The cognitive behavioural therapy (CBT) approach is the most frequently used in the workplace, while interventions that combine different therapeutic approaches showed the most promising results. A universal intervention in the workplace that combines CBT and coping flexibility recorded the highest effect size (d=1.45 at 4 months' follow-up). Most interventions were delivered in group format and showed low attrition rates compared with other delivery formats. Although all studies reviewed were RCTs, the quality of reporting is low. Interventions using different therapeutic approaches with different modes of delivery have been used. Most of these interventions were shown to reduce depression levels among employees in the workplace, particularly those that combine more than one therapeutic approaches. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Hospital-Based Therapeutic Lifestyle Program for Women With Metabolic Syndrome

Directory of Open Access Journals (Sweden)

Hei-Jen Jou

2010-12-01

Conclusion: The therapeutic lifestyle program with diet control and regular exercise improves most markers of MetS except for levels of high density lipoprotein cholesterol. Therapeutic lifestyle intervention may be the best way of reducing the risk of cardiovascular disease in women with MetS.

A prospective study of group cohesiveness in therapeutic horticulture for clinical depression.

Science.gov (United States)

Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil W; Kirkevold, Marit

2011-04-01

This study aimed to assess changes in psychological distress and social participation in adults diagnosed with clinical depression during and after participating in a therapeutic horticulture programme, and to investigate if the changes covaried with levels of group cohesiveness during the intervention. An intervention with a single-group design was repeated with different samples in successive years (pooled n = 46). In each year, five groups of 3-7 participants went through the intervention. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, as well as at 3-months' follow up. Mental health assessments included the Beck Depression Inventory, the State Subscale of Spielberger State-Trait Anxiety Inventory, the Positive Affect Scale from the Positive and Negative Affect Scale, the Perceived Stress Scale, and the Therapeutic Factors Inventory-Cohesiveness Scale. The analysis of the pooled data confirmed significant beneficial change in all mental health variables during the intervention. Change from baseline in depression severity persisted at 3-months' follow up. Increased social activity after the intervention was reported for 38% of the participants. The groups quickly established strong cohesiveness, and this continued to increase during the intervention. The average level of group cohesiveness correlated positively, but not significantly, with change in all mental health outcome variables. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Work-Life and Well-Being in U.K. Therapeutic Prison Officers: A Thematic Analysis.

Science.gov (United States)

Walker, Emma J; Egan, Helen H; Jackson, Craig A; Tonkin, Matthew

2018-06-01

Previous research has clearly demonstrated the positive impact of therapeutic interventions on offenders' well-being. Much less is known about the impact on prison staff facilitating and delivering such interventions. We employed qualitative methodology to capture a deeper understanding of the work of therapeutic prison officers. Seven prison officers working in a U.K. Category B therapeutic community prison were interviewed about their working lives, including their own participation in therapy. Following a thematic analysis approach, key findings indicated that the physical and cultural work environment was very important to staff; the therapeutic element of their job role, although demanding, was both satisfying and rewarding; and that working in a therapeutic prison environment provided the opportunity for personal as well as professional development. We conclude that further attention should be given to the unique nature of therapeutic prison work and the positive impact it can have on well-being at work.

Putative periodontopathic bacteria and herpesviruses in pregnant women: a case-control study

OpenAIRE

Lu, Haixia; Zhu, Ce; Li, Fei; Xu, Wei; Tao, Danying; Feng, Xiping

2016-01-01

Little is known about herpesvirus and putative periodontopathic bacteria in maternal chronic periodontitis. The present case-control study aimed to explore the potential relationship between putative periodontopathic bacteria and herpesviruses in maternal chronic periodontitis.Saliva samples were collected from 36 pregnant women with chronic periodontitis (cases) and 36 pregnant women with healthy periodontal status (controls). Six putative periodontopathic bacteria (Porphyromonas gingivalis ...

Circulating MicroRNA Responses between 'High' and 'Low' Responders to a 16-Wk Diet and Exercise Weight Loss Intervention.

Science.gov (United States)

Parr, Evelyn B; Camera, Donny M; Burke, Louise M; Phillips, Stuart M; Coffey, Vernon G; Hawley, John A

2016-01-01

Interactions between diet, physical activity and genetic predisposition contribute to variable body mass changes observed in response to weight loss interventions. Circulating microRNAs (c-miRNAs) may act as 'biomarkers' that are associated with the rate of change in weight loss, and/or play a role in regulating the biological variation, in response to energy restriction. To quantify targeted c-miRNAs with putative roles in energy metabolism and exercise adaptations following a 16 wk diet and exercise intervention in individuals with large (high responders; HiRes) versus small (low responders; LoRes) losses in body mass. From 89 male and female overweight/obese participants who completed the intervention (energy restriction from diet, 250 kcal/d, and exercise, 250 kcal/d), subgroups of HiRes (>10% body mass loss, n = 22) and LoRes (exercise and diet intervention suggests a putative role for these 'biomarkers' in the prediction or detection of individual variability to weight loss interventions.

Diffusion MRI: A New Strategy for Assessment of Cancer Therapeutic Efficacy

OpenAIRE

Thomas L. Chenevert; Charles R. Meyer; Bradford A. Moffat; Alnawaz Rehemtulla; Suresh K. Mukherji; Stephen S. Gebarski; Douglas J. Quint; Patricia L. Robertson; Theodore S. Lawrence; Larry Junck; Jeremy M. G. Taylor; Timothy D. Johnson; Qian Dong; Karin M. Muraszko; James A. Brunberg

2002-01-01

The use of anatomical imaging in clinical oncology practice traditionally relies on comparison of patient scans acquired before and following completion of therapeutic intervention. Therapeutic success is typically determined from inspection of gross anatomical images to assess changes in tumor size. Imaging could provide significant additional insight into therapeutic impact if a specific parameter or combination of parameters could be identified which reflect tissue changes at the cellular ...

Trichogram To Monitor Therapeutic Benefit In Hair Loss

Directory of Open Access Journals (Sweden)

Uppal Monica

2004-01-01

Full Text Available Trichogram is a method of quantifying hair. We report 3 cases of diffuse hair loss of varying etiology in whom the improvement after therapeutic intervention could be objectively documented using trichogram.

Attribution Theory and Crisis Intervention Therapy.

Science.gov (United States)

Skilbeck, William M.

It was proposed that existing therapeutic procedures may influence attributions about emotional states. Therefore an attributional analysis of crisis intervention, a model of community-based, short-term consultation, was presented. This analysis suggested that crisis intervention provides attributionally-relevant information about both the source…

Psychosocial Benefits of Cooking Interventions: A Systematic Review

Science.gov (United States)

Farmer, Nicole; Touchton-Leonard, Katherine; Ross, Alyson

2018-01-01

Objectives: Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods: A systematic review of the…

Role of interventional radiology in the management of acute gastrointestinal bleeding

Science.gov (United States)

Ramaswamy, Raja S; Choi, Hyung Won; Mouser, Hans C; Narsinh, Kazim H; McCammack, Kevin C; Treesit, Tharintorn; Kinney, Thomas B

2014-01-01

Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB. PMID:24778770

Digital Therapeutics: An Integral Component of Digital Innovation in Drug Development.

Science.gov (United States)

Sverdlov, Oleksandr; van Dam, Joris; Hannesdottir, Kristin; Thornton-Wells, Tricia

2018-07-01

Digital therapeutics represent a new treatment modality in which digital systems such as smartphone apps are used as regulatory-approved, prescribed therapeutic interventions to treat medical conditions. In this article we provide a critical overview of the rationale for investing in such novel modalities, including the unmet medical needs addressed by digital therapeutics and the potential for reducing current costs of medical care. We also discuss emerging pathways to regulatory approval and how innovative business models are enabling further growth in the development of digital therapeutics. We conclude by providing some recent examples of digital therapeutics that have gained regulatory approval and highlight opportunities for the near future. © 2018 American Society for Clinical Pharmacology and Therapeutics.

Deterministic effects of interventional radiology procedures

International Nuclear Information System (INIS)

Shope, Thomas B.

1997-01-01

The purpose of this paper is to describe deterministic radiation injuries reported to the Food and Drug Administration (FDA) that resulted from therapeutic, interventional procedures performed under fluoroscopic guidance, and to investigate the procedure or equipment-related factors that may have contributed to the injury. Reports submitted to the FDA under both mandatory and voluntary reporting requirements which described radiation-induced skin injuries from fluoroscopy were investigated. Serious skin injuries, including moist desquamation and tissues necrosis, have occurred since 1992. These injuries have resulted from a variety of interventional procedures which have required extended periods of fluoroscopy compared to typical diagnostic procedures. Facilities conducting therapeutic interventional procedures need to be aware of the potential for patient radiation injury and take appropriate steps to limit the potential for injury. (author)

Caspase dependent programmed cell death in developing embryos: a potential target for therapeutic intervention against pathogenic nematodes.

Directory of Open Access Journals (Sweden)

Alok Das Mohapatra

2011-09-01

developing embryos can be a potential approach for therapeutic intervention against pathogenic nematodes and flow cytometry can be used to address different issues of biological importance during embryogenesis of parasitic worms.

Therapeutic horticulture in clinical depression: a prospective study.

Science.gov (United States)

Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil W; Kirkevold, Marit

2009-01-01

Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N=18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p or =6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N=16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.

Innovative Therapeutic Intervention for Children: Animal-Assisted Therapy in South Australia

Science.gov (United States)

Jones, Mel

2018-01-01

Unique approaches are important to explore for every aspect of our work with children, including therapeutic support for traumatized children. Sometimes, these techniques involve inviting some furry friends into the classroom.

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

DEFF Research Database (Denmark)

Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang

2017-01-01

radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement...... and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping...

Circulating MicroRNA Responses between ‘High’ and ‘Low’ Responders to a 16-Wk Diet and Exercise Weight Loss Intervention

Science.gov (United States)

Parr, Evelyn B.; Camera, Donny M.; Burke, Louise M.; Phillips, Stuart M.; Coffey, Vernon G.; Hawley, John A.

2016-01-01

Background Interactions between diet, physical activity and genetic predisposition contribute to variable body mass changes observed in response to weight loss interventions. Circulating microRNAs (c-miRNAs) may act as ‘biomarkers’ that are associated with the rate of change in weight loss, and/or play a role in regulating the biological variation, in response to energy restriction. Objective To quantify targeted c-miRNAs with putative roles in energy metabolism and exercise adaptations following a 16 wk diet and exercise intervention in individuals with large (high responders; HiRes) versus small (low responders; LoRes) losses in body mass. Methods From 89 male and female overweight/obese participants who completed the intervention (energy restriction from diet, 250 kcal/d, and exercise, 250 kcal/d), subgroups of HiRes (>10% body mass loss, n = 22) and LoRes (exercise and diet intervention suggests a putative role for these ‘biomarkers’ in the prediction or detection of individual variability to weight loss interventions. PMID:27101373

The importance of the genomic landscape in Waldenström's Macroglobulinemia for targeted therapeutical interventions.

Science.gov (United States)

Sacco, Antonio; Fenotti, Adriano; Affò, Loredana; Bazzana, Stefano; Russo, Domenico; Presta, Marco; Malagola, Michele; Anastasia, Antonella; Motta, Marina; Patterson, Christopher J; Rossi, Giuseppe; Imberti, Luisa; Treon, Steven P; Ghobrial, Irene M; Roccaro, Aldo M

2017-05-23

The Literature has recently reported on the importance of genomics in the field of hematologic malignancies, including B-cell lymphoproliferative disorders such as Waldenström's Macrolgobulinemia (WM). Particularly, whole exome sequencing has led to the identification of the MYD88L265P and CXCR4C1013G somatic variants in WM, occurring in about 90% and 30% of the patients, respectively. Subsequently, functional studies have demonstrated their functional role in supporting WM pathogenesis and disease progression, both in vitro and in vivo, thus providing the pre-clinical evidences for extremely attractive targets for novel therapeutic interventions in WM. Of note, recent evidences have also approached and defined the transcriptome profiling of WM cells, revealing a signature that mirrors the somatic aberrations demonstrated within the tumor clone. A parallel research field has also reported on microRNAs (miRNAs), highlighting the oncogenic role of miRNA-155 in WM. In the present review, we focus on the latest reports on genomics and miRNAs in WM, providing an overview of the clinical relevance of the latest acquired knowledge about genomics and miRNA aberrations in WM.

Opportunity of interventional radiology: advantages and application of interventional technique in biological target therapy

International Nuclear Information System (INIS)

Teng Gaojun; Lu Qin

2007-01-01

Interventional techniques not only provide opportunity of treatment for many diseases, but also alter the traditional therapeutic pattern. With the new century of wide application of biological therapies, interventional technique also shows extensive roles. The current biological therapy, including gene therapy, cell transplantation therapy, immunobiologic molecule therapy containing cell factors, tumor antibody or vaccine, recombined proteins, radioactive-particles and targeting materials therapy, can be locally administrated by interventional techniques. The combination of targeting biological therapies and high-targeted interventional technique holds advantages of minimal invasion, accurate delivery, vigorous local effect, and less systemic adverse reactions. Authors believe that the biological therapy may arise a great opportunity for interventional radiology, therefore interventional colleagues should grasp firmly and promptly for the development and extension in this field. (authors)

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part v - EUS-Guided Therapeutic Interventions (short version)

DEFF Research Database (Denmark)

Fusaroli, P; Jenssen, C.; Hocke, Martine

2016-01-01

and block, vascular intervention, drainage of fluid collections, drainage of biliary and pancreatic ducts, and experimental tumor ablation techniques are discussed. For each topic, all current evidence has been extensively analyzed and summarized into major recommendations for reader consultation (short...

Interventional embolization with coils for the treatment of surgical stoma bleeding caused by portal hypertension: a therapeutic analysis

International Nuclear Information System (INIS)

Chen Feng; Chen Shiwei; Qiao Delin; Tang Zhen

2010-01-01

Objective: To assess the feasibility and safety of interventional embolization with coils in treating surgical stoma bleeding caused by portal hypertension. Methods: From February 2008 to May 2010, the authors treated eight patients with surgical stoma bleeding associated with portal hypertension. The patients included 5 females and 3 males, with a mean age of 57 years. The diagnosis was confirmed preoperatively by enhanced CT scanning and vascular reconstruction, and was further verified by angiography after operation. All patients were treated with coil embolization. The percutaneous transhepatic catheterization was performed, after that the catheter was manipulated to pass portal vein into the tortuous dilated mesenteric vein. The bleeding veins were occluded with gelatin sponge, and the spleen was embolized at the same time. The patients were followed up for two months to two years. Based on CT angiographic manifestations, color-Doppler ultrasound findings and clinical conditions the therapeutic results were evaluated. Results: Technical success with single procedure was achieved in all eight patients, the hemostasis rate was 100%. No serious complications occurred. During the follow-up period no recurrent bleeding of the surgical stoma was seen. Conclusion: For the treatment of surgical stoma bleeding caused by portal hypertension interventional embolization with coils is a safe and effective technique. It is worth popularizing this method in clinical practice. (authors)

Therapeutic interventions for acute hamstring injuries: A systematic review

NARCIS (Netherlands)

G. Reurink (Gustaaf); G.J. Goudswaard (Gert Jan); J.L. Tol (Johannes); J.A.N. Verhaar (Jan); A. Weir (Adam); M.H. Moen (Maaike)

2012-01-01

textabstractBackground Despite the high rate of hamstring injuries, there is no consensus on their management, with a large number of different interventions being used. Recently several new injection therapies have been introduced. Objective To systematically review the literature on the

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2011-03-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Interventional chest procedures in pregnancy.

LENUS (Irish Health Repository)

Morgan, Ross K

2012-02-01

Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

Effect of shared decision-making on therapeutic alliance in addiction health care

Directory of Open Access Journals (Sweden)

EAG Joosten

2008-10-01

Full Text Available EAG Joosten1,2, GH de Weert3, T Sensky4, CPF van der Staak5, CAJ de Jong1,21Novadic-Kentron, Network for Addiction Treatment Services, Vught, the Netherlands; 2Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA, Nijmegen, the Netherlands; 3Julius Center for Health Sciences and Primary Health Care, UMC Utrecht, Utrecht, the Netherlands; 4Department of Psychological Medicine, Imperial College London, London, United Kingdom; 5Academic Centre for Social Sciences, Radboud University Nijmegen, Nijmegen, the NetherlandsBackground: In recent decades, shared decision-making (SDM models have been developed to increase patient involvement in treatment decisions. The purpose of this study was to examine the effect of a shared decision-making intervention (SDMI for substance-dependent patients on patients’ and clinicians’ perceptions of therapeutic alliance.Methods: Clinicians were randomly assigned to SDMI or usual procedures to reach a treatment agreement. SDMI is a structured, manualized, 5-session procedure to facilitate treatment agreement and consists of five standardized sessions.Results: Patients’ perceptions of the therapeutic alliance were very favorable at start of treatment, and no differences were found between intervention groups. Clinicians’ scores on perceived helpfulness and on the overall therapeutic alliance were higher in the SDMI group than in the controls, after 8 weeks of treatment and at the end of treatment.Conclusion: The present study has shown that a specific intervention to enhance shared decision-making results in favorable changes in clinicians’ perceptions of the therapeutic alliance.Keywords: therapeutic alliance, helping alliance, shared decision-making, addiction, substance-dependence

Organoid technology for brain and therapeutics research.

Science.gov (United States)

Wang, Zhi; Wang, Shu-Na; Xu, Tian-Ying; Miao, Zhu-Wei; Su, Ding-Feng; Miao, Chao-Yu

2017-10-01

Brain is one of the most complex organs in human. The current brain research is mainly based on the animal models and traditional cell culture. However, the inherent species differences between humans and animals as well as the gap between organ level and cell level make it difficult to study human brain development and associated disorders through traditional technologies. Recently, the brain organoids derived from pluripotent stem cells have been reported to recapitulate many key features of human brain in vivo, for example recapitulating the zone of putative outer radial glia cells. Brain organoids offer a new platform for scientists to study brain development, neurological diseases, drug discovery and personalized medicine, regenerative medicine, and so on. Here, we discuss the progress, applications, advantages, limitations, and prospects of brain organoid technology in neurosciences and related therapeutics. © 2017 John Wiley & Sons Ltd.

[Therapeutic effect of early applying hydrotherapy with Chinese drugs on children hypoxic ischemic encephalopathy].

Science.gov (United States)

Ma, Yun-Zhi; Zhai, Hong-Yin; Su, Chun-Ya

2009-02-01

To observe the therapeutic effect of hydrotherapy with Chinese drugs (HT-C) in early intervention on children hypoxic ischemic encephalopathy (HIE). HIE children were assigned to the treatment group and the control group, 50 in each, at random depending on the willingness of patients' parents. Both groups received the conventional functional training, according to the "0 -3-year-old early intervention outline", but for the treatment group, HT-C was applied additionally. Indexes for quality of sleep, gross motor function, severity of spasm and intellectual development were observed and compared before and after treatment to assess the therapeutic effects. Therapeutic effect in the treatment group was better than that in the control group in all the indexes observed, showing statistical significance (all P <0.05). Early intervention of HT-C could improve clinical symptom, promote the functional recovery and intellectual development in children HIE, and also could reduce or prevent the sequelae occurrence of the nervous system in them.

Interventions for motor apraxia following stroke.

Science.gov (United States)

West, C; Bowen, A; Hesketh, A; Vail, A

2008-01-23

Apraxia is a cognitive disorder that can occur after stroke. It prevents a person from carrying out a learned movement. Various interventions are used to treat apraxia but evidence of their benefit has been lacking. To determine which therapeutic interventions targeted at motor apraxia reduce disability. We searched the Cochrane Stroke Group Trials Register (last searched November 2006). In addition, we searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2006), CINAHL (1982 to November 2006), PsycINFO (1974 to November 2006), the Research Index of the Occupational Therapy Journal (searched November 2006), REHABDATA (1956 to November 2006), the National Research Register (searched November 2006) and Current Controlled Trials Register (searched November 2006). We reviewed the reference lists of all articles that we identified as relevant. We made efforts to find both published and unpublished trials by writing to key authors and journals. Randomised controlled trials of therapeutic intervention for motor apraxia in stroke. One review author searched the titles, abstracts and keywords. Four review authors extracted data and analysed trial quality. We contacted investigators for further details of trials if necessary. Three trials including a total of 132 participants were included in the review. There was evidence of a small and short-lived therapeutic effect in the two studies that reported change in activities of daily living (102 participants) but this was not considered clinically significant and did not persist at the longer-term follow up. There is insufficient evidence to support or refute the effectiveness of specific therapeutic interventions for motor apraxia after stroke. Further research of higher quality is required. As we did not review whether patients with apraxia benefit from rehabilitation input in general, they

Animal-assisted intervention and social skills strengthening

OpenAIRE

Božič, Tjaša

2014-01-01

The diploma thesis describe animal-assisted interventions, more precisely, the significance of animal-assisted interventions for strengthening of social skills. Theoretical part includes a detailed presentation of the benefits of therapeutic dog in work with vulnerable populations. I focused on delimitation of the term animal-assisted interventions which includes animal-assisted therapy and animal-assisted activity and the differences and similarities between them. I continued with therapeuti...

BET inhibitors in metastatic prostate cancer: therapeutic implications and rational drug combinations.

Science.gov (United States)

Markowski, Mark C; De Marzo, Angelo M; Antonarakis, Emmanuel S

2017-12-01

The bromodomain and extra-terminal (BET) family of proteins are epigenetic readers of acetylated histones regulating a vast network of protein expression across many different cancers. Therapeutic targeting of BET is an attractive area of clinical development for metastatic castration-resistant prostate cancer (mCRPC), particularly due to its putative effect on c-MYC expression and its interaction with the androgen receptor (AR). Areas covered: We speculate that a combination approach using inhibitors of BET proteins (BETi) with other targeted therapies may be required to improve the therapeutic index of BET inhibition in the management of prostate cancer. Preclinical data has identified several molecular targets that may enhance the effect of BET inhibition in the clinic. This review will summarize the known preclinical data implicating BET as an important therapeutic target in advanced prostate cancer, highlight the ongoing clinical trials targeting this protein family, and speculate on rationale combination strategies using BETi together with other agents in prostate cancer. A literature search using Pubmed was performed for this review. Expert opinion: Use of BETi in the treatment of mCRPC patients may require the addition of a second novel agent.

Descriptive analysis of the verbal behavior of a therapist: a known-group validity analysis of the putative behavioral functions involved in clinical interaction.

Science.gov (United States)

Virues-Ortega, Javier; Montaño-Fidalgo, Montserrat; Froján-Parga, María Xesús; Calero-Elvira, Ana

2011-12-01

This study analyzes the interobserver agreement and hypothesis-based known-group validity of the Therapist's Verbal Behavior Category System (SISC-INTER). The SISC-INTER is a behavioral observation protocol comprised of a set of verbal categories representing putative behavioral functions of the in-session verbal behavior of a therapist (e.g., discriminative, reinforcing, punishing, and motivational operations). The complete therapeutic process of a clinical case of an individual with marital problems was recorded (10 sessions, 8 hours), and data were arranged in a temporal sequence using 10-min periods. Hypotheses based on the expected performance of the putative behavioral functions portrayed by the SISC-INTER codes across prevalent clinical activities (i.e., assessing, explaining, Socratic method, providing clinical guidance) were tested using autoregressive integrated moving average (ARIMA) models. Known-group validity analyses provided support to all hypotheses. The SISC-INTER may be a useful tool to describe therapist-client interaction in operant terms. The utility of reliable and valid protocols for the descriptive analysis of clinical practice in terms of verbal behavior is discussed. Copyright © 2011. Published by Elsevier Ltd.

The interventional therapy of lung abscess

International Nuclear Information System (INIS)

Huang Changcen

2000-01-01

Objective: To observe the therapeutic effect of chronic lung abscess by interventional therapy under CT guidance. Methods: The group consisted of 12 patients. Firstly, the positions of abscess were localized by CT, secondly under CT guidance puncturing into the abscess with a needle and then thirdly, drain aging through the abscess and injecting some antibiotics through the needle. The treatment consisted by 16 times with an average drawing volume out 10-100 ml, during 18-28 days as a course. All patients were cured. Conclusion: The interventional therapy under CT guidance for chronic lung abscess can increase the therapeutic effect, decrease the course of treatment and avoid the operation. Therefore, it is a safe, simple and convenient method

Method selection and evaluation of midtrimester and long-term therapeutic efficiency of achalasia with three methods of interventional procedure

International Nuclear Information System (INIS)

Cheng Yingsheng; Yang Renjie; Li Minghua; Chen Weixiong; Shang Kezhong; Zhuang Qixin; Xu Jianrong; Chen Niwei; Zhu Yude

2000-01-01

Objective: To study method selection and evaluation of midtrimester and long-term therapeutic efficiency of achalasia with three methods of interventional procedure. Method: 50 cases achalasia with 30 cases performing with balloon dilation (group A) and 5 cases with permanent metallic internal stent dilation (group B) and 15 cases with temporary metallic internal stent dilation (group C) under fluoroscopy. Results: 30 cases of group A had 56 times of dilations (mean 1.9 times). The mean diameter of cardia was (2.4 +- 1.2) mm before dilation and (9.7 +- 3.0) mm after dilation. The mean dysphagia scores were 2.4 +- 1.2 grades before dilation and 1.0 +- 0.3 grades after dilation. Complications in 30 cases included chest pain (n = 9), reflux (n = 8) and bleeding (n = 3). 18(60%) of 30 cases showed dysphagia relapse during follow-up over 6 months, 18(90%) of 20 cases showed dysphagia relapse during follow-up over 12 months. 5 uncovered expandable metal stents were permanently placed in 5 cases of group B. The mean diameter of cardia was (3.2 +- 2.0) mm before dilation and (18.4 +- 1.7) mm after dilation. The mean dysphagia scores were (2.4 +- 1.1) grade before dilation and (0.4 +- 0.2) grade after dilation. Complications in 5 cases included chest pain (n = 3), reflux (n = 4), bleeding (n = 1) and hyperplasia of granulation tissue (n 2). 3(60%) in 5 cases showed dysphagia relapse during follow-up over 6 months, 1(50%) in 2 cases were dysphagia relapse during follow-up over 12 months. 15 covered expandable metal stents were temporarily placed in 15 cases of group C and drawn out at the 3-7 days via gastroscopy. The mean diameter of cardia was (3.4 +- 2.9) mm before dilation and (14.7 +- 2.9) mm after dilation. The mean dysphagia scores were (2.5 +- 1.1) grades before dilation and (0.6 +- 0.3) grades after dilation. Complications in 15 cases included chest pain (n = 3), reflux (n = 3) and bleeding (n = 2). 3(20%) in 15 cases showed dysphagia relapse during follow-up over 6

Therapeutic Effects of Extinction Learning as a Model of Exposure Therapy in Rats

Science.gov (United States)

Fucich, Elizabeth A; Paredes, Denisse; Morilak, David A

2016-01-01

Current treatments for stress-related psychiatric disorders, such as depression and posttraumatic stress disorder (PTSD), are inadequate. Cognitive behavioral psychotherapies, including exposure therapy, are an alternative to pharmacotherapy, but the neurobiological mechanisms are unknown. Preclinical models demonstrating therapeutic effects of behavioral interventions are required to investigate such mechanisms. Exposure therapy bears similarity to extinction learning. Thus, we investigated the therapeutic effects of extinction learning as a behavioral intervention to model exposure therapy in rats, testing its effectiveness in reversing chronic stress-induced deficits in cognitive flexibility and coping behavior that resemble dimensions of depression and PTSD. Rats were fear-conditioned by pairing a tone with footshock, and then exposed to chronic unpredictable stress (CUS) that induces deficits in cognitive set-shifting and active coping behavior. They then received an extinction learning session as a therapeutic intervention by repeated exposure to the tone with no shock. Effects on cognitive flexibility and coping behavior were assessed 24 h later on the attentional set-shifting test or shock-probe defensive burying test, respectively. Extinction reversed the CUS-induced deficits in cognitive flexibility and coping behavior, and increased phosphorylation of ribosomal protein S6 in the medial prefrontal cortex (mPFC) of stress-compromised rats, suggesting a role for activity-dependent protein synthesis in the therapeutic effect. Inhibiting protein synthesis by microinjecting anisomycin into mPFC blocked the therapeutic effect of extinction on cognitive flexibility. These results demonstrate the utility of extinction as a model by which to study mechanisms underlying exposure therapy, and suggest these mechanisms involve protein synthesis in the mPFC, the further study of which may identify novel therapeutic targets. PMID:27417516

[Clinical use of interventional MR imaging].

Science.gov (United States)

Kahn, Thomas; Schulz, Thomas; Moche, Michael; Prothmann, Sascha; Schneider, Jens-Peter

2003-01-01

The integration of diagnostic and therapeutic procedures by MRI is based on the combination of excellent morphologic and functional imaging. The spectrum of MR-guided interventions includes biopsies, thermal ablation procedures, vascular applications, and intraoperative MRI. In all these applications, different scientific groups have obtained convincing results in basic developments as well as in clinical use. Interventional MRI (iMRI) is expected to attain an important role in interventional radiology, minimal invasive therapy, and monitoring of surgical procedures.

Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neoadjuvant Therapy in Women with Stage I–III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue

Directory of Open Access Journals (Sweden)

Désirée Lötzke

2016-01-01

Full Text Available This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neoadjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI (n=45 or for a physical exercise intervention (PEI (n=47. Measurements were obtained before (t0 and after the intervention (t1 as well as 3 months after finishing intervention (t2 using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p<0.05 but not under YI (t0 to t2. Regarding quality of life (EORTC QLQ-C30 a direct effect (t0 to t1; p<0.001 of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p<0.001 were observed at both t1 and t2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t1 nor for t2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

Evaluation of somatostatin and nucleolin receptors for therapeutic delivery in non-small cell lung cancer stem cells applying the somatostatin-analog DOTATATE and the nucleolin-targeting aptamer AS1411

DEFF Research Database (Denmark)

Holmboe, Sif; Hansen, Pernille Lund; Thisgaard, Helge

2017-01-01

Cancer stem cells represent the putative tumor-driving subpopulation thought to account for drug resistance, relapse, and metastatic spread of epithelial and other cancer types. Accordingly, cell surface markers for therapeutic delivery to cancer stem cells are subject of intense research. Somato...

A prospective study of existential issues in therapeutic horticulture for clinical depression.

Science.gov (United States)

Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil Wilhelm; Kirkevold, Marit

2011-01-01

Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants' open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.

Diffusion MRI: A New Strategy for Assessment of Cancer Therapeutic Efficacy

Directory of Open Access Journals (Sweden)

Thomas L. Chenevert

2002-10-01

Full Text Available The use of anatomical imaging in clinical oncology practice traditionally relies on comparison of patient scans acquired before and following completion of therapeutic intervention. Therapeutic success is typically determined from inspection of gross anatomical images to assess changes in tumor size. Imaging could provide significant additional insight into therapeutic impact if a specific parameter or combination of parameters could be identified which reflect tissue changes at the cellular or physiologic level. This would provide an early indicator of treatment response/outcome in an individual patient before completion of therapy. Moreover, response of a tumor to therapeutic intervention may be heterogeneous. The use of imaging could assist in delineating therapeutic-induced spatial heterogeneity within a tumor mass by providing information related to specific regions that are resistant or responsive to treatment. Largely untapped potential resides in exploratory methods such as diffusion MRI, which is a non-volumetric intravoxel measure of tumor response based upon water molecular mobility. Alterations in water mobility reflect changes in tissue structure at the cellular level. While the clinical utility of diffusion MRI for oncologic practice is still under active investigation, this overview on the use of diffusion MRI for the evaluation of brain tumors will serve to introduce how this approach may be applied in the future for the management of patients with solid tumors.

[Music-based intervention in children].

Science.gov (United States)

Kiese-Himmel, Christiane

2012-01-01

Music-based interventions with children are an effective method in health and sickness treatment and in education systems. The engagement with music enables positive transfer effects on extra-musical developmental domains. Music therapy was applied primarily as a practically-oriented scientific discipline both within the framework of a multi-modal therapy approach as one treatment component and focused specifically on children with emotional disorders within a somatic therapy concept and in rehabilitation. The following narrative overview will present music therapy's working basis, treatment goals, and select outcome research in children from 2005-2010. There currently exists a substantial lack, even within empirical research, in relation to the application of music therapy to children. This is an opportunity to initiate a broad range of study for the future. Current challenges and opportunities in scientific, music-based intervention in the paediatric population lie in the concretization of differential indications (both in intervention approach and duration), replicable comparative therapy (alternated treatment-design), the application of a music-therapeutic placebo requirement, as well as in the verification and analysis of specific music therapeutic mechanisms.

Update on therapeutic interventions for the management of achalasia.

Science.gov (United States)

Gunasingam, Nishmi; Perczuk, Adam; Talbot, Michael; Kaffes, Arthur; Saxena, Payal

2016-08-01

Achalasia is a primary esophageal motility disorder. It is the absence of peristalsis in the esophageal body and inability of the lower esophageal sphincter to relax, which characterizes this rare condition. Its features typically include dysphagia, regurgitation, chest pain, and weight loss. The ultimate goal in treating achalasia is to relieve the patient's symptoms, improve esophageal emptying, and prevent further dilatation of the esophagus. Current treatment modalities targeted at achalasia include pharmacological therapy, endoscopic therapy, and surgery. This review focuses on the current therapeutic options and explores the role of peroral endoscopic myotomy in the management armamentarium. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Cost-benefit analysis of internet therapeutic intervention on patients with diabetes.

Science.gov (United States)

Deng, Lan; White, Adam S; Pawlowska, Monika; Pottinger, Betty; Aydin, Jessica; Chow, Nelson; Tildesley, Hugh D

2015-04-01

With the emergence of IBGMS for allowing for patients to communicate their self-monitored blood glucose (SMBG) readings with their health care providers, their impact on the management of diabetes is becoming well-supported with regards to clinical benefits. Their impact on healthcare costs, however, has yet to be investigated. This study aims to determine the cost-benefits of such interventions in comparison to routine care. To analyze the cost-benefit of an Internet Blood Glucose Monitoring Service (IBGMS) in comparison to routine diabetes care. 200 patients were surveyed to assess the cost associated with doctor appointments in the past 12 months. Annual number of visits to medical services for diabetes and costs of transportation, parking, and time taken off work for visits were surveyed. Self-reported frequency of SMBG and most recent A1C were also surveyed. We compared 100 patients who used the IBGMS with 100 patients who only used routine care. There is a trend of lowered total cost in the intervention group compared to the control group. The control group spent $210.89 per year on visits to physicians; the intervention group spent $131.26 (P = 0.128). Patients in control group visited their endocrinologist 1.76 times per year, those in intervention group visited their endocrinologist 1.36 times per year, significantly less frequently than the control group (P = 0.014). Number of visits to other medical services is similar between the groups. Average A1C in intervention group is 7.57%, in control group is 7.69% (P = 0.309). We have demonstrated that IBGMS, while not reaching statistical significance, may be associated with slightly reduced A1C and cost due to visiting physicians.

Cerebellar neurophysiology in Gilles de la Tourette syndrome and its role as a target for therapeutic intervention.

Science.gov (United States)

Pedroarena-Leal, Nicole; Ruge, Diane

2017-09-01

Therapy resistance of approximately one-third of patients with Gilles de la Tourette syndrome (GTS) requires consideration of alternative therapeutic interventions. The article demonstrates the role of the cerebellum in neuropsychiatric disorders and GTS in particular, specifically its role in functions relating to motor and cognitive symptoms. Certain circuits in the cerebellum have been shown to undergo learning-induced changes during conditioning, with cells in the cortex of the cerebellum appearing to decrease their activity whilst those in deep nuclei seem to do the inverse. Evidence exists showing that abnormal excitability of the motor cortex via the cerebellum could be expected to participate in motor tics in GTS possibly due to aberrations in certain structures of involved circuits. The role of the cerebellum in learning and plasticity processes renders it a strategic and valuable structure to consider for brain stimulation when investigating potential treatment options for neuropsychiatric disorders such as GTS. This article puts forth the concept of using non-invasive and invasive brain stimulation techniques as a novel platform for non-pharmacological neuromodulation of GTS symptoms. © 2015 The British Psychological Society.

Interventional treatment of diabetic ischemic diseases of lower limb:a therapeutic observation

International Nuclear Information System (INIS)

Wang Zhaoyang; Liu Xiang

2010-01-01

Objective: To assess the clinical effects of endovascular interventional treatment for diabetic ischemic diseases of lower limb. Methods: Endovascular interventional management was performed in 47 patients with diabetic ischemic diseases of lower limb. The ankle-to-brachial index and the diameter of lower limb vessel were estimated both before the treatment and 3, 30 days after the treatment. The results were compared and analyzed. Results: Obvious improvement in ankle-to-brachial index and the diameter of lower limb vessel were observed after the treatment. Conclusion: Endovascular interventional treatment is very effective and reliable for diabetic ischemic diseases of lower limb. (authors)

Current therapeutic interventions in the glycation pathway: evidence from clinical studies.

Science.gov (United States)

Engelen, L; Stehouwer, C D A; Schalkwijk, C G

2013-08-01

The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia-induced micro- and macrovascular disease in diabetes. In vitro and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential clinical value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE-inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The clinical evidence on the potential AGE-inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub-optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing. © 2012 Blackwell Publishing Ltd.

MicroRNA silencing in primates: towards development of novel therapeutics

DEFF Research Database (Denmark)

Petri, Andreas; Lindow, Morten; Kauppinen, Sakari

2009-01-01

MicroRNAs (miRNA) comprise an abundant class of small noncoding RNAs that act as important posttranscriptional regulators of gene expression. Accumulating evidence showing that aberrantly expressed miRNAs play important roles in human cancers underscores them as potential targets for therapeutic ...... intervention. Recent reports on efficient miRNA silencing in rodents and nonhuman primates using high-affinity targeting by chemically modified antisense oligonucleotides highlight the utility of such compounds in the development of miRNA-based cancer therapeutics....

A review of vagus nerve stimulation as a therapeutic intervention

Directory of Open Access Journals (Sweden)

Johnson RL

2018-05-01

Full Text Available Rhaya L Johnson,1 Christopher G Wilson1,2 1Lawrence D Longo MD Center for Perinatal Biology, Department of Basic Sciences, Loma Linda University, Loma Linda, CA, USA; 2Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA Abstract: In this review, we provide an overview of the US Food and Drug Administration (FDA-approved clinical uses of vagus nerve stimulation (VNS as well as information about the ongoing studies and preclinical research to expand the use of VNS to additional applications. VNS is currently FDA approved for therapeutic use in patients aged >12 years with drug-resistant epilepsy and depression. Recent studies of VNS in in vivo systems have shown that it has anti-inflammatory properties which has led to more preclinical research aimed at expanding VNS treatment across a wider range of inflammatory disorders. Although the signaling pathway and mechanism by which VNS affects inflammation remain unknown, VNS has shown promising results in treating chronic inflammatory disorders such as sepsis, lung injury, rheumatoid arthritis (RA, and diabetes. It is also being used to control pain in fibromyalgia and migraines. This new preclinical research shows that VNS bears the promise of being applied to a wider range of therapeutic applications. Keywords: vagus nerve stimulation, pediatrics, inflammation, peripheral nerve stimulation, autonomic circuits

Therapeutic Effects of Islamic Intercessory Prayer on Warts.

Science.gov (United States)

Hoşrik, Evren M; Cüceloğlu, Aydın E; Erpolat, Seval

2017-12-01

The present study aimed to examine the therapeutic effects of Islamic intercessory prayer on warts. Forty-five participants who are mostly Muslims and infected with warts were randomized into three groups: Group-1 (uncertain, with intercessory prayer), Group-2 (uncertain, no intercessory prayer), and control group (informed, no intervention). Stress symptoms were also measured before and after prayer sessions for these three groups. The results revealed that there were no significant differences between the groups in terms of healing. Although participants believed in the therapeutic effects of prayer, when participants did not trust the intercessor, prayer had no effect on warts.

CLONING, SEQUENCE ANALYSIS, AND CHARACTERIZATION OF PUTATIVE BETA-LACTAMASE OF STENOTROPHOMONAS MALTOPHILIA

Directory of Open Access Journals (Sweden)

Chong Seng Shueh

2012-10-01

Full Text Available The main objective of current study was to explore the function of chromosomal putative beta-lactamase gene (smlt 0115 in clinical Stenotrophomonas maltophilia. Antibiotic susceptibility test (AST screening for current antimicrobial drugs was done and Minimum Inhibitory Concentration (MIC level towards beta-lactams was determined by E-test. Putative beta-lactamase gene of S. maltophilia was amplified via PCR, with specific primers, then cloned into pET-15 expression plasmid and transformed into Escherichia coli BL21. The gene was sequenced and analyzed. The expressed protein was purified by affinity chromatography and the kinetic assay was performed. S. maltophilia ATCC 13637 was included in this experiment. Besides, a hospital strain which exhibited resistant to a series of beta-lactams including cefepime was identified via AST and MIC, hence it was named as S2 strain and was considered in this study. Sequencing result showed that putative beta-lactamase gene obtained from ATCC 13637 and S2 strains were predicted to have cephalosporinase activity by National Center for Biotechnology Information (NCBI blast program. Differences in the sequences of both ATCC 13637 and S2 strains were found via ClustalW alignment software. Kinetic assay proved a cephalosporinase characteristic produced by E. coli BL21 clone that overexpressed the putative beta-lactamase gene cloned under the control of an external promoter. Yet, expressed protein purified from S2 strain had high catalytic activity against beta-lactam antibiotics which was 14-fold higher than expressed protein purified from ATCC 13637 strain. This study represents the characterization analysis of putative beta-lactamase gene (smlt 0115 of S. maltophilia. The presence of the respective gene in the chromosome of S. maltophilia suggested that putative beta-lactamase gene (smlt 0115 of S. maltophilia plays a role in beta-lactamase resistance.

Paciente com paralisa cerebral coreoatetoide: evolução clínica pós-intervenção Patient with choreoathetoid cerebral palsy: post therapeutic intervention

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Carolina Castelli Silvério

2010-04-01

Full Text Available OBJETIVO: verificar a eficácia da intervenção terapêutica na função de deglutição e na estabilidade clínica de crianças portadoras de paralisia cerebral (PC coreoatetoide com disfagia orofaríngea. MÉTODOS: 11 crianças portadoras de PC do tipo coreoatetoide, com média de idade de três anos e três meses, que frequentaram terapia fonoaudiológica. Foram levantados os seguintes dados: escala de avaliação funcional da alimentação (Functional Oral Intake Scale - FOIS; grau de severidade da disfagia; broncopneumonias (BCP, hipersecretividade pulmonar e peso; consistência alimentar; sinais de penetração e/ou aspiração laringotraqueal. Os dados foram levantados no relatório de avaliação antes da intervenção terapêutica e no relatório final de evolução, no momento da alta. RESULTADOS: com relação à aplicação da escala FOIS, obteve-se que, tanto antes, quanto após a intervenção, a maioria dos pacientes encontrou-se no nível V da escala, com diminuição no segundo momento. Aumento dos pacientes nos níveis III e IV. Após intervenção terapêutica, houve diminuição de pacientes que ingeriam líquidos, aumento do uso do líquido espesso e do pastoso homogêneo. Houve diminuição da severidade da disfagia, redução dos episódios de BCP e de hipersecretividade pulmonar, aumento de peso e redução dos sinais de penetração e/ou aspiração laringotraqueal. CONCLUSÃO: a intervenção fonoaudiológica, dentro de uma equipe multidisciplinar em disfagia, em crianças portadoras de PC coreoatetoide promove deglutição mais segura e eficaz, com redução dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, dos episódios de BCP e de hipersecretividade pulmonar, e aumento do peso.PURPOSE: to investigate the efficacy of therapeutic intervention in swallowing and clinical stability of children with choreoathetoid cerebral palsy and oropharyngeal dysphagia. METHODS: 11 children with choreoathetoid

Nelson Syndrome: Update on Therapeutic Approaches.

Science.gov (United States)

Azad, Tej D; Veeravagu, Anand; Kumar, Sunny; Katznelson, Laurence

2015-06-01

To review the pathophysiology and therapeutic modalities availble for Nelson syndrome. We reviewed the current literature including managment for Nelson syndrome. For patients with NS, surgical intervention is often the first-line therapy. With refractory NS or tumors with extrasellar involvement, radiosurgery offers an important alternative or adjuvant option. Pharmacologic interventions have demonstrated limited usefulness, although recent evidence supports the feasibility of a novel somatostatin analog for patients with NS. Modern neuroimaging, improved surgical techniques, and the advent of stereotactic radiotherapy have transformed the management of NS. An up-to-date understanding of the pathophysiology underlying Nelson Syndrome and evidence-based management is imperative. Early detection may allow for more successful therapy in patients with Nelson Syndrome. Improved radiotherapeutic interventions and rapidly evolving pharmacologic therapies offer an opportunity to create targeted, multifocal treatment regiments for patients with Nelson Syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

Gut Microbiome and Putative Resistome of Inca and Italian Nobility Mummies.

Science.gov (United States)

Santiago-Rodriguez, Tasha M; Fornaciari, Gino; Luciani, Stefania; Toranzos, Gary A; Marota, Isolina; Giuffra, Valentina; Cano, Raul J

2017-11-07

Little is still known about the microbiome resulting from the process of mummification of the human gut. In the present study, the gut microbiota, genes associated with metabolism, and putative resistome of Inca and Italian nobility mummies were characterized by using high-throughput sequencing. The Italian nobility mummies exhibited a higher bacterial diversity as compared to the Inca mummies when using 16S ribosomal (rRNA) gene amplicon sequencing, but both groups showed bacterial and fungal taxa when using shotgun metagenomic sequencing that may resemble both the thanatomicrobiome and extant human gut microbiomes. Identification of sequences associated with plants, animals, and carbohydrate-active enzymes (CAZymes) may provide further insights into the dietary habits of Inca and Italian nobility mummies. Putative antibiotic-resistance genes in the Inca and Italian nobility mummies support a human gut resistome prior to the antibiotic therapy era. The higher proportion of putative antibiotic-resistance genes in the Inca compared to Italian nobility mummies may support the hypotheses that a greater exposure to the environment may result in a greater acquisition of antibiotic-resistance genes. The present study adds knowledge of the microbiome resulting from the process of mummification of the human gut, insights of ancient dietary habits, and the preserved putative human gut resistome prior the antibiotic therapy era.

A Functional Assay for Putative Mouse and Human Definitive Endoderm using Chick Whole-Embryo Cultures

DEFF Research Database (Denmark)

Johannesson, Martina; Semb, Tor Henrik; Serup, Palle

2012-01-01

. Thus, the purpose of this study is to describe a method whereby the in vivo functionality of DE derived from ESCs can be assessed. Methods: By directed differentiation, putative DE was derived from human and mouse ESCs. This putative DE was subsequently transplanted into the endoderm of chick embryos...... to determine any occurrence of integration. Putative DE was analyzed by gene and protein expression prior to transplantation and 48 h post transplantation. Results: Putative DE, derived from mouse and human ESCs, was successfully integrated within the chick endoderm. Endoderm-specific genes were expressed...... result show that putative DE integrates with the chick endoderm and participate in the development of the chicken gut, indicating the generation of functional DE from ESCs. This functional assay can be used to assess the generation of functional DE derived from both human and mouse ESCs and provides...

Antiviral Activities and Putative Identification of Compounds in Microbial Extracts from the Hawaiian Coastal Waters

Directory of Open Access Journals (Sweden)

Yuanan Lu

2012-02-01

Full Text Available Marine environments are a rich source of significant bioactive compounds. The Hawaiian archipelago, located in the middle of the Pacific Ocean, hosts diverse microorganisms, including many endemic species. Thirty-eight microbial extracts from Hawaiian coastal waters were evaluated for their antiviral activity against four mammalian viruses including herpes simplex virus type one (HSV-1, vesicular stomatitis virus (VSV, vaccinia virus and poliovirus type one (poliovirus-1 using in vitro cell culture assay. Nine of the 38 microbial crude extracts showed antiviral potencies and three of these nine microbial extracts exhibited significant activity against the enveloped viruses. A secosteroid, 5α(H,17α(H,(20R-beta-acetoxyergost-8(14-ene was putatively identified and confirmed to be the active compound in these marine microbial extracts. These results warrant future in-depth tests on the isolation of these active elements in order to explore and validate their antiviral potential as important therapeutic remedies.

[The place of a new drug in the therapeutic strategy].

Science.gov (United States)

Castaigne, A; Goehrs, J M; Ravoire, S

A therapeutic strategy is a hierarchical set of appropriate measures to provide an answer to a pathological state. A drug is a part of this set (together with the diagnosis, the environment and the other medicinal interventions or not). A new drug's place in a therapeutic strategy can be evaluated according to one or several referential(s) when it (or they) exist, referentials which express the state of knowledge before launch of the new drug. The drug's profile (indication or contraindication, etc.), at the point when the marketing authorization is given, is purely theoretical. One must evaluate the real place of the drug under its real conditions of use (pragmatic trials, observable surveys). A new drugs' place in a therapeutic strategy can only be evaluated in the course of time unless a therapeutic revolution occurs.

Therapeutic Approaches of Botulinum Toxin in Gynecology.

Science.gov (United States)

Moga, Marius Alexandru; Dimienescu, Oana Gabriela; Bălan, Andreea; Scârneciu, Ioan; Barabaș, Barna; Pleș, Liana

2018-04-21

Botulinum toxins (BoNTs) are produced by several anaerobic species of the genus Clostridium and, although they were originally considered lethal toxins, today they find their usefulness in the treatment of a wide range of pathologies in various medical specialties. Botulinum neurotoxin has been identified in seven different isoforms (BoNT-A, BoNT-B, BoNT-C, BoNT-D, BoNT-E, BoNT-F, and BoNT-G). Neurotoxigenic Clostridia can produce more than 40 different BoNT subtypes and, recently, a new BoNT serotype (BoNT-X) has been reported in some studies. BoNT-X has not been shown to actually be an active neurotoxin despite its catalytically active LC, so it should be described as a putative eighth serotype. The mechanism of action of the serotypes is similar: they inhibit the release of acetylcholine from the nerve endings but their therapeutically potency varies. Botulinum toxin type A (BoNT-A) is the most studied serotype for therapeutic purposes. Regarding the gynecological pathology, a series of studies based on the efficiency of its use in the treatment of refractory myofascial pelvic pain, vaginism, dyspareunia, vulvodynia and overactive bladder or urinary incontinence have been reported. The current study is a review of the literature regarding the efficiency of BoNT-A in the gynecological pathology and on the long and short-term effects of its administration.

The Role of Therapeutic Mentoring in Enhancing Outcomes for Youth in Foster Care

Science.gov (United States)

Johnson, Sara B.; Pryce, Julia M.; Martinovich, Zoran

2011-01-01

Effective service interventions greatly enhance the well-being of foster youth. A study of 262 foster youth examined one such intervention, therapeutic mentoring. Results showed that mentored youth improved significantly in the areas of family and social functioning, school behavior, and recreational activities, as well as in the reduction of…

Toddlers' Duration of Attention toward Putative Threat

Science.gov (United States)

Kiel, Elizabeth J.; Buss, Kristin A.

2011-01-01

Although individual differences in reactions to novelty in the toddler years have been consistently linked to risk of developing anxious behavior, toddlers' attention toward a novel, putatively threatening stimulus while in the presence of other enjoyable activities has rarely been examined as a precursor to such risk. The current study examined…

Periostin: a promising target of therapeutical intervention for prostate cancer

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Ding Weihong

2011-06-01

RNA-Periostin LNCap cells growed slowly in vitro and in vivo. The tissues of xenografts as PCa were verificated by HE staining. Additionally, the weak positive Periostin expressed tumor cells could be seen in the tissues of 6 xenografts from the group of down-regulated Periostin LNCap cells which had a significant decrease of the amount of Periostin compared to the other two group. Furthermore, our results demonstrated that sliencing Periostin could inhibit migration of LNCap cells in vitro. Conclusions Our data indicates that Periostin as an up-regulated protein in PCa may be a promising target of therapeutical intervention for PCa in future.

Groups and addictions: The therapeutic function of the relationship on substance abuse

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Calogero Lo Piccolo

2014-09-01

Full Text Available The paper shows how the therapeutic analytic group tackles the issue of pathological substance addiction, how the focus on intervention has changed in the course of the last years, especially as regards the social transformations which have changed the nature itself of dependence and of the underlying issues. Attention is drawn especially on the therapeutic value of the analytic group, seen as the preferred instrument for the transformative treatment of the issues underlying dependence in the contemporary world.Key words: lifestyles, consumer styles, therapeutic group, pathological dependencies, Trauma of the Future

Further understanding of the complications after orthotopic liver transplantation and their interventional management

International Nuclear Information System (INIS)

Shan Hong; Jiang Zaibo

2009-01-01

The majority of complications due to orthotopic liver transplantation (OLT)need interventional treatment. For arterial and venous complications after OLT, we have established clear and definite interventional therapeutic mode. However, it has been the difficult point as well as the weak point for interventional radiologists to treat the biliary complications. With the technical improvement and deep-going understanding, a part of biliary complications of OLT can be relieved or even finally be cured with percutaneous biliary drainage (PTBD) and endoscopic nasobiliary drainage (ENBD). For some patients, PTBD and ENBD seem to be the main palliative therapeutic means, which might accompany the patients for a lifetime. Now, it is an urgent demand to formulate the clinical therapeutic guidelines for the treatment of biliary complications after OLT. (authors)

Driving While Impaired (DWI) Intervention Service Provider Orientations: The Scales of the DWI Therapeutic Educator Inventory (DTEI)

Science.gov (United States)

DeMuro, Scott; Wanberg, Kenneth; Anderson, Rachel

2011-01-01

The therapeutic educator who provides services to driving while impaired (DWI) offenders is a unique professional hybrid, combining education and therapeutic service delivery. In an effort to understand and address this service provider, a 69-item DWI Therapeutic Educator Inventory (DTEI) was constructed. Using principal components and common…

Identification and characterization of putative conserved IAM ...

African Journals Online (AJOL)

Available putative AMI sequences from a wide array of monocot and dicot plants were identified and the phylogenetic tree was constructed and analyzed. We identified in this tree, a clade that contained sequences from species across the plant kingdom suggesting that AMI is conserved and may have a primary role in plant ...

Experimental Models of Status Epilepticus and Neuronal Injury for Evaluation of Therapeutic Interventions

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Ramkumar Kuruba

2013-09-01

Full Text Available This article describes current experimental models of status epilepticus (SE and neuronal injury for use in the screening of new therapeutic agents. Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures. SE is an emergency condition associated with continuous seizures lasting more than 30 min. It causes significant mortality and morbidity. SE can cause devastating damage to the brain leading to cognitive impairment and increased risk of epilepsy. Benzodiazepines are the first-line drugs for the treatment of SE, however, many people exhibit partial or complete resistance due to a breakdown of GABA inhibition. Therefore, new drugs with neuroprotective effects against the SE-induced neuronal injury and degeneration are desirable. Animal models are used to study the pathophysiology of SE and for the discovery of newer anticonvulsants. In SE paradigms, seizures are induced in rodents by chemical agents or by electrical stimulation of brain structures. Electrical stimulation includes perforant path and self-sustaining stimulation models. Pharmacological models include kainic acid, pilocarpine, flurothyl, organophosphates and other convulsants that induce SE in rodents. Neuronal injury occurs within the initial SE episode, and animals exhibit cognitive dysfunction and spontaneous seizures several weeks after this precipitating event. Current SE models have potential applications but have some limitations. In general, the experimental SE model should be analogous to the human seizure state and it should share very similar neuropathological mechanisms. The pilocarpine and diisopropylfluorophosphate models are associated with prolonged, diazepam-insensitive seizures and neurodegeneration and therefore represent paradigms of refractory SE. Novel mechanism-based or clinically relevant models are essential to identify new therapies for SE and neuroprotective interventions.

A Web-Based Therapeutic Workplace for the Treatment of Drug Addiction and Chronic Unemployment

Science.gov (United States)

Silverman, Kenneth; Wong, Conrad J.; Grabinski, Michael J.; Hampton, Jacqueline; Sylvest, Christine E.; Dillon, Erin M.; Wentland, R. Daniel

2005-01-01

This article describes a Web-based therapeutic workplace intervention designed to promote heroin and cocaine abstinence and train and employ participants as data entry operators. Patients are paid to participate in training and then to perform data entry jobs in a therapeutic workplace business. Salary is linked to abstinence by requiring patients…

Change in therapeutic apheresis practices: Role of continuing medical education (CME).

Science.gov (United States)

Tiwari, Aseem Kumar; Dara, Ravi C; Pandey, Prashant; Arora, Dinesh; Rawat, Ganesh; Raina, Vimarsh

2016-02-01

American society for apheresis (ASFA) publishes guidelines for therapeutic apheresis (TA) and physicians ordering TA procedures should be aware of the appropriate indications based on scientific evidence. Transfusion Medicine specialists (apheresis physicians) can steer physicians in right direction through CME on right indications, duration of therapy and replacement fluid. Therefore, authors reviewed, collated, and interpreted effect of formal CME interventions. Retrospective study was conducted in a large hospital in India. CME interventions to teach clinical and managerial aspects of TA were conducted in the first quarter of 2012. Sessions involved ASFA guidelines and recommendations for TA. Data was collected and changes in practice related to TA before (March 2010 to December 2011) and after (April 2012 to December 2013) the intervention was analyzed. Seventy-three subjects participated in the interventions. Five hundred and eighty-nine TA procedures were performed during study period; 214 procedures in 49 patients before intervention and 375 procedures in 84 patients after intervention. After intervention there was significant improvement in indications of category I (38.7% vs. 64.3%; P = 0.004), category II (22.5% vs. 16.6%), category III (12.2% vs. 11.9%), and category IV (6.1% vs. 2.4%; P = 0.0001). Significant reduction was seen in procedures not belonging to any category from 20.5% to 4.8% (P = 0.002). Change in practices was also observed in context of duration of therapy and replacement fluid. CME intervention, based on the 2010 edition of ASFA guidelines for therapeutic apheresis appears to have had a positive impact on physicians TA practices. © 2015 Wiley Periodicals, Inc.

Interventional treatment of severe portal hypertension due to hepatolenticular degeneration: therapeutic evaluation of 8 cases

International Nuclear Information System (INIS)

Zhao Hongwei; Liu Fuquan; Yue Zhendong; Wang Lei

2011-01-01

Objective: To evaluate the therapeutic efficacy of sclerotic embolization of esophagogastric varices (SEEV) and partial splenic embolization (PSE) in treating esophagogastric varices and portal hypertension, respectively, in patients with hepatolenticular degeneration. Methods: Eight patients with severe portal hypertension complicated with upper gastrointestinal bleeding and hypersplenism were involved in this study. White blood cell (WBC) counts, platelet counts, and portal vein pressure were determined before and after operation, the results were compared with each other. Results: No recurrence or complication occurred after operation in all patients. After the treatment (SEEV and PSE) the hepatic function showed no obvious changes. The WBC counts increased obviously in the first week after operation, and returned to normal range in 2 weeks. The platelet counts gradually returned to normal level from the second week. The portal vein pressure after operation went up a little, from (45.13±8.69) cm H 2 O to (48.63±10.48) cm H 2 O in SEEV group and to (47.88±11.43) cm H 2 O in PSE group, but the difference was of no statistic significance (P>0.05). Conclusion: Interventional therapy can reduce the portal hypertension caused by hepatolenticular degeneration. The technique is safe and effective, and is very helpful for returning to anti-copper treatment. (authors)

Strengthening the technical research and clinical application for vertebral interventional radiology

International Nuclear Information System (INIS)

Wu Chungen; Cheng Yongde

2008-01-01

Interventional diagnostic and therapeutic techniques have developed rapidly in recent years with more and more practically and widely utilization as time goes by. The diagnostic procedures consist of percutaneous biopsy, CT discography, pressure measurement of intervertebral disc; and the therapeutic measures include percutaneous periradicular and joint therapy, decompression of sacral cyst, vertebroplasty, kyphoplasty, decompression of intervertebral disc, transarterial chemotherapy and embolization in spinal tumor, and newly developed percutaneous posterior lumbar intervertebral fusion. All above mentioned interventional techniques for spinal column diseases are developing day by day with a promising future and will play an important role in the field of interventional radiologist research. (authors)

The social dimensions of therapeutic horticulture

OpenAIRE

Harris, Holly

2017-01-01

Harnessing nature to promote mental health is increasingly seen as a sustainable solution to healthcare across the industrialised world. The benefits of these approaches to well-being include reduced symptoms of anxiety, depression and improved social functioning. Many studies assume that contact with nature is the main therapeutic component of these interventions yet ‘green care’ programmes typically include activities not based on ‘nature’ that may contribute to positive outcomes. This stud...

Interventions in Infrainguinal Bypass Grafts

International Nuclear Information System (INIS)

Mueller-Huelsbeck, S.; Order, B.-M.; Jahnke, T.

2006-01-01

The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft

Gut Microbiome and Putative Resistome of Inca and Italian Nobility Mummies

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Tasha M. Santiago-Rodriguez

2017-11-01

Full Text Available Little is still known about the microbiome resulting from the process of mummification of the human gut. In the present study, the gut microbiota, genes associated with metabolism, and putative resistome of Inca and Italian nobility mummies were characterized by using high-throughput sequencing. The Italian nobility mummies exhibited a higher bacterial diversity as compared to the Inca mummies when using 16S ribosomal (rRNA gene amplicon sequencing, but both groups showed bacterial and fungal taxa when using shotgun metagenomic sequencing that may resemble both the thanatomicrobiome and extant human gut microbiomes. Identification of sequences associated with plants, animals, and carbohydrate-active enzymes (CAZymes may provide further insights into the dietary habits of Inca and Italian nobility mummies. Putative antibiotic-resistance genes in the Inca and Italian nobility mummies support a human gut resistome prior to the antibiotic therapy era. The higher proportion of putative antibiotic-resistance genes in the Inca compared to Italian nobility mummies may support the hypotheses that a greater exposure to the environment may result in a greater acquisition of antibiotic-resistance genes. The present study adds knowledge of the microbiome resulting from the process of mummification of the human gut, insights of ancient dietary habits, and the preserved putative human gut resistome prior the antibiotic therapy era.

Review of refugee mental health interventions following resettlement: best practices and recommendations.

Science.gov (United States)

Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

2010-10-01

There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. © 2010 American Orthopsychiatric Association.

Ten Putative Contributors to the Obesity Epidemic

Science.gov (United States)

McAllister, Emily J.; Dhurandhar, Nikhil V.; Keith, Scott W.; Aronne, Louis J.; Barger, Jamie; Baskin, Monica; Benca, Ruth M.; Biggio, Joseph; Boggiano, Mary M.; Eisenmann, Joe C.; Elobeid, Mai; Fontaine, Kevin R.; Gluckman, Peter; Hanlon, Erin C.; Katzmarzyk, Peter; Pietrobelli, Angelo; Redden, David T.; Ruden, Douglas M.; Wang, Chenxi; Waterland, Robert A.; Wright, Suzanne M.; Allison, David B.

2010-01-01

The obesity epidemic is a global issue and shows no signs of abating, while the cause of this epidemic remains unclear. Marketing practices of energy-dense foods and institutionally-driven declines in physical activity are the alleged perpetrators for the epidemic, despite a lack of solid evidence to demonstrate their causal role. While both may contribute to obesity, we call attention to their unquestioned dominance in program funding and public efforts to reduce obesity, and propose several alternative putative contributors that would benefit from equal consideration and attention. Evidence for microorganisms, epigenetics, increasing maternal age, greater fecundity among people with higher adiposity, assortative mating, sleep debt, endocrine disruptors, pharmaceutical iatrogenesis, reduction in variability of ambient temperatures, and intrauterine and intergenerational effects, as contributing factors to the obesity epidemic are reviewed herein. While the evidence is strong for some contributors such as pharmaceutical-induced weight gain, it is still emerging for other reviewed factors. Considering the role of such putative etiological factors of obesity may lead to comprehensive, cause specific, and effective strategies for prevention and treatment of this global epidemic. PMID:19960394

Therapeutic mentoring: reducing the impact of trauma for foster youth.

Science.gov (United States)

Johnson, Sara B; Pryce, Julia M

2013-01-01

This study utilized secondary data analysis to examine therapeutic mentoring (TM) as a service intervention in helping to reduce trauma symptoms in foster youth. Outcomes were compared for mentored (n = 106) and non-mentored (n = 156) foster youth related to experience and symptoms of trauma. Results showed that mentored youth improved significantly in the reduction of trauma symptoms relative to non-mentored youth, suggesting that TM shows promise as an important treatment intervention for foster youth with trauma experiences.

[Quality assurance in interventional cardiology].

Science.gov (United States)

Gülker, H

2009-10-01

Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

Putative Risk Factors in Developmental Dyslexia: A Case-Control Study of Italian Children

Science.gov (United States)

Mascheretti, Sara; Marino, Cecilia; Simone, Daniela; Quadrelli, Ermanno; Riva, Valentina; Cellino, Maria Rosaria; Maziade, Michel; Brombin, Chiara; Battaglia, Marco

2015-01-01

Although dyslexia runs in families, several putative risk factors that cannot be immediately identified as genetic predict reading disability. Published studies analyzed one or a few risk factors at a time, with relatively inconsistent results. To assess the contribution of several putative risk factors to the development of dyslexia, we conducted…

A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD: Part 3 – Interventions for Subacute WAD

Directory of Open Access Journals (Sweden)

Robert W Teasell

2010-01-01

Full Text Available Whiplash-associated disorder (WAD represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks, subacute (two to 12 weeks or chronic (longer than 12 weeks WAD. The present article, the third in a five-part series, evaluates the evidence for interventions initiated during the subacute phase of WAD. Thirteen studies that met the inclusion criteria were identified, six of which were randomized controlled trials with ‘good’ overall methodology (median Physiotherapy Evidence Database score of 6. Although some evidence was identified to support the use of interdisciplinary interventions and chiropractic manipulation, the evidence was not strong for any of the evaluated treatments. There is a clear need for further research to evaluate interventions aimed at treating patients with subacute WAD because there are currently no interventions satisfactorily supported by the research literature.

Therapeutic touch and agitation in individuals with Alzheimer's disease.

Science.gov (United States)

Hawranik, Pamela; Johnston, Pat; Deatrich, Judith

2008-06-01

Limited effective strategies exist to alleviate or treat disruptive behaviors in people with Alzheimer's disease. Fifty-one residents of a long-term care facility with Alzheimer's disease were randomly assigned to one of three intervention groups. A multiple time series, blinded, experimental design was used to compare the effectiveness of therapeutic touch, simulated therapeutic touch, and usual care on disruptive behavior. Three forms of disruptive behavior comprised the dependent variables: physical aggression, physical nonaggression, and verbal agitation. Physical nonaggressive behaviors decreased significantly in those residents who received therapeutic touch compared with those who received the simulated version and the usual care. No significant differences in physically aggressive and verbally agitated behaviors were observed across the three study groups. The study provided preliminary evidence for the potential for therapeutic touch in dealing with agitated behaviors by people with dementia. Researchers and practitioners must consider a broad array of strategies to deal with these behaviors.

Dexmedetomidine in PRES: An appropriate therapeutic decision

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Geeta Ahlawat

2017-07-01

Full Text Available PRES, a reversible white matter lesion characterized by cerebral edema, found in 7–20% of the patients with preeclampsia and eclampsia, needs early diagnosis and therapeutic intervention. We report PRES in a young preeclamptic primigravida and the role of dexmedetomidine in controlling her uncontrollable blood pressure in ICU. Dexmedetomidine, has cerebroprotective cardioprotective and renoprotective properties all of which, helped the patient improving clinically.

Therapeutic options in chronic heart failure. Findings on chest X-ray

International Nuclear Information System (INIS)

Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C.

2016-01-01

The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

Interventional radiological therapy of benign low back pain syndromes

International Nuclear Information System (INIS)

Huegli, R.W.; Jacob, A.L.; Steinbrich, W.

2007-01-01

Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed

Probiotics in inflammatory bowel disease--therapeutic rationale and role.

LENUS (Irish Health Repository)

Shanahan, Fergus

2012-02-03

The intestinal flora has a conditioning effect on intestinal homeostasis, delivering regulatory signals to the epithelium, the mucosal immune system and to the neuromuscular activity of the gut. Beneficial metabolic activities of the enteric flora include nutrient production, metabolism of dietary carcinogens, conversion of prodrugs to active drugs. However, increasing evidence suggests that some components of the enteric flora are essential ingredients in the pathogenesis of inflammatory bowel disease (IBD); this has prompted interest in therapeutic manipulation of the flora with probiotics. Probiotics are biologic control agents-described as live microbial food supplements which confer a health benefit beyond inherent basic nutrition. Multiple potential beneficial effects have been attributed to the probiotic use of lactic acid bacteria, bifidobacteria and other non-pathogenic commensals. At present, much of the promise of probiotics remains outside the realm of evidence-based medicine and awaits the results of prospective trials, now underway. No reliable in vitro predictors of in vivo efficacy of putative probiotics have been identified. Rigorous comparisons of probiotic performance have not been performed and the suitability of a given probiotic for different individuals is largely unexplored. Notwithstanding, an improved understanding of the normal commensal flora and host-flora interactions has the potential to open up new therapeutic strategies for inflammatory disorders of the gut.

A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions

Science.gov (United States)

Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

2013-01-01

Background If trials of therapeutic interventions are to serve society’s interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world’s nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial’s stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. PMID:21429960

New Sides of Aldosterone Action in Cardiovascular System as Potential Targets for Therapeutic Intervention.

Science.gov (United States)

Kolodziejczyk, Patrycjusz; Gromotowicz-Poplawska, Anna; Aleksiejczuk, Michal; Chabielska, Ewa; Tutka, Piotr; Miltyk, Wojciech

2018-03-26

Aldosterone, the main mineralocorticoid hormone, plays a crucial role in the regulation of electrolyte homeostasis and blood pressure. Although, this role is undoubtedly important, it is not a hormonal action that attracts the most attention. Aldosterone seems to be very important important as a local messenger in the pathology of cardiovascular diseases (CVD). In the last few years, the attention was focused on the correlation between raised aldosterone level and increased risk of cardiovascular events. It has been demonstrated that aldosterone contributes to fibrosis, inflammation, endothelial dysfunction, fibrinolytic disordes, and oxidative stress leading to CVD development and progression. It used to be thought that the effects of aldosterone are mediated via classic nuclear receptors - mineralocorticoid receptors (MR). Now we know that the mechanism of aldosterone action in cardiovascular system is much more complex, since experimental and clinical studies indicate that MR blockade may be not sufficient to abolish aldosterone-incuced harmful effects in the cardiovascular system. Therefore, the involvement of some other than MR, receptors and factors is suggested. Moreover, in addition to the generally known genomic action of aldosterone, which involves MR activation, the nongenomic pathways are postulated in the mode of hormone action. More and more attention is focused on the membrane-coupled receptors, which mediate the rapid effects of aldosterone and have been already confirmed in different cells and tissues of a cardiovascular system. The confirmation of multiple mechanisms of aldosterone action opens a new perspective for more effective therapeutic intervention in aldosterone-related CVD. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association

Energy Technology Data Exchange (ETDEWEB)

Millward, S.F.; Holley, M.L. [Univ. of Western Ontario, London Health Sciences Centre, Dept. of Radiology, London, Ontario (Canada)

2001-04-01

To evaluate the current status of interventional radiology in Canada. A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to

Vascular complications following therapeutic and diagnostic cardiac catheterisation by the femoral artery

DEFF Research Database (Denmark)

Bitsch, M; Liisberg-Larsen, Ole Christian; Schroeder, T V

1994-01-01

Twenty-one of 6327 (0.33%) patients undergoing cardiac catheterisation via the femoral artery had an acute vascular complication requiring surgical intervention. The complication rate was 0.1% after coronary angiography, 2% after PTCA and 6% after aortic ballon dilatation. The size of the cathete...... and evaluation of vascular injuries following diagnostic and therapeutic invasive interventions could have a self limitating effect on the complication rate....

Central venous catheters: detection of catheter complications and therapeutical options

International Nuclear Information System (INIS)

Gebauer, B.; Beck, A.; Wagner, H.J.; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg

2008-01-01

For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary

Effects of weekly and fortnightly therapeutic exercise on physical function and health-related quality of life in individuals with hip osteoarthritis.

Science.gov (United States)

Jigami, Hirofumi; Sato, Daisuke; Tsubaki, Atsuhiro; Tokunaga, Yuta; Ishikawa, Tomoji; Dohmae, Yoichiro; Iga, Toshiroh; Minato, Izumi; Yamamoto, Noriaki; Endo, Naoto

2012-11-01

Most previous studies on the effects of therapeutic exercise on osteoarthritis (OA) of the hip joint included participants with knee OA or postoperative participants. Moreover, although some systematic reviews recommend therapeutic exercise for hip OA, a consensus on the effective interventional frequency has not been reached. This study aimed to investigate the effects of therapeutic exercise performed at different frequencies on physical function and health-related quality of life in participants with hip OA. Individuals diagnosed with hip OA (36 women, age 42-79 years; 19 in 2009 and 17 in 2010) were recruited from the cooperating medical institutions. They were divided into two groups depending on the frequency of therapeutic exercise: fortnightly in 2009 (fortnightly group) and weekly in 2010 (weekly group). Participants in each group performed the same land-based and aquatic exercises on the same day for a total of ten sessions. Muscle strength of the lower extremity, "timed up and go" (TUG), time of one-leg standing with open eyes (TOLS), Harris Hip Score, and scores of the Medical Outcomes Survey Short Form-36 questionnaire, were measured before and after interventions. The fortnightly group had no significant changes in lower-extremity muscle strength following intervention, but the strength of all muscles in the weekly group improved significantly after intervention. Further, in both groups, TUG and TOLS of the worse side of the hip joint significantly improved after interventions. Weekly exercise improves muscle strength of the lower extremity and may therefore be an effective interventional technique for managing hip OA. In addition, in persons with hip OA, therapeutic exercise consisting of both land- and water-based exercises markedly improved physical function.

Cognitive Remediation Interventions for Gambling Disorder: A Systematic Review

Directory of Open Access Journals (Sweden)

Gaëlle Challet-Bouju

2017-12-01

Full Text Available Various therapeutic approaches are available for the treatment of gambling disorder (GD, especially cognitive behavioral therapy (CBT; the most widely used treatment. However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR

Cognitive Remediation Interventions for Gambling Disorder: A Systematic Review.

Science.gov (United States)

Challet-Bouju, Gaëlle; Bruneau, Mélanie; Victorri-Vigneau, Caroline; Grall-Bronnec, Marie

2017-01-01

Various therapeutic approaches are available for the treatment of gambling disorder (GD), especially cognitive behavioral therapy (CBT; the most widely used treatment). However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR) interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR interventions (duration

The Therapeutic Utility of Employment in Treating Drug Addiction: Science to Application

OpenAIRE

Silverman, Kenneth; Holtyn, August F.; Morrison, Reed

2016-01-01

Research on a model Therapeutic Workplace has allowed for evaluation of the use of employment in the treatment of drug addiction. Under the Therapeutic Workplace intervention, adults with histories of drug addiction are hired and paid to work. To promote drug abstinence or adherence to addiction medications, participants are required to provide drug-free urine samples or take prescribed addiction medications, respectively, to gain access to the workplace and/or to maintain their maximum rate ...

Integrating school-based and therapeutic conflict management models at schools.

Science.gov (United States)

D'Oosterlinck, Franky; Broekaert, Eric

2003-08-01

Including children with emotional and behavioral needs in mainstream school systems leads to growing concern about the increasing number of violent and nonviolent conflicts. Schools must adapt to this evolution and adopt a more therapeutic dimension. This paper explores the possibility of integrating school-based and therapeutic conflict management models and compares two management models: a school-based conflict management program. Teaching Students To Be Peacemakers; and a therapeutic conflict management program, Life Space Crisis Intervention. The authors conclude that integration might be possible, but depends on establishing a positive school atmosphere, the central position of the teacher, and collaborative and social learning for pupils. Further implementation of integrated conflict management models can be considered but must be underpinned by appropriate scientific research.

HaploReg v4: systematic mining of putative causal variants, cell types, regulators and target genes for human complex traits and disease.

Science.gov (United States)

Ward, Lucas D; Kellis, Manolis

2016-01-04

More than 90% of common variants associated with complex traits do not affect proteins directly, but instead the circuits that control gene expression. This has increased the urgency of understanding the regulatory genome as a key component for translating genetic results into mechanistic insights and ultimately therapeutics. To address this challenge, we developed HaploReg (http://compbio.mit.edu/HaploReg) to aid the functional dissection of genome-wide association study (GWAS) results, the prediction of putative causal variants in haplotype blocks, the prediction of likely cell types of action, and the prediction of candidate target genes by systematic mining of comparative, epigenomic and regulatory annotations. Since first launching the website in 2011, we have greatly expanded HaploReg, increasing the number of chromatin state maps to 127 reference epigenomes from ENCODE 2012 and Roadmap Epigenomics, incorporating regulator binding data, expanding regulatory motif disruption annotations, and integrating expression quantitative trait locus (eQTL) variants and their tissue-specific target genes from GTEx, Geuvadis, and other recent studies. We present these updates as HaploReg v4, and illustrate a use case of HaploReg for attention deficit hyperactivity disorder (ADHD)-associated SNPs with putative brain regulatory mechanisms. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

THE ROLE OF LAPAROSCOPY IN BLUNT ABDOMINAL TRAUMA: DIAGNOSTIC, THERAPEUTIC OR BOTH?

Science.gov (United States)

Mosai, F

2017-09-01

The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. A retrospective analysis of a prospectively collected data was done. All adult patients who presented with abdominal trauma and were offered laparoscopic surgery at DGMAH from 2012 to 2015 were reviewed. Data was retrieved from our departmental database and analysed using descriptive statistics. A total of 318 patients were reviewed and 35 patients had blunt abdominal trauma and were included in the study. All the patients were offered laparoscopy. The median age was 30, with 91% of our patients being males. The highest injury severity score calculated was 38. At least 77% of the patients were managed using laparoscopy. This includes 43% who had both diagnostic and therapeutic intervention and 34% had only diagnostic laparoscopy. Eight patients were converted to open surgery mainly due to active bleeding and complex injuries. We did not have any non-therapeutic laparotomies, with no documented procedure related morbidity and mortality. The positive outcomes seen from the study suggest that laparoscopy can be safe and feasible in both diagnostic and therapeutic interventions in carefully selected blunt abdominal trauma patients. A conversion to open surgery should not be regarded as a failure but rather as a sign of mature and sound clinical judgement acknowledging the limitations of laparoscopy and/or the surgeon.

Therapeutic Endoscopy for the Control of Nonvariceal Upper Gastrointestinal Bleeding in Children: A Case Series.

Science.gov (United States)

Banc-Husu, Anna M; Ahmad, Nuzhat A; Chandrasekhara, Vinay; Ginsberg, Gregory G; Jaffe, David L; Kochman, Michael L; Rajala, Michael W; Mamula, Petar

2017-04-01

Gastrointestinal bleeding is one of the most common indications for urgent endoscopy in the pediatric setting. The majority of these procedures are performed for control of variceal bleeding, with few performed for nonvariceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are sparse. The aims of our study were to review our experience with NVUGI bleeding, describe technical aspects and outcomes of therapeutic endoscopy, and determine gastroenterology fellows' training opportunities according to the national training guidelines. We performed a retrospective review of endoscopy database (Endoworks, Olympus Inc, Center Valley, PA) from January 2009 to December 2014. The search used the following keywords: bleeding, hematemesis, melena, injection, epinephrine, cautery, clip, and argon plasma coagulation. The collected data included demographics, description of bleeding lesion and medical/endoscopic therapy, rate of rebleeding, relevant laboratories, physical examination, and need for transfusion and surgery. The study was approved by the institutional review board. During the study period 12,737 upper endoscopies (esophagogastroduodenoscopies) were performed. A total of 15 patients underwent 17 esophagogastroduodenoscopies that required therapeutic intervention to control bleeding (1:750 procedures). The mean ± standard deviation (median) age of patients who required endoscopic intervention was 11.6 ± 6.0 years (14.0 years). Seven out of 17 patients received dual therapy to control the bleeding lesions. All but 3 patients received medical therapy with intravenous proton pump inhibitor, and 3 received octreotide infusions. Six of the patients experienced rebleeding (40%), with 4 out of 6 initially only receiving single modality therapy. Two of these patients eventually required surgical intervention to control bleeding and both patients presented with bleeding duodenal ulcers. There were no cases of aspiration

Therapeutic Approaches of Botulinum Toxin in Gynecology

Directory of Open Access Journals (Sweden)

Marius Alexandru Moga

2018-04-01

Full Text Available Botulinum toxins (BoNTs are produced by several anaerobic species of the genus Clostridium and, although they were originally considered lethal toxins, today they find their usefulness in the treatment of a wide range of pathologies in various medical specialties. Botulinum neurotoxin has been identified in seven different isoforms (BoNT-A, BoNT-B, BoNT-C, BoNT-D, BoNT-E, BoNT-F, and BoNT-G. Neurotoxigenic Clostridia can produce more than 40 different BoNT subtypes and, recently, a new BoNT serotype (BoNT-X has been reported in some studies. BoNT-X has not been shown to actually be an active neurotoxin despite its catalytically active LC, so it should be described as a putative eighth serotype. The mechanism of action of the serotypes is similar: they inhibit the release of acetylcholine from the nerve endings but their therapeutically potency varies. Botulinum toxin type A (BoNT-A is the most studied serotype for therapeutic purposes. Regarding the gynecological pathology, a series of studies based on the efficiency of its use in the treatment of refractory myofascial pelvic pain, vaginism, dyspareunia, vulvodynia and overactive bladder or urinary incontinence have been reported. The current study is a review of the literature regarding the efficiency of BoNT-A in the gynecological pathology and on the long and short-term effects of its administration.

The impact of an educational intervention, the New GP Contract and NICE guidelines on anti-epilepsy therapeutic drug monitoring.

Science.gov (United States)

Minshall, I; Berry, D; Smith, D

2011-03-01

Since the early 1970s therapeutic drug monitoring (TDM) of anti-epilepsy drug (AED) levels has been available to assist in the review process of patients with epilepsy. Routine blood levels were not part of the Quality and Outcomes Framework in the New GP Contract, neither have they been generally recommended in National Guidelines (NICE and SIGN) for the management of patients with epilepsy. To assess the impact of an educational intervention, the New GP Contract and NICE guidelines on the number of requests for TDM. Retrospective study. 39 general practices serving Chester (13), the Rural area surrounding Chester (13) and Ellesmere Port (13). An educational intervention took place in the individual Chester practices between December 2001 and March 2003. For the Rural and Ellesmere Port practices there was one combined event in March 2004 and in March 2007, respectively. Practices were encouraged, not to routinely request TDM, except in certain circumstances. The number of TDM requests for Chester, Rural and Ellesmere Port were obtained from the local laboratory in Chester, plus other nearby hospitals, to provide control groups. The number of TDM requests from primary care for Chester, Rural, Ellesmere Port, Wirral, Crewe, Warrington and Wrexham, April to April, 2002 through to 2008, where available. There has been a fall in the number requests in all districts. The most significant falls were in Chester (47%), Rural (34%) and Ellesmere Port (47%), and corresponded to the time of their educational intervention. The fall has been less marked in Wirral (25%), Crewe (27%), Wrexham (10%) and Warrington (9%). In 2004, the first year after the introduction of the New GP Contract, TDM in Chester and the Rural fell significantly, while those in Ellesmere Port, Wirral, Crewe and Wrexham increased. TDM dropped significantly in Ellesmere Port in the year after their educational intervention. Despite the valproate assay being clinically unhelpful there were still 611 requests

Involvement of Renin-Angiotensin System in Retinopathy of Prematurity - A Possible Target for Therapeutic Intervention.

Directory of Open Access Journals (Sweden)

Madhu Nath

Full Text Available Examining the Retinal Renin Angiotensin System (RRAS in the ROP neonates and analyzing the possibility of modulating the RRAS to prevent the progression in Oxygen Induced Retinopathy (OIR model.Vitreous of ROP patients (n = 44, median age 5.5 months was quantified for RRAS components, VEGF, HIF-1α and compared with age matched control. The involvement of RRAS in ROP was tested in the rat model of OIR and compared with normoxia. Expressions of RAS components, VEGF and HIF-1α in retina were analyzed using qPCR and retinal structure and function was also analyzed. Effect of Angiotensin Converting Enzyme Inhibitor (ACEI and Angiotensin Receptor Blocker (ARB was evaluated and compared with Bevacizumab which served as a positive control. Drug penetration into retina was confirmed by liquid chromatography coupled ESI-tandem mass spectroscopy (LC-MS/MS.Multifold increase in the expression of RAS components in human vitreous and rat retina showed their involvement in ROP. ERG & fundus studies in OIR revealed the altered function of retina and were successfully prevented by ARB (telmisartan, ACEI (lisinopril and bevacizumab. Retinal analysis revealed the presence of ACEI and ARB in their therapeutic levels.This study for the first time demonstrates the upregulated level of RAS components in human ROP vitreous and further that the pharmacological intervention in RRAS can functionally and structurally preserve retina against the progression of ROP in the OIR model.

Controlling radiation exposure during interventional procedures in childhood cancer patients

International Nuclear Information System (INIS)

Racadio, John M.

2009-01-01

Many pediatric cancer patients undergo multiple diagnostic and therapeutic radiologic procedures over the course of their illnesses and are therefore at high risk for radiation exposure. There are a variety of measures that radiologists can employ to reduce this risk. These include limiting the use of radiation whenever possible, using specific strategies to reduce radiation exposure during interventional procedures, using quality assurance programs to ensure compliance, and maintaining continuing staff radiation safety educational programs. Some of the diagnostic and therapeutic interventional radiologic procedures that are performed in pediatric oncology patients are discussed here, along with specific tips for managing radiation exposure. (orig.)

Patient doses in interventional cardiology

International Nuclear Information System (INIS)

Carrera, F.; Ojeda, C.; Ruiz-Cruces, R.; Francisco Diaz, J.; Sanchez, A.; Tort, I.

2001-01-01

Cardiovascular diseases are the first cause of death in Spain. The most usual procedures in interventional cardiology are coronariography and PTCA. The first is a diagnostic technique, and the second one is interventional. Our goal has been to study procedures made during the first six months in the Interventional Cardiology Unit of the Juan Ramon Jimenez Hospital (Huelva-Spain), taking into account radiation protection issues. We have studied 178 patients; 145 of them underwent coronariography, and 33 of the patients had PTCA too. Every case was analyzed taking into account technical and dosimetric parameters. We show parameters values gathered: Diagnostic techniques (valvular and non-valvular patients), and interventional techniques (coronariography and PTCA in different or in the same intervention). Higher doses were obtained with valvular patients, although the number of frames was similar. Attending to therapeutic procedures, the highest values were gotten with the 'double' interventions. Interventional procedures exceed in 60% doses gotten in diagnostic studies: this is because of the number of series and number of frames per series. Similar values obtained by other authors have been gotten. (author)

Leptin deficiency: clinical implications and opportunities for therapeutic interventions.

Science.gov (United States)

Blüher, Susan; Shah, Sunali; Mantzoros, Christos S

2009-10-01

The discovery of leptin has significantly advanced our understanding of the metabolic importance of adipose tissue and has revealed that both leptin deficiency and leptin excess are associated with severe metabolic, endocrine, and immunological consequences. We and others have shown that a prominent role of leptin in humans is to mediate the neuroendocrine adaptation to energy deprivation. Humans with genetic mutations in the leptin and leptin receptor genes have deregulated food intake and energy expenditure leading to a morbidly obese phenotype and a disrupted regulation in neuroendocrine and immune function and in glucose and fat metabolism. Observational and interventional studies in humans with (complete) congenital leptin deficiency caused by mutations in the leptin gene or with relative leptin deficiency as seen in states of negative energy balance such as lipoatrophy, anorexia nervosa, or exercise-induced hypothalamic and neuroendocrine dysfunction have contributed to the elucidation of the pathophysiological role of leptin in these conditions and of the clinical significance of leptin administration in these subjects. More specifically, interventional studies have demonstrated that several neuroendocrine, metabolic, or immune disturbances in these states could be restored by leptin administration. Leptin replacement therapy is currently available through a compassionate use program for congenital complete leptin deficiency and under an expanded access program to subjects with leptin deficiency associated with congenital or acquired lipoatrophy. In addition, leptin remains a potentially forthcoming treatment for several other states of energy deprivation including anorexia nervosa or milder forms of hypothalamic amenorrhea pending appropriate clinical trials.

Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review

Science.gov (United States)

Barnes, Steven

2018-01-01

Background Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. Objective The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. Methods A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. Results A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials

Comparative transcriptome analysis links distinct peritoneal tumor spread types, miliary and non-miliary, with putative origin, tubes and ovaries, in high grade serous ovarian cancer.

Science.gov (United States)

Auer, Katharina; Bachmayr-Heyda, Anna; Aust, Stefanie; Grunt, Thomas W; Pils, Dietmar

2017-03-01

High grade serous ovarian cancer (HGSOC) is characterized by extensive local, i.e. peritoneal, tumor spread, manifested in two different clinical presentations, miliary (many millet sized peritoneal implants) and non-miliary (few large exophytically growing peritoneal nodes), and an overall unfavorable outcome. HGSOC is thought to arise from fallopian tube secretory epithelial cells, via so called serous tubal intraepithelial carcinomas (STICs) but an ovarian origin was never ruled out for at least some cases. Comparative transcriptome analyses of isolated tumor cells from fresh HGSOC tissues and (immortalized) ovarian surface epithelial and fallopian tube secretory epithelial cell lines revealed a close relation between putative origin and tumor spread characteristic, i.e. miliary from tubes and non-miliary from ovaries. The latter were characterized by more mesenchymal cell characteristics, more adaptive tumor immune infiltration, and a favorable overall survival. Several molecular sub-classification systems (Crijns' overall survival signature, Yoshihara's subclasses, and a collagen-remodeling signature) seem to already indicate origin. Putative origin alone is a significant independent predictor for HGSOC outcome, validated in independent patient cohorts. Characteristics of both spread types could guide development of new targeted therapeutics, which are urgently needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychological treatment and therapeutic change in incarcerated rapists

Directory of Open Access Journals (Sweden)

Ana Martínez-Catena

2017-01-01

Full Text Available Abstract Most Spanish prisons provide specialised treatment for incarcerated sex offenders, both rapists and child molesters. This treatment is a cognitive-behavioural intervention that has shown relative effectiveness in previous research. With regard to offenders’ rehabilitation, recidivism assessments are necessary as a final measure of treatment effectiveness. However, the evaluation of recidivism by itself does not provide sufficient information on the treatment process and the specific effects that treated subjects could undergo. This paper aims to analyse the therapeutic effectiveness of psychological treatment provided to rapists (in general, males sentenced for committing a sexual offence against women. To this aim, a group of treated rapists (N=153 serving a sentence in prison was analysed. Using a specially designed scale (PASSO, the global therapeutic change and ten specific variables (including assertiveness, readiness to change, cognitive distortions, impulsivity, etc. were assessed. The within-subjects comparison showed that treated sex offenders improved, in therapeutic terms, globally as well as in most of the specific variables assessed (improvements not experimented by the control group. Also, different therapeutic subscales showed relevant associations between them. The findings regarding treatment effectiveness are discussed.

Target concentration intervention: beyond Y2K.

Science.gov (United States)

Holford, N H

2001-01-01

Target concentration intervention (TCI) is proposed as an alternative conceptual strategy to therapeutic drug monitoring (TDM). It is argued that the idea of a therapeutic range has limited the interpretation of measured drug concentrations and diminished the anticipated clinical benefit to patients by use of an oversimplified pharmacodynamic model. TCI on the other hand embraces pharmacokinetic and pharmacodynamic concepts and uses the idea of a target effect and associated target concentration to make rational individual dose decisions.

Putative Lineage of Novel African Usutu Virus, Central Europe

Centers for Disease Control (CDC) Podcasts

2015-10-15

Sarah Gregory reads an abridged version of "Putative Lineage of Novel African Usutu Virus, Central Europe.".  Created: 10/15/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/15/2015.

ePrescribing: Reducing Costs through In-Class Therapeutic Interchange.

Science.gov (United States)

Stenner, Shane P; Chakravarthy, Rohini; Johnson, Kevin B; Miller, William L; Olson, Julie; Wickizer, Marleen; Johnson, Nate N; Ohmer, Rick; Uskavitch, David R; Bernard, Gordon R; Neal, Erin B; Lehmann, Christoph U

2016-12-14

Spending on pharmaceuticals in the US reached $373.9 billion in 2014. Therapeutic interchange offers potential medication cost savings by replacing a prescribed drug for an equally efficacious therapeutic alternative. Hard-stop therapeutic interchange recommendation alerts were developed for four medication classes (HMG-CoA reductase inhibitors, serotonin receptor agonists, intranasal steroid sprays, and proton-pump inhibitors) in an electronic prescription-writing tool for outpatient prescriptions. Using prescription data from January 2012 to June 2015, the Compliance Ratio (CR) was calculated by dividing the number of prescriptions with recommended therapeutic interchange medications by the number of prescriptions with non-recommended medications to measure effectiveness. To explore potential cost savings, prescription data and medication costs were analyzed for the 45,000 Vanderbilt Employee Health Plan members. For all medication classes, significant improvements were demonstrated - the CR improved (proton-pump inhibitors 2.8 to 5.32, nasal steroids 2.44 to 8.16, statins 2.06 to 5.51, and serotonin receptor agonists 0.8 to 1.52). Quarterly savings through the four therapeutic interchange interventions combined exceeded $200,000 with an estimated annual savings for the health plan of $800,000, or more than $17 per member. A therapeutic interchange clinical decision support tool at the point of prescribing resulted in increased compliance with recommendations for outpatient prescriptions while producing substantial cost savings to the Vanderbilt Employee Health Plan - $17.77 per member per year. Therapeutic interchange rules require rational targeting, appropriate governance, and vigilant content updates.

Therapeutic horticulture in clinical depression: a prospective study of active components.

Science.gov (United States)

Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil W; Kirkevold, Marit

2010-09-01

This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination. Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity. A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale. Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up. Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.

Molecular cloning and characterization of a putative OGG_N domain ...

African Journals Online (AJOL)

Molecular cloning and characterization of a putative OGG_N domain from the camel, Camelus dromedarius. Farid Shokry Ataya, Mohammad Saud Alanazi, Dalia Fouad, Hehsam Mahmoud Saeed, Mohammad Bazzi ...

[Limitation of the therapeutic effort].

Science.gov (United States)

Herreros, B; Palacios, G; Pacho, E

2012-03-01

The limitation of the therapeutic effort (LTE) consists in not applying extraordinary or disproportionate measures for therapeutic purposes that are proposed for a patient with poor life prognosis and/or poor quality of life. There are two types. The first is to not initiate certain measures or to withdraw them when they are established. A decision of the LTE should be based on some rigorous criteria, so that we make the following proposal. First, it is necessary to know the most relevant details of the case to make a decision: the preferences of the patient, the preferences of the family when pertinent, the prognosis (severity), the quality of life and distribution of the limited resources. After, the decision should be made. In this phase, participatory deliberation should be established to clarify the end of the intervention. Finally, if it is decided to perform an LTE, it should be decided how to do it. Special procedures, disproportionate measures, that are useless and vain should not be initiated for the therapeutic objective designed (withdraw them if they have been established). When it has been decided to treat a condition (interim measures), the treatment should be maintained. This complex phase may need stratification of he measures. Finally, the necessary palliative measures should be established. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Therapeutic interventions and success in risk factor control for secondary prevention of stroke.

Science.gov (United States)

Alvarez-Sabin, Jose; Quintana, Manuel; Hernandez-Presa, Miguel Angel; Alvarez, Carlos; Chaves, Jose; Ribo, Marc

2009-01-01

We sought to evaluate the success rates in achieving preventive therapeutic goals in patients who experienced an ischemic stroke (IS) and compare them with those achieved in patients with coronary artery disease (CAD). This was an observational multicenter case-control study (3 patients with IS and one control subject with CAD) performed in 1444 primary health centers in Spain. Preventive therapeutic objectives according to American Heart Association guidelines were predefined. Demographic data, vascular risk factors, and success/failure in achievement of objectives were recorded and compared between patients with IS and CAD. A total of 5458 patients were included, 4098 (75.1%) had IS and 1360 (24.9%) had CAD. Although more than 90% of patients with hypertension, diabetes, or dyslipidemia were under specific drug regimens, only about 25% achieved the recommended therapeutic objective for each risk factor. Success rate was especially low among patients with IS compared with CAD: hypertension (23.8% v 27.2%; P = .028); dyslipidemia (13.6% v 20.3%; P risk factors under control, compared with 5.6% of those with CAD (P = .006). For all patients, multivariate logistic regression model showed that independent predictors of full risk factor control were: presence of CAD as compared with IS (odds ratio [OR] 2.11; 95% confidence interval [CI] 1.35-3.29; P = .001), older age (OR 1.02; 95% CI 1.00-1.04; P = .028), and having less than 3 risk factors (OR 16.98; 95% CI 9.02-31.97; P risk factor control.

Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.

Science.gov (United States)

Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R Claire; Szmukler, George; Thornicroft, Graham

2015-12-01

Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship. © The Author(s) 2015.

The Putative Chemosignal Androstadienone Makes Women More Generous.

Science.gov (United States)

Perrotta, Valentina; Graffeo, Michele; Bonini, Nicolao; Gottfried, Jay A

2016-06-01

Putative human chemosignals have been shown to influence mood states and emotional processing, but the connection between these effects and higher-order cognitive processing is not well established. This study utilized an economic game (Dictator Game) to test whether androstadienone (AND), an odorous compound derived from testosterone, impacts on altruistic behavior. We predicted that the female participants would act more generously in the AND condition, exhibiting a significant interaction effect between gender and AND on Dictator Game contributions. We also expected that the presence of AND should increase the positive mood of the female participants, compared to a control odor condition and also compared to the mood of the male participants. The results confirm our hypotheses: for women the subliminal perception of AND led to larger monetary donations, compared to a control odor, and also increased positive mood. These effects were absent or significantly weaker in men. Our findings highlight the capacity of human putative chemosignals to influence emotions and higher cognitive processes - in particular the processes used in the context of economic decisions - in a gender-specific way.

Characteristics of functional enrichment and gene expression level of human putative transcriptional target genes.

Science.gov (United States)

Osato, Naoki

2018-01-19

Transcriptional target genes show functional enrichment of genes. However, how many and how significantly transcriptional target genes include functional enrichments are still unclear. To address these issues, I predicted human transcriptional target genes using open chromatin regions, ChIP-seq data and DNA binding sequences of transcription factors in databases, and examined functional enrichment and gene expression level of putative transcriptional target genes. Gene Ontology annotations showed four times larger numbers of functional enrichments in putative transcriptional target genes than gene expression information alone, independent of transcriptional target genes. To compare the number of functional enrichments of putative transcriptional target genes between cells or search conditions, I normalized the number of functional enrichment by calculating its ratios in the total number of transcriptional target genes. With this analysis, native putative transcriptional target genes showed the largest normalized number of functional enrichments, compared with target genes including 5-60% of randomly selected genes. The normalized number of functional enrichments was changed according to the criteria of enhancer-promoter interactions such as distance from transcriptional start sites and orientation of CTCF-binding sites. Forward-reverse orientation of CTCF-binding sites showed significantly higher normalized number of functional enrichments than the other orientations. Journal papers showed that the top five frequent functional enrichments were related to the cellular functions in the three cell types. The median expression level of transcriptional target genes changed according to the criteria of enhancer-promoter assignments (i.e. interactions) and was correlated with the changes of the normalized number of functional enrichments of transcriptional target genes. Human putative transcriptional target genes showed significant functional enrichments. Functional

The diagnostic and therapeutic management of a peculiar case of rectal submucosal adenocarcinoma

Directory of Open Access Journals (Sweden)

Angela Blajin

2018-05-01

Full Text Available Introduction We are presenting the case of a 50 years old female patient with rectal cancer, developed from the submucosal level, who raised difficulties in diagnoses process and therapeutic management. Case report The patient’s symptomatology began four months before the definitive diagnose. Various investigations have been performed, including multiple biopsies which were inconclusive. Surgical intervention was performed to obtain definitive malignancy HP result. The postoperative evolution was peculiar, marked by complications, which required multiple surgical interventions. Conclusions The development of the adenoma, predominantly at the submucosal and muscular level has caused difficulties in both establishing the diagnosis and in the therapeutic management. Sclerosing encapsulated peritonitis (SEP is a rare clinical entity, usually discovered in postoperative intestinal obstruction cases. The etiology and frequency of the SEP depend on its’ type.

Evidence of novel miR-34a-based therapeutic approaches for multiple myeloma treatment

Czech Academy of Sciences Publication Activity Database

Zarone, M.R.; Misso, G.; Grimaldi, A.; Zappavigna, S.; Russo, M.; Amler, Evžen; Di Martino, M.T.; Amodio, N.; Tagliaferri, P.; Tassone, P.; Caraglia, M.

2017-01-01

Roč. 7, dec (2017), s. 17949 ISSN 2045-2322 Institutional support: RVO:68378041 Keywords : gamma-secretase inhibitors * tumor-suppressor network * breast - cancer Subject RIV: FP - Other Medical Disciplines OBOR OECD: Technologies involving identifying the functioning of DNA, proteins and enzymes and how they influence the onset of disease and maintenance of well-being (gene-based diagnostics and therapeutic interventions (pharmacogenomics, gene-based therapeutics) Impact factor: 4.259, year: 2016

Influence of putative exopolysaccharide genes on Pseudomonas putida KT2440 biofilm stability

DEFF Research Database (Denmark)

Nilsson, Martin; Chiang, Wen-Chi; Fazli, Mustafa

2011-01-01

We report a study of the role of putative exopolysaccharide gene clusters in the formation and stability of Pseudomonas putida KT2440 biofilm. Two novel putative exopolysaccharide gene clusters, pea and peb, were identified, and evidence is provided that they encode products that stabilize P....... putida KT2440 biofilm. The gene clusters alg and bcs, which code for proteins mediating alginate and cellulose biosynthesis, were found to play minor roles in P. putida KT2440 biofilm formation and stability under the conditions tested. A P. putida KT2440 derivative devoid of any identifiable...

Dengue infection associated hemophagocytic syndrome: Therapeutic interventions and outcome.

Science.gov (United States)

Wan Jamaludin, Wan Fariza; Periyasamy, Petrick; Wan Mat, Wan Rahiza; Abdul Wahid, S Fadilah

2015-08-01

Infection associated hemophagocytic syndrome is increasingly recognized as a potentially fatal complication of dengue fever. It should be suspected with prolonged fever beyond seven days associated with hepatosplenomegaly, hyperferritinemia, worsening cytopenias and development of multiorgan dysfunction. Surge of similar pro-inflammatory cytokines observed in dengue associated hemophagocytic syndrome and multiorgan dysfunction may indicate they are part of related inflammatory spectrum. A proportion of patients recovered with supportive therapy, however most required interventions with corticosteroids, intravenous immunoglobulin or chemotherapy. We report three cases of dengue associated IAHS with good outcome following early recognition and treatment with dexamethasone and intravenous immunoglobulin. Copyright © 2015 Elsevier B.V. All rights reserved.

[Guideline development for rehabilitation of breast cancer patients - phase 2: findings from the classification of therapeutic procedures, KTL-data-analysis].

Science.gov (United States)

Domann, U; Brüggemann, S; Klosterhuis, H; Weis, J

2007-08-01

Aim of this project is the development of an evidence based guideline for the rehabilitation of breast cancer patients, funded by the German Pension Insurance scheme. The project consists of four phases. This paper is focused on the 2nd phase, i.e., analysis of procedures in rehabilitation based on evidence based therapeutic modules. As a result of a systematic literature review 14 therapeutic modules were defined. From a total of 840 possible KTL Codes (Klassifikation Therapeutischer Leistungen, Classification of therapeutic procedures), 229 could be assigned to these modules. These analyses are based on 24685 patients in 57 rehabilitation clinics, who had been treated in 2003. For these modules the number of patients having received those interventions as well as the duration of the modules were calculated. The data were analysed with respect to the influence of age and comorbidity. Moreover, differences between rehabilitation clinics were investigated according to the category of interventions. Our findings show great variability in the use of the therapeutic modules. Therapeutic modules like Physiotherapy (91.6%), Training Therapy (85.2%) and Information (97.8%) are provided to most of the patients. Younger patients receive more treatments than older patients, and patients with higher comorbidity receive more Physiotherapie, Lymphoedema Therapy and Psychological Interventions than patients without comorbidities. Data analysis shows wide interindividual variability with regard to the therapeutic modules. This variability is related to age and comorbidity of the patients. Furthermore, great differences were found between the rehabilitation clinics concerning the use of the various interventions. This variability supports the necessity of developing and implementing an evidence based guideline for the rehabilitation of breast cancer patients. The next step will be discussing these findings with experts from science and clinical practice.

Blended Interventions to Change Behavior in Patients With Chronic Somatic Disorders: Systematic Review.

Science.gov (United States)

Kloek, Corelien; Bossen, Daniël; de Bakker, Dinny H; Veenhof, Cindy; Dekker, Joost

2017-12-21

Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of blended behavior change interventions and how they should be composed is scattered. This comprehensive systematic review aimed to provide an overview of characteristics and effectiveness of blended behavior change interventions for patients with chronic somatic disorders. We searched for randomized controlled trials published from 2000 to April 2017 in PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the Cochrane Collaboration tool. Study characteristics, intervention characteristics, and outcome data were extracted. Studies were sorted based on their comparison group. A best-evidence synthesis was conducted to summarize the effectiveness. A total of 25 out of the 29 included studies were of high quality. Most studies (n=21; 72%) compared a blended intervention with no intervention. The majority of interventions focused on changing pain behavior (n=17; 59%), and the other interventions focused on lifestyle change (n=12; 41%). In addition, 26 studies (90%) focused on one type of behavior, whereas 3 studies (10%) focused on multiple behaviors. A total of 23 studies (79%) mentioned a theory as basis for the intervention. The therapeutic guidance in most studies (n=18; 62%) was non face-to-face by using email, phone, or videoconferencing, and in the other studies (partly), it was face-to-face (n=11; 38%). In 26 studies (90%), the online care was provided via a website, and in 3 studies (10%) via an app. In 22 studies (76%), the therapeutic guidance and online care were integrated instead of two separate aspects. A total of 26 outcome measures were included in the evidence synthesis comparing blended interventions with no

Heat Shock Proteins and Autophagy Pathways in Neuroprotection: from Molecular Bases to Pharmacological Interventions

Directory of Open Access Journals (Sweden)

Botond Penke

2018-01-01

Full Text Available Neurodegenerative diseases (NDDs such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease (HD, amyotrophic lateral sclerosis, and prion diseases are all characterized by the accumulation of protein aggregates (amyloids into inclusions and/or plaques. The ubiquitous presence of amyloids in NDDs suggests the involvement of disturbed protein homeostasis (proteostasis in the underlying pathomechanisms. This review summarizes specific mechanisms that maintain proteostasis, including molecular chaperons, the ubiquitin-proteasome system (UPS, endoplasmic reticulum associated degradation (ERAD, and different autophagic pathways (chaperon mediated-, micro-, and macro-autophagy. The role of heat shock proteins (Hsps in cellular quality control and degradation of pathogenic proteins is reviewed. Finally, putative therapeutic strategies for efficient removal of cytotoxic proteins from neurons and design of new therapeutic targets against the progression of NDDs are discussed.

Image guided percutaneous splenic interventions

International Nuclear Information System (INIS)

Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

2007-01-01

Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

Appropriate Use Criteria for Fluoroscopically Guided Diagnostic and Therapeutic Sacroiliac Interventions: Results from the Spine Intervention Society Convened Multispecialty Collaborative.

Science.gov (United States)

MacVicar, John; Kreiner, D Scott; Duszynski, Belinda; Kennedy, David J

2017-11-01

To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed. The rating panel considered the evidence presented in the systematic reviews, carefully reviewed the definitions and assumptions, and rated the clinical scenarios. Final median ratings, in combination with the level of agreement, determined the final ratings for the appropriate use of sacroiliac injections and radiofrequency neurotomy. More than 10,000 scenarios were addressed in the appropriate use criteria and are housed within five modules in the portal, available on the Spine Intervention Society website: Module 1: Clinical Indications and Imaging; Module 2: Anticoagulants; Module 3: Timing of Injections; Module 4: Number of Injections; and Module 5: Lateral Branch Radiofrequency Neurotomy. Within several of these modules, several issues of interest are identified and discussed. Physicians and payers can access the appropriate use criteria portal on the Spine Intervention Society's website and select specific clinical indications for a particular patient in order to learn more about the appropriateness of the intervention(s) under consideration. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Dengue Virus Infection of Aedes aegypti Requires a Putative Cysteine Rich Venom Protein.

Directory of Open Access Journals (Sweden)

Berlin Londono-Renteria

2015-10-01

Full Text Available Dengue virus (DENV is a mosquito-borne flavivirus that causes serious human disease and mortality worldwide. There is no specific antiviral therapy or vaccine for DENV infection. Alterations in gene expression during DENV infection of the mosquito and the impact of these changes on virus infection are important events to investigate in hopes of creating new treatments and vaccines. We previously identified 203 genes that were ≥5-fold differentially upregulated during flavivirus infection of the mosquito. Here, we examined the impact of silencing 100 of the most highly upregulated gene targets on DENV infection in its mosquito vector. We identified 20 genes that reduced DENV infection by at least 60% when silenced. We focused on one gene, a putative cysteine rich venom protein (SeqID AAEL000379; CRVP379, whose silencing significantly reduced DENV infection in Aedes aegypti cells. Here, we examine the requirement for CRVP379 during DENV infection of the mosquito and investigate the mechanisms surrounding this phenomenon. We also show that blocking CRVP379 protein with either RNAi or specific antisera inhibits DENV infection in Aedes aegypti. This work identifies a novel mosquito gene target for controlling DENV infection in mosquitoes that may also be used to develop broad preventative and therapeutic measures for multiple flaviviruses.

Empirical Evidence for the Outcomes of Therapeutic Video Games for Adolescents With Anxiety Disorders: Systematic Review.

Science.gov (United States)

Barnes, Steven; Prescott, Julie

2018-02-28

Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers. The growing discrepancy between demand for, and access to, clinical interventions for anxiety has led to the development of a range of eHealth (health care practice supported by electronic processes and communication) and mHealth (versions of eHealth using mobile devices) interventions. One such protocol is therapeutic games, which aim to provide clinical frameworks in dynamic, adaptable, and personalized virtual environments. Although some evidence exists to suggest therapeutic games are associated with reductions in subjective anxiety and observed stress reactivity, there is currently, to our knowledge, no systematic review of the adherence to, and effectiveness of, therapeutic games for adolescent anxiety. The aim of this review was to establish the effectiveness of therapeutic games in making clinically measurable reductions in anxiety symptoms in adolescent samples. A systematic search of the existing academic literature published between 1990 and July 2017 was conducted using the databases Journal of Medical Internet Research, Journal Storage, Psychology Articles, Psychology Info, ScienceDIRECT, and Scopus. Records linked to empirical papers on therapeutic games for anxiety using adolescent samples were evaluated. A total of 5 studies (N=410 participants) met the inclusion criteria, and 3 gamified anxiety interventions for adolescents were identified. The papers included a mixture of randomized controlled trials, quasi-experimental studies, and

Exploring universal partnerships and putative marriages as tools for ...

African Journals Online (AJOL)

Following upon the Supreme Court of Appeal's judgment in Butters v Mncora 2012 4 SA 1 (SCA), which broadened the criteria and consequences of universal partnerships in cohabitation relationships, this article investigates the potential of universal partnerships and putative marriages to allocate rights to share in ...

Pain and endometriosis: Etiology, impact, and therapeutics

Directory of Open Access Journals (Sweden)

Robert N. Taylor

2012-12-01

Full Text Available The association of pain and endometriosis was recognized with the first definitive published reports of this disorder. Unfortunately, the precise etiologies and pathways leading to nociception and pain symptoms in endometriosis remain poorly understood, and as a result, effective therapeutic interventions are lacking with consequent profound effects on affected women’s quality of life. In this opinion paper we summarize selected proceedings presented at the 28th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE in Istanbul, Turkey, and review the clinical and translational evidence of chronic pain, neurogenesis, and the pernicious impact of dyspareunia on women with symptomatic endometriosis. The effectiveness of medical treatments is critically assessed and the findings indicate that good therapeutic options are available with extant medications effective in some sub-groups of women with endometriosis, many of which are affordable globally. Nevertheless, new management strategies and drugs need to be developed to increase the options of all afflicted women to minimize and ideally eradicate painful symptoms of endometriosis. However, only by elucidating distinctions among sub-groups with specific symptoms, suggesting different mechanisms, are we likely to derive truly successful therapeutic strategies.

Hepatitis B core protein as a therapeutic target.

Science.gov (United States)

Mak, Lung-Yi; Wong, Danny Ka-Ho; Seto, Wai-Kay; Lai, Ching-Lung; Yuen, Man Fung

2017-12-01

Chronic hepatitis B virus (HBV) infection is difficult to cure, due to the presence of covalently-closed-circular DNA and virus-mediated blunting of host immune response. Existing therapies with nucleos(t)ide analogue or pegylated-interferon are not sufficient to achieve a high rate of HBV surface antigen seroclearance, a more desirable treatment outcome. Novel therapeutic agents targeting alternative viral replication steps are being developed. In this review, we will discuss the hepatitis B core antigen (HBcAg) as a therapeutic target. Areas covered: The basic structure and fundamental functions of HBcAg including nucleocapsid assembly, pre-genomic RNA encapsidation, reverse transcription, virion formation, cccDNA amplification, immune response regulation, and HBx protein interaction will be reviewed. Most of these are identified as therapeutic targets and tested in in vitro and in vivo studies, although clinical trials are scanty. Among the different components, the core protein allosteric modulators (CpAM) have been most widely investigated and appear promising in clinical trials. Expert opinion: The multiple and essential functions of HBcAg for HBV life cycle are important and attractive targets for HBV therapeutic interventions. Controlled trials involving CpAM are awaited. Apart from CpAM, drugs directed against different functions of HBcAg may be further explored to maximize the chance of cure.

A new putative deltapartitivirus recovered from Dianthus amurensis.

Science.gov (United States)

An, Hongliu; Tan, Guanlin; Xiong, Guihong; Li, Meirong; Fang, Shouguo; Islam, Saif Ul; Zhang, Songbai; Li, Fan

2017-09-01

Two double stranded RNAs (dsRNA), likely representing the genome of a novel deltapartitivirus, provisionally named carnation cryptic virus 3 (CCV3), were recovered from Dianthus amurensis. The two dsRNAs were 1,573 (dsRNA1) and 1,561 (dsRNA2) bp in size, each containing a single open reading frame (ORF) encoding a 475- and 411-aa protein, respectively. The 475-aa protein contains a conserved RNA dependent RNA polymerase (RdRp) domain which shows significant homology to RdRps of established or putative partitiviruses, particularly those belonging to the genus Deltapartitivirus. However, it shares an amino acid identity of 75% with its closest relative, the RdRp of the deltapartitivirus beet cryptic virus 2 (BCV2), and is <62% identical to the RdRps of other partitiviruses. In a phylogenetic tree constructed with RdRps of selected partitiviruses, CCV3 clustered with BCV2 and formed a well-supported monophyletic clade with known or putative deltapartitiviruses.

Zinc and glutamate dehydrogenase in putative glutamatergic brain structures.

Science.gov (United States)

Wolf, G; Schmidt, W

1983-01-01

A certain topographic parallelism between the distribution of histochemically (TIMM staining) identified zinc and putative glutamatergic structures in the rat brain was demonstrated. Glutamate dehydrogenase as a zinc containing protein is in consideration to be an enzyme synthesizing transmitter glutamate. In a low concentration range externally added zinc ions (10(-9) to 10(-7) M) induced an increase in the activity of glutamate dehydrogenase (GDH) originating from rat hippocampal formation, neocortex, and cerebellum up to 142.4%. With rising molarity of Zn(II) in the incubation medium, the enzyme of hippocampal formation and cerebellum showed a biphasic course of activation. Zinc ions of a concentration higher than 10(-6) M caused a strong inhibition of GDH. The effect of Zn(II) on GDH originating from spinal ganglia and liver led only to a decrease of enzyme activity. These results are discussed in connection with a functional correlation between zinc and putatively glutamatergic system.

Is hair loss a reality in neuro-interventional radiology?

LENUS (Irish Health Repository)

Gavagan, L

2012-02-01

Reports in the literature of radiation-induced hair loss are becoming increasingly common. This work describes a retrospective dose study of patients (n = 958) undergoing diagnostic (primarily cerebral angiograms) and therapeutic (primarily cerebral embolisation) procedures in a neuro-interventional suite. A comparison of patient doses as dose area product (DAP) readings from a single-plane image intensifier system (mean DAP value of 8772 cGy cm(2)) were compared with patient doses from a flat panel biplane system (mean DAP value of 7855 cGy cm(2)). Over 80 % of patients requiring neuro-interventional procedures were found to undergo two procedures or more. An estimated 7 % of therapeutic procedures were found to reach the International Commission on Radiological Protection threshold for temporary epilation.

Genome-Wide Analysis of Corynespora cassiicola Leaf Fall Disease Putative Effectors.

Science.gov (United States)

Lopez, David; Ribeiro, Sébastien; Label, Philippe; Fumanal, Boris; Venisse, Jean-Stéphane; Kohler, Annegret; de Oliveira, Ricardo R; Labutti, Kurt; Lipzen, Anna; Lail, Kathleen; Bauer, Diane; Ohm, Robin A; Barry, Kerrie W; Spatafora, Joseph; Grigoriev, Igor V; Martin, Francis M; Pujade-Renaud, Valérie

2018-01-01

Corynespora cassiicola is an Ascomycetes fungus with a broad host range and diverse life styles. Mostly known as a necrotrophic plant pathogen, it has also been associated with rare cases of human infection. In the rubber tree, this fungus causes the Corynespora leaf fall (CLF) disease, which increasingly affects natural rubber production in Asia and Africa. It has also been found as an endophyte in South American rubber plantations where no CLF outbreak has yet occurred. The C. cassiicola species is genetically highly diverse, but no clear relationship has been evidenced between phylogenetic lineage and pathogenicity. Cassiicolin, a small glycosylated secreted protein effector, is thought to be involved in the necrotrophic interaction with the rubber tree but some virulent C. cassiicola isolates do not have a cassiicolin gene. This study set out to identify other putative effectors involved in CLF. The genome of a highly virulent C. cassiicola isolate from the rubber tree (CCP) was sequenced and assembled. In silico prediction revealed 2870 putative effectors, comprising CAZymes, lipases, peptidases, secreted proteins and enzymes associated with secondary metabolism. Comparison with the genomes of 44 other fungal species, focusing on effector content, revealed a striking proximity with phylogenetically unrelated species ( Colletotrichum acutatum, Colletotrichum gloesporioides, Fusarium oxysporum, nectria hematococca , and Botrosphaeria dothidea ) sharing life style plasticity and broad host range. Candidate effectors involved in the compatible interaction with the rubber tree were identified by transcriptomic analysis. Differentially expressed genes included 92 putative effectors, among which cassiicolin and two other secreted singleton proteins. Finally, the genomes of 35 C. cassiicola isolates representing the genetic diversity of the species were sequenced and assembled, and putative effectors identified. At the intraspecific level, effector

Genome-Wide Analysis of Corynespora cassiicola Leaf Fall Disease Putative Effectors

Directory of Open Access Journals (Sweden)

David Lopez

2018-03-01

Full Text Available Corynespora cassiicola is an Ascomycetes fungus with a broad host range and diverse life styles. Mostly known as a necrotrophic plant pathogen, it has also been associated with rare cases of human infection. In the rubber tree, this fungus causes the Corynespora leaf fall (CLF disease, which increasingly affects natural rubber production in Asia and Africa. It has also been found as an endophyte in South American rubber plantations where no CLF outbreak has yet occurred. The C. cassiicola species is genetically highly diverse, but no clear relationship has been evidenced between phylogenetic lineage and pathogenicity. Cassiicolin, a small glycosylated secreted protein effector, is thought to be involved in the necrotrophic interaction with the rubber tree but some virulent C. cassiicola isolates do not have a cassiicolin gene. This study set out to identify other putative effectors involved in CLF. The genome of a highly virulent C. cassiicola isolate from the rubber tree (CCP was sequenced and assembled. In silico prediction revealed 2870 putative effectors, comprising CAZymes, lipases, peptidases, secreted proteins and enzymes associated with secondary metabolism. Comparison with the genomes of 44 other fungal species, focusing on effector content, revealed a striking proximity with phylogenetically unrelated species (Colletotrichum acutatum, Colletotrichum gloesporioides, Fusarium oxysporum, nectria hematococca, and Botrosphaeria dothidea sharing life style plasticity and broad host range. Candidate effectors involved in the compatible interaction with the rubber tree were identified by transcriptomic analysis. Differentially expressed genes included 92 putative effectors, among which cassiicolin and two other secreted singleton proteins. Finally, the genomes of 35 C. cassiicola isolates representing the genetic diversity of the species were sequenced and assembled, and putative effectors identified. At the intraspecific level, effector

The therapeutic use of music as experienced by cardiac surgery ...

African Journals Online (AJOL)

The aim of the study on which this article is based was to describe cardiac surgery patients' experiences of music as a therapeutic intervention in the ICU of a public hospital. The objectives of this article were to introduce and then expose the cardiac patients to music as part of their routine postoperative care and to explore ...

Harnessing insulin- and leptin-induced oxidation of PTP1B for therapeutic development.

Science.gov (United States)

Krishnan, Navasona; Bonham, Christopher A; Rus, Ioana A; Shrestha, Om Kumar; Gauss, Carla M; Haque, Aftabul; Tocilj, Ante; Joshua-Tor, Leemor; Tonks, Nicholas K

2018-01-18

The protein tyrosine phosphatase PTP1B is a major regulator of glucose homeostasis and energy metabolism, and a validated target for therapeutic intervention in diabetes and obesity. Nevertheless, it is a challenging target for inhibitor development. Previously, we generated a recombinant antibody (scFv45) that recognizes selectively the oxidized, inactive conformation of PTP1B. Here, we provide a molecular basis for its interaction with reversibly oxidized PTP1B. Furthermore, we have identified a small molecule inhibitor that mimics the effects of scFv45. Our data provide proof-of-concept that stabilization of PTP1B in an inactive, oxidized conformation by small molecules can promote insulin and leptin signaling. This work illustrates a novel paradigm for inhibiting the signaling function of PTP1B that may be exploited for therapeutic intervention in diabetes and obesity.

CK1δ in lymphoma: gene expression and mutation analyses and validation of CK1δ kinase activity for therapeutic application

Directory of Open Access Journals (Sweden)

Brigitte Sophia Winkler

2015-02-01

Full Text Available The prognosis of lymphoid neoplasms has improved considerably during the last decades. However, treatment response for some lymphoid neoplasms is still poor, indicating the need for new therapeutic approaches. One promising new strategy is the inhibition of kinases regulating key signal transduction pathways, which are of central importance in tumorigenesis. Kinases of the CK1 family may represent an attractive drug target since CK1 expression and/or activity are associated with the pathogenesis of malignant diseases. Over the last years efforts were taken to develop highly potent and selective CK1-specific inhibitor compounds and their therapeutic potential has now to be proved in pre-clinical trials. Therefore, we analyzed expression and mutational status of CK1δ in several cell lines representing established lymphoma entities, and also measured the mRNA expression level in primary lymphoma tissue as well as non-neoplastic blood cells. For a selection of lymphoma cell lines we furthermore determined CK1δ kinase activity and demonstrated therapeutic potential of CK1-specific inhibitors as a putative therapeutic option in the treatment of lymphoid neoplasms.

Crystal structure and putative substrate identification for the Entamoeba histolytica low molecular weight tyrosine phosphatase.

Science.gov (United States)

Linford, Alicia S; Jiang, Nona M; Edwards, Thomas E; Sherman, Nicholas E; Van Voorhis, Wesley C; Stewart, Lance J; Myler, Peter J; Staker, Bart L; Petri, William A

2014-01-01

Entamoeba histolytica is a eukaryotic intestinal parasite of humans, and is endemic in developing countries. We have characterized the E. histolytica putative low molecular weight protein tyrosine phosphatase (LMW-PTP). The structure for this amebic tyrosine phosphatase was solved, showing the ligand-induced conformational changes necessary for binding of substrate. In amebae, it was expressed at low but detectable levels as detected by immunoprecipitation followed by immunoblotting. A mutant LMW-PTP protein in which the catalytic cysteine in the active site was replaced with a serine lacked phosphatase activity, and was used to identify a number of trapped putative substrate proteins via mass spectrometry analysis. Seven of these putative substrate protein genes were cloned with an epitope tag and overexpressed in amebae. Five of these seven putative substrate proteins were demonstrated to interact specifically with the mutant LMW-PTP. This is the first biochemical study of a small tyrosine phosphatase in Entamoeba, and sets the stage for understanding its role in amebic biology and pathogenesis. Copyright © 2014 Elsevier B.V. All rights reserved.

Parenting Interventions for Children with Tic Disorders: Professionals' Perspectives.

Science.gov (United States)

Evans, Gemma A L; Wittkowski, Anja; Butler, Hannah; Hedderly, Tammy; Bunton, Penny

Tic disorders can have an emotional and social impact on children and families, which can in turn have a reciprocal impact on tics. Research into parenting interventions within this population is limited. Twenty-five professionals' views on the acceptability, effectiveness, feasibility and utility of parenting interventions were explored using Q-methodology. Three highly correlated factors emerged, indicating three viewpoints with discrete elements that were underpinned by similar general perspectives. All factors endorsed a psychological approach, the importance of parenting practices, and theoretical and clinical justifications for parenting interventions. Discrete elements of the viewpoints debated the advocated focus, barriers and audience of interventions. Multidisciplinary professionals endorsed parenting interventions as a therapeutic tool within tic disorders. Results provide suggestions to further develop and implement interventions.

Therapeutic touch for nausea in breast cancer patients receiving chemotherapy: Composing a treatment.

Science.gov (United States)

Vanaki, Zohreh; Matourypour, Pegah; Gholami, Roya; Zare, Zahra; Mehrzad, Valiolah; Dehghan, Mojtaba

2016-02-01

Therapeutic touch (TT) is independent nursing intervention which is effective on nausea induced by chemotherapy but technique, steps and variables affected by this therapy are not yet well known. The aim of this study was to elicit descriptions of how TT is used with cancer patients, providing a basis for the systematic use and evaluation of TT with patients. In this research, 108 patients were examined with intentional sampling and random allocation in 3 groups (control, placebo and intervention) in 2013 (each group 36). Intervention received therapeutic touch (touching of first energy layer) and demographic form, visual analog scale (VAS) for intensity of nausea, check list for duration and times of nausea in the morning, noon, afternoon and night at acute phase were used. Data were analyzed by Kruskal Wallis, χ(2) and analysis of variance (ANOVA). Duration, frequency and intensity of nausea were significantly lower in the test group (P < 0.001, P < 0.001 and P < 0.001). The mean duration of intervention (whole process) was 21.38 min [SD 6.04]. In 69.4% of women there was a need for re-intervention after reassessment phase. Results of this randomized control trial showed that TT is effective on duration, times and intensity of nausea; therefore, TT can be used as an alternative method for patients who are willing to use this technique. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox - an animal model of smallpox.

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Parker, Scott; Chen, Nanhai G; Foster, Scott; Hartzler, Hollyce; Hembrador, Ed; Hruby, Dennis; Jordan, Robert; Lanier, Randall; Painter, George; Painter, Wesley; Sagartz, John E; Schriewer, Jill; Mark Buller, R

2012-04-01

The human population is currently faced with the potential use of natural or recombinant variola and monkeypox viruses as biological weapons. Furthermore, the emergence of human monkeypox in Africa and its expanding environs poses a significant natural threat. Such occurrences would require therapeutic and prophylactic intervention with antivirals to minimize morbidity and mortality of exposed populations. Two orally-bioavailable antivirals are currently in clinical trials; namely CMX001, an ether-lipid analog of cidofovir with activity at the DNA replication stage and ST-246, a novel viral egress inhibitor. Both of these drugs have previously been evaluated in the ectromelia/mousepox system; however, the trigger for intervention was not linked to a disease biomarker or a specific marker of virus replication. In this study we used lethal, intranasal, ectromelia virus infections of C57BL/6 and hairless SKH1 mice to model human disease and evaluate exanthematous rash (rash) as an indicator to initiate antiviral treatment. We show that significant protection can be provided to C57BL/6 mice by CMX001 or ST-246 when therapy is initiated on day 6 post infection or earlier. We also show that significant protection can be provided to SKH1 mice treated with CMX001 at day 3 post infection or earlier, but this is four or more days before detection of rash (ST-246 not tested). Although in this model rash could not be used as a treatment trigger, viral DNA was detected in blood by day 4 post infection and in the oropharyngeal secretions (saliva) by day 2-3 post infection - thus providing robust and specific markers of virus replication for therapy initiation. These findings are discussed in the context of current respiratory challenge animal models in use for the evaluation of poxvirus antivirals. Copyright © 2012 Elsevier B.V. All rights reserved.

Preconditioning With Low-Level Laser Irradiation Enhances the Therapeutic Potential of Human Adipose-derived Stem Cells in a Mouse Model of Photoaged Skin.

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Liao, Xuan; Li, Sheng-Hong; Xie, Guang-Hui; Xie, Shan; Xiao, Li-Ling; Song, Jian-Xing; Liu, Hong-Wei

2018-02-19

This study was conducted to explore the therapeutic potential of human adipose-derived stem cells (ADSCs) irradiated with a low-level laser (LLL). Cultured ADSCs were treated with 650-nm GaAlAs laser irradiation at 2, 4 and 8 J cm -2 . Cell proliferation was quantified by MTT assays, cytokine secretion was determined by enzyme-linked immunosorbent assays, and adipogenic differentiation was examined by oil red O staining. Additionally, the expression profiles of putative ADSC surface markers were analyzed by quantitative real-time PCR. In addition, a mouse photoaged skin model was established by UVB irradiation. Effects of GaAlAs laser-treated ADSCs on the thicknesses of the epidermis and dermis were analyzed by hematoxylin and eosin staining. The results showed that GaAlAs laser treatment of cells at a radiant exposure of 4 J cm -2 enhanced ADSC proliferation and adipogenic differentiation and increased secretion of growth factors. Furthermore, GaAlAs laser irradiation upregulated the expression of putative ADSC surface markers. In the mouse model of photoaged skin, ADSCs treated with GaAlAs laser irradiation had markedly decreased the epidermal thickness and increased the dermal thickness of photoaged mouse skin. Our data indicate that LLL irradiation is an effective biostimulator of ADSCs and might enhance the therapeutic potential of ADSCs for clinical use. © 2018 The American Society of Photobiology.

MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial.

Science.gov (United States)

Loh, Debbie Ann; Hairi, Noran Naqiah; Choo, Wan Yuen; Mohd Hairi, Farizah; Peramalah, Devi; Kandiben, Shathanapriya; Lee, Pek Ling; Gani, Norlissa; Madzlan, Mohamed Faris; Abd Hamid, Mohd Alif Idham; Akram, Zohaib; Chu, Ai Sean; Bulgiba, Awang; Cumming, Robert G

2015-02-11

The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia. This cluster randomised controlled trial will be a 6-week community-based intervention programme for older people aged 60 years and above from urban poor settings. A minimum of 164 eligible participants will be recruited from 8 clusters (low-cost public subsidised flats) and randomised to the intervention and control arm. This study will be underpinned by the Health Belief Model with an emphasis towards self-efficacy. The intervention will comprise multicomponent group exercise sessions, nutrition education, oral care education and on-going support and counselling. These will be complemented with a kit containing practical tips on exercise, nutrition and oral care after each session. Data will be collected over four time points; at baseline, immediately post-intervention, 3-months and 6-months follow-up. Findings from this trial will potentially provide valuable evidence to improve physical function and maintain independence among older people from low-resource settings. This will inform health policies and identify locally acceptable strategies to promote healthy aging, prevent and delay functional decline among older Malaysian adults. ISRCTN22749696.

Patient affect experiencing following therapist interventions in short-term dynamic psychotherapy.

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Town, Joel M; Hardy, Gillian E; McCullough, Leigh; Stride, Chris

2012-01-01

The aim of this research was to examine the relationship between therapist interventions and patient affect responses in Short-Term Dynamic Psychotherapy (STDP). The Affect Experiencing subscale from the Achievement of Therapeutic Objectives Scale (ATOS) was adapted to measure individual immediate affect experiencing (I-AES) responses in relation to therapist interventions coded within the preceding speaking turn, using the Psychotherapy Interaction Coding (PIC) system. A hierarchical linear modelling procedure was used to assess the change in affect experiencing and the relationship between affect experiencing and therapist interventions within and across segments of therapy. Process data was taken from six STDP cases; in total 24 hours of video-taped sessions were examined. Therapist interventions were found to account for a statistically significant amount of variance in immediate affect experiencing. Higher levels of immediate affect experiencing followed the therapist's use of Confrontation, Clarification and Support compared to Questions, Self-disclosure and Information interventions. Therapist Confrontation interventions that attempted to direct pressure towards either the visceral experience of affect or a patient's defences against feelings led to the highest levels of immediate affect experiencing. The type of therapist intervention accounts for a small but significant amount of the variation observed in a patient's immediate emotional arousal. Empirical findings support clinical theory in STDP that suggests strategic verbal responses promote the achievement of this specific therapeutic objective.

Putative drug and vaccine target protein identification using comparative genomic analysis of KEGG annotated metabolic pathways of Mycoplasma hyopneumoniae.

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Damte, Dereje; Suh, Joo-Won; Lee, Seung-Jin; Yohannes, Sileshi Belew; Hossain, Md Akil; Park, Seung-Chun

2013-07-01

In the present study, a computational comparative and subtractive genomic/proteomic analysis aimed at the identification of putative therapeutic target and vaccine candidate proteins from Kyoto Encyclopedia of Genes and Genomes (KEGG) annotated metabolic pathways of Mycoplasma hyopneumoniae was performed for drug design and vaccine production pipelines against M.hyopneumoniae. The employed comparative genomic and metabolic pathway analysis with a predefined computational systemic workflow extracted a total of 41 annotated metabolic pathways from KEGG among which five were unique to M. hyopneumoniae. A total of 234 proteins were identified to be involved in these metabolic pathways. Although 125 non homologous and predicted essential proteins were found from the total that could serve as potential drug targets and vaccine candidates, additional prioritizing parameters characterize 21 proteins as vaccine candidate while druggability of each of the identified proteins evaluated by the DrugBank database prioritized 42 proteins suitable for drug targets. Copyright © 2013 Elsevier Inc. All rights reserved.

Putative periodontopathic bacteria and herpesviruses in pregnant women: a case-control study.

Science.gov (United States)

Lu, Haixia; Zhu, Ce; Li, Fei; Xu, Wei; Tao, Danying; Feng, Xiping

2016-06-15

Little is known about herpesvirus and putative periodontopathic bacteria in maternal chronic periodontitis. The present case-control study aimed to explore the potential relationship between putative periodontopathic bacteria and herpesviruses in maternal chronic periodontitis.Saliva samples were collected from 36 pregnant women with chronic periodontitis (cases) and 36 pregnant women with healthy periodontal status (controls). Six putative periodontopathic bacteria (Porphyromonas gingivalis [Pg], Aggregatibacer actinomycetemcomitans [Aa], Fusobacterium nucleatum [Fn], Prevotella intermedia [Pi], Tannerella forsythia [Tf], and Treponema denticola [Td]) and three herpesviruses (Epstein-Barr virus [EBV], human cytomegalovirus [HCMV], and herpes simplex virus [HSV]) were detected. Socio-demographic data and oral health related behaviors, and salivary estradiol and progesterone levels were also collected. The results showed no significant differences in socio-demographic background, oral health related behaviors, and salivary estradiol and progesterone levels between the two groups (all P > 0.05). The detection rates of included periodontopathic microorganisms were not significantly different between the two groups (all P > 0.05), but the coinfection rate of EBV and Pg was significantly higher in the case group than in the control group (P = 0.028). EBV and Pg coinfection may promote the development of chronic periodontitis among pregnant women.

Computational identification of putative cytochrome P450 genes in ...

African Journals Online (AJOL)

In this work, a computational study of expressed sequence tags (ESTs) of soybean was performed by data mining methods and bio-informatics tools and as a result 78 putative P450 genes were identified, including 57 new ones. These genes were classified into five clans and 20 families by sequence similarities and among ...

Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

Directory of Open Access Journals (Sweden)

Shauna Kingsnorth

2011-01-01

Full Text Available This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood and behavior (facial expressions and vocalizations. Semistructured interviews were completed with verbally expressive children (n = 7 and nurses of participating children (n = 13. Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self and nurses' (observed reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings.

Therapeutic Self-Disclosure within DBT, Schema Therapy, and CBASP: Opportunities and Challenges.

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Köhler, Stephan; Guhn, Anne; Betzler, Felix; Stiglmayr, Christian; Brakemeier, Eva-Lotta; Sterzer, Philipp

2017-01-01

In recent years, various therapeutic interventions have been established that extended behavior and cognitive behavior therapy (CBT) by so-called "third-wave" strategies. In order to address specific therapeutic challenges in certain subgroups of patients who do not sufficiently respond to "classical CBT," some of these third-wave strategies put particular emphasis on therapist self-disclosure. This article highlights therapeutic self-disclosure as a means to address interpersonal problems by comparing three third-wave strategies: (a) acceptance and change strategies as used in Dialectical Behavioral Therapy (DBT), (b) the concept of "limited reparenting" as used in Schema Therapy (ST), and (c) disciplined personal involvement as used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). On the basis of a critical discussion on opportunities and challenges within these three concepts, self-disclosure is proposed to be a promising therapeutic tool that is worth to be investigated in more depth in future studies.

Therapeutic Self-Disclosure within DBT, Schema Therapy, and CBASP: Opportunities and Challenges

Directory of Open Access Journals (Sweden)

Stephan Köhler

2017-11-01

Full Text Available In recent years, various therapeutic interventions have been established that extended behavior and cognitive behavior therapy (CBT by so-called “third-wave” strategies. In order to address specific therapeutic challenges in certain subgroups of patients who do not sufficiently respond to “classical CBT,” some of these third-wave strategies put particular emphasis on therapist self-disclosure. This article highlights therapeutic self-disclosure as a means to address interpersonal problems by comparing three third-wave strategies: (a acceptance and change strategies as used in Dialectical Behavioral Therapy (DBT, (b the concept of “limited reparenting” as used in Schema Therapy (ST, and (c disciplined personal involvement as used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP. On the basis of a critical discussion on opportunities and challenges within these three concepts, self-disclosure is proposed to be a promising therapeutic tool that is worth to be investigated in more depth in future studies.

Chemopreventive and therapeutic activity of dietary blueberry against estrogen-mediated breast cancer.

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Jeyabalan, Jeyaprakash; Aqil, Farrukh; Munagala, Radha; Annamalai, Lakshmanan; Vadhanam, Manicka V; Gupta, Ramesh C

2014-05-07

Berries are gaining increasing importance lately for their chemopreventive and therapeutic potential against several cancers. In earlier studies, a blueberry-supplemented diet has shown protection against 17β-estradiol (E2)-mediated mammary tumorigenesis. This study tested both preventive and therapeutic activities of diet supplemented with whole blueberry powder (50:50 blend of Tifblue and Rubel). Animals received 5% blueberry diet, either 2 weeks prior to or 12 weeks after E2 treatment in preventive and therapeutic groups, respectively. Both interventions delayed the tumor latency for palpable mammary tumors by 28 and 37 days, respectively. Tumor volume and multiplicity were also reduced significantly in both modes. The effect on mammary tumorigenesis was largely due to down-regulation of CYP 1A1 and ER-α gene expression and also favorable modulation of microRNA (miR-18a and miR-34c) levels. These data suggest that the blueberry blend tested is effective in inhibiting E2-mediated mammary tumorigenesis in both preventive and therapeutic modes.

Calcium Regulation of Hemorrhagic Fever Virus Budding: Mechanistic Implications for Host-Oriented Therapeutic Intervention.

Directory of Open Access Journals (Sweden)

Ziying Han

2015-10-01

Full Text Available Hemorrhagic fever viruses, including the filoviruses (Ebola and Marburg and arenaviruses (Lassa and Junín viruses, are serious human pathogens for which there are currently no FDA approved therapeutics or vaccines. Importantly, transmission of these viruses, and specifically late steps of budding, critically depend upon host cell machinery. Consequently, strategies which target these mechanisms represent potential targets for broad spectrum host oriented therapeutics. An important cellular signal implicated previously in EBOV budding is calcium. Indeed, host cell calcium signals are increasingly being recognized to play a role in steps of entry, replication, and transmission for a range of viruses, but if and how filoviruses and arenaviruses mobilize calcium and the precise stage of virus transmission regulated by calcium have not been defined. Here we demonstrate that expression of matrix proteins from both filoviruses and arenaviruses triggers an increase in host cytoplasmic Ca2+ concentration by a mechanism that requires host Orai1 channels. Furthermore, we demonstrate that Orai1 regulates both VLP and infectious filovirus and arenavirus production and spread. Notably, suppression of the protein that triggers Orai activation (Stromal Interaction Molecule 1, STIM1 and genetic inactivation or pharmacological blockade of Orai1 channels inhibits VLP and infectious virus egress. These findings are highly significant as they expand our understanding of host mechanisms that may broadly control enveloped RNA virus budding, and they establish Orai and STIM1 as novel targets for broad-spectrum host-oriented therapeutics to combat these emerging BSL-4 pathogens and potentially other enveloped RNA viruses that bud via similar mechanisms.

Translational research in addiction: toward a framework for the development of novel therapeutics.

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Paterson, Neil E

2011-06-15

The development of novel substance use disorder (SUD) therapeutics is insufficient to meet the medical needs of a growing SUD patient population. The identification of translatable SUD models and tests is a crucial step in establishing a framework for SUD therapeutic development programs. The present review begins by identifying the clinical features of SUDs and highlights the narrow regulatory end-point required for approval of a novel SUD therapeutic. A conceptual overview of dependence is provided, followed by identification of potential intervention targets in the addiction cycle. The main components of the addiction cycle provide the framework for a discussion of preclinical models and their clinical analogs, all of which are focused on isolated behavioral end-points thought to be relevant to the persistence of compulsive drug use. Thus, the greatest obstacle to successful development is the gap between the multiplicity of preclinical and early clinical end-points and the regulatory end-point of sustained abstinence. This review proposes two pathways to bridging this gap: further development and validation of the preclinical extended access self-administration model; inclusion of secondary end-points comprising all of the measures highlighted in the present discussion in Phase 3 trials. Further, completion of the postdictive validation of analogous preclinical and clinical assays is of high priority. Ultimately, demonstration of the relevance and validity of a variety of end-points to the ultimate goal of abstinence will allow researchers to identify truly relevant therapeutic mechanisms and intervention targets, and establish a framework for SUD therapeutic development that allows optimal decision-making and resource allocation. 2011 Elsevier Inc. All rights reserved.

The Therapeutic Utility of Employment in Treating Drug Addiction: Science to Application.

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Silverman, Kenneth; Holtyn, August F; Morrison, Reed

2016-06-01

Research on a model Therapeutic Workplace has allowed for evaluation of the use of employment in the treatment of drug addiction. Under the Therapeutic Workplace intervention, adults with histories of drug addiction are hired and paid to work. To promote drug abstinence or adherence to addiction medications, participants are required to provide drug-free urine samples or take prescribed addiction medications, respectively, to gain access to the workplace and/or to maintain their maximum rate of pay. Research has shown that the Therapeutic Workplace intervention is effective in promoting and maintaining abstinence from heroin, cocaine and alcohol and in promoting adherence to naltrexone. Three models could be used to implement and maintain employment-based reinforcement in the treatment of drug addiction: A Social Business model, a Cooperative Employer model, and a Wage Supplement model. Under all models, participants initiate abstinence in a training and abstinence initiation phase (Phase 1). Under the Social Business model, Phase 1 graduates are hired as employees in a social business and required to maintain abstinence to maintain employment and/or maximum pay. Under the Cooperative Employer model, cooperating community employers hire graduates of Phase 1 and require them to maintain abstinence to maintain employment and/or maximum pay. Under the Wage Supplement Model, graduates of Phase 1 are offered abstinence-contingent wage supplements if they maintain competitive employment in a community job. Given the severity and persistence of the problem of drug addiction and the lack of treatments that can produce lasting effects, continued development of the Therapeutic Workplace is warranted.

Therapeutic laryngoscopy during exercise: A novel non-surgical therapy for refractory EILO.

Science.gov (United States)

Olin, J Tod; Deardorff, Emily H; Fan, Elizabeth M; Johnston, Kristina L; Keever, Valerie L; Moore, Camille M; Bender, Bruce G

2017-06-01

Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness. Clinical EILO patients with symptoms refractory to conventional respiratory retraining and other therapies were referred for the procedure which features laryngoscopy video as biofeedback during serial physician-guided 1-min exercise sprints. We quantify perceptions of procedure safety, tolerability, learning value, and effectiveness through questionnaires offered to all patients as well as observers of the procedure. Forty-one patients and 37 parent observers were approached for feedback; 88% of patients and 95% of observers consented to participation. Patients and observers reported perceptions of safety and tolerability (81% and 86%, respectively), learning value (78% and 91%, respectively), and effectiveness (58% and 80%, respectively) with patient age predicting some responses. Seventy-five percent of patients noted that "Since the procedure, my breathing during exercise has improved," and 85% of this group noted that therapeutic laryngoscopy during exercise was "the most important therapy leading to my breathing improvement." The procedure also provided insight into the psychological experience of patients, a domain not clinically apparent prior to the procedure. Our data support further study of therapeutic laryngoscopy during exercise as a possible intervention for patients with refractory EILO. Pediatr Pulmonol. 2017;52:813-819. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Visual stimuli in intervention approaches for pre-schoolers diagnosed with phonological delay.

Science.gov (United States)

Pedro, Cassandra Ferreira; Lousada, Marisa; Hall, Andreia; Jesus, Luis M T

2018-04-01

The aim of this study was to develop and content validate specific speech and language intervention picture cards: The Letter-Sound (L&S) cards. The present study was also focused on assessing the influence of these cards on letter-sound correspondences and speech sound production. An expert panel of six speech and language therapists analysed and discussed the L&S cards based on several criteria previously established. A Speech and Language Therapist carried out a 6-week therapeutic intervention with a group of seven Portuguese phonologically delayed pre-schoolers aged 5;3 to 6;5. The modified Bland-Altman method revealed good agreement among evaluators, that is the majority of the values was between the agreement limits. Additional outcome measures were collected before and after the therapeutic intervention process. Results indicate that the L&S cards facilitate the acquisition of letter-sound correspondences. Regarding speech sound production, some improvements were also observed at word level. The L&S cards are therefore likely to give phonetic cues, which are crucial for the correct production of therapeutic targets. These visual cues seemed to have helped children with phonological delay develop the above-mentioned skills.

Tough love: A brief cultural history of the addiction intervention.

Science.gov (United States)

Clark, Claire D

2012-08-01

Popular media depictions of intervention and associated confrontational therapies often implicitly reference-and sometimes explicitly present-dated and discredited therapeutic practices. Furthermore, rather than reenacting these practices, contemporary televised interventions revive them. Drawing on a range of literature in family history, psychology, and media studies that covers the course of the last 3 decades, this paper argues that competing discourses about the nuclear family enabled this revival. Historians such as Stephanie Coontz, Elaine Tyler May, and Natasha Zaretsky have demonstrated that the ideal nuclear family in the post-WWII United States was defined by strictly gendered roles for parents and appropriate levels of parental engagement with children. These qualities were supposedly strongly associated with middle-class decorum and material comfort. By the 1970s, this familial ideal was subjected to a variety of criticisms, most notably from mental health practitioners who studied-or attempted to remedy-the problematic family dynamics that arose from, for example, anxious mothers or absent fathers. After psychological professionals began to question the logic of treating maladjusted individuals for the sake of preserving the nuclear family, a therapeutic process for doing exactly that was popularized: the addiction intervention. The delayed prevalence of therapeutic interventions arises from a tension between the psychological establishment that increasingly viewed the nuclear family as the primary site and source of social and psychological ills, and the producers of popular media, who relied on the redemptive myth of the nuclear family as a source of drama. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Synthetic biology in mammalian cells: Next generation research tools and therapeutics

Science.gov (United States)

Lienert, Florian; Lohmueller, Jason J; Garg, Abhishek; Silver, Pamela A

2014-01-01

Recent progress in DNA manipulation and gene circuit engineering has greatly improved our ability to programme and probe mammalian cell behaviour. These advances have led to a new generation of synthetic biology research tools and potential therapeutic applications. Programmable DNA-binding domains and RNA regulators are leading to unprecedented control of gene expression and elucidation of gene function. Rebuilding complex biological circuits such as T cell receptor signalling in isolation from their natural context has deepened our understanding of network motifs and signalling pathways. Synthetic biology is also leading to innovative therapeutic interventions based on cell-based therapies, protein drugs, vaccines and gene therapies. PMID:24434884

Contingency management of reliable attendance of chronically unemployed substance abusers in a therapeutic workplace.

Science.gov (United States)

Wong, Conrad J; Dillon, Erin M; Sylvest, Christine E; Silverman, Kenneth

2004-02-01

The Therapeutic Workplace is an effective drug abuse treatment that integrates abstinence reinforcement into a work setting by using a salary that drug abusers earn for work. Drug abuse patients are trained and hired to become data entry operators in a Therapeutic Workplace business. Despite the opportunity to earn a high wage, participants frequently arrive at work late and fail to work complete shifts. In the present study, a contingency management intervention to promote consistent and reliable attendance was evaluated in 4 participants. Participants were not allowed to work on days that they arrived late, and their pay was temporarily reduced each time they arrived late at work or failed to complete a work shift. A within-subject reversal design showed that the intervention increased the frequency with which participants arrived at work on time and completed work shifts.

Putative golden proportions as predictors of facial esthetics in adolescents.

NARCIS (Netherlands)

Kiekens, R.M.A.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Hof, B.E. van 't; Maltha, J.C.

2008-01-01

INTRODUCTION: In orthodontics, facial esthetics is assumed to be related to golden proportions apparent in the ideal human face. The aim of the study was to analyze the putative relationship between facial esthetics and golden proportions in white adolescents. METHODS: Seventy-six adult laypeople

Putative Dementia Cases Fluctuate as a Function of Mini-Mental State Examination Cut-Off Points.

Science.gov (United States)

Rosa, Ilka M; Henriques, Ana G; Wiltfang, Jens; da Cruz E Silva, Odete A B

2018-01-01

As the population ages, there is a growing need to quickly and accurately identify putative dementia cases. Many cognitive tests are available; among those commonly used are the Cognitive Dementia Rating (CDR) and the Mini-Mental Status Examination (MMSE). The aim of this work was to compare the validity and reliability of these cognitive tests in a primary care based cohort (pcb-Cohort). The MMSE and the CDR were applied to 568 volunteers in the pcb-Cohort. Distinct cut-off points for the MMSE were considered, namely MMSE 27, MMSE 24, and MMSE PT (adapted for the Portuguese population). The MMSE 27 identified the greatest number of putative dementia cases, and, as determined by the ROC curve, it was the most sensitive and specific of the MMSE cut-offs considered. Putative predictive or risk factors identified included age, literacy, depression, and diabetes mellitus (DM). DM has previously been indicated as a risk factor for dementia and Alzheimer's disease. Comparatively, the MMSE 27 cut-off has the greatest sensibility (94.9%) and specificity (66.3%) when compared to MMSE PT and MMSE 24. Upon comparing MMSE and CDR scores, the latter identified a further 146 putative dementia cases, thus permitting one to propose that in an ideal situation, both tests should be employed. This increases the likelihood of identifying putative dementia cases for subsequent follow up work, thus these cognitive tests represent important tools in patient care. Further, this is a significant study for Portuguese populations, where few of these studies have been carried out.

Effectiveness of therapeutic behavioral interventions for parents of low birth weight premature infants: A review

Science.gov (United States)

Brecht, Carrie; Shaw, Richard J.; Horwitz, Sarah M.; John, Nicholas H. St.

2014-01-01

Premature birth has been associated with a number of adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants and children who were premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent. In response to these findings, there have been a number of educational and behavioral interventions developed that target maternal psychological functioning, parenting and aspects of the parent-infant relationship. Since the last comprehensive review of this topic in 2002, there have been a significant number of developments in the quality of the studies conducted and the theoretical models that address the experience of parents of premature infants. In the current review, eighteen new interventions were identified and grouped into four categories based on treatment length and the target of the intervention. Findings suggest a trend towards early, brief interventions that are theoretically based, specifically target parent trauma, and utilize cognitive behavioral techniques. Although it is difficult to generalize study findings, conclusions from the review suggest that targeted interventions may have positive effects on both maternal and infant outcomes. PMID:24532861

Development of therapeutic antibodies to G protein-coupled receptors and ion channels: Opportunities, challenges and their therapeutic potential in respiratory diseases.

Science.gov (United States)

Douthwaite, Julie A; Finch, Donna K; Mustelin, Tomas; Wilkinson, Trevor C I

2017-01-01

The development of recombinant antibody therapeutics continues to be a significant area of growth in the pharmaceutical industry with almost 50 approved monoclonal antibodies on the market in the US and Europe. Therapeutic drug targets such as soluble cytokines, growth factors and single transmembrane spanning receptors have been successfully targeted by recombinant monoclonal antibodies and the development of new product candidates continues. Despite this growth, however, certain classes of important disease targets have remained intractable to therapeutic antibodies due to the complexity of the target molecules. These complex target molecules include G protein-coupled receptors and ion channels which represent a large target class for therapeutic intervention with monoclonal antibodies. Although these targets have typically been addressed by small molecule approaches, the exquisite specificity of antibodies provides a significant opportunity to provide selective modulation of these important regulators of cell function. Given this opportunity, a significant effort has been applied to address the challenges of targeting these complex molecules and a number of targets are linked to the pathophysiology of respiratory diseases. In this review, we provide a summary of the importance of GPCRs and ion channels involved in respiratory disease and discuss advantages offered by antibodies as therapeutics at these targets. We highlight some recent GPCRs and ion channels linked to respiratory disease mechanisms and describe in detail recent progress made in the strategies for discovery of functional antibodies against challenging membrane protein targets such as GPCRs and ion channels. Copyright © 2016 Elsevier Inc. All rights reserved.

Heterologous expression and characterization of a putative glycoside hydrolase family 43 arabinofuranosidase from Clostridium thermocellum B8

NARCIS (Netherlands)

Camargo, de Brenda R.; Claassens, Nico J.; Quirino, Betania Ferraz; Noronha, Eliane F.; Kengen, Servé W.M.

2018-01-01

An extensive list of putative cellulosomal enzymes from C. thermocellum is now available in the public databanks, however, most of these remain unvalidated with regard to their activity and expression control mechanisms. This is particularly true of those enzymes putatively involved in hemicellulose

MicroRNA-196a is a putative diagnostic biomarker and therapeutic target for laryngeal cancer.

Directory of Open Access Journals (Sweden)

Koichiro Saito

Full Text Available BACKGROUND: MicroRNA (miRNA is an emerging subclass of small non-coding RNAs that regulates gene expression and has a pivotal role for many physiological processes including cancer development. Recent reports revealed the role of miRNAs as ideal biomarkers and therapeutic targets due to their tissue- or disease-specific nature. Head and neck cancer (HNC is a major cause of cancer-related mortality and morbidity, and laryngeal cancer has the highest incidence in it. However, the molecular mechanisms involved in laryngeal cancer development remain to be known and highly sensitive biomarkers and novel promising therapy is necessary. METHODOLOGY/PRINCIPAL FINDINGS: To explore laryngeal cancer-specific miRNAs, RNA from 5 laryngeal surgical specimens including cancer and non-cancer tissues were hybridized to microarray carrying 723 human miRNAs. The resultant differentially expressed miRNAs were further tested by using quantitative real time PCR (qRT-PCR on 43 laryngeal tissue samples including cancers, noncancerous counterparts, benign diseases and precancerous dysplasias. Significant expressional differences between matched pairs were reproduced in miR-133b, miR-455-5p, and miR-196a, among which miR-196a being the most promising cancer biomarker as validated by qRT-PCR analyses on additional 84 tissue samples. Deep sequencing analysis revealed both quantitative and qualitative deviation of miR-196a isomiR expression in laryngeal cancer. In situ hybridization confirmed laryngeal cancer-specific expression of miR-196a in both cancer and cancer stroma cells. Finally, inhibition of miR-196a counteracted cancer cell proliferation in both laryngeal cancer-derived cells and mouse xenograft model. CONCLUSIONS/SIGNIFICANCE: Our study provided the possibilities that miR-196a might be very useful in diagnosing and treating laryngeal cancer.

Clinical analysis of the therapy for recurrent and intractable non-small cell lung cancer with combination of cryoablation and intervention

International Nuclear Information System (INIS)

Zhang Futong; Li Xiuli; Li Huijie; An Yonghui

2007-01-01

Objective: To explore the re-treatment approach for nonsmall-cell lung cancer (NSCLC )in clinic with therapeutic alliance of cryotherapy and interventional chemotherapy. Methods: Sixty two patients with uncontrolled NSCLC after common radiotherapy and (or)chemotherapy were re-treated with therapeutic alliance of cryotherapy and interventional chemotherapy, and their serum tumor markers of NSE, CEA, CY21- 1 and the value (I.S%,I.O.D%)of correlative protein in nucleolus region-Ag-NORs were tested before and after the re-treatment. Meanwhile, patients one year survival and therapeutic effect to NSCLC were recorded during the follow up. Results: After the re-treatment, distinguished decline of the serum tumor markers was observed (P<0.01)and values of Ag-NORs(I.S% and I.O.D%)were obviously lowered down. The therapeutic effect and one year survival were 79.03%(49/62)and 80.63%(50/62)respectively. Conclusion: Therapeutic alliance of cryotherapy and interventional chemotherapy is a kind of effective re-treatment for NSCLC and also as a new approach for the refractory NSCLC. (authors)

An assessment of the utilization of the preclinical rodent model literature in clinical trials of putative therapeutics for the treatment of alcohol use disorders.

Science.gov (United States)

Barajaz, Ashley M; Kliethermes, Christopher L

2017-12-01

Rodent models of Alcohol Use Disorders (AUD) are used extensively by preclinical researchers to develop new therapeutics for the treatment of AUD. Although these models play an important role in the development of novel, targeted therapeutics, their role in bringing therapeutics to clinical trials is unclear, as off-label use of existing medications not approved for the treatment of AUD is commonly seen in the clinic and clinical trials. In the current study, we used the Clinicaltrials.gov database to obtain a list of drugs that have been tested for efficacy in a clinical trial between 1997 and 2017. We then conducted a set of literature searches to determine which of the 98 unique drugs we identified had shown efficacy in a rodent model of an AUD prior to being tested in a clinical trial. We found that slightly less than half of the drugs tested in clinical trials (48%) had shown prior efficacy in any rodent model of an AUD, while the remaining 52% of drugs were used off-label, or in some cases, following non-published studies. This study raises the question of how clinical researchers incorporate results from preclinical studies in the decision to bring a drug to a clinical trial. Our results underscore the need for ongoing communication among preclinical and clinical researchers. Copyright © 2017 Elsevier B.V. All rights reserved.

Emerging targets and therapeutic approaches for the treatment of osteoarthritis pain.

Science.gov (United States)

Rahman, Wahida; Dickenson, Anthony H

2015-06-01

Osteoarthritis is a complex and often painful disease that is inadequately controlled with current analgesics. This review discusses emerging targets and therapeutic approaches that may lead to the development of better analgesics. Aberrant excitability in peripheral and central pain pathways drives osteoarthritis pain, reversing this via modulation of nerve growth factor, voltage-gated sodium channel, voltage-gated calcium channel and transient receptor potential vanilloid one activity, and increasing inhibitory mechanisms through modulation of cannabinoid and descending modulatory systems hold promise for osteoarthritis pain therapy. Somatosensory phenotyping of chronic pain patients, as a surrogate of putative pain generating mechanisms, may predict patient response to treatment. Identification of new targets will inform and guide future research, aiding the development of more effective analgesics. Future clinical trial designs should implement sensory phenotyping of patients, as an inclusion or stratification criterion, in order to establish an individualized, mechanism-based treatment of osteoarthritis pain.

Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease. Potential benefits and underlying mechanisms: A mini review

Directory of Open Access Journals (Sweden)

Kim E Innes

2014-04-01

Full Text Available Alzheimer's disease (AD is a chronic, progressive, brain disorder that affects at least 5.3 million Americans at an estimated cost of $148 billion, figures that are expected to rise steeply in coming years. Despite decades of research, there is still no cure for AD, and effective therapies for preventing or slowing progression of cognitive decline in at-risk populations remain elusive. While the etiology of AD remains uncertain, chronic stress, sleep deficits, and mood disturbance, conditions common in those with cognitive impairment, have been prospectively linked to the development and progression of both chronic illness and memory loss and are significant predictors of AD. Therapies such as meditation that specifically target these risk factors may thus hold promise for slowing and possibly preventing cognitive decline in those at risk. In this paper, we briefly review the existing evidence regarding the potential utility of meditation as a therapeutic intervention for those with and at risk for AD, discuss possible mechanisms underlying the observed benefits of meditation, and outline directions for future research.

Endovascular interventions for multiple trauma

International Nuclear Information System (INIS)

Kinstner, C.; Funovics, M.

2014-01-01

In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD.

Science.gov (United States)

Langberg, Joshua M; Becker, Stephen P; Epstein, Jeffery N; Vaughn, Aaron J; Girio-Herrera, Erin

2013-10-01

The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6-8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.

Respiratory virus modulation of host nucleocytoplasmic transport; target for therapeutic intervention?

Directory of Open Access Journals (Sweden)

Leon eCaly

2015-08-01

Full Text Available The respiratory diseases caused by Rhinovirus, Respiratory Syncytial Virus and Influenza virus represent a large social and financial burden on healthcare worldwide. Although all three viruses have distinctly unique properties in terms of infection and replication, they share the ability to exploit/manipulate the host-cell nucleocytoplasmic transport system in order to replicate effectively and efficiently. This review outlines the various ways in which infection by these viruses impacts on the host nucleocytoplasmic transport system, and examples where inhibition thereof in turn decreases viral replication. The highly conserved nature of the nucleocytoplasmic transport system and the viral proteins that interact with it make this virus-host interface a prime candidate for the development of specific antiviral therapeutics in the future.

Prospective utility of therapeutic ultrasound in dentistry-Review with recent comprehensive update

Directory of Open Access Journals (Sweden)

Shalu Rai

2012-01-01

Full Text Available Background: The utility of ultrasound (US for therapeutic purposes is still in its infancy. Therapeutic US (TUS has been used widely in medical field for urological application, surgical intervention, bone healing, and osteointegration in cancer and healing of full thickness excised skin lesions, and within dentistry as a prediagnostic, diagnostic and therapeutic purpose. The purpose of the paper is to review and determine the efficacy of US as one of the treatment modalities for its role in maxillofacial region to reduce pain and promote soft tissue healing. Materials and Methods: A Medline search included of the international literature published between 1976 and 2011 and was restricted to English language articles, published work of past researchers including in vitro and in vivo studies, recent additions of textbooks on surgical and therapeutic applications of US and, current articles in conference papers and reports accessed from the internet using Google search engine on therapeutic ultrasound. Results: Very few article regarding effect of therapeutic of US for its use of insonation for treatment of patient with pain and soft tissue injury are available. This review article mainly emphasizes the therapeutic utility of US in dentistry for its effectiveness to decrease joint stiffness, reduce pain and muscle spasms and improve muscle mobility. In vivo studies have shown very little clinical effects. Conclusions: Further research is warranted in this clinically important area to make the development of noninvasive, multifunctional ultrasound devices for repair, regeneration and other therapeutic utility a success.

Natural products against Alzheimer's disease: Pharmaco-therapeutics and biotechnological interventions.

Science.gov (United States)

Dey, Abhijit; Bhattacharya, Raktim; Mukherjee, Anuradha; Pandey, Devendra Kumar

Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress. The current treatment provides only symptomatic relief by offering temporary palliative therapy which declines the rate of cognitive impairment associated with AD. Inhibition of the enzyme acetylcholinesterase (AChE) is considered as one of the major therapeutic strategies offering only symptomatic relief and moderate disease-modifying effect. Other non-cholinergic therapeutic approaches include antioxidant and vitamin therapy, stem cell therapy, hormonal therapy, use of antihypertensive or lipid-lowering medications and selective phosphodiesterase (PDE) inhibitors, inhibition of β-secretase and γ-secretase and Aβ aggregation, inhibition of tau hyperphosphorylation and intracellular NFT, use of nonsteroidal anti-inflammatory drugs (NSAIDs), transition metal chelators, insulin resistance drugs, etanercept, brain-derived neurotrophic factor (BDNF) etc. Medicinal plants have been reported for possible anti-AD activity in a number of preclinical and clinical trials. Ethnobotany, being popular in China and in the Far East and possibly less emphasized in Europe, plays a substantial role in the discovery of anti-AD agents from botanicals. Chinese Material Medica (CMM) involving Chinese medicinal plants has been used traditionally in China in the treatment of AD. Ayurveda has already provided numerous lead compounds in drug discovery and many of these are also undergoing clinical investigations. A number of medicinal plants

Supplementary data: Variation in the PTEN-induced putative kinase ...

Indian Academy of Sciences (India)

Variation in the PTEN-induced putative kinase 1 gene associated with the increase risk of type 2 diabetes in northern Chinese. Yanchun Qu, Liang Sun, Ze Yang and Ruifa Han. J. Genet. 90, 125–128. Table 1. Clinical characteristics of cases and controls. Phenotype. T2DM. Controls. P value. Age (years). 49.5 ± 11.1. 50.4 ± ...

Geroprotectors.org: a new, structured and curated database of current therapeutic interventions in aging and age-related disease

Science.gov (United States)

Moskalev, Alexey; Chernyagina, Elizaveta; de Magalhães, João Pedro; Barardo, Diogo; Thoppil, Harikrishnan; Shaposhnikov, Mikhail; Budovsky, Arie; Fraifeld, Vadim E.; Garazha, Andrew; Tsvetkov, Vasily; Bronovitsky, Evgeny; Bogomolov, Vladislav; Scerbacov, Alexei; Kuryan, Oleg; Gurinovich, Roman; Jellen, Leslie C.; Kennedy, Brian; Mamoshina, Polina; Dobrovolskaya, Evgeniya; Aliper, Alex; Kaminsky, Dmitry; Zhavoronkov, Alex

2015-01-01

As the level of interest in aging research increases, there is a growing number of geroprotectors, or therapeutic interventions that aim to extend the healthy lifespan and repair or reduce aging-related damage in model organisms and, eventually, in humans. There is a clear need for a manually-curated database of geroprotectors to compile and index their effects on aging and age-related diseases and link these effects to relevant studies and multiple biochemical and drug databases. Here, we introduce the first such resource, Geroprotectors (http://geroprotectors.org). Geroprotectors is a public, rapidly explorable database that catalogs over 250 experiments involving over 200 known or candidate geroprotectors that extend lifespan in model organisms. Each compound has a comprehensive profile complete with biochemistry, mechanisms, and lifespan effects in various model organisms, along with information ranging from chemical structure, side effects, and toxicity to FDA drug status. These are presented in a visually intuitive, efficient framework fit for casual browsing or in-depth research alike. Data are linked to the source studies or databases, providing quick and convenient access to original data. The Geroprotectors database facilitates cross-study, cross-organism, and cross-discipline analysis and saves countless hours of inefficient literature and web searching. Geroprotectors is a one-stop, knowledge-sharing, time-saving resource for researchers seeking healthy aging solutions. PMID:26342919

CT-guided interventions in children

International Nuclear Information System (INIS)

Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A.

2007-01-01

In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

Alkenenitrile Transmissive Olefination: Synthesis of the Putative Lignan "Morinol I"

Science.gov (United States)

Fleming, Fraser F.; Liu, Wang; Yao, Lihua; Pitta, Bhaskar; Purzycki, Matthew; Ravikumar, P. C.

2012-01-01

Grignard reagents trigger an addition-elimination with α'-hydroxy acrylonitriles to selectively generate Z-alkenenitriles. The modular assembly of Z-alkenenitriles from a Grignard reagent, acrylonitrile, and an aldehyde is ideal for stereoselectively synthesizing alkenes as illustrated in the synthesis of the putative lignan "morinol I." PMID:22545004

[Therapeutic goals and indications: psychotherapy patient's self-reports during diagnostic assessment].

Science.gov (United States)

Faller, H

2000-07-01

Although individual therapeutic goals are considered to be important factors motivating patients to engage in therapeutic work, they have gained little attention in empirical research. In the present study, patients were given a questionnaire containing 24 therapeutic goals which could be rated according to their subjective relevance on a 5-point scale. N = 152 patients (mean age 34.5 years, 59.2% female) who presented at a university psychotherapy outpatient department to attend a diagnostic interview participated in the study. "To solve my problems" and "to get relief from my complaints" were the goals that were rated as most important. Goals pertaining to mental health such as more contentness and calmness, self-assertion and insight scored high, too. Three rational scales were constructed: 1. insight, 2. sociability, and 3. self-assertion. These scales were correlated with both patients' causal attributions and therapy expectations in plausible ways. However, the general strength of intercorrelations point of the conception patients goals were not very succinct at the time of the intake interview. Indication groups regarding specific therapeutic measures did not differ with respect to therapy goals. Only the general decision whether to recommend a psychotherapeutic intervention or not seemed to be influenced by patients' therapeutic aims.

The impact of therapeutic hypothermia on neurological function and quality of life after cardiac arrest

DEFF Research Database (Denmark)

Bro-Jeppesen, John; Kjaergaard, Jesper; Horsted, Tina I

2008-01-01

AIMS: To assess the impact of therapeutic hypothermia on cognitive function and quality of life in comatose survivors of out of Hospital Cardiac arrest (OHCA). METHODS: We prospectively studied comatose survivors of OHCA consecutively admitted in a 4-year period. Therapeutic hypothermia......=0.01. No significant differences were found in long-term survival (57% vs. 56% alive at 30 months), MMSE, or SF-36. Therapeutic hypothermia (hazard ratio: 0.15, p=0.007) and bystander CPR (hazard ratio 0.19, p=0.002) were significantly related to survival in the intervention period. CONCLUSION: CPC...... at discharge from hospital was significantly improved following implementation of therapeutic hypothermia in comatose patients resuscitated from OCHA with VF/VT. However, significant improvement in survival, cognitive status or quality of life could not be detected at long-term follow-up....

Modified crisis intervention for personality disorder.

Science.gov (United States)

Rudnick, A

1998-01-01

This study proposes that the goal of crisis intervention for persons with personality disorders should be to return them to their pre-crisis level of functioning, even though this is maladaptive. This is contrasted with standard crisis intervention, which aims to return normal or neurotic persons to their pre-crisis normal or neurotic functioning, usually by means of few and short-term therapeutic encounters. The modification proposed costs more time and resources in persons with personality disorders in crisis and fits the intervention to the personality type. This is illustrated by the case of Eve, a patient in crisis, whose pre-crisis functioning was maladaptive because of a dependent personality disorder. The goal of (modified) crisis intervention in this case was to return the patient to her dependent lifestyle, by means of pharmacotherapy combined with intensive supportive psychotherapy during 3-4 months of partial (day) hospitalization. The special nature of crisis in personality disorders is discussed.

Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy.

Science.gov (United States)

Matourypour, Pegah; Vanaki, Zohreh; Zare, Zahra; Mehrzad, Valiolah; Dehghan, Mojtaba; Ranjbaran, Mehdi

2016-01-01

Nausea and vomiting are the worst and the most prevalent complications experienced by 70-80% of patients. Complementary treatments including therapeutic touch are cost-effective and low-risk, independent nursing interventions. Present research aims at investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in these patients. As a single-blind, randomized clinical trial, the present research was carried out on women with breast cancer undergoing chemotherapy in Isfahan, Iran. The subjects were divided into three groups of control, placebo, and intervention. The intervention was applied to each patient once for 20 min on the aura (human energy field) focusing on solar chakra. Data gathering instruments included demographic questionnaire and acute vomiting intensity scale. There was a significant difference among the three groups (and also after the intervention) (P touch was effective in reducing vomiting in the intervention group. However, the patients experienced lower-intensity vomiting which may be because of presence of a therapist and probably the reduced anxiety related to an additional intervention. So, further research is recommended considering the placebo group and employing another person in addition to the therapist, who is not skilled for this technique.

Therapeutic hypothermia after out-of-hospital cardiac arrest in children.

Science.gov (United States)

Moler, Frank W; Silverstein, Faye S; Holubkov, Richard; Slomine, Beth S; Christensen, James R; Nadkarni, Vinay M; Meert, Kathleen L; Clark, Amy E; Browning, Brittan; Pemberton, Victoria L; Page, Kent; Shankaran, Seetha; Hutchison, Jamie S; Newth, Christopher J L; Bennett, Kimberly S; Berger, John T; Topjian, Alexis; Pineda, Jose A; Koch, Joshua D; Schleien, Charles L; Dalton, Heidi J; Ofori-Amanfo, George; Goodman, Denise M; Fink, Ericka L; McQuillen, Patrick; Zimmerman, Jerry J; Thomas, Neal J; van der Jagt, Elise W; Porter, Melissa B; Meyer, Michael T; Harrison, Rick; Pham, Nga; Schwarz, Adam J; Nowak, Jeffrey E; Alten, Jeffrey; Wheeler, Derek S; Bhalala, Utpal S; Lidsky, Karen; Lloyd, Eric; Mathur, Mudit; Shah, Samir; Wu, Theodore; Theodorou, Andreas A; Sanders, Ronald C; Dean, J Michael

2015-05-14

Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiac arrest, but data about this intervention in children are limited. We conducted this trial of two targeted temperature interventions at 38 children's hospitals involving children who remained unconscious after out-of-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose patients who were older than 2 days and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or therapeutic normothermia (target temperature, 36.8°C). The primary efficacy outcome, survival at 12 months after cardiac arrest with a Vineland Adaptive Behavior Scales, second edition (VABS-II), score of 70 or higher (on a scale from 20 to 160, with higher scores indicating better function), was evaluated among patients with a VABS-II score of at least 70 before cardiac arrest. A total of 295 patients underwent randomization. Among the 260 patients with data that could be evaluated and who had a VABS-II score of at least 70 before cardiac arrest, there was no significant difference in the primary outcome between the hypothermia group and the normothermia group (20% vs. 12%; relative likelihood, 1.54; 95% confidence interval [CI], 0.86 to 2.76; P=0.14). Among all the patients with data that could be evaluated, the change in the VABS-II score from baseline to 12 months was not significantly different (P=0.13) and 1-year survival was similar (38% in the hypothermia group vs. 29% in the normothermia group; relative likelihood, 1.29; 95% CI, 0.93 to 1.79; P=0.13). The groups had similar incidences of infection and serious arrhythmias, as well as similar use of blood products and 28-day mortality. In comatose children who survived out-of-hospital cardiac arrest, therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a good functional outcome at 1 year. (Funded by

Identification of a putative nuclear export signal motif in human NANOG homeobox domain

International Nuclear Information System (INIS)

Park, Sung-Won; Do, Hyun-Jin; Huh, Sun-Hyung; Sung, Boreum; Uhm, Sang-Jun; Song, Hyuk; Kim, Nam-Hyung; Kim, Jae-Hwan

2012-01-01

Highlights: ► We found the putative nuclear export signal motif within human NANOG homeodomain. ► Leucine-rich residues are important for human NANOG homeodomain nuclear export. ► CRM1-specific inhibitor LMB blocked the potent human NANOG NES-mediated nuclear export. -- Abstract: NANOG is a homeobox-containing transcription factor that plays an important role in pluripotent stem cells and tumorigenic cells. To understand how nuclear localization of human NANOG is regulated, the NANOG sequence was examined and a leucine-rich nuclear export signal (NES) motif ( 125 MQELSNILNL 134 ) was found in the homeodomain (HD). To functionally validate the putative NES motif, deletion and site-directed mutants were fused to an EGFP expression vector and transfected into COS-7 cells, and the localization of the proteins was examined. While hNANOG HD exclusively localized to the nucleus, a mutant with both NLSs deleted and only the putative NES motif contained (hNANOG HD-ΔNLSs) was predominantly cytoplasmic, as observed by nucleo/cytoplasmic fractionation and Western blot analysis as well as confocal microscopy. Furthermore, site-directed mutagenesis of the putative NES motif in a partial hNANOG HD only containing either one of the two NLS motifs led to localization in the nucleus, suggesting that the NES motif may play a functional role in nuclear export. Furthermore, CRM1-specific nuclear export inhibitor LMB blocked the hNANOG potent NES-mediated export, suggesting that the leucine-rich motif may function in CRM1-mediated nuclear export of hNANOG. Collectively, a NES motif is present in the hNANOG HD and may be functionally involved in CRM1-mediated nuclear export pathway.

Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA.

Science.gov (United States)

Díaz Zuluaga, Ana M; Duica, Kelly; Ruiz Galeano, Carlos; Vargas, Cristian; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme. To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks. After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Evaluation of Two Dry Commercial Therapeutic Diets for the Management of Feline Chronic Gastroenteropathy

Directory of Open Access Journals (Sweden)

Sally C. Perea

2017-05-01

Full Text Available Management of feline chronic gastroenteropathies has included intervention with both veterinary therapeutic formulas designed to manage non-specific gastrointestinal disorders and those designed with limited novel or hydrolyzed ingredients for management of food-responsive enteropathies and steroid-responsive enteropathies (inflammatory bowel disease. There have been few studies evaluating the use of dietary intervention for the management of feline chronic gastroenteropathy. This prospective, multi-center study evaluated the use of two commercially available feline veterinary therapeutic dry diets designed to manage non-specific gastrointestinal disorders in 28 cats with a history of chronic vomiting and/or diarrhea. The majority of cats enrolled in the study had a history of vomiting (n = 25, with a smaller number having a history of concurrent diarrhea (n = 2 or diarrhea alone (n = 3. Cats were excluded if diagnostic tests identified any systemic or infectious disease that could be associated with the clinical signs of vomiting or diarrhea, and if they were panhypoproteinemic, hypoalbuminemic, hypocobalaminemic, or had a Spec fPL ≥5.4 µg/L. Cats were randomized to one of two veterinary therapeutic diets for 4 weeks. Feeding of both therapeutic diets resulted in a numeric reduction in the number of vomiting episodes over the 4-week period, but no significant differences were seen between dietary interventions. When looking within dietary groups, significant differences were seen in cats fed Diet A with reductions of 69.1, 73.3, and 63.2% (p values of 0.008, 0.003, and 0.029 in weeks 2, 3, and 4, respectively, when compared to week 0. The probability of vomiting also showed significant reductions in cats fed Diet A between weeks 0 and 2, 3, and 4, with odds ratios of 0.008, 0.005, and 0.005, respectively (p values of 0.038, 0.23, and 0.23. Results of this study demonstrate that a veterinary therapeutic gastrointestinal

Therapeutic target for protozoal diseases

Science.gov (United States)

Rathore, Dharmendar [Blacksburg, VA; Jani, Dewal [Blacksburg, VA; Nagarkatti, Rana [Blacksburg, VA

2008-10-21

A novel Fasciclin Related Adhesive Protein (FRAP) from Plasmodium and related parasites is provided as a target for therapeutic intervention in diseases caused by the parasites. FRAP has been shown to play a critical role in adhesion to, or invasion into, host cells by the parasite. Furthermore, FRAP catalyzes the neutralization of heme by the parasite, by promoting its polymerization into hemozoin. This invention provides methods and compositions for therapies based on the administration of protein, DNA or cell-based vaccines and/or antibodies based on FRAP, or antigenic epitopes of FRAP, either alone or in combination with other parasite antigens. Methods for the development of compounds that inhibit the catalytic activity of FRAP, and diagnostic and laboratory methods utilizing FRAP are also provided.

Gynecologic cancer treatment: risk factors for therapeutically induced neoplasia

International Nuclear Information System (INIS)

Messerschmidt, G.L.; Hoover, R.; Young, R.C.

1980-01-01

Therapeutic intervention in a course of illness, while producing the desired result, also may have some adverse long-term effects on the patient. Second malignancies are one of the known complications of therapy. The treatments of gynecologic cancers by surgery, irradiation and chemotherapy have been associated with subsequent neoplasms. The use of normal skin from the thigh to fabricate an artificial vagina has resulted in more squamous cell carcinomas than expected. Alkylating agents used in the treatment of ovarian cancer and other diseases have been shown to lead to an increased risk of leukemia. The incidence of lymphoma and uterine, urinary bladder and colon carcinomas has been associated with prior irradiation for gynecologic disease. The literature regarding the therapeutically induced risk factors in gynecologic therapy is reviewed and areas of our knowledge that require more investigation are identified

Gene Therapy for Advanced Melanoma: Selective Targeting and Therapeutic Nucleic Acids

Directory of Open Access Journals (Sweden)

Joana R. Viola

2013-01-01

Full Text Available Despite recent advances, the treatment of malignant melanoma still results in the relapse of the disease, and second line treatment mostly fails due to the occurrence of resistance. A wide range of mutations are known to prevent effective treatment with chemotherapeutic drugs. Hence, approaches with biopharmaceuticals including proteins, like antibodies or cytokines, are applied. As an alternative, regimens with therapeutically active nucleic acids offer the possibility for highly selective cancer treatment whilst avoiding unwanted and toxic side effects. This paper gives a brief introduction into the mechanism of this devastating disease, discusses the shortcoming of current therapy approaches, and pinpoints anchor points which could be harnessed for therapeutic intervention with nucleic acids. We bring the delivery of nucleic acid nanopharmaceutics into perspective as a novel antimelanoma therapeutic approach and discuss the possibilities for melanoma specific targeting. The latest reports on preclinical and already clinical application of nucleic acids in melanoma are discussed.

Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study.

Science.gov (United States)

Tarocchi, Anna; Aschieri, Filippo; Fantini, Francesca; Smith, Justin D

2013-06-01

The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including establishing a safe therapeutic environment, reprocessing the trauma, constructing a new narrative, and managing emotional dysregulation. Therapeutic Assessment (TA) is a semistructured, brief intervention that uses psychological testing to promote positive change. The case study of Kelly, a middle-aged woman with a history of repeated interpersonal trauma, illustrates delivery of the TA model for CPTSD. Results of this single-case time-series experiment indicate statistically significant symptom improvement as a result of participating in TA. We discuss the implications of these findings for assessing and treating trauma-related concerns, such as CPTSD.

Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

Science.gov (United States)

Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

2018-02-01

Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three

Inpatient Therapeutic Assessment With Narcissistic Personality Disorder.

Science.gov (United States)

Hinrichs, Jon

2016-01-01

Growing evidence supporting the effectiveness of Collaborative/Therapeutic Assessment (C/TA) has led clinicians and researchers to apply C/TA to a variety of clinical populations and treatment settings. This case example presents a C/TA inpatient adaptation illustrated with narcissistic personality disorder. After a brief overview of salient concepts, I provide a detailed account of the clinical interview, test interpretation paired with diagnostic considerations specific to narcissism, planned intervention, and discussion of assessment results. Throughout the case study, I attempt to demonstrate defining features of C/TA, inpatient adaptations, and clinical techniques that encourage meaningful engagement with a "hard to reach" personality.

The Use of Therapeutic Stories in Counseling Child and Adolescent Sexual Abuse Survivors

Science.gov (United States)

Kress, Victoria E.; Adamson, Nicole A.; Yensel, Jennifer

2010-01-01

Counselors will regularly counsel children and adolescents with histories of sexual abuse and be challenged with providing supportive and empowering interventions that serve to move the client from victim to survivor status. Therapeutic stories are a creative counseling technique that can be used when counseling child and adolescent sexual abuse…

Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

Energy Technology Data Exchange (ETDEWEB)

Truffa, Márcio A. M., E-mail: marciotruffa@yahoo.com.br; Alves, Gustavo M.P.; Bernardi, Fernando; Esteves Filho, Antonio; Ribeiro, Expedito; Galon, Micheli Z.; Spadaro, André; Kajita, Luiz J.; Arrieta, Raul; Lemos, Pedro A. [Instituto do Coração - Hospital das Clínicas - Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil)

2015-11-15

Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm{sup 2}, while the staged group, to 139.2 ± 75.3 Gycm{sup 2} (p < 0.001). Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times.

Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

International Nuclear Information System (INIS)

Truffa, Márcio A. M.; Alves, Gustavo M.P.; Bernardi, Fernando; Esteves Filho, Antonio; Ribeiro, Expedito; Galon, Micheli Z.; Spadaro, André; Kajita, Luiz J.; Arrieta, Raul; Lemos, Pedro A.

2015-01-01

Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm 2 , while the staged group, to 139.2 ± 75.3 Gycm 2 (p < 0.001). Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times

Real time CT-fluoroscopy: diagnostic and therapeutic applications

International Nuclear Information System (INIS)

Mey, J. de; Op de Beeck, B.; Meysman, M.; Noppen, M.; Maeseneer, M. de; Vanhoey, M.; Vincken, W.; Osteaux, M.

2000-01-01

The synergetic progression of CT technology and computer hardware has made ultrafast acquisition and image reconstruction possible. This has lead to the availability of CT interactive diagnosis and therapeutic procedures. Making use of our own material (337 intervention procedures during the last 17 months), we have compared our techniques and results to the recent literature data. One of the advantages of the biopsy technique is an improved sensitivity for neoplastic lesions, most certainly in cases of intrapulmonary lesions, surrounded by aerated tissue (now 94% compared to 87% in our previous study). A second advantage is the safety of the technique (only one major complication in our series). Fluid collection drainages, and more complex interventions like local injection of drugs, radio-frequency ablation, wire hook placement and ethanol injection were performed without complication. Yet another interesting feature is the shortening of the procedure time (reduced in average to an 'in-room' time of less than 30 min), which has definite economical implications. Furthermore it increases the patient's comfort and safety, and extends the scope of outpatient procedures (80% outpatient procedures in our material). On the other side the radiation exposure can be raised as an issue, especially when we consider the operator's hands. However, the described technique and the use of dedicated tools can alleviate the problem. As a conclusion, real time CT fluoroscopy has given a new input and broadens the scope of clinical indications of CT-guided diagnostic and therapeutic procedures

Attention for pediatric interventional radiology

International Nuclear Information System (INIS)

Zhu Ming; Cheng Yongde

2005-01-01

Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

Search strings for the study of putative occupational determinants of disease

NARCIS (Netherlands)

Mattioli, Stefano; Zanardi, Francesca; Baldasseroni, Alberto; Schaafsma, Frederieke; Cooke, Robin M. T.; Mancini, Gianpiero; Fierro, Mauro; Santangelo, Chiara; Farioli, Andrea; Fucksia, Serenella; Curti, Stefania; Violante, Francesco S.; Verbeek, Jos

2010-01-01

To identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of conditions not generally considered to be work related. Based on MeSH definitions and expert knowledge, we selected as candidate search terms the four MeSH terms describing

Periodontal disease and pregnancy outcomes: exposure, risk and intervention.

Science.gov (United States)

Clothier, B; Stringer, M; Jeffcoat, Marjorie K

2007-06-01

Despite the many advances in medicine, the rate of preterm birth has not significantly decreased in the United States over the past several decades. In fact, the rate rose in 2003 to more than 12% of all births in the United States. This equates to over half a million premature births in the United States alone. Consequently, the identification of risk factors for preterm birth which are amenable to intervention would have far-reaching and long-lasting effects. There is emerging evidence of a relationship between periodontal health and adverse pregnancy outcomes, particularly preterm birth/preterm low-birth-weight infants. Therefore this chapter explores the putative association between periodontal disease and infant prematurity, as well as the results of intervention studies which treated periodontal disease in order to reduce the incidence of prematurity. Of 31 published studies, 22 show a positive association between premature birth and periodontal disease. Ongoing studies are addressing the efficacy of periodontal treatment for decreasing the incidence of infant prematurity.

Putative Biomarkers and Targets of Estrogen Receptor Negative Human Breast Cancer

Directory of Open Access Journals (Sweden)

Stephen W. Byers

2011-07-01

Full Text Available Breast cancer is a progressive and potentially fatal disease that affects women of all ages. Like all progressive diseases, early and reliable diagnosis is the key for successful treatment and annihilation. Biomarkers serve as indicators of pathological, physiological, or pharmacological processes. Her2/neu, CA15.3, estrogen receptor (ER, progesterone receptor (PR, and cytokeratins are biomarkers that have been approved by the Food and Drug Administration for disease diagnosis, prognosis, and therapy selection. The structural and functional complexity of protein biomarkers and the heterogeneity of the breast cancer pathology present challenges to the scientific community. Here we review estrogen receptor-related putative breast cancer biomarkers, including those of putative breast cancer stem cells, a minor population of estrogen receptor negative tumor cells that retain the stem cell property of self renewal. We also review a few promising cytoskeleton targets for ER alpha negative breast cancer.

Post-hemorrhagic hydrocephalus: Recent advances and new therapeutic insights.

Science.gov (United States)

Chen, Qianwei; Feng, Zhou; Tan, Qiang; Guo, Jing; Tang, Jun; Tan, Liang; Feng, Hua; Chen, Zhi

2017-04-15

Post-hemorrhagic hydrocephalus (PHH), also referred to as progressive ventricular dilatation, is caused by disturbances in cerebrospinal fluid (CSF) flow or absorption following hemorrhage in the brain. As one of the most serious complications of neonatal/adult intraventricular hemorrhage (IVH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI), PHH is associated with increased morbidity and disability of these events. Common sequelae of PHH include neurocognitive impairment, motor dysfunction, and growth impairment. Non-surgical measures to reduce increased intracranial pressure (ICP) in PHH have shown little success and most patients will ultimately require surgical management, such as external ventricular drainage and shunting which mostly by inserting a CSF drainage shunt. Unfortunately, shunt complications are common and the optimum time for intervention is unclear. To date, there remains no comprehensive strategy for PHH management and it becomes imperative that to explore new therapeutic targets and methods for PHH. Over past decades, increasing evidence have indicated that hemorrhage-derived blood and subsequent metabolic products may play a key role in the development of IVH-, SAH- and TBI-associated PHH. Several intervention strategies have recently been evaluated and cross-referenced. In this review, we summarized and discussed the common aspects of hydrocephalus following IVH, SAH and TBI, relevant experimental animal models, clinical translation of in vivo experiments, and potential preventive and therapeutic targets for PHH. Copyright © 2017 Elsevier B.V. All rights reserved.

Sequence analysis of putative swrW gene required for surfactant ...

African Journals Online (AJOL)

owner

2012-07-17

Jul 17, 2012 ... These nucleotide and protein sequence analysis of the putative swrW gene provides vital information on the versatility .... chain reaction (PCR) products were stored at 4°C. Presence of ... identical to the same gene with an E-value of 0.0. .... The Prokaryotes-A Handbook on the Biol. of Bacteria:Ecophysiol.

A Systematic Review of Electronic Mindfulness-Based Therapeutic Interventions for Weight, Weight-Related Behaviors, and Psychological Stress.

Science.gov (United States)

Lyzwinski, Lynnette Nathalie; Caffery, Liam; Bambling, Matthew; Edirippulige, Sisira

2018-03-01

Recent research indicates that mindfulness-based interventions are effective for stress, maladaptive weight-related behaviors, and weight loss. Little is presently known about their applicability and effectiveness when delivered electronically, including through Web-based and mobile device media. The primary aims of this review were to identify what types of electronic mindfulness-based interventions have been undertaken for stress, maladaptive weight-related behaviors, and weight loss, and to assess their overall effectiveness. A systematic search of PubMed (MEDLINE), Embase, CINAHL, and Web of Science databases was undertaken in June 2016. A total of 21 studies were identified that met inclusion criteria and were selected in the final review. Of these, 19 were mindfulness-based interventions for stress reduction. Two were Web-based mindful eating/intuitive eating interventions for weight. Only one electronic mindfulness-based study was identified that targeted both stress and maladaptive weight-related behaviors. Most electronic interventions were effective for stress reduction N = 14/19 (74%). There were insufficient electronic mindfulness-based interventions for weight to determine if they were effective or not. Additionally, no mobile mindfulness-based intervention was identified for weight or weight-related behaviors. Electronic mindfulness-based interventions through diverse media appear to be effective for stress reduction. More studies are needed that target weight and weight-related behaviors as well as studies that target both stress and weight. More randomized controlled trials (RCTs) that assess mobile mindfulness-based apps are needed as we only identified four app trials for stress. Mobile mindfulness-based interventions for weight and weight-related behaviors are a future area of research novelty.

Strategies for implementing and sustaining therapeutic lifestyle changes as part of hypertension management in African Americans.

Science.gov (United States)

Scisney-Matlock, Margaret; Bosworth, Hayden B; Giger, Joyce Newman; Strickland, Ora L; Harrison, R Van; Coverson, Dorothy; Shah, Nirav R; Dennison, Cheryl R; Dunbar-Jacob, Jacqueline M; Jones, Loretta; Ogedegbe, Gbenga; Batts-Turner, Marian L; Jamerson, Kenneth A

2009-05-01

African Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management. However, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers. Therapeutic lifestyle change interventions should emphasize patient self-management, supported by providers, family, and the community. Interventions should be tailored to an individual's cultural heritage, beliefs, and behavioral norms. Simultaneously targeting multiple factors that impede BP control will maximize the likelihood of success. The panel cited limited progress with integrating the Dietary Approaches to Stop Hypertension (DASH) eating plan into the African American diet as an example of the need for more strategically developed interventions. Culturally sensitive instruments to assess impact will help guide improved provision of TLC in special populations. The challenge of improving BP control in African Americans and delivery of hypertension care requires changes at the health system and public policy levels. At the patient level, culturally sensitive interventions that apply the strategies described and optimize community involvement will advance TLC in African Americans with high BP.

Therapeutic writing as an intervention for symptoms of bulimia nervosa: effects and mechanism of change.

Science.gov (United States)

Johnston, Olwyn; Startup, Helen; Lavender, Anna; Godfrey, Emma; Schmidt, Ulrike

2010-07-01

This study explored the effects on bulimic symptomatology of a writing task intended to reduce emotional avoidance. Eighty individuals reporting symptoms of bulimia completed, by e-mail, a therapeutic or control writing task. Participants completed questionnaires on bulimic symptoms, mood, and potential moderating and mediating factors, and were followed up after 4 and 8 weeks. Writing content was explored using a word count package and qualitative framework analysis. Bulimic symptoms decreased in both groups, although in both groups the number of participants who improved was approximately equal to the number who did not improve. Symptom decreases were associated with increases in perceived mood regulation abilities, and decreases in negative beliefs about emotions. Participants preferred internet delivery to face to face discussion. For individuals experiencing symptoms of bulimia, the effects of therapeutic writing did not differ significantly from effects of a control writing task. 2009 by Wiley Periodicals, Inc.

A Proteomics Approach to Identify New Putative Cardiac Intercalated Disk Proteins.

Directory of Open Access Journals (Sweden)

Siddarth Soni

Full Text Available Synchronous beating of the heart is dependent on the efficient functioning of the cardiac intercalated disk (ID. The ID is composed of a complex protein network enabling electrical continuity and chemical communication between individual cardiomyocytes. Recently, several different studies have shed light on increasingly prevalent cardiac diseases involving the ID. Insufficient knowledge of its composition makes it difficult to study these disease mechanisms in more detail and therefore here we aim expand the ID proteome. Here, using a combination of general membrane enrichment, in-depth quantitative proteomics and an intracellular location driven bioinformatics approach, we aim to discover new putative ID proteins in rat ventricular tissue.General membrane isolation, enriched amongst others also with ID proteins as based on presence of the established markers connexin-43 and n-cadherin, was performed using centrifugation. By mass spectrometry, we quantitatively evaluated the level of 3455 proteins in the enriched membrane fraction (EMF and its counterpart, the soluble cytoplasmic fraction. These data were stringently filtered to generate a final set of 97 enriched, putative ID proteins. These included Cx43 and n-cadherin, but also many interesting novel candidates. We selected 4 candidates (Flotillin-2 (FLOT2, Nexilin (NEXN, Popeye-domain-containg-protein 2 (POPDC2 and thioredoxin-related-transmembrane-protein 2 (TMX2 and confirmed their co-localization with n-cadherin in the ID of human and rat heart cryo-sections, and isolated dog cardiomyocytes.The presented proteomics dataset of putative new ID proteins is a valuable resource for future research into this important molecular intersection of the heart.

Indications and interventional options for non-resectable tracheal stenosis

Science.gov (United States)

Bacon, Jenny Louise; Patterson, Caroline Marie

2014-01-01

Non-specific presentation and normal examination findings in early disease often result in tracheal obstruction being overlooked as a diagnosis until patients present acutely. Once diagnosed, surgical options should be considered, but often patient co-morbidity necessitates other interventional options. Non-resectable tracheal stenosis can be successfully managed by interventional bronchoscopy, with therapeutic options including airway dilatation, local tissue destruction and airway stenting. There are common aspects to the management of tracheal obstruction, tracheomalacia and tracheal fistulae. This paper reviews the pathogenesis, presentation, investigation and management of tracheal disease, with a focus on tracheal obstruction and the role of endotracheal intervention in management. PMID:24624290

The endocrine system and sarcopenia: potential therapeutic benefits.

Science.gov (United States)

McIntire, Kevin L; Hoffman, Andrew R

2011-12-01

Age related muscle loss, known as sarcopenia, is a major factor in disability, loss of mobility and quality of life in the elderly. There are many proposed mechanisms of age-related muscle loss that include the endocrine system. A variety of hormones regulate growth, development and metabolism throughout the lifespan. Hormone activity may change with age as a result of reduced hormone secretion or decreased tissue responsiveness. This review will focus on the complex interplay between the endocrine system, aging and skeletal muscle and will present possible benefits of therapeutic interventions for sarcopenia.

Therapeutic Targets of Triglyceride Metabolism as Informed by Human Genetics.

Science.gov (United States)

Bauer, Robert C; Khetarpal, Sumeet A; Hand, Nicholas J; Rader, Daniel J

2016-04-01

Human genetics has contributed to the development of multiple drugs to treat hyperlipidemia and coronary artery disease (CAD), most recently including antibodies targeting PCSK9 to reduce LDL cholesterol. Despite these successes, a large burden of CAD remains. Genetic and epidemiological studies have suggested that circulating triglyceride (TG)-rich lipoproteins (TRLs) are a causal risk factor for CAD, presenting an opportunity for novel therapeutic strategies. We discuss recent unbiased human genetics testing, including genome-wide association studies (GWAS) and whole-genome or -exome sequencing, that have identified the lipoprotein lipase (LPL) and hepatic lipogenesis pathways as important mechanisms in the regulation of circulating TRLs. Further strengthening the causal relationship between TRLs and CAD, findings such as these may provide novel targets for much-needed potential therapeutic interventions. Copyright © 2016. Published by Elsevier Ltd.

Scaling dynamic response and destructive metabolism in an immunosurveillant anti-tumor system modulated by different external periodic interventions.

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Yuanzhi Shao

Full Text Available On the basis of two universal power-law scaling laws, i.e. the scaling dynamic hysteresis in physics and the allometric scaling metabolism in biosystem, we studied the dynamic response and the evolution of an immunosurveillant anti-tumor system subjected to a periodic external intervention, which is equivalent to the scheme of a radiotherapy or chemotherapy, within the framework of the growth dynamics of tumor. Under the modulation of either an abrupt or a gradual change external intervention, the population density of tumors exhibits a dynamic hysteresis to the intervention. The area of dynamic hysteresis loop characterizes a sort of dissipative-therapeutic relationship of the dynamic responding of treated tumors with the dose consumption of accumulated external intervention per cycle of therapy. Scaling the area of dynamic hysteresis loops against the intensity of an external intervention, we deduced a characteristic quantity which was defined as the theoretical therapeutic effectiveness of treated tumor and related with the destructive metabolism of tumor under treatment. The calculated dose-effectiveness profiles, namely the dose cumulant per cycle of intervention versus the therapeutic effectiveness, could be well scaled into a universal quadratic formula regardless of either an abrupt or a gradual change intervention involved. We present a new concept, i.e., the therapy-effect matrix and the dose cumulant matrix, to expound the new finding observed in the growth and regression dynamics of a modulated anti-tumor system.

Putative and unique gene sequence utilization for the design of species specific probes as modeled by Lactobacillus plantarum

Science.gov (United States)

The concept of utilizing putative and unique gene sequences for the design of species specific probes was tested. The abundance profile of assigned functions within the Lactobacillus plantarum genome was used for the identification of the putative and unique gene sequence, csh. The targeted gene (cs...

Search strings for the study of putative occupational determinants of disease

NARCIS (Netherlands)

Mattioli, S.; Zanardi, F.; Baldasseroni, A.; Schaafsma, F.; Cooke, R.M.T.; Mancini, G.; Fierro, M.; Santangelo, C.; Farioli, A.; Fucksia, S.; Curti, S.; Violante, F.S.; Verbeek, J.

2010-01-01

Objective To identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of conditions not generally considered to be work related. Methods Based on MeSH definitions and expert knowledge, we selected as candidate search terms the four MeSH terms

The situation and prospects of interventional nursing care in China

International Nuclear Information System (INIS)

Li Xiaorong; Xu Xiufang; Cheng Yongde

2009-01-01

Through the exploration and practice,the interventional nursing care has become an important part of Interventional Radiology, which bears a close relations to the pros and cons of the interventional therapeutic quality. The interventional nursing has been developing along the direction to become an independent nursing specialty. At the same time,various issues that affect the interventional nursing development start to emerge. At present, the setting up of a system to strengthen the establishment of the special care unit and human resources is urgently needed. The following measures are indispensable to promote the sustainable development of interventional care: to raise special awareness, to work out nursing routine and quality control standards, to explore the proficiency in order to stabilize nursing team, to pay attention to specialty education and to establish an integration mode for standardized training and professional development. (authors)

Actin dynamics at focal adhesions: a common endpoint and putative therapeutic target for proteinuric kidney diseases.

Science.gov (United States)

Sever, Sanja; Schiffer, Mario

2018-06-01

Proteinuria encompasses diverse causes including both genetic diseases and acquired forms such as diabetic and hypertensive nephropathy. The basis of proteinuria is a disturbance in size selectivity of the glomerular filtration barrier, which largely depends on the podocyte: a terminally differentiated epithelial cell type covering the outer surface of the glomerulus. Compromised podocyte structure is one of the earliest signs of glomerular injury. The phenotype of diverse animal models and podocyte cell culture firmly established the essential role of the actin cytoskeleton in maintaining functional podocyte structure. Podocyte foot processes, actin-based membrane extensions, contain 2 molecularly distinct "hubs" that control actin dynamics: a slit diaphragm and focal adhesions. Although loss of foot processes encompasses disassembly of slit diaphragm multiprotein complexes, as long as cells are attached to the glomerular basement membrane, focal adhesions will be the sites in which stress due to filtration flow is counteracted by forces generated by the actin network in foot processes. Numerous studies within last 20 years have identified actin binding and regulatory proteins as well as integrins as essential components of signaling and actin dynamics at focal adhesions in podocytes, suggesting that some of them may become novel, druggable targets for proteinuric kidney diseases. Here we review evidence supporting the idea that current treatments for chronic kidney diseases beneficially and directly target the podocyte actin cytoskeleton associated with focal adhesions and suggest that therapeutic reagents that target the focal adhesion-regulated actin cytoskeleton in foot processes have potential to modernize treatments for chronic kidney diseases. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Glycogen synthase kinase-3: A promising therapeutic target for Fragile X Syndrome

Directory of Open Access Journals (Sweden)

Marjelo M. Mines

2011-11-01

Full Text Available Recent advances in understanding the pathophysiological mechanisms contributing to Fragile X Syndrome (FXS have increased optimism that drug interventions can provide significant therapeutic benefits. FXS results from inadequate expression of functional fragile X mental retardation protein (FMRP. FMRP may have several functions, but it is most well-established as an RNA-binding protein that regulates translation, and it is by this mechanism that FMRP is capable of affecting numerous cellular processes by selectively regulating protein levels. The multiple cellular functions regulated by FMRP suggest that multiple interventions may be required for reversing the effects of deficient FMRP. Evidence that inhibitors of glycogen synthase kinase-3 (GSK3 may contribute to the therapeutic treatment of FXS is reviewed here. In the mouse model of FXS, which lacks FMRP expression (FX mice, GSK3 is hyperactive in several brain regions. Furthermore, significant improvements in several FX-related phenotypes have been obtained in FX mice following the administration of lithium, and in some case other GSK3 inhibitors. These responses include normalization of heightened audiogenic seizure susceptibility and of hyperactive locomotor behavior, enhancement of passive avoidance learning retention and of sociability behaviors, and corrections of macroorchidism, neuronal spine density, and neural plasticity measured electrophysiologically as long term depression. A pilot clinical trial of lithium in FXS patients also found improvements in several measures of behavior. Taken together, these findings indicate that lithium and other inhibitors of GSK3 are promising candidate therapeutic agents for treating FXS.

Putative contact ketoconazole shampoo-triggered pemphigus foliaceus in a dog.

Science.gov (United States)

Sung, Hyun-Jeong; Yoon, In-Hwa; Kim, Jung-Hyun

2017-09-01

A 10-year-old spayed female cocker spaniel dog was referred for an evaluation of acute-onset generalized pustular cutaneous lesions following application of ketoconazole shampoo. Cytologic and histopathologic examinations of the lesions revealed intra-epidermal pustules with predominantly neutrophils and acantholytic cells. This is the first description of putative contact ketoconazole shampoo-triggered pemphigus foliaceus in a dog.

Differential expressions of putative genes in various floral organs of ...

African Journals Online (AJOL)

STORAGESEVER

2009-06-03

Jun 3, 2009 ... Full Length Research Paper. Differential expressions of putative genes in various floral organs of the Pigeon orchid (Dendrobium crumenatum) using GeneFishing. Faridah, Q. Z.1, 2, Ng, B. Z.3, Raha, A. R.4, Umi, K. A. B.5 and Khosravi, A. R.2*. 1Department of Biology, Faculty Science, University Putra ...

[Intervention of Schizophrenia From the Community Model].

Science.gov (United States)

Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Therapeutic spaces of care farming: Transformative or ameliorating?

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Kaley, Alexandra; Hatton, Chris; Milligan, Christine

2018-05-04

Since Wil Gesler's earliest articulation (Gesler, 1992; Gesler, 1996) key thinkers in the field of therapeutic landscapes have sought to emphasise the embodied, contextual and wholly relational nature of the relationship that exists between people and place. However, the extant research has tended to focus on the relational healing experience as this occurs 'in the moment' and with reference to a specific location or site of healing, with less attention being paid to what happens to people when they return to their ordinary or everyday places. In this paper, we reflect on findings from visual ethnographic work (including photography and film) that explored the therapeutic landscape experiences of people with intellectual disabilities engaged in care farming interventions for health and wellbeing. The study also recruited farm staff and family members or carers to take part, and comprised 20 participants in total. Having identified a gap in our understanding, consideration is given to wider impact that engaging in these sorts of activities had on the everyday lives of the participants in this study. We argue that this study has identified two types of therapeutic journey that broadly fit the experiences of study participants. The first type of journey denotes landscape experiences that are transformative. Here the therapeutic power of the care farm landscape resides in the ability of activities conducted on care farms to influence other aspects of participants' lives in ways that promote wellbeing. By contrast, there is another type of journey where the therapeutic power of the care farm resides in its ability to ameliorate challenging or harmful life situations, thus offering people a temporary site of respite or refuge. We conclude that these findings denote an important development for this sub-field of health geography, not only because they draw attention to the transformative power of the therapeutic encounter, but also the broader socio-spatial environments

Therapeutic potential of systemic brain rejuvenation strategies for neurodegenerative disease [version 1; referees: 3 approved

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Alana M. Horowitz

2017-08-01

Full Text Available Neurodegenerative diseases are a devastating group of conditions that cause progressive loss of neuronal integrity, affecting cognitive and motor functioning in an ever-increasing number of older individuals. Attempts to slow neurodegenerative disease advancement have met with little success in the clinic; however, a new therapeutic approach may stem from classic interventions, such as caloric restriction, exercise, and parabiosis. For decades, researchers have reported that these systemic-level manipulations can promote major functional changes that extend organismal lifespan and healthspan. Only recently, however, have the functional effects of these interventions on the brain begun to be appreciated at a molecular and cellular level. The potential to counteract the effects of aging in the brain, in effect rejuvenating the aged brain, could offer broad therapeutic potential to combat dementia-related neurodegenerative disease in the elderly. In particular, results from heterochronic parabiosis and young plasma administration studies indicate that pro-aging and rejuvenating factors exist in the circulation that can independently promote or reverse age-related phenotypes. The recent demonstration that human umbilical cord blood similarly functions to rejuvenate the aged brain further advances this work to clinical translation. In this review, we focus on these blood-based rejuvenation strategies and their capacity to delay age-related molecular and functional decline in the aging brain. We discuss new findings that extend the beneficial effects of young blood to neurodegenerative disease models. Lastly, we explore the translational potential of blood-based interventions, highlighting current clinical trials aimed at addressing therapeutic applications for the treatment of dementia-related neurodegenerative disease in humans.

Designer exosomes produced by implanted cells intracerebrally deliver therapeutic cargo for Parkinson's disease treatment.

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Kojima, Ryosuke; Bojar, Daniel; Rizzi, Giorgio; Hamri, Ghislaine Charpin-El; El-Baba, Marie Daoud; Saxena, Pratik; Ausländer, Simon; Tan, Kelly R; Fussenegger, Martin

2018-04-03

Exosomes are cell-derived nanovesicles (50-150 nm), which mediate intercellular communication, and are candidate therapeutic agents. However, inefficiency of exosomal message transfer, such as mRNA, and lack of methods to create designer exosomes have hampered their development into therapeutic interventions. Here, we report a set of EXOsomal transfer into cells (EXOtic) devices that enable efficient, customizable production of designer exosomes in engineered mammalian cells. These genetically encoded devices in exosome producer cells enhance exosome production, specific mRNA packaging, and delivery of the mRNA into the cytosol of target cells, enabling efficient cell-to-cell communication without the need to concentrate exosomes. Further, engineered producer cells implanted in living mice could consistently deliver cargo mRNA to the brain. Therapeutic catalase mRNA delivery by designer exosomes attenuated neurotoxicity and neuroinflammation in in vitro and in vivo models of Parkinson's disease, indicating the potential usefulness of the EXOtic devices for RNA delivery-based therapeutic applications.

Interventional radiological therapy of benign low back pain syndromes; Interventionell radiologische Therapie benigner lumbaler Schmerzsyndrome

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Huegli, R.W.; Jacob, A.L.; Steinbrich, W. [Universitaetsspital Basel (Switzerland). Interventionelle Radiologie

2007-03-15

Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed.

Client perceptions of the Tree Theme Method™: a structured intervention based on storytelling and creative activities.

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Gunnarsson, A Birgitta; Peterson, Kerstin; Leufstadius, Christel; Jansson, Jan-Ake; Eklund, Mona

2010-09-01

The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: “From feeling a pressure to perform to becoming focused and expressive”, “Expressing oneself and one's life situation led to awakening of memories and feelings”, “New perspectives of self-image, everyday life and relations to others”, “Story-making led to shaping and reconstructing one's life story”, “Interaction was of importance when reconstructing one's life story” and, finally, “The attitude of the occupational therapist was of importance for the development of the therapeutic relationship”. There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client–therapist relationship.

Use of therapeutic surfactant lavage in a preterm infant with massive pulmonary hemorrhage

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Ino Kanavaki

2012-08-01

Full Text Available We report a case of a premature infant presenting with recurrent pulmonary hemorrhage in which we performed a therapeutic lavage with diluted surfactant after an acute episode of bleeding with severe intractable hypoxemia. Repeated small aliquots of diluted surfactant (10x2 mL allowed rapid improvement in oxygenation and reduction of required mean airway pressures during high frequency oscillatory ventilation. This observation may suggest that surfactant lavage could be beneficial in massive pulmonary hemorrhage in infants. A randomized controlled trial might be needed to clarify the potential benefit of this therapeutic intervention on outcome of infants suffering from this life-threatening complication.

Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

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Slone, Michelle; Shoshani, Anat

2010-01-01

The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

Targeting Beta-Amyloid at the CSF: A New Therapeutic Strategy in Alzheimer's Disease.

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Menendez-Gonzalez, Manuel; Padilla-Zambrano, Huber S; Alvarez, Gabriel; Capetillo-Zarate, Estibaliz; Tomas-Zapico, Cristina; Costa, Agustin

2018-01-01

Although immunotherapies against the amyloid-β (Aβ) peptide tried so date failed to prove sufficient clinical benefit, Aβ still remains the main target in Alzheimer's disease (AD). This article aims to show the rationale of a new therapeutic strategy: clearing Aβ from the CSF continuously (the "CSF-sink" therapeutic strategy). First, we describe the physiologic mechanisms of Aβ clearance and the resulting AD pathology when these mechanisms are altered. Then, we review the experiences with peripheral Aβ-immunotherapy and discuss the related hypothesis of the mechanism of action of "peripheral sink." We also present Aβ-immunotherapies acting on the CNS directly. Finally, we introduce alternative methods of removing Aβ including the "CSF-sink" therapeutic strategy. As soluble peptides are in constant equilibrium between the ISF and the CSF, altering the levels of Aβ oligomers in the CSF would also alter the levels of such proteins in the brain parenchyma. We conclude that interventions based in a "CSF-sink" of Aβ will probably produce a steady clearance of Aβ in the ISF and therefore it may represent a new therapeutic strategy in AD.

Inhibitory Synaptic Plasticity - Spike timing dependence and putative network function.

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Tim P Vogels

2013-07-01

Full Text Available While the plasticity of excitatory synaptic connections in the brain has been widely studied, the plasticity of inhibitory connections is much less understood. Here, we present recent experimental and theoretical □ndings concerning the rules of spike timing-dependent inhibitory plasticity and their putative network function. This is a summary of a workshop at the COSYNE conference 2012.

Interventional vascular radiology

International Nuclear Information System (INIS)

Yune, H.Y.

1984-01-01

The papers published during this past year in the area of interventional vascular radiology presented some useful modifications and further experiences both in the area of thromboembolic therapy and in dilation and thrombolysis, but no new techniques. As an introductory subject, an excellent monograph reviewing the current spectrum of pharmacoangiography was presented in Radiographics. Although the presented material is primarily in diagnostic application of various pharmacologic agents used today to facilitate demonstration of certain diagnostic criteria of various disease processes, both vasodilatory and vasoconstrictive reaction to these agents are widely used in various therapeutic vascular procedures. This monograph should be reviewed by every angiographer whether or not he or she performs interventional procedures, and it would be very convenient to have this table available in the angiography suite. In a related subject, Bookstein and co-workers have written an excellent review concerning pharmacologic manipulations of various blood coagulative parameters during angiography. Understanding the proper method of manipulation of the bloodclotting factors during angiography, and especially during interventional angiography, is extremely important. Particularly, the method of manipulating the coagulation with the use of heparin and protamine and modification of the platelet activity by using aspirin and dipyridamole are succinctly reviewed. The systemic and selective thrombolytic activities of streptokianse are also discussed

Value of MR contrast media in image-guided body interventions.

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Saeed, Maythem; Wilson, Mark

2012-01-28

In the past few years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain from conventional surgery and increase drug effectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side effects of some drugs to other organs. The success of MR-guided procedures depends on visualization of the targets in 3D and precise deployment of ablation catheters, local therapies and devices. MR contrast media provide a wealth of tissue contrast and allows 3D and 4D image acquisitions. After the development of fast imaging sequences, the clinical applications of MR contrast media have been substantially expanded to include pre- during- and post-interventions. Prior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues of vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also offer other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. After intervention, MR contrast media have been used for assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications of MR contrast media in image-guided procedures depend on their safety, tolerability

Therapeutic management of radiation-induced oral mucositis

International Nuclear Information System (INIS)

Doerr, W.; Doelling-Jochem, I.; Baumann, M.; Herrmann, T.

1997-01-01

Background: Acute reactions of oral mucosa are a frequent side effect of radiotherapy, which often necessitates interruption of the treatment. Marked proliferation of tumor stem cells during treatment interruptions may occur in squamous cell carcinomata, which represent the majority of tumors in the head and neck area. Hence a fatal consequence of treatment breaks may be a significant decrease in tumor cure rates. Furthermore, marked acute responses frequently result in increased late sequelae ('consequential damage'). Therefore, amelioration of the mucosal response aiming at avoiding treatment breaks and at reduction of late reactions coul definitely increase the therapeutic success of radiation treatment. Results: A variety of prophylactic and therapeutic methods have been proposed for the management of acute radiation reactions of the oral mucosa. Frequently, their efficiacy has been established for chemotherapy or in combination with other immunosuppressive treatments. Hence, systemical rather than local effects have to be considered. Conclusions: In general, prophylaxis of oral mucositis is mainly based on dental restoration or edentation, in combination with frequent oral hygienic measures after the meals and with antiseptic mouthwashes. Intensive personal care is recommended. The necessity of a percutaneous endoscopic gastrostoma is dependent on the status of the patient and on size and localization of the treatment area, i.e. the impairment of food uptake which is to be expected. Therapeutic intervention is restricted to local or systemic treatment of pain and local application of antimycotics and antibiotics. (orig./VHE) [de

Is there still a place for the concept of 'therapeutic regression' in psychoanalysis?

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Spurling, Laurence S

2008-06-01

The author uses his own failure to find a place for the idea of therapeutic regression in his clinical thinking or practice as the basis for an investigation into its meaning and usefulness. He makes a distinction between three ways the term 'regression' is used in psychoanalytic discourse: as a way of evoking a primitive level of experience; as a reminder in some clinical situations of the value of non-intervention on the part of the analyst; and as a description of a phase of an analytic treatment with some patients where the analyst needs to put aside normal analytic technique in order to foster a regression in the patient. It is this third meaning, which the author terms "therapeutic regression" that this paper examines, principally by means of an extended discussion of two clinical examples of a patient making a so-called therapeutic regression, one given by Winnicott and the other by Masud Khan. The author argues that in these examples the introduction of the concept of therapeutic regression obscures rather than clarifies the clinical process. He concludes that, as a substantial clinical concept, the idea of therapeutic regression has outlived its usefulness. However he also notes that many psychoanalytic writers continue to find a use for the more generic concept of regression, and that the very engagement with the more particular idea of therapeutic regression has value in provoking questions as to what is truly therapeutic in psychoanalytic treatment.

Integrative Therapeutic Approaches for the Management and Control of Nausea in Children Undergoing Cancer Treatment: A Systematic Review of Literature.

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Momani, Tha'er G; Berry, Donna L

Chemotherapy-induced nausea and vomiting (CINV) continues to be a common symptom experienced by children undergoing cancer treatment despite the use of contemporary antiemetics. Integrative therapeutic approaches in addition to standard pharmacologic antiemetic regimes offer potential to control CINV. The purpose of this review was to identify current evidence on integrative therapeutic approaches for the control of CINV in children with cancer. Online search engines (PubMed, CINAHL, PsychINFO) were queried using MESH terms. Titles, abstracts, and then full-text articles were reviewed for relevance to the review. The search resulted in 53 studies. Twenty-one studies met our review criteria. Integrative therapies identified included acupuncture/acupressure, aromatherapy, herbal supplements, hypnosis, and other cognitive behavioral interventions. Our review identified little information on the effectiveness and safety of most integrative therapeutic approaches for the control and management of CINV in children with cancer. However, evidence from adult cancer studies and some pediatric studies identify promising interventions for further testing.

Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation.

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Thome, Janine; Koppe, Georgia; Hauschild, Sophie; Liebke, Lisa; Schmahl, Christian; Lis, Stefanie; Bohus, Martin

2016-01-01

Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response. Differential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus. Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of psychotherapeutic interventions. This

Modification of Fear Memory by Pharmacological and Behavioural Interventions during Reconsolidation

Science.gov (United States)

Thome, Janine; Koppe, Georgia; Hauschild, Sophie; Liebke, Lisa; Schmahl, Christian; Lis, Stefanie; Bohus, Martin

2016-01-01

Background Dysfunctional fear responses play a central role in many mental disorders. New insights in learning and memory suggest that pharmacological and behavioural interventions during the reconsolidation of reactivated fear memories may increase the efficacy of therapeutic interventions. It has been proposed that interventions applied during reconsolidation may modify the original fear memory, and thus prevent the spontaneous recovery and reinstatement of the fear response. Methods We investigated whether pharmacological (propranolol) and behavioural (reappraisal, multisensory stimulation) interventions reduce fear memory, and prevent reinstatement of fear in comparison to a placebo control group. Eighty healthy female subjects underwent a differential fear conditioning procedure with three stimuli (CS). Two of these (CS+) were paired with an electric shock on day 1. On day 2, 20 subjects were pseudo-randomly assigned to either the propranolol or placebo condition, or underwent one of the two behavioural interventions after one of the two CS+ was reactivated. On day 3, all subjects underwent an extinction phase, followed by a reinstatement test. Dependent variables were US expectancy ratings, fear-potentiated startle, and skin conductance response. Results Differential fear responses to the reactivated and non-reactivated CS+ were observed only in the propranolol condition. Here, the non-reactivated CS+ evoked stronger fear-potentiated startle-responses compared to the placebo group. None of the interventions prevented the return of the extinguished fear response after re-exposure to the unconditioned stimulus. Conclusions Our data are in line with an increasing body of research stating that the occurrence of reconsolidation may be constrained by boundary conditions such as subtle differences in experimental manipulations and instructions. In conclusion, our findings do not support a beneficial effect in using reconsolidation processes to enhance effects of

Professional's Attitudes Do Not Influence Screening and Brief Interventions Rates for Hazardous and Harmful Drinkers: Results from ODHIN Study.

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Bendtsen, Preben; Anderson, Peter; Wojnar, Marcin; Newbury-Birch, Dorothy; Müssener, Ulrika; Colom, Joan; Karlsson, Nadine; Brzózka, Krzysztof; Spak, Fredrik; Deluca, Paolo; Drummond, Colin; Kaner, Eileen; Kłoda, Karolina; Mierzecki, Artur; Okulicz-Kozaryn, Katarzyna; Parkinson, Kathryn; Reynolds, Jillian; Ronda, Gaby; Segura, Lidia; Palacio, Jorge; Baena, Begoña; Slodownik, Luiza; van Steenkiste, Ben; Wolstenholme, Amy; Wallace, Paul; Keurhorst, Myrna N; Laurant, Miranda G H; Gual, Antoni

2015-07-01

To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals. Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine. The participants also completed the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), which measure role security and therapeutic commitment. The only significant but small relationship was found between role security and screening rate in a multilevel logistic regression analysis adjusted for occupation of the provider, number of eligible patients and the random effects of jurisdictions and primary health care units (PHCU). No significant relationship was found between role security and brief intervention rate nor between therapeutic commitment and screening rate/brief intervention rate. The proportion of patients screened varied across jurisdictions between 2 and 10%. The findings show that the studied factors (role security and therapeutic commitment) are not of great importance for alcohol screening and BI rates. Given the fact that screening and brief intervention implementation rate has not changed much in the last decade in spite of increased policy emphasis, training initiatives and more research being published, this raises a question about what else is needed to enhance implementation. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Cloning and sequence analysis of putative type II fatty acid synthase ...

Indian Academy of Sciences (India)

Prakash

Cloning and sequence analysis of putative type II fatty acid synthase genes from Arachis hypogaea L. ... acyl carrier protein (ACP), malonyl-CoA:ACP transacylase, β-ketoacyl-ACP .... Helix II plays a dominant role in the interaction ... main distinguishing features of plant ACPs in plastids and ..... synthase component; J. Biol.

Glycogen synthase kinase 3 (GSK3) in the heart: a point of integration in hypertrophic signalling and a therapeutic target? A critical analysis.

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Sugden, P H; Fuller, S J; Weiss, S C; Clerk, A

2008-03-01

Glycogen synthase kinase 3 (GSK3, of which there are two isoforms, GSK3alpha and GSK3beta) was originally characterized in the context of regulation of glycogen metabolism, though it is now known to regulate many other cellular processes. Phosphorylation of GSK3alpha(Ser21) and GSK3beta(Ser9) inhibits their activity. In the heart, emphasis has been placed particularly on GSK3beta, rather than GSK3alpha. Importantly, catalytically-active GSK3 generally restrains gene expression and, in the heart, catalytically-active GSK3 has been implicated in anti-hypertrophic signalling. Inhibition of GSK3 results in changes in the activities of transcription and translation factors in the heart and promotes hypertrophic responses, and it is generally assumed that signal transduction from hypertrophic stimuli to GSK3 passes primarily through protein kinase B/Akt (PKB/Akt). However, recent data suggest that the situation is far more complex. We review evidence pertaining to the role of GSK3 in the myocardium and discuss effects of genetic manipulation of GSK3 activity in vivo. We also discuss the signalling pathways potentially regulating GSK3 activity and propose that, depending on the stimulus, phosphorylation of GSK3 is independent of PKB/Akt. Potential GSK3 substrates studied in relation to myocardial hypertrophy include nuclear factors of activated T cells, beta-catenin, GATA4, myocardin, CREB, and eukaryotic initiation factor 2Bvarepsilon. These and other transcription factor substrates putatively important in the heart are considered. We discuss whether cardiac pathologies could be treated by therapeutic intervention at the GSK3 level but conclude that any intervention would be premature without greater understanding of the precise role of GSK3 in cardiac processes.

Molecular, Phenotypic Aspects and Therapeutic Horizons of Rare Genetic Bone Disorders

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Taha Faruqi

2014-01-01

Full Text Available A rare disease afflicts less than 200,000 individuals, according to the National Organization for Rare Diseases (NORD of the United States. Over 6,000 rare disorders affect approximately 1 in 10 Americans. Rare genetic bone disorders remain the major causes of disability in US patients. These rare bone disorders also represent a therapeutic challenge for clinicians, due to lack of understanding of underlying mechanisms. This systematic review explored current literature on therapeutic directions for the following rare genetic bone disorders: fibrous dysplasia, Gorham-Stout syndrome, fibrodysplasia ossificans progressiva, melorheostosis, multiple hereditary exostosis, osteogenesis imperfecta, craniometaphyseal dysplasia, achondroplasia, and hypophosphatasia. The disease mechanisms of Gorham-Stout disease, melorheostosis, and multiple hereditary exostosis are not fully elucidated. Inhibitors of the ACVR1/ALK2 pathway may serve as possible therapeutic intervention for FOP. The use of bisphosphonates and IL-6 inhibitors has been explored to be useful in the treatment of fibrous dysplasia, but more research is warranted. Cell therapy, bisphosphonate polytherapy, and human growth hormone may avert the pathology in osteogenesis imperfecta, but further studies are needed. There are still no current effective treatments for these bone disorders; however, significant promising advances in therapeutic modalities were developed that will limit patient suffering and treat their skeletal disabilities.

Putative golden proportions as predictors of facial esthetics in adolescents.

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Kiekens, Rosemie M A; Kuijpers-Jagtman, Anne Marie; van 't Hof, Martin A; van 't Hof, Bep E; Maltha, Jaap C

2008-10-01

In orthodontics, facial esthetics is assumed to be related to golden proportions apparent in the ideal human face. The aim of the study was to analyze the putative relationship between facial esthetics and golden proportions in white adolescents. Seventy-six adult laypeople evaluated sets of photographs of 64 adolescents on a visual analog scale (VAS) from 0 to 100. The facial esthetic value of each subject was calculated as a mean VAS score. Three observers recorded the position of 13 facial landmarks included in 19 putative golden proportions, based on the golden proportions as defined by Ricketts. The proportions and each proportion's deviation from the golden target (1.618) were calculated. This deviation was then related to the VAS scores. Only 4 of the 19 proportions had a significant negative correlation with the VAS scores, indicating that beautiful faces showed less deviation from the golden standard than less beautiful faces. Together, these variables explained only 16% of the variance. Few golden proportions have a significant relationship with facial esthetics in adolescents. The explained variance of these variables is too small to be of clinical importance.

The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

International Nuclear Information System (INIS)

Tapping, Charles R.; Bratby, Mark J.

2013-01-01

Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies

The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

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Tapping, Charles R., E-mail: crtapping@doctors.org.uk; Bratby, Mark J., E-mail: mark.bratby@ouh.nhs.uk [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom)

2013-08-01

Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies.

Effects of therapeutic touch on the vital signs of patients before coronary artery bypass graft surgery.

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Zare, Zahra; Shahsavari, Hooman; Moeini, Mahin

2010-01-01

Currently healthy heart word considered to be the objective of community health applications in many countries of the world because cardiovascular diseases are the most important factor in mortality of humans, worldwide. Coronary artery bypass graft surgery is one of the most common surgery procedures for these patients. The purpose of this study is to assess the impact of therapeutic touch on medical vital signs of patients before coronary artery bypass graft surgery. The present study is a clinical trial with 44 samples that were selected by easy sampling method and based on two separate lists of random numbers for both men and women; they were divided into two groups. In the therapeutic touch group, intervention therapy was applied on patents for 20 minutes. Data was analyzed using descriptive and inferential statistics. Test results showed that there was a significant difference between the mean pulse rate before and after intervention in both groups (p touch therapy as a safe and effective intervention on the patients which were revealed in this study, this technique can be used as a simple, cheap and applicable technique in all health care centers to help these patients.

The therapeutic use of music as experienced by cardiac surgery patients of an intensive care unit

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Varshika M. Bhana

2014-04-01

Full Text Available Patients perceive the intensive care unit (ICU as being a stressful and anxiety-provoking environment. The physiological effects of stress and anxiety are found to be harmful and therefore should be avoided in cardiac surgery patients. The aim of the study on which this article is based was to describe cardiac surgery patients’ experiences of music as a therapeutic intervention in the ICU of a public hospital. The objectives of this article were to introduce and then expose the cardiac patients to music as part of their routine postoperative care and to explore and describe their experiences of the music intervention. The findings of the research are to be the basis for making recommendations for the inclusion of music as part of the routine postoperative care received by cardiac surgery patients in the ICU. A qualitative research methodology, using a contextual, explorative and descriptive research design, was adopted. The population of the study was cardiac surgery patients admitted to the ICU of a public hospital. An unstructured interview was conducted with each participant and content analysis and coding procedures were used to analyse the data. Four main themes were identified in the results, namely practical and operational aspects of the music sessions; participants’ experiences; discomfort due to therapeutic apparatus and the ICU environment; and the role of music and recommendations for music as a therapeutic intervention. Participants’ experiences were mainly positive. Results focused on experiences of the music and also on the participants’ experiences of the operational aspects of the therapy, as well as factors within and around the participants.

A Therapeutic Workplace for the Long-Term Treatment of Drug Addiction and Unemployment: Eight-Year Outcomes of a Social Business Intervention

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Aklin, Will M.; Wong, Conrad J.; Hampton, Jacqueline; Svikis, Dace S.; Stitzer, Maxine L.; Bigelow, George E.; Silverman, Kenneth

2014-01-01

This study evaluated the long-term effects of a Therapeutic Workplace social business on drug abstinence and employment. Pregnant and postpartum women (N=40) enrolled in methadone treatment were randomly assigned to a Therapeutic Workplace or Usual Care Control group. Therapeutic Workplace participants could work weekdays in training and then as employees of a social business, but were required to provide drug-free urine samples to work and maintain maximum pay. Three-year outcomes were repor...

Mitochondria, Bioenergetics and Excitotoxicity: New Therapeutic Targets in Perinatal Brain Injury

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Bryan Leaw

2017-07-01

Full Text Available Injury to the fragile immature brain is implicated in the manifestation of long-term neurological disorders, including childhood disability such as cerebral palsy, learning disability and behavioral disorders. Advancements in perinatal practice and improved care mean the majority of infants suffering from perinatal brain injury will survive, with many subtle clinical symptoms going undiagnosed until later in life. Hypoxic-ischemia is the dominant cause of perinatal brain injury, and constitutes a significant socioeconomic burden to both developed and developing countries. Therapeutic hypothermia is the sole validated clinical intervention to perinatal asphyxia; however it is not always neuroprotective and its utility is limited to developed countries. There is an urgent need to better understand the molecular pathways underlying hypoxic-ischemic injury to identify new therapeutic targets in such a small but critical therapeutic window. Mitochondria are highly implicated following ischemic injury due to their roles as the powerhouse and main energy generators of the cell, as well as cell death processes. While the link between impaired mitochondrial bioenergetics and secondary energy failure following loss of high-energy phosphates is well established after hypoxia-ischemia (HI, there is emerging evidence that the roles of mitochondria in disease extend far beyond this. Indeed, mitochondrial turnover, including processes such as mitochondrial biogenesis, fusion, fission and mitophagy, affect recovery of neurons after injury and mitochondria are involved in the regulation of the innate immune response to inflammation. This review article will explore these mitochondrial pathways, and finally will summarize past and current efforts in targeting these pathways after hypoxic-ischemic injury, as a means of identifying new avenues for clinical intervention.

The social dimensions of therapeutic horticulture.

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Harris, Holly

2017-07-01

Harnessing nature to promote mental health is increasingly seen as a sustainable solution to healthcare across the industrialised world. The benefits of these approaches to well-being include reduced symptoms of anxiety, depression and improved social functioning. Many studies assume that contact with nature is the main therapeutic component of these interventions yet 'green care' programmes typically include activities not based on 'nature' that may contribute to positive outcomes. This study explored the views of service users participating in a Therapeutic Horticultural programme on what factors promoted their engagement in the project, to identify variables other than 'nature' that may be responsible for successful engagement in these programmes. A secondary aim was to assess the significance 'nature' plays including, for example whether a prior interest in horticultural-related activities, such as gardening, is significant. Two focus groups were held with mental health service users (n = 15) attending a gardening project in south-east England. Findings revealed that the social element of the project was the key facilitator to engagement; the flexible structure of the gardening project was also significant and allowed service users to feel empowered. 'Nature' evoked a sense of calm and provided participants with a non-threatening space that was engaging. © 2017 John Wiley & Sons Ltd.

Vitamin A-aldehyde adducts: AMD risk and targeted therapeutics.

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Sparrow, Janet R

2016-04-26

Although currently available treatment options for age-related macular degeneration (AMD) are limited, particularly for atrophic AMD, the identification of predisposing genetic variations has informed clinical studies addressing therapeutic options such as complement inhibitors and anti-inflammatory agents. To lower risk of early AMD, recommended lifestyle interventions such as the avoidance of smoking and the intake of low glycemic antioxidant-rich diets have largely followed from the identification of nongenetic modifiable factors. On the other hand, the challenge of understanding the complex relationship between aging and cumulative damage leading to AMD has fueled investigations of the visual cycle adducts that accumulate in retinal pigment epithelial (RPE) cells and are a hallmark of aging retina. These studies have revealed properties of these compounds that provide insights into processes that may compromise RPE and could contribute to disease mechanisms in AMD. This work has also led to the design of targeted therapeutics that are currently under investigation.

Crystalline dose of interventional radiologists; Dosis en cristalino de radiologicos intervencionistas

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Hernandez Concepcion, E.; Diaz Romero, F.; Catalan Acosta, A.; Hernandez Armas, J.

2013-07-01

The measured dose area product in radiology equipment used in angio radiology during different diagnostic and therapeutic can be used to estimate the value of the dose in the lens of doctors or medical personnel carrying out such interventions. (Author)

[Assessment of an intervention on cardiovascular risk factors in patients with rheumatoid arthritis].

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Zacarías, Andrea; Narváez, Javier; Rodríguez Moreno, Jesús; Jordana, Montserrat; Nolla, Joan M; Gómez Vaquero, Carmen

2016-08-05

To evaluate the effectiveness of an intervention on cardiovascular risk factors (CVRF) in patients with rheumatoid arthritis. After determining their CVRF and cardiovascular risk (CVR) by modified SCORE, we gave the patients a letter for their general practitioners in which they were requested for their cooperation in controlling CVRF and where the therapeutic goal for LDL cholesterol was specified. Three months later, any therapeutic intervention was recorded as well as the results. We included 211 patients, 29% with a high CVR. There were new diagnoses of CVRF in 100 patients (47%). The general practitioner changed the treatment in 2/12 diabetes, 30/84 HBP, 74/167 with elevation of LDL cholesterol and 21/51 with hypertriglyceridemia. The percentage of patients with good control over CVRF was: a) in HBP, 25 to 73%; b) elevation of LDL cholesterol from 10 to 17%; and c) in hypertriglyceridemia, 25 to 38%. Through this intervention, a new CVRF was diagnosed in nearly half of the patients. The effectiveness of the intervention on CVRF was low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Memory-guided sensory comparisons in the prefrontal cortex: contribution of putative pyramidal cells and interneurons.

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Hussar, Cory R; Pasternak, Tatiana

2012-02-22

Comparing two stimuli that occur at different times demands the coordination of bottom-up and top-down processes. It has been hypothesized that the dorsolateral prefrontal (PFC) cortex, the likely source of top-down cortical influences, plays a key role in such tasks, contributing to both maintenance and sensory comparisons. We examined this hypothesis by recording from the PFC of monkeys comparing directions of two moving stimuli, S1 and S2, separated by a memory delay. We determined the contribution of the two principal cell types to these processes by classifying neurons into broad-spiking (BS) putative pyramidal cells and narrow-spiking (NS) putative local interneurons. During the delay, BS cells were more likely to exhibit anticipatory modulation and represent the remembered direction. While this representation was transient, appearing at different times in different neurons, it weakened when direction was not task relevant, suggesting its utility. During S2, both putative cell types showed comparison-related activity modulations. These modulations were of two types, each carried by different neurons, which either preferred trials with stimuli moving in the same direction or trials with stimuli of different directions. These comparison effects were strongly correlated with choice, suggesting their role in circuitry underlying decision making. These results provide the first demonstration of distinct contributions made by principal cell types to memory-guided perceptual decisions. During sensory stimulation both cell types represent behaviorally relevant stimulus features contributing to comparison and decision-related activity. However in the absence of sensory stimulation, putative pyramidal cells dominated, carrying information about the elapsed time and the preceding direction.

Mandated college students' response to sequentially administered alcohol interventions in a randomized clinical trial using stepped care.

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Borsari, Brian; Magill, Molly; Mastroleo, Nadine R; Hustad, John T P; Tevyaw, Tracy O'Leary; Barnett, Nancy P; Kahler, Christopher W; Eaton, Erica; Monti, Peter M

2016-02-01

Students referred to school administration for alcohol policies violations currently receive a wide variety of interventions. This study examined predictors of response to 2 interventions delivered to mandated college students (N = 598) using a stepped care approach incorporating a peer-delivered 15-min brief advice (BA) session (Step 1) and a 60- to 90-min brief motivational intervention (BMI) delivered by trained interventionists (Step 2). Analyses were completed in 2 stages. First, 3 types of variables (screening variables, alcohol-related cognitions, mandated student profile) were examined in a logistic regression model as putative predictors of lower risk drinking (defined as 3 or fewer heavy episodic drinking [HED] episodes and/or 4 or fewer alcohol-related consequences in the past month) 6 weeks following the BA session. Second, we used generalized estimating equations to examine putative moderators of BMI effects on HED and peak blood alcohol content compared with assessment only (AO) control over the 3-, 6-, and 9-month follow-ups. Participants reporting lower scores on the Alcohol Use Disorders Identification Test, more benefits to changing alcohol use, and those who fit the "Bad Incident" profile at baseline were more likely to report lower risk drinking 6 weeks after the BA session. Moderation analyses revealed that Bad Incident students who received the BMI reported more HED at 9-month follow-up than those who received AO. Current alcohol use as well as personal reaction to the referral event may have clinical utility in identifying which mandated students benefit from treatments of varying content and intensity. (c) 2016 APA, all rights reserved).

Choosing a control intervention for a randomised clinical trial

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Djulbegovic Benjamin

2003-04-01

Full Text Available Abstract Background Randomised controlled clinical trials are performed to resolve uncertainty concerning comparator interventions. Appropriate acknowledgment of uncertainty enables the concurrent achievement of two goals : the acquisition of valuable scientific knowledge and an optimum treatment choice for the patient-participant. The ethical recruitment of patients requires the presence of clinical equipoise. This involves the appropriate choice of a control intervention, particularly when unapproved drugs or innovative interventions are being evaluated. Discussion We argue that the choice of a control intervention should be supported by a systematic review of the relevant literature and, where necessary, solicitation of the informed beliefs of clinical experts through formal surveys and publication of the proposed trial's protocol. Summary When clinical equipoise is present, physicians may confidently propose trial enrollment to their eligible patients as an act of therapeutic beneficence.

Measuring Effects of a Skills Training Intervention for Drug Abusers.

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Hawkins, J. David; And Others

1986-01-01

A test was conducted of a supplemental skills training and social-network-development aftercare program with 130 drug abusers from four residential therapeutic communities. The intervention produced positive effects on subjects' performance at the conclusion of treatment. Performance improved in situations involving avoidance of drug use, coping…

Improving medication adherence among community-dwelling seniors with cognitive impairment: a systematic review of interventions.

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Kröger, Edeltraut; Tatar, Ovidiu; Vedel, Isabelle; Giguère, Anik M C; Voyer, Philippe; Guillaumie, Laurence; Grégoire, Jean-Pierre; Guénette, Line

2017-08-01

Background Medication non-adherence may lead to poor therapeutic outcomes. Cognitive functions deteriorate with age, contributing to decreased adherence. Interventions have been tested to improve adherence in seniors with cognitive impairment or Alzheimer disease (AD), but high-quality systematic reviews are lacking. It remains unclear which interventions are promising. Objectives We conducted a systematic review to identify, describe, and evaluate interventions aimed at improving medication adherence among seniors with any type of cognitive impairment. Methods Following NICE guidance, databases and websites were searched using combinations of controlled and free vocabulary. All adherence-enhancing interventions and study designs were considered. Studies had to include community dwelling seniors, aged 65 years or older, with cognitive impairment, receiving at least one medication for a chronic condition, and an adherence measure. Study characteristics and methodological quality were assessed. Results We identified 13 interventions, including six RCTs. Two studies were of poor, nine of low/medium and two of high quality. Seven studies had sample sizes below 50 and six interventions focused on adherence to AD medication. Six interventions tested a behavioral, four a medication oriented, two an educational and one a multi-faceted approach. Studies rarely assessed therapeutic outcomes. All but one intervention showed improved adherence. Conclusion Three medium quality studies showed better adherence with patches than with pills for AD treatment. Promising interventions used educational or reminding strategies, including one high quality RCT. Nine studies were of low/moderate quality. High quality RCTs using a theoretical framework for intervention selection are needed to identify strategies for improved adherence in these seniors.

Investigating the effect of therapeutic touch on the intensity of acute chemotherapy-induced vomiting in breast cancer women under chemotherapy

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Pegah Matourypour

2016-01-01

Conclusions: Therapeutic touch was effective in reducing vomiting in the intervention group. However, the patients experienced lower-intensity vomiting which may be because of presence of a therapist and probably the reduced anxiety related to an additional intervention. So, further research is recommended considering the placebo group and employing another person in addition to the therapist, who is not skilled for this technique.

Changing the risky beliefs of post-partum women about therapeutic sun-exposure.

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Harrison, Simone L; Devine, Susan G; Saunders, Vicki L; Smith, Annika D; Buettner, Petra G; Nowak, Madeleine J

2013-09-01

Many post-partum women hold risky beliefs about perceived therapeutic benefits of sun-exposure in the post-partum period and infancy. Can a maternity hospital based educational intervention reduce the prevalence of such beliefs among post-partum women? In this outcome evaluation of an interventional study, two groups of healthy post-partum women (hospital inpatients) were interviewed, 1-4 days following delivery. The first cross-section (106 women) was recruited prior to in-services for maternity staff; the second (203 women) was recruited after completion of the in-services. Data were compared between the groups. More pre-intervention than post-intervention women reported they would expose their baby to sunlight to treat suspected jaundice (28.8% vs. 13.3%; p<0.001) or help his/her skin adapt to the sun (10.5% vs. 2.5%; p=0.003); or use sunlight to manage breastfeeding-associated sore/cracked nipples (7.6% vs. 2%; p=0.026). This simple, effective educational intervention could be implemented in programmes for parents, health professionals and students. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Crystallization and preliminary crystallographic analysis of a putative glucokinase/hexokinase from Thermus thermophilus

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Nakamura, Tsutomu; Kashima, Yasuhiro; Mine, Shouhei; Oku, Takashi; Uegaki, Koichi

2011-01-01

In this study, a putative glucokinase/hexokinase from T. thermophilus was purified and crystallized. Diffraction data were collected and processed to 2.02 Å resolution. Glucokinase/hexokinase catalyzes the phosphorylation of glucose to glucose 6-phosphate, which is the first step of glycolysis. The open reading frame TTHA0299 of the extreme thermophile Thermus thermophilus encodes a putative glucokinase/hexokinase which contains the consensus sequence for proteins from the repressors, open reading frames and sugar kinases family. In this study, the glucokinase/hexokinase from T. thermophilus was purified and crystallized using polyethylene glycol 8000 as a precipitant. Diffraction data were collected and processed to 2.02 Å resolution. The crystal belonged to space group P2 1 , with unit-cell parameters a = 70.93, b = 138.14, c = 75.16 Å, β = 95.41°

Evaluation of surveillance of dengue fever cases in the public health centre of Putat Jaya based on attribute surveillance

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Zumaroh Zumaroh

2015-01-01

Full Text Available Dengue Hemorrhagic Fever (DHF is a public health problem in the village of Putat Jaya which is an endemic area. Surveilans activity in DHF control program is the most important activity in controlling and monitoring disease progression. The program is expected to achieve incidence rate 55/100.000 population. This study aimed to evaluate the implementation of case surveilans in health centre of putat jaya based on attribute surveillance. Attribute surveillance is an indicator that describes the characteristics of the surveillance system. This research was an evaluation research with descriptive study design. As informants were clinic staff who deal specifically with cases of dengue hemorrhagic fever and laboratory workers. The techniques of data collection by interviews and document study. The variables of this study were simplicity, flexibility, acceptability, sensitivity, positive predictive value, representativeness, timeliness, data quality and data stability. It could be seen from Incidence Rate in 2013 has reached 133/100.00 population. The activity of surveilance in the village of Putat Jaya reviewed from disease contol program management was not succeed into decrease incidence rate of DHF. Therefore, dengue control programs in health centers Putat Jaya need to do cross-sector cooperation and cross-program cooperation, strengthening the case reporting system by way increasing in the utilization of information and communication technology electromedia. Keywords: case surveillance, dengue hemorrhagic fever, evaluation, attribute surveillance, Putat Jaya

Fecal Microbiota-based Therapeutics for Recurrent Clostridium difficile Infection, Ulcerative Colitis and Obesity

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Christian Carlucci

2016-11-01

Full Text Available The human gut microbiome is a complex ecosystem of fundamental importance to human health. Our increased understanding of gut microbial composition and functional interactions in health and disease states has spurred research efforts examining the gut microbiome as a valuable target for therapeutic intervention. This review provides updated insight into the state of the gut microbiome in recurrent Clostridium difficile infection (CDI, ulcerative colitis (UC, and obesity while addressing the rationale for the modulation of the gut microbiome using fecal microbiota transplant (FMT-based therapies. Current microbiome-based therapeutics in pre-clinical or clinical development are discussed. We end by putting this within the context of the current regulatory framework surrounding FMT and related therapies.

Are Non-Pharmacological Interventions Effective in Reducing Drug Use and Criminality? A Systematic and Meta-Analytical Review with an Economic Appraisal of These Interventions

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Amanda E. Perry

2016-09-01

Full Text Available Background: The numbers of incarcerated people suffering from drug dependence has steadily risen since the 1980s and only a small proportion of these receive appropriate treatment. A systematic review to evaluate the effectiveness and economic evidence of non-pharmacological interventions for drug using offenders was conducted. Methods: Cochrane Collaboration criteria were used to identify trials across 14 databases between 2004 and 2014. A series of meta-analyses and an economic appraisal were conducted. Results: 43 trials were identified showing to have limited effect in reducing re-arrests RR 0.97 (95% CI 0.89–1.07 and drug use RR 0.90 (95% CI 0.80–1.00 but were found to significantly reduce re-incarceration RR 0.70 (95% CI 0.57–0.85. Therapeutic community programs were found to significantly reduce the number of re-arrests RR 0.70 (95% CI 0.56–0.87. 10 papers contained economic information. One paper presented a cost-benefit analysis and two reported on the cost and cost effectiveness of the intervention. Conclusions: We suggest that therapeutic community interventions have some benefit in reducing subsequent re-arrest. We recommend that economic evaluations should form part of standard trial protocols.

PD-1 and PD-L1 as emerging therapeutic targets in gastric cancer: current evidence

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Tran PN

2017-05-01

Full Text Available Phu N Tran,1* Sarmen Sarkissian,1* Joseph Chao,2 Samuel J Klempner3,4 1Division of Hematology-Oncology, University of California Irvine, Orange, 2Department of Medical Oncology and Developmental Therapeutics, City of Hope, Duarte, 3Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 4The Angeles Clinic and Research Institute, Los Angeles, CA, USA *These authors contributed equally to this work Abstract: Gastric adenocarcinoma is a leading cause of global cancer-related morbidity and mortality, and new therapeutic approaches are needed. Despite the improved outcomes with monoclonal antibodies targeting human epidermal growth factor receptor 2 and vascular endothelial growth factor receptor 2, durable responses are uncommon. Targeting immune checkpoints including PD-1, PD-L1 and CTLA-4 have led to improved survival across several tumor types, frequently characterized by prolonged benefit in responding patients. Tumoral and lymphocyte-derived immunohistochemical staining for PD-1, PD-L1, and tumor mutational burden have shown potential as predictive response biomarkers in several tumor types. Optimal incorporation of immune-mediated therapies into gastric cancer (GC is an area of intense ongoing investigation and benefit has been demonstrated in smaller studies of advanced patients. Important questions of biomarker selection, roles for molecular characterization, optimal combinatorial approaches, and therapeutic sequencing remain. In this study, current data are reviewed for immune checkpoint inhibitors in GC, and putative biomarkers, ongoing trials, and future considerations are discussed. Keywords: immunotherapy, stomach cancer, checkpoint inhibitor, nivolumab, pembrolizumab, tumor mutational burden

Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of hip osteoarthritis.

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Brosseau, Lucie; Wells, George A; Pugh, Arlanna G; Smith, Christine Am; Rahman, Prinon; Àlvarez Gallardo, Inmaculada C; Toupin-April, Karine; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Taki, Jade; Marcotte, Rachel; Fransen, Marlene; Hernandez-Molina, Gabriela; Kenny, Glen P; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; Brooks, Sydney; Laferriere, Lucie; McLean, Linda; Longchamp, Guy

2016-10-01

The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. The search strategy and modified selection criteria from a Cochrane review were used. Studies included hip osteoarthritis patients in comparative controlled trials with therapeutic exercise interventions. An Expert Panel arrived at a Delphi survey consensus to endorse the recommendations. The Ottawa Panel hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) considered the study design (level I: randomized controlled trial and level II: controlled clinical trial), statistical significance (p osteoarthritis. Strength training exercises displayed the greatest improvements for pain (Grade A), disability (Grades A and C+), physical function (Grade A), stiffness (Grade A), and range of motion (Grade A) within a short time period (8-24 weeks). Stretching also greatly improved physical function (Grade A), and flexibility exercises improved pain (Grade A), range of motion (Grade A), physical function (Grade A), and stiffness (Grade C+). The Ottawa Panel recommends land-based therapeutic exercise, notably strength training, for management of hip osteoarthritis in reducing pain, stiffness and self-reported disability, and improving physical function and range of motion. © The Author(s) 2015.

Nondirective counseling interventions with schizophrenics.

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Gerwood, J B

1993-12-01

Counseling interventions with paranoid schizophrenics can be daunting. While chemical, directive, and behavioral controls often are considered important, nondirective counseling techniques used by the therapeutic staff may help schizophrenic patients explore their thoughts and feelings. Several nondirective concepts pioneered by Carl Rogers are examined. These methods, which represent basic concepts of the person-centered approach, are empathy, unconditional positive regard, and congruence. A brief illustration of an interaction with a patient diagnosed as paranoid schizophrenic is presented to suggest the effectiveness of Rogerian counseling.

Key Elements of a Family Intervention for Schizophrenia: A Qualitative Analysis of an RCT.

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Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian

2018-03-01

Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach. © 2016 Family Process Institute.

An Analysis of a Novel, Short-Term Therapeutic Psychoeducational Program for Children and Adolescents with Chronic Neurological Illness and Their Parents; Feasibility and Efficacy.

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Joo, Bonglim; Lee, Young-Mock; Kim, Heung Dong; Eom, Soyong

2017-01-01

The purpose of this intervention was to develop a therapeutic psycho-educational program that improves quality of life in children and adolescents who are experiencing chronic neurological illness, including epilepsy, and their parents, and to analyze the intervention's feasibility and efficacy and participants' satisfaction. Participants were eight children ( n = 8) and adolescents and their parents; participating children were experiencing chronic neurological illness with psychological comorbidity; children with intellectual impairment were excluded (IQ Stress Index, Beck Depression Inventory, Children's Depression Inventory, and Revised Children's Manifest Anxiety Scale) at pre- and post-intervention, and administered satisfaction surveys following the intervention. Participants' opinions about the program's necessity, contents, and process, and participants' overall program satisfaction were analyzed. Parents and children reported high levels of satisfaction with the program. Externalizing behavioral problems, anxiety/depression, and emotional functioning from quality of life showed improvement after the intervention. Although not statistically significant, total child stress trended downward from pre- to post-intervention. A four-session structured therapeutic psycho-educational program for children and adolescents with chronic neurological illness and their parents was successfully implemented, showing good compliance and high satisfaction and efficacy.

Expression of putative expansin genes in phylloxera (Daktulosphaira vitifoliae Fitch) induced root galls of Vitis spp.

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Lawo, N C; Griesser, M; Forneck, A

Grape phylloxera ( Daktulosphaira vitifoliae Fitch) is a serious global pest in viticulture. The insects are sedentary feeders and require a gall to feed and reproduce. The insects induce their feeding site within the meristematic zone of the root tip, where they stay attached, feeding both intra- and intercellularly, and causing damage by reducing plant vigour. Several changes in cell structure and composition, including increased cell division and tissue swelling close to the feeding site, cause an organoid gall called a nodosity to develop. Because alpha expansin genes are involved in cell enlargement and cell wall loosening in many plant tissues it may be anticipated that they are also involved in nodosity formation. To identify expansin genes in Vitis vinifera cv. Pinot noir , we mined for orthologues genes in a comparative analysis. Eleven putative expansin genes were identified and shown to be present in the rootstock Teleki 5C ( V. berlandieri Planch. x V. riparia Michx.) using specific PCR followed by DNA sequencing. Expression analysis of young and mature nodosities and uninfested root tips were conducted via quantitative real time PCR (qRT-PCR). Up-regulation was measured for three putative expansin genes (VvEXPA15, -A17 and partly -A20) or down-regulation for three other putative genes (VvEXPA7, -A12, -A20) in nodosities. The present study clearly shows the involvement of putative expansin genes in the phylloxera-root interaction.

The use of empathy and transference as interventions in psychotherapy with attention deficit hyperactive disorder latency-aged boys.

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Conway, Francine

2014-03-01

Psychodynamic-oriented therapies are uniquely positioned to address the internal experiences of a child whose external presentation is consistent with an Attention Deficit Hyperactivity Disorder (ADHD) diagnosis, an area of treatment intervention that is conspicuously absent from common ADHD treatment modalities. This article presents two psychodynamic psychotherapy treatment interventions that demonstrate (1) the importance of empathy in the therapeutic relationship and (2) the use of transference in psychotherapy with ADHD children. Through the use of case examples, the use of empathy is demonstrated in developing the therapeutic alliance, facilitating the development of the child's reflective capacity on affective states, and organizing the child's affective experiences. The benefits of transference interventions with ADHD children are reviewed, and case examples are provided to demonstrate how the therapist worked with the idealized and mirroring transference. Interventions are presented in the context of Object Relations and Self-Psychology Theories. (c) 2014 APA, all rights reserved.

Integrins as Therapeutic Targets: Successes and Cancers

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Sabine Raab-Westphal

2017-08-01

Full Text Available Integrins are transmembrane receptors that are central to the biology of many human pathologies. Classically mediating cell-extracellular matrix and cell-cell interaction, and with an emerging role as local activators of TGFβ, they influence cancer, fibrosis, thrombosis and inflammation. Their ligand binding and some regulatory sites are extracellular and sensitive to pharmacological intervention, as proven by the clinical success of seven drugs targeting them. The six drugs on the market in 2016 generated revenues of some US$3.5 billion, mainly from inhibitors of α4-series integrins. In this review we examine the current developments in integrin therapeutics, especially in cancer, and comment on the health economic implications of these developments.

Distribution of putative virulence genes and antimicrobial drug resistance in Vibrio harveyi

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Parvathi, A.; Mendez, D.; Anto, C.

zonula occludens toxin (Zot) and a hemolysin-coregulated protein gene (hcp) by polymerase chain reaction (PCR). Of the four putative reversible toxin genes, vhh-1 was detected in 31% of the isolates, vhh-2 in 46%, vhh-3 in 23% and vhh-4 was detected in 27...

Cloning and characterization of prunus serotina AGAMOUS, a putative flower homeotic gene

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Xiaomei Liu; Joseph Anderson; Paula Pijut

2010-01-01

Members of the AGAMOUS subfamily of MADS-box transcription factors play an important role in regulating the development of reproductive organs in flowering plants. To help understand the mechanism of floral development in black cherry (Prunus serotina), PsAG (a putative flower homeotic identity gene) was isolated...

Social Learning Conceptualization for Substance Abuse: Implications for Therapeutic Interventions

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Theodoros Giovazolias

2014-03-01

Full Text Available Substance misuse and abuse among adolescents and young adults, especially students, remain a significant public health issue, often associated with serious academic, psychological and health problems. Theoretical models of social behaviour emphasize the importance of peer behaviour as a modelling or normative influence. The processes by which social influence factors contribute to substance misuse behaviour have been described in models derived from the social learning paradigm, including both socio-environmental (e.g. social modelling, perceived norms and coping skills and cognitive variables (e.g. self-efficacy, outcome expectancies. However, this growing body of the literature often reveals contradictory findings regarding the precise mechanisms of processes by which social and cognitive variables may influence substance misuse in youth populations. This review critically examines the literature on different forms of peer influence and accordingly provides suggestions for intervention strategies that take into consideration the relevant research findings on social learning constructs.

The interventional diagnosis and therapy for thyroid disease should be studied deeply and developed prudently

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Zhao Wei; Cheng Yongde

2007-01-01

Many details concerning the interventional diagnosis and therapy of thyroid disease need to be studied deeply and carefully; for example, the thyroid applied anatomy, especially the anatomical imageology study of the thyroid arterial anastomosis involving the therapeutic effects and complications, the thyroid artery embolization treatment, presently as a substitution or the supplement therapy for the traditional classical therapy of Graves disease. There are many exploration to extend the indication scope, the therapeutic effect, embolization scope in intervention for Graves disease due to having no accurate individual quantification standard, and so on. The thyroid arterial embolization for Graves disease is to reduce the main cause of thyroxin secretion. Simultaneously, the comprehensive therapeutic effects might have possibly produce the thyroidcytic apoptosis and immune adjustments. Serious complications such as the cerebral infarction, the hyperthyroidism crisis, the hypocalcemia, the periodic paralysis, and so on commonly occured in thyroid arterial embolization. It is necessary to keep strictly the procedure rule and the indication. The mid-and long- term therapeutic effect of thyroid artery embolization for Graves disease is good, but still need more extensive and prudent research for the prospective achievement. (authors)

Regulatory roles and therapeutic potential of microRNA in sarcoma.

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Lim, Hui Jun; Yang, Jia-Lin

2016-01-01

MicroRNAs (miRNAs) are single-stranded noncoding RNAs involved in various biological processes, including cell differentiation and development. They play multiple key roles as tumour suppressors, oncogenes or both in particular cases. This review aims to summarise current findings of the expression of miRNAs and their role in clinical oncology. Current knowledge regarding the involvement of miRNAs in different sarcoma subtypes will be assessed, in conjunction with their potential application as therapeutic targets. Relevant articles in scientific databases were identified using a combination of search terms, including "microRNA," "deregulation," "sarcoma," and "targeted therapy". These databases included Medline, Embase, Cochrane Review, Pubmed and Scopus. Aberrant miRNA expression patterns have been identified in a range of sarcoma subtypes, and differences in miRNA expression profiles between malignant cells and their normal counterparts suggests that miRNAs play key roles in sarcoma development. The identification of unique miRNA patterns in individual tumour types could possibly be used as a diagnostic tool in sarcoma. Moreover, identification of these miRNAs provides novel targets for the development of therapeutic strategies in distinct sarcoma subtypes. miRNAs hold significant potential as diagnostic biomarkers, as well as therapeutic targets in sarcoma. Possible future clinical applications include the use of miRNA pathways as therapeutic targets or miRNA expression profiling as a means of patient selection. The involvement miRNAs will undoubtedly contribute to the advancement of future targeted therapeutic interventions in sarcoma, and further establishment of appropriate delivery systems is vital for their use in clinical settings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

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Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct

CRYSTAL STRUCTURE ANALYSIS OF A PUTATIVE OXIDOREDUCTASE FROM KLEBSIELLA PNEUMONIAE

Energy Technology Data Exchange (ETDEWEB)

Baig, M.; Brown, A.; Eswaramoorthy, S.; Swaminathan, S.

2009-01-01

Klebsiella pneumoniae, a gram-negative enteric bacterium, is found in nosocomial infections which are acquired during hospital stays for about 10% of hospital patients in the United States. The crystal structure of a putative oxidoreductase from K. pneumoniae has been determined. The structural information of this K. pneumoniae protein was used to understand its function. Crystals of the putative oxidoreductase enzyme were obtained by the sitting drop vapor diffusion method using Polyethylene glycol (PEG) 3350, Bis-Tris buffer, pH 5.5 as precipitant. These crystals were used to collect X-ray data at beam line X12C of the National Synchrotron Light Source (NSLS) at Brookhaven National Laboratory (BNL). The crystal structure was determined using the SHELX program and refi ned with CNS 1.1. This protein, which is involved in the catalysis of an oxidation-reduction (redox) reaction, has an alpha/beta structure. It utilizes nicotinamide adenine dinucleotide phosphate (NADP) or nicotine adenine dinucleotide (NAD) to perform its function. This structure could be used to determine the active and co-factor binding sites of the protein, information that could help pharmaceutical companies in drug design and in determining the protein’s relationship to disease treatment such as that for pneumonia and other related pathologies.

Diagnostic and therapeutic approach to hypothalamic amenorrhea.

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Genazzani, Alessandro D; Ricchieri, Federica; Lanzoni, Chiara; Strucchi, Claudia; Jasonni, Valerio M

2006-12-01

Hypothalamic amenorrhea (HA) is a secondary amenorrhea with no evidence of endocrine/systemic causal factors, mainly related to various stressors affecting neuroendocrine control of the reproductive axis. In clinical practice, HA is mainly associated with metabolic, physical, or psychological stress. Stress is the adaptive response of our body through all its homeostatic systems, to external and/or internal stimuli that activate specific and nonspecific physiological pathways. HA occurs generally after severe stress conditions/situations such as dieting, heavy training, or intense emotional events, all situations that can induce amenorrhea with or without body weight loss and HA is a secondary amenorrhea with a diagnosis of exclusion. In fact, the diagnosis is essentially based on a good anamnestic investigation. It has to be investigated using the clinical history of the patient: occurrence of menarche, menstrual cyclicity, time and modality of amenorrhea, and it has to be exclude any endocrine disease or any metabolic (i.e., diabetes) and systemic disorders. It is necessary to identify any stress situation induced by loss, family or working problems, weight loss or eating disorders, or physical training or agonist activity. Peculiar, though not specific, endocrine investigations might be proposed but no absolute parameter can be proposed since HA is greatly dependent from individual response to stressors and/or the adaptive response to stress. This article tries to give insights into diagnosis and putative therapeutic strategies.

Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience)

Energy Technology Data Exchange (ETDEWEB)

Thanos, Loukas E-mail: loutharad@yahoo.com; Mylona, Sophia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos

2004-06-01

Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, which are a useful diagnostic and therapeutic tool. In this study we present our experience in CT-guided percutaneous musculoskeletal biopsies, drainages of musculoskeletal abscesses, facet and sacroiliac joint injection and radiofrequency thermal ablation of painful metastases or osteoid osteomas.

Global Distribution of Businesses Marketing Stem Cell-Based Interventions.

Science.gov (United States)

Berger, Israel; Ahmad, Amina; Bansal, Akhil; Kapoor, Tanvir; Sipp, Douglas; Rasko, John E J

2016-08-04

A structured search reveals that online marketing of stem-cell-based interventions is skewed toward developed economies including the United States, Ireland, Australia, and Germany. Websites made broad, imprecise therapeutic claims and frequently failed to detail procedures. Widespread marketing poses challenges to regulators, bioethicists, and those seeking realistic hope from therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

Shifting the balance of mitochondrial apoptosis: therapeutic perspectives

International Nuclear Information System (INIS)

Fulda, Simone

2012-01-01

Signaling via the intrinsic (mitochondrial) pathway of apoptosis represents one of the critical signal transduction cascades that control the regulation of cell death. This pathway is typically altered in human cancers, thereby providing a suitable target for therapeutic intervention. Members of the Bcl-2 family of proteins as well as cell survival signaling cascades such as the PI3K/Akt/mTOR pathway are involved in the regulation of mitochondria-mediated apoptosis. Therefore, further insights into the molecular mechanisms that form the basis for the control of mitochondria-mediated apoptosis will likely open new perspectives to bypass evasion of apoptosis and treatment resistance in human cancers.

Shifting the balance of mitochondrial apoptosis: therapeutic perspectives

Energy Technology Data Exchange (ETDEWEB)

Fulda, Simone, E-mail: simone.fulda@kgu.de [Institute for Experimental Cancer Research in Pediatrics, Goethe-University, Frankfurt (Germany)

2012-10-08

Signaling via the intrinsic (mitochondrial) pathway of apoptosis represents one of the critical signal transduction cascades that control the regulation of cell death. This pathway is typically altered in human cancers, thereby providing a suitable target for therapeutic intervention. Members of the Bcl-2 family of proteins as well as cell survival signaling cascades such as the PI3K/Akt/mTOR pathway are involved in the regulation of mitochondria-mediated apoptosis. Therefore, further insights into the molecular mechanisms that form the basis for the control of mitochondria-mediated apoptosis will likely open new perspectives to bypass evasion of apoptosis and treatment resistance in human cancers.

Shifting the balance of mitochondrial apoptosis: therapeutic perspectives

Directory of Open Access Journals (Sweden)

Simone eFulda

2012-10-01

Full Text Available Signaling via the intrinsic (mitochondrial pathway of apoptosis represents one of the critical signal transduction cascades that control the regulation of cell death. This pathway is typically altered in human cancers, thereby providing a suitable target for therapeutic intervention. Members of the Bcl-2 family of proteins as well as cell survival signaling cascades such as the PI3K/Akt/mTOR pathway are involved in the regulation of mitochondria-mediated apoptosis. Therefore, further insights into the molecular mechanisms that form the basis for the control of mitochondria-mediated apoptosis will likely open new perspectives to bypass evasion of apoptosis and treatment resistance in human cancers.

Relevant Aspects of Nutritional and Dietary Interventions in Non-Alcoholic Fatty Liver Disease

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Maria Catalina Hernandez-Rodas

2015-10-01

Full Text Available Non-alcoholic fatty liver disease (NAFLD is the main cause of liver disease worldwide. NAFLD is linked to circumstances such as type 2 diabetes, insulin resistance, obesity, hyperlipidemia, and hypertension. Since the obesity figures and related comorbidities are increasing, NAFLD has turned into a liver problem that has become progressively more common. Currently, there is no effective drug therapy for NAFLD; therefore, interventions in lifestyles remain the first line of treatment. Bearing in mind that adherence rates to this type of treatment are poor, great efforts are currently focused on finding novel therapeutic agents for the prevention in the development of hepatic steatosis and its progression to nonalcoholic steatohepatitis and cirrhosis. This review presents a compilation of the scientific evidence found in the last years showing the results of interventions in lifestyle, diet, and behavioral therapies and research results in human, animal and cell models. Possible therapeutic agents ranging from supplementation with vitamins, amino acids, prebiotics, probiotics, symbiotics, polyunsaturated fatty acids and polyphenols to interventions with medicinal plants are analyzed.

Cumulative Childhood Trauma and Therapeutic Alliance: The Moderator Role of Attachment in Adult Patients Consulting in Sex Therapy.

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Lafrenaye-Dugas, Anne-Julie; Godbout, Natacha; Hébert, Martine

2018-03-05

While it is documented that clients consulting in sex therapy tend to report high rates of childhood interpersonal traumas (e.g., physical, psychological and sexual abuse), which are associated to insecure attachment and poorer therapeutic alliance, the interrelations of these variables have not yet been evaluated in this specific population. This study examined the associations between attachment, cumulative trauma and therapeutic alliance in 278 sex therapy patients who filled out self-report questionnaires. Results revealed that avoidant attachment acted as a moderator between cumulative trauma and the agreement on tasks dimension of therapeutic alliance. Results suggests the relevance for sex therapists to investigate past traumas and current attachment representations to guide interventions and optimize treatment benefits.

Review of therapeutic agents for burns pruritus and protocols for management in adult and paediatric patients using the GRADE classification

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Goutos Ioannis

2010-10-01

Full Text Available To review the current evidence on therapeutic agents for burns pruritus and use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE classification to propose therapeutic protocols for adult and paediatric patients. All published interventions for burns pruritus were analysed by a multidisciplinary panel of burns specialists following the GRADE classification to rate individual agents. Following the collation of results and panel discussion, consensus protocols are presented. Twenty-three studies appraising therapeutic agents in the burns literature were identified. The majority of these studies (16 out of 23 are of an observational nature, making an evidence-based approach to defining optimal therapy not feasible. Our multidisciplinary approach employing the GRADE classification recommends the use of antihistamines (cetirizine and cimetidine and gabapentin as the first-line pharmacological agents for both adult and paediatric patients. Ondansetron and loratadine are the second-line medications in our protocols. We additionally recommend a variety of non-pharmacological adjuncts for the perusal of clinicians in order to maximise symptomatic relief in patients troubled with postburn itch. Most studies in the subject area lack sufficient statistical power to dictate a ′gold standard′ treatment agent for burns itch. We encourage clinicians to employ the GRADE system in order to delineate the most appropriate therapeutic approach for burns pruritus until further research elucidates the most efficacious interventions. This widely adopted classification empowers burns clinicians to tailor therapeutic regimens according to current evidence, patient values, risks and resource considerations in different medical environments.

Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry.

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Alsharif, Naser Z.; And Others

1997-01-01

Explains structurally based therapeutic evaluation of drugs, which uses seven therapeutic criteria in translating chemical and structural knowledge into therapeutic decision making in pharmaceutical care. In a Creighton University (Nebraska) medicinal chemistry course, students apply the approach to solve patient-related therapeutic problems in…

The special effects of hypnosis and hypnotherapy: A contribution to an ecological model of therapeutic change.

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Mende, Matthias

2006-04-01

There is ample evidence that hypnosis enhances the effectiveness of psychotherapy and produces some astounding effects of its own. In this paper, the effective components and principles of hypnosis and hypnotherapy are analyzed. The "special" hypnotic and hypnotherapeutic effects are linked to the fact that the ecological requirements of therapeutic change are taken into account implicitly and/or explicitly when working with hypnotic trances in a therapeutic setting. The hypnotic situation is described--theoretically and in case examples--as a therapeutic modality that gratifies and aligns the basic emotional needs to feel autonomous, related, competent, and oriented. It is shown how the hypnotic relationship can help promote a sound ecological balance between these needs--a balance that is deemed to be a necessary prerequisite for salutogenesis. Practical implications for planning hypnotherapeutic interventions are discussed.

Theory-guided Therapeutic Function of Music to facilitate emotion regulation development in preschool-aged children

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Kimberly eSena Moore

2015-10-01

Full Text Available Emotion regulation is an umbrella term to describe interactive, goal-dependent explicit and implicit processes that are intended to help an individual manage and shift an emotional experience. The primary window for appropriate emotion regulation development occurs during the infant, toddler, and preschool years. Atypical emotion regulation development is considered a risk factor for mental health problems and has been implicated as a primary mechanism underlying childhood pathologies. Current treatments are predominantly verbal- and behavioral-based and lack the opportunity to practice in-the-moment management of emotionally charged situations. There is also an absence of caregiver-child interaction in these treatment strategies. Based on behavioral and neural support for music as a therapeutic mechanism, the incorporation of intentional music experiences, facilitated by a music therapist, may be one way to address these limitations. Musical Contour Regulation Facilitation is an interactive therapist-child music-based intervention for emotion regulation development practice in preschoolers. The Musical Contour Regulation Facilitation intervention uses the deliberate contour and temporal structure of a music therapy session to mirror the changing flow of the caregiver-child interaction through the alternation of high arousal and low arousal music experiences. The purpose of this paper is to describe the Therapeutic Function of Music, a theory-based description of the structural characteristics for a music-based stimulus to musically facilitate developmentally appropriate high arousal and low arousal in-the-moment emotion regulation experiences. The Therapeutic Function of Music analysis is based on a review of the music theory, music neuroscience, and music development literature and provides a preliminary model of the structural characteristics of the music as a core component of the Musical Contour Regulation Facilitation intervention.

Advances in Antisense Oligonucleotide Development for Target Identification, Validation, and as Novel Therapeutics

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Moizza Mansoor

2008-01-01

Full Text Available Antisense oligonucleotides (As-ODNs are single stranded, synthetically prepared strands of deoxynucleotide sequences, usually 18–21 nucleotides in length, complementary to the mRNA sequence of the target gene. As-ODNs are able to selectively bind cognate mRNA sequences by sequence-specific hybridization. This results in cleavage or disablement of the mRNA and, thus, inhibits the expression of the target gene. The specificity of the As approach is based on the probability that, in the human genome, any sequence longer than a minimal number of nucleotides (nt, 13 for RNA and 17 for DNA, normally occurs only once. The potential applications of As-ODNs are numerous because mRNA is ubiquitous and is more accessible to manipulation than DNA. With the publication of the human genome sequence, it has become theoretically possible to inhibit mRNA of almost any gene by As-ODNs, in order to get a better understanding of gene function, investigate its role in disease pathology and to study novel therapeutic targets for the diseases caused by dysregulated gene expression. The conceptual simplicity, the availability of gene sequence information from the human genome, the inexpensive availability of synthetic oligonucleotides and the possibility of rational drug design makes As-ODNs powerful tools for target identification, validation and therapeutic intervention. In this review we discuss the latest developments in antisense oligonucleotide design, delivery, pharmacokinetics and potential side effects, as well as its uses in target identification and validation, and finally focus on the current developments of antisense oligonucleotides in therapeutic intervention in various diseases.

Coronary Computed Tomographic Angiography-Derived Fractional Flow Reserve for Therapeutic Decision Making.

Science.gov (United States)

Tesche, Christian; Vliegenthart, Rozemarijn; Duguay, Taylor M; De Cecco, Carlo N; Albrecht, Moritz H; De Santis, Domenico; Langenbach, Marcel C; Varga-Szemes, Akos; Jacobs, Brian E; Jochheim, David; Baquet, Moritz; Bayer, Richard R; Litwin, Sheldon E; Hoffmann, Ellen; Steinberg, Daniel H; Schoepf, U Joseph

2017-12-15

This study investigated the performance of coronary computed tomography angiography (cCTA) with cCTA-derived fractional flow reserve (CT-FFR) compared with invasive coronary angiography (ICA) with fractional flow reserve (FFR) for therapeutic decision making in patients with suspected coronary artery disease (CAD). Seventy-four patients (62 ± 11 years, 62% men) with at least 1 coronary stenosis of ≥50% on clinically indicated dual-source cCTA, who had subsequently undergone ICA with FFR measurement, were retrospectively evaluated. CT-FFR values were computed using an on-site machine-learning algorithm to assess the functional significance of CAD. The therapeutic strategy (optimal medical therapy alone vs revascularization) and the appropriate revascularization procedure (percutaneous coronary intervention vs coronary artery bypass grafting) were selected using cCTA-CT-FFR. Thirty-six patients (49%) had a functionally significant CAD based on ICA-FFR. cCTA-CT-FFR correctly identified a functionally significant CAD and the need of revascularization in 35 of 36 patients (97%). When revascularization was deemed indicated, the same revascularization procedure (32 percutaneous coronary interventions and 3 coronary artery bypass grafting) was chosen in 35 of 35 patients (100%). Overall, identical management strategies were selected in 73 of the 74 patients (99%). cCTA-CT-FFR shows excellent performance to identify patients with and without the need for revascularization and to select the appropriate revascularization strategy. cCTA-CT-FFR as a noninvasive "one-stop shop" has the potential to change diagnostic workflows and to directly inform therapeutic decision making in patients with suspected CAD. Copyright © 2017 Elsevier Inc. All rights reserved.

From Mollusks to Medicine: A Venomics Approach for the Discovery and Characterization of Therapeutics from Terebridae Peptide Toxins

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Aida Verdes

2016-04-01

Full Text Available Animal venoms comprise a diversity of peptide toxins that manipulate molecular targets such as ion channels and receptors, making venom peptides attractive candidates for the development of therapeutics to benefit human health. However, identifying bioactive venom peptides remains a significant challenge. In this review we describe our particular venomics strategy for the discovery, characterization, and optimization of Terebridae venom peptides, teretoxins. Our strategy reflects the scientific path from mollusks to medicine in an integrative sequential approach with the following steps: (1 delimitation of venomous Terebridae lineages through taxonomic and phylogenetic analyses; (2 identification and classification of putative teretoxins through omics methodologies, including genomics, transcriptomics, and proteomics; (3 chemical and recombinant synthesis of promising peptide toxins; (4 structural characterization through experimental and computational methods; (5 determination of teretoxin bioactivity and molecular function through biological assays and computational modeling; (6 optimization of peptide toxin affinity and selectivity to molecular target; and (7 development of strategies for effective delivery of venom peptide therapeutics. While our research focuses on terebrids, the venomics approach outlined here can be applied to the discovery and characterization of peptide toxins from any venomous taxa.

Putative neuroprotective agents in neuropsychiatric disorders.

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Dodd, Seetal; Maes, Michael; Anderson, George; Dean, Olivia M; Moylan, Steven; Berk, Michael

2013-04-05

In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

Nature-based interventions in institutional and organisational settings: a scoping review.

Science.gov (United States)

Moeller, Chris; King, Nigel; Burr, Viv; Gibbs, Graham R; Gomersall, Tim

2018-04-26

The objective of this review was to scope the literature on nature-based interventions that could be conducted in institutional settings where people reside full-time for care or rehabilitation purposes. Systematic searches were conducted across CINAHL, Medline, Criminal Justice Abstracts, PsycINFO, Scopus, Social Care Online and Cochrane CENTRAL. A total of 85 studies (reported in 86 articles) were included. Four intervention modalities were identified: Gardening/therapeutic horticulture; animal-assisted therapies; care farming and virtual reality-based simulations of natural environments. The interventions were conducted across a range of settings, including inpatient wards, care homes, prisons and women's shelters. Generally, favourable impacts were seen across intervention types, although the reported effects varied widely. There is a growing body of literature on nature-based interventions that could be applied to a variety of institutional settings. Within most intervention types, there is sufficient research data available to perform full systematic reviews. Recommendations for future systematic reviews are offered.

Distribution and innervation of putative peripheral arterial chemoreceptors in the red-eared slider (Trachemys scripta elegans).

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Reyes, Catalina; Fong, Angelina Y; Milsom, William K

2015-06-15

Peripheral arterial chemoreceptors have been isolated to the common carotid artery, aorta, and pulmonary artery of turtles. However, the putative neurotransmitters associated with these chemoreceptors have not yet been described. The goal of the present study was to determine the neurochemical content, innervations, and distribution of putative oxygen-sensing cells in the central vasculature of turtles and to derive homologies with peripheral arterial chemoreceptors of other vertebrates. We used tract tracing together with immunohistochemical markers for cholinergic cells (vesicular acetylcholine transporter [VAChT]), tyrosine hydroxylase (TH; the rate-limiting enzyme in catecholamine synthesis), and serotonin (5HT) to identify putative oxygen-sensing cells and to determine their anatomical relation to branches of the vagus nerve (Xth cranial nerve). We found potential oxygen-sensing cells in all three chemosensory areas innervated by branches of the Xth cranial nerve. Cells containing either 5HT or VAChT were found in all three sites. The morphology and size of these cells resemble glomus cells found in amphibians, mammals, tortoises, and lizards. Furthermore, we found populations of cholinergic cells located at the base of the aorta and pulmonary artery that are likely involved in efferent regulation of vessel resistance. Catecholamine-containing cells were not found in any of the putative chemosensitive areas. The presence of 5HT- and VAChT-immunoreactive cells in segments of the common carotid artery, aorta, and pulmonary artery appears to reflect a transition between cells containing the major neurotransmitters seen in fish (5HT) and mammals (ACh and adenosine). © 2015 Wiley Periodicals, Inc.

Draft genome sequence of Streptomyces coelicoflavus ZG0656 reveals the putative biosynthetic gene cluster of acarviostatin family α-amylase inhibitors.

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Guo, X; Geng, P; Bai, F; Bai, G; Sun, T; Li, X; Shi, L; Zhong, Q

2012-08-01

The aims of this study are to obtain the draft genome sequence of Streptomyces coelicoflavus ZG0656, which produces novel acarviostatin family α-amylase inhibitors, and then to reveal the putative acarviostatin-related gene cluster and the biosynthetic pathway. The draft genome sequence of S. coelicoflavus ZG0656 was generated using a shotgun approach employing a combination of 454 and Solexa sequencing technologies. Genome analysis revealed a putative gene cluster for acarviostatin biosynthesis, termed sct-cluster. The cluster contains 13 acarviostatin synthetic genes, six transporter genes, four starch degrading or transglycosylation enzyme genes and two regulator genes. On the basis of bioinformatic analysis, we proposed a putative biosynthetic pathway of acarviostatins. The intracellular steps produce a structural core, acarviostatin I00-7-P, and the extracellular assemblies lead to diverse acarviostatin end products. The draft genome sequence of S. coelicoflavus ZG0656 revealed the putative biosynthetic gene cluster of acarviostatins and a putative pathway of acarviostatin production. To our knowledge, S. coelicoflavus ZG0656 is the first strain in this species for which a genome sequence has been reported. The analysis of sct-cluster provided important insights into the biosynthesis of acarviostatins. This work will be a platform for producing novel variants and yield improvement. © 2012 The Authors. Letters in Applied Microbiology © 2012 The Society for Applied Microbiology.

A multistage chronobiologic intervention for the treatment of depression: a pilot study.

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Moscovici, Lucian; Kotler, Moshe

2009-08-01

Most antidepressant medications in current use have several disadvantages: a delayed therapeutic effect, side effects, stigmatization and concerns about safety for the developing fetus during pregnancy. Several chronobiologic techniques which are free of these disadvantages were proposed as an alternative. The current article reports the design and the initial outcome results of a new chronobiologic multistage intervention (CMI) that is comprised of the following techniques: (i) partial sleep deprivation during the second half of the night (wake therapy--WT), (ii) medium (green) wavelength light in combination with dawn simulation (DS), (iii) bright light therapy (BLT), and (iv) sleep phase advance (SPA). The study was conducted as a set of 12 single-case designs with moderate-to-severe depressive volunteering patients. Depression, anxiety and tension measurements were taken on a daily basis beginning with a baseline measurement (T0), followed by a set of four consecutive morning measurements during the therapeutic intervention (T1-T4),and with a final measurement carried out at the end of 4 weeks of follow-up (T5). A clinically significant rapid improvement of the depressive symptoms was demonstrated and maintained for at least 4 weeks after the end of the intervention. No dropouts or compliance difficulties were observed. Patient satisfaction was high, and other than having to sleep for four nights at the Research and Development Unit, participants were not inconvenienced by the nature of the therapeutic design. Sleepiness in the late afternoon hours was reported by several of the participants, but did not reach a level that interfered with their ability to function. Levels of tension did not show a consistent improvement along the intervention procedure and were not maintained in follow-up. There was some unexpected improvement in the level of anxiety that persisted at follow-up. This latter finding requires further validation by additional studies. These

Internet addiction neuroscientific approaches and therapeutical implications including smartphone addiction

CERN Document Server

Reuter, Martin

2017-01-01

The second edition of this successful book provides further and in-depth insight into theoretical models dealing with Internet addiction, as well as includes new therapeutical approaches. The editors also broach the emerging topic of smartphone addiction. This book combines a scholarly introduction with state-of-the-art research in the characterization of Internet addiction. It is intended for a broad audience including scientists, students and practitioners. The first part of the book contains an introduction to Internet addiction and their pathogenesis. The second part of the book is dedicated to an in-depth review of neuroscientific findings which cover studies using a variety of biological techniques including brain imaging and molecular genetics. The third part of the book focuses on therapeutic interventions for Internet addiction. The fourth part of the present book is an extension to the first edition and deals with a new emerging potential disorder related to Internet addiction – smartphone addicti...

Semi-automated literature mining to identify putative biomarkers of disease from multiple biofluids

Science.gov (United States)

2014-01-01

Background Computational methods for mining of biomedical literature can be useful in augmenting manual searches of the literature using keywords for disease-specific biomarker discovery from biofluids. In this work, we develop and apply a semi-automated literature mining method to mine abstracts obtained from PubMed to discover putative biomarkers of breast and lung cancers in specific biofluids. Methodology A positive set of abstracts was defined by the terms ‘breast cancer’ and ‘lung cancer’ in conjunction with 14 separate ‘biofluids’ (bile, blood, breastmilk, cerebrospinal fluid, mucus, plasma, saliva, semen, serum, synovial fluid, stool, sweat, tears, and urine), while a negative set of abstracts was defined by the terms ‘(biofluid) NOT breast cancer’ or ‘(biofluid) NOT lung cancer.’ More than 5.3 million total abstracts were obtained from PubMed and examined for biomarker-disease-biofluid associations (34,296 positive and 2,653,396 negative for breast cancer; 28,355 positive and 2,595,034 negative for lung cancer). Biological entities such as genes and proteins were tagged using ABNER, and processed using Python scripts to produce a list of putative biomarkers. Z-scores were calculated, ranked, and used to determine significance of putative biomarkers found. Manual verification of relevant abstracts was performed to assess our method’s performance. Results Biofluid-specific markers were identified from the literature, assigned relevance scores based on frequency of occurrence, and validated using known biomarker lists and/or databases for lung and breast cancer [NCBI’s On-line Mendelian Inheritance in Man (OMIM), Cancer Gene annotation server for cancer genomics (CAGE), NCBI’s Genes & Disease, NCI’s Early Detection Research Network (EDRN), and others]. The specificity of each marker for a given biofluid was calculated, and the performance of our semi-automated literature mining method assessed for breast and lung cancer

Optimisation of patient and staff exposure in interventional cardiology

International Nuclear Information System (INIS)

Padovani, R.; Malisan, M.R.; Bernardi, G.; Vano, E.; Neofotistou, V.

2001-01-01

The Council Directive of the European Community 97/43/Euratom (MED) deals with the health protection of individuals against dangers of ionising radiation in relation to medical exposure, and also focuses attention on some special practices (Art. 9), including interventional radiology, a technique involving high doses to the patient. The paper presents the European approach to optimisation of exposure in interventional cardiology. The DIMOND research consortium (DIMOND: Digital Imaging: Measures for Optimising Radiological Information Content and Dose) is working to develop quality criteria for cineangiographic images, to develop procedures for the classification of complexity of therapeutic and diagnostic procedures and to derive reference levels, related also to procedure complexity. DIMOND project also includes aspects of equipment characteristics and performance and content of training in radiation protection of personnel working in interventional radiology field. (author)

Young adults’ use of food as a self-therapeutic intervention

Directory of Open Access Journals (Sweden)

Elisabeth Von Essen

2014-04-01

Full Text Available The aim of this study was to investigate how young adults use their lived body as a starting point for lifestyle explorations and as a strategy for well-being. The transcripts of 10 interviews with persons 18 to 33 years old, collected in Sweden, were analysed for variation in the practises and experiences related to this way of using food. An application of the descriptive phenomenological psychological research method guided the process. The young adults were: (1 listening to the body; (2 moderating conditions and feelings; (3 developing vitality and resilience; (4 creating mindful space for rest, and (5 participating in creative activity. The results show how young adults perceive their choice of food and related practises associated with positive feelings and experiences as ways to promote well-being and mitigate different problems in life. The usefulness of knowledge about how young adults try to use food for self-therapy by enhancing mind-body awareness is discussed in relation to health issues and food-related interventions.

DETERMINATION OF ROCURONIUM AND ITS PUTATIVE METABOLITES IN BODY-FLUIDS AND TISSUE-HOMOGENATES

NARCIS (Netherlands)

KLEEF, UW; PROOST, JH; ROGGEVELD, J

1993-01-01

A sensitive and selective HPLC method was developed for the quantification of the neuromuscular blocking agent rocuronium and its putative metabolites (the 17-desacetyl derivative and the N-desallyl derivative of rocuronium) in plasma, urine, bile, tissue homogenates and stoma fluid. Samples were

The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

OpenAIRE

Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W.; Wiegand, Susanna

2013-01-01

Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software ...

Social Workers' Reflections on the Therapeutic Encounter With Elder Abuse and Neglect.

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Goldblatt, Hadass; Band-Winterstein, Tova; Alon, Sara

2016-02-24

The aim of this qualitative study was to explore social workers' reflections on their experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect. The research questions were as follows: How do social workers tune themselves toward the therapeutic encounter with elder abuse? How do they position themselves vis-à-vis the clients? How do social workers describe the meaning of the intervention both for the clients and for themselves? What is the added value of the therapeutic encounter in this field for the social workers? Participants were 17 experienced women social workers, who worked with abusers and with abused and neglected older adults in Israel. Data were collected via in-depth semi-structured interviews, which were later transcribed and content analyzed. Two main themes emerged from the findings, emphasizing two key aspects of the social workers' reflective process experienced during the therapeutic encounter: (a) focus on the client: "This is the journey of their lives"-reflection on the therapeutic "journey"; (b) focus on the social worker's inner and professional world: "'There is nothing to be done' is no longer in my vocabulary"-a personal and professional maturation process. The social workers expressed a positive attitude toward their elder clients. A unique dialogue developed in the therapeutic encounter, whereby the social workers considered any change as valuable if it allowed the elders a sense of control and self-worth, whereas the social workers were enriched by the elders' life experience, and matured both personally and professionally. Thus, both sides benefited from this reciprocal relationship. Implications for further research and practice are discussed. © The Author(s) 2016.

Psychosocial interventions for the diabetic patient

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Harvey JN

2015-01-01

Full Text Available John N Harvey Diabetes Research Group, Wrexham Academic Unit, Bangor University, Wrexham, UK Abstract: Diabetes usually requires substantial life-long self-management by the patient. Psychological factors and the patient's health beliefs are important determinants of self-care behavior. Education has a modest influence on generating better self-care, but psychologically based interventions are clearly more effective. This review gives an overview of these interventions with some discussion of their basis in psychological theory. Some labels such as cognitive behavioral therapy and family therapy include a wide range of approaches. Randomized trials have generally produced improvement in measures of psychological well-being, but improved glycemic control has been more elusive. The influence on behavior can be very dependent on the individual therapist. Only a few trials have managed to sustain improvement in glycosylated hemoglobin beyond a year. Not all patients are prepared to engage and accept these forms of therapeutic intervention. We are still some way from moving psychological management from the trial situation into the diabetic clinic. Keywords: health beliefs, motivational interviewing, cognitive behavioral therapy, family therapy, adolescence

More attention on the application of interventional management in patients with diabetic foot

International Nuclear Information System (INIS)

Teng Gaojun; Qin Yonglin

2008-01-01

Arterial stenotic and occlusive disorders of low limb are commonly the most important factors associated with the prognosis of diabetic foot. The effect of traditional bypass operation is unpredictable for lack of runoff artery. On the other hand, the contributions of special interventional devices and techniques targeted at infrapopliteal artery show unique therapeutic outcomes of interventional management; together with furthermore stem cell thansplantation would present a promising future for the treatment of diabetic foot. (authors)

Family and home in cognitive rehabilitation after brain injury: The importance of family oriented interventions.

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Wulf-Andersen, Camilla; Mogensen, Jesper

2017-01-01

Acquired brain injury (ABI) severely affects both the injured patient and her/his family. This fact alone calls for a therapeutic approach addressing not only the individual victim of ABI but also her/his family. Additionally, the optimal outcome of posttraumatic cognitive rehabilitation may be best obtained by supplementing the institution-based cognitive training with home-based training. Moving cognitive training and other therapeutic interventions into the home environment does, however, constitute an additional challenge to the family structure and psychological wellbeing of all family members. We presently argue in favour of an increased utilization of family-based intervention programs for the families of brain injured patients - in general and especially in case of utilization of home-based rehabilitative training.

Steadily promoting the technical research and the clinical application of interventional radiology for cervical spine

International Nuclear Information System (INIS)

Wu Chungen; Zhou Bing

2009-01-01

Many interventional procedures have been practiced in the treatment of cervical spine diseases for recent years. There are percutaneous biopsy, periradicular therapy for cervical never pain, percutaneous vertebroplasty and many kinds of intervertebral disc decompression. However, because of the manipulation difficulties and high risks of these procedures the popularization of interventional techniques in treating cervical spine disorders has actually been beset with difficulties. The main risks caused by interventional operation are puncture injuries and side-effect of therapeutic design. Therefore, how to reduce the procedure's risk is a great challenge to interventional radiologists as well as an urgent research task. (authors)

Kinetic Assessment and Therapeutic Modulation of Metabolic and Inflammatory Profiles in Mice on a High-Fat and Cholesterol Diet

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Laura W. Engstrom

2010-01-01

Full Text Available The kinetics of metabolic and inflammatory parameters associated with obesity were evaluated in a murine diet-induced obesity (DIO model using a diet high in fat and cholesterol. Cellular infiltration and mediator production were assessed and shown to be therapeutically modulated by the PPARgamma agonist rosiglitazone. C57BL/6 mice were maintained on a 45% fat/0.12% cholesterol (HF/CH or Chow diet for 3, 6, 16, or 27 weeks. Flow cytometry was employed to monitor peripheral blood monocytes and adipose tissue macrophages (ATM. Gene expression and protein analysis methods were used to evaluate mediator production from total epididymal fat (EF, stromal vascular fraction (SVF, and sorted SVF cells. To investigate therapeutic intervention, mice were fed a HF/CH diet for 12 weeks and then a diet formulated with rosiglitazone (5 mg/kg for an additional 6 weeks. A HF/CH diet correlated with obesity and a dramatic proinflammatory state. Therapeutic intervention with rosiglitazone attenuated the HF/CH induced inflammation. In addition, a novel population was found that expressed the highest levels of the pro-inflammatory mediators CCL2 and IL-6.

Hypoxic conditioning as a new therapeutic modality

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Samuel eVerges

2015-06-01

Full Text Available Preconditioning refers to a procedure by which a single noxious stimulus below the threshold of damage is applied to the tissue in order to increase resistance to the same or even different noxious stimuli given above the threshold of damage. Hypoxic preconditioning relies on complex and active defenses that organisms have developed to counter the adverse consequences of oxygen deprivation. The protection it confers against ischemic attack for instance as well as the underlying biological mechanisms have been extensively investigated in animal models. Based on these data, hypoxic conditioning (consisting in recurrent exposure to hypoxia has been suggested a potential non-pharmacological therapeutic intervention to enhance some physiological functions in individuals in whom acute or chronic pathological events are anticipated or existing. In addition to healthy subjects, some benefits have been reported in patients with cardiovascular and pulmonary diseases as well as in overweight and obese individuals. Hypoxic conditioning consisting in sessions of intermittent exposure to moderate hypoxia repeated over several weeks may induce hematological, vascular, metabolic and neurological effects. This review addresses the existing evidence regarding the use of hypoxic conditioning as a potential therapeutic modality and emphasizes on many remaining issues to clarify and future researches to be performed in the field.

Isolation and characterization of two mitoviruses and a putative alphapartitivirus from Fusarium spp.

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Osaki, Hideki; Sasaki, Atsuko; Nomiyama, Koji; Sekiguchi, Hiroyuki; Tomioka, Keisuke; Takehara, Toshiaki

2015-06-01

The filamentous fungus Fusarium spp. includes several important plant pathogens. We attempted to reveal presence of double-stranded (ds) RNAs in the genus. Thirty-seven Fusarium spp. at the MAFF collection were analyzed. In the strains of Fusarium coeruleum, Fusarium globosum and Fusarium solani f. sp. pisi, single dsRNA bands were detected. The strains of F. coeruleum and F. solani f. sp. pisi cause potato dry rot and mulberry twig blight, respectively. Sequence analyses revealed that dsRNAs in F. coeruleum and F. globosum consisted of 2423 and 2414 bp, respectively. Using the fungal mitochondrial translation table, the positive strands of these cDNAs were found to contain single open reading frames with the potential to encode a protein of putative 757 and 717 amino acids (molecular mass 88.5 and 84.0 kDa, respectively), similar to RNA-dependent RNA polymerases of members of the genus Mitovirus. These dsRNAs in F. coeruleum and F. globosum were assigned to the genus Mitovirus (family Narnaviridae), and these two mitoviruses were designated as Fusarium coeruleum mitovirus 1 and Fusarium globosum mitovirus 1. On the other hand, a positive strand of cDNA (1950 bp) from dsRNA in F. solani f. sp. pisi contained an ORF potentially encoding a putative RdRp of 608 amino acids (72.0 kDa). The putative RdRp was shown to be related to those of members of the genus of Alphapartitivirus (family Partitiviridae). We coined the name Fusarium solani partitivirus 2 for dsRNA in F. solani f. sp. pisi.

Genome-wide analysis of putative peroxiredoxin in unicellular and filamentous cyanobacteria

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Cui Hongli

2012-11-01

Full Text Available Abstract Background Cyanobacteria are photoautotrophic prokaryotes with wide variations in genome sizes and ecological habitats. Peroxiredoxin (PRX is an important protein that plays essential roles in protecting own cells against reactive oxygen species (ROS. PRXs have been identified from mammals, fungi and higher plants. However, knowledge on cyanobacterial PRXs still remains obscure. With the availability of 37 sequenced cyanobacterial genomes, we performed a comprehensive comparative analysis of PRXs and explored their diversity, distribution, domain structure and evolution. Results Overall 244 putative prx genes were identified, which were abundant in filamentous diazotrophic cyanobacteria, Acaryochloris marina MBIC 11017, and unicellular cyanobacteria inhabiting freshwater and hot-springs, while poor in all Prochlorococcus and marine Synechococcus strains. Among these putative genes, 25 open reading frames (ORFs encoding hypothetical proteins were identified as prx gene family members and the others were already annotated as prx genes. All 244 putative PRXs were classified into five major subfamilies (1-Cys, 2-Cys, BCP, PRX5_like, and PRX-like according to their domain structures. The catalytic motifs of the cyanobacterial PRXs were similar to those of eukaryotic PRXs and highly conserved in all but the PRX-like subfamily. Classical motif (CXXC of thioredoxin was detected in protein sequences from the PRX-like subfamily. Phylogenetic tree constructed of catalytic domains coincided well with the domain structures of PRXs and the phylogenies based on 16s rRNA. Conclusions The distribution of genes encoding PRXs in different unicellular and filamentous cyanobacteria especially those sub-families like PRX-like or 1-Cys PRX correlate with the genome size, eco-physiology, and physiological properties of the organisms. Cyanobacterial and eukaryotic PRXs share similar conserved motifs, indicating that cyanobacteria adopt similar catalytic

Genome-wide analysis of putative peroxiredoxin in unicellular and filamentous cyanobacteria.

Science.gov (United States)

Cui, Hongli; Wang, Yipeng; Wang, Yinchu; Qin, Song

2012-11-16

Cyanobacteria are photoautotrophic prokaryotes with wide variations in genome sizes and ecological habitats. Peroxiredoxin (PRX) is an important protein that plays essential roles in protecting own cells against reactive oxygen species (ROS). PRXs have been identified from mammals, fungi and higher plants. However, knowledge on cyanobacterial PRXs still remains obscure. With the availability of 37 sequenced cyanobacterial genomes, we performed a comprehensive comparative analysis of PRXs and explored their diversity, distribution, domain structure and evolution. Overall 244 putative prx genes were identified, which were abundant in filamentous diazotrophic cyanobacteria, Acaryochloris marina MBIC 11017, and unicellular cyanobacteria inhabiting freshwater and hot-springs, while poor in all Prochlorococcus and marine Synechococcus strains. Among these putative genes, 25 open reading frames (ORFs) encoding hypothetical proteins were identified as prx gene family members and the others were already annotated as prx genes. All 244 putative PRXs were classified into five major subfamilies (1-Cys, 2-Cys, BCP, PRX5_like, and PRX-like) according to their domain structures. The catalytic motifs of the cyanobacterial PRXs were similar to those of eukaryotic PRXs and highly conserved in all but the PRX-like subfamily. Classical motif (CXXC) of thioredoxin was detected in protein sequences from the PRX-like subfamily. Phylogenetic tree constructed of catalytic domains coincided well with the domain structures of PRXs and the phylogenies based on 16s rRNA. The distribution of genes encoding PRXs in different unicellular and filamentous cyanobacteria especially those sub-families like PRX-like or 1-Cys PRX correlate with the genome size, eco-physiology, and physiological properties of the organisms. Cyanobacterial and eukaryotic PRXs share similar conserved motifs, indicating that cyanobacteria adopt similar catalytic mechanisms as eukaryotes. All cyanobacterial PRX proteins

Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.

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Burke, Jeffrey D; Loeber, Rolf

2016-01-01

Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.

Reporting of conflicts of interest in guidelines of preventive and therapeutic interventions

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Giannakakis Ioannis A

2001-06-01

Full Text Available Abstract Background Guidelines published in major medical journals are very influential in determining clinical practice. It would be essential to evaluate whether conflicts of interests are disclosed in these publications. We evaluated the reporting of conflicts of interest and the factors that may affect such disclosure in a sample of 191 guidelines on therapeutic and/or preventive measures published in 6 major clinical journals (Annals of Internal Medicine, BMJ, JAMA, Lancet, New England Journal of Medicine, Pediatrics in 1979, 1984, 1989, 1994 and 1999. Results Only 7 guidelines (3.7% mentioned conflicts of interest and all were published in 1999 (17.5% (7/40 of guidelines published in 1999 alone. Reporting of conflicts of interest differed significantly by journal (p=0.026, availability of disclosure policy by the journal (p=0.043, source of funding (p Conclusions Despite some recent improvement, reporting of conflicts of interest in clinical guidelines published in influential journals is largely neglected.

The therapeutic use of doll therapy in dementia.

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Mitchell, Gary; O'Donnell, Hugh

Over the next 15 years, the number of people with dementia in the UK will increase significantly. There are clear limitations associated with the sole use of pharmacological interventions to address the cognitive decline and related problems that people with dementia and their carers will experience. As a result, health professionals, including nurses, need to consider the development and use of nonpharmacological therapies to help resolve the distress and decline in social function that people with dementia can experience. The use of doll therapy in dementia care appears to be increasing, even though there is limited empirical evidence to support its use and therapeutic effectiveness. It is suggested by advocates of doll therapy that its use can alleviate distress and promote comfort in some people with dementia. Despite these encouraging claims, the theoretical basis for the use of doll therapy in dementia is poorly understood and morally questionable. The purpose of this article is to provide healthcare professionals with a succinct overview of the theory behind the therapeutic use of dolls for people with dementia, a presentation and appraisal of the available empirical evidence and an appreciation of the potential ethical dilemmas that are involved.

Therapeutic Hypothermia in Stroke and Traumatic Brain Injury

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Alireza eFaridar

2011-12-01

Full Text Available Therapeutic hypothermia (TH is considered to improve survival with favorable neurological outcome in the case of global cerebral ischemia after cardiac arrest and perinatal asphyxia. The efficacy of hypothermia in acute ischemic stroke (AIS and traumatic brain injury (TBI, however, is not well studied. Induction of TH typically requires a multimodal approach, including the use of both pharmacological agents and physical techniques. To date, clinical outcomes for patients with either AIS or TBI who received TH have yielded conflicting results; thus, no adequate therapeutic consensus has been reached. Nevertheless, it seems that by determining optimal TH parameters and also appropriate applications, cooling therapy still has the potential to become a valuable neuroprotective intervention.Among the various methods for hypothermia induction, intravascular cooling (IVC may have the most promise in the awake patient in terms of clinical outcomes. Currently, the IVC method has the capability of more rapid target temperature attainment and more precise control of temperature. However, this technique requires expertise in endovascular surgery that can preclude its application in the field and/or in most emergency settings. It is very likely that combining neuroprotective strategies will yield better outcomes than utilizing a single approach.

Improved walking ability and reduced therapeutic stress with an electromechanical gait device.

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Freivogel, Susanna; Schmalohr, Dieter; Mehrholz, Jan

2009-09-01

To evaluate the effectiveness of repetitive locomotor training using a newly developed electromechanical gait device compared with treadmill training/gait training with respect to patient's ambulatory motor outcome, necessary personnel resources, and discomfort experienced by therapists and patients. Randomized, controlled, cross-over trial. Sixteen non-ambulatory patients after stroke, severe brain or spinal cord injury sequentially received 2 kinds of gait training. Study intervention A: 20 treatments of locomotor training with an electromechanical gait device; control intervention B: 20 treatments of locomotor training with treadmill or task-oriented gait training. The primary variable was walking ability (Functional Ambulation Category). Secondary variables included gait velocity, Motricity-Index, Rivermead-Mobility-Index, number of therapists needed, and discomfort and effort of patients and therapists during training. Gait ability and the other motor outcome related parameters improved for all patients, but without significant difference between intervention types. However, during intervention A, significantly fewer therapists were needed, and they reported less discomfort and a lower level of effort during training sessions. Locomotor training with or without an electromechanical gait trainer leads to improved gait ability; however, using the electromechanical gait trainer requires less therapeutic assistance, and therapist discomfort is reduced.

The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

Science.gov (United States)

Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W; Wiegand, Susanna

2013-01-01

Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8%) attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19) compared to those presenting moderate (Δ BMI-SDS -0.14) and high social risk (Δ BMI-SDS -0.11). Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents. Copyright © 2013 S. Karger GmbH, Freiburg

The Key Role of Psychosocial Risk on Therapeutic Outcome in Obese Children and Adolescents. Results from a Longitudinal Multicenter Study

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Markus Röbl

2013-06-01

Full Text Available Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8% attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Results: Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19 compared to those presenting moderate (Δ BMI-SDS -0.14 and high social risk (Δ BMI-SDS -0.11. Conclusion: Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents.

Animal-Assisted Intervention for Autism Spectrum Disorder: A Systematic Literature Review

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O'Haire, Marguerite E.

2013-01-01

The inclusion of animals in therapeutic activities, known as animal-assisted intervention (AAI), has been suggested as a treatment practice for autism spectrum disorder (ASD). This paper presents a systematic review of the empirical research on AAI for ASD. Fourteen studies published in peer-reviewed journals qualified for inclusion. The…

Effect of Therapeutic Touch in Patients with Cancer: a Literature Review.

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Tabatabaee, Amir; Tafreshi, Mansoureh Zagheri; Rassouli, Maryam; Aledavood, Seyed Amir; AlaviMajd, Hamid; Farahmand, Seyed Kazem

2016-04-01

The use of complementary and alternative medicine (CAM) techniques has been growing. The National Center for Complementary and Alternative Medicine places therapeutic touch (TT) into the category of bio field energy. This literature review is aimed at critically evaluating the data from clinical trials examining the clinical efficacy of therapeutic touch as a supportive care modality in adult patients with cancer. Electronic databases (PubMed, Scopus, Scholar Google, and Science Direct) were searched from the year 1990 to 2015 to locate potentially relevant peer-reviewed articles using the key words therapeutic touch, touch therapy, neoplasm, cancer, and CAM. Additionally, relevant journals and references of all the located articles were manually searched for other potentially relevant studies. The number of 334 articles was found on the basis of the key words, of which 17 articles related to the clinical trial were examined in accordance with the objectives of the study. A total of 6 articles were in the final dataset in which several examples of the positive effects of healing touch on pain, nausea, anxiety and fatigue, and life quality and also on biochemical parameters were observed. Based on the results of this study, an affirmation can be made regarding the use of TT, as a non-invasive intervention for improving the health status in patients with cancer. Moreover, therapeutic touch was proved to be a useful strategy for adult patients with cancer.

Identification of EhTIF-IA: The putative E. histolytica orthologue of the ...

Indian Academy of Sciences (India)

2016-02-04

Feb 4, 2016 ... We have identified the E. histolytica equivalent of TIF-1A (EhTIF-IA) by homology search within ..... a putative EhTIF-IA with e-value (3e−25). Comparison of .... some biogenesis is correlated with altered rates of rDNA transcription ..... ylation by CK2 facilitates rDNA transcription by promoting dissociation of ...

Guidelines for Rational Cancer Therapeutics

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Byunghee Yoo

2017-12-01

Full Text Available Traditionally, cancer therapy has relied on surgery, radiation therapy, and chemotherapy. In recent years, these interventions have become increasingly replaced or complemented by more targeted approaches that are informed by a deeper understanding of the underlying biology. Still, the implementation of fully rational patient-specific drug design appears to be years away. Here, we present a vision of rational drug design for cancer that is defined by two major components: modularity and image guidance. We suggest that modularity can be achieved by combining a nanocarrier and an oligonucleotide component into the therapeutic. Image guidance can be incorporated into the nanocarrier component by labeling with a specific imaging reporter, such as a radionuclide or contrast agent for magnetic resonance imaging. While limited by the need for additional technological advancement in the areas of cancer biology, nanotechnology, and imaging, this vision for the future of cancer therapy can be used as a guide to future research endeavors.

Narrative Financial Therapy: Integrating a Financial Planning Approach with Therapeutic Theory

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Megan A. McCoy

2014-03-01

Full Text Available The article serves as one of the first attempts to develop an integrated theoretical approach to financial therapy that can be used by practitioners from multiple disciplines. The presented approach integrates the components of the six-step financial planning process with components of empirically-supported therapeutic methods. This integration provides the foundation for a manualized approach to financial therapy, shaped by the writings of narrative theorists and select cognitive-behavioral interventions that can be used both by mental health and financial professionals.

A unique carrier for delivery of therapeutic compounds beyond the blood-brain barrier.

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Delara Karkan

Full Text Available BACKGROUND: Therapeutic intervention in many neurological diseases is thwarted by the physical obstacle formed by the blood-brain barrier (BBB that excludes most drugs from entering the brain from the blood. Thus, identifying efficacious modes of drug delivery to the brain remains a "holy grail" in molecular medicine and nanobiotechnology. Brain capillaries, that comprise the BBB, possess an endogenous receptor that ferries an iron-transport protein, termed p97 (melanotransferrin, across the BBB. Here, we explored the hypothesis that therapeutic drugs "piggybacked" as conjugates of p97 can be shuttled across the BBB for treatment of otherwise inoperable brain tumors. APPROACH: Human p97 was covalently linked with the chemotherapeutic agents paclitaxel (PTAX or adriamycin (ADR and following intravenous injection, measured their penetration into brain tissue and other organs using radiolabeled and fluorescent derivatives of the drugs. In order to establish efficacy of the conjugates, we used nude mouse models to assess p97-drug conjugate activity towards glioma and mammary tumors growing subcutaneously compared to those growing intracranially. PRINCIPAL FINDINGS: Bolus-injected p97-drug conjugates and unconjugated p97 traversed brain capillary endothelium within a few minutes and accumulated to 1-2% of the injected by 24 hours. Brain delivery with p97-drug conjugates was quantitatively 10 fold higher than with free drug controls. Furthermore, both free-ADR and p97-ADR conjugates equally inhibited the subcutaneous growth of gliomas growing outside the brain. Evocatively, only p97-ADR conjugates significantly prolonged the survival of animals bearing intracranial gliomas or mammary tumors when compared to similar cumulated doses of free-ADR. SIGNIFICANCE: This study provides the initial proof of concept for p97 as a carrier capable of shuttling therapeutic levels of drugs from the blood to the brain for the treatment of neurological disorders

[Eye contact effects: A therapeutic issue?

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Baltazar, M; Conty, L

2016-12-01

following the view that people with autism are not interested in processing social signals such as gaze but could do so efficiently if properly motivated. For each pathology we emphasize that eye contact could be used, for example, to enhance sensitivity to bodily states, thus improving emotional decision making (in autism); to lead to more positive appraisal of the self and others (in depression); to improve memory performances (in Alzheimer disease) and, more generally, to motivate the recipient to engage in the therapeutic process. (3) Finally we propose two concrete ways to employ eye contact effects as a therapeutic tool. The first is to develop cognitive-behavioral tools to learn and/or motivate the recipient to create frequent and prolonged eye contact periods. The second is to raise awareness among caregivers of the beneficial effects of eye contact and to teach them the way to use eye contact to reach its optimum effects. Future investigations are however needed to explore the ways in which eye contact effects can be efficiently integrated in therapeutic strategies, as well as to identify the clinical populations that can benefit from such therapeutic interventions. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Evaluation Methods for Assessing Users' Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review.

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Feather, Jacqueline Susan; Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

2016-06-30

The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users' experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic

Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

Science.gov (United States)

Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

2016-01-01

Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main

Targeting Microglial Activation States as a Therapeutic Avenue in Parkinson’s Disease

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Sudhakar R. Subramaniam

2017-06-01

Full Text Available Parkinson’s disease (PD is a chronic and progressive disorder characterized neuropathologically by loss of dopamine neurons in the substantia nigra, intracellular proteinaceous inclusions, reduction of dopaminergic terminals in the striatum, and increased neuroinflammatory cells. The consequent reduction of dopamine in the basal ganglia results in the classical parkinsonian motor phenotype. A growing body of evidence suggest that neuroinflammation mediated by microglia, the resident macrophage-like immune cells in the brain, play a contributory role in PD pathogenesis. Microglia participate in both physiological and pathological conditions. In the former, microglia restore the integrity of the central nervous system and, in the latter, they promote disease progression. Microglia acquire different activation states to modulate these cellular functions. Upon activation to the M1 phenotype, microglia elaborate pro-inflammatory cytokines and neurotoxic molecules promoting inflammation and cytotoxic responses. In contrast, when adopting the M2 phenotype microglia secrete anti-inflammatory gene products and trophic factors that promote repair, regeneration, and restore homeostasis. Relatively little is known about the different microglial activation states in PD and a better understanding is essential for developing putative neuroprotective agents. Targeting microglial activation states by suppressing their deleterious pro-inflammatory neurotoxicity and/or simultaneously enhancing their beneficial anti-inflammatory protective functions appear as a valid therapeutic approach for PD treatment. In this review, we summarize microglial functions and, their dual neurotoxic and neuroprotective role in PD. We also review molecules that modulate microglial activation states as a therapeutic option for PD treatment.

Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

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Loeb, Katharine L.; Wilson, G. Terence; Labouvie, Erich; Pratt, Elizabeth M.; Hayaki, Jumi; Walsh, B. Timothy; Agras, W. Stewart; Fairburn, Christopher G.

2005-01-01

The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome…

Putative midkine family protein up-regulation in Patella caerulea (Mollusca, Gastropoda) exposed to sublethal concentrations of cadmium

International Nuclear Information System (INIS)

Vanucci, Silvana; Minerdi, Daniela; Kadomatsu, Kenji; Mengoni, Alessio; Bazzicalupo, Marco

2005-01-01

A cDNA sequence of a putative midkine (MK) family protein was identified and characterised in the mollusc Patella caerulea. The midkine family consists of two members, midkine and pleiotrophin (PTN), and it is one of the recently discovered cytokines. Our results show that this putative midkine protein is up-regulated in specimens of P. caerulea exposed to sublethal cadmium concentrations (i.e. 0.5 and 1 mg l -1 Cd) over a 10-day exposure period. Semiquantitative RT-PCR and quantitative Real time RT-PCR estimations indicate elevated expression of midkine mRNA in exposed specimens compared to controls. Moreover, RT-PCR Real time values were higher in the viscera (here defined as the part of the soft tissue including digestive gland plus gills) than in the foot (i.e. foot plus head plus heart) of the limpets. At present, information on the functional signalling significance of the midkine family proteins suggests that the up-regulation of P. caerulea putative midkine family protein is a distress signal likely with informative value on health status of the organism and with potential prognostic capability

Gratitude as a psychotherapeutic intervention.

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Emmons, Robert A; Stern, Robin

2013-08-01

Gratitude practice can be a catalyzing and relational healing force, often untapped in clinical practice. In this article, we provide an overview of current thinking about gratitude's defining and beneficial properties, followed by a brief review of the research on mental health outcomes that result from gratitude practice. Following an analysis of our case study of the use of gratitude as a psychotherapeutic intervention, we present various self-strategies and techniques for consciously choosing and cultivating gratitude. We conclude by describing ways in which gratitude might be capitalized upon for beneficial outcomes in therapeutic settings. © 2013 Wiley Periodicals, Inc.

How effective are expressive writing interventions for adolescents? A meta-analytic review.

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Travagin, Gabriele; Margola, Davide; Revenson, Tracey A

2015-03-01

This meta-analysis evaluated the effects of the expressive writing intervention (EW; Pennebaker & Beall, 1986) among adolescents. Twenty-one independent studies that assessed the efficacy of expressive writing on youth samples aged 10-18 ears were collected and analyzed. Results indicated an overall mean g-effect size that was positive in direction but relatively small (0.127), as well as significant g-effect sizes ranging from 0.107 to 0.246 for the outcome domains of Emotional Distress, Problem Behavior, Social Adjustment, and School Participation. Few significant effects were found within specific outcome domains for putative moderator variables that included characteristics of the participants, intervention instructions, or research design. Studies involving adolescents with high levels of emotional problems at baseline reported larger effects on school performance. Studies that implemented a higher dosage intervention (i.e., greater number and, to some extent, greater spacing of sessions) reported larger effects on somatic complaints. Overall, the findings suggest that expressive writing tends to produce small yet significant improvements on adolescents' well-being. The findings highlight the importance of modifying the traditional expressive writing protocol to enhance its efficacy and reduce potential detrimental effects. At this stage of research the evidence on expressive writing as a viable intervention for adolescents is promising but not decisive. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving medication adherence: a framework for community pharmacy-based interventions

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Pringle J

2015-11-01

Full Text Available Janice Pringle,1 Kim C Coley2 1Program Evaluation and Research Unit, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; 2Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Abstract: Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1 defining the program's pharmacy service vision, 2 using evidence-based, patient-centered communication and intervention strategies, 3 using specific implementation approaches that ensure fidelity, and 4 applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well

Total synthesis of the putative structure of the novel triquinane natural product isocapnellenone

OpenAIRE

Mehta, Goverdhan; Murthy, Sai Krishna A; Umarye, Jayant D

2002-01-01

A total synthesis of the ‘putative structure’ 7, attributed to the novel triquinane sesquiterpene isolated recently from two Buddelia species has been accomplished. The spectral data for 7 is a complete mismatch with those reported for the natural product and warrants a revision of the assigned structure.

Blended interventions to change behavior in patients with chronic somatic disorders : Systematic review

NARCIS (Netherlands)

Kloek, C.J.J.; Bossen, D.; de Bakker, D.H.; Veenhof, C.; Dekker, J.

2017-01-01

Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of blended

Blended interventions to change behavior in patients with Chronic somatic disorders : Systematic review

NARCIS (Netherlands)

Kloek, Corelien; Bossen, Daniël; Bakker, Dinny H.De; Veenhof, Cindy; Dekker, Joost

2017-01-01

Background: Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of

Blended Interventions to Change Behavior in Patients With Chronic Somatic Disorders: Systematic Review

NARCIS (Netherlands)

Kloek, Corelien; Bossen, Daniel; de Bakker, Dinny H.; Veenhof, Cindy; Dekker, Joost

2017-01-01

Background: Blended behavior change interventions combine therapeutic guidance with online care. This new way of delivering health care is supposed to stimulate patients with chronic somatic disorders in taking an active role in their disease management. However, knowledge about the effectiveness of

Interventions for vaginismus.

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Melnik, Tamara; Hawton, Keith; McGuire, Hugh

2012-12-12

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising. To assess the effects of different interventions for vaginismus. We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) to August 2012. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched reference lists and conference abstracts. We contacted experts in the field regarding unpublished material. Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control. The review authors extracted data which we verified with the trial investigator where possible. Five studies were included, of which four with a total of 282 participants provided data. No meta-analysis was possible due to heterogeneity of comparisons within included studies as well as inadequate reporting of data. All studies were considered to be at either moderate or high risk of bias. The results of this systematic review indicate that there is no clinical or statistical difference between systematic desensitisation and any of the control interventions (either waiting list control, systematic desensitisation combined with group therapy or in vitro (with women under instruction by the therapist) desensitisation) for the treatment of vaginismus. The drop-out rates were higher in the waiting list groups. A clinically relevant effect of systematic desensitisation when compared with any of the control interventions cannot be ruled out. None of the included trials compared other behaviour therapies (e

A pilot study of "post-seclusion and/or restraint review" intervention with patients and staff in a mental health setting.

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Goulet, Marie-Hélène; Larue, Caroline; Lemieux, Ashley J

2018-04-01

To develop and evaluate a "post-seclusion and/or restraint review" (PSRR) intervention implemented in an acute psychiatric care unit. Twelve staff members and three patients were enrolled in a participatory case study. To evaluate PSRR intervention, qualitative analysis was carried out. Seclusion and restraint use 6 months before and after the PSRR implementation was compared. Nurses reported that they were able to explore the patient's feelings during the PSRR intervention with patients, which led to restoration of the therapeutic relationship. PSRR with the treatment team was perceived as a learning opportunity, which allowed to improve the therapeutic intervention. Both the use of seclusion and the time spent in seclusion were significantly reduced 6 months after the implementation of PSRR intervention. Our results suggest the efficacy of PSRR in overcoming the discomfort perceived by both staff and patient and, in the meantime, in reducing the need for coercive procedures. Systematic PSRR could permit to improve the quality of care and the safety of aggressiveness management. © 2017 Wiley Periodicals, Inc.

A comparison of the boomerang wire vascular access management system versus manual compression alone during percutaneous diagnostic and interventional cardiovascular procedures.

Science.gov (United States)

Echeverria, Angela; Krajcer, Zvonimir

2016-01-01

Vascular closure devices allow for early sheath removal, allowing for earlier patient mobilization The Boomerang vascular access management system does not alter arterial integrity for future interventions Access site complications provide significant morbidity in diagnostic and therapeutic interventions. © 2016 Wiley Periodicals, Inc.

Hypothalamic amenorrhea: from diagnosis to therapeutical approach.

Science.gov (United States)

Genazzani, A D; Chierchia, E; Santagni, S; Rattighieri, E; Farinetti, A; Lanzoni, C

2010-05-01

Among secondary amenorrheas, hypothalamic amenorrhea (HA) is the one with no evidence of endocrine/systemic causal factors. HA is mainly related to various stressors affecting neuroendocrine control of the reproductive axis. In clinical practice, HA is mainly associated with metabolic, physical, or psychological stress. Stress is the adaptive response of our body through all its homeostatic systems, to external and/or internal stimuli that activate specific and nonspecific physiological pathways. HA occurs generally after severe stressed conditions/situations such as dieting, heavy training, or intense emotional events, all situations that can induce amenorrhea with or without body weight loss and HA is a secondary amenorrhea with a diagnosis of exclusion. In fact, the diagnosis is essentially based on a good anamnestic investigation. It has to be investigated using the clinical history of the patient: occurrence of menarche, menstrual cyclicity, time and modality of amenorrhea, and it has to be excluded any endocrine disease or any metabolic (i.e., diabetes) and systemic disorders. It is necessary to identify any stressed situation induced by loss, family or working problems, weight loss or eating disorders, or physical training or agonist activity. Peculiar, though not specific, endocrine investigations might be proposed but no absolute parameter can be proposed since HA is greatly dependent from individual response to stressors and/or the adaptive response to stress. This chapter aims to give insights into diagnosis and putative therapeutic strategies. Copyright 2010 Elsevier Masson SAS. All rights reserved.

THERAPEUTIC EFFECTS OF A COGNITIVE-BEHAVIOURAL TREATMENT WITH JUVENILE OFFENDERS