WorldWideScience

Sample records for relevant therapeutic interventions

  1. 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.

  2. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

  3. Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

    Directory of Open Access Journals (Sweden)

    Danbo Yang

    2010-12-01

    Full Text Available The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(L-g-glutamylglutamine-paclitaxel nano-conjugate (PGG-PTX. PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic.

  4. Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

    International Nuclear Information System (INIS)

    Yang, Danbo; Yu, Lei; Van, Sang

    2010-01-01

    The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(l-γ-glutamylglutamine)-paclitaxel nano-conjugate (PGG-PTX). PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic

  5. Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Danbo [Biomedical Engineering and Technology Institute, Institutes for Advanced Interdisciplinary Research, East China Normal University, 3663 North Zhongshan Road, Shanghai, 200062 (China); Yu, Lei, E-mail: yu-lei@gg.nitto.co.jp [Biomedical Engineering and Technology Institute, Institutes for Advanced Interdisciplinary Research, East China Normal University, 3663 North Zhongshan Road, Shanghai, 200062 (China); Biomedical Group, Nitto Denko Technical Corporation, 501 Via Del Monte, Oceanside, CA 92058 (United States); Van, Sang [Biomedical Group, Nitto Denko Technical Corporation, 501 Via Del Monte, Oceanside, CA 92058 (United States)

    2010-12-23

    The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(l-γ-glutamylglutamine)-paclitaxel nano-conjugate (PGG-PTX). PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic.

  6. 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...

  7. 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.

  8. Initial diagnosis of therapeutically relevant thoracic lesions in polytraumatised patients

    International Nuclear Information System (INIS)

    Danz, B.; Biehl, C.; Baehren, W.

    1996-01-01

    To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients. 303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes. The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%). Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time. (orig.) [de

  9. 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

  10. Humor: A Therapeutic Intervention for Child Counseling

    Science.gov (United States)

    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…

  11. Therapeutic intervention in violence against women in Colombia

    Directory of Open Access Journals (Sweden)

    Lina María Martínez González

    2018-01-01

    Full Text Available The article presents some reflections regarding the unspecified place of therapeutic intervention in the Colombian State’s strategies to address violence against women in the context of couple relationships. It focuses on professional intervention, concretely, therapeutic intervention, and states that despite its significant role in the potential transformation of the imaginaries and subjectivities that support that violence, this type of intervention occupies an unspecified place in the measures stipulated by the law, as well as in Colombian public policies aimed at countering that violence. The article also highlights some of the perspectives that therapists consider useful in the construction of non-violent functional conditions for couples.

  12. 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…

  13. Clinical relevance of pharmacist intervention in an emergency department.

    Science.gov (United States)

    Pérez-Moreno, Maria Antonia; Rodríguez-Camacho, Juan Manuel; Calderón-Hernanz, Beatriz; Comas-Díaz, Bernardino; Tarradas-Torras, Jordi

    2017-08-01

    To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists. We determined whether the intervention occurred in the process of medication reconciliation or another activity, and whether the drug involved belonged to the High-Alert Medications Institute for Safe Medication Practices (ISMP) list. To evaluate the severity of the errors detected and clinical relevance of the pharmacist intervention, a modified assessment scale of Overhage and Lukes was used. Relationship between clinical relevance of pharmacist intervention and the severity of medication errors was assessed using ORs and Spearman's correlation coefficient. During the observation period, pharmacists reviewed the pharmacotherapy history and medication orders of 2984 patients. A total of 991 interventions were recorded in 557 patients; 67.2% of the errors were detected during medication reconciliation. Medication errors were considered severe in 57.2% of cases and 64.9% of pharmacist intervention were considered relevant. About 10.9% of the drugs involved are in the High-Alert Medications ISMP list. The severity of the medication error and the clinical significance of the pharmacist intervention were correlated (Spearman's ρ=0.728/pclinical pharmacists identified and intervened on a high number of severe medication errors. This suggests that emergency services will benefit from pharmacist-provided drug therapy services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Therapeutic interventions for acute hamstring injuries: a systematic review

    NARCIS (Netherlands)

    Reurink, Gustaaf; Goudswaard, Gert Jan; Tol, Johannes L.; Verhaar, Jan A. N.; Weir, Adam; Moen, Maarten H.

    2012-01-01

    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. To systematically review the literature on the effectiveness of therapeutic interventions

  15. Therapeutic enhancement: nursing intervention category for patients diagnosed with Readiness for Therapeutic Regimen Management.

    Science.gov (United States)

    Kelly, Cynthia W

    2008-04-01

    To present a new nursing intervention category called therapeutic enhancement. Fewer than half of North Americans follow their physician's recommendations for diet and exercise, even when such are crucial to their health or recovery. It is imperative that nurses consider new ways to promote healthy behaviours. Therapeutic enhancement is intended to provide such a fresh approach. Traditional intervention techniques focusing on education, contracts, social support and more frequent interaction with physicians appear not to be effective when used alone. Successful strategies have been multidisciplinary; and have included interventions by professional nurses who assist patients to understand their disease and the disease process and that helps them to develop disease-management and self-management skills. Therapeutic enhancement incorporates The Stages of Change Theory, Commitment to Health Theory, Motivational Interviewing techniques and instrumentation specifically designed for process evaluation of health-promoting interventions. This is a critical review of approaches that, heretofore, have not been synthesised in a single published article. Based on the commonly used Stages of Change model, therapeutic enhancement is useful for patients who are at the action stage of change. Using therapeutic enhancement as well as therapeutic strategies identified in Stages of Change Theory, such as contingency management, helping relationships, counterconditioning, stimulus control and Motivational Interviewing techniques, nursing professionals can significantly increase the chances of patients moving from action to the maintenance stage of change for a specific health behaviour. Using the nursing intervention category, therapeutic enhancement can increase caregivers' success in helping patients maintain healthy behaviours.

  16. Telephone based weight loss intervention: Relevance for developing countries.

    Science.gov (United States)

    Ayisi Addo, Sandra; Steiner-Asiedu, Matilda

    2018-02-08

    Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.

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

    Science.gov (United States)

    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.

  18. Interleukin-6 in Schizophrenia—Is There a Therapeutic Relevance?

    Directory of Open Access Journals (Sweden)

    Milica Milovan Borovcanin

    2017-11-01

    Full Text Available Renewing interest in immune aspects of schizophrenia and new findings about the brain-fat axis encourage us to discuss the possible role of interleukin-6 (IL-6 in schizophrenia. Previously, it was suggested that a primary alteration of the innate immune system may be relevant in schizophrenia. Functional dichotomy of IL-6 suggests that this chemical messenger may be responsible for regulating the balance between pro- and anti-inflammatory responses, with tissue-specific properties at the periphery and in the central nervous system. Specific phase of this chronic and deteriorating disorder must be considered, which can involve IL-6 in acute or possible chronic inflammation and/or autoimmunity. We give an overview of IL-6 role in the onset and progression of this disorder, also considering cognitive impairment and metabolic changes in patients with schizophrenia. Data suggest that decreased serum level of IL-6 following antipsychotic therapy could be predisposing factor for the development of obesity and obesity-related metabolic disorders in schizophrenia. As we reviewed, the IL-6 plays significant role in disease genesis and progression, so the use of specific inhibitors may not only be beneficial for exacerbation and alleviation of positive symptoms, but may attenuate cognitive impairment in patients with schizophrenia.

  19. Pulmonary embolism. Clinical relevance, requirements for diagnostic and therapeutic strategies

    International Nuclear Information System (INIS)

    Nowak, F.G.; Halbfass, P.; Hoffmann, E.

    2007-01-01

    In the population the annual incidence of pulmonary embolism amounts to 1.3-2.8 per 1000 at the age of 65-89 years. Mortality reaches about 17% within the first 3 months. Acute pulmonary embolism is characterized by an increase in pulmonary arterial pressure and an impairment of the pulmonary gas exchange. Elevation of the right cardiac pressure up to right heart decompensation may follow. In addition, hypoxemia, hyperventilation, dead space ventilation, right to left shunting, bronchoconstriction, and vasoconstriction may occur. Clinical examination, ECG, laboratory findings such as elevated D-dimer, blood gas analysis, ultrasound examination of the veins of the lower extremities, and transthoracic echocardiography are acutely available diagnostic methods of an emergency department. In addition, extensive diagnostic procedures like pulmonary scintigraphy and pulmonary angiography may be required. The aim is to get a definite diagnosis as quickly as possible to direct therapy. In acute pulmonary embolism with cardiac shock, monitoring and stabilization of the circulatory function as well as an appropriate anticoagulant therapy are essential. In some cases surgery or a local fibrinolytic intervention is indicated. (orig.) [de

  20. Family interventions in schizophrenia: Issues of relevance for Asian countries.

    Science.gov (United States)

    Chakrabarti, Subho

    2011-12-31

    A growing body of research evidence has confirmed the efficacy of family-interventions as adjuncts to antipsychotics for the treatment of schizophrenia. Much of the recent evidence for such interventions derives from Asian, principally Chinese, studies. These trials have shown that relatively simple forms of family-interventions have wide ranging benefits, and can be implemented successfully in routine clinical settings. With the accumulation of this evidence in their favour, family-interventions for schizophrenia in Asia are poised to take the next critical step, that of wider implementation and improved accessibility for potential users. However, several issues merit consideration. Family-interventions need to be based on a culturally-informed theory, which incorporates cultural variables of relevance in these countries. While the ideal format for conducting family-interventions is still to be determined, it is quite evident that for such interventions to be useful they need to be simple, inexpensive, needs-based, and tailored to suit the socio-cultural realities of mental health systems in Asian countries. The evidence also suggests that delivery by non-specialist personnel is the best way to ensure that such services reach those who stand to benefit most from these treatments. However, there are several existing challenges to the process of dissemination of family-interventions. The major challenges include the achievement of a critical mass of trained professionals capable of delivering these interventions, and finding innovative solutions to make family-interventions more acceptable to families. If these hurdles are overcome, we could look forward to a genuine collaboration with families, who have always been the mainstay of care for the mentally ill in Asia.

  1. 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,…

  2. Neurodevelopmental Treatment (NDT): Therapeutic Intervention and Its Efficacy.

    Science.gov (United States)

    Stern, Francine Martin; Gorga, Delia

    1988-01-01

    Use of neurodevelopmental treatment, also known as the Bobath method, is discussed, including its history, philosophy, goals, and treatment emphasis with infants and children with movement disorders. Examples of children before and after therapeutic intervention illustrate use of the technique, and controversies in measuring therapy efficacy are…

  3. Colonization, Pathogenicity, Host Susceptibility and Therapeutics for Staphylococcus aureus: What is the Clinical Relevance?1

    Science.gov (United States)

    Tong, Steven Y.C.; Chen, Luke F.; Fowler, Vance G.

    2011-01-01

    Staphylococcus aureus is a human commensal that can also cause a broad spectrum of clinical disease. Factors associated with clinical disease are myriad and dynamic and include pathogen virulence, antimicrobial resistance and host susceptibility. Additionally, infection control measures aimed at the environmental niches of S. aureus and therapeutic advances continue to impact upon the incidence and outcomes of staphylococcal infections. This review article focuses on the clinical relevance of advances in our understanding of staphylococcal colonization, virulence, host susceptibility and therapeutics. Over the past decade key developments have arisen. First, rates of nosocomial methicillin-resistant S. aureus (MRSA) infections have significantly declined in many countries. Second, we have made great strides in our understanding of the molecular pathogenesis of S. aureus in general and community-associated MRSA in particular. Third, host risk factors for invasive staphylococcal infections, such as advancing age, increasing numbers of invasive medical interventions, and a growing proportion of patients with healthcare contact, remain dynamic. Finally, several new antimicrobial agents active against MRSA have become available for clinical use. Humans and S. aureus co-exist and the dynamic interface between host, pathogen and our attempts to influence these interactions will continue to rapidly change. Although progress has been made in the past decade, we are likely to face further surprises such as the recent waves of community-associated MRSA. PMID:22160374

  4. Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Pol, Jochem van der; Voeoe, Stefan [Maastricht University Medical Centre (MUMC+), Department of Radiology and Nuclear Medicine, Postbox 5800, Maastricht (Netherlands); Bucerius, Jan; Mottaghy, Felix M. [Maastricht University Medical Centre (MUMC+), Department of Radiology and Nuclear Medicine, Postbox 5800, Maastricht (Netherlands); University Hospital, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany)

    2017-07-15

    Radiopharmaceutical extravasation can potentially lead to severe soft tissue damage, but little is known about incidence, medical consequences, possible interventions, and effectiveness of these. The aims of this study are to estimate the incidence of extravasation of diagnostic and therapeutic radiopharmaceuticals, to evaluate medical consequences, and to evaluate medical treatment applied subsequently to those incidents. A sensitive and elaborate literature search was performed in Embase and PubMed using the keywords ''misadministration'', ''extravasation'', ''paravascular infiltration'', combined with ''tracer'', ''radionuclide'', ''radiopharmaceutical'', and a list of keywords referring to clinically used tracers (i.e. ''Technetium-99m'', ''Yttrium-90''). Reported data on radiopharmaceutical extravasation and applied interventions was extracted and summarised. Thirty-seven publications reported 3016 cases of diagnostic radiopharmaceutical extravasation, of which three cases reported symptoms after extravasation. Eight publications reported 10 cases of therapeutic tracer extravasation. The most severe symptom was ulceration. Thirty-four different intervention and prevention strategies were performed or proposed in literature. Extravasation of diagnostic radiopharmaceuticals is common. {sup 99m}Tc, {sup 123}I, {sup 18}F, and {sup 68}Ga labelled tracers do not require specific intervention. Extravasation of therapeutic radiopharmaceuticals can give severe soft tissue lesions. Although not evidence based, surgical intervention should be considered. Furthermore, dispersive intervention, dosimetry and follow up is advised. Pharmaceutical intervention has no place yet in the immediate care of radiopharmaceutical extravasation. (orig.)

  5. 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.

  6. A therapeutic skating intervention for children with autism spectrum disorder.

    Science.gov (United States)

    Casey, Amanda Faith; Quenneville-Himbeault, Gabriel; Normore, Alexa; Davis, Hanna; Martell, Stephen G

    2015-01-01

    The purpose of this study was to evaluate the effects of a highly structured therapeutic skating intervention on motor outcomes and functional capacity in 2 boys with autism spectrum disorder aged 7 and 10 years. This multiple-baseline, single-subject study assigned participants to three 1-hour skating sessions per week for 12 weeks focusing on skill and motor development. Multiple data points assessed (a) fidelity to the intervention and (b) outcomes measures including the Pediatric Balance Scale, Timed Up and Go, floor to stand, Six-Minute Walk Test, goal attainment, and weekly on-ice testing. Improvements were found in balance, motor behavior, and functional capacity by posttest with gains remaining above pretest levels at follow-up. Therapeutic skating may produce physical benefits for children with autism spectrum disorder and offer a viable, inexpensive community-based alternative to other forms of physical activity.

  7. Systematic Review of the Diagnostic Accuracy and Therapeutic Effectiveness of Sacroiliac Joint Interventions.

    Science.gov (United States)

    Simopoulos, Thomas T; Manchikanti, Laxmaiah; Gupta, Sanjeeva; Aydin, Steve M; Kim, Chong Hwan; Solanki, Daneshvari; Nampiaparampil, Devi E; Singh, Vijay; Staats, Peter S; Hirsch, Joshua A

    2015-01-01

    The sacroiliac joint is well known as a cause of low back and lower extremity pain. Prevalence estimates are 10% to 25% in patients with persistent axial low back pain without disc herniation, discogenic pain, or radiculitis based on multiple diagnostic studies and systematic reviews. However, at present there are no definitive management options for treating sacroiliac joint pain. To evaluate the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. A systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. The available literature on diagnostic and therapeutic sacroiliac joint interventions was reviewed. The quality assessment criteria utilized were the Quality Appraisal of Reliability Studies (QAREL) checklist for diagnostic accuracy studies, Cochrane review criteria to assess sources of risk of bias, and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) criteria for randomized therapeutic trials and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR) for observational therapeutic assessments. The level of evidence was based on a best evidence synthesis with modified grading of qualitative evidence from Level I to Level V. Data sources included relevant literature published from 1966 through March 2015 that were identified through searches of PubMed and EMBASE, manual searches of the bibliographies of known primary and review articles, and all other sources. For the diagnostic accuracy assessment, and for the therapeutic modalities, the primary outcome measure of pain relief and improvement in functional status were utilized. A total of 11 diagnostic accuracy studies and 14 therapeutic studies were included. The evidence for diagnostic accuracy is Level II for dual diagnostic blocks with at least 70% pain relief as the criterion

  8. 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.

  9. 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

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Vogl, T.J.; Mueller, P.K.; Mack, M.G.; Straub, R.; Engelmann, K.; Neuhaus, P.

    1999-01-01

    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.)

  13. Therapeutic relevance of penicillin-induced hypersensitivity of Staphylococcus aureus to killing by polymorphonuclear leukocytes.

    OpenAIRE

    Lam, C; Georgopoulos, A; Laber, G; Schütze, E

    1984-01-01

    There is an overwhelming body of evidence that certain Staphylococcus aureus strains become more sensitive to killing by polymorphonuclear leukocytes after their growth in media containing subinhibitory concentrations of penicillin. However, it is not clear to what extent this phenomenon contributes to the curative effect of penicillin in vivo. To explore its therapeutic relevance, we evaluated the interaction of staphylococci pretreated with penicillin in vitro with leukocytes in cell-proof ...

  14. Social Learning Conceptualization for Substance Abuse: Implications for Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    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.

  15. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  18. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

    Science.gov (United States)

    Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

    2014-01-01

    African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

  19. Periostin: a promising target of therapeutical intervention for prostate cancer

    Directory of Open Access Journals (Sweden)

    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.

  20. Inhibiting DNA Polymerases as a Therapeutic Intervention against Cancer

    Directory of Open Access Journals (Sweden)

    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.

  1. Effects of an Alternative to Suspension Intervention in a Therapeutic High School

    Science.gov (United States)

    Hernandez-Melis, Claudia; Fenning, Pamela; Lawrence, Elizabeth

    2016-01-01

    The purpose of the current study was to assess the effects of an alternative to suspension intervention on students' subsequent major referrals. The intervention included activities designed to teach social coping strategies as well as mediation to resolve interpersonal conflicts. The intervention was implemented in a therapeutic high school, and…

  2. 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.

  3. 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...

  4. 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...

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Suhartini Suhartini

    2011-01-01

    Full Text Available 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 music intervention for therapeutic purposes and to describe the perspective of gamelan music used in nursing interventionMethods: Using five bibliography databases (MEDLINE, CINAHL, Science Direct, Interscience, and Proquest were searched from 1999-2010 for original clinical reports or reviews that evaluated the use of complementary therapy for therapeutic intervention in patients with ventilator support. The term of complementary therapy, anxiety, and pain were used in a comprehensive search of electronic databases. Articles were screened and excluded based on the title and abstract information.Results: Music brings about helpful changes in the emotional and physical health of patients, and has the ability to provide an altered state of physical arousal and subsequent mood improvement by processing a progression of musical notes of varying tone, rhythm, and instrumentation for a pleasing effect.Conclusion: Music can be used for therapeutic purposes, for instance to reduce anxiety, to decrease pain sensation, and some effects of psychological impact. Include, the gamelan music can be offer for patients for Javanese people in Indonesia.Key words: Music, music intervention, therapeutic purposes

  7. CT-guided biopsy: diagnostic relevance, therapeutic consequences and economic aspects

    International Nuclear Information System (INIS)

    Schwarzenberg, H.; Mueller-Huelsbeck, S.; Link, J.; Brossmann, J.; Fahl, M.; Quirin, A.; Heller, M.

    1996-01-01

    Purpose: To evaluate the diagnostic and clinical relevance and therapeutic consequences of CT-guided biopsy with regard to economic aspects. Methods: 213 CT-guided biopsies in 190 were evaluated. All information regarding patient referral, reason for request, body region, underlying diagnosis, and clinical consequences were registered over a period of 22.2±9.4 month. Results: Patient referral to biopsy was mainly from the departments of surgery, internal medicine, and radiotherapy with the question of tumor and metastasis. Less than 5% of biopsies were performed in outpatients. Main regions were the lung (39%), the abdomen (35%), and the skeleton (11%). Biopsy and surgical histology corresponded in 73%. Largest diagnosis groups were benign unspecific tissues or other benign lesions in 24%. As a result of CTP no further procedures necessary in 22.5%. Follow-up studies or conservative treatment were indicated in 11.3%. Surgical procedures were needed in only 15.5%. There was only one complication requiring therapy. Conclusion: CT-guided biopsy is a safe procedure, which helps to avoid unnecessary cost-intensive diagnostics and surgical treatment. If CTP is performed early and in outpatients residence time in the hospital is reduced and thus money is saved. (orig.) [de

  8. Fostering Adolescents' Value Beliefs for Mathematics with a Relevance Intervention in the Classroom

    Science.gov (United States)

    Gaspard, Hanna; Dicke, Anna-Lena; Flunger, Barbara; Brisson, Brigitte Maria; Häfner, Isabelle; Nagengast, Benjamin; Trautwein, Ulrich

    2015-01-01

    Interventions targeting students' perceived relevance of the learning content have been shown to effectively promote student motivation within science classes (e.g., Hulleman & Harackiewicz, 2009). Yet, further research is warranted to understand better how such interventions should be designed in order to be successfully implemented in the…

  9. 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

  10. 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

  11. 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.

  12. Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2005-06-01

    Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

  13. 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

  14. Economic Cost of the Therapeutic Workplace Intervention Added to Methadone Maintenance

    Science.gov (United States)

    Knealing, Todd W.; Roebuck, M. Christopher; Wong, Conrad J.; Silverman, Kenneth

    2008-01-01

    The therapeutic workplace is a novel intervention that uses access to paid training and employment to reinforce drug abstinence within the context of standard methadone maintenance. We used the Drug Abuse Treatment Cost Analysis Program as a standard method of estimating the economic costs of this intervention. Over a one-year period, the therapeutic workplace served 122 methadone maintenance clients who had a median length of stay of 22 weeks. The workplace maintained a mean daily census of 48 clients. The combined cost of methadone maintenance and the therapeutic workplace was estimated at $362 per week. This cost is less than other treatments that might be used to promote abstinence in individuals who continue to use drugs during methadone treatment. Given prior evidence of effectiveness, these cost data may be useful to policymakers, social service agencies, and researchers interested in using or further developing the therapeutic workplace intervention. PMID:17614239

  15. Robin Hood effects on motivation in math: Family interest moderates the effects of relevance interventions.

    Science.gov (United States)

    Häfner, Isabelle; Flunger, Barbara; Dicke, Anna-Lena; Gaspard, Hanna; Brisson, Brigitte M; Nagengast, Benjamin; Trautwein, Ulrich

    2017-08-01

    Using a cluster randomized field trial, the present study tested whether 2 relevance interventions affected students' value beliefs, self-concept, and effort in math differently depending on family background (socioeconomic status, family interest (FI), and parental utility value). Eighty-two classrooms were randomly assigned to either 1 of 2 intervention conditions or a control group. Data from 1,916 students (M age = 14.62, SD age = 0.47) and their predominantly Caucasian middle-class parents were obtained via separate questionnaires. Multilevel regression analyses with cross-level interactions were used to investigate differential intervention effects on students' motivational beliefs 6 weeks and 5 months after the intervention. Socioeconomic status, FI, and parental utility values were investigated as moderators of the intervention effects. The intervention conditions were especially effective in promoting students' utility, attainment, intrinsic value beliefs, and effort 5 months after the intervention for students whose parents reported lower levels of math interest. Furthermore, students whose parents reported low math utility values especially profited in terms of their utility and attainment math values 5 months after the intervention. No systematic differential intervention effects were found for socioeconomic status. These results highlight the effectiveness of relevance interventions in decreasing motivational gaps between students from families with fewer or more motivational resources. Findings point to the substantial importance of motivational family resources, which have been neglected in previous research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. 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.

  17. 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.

  18. Therapeutic interventions for increasing ankle dorsiflexion after ankle sprain: a systematic review.

    Science.gov (United States)

    Terada, Masafumi; Pietrosimone, Brian G; Gribble, Phillip A

    2013-01-01

    Clinicians perform therapeutic interventions, such as stretching, manual therapy, electrotherapy, ultrasound, and exercises, to increase ankle dorsiflexion. However, authors of previous studies have not determined which intervention or combination of interventions is most effective. To determine the magnitude of therapeutic intervention effects on and the most effective therapeutic interventions for restoring normal ankle dorsiflexion after ankle sprain. We performed a comprehensive literature search in Web of Science and EBSCO HOST from 1965 to May 29, 2011, with 19 search terms related to ankle sprain, dorsiflexion, and intervention and by cross-referencing pertinent articles. Eligible studies had to be written in English and include the means and standard deviations of both pretreatment and posttreatment in patients with acute, subacute, or chronic ankle sprains. Outcomes of interest included various joint mobilizations, stretching, local vibration, hyperbaric oxygen therapy, electrical stimulation, and mental-relaxation interventions. We extracted data on dorsiflexion improvements among various therapeutic applications by calculating Cohen d effect sizes with associated 95% confidence intervals (CIs) and evaluated the methodologic quality using the Physiotherapy Evidence Database (PEDro) scale. In total, 9 studies (PEDro score = 5.22 ± 1.92) met the inclusion criteria. Static-stretching interventions with a home exercise program had the strongest effects on increasing dorsiflexion in patients 2 weeks after acute ankle sprains (Cohen d = 1.06; 95% CI = 0.12, 2.42). The range of effect sizes for movement with mobilization on ankle dorsiflexion among individuals with recurrent ankle sprains was small (Cohen d range = 0.14 to 0.39). Static-stretching intervention as a part of standardized care yielded the strongest effects on dorsiflexion after acute ankle sprains. The existing evidence suggests that clinicians need to consider what may be the limiting factor of

  19. 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.

  20. Assessing therapeutic relevance of biologically interesting, ampholytic substances based on their physicochemical and spectral characteristics with chemometric tools

    Science.gov (United States)

    Judycka, U.; Jagiello, K.; Bober, L.; Błażejowski, J.; Puzyn, T.

    2018-06-01

    Chemometric tools were applied to investigate the biological behaviour of ampholytic substances in relation to their physicochemical and spectral properties. Results of the Principal Component Analysis suggest that size of molecules and their electronic and spectral characteristics are the key properties required to predict therapeutic relevance of the compounds examined. These properties were used for developing the structure-activity classification model. The classification model allows assessing the therapeutic behaviour of ampholytic substances on the basis of solely values of descriptors that can be obtained computationally. Thus, the prediction is possible without necessity of carrying out time-consuming and expensive laboratory tests, which is its main advantage.

  1. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. 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.

  3. 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

  4. Use of a New International Classification of Health Interventions for Capturing Information on Health Interventions Relevant to People with Disabilities.

    Science.gov (United States)

    Fortune, Nicola; Madden, Richard; Almborg, Ann-Helene

    2018-01-17

    Development of the World Health Organization's International Classification of Health Interventions (ICHI) is currently underway. Once finalised, ICHI will provide a standard basis for collecting, aggregating, analysing, and comparing data on health interventions across all sectors of the health system. In this paper, we introduce the classification, describing its underlying tri-axial structure, organisation and content. We then discuss the potential value of ICHI for capturing information on met and unmet need for health interventions relevant to people with a disability, with a particular focus on interventions to support functioning and health promotion interventions. Early experiences of use of the Swedish National Classification of Social Care Interventions and Activities, which is based closely on ICHI, illustrate the value of a standard classification to support practice and collect statistical data. Testing of the ICHI beta version in a wide range of countries and contexts is now needed so that improvements can be made before it is finalised. Input from those with an interest in the health of people with disabilities and health promotion more broadly is welcomed.

  5. A pragmatic definition of therapeutic synergy suitable for clinically relevant in vitro multicompound analyses.

    Science.gov (United States)

    Kashif, Muhammad; Andersson, Claes; Åberg, Magnus; Nygren, Peter; Sjöblom, Tobias; Hammerling, Ulf; Larsson, Rolf; Gustafsson, Mats G

    2014-07-01

    For decades, the standard procedure when screening for candidate anticancer drug combinations has been to search for synergy, defined as any positive deviation from trivial cases like when the drugs are regarded as diluted versions of each other (Loewe additivity), independent actions (Bliss independence), or no interaction terms in a response surface model (no interaction). Here, we show that this kind of conventional synergy analysis may be completely misleading when the goal is to detect if there is a promising in vitro therapeutic window. Motivated by this result, and the fact that a drug combination offering a promising therapeutic window seldom is interesting if one of its constituent drugs can provide the same window alone, the largely overlooked concept of therapeutic synergy (TS) is reintroduced. In vitro TS is said to occur when the largest therapeutic window obtained by the best drug combination cannot be achieved by any single drug within the concentration range studied. Using this definition of TS, we introduce a procedure that enables its use in modern massively parallel experiments supported by a statistical omnibus test for TS designed to avoid the multiple testing problem. Finally, we suggest how one may perform TS analysis, via computational predictions of the reference cell responses, when only the target cell responses are available. In conclusion, the conventional error-prone search for promising drug combinations may be improved by replacing conventional (toxicology-rooted) synergy analysis with an analysis focused on (clinically motivated) TS. ©2014 American Association for Cancer Research.

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

    Science.gov (United States)

    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.

  7. 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,

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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

  10. Reducing therapeutic misconception: A randomized intervention trial in hypothetical clinical trials.

    Directory of Open Access Journals (Sweden)

    Paul P Christopher

    Full Text Available Participants in clinical trials frequently fail to appreciate key differences between research and clinical care. This phenomenon, known as therapeutic misconception, undermines informed consent to clinical research, but to date there have been no effective interventions to reduce it and concerns have been expressed that to do so might impede recruitment. We determined whether a scientific reframing intervention reduces therapeutic misconception without significantly reducing willingness to participate in hypothetical clinical trials.This prospective randomized trial was conducted from 2015 to 2016 to test the efficacy of an informed consent intervention based on scientific reframing compared to a traditional informed consent procedure (control in reducing therapeutic misconception among patients considering enrollment in hypothetical clinical trials modeled on real-world studies for one of five disease categories. Patients with diabetes mellitus, hypertension, coronary artery disease, head/neck cancer, breast cancer, and major depression were recruited from medical clinics and a clinical research volunteer database. The primary outcomes were therapeutic misconception, as measured by a validated, ten-item Therapeutic Misconception Scale (range = 10-50, and willingness to participate in the clinical trial.154 participants completed the study (age range, 23-87 years; 92.3% white, 56.5% female; 74 (48.1% had been randomized to receive the experimental intervention. Therapeutic misconception was significantly lower (p = 0.004 in the scientific reframing group (26.4, 95% CI [23.7 to 29.1] compared to the control group (30.9, 95% CI [28.4 to 33.5], and remained so after controlling for education (p = 0.017. Willingness to participate in the hypothetical trial was not significantly different (p = 0.603 between intervention (52.1%, 95% CI [40.2% to 62.4%] and control (56.3%, 95% CI [45.3% to 66.6%] groups.An enhanced educational intervention augmenting

  11. 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.

  12. 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...

  13. Significance of antioxidant potential of plants and its relevance to therapeutic applications.

    Science.gov (United States)

    Kasote, Deepak M; Katyare, Surendra S; Hegde, Mahabaleshwar V; Bae, Hanhong

    2015-01-01

    Oxidative stress has been identified as the root cause of the development and progression of several diseases. Supplementation of exogenous antioxidants or boosting endogenous antioxidant defenses of the body is a promising way of combating the undesirable effects of reactive oxygen species (ROS) induced oxidative damage. Plants have an innate ability to biosynthesize a wide range of non-enzymatic antioxidants capable of attenuating ROS- induced oxidative damage. Several in vitro methods have been used to screen plants for their antioxidant potential, and in most of these assays they revealed potent antioxidant activity. However, prior to confirming their in vivo therapeutic efficacy, plant antioxidants have to pass through several physiopharmacological processes. Consequently, the findings of in vitro and in vivo antioxidant potential assessment studies are not always the same. Nevertheless, the results of in vitro assays have been irrelevantly extrapolated to the therapeutic application of plant antioxidants without undertaking sufficient in vivo studies. Therefore, we have briefly reviewed the physiology and redox biology of both plants and humans to improve our understanding of plant antioxidants as therapeutic entities. The applications and limitations of antioxidant activity measurement assays were also highlighted to identify the precise path to be followed for future research in the area of plant antioxidants.

  14. Clinically Relevant Physical Benefits of Exercise Interventions in Breast Cancer Survivors.

    Science.gov (United States)

    Kirkham, Amy A; Bland, Kelcey A; Sayyari, Sarah; Campbell, Kristin L; Davis, Margot K

    2016-02-01

    Evidence is currently limited for the effect of exercise on breast cancer clinical outcomes. However, several of the reported physical benefits of exercise, including peak oxygen consumption, functional capacity, muscle strength and lean mass, cardiovascular risk factors, and bone health, have established associations with disability, cardiovascular disease risk, morbidity, and mortality. This review will summarize the clinically relevant physical benefits of exercise interventions in breast cancer survivors and discuss recommendations for achieving these benefits. It will also describe potential differences in intervention delivery that may impact outcomes and, lastly, describe current physical activity guidelines for cancer survivors.

  15. Genomics and systems biology - How relevant are the developments to veterinary pharmacology, toxicology and therapeutics?

    NARCIS (Netherlands)

    Witkamp, R.F.

    2005-01-01

    This review discusses some of the recent developments in genomics and its current and future relevance for veterinary pharmacology and toxicology. With the rapid progress made in this field several new approaches in pharmacological and toxicological research have developed and drug discovery and

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. Relevant Aspects of Nutritional and Dietary Interventions in Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    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.

  19. Operationalization and reliability testing of ICF categories relevant for physiotherapists' interventions in the acute hospital

    OpenAIRE

    Grill, E; Gloor-Juzi, T; Huber, E O; Stucki, G

    2011-01-01

    Objective: To operationalize items based on categories of the International Classification of Functioning, Disability and Health (ICF) relevant to patient problems that are addressed by physiotherapeutic interventions in the acute hospital, and to test the reliability of these items when applied by physiotherapists. Methods: A selection of 124 ICF categories was operationalized in a formal decision-making and consensus process. The reliability of the newly operationalized item list ...

  20. 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

  1. Expanding the scope and relevance of health interventions: Moving beyond clinical trials and behavior change models

    Directory of Open Access Journals (Sweden)

    Khary K. Rigg

    2014-07-01

    Full Text Available An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.

  2. 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

  3. 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

  4. Blood Outgrowth Endothelial Cells Increase Tumor Growth Rates and Modify Tumor Physiology: Relevance for Therapeutic Targeting

    Energy Technology Data Exchange (ETDEWEB)

    Pagan, Jonathan, E-mail: jdpagan@uams.edu; Przybyla, Beata; Jamshidi-Parsian, Azemat [Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205 (United States); Gupta, Kalpna [Vascular Biology Center and Division of Hematology-Oncology Transplantation, Department of Medicine, University of Minnesota Medical School, MN 72223 (United States); Griffin, Robert J. [Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205 (United States)

    2013-02-18

    Endothelial cell precursors from human peripheral blood have been shown to home to areas of neovascularization and may assist tumor growth by increasing or fortifying blood vessel growth. In the present study, the influence of these cells on tumor growth and physiology was investigated and the role of these cells as a therapeutic target or in determining treatment sensitivity was tested. After isolation from human blood and expansion in vitro, actively growing cells with verified endothelial phenotype (Blood Outgrowth Endothelial Cell, BOEC) were injected i.v. into tumor bearing mice for three consecutive days. The growth rate was significantly enhanced in relatively small RERF human lung tumors (i.e., less than 150 mm{sup 3}) grown in immunocompromised mice by an average of 1.5-fold while it had no effect when injections were given to animals bearing larger tumors. There were no signs of toxicity or unwanted systemic effects. We also observed evidence of increased perfusion, vessel number, response to 15 Gy radiation and oxygenation in RERF tumors of animals injected with BOECs compared to control tumors. In addition, FSaII murine fibrosarcoma tumors were found to grow faster upon injection of BOECs. When FSaII tumors were subjected to a partial thermal ablation treatment using high intensity focused ultrasound (HIFU) there was consistently elevated detection of fluorescently labeled and i.v. injected endothelial precursors in the tumor when analyzed with optical imaging and/or histological preparations. Importantly, we also observed that BOECs treated with the novel anti-angiogenic peptide anginex in-vitro, show decreased proliferation and increased sensitivity to radiation. In vivo, the normal increase in FSaII tumor growth induced by injected BOECs was blunted by the addition of anginex treatment. It appears that endothelial precursors may significantly contribute to tumor vessel growth, tumor progression and/or repair of tumor damage and may improve the

  5. Blood Outgrowth Endothelial Cells Increase Tumor Growth Rates and Modify Tumor Physiology: Relevance for Therapeutic Targeting

    International Nuclear Information System (INIS)

    Pagan, Jonathan; Przybyla, Beata; Jamshidi-Parsian, Azemat; Gupta, Kalpna; Griffin, Robert J.

    2013-01-01

    Endothelial cell precursors from human peripheral blood have been shown to home to areas of neovascularization and may assist tumor growth by increasing or fortifying blood vessel growth. In the present study, the influence of these cells on tumor growth and physiology was investigated and the role of these cells as a therapeutic target or in determining treatment sensitivity was tested. After isolation from human blood and expansion in vitro, actively growing cells with verified endothelial phenotype (Blood Outgrowth Endothelial Cell, BOEC) were injected i.v. into tumor bearing mice for three consecutive days. The growth rate was significantly enhanced in relatively small RERF human lung tumors (i.e., less than 150 mm 3 ) grown in immunocompromised mice by an average of 1.5-fold while it had no effect when injections were given to animals bearing larger tumors. There were no signs of toxicity or unwanted systemic effects. We also observed evidence of increased perfusion, vessel number, response to 15 Gy radiation and oxygenation in RERF tumors of animals injected with BOECs compared to control tumors. In addition, FSaII murine fibrosarcoma tumors were found to grow faster upon injection of BOECs. When FSaII tumors were subjected to a partial thermal ablation treatment using high intensity focused ultrasound (HIFU) there was consistently elevated detection of fluorescently labeled and i.v. injected endothelial precursors in the tumor when analyzed with optical imaging and/or histological preparations. Importantly, we also observed that BOECs treated with the novel anti-angiogenic peptide anginex in-vitro, show decreased proliferation and increased sensitivity to radiation. In vivo, the normal increase in FSaII tumor growth induced by injected BOECs was blunted by the addition of anginex treatment. It appears that endothelial precursors may significantly contribute to tumor vessel growth, tumor progression and/or repair of tumor damage and may improve the

  6. Facilitators and barriers to the provision of therapeutic interventions by school psychologists

    Science.gov (United States)

    Squires, Garry; Bragg, Joanna; Muscutt, Janet; Wasilewski, David

    2014-01-01

    There is growing concern internationally about the prevalence of mental health problems among school-aged children and their access to specialist services. School psychologists (SPs) may be one group of professionals well-positioned to support the well-being of children and young people, due to their position as applied psychologists working within educational settings and their capability to deliver therapeutic interventions. This research considers findings from a large scale, United Kingdom (UK)-wide survey of the views of SPs (N = 455) about facilitators and barriers to the provision of therapeutic interventions to children and young people. Principal Components Analyses of ranked questionnaire responses yielded three components: The role of the SP; training and practice; and support and psychology service context. Quantitative findings were then triangulated, using qualitative responses from the survey. Greater direction and clarification of the role of the SP as a provider of therapeutic interventions is recommended, particularly given the diverse roles undertaken by SPs and competing demands, particularly from assessment activities. PMID:26412911

  7. Mycobacterium biofilms: factors involved in development, dispersal, and therapeutic strategies against biofilm-relevant pathogens.

    Science.gov (United States)

    Xiang, Xiaohong; Deng, Wanyan; Liu, Minqiang; Xie, Jianping

    2014-01-01

    Many bacteria can develop biofilm (BF), a multicellular structure largely combining bacteria and their extracellular polymeric substances (EPS). The formation of biofilm results in an alternative existence in which microbes ensure their survival in adverse environments. Biofilm-relevant infections are more persistent, resistant to most antibiotics, and more recalcitrant to host immunity. Mycobacterium tuberculosis, the causative agent of tuberculosis, can develop biofilm, though whether M. tuberculosis can form biofilm within tuberculosis patients has yet to be determined. Here, we summarize the factors involved in the development and dispersal of mycobacterial biofilms, as well as underlying regulatory factors and inhibitors against biofilm to deepen our understanding of their development and to elucidate potential novel modes of action for future antibiotics. Key factors in biofilm formation identified as drug targets represent a novel and promising avenue for developing better antibiotics.

  8. Podoplanin emerges as a functionally relevant oral cancer biomarker and therapeutic target.

    Science.gov (United States)

    Retzbach, Edward P; Sheehan, Stephanie A; Nevel, Evan M; Batra, Amber; Phi, Tran; Nguyen, Angels T P; Kato, Yukinari; Baredes, Soly; Fatahzadeh, Mahnaz; Shienbaum, Alan J; Goldberg, Gary S

    2018-03-01

    Oral cancer has become one of the most aggressive types of cancer, killing 140,000 people worldwide every year. Current treatments for oral cancer include surgery and radiation therapies. These procedures can be very effective; however, they can also drastically decrease the quality of life for survivors. New chemotherapeutic treatments are needed to more effectively combat oral cancer. The transmembrane receptor podoplanin (PDPN) has emerged as a functionally relevant oral cancer biomarker and chemotherapeutic target. PDPN expression promotes tumor cell migration leading to oral cancer invasion and metastasis. Here, we describe the role of PDPN in oral squamous cell carcinoma progression, and how it may be exploited to prevent and treat oral cancer. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Stunning in radioiodine therapy of benign thyroid disease. Quantification and therapeutic relevance

    International Nuclear Information System (INIS)

    Krohn, T.; Meyer, P.T.; Knollmann, D.; Nowak, B.; Schaefer, W.M.; Ocklenburg, C.

    2008-01-01

    In radioiodine therapy of benign thyroid disease, a reduction of radioiodine uptake is known for consecutive administrations of 131I, which needs to be considered in therapy planning. Aim: Analysis of uptake reduction with regard on the time interval between radioiodine administration and the delivered dose to the thyroid tissue. Patients, methods: 200 patients were enrolled in the study and distributed into two groups (matched for diagnoses), each containing 32 patients with Graves' disease (target dose 250 Gy), 24 with focal (400 Gy), 44 with disseminated thyroid autonomy (150 Gy). In one group, a second fraction of radioiodine was given after 48 h (2d) due to an unexpected low radioiodine uptake or effective half-life, whereas in the other group the second fraction was given after 96 h (4d). Results: There was no significant difference between delivered doses due to the first fraction after four days: 2d: 86 ± 48 Gy (extrapolated) vs. 4d: 87 ± 41 Gy, p > 0.05. In 2d, delivered dose at time of second administration was significantly lower (51 μ 29 Gy) than in 4d (p < 0.01). The radioiodine uptake of the second fraction relative to the initial uptake was significantly lower in the 4d (4d: 63 ± 25% vs. 2d: 82 ± 24%, p < 0.01). In addition, a correlation between uptake reduction and delivered dose and an influence of the time interval between radioiodine administrations could be shown. Conclusions: Relative uptake of subsequent radioiodine fractions decreases with time after first administration and with increasing delivered dose to the thyroid. If a second fraction of 131I is given at an earlier time, the same therapeutic effect can be reached using lower amounts of activity, minimising radiation exposure and increasing efficiency of radioiodine therapy. (orig.)

  10. Therapeutic relevance of the PP2A-B55 inhibitory kinase MASTL/Greatwall in breast cancer.

    Science.gov (United States)

    Álvarez-Fernández, Mónica; Sanz-Flores, María; Sanz-Castillo, Belén; Salazar-Roa, María; Partida, David; Zapatero-Solana, Elisabet; Ali, H Raza; Manchado, Eusebio; Lowe, Scott; VanArsdale, Todd; Shields, David; Caldas, Carlos; Quintela-Fandino, Miguel; Malumbres, Marcos

    2017-12-11

    PP2A is a major tumor suppressor whose inactivation is frequently found in a wide spectrum of human tumors. In particular, deletion or epigenetic silencing of genes encoding the B55 family of PP2A regulatory subunits is a common feature of breast cancer cells. A key player in the regulation of PP2A/B55 phosphatase complexes is the cell cycle kinase MASTL (also known as Greatwall). During cell division, inhibition of PP2A-B55 by MASTL is required to maintain the mitotic state, whereas inactivation of MASTL and PP2A reactivation is required for mitotic exit. Despite its critical role in cell cycle progression in multiple organisms, its relevance as a therapeutic target in human cancer and its dependence of PP2A activity is mostly unknown. Here we show that MASTL overexpression predicts poor survival and shows prognostic value in breast cancer patients. MASTL knockdown or knockout using RNA interference or CRISPR/Cas9 systems impairs proliferation of a subset of breast cancer cells. The proliferative function of MASTL in these tumor cells requires its kinase activity and the presence of PP2A-B55 complexes. By using a new inducible CRISPR/Cas9 system in breast cancer cells, we show that genetic ablation of MASTL displays a significant therapeutic effect in vivo. All together, these data suggest that the PP2A inhibitory kinase MASTL may have both prognostic and therapeutic value in human breast cancer.

  11. 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.

  12. 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.

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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

  16. Social marketing: approach to cultural and contextual relevance in a community-based physical activity intervention

    Science.gov (United States)

    Keller, Colleen; Vega-López, Sonia; Ainsworth, Barbara; Nagle-Williams, Allison; Records, Kathie; Permana, Paska; Coonrod, Dean

    2014-01-01

    We report the social marketing strategies used for the design, recruitment and retention of participants in a community-based physical activity (PA) intervention, Madres para la Salud (Mothers for Health). The study example used to illustrate the use of social marketing is a 48-week prescribed walking program, Madres para la Salud (Mothers for Health), which tests a social support intervention to explore the effectiveness of a culturally specific program using ‘bouts’ of PA to effect the changes in body fat, fat tissue inflammation and postpartum depression symptoms in sedentary Hispanic women. Using the guidelines from the National Benchmark Criteria, we developed intervention, recruitment and retention strategies that reflect efforts to draw on community values, traditions and customs in intervention design, through partnership with community members. Most of the women enrolled in Madres para la Salud were born in Mexico, largely never or unemployed and resided among the highest crime neighborhoods with poor access to resources. We developed recruitment and retention strategies that characterized social marketing strategies that employed a culturally relevant, consumer driven and problem-specific design. Cost and benefit of program participation, consumer-derived motivation and segmentation strategies considered the development transition of the young Latinas as well as cultural and neighborhood barriers that impacted retention are described. PMID:23002252

  17. Social marketing: approach to cultural and contextual relevance in a community-based physical activity intervention.

    Science.gov (United States)

    Keller, Colleen; Vega-López, Sonia; Ainsworth, Barbara; Nagle-Williams, Allison; Records, Kathie; Permana, Paska; Coonrod, Dean

    2014-03-01

    We report the social marketing strategies used for the design, recruitment and retention of participants in a community-based physical activity (PA) intervention, Madres para la Salud (Mothers for Health). The study example used to illustrate the use of social marketing is a 48-week prescribed walking program, Madres para la Salud (Mothers for Health), which tests a social support intervention to explore the effectiveness of a culturally specific program using 'bouts' of PA to effect the changes in body fat, fat tissue inflammation and postpartum depression symptoms in sedentary Hispanic women. Using the guidelines from the National Benchmark Criteria, we developed intervention, recruitment and retention strategies that reflect efforts to draw on community values, traditions and customs in intervention design, through partnership with community members. Most of the women enrolled in Madres para la Salud were born in Mexico, largely never or unemployed and resided among the highest crime neighborhoods with poor access to resources. We developed recruitment and retention strategies that characterized social marketing strategies that employed a culturally relevant, consumer driven and problem-specific design. Cost and benefit of program participation, consumer-derived motivation and segmentation strategies considered the development transition of the young Latinas as well as cultural and neighborhood barriers that impacted retention are described.

  18. Theories, models and frameworks used in capacity building interventions relevant to public health: a systematic review.

    Science.gov (United States)

    Bergeron, Kim; Abdi, Samiya; DeCorby, Kara; Mensah, Gloria; Rempel, Benjamin; Manson, Heather

    2017-11-28

    There is limited research on capacity building interventions that include theoretical foundations. The purpose of this systematic review is to identify underlying theories, models and frameworks used to support capacity building interventions relevant to public health practice. The aim is to inform and improve capacity building practices and services offered by public health organizations. Four search strategies were used: 1) electronic database searching; 2) reference lists of included papers; 3) key informant consultation; and 4) grey literature searching. Inclusion and exclusion criteria are outlined with included papers focusing on capacity building, learning plans, professional development plans in combination with tools, resources, processes, procedures, steps, model, framework, guideline, described in a public health or healthcare setting, or non-government, government, or community organizations as they relate to healthcare, and explicitly or implicitly mention a theory, model and/or framework that grounds the type of capacity building approach developed. Quality assessment were performed on all included articles. Data analysis included a process for synthesizing, analyzing and presenting descriptive summaries, categorizing theoretical foundations according to which theory, model and/or framework was used and whether or not the theory, model or framework was implied or explicitly identified. Nineteen articles were included in this review. A total of 28 theories, models and frameworks were identified. Of this number, two theories (Diffusion of Innovations and Transformational Learning), two models (Ecological and Interactive Systems Framework for Dissemination and Implementation) and one framework (Bloom's Taxonomy of Learning) were identified as the most frequently cited. This review identifies specific theories, models and frameworks to support capacity building interventions relevant to public health organizations. It provides public health practitioners

  19. WINCS Harmoni: Closed-loop dynamic neurochemical control of therapeutic interventions

    Science.gov (United States)

    Lee, Kendall H.; Lujan, J. Luis; Trevathan, James K.; Ross, Erika K.; Bartoletta, John J.; Park, Hyung Ook; Paek, Seungleal Brian; Nicolai, Evan N.; Lee, Jannifer H.; Min, Hoon-Ki; Kimble, Christopher J.; Blaha, Charles D.; Bennet, Kevin E.

    2017-04-01

    There has been significant progress in understanding the role of neurotransmitters in normal and pathologic brain function. However, preclinical trials aimed at improving therapeutic interventions do not take advantage of real-time in vivo neurochemical changes in dynamic brain processes such as disease progression and response to pharmacologic, cognitive, behavioral, and neuromodulation therapies. This is due in part to a lack of flexible research tools that allow in vivo measurement of the dynamic changes in brain chemistry. Here, we present a research platform, WINCS Harmoni, which can measure in vivo neurochemical activity simultaneously across multiple anatomical targets to study normal and pathologic brain function. In addition, WINCS Harmoni can provide real-time neurochemical feedback for closed-loop control of neurochemical levels via its synchronized stimulation and neurochemical sensing capabilities. We demonstrate these and other key features of this platform in non-human primate, swine, and rodent models of deep brain stimulation (DBS). Ultimately, systems like the one described here will improve our understanding of the dynamics of brain physiology in the context of neurologic disease and therapeutic interventions, which may lead to the development of precision medicine and personalized therapies for optimal therapeutic efficacy.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  3. A Review of Cochrane Systematic Reviews of Interventions Relevant to Orthoptic Practice.

    Science.gov (United States)

    Rowe, Fiona J; Elliott, Sue; Gordon, Iris; Shah, Anupa

    2017-09-01

    To present an overview of the range of systematic reviews on intervention trials pertinent to orthoptic practice, produced by the Cochrane Eyes and Vision group (CEV). We searched the 2016 Cochrane Library database (31.03.2016) to identify completed reviews and protocols of direct relevance to orthoptic practice. These reviews are currently completed and published, available on www.thecochranelibrary.com (free to UK health employees) or via the CEV website (http://eyes.cochrane.org/) . We found 27 completed CEV reviews across the topics of strabismus, amblyopia, refractive errors, and low vision. Seven completed CEV protocols addressed topics of strabismus, amblyopia, refractive errors, low vision, and screening. We found 3 completed Cochrane Stroke reviews addressing visual field loss, eye movement impairment, and age-related vision loss. The systematic review process presents an important opportunity for any clinician to contribute to the establishment of reliable, evidence-based orthoptic practice. Each review has an abstract and plain language summary that many non-clinicians find useful, followed by a full copy of the review (background, objectives, methods, results, discussion) with a conclusion section that is divided into implications for practice and implications for research. The current reviews provide patients/parents/carers with information about various different conditions and treatment options, but also provide clinicians with a summary of the available evidence on interventions, to use as a guide for both clinical practice and future research planning. The reviews identified in this overview highlight the evidence available for effective interventions for strabismus, amblyopia, refractive errors, and low vision or stroke rehabilitation as well as the gaps in the evidence base. Thus, a demand exists for future robust, randomized, controlled trials of such interventions of importance in orthoptic practice.

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

    Science.gov (United States)

    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.

  5. Meta-analysis of the Effectiveness of Educational and Therapeutic Interventions on the Four Classes of Learning Disorders

    Directory of Open Access Journals (Sweden)

    Javad Mesrabadi

    2018-04-01

    Full Text Available Abstract Background: Learning disorders is one of the most common problems of students, which attracted the attention of many psychologists and many studies have been conducted on the effectiveness of various interventions on different classes of learning disorder. The present study aimed to conclude general conclusions about the effectiveness of various educational and therapeutic interventions and the discovery of possible moderating variables. Materials and Methods: In order to achieve the research purpose by using meta-analysis method, quantitative results of 128 selected researches which were obtained according to the criteria for entering and leaving and using keywords were used. In total, 623 primary effect sizes were obtained and analyzed by using CMA2 software. Results: The results of the analysis showed that amount of combined effect size of the educational and therapeutic interventions on learning disorders was 1.13, and after dividing into multiple predecessor and consequence variables, the amounts of the combined effect size for educational interventions and therapeutic interventions for overall class of learning disabilities were respectively 0.74 and 1.26, for reading disorder 0.87 and 1.01, for writing disorder 1.20 and 1.22, and for mathematical disorder 1.29 and 1.26 that all of these effects size were significant (p≤0.001. Also, the results of independent t-test showed that the difference in the effectiveness of therapeutic interventions on reading disorder and educational interventions on mathematical disorder is significant (p≤0.001. Conclusion: Based on the size of the effects obtained, it can be said that educational and therapeutic interventions have a very high effect on learning disabilities, and the use of therapeutic interventions for reading disorder and educational interventions for mathematical disorder is more effective.

  6. Second-Grade Urban Learners: Preliminary Findings for a Computer-Assisted, Culturally Relevant, Repeated Reading Intervention

    Science.gov (United States)

    Bennett, Jessica G.; Gardner, Ralph, III; Cartledge, Gwendolyn; Ramnath, Rajiv; Council, Morris R., III

    2017-01-01

    This study investigated the effects of a multicomponent, supplemental intervention on the reading fluency of second-grade African-American urban students who showed reading and special education risk. The packaged intervention combined repeated readings and culturally relevant stories, delivered through a novel computer software program to enhance…

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. Relevance of various animal models of human infections to establish therapeutic equivalence of a generic product of piperacillin/tazobactam.

    Science.gov (United States)

    Agudelo, Maria; Rodriguez, Carlos A; Zuluaga, Andres F; Vesga, Omar

    2015-02-01

    After demonstrating with diverse intravenous antibacterials that pharmaceutical equivalence (PE) does not predict therapeutic equivalence, we tested a single generic product of piperacillin/tazobactam (TZP) in terms of PE, pharmacokinetics and in vitro/vivo pharmacodynamics against several pathogens in neutropenic mouse thigh, lung and brain infection models. A generic product was compared head-to-head against the innovator. PE was evaluated by microbiological assay. Single-dose serum pharmacokinetics were determined in infected mice, and the MIC/MBC were determined by broth microdilution. In vivo experiments were done in a blind fashion. Reproducibility was tested on different days using different infecting organisms and animal models. Neutropenic MPF mice were infected in the thighs with Staphylococcus aureus GRP-0057 or Pseudomonas aeruginosa PA01 and in the lungs or brain with Klebsiella pneumoniae ATCC 10031. Treatment started 2h (thigh and brain) or 14 h (lung) after infection and was administered every 3h over 24h (thigh and lung) or 48 h (brain). Both products exhibited the same MIC/MBC against each strain, yielded overlaid curves in the microbiological assay (P>0.21) and were bioequivalent (IC90 83-117% for AUC test/reference ratio). In vivo, the generic product and innovator were again undistinguishable in all models and against the different bacterial pathogens involved. The relevance of these neutropenic murine models of infection was established by demonstrating their accuracy to predict the biological response following simultaneous treatment with a generic product or the innovator of TZP. Therapeutic equivalence of the generic product was proved in every model and against different pathogens. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  10. 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?

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

    Science.gov (United States)

    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.

  12. Initial diagnosis of therapeutically relevant thoracic lesions in polytraumatised patients; Zur Akutdiagnostik therapierelevanter Thoraxverletzungen bei schwer- und polytraumatisierten Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Danz, B. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Biehl, C. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany); Baehren, W. [Radiologische Abt., Bundeswehrkrankenhaus Ulm (Germany)

    1996-04-01

    To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients. 303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes. The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%). Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time. (orig.) [Deutsch] Das Ziel dieser retrospektiven Untersuchung bestand darin, die Wertigkeit der a.p. Thoraxaufnahme im Liegen im Vergleich zur orientierenden Computertomographie der Thoraxorgane im Rahmen der Akutdiagnostik bei schwer- und polytraumatisierten Patienten zu analysieren. Im Zeitraum von 1988 bis 1993 bestand bei 303 Patienten wegen eines Schaedel-Hirn-Traumas die primaere Indikation zu einem CCT. Im Anschluss an das CCT wurde routinemaessig ein orientierendes CT der Thoraxorgane mit im Durchschnitt 6 Schichten ohne Umlagerung und einem medianen Zeitaufwand von 4 Minuten durchgefuehrt. Die Befunde des CT des Thorax wurden mit den Ergebnissen der durchgefuehrten a.p. Thoraxliegendaufnahmen im Hinblick auf die Erfassung therapierelevanter pathologischer Veraenderungen verglichen. Die Sensitivitaet fuer die Erkennung eines Pneumothorax in

  13. Development of a theory-based (PEN-3 and Health Belief Model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping.

    Science.gov (United States)

    Scarinci, Isabel C; Bandura, Lisa; Hidalgo, Bertha; Cherrington, Andrea

    2012-01-01

    The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the sociocultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants.

  14. Api m 10, a genuine A. mellifera venom allergen, is clinically relevant but underrepresented in therapeutic extracts.

    Science.gov (United States)

    Blank, S; Seismann, H; Michel, Y; McIntyre, M; Cifuentes, L; Braren, I; Grunwald, T; Darsow, U; Ring, J; Bredehorst, R; Ollert, M; Spillner, E

    2011-10-01

    Generalized systemic reactions to stinging hymenoptera venom constitute a potentially fatal condition in venom-allergic individuals. Hence, the identification and characterization of all allergens is imperative for improvement of diagnosis and design of effective immunotherapeutic approaches. Our aim was the immunochemical characterization of the carbohydrate-rich protein Api m 10, an Apis mellifera venom component and putative allergen, with focus on the relevance of glycosylation. Furthermore, the presence of Api m 10 in honeybee venom (HBV) and licensed venom immunotherapy preparations was addressed. Api m 10 was produced as soluble, aglycosylated protein in Escherichia coli and as differentially glycosylated protein providing a varying degree of fucosylation in insect cells. IgE reactivity and basophil activation of allergic patients were analyzed. For detection of Api m 10 in different venom preparations, a monoclonal human IgE antibody was generated. Both, the aglycosylated and the glycosylated variant of Api m 10 devoid of cross-reactive carbohydrate determinants (CCD), exhibited IgE reactivity with approximately 50% of HBV-sensitized patients. A corresponding reactivity could be documented for the activation of basophils. Although the detection of the native protein in crude HBV suggested content comparable to other relevant allergens, three therapeutical HBV extracts lacked detectable amounts of this component. Api m 10 is a genuine allergen of A. mellifera venom with IgE sensitizing potential in a significant fraction of allergic patients independent of CCD reactivity. Thus, Api m 10 could become a key element for component-resolved diagnostic tests and improved immunotherapeutic approaches in hymenoptera venom allergy. © 2011 John Wiley & Sons A/S.

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

    Science.gov (United States)

    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.

  16. 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

  17. Using Confidence Interval-Based Estimation of Relevance to Select Social-Cognitive Determinants for Behavior Change Interventions

    Directory of Open Access Journals (Sweden)

    Rik Crutzen

    2017-07-01

    Full Text Available When developing an intervention aimed at behavior change, one of the crucial steps in the development process is to select the most relevant social-cognitive determinants. These determinants can be seen as the buttons one needs to push to establish behavior change. Insight into these determinants is needed to select behavior change methods (i.e., general behavior change techniques that are applied in an intervention in the development process. Therefore, a study on determinants is often conducted as formative research in the intervention development process. Ideally, all relevant determinants identified in such a study are addressed by an intervention. However, when developing a behavior change intervention, there are limits in terms of, for example, resources available for intervention development and the amount of content that participants of an intervention can be exposed to. Hence, it is important to select those determinants that are most relevant to the target behavior as these determinants should be addressed in an intervention. The aim of the current paper is to introduce a novel approach to select the most relevant social-cognitive determinants and use them in intervention development. This approach is based on visualization of confidence intervals for the means and correlation coefficients for all determinants simultaneously. This visualization facilitates comparison, which is necessary when making selections. By means of a case study on the determinants of using a high dose of 3,4-methylenedioxymethamphetamine (commonly known as ecstasy, we illustrate this approach. We provide a freely available tool to facilitate the analyses needed in this approach.

  18. Using Confidence Interval-Based Estimation of Relevance to Select Social-Cognitive Determinants for Behavior Change Interventions.

    Science.gov (United States)

    Crutzen, Rik; Peters, Gjalt-Jorn Ygram; Noijen, Judith

    2017-01-01

    When developing an intervention aimed at behavior change, one of the crucial steps in the development process is to select the most relevant social-cognitive determinants. These determinants can be seen as the buttons one needs to push to establish behavior change. Insight into these determinants is needed to select behavior change methods (i.e., general behavior change techniques that are applied in an intervention) in the development process. Therefore, a study on determinants is often conducted as formative research in the intervention development process. Ideally, all relevant determinants identified in such a study are addressed by an intervention. However, when developing a behavior change intervention, there are limits in terms of, for example, resources available for intervention development and the amount of content that participants of an intervention can be exposed to. Hence, it is important to select those determinants that are most relevant to the target behavior as these determinants should be addressed in an intervention. The aim of the current paper is to introduce a novel approach to select the most relevant social-cognitive determinants and use them in intervention development. This approach is based on visualization of confidence intervals for the means and correlation coefficients for all determinants simultaneously. This visualization facilitates comparison, which is necessary when making selections. By means of a case study on the determinants of using a high dose of 3,4-methylenedioxymethamphetamine (commonly known as ecstasy), we illustrate this approach. We provide a freely available tool to facilitate the analyses needed in this approach.

  19. 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.

  20. The desmoid tumour: Therapeutic results of surgical intervention as compared to those achieved with radiotherapy

    International Nuclear Information System (INIS)

    Weindler, J.

    1983-01-01

    Discussion of the case reports of nine patients treated for desmoid tumours in the light of 62 such cases described in the relevant literature between 1975 and 1979. Among the patients analysed for the purposes of this study 9 had desmoid tumours treated at our clinic, while the other 60 cases were described in the relevant literature of the past 5 years. The methods used in this cohort were surgery for 37 patients, radiation for 20 patients, excision and post-surgical radiation for 5 patients and various other treatments for the remaining cases. Careful analysis and assessment of the results led to the conclusion that the vast majority of desmoids can be expected to show a satisfactory response to radiation, even though no clear therapeutic superiority could be established for either radical excision or radiation. If surgery is chosen, this should be carried out with the aim of removing all of the tumour. In circumstances precluding radical excision it appears wise to use post-surgical radiation. Follow-up examinations should be carried out in all patients so as to permit immediate diagnosis and treatment of any recurrent tumours. Each desmoid tumour is to be treated on an individual basis. In small tumours it is safer to remove not only the lesion itself but also some of the surrounding intact tissue, tumours at a more advanced stage should be subjected to radiation or both surgery and subsequent radiotherapy. (orig./MG) [de

  1. 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

  2. A review of Grey and academic literature of evaluation guidance relevant to public health interventions.

    Science.gov (United States)

    Denford, Sarah; Abraham, Charles; Callaghan, Margaret; Aighton, Peter; De Vocht, Frank; Arris, Steven

    2017-09-12

    Public Health evaluation is essential to understanding what does and does not work, and robust demonstration of effectiveness may be crucial to securing future funding. Despite this, programs are often implemented with poor, incomplete or no evaluation. Public health practitioners are frequently required to provide evidence for the effectiveness of their services; thus, there is a growing need for evaluation guidance on how to evaluate public health programs. The aim of this study is to identify accessible high-quality, evaluation guidance, available to researchers and practitioners and to catalogue, summarise and categorise the content of a subset of accessible, quality guides to evaluation. We systematically reviewed grey and academic literature for documents providing support for evaluation of complex health interventions. Searches were conducted January to March 2015, and included academic databases, internet search engines, and consultations with academic and practicing public health experts. Data were extracted by two authors and sent to the authors of the guidance documents for comments. Our initial search identified 402 unique documents that were screened to identify those that were (1) developed by or for a national or international organization (2) freely available to all (3) published during or after 2000 (4) specific to public health. This yielded 98 documents from 43 organisations. Of these, 48 were reviewed in detail. This generated a detailed catalogue of quality evaluation guidance. The content included in documents covers 37 facets of evaluation. A wide range of guidance on evaluation of public health initiatives is available. Time and knowledge constraints may mean that busy practitioners find it challenging to access the most, up-to-date, relevant and useful guidance. This review presents links to and reviews of 48 quality guides to evaluation as well as categorising their content. This facilitates quick and each access to multiple selected

  3. 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.

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

    Science.gov (United States)

    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…

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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)

  10. Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance.

    LENUS (Irish Health Repository)

    Wallace, John

    2014-01-01

    Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.

  11. 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

  12. 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.

  13. The role of cholesterol metabolism and cholesterol transport in carcinogenesis; A review of scientific findings, relevant to future cancer therapeutics.

    Directory of Open Access Journals (Sweden)

    Pedro Miguel Cruz

    2013-09-01

    Full Text Available While the unique metabolic activities of malignant tissues as potential targets for cancer therapeutics has been the subject of several recent reviews, the role of cholesterol metabolism in this context is yet to be fully explored. Cholesterol is an essential component of mammalian cell membranes as well as a precursor of bile acids and steroid hormones. The hypothesis that cancer cells need excess cholesterol and intermediates of the cholesterol biosynthesis pathway to maintain a high level of proliferation is well accepted, however the mechanisms by which malignant cells and tissues reprogram cholesterol synthesis, uptake and efflux are yet to be fully elucidated as potential therapeutic targets. High and low density plasma lipoproteins, area the likely major suppliers of cholesterol to cancer cells and tumors, potentially via receptor mediated mechanisms. This review is primarily focused on the role(s of lipoproteins in carcinogenesis, and their future roles as drug delivery vehicles for targeted cancer chemotherapy.

  14. Behavior Bingo: The Effects of a Culturally Relevant Group Contingency Intervention for Students with EBD

    Science.gov (United States)

    Collins, Tai A.; Hawkins, Renee O.; Flowers, Emily M.; Kalra, Hilary D.; Richard, Jessie; Haas, Lauren E.

    2018-01-01

    Students with emotional and behavioral disorders (EBD) have difficulty with academic engagement during independent seatwork tasks. The goal of the current study was to evaluate the effectiveness of Behavior Bingo, a novel interdependent group contingency intervention, on the academic engagement, off-task, and disruptive behavior of students with…

  15. [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.

  16. 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

  17. 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.

  18. 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.

  19. Liver fat: a relevant target for dietary intervention? Summary of a Unilever workshop.

    Science.gov (United States)

    Peters, Harry P F; Schrauwen, Patrick; Verhoef, Petra; Byrne, Christopher D; Mela, David J; Pfeiffer, Andreas F H; Risérus, Ulf; Rosendaal, Frits R; Schrauwen-Hinderling, Vera

    2017-01-01

    Currently it is estimated that about 1 billion people globally have non-alcoholic fatty liver disease (NAFLD), a condition in which liver fat exceeds 5 % of liver weight in the absence of significant alcohol intake. Due to the central role of the liver in metabolism, the prevalence of NAFLD is increasing in parallel with the prevalence of obesity, insulin resistance and other risk factors of metabolic diseases. However, the contribution of liver fat to the risk of type 2 diabetes mellitus and CVD, relative to other ectopic fat depots and to other risk markers, is unclear. Various studies have suggested that the accumulation of liver fat can be reduced or prevented via dietary changes. However, the amount of liver fat reduction that would be physiologically relevant, and the timeframes and dose-effect relationships for achieving this through different diet-based approaches, are unclear. Also, it is still uncertain whether the changes in liver fat per se or the associated metabolic changes are relevant. Furthermore, the methods available to measure liver fat, or even individual fatty acids, differ in sensitivity and reliability. The present report summarises key messages of presentations from different experts and related discussions from a workshop intended to capture current views and research gaps relating to the points above.

  20. Relevant radiological anatomy of the pig as a training model in interventional radiology

    International Nuclear Information System (INIS)

    Dondelinger, R.F.; Ghysels, M.P.; Brisbois, D.; Donkers, E.; Snaps, F.R.; Saunders, J.; Deviere, J.

    1998-01-01

    The use of swine for teaching purposes in medicine and surgery has largely increased in recent years. Detailed knowledge of the porcine anatomy and physiology is a prerequisite for proper use of pigs as a teaching or an experimental model in interventional radiology. A systematic study of the radiological anatomy was undertaken in more than 100 female pigs aged 6-8 weeks. All studies were performed under general anesthesia in a single session. Animals were sacrificed at the end of the study. Selective angiographies were systematically obtained in all anatomical territories. In other animals CT and MRI examinations were performed and were correlated to anatomical sections and acrylic casts of the vascular structures. Endoscopical examinations of the upper gastrointestinal tract, including retrograde opacification of the biliary and pancreatic ducts, were added in selected animals. The main angiographic aspects of the brain, head and neck, thorax, abdomen, and pelvis were recorded. Similarities and differences in comparison with human anatomy are stressed. Potential applications in interventional radiology are indicated. (orig.)

  1. Motor Development and Motor Resonance Difficulties in Autism: Relevance to Early Intervention for Language and Communication Skills

    Directory of Open Access Journals (Sweden)

    Joseph P. Mccleery

    2013-04-01

    Full Text Available Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural mirroring mechanisms activated when we observe the actions of others deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective.

  2. Motor development and motor resonance difficulties in autism: relevance to early intervention for language and communication skills

    Science.gov (United States)

    McCleery, Joseph P.; Elliott, Natasha A.; Sampanis, Dimitrios S.; Stefanidou, Chrysi A.

    2013-01-01

    Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural “mirroring” mechanisms activated when we observe the actions of others) deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective. PMID:23630476

  3. 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)

  4. 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.

  5. Interactions of AChE with Aβ Aggregates in Alzheimer’s Brain: Therapeutic Relevance of IDN 5706

    Directory of Open Access Journals (Sweden)

    Francisco Javier Carvajal

    2011-09-01

    Full Text Available Acetylcholinesterase (AChE; EC 3.1.1.7 plays a crucial role in the rapid hydrolysis of the neurotransmitter acetylcholine, in the central and peripheral nervous system and might also participate in non-cholinergic mechanism related to neurodegenerative diseases. Alzheimer’s disease (AD is a neurodegenerative disorder characterized by a progressive deterioration of cognitive abilities, amyloid-β peptide (Aβ accumulation and synaptic alterations. We have previously shown that AChE is able to accelerate the Aβ peptide assembly into Alzheimer-type aggregates increasing its neurotoxicity. Furthermore, AChE activity is altered in brain and blood of Alzheimer’s patients. The enzyme associated to amyloid plaques changes its enzymatic and pharmacological properties, as well as, increases its resistant to low pH, inhibitors and excess of substrate. Here, we reviewed the effects of IDN 5706, a hyperforin derivative that has potential preventive effects on the development of AD. Our results show that treatment with IDN5706 for 10 weeks increases brain AChE activity in seven month-old double transgenic mice (APPswe - PS1 and decreases the content of AChE associated with different types of amyloid plaques in this Alzheimer’s model. We concluded that early treatment with IDN 5706 decreases AChE-Aβ interaction and this effect might be of therapeutic interest in the treatment of AD.

  6. Out-of-Field Dose Equivalents Delivered by Passively Scattered Therapeutic Proton Beams for Clinically Relevant Field Configurations

    International Nuclear Information System (INIS)

    Wroe, Andrew; Clasie, Ben; Kooy, Hanne; Flanz, Jay; Schulte, Reinhard; Rosenfeld, Anatoly

    2009-01-01

    Purpose: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Methods and Materials: Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement from the treatment field edge and distance downstream of the beam's distal edge. Results: Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. Conclusions: This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

  9. Porcine Tricuspid Valve Anatomy and Human Compatibility: Relevance for Preclinical Validation of Novel Valve Interventions.

    Science.gov (United States)

    Waziri, Farhad; Lyager Nielsen, Sten; Michael Hasenkam, John

    2016-09-01

    Tricuspid regurgitation may be a precursor for heart failure, reduced functional capacity, and poor survival. A human compatible experimental model is required to understand the pathophysiology of the tricuspid valve disease as a basis for validating novel tricuspid valve interventions before clinical use. The study aim was to evaluate and compare the tricuspid valve anatomy of porcine and human hearts. The anatomy of the tricuspid valve and the surrounding structures that affect the valve during a cardiac cycle were examined in detail in 100 fresh and 19 formalin-fixed porcine hearts obtained from Danish Landrace pigs (body weight 80 kg). All valvular dimensions were compared with human data acquired from literature sources. No difference was seen in the tricuspid annulus circumference between porcine and human hearts (13.0 ± 1.2 cm versus 13.5 ± 1.5 cm; p = NS), or in valve area (5.7 ± 1.6 cm2 versus 5.6 ± 1.0 cm2; p = NS). The majority of chordae types exhibited a larger chordal length and thickness in human hearts compared to porcine hearts. In both species, the anterior papillary muscle (PM) was larger than other PMs in the right ventricle, but muscle length varied greatly (range: 5.2-40.3 mm) and was significantly different in pigs and in humans (12.2 ± 3.2 mm versus 19.2 mm; p human hearts.

  10. 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.

  11. A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD: Part 4 – Noninvasive Interventions for Chronic 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 for 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 fourth in a five-part series, evaluates the evidence for noninvasive interventions initiated during the chronic phase of WAD. Twenty-two studies that met the inclusion criteria were identified, 12 of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 6. For the treatment of chronic WAD, there is evidence to suggest that exercise programs are effective in relieving whiplash-related pain, at least over the short term. While the majority of a subset of nine studies supported the effectiveness of interdisciplinary interventions, the two randomized controlled trials provided conflicting results. Finally, there was limited evidence, consisting of one supportive case series each, that both manual joint manipulation and myofeedback training may provide some benefit. Based on the available research, exercise programs were the most effective noninvasive treatment for patients with chronic WAD, although many questions remain regarding the relative effectiveness of various exercise regimens.

  12. Sourcing of an alternative pericyte-like cell type from peripheral blood in clinically relevant numbers for therapeutic angiogenic applications.

    Science.gov (United States)

    Blocki, Anna; Wang, Yingting; Koch, Maria; Goralczyk, Anna; Beyer, Sebastian; Agarwal, Nikita; Lee, Michelle; Moonshi, Shehzahdi; Dewavrin, Jean-Yves; Peh, Priscilla; Schwarz, Herbert; Bhakoo, Kishore; Raghunath, Michael

    2015-03-01

    Autologous cells hold great potential for personalized cell therapy, reducing immunological and risk of infections. However, low cell counts at harvest with subsequently long expansion times with associated cell function loss currently impede the advancement of autologous cell therapy approaches. Here, we aimed to source clinically relevant numbers of proangiogenic cells from an easy accessible cell source, namely peripheral blood. Using macromolecular crowding (MMC) as a biotechnological platform, we derived a novel cell type from peripheral blood that is generated within 5 days in large numbers (10-40 million cells per 100 ml of blood). This blood-derived angiogenic cell (BDAC) type is of monocytic origin, but exhibits pericyte markers PDGFR-β and NG2 and demonstrates strong angiogenic activity, hitherto ascribed only to MSC-like pericytes. Our findings suggest that BDACs represent an alternative pericyte-like cell population of hematopoietic origin that is involved in promoting early stages of microvasculature formation. As a proof of principle of BDAC efficacy in an ischemic disease model, BDAC injection rescued affected tissues in a murine hind limb ischemia model by accelerating and enhancing revascularization. Derived from a renewable tissue that is easy to collect, BDACs overcome current short-comings of autologous cell therapy, in particular for tissue repair strategies.

  13. Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

    Science.gov (United States)

    Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

    2006-01-01

    Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

  14. 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.

  15. 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.

  16. 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

  17. Precision Medicine for Hypertension Management in Chronic Kidney Disease: Relevance of SPRINT for Therapeutic Targets in Nondiabetic Renal Disease.

    Science.gov (United States)

    Ruzicka, Marcel; Burns, Kevin D; Hiremath, Swapnil

    2017-05-01

    In this review we evaluate the literature to determine if lower blood pressure (BP) targets are beneficial for patients with nondiabetic chronic kidney disease (CKD). Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), and Ramipril Efficacy in Nephropathy-2 (REIN-2), designed to assess the benefit of lower BP on progression of nondiabetic CKD, generally came to the same negative conclusion. They were not designed and powered to assess an effect of lower BP on cardiovascular outcomes. The Systolic Blood Pressure Intervention Trial (SPRINT) was the first trial designed and powered to address this issue, and showed a clear benefit of a lower targeted and achieved BP. SPRINT did not show any renal benefits from lower BP, and it was not designed to assess this outcome, and it enrolled patients with less "renal risk" per se. A distinguishing feature of SPRINT compared with other large trials is that it highlighted the importance of precise BP measurement methods in defining targets in hypertension treatment. Accordingly, we propose that SPRINT is truly a "game-changing" clinical trial that sets the bar for management of hypertension in select patients with nondiabetic CKD. In these patients, systolic BP target depends critically on the BP measurement method: < 140 mm Hg when derived from 3 readings using a mercury sphygmomanometer after 5 minutes of rest, < 130 mm Hg when calculated from at a minimum of 3 readings using an automated oscillometric device, and < 120 mm Hg when taken using an automated oscillometric device after 5 minutes of unattended rest. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. Sleep-time blood pressure: prognostic value and relevance as a therapeutic target for cardiovascular risk reduction.

    Science.gov (United States)

    Hermida, Ramón C; Ayala, Diana E; Fernández, José R; Mojón, Artemio

    2013-03-01

    showed that the asleep systolic BP mean was the most significant predictor of both total CVD events and major CVD events (a composite of CVD death, myocardial infarction, and stroke). Moreover, when the asleep BP mean was adjusted by the awake mean, only the former was a significant independent predictor of outcome in a Cox proportional-hazard model adjusted for sex, age, diabetes, anemia, and chronic kidney disease. Analyses of changes in ambulatory BP during follow-up revealed 17% reduction in CVD risk for each 5 mm Hg decrease in the asleep systolic BP mean (p < .001), independent of changes in any other clinic or ambulatory BP parameter. The increased event-free survival associated with the progressive reduction in the asleep systolic BP mean during follow-up was significant for subjects with either normal or elevated BP at baseline. The ABPM-derived asleep BP mean was the most significant prognostic marker of CVD morbidity and mortality. Most important, the progressive decrease in asleep BP mean, a novel therapeutic target that requires proper patient evaluation by ABPM and best achieved by ingestion of at least one hypertension medication at bedtime, was the most significant predictor of event-free survival.

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

    Science.gov (United States)

    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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. A systematic review of the literature on self-management interventions and discussion of their potential relevance for people living with HIV in sub-Saharan Africa

    NARCIS (Netherlands)

    Aantjes, C.J.; Rameran, L; Bunders-Aelen, J.G.F.

    2014-01-01

    Objective: This study systematically reviews the literature on self-management interventions provided by health care teams, community partners, patients and families and discusses the potential relevance of these interventions for people living with HIV in sub-Saharan Africa. Methods: We searched

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

    OpenAIRE

    Salca Amalia; Checiches Alexandra; Irsay Laszlo

    2015-01-01

    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...

  8. Incidence of milrinone blood levels outside the therapeutic range and their relevance in children after cardiac surgery for congenital heart disease.

    Science.gov (United States)

    Garcia Guerra, Gonzalo; Joffe, Ari R; Senthilselvan, Ambikaipakan; Kutsogiannis, Demetrios J; Parshuram, Christopher S

    2013-05-01

    To evaluate whether variability in milrinone blood levels (MBL) occurs during administration to critically ill children after surgical repair of congenital heart disease, and the clinical relevance of this variability. Prospective cohort study conducted in the pediatric intensive care unit of a tertiary care teaching and referral hospital. MBL were measured at three time periods after starting milrinone infusion (9-12, 18-24, 40-48 h) and at the end of the infusion. MBL were categorized as within (100-300 ng/ml) or outside the therapeutic range. Low cardiac output syndrome was defined by elevation of either lactate (>2 mmol/l) or arteriovenous oxygen difference (>30%). Five other clinical outcomes were evaluated. Regression analyses evaluated the relationships between MBL and outcomes. Sixty-three patients were included with a total of 220 MBL. Quantification of MBL was by high-performance liquid chromatography. Overall, 114 (52%) MBL were outside the therapeutic range: 78 (36%) subtherapeutic, and 36 (16%) supratherapeutic. Repeated-measures analysis found a significant association between supratherapeutic MBL and low cardiac output syndrome (p = 0.02), and supratherapeutic MBL were associated with arterial-central venous oxygen saturation difference >30% at time 3 (p = 0.007). In this cohort, nontherapeutic MBL were common. Further investigation of milrinone dosing recommendations may improve the postoperative outcomes of children.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Therapeutic landscapes of home: Exploring Indigenous peoples' experiences of a Housing First intervention in Winnipeg.

    Science.gov (United States)

    Alaazi, Dominic A; Masuda, Jeffrey R; Evans, Joshua; Distasio, Jino

    2015-12-01

    In this paper, we explore Indigenous perspectives of culture, place, and health among participants in a landmark Canadian Housing First initiative: At Home/Chez Soi (AHCS) project. Implemented from 2009 to 2013 in Winnipeg and four other Canadian cities, AHCS was a multi-city randomized control trial that sought to test the effectiveness of Housing First as a model for addressing chronic homelessness among people living with mental illnesses. As Winnipeg's homeless population is over 70% Indigenous, significant efforts were made to accommodate the culturally specific health, spiritual, and lifestyle preferences of the project's Indigenous participants. While a daunting challenge from an intervention perspective, Winnipeg's experience also provides a unique opportunity to examine how Indigenous participants' experiences can inform improved housing and mental health policy in Canada. In our study, conducted independently from, but with endorsement of the AHCS project, we utilized a case study approach to explore the experiences of the project's Indigenous participants. Data were collected by means of in-depth qualitative interviews with Indigenous participants (N = 14) and key informant project staff and investigators (N = 6). Our exploratory work demonstrates that despite relative satisfaction with the AHCS intervention, Indigenous peoples' sense of place in the city remains largely disconnected from their housing experiences. We found that structural factors, particularly the shortage of affordable housing and systemic erasure of Indigeneity from the urban sociocultural and political landscape, have adversely impacted Indigenous peoples' sense of place and home. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Course of life satisfaction in patients with depressive and addictive disorders after therapeutic intervention.

    Science.gov (United States)

    Büssing, Arndt; Heusser, Peter; Mundle, Götz

    2012-05-01

    To analyse the course of life satisfaction during the clinic stay of patients with depressive and/or addictive disorders. In a cohort study, 199 patients with depressive and addictive diseases were asked to complete a series of questionnaires at the start and the end of their psychotherapeutic treatment (on average 4.2 ± 2.3 weeks later). The questionnaires were the Brief Multidimensional Life Satisfaction Scale (BMLSS), the Positive Life Construction/Contentedness/Well-Being Scale from the ERDA (Emotional/Rational Disease Acceptance) questionnaire, Beck's Depression Inventory and the revised Symptom Checklist (SCL-90-R). The psychotherapeutic interventions improved the clinical situation of the patients and resulted in strong effects with respect to positive life construction (d = 1.07) and moderate effects on life satisfaction (d = 0.71). Stronger effects were noted in patients with depressive disorders (d = 0.80) than in patients with addictive disorders (d = 0.69). Regression analyses revealed that pre-treatment life satisfaction can be explained negatively by an escape-avoidance strategy (Escape from Illness), and positively by positive life construction. In contrast, post-treatment life satisfaction can be explained negatively by psychological distress and depression, and positively by positive life construction and living with a partner. The hypothesis that life satisfaction changes are associated with the clinical situation of patients was confirmed. In particular, patients with depressive disorders profited from the psychotherapeutic interventions.

  13. Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions.

    Science.gov (United States)

    Evagorou, Olympia; Arvaniti, Aikaterini; Samakouri, Maria

    2016-03-01

    It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.

  14. 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

  15. Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

    Directory of Open Access Journals (Sweden)

    Makaula Peter

    2012-09-01

    Full Text Available Abstract Background Primary Health Care (PHC is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi and community-directed interventions (CDI are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated with PHC. The CDI approach has successfully been used to improve the delivery of interventions in areas that have previously used CDTi. However, little is known about the added value of community participation in areas without prior experience with CDTi. This study aimed at assessing PHC in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. We examined health service providers’ and beneficiaries’ perceptions on existing PHC practices, and their perspectives on official priorities and strategies to strengthen PHC. Methods We conducted 27 key informant interviews with health officials and partners at national, district and health centre levels; 32 focus group discussions with community members and in-depth interviews with 32 community members and 32 community leaders. Additionally, official PHC related documents were reviewed. Results The findings show that there is a functional PHC system in place in the two study districts, though its implementation is faced with various challenges related to accessibility of services and shortage of resources. Health service providers and consumers shared perceptions on the importance of intensifying community participation to strengthen PHC, particularly within the areas of provision of insecticide treated bed nets, home case management for

  16. Reporting of conflicts of interest in guidelines of preventive and therapeutic interventions

    Directory of Open Access Journals (Sweden)

    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.

  17. The analysis of the antibiotic resistome offers new opportunities for therapeutic intervention.

    Science.gov (United States)

    Corona, Fernando; Blanco, Paula; Alcalde-Rico, Manuel; Hernando-Amado, Sara; Lira, Felipe; Bernardini, Alejandra; Sánchez, María B; Martínez, José L

    2016-06-01

    Most efforts in the development of antimicrobials have focused on the screening of lethal targets. Nevertheless, the constant expansion of antimicrobial resistance makes the antibiotic resistance determinants themselves suitable targets for finding inhibitors to be used in combination with antibiotics. Among them, inhibitors of antibiotic inactivating enzymes and of multidrug efflux pumps are suitable candidates for improving the efficacy of antibiotics. In addition, the application of systems biology tools is helping to understand the changes in bacterial physiology associated to the acquisition of resistance, including the increased susceptibility to other antibiotics displayed by some antibiotic-resistant mutants. This information is useful for implementing novel strategies based in metabolic interventions or combination of antibiotics for improving the efficacy of antibacterial therapy.

  18. 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.

  19. 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.

  20. 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.

  1. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

    International Nuclear Information System (INIS)

    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko; Murat, Dogru; Nakamura, Shigeru; Nakashima, Hideo; Shimmura, Shigeto; Shinmura, Ken; Tsubota, Kazuo

    2010-01-01

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.

  2. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats.

    Science.gov (United States)

    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko; Murat, Dogru; Nakamura, Shigeru; Nakashima, Hideo; Shimmura, Shigeto; Shinmura, Ken; Tsubota, Kazuo

    2010-07-09

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome. Copyright 2010 Elsevier Inc. All rights reserved.

  3. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

    Energy Technology Data Exchange (ETDEWEB)

    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Murat, Dogru [Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo (Japan); Nakamura, Shigeru; Nakashima, Hideo [Research Center, Ophtecs Corporation, Hyogo (Japan); Shimmura, Shigeto [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Shinmura, Ken [Division of Geriatric Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo (Japan); Tsubota, Kazuo, E-mail: tsubota@sc.itc.keio.ac.jp [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan)

    2010-07-09

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.

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

    Science.gov (United States)

    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.

  5. 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.

  6. Yoga as a Therapeutic Intervention in the Management of Dysfunctional Uterine Bleeding: A Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Snehal Pankaj Nalgirkar

    2018-01-01

    Full Text Available Background: Dysfunctional uterine bleeding (DUB is one of the most common gynecological disorders encountered in women during the reproductive age. Yoga therapy has shown promising benefits in several gynecological disorders. Methods: Thirty women between the ages of 20 and 40 years with primary DUB were randomly assigned to a yoga (n = 15 and a waitlist control group (n = 15. Participants in the yoga group received a 3-month yoga module and were assessed for hemoglobin values, endometrial thickness (ET, pictorial blood loss assessment chart (PBAC, State-Trait Anxiety Inventory, perceived stress scale, and Pittsburgh Sleep Quality Index (PSQI before and after a 3-month follow-up period. Results: At the end of 3 months of intervention, the yoga group, unlike the control group, reported a significant reduction in the anxiety scores (P < 0.05 and perceived stress (P < 0.05. The PSQI scores indicated a reduction in sleep disturbances (P < 0.001 and the need for sleep medications (P < 0.01 and higher global scores (P < 0.001. However, there were no changes in PBAC and ET in both the groups. Conclusion: The results indicate that yoga therapy positively impacts the outcome of DUB by reducing the perceived stress and state anxiety and improving the quality of sleep. This warrants larger clinical trials to validate the findings of this pilot study.

  7. Role of PPAR-gamma in inflammation. Prospects for therapeutic intervention by food components

    International Nuclear Information System (INIS)

    Martin, Harry

    2009-01-01

    Peroxisome proliferator activated receptor gamma (PPARγ) is a ligand-dependent transcription factor and a member of the nuclear receptor superfamily. Acting as sensors of hormones, vitamins, endogenous metabolites and xenobiotic compounds, the nuclear receptors control the expression of a very large number of genes. PPARγ has been known for some time to regulate adipocyte differentiation, fatty acid storage and glucose metabolism, and is a target of anti-diabetic drugs. More recently, PPARγ has been recognized as playing a fundamentally important role in the immune response through its ability to inhibit the expression of inflammatory cytokines and to direct the differentiation of immune cells towards anti-inflammatory phenotypes. A feature of PPARγ is the structural diversity of its ligands, which encompass endogenous metabolites, dietary compounds and synthetic drugs. The high and increasing incidence of inflammatory and allergic disease, coupled with encouraging results from recent clinical trials, suggest that natural PPARγ agonists found in foods may be beneficial to human health by acting as anti-inflammatory molecules. PPARγ is therefore not only a target of the pharmaceutical industry, but also of great potential interest to the food industry, since it is activated by several natural dietary constituents. The prospects for dietary intervention in inflammatory disease have improved somewhat over the last few years, and are reviewed here.

  8. The Increasing Complexity of the Oncofetal H19 Gene Locus: Functional Dissection and Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    Abraham Hochberg

    2013-02-01

    Full Text Available The field of the long non-coding RNA (lncRNA is advancing rapidly. Currently, it is one of the most popular fields in the biological and medical sciences. It is becoming increasingly obvious that the majority of the human transcriptome has little or no-protein coding capacity. Historically, H19 was the first imprinted non-coding RNA (ncRNA transcript identified, and the H19/IGF2 locus has served as a paradigm for the study of genomic imprinting since its discovery. In recent years, we have extensively investigated the expression of the H19 gene in a number of human cancers and explored the role of H19 RNA in tumor development. Here, we discuss recently published data from our group and others that provide further support for a central role of H19 RNA in the process of tumorigenesis. Furthermore, we focus on major transcriptional modulators of the H19 gene and discuss them in the context of the tumor-promoting activity of the H19 RNA. Based on the pivotal role of the H19 gene in human cancers, we have developed a DNA-based therapeutic approach for the treatment of cancers that have upregulated levels of H19 expression. This approach uses a diphtheria toxin A (DTA protein expressed under the regulation of the H19 promoter to treat tumors with significant expression of H19 RNA. In this review, we discuss the treatment of four cancer indications in human subjects using this approach, which is currently under development. This represents perhaps one of the very few examples of an existing DNA-based therapy centered on an lncRNA system. Apart from cancer, H19 expression has been reported also in other conditions, syndromes and diseases, where deregulated imprinting at the H19 locus was obvious in some cases and will be summarized below. Moreover, the H19 locus proved to be much more complicated than initially thought. It houses a genomic sequence that can transcribe, yielding various transcriptional outputs, both in sense and antisense directions. The

  9. 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)

  10. Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013

    Science.gov (United States)

    Slutsky, Jeremiah; Singh, Nilkamal; Khalsa, Sat Bir S.

    2015-01-01

    Abstract Objective: A comprehensive bibliometric analysis was conducted on publications for yoga therapy research in clinical populations. Methods: Major electronic databases were searched for articles in all languages published between 1967 and 2013. Databases included PubMed, PsychInfo, MEDLINE, IndMed, Indian Citation Index, Index Medicus for South-East Asia Region, Web of Knowledge, Embase, EBSCO, and Google Scholar. Nonindexed journals were searched manually. Key search words included yoga, yoga therapy, pranayama, asana. All studies met the definition of a clinical trial. All styles of yoga were included. The authors extracted the data. Results: A total of 486 articles met the inclusion criteria and were published in 217 different peer-reviewed journals from 29 different countries on 28,080 study participants. The primary result observed is the three-fold increase in number of publications seen in the last 10 years, inclusive of all study designs. Overall, 45% of the studies published were randomized controlled trials, 18% were controlled studies, and 37% were uncontrolled studies. Most publications originated from India (n=258), followed by the United States (n=122) and Canada (n=13). The top three disorders addressed by yoga interventions were mental health, cardiovascular disease, and respiratory disease. Conclusion: A surge in publications on yoga to mitigate disease-related symptoms in clinical populations has occurred despite challenges facing the field of yoga research, which include standardization and limitations in funding, time, and resources. The population at large has observed a parallel surge in the use of yoga outside of clinical practice. The use of yoga as a complementary therapy in clinical practice may lead to health benefits beyond traditional treatment alone; however, to effect changes in health care policy, more high-quality, evidence-based research is needed. PMID:26196166

  11. 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...

  12. Assessment of functioning in the acute hospital: operationalisation and reliability testing of ICF categories relevant for physical therapists interventions.

    Science.gov (United States)

    Grill, Eva; Gloor-Juzi, Thomas; Huber, Erika O; Stucki, Gerold

    2011-01-01

    To operationalize items based on categories of the International Classification of Functioning, Disability and Health (ICF) relevant to patient problems that are addressed by physiotherapeutic interventions in the acute hospital, and to test the reliability of these items when applied by physiotherapists. A selection of 124 ICF categories was operation-alized in a formal decision-making and consensus process. The reliability of the newly operationalized item list was tested with a cross-sectional study with repeated measurements. The item writing process resulted in 94 dichotomous and 30 polytomous items. Data were collected in a convenience sample of 28 patients with neurological, musculoske-letal, cardiopulmonary, or internal organ conditions, requiring physical therapy in an acute hospital. Fifty-six percent of the polytomous and 68% of the dichotomous items had a raw agreement of 0.7 or above, whereas 36% of all polytomous and 34% of all dichotomous items had a kappa coefficient of 0.7 and above. The study supports that the ICF is adaptable to professional and setting-specific needs of physiotherapists. Further research towards the development of reliable instruments for physiotherapists based on the ICF seems justified. :

  13. 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

  14. 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

  15. 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

  16. Vision and Relevant Risk Factor Interventions for Preventing Falls among Older People: A Network Meta-analysis.

    Science.gov (United States)

    Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping

    2015-05-28

    Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis.

  17. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients.

    Science.gov (United States)

    Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

    2014-01-01

    Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer's agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug-drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of FRIDs, pharmacist-conducted clinical medication

  18. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

    Science.gov (United States)

    Chen, Ying; Zhu, Ling-Ling; Zhou, Quan

    2014-01-01

    Background Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results Fall-risk-increasing drugs (FRIDs) include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class) and/or characteristics of medication use (eg, number of medications and drug–drug interactions, dose strength, duration of medication use and time since stopping, medication change, prescribing appropriateness, and medication adherence). Pharmacological interventions, including withdrawal of

  19. A review of the characteristics of dietary fibers relevant to appetite and energy intake outcomes in human intervention trials.

    Science.gov (United States)

    Poutanen, Kaisa S; Dussort, Pierre; Erkner, Alfrun; Fiszman, Susana; Karnik, Kavita; Kristensen, Mette; Marsaux, Cyril Fm; Miquel-Kergoat, Sophie; Pentikäinen, Saara P; Putz, Peter; Slavin, Joanne L; Steinert, Robert E; Mela, David J

    2017-09-01

    Background: Many intervention studies have tested the effect of dietary fibers (DFs) on appetite-related outcomes, with inconsistent results. However, DFs comprise a wide range of compounds with diverse properties, and the specific contribution of these to appetite control is not well characterized. Objective: The influence of specific DF characteristics [i.e., viscosity, gel-forming capacity, fermentability, or molecular weight (MW)] on appetite-related outcomes was assessed in healthy humans. Design: Controlled human intervention trials that tested the effects of well-characterized DFs on appetite ratings or energy intake were identified from a systematic search of literature. Studies were included only if they reported 1 ) DF name and origin and 2 ) data on viscosity, gelling properties, fermentability, or MW of the DF materials or DF-containing matrixes. Results: A high proportion of the potentially relevant literature was excluded because of lack of adequate DF characterization. In total, 49 articles that met these criteria were identified, which reported 90 comparisons of various DFs in foods, beverages, or supplements in acute or sustained-exposure trials. In 51 of the 90 comparisons, the DF-containing material of interest was efficacious for ≥1 appetite-related outcome. Reported differences in material viscosity, MW, or fermentability did not clearly correspond to differences in efficacy, whereas gel-forming DF sources were consistently efficacious (but with very few comparisons). Conclusions: The overall inconsistent relations of DF properties with respect to efficacy may reflect variation in measurement methodology, nature of the DF preparation and matrix, and study designs. Methods of DF characterization, incorporation, and study design are too inconsistent to allow generalized conclusions about the effects of DF properties on appetite and preclude the development of reliable, predictive, structure-function relations. Improved standards for

  20. New frontiers in developmental neuropharmacology: Can long-term therapeutic effects of drugs be optimized through carefully timed early intervention?

    Science.gov (United States)

    Andersen, Susan L.; Navalta, Carryl P.

    2010-01-01

    Our aim is to present a working model that may serve as a valuable heuristic to predict enduring effects of drugs when administered during development. Our primary tenet is that a greater understanding of neurodevelopment can lead to improved treatment that intervenes early in the progression of a given disorder and prevents symptoms from manifesting. The immature brain undergoes significant changes during the transitions between childhood, adolescence, and adulthood. Such changes in innervation, neurotransmitter levels, and their respective signaling mechanisms have profound and observable changes on typical behavior, but also increase vulnerability to psychiatric disorders when the maturational process goes awry. Given the remarkable plasticity of the immature brain to adapt to its external milieu, preventive interventions may be possible. We intend for this review to initiate a discussion of how currently used psychotropic agents can influence brain development. Drug exposure during sensitive periods may have beneficial long-term effects, but harmful delayed consequences may be possible as well. Regardless of the outcome, this information needs to be used to improve or develop alternative approaches for the treatment of childhood disorders. With this framework in mind, we present what is known about the effects of stimulants, antidepressants, and antipsychotics on brain maturation (including animal studies that use more clinically-relevant dosing paradigms or relevant animal models). We endeavor to provocatively set the stage for altering treatment approaches for improving mental health in non-adult populations. PMID:21309771

  1. A Group Therapeutic Songwriting Intervention for Family Caregivers of People Living With Dementia: A Feasibility Study With Thematic Analysis.

    Science.gov (United States)

    Baker, Felicity A; Stretton-Smith, Phoebe; Clark, Imogen N; Tamplin, Jeanette; Lee, Young-Eun C

    2018-01-01

    This study aimed to test the feasibility of implementing a group songwriting program with family caregivers (FCGs) of people living with dementia. Fourteen FCGs consented to participate in either the songwriting group ( n = 8) or control condition ( n = 6). Participants completed baseline and 7-week measures of depression (PHQ-9), perceptions of their caregiving experience (PACQ), and perceptions of their relationship with the care recipient (QCPR). A six-session group songwriting program was implemented across two sites, focusing on participants co-creating a song about their caregiving experiences. Participation and retention rates were high suggesting the intervention was acceptable. An observed pre-post effect size for the PHQ-9 in the experimental group ( d = 0.64) and control group ( d = -0.33) suggests the measure is sensitive to change over a short period of time in this population and has the potential to detect significant change in a larger controlled trial. Qualitative analysis of focus group interviews suggested the songwriting process allowed participants to share their entire caregiver journey with others, differentiating the intervention from standard carer support groups. Participants described group songwriting as enabling them to find connections with other caregivers, create a group identity, and gain insight into their carer journey, subsequently leading to the development of inner strength and personal growth. Qualitative findings suggest coping may be a more relevant construct to measure than caregiver-patient relationship quality or caregivers' perception of caregiving.

  2. 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

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

    Science.gov (United States)

    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.

  4. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors.

    Science.gov (United States)

    Kuijpers, Wilma; Groen, Wim G; Aaronson, Neil K; van Harten, Wim H

    2013-02-20

    Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such interventions are still uncommon for cancer survivors. The objective of this study was to systematically review the literature regarding interactive Web-based interventions. We focused on interventions aimed at increasing patient empowerment and physical activity for various chronic conditions, and explored their possible relevance for cancer survivors. Searches were performed in PubMed, Embase, and Scopus to identify peer-reviewed papers reporting on randomized controlled trials that studied the effects of Web-based interventions. These interventions were developed for adults with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, heart failure, or cancer. Intervention characteristics, effects on patient empowerment and physical activity, information on barriers to and facilitators of intervention use, users' experiences, and methodological quality were assessed. Results were summarized in a qualitative way. We used the recommendations of the Institute of Medicine (IOM) regarding cancer survivorship care to explore the relevance of the interventions for cancer survivors. We included 19 papers reporting on trials with 18 unique studies. Significant, positive effects on patient empowerment were reported by 4 studies and 2 studies reported positive effects on physical activity. The remaining studies yielded mixed results or no significant group differences in these outcomes (ie, no change or improvement for all groups). Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included education, self-monitoring, feedback/tailored information, self-management training, personal exercise program, and

  5. 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.

  6. 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

  7. 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…

  8. "I was in the darkness but the group brought me light": Development, relevance and feasibility of the Sondela HIV adjustment and coping intervention.

    Directory of Open Access Journals (Sweden)

    Nwabisa Shai

    Full Text Available Developing interventions that address psychosocial wellbeing of people living with HIV is critical to ensure strong linkages to and retention in HIV care. This paper describes the development of Sondela, an HIV adjustment and coping intervention for heterosexual men and women living with HIV, and its relevance and feasibility in the South African context. Sondela is a six three-hour, small group-based, participatory workshop series. We followed an iterative, multi-phased process of curriculum development that involved research, theoretical frameworks and piloting. A systematic review highlighted the absence of psychosocial interventions targeting heterosexual HIV positive populations living in high HIV prevalence and resource-poor settings. Formative studies demonstrated risk and social factors associated with adjustment and coping with HIV, emphasising the need for interventions that acknowledge gendered experiences. Our pilot of Sondela demonstrated high levels of relevance and feasibility. Men appreciated the workshop "space" to openly talk about their HIV positive status and what is means for their role as partners and fathers and friends. Women valued the skills and approaches because they were relevant to "real life" situations and not just about HIV. Sondela promises to be valuable in supporting health system initiatives and psychosocial support to strengthen linkages to and retention in HIV care, and this suggests a need for rigorous evaluation of Sondela to establish evidence for its effectiveness in a general population.

  9. Expression of SIRT1 in the ovaries of rats with polycystic ovary syndrome before and after therapeutic intervention with exenatide.

    Science.gov (United States)

    Tao, Xin; Zhang, Xiao; Ge, Shu-Qi; Zhang, Er-Hong; Zhang, Bin

    2015-01-01

    To investigate the expression of silent information regulator 1 (SIRT1) in rats with polycystic ovary syndrome (PCOS) and its alteration after exenatide treatment. PCOS rat model was established by dehydroepiandrosterone induction. The animals were randomly divided into exenatide treatment group (EX group, n = 10), metformin treatment group (MF group, n = 10), PCOS group (PCOS group, n = 9) and normal control group (NC group, n = 10). Histological changes of the ovarian tissues were examined by HE staining. SIRT1 expression in the ovarian tissue was detected by RT-PCR and immunohistochemistry. Rats in the PCOS group lost their estrous cycle. Histological observation of the ovary showed saccular dilatation of the follicle, decreased number of corpora lutea, fewer layers of granulosa cells aligned loosely, and thickened layer of theca cells. The changes in reproductive hormones and the development of insulin resistance suggested the successful establishment of the animal models. Immunohistochemistry and Q-PCR detected the mRNA and protein expressions of SIRT1 in the ovary tissues of rats in the normal control group. The SIRT1 expression was significantly lower in PCOS group than in control group (P < 0.05); after drug intervention, the SIRT1 expression significantly increased in EX and MF groups (compared with the PCOS group), whereas no significant difference was noted between the EX group and MF group. The SIRT1 expression in the ovary tissue decreases in PCOS rats (compare with the normal rats) but can be up-regulated after Ex or MF treatment. These drugs may affect the process and development of PCOS by regulating the SIRT1 expression. Exenatide may be therapeutic for PCOS by up-regulating the SITR1 expression.

  10. Culturally adapting an evidence-based parenting intervention for Latino immigrants: the need to integrate fidelity and cultural relevance.

    Science.gov (United States)

    Parra Cardona, Jose Ruben; Domenech-Rodriguez, Melanie; Forgatch, Marion; Sullivan, Cris; Bybee, Deborah; Holtrop, Kendal; Escobar-Chew, Ana Rocio; Tams, Lisa; Dates, Brian; Bernal, Guillermo

    2012-03-01

    Latinos constitute the largest ethnic minority group in the United States. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce despite extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is threefold: (1) justify the importance of cultural adaptation research as a key strategy to disseminate efficacious interventions among Latinos, (2) describe the initial steps of a program of prevention research with Latino immigrants aimed at culturally adapting an evidence-based intervention informed by parent management training principles, and (3) discuss implications for advancing cultural adaptation prevention practice and research, based on the initial feasibility and cultural acceptability findings of the current investigation. © FPI, Inc.

  11. Culturally Adapting an Evidence-Based Parenting Intervention for Latino Immigrants: The Need to Integrate Fidelity and Cultural Relevance1

    Science.gov (United States)

    Cardona, Jose Ruben Parra; Domenech-Rodriguez, Melanie; Forgatch, Marion; Sullivan, Cris; Bybee, Deborah; Holtrop, Kendal; Escobar-Chew, Ana Rocio; Tams, Lisa; Dates, Brian; Bernal, Guillermo

    2011-01-01

    Latinos constitute the largest ethnic minority group in the US. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce in spite of extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is threefold: (a) justify the importance of cultural adaptation research as a key strategy to disseminate efficacious interventions among Latinos, (b) describe the initial steps of a program of prevention research with Latino immigrants aimed at culturally adapting an evidence-based intervention informed by parent management training (PMT) principles, and (c) discuss implications for advancing cultural adaptation prevention practice and research, based on the initial feasibility and cultural acceptability findings of the current investigation. PMID:22428711

  12. 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. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. 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

  14. 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.

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  17. Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

    Directory of Open Access Journals (Sweden)

    Chen Y

    2014-06-01

    Full Text Available Ying Chen,1 Ling-Ling Zhu,2 Quan Zhou3 1Liaison Office of Geriatric VIP Patients, 2First Geriatric VIP Ward, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China Background: Falls among the elderly are an issue internationally and a public health problem that brings substantial economic and quality-of-life burdens to individuals and society. Falls prevention is an important measure of nursing quality and patient safety. Numerous studies have evaluated the association of medication use with fall risk in elderly patients. However, an up-to-date review has not been available to summarize the multifaceted pharmaceutical concerns in the prevention of medication-related falls. Materials and methods: Relevant literature was identified by performing searches in PubMed, Web of Science, and the Cochrane Library, covering the period until February 2014. We included studies that described an association between medications and falls, and effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and pharmacological interventions on fall risk in elderly patients. The full text of each included article was critically reviewed, and data interpretation was performed. Results: Fall-risk-increasing drugs (FRIDs include central nervous system-acting agents, cough preparations, nonsteroidal anti-inflammatory drugs, anti-Alzheimer’s agents, antiplatelet agents, calcium antagonists, diuretics, α-blockers, digoxin, hypoglycemic drugs, neurotoxic chemotherapeutic agents, nasal preparations, and antiglaucoma ophthalmic preparations. The degree of medication-related fall risk was dependent on one or some of the following factors: drug pharmacokinetic/pharmacodynamic properties (eg, elimination half-life, metabolic pathway, genetic polymorphism, risk rating of medications despite belonging to the same therapeutic class and

  18. Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

    DEFF Research Database (Denmark)

    Makaula, Peter; Bloch, Paul; Banda, Hastings T.

    2012-01-01

    Primary Health Care (PHC) is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions...... is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated...

  19. Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

    Science.gov (United States)

    Cristea, I A; Naudet, F

    2017-11-29

    about antidepressants, 18 (15%) about antipsychotics. Forty (33%) of the citing papers included data. COIs were reported in 55 papers (46%). Univariate and multivariate regressions showed an association between a quote justifying small or modest effects and the point that treatment effectiveness in psychiatry closely resembles that in general medicine. Our evaluation revealed an overwhelmingly uncritical reception and seemed to indicate that beyond defending psychiatry as a discipline, the paper by Leucht et al. served to lend support and credibility to a therapeutic myth: trivial effects of mental health interventions, most often drugs, are to be expected and therefore accepted. Protocol registration: https://osf.io/9dqat/.

  20. Preference-based comparative effectiveness and cost–effectiveness: a review and relevance of value-based medicine for vitreoretinal interventions.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

    2012-05-01

    This analysis discusses the comparative effectiveness and cost-effectiveness of vitreoretinal interventions, measured in quality-adjusted life years (QALYs) and percentage patient value (PPV gain, or improvement in quality of life and/or length of life). The material is relevant since the Patient Protection and Affordable Care Act enacted by Congress with the support of the President has emphasized the critical importance of patient-based preferences. The majority of preference-based, comparative effectiveness and cost-effectiveness vitreoretinal interventions assessed in the US healthcare literature are Value-Based Medicine analyses, thus comparable. These interventions confer a mean patient (human) value gain (improvement in quality of life) of 8.3% [SD 6.3%, 95% confidence interval (CI) + 2.6%]. The average cost-utility of these vitreoretinal interventions is US$23 026/QALY (SD US$24 508, 95% CI + US$8770). Most vitreoretinal interventions are very cost effective using a conventional US standard of US$50 000/QALY as the upper anchor for a very cost-effective intervention, and the World Health Organization of approximately US$142 200/QALY as the upper anchor for a cost-effective intervention. Most vitreoretinal interventions confer considerable patient value and are very cost effective. Further standardization across healthcare is needed in the preference-based, comparative and cost-utility (cost-effectiveness) arena. The metrics of PPV (percentage patient value) gain and US$/PPV (dollars expended per percentage patient value gain) or financial value gain may be more user-friendly than the QALY.

  1. Associations between Culturally Relevant Recruitment Strategies and Participant Interest, Enrollment and Generalizability in a Weight-loss Intervention for African American Families.

    Science.gov (United States)

    Huffman, Lauren E; Wilson, Dawn K; Kitzman-Ulrich, Heather; Lyerly, Jordan E; Gause, Haylee M; Resnicow, Ken

    2016-07-21

    Culturally relevant recruitment strategies may be an important approach for recruiting ethnic minorities for interventions. Previous research has examined associations between recruitment strategies and enrollment of African Americans (AA), but has not explored more deeply the role of incorporating sociocultural values into recruitment strategies. Our current study explores whether sociocultural recruitment mediums were associated with demographics, interest and enrollment in a weight-loss intervention. Sociocultural mediums included community partnerships, culturally relevant ads, sociocultural events, or word-of-mouth. Non-sociocultural mediums included community/school events that did not specifically target AAs. Analyses examined whether demographics of enrolled families differed by recruitment strategy and if recruitment strategy predicted scheduling a baseline visit, enrolling in a run-in phase, and enrolling in the intervention program. Families recruited from culturally relevant ads, sociocultural events, or word-of-mouth were 1.96 times more likely to schedule a baseline visit (OR=1.96, 95% CI=1.05, 3.68) than families recruited from non-sociocultural mediums. No differences were found for sociocultural mediums on enrolling in the run-in phase or the intervention. However, among enrolled families, those recruited from sociocultural mediums were less likely to be employed (X(2) [1, N=142] =5.53, P<.05) and more likely to have lower income (X(2) [1, N=142] =13.57, P<.05). Sociocultural mediums were associated with scheduling a baseline visit, but not enrollment. They were, however, effective in recruiting a more generalizable sample among enrolled participants based on demographic characteristics. Integrating sociocultural values into recruitment methods may be a valuable strategy for increasing interest in participation among underrepresented AA families.

  2. Pain management intervention targeting nursing staff and general practitioners: Pain intensity, consequences and clinical relevance for nursing home residents.

    Science.gov (United States)

    Dräger, Dagmar; Budnick, Andrea; Kuhnert, Ronny; Kalinowski, Sonja; Könner, Franziska; Kreutz, Reinhold

    2017-10-01

    Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement. A modified German version of the Brief Pain Inventory was used to assess pain sites, pain intensity and pain interference with function in various domains of life. The intervention consisted of separate training measures for nursing staff and treating physicians. The primary objective of reducing the mean pain intensity by 2 points was not achieved, partly because the mean pain intensity at baseline was relatively low. However, marginal reductions in pain were observed in the longitudinal assessment at 6-month follow up. The intervention and control groups differed significantly in the intensity sum score and in the domain of walking. Furthermore, the proportion of respondents with pain scores >0 on three pain intensity items decreased significantly. Given the multifocal nature of the pain experienced by nursing home residents, improving the pain situation of this vulnerable group is a major challenge. To achieve meaningful effects not only in pain intensity, but especially in pain interference with function, training measures for nursing staff and physicians need to be intensified, and long-term implementation appears necessary. Geriatr Gerontol Int 2017; 17: 1534-1543. © 2016 Japan Geriatrics Society.

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

    Science.gov (United States)

    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

  4. 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

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

    Science.gov (United States)

    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.

  6. 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.

  7. A case of deep venous thrombosis following protracted catatonic immobility recovered with electroconvulsive therapy: the relevance for an early intervention.

    Science.gov (United States)

    Medda, Pierpaolo; Fornaro, Michele; Fratta, Sara; Callari, Antonio; Manzo, Valerio; Ciaponi, Benedetta; Perugi, Giulio

    2012-01-01

    Catatonic patients often experience prolonged inactivity and dehydration, thus being prone to venous stasis leading to life-threatening thrombosis and pulmonary embolism (PE). When this occurs, the prescription of electroconvulsive therapy (ECT), actually irreplaceable in most life-threatening cases, remains controversial essentially due to an increased risk for PE and cerebral haemorrhage, with timing clinical decisions being as crucial as difficult to take. We report the case of a catatonic patient affected by malnutrition, deep venous thrombosis, severe pressure ulcers and septic syndrome resulting from previous untimely management, successfully treated with 16 well-tolerated ECT applications upon intensive supportive care. Although anecdotal, cases like this remind the relevance of early ECT to reduce the risk for potentially life-threatening complications due to prolonged catatonic inactivity, especially to those clinicians substantially disregarding this practice. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Could Participant-Produced Photography Augment Therapeutic Interventions for People with Intellectual Disabilities? A Systematic Review of the Available Evidence

    Science.gov (United States)

    Boulton, Natalie E.; Williams, Jonathan; Jones, Robert S. P.

    2018-01-01

    Background: People with intellectual disabilities are entitled to equitable access to psychological support. Traditional therapeutic approaches often rely on a person's ability to verbally articulate a description of their life, which can be particularly difficult for emotionally salient information. Methods: A systematic literature review was…

  9. Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

    Science.gov (United States)

    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…

  10. Impact of Therapeutic Interventions on Survival of Elderly Patients with Gallbladder Carcinoma: A 10-year Single Center Experience

    Directory of Open Access Journals (Sweden)

    Ching-Wei Chang

    2015-12-01

    Conclusion: Most elderly patients at the time of diagnosis of GBC were in TNM Stage IV. Surgery was the predominant treatment at our hospital. Surgical interventions might be associated with better survival for elderly patients with GBC.

  11. 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

  12. 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…

  13. Influence of geometric and material properties on artifacts generated by interventional MRI devices: Relevance to PRF-shift thermometry

    Energy Technology Data Exchange (ETDEWEB)

    Tatebe, Ken, E-mail: Ken.Tatebe@gmail.com [Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390 (United States); Ramsay, Elizabeth; Kazem, Mohammad; Peikari, Hamed [Physical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N3M5 (Canada); Mougenot, Charles [Philips Healthcare, 281 Hillmount Road, Markham, Ontario L6C 2S3 (Canada); Bronskill, Michael [Physical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N3M5, Canada and Department of Medical Biophysics, University of Toronto, 610 University Avenue, Toronto, Ontario M5G2M9 (Canada); Chopra, Rajiv [Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390 (United States); Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390 (United States); Physical Sciences, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N3M5 (Canada); Department of Medical Biophysics, University of Toronto, 610 University Avenue, Toronto, Ontario M5G2M9 (Canada)

    2016-01-15

    orientations. These new strategies are being incorporated into the next generation of applicators. The general strategy described in this study can be applied to the design of other interventional devices intended for use with MRI.

  14. Influence of geometric and material properties on artifacts generated by interventional MRI devices: Relevance to PRF-shift thermometry

    International Nuclear Information System (INIS)

    Tatebe, Ken; Ramsay, Elizabeth; Kazem, Mohammad; Peikari, Hamed; Mougenot, Charles; Bronskill, Michael; Chopra, Rajiv

    2016-01-01

    orientations. These new strategies are being incorporated into the next generation of applicators. The general strategy described in this study can be applied to the design of other interventional devices intended for use with MRI

  15. MMP-10 Is Overexpressed, Proteolytically Active, and a Potential Target for Therapeutic Intervention in Human Lung Carcinomas

    Directory of Open Access Journals (Sweden)

    Jason H. Gill

    2004-11-01

    Full Text Available Matrix metalloproteinase (MMP-mediated degradation of the extracellular matrix is a major factor for tumor development and expansion. This study analysed MMP-10 protein expression and activity in human lung tumors of various grade, stage, and type to address the relationship between MMP-10 and tumor characteristics and to evaluate MMP-10 as a therapeutic target in non small cell lung carcinoma (NSCLC. Unlike the majority of MMPs, MMP-10 was located in the tumor mass as opposed to tumor stroma. MMP-10 protein was observed at low levels in normal human lung tissues and at significantly higher levels in all types of NSCLC. No correlation was observed between MMP-10 protein expression and tumor type, stage, or lymph node invasion. To discriminate between active and inactive forms of MMP-10 in samples of human NSCLC, we have developed an ex vivo fluorescent assay. Measurable MMP-10 activity was detected in 42 of 50 specimens of lung cancer and only 2 of 10 specimens of histologically normal lung tissue. No relationship was observed between MMP-10 activity levels and clinicopathologic characteristics. Our results suggest that MMP-10 is expressed and active at high levels in human NSCLC compared to normal lung tissues, and, as such, is a potential target for the development of novel therapeutics for lung cancer treatment.

  16. Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

    Science.gov (United States)

    Joseph, Rodney P; Keller, Colleen; Adams, Marc A; Ainsworth, Barbara E

    2015-03-27

    African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women. Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction. All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's  .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P program to a friend

  17. Trafficking of drug candidates relevant for sports drug testing: detection of non-approved therapeutics categorized as anabolic and gene doping agents in products distributed via the Internet.

    Science.gov (United States)

    Thevis, Mario; Geyer, Hans; Thomas, Andreas; Schänzer, Wilhelm

    2011-05-01

    Identifying the use of non-approved drugs by cheating athletes has been a great challenge for doping control laboratories. This is due to the additional complexities associated with identifying relatively unknown and uncharacterized compounds and their metabolites as opposed to known and well-studied therapeutics. In 2010, the prohibited drug candidates and gene doping substances AICAR and GW1516, together with the selective androgen receptor modulator (SARM) MK-2866 were obtained by the Cologne Doping Control Laboratory from Internet suppliers and their structure, quantity, and formulation elucidated. All three compounds proved authentic as determined by liquid chromatography-high resolution/high accuracy (tandem) mass spectrometry and comparison to reference material. While AICAR was provided as a colourless powder in 100 mg aliquots, GW1516 was obtained as an orange/yellow suspension in water/glycerol (150 mg/ml), and MK-2866 (25 mg/ml) was shipped dissolved in polyethylene glycol (PEG) 300. In all cases, the quantified amounts were considerably lower than indicated on the label. The substances were delivered via courier, with packaging identifying them as containing 'amino acids' and 'green tea extract', arguably to circumvent customs control. Although all of the substances were declared 'for research only', their potential misuse in illicit performance-enhancement cannot be excluded; moreover sports drug testing authorities should be aware of the facile availability of black market copies of these drug candidates. Copyright © 2011 John Wiley & Sons, Ltd.

  18. Logical network of genotoxic stress-induced NF-kappaB signal transduction predicts putative target structures for therapeutic intervention strategies

    Directory of Open Access Journals (Sweden)

    Rainer Poltz

    2009-12-01

    Full Text Available Rainer Poltz1, Raimo Franke1,#, Katrin Schweitzer1, Steffen Klamt2, Ernst-Dieter Gilles2, Michael Naumann11Institute of Experimental Internal Medicine, Otto von Guericke University, Magdeburg, Germany; 2Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany; #Present address: Department of Chemical Biology, Helmholtz Centre for Infection Research, Braunschweig, GermanyAbstract: Genotoxic stress is induced by a broad range of DNA-damaging agents and could lead to a variety of human diseases including cancer. DNA damage is also therapeutically induced for cancer treatment with the aim to eliminate tumor cells. However, the effectiveness of radio- and chemotherapy is strongly hampered by tumor cell resistance. A major reason for radio- and chemotherapeutic resistances is the simultaneous activation of cell survival pathways resulting in the activation of the transcription factor nuclear factor-kappa B (NF-κB. Here, we present a Boolean network model of the NF-κB signal transduction induced by genotoxic stress in epithelial cells. For the representation and analysis of the model, we used the formalism of logical interaction hypergraphs. Model reconstruction was based on a careful meta-analysis of published data. By calculating minimal intervention sets, we identified p53-induced protein with a death domain (PIDD, receptor-interacting protein 1 (RIP1, and protein inhibitor of activated STAT y (PIASy as putative therapeutic targets to abrogate NF-κB activation resulting in apoptosis. Targeting these structures therapeutically may potentiate the effectiveness of radio- and chemotherapy. Thus, the presented model allows a better understanding of the signal transduction in tumor cells and provides candidates as new therapeutic target structures.Keywords: apoptosis, Boolean network, cancer therapy, DNA-damage response, NF-κB

  19. Culturally Relevant Cyberbullying Prevention

    OpenAIRE

    Phillips, Gregory John

    2017-01-01

    In this action research study, I, along with a student intervention committee of 14 members, developed a cyberbullying intervention for a large urban high school on the west coast. This high school contained a predominantly African American student population. I aimed to discover culturally relevant cyberbullying prevention strategies for African American students. The intervention committee selected video safety messages featuring African American actors as the most culturally relevant cyber...

  20. 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.

  1. The relevance of social contexts and social action in reducing substance use and victimization among women participating in an HIV prevention intervention in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Reed E

    2013-06-01

    community on issues relevant to substance use prevention or other health topics promoted within the program, as well as outside social influences within women's life contexts (eg, support from non-substance using family or male partners, leaving male partners or other peer relationships characterized by drug use, or finding employment were key factors reported by women in terms of facilitating their substance use abstinence and in reducing women's exposures to victimization. Conclusion: Findings highlight the potential for group-delivered interventions that include mobilizing women to take social action in the larger community to be effective approaches for facilitating substance use abstinence, reductions in victimization, and ultimately, to address the intersection between substance use, violence, and HIV risk among women in this high HIV prevalence setting. Keywords: HIV prevention, substance use, social context, women

  2. Are the stages of change relevant for the development and implementation of a web-based tailored alcohol intervention? A cross-sectional study.

    Science.gov (United States)

    Schulz, Daniela N; Kremers, Stef P J; de Vries, Hein

    2012-05-17

    Computer-tailored programs are a promising tool to stimulate health behavior change, such as reducing alcohol intake. Yet more research is needed to assess whether groups differing in their motivational level to change may need different types of feedback. Furthermore, it is unknown whether motivational level may also determine reactions to computer-tailored interventions. Our aim is to identify the potential relevance of the application of the stages of change concept in the development and implementation of alcohol interventions. A web-based instrument was used to disseminate a questionnaire and to provide tailored feedback messages among adults in the Netherlands (N = 170; 96 females). Motivational level was assessed by the stage of change construct. The survey furthermore assessed alcohol consumption, attitude, social influence, self-efficacy, and program evaluation (i.e., survey items, tailored advice, layout and functionality of the program). The Least Significant Difference method was used to compare people in different stages of change with regard to psychosocial determinants of drinking behavior and program evaluation. Of the respondents, 34.1% (n = 58) reported no intention to change to healthier drinking habits in the foreseeable future (precontemplation), 22.9% (n = 39) intended to improve their drinking behavior in the near future (contemplation/preparation) and 42.9% (n = 73) reported to currently adhere to the Dutch alcohol consumption guidelines (action/maintenance). When comparing the three groups, people in the action or maintenance stage reported the lowest number of pros of drinking alcohol, having most healthy drinking role models and the highest levels of self-efficacy regarding healthy drinking in difficult situations, whereas precontemplators reported to receive the least social support regarding healthy drinking. In general, the intervention was positively evaluated, but it seemed to be most appreciated by contemplators and preparers. Stage

  3. Are the stages of change relevant for the development and implementation of a web-based tailored alcohol intervention? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Schulz Daniela N

    2012-05-01

    Full Text Available Abstract Background Computer-tailored programs are a promising tool to stimulate health behavior change, such as reducing alcohol intake. Yet more research is needed to assess whether groups differing in their motivational level to change may need different types of feedback. Furthermore, it is unknown whether motivational level may also determine reactions to computer-tailored interventions. Our aim is to identify the potential relevance of the application of the stages of change concept in the development and implementation of alcohol interventions. Methods A web-based instrument was used to disseminate a questionnaire and to provide tailored feedback messages among adults in the Netherlands (N = 170; 96 females. Motivational level was assessed by the stage of change construct. The survey furthermore assessed alcohol consumption, attitude, social influence, self-efficacy, and program evaluation (i.e., survey items, tailored advice, layout and functionality of the program. The Least Significant Difference method was used to compare people in different stages of change with regard to psychosocial determinants of drinking behavior and program evaluation. Results Of the respondents, 34.1% (n = 58 reported no intention to change to healthier drinking habits in the foreseeable future (precontemplation, 22.9% (n = 39 intended to improve their drinking behavior in the near future (contemplation/preparation and 42.9% (n = 73 reported to currently adhere to the Dutch alcohol consumption guidelines (action/maintenance. When comparing the three groups, people in the action or maintenance stage reported the lowest number of pros of drinking alcohol, having most healthy drinking role models and the highest levels of self-efficacy regarding healthy drinking in difficult situations, whereas precontemplators reported to receive the least social support regarding healthy drinking. In general, the intervention was positively evaluated, but it

  4. Development, validation, and application of a fast and simple GC-MS method for determination of some therapeutic drugs relevant in emergency toxicology.

    Science.gov (United States)

    Meyer, Markus R; Welter, Jessica; Weber, Armin A; Maurer, Hans H

    2011-10-01

    To date, immunoassays are commercially available for quantification of valproic acid, salicylic acid, paracetamol, phenobarbital, phenytoin, and primidone. As they are no longer available, a fast, simple, and cost-effective quantitative gas chromatography-mass spectrometry (GC-MS) method was developed and fully validated for these drugs. After simple and fast liquid-liquid extraction, the samples were analyzed by GC-MS using the selected ion monitoring mode. The method was validated including the parameters selectivity, calibration model, precision, accuracy, and extraction efficiency. The above-mentioned analytes were separated within 8.5 minutes and sensitively detected. No interfering peaks were observed in blank samples from 8 different sources. The linearity ranges were 20-200 mg/L for valproic acid, 100-1200 mg/L for salicylic acid, 10-200 mg/L for paracetamol, 10-200 mg/L for phenobarbital, 4-20 mg/L for primidone, and 2.5-30 mg/L for phenytoin. Generally accepted criteria for accuracy and precision were fulfilled for all analytes using 6-point calibration. Even 1-point calibration was applicable for all analytes. The assay was successfully applied to analysis of real plasma samples and proficiency testing material. The assay described allowed fast and reliable determination of analytes relevant in the diagnosis of poisonings. Furthermore, time- and cost-saving 1-point calibration was shown to be suitable for daily routine work, especially in emergency cases.

  5. Is photodynamic therapy a relevant therapeutic option in refractory benign familial pemphigus (Hailey-Hailey disease)? A series of eight patients.

    Science.gov (United States)

    Alsahli, Maha; Debu, Anca; Girard, Celine; Bessis, Didier; Du Thanh, Aurélie; Guillot, Bernard; Dereure, Olivier

    2017-11-01

    Treatment of benign familial pemphigus or Hailey-Hailey disease (HHD), a rare inherited condition associated with a significant impairment of quality of life, is often challenging and disappointing with frequent relapses and infectious complications. Topical photodynamic therapy (PDT) may offer new perspectives in this difficult setting. Eight patients with long-lasting HHD lesions refractory to multiple treatments were treated on at least one involved site with PDT using methyl-amino levulinate with a standardized protocol of three sessions of irradiation separated by 3-week intervals. A complete or partial clearing was achieved in all treated areas, and the result was satisfactorily maintained in all cases after a follow-up period ranging from 3 to 36 months. Results were of higher quality in non-inguinal areas. Tolerance was overall acceptable with local pain during and shortly after irradiation being the main limiting factor. Our series, although limited in size, emphasizes the interest of PDT in this difficult condition even though results may be incomplete. Treatment-related pain can be adequately managed by prior analgesics, cooling with sprayed water and local tumescent anesthesia. Overall, PDT appears as a relevant option in refractory HHD management with a favorable benefit/risk ratio.

  6. Comparison of cell-based and non-cell-based assay platforms for the detection of clinically relevant anti-drug neutralizing antibodies for immunogenicity assessment of therapeutic proteins.

    Science.gov (United States)

    Hu, Jenny; Wala, Iwona; Han, Hong; Nagatani, Janice; Barger, Troy; Civoli, Francesca; Kaliyaperumal, Arunan; Zhuang, Yao; Gupta, Shalini

    2015-04-01

    Anti-drug neutralizing antibodies (NAbs) formed due to unwanted immunogenicity of a therapeutic protein point towards a mature immune response. NAb detection is important in interpreting the therapeutic's efficacy and safety in vivo. In vitro cell-based NAb assays provide a physiological system for NAb detection, however are complex assays. Non-cell-based competitive ligand binding (CLB) approaches are also employed for NAb detection. Instead of cells, CLB assays use soluble receptor and conjugated reagents and are easier to perform, however have reduced physiological relevance. The aim of this study was to compare the performance of CLB assays to established cell-based assays to determine the former's ability to detect clinically relevant NAbs towards therapeutics that (i) acted as an agonist or (ii) acted as antagonists by binding to a target receptor. We performed a head-to-head comparison of the performance of cell-based and CLB NAb assays for erythropoietin (EPO) and two anti-receptor monoclonal antibodies (AMG-X and AMG 317). Clinically relevant NAb-positive samples identified previously by a cell-based assay were assessed in the corresponding CLB format(s). A panel of 12 engineered fully human anti-EPO monoclonal antibodies (MAbs) was tested in both EPO NAb assay formats. Our results showed that the CLB format was (i) capable of detecting human anti-EPO MAbs of differing neutralizing capabilities and affinities and (ii) provided similar results as the cell-based assay for detecting NAbs in patient samples. The cell-based and CLB assays also behaved comparably in detecting NAbs in clinical samples for AMG-X. In the case of anti-AMG 317 NAbs, the CLB format failed to detect NAbs in more than 50% of the tested samples. We conclude that assay sensitivity, drug tolerance and the selected assay matrix played an important role in the inability of AMG 317 CLB assays to detect clinically relevant NAbs. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: an expert consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI).

    Science.gov (United States)

    Moussa, Issam D; Klein, Lloyd W; Shah, Binita; Mehran, Roxana; Mack, Michael J; Brilakis, Emmanouil S; Reilly, John P; Zoghbi, Gilbert; Holper, Elizabeth; Stone, Gregg W

    2014-01-01

    Numerous definitions have been proposed for the diagnosis of myocardial infarction (MI) after coronary revascularization. The universal definition for MI designates post procedural biomarker thresholds for defining percutaneous coronary intervention (PCI)-related MI (type 4a) and coronary artery bypass grafting (CABG)-related MI (type 5) which are of uncertain prognostic importance. In addition, for both MI types cTn is recommended as the biomarker of choice, the prognostic significance of which is less well validated than CK-MB. Widespread adoption of a MI definition not clearly linked to subsequent adverse events such as mortality or heart failure may have serious consequences for the appropriate assessment of devices and therapies, may affect clinical care pathways, and may result in misinterpretation of physician competence. Rather than employing an MI definition sensitive for small degrees of myonecrosis (the occurrence of which, based on contemporary large-scale studies, are unlikely to have important clinical consequences), it is instead recommended that a threshold level of biomarker elevation which has been strongly linked to subsequent adverse events in clinical studies be used to define a "clinically relevant MI." The present document introduces a new definition for "clinically relevant MI" after coronary revascularization (PCI or CABG) which is applicable for use in clinical trials, patient care, and quality outcomes assessment. Copyright © 2013 Wiley Periodicals, Inc.

  8. Mapping Environmental Inequalities Relevant for Health for Informing Urban Planning Interventions-A Case Study in the City of Dortmund, Germany.

    Science.gov (United States)

    Flacke, Johannes; Schüle, Steffen Andreas; Köckler, Heike; Bolte, Gabriele

    2016-07-13

    Spatial differences in urban environmental conditions contribute to health inequalities within cities. The purpose of the paper is to map environmental inequalities relevant for health in the City of Dortmund, Germany, in order to identify needs for planning interventions. We develop suitable indicators for mapping socioeconomically-driven environmental inequalities at the neighborhood level based on published scientific evidence and inputs from local stakeholders. Relationships between socioeconomic and environmental indicators at the level of 170 neighborhoods were analyzed continuously with Spearman rank correlation coefficients and categorically applying chi-squared tests. Reclassified socioeconomic and environmental indicators were then mapped at the neighborhood level in order to determine multiple environmental burdens and hotspots of environmental inequalities related to health. Results show that the majority of environmental indicators correlate significantly, leading to multiple environmental burdens in specific neighborhoods. Some of these neighborhoods also have significantly larger proportions of inhabitants of a lower socioeconomic position indicating hotspots of environmental inequalities. Suitable planning interventions mainly comprise transport planning and green space management. In the conclusions, we discuss how the analysis can be used to improve state of the art planning instruments, such as clean air action planning or noise reduction planning towards the consideration of the vulnerability of the population.

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

    Science.gov (United States)

    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.

  10. Combination therapy of ifenprodil with piroxicam may be an effective therapeutic intervention in cerebral stroke: a hypothesis.

    Science.gov (United States)

    Bhattacharya, Pallab; Pandey, Anand Kumar; Paul, Sudip; Patnaik, Ranjana

    2012-10-01

    Owing to the intricate and multifaceted pathology of cerebral stroke, multiple drug therapy had long been suggested for effective stroke treatment. Therefore, the development of a potential new combination of drug is necessitated which can bring about desirable improved neuroprotection targeting different pathways against ischemic stroke. In this context, we hypothesize the combination effect of Piroxicam, a Non steroidal anti inflammatory drug with Ifenprodil, a NR2b selective NMDAR antagonist in animal model of cerebral ischemia. A few past studies have enumerated the neuroprotective roles of Piroxicam and Ifenprodil administered in singlet against cerebral ischemia in animal model, hence we hypothesized that by using Piroxicam and Ifenprodil in combination would provide additive neuroprotection than either of the agents used alone. In this article, we discuss our hypothesis regarding the possibility of Piroxicam and Ifenprodil as a potent combination which may have a positive therapeutic role in treatment of cerebral ischemia through its anti-inflammatory, anti-apoptotic and anti-oxidative characteristics of Piroxicam with Ifenprodil which has been proved to have neuroprotective, anticonvulsant and antinociceptive effects and has potentials for the treatment of several neuropsychiatric disorders, such as Parkinson's disease alcoholism and drug addiction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Men's Experience with Penile Rehabilitation Following Radical Prostatectomy: A Qualitative Study with the Goal of Informing a Therapeutic Intervention

    Science.gov (United States)

    Nelson, Christian J.; Lacey, Stephanie; Kenowitz, Joslyn; Pessin, Hayley; Shuk, Elyse; Mulhall, John P.

    2016-01-01

    Objectives Erectile rehabilitation (ER) following radical prostatectomy (RP) is considered an essential component to help men regain erectile functioning; however many men have difficulty adhering to this type of a program. This qualitative study explored men's experience with ER, erectile dysfunction (ED), and ED treatments to inform a psychological intervention designed to help men adhere to ER post-RP. Methods Thirty men, one to three years post-RP, who took part in an ER program, participated in one of four focus groups. Thematic analysis was used to identify the primary themes. Results Average age was 59 (SD=7); mean time since surgery was 26 months (SD=6). Six primary themes emerged: 1) frustration with the lack of information about post-surgery ED; 2) negative emotional impact of ED and avoidance of sexual situations; 3) negative emotional experience with penile injections and barriers leading to avoidance; 4) the benefit of focusing on the long-term advantage of ER versus short-term anxiety; 5) using humor to help cope; and 6) the benefit of support from partners and peers. Conclusions Men's frustration surrounding ED can lead to avoidance of sexual situations and ED treatments, which negatively impact men's adherence to an ER program. The theoretical construct of Acceptance and Commitment Therapy (ACT) was used to place the themes into a framework to conceptualize the mechanisms underlying both avoidance and adherence in this population. As such, ACT has the potential to serve as a conceptual underpinning of a psychological intervention to help men reduce avoidance to penile injections and adhere to an ER program. PMID:25707812

  12. Novel therapeutic intervention for osteoporosis prepared with strontium hydroxyapatite and zoledronic acid: In vitro and pharmacodynamic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Khajuria, Deepak Kumar, E-mail: deepak_kumarkhajuria@yahoo.co.in [The Musculoskeletal Genetics Laboratory, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed (Israel); Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore (India); Vasireddi, Ramakrishna; Trebbin, Martin [Hamburg Center for Ultrafast Imaging, University of Hamburg, Hamburg (Germany); Karasik, David [The Musculoskeletal Genetics Laboratory, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed (Israel); Razdan, Rema [Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore (India)

    2017-02-01

    Osteoporosis therapeutics has been monopolized mainly by bisphosphonates, which are potent anti-osteoporotic drugs, while they do not promote bone formation or replenish the already resorbed bone. Although strontium substituted hydroxyapatite (SrHA) has been proclaimed to improve bone properties in an osteoporotic animal model, there is no published data on direct delivery of SrHA nanoparticles by bisphosphonate-like zoledronic acid (ZOL) to the bone. Therefore, this study was designed to investigate the potential of using SrHA/ZOL nanoparticle-based drug formulation in an ovariectomized rat model of postmenopausal osteoporosis. SrHA and SrHA/ZOL nanoparticles were prepared and characterized by field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). Twelve weeks after ovariectomy, rats were treated with either single intravenous dose of SrHA/ZOL (100, 50 or 25 μg/kg); ZOL (100 μg/kg); or SrHA (100 μg/kg). Saline-treated OVX and SHAM-OVX groups served as controls. The energy-dispersive X-ray (EDX) microanalysis of bone specimen obtained from SrHA/ZOL groups yielded range between 64.3 ± 6.7 to 66.9 ± 6.8 of calcium weight (wt) % and 1.64 ± 0.6 to 1.74 ± 0.8 of calcium/phosphorus (Ca/P) ratio which was significantly higher when compared with 39.7 ± 9.3 calcium and 1.30 ± 0.2 Ca/P ratio for OVX group. Moreover, the strontium wt% in SrHA/ZOL group (between 3.1 ± 0.5 and 6.8 ± 0.4) was significantly higher than SrHA group (1.8 ± 0.9). These results confirmed targeted delivery of SrHA nanoparticles by ZOL to the bone. Therapy with SrHA/ZOL showed significant improvements in trabecular bone microarchitecture and mechanical strength as compared to ZOL or SrHA (p < 0.05). Moreover, treatment with SrHA/ZOL significantly precluded an increase in serum bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase than either ZOL or SrHA (p < 0.05). These results strongly implicate

  13. Theatre Is a Valid Add-On Therapeutic Intervention for Emotional Rehabilitation of Parkinson’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Giovanni Mirabella

    2017-01-01

    Full Text Available Conventional medical treatments of Parkinson’s disease (PD are effective on motor disturbances but may have little impact on nonmotor symptoms, especially psychiatric ones. Thus, even when motor symptomatology improves, patients might experience deterioration in their quality of life. We have shown that 3 years of active theatre is a valid complementary intervention for PD as it significantly improves the well-being of patients in comparison to patients undergoing conventional physiotherapy. Our aim was to replicate these findings while improving the efficacy of the treatment. We ran a single-blinded pilot study lasting 15 months on 24 subjects with moderate idiopathic PD. 12 were assigned to a theatre program in which patients underwent “emotional” training. The other 12 underwent group physiotherapy. Patients were evaluated at the beginning and at the end of their treatments, using a battery of eight clinical and five neuropsychological scales. We found that the emotional theatre training improved the emotional well-being of patients, whereas physiotherapy did not. Interestingly, neither of the groups showed improvements in either motor symptoms or cognitive abilities tested by the neuropsychological battery. We confirmed that theatre therapy might be helpful in improving emotional well-being in PD.

  14. Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space

    Directory of Open Access Journals (Sweden)

    Sartor A Oliver

    2011-04-01

    Full Text Available Abstract Despite the proven success of hormonal therapy for prostate cancer using chemical or surgical castration, most patients eventually will progress to a phase of the disease that is metastatic and shows resistance to further hormonal manipulation. This has been termed metastatic castrate-resistant prostate cancer (mCRPC. Despite this designation, however, there is evidence that androgen receptor (AR-mediated signaling and gene expression can persist in mCRPC, even in the face of castrate levels of androgen. This may be due in part to the upregulation of enzymes involved in androgen synthesis, the overexpression of AR, or the emergence of mutant ARs with promiscuous recognition of various steroidal ligands. The therapeutic options were limited and palliative in nature until trials in 2004 demonstrated that docetaxel chemotherapy could significantly improve survival. These results established first-line docetaxel as the standard of care for mCRPC. After resistance to further docetaxel therapy develops, treatment options were once again limited. Recently reported results from phase 3 trials have shown that additional therapy with the novel taxane cabazitaxel (with prednisone, or treatment with the antiandrogen abiraterone (with prednisone could improve survival for patients with mCRPC following docetaxel therapy. Compared with mitoxantrone/prednisone, cabazitaxel/prednisone significantly improved overall survival, with a 30% reduction in rate of death, in patients with progression of mCRPC after docetaxel therapy in the TROPIC trial. Similarly, abiraterone acetate (an inhibitor of androgen biosynthesis plus prednisone significantly decreased the rate of death by 35% compared with placebo plus prednisone in mCRPC patients progressing after prior docetaxel therapy in the COU-AA-301 trial. Results of these trials have thus established two additional treatment options for mCRPC patients in the "post-docetaxel space." In view of the continued AR

  15. Inhibition of peroxynitrite-mediated DNA strand cleavage and hydroxyl radical formation by aspirin at pharmacologically relevant concentrations: Implications for cancer intervention

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wei [Division of Biomedical Sciences, Edward Via Virginia College of Osteopathic Medicine, Virginia Tech Corporate Research Center, Blacksburg, VA 24060 (United States); College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310035 (China); Department of Food Science and Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States); Zhu, Hong; Jia, Zhenquan [Division of Biomedical Sciences, Edward Via Virginia College of Osteopathic Medicine, Virginia Tech Corporate Research Center, Blacksburg, VA 24060 (United States); Li, Jianrong [College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310035 (China); Misra, Hara P. [Division of Biomedical Sciences, Edward Via Virginia College of Osteopathic Medicine, Virginia Tech Corporate Research Center, Blacksburg, VA 24060 (United States); Zhou, Kequan, E-mail: kzhou@wayne.edu [Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202 (United States); Li, Yunbo, E-mail: yli@vcom.vt.edu [Division of Biomedical Sciences, Edward Via Virginia College of Osteopathic Medicine, Virginia Tech Corporate Research Center, Blacksburg, VA 24060 (United States)

    2009-12-04

    Epidemiological studies have suggested that the long-term use of aspirin is associated with a decreased incidence of human malignancies, especially colorectal cancer. Since accumulating evidence indicates that peroxynitrite is critically involved in multistage carcinogenesis, this study was undertaken to investigate the ability of aspirin to inhibit peroxynitrite-mediated DNA damage. Peroxynitrite and its generator 3-morpholinosydnonimine (SIN-1) were used to cause DNA strand breaks in {phi}X-174 plasmid DNA. We demonstrated that the presence of aspirin at concentrations (0.25-2 mM) compatible with amounts in plasma during chronic anti-inflammatory therapy resulted in a significant inhibition of DNA cleavage induced by both peroxynitrite and SIN-1. Moreover, the consumption of oxygen caused by 250 {mu}M SIN-1 was found to be decreased in the presence of aspirin, indicating that aspirin might affect the auto-oxidation of SIN-1. Furthermore, EPR spectroscopy using 5,5-dimethylpyrroline-N-oxide (DMPO) as a spin trap demonstrated the formation of DMPO-hydroxyl radical adduct (DMPO-OH) from authentic peroxynitrite, and that aspirin at 0.25-2 mM potently diminished the radical adduct formation in a concentration-dependent manner. Taken together, these results demonstrate for the first time that aspirin at pharmacologically relevant concentrations can inhibit peroxynitrite-mediated DNA strand breakage and hydroxyl radical formation. These results may have implications for cancer intervention by aspirin.

  16. Inhibition of peroxynitrite-mediated DNA strand cleavage and hydroxyl radical formation by aspirin at pharmacologically relevant concentrations: Implications for cancer intervention

    International Nuclear Information System (INIS)

    Chen, Wei; Zhu, Hong; Jia, Zhenquan; Li, Jianrong; Misra, Hara P.; Zhou, Kequan; Li, Yunbo

    2009-01-01

    Epidemiological studies have suggested that the long-term use of aspirin is associated with a decreased incidence of human malignancies, especially colorectal cancer. Since accumulating evidence indicates that peroxynitrite is critically involved in multistage carcinogenesis, this study was undertaken to investigate the ability of aspirin to inhibit peroxynitrite-mediated DNA damage. Peroxynitrite and its generator 3-morpholinosydnonimine (SIN-1) were used to cause DNA strand breaks in φX-174 plasmid DNA. We demonstrated that the presence of aspirin at concentrations (0.25-2 mM) compatible with amounts in plasma during chronic anti-inflammatory therapy resulted in a significant inhibition of DNA cleavage induced by both peroxynitrite and SIN-1. Moreover, the consumption of oxygen caused by 250 μM SIN-1 was found to be decreased in the presence of aspirin, indicating that aspirin might affect the auto-oxidation of SIN-1. Furthermore, EPR spectroscopy using 5,5-dimethylpyrroline-N-oxide (DMPO) as a spin trap demonstrated the formation of DMPO-hydroxyl radical adduct (DMPO-OH) from authentic peroxynitrite, and that aspirin at 0.25-2 mM potently diminished the radical adduct formation in a concentration-dependent manner. Taken together, these results demonstrate for the first time that aspirin at pharmacologically relevant concentrations can inhibit peroxynitrite-mediated DNA strand breakage and hydroxyl radical formation. These results may have implications for cancer intervention by aspirin.

  17. Rhenium-188 - advantages and clinical potential for use of a readily available, cost effective therapeutic radioisotope for applications in nuclear medicine, oncology and interventional cardiology

    International Nuclear Information System (INIS)

    Knapp, F.F. jr.

    2002-01-01

    Full text: Carrier-free rhenium-188 (Re-188) is readily available from the alumina-based tungsten-188/rhenium-188 generator system and has many attractive properties for a wide variety of therapeutic applications. The 16.9 h half-life, emission of the 2.2 MeV beta particle and versatile chemistry make Re-188 an important candidate for applications where high radiation penetration is required. In addition, emission of a gamma photon (155 KeV, 15 %) permits evaluation of biodistribution, pharmacokinetics and dosimetry estimates. The long physical half-life of the tungsten-188 (W-188) parent (t 1/2 69 days) and consistent generator performance - with high Re-188 yields and low W-188 parent breakthrough - result in an indefinite shelf-life of several months, dependent on the levels of Re-188 required. Post generator elution in-growth of 62 % of Re-188 after 24 hours in combination with high elution yields (75-85 %) result in 50 % daily yields of the maximal Re-188 available. In addition to research being conducted for the development of a wide variety of new therapeutic radiopharmaceuticals and devices, Re-188 is also being evaluated in physician-sponsored clinical trials in over 15 countries, with applications in nuclear medicine, oncology and interventional cardiology. One major current clinical application involves post-angiographic treatment of arterial segments following PTCA using Re-188 perrhenate or MAG3 liquid-filled balloons as an effective and cost-effective approach for inhibition of the hyperplastic response to vessel damage, which delivers uniform dose to the vessel wall. Re-188-HEDP is being used for palliation of metastatic bone pain palliation. This agent is readily prepared from a simple 'kit' and provides pain palliation as effective as other commercially available agents. The use of the Re-188-labeled Anti-NCA-95 antibody (BW 50/183; CD66 a,b,c,e) in conjunction which external beam irradiation and chemotherapy is an effective method for

  18. 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.

  19. Therapeutic interventions in severe asthma.

    Science.gov (United States)

    Canonica, Giorgio Walter; Senna, Gianenrico; Mitchell, Patrick D; O'Byrne, Paul M; Passalacqua, Giovanni; Varricchi, Gilda

    2016-01-01

    The present paper addresses severe asthma which is limited to 5-10% of the overall population of asthmatics. However, it accounts for 50% or more of socials costs of the disease, as it is responsible for hospitalizations and Emergency Department accesses as well as expensive treatments. The recent identification of different endotypes of asthma, based on the inflammatory pattern, has led to the development of tailored treatments that target different inflammatory mediators. These are major achievements in the perspective of Precision Medicine: a leading approach to the modern treatment strategy. Omalizumab, an anti-IgE antibody, has been the only biologic treatment available on the market for severe asthma during the last decade. It prevents the linkage of the IgE and the receptors, thereby inhibiting mast cell degranulation. In clinical practice omalizumab significantly reduced the asthma exacerbations as well as the concomitant use of oral glucocorticoids. In the "Th2-high asthma" phenotype, the hallmarks are increased levels of eosinophils and other markers (such as periostin). Because anti-IL-5 in this condition plays a crucial role in driving eosinophil inflammation, this cytokine or its receptors on the eosinophil surface has been studied as a potential target for therapy. Two different anti-IL-5 humanized monoclonal antibodies, mepolizumab and reslizumab, have been proven effective in this phenotype of asthma (recently they both came on the market in the United States), as well as an anti-IL-5 receptor alpha (IL5Rα), benralizumab. Other monoclonal antibodies, targeting different cytokines (IL-13, IL-4, IL-17 and TSLP) are still under evaluation, though the preliminary results are encouraging. Finally, AIT, Allergen Immunotherapy, a prototype of Precision Medicine, is considered, also in light of the recent evidences of Sublingual Immunotherapy (SLIT) tablet efficacy and safety in mite allergic asthma patients. Given the high costs of these therapies, however, there is an urgent need to identify biomarkers that can predict the clinical responders.

  20. Nature-based therapeutic interventions

    DEFF Research Database (Denmark)

    Stigsdotter, Anna Ulrika Karlsson; Palsdottir, Anna Maria; Burls, Ambra

    2011-01-01

    The link between modern lifestyles and increasing levels of chronic heart disease, obesity, stress and poor mental health is a concern across the world. The cost of dealing with these conditions places a large burden on national public health budgets so that policymakers are increasingly looking ...

  1. Annual Research Review: New frontiers in developmental neuropharmacology: can long-term therapeutic effects of drugs be optimized through carefully timed early intervention?

    Science.gov (United States)

    Andersen, Susan L; Navalta, Carryl P

    2011-04-01

    Our aim is to present a working model that may serve as a valuable heuristic to predict enduring effects of drugs when administered during development. Our primary tenet is that a greater understanding of neurodevelopment can lead to improved treatment that intervenes early in the progression of a given disorder and prevents symptoms from manifesting. The immature brain undergoes significant changes during the transitions between childhood, adolescence, and adulthood. Such changes in innervation, neurotransmitter levels, and their respective signaling mechanisms have profound and observable changes on typical behavior, but also increase vulnerability to psychiatric disorders when the maturational process goes awry. Given the remarkable plasticity of the immature brain to adapt to its external milieu, preventive interventions may be possible. We intend for this review to initiate a discussion of how currently used psychotropic agents can influence brain development. Drug exposure during sensitive periods may have beneficial long-term effects, but harmful delayed consequences may be possible as well. Regardless of the outcome, this information needs to be used to improve or develop alternative approaches for the treatment of childhood disorders. With this framework in mind, we present what is known about the effects of stimulants, antidepressants, and antipsychotics on brain maturation (including animal studies that use more clinically-relevant dosing paradigms or relevant animal models). We endeavor to provocatively set the stage for altering treatment approaches for improving mental health in non-adult populations. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  2. Response of the medial temporal lobe network in amnestic mild cognitive impairment to therapeutic intervention assessed by fMRI and memory task performance

    Directory of Open Access Journals (Sweden)

    Arnold Bakker

    2015-01-01

    detected by fMRI in individuals with aMCI and therapeutic intervention using fMRI to detect target engagement in response to treatment.

  3. High-frequency ultrasound imaging of tattoo reactions with histopathology as a comparative method. Introduction of preoperative ultrasound diagnostics as a guide to therapeutic intervention.

    Science.gov (United States)

    Carlsen, K Hutton; Tolstrup, J; Serup, J

    2014-08-01

    Tattoo adverse reactions requiring diagnostic evaluation and treatment are becoming more common. The aim of this study was to assess tattoo reactions by 20-MHz ultrasonography referenced to histopathology as a comparative method. A total of 73 individuals with clinical adverse reactions in their tattoos were studied. Punch biopsies for reference histology were available from 58 patients. The Dermascan C(®) of Cortex Technology, Denmark, was employed. Total skin thickness and echo density of the echolucent band in the outer dermis were measured. Biopsy served for diagnosis and for determination of the level of cellular infiltration in the dermis. In every tattoo reaction studied, the skin affected was found thicker compared with regional control of the same individual (mean difference 0.73 mm). A prominent echolucent band of mean thickness 0.89 mm was demonstrated, primarily located in the very outer dermis but propagating to deeper dermal layers parallel to increasing severity of reactions. The thickness of the echolucent band correlated with the thickness of cellular infiltration determined by microscopic examination, R = 0.6412 (P tattoo reactions showed no distinct characteristics by ultrasound, but mainly displayed themselves by their advanced inflammatory component. It is demonstrated for the first time that ultrasound, with histopathology as the comparative method, can quantify the severity of tattoo reactions and non-invasively diagnose the depth of the inflammatory process in the dermis elicited by the microparticulate tattoo pigment, which itself is too minute to be imaged by ultrasound. Preoperative 20-MHz ultrasound scanning is introduced as a potentially useful method to guide therapeutic interventions by surgery and lasers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Streptozotocin Intracerebroventricular-Induced Neurotoxicity and Brain Insulin Resistance: a Therapeutic Intervention for Treatment of Sporadic Alzheimer's Disease (sAD)-Like Pathology.

    Science.gov (United States)

    Kamat, Pradip K; Kalani, Anuradha; Rai, Shivika; Tota, Santosh Kumar; Kumar, Ashok; Ahmad, Abdullah S

    2016-09-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that is remarkably characterized by pathological hallmarks which include amyloid plaques, neurofibrillary tangles, neuronal loss, and progressive cognitive loss. Several well-known genetic mutations which are being used for the development of a transgenic model of AD lead to an early onset familial AD (fAD)-like condition. However, these settings are only reasons for a small percentage of the total AD cases. The large majorities of AD cases are considered as a sporadic in origin and are less influenced by a single mutation of a gene. The etiology of sporadic Alzheimer's disease (sAD) remains unclear, but numerous risk factors have been identified that increase the chance of developing AD. Among these risk factors are insulin desensitization/resistance state, oxidative stress, neuroinflammation, synapse dysfunction, tau hyperphosphorylation, and deposition of Aβ in the brain. Subsequently, these risk factors lead to development of sAD. However, the underlying molecular mechanism is not so clear. Streptozotocin (STZ) produces similar characteristic pathology of sAD such as altered glucose metabolism, insulin signaling, synaptic dysfunction, protein kinases such as protein kinase B/C, glycogen synthase-3β (GSK-3β) activation, tau hyperphosphorylation, Aβ deposition, and neuronal apoptosis. Further, STZ also leads to inhibition of Akt/PKB, insulin receptor (IR) signaling molecule, and insulin resistance in brain. These alterations mediated by STZ can be used to explore the underlying molecular and pathophysiological mechanism of AD (especially sAD) and their therapeutic intervention for drug development against AD pathology.

  5. Preliminary evaluation of a commercially available videogame system as an adjunct therapeutic intervention for improving balance among children and adolescents with lower limb amputations.

    Science.gov (United States)

    Andrysek, Jan; Klejman, Susan; Steinnagel, Bryan; Torres-Moreno, Ricardo; Zabjek, Karl F; Salbach, Nancy M; Moody, Kim

    2012-02-01

    To examine the safety, feasibility, and balance performance effects of a 4-week home-based balance therapy program using a commercially available videogame system. A pilot study involving a preintervention and postintervention design was conducted with measurements taken at baseline, immediately postintervention (week 5), and at follow-up (week 13) for retention. University hospital outpatient clinic and participants' places of residence. Children and adolescents with unilateral lower limb amputation (n=6; 3 transfemoral [TF] and 3 Van Ness) and age-matched, typically developing individuals (n=10) for baseline comparison. Two videogames involving weight shifting in standing were each played at home for 20 min/d, 4d/wk for a period of 4 weeks. A physical therapist provided initial instruction and monitoring. Postural control characteristics using center of pressure (COP) displacements during quiet standing; functional balance using the Community Balance and Mobility Scale (CB&M); and compliance, safety, and feasibility using custom questionnaires. Average playing times for the first 3 weeks ranged from 16.0 to 21.1 minutes for the 2 games. At baseline, the children and adolescents with TF amputation had substantially greater COP displacements than the Van Ness group and typically developing children and adolescents. Immediately postintervention, the COP displacements decreased in the TF amputees, resulting in values that were closer to those of the typically developing children. The average increase in CB&M score from baseline to follow-up was 6 points across participants. In-home, videogame-based balance training therapies can achieve excellent compliance in children and adolescents with lower limb amputation. With proper instructions and monitoring, the therapeutic intervention can be safely administered. Some improvements in postural control characteristics were seen in children and adolescents with balance deficits immediately postintervention, but long

  6. The search for relevant outcome measures for cost-utility analysis of systemic family interventions in adolescents with substance use disorder and delinquent behavior: A systematic literature review

    NARCIS (Netherlands)

    S.J. Schawo (Saskia); C.A.M. Bouwmans-Frijters (Clazien); van der Schee, E. (E.); V. Hendriks (Vincent); W.B.F. Brouwer (Werner); L. van Hakkaart-van Roijen (Leona)

    2017-01-01

    textabstractPurpose: Systemic family interventions have shown to be effective in adolescents with substance use disorder and delinquent behavior. The interventions target interactions between the adolescent and involved systems (i.e. youth, family, peers, neighbors, school, work, and society). Next

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

    OpenAIRE

    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...

  8. [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.

  9. The search for relevant outcome measures for cost-utility analysis of systemic family interventions in adolescents with substance use disorder and delinquent behavior: a systematic literature review.

    Science.gov (United States)

    Schawo, S; Bouwmans, C; van der Schee, E; Hendriks, V; Brouwer, W; Hakkaart, L

    2017-09-19

    Systemic family interventions have shown to be effective in adolescents with substance use disorder and delinquent behavior. The interventions target interactions between the adolescent and involved systems (i.e. youth, family, peers, neighbors, school, work, and society). Next to effectiveness considerations, economic aspects have gained attention. However, conventional generic quality of life measures used in health economic evaluations may not be able to capture the broad effects of systemic interventions. This study aims to identify existing outcome measures, which capture the broad effects of systemic family interventions, and allow use in a health economic framework. We based our systematic review on clinical studies in the field. Our goal was to identify effectiveness studies of psychosocial interventions for adolescents with substance use disorder and delinquent behavior and to distill the instruments used in these studies to measure effects. Searched databases were PubMed, Education Resource Information Center (ERIC), Cochrane and Psychnet (PsycBOOKSc, PsycCRITIQUES, print). Identified instruments were ranked according to the number of systems covered (comprehensiveness). In addition, their use for health economic analyses was evaluated according to suitability characteristics such as brevity, accessibility, psychometric properties, etc. One thousand three hundred seventy-eight articles were found and screened for eligibility. Eighty articles were selected, 8 instruments were identified covering 5 or more systems. The systematic review identified instruments from the clinical field suitable to evaluate systemic family interventions in a health economic framework. None of them had preference-weights available. Hence, a next step could be to attach preference-weights to one of the identified instruments to allow health economic evaluations of systemic family interventions.

  10. Radiation-Induced Esophagitis In Vivo and In Vitro Reveals That Epidermal Growth Factor Is a Potential Candidate for Therapeutic Intervention Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Su [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jeon, Seong-Uk; Lee, Chan-Ju; Kim, Young-Eun; Bok, Seoyeon; Hong, Beom-Ju; Park, Dong-Young [Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Gyeongbuk (Korea, Republic of); Ahn, G-One, E-mail: goneahn@postech.ac.kr [Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Gyeongbuk (Korea, Republic of); Kim, Hak Jae, E-mail: khjae@snu.ac.kr [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-07-01

    in the irradiated esophagus suggests that EGF may be a potential therapeutic intervention strategy to treat RIE.

  11. 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.

  12. Relevant outcomes for nutrition interventions to treat and prevent malnutrition in older people : a collaborative senator-ontop and manuel delphi study

    NARCIS (Netherlands)

    Correa-Pérez, Andrea; Lozano-Montoya, Isabel; Volkert, Dorothee; Visser, Marjolein; Cruz-Jentoft, Alfonso J.

    Background and aims: Research in malnutrition in older people is limited by the lack of consensus on relevant outcomes. Researchers of two European initiatives, the ‘Malnutrition in the Elderly (MaNuEL) Knowledge Hub’ (mostly experts in nutrition) and the Optimal Evidence-Based Non-drug Therapies in

  13. A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors

    NARCIS (Netherlands)

    Kuijpers, W.; Groen, W.G.; Aaronson, N.K.; van Harten, W.H.

    2013-01-01

    Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such

  14. A Systematic Review of Web-Based Interventions for Patient Empowerment and Physical Activity in Chronic Diseases : Relevance for Cancer Survivors

    NARCIS (Netherlands)

    Kuijpers, W.; Groen, W.G.; Aaronson, N.K.; van Harten, Willem H.

    2013-01-01

    Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such

  15. Therapeutic effect assessment of integrated intervention for learning difficulties in children%综合干预学习困难儿童的疗效评估

    Institute of Scientific and Technical Information of China (English)

    林桂秀; 陈珊; 陈达光; 胡君; 殷晓荣

    2005-01-01

    BACKGROUND:Children with learning difficulty often present with cognitive impairments and imbalanced development of intelligence accompanied by emotional and behavioral problems.OBJECTIVE:To evaluate the therapeutic effects of integrated interventions in multiple aspects for children with learning difficulties.DESIGN:A case-control study of children with learning difficulties.SETTING:Department of Pediatric Internal Medicine, Union Hospital Affiliated to Fujian Medical University.PARTICIPANTS:This study involved school-age children of 6 to 12years old with learning difficulties who came to the department specialized in pediatric psychology for consultation from July 1998 to July 2001. The diagnosis of learning difficulties conformed to the diagnostic criteria for special learning disability in ICD-10 with IQ > 70 as an essential condition. Children with emotional disorders, mental deficiency, hyperactivity,visual and auditory dysfunctions and organic cerebral diseases were excluded. The diagnosis was further verified by a professor specialized in neuropsychology. The children voluntarily participated in the cognitive training, behavioral intervention and comprehensive trainings of senses and those who fulfilled the one-year treatment were included in this study. The ratio of therapists to the children was 1:2, and each session of treatment lasted for 90-120 minutes given 2-3 times a week, and a treatment course consisted of 24 sessions. The children were supposed to complete 4 consecutive treatment courses. Totally 31 children completed the treatment courses, including 24 boys and 7 girls with the mean age of(7.7±1.2)years who had an average IQ of 87.5±8.6.grated interventions for one year consisting of cognitive training, behavioral intervention and comprehensive training of the senses. Raven's Deductive Reasoning test and Beery Visual-Motor Integration Test were use to examine the deductive reasoning ability and visual-motor integration of the children, and

  16. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Justin Shmalberg

    2015-01-01

    Full Text Available Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions. The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.. Older neutered or spayed dogs (mean age = 9.0 years and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients. Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P<0.05. The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.

  17. Design Effectiveness Analysis of a Media Literacy Intervention to Reduce Violent Video Games Consumption Among Adolescents: The Relevance of Lifestyles Segmentation.

    Science.gov (United States)

    Rivera, Reynaldo; Santos, David; Brändle, Gaspar; Cárdaba, Miguel Ángel M

    2016-04-01

    Exposure to media violence might have detrimental effects on psychological adjustment and is associated with aggression-related attitudes and behaviors. As a result, many media literacy programs were implemented to tackle that major public health issue. However, there is little evidence about their effectiveness. Evaluating design effectiveness, particularly regarding targeting process, would prevent adverse effects and improve the evaluation of evidence-based media literacy programs. The present research examined whether or not different relational lifestyles may explain the different effects of an antiviolence intervention program. Based on relational and lifestyles theory, the authors designed a randomized controlled trial and applied an analysis of variance 2 (treatment: experimental vs. control) × 4 (lifestyle classes emerged from data using latent class analysis: communicative vs. autonomous vs. meta-reflexive vs. fractured). Seven hundred and thirty-five Italian students distributed in 47 classes participated anonymously in the research (51.3% females). Participants completed a lifestyle questionnaire as well as their attitudes and behavioral intentions as the dependent measures. The results indicated that the program was effective in changing adolescents' attitudes toward violence. However, behavioral intentions toward consumption of violent video games were moderated by lifestyles. Those with communicative relational lifestyles showed fewer intentions to consume violent video games, while a boomerang effect was found among participants with problematic lifestyles. Adolescents' lifestyles played an important role in influencing the effectiveness of an intervention aimed at changing behavioral intentions toward the consumption of violent video games. For that reason, audience lifestyle segmentation analysis should be considered an essential technique for designing, evaluating, and improving media literacy programs. © The Author(s) 2016.

  18. Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations.

    Science.gov (United States)

    Spagnolo, Jessica; Champagne, François; Leduc, Nicole; Melki, Wahid; Guesmi, Imen; Bram, Nesrine; Guisset, Ann-Lise; Piat, Myra; Laporta, Marc; Charfi, Fatma

    2018-01-01

    In order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0) , developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia. The phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations. Through the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care. Targeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

  19. 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.

  20. Crystal clear: visualizing the intervention mechanism of the PD-1/PD-L1 interaction by two cancer therapeutic monoclonal antibodies

    Directory of Open Access Journals (Sweden)

    Shuguang Tan

    2016-11-01

    Full Text Available Abstract Antibody-based PD-1/PD-L1 blockade therapies have taken center stage in immunotherapies for cancer, with multiple clinical successes. PD-1 signaling plays pivotal roles in tumor-driven T-cell dysfunction. In contrast to prior approaches to generate or boost tumor-specific T-cell responses, antibody-based PD-1/PD-L1 blockade targets tumor-induced T-cell defects and restores pre-existing T-cell function to modulate antitumor immunity. In this review, the fundamental knowledge on the expression regulations and inhibitory functions of PD-1 and the present understanding of antibody-based PD-1/PD-L1 blockade therapies are briefly summarized. We then focus on the recent breakthrough work concerning the structural basis of the PD-1/PD-Ls interaction and how therapeutic antibodies, pembrolizumab targeting PD-1 and avelumab targeting PD-L1, compete with the binding of PD-1/PD-L1 to interrupt the PD-1/PD-L1 interaction. We believe that this structural information will benefit the design and improvement of therapeutic antibodies targeting PD-1 signaling.

  1. Clinical Relevance of Adipokines

    Directory of Open Access Journals (Sweden)

    Matthias Blüher

    2012-10-01

    Full Text Available The incidence of obesity has increased dramatically during recent decades. Obesity increases the risk for metabolic and cardiovascular diseases and may therefore contribute to premature death. With increasing fat mass, secretion of adipose tissue derived bioactive molecules (adipokines changes towards a pro-inflammatory, diabetogenic and atherogenic pattern. Adipokines are involved in the regulation of appetite and satiety, energy expenditure, activity, endothelial function, hemostasis, blood pressure, insulin sensitivity, energy metabolism in insulin sensitive tissues, adipogenesis, fat distribution and insulin secretion in pancreatic β-cells. Therefore, adipokines are clinically relevant as biomarkers for fat distribution, adipose tissue function, liver fat content, insulin sensitivity, chronic inflammation and have the potential for future pharmacological treatment strategies for obesity and its related diseases. This review focuses on the clinical relevance of selected adipokines as markers or predictors of obesity related diseases and as potential therapeutic tools or targets in metabolic and cardiovascular diseases.

  2. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures.

    Science.gov (United States)

    Schneider, Jeremy A; Cohen, Philip R

    2017-06-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. PubMed was searched with the key words: corticosteroids, cyclosporine, etanercept, intravenous immunoglobulin, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The papers generated by the search, and their references, were reviewed. Supportive care is the most universally accepted intervention for SJS/TEN. Specific guidelines differ from the care required for patients with thermal burns. Adjuvant therapies are utilized in most severe cases, but the data are thus far underwhelming and underpowered. Using systemic corticosteroids as sole therapy is not supported. A consensus regarding combined corticosteroids and intravenous immunoglobulin (IVIG) has not been reached. Data regarding IVIG, currently the standard of care for most referral centers, is conflicting. Newer studies regarding cyclosporine and tumor necrosis factor inhibitors are promising, but not powered to provide definitive evidence of efficacy. Data regarding plasmapheresis is equivocal. Thalidomide increases mortality. Clinicians who manage SJS/TEN should seek to employ interventions with the greatest impact on their patients' condition. While supportive care measures may seem an obvious aspect of SJS/TEN patient care, providers should understand that these interventions are imperative and that they differ from the care recommended for other critically ill or burn patients. While adjuvant therapies are frequently discussed and debated for hospitalized patients with SJS/TEN, a standardized management approach is not yet clear based on the current data. Therefore, until further data

  3. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures

    OpenAIRE

    Schneider, Jeremy A.; Cohen, Philip R.

    2017-01-01

    Introduction Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. Purpose The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. Methods PubMed was searched with the key words: cortic...

  4. 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

  5. S3 Guideline. Diagnosis and treatment of colorectal carcinoma. Relevance for radiologic imaging and interventions; Aktualisierte S3-Leitlinie zur Diagnostik und Therapie des kolorektalen Karzinoms. Bedeutung fuer die radiologische Diagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Fischer, S. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schmiegel, W.; Pox, C. [Bochum Univ. (Germany). Medizinische Universitaetsklinik; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin; Brambs, H.J. [Universitaetsklinikum Ulm (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lux, P. [Universitaetsklinikum Erlangen (Germany). Chirurgische Klinik

    2013-08-15

    The new German S3 guideline 'Colorectal Carcinoma' was created as part of the German Guideline Program in Oncology of the Association of the Scientific Medical Societies in Germany, the German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Diseases and replaces the guideline from 2008. With its evidence-based treatment recommendations, the guideline contains numerous updates and detailed definitions regarding the diagnosis and treatment of colon and rectal cancer. In particular, consensus-based recommendations regarding early detection, preoperative diagnostic method selection, and the use of interventional radiological treatment methods are detailed. The guideline also includes quality indicators so that standardized quality assurance methods can be used to optimize patient-related processes. The present article discusses the significance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and care by increasing distribution. (orig.)

  6. Understanding access and use of technology among youth with first-episode psychosis to inform the development of technology-enabled therapeutic interventions.

    Science.gov (United States)

    Abdel-Baki, Amal; Lal, Shalini; D-Charron, Olivier; Stip, Emmanuel; Kara, Nadjia

    2017-02-01

    Computers, video games and technological devices are part of young people's everyday lives. However, their use in first-episode psychosis (FEP) treatment is rare. The purpose of this study was to better understand the access and use of technology among individuals with FEP, including gaming activities, to inform future development of technology-enabled therapeutic applications. Self-administered survey on use of technological tools in 71 FEP individuals. PCs/laptops were used by all participants; cellphones/smartphones by 92%, consoles by 83% (mainly male and younger participants). Women texted and used social networks more frequently; men played games (mainly action) more often. The younger individuals reported playing games frequently (32% daily) with less use of the Web and social networks (favourite: Facebook). These data will be useful for developing Web-based psychoeducation tools and cognitive remediation video games for youth with FEP. © 2015 Wiley Publishing Asia Pty Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Macromolecular therapeutics.

    Science.gov (United States)

    Yang, Jiyuan; Kopeček, Jindřich

    2014-09-28

    This review covers water-soluble polymer-drug conjugates and macromolecules that possess biological activity without attached low molecular weight drugs. The main design principles of traditional and backbone degradable polymer-drug conjugates as well as the development of a new paradigm in nanomedicines - (low molecular weight) drug-free macromolecular therapeutics are discussed. To address the biological features of cancer, macromolecular therapeutics directed to stem/progenitor cells and the tumor microenvironment are deliberated. Finally, the future perspectives of the field are briefly debated. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Experiential or behavioral processes: which one is prominent in physical activity? Examining the processes of change 1 year after an intervention of therapeutic education among adults with obesity.

    Science.gov (United States)

    Romain, A J; Attalin, V; Sultan, A; Boegner, C; Gernigon, C; Avignon, A

    2014-11-01

    Although physical activity (PA) is essential, most obese people will not engage in its practice. The transtheoretical model (TTM) and its processes of change (POC) contribute to the understanding of behavior change regarding PA. The present study aimed to test how POC are associated with a progression through the stages of change (SOC) and whether they predict BMI change. Interventional study. A total of 134 subjects participated in an education program, were called at 1 year and 62 of them provided follow-up data. Participants completed the SOC and POC questionnaires at baseline, at 1 year and were classified according to their SOC progression. Participants who progressed through SOC lost more weight (pbehavioral POC. Results support the previous cross-sectional studies showing that physically active people use more frequently POC. The present findings support the development of TTM-grounded behavioral interventions targeted to obese patients. Identifying methods to promote POC use to improve adherence to weight guidelines may lead to improved clinical outcomes and quality of life. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Interventions for vaginismus.

    Science.gov (United States)

    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

  11. Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions.

    Science.gov (United States)

    Suárez, María Fernanda; Correa, Leandro; Crim, Nicolás; Espósito, Evangelina; Monti, Rodolfo; Urrets-Zavalía, Julio Alberto; Serra, Horacio Marcelo

    2015-01-01

    Climatic droplet keratopathy (CDK) is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy). A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA) was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight.

  12. Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    María Fernanda Suárez

    2015-01-01

    Full Text Available Climatic droplet keratopathy (CDK is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy. A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight.

  13. Therapeutic Nanodevices

    Science.gov (United States)

    Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

    Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

  14. Improved ambulation and speech production in an adolescent post-traumatic brain injury through a therapeutic intervention to increase postural control.

    Science.gov (United States)

    Reinthal, Ann Karas; Mansour, Linda Moeller; Greenwald, Glenna

    2004-01-01

    This case study examined the effectiveness of a programme designed to improve anticipatory postural control in an adolescent over years 2 and 3 post-traumatic brain injury (TBI). It was hypothesized that her difficulty in walking and talking simultaneously was caused by excessive co-activation of extremity, trunk, and oral musculature during upright activities. The participant was treated weekly by physical and speech therapy. Treatment focussed on improving anticipatory postural control during gross motor activities in conjunction with oral-motor function. Initially, the participant walked using a walker at a speed of 23 cm s(-1). Two years later, she could walk without a device at 53 cm s(-1). Initial laryngoscopic examination showed minimal movement of the velum or pharyngeal walls; full movement was present after treatment. The measure of intelligibility improved from no single word intelligible utterances to 85% intelligible utterances after 2 years. The results suggest that less compensatory rigidification of oral musculature was needed to maintain an upright position against gravity as postural control improved. An adolescent 1-year post-TBI was followed as she underwent additional rehabilitation focussed on improving anticipatory postural control. The functional goal of simultaneously talking while walking was achieved through this intervention.

  15. Proceso de Cambio Psicoterapéutico: Análisis de Episodios Relevantes en una Terapia Grupal con Pacientes Adictos Therapeutic Change Process: Analysis of Relevant Episodes in a Group Therapy With Addict Patients

    Directory of Open Access Journals (Sweden)

    Nelson Valdés

    2005-11-01

    Full Text Available En el presente artículo se presentan los resultados de una investigación que tuvo como objetivo determinar y describir el tipo de acciones comunicacionales realizadas por terapeutas y pacientes durante las sesiones de una terapia grupal. Para esto se utilizó una metodología orientada al descubrimiento empleando un análisis cualitativo de contenido. En los resultados se incluye tanto la descripción de las acciones identificadas de acuerdo al nivel de análisis, así como los patrones ideales de secuencia de dichos componentes asociados al cambio y propios de esta modalidad terapéutica. Finalmente, los resultados son discutidos considerando los principales antecedentes teóricos y empíricos en materia de investigación en psicoterapia.This article presents the results of a study aimed to determine and describe the type of communicative actions made by therapists and patients during the sessions of a group therapy. A discovery-oriented methodology was applied, conducting qualitative content analysis. Results include the description of the identified actions by levels of analysis, and their ideal sequential patterns, associated to in-session change and particularly to this therapeutic modality. Finally, the results are discussed considering the main theoretical and empirical frameworks in psychotherapy research.

  16. Therapeutic ultrasound

    International Nuclear Information System (INIS)

    Crum, Lawrence A

    2004-01-01

    The use of ultrasound in medicine is now quite commonplace, especially with the recent introduction of small, portable and relatively inexpensive, hand-held diagnostic imaging devices. Moreover, ultrasound has expanded beyond the imaging realm, with methods and applications extending to novel therapeutic and surgical uses. These applications broadly include: tissue ablation, acoustocautery, lipoplasty, site-specific and ultrasound mediated drug activity, extracorporeal lithotripsy, and the enhancement of natural physiological functions such as wound healing and tissue regeneration. A particularly attractive aspect of this technology is that diagnostic and therapeutic systems can be combined to produce totally non-invasive, imageguided therapy. This general lecture will review a number of these exciting new applications of ultrasound and address some of the basic scientific questions and future challenges in developing these methods and technologies for general use in our society. We shall particularly emphasize the use of High Intensity Focused Ultrasound (HIFU) in the treatment of benign and malignant tumors as well as the introduction of acoustic hemostasis, especially in organs which are difficult to treat using conventional medical and surgical techniques. (amum lecture)

  17. A Wnt1 regulated Frizzled-1/β-Catenin signaling pathway as a candidate regulatory circuit controlling mesencephalic dopaminergic neuron-astrocyte crosstalk: Therapeutical relevance for neuron survival and neuroprotection

    Directory of Open Access Journals (Sweden)

    Pluchino Stefano

    2011-07-01

    /β-catenin antagonist within the SN induces reactive astrocytosis and acutely inhibits TH+ neuron survival in ipsilateral SNpc, an effect efficiently prevented by pharmacological activation of β-catenin signaling within the SNpc. Conclusion These results defining a novel Wnt1/Fzd-1/β-catenin astrocyte-DA autoprotective loop provide a new mechanistic inside into the regulation of pro-survival processes, with potentially relevant consequences for drug design or drug action in Parkinson's disease.

  18. 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.

  19. Exploring effects of therapeutic massage and patient teaching in the practice of diaphragmatic breathing on blood pressure, stress, and anxiety in hypertensive African-American women: an intervention study.

    Science.gov (United States)

    Jefferson, Lenetra L

    2010-07-01

    The problem of hypertension among African-Americans is one of the major areas of health disparities. The American Heart Association (2009) noted that the prevalence of hypertension among African-Americans is perhaps among the highest in the world and this is particularly so among African-American women (44.0%). The purpose of this study was to determine how therapeutic chair massage and patient teaching in diaphragmatic breathing affected African-American women's blood pressure, stress, and anxiety levels over one week or six weeks time periods. A Modified Stress, Coping, and Adaptation Model (Roy, 1976; Lazarus, 1966), Descriptives, T-tests, Pearson Product Moment Correlations, Multivariate analysis of variance (MANOVA), and Multivariate analysis of variance with covariate (MANCOVA) were used. Descriptive statistics indicated a significance for decreased systolic blood pressure levels for the one week post massage intervention measurement with p = .01, diastolic blood pressure level significance for the same group p = .02, significance for this group's State Trait Anxiety Inventory (STAI) Y2 Scale score p = .01, and Roy's Largest Root p = .03.

  20. Aquatic Therapy: A Viable Therapeutic Recreation Intervention.

    Science.gov (United States)

    Broach, Ellen; Dattilo, John

    1996-01-01

    Reviews literature on the effects of aquatic therapy (swimming and exercise) to improve function. Research shows that aquatic therapy has numerous psychological and physical benefits, and it supports the belief that participation can provide a realistic solution to maintaining physical fitness and rehabilitation goals while engaging in enjoyable…

  1. 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)

  2. Why relevance theory is relevant for lexicography

    DEFF Research Database (Denmark)

    Bothma, Theo; Tarp, Sven

    2014-01-01

    This article starts by providing a brief summary of relevance theory in information science in relation to the function theory of lexicography, explaining the different types of relevance, viz. objective system relevance and the subjective types of relevance, i.e. topical, cognitive, situational...... that is very important for lexicography as well as for information science, viz. functional relevance. Since all lexicographic work is ultimately aimed at satisfying users’ information needs, the article then discusses why the lexicographer should take note of all these types of relevance when planning a new...... dictionary project, identifying new tasks and responsibilities of the modern lexicographer. The article furthermore discusses how relevance theory impacts on teaching dictionary culture and reference skills. By integrating insights from lexicography and information science, the article contributes to new...

  3. Therapeutic relevance of HRCT findings from a pneumological viewpoint

    International Nuclear Information System (INIS)

    Suchy, R.; Pfeifer, M.

    2014-01-01

    The high-resolution computed tomography (HRCT) technique is an essential component in diagnosing interstitial lung disease (ILD) as it provides important and specialized information and a much greater accuracy than chest X-rays. It contributes to a narrowing down of the differential diagnoses and is also important for planning further invasive investigations, e.g. bronchoscopy, bronchoalveolar lavage, transbronchial lung biopsy and surgical lung biopsy, if needed. An accurate diagnosis of ILD is based on a multidisciplinary discussion involving pulmonologists, radiologists and pathologists experienced in the diagnosis of ILD. The therapy approaches of five different entities of ILD are shown as examples. In hypersensitivity pneumonitis the mainstay of treatment is complete avoidance of exposure to the provoking antigen. In cryptogenic organizing pneumonia most patients recover with corticosteroid therapy with prednisolone over a period of 6 months to 1 year. In cases of sarcoidosis therapy depends on organ involvement and functional impairment but there is no durable benefit to routine treatment of patients with acute pulmonary sarcoidosis, even among those with stage II or III chest radiographs. In general, patients with severe or progressive disease will require treatment. In idiopathic pulmonary fibrosis (IPF) a confident radiological diagnosis of definitive usual interstitial pneumonia (UIP) obviates the need for surgical lung biopsy. Other etiologies of a HRCT pattern of UIP, such as domestic and occupational environmental exposure, connective tissue disease and drug toxicity must be ruled out. In IPF antifibrotic therapy with pirfenidone (approval since 2011) or the triple tyrosine kinase inhibitor nintendanib (pending approval in 2015) can reduce disease progression but therapy with acetylcysteine alone or in combination with prednisolone and azathioprine failed to meet efficacy endpoints. In the management of scleroderma associated ILD rapid semiquantitative evaluation of the extent of the disease on HRCT > 20 % is useful for identifying patients who require treatment. (orig.) [de

  4. A therapeutic community as a relevant and efficient ecclesial model ...

    African Journals Online (AJOL)

    2016-07-15

    Jul 15, 2016 ... doctors, sangomas and prophets to ensure that their health and that of their .... in the sense of acknowledgment, appreciation and respect. Heimbrock .... A thorough critical introspection by the African church in this at ..... theology: Only study guide for CGM112P, University of South Africa, Pretoria. Uka, E.M. ...

  5. Therapeutic emails

    Directory of Open Access Journals (Sweden)

    Sinkule Jennifer

    2007-02-01

    Full Text Available Abstract Background In this paper, we show how counselors and psychologists can use emails for online management of substance abusers, including the anatomy and content of emails that clinicians should send substance abusers. Some investigators have attempted to determine if providing mental health services online is an efficacious delivery of treatment. The question of efficacy is an empirical issue that cannot be settled unless we are explicitly clear about the content and nature of online treatment. We believe that it is not the communications via internet that matters, but the content of these communications. The purpose of this paper is to provide the content of our online counseling services so others can duplicate the work and investigate its efficacy. Results We have managed nearly 300 clients online for recovery from substance abuse. Treatment included individual counseling (motivational interviewing, cognitive-behavior therapy, relapse prevention assignments, participation in an electronic support group and the development of a recovery team. Our findings of success with these interventions are reported elsewhere. Our experience has led to development of a protocol of care that is described more fully in this paper. This protocol is based on stages of change and relapse prevention theories and follows a Motivational Interviewing method of counseling. Conclusion The use of electronic media in providing mental health treatment remains controversial due to concerns about confidentiality, security and legal considerations. More research is needed to validate and generalize the use of online treatment for mental health problems. If researchers have to build on each others work, it is paramount that we share our protocols of care, as we have done in this paper.

  6. 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.

  7. 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.

  8. Deep learning relevance

    DEFF Research Database (Denmark)

    Lioma, Christina; Larsen, Birger; Petersen, Casper

    2016-01-01

    train a Recurrent Neural Network (RNN) on existing relevant information to that query. We then use the RNN to "deep learn" a single, synthetic, and we assume, relevant document for that query. We design a crowdsourcing experiment to assess how relevant the "deep learned" document is, compared...... to existing relevant documents. Users are shown a query and four wordclouds (of three existing relevant documents and our deep learned synthetic document). The synthetic document is ranked on average most relevant of all....

  9. Antibody Engineering and Therapeutics

    Science.gov (United States)

    Almagro, Juan Carlos; Gilliland, Gary L; Breden, Felix; Scott, Jamie K; Sok, Devin; Pauthner, Matthias; Reichert, Janice M; Helguera, Gustavo; Andrabi, Raiees; Mabry, Robert; Bléry, Mathieu; Voss, James E; Laurén, Juha; Abuqayyas, Lubna; Barghorn, Stefan; Ben-Jacob, Eshel; Crowe, James E; Huston, James S; Johnston, Stephen Albert; Krauland, Eric; Lund-Johansen, Fridtjof; Marasco, Wayne A; Parren, Paul WHI; Xu, Kai Y

    2014-01-01

    The 24th Antibody Engineering & Therapeutics meeting brought together a broad range of participants who were updated on the latest advances in antibody research and development. Organized by IBC Life Sciences, the gathering is the annual meeting of The Antibody Society, which serves as the scientific sponsor. Preconference workshops on 3D modeling and delineation of clonal lineages were featured, and the conference included sessions on a wide variety of topics relevant to researchers, including systems biology; antibody deep sequencing and repertoires; the effects of antibody gene variation and usage on antibody response; directed evolution; knowledge-based design; antibodies in a complex environment; polyreactive antibodies and polyspecificity; the interface between antibody therapy and cellular immunity in cancer; antibodies in cardiometabolic medicine; antibody pharmacokinetics, distribution and off-target toxicity; optimizing antibody formats for immunotherapy; polyclonals, oligoclonals and bispecifics; antibody discovery platforms; and antibody-drug conjugates. PMID:24589717

  10. Therapeutic and diagnostic nanomaterials

    CERN Document Server

    Devasena T

    2017-01-01

    This brief highlights nanoparticles used in the diagnosis and treatment of prominent diseases and toxic conditions. Ecofriendly methods which are ideal for the synthesis of medicinally valued nanoparticles are explained and the characteristic features of these particles projected. The role of these particles in the therapeutic field, and the induced biological changes in some diseases are discussed. The main focus is on inflammation, oxidative stress and cellular membrane integrity alterations. The effect of nanoparticles on these changes produced by various agents are highlighted using in vitro and in vivo models. The mechanism of nanoparticles in ameliorating the biological changes is supported by relevant images and data. Finally, the brief demonstrates recent developments on the use of nanoparticles in diagnosis or sensing of some biological materials and biologically hazardous environmental materials.

  11. Effect of Therapeutic Touch in Patients with Cancer: a Literature Review.

    Science.gov (United States)

    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.

  12. 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

  13. The effects of therapeutic touch on pain.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  15. Conflicts in the therapeutic field

    Directory of Open Access Journals (Sweden)

    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.

  16. A efetividade dos testes complementares no acompanhamento da intervenção terapêutica no transtorno fonológico Effectiveness of complementary tests in monitoring therapeutic intervention in speech sound disorders

    Directory of Open Access Journals (Sweden)

    Haydée Fiszbein Wertzner

    2012-12-01

    effectiveness and the efficiency in using the Percentage of Consonants Correct - Revised (PCC-R index as well as complementary tests of speech inconsistency, stimulability and phonological awareness skills in monitoring therapeutic intervention in children with speech sound disorders. The study included three male children. At the time of initial evaluation, Case 1 was 6 years and 9 months old, Case 2, 8 years and 10 months old, and Case 3, 9 years and 7 months old. In addition to the specific assessment of phonology, complementary tests were used to help in verifying the underlying deficits for each specific case. Subjects were also evaluated on phonological awareness abilities, speech inconsistency and speech stimulability. Data analysis confirmed that the complementary tests selected for this case study were effective and efficient to complement initial diagnostic as well as to demonstrate modifications that occurred in the three subjects with speech sound disorders.

  17. 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

  18. THERAPEUTIC EFFECTIVENESS OF THORACIC FACET JOINT INTERVENTIONS IN CHRONIC THORACIC PAIN%X光引导胸椎小关节注射治疗胸背痛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李晓宏; 李世杰; 黄翔; 富沛勇; 杨承祥

    2013-01-01

    目的:评价小关节注射治疗胸背部疼痛的临床疗效及安全性.方法:60例经保守治疗无效的慢性胸背痛患者,随机分为超激光治疗组(S组,n=30)和介入治疗组(Ⅰ组,n=30).S组患者取俯卧位,超激光照射病变关节部位,每天1次,每次15 rain,共14次;Ⅰ组患者取俯卧位,在X光引导下确定病变小关节平面,穿刺针经皮正确无误到达胸椎后关节突关节间隙,到位后注射消炎镇痛液.对治疗后第1周、2周、1个月、3个月的VAS进行评分、生活质量改善情况及安全性进行评估.结果:与S组比较,Ⅰ组治疗患者术后3个月的VAS评分较治疗前有显著性降低(P<0.05),且未发现有严重并发症.结论:小关节注射治疗胸背痛是一项操作简便、安全,疗效确切、可靠的微创介入治疗方法.%Objective:To determine the clinical effectiveness of zygapophysial joint injections with fluoroscopy in managing chronic mid back or upper back pain of facet joint origin.Methods:A total of 60 patients were randomized divided into two groups,with 30 patients in each of the super laser and facet joint interventions groups.All of the patients met the diagnostic criteria of thoracic facet joint pain by means of the inclusion criteria.Group S patients received thoracic facet joint with super laser,whereas Group Ⅰ patients received thoracic facet joint intervention with bupivacaine and non-particulate betamethasone.The clinical efficacy were assessed by patients with visual analogue scale(VAS).All outcomes were assessed at baseline,1 week,2 weeks,1 month,and 3 months after treatment.Results:In Group S,compared with baseline,patients showed significant pain relief and functional improvement at 1 week (P < 0.05) But there were no significant pain relief after 2 weeks.In Group Ⅰ,patients showed significant pain relief and functional improvement after facet joint injection,a significant change 3 months after treatment from baseline (P < 0

  19. Choosing a control intervention for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. [Eye contact effects: A therapeutic issue?

    Science.gov (United States)

    Baltazar, M; Conty, L

    2016-12-01

    The perception of a direct gaze - that is, of another individual's gaze directed at the observer that leads to eye contact - is known to influence a wide range of cognitive processes and behaviors. We stress that these effects mainly reflect positive impacts on human cognition and may thus be used as relevant tools for therapeutic purposes. In this review, we aim (1) to provide an exhaustive review of eye contact effects while discussing the limits of the dominant models used to explain these effects, (2) to illustrate the therapeutic potential of eye contact by targeting those pathologies that show both preserved gaze processing and deficits in one or several functions that are targeted by the eye contact effects, and (3) to propose concrete ways in which eye contact could be employed as a therapeutic tool. (1) We regroup the variety of eye contact effects into four categories, including memory effects, activation of prosocial behavior, positive appraisals of self and others and the enhancement of self-awareness. We emphasize that the models proposed to account for these effects have a poor predictive value and that further descriptions of these effects is needed. (2) We then emphasize that people with pathologies that affect memory, social behavior, and self and/or other appraisal, and self-awareness could benefit from eye contact effects. We focus on depression, autism and Alzheimer's disease to illustrate our proposal. To our knowledge, no anomaly of eye contact has been reported in depression. Patients suffering from Alzheimer disease, at the early and moderate stage, have been shown to maintain a normal amount of eye contact with their interlocutor. We take into account that autism is controversial regarding whether gaze processing is preserved or altered. In the first view, individuals are thought to elude or omit gazing at another's eyes while in the second, individuals are considered to not be able to process the gaze of others. We adopt the first stance

  2. Statistical significant change versus relevant or important change in (quasi) experimental design : some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research

    NARCIS (Netherlands)

    Middel, Berrie; van Sonderen, Eric

    2002-01-01

    This paper aims to identify problems in estimating and the interpretation of the magnitude of intervention-related change over time or responsiveness assessed with health outcome measures. Responsiveness is a problematic construct and there is no consensus on how to quantify the appropriate index to

  3. Variáveis relevantes no processo terapêutico para a aquisição do onset complexo na fala de crianças com desvio fonológico Relevant variables in the therapeutic process for the consonant clusters acquisition in the speech of children with phonological disorder

    Directory of Open Access Journals (Sweden)

    Vanessa Giacchini

    2012-01-01

    Full Text Available OBJETIVO: apresentar variáveis relevantes no processo terapêutico de aquisição do onset complexo (OC em crianças que realizam a simplificação dessa estrutura. MÉTODO: participaram do estudo quatro crianças com diagnóstico de desvio fonológico (DF, com idades entre 5:4 a 7:7, que utilizavam a estratégia de alongamento compensatório (EAC, possuíam [r] e [l] no seu inventário fonético e realizavam a simplificação do OC. As crianças foram submetidas a diferentes modelos terapêuticos e, a partir dos dados obtidos nas sondagens, realizaram-se análises das variáveis linguísticas e extralinguísticas relevantes durante o processo terapêutico. A análise dos dados de fala foram realizadas por meio do programa estatístico VARBRUL. RESULTADOS: a variável gravidade do desvio foi a que o programa selecionou como relevante para a produção correta do OC, para sua simplificação e para a distorção da líquida da estrutura. Ele apontou que quando o sujeito é submetido à terapia articulatória (TA, há maior probabilidade de ocorrência de produção correta de CCV, realização de distorção e metátese. O fonema /d/ se mostrou favorecedor da estratégia de metátese. A substituição da líquida foi influenciada pela variável sujeito e pelo tipo de líquida formadora do OC. CONCLUSÃO: quanto às variáveis, a gravidade do DF mostra-se importante tanto para o sucesso da terapia (produção correta de CCV, como para o uso de estratégias de reparo. Observou-se que aplicar tipos de terapia distintos faz com que as crianças respondam de forma diferenciada a cada um deles, com melhor desempenho na TA.PURPOSE: to provide relevant variable aspects in the therapeutic process of consonant clusters (CC acquisition in children but maintains the CCV simplification. METHOD: four children diagnosed with phonological disorders, aged 5:4 to 7:7 took part in the study, using the strategy of compensatory lengthening, having [r] and [l] in the

  4. Therapeutic Basis of Clinical Pain Modulation

    Science.gov (United States)

    Kirkpatrick, Daniel R.; McEntire, Dan M.; Hambsch, Zakary J.; Kerfeld, Mitchell J.; Smith, Tyler A.; Reisbig, Mark D.; Youngblood, Charles F.

    2015-01-01

    Abstract Pain is a hallmark of almost all bodily ailments and can be modulated by agents, including analgesics and anesthetics that suppress pain signals in the central nervous system. Defects in the modulatory systems, including the endogenous pain‐inhibitory pathways, are a major factor in the initiation and chronicity of pain. Thus, pain modulation is particularly applicable to the practice of medicine. This review summarizes the existing literature on pain modulation. Here, we critically reviewed the literature from PubMed on pain modulation published primarily within the past 5 years in high impact journals. Specifically, we have discussed important anatomical landmarks of pain modulation and outlined the endogenous networks and underlying mechanisms of clinically relevant pain modulatory methods. The Gate Control Theory is briefly presented with discussion on the capacity of pain modulation to cause both hyper‐ and hypoalgesia. An emphasis has been given to highlight key areas in pain research that, because of unanswered questions or therapeutic potential, merit additional scientific scrutiny. The information presented in this paper would be helpful in developing novel therapies, metrics, and interventions for improved patient management. PMID:25962969

  5. Diagnostic and therapeutic peroral cholangioscopy

    Directory of Open Access Journals (Sweden)

    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.

  6. Relevance of nanotechnology to Africa: synthesis, applications and safety

    CSIR Research Space (South Africa)

    Musee, N

    2012-07-01

    Full Text Available In this chapter, two nanotechnology-based applications relevant to Africa in promoting sustainability and achievement of the Millennium Development Goals (MDGs) are presented. The applications comprise the provision of therapeutic treatment...

  7. The Use of Music and Other Forms of Organized Sound as a Therapeutic Intervention for Students with Auditory Processing Disorder: Providing the Best Auditory Experience for Children with Learning Differences

    Science.gov (United States)

    Faronii-Butler, Kishasha O.

    2013-01-01

    This auto-ethnographical inquiry used vignettes and interviews to examine the therapeutic use of music and other forms of organized sound in the learning environment of individuals with Central Auditory Processing Disorders. It is an investigation of the traditions of healing with sound vibrations, from its earliest cultural roots in shamanism and…

  8. Image fusion of MRI and fMRI with intraoperative MRI data: methods and clinical relevance for neurosurgical interventions; Fusion von MRT-, fMRT- und intraoperativen MRT-Daten. Methode und klinische Bedeutung am Beispiel neurochirurgischer Interventionen

    Energy Technology Data Exchange (ETDEWEB)

    Moche, M.; Busse, H.; Dannenberg, C.; Schulz, T.; Schmidt, F.; Kahn, T. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Diagnostische Radiologie; Schmitgen, A. [GMD Forschungszentrum Informationstechnik GmbH-FIT, Sankt Augustin (Germany); Trantakis, C.; Winkler, D. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Leipzig (Germany)

    2001-11-01

    The aim of this work was to realize and clinically evaluate an image fusion platform for the integration of preoperative MRI and fMRI data into the intraoperative images of an interventional MRI system with a focus on neurosurgical procedures. A vertically open 0.5 T MRI scanner was equipped with a dedicated navigation system enabling the registration of additional imaging modalities (MRI, fMRI, CT) with the intraoperatively acquired data sets. These merged image data served as the basis for interventional planning and multimodal navigation. So far, the system has been used in 70 neurosurgical interventions (13 of which involved image data fusion - requiring 15 minutes extra time). The augmented navigation system is characterized by a higher frame rate and a higher image quality as compared to the system-integrated navigation based on continuously acquired (near) real time images. Patient movement and tissue shifts can be immediately detected by monitoring the morphological differences between both navigation scenes. The multimodal image fusion allowed a refined navigation planning especially for the resection of deeply seated brain lesions or pathologies close to eloquent areas. Augmented intraoperative orientation and instrument guidance improve the safety and accuracy of neurosurgical interventions. (orig.) [German] Ziel dieser Arbeit waren die Realisierung und klinische Bewertung einer Bildfusion praeoperativer MRT- und fMRT-Bilder mit intraoperativen Datensaetzen eines interventionellen MRT-Systems am Beispiel neurochirurgischer Eingriffe. Ein vertikal offenes 0,5-T-MRT-System wurde mit einem erweiterten Navigationssystem ausgestattet, welches eine Integration zusaetzlicher Bildinformationen (Hochfeld-MRT, fMRT, CT) in die intraoperativ akquirierten Datensaetze erlaubt. Diese fusionierten Bilddaten wurden zur Interventionsplanung und multimodalen Navigation verwendet. Bisher wurde das System bei insgesamt 70 neurochirurgischen Eingriffen eingesetzt, davon 13

  9. Making Deferred Taxes Relevant

    NARCIS (Netherlands)

    Brouwer, Arjan; Naarding, Ewout

    2018-01-01

    We analyse the conceptual problems in current accounting for deferred taxes and provide solutions derived from the literature in order to make International Financial Reporting Standards (IFRS) deferred tax numbers value-relevant. In our view, the empirical results concerning the value relevance of

  10. Parsimonious relevance models

    NARCIS (Netherlands)

    Meij, E.; Weerkamp, W.; Balog, K.; de Rijke, M.; Myang, S.-H.; Oard, D.W.; Sebastiani, F.; Chua, T.-S.; Leong, M.-K.

    2008-01-01

    We describe a method for applying parsimonious language models to re-estimate the term probabilities assigned by relevance models. We apply our method to six topic sets from test collections in five different genres. Our parsimonious relevance models (i) improve retrieval effectiveness in terms of

  11. [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.

  12. Enactments in Psychoanalysis: Therapeutic Benefits.

    Science.gov (United States)

    Stern, Stanley

    The therapeutic benefits of enactments are addressed. Relevant literature reveals disparate conceptions about the nature and use of enactments. Clarification of the term is discussed. This analyst's theoretical and technical evolution is addressed; it is inextricably related to using enactments. How can it not be? A taxonomy of enactments is presented. The article considers that enactments may be fundamental in the evolution from orthodox to contemporary analytic technique. Assumptions underlying enactments are explored, as are guidelines for using enactments. Finally, the article posits that enactments have widened the scope of analysis and contributed to its vitality.

  13. Cumulative Childhood Trauma and Therapeutic Alliance: The Moderator Role of Attachment in Adult Patients Consulting in Sex Therapy.

    Science.gov (United States)

    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.

  14. The cerebral collateral circulation: Relevance to pathophysiology and treatment of stroke.

    Science.gov (United States)

    Ginsberg, Myron D

    2017-08-09

    The brain's collateral circulation consists of arterial anastomotic channels capable of providing nutrient perfusion to brain regions whose normal sources of flow have become compromised, as occurs in acute ischemic stroke. Modern CT-based neuroimaging is capable of providing detailed information as to collateral extent and sufficiency and is complemented by magnetic resonance-based methods. In the present era of standard-of-care IV thrombolysis for acute ischemic stroke, and following the recent therapeutic successes of randomized clinical trials of acute endovascular intervention, the sufficiency of the collateral circulation has been convincingly established as a key factor influencing the likelihood of successful reperfusion and favorable clinical outcome. This article reviews the features of the brain's collateral circulation; methods for its evaluation in the acute clinical setting; the relevance of collateral circulation to prognosis in acute ischemic stroke; the specific insights into the collateral circulation learned from recent trials of endovascular intervention; and the major influence of genetic factors. Finally, we emphasize the need to develop therapeutic approaches to augment collateral perfusion as an adjunctive strategy to be employed along with, or prior to, thrombolysis and endovascular interventions, and we highlight the possible potential of inhaled nitric oxide, albumin, and other approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. 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

  16. Interpersonal communication: It's relevance to nursing practice ...

    African Journals Online (AJOL)

    This paper is aimed at highlighting how essential interpersonal communication is necessary for establishing rapport, understanding the needs of the patients and planning effective intervention for meeting holistic health care. To be continually relevant, Nurses have to improve on their communication skills to meet the ...

  17. 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.

  18. Internet-Based Interventions for Addictive Behaviours: A Systematic Review.

    Science.gov (United States)

    Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M

    2016-12-01

    Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.

  19. A importância do controle de qualidade em serviços de hemodinâmica e cardiologia intervencionista The relevance of quality control in services of hemodynamics and interventional cardiology

    Directory of Open Access Journals (Sweden)

    Eara de Souza Luz

    2007-02-01

    Full Text Available OBJETIVO: Avaliar o desempenho de um equipamento de raios X utilizado em radiologia intervencionista e a qualidade de imagem produzida, aplicando alguns testes de controle de qualidade. MATERIAIS E MÉTODOS: O equipamento de raios X testado foi da marca Philips (Integris H3000, do serviço de hemodinâmica de um hospital do Rio de Janeiro. Foram utilizados objetos de teste de Leeds para avaliar a qualidade da imagem, e um sistema Radcal 9015 para medições dosimétricas. RESULTADOS: Nos modos high e normal, os valores medidos das taxas de kerma no ar foram diferentes dos esperados. Em alguns casos, os valores das taxas medidas não foram afetados pelo uso de diferentes modos de magnificação. A avaliação da qualidade da imagem apresentou resultados diferentes dos valores recomendados pelas normas. Isto pode levar à obtenção de imagens de menor qualidade e ao aumento da exposição à radiação de pacientes e profissionais. CONCLUSÃO: Os resultados mostraram a importância da aplicação periódica de testes de controle de qualidade, que permitem monitorar o desempenho do equipamento e estimar a exposição dos pacientes e trabalhadores. Os resultados obtidos sugerem a necessidade de uma revisão no sistema de aquisição de imagens do equipamento.OBJECTIVE: To evaluate the performance and quality of images of a x-ray equipment utilized in interventional radiology, by means of some tests of quality control. MATERIALS AND METHODS: Measurements have been performed on a Philips Integris H3000 x-ray equipment dedicated to interventional procedures in the hemodynamics laboratory of a hospital in Rio de Janeiro, RJ, Brazil. Leeds test objects have been used to evaluate the image quality. Dosimetric measurements have been developed with a Radcal 9015 dosimetric system. RESULTS: In high and normal modes, the air kerma rates have been different from the expected results. In some cases, values have not been affected by the use of different

  20. Polycystic Ovary Syndrome: Insights into the Therapeutic Approach with Inositols

    Science.gov (United States)

    Sortino, Maria A.; Salomone, Salvatore; Carruba, Michele O.; Drago, Filippo

    2017-01-01

    Polycystic ovary syndrome (PCOS) is characterized by hormonal abnormalities that cause menstrual irregularity and reduce ovulation rate and fertility, associated to insulin resistance. Myo-inositol (cis-1,2,3,5-trans-4,6-cyclohexanehexol, MI) and D-chiro-inositol (cis-1,2,4-trans-3,5,6-cyclohexanehexol, DCI) represent promising treatments for PCOS, having shown some therapeutic benefits without substantial side effects. Because the use of inositols for treating PCOS is widespread, a deep understanding of this treatment option is needed, both in terms of potential mechanisms and efficacy. This review summarizes the current knowledge on the biological effects of MI and DCI and the results obtained from relevant intervention studies with inositols in PCOS. Based on the published results, both MI and DCI represent potential valid therapeutic approaches for the treatment of insulin resistance and its associated metabolic and reproductive disorders, such as those occurring in women affected by PCOS. Furthermore, the combination MI/DCI seems also effective and might be even superior to either inositol species alone. However, based on available data, a particular MI:DCI ratio to be administered to PCOS patients cannot be established. Further studies are then necessary to understand the real contents of MI or DCI uptaken by the ovary following oral administration in order to identify optimal doses and/or combination ratios. PMID:28642705

  1. Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature.

    Science.gov (United States)

    Babatunde, Folarin; MacDermid, Joy; MacIntyre, Norma

    2017-05-30

    Most conventional treatment for musculoskeletal conditions continue to show moderate effects, prompting calls for ways to increase effectiveness, including drawing from strategies used across other health conditions. Therapeutic alliance refers to the relational processes at play in treatment which can act in combination or independently of specific interventions. Current evidence guiding the use of therapeutic alliance in health care arises largely from psychotherapy and medicine literature. The objective of this review was to map out the available literature on therapeutic alliance conceptual frameworks, themes, measures and determinants in musculoskeletal rehabilitation across physiotherapy and occupational therapy disciplines. A scoping review of the literature published in English since inception to July 2015 was conducted using Medline, EMBASE, PsychINFO, PEDro, SportDISCUS, AMED, OTSeeker, AMED and the grey literature. A key search term strategy was employed using "physiotherapy", "occupational therapy", "therapeutic alliance", and "musculoskeletal" to identify relevant studies. All searches were performed between December 2014 and July 2015 with an updated search on January 2017. Two investigators screened article title, abstract and full text review for articles meeting the inclusion criteria and extracted therapeutic alliance data and details of each study. One hundred and thirty articles met the inclusion criteria including quantitative (33%), qualitative (39%), mixed methods (7%) and reviews and discussions (23%) and most data came from the USA (23%). Randomized trials and systematic reviews were 4.6 and 2.3% respectively. Low back pain condition (22%) and primary care (30.7%) were the most reported condition and setting respectively. One theory, 9 frameworks, 26 models, 8 themes and 42 subthemes of therapeutic alliance were identified. Twenty-six measures were identified; the Working Alliance Inventory (WAI) was the most utilized measure (13%). Most of

  2. 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.

  3. The Limits to Relevance

    Science.gov (United States)

    Averill, M.; Briggle, A.

    2006-12-01

    Science policy and knowledge production lately have taken a pragmatic turn. Funding agencies increasingly are requiring scientists to explain the relevance of their work to society. This stems in part from mounting critiques of the "linear model" of knowledge production in which scientists operating according to their own interests or disciplinary standards are presumed to automatically produce knowledge that is of relevance outside of their narrow communities. Many contend that funded scientific research should be linked more directly to societal goals, which implies a shift in the kind of research that will be funded. While both authors support the concept of useful science, we question the exact meaning of "relevance" and the wisdom of allowing it to control research agendas. We hope to contribute to the conversation by thinking more critically about the meaning and limits of the term "relevance" and the trade-offs implicit in a narrow utilitarian approach. The paper will consider which interests tend to be privileged by an emphasis on relevance and address issues such as whose goals ought to be pursued and why, and who gets to decide. We will consider how relevance, narrowly construed, may actually limit the ultimate utility of scientific research. The paper also will reflect on the worthiness of research goals themselves and their relationship to a broader view of what it means to be human and to live in society. Just as there is more to being human than the pragmatic demands of daily life, there is more at issue with knowledge production than finding the most efficient ways to satisfy consumer preferences or fix near-term policy problems. We will conclude by calling for a balanced approach to funding research that addresses society's most pressing needs but also supports innovative research with less immediately apparent application.

  4. Relevant Subspace Clustering

    DEFF Research Database (Denmark)

    Müller, Emmanuel; Assent, Ira; Günnemann, Stephan

    2009-01-01

    Subspace clustering aims at detecting clusters in any subspace projection of a high dimensional space. As the number of possible subspace projections is exponential in the number of dimensions, the result is often tremendously large. Recent approaches fail to reduce results to relevant subspace...... clusters. Their results are typically highly redundant, i.e. many clusters are detected multiple times in several projections. In this work, we propose a novel model for relevant subspace clustering (RESCU). We present a global optimization which detects the most interesting non-redundant subspace clusters...... achieves top clustering quality while competing approaches show greatly varying performance....

  5. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    Science.gov (United States)

    Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

    2008-01-01

    Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post

  6. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    Directory of Open Access Journals (Sweden)

    Strobl Ralf

    2008-02-01

    Full Text Available Abstract Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets. Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute

  7. Is Information Still Relevant?

    Science.gov (United States)

    Ma, Lia

    2013-01-01

    Introduction: The term "information" in information science does not share the characteristics of those of a nomenclature: it does not bear a generally accepted definition and it does not serve as the bases and assumptions for research studies. As the data deluge has arrived, is the concept of information still relevant for information…

  8. Mind-Body Interventions to Reduce Risk for Health Disparities Related to Stress and Strength Among African American Women: The Potential of Mindfulness-Based Stress Reduction, Loving-Kindness, and the NTU Therapeutic Framework.

    Science.gov (United States)

    Woods-Giscombé, Cheryl L; Black, Angela R

    2010-12-14

    In the current article, the authors examine the potential role of mind-body interventions for preventing or reducing health disparities in a specific group-African American women. The authors first discuss how health disparities affect this group, including empirical evidence regarding the influence of biopsychosocial processes (e.g., psychological stress and social context) on disparate health outcomes. They also detail how African American women's unique stress experiences as a result of distinct sociohistorical and cultural experiences related to race and gender potentially widen exposure to stressors and influence stress responses and coping behaviors. Using two independent, but related, frameworks (Superwoman Schema [SWS] and the Strong Black Woman Script [SBW-S]), they discuss how, for African American women, stress is affected by "strength" (vis-à-vis resilience, fortitude, and self-sufficiency) and the emergent health-compromising behaviors related to strength (e.g., emotional suppression, extraordinary caregiving, and self-care postponement). The authors then describe the potential utility of three mind-body interventions-mindfulness-based stress reduction (MBSR), loving-kindness meditation (LKM), and NTU psychotherapy-for specifically targeting the stress-, strength-, and contextually related factors that are thought to influence disparate outcomes for African American women. Self-awareness, self-care, inter- and intrapersonal restorative healing and a redefinition of inner strength may manifest through developing a mindfulness practice to decrease stress-related responses; using LKM to cultivate compassion and forgiveness for self and others; and the balance of independence and interdependence as a grounding NTU principle for redefining strength. The authors conclude with a discussion of potential benefits for integrating key aspects of the interventions with recommendations for future research.

  9. Information Needs/Relevance

    OpenAIRE

    Wildemuth, Barbara M.

    2009-01-01

    A user's interaction with a DL is often initiated as the result of the user experiencing an information need of some kind. Aspects of that experience and how it might affect the user's interactions with the DL are discussed in this module. In addition, users continuously make decisions about and evaluations of the materials retrieved from a DL, relative to their information needs. Relevance judgments, and their relationship to the user's information needs, are discussed in this module. Draft

  10. Individualised cancer therapeutics: dream or reality? Therapeutics construction.

    Science.gov (United States)

    Shen, Yuqiao; Senzer, Neil; Nemunaitis, John

    2005-11-01

    The analysis of DNA microarray and proteomic data, and the subsequent integration into functional expression sets, provides a circuit map of the hierarchical cellular networks responsible for sustaining the viability and environmental competitiveness of cancer cells, that is, their robust systematics. These technologies can be used to 'snapshot' the unique patterns of molecular derangements and modified interactions in cancer, and allow for strategic selection of therapeutics that best match the individual profile of the tumour. This review highlights technology that can be used to selectively disrupt critical molecular targets and describes possible vehicles to deliver the synthesised molecular therapeutics to the relevant cellular compartments of the malignant cells. RNA interference (RNAi) involves a group of evolutionarily conserved gene silencing mechanisms in which small sequences of double-stranded RNA or intrinsic antisense RNA trigger mRNA cleavage or translational repression, respectively. Although RNAi molecules can be synthesised to 'silence' virtually any gene, even if upregulated, a mechanism for selective delivery of RNAi effectors to sites of malignant disease remains challenging. The authors will discuss gene-modified conditionally replicating viruses as candidate vehicles for the delivery of RNAi.

  11. [Online Counselling: The prospect of a therapeutic connection].

    Science.gov (United States)

    Giotakos, O; Papadomarkaki, E

    2016-01-01

    Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers. The advent of remote support services dates back in the decade of 1970-1980. In the present time, they consist of informative guides and self-help groups or online counselling. The latter is defined as the process in which both parties, namely the therapist and the client, are involved in an oral or written conciliation through means of an internet connection, videoconferencing, live chat or e-mail exchange. The benefits of this practice - accessibility, relocation, convenience, anonymity, facilitation of face-to-face psychotherapy and low cost - could make online counseling, in specific cases, the treatment of choice. While the usage of the World Wide Web seems promising for the rectification of mental health disorders, there is some debate among experts regarding the ethical aspect of practicing psychotherapy in an interactive digital environment. Issues such as technical expertise and the tackling of related problems, difficulties in the diagnostic process, interchange of verbal and nonverbal cues, crisis management, safeguarding the therapeutic alliance, protection of personal data, age restriction, keeping boundaries in relation to the setting, the time and the dynamics of the therapeutic relationship and, finally, training and supervisory process of online therapist, are some subjects of disagreement. Relevant research reveals

  12. 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.

  13. Guidelines for Rational Cancer Therapeutics

    Directory of Open Access Journals (Sweden)

    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.

  14. Therapeutic potential of eccentric exercises for age-related muscle atrophy

    Directory of Open Access Journals (Sweden)

    Jae-Young Lim

    2016-09-01

    Full Text Available Recent studies have focused on evidence-based interventions to prevent mobility decline and enhance physical performance in older adults. Several modalities, in addition to traditional strengthening programs, have been designed to manage age-related functional decline more effectively. In this study, we reviewed the current relevant literatures to assess the therapeutic potential of eccentric exercises for age-related muscle atrophy (sarcopenia. Age-related changes in human skeletal muscle, and their relationship with physical performance, are discussed with reference to in vitro physiologic and human biomechanics studies. An overview of issues relevant to sarcopenia is provided in the context of the recent consensus on the diagnosis and management of the condition. A decline in mobility among the aging population is closely linked with changes in the muscle force–velocity relationship. Interventions based specifically on increasing velocity and eccentric strength can improve function more effectively compared with traditional strengthening programs. Eccentric strengthening programs are introduced as a specific method for improving both muscle force and velocity. To be more effective, exercise interventions for older adults should focus on enhancing the muscle force–velocity relationship. Exercises that can be performed easily, and that utilize eccentric strength (which is relatively spared during the aging process, are needed to improve both muscle force and velocity.

  15. 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.

  16. [Relevant public health enteropathogens].

    Science.gov (United States)

    Riveros, Maribel; Ochoa, Theresa J

    2015-01-01

    Diarrhea remains the third leading cause of death in children under five years, despite recent advances in the management and prevention of this disease. It is caused by multiple pathogens, however, the prevalence of each varies by age group, geographical area and the scenario where cases (community vs hospital) are recorded. The most relevant pathogens in public health are those associated with the highest burden of disease, severity, complications and mortality. In our country, norovirus, Campylobacter and diarrheagenic E. coli are the most prevalent pathogens at the community level in children. In this paper we review the local epidemiology and potential areas of development in five selected pathogens: rotavirus, norovirus, Shiga toxin-producing E. coli (STEC), Shigella and Salmonella. Of these, rotavirus is the most important in the pediatric population and the main agent responsible for child mortality from diarrhea. The introduction of rotavirus vaccination in Peru will have a significant impact on disease burden and mortality from diarrhea. However, surveillance studies are needed to determine the impact of vaccination and changes in the epidemiology of diarrhea in Peru following the introduction of new vaccines, as well as antibiotic resistance surveillance of clinical relevant bacteria.

  17. The Relevance of Humanitarian Intervention in the New ...

    African Journals Online (AJOL)

    They played a key role in restoring confidence among Burundians by insuring that the situation in the country did not degenerate into chaos. Their support towards the peace process ensured the implementation of the Arusha agreement for Burundi. La fin de la Guerre Froide a rendu possible un changement fondamental ...

  18. The Relevance of Humanitarian Intervention in the New ...

    African Journals Online (AJOL)

    User

    clé en restaurant la confiance entre les Burundais en s'assurant que la situation dans le pays .... protection purposes needs to meet at least four basic objectives: ... unreasonable for the United Nations Operation in Burundi (UNOB) to enforce.

  19. Biomedical and therapeutic applications of biosurfactants

    OpenAIRE

    Rodrigues, L. R.; Teixeira, J. A.

    2010-01-01

    During the last years, several applications of biosurfactants with medical purposes have been reported. Biosurfactants are considered relevant molecules for applications in combating many diseases and as therapeutic agents due to their antibacterial, antifungal and antiviral activities. Furthermore, their role as anti-adhesive agents against several pathogens illustrate their utility as suitable anti-adhesive coating agents for medical insertional materials leading to a reduction of a large n...

  20. 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...

  1. Dexmedetomidine in PRES: An appropriate therapeutic decision

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. 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.

  4. Other relevant biological papers

    International Nuclear Information System (INIS)

    Shimizu, M.

    1989-01-01

    A considerable number of CRESP-relevant papers concerning deep-sea biology and radioecology have been published. It is the purpose of this study to call attention to them. They fall into three general categories. The first is papers of general interest. They are mentioned only briefly, and include text references to the global bibliography at the end of the volume. The second are papers that are not only mentioned and referenced, but for various reasons are described in abstract form. The last is a list of papers compiled by H.S.J. Roe specifically for this volume. They are listed in bibliographic form, and are also included in the global bibliography at the end of the volume

  5. 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.

  6. Therapeutic HIV Peptide Vaccine

    DEFF Research Database (Denmark)

    Fomsgaard, Anders

    2015-01-01

    Therapeutic vaccines aim to control chronic HIV infection and eliminate the need for lifelong antiretroviral therapy (ART). Therapeutic HIV vaccine is being pursued as part of a functional cure for HIV/AIDS. We have outlined a basic protocol for inducing new T cell immunity during chronic HIV-1...... infection directed to subdominant conserved HIV-1 epitopes restricted to frequent HLA supertypes. The rationale for selecting HIV peptides and adjuvants are provided. Peptide subunit vaccines are regarded as safe due to the simplicity, quality, purity, and low toxicity. The caveat is reduced immunogenicity...

  7. Mindfulness Interventions.

    Science.gov (United States)

    Creswell, J David

    2017-01-03

    Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

  8. Marketing therapeutic recreation services.

    Science.gov (United States)

    Thorn, B E

    1984-01-01

    The use of marketing strategies can enhance the delivery of therapeutic recreation services. This article discusses how agencies can adapt marketing techniques and use them to identify potential markets, improve image, evaluate external pressures, and maximize internal strengths. Four variables that can be controlled and manipulated in a proposed marketing plan are product, price, place and promotion.

  9. Therapeutic Recombinant Monoclonal Antibodies

    Science.gov (United States)

    Bakhtiar, Ray

    2012-01-01

    During the last two decades, the rapid growth of biotechnology-derived techniques has led to a myriad of therapeutic recombinant monoclonal antibodies with significant clinical benefits. Recombinant monoclonal antibodies can be obtained from a number of natural sources such as animal cell cultures using recombinant DNA engineering. In contrast to…

  10. Therapeutic applications of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Baker, W.J.; Datz, F.L.; Beightol, R.W.

    1987-01-01

    Whether a radiopharmaceutical has diagnostic or therapeutic application depends on both the isotope and pharmaceutical used. For diagnostic applications, the isotope should undergo only γ-decay, since usually only γ-radiation is detected by nuclear medicine cameras. The half-life should be just long enough to allow the procedure to be performed. In contrast, the isotope needed for therapeutic purposes should have particulate radiation, such as a β-particle (electron), since these are locally absorbed an increase the local radiation dose. γ-Radiation, which penetrates the tissues, produces less radiation dose than do Β-particles. Several references dealing with radioactive decay, particulate interactions, and diagnostic and therapeutic applications of radiopharmaceuticals are available. Radiopharmaceuticals can legally be used only by physicians who are qualified by specific training in the safe handling of radionuclides. The experience and training of these physicians must be approved by the Nuclear Regulatory Commission or Agreement State Agency authorized to license the use of radiopharmaceuticals. A list of all byproduct material and procedures is available in the Code of Federal Regulations. Of the many radiopharmaceuticals available for diagnostic and therapeutic use, only those commonly used are discussed in this chapter

  11. Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians.

    Science.gov (United States)

    Demers, Marika; Chan Chun Kong, Daniel; Levin, Mindy F

    2018-03-11

    To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation.

  12. User perspectives on relevance criteria

    DEFF Research Database (Denmark)

    Maglaughlin, Kelly L.; Sonnenwald, Diane H.

    2002-01-01

    , partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance......This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant...... matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially...

  13. Regulatory roles and therapeutic potential of microRNA in sarcoma.

    Science.gov (United States)

    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.

  14. Therapeutic treatment with a novel hypoxia-inducible factor hydroxylase inhibitor (TRC160334 ameliorates murine colitis

    Directory of Open Access Journals (Sweden)

    Gupta R

    2014-01-01

    Full Text Available Ram Gupta,1 Anita R Chaudhary,2 Binita N Shah,1 Avinash V Jadhav,3 Shitalkumar P Zambad,1 Ramesh Chandra Gupta,4 Shailesh Deshpande,4 Vijay Chauthaiwale,4 Chaitanya Dutt4 1Department of Pharmacology, 2Cellular and Molecular Biology, 3Preclinical Safety Evaluation, 4Discovery, Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gandhinagar, Gujarat, India Background and aim: Mucosal healing in inflammatory bowel disease (IBD can be achieved by improvement of intestinal barrier protection. Activation of hypoxia-inducible factor (HIF has been identified as a critical factor for barrier protection during mucosal insult and is linked with improvement in symptoms of colitis. Although prophylactic efficacy of HIF hydroxylase inhibitors in murine colitis have been established, its therapeutic efficacy in clinically relevant therapeutic settings have not been established. In the present study we aim to establish therapeutic efficacy of TRC160334, a novel HIF hydroxylase inhibitor, in animal models of colitis. Methods: The efficacy of TRC160334 was evaluated in two different mouse models of colitis by oral route. A prophylactic efficacy study was performed in a 2,4,6-trinitrobenzene sulfonic acid-induced mouse model of colitis representing human Crohn's disease pathology. Additionally, a therapeutic efficacy study was performed in a dextran sulfate sodium-induced mouse model of colitis, a model simulating human ulcerative colitis. Results: TRC160334 treatment resulted in significant improvement in disease end points in both models of colitis. TRC160334 treatment resulted into cytoprotective heatshock protein 70 induction in inflamed colon. TRC160334 successfully attenuated the rate of fall in body weight, disease activity index, and macroscopic and microscopic scores of colonic damage leading to overall improvement in study outcome. Conclusion: Our findings are the first to demonstrate that therapeutic intervention with a HIF hydroxylase inhibitor

  15. 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.

  16. Clínica ampliada em saúde mental: cuidar e suposição de saber no acompanhamento terapêutico Wide-spectrum clinical interventions in mental health: " care" and " subject supposed to know" in therapeutic assistance

    Directory of Open Access Journals (Sweden)

    Carlos Estellita-Lins

    2009-02-01

    Full Text Available Este trabalho investiga o acompanhamento terapêutico, entendido como intervenção em saúde mental baseada em cuidados domiciliares. Destacamos a importância de intervenções comunitárias privilegiando formas de lidar com o sofrimento, seja através de uma concepção médica dos sintomas, fundada na visibilidade, seja valorizando uma leitura psicanalítica que recorre à escuta. Carecendo de teorização independente que fundamente sua prática, o AT (acompanhamento terapêutico apropria-se de teorias provenientes de outros campos do saber que guardam afinidades. Neste sentido, abordamos a influência da psicanálise e sua participação na clínica ampliada em saúde mental através da prática clínica do AT, utilizando dois conceitos operatórios de amplo alcance, que são: sujeito suposto saber, proveniente da obra de Lacan, e cuidado, derivado de Winnicott. Ambos respondem a questões do campo teórico e orientam a atuação clínica. Concluímos que o AT realiza exigências do manejo transferencial sob a forma do cuidar exercido no cotidiano do sujeito, no qual desejo e subjetividade são necessariamente reconhecidos, sem que se configure como tecnologia psicoterápica, situando-se mais propriamente como sentinela clínica no campo da psiquiatria comunitária e saúde coletiva.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

  17. Relevance of Programs for Emotionally Disturbed Youth in Other Lands

    Science.gov (United States)

    David, Henry P.

    1970-01-01

    A survey of current trends was conducted in more than 40 countries. Focus was on the organization of services and their relevance for evolving practices in the United States. Apparent was a willingness to experiment with administrative and therapeutic roles. Ideological differences are important determinants of the organization, range, and quality…

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

    Science.gov (United States)

    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.

  19. Post-therapeutic imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Pollice, Saverio, E-mail: saveriopollice@hotmail.it [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy); Muto, Mario, E-mail: mutomar@tiscali.it [Department of Neuroradiology, “Cardarelli Hospital”, Naples (Italy); Scarabino, Tommaso, E-mail: tscarabino@hotmail.com [Department of Radiology and Neuroradiology, “L. Bonomo Hospital”, 76123 Andria, BT (Italy)

    2015-05-15

    Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

  20. Post-therapeutic imaging findings

    International Nuclear Information System (INIS)

    Pollice, Saverio; Muto, Mario; Scarabino, Tommaso

    2015-01-01

    Highlights: • This study is the result of collaboration between neuroradiologists and neurosurgeons. • Comparison between neuroimaging techniques to better evaluate the complications after treatment of the spin. • Evaluation of the imaging features of complications and definition of follow-up. - Abstract: Any surgical approach modifies the normal anatomical and functional arrangement of the segmental spine which is aimed, therefore image interpretation cannot ignore a correct set of knowledge in the field of anatomy, pathophysiology, drug compliance, interventional radiology and surgery. Neuroradiological imaging has an important role before surgery to direct the surgeon or interventional radiologist during the operation, both in post-surgery, where imaging examination can rightly evaluate properties and effects of the treatment and can detect potential complications as infections, abscess, bleeding, exuberant scar, mobilization and rupture of devices. The available methods of imaging are the X-rays (XR) made at least in two projections, Computed Tomography (CT) with MPR (multiplanar) and VR (volume rendering) reconstruction, and Magnetic Resonance (MR), often performed before and after contrast media injection. Imaging assessment of spine after surgery is complex and depends upon several factors, including surgical procedures and disease for which it was performed; biomechanical of the underlying cortical and cancellous bone findings; conditions of muscles, intervertebral disk and ligaments; time since surgery procedures; duration and nature of the post-surgical syndrome. Depending upon several factors, one or a combination of complementary imaging modalities (X-rays, Computed Tomography, Magnetic Resonance) may be required to evaluate effectiveness of the treatment; to demonstrate any clinically relevant abnormality at the treated region and adjacent structures (complications such as inflammation, abscesses, bleeding and misplacement of the device); to

  1. 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.

  2. PYTHIOSIS: A THERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    C. M. C. Falcão

    2015-10-01

    Full Text Available Pythiosis, a disease caused by the oomycete Pythium insidiosum, often presents inefficient response to chemotherapy. It is a consensus that, in spite the several therapeutic protocols, a combination of surgery, chemotherapy and immunotherapy should be used. Surgical excision requires the removal of the entire affected area, with a wide margin of safety. The use of antifungal drugs has resulted in variable results, both in vitro and in vivo, and presents low therapeutic efficiency due to differences in the agent characteristics, which differ from true fungi. Immunotherapy is a non-invasive alternative for the treatment of pythiosis, which aims at modifying the immune response of the host, thereby producing an effective response to the agent. Photodynamic therapy has emerged as a promising technique, with good activity against P. insidiosum in vitro and in vivo. However, more studies are necessary to increase the efficiency of the current treatment protocols and consequently improve the cure rates. This paper aims to conduct a review covering the conventional and recent therapeutic methods against P. insidiosum infections

  3. Interventional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Debatin, J.F.; Adam, G.

    1998-01-01

    With the advent of open configuration MR imaging systems, the vision of MRI-based guidance, control, and monitoring of minimally invasive interventions has evolved from a hypothetical concept to a practical possibility. This book provides a comprehensive overview of the very exciting emerging field of interventional MRI. The international authorship provides firsthand experience of all relevant topics. This book will familiarize the reader with the basic principles underlying currently available hardware and software configurations. In addition, technical aspects of thermosensitive imaging, techniques for instrument visualization, and safety aspects are covered. Finally, the book emphasizes both existing and future clinical applications. (orig.)

  4. 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.

  5. 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

  6. Therapeutic drug monitoring of antimicrobials

    Science.gov (United States)

    Roberts, Jason A; Norris, Ross; Paterson, David L; Martin, Jennifer H

    2012-01-01

    Optimizing the prescription of antimicrobials is required to improve clinical outcome from infections and to reduce the development of antimicrobial resistance. One such method to improve antimicrobial dosing in individual patients is through application of therapeutic drug monitoring (TDM). The aim of this manuscript is to review the place of TDM in the dosing of antimicrobial agents, specifically the importance of pharmacokinetics (PK) and pharmacodynamics (PD) to define the antimicrobial exposures necessary for maximizing killing or inhibition of bacterial growth. In this context, there are robust data for some antimicrobials, including the ratio of a PK parameter (e.g. peak concentration) to the minimal inhibitory concentration of the bacteria associated with maximal antimicrobial effect. Blood sampling of an individual patient can then further define the relevant PK parameter value in that patient and, if necessary, antimicrobial dosing can be adjusted to enable achievement of the target PK/PD ratio. To date, the clinical outcome benefits of a systematic TDM programme for antimicrobials have only been demonstrated for aminoglycosides, although the decreasing susceptibility of bacteria to available antimicrobials and the increasing costs of pharmaceuticals, as well as emerging data on pharmacokinetic variability, suggest that benefits are likely. PMID:21831196

  7. Neuropathology and Therapeutic Intervention in Spinal and Bulbar Muscular Atrophy

    Directory of Open Access Journals (Sweden)

    Haruhiko Banno

    2009-03-01

    Full Text Available Spinal and bulbar muscular atrophy (SBMA is a hereditary motor neuron disease caused by the expansion of a polyglutamine tract in the androgen receptor (AR. The histopathological finding in SBMA is loss of lower motor neurons in the anterior horn of the spinal cord as well as in the brainstem motor nuclei. Animal studies have revealed that the pathogenesis of SBMA depends on the level of serum testosterone, and that androgen deprivation mitigates neurodegeneration through inhibition of nuclear accumulation of the pathogenic AR. Heat shock proteins, ubiquitin-proteasome system and transcriptional regulation are also potential targets of therapy development for SBMA.

  8. Cybertherapy 2004: Using Interactive Media in Training and Therapeutic Interventions

    National Research Council Canada - National Science Library

    Wiederhold, B. K

    2005-01-01

    ... concerning conceptual matters and future possibilities. I am happy to report that after 9 years, we have progressed to a three-day conference, accompanied by a full day of pre-conference workshops on specialty topics...

  9. A review of vagus nerve stimulation as a therapeutic intervention

    OpenAIRE

    Johnson RL; Wilson CG

    2018-01-01

    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 addition...

  10. Dopamine receptors - physiological understanding to therapeutic intervention potential

    NARCIS (Netherlands)

    Emilien, G; Maloteaux, JM; Hoogenberg, K; Cragg, S

    1999-01-01

    There are two families of dopamine (DA) receptors, called D(1) and D(2), respectively. The D(1) family consists of D(1)- and D(5)-receptor subtypes and the D(2) family consists of D(2)-, D(3)-, and D(4)-receptor subtypes. The amino acid sequences of these receptors show that they all belong to a

  11. Outline of therapeutic interventions with muscarinic receptor-mediated transmission

    Czech Academy of Sciences Publication Activity Database

    Jakubík, Jan; Šantrůčková, Eva; Randáková, Alena; Janíčková, Helena; Zimčík, Pavel; Rudajev, Vladimír; Michal, Pavel; El-Fakahany, E. E.; Doležal, Vladimír

    2014-01-01

    Roč. 63, Suppl.1 (2014), S177-S189 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA305/09/0681; GA ČR(CZ) GAP304/12/0259; GA MŠk(CZ) 7E10060 Institutional support: RVO:67985823 Keywords : cholinergic transmission * muscarinic receptors * therapy * Alzheimer's disease, * schizophrenia Subject RIV: ED - Physiology Impact factor: 1.293, year: 2014

  12. Clinical work in prison: Which areas of therapeutic interventions

    Directory of Open Access Journals (Sweden)

    Francesca Campostrini

    2014-09-01

    Full Text Available Working in prison is a stressful situation for a clinical psychologist, given the contextual constraints. The psychologist is supposed to build caring relationships with psychiatric patients restricted in a iatrogenic context as the prison is. The authoridentifiesthree clustersof constraints at work in the prison context: legislative, institutional and cultural. Within this framework, the prison is faced to a conflict between custody and rehabilitation. The clinical psychologist has to manage this conflict and must build clinical settings similar to those outside the prison. The paper is based on the authors experience with short-time groups, of which a short description is givenKeywords:Prison; Prison and mental health; Custody; Rehabilitation; Clinical practice 

  13. New Epigenetic Therapeutic Intervention for Metastatic Breast Cancer

    Science.gov (United States)

    2017-04-01

    Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China...Foundation 2016 NIH - New Innovator Award 2017 NIH - “ Cancer Drug Development & Therapeutics” (CDDT) 2017 NIH/NIAID - Special Emphasis Panel...Chemistry 2011 - Editor, Cancer Reports, Pancreatic Disorders & Therapy 2015 - Associate Editor, Molecular and Cellular Oncology (sections of

  14. Gaucher disease: from fundamental research to effective therapeutic interventions

    NARCIS (Netherlands)

    de Fost, M.; Aerts, J. M. F. G.; Hollak, C. E. M.

    2003-01-01

    Gaucher disease type I is the most common lysosomal storage disorder, with a prevalence Of 1:50,000 in most countries. It is caused by an autosomally recessive inherited deficiency of the lysosomal enzyme glucocerebrosidase, leading to the accumulation of glucocerebroside in the macrophages. The

  15. Dopamine receptors - physiological understanding to therapeutic intervention potential

    NARCIS (Netherlands)

    Emilien, G; Maloteaux, JM; Hoogenberg, K; Cragg, S

    There are two families of dopamine (DA) receptors, called D(1) and D(2), respectively. The D(1) family consists of D(1)- and D(5)-receptor subtypes and the D(2) family consists of D(2)-, D(3)-, and D(4)-receptor subtypes. The amino acid sequences of these receptors show that they all belong to a

  16. Leptin Deficiency: Clinical Implications and Opportunities for Therapeutic Interventions

    OpenAIRE

    Bl?her, Susan; Shah, Sunali; Mantzoros, Christos S.

    2009-01-01

    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 e...

  17. Cybertherapy 2004: Using Interactive Media in Training and Therapeutic Interventions

    Science.gov (United States)

    2005-03-01

    Burnout syndrome [2], which causes cates an aged society. Fig.1 shows change of members of the nursing staff to feel irritated and the ratio of most...and a prolifera- tion of formal initiatives, widespread diffusion of telemedicine services has not occurred. To understand why, this paper explores...Whtisite gnrlatit or e estimate their practical costs and benefits for medicine applications? the public sector, caregivers , and consumers2 . * How

  18. Psychotherapist countertransference in the nuclear age: Effects on therapeutic interventions

    International Nuclear Information System (INIS)

    Oderberg, N.A.

    1991-01-01

    Since the early 1980s, there has been considerable attention in the psychology literature to mental health problems related to living in a world threatened by nuclear destruction. Questionnaires were mailed to 630 psychotherapists from the Colorado Psychological Association, California Psychotherapists for Social Responsibility, California Psychologists for Social Responsibility, the US Army, and the APA Division of Military Psychology; 174 questionnaires were returned. It was hypothesized that liberalism, nuclear weapons opposition, nuclear concern, nuclear awareness, and anti-nuclear activism in psychotherapists would facilitate perception of, and openness to working with, a client's nuclear concerns and thus, would be positively correlated with intentions to discuss nuclear issues with clients in three different clinical vignettes. Results indicated that when controlling for subject group, psychotherapy orientation, age, sex, and income, all five independent variables were positively correlated with responses to all three clinical vignettes, with nuclear concern having the strongest unique effect in accounting for variance in responses to the vignettes

  19. Therapeutic intervention based on protein prenylation and associated modifications

    NARCIS (Netherlands)

    Gelb, M.H.; Brunsveld, L.; Hrycyna, C.A.; Michaelis, S.; Tamanoi, F.

    2006-01-01

    In eukaryotic cells, a specific set of proteins are modified by C-terminal attachment of 15-carbon farnesyl groups or 20-carbon geranylgeranyl groups that function both as anchors for fixing proteins to membranes and as molecular handles for facilitating binding of these lipidated proteins to other

  20. State of the art thoracic ultrasound: intervention and therapeutics

    NARCIS (Netherlands)

    Corcoran, John P.; Tazi-Mezalek, Rachid; Maldonado, Fabien; Yarmus, Lonny B.; Annema, Jouke T.; Koegelenberg, Coenraad F. N.; St Noble, Victoria; Rahman, Najib M.

    2017-01-01

    The use of thoracic ultrasound outside the radiology department and in everyday clinical practice is becoming increasingly common, having been incorporated into standards of care for many specialties. For the majority of practitioners, their experience of, and exposure to, thoracic ultrasound will

  1. Experimental focal cerebral ischemia : Optimization of models and therapeutic interventions

    NARCIS (Netherlands)

    Shanbhag, Nagesh Chandrakant

    2016-01-01

    Stroke is the second most common cause of death and leading cause of adult disability, accounting for 11% of total deaths worldwide. Ischemic stroke (80% of all cases) results from a blood clot formation in an artery to or in the brain resulting in ischemic damage and neurological impairment. Many

  2. New Epigenetic Therapeutic Intervention for Metastatic Breast Cancer

    Science.gov (United States)

    2017-04-01

    Metastasis” 04/20/2017 Distinguished Scientist Speaker, University of Southern Alabama Mitchell Cancer Institute, Mobile , AL, “Role and Regulation...tracks for Il21 andRock2, two important genes in Th17 cell differentiation (Figure 3G ). Further, the functional dif- ferences of Brd2 and Brd4 in gene...terminal Dub3 (Fig. 2f). Consistent with this, Dub3 only stabilized the N-terminal but not the C-terminal fragments of Snail1 (Fig. 2g ). The interaction

  3. Stroke and Therapeutic Hypothermia

    Directory of Open Access Journals (Sweden)

    Ozlem Ozkan Kuscu

    2016-09-01

    Full Text Available Stroke is significant cause of morbidity and mortality caused by disruption of blood flow. Neural injury occurs with two stage; while primary neural injury occurs with disruption of blood flow, after days and hours with metabolic processes secondary injury develops in tissues which is non injured in the first stage. Therefore it is important to prevent and treat the secondary injury as much as preventing and treating the primary neural injury. In this article developing pathophysiological changes after stroke, mechanisms of therapeutic hypothermia, application methods, the factors that determine the effectiveness, side effects and complications were reviewed. [Archives Medical Review Journal 2016; 25(3.000: 351-368

  4. New class of monoclonal antibodies against severe influenza: prophylactic and therapeutic efficacy in ferrets.

    Directory of Open Access Journals (Sweden)

    Robert H E Friesen

    2010-02-01

    Full Text Available The urgent medical need for innovative approaches to control influenza is emphasized by the widespread resistance of circulating subtype H1N1 viruses to the leading antiviral drug oseltamivir, the pandemic threat posed by the occurrences of human infections with highly pathogenic avian H5N1 viruses, and indeed the evolving swine-origin H1N1 influenza pandemic. A recently discovered class of human monoclonal antibodies with the ability to neutralize a broad spectrum of influenza viruses (including H1, H2, H5, H6 and H9 subtypes has the potential to prevent and treat influenza in humans. Here we report the latest efficacy data for a representative antibody of this novel class.We evaluated the prophylactic and therapeutic efficacy of the human monoclonal antibody CR6261 against lethal challenge with the highly pathogenic avian H5N1 virus in ferrets, the optimal model of human influenza infection. Survival rates, clinically relevant disease signs such as changes in body weight and temperature, virus replication in lungs and upper respiratory tract, as well as macro- and microscopic pathology were investigated. Prophylactic administration of 30 and 10 mg/kg CR6261 prior to viral challenge completely prevented mortality, weight loss and reduced the amount of infectious virus in the lungs by more than 99.9%, abolished shedding of virus in pharyngeal secretions and largely prevented H5N1-induced lung pathology. When administered therapeutically 1 day after challenge, 30 mg/kg CR6261 prevented death in all animals and blunted disease, as evidenced by decreased weight loss and temperature rise, reduced lung viral loads and shedding, and less lung damage.These data demonstrate the prophylactic and therapeutic efficacy of this new class of human monoclonal antibodies in a highly stringent and clinically relevant animal model of influenza and justify clinical development of this approach as intervention for both seasonal and pandemic influenza.

  5. Indicadores da evolução do paciente com paralisia cerebral e disfagia orofaríngea após intervenção terapêutica Evolution indicators of patients with cerebral palsy and oropharyngeal dysphagia after therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Carolina Castelli Silvério

    2009-01-01

    Full Text Available OBJETIVO: Verificar a evolução na função de alimentação e estabilidade clínica de crianças com paralisia cerebral tetraparética espástica após intervenção terapêutica. MÉTODOS: Foram levantados em prontuário médico, antes e após a terapia, os dados de classificação da funcionalidade da alimentação (escala FOIS e grau de disfagia, consistências alimentares e sinais sugestivos de penetração e/ou aspiração laringotraqueal de 36 crianças com paralisia cerebral espástica. RESULTADOS: A maioria dos sujeitos alimentava-se com preparo especial, antes e após a intervenção, ocorrendo restrição de sólidos e líquidos no segundo momento. Houve diminuição da severidade da disfagia, redução de broncopneumonias e hipersecretividade pulmonar, aumento do peso e diminuição dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, exceto recusa alimentar e cianose. CONCLUSÃO: A intervenção fonoaudiológica, em conjunto com a equipe multidisciplinar em disfagia, promove maior funcionalidade da deglutição e diminuição dos sinais sugestivos de penetração e/ou aspiração traqueal, além de maior estabilidade clínica.PURPOSE: To verify the evolution in nutrition and clinical stability of children with spastic tetraparetic cerebral palsy, after therapeutic intervention. METHODS: Data from before and after the therapeutic process were raised from the medical records of 36 children with spastic cerebral palsy, regarding classification of functional oral intake (FOIS scale and degree of dysphagia, food consistency, and suggestive signs of penetration and/or tracheal aspiration. RESULTS: Most subjects were fed with special preparation, before and after intervention, with restrictions to solid and liquid foods in the second instance. It was observed decrease of the severity of dysphagia, reduction of the incidence of bronchopneumonia and pulmonary hypersecretion, weight increase, and reduction of suggestive

  6. Psychophysiological prediction of choice: relevance to insight and drug addiction

    Science.gov (United States)

    Moeller, Scott J.; Hajcak, Greg; Parvaz, Muhammad A.; Dunning, Jonathan P.; Volkow, Nora D.

    2012-01-01

    An important goal of addiction research and treatment is to predict behavioural responses to drug-related stimuli. This goal is especially important for patients with impaired insight, which can interfere with therapeutic interventions and potentially invalidate self-report questionnaires. This research tested (i) whether event-related potentials, specifically the late positive potential, predict choice to view cocaine images in cocaine addiction; and (ii) whether such behaviour prediction differs by insight (operationalized in this study as self-awareness of image choice). Fifty-nine cocaine abusers and 32 healthy controls provided data for the following laboratory components that were completed in a fixed-sequence (to establish prediction): (i) event-related potential recordings while passively viewing pleasant, unpleasant, neutral and cocaine images, during which early (400–1000 ms) and late (1000–2000 ms) window late positive potentials were collected; (ii) self-reported arousal ratings for each picture; and (iii) two previously validated tasks: one to assess choice for viewing these same images, and the other to group cocaine abusers by insight. Results showed that pleasant-related late positive potentials and arousal ratings predicted pleasant choice (the choice to view pleasant pictures) in all subjects, validating the method. In the cocaine abusers, the predictive ability of the late positive potentials and arousal ratings depended on insight. Cocaine-related late positive potentials better predicted cocaine image choice in cocaine abusers with impaired insight. Another emotion-relevant event-related potential component (the early posterior negativity) did not show these results, indicating specificity of the late positive potential. In contrast, arousal ratings better predicted respective cocaine image choice (and actual cocaine use severity) in cocaine abusers with intact insight. Taken together, the late positive potential could serve as a biomarker

  7. Pharmacogenetics approach to therapeutics.

    Science.gov (United States)

    Koo, Seok Hwee; Lee, Edmund Jon Deoon

    2006-01-01

    1. Pharmacogenetics refers to the study of genetically controlled variations in drug response. Functional variants caused by single nucleotide polymorphisms (SNPs) in genes encoding drug-metabolising enzymes, transporters, ion channels and drug receptors have been known to be associated with interindividual and interethnic variation in drug response. Genetic variations in these genes play a role in influencing the efficacy and toxicity of medications. 2. Rapid, precise and cost-effective high-throughput technological platforms are essential for performing large-scale mutational analysis of genetic markers involved in the aetiology of variable responses to drug therapy. 3. The application of a pharmacogenetics approach to therapeutics in general clinical practice is still far from being achieved today owing to various constraints, such as limited accessibility of technology, inadequate knowledge, ambiguity of the role of variants and ethical concerns. 4. Drug actions are determined by the interplay of several genes encoding different proteins involved in various biochemical pathways. With rapidly emerging SNP discovery technological platforms and widespread knowledge on the role of SNPs in disease susceptibility and variability in drug response, the pharmacogenetics approach to therapeutics is anticipated to take off in the not-too-distant future. This will present profound clinical, economic and social implications for health care.

  8. Therapeutic nuclear medicine

    International Nuclear Information System (INIS)

    Baum, Richard P.

    2014-01-01

    Discusses all aspects of radionuclide therapy, including basic principles, newly available treatments, regulatory requirements, and future trends. Provides the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Explains the role of the therapeutic nuclear physician in effectively coordinating a diverse multidisciplinary team. Written by leading experts. The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. The selective irradiation of tumor cells through molecular biological mechanisms is now permitting the radiopharmaceutical control of tumors that are unresectable and unresponsive to either chemotherapy or conventional radiotherapy. In this up-to-date, comprehensive book, world-renowned experts discuss the basic principles of radionuclide therapy, explore in detail the available treatments, explain the regulatory requirements, and examine likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the important role of the therapeutic nuclear physician in delivering the effective coordination of a diverse multidisciplinary team that is essential to the safe provision of treatment.

  9. Mechanisms of Plasma Therapeutics

    Science.gov (United States)

    Graves, David

    2015-09-01

    In this talk, I address research directed towards biomedical applications of atmospheric pressure plasma such as sterilization, surgery, wound healing and anti-cancer therapy. The field has seen remarkable growth in the last 3-5 years, but the mechanisms responsible for the biomedical effects have remained mysterious. It is known that plasmas readily create reactive oxygen species (ROS) and reactive nitrogen species (RNS). ROS and RNS (or RONS), in addition to a suite of other radical and non-radical reactive species, are essential actors in an important sub-field of aerobic biology termed ``redox'' (or oxidation-reduction) biology. It is postulated that cold atmospheric plasma (CAP) can trigger a therapeutic shielding response in tissue in part by creating a time- and space-localized, burst-like form of oxy-nitrosative stress on near-surface exposed cells through the flux of plasma-generated RONS. RONS-exposed surface layers of cells communicate to the deeper levels of tissue via a form of the ``bystander effect,'' similar to responses to other forms of cell stress. In this proposed model of CAP therapeutics, the plasma stimulates a cellular survival mechanism through which aerobic organisms shield themselves from infection and other challenges.

  10. Therapeutic nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Richard P. (ed.) [ENETS Center of Excellence, Bad Berka (Germany). THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging

    2014-07-01

    Discusses all aspects of radionuclide therapy, including basic principles, newly available treatments, regulatory requirements, and future trends. Provides the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Explains the role of the therapeutic nuclear physician in effectively coordinating a diverse multidisciplinary team. Written by leading experts. The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. The selective irradiation of tumor cells through molecular biological mechanisms is now permitting the radiopharmaceutical control of tumors that are unresectable and unresponsive to either chemotherapy or conventional radiotherapy. In this up-to-date, comprehensive book, world-renowned experts discuss the basic principles of radionuclide therapy, explore in detail the available treatments, explain the regulatory requirements, and examine likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the important role of the therapeutic nuclear physician in delivering the effective coordination of a diverse multidisciplinary team that is essential to the safe provision of treatment.

  11. 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.

  12. Refusal to medical interventions.

    Science.gov (United States)

    Palacios, G; Herreros, B; Pacho, E

    2014-10-01

    Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  13. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  14. 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.

  15. [Therapeutic education didactic techniques].

    Science.gov (United States)

    Valverde, Maite; Vidal, Mercè; Jansa, Margarida

    2012-10-01

    This article includes an introduction to the role of Therapeutic Education for Diabetes treatment according to the recommendations of the American Diabetes Association (ADA), the Diabetes Education Study Group (DESG) of the "European Association for Study of Diabetes (EASD) and the clinical Practice Guidelines (CPG) of the Spanish Ministry of Health. We analyze theoretical models and the differences between teaching vs. learning as well as current trends (including Internet), that can facilitate meaningful learning of people with diabetes and their families and relatives. We analyze the differences, similarities, advantages and disadvantages of individual and group education. Finally, we describe different educational techniques (metaplan, case method, brainstorming, role playing, games, seminars, autobiography, forums, chats,..) applicable to individual, group or virtual education and its application depending on the learning objective.

  16. [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.

  17. Interventional ultrasound

    International Nuclear Information System (INIS)

    VanSonnenberg, E.

    1987-01-01

    This book contains 12 chapters and several case studies. Some of the chapter titles are: The Interplay of Ultrasound and Computed Tomography in the Planning and Execution of Interventional Procedures: Ulltrasound Guided Biopsy; Interventioal Genitourinary Sonography; Diagnosis and Treatment of Pericardial Effusion Using Ultrasonic Guidance; and New Ultrasound-Guided Interventional Procedures--Cholecystostomy, Pancreatography, Gastrostomy

  18. Os grupos na atenção básica de saúde de Porto Alegre: usos e modos de intervenção terapêutica Groups in basic health attention in Porto Alegre: uses and forms of therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Rosana Maffacciolli

    2011-01-01

    Full Text Available Esse artigo trata dos grupos como modalidade assistencial utilizada pelos serviços de atenção básica de saúde. Oficinas, grupos de educação em saúde e palestras constituem atividades diferenciadas em relação aos demais atendimentos tradicionais. O estudo que subsidia essa discussão teve como objetivo conhecer o perfil da assistência, sob a forma de grupos, prestada nas unidades que compõem a rede básica de saúde de Porto Alegre. Foram abordados 116 profissionais, de um total de 124 serviços de saúde, entre os quais 96 desenvolviam grupos. Evidenciou-se que os mesmos têm relevância terapêutica por favorecerem a troca de informações e o aprendizado sobre aspectos relacionados à saúde/doença. Constituem práticas inclusivas, capazes de vincular os usuários aos serviços e de reformular o modelo assistencial vigente. Assim, constatou-se que a compreensão dessas práticas remete a sua dimensão de qualificação da assistência coletiva e também a uma dimensão estratégica de compensação de atendimento às crescentes demandas de saúde.This article deals with groups as an assistential modality used by the services of basic health attention. Workshops, health education groups, as well as, lectures are different activities done in relation to other traditional attendances. The study that is behind this discussion had as its main aim to know the profile of assistance, under groups' organization, offered in the Units which make part of the Basic Health Network in Porto Alegre. Within a total of 124 health services, 116 professionals were approached, among them, 96 developed groups. We could verify that the groups have therapeutic relevance because they favor the sharing of information and the learning about aspects which are related to the topic health-sickness. They constitute inclusive practices, which are able to create a link with the users and the service, as well as, to reformulate the existing assistential model

  19. Intervenções terapêuticas ocupacionais com pacientes renais crônicos no contexto hospitalar: uma análise da prática/ Occupational therapeutic interventions with chronic renal patients in the hospital context: a practice analysis

    Directory of Open Access Journals (Sweden)

    Kátia Maki Omura

    2018-01-01

    Full Text Available O presente estudo tem como objetivo analisar a prática de estudantes na clínica de nefrologia de um hospital público. Durante o estágio, foram atendidos 8 pacientes. Avaliaram-se componentes de equilíbrio e força, além dos aspectos relacionados ao desempenho das atividades de vida diária e os aspectos emocionais. Posteriormente, foram traçados os planos terapêuticos e nas intervenções foram utilizadas atividades auto-expressivas, motoras e sensoriais e planejamento de um novo papel ocupacional. Conclui-se que foi possível evidenciar a importância do trabalho do terapeuta ocupacional na nefrologia, com melhorias nos componentes de desempenho, aumentando a independência na locomoção e nas atividades de autocuidado. AbstractThe present report aims to analyze the practice of students in the nephrology clinic of a public hospital. During the internship, 8 patients were attended. It was evaluated components of balance and strength, as well as aspects related to the performance of daily life activities and emotional aspects. Subsequently, the therapeutic plans were drawn and in interventions were used expressive, motor and sensorial activities and planning of a new occupational role. It was concluded that it was possible to highlight the importance of the occupational therapist work in nephrology, with improvements in performance components, increasing independence in locomotion and self-care activities.Keywords: Hospital; Chronic renal insufficiency; Occupational therapy. 

  20. Therapeutic Enactment: Integrating Individual and Group Counseling Models for Change

    Science.gov (United States)

    Westwood, Marvin J.; Keats, Patrice A.; Wilensky, Patricia

    2003-01-01

    The purpose of this article is to introduce the reader to a group-based therapy model known as therapeutic enactment. A description of this multimodal change model is provided by outlining the relevant background information, key concepts related to specific change processes, and the differences in this model compared to earlier psychodrama…

  1. 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 ...

  2. Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care

    Science.gov (United States)

    2014-01-01

    Self-efficacy, denoting the degree of confidence an individual has in carrying out a specific activity, was initially discussed in the 1970s as a potential correlate of disease outcomes. Drawn from 35 years of related research, this review provides an updated understanding of the concept of self-efficacy and its relevance for arthritis management. There is a consistent link between self-efficacy, arthritis pain and disability, and adherence to recommended therapeutic strategies. A wide variety of intervention strategies improve arthritis self-efficacy, as well as outcomes. Steps to assess and intervene thoughtfully to maximize self-efficacy beliefs are likely to impact arthritis disability outcomes quite favorably and significantly, regardless of disease type, duration, or sociodemographic factors. PMID:28070346

  3. [Terbinafine : Relevant drug interactions and their management].

    Science.gov (United States)

    Dürrbeck, A; Nenoff, P

    2016-09-01

    The allylamine terbinafine is the probably most frequently prescribed systemic antifungal agent in Germany for the treatment of dermatomycoses and onychomycoses. According to the German drug law, terbinafine is approved for patients who are 18 years and older; however, this antifungal agent is increasingly used off-label for treatment of onychomycoses and tinea capitis in children. Terbinafine is associated with only a few interactions with other drugs, which is why terbinafine can generally be used without problems in older and multimorbid patients. Nevertheless, some potential interactions of terbinafine with certain drug substances are known, including substances of the group of antidepressants/antipsychotics and some cardiovascular drugs. Decisive for the relevance of interactions is-along with the therapeutic index of the substrate and the possible alternative degradation pathways-the genetically determined type of metabolism. When combining terbinafine with tricyclic antidepressants or selective serotonin reuptake inhibitors and serotonin/noradrenalin reuptake inhibitors, the clinical response and potential side effects must be monitored. Problematic is the use of terbinafine with simultaneous treatment with tamoxifen. The administration of potent CYP2D6 inhibitors leads to a diminished efficacy of tamoxifen because one of its most important active metabolites-endoxifen-is not sufficiently available. Therefore, combination of tamoxifen and terbinafine should be avoided. In conclusion, the number of substances which are able to cause clinically relevant interactions in case of simultaneously administration with terbinafine is clear and should be manageable in the dermatological office with adequate monitoring.

  4. Profiles of Dialogue for Relevance

    Directory of Open Access Journals (Sweden)

    Douglas Walton

    2016-12-01

    Full Text Available This paper uses argument diagrams, argumentation schemes, and some tools from formal argumentation systems developed in artificial intelligence to build a graph-theoretic model of relevance shown to be applicable (with some extensions as a practical method for helping a third party judge issues of relevance or irrelevance of an argument in real examples. Examples used to illustrate how the method works are drawn from disputes about relevance in natural language discourse, including a criminal trial and a parliamentary debate.

  5. [Nuclear transfer and therapeutic cloning].

    Science.gov (United States)

    Xu, Xiao-Ming; Lei, An-Min; Hua, Jin-Lian; Dou, Zhong-Ying

    2005-03-01

    Nuclear transfer and therapeutic cloning have widespread and attractive prospects in animal agriculture and biomedical applications. We reviewed that the quality of oocytes and nuclear reprogramming of somatic donor cells were the main reasons of the common abnormalities in cloned animals and the low efficiency of cloning and showed the problems and outlets in therapeutic cloning, such as some basic problems in nuclear transfer affected clinical applications of therapeutic cloning. Study on isolation and culture of nuclear transfer embryonic stem (ntES) cells and specific differentiation of ntES cells into important functional cells should be emphasized and could enhance the efficiency. Adult stem cells could help to cure some great diseases, but could not replace therapeutic cloning. Ethics also impeded the development of therapeutic cloning. It is necessary to improve many techniques and reinforce the research of some basic theories, then somatic nuclear transfer and therapeutic cloning may apply to agriculture reproduction and benefit to human life better.

  6. 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.

  7. Molecularly targeted therapeutic radiopharmaceuticals

    International Nuclear Information System (INIS)

    Saw, M.M.

    2007-01-01

    Full text: It is generally agreed that current focus of nuclear medicine development should be on molecular imaging and therapy. Though, the widespread use of the terminology 'molecular imaging' is quite recent, nuclear medicine has used molecular imaging techniques for more than 20 years ago. A variety of radiopharmaceuticals have been introduced for the internal therapy of malignant and inflammatory lesions in nuclear medicine. In the field of bio/medical imaging, nuclear medicine is one of the disciplines which has the privilege of organized and well developed chemistry/ pharmacy section; radio-chemistry/radiopharmacy. Fundamental principles have been developed more than 40 years ago and advanced research is going well into postgenomic era. The genomic revolution and dramatically increased insight in the molecular mechanisms underlying pathology have led to paradigm shift in drug development. Likewise does in the nuclear medicine. Here, the author will present current clinical and pre-clinical therapeutic radiopharmaceuticals based on molecular targets such as membrane-bound receptors, enzymes, nucleic acids, sodium iodide symporter, etc, in correlation with fundamentals of radiopharmacy. (author)

  8. Rethinking Therapeutic Misconception in Biobanking

    DEFF Research Database (Denmark)

    Tupasela, Aaro; Snell, Karoliina; Cañada, Jose

    2017-01-01

    Some authors have noted that in biobank research participants may be guided by what is called therapeutic misconception, whereby participants attribute therapeutic intent to research procedures.This article argues that the notion of therapeutic misconception is increasingly less justified when...... underpinnings for the need to separate research and treatment, and thus the notion of therapeutic misconception in the fi rst place. We call this tension between research and treatment ambivalent research advancement to highlight the difficulties that various actors have in managing such shifts within...

  9. Therapeutic cloning: The ethical limits

    International Nuclear Information System (INIS)

    Whittaker, Peter A.

    2005-01-01

    A brief outline of stem cells, stem cell therapy and therapeutic cloning is given. The position of therapeutic cloning with regard to other embryonic manipulations - IVF-based reproduction, embryonic stem formation from IVF embryos and reproductive cloning - is indicated. The main ethically challenging stages in therapeutic cloning are considered to be the nuclear transfer process including the source of eggs for this and the destruction of an embryo to provide stem cells for therapeutic use. The extremely polarised nature of the debate regarding the status of an early human embryo is noted, and some potential alternative strategies for preparing immunocompatible pluripotent stem cells are indicated

  10. Therapeutic cloning in the mouse

    Science.gov (United States)

    Mombaerts, Peter

    2003-01-01

    Nuclear transfer technology can be applied to produce autologous differentiated cells for therapeutic purposes, a concept termed therapeutic cloning. Countless articles have been published on the ethics and politics of human therapeutic cloning, reflecting the high expectations from this new opportunity for rejuvenation of the aging or diseased body. Yet the research literature on therapeutic cloning, strictly speaking, is comprised of only four articles, all in the mouse. The efficiency of derivation of embryonic stem cell lines via nuclear transfer is remarkably consistent among these reports. However, the efficiency is so low that, in its present form, the concept is unlikely to become widespread in clinical practice. PMID:12949262

  11. Prognostic relevance of PCI-related myocardial infarction

    NARCIS (Netherlands)

    Woudstra, Pier; Grundeken, Maik J.; van de Hoef, Tim P.; Wallentin, Lars; Fox, Keith A.; de Winter, Robbert J.; Damman, Peter

    2013-01-01

    Procedure-related myocardial infarction (pMI) is directly associated with a coronary revascularization procedure, such as percutaneous coronary intervention (PCI) or CABG surgery. In contrast to spontaneous myocardial infarction (MI), the prognostic relevance of pMI is the subject of ongoing debate.

  12. Relevance theory: pragmatics and cognition.

    Science.gov (United States)

    Wearing, Catherine J

    2015-01-01

    Relevance Theory is a cognitively oriented theory of pragmatics, i.e., a theory of language use. It builds on the seminal work of H.P. Grice(1) to develop a pragmatic theory which is at once philosophically sensitive and empirically plausible (in both psychological and evolutionary terms). This entry reviews the central commitments and chief contributions of Relevance Theory, including its Gricean commitment to the centrality of intention-reading and inference in communication; the cognitively grounded notion of relevance which provides the mechanism for explaining pragmatic interpretation as an intention-driven, inferential process; and several key applications of the theory (lexical pragmatics, metaphor and irony, procedural meaning). Relevance Theory is an important contribution to our understanding of the pragmatics of communication. © 2014 John Wiley & Sons, Ltd.

  13. Interventional neuroradiology of the head and neck.

    Science.gov (United States)

    Turowski, Bernd; Zanella, Friedhelm E

    2003-08-01

    Vascular interventions are important and helpful for treatment of various pathologies of the head and neck. Interventional neuroradiology of the head and neck includes image-guided biopsies, vessel occlusion, and local chemotherapy. Knowledge of anatomy, functional relationships between intra- and extracranial vessels, and pathology are the basis for therapeutic success. The interventional neuroradiologist is responsible for appropriate selection of patients based on clinical information, indications, and risk assessment. Neuroradiologic imaging, especially CT and MR imaging, and appropriate analysis of angiographic findings help ensure indication for treatment and plan an intervention. Technical equipment, including an angiographic unit, catheters, needles, embolizing materials, and so forth, are important. Knowledge of hemodynamics is relevant to avoid complications and to find the optimal technique for solving the clinical problem. Indications for image-guided biopsies are preverterbal fluid-collections, spinal and paraspinal inflammations and abscesses, deep cervical malignancies, vertebral body, and skull base tumors. Special care should be taken to preserve critical structures in this region, including spinal nerve roots, cervical plexus, main peripheral nerves, and vessels. Indications for vessel occlusion are emergency situations to stop bleeding in vascular lesions (traumatic, malformation, or tumors) by reduction of pressure, preoperative reduction of blood flow to minimize the surgical risk, palliative occlusion of feeding vessels to produce tumor necrosis, or potential curative (or presurgical) occlusion of vascular malformations. Pressure reduction to support normal coagulation, such as epistaxis, in hereditary hemorrhagic telangiectasia can be achieved by proximal vessel occlusion with large particles or platinum coils. Prevention of intraoperative bleeding requires occlusion of the microvascular bed with small particles. Examples of these

  14. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  15. Programa de treinamento sobre a intervenção terapêutica "relaxamento, imagens mentais e espiritualidade" (RIME para re-significar a dor espiritual de pacientes terminais Training program about the therapeutical intervention "relaxation, mental images and spirituality" (RIME to resignify the spiritual pain of terminal patients

    Directory of Open Access Journals (Sweden)

    Ana Catarina Araújo Elias

    2007-01-01

    Full Text Available CONTEXTO: Neste artigo, apresentamos um programa de treinamento sobre a intervenção terapêutica relaxamento, imagens mentais e espiritualidade (RIME para profissionais de saúde, que objetiva re-significar a dor espiritual de pacientes terminais. OBJETIVO: Analisar um programa de treinamento por meio da compreensão da experiência de profissionais na utilização da Intervenção RIME e da compreensão da experiência dos doentes na re-significação da dor espiritual, manifestada durante a aplicação do RIME por profissionais treinados. MÉTODOS: Os sujeitos foram uma enfermeira, uma médica, três psicólogos e uma terapeuta alternativa voluntária, todos experientes ou estudiosos em cuidados paliativos, selecionados por convite e que atenderam 11 pacientes terminais internados em hospitais públicos das cidades de Campinas, Piracicaba e São Paulo (SP. A metodologia utilizada teve como base a pesquisa-ação e a fenomenologia. Os resultados qualitativos foram analisados pelo método análise do conteúdo por meio da técnica análise temática e os quantitativos foram analisados pelo método descritivo, utilizando-se o teste de Wilcoxon. RESULTADOS: Na análise da vivência dos profissionais, encontramos cinco categorias e 15 subcategorias. Na análise da natureza da dor espiritual, encontramos como categorias mais prevalentes os medos da morte expresso pela negação e pela percepção do quadro clínico. Na aplicação do RIME, observamos diferença estatisticamente significativa (p BACKGROUND: This article presents a training program for a therapeutic intervention involving relaxation, mental images and spirituality (RIME, which can be administered to help terminal patients to resignify their spiritual pain. OBJECTIVE: Analysis of a training program based on the understanding of the experience of professionals in the use of RIME intervention and of patients in their resignification of spiritual pain, as revealed during the

  16. 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.

  17. [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.

  18. [Serious game as a therapeutic tool in psychiatry: A systematic review].

    Science.gov (United States)

    Fovet, T; Micoulaud-Franchi, J-A; Vaiva, G; Thomas, P; Jardri, R; Amad, A

    2016-10-01

    The growing field of new technologies offers new ways to tackle psychiatric disorders (e.g. virtual reality therapy, neurofeedback, etc.). Serious games (SG) are computer applications combining serious aspects with the fun side of video games. This kind of new media could find applications to treat psychiatric disorders. This paper summarizes available data in the literature about therapeutic interventions using SG in psychiatry. A Medline search was conducted in May 2014 using the following Medical Subject Headings (MESH) terms: "video games", "mental disorders", and "psychotherapy". Only 10 relevant references were identified according to our inclusion criteria. These studies show that SG are very interesting tools to improve the management of psychiatric disorders. However, only low-level evidence is available to support treatment with SG in patients suffering from psychiatric disorders. Indeed, randomized controlled trials are rare in this field of research. SG provide promising therapeutic innovations for the management of psychiatric disorders. Moreover, they could easily be developed in accordance with current dimensional approaches. Finally, major issues to facilitate the implementation of future work on SG in psychiatry are discussed. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  19. DISC1 pathway in brain development: exploring therapeutic targets for major psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Atsushi eKamiya

    2012-03-01

    Full Text Available Genetic risk factors for major psychiatric disorders play key roles in neurodevelopment. Thus, exploring the molecular pathways of risk genes is important not only for understanding the molecular mechanisms underlying brain development, but also to decipher how genetic disturbances affect brain maturation and functioning relevant to major mental illnesses. During the last decade, there has been significant progress in determining the mechanisms whereby risk genes impact brain development. Nonetheless, given that the majority of psychiatric disorders have etiological complexities encompassing multiple risk genes and environmental factors, the biological mechanisms of these diseases remain poorly understood. How can we move forward in our research for discovery of the biological markers and novel therapeutic targets for major mental disorders? Here we review recent progress in the neurobiology of Disrupted in schizophrenia 1 (DISC1, a major risk gene for major mental disorders, with a particular focus on its roles in cerebral cortex development. Convergent findings implicate DISC1 as part of a large, multi-step pathway implicated in various cellular processes and signal transduction. We discuss links between the DISC1 pathway and environmental factors, such as immune/inflammatory responses, which may suggest novel therapeutic targets. Existing treatments for major mental disorders are hampered by a limited number of pharmacological targets. Consequently, elucidation of the DISC1 pathway, and its association with neuropsychiatric disorders, may offer hope for novel treatment interventions.

  20. 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…

  1. Purinergic Signalling: Therapeutic Developments

    Directory of Open Access Journals (Sweden)

    Geoffrey Burnstock

    2017-09-01

    Full Text Available Purinergic signalling, i.e., the role of nucleotides as extracellular signalling molecules, was proposed in 1972. However, this concept was not well accepted until the early 1990’s when receptor subtypes for purines and pyrimidines were cloned and characterised, which includes four subtypes of the P1 (adenosine receptor, seven subtypes of P2X ion channel receptors and 8 subtypes of the P2Y G protein-coupled receptor. Early studies were largely concerned with the physiology, pharmacology and biochemistry of purinergic signalling. More recently, the focus has been on the pathophysiology and therapeutic potential. There was early recognition of the use of P1 receptor agonists for the treatment of supraventricular tachycardia and A2A receptor antagonists are promising for the treatment of Parkinson’s disease. Clopidogrel, a P2Y12 antagonist, is widely used for the treatment of thrombosis and stroke, blocking P2Y12 receptor-mediated platelet aggregation. Diquafosol, a long acting P2Y2 receptor agonist, is being used for the treatment of dry eye. P2X3 receptor antagonists have been developed that are orally bioavailable and stable in vivo and are currently in clinical trials for the treatment of chronic cough, bladder incontinence, visceral pain and hypertension. Antagonists to P2X7 receptors are being investigated for the treatment of inflammatory disorders, including neurodegenerative diseases. Other investigations are in progress for the use of purinergic agents for the treatment of osteoporosis, myocardial infarction, irritable bowel syndrome, epilepsy, atherosclerosis, depression, autism, diabetes, and cancer.

  2. Dental therapeutic systems.

    Science.gov (United States)

    Iqbal, Zeenat; Jain, Nilu; Jain, Gaurav K; Talegaonkar, Sushama; Ahuja, Alka; Khar, Roop K; Ahmad, Farhan J

    2008-01-01

    The recognition of periodontal diseases as amenable to local antibiotherapy has resulted in a paradigmatic shift in treatment modalities of dental afflictions. Moreover the presence of antimicrobial resistance, surfacing of untoward reactions owing to systemic consumption of antibiotics has further advocated the use of local delivery of physiologically active substances into the periodontal pocket. While antimicrobials polymerized into acrylic strips, incorporated into biodegradable collagen and hollow permeable cellulose acetate fibers, multiparticulate systems, bio-absorbable dental materials, biodegradable gels/ointments, injectables, mucoadhesive microcapsules and nanospheres will be more amenable for direct placement into the periodontal pockets the lozenges, buccoadhesive tablets, discs or gels could be effectively used to mitigate the overall gingival inflammation. Whilst effecting controlled local delivery of a few milligram of an antibacterial agent within the gingival crevicular fluid for a longer period of time, maintaining therapeutic concentrations such delivery devices will circumvent all adverse effects to non- oral sites. Since the pioneering efforts of Goodson and Lindhe in 1989, delivery at gingival and subgingival sites has witnessed a considerable progress. The interest in locally active systems is evident from the patents being filed and granted. The present article shall dwell in reviewing the recent approaches being proffered in the field. Patents as by Shefer, et al. US patent, 6589562 dealing with multicomponent biodegradable bioadhesive controlled release system for oral care products, Lee, et al. 2001, US patent 6193994, encompassing a locally administrable, biodegradable and sustained-release pharmaceutical composition for periodontitis and process for preparation thereof and method of treating periodontal disease as suggested by Basara in 2004via US patent 6830757, shall be the types of intellectual property reviewed and presented in

  3. Early detection and intervention in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Larsen, Tor Ketil; Friis, Svein; Haahr, U

    2001-01-01

    OBJECTIVE: To review the literature on early intervention in psychosis and to evaluate relevant studies. METHOD: Early intervention was defined as intervention in the prodromal phase (primary prevention) and intervention after the onset of psychosis, i.e. shortening of duration of untreated psych...

  4. 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...

  5. 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.

  6. Therapeutical aspect of trichomoniasis

    Directory of Open Access Journals (Sweden)

    Vukićević Jelica

    2003-01-01

    Full Text Available Trichomoniasis is frequent, parasitic and sexually transmitted infection of genitourinary tract. It is treated by metronidazole (5-nitroimidazole according to protocol recommended by Center for Disease Control (CDC formerly called: Communicable Disease Center [19]. The resistance of Trichomonas vaginalis (TV strains to metronidazole (MND was described in USA in 1960, and later on in many European countries [8, 9, 10, 11, 12, 13]. In these cases, due to persistent trichomonas infection, it is necessary to repeat MND treatment with moderate modification of dose and/or length of its application. Nevertheless, oncogenic and toxic effects of MND have to be taken into consideration. OBJECT The aim of this study was to investigate and analyze the incidence of TV in STD and lower susceptibility of certain TV strains to MND were analyzed. MATERIAL AND METHODS In three-year period (1999-2001 612 patients (244 females and 368 males suspected of STD were examined clinically and microbiologically at the Institute of Dermatovenereology in Belgrade. The patients detected for TV were treated according to CDC protocol. The affected were considered cured if there was no manifest clinical infection, and no TV verified by microbiological test. Results TV was isolated in 216 patients (35.29 % of all subjects. Trichomonas infection was found in 90 (36.88 % out of 244 tested females and in 126 (32.34 % of 368 males. Clinically manifested infection, with extensive urethral and vaginal secretion, was recorded in 161 patients, while the asymptomatic form was found in 55 subjects. This result indicates the predominance of manifested trichomonas infections (75.54 % of cases. The difference of distribution of clinical forms of trichomoniasis, in relation to sex, was not statistically significant (c2=0.854; p>0.05. The patients with verified trichomonas infection were treated by metronidazole according to CDC protocol. The recommended therapeutical scheme consisted of three

  7. Effectiveness of pharmacovigilance: multifaceted educational intervention related to the knowledge, skills and attitudes of multidisciplinary hospital staff

    Directory of Open Access Journals (Sweden)

    Fabiana Rossi Varallo

    Full Text Available OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil. The intervention involved four activities: 1 an interactive lecture, 2 a practical class, 3 a pre-post questionnaire administered to professionals on a multidisciplinary team, and 4 educational material. The intervention’s impact on the professionals’ knowledge and skills was assessed using the World Health Organization’s definitions. The intervention’s effect on the professionals’ attitudes was analysed by the prevalence of adverse drug event reports (adverse drug reactions, medication errors, therapeutic failure and drug quality deviations and the relevance (seriousness and expectancy of the events. RESULTS: One hundred seventy-three professionals were enrolled. A 70-fold increase in the number of adverse drug event reports was observed during the 12 months post-intervention. The intervention improved the professionals’ form-completion skills (p<0.0001 and their knowledge of pharmacovigilance (p<0.0001. The intervention also contributed to detecting serious drug-induced events. The nursing staff reported medication errors, and pharmacists and physiotherapists recognized serious adverse drug reactions. Physicians communicated suspicions of therapeutic failure. CONCLUSIONS: A multidisciplinary approach to drug-safety assessments contributes to identifying new, relevant drug-related problems and improving the rate of adverse drug event reporting. This strategy may therefore be applied to improve risk communication in

  8. Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke.

    Science.gov (United States)

    Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura

    2018-05-01

    Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in

  9. Immediate field of intervention: undergraduate college Preparation ...

    Indian Academy of Sciences (India)

    ... field of intervention: undergraduate college Preparation: at research institutes and universities The challenge: to transform the disciplines themselves Make them relevant and responsive. First step: create innovative interactions across the higher education spectrum, between Research Institute-University-College.

  10. Therapeutic Inertia and Treatment Intensification.

    Science.gov (United States)

    Josiah Willock, Robina; Miller, Joseph B; Mohyi, Michelle; Abuzaanona, Ahmed; Muminovic, Meri; Levy, Phillip D

    2018-01-29

    This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations. Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

  11. Psychosocial group rehabilitation for lonely older people: favourable processes and mediating factors of the intervention leading to alleviated loneliness.

    Science.gov (United States)

    Savikko, Niina; Routasalo, Pirkko; Tilvis, Reijo; Pitkälä, Kaisu

    2010-03-01

    Loneliness among community-dwelling older people is a common problem, with serious health consequences. The favourable processes and mediating factors of a psychosocial group rehabilitation intervention in alleviating older people's loneliness were evaluated. Altogether, 117 lonely, home-dwelling individuals (aged ≥75 years) participated in a psychosocial group rehabilitation intervention. The content comprised (i) art and inspiring activities, (ii) group exercise and discussions or (iii) therapeutic writing and group therapy. The psychosocial group rehabilitation intervention was evaluated from the group leaders' diaries and by observing the groups. Experiences of loneliness and social participation were collected by postintervention questionnaires from the participants. Data were analysed using methodological triangulation. Doing things together and sharing experiences with their peers inspired lively discussions, created a feeling of togetherness and led to participants' empowerment and increased self-esteem. The intervention socially activated the participants, and their feelings of loneliness had been alleviated during the intervention. Several common favourable processes and mediating factors were identified in the psychosocial group rehabilitation intervention that led to alleviation of loneliness among older people. Relevance to clinical practice.  The psychosocial group rehabilitation intervention gives nurses an effective tool to support older people's psychosocial resources by activating them and alleviating their loneliness. © 2009 Blackwell Publishing Ltd.

  12. 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 ...

  13. Exubera. Inhale therapeutic systems.

    Science.gov (United States)

    Bindra, Sanjit; Cefalu, William T

    2002-05-01

    Inhale, in colaboration with Pfizer and Aventis Pharma (formerly Hoechst Marion Roussel; HMR), is developing an insulin formulation utilizing its pulmonary delivery technology for macromolecules for the potential treatment of type I and II diabetes. By July 2001, the phase III program had been completed and the companies had begun to assemble data for MAA and NDA filings; however, it was already clear at this time that additional data might be required for filing. By December 2001, it had been decided that the NDA should include an increased level of controlled, long-term pulmonary safety data in diabetic patients and a major study was planned to be completed in 2002, with the NDA filed thereafter (during 2002). US-05997848 was issued to Inhale Therapeutic Systems in December 1999, and corresponds to WO-09524183, filed in February 1995. Equivalent applications have appeared to date in Australia, Brazil, Canada, China, Czech Republic, Europe, Finland, Hungary, Japan, Norway, New Zealand, Poland and South Africa. This family of applications is specific to pulmonary delivery of insulin. In February 1999, Lehman Brothers gave this inhaled insulin a 60% probability of reaching market, with a possible launch date of 2001. The analysts estimated peak sales at $3 billion in 2011. In May 2000, Aventis predicted that estimated peak sales would be in excess of $1 billion. In February 2000, Merrill Lynch expected product launch in 2002 and predicted that it would be a multibillion-dollar product. Analysts Merril Lynch predicted, in September and November 2000, that the product would be launched by 2002, with sales in that year of e75 million, rising to euro 500 million in 2004. In April 2001, Merrill Lynch predicted that filing for this drug would occur in 2001. Following the report of the potential delay in regulatory filing, issued in July 2001, Deutsche Banc Alex Brown predicted a filing would take place in the fourth quarter of 2002 and launch would take place in the first

  14. 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…

  15. 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.

  16. 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…

  17. Relevance of protection quantities in medical exposures

    International Nuclear Information System (INIS)

    Pradhan, A.S.

    2008-01-01

    International Commission on Radiological Protection (ICRP) continues to classify the exposures to radiation in three categories; namely 1- occupational exposure, 2- public exposure, and 3- medical exposure. Protection quantities are primarily meant for the regulatory purpose in radiological protection for controlling and limiting stochastic risks in occupational and public exposures. These are based on two basic assumptions of 1- linear no-threshold dose-effect relationship (LNT) at low doses and 2- long-term additivity of low doses. Medical exposure are predominantly delivered to individuals (patients) undergoing diagnostic examinations, interventional procedures and radiation therapy but also include individual caring for or comforting patients incurring exposure and the volunteers of biomedical medical research programmes. Radiation protection is as relevant to occupational and public exposure as to medical exposures except that the dose limits set for the formers are not applicable to medical exposure but reference levels and dose constrains are recommended for diagnostic and interventional medical procedures. In medical institutions, both the occupational and medical exposure takes place. Since the doses in diagnostic examinations are low, it has been observed that not only the protection quantities are often used in such cases but these are extended to estimate the number of cancer deaths due to such practices. One of the striking features of the new ICRP recommendations has been to elaborate the concepts of the dosimetric quantities. The limitation of protection quantities ((Effective dose, E=Σ RT D TR .W T .W R and Equivalent Dose H T =Σ RT D TR .W R ) have been brought out and this has raised a great concern and initiated debates on the use of these quantities in medical exposures. Consequently, ICRP has set a task group to provide more details and the recommendations. It has, therefore, became important to draw the attention of medical physics community

  18. 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

  19. Mental Health Disorder Therapeutic Modalities Modified for the GMS.

    Science.gov (United States)

    Sumneangsanor, Tipsuda; Vuthiarpa, Sararud; Somprasert, Chomchueun

    2017-12-01

    Mental health disorders can affect physical and psychological behaviors. The people of the Greater Mekong Subregion (GMS) have a high risk of mental health disorders, such as depression, stress, and substance abuse be-cause the people in this region are trafficked for forced sex work and various forms of forced labor. In these situations, vic-tims often endure violence and abuse from trafficking recruiters, employers, and other individuals. The purposes of this study were to identify the elements characterizing mental health disorders, especially in terms of depression, stress, and sub-stance abuse, and to identify the treatment modalities for mental health disorders in the GMS. The researcher undertook a comparative analysis of the literature, reviews of epidemiological studies and mental disorder therapies, and overviews of previous research studies, were used to generate a synthesis of the existing knowledge of the mental disorder therapeutic modalities. Regarding the search methods, the data from the electronic databases PubMed, PsycINFO, Dynamed and ScienceDirect were supplemented with a manual reference search covering relevant studies from 2005 to 2016. Thirty-one papers were included in the review of elements characterizing mental health disorders, especially in terms of depression, stress, and substance abuse, and to identify the treatment modalities for mental health disorders in the GMS. Nine papers defined characterizing mental health disorders, in terms of depression, stress, and substance abuse. Twenty-two papers showed the treatment modalities for mental health disorders that the treatment was effective, these in-cluded pharmacological treatments and psychological treatments, such as mindfulness-based cognitive therapy, biofeedback, and music therapy. Useful guidance can be provided for the prevention and treatment of mental health disorders, and for the care of people in the Greater Mekong Subregion. The finding of this review confirms the

  20. Shippingport: A relevant decommissioning project

    International Nuclear Information System (INIS)

    Crimi, F.P.

    1988-01-01

    Because of Shippingport's low electrical power rating (72 MWe), there has been some misunderstanding on the relevancy of the Shippingport Station Decommissioning Project (SSDP) to a modern 1175 MWe commercial pressurized water reactor (PWR) power station. This paper provides a comparison of the major components of the reactor plant of the 72 MWe Shippingport Atomic Power Station and an 1175 MWe nuclear plant and the relevancy of the Shippingport decommissioning as a demonstration project for the nuclear industry. For the purpose of this comparison, Portland General Electric Company's 1175 MWe Trojan Nuclear Plant at Rainier, Oregon, has been used as the reference nuclear power plant. 2 refs., 2 figs., 1 tab

  1. 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.

  2. Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review.

    Science.gov (United States)

    Oquendo, Lissete González; Asencio, José Miguel Morales; de Las Nieves, Candela Bonill

    2017-12-01

    The objective of this integrative review is to identify the factors that contribute to diet adherence in people suffering from kidney disease who are receiving haemodialysis treatment. Adherence to the therapeutic regimen determines therapeutic success, quality of life and survival in patients on haemodialysis. Lack of diet adherence ranges from 25%-86% in patients receiving haemodialysis treatment and affects patient morbidity and mortality. An integrative literature review was conducted based on the criteria of Whittemore & Knafl. A literature review was performed by two members of the team using twelve databases including PubMed, CUIDEN, CINAHL, The Cochrane Library and ScienceDirect. The main issues identified after analysing the results were as follows: the intrinsic barriers (age, dialysis time, motivation, perceived benefit, distorted perception of adherence) and facilitators (self-efficacy, perception of disease, perception of control), extrinsic barriers (family dysfunction, lack of social support, cultural patterns of consumption of food) and facilitators (social support, relationship with healthcare providers), and interventions to encourage diet adherence, such as the use of motivational interviewing in educational interventions, and the training and education of relevant professionals in communication skills. Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition. The onset of depression signs and the level of social support available to the patient should be assessed, because these are important factors that determine adherence to treatment. Professionals should be trained in health education and communication techniques to contribute to the patient's self-management and motivation for diet adherence. Controlled and randomised clinical studies involving predialysis stages should be performed to investigate the impact of the assessment and control of barriers to diet adherence. © 2017

  3. Human Factor in Therapeutic Relationship

    Directory of Open Access Journals (Sweden)

    Ramazan Akdogan

    2011-03-01

    Full Text Available herapeutic relationship is a professional relationship that has been structured based on theoretical props. This relationship is a complicated, wide and unique relationship which develops between two people, where both sides' personality and attitudes inevitably interfere. Therapist-client relationship experienced through transference and counter transference, especially in psychodynamic approaches, is accepted as the main aspect of therapeutic process. However, the approaches without dynamic/deterministic tendency also take therapist-client relationship into account seriously and stress uniqueness of interaction between two people. Being a person and a human naturally sometimes may negatively influence the relationship between the therapist and client and result in a relationship going out of the theoretical frame at times. As effective components of a therapeutic process, the factors that stem from being human include the unique personalities of the therapist and the client, their values and their attitude either made consciously or subconsciously. Literature has shown that the human-related factors are too effective to be denied in therapeutic relationship process. Ethical and theoretical knowledge can be inefficient to prevent the negative effects of these factors in therapeutic process at which point a deep insight and supervision would have a critical role in continuing an acceptable therapeutic relationship. This review is focused on the reflection of some therapeutic factors resulting from being human and development of counter transference onto the therapeutic process.

  4. Systems-level thinking for nanoparticle-mediated therapeutic delivery to neurological diseases.

    Science.gov (United States)

    Curtis, Chad; Zhang, Mengying; Liao, Rick; Wood, Thomas; Nance, Elizabeth

    2017-03-01

    Neurological diseases account for 13% of the global burden of disease. As a result, treating these diseases costs $750 billion a year. Nanotechnology, which consists of small (~1-100 nm) but highly tailorable platforms, can provide significant opportunities for improving therapeutic delivery to the brain. Nanoparticles can increase drug solubility, overcome the blood-brain and brain penetration barriers, and provide timed release of a drug at a site of interest. Many researchers have successfully used nanotechnology to overcome individual barriers to therapeutic delivery to the brain, yet no platform has translated into a standard of care for any neurological disease. The challenge in translating nanotechnology platforms into clinical use for patients with neurological disease necessitates a new approach to: (1) collect information from the fields associated with understanding and treating brain diseases and (2) apply that information using scalable technologies in a clinically-relevant way. This approach requires systems-level thinking to integrate an understanding of biological barriers to therapeutic intervention in the brain with the engineering of nanoparticle material properties to overcome those barriers. To demonstrate how a systems perspective can tackle the challenge of treating neurological diseases using nanotechnology, this review will first present physiological barriers to drug delivery in the brain and common neurological disease hallmarks that influence these barriers. We will then analyze the design of nanotechnology platforms in preclinical in vivo efficacy studies for treatment of neurological disease, and map concepts for the interaction of nanoparticle physicochemical properties and pathophysiological hallmarks in the brain. WIREs Nanomed Nanobiotechnol 2017, 9:e1422. doi: 10.1002/wnan.1422 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.

  5. 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)

  6. Lovastatin induces apoptosis of ovarian cancer cells and synergizes with doxorubicin: potential therapeutic relevance

    International Nuclear Information System (INIS)

    Martirosyan, Anna; Clendening, James W; Goard, Carolyn A; Penn, Linda Z

    2010-01-01

    Ovarian carcinoma is a rarely curable disease, for which new treatment options are required. As agents that block HMG-CoA reductase and the mevalonate pathway, the statin family of drugs are used in the treatment of hypercholesterolemia and have been shown to trigger apoptosis in a tumor-specific manner. Recent clinical trials show that the addition of statins to traditional chemotherapeutic strategies can increase efficacy of targeting statin-sensitive tumors. Our goal was to assess statin-induced apoptosis of ovarian cancer cells, either alone or in combination with chemotherapeutics, and then determine these mechanisms of action. The effect of lovastatin on ovarian cancer cell lines was evaluated alone and in combination with cisplatin and doxorubicin using several assays (MTT, TUNEL, fixed PI, PARP cleavage) and synergy determined by evaluating the combination index. The mechanisms of action were evaluated using functional, molecular, and pharmacologic approaches. We demonstrate that lovastatin induces apoptosis of ovarian cancer cells in a p53-independent manner and synergizes with doxorubicin, a chemotherapeutic agent used to treat recurrent cases of ovarian cancer. Lovastatin drives ovarian tumor cell death by two mechanisms: first, by blocking HMG-CoA reductase activity, and second, by sensitizing multi-drug resistant cells to doxorubicin by a novel mevalonate-independent mechanism. This inhibition of drug transport, likely through inhibition of P-glycoprotein, potentiates both DNA damage and tumor cell apoptosis. The results of this research provide pre-clinical data to warrant further evaluation of statins as potential anti-cancer agents to treat ovarian carcinoma. Many statins are inexpensive, off-patent generic drugs that are immediately available for use as anti-cancer agents. We provide evidence that lovastatin triggers apoptosis of ovarian cancer cells as a single agent by a mevalonate-dependent mechanism. Moreover, we also show lovastatin synergizes with doxorubicin, an agent administered for recurrent disease. This synergy occurs by a novel mevalonate-independent mechanism that antagonizes drug resistance, likely by inhibiting P-glycoprotein. These data raise important issues that may impact how statins can best be included in chemotherapy regimens

  7. Social and psychological consequences of not crying : Possible associations with psychopathology and therapeutic relevance

    NARCIS (Netherlands)

    Hesdorffer, D.C.; Vingerhoets, A.J.J.M.; Trimble, M.R.

    2017-01-01

    Emotional crying is hypothesized to serve intra- and interpersonal functions. Intrapersonal functions are assumed to facilitate the capacity to recover from emotional distress, thus promoting well-being. Interpersonal functions are postulated to have a major impact on social functioning. We

  8. Altered drug binding to serum proteins in pregnant women: therapeutic relevance.

    OpenAIRE

    Perucca, E; Ruprah, M; Richens, A

    1981-01-01

    The binding of diazepam, phenytoin and valproic acid to serum proteins in vitro has been compared in pregnant women of different gestational ages and in controls. The unbound fraction of each of three drugs was elevated during pregnancy (particularly during the last 8 weeks) probably due, at least in part, to a fall in serum albumin concentration. These findings may provide a partial explanation for the increase in the clearance of certain drugs during pregnancy and need to be taken into acco...

  9. Severe Alcoholic Pancreatitis-Associated Acute Lung Injury in Veterans: Risks, Mechanisms, Prediction, and Therapeutic Relevance

    Science.gov (United States)

    2017-10-01

    Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Background: Acute pancreatitis is a painful, potentially life -threatening condition of the...pancreas with an unpredictable course. In this study we hope to identify and propose simple and reliable ways to predict and treat acute...time period of 9/30/2016-9/29/2017. Acute pancreatitis is a painful, potentially life -threatening condition of the pancreas with a typically abrupt

  10. Parasite Cathepsin D-Like Peptidases and Their Relevance as Therapeutic Targets

    Czech Academy of Sciences Publication Activity Database

    Sojka, Daniel; Hartmann, David; Bartošová-Sojková, Pavla; Dvořák, Jan

    2016-01-01

    Roč. 32, č. 9 (2016), s. 708-723 ISSN 1471-4922 R&D Projects: GA ČR GA14-33693S; GA ČR GA13-11043S; GA ČR(CZ) GAP302/11/1481 EU Projects: European Commission(XE) 248642 - SCHISTOSOMA PROTEASE Institutional support: RVO:60077344 ; RVO:68378050 Keywords : aspartic peptidases * cathepsin D * hemoglobinolysis * parasites * vectors Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 6.333, year: 2016

  11. Parasite Cathepsin D-Like Peptidases and Their Relevance as Therapeutic Targets

    Czech Academy of Sciences Publication Activity Database

    Sojka, D.; Hartmann, D.; Bartošová-Sojková, P.; Dvořák, Jan

    2016-01-01

    Roč. 32, č. 9 (2016), s. 708-723 ISSN 1471-4922 R&D Projects: GA ČR GA13-11043S; GA ČR(CZ) GAP302/11/1481 Institutional support: RVO:61388963 Keywords : aspartic peptidases * cathepsin D * hemoglobinolysis * parasites * vectors Subject RIV: CE - Biochemistry Impact factor: 6.333, year: 2016

  12. [End therapeutic nihilism towards COPD].

    Science.gov (United States)

    Juergens, Uwe R

    2007-03-15

    Prevention of COPD requires appropriate patient education, especially of adolescents, as well as the establishment of an effective national health policy. The new GOLD guidelines represent the current standard of knowledge on the management of chronic, progressive, obstructive pulmonary diseases. It points out that COPD is avoidable and treatable,and hence, there is no reason for therapeutic nihilism. Chronic bronchitis preceding a progressive respiratory obstruction cannot be improved with the presently available respiratory therapeutics. For this reason, therapeutic measures concentrate on the avoidance of exacerbations, which are primarily responsible for the severity of the course of COPD.

  13. Frontiers in nano-therapeutics

    CERN Document Server

    Tasnim, Nishat; Sai Krishna, Katla; Kalagara, Sudhakar; Narayan, Mahesh; Noveron, Juan C; Joddar, Binata

    2017-01-01

    This brief highlights recent research advances in the area of nano-therapeutics. Nanotechnology holds immense potential for application in a wide range of biological and engineering applications such as molecular sensors for disease diagnosis, therapeutic agents for the treatment of diseases, a vehicle for delivering therapeutics and imaging agents for theranostic applications, both in-vitro and in-vivo. The brief is grouped into the following sections namely, A) Discrete Nanosystems ; B) Anisotropic Nanoparticles; C) Nano-films/coated/layered and D) Nano-composites.

  14. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  15. Dramatic lives and relevant becomings

    DEFF Research Database (Denmark)

    Henriksen, Ann-Karina; Miller, Jody

    2012-01-01

    of marginality into positions of relevance. The analysis builds on empirical data from Copenhagen, Denmark, gained through ethnographic fieldwork with the participation of 20 female informants aged 13–22. The theoretical contribution proposes viewing conflicts as multi-linear, multi-causal and non...

  16. Regularization in Matrix Relevance Learning

    NARCIS (Netherlands)

    Schneider, Petra; Bunte, Kerstin; Stiekema, Han; Hammer, Barbara; Villmann, Thomas; Biehl, Michael

    A In this paper, we present a regularization technique to extend recently proposed matrix learning schemes in learning vector quantization (LVQ). These learning algorithms extend the concept of adaptive distance measures in LVQ to the use of relevance matrices. In general, metric learning can

  17. 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.

  18. Empiricist Interventions

    DEFF Research Database (Denmark)

    Munk, Anders Kristian; Abrahamsson, Sebastian

    2012-01-01

    Recent papers by prominent scholars in science and technology studies (notably JohnLaw and Bruno Latour) have crystallized a fundamental disagreement about the scope and purpose of intervention in actor-network theory or what we here choose to bracket as empirical philosophy. While the precept of...... contending agendas as distinct options which map on to the positions of our two main interlocutors. In doing so, it becomes possible to compare their respective tactical implications as we work through two examples of what might constitute an empiricist intervention.......Recent papers by prominent scholars in science and technology studies (notably JohnLaw and Bruno Latour) have crystallized a fundamental disagreement about the scope and purpose of intervention in actor-network theory or what we here choose to bracket as empirical philosophy. While the precept...... by notions of due process and parliamentary procedure? In this paper we think about this disagreement as a question of research strategy (a normative discord about the desirable outcome of an intervention) in order to assess its implications for research tactics (a descriptive accord about the practical...

  19. 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

  20. 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.

  1. Design Considerations in Therapeutic Exergaming

    OpenAIRE

    Doyle, Julie; Kelly, Daniel; Caulfield, B.

    2011-01-01

    In this paper we discuss the importance of feedback in therapeutic exergaming. It is widely believed that exergaming benefits the patient in terms of encouraging adherence and boosting the patient’s confidence of correct execution and feedback is essential in achieving these. However, feedback and in particular visual feedback, may also have potential negative effects on the quality of the exercise. We describe in this paper a prototype single-sensor therapeutic exergame that we have develope...

  2. Evaluation of therapeutic patient education

    OpenAIRE

    D'Ivernois , Jean-François; Gagnayre , Rémi; Assal , Jean-Philippe; Golay , Alain; Libion , France; Deccache , Alain

    2006-01-01

    9 pages; These guidelines mainly focus on the principles of evaluating Therapeutic Patient Education; Over the past thirty years, therapeutic patient education (TPE) has become an essential part of the treatment of long-term diseases. Evaluations of this new practice are expected, and are sometimes imposed according to protocols and criteria that do not always reflect the complexity of changes taking place within patients and healthcare providers. Sometimes, expected results are not achieved ...

  3. Profiling Prostate Cancer Therapeutic Resistance

    OpenAIRE

    Cameron A. Wade; Natasha Kyprianou

    2018-01-01

    The major challenge in the treatment of patients with advanced lethal prostate cancer is therapeutic resistance to androgen-deprivation therapy (ADT) and chemotherapy. Overriding this resistance requires understanding of the driving mechanisms of the tumor microenvironment, not just the androgen receptor (AR)-signaling cascade, that facilitate therapeutic resistance in order to identify new drug targets. The tumor microenvironment enables key signaling pathways promoting cancer cell survival ...

  4. Ethical considerations of therapeutic hypnosis and children.

    Science.gov (United States)

    Etzrodt, Christine M

    2013-04-01

    Historically, therapeutic hypnosis has been met with skepticism within some fields, although acceptance has expanded in recent decades. Development and application of ethical standards and principles has contributed to increased acceptance of hypnosis with children. The Ethics Code of the American Psychological Association (APA, 2002) and the Code of Conduct of the American Society of Clinical Hypnosis (ASCH, 2000) serve as guides to ethical considerations when treating children. From a developmental and practical perspective, children have limited decision-making capacities, therefore special attention should be paid to their rights and welfare. Important ethical considerations relevant to children and hypnosis have emerged, including competence, supervision, informed consent, confidentiality, and boundaries. Considerations are reviewed from a normal and abnormal child development perspective.

  5. Cell-Specific Aptamers as Emerging Therapeutics

    Directory of Open Access Journals (Sweden)

    Cindy Meyer

    2011-01-01

    Full Text Available Aptamers are short nucleic acids that bind to defined targets with high affinity and specificity. The first aptamers have been selected about two decades ago by an in vitro process named SELEX (systematic evolution of ligands by exponential enrichment. Since then, numerous aptamers with specificities for a variety of targets from small molecules to proteins or even whole cells have been selected. Their applications range from biosensing and diagnostics to therapy and target-oriented drug delivery. More recently, selections using complex targets such as live cells have become feasible. This paper summarizes progress in cell-SELEX techniques and highlights recent developments, particularly in the field of medically relevant aptamers with a focus on therapeutic and drug-delivery applications.

  6. Therapeutic drug monitoring of atypical antipsychotic drugs

    Directory of Open Access Journals (Sweden)

    Grundmann Milan

    2014-12-01

    Full Text Available Schizophrenia is a severe psychiatric disorder often associated with cognitive impairment and affective, mainly depressive, symptoms. Antipsychotic medication is the primary intervention for stabilization of acute psychotic episodes and prevention of recurrences and relapses in patients with schizophrenia. Typical antipsychotics, the older class of antipsychotic agents, are currently used much less frequently than newer atypical antipsychotics. Therapeutic drug monitoring (TDM of antipsychotic drugs is the specific method of clinical pharmacology, which involves measurement of drug serum concentrations followed by interpretation and good cooperation with the clinician. TDM is a powerful tool that allows tailor-made treatment for the specific needs of individual patients. It can help in monitoring adherence, dose adjustment, minimizing the risk of toxicity and in cost-effectiveness in the treatment of psychiatric disorders. The review provides complex knowledge indispensable to clinical pharmacologists, pharmacists and clinicians for interpretation of TDM results.

  7. Integrins as Therapeutic Targets: Successes and Cancers

    Directory of Open Access Journals (Sweden)

    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.

  8. Therapeutic Songwriting in Music Therapy Part I

    DEFF Research Database (Denmark)

    Baker, Felicity; Wigram, Tony; Stott, Dave

    2008-01-01

    Songwriting as therapeutic intervention has received increasing attention in the field of music therapy over the past decade however much of the publications focus on clinical outcomes rather than methods of practice. This paper, part of a two-part research report into trends in the clinical...... practice of songwriting, aims to describe the most frequently employed goal areas across a range of clinical populations and compare these findings with the published literature. Responses to a 21-question on-line survey were obtained from 477 professional music therapists practicing in 29 countries which...... of songwriting clinical practice and the frequency with which songwriting is employed in practice. The data highlights that songwriting is frequently employed in developmental disability and ASD practice, with reports on songwriting with these diagnostic groups being underrepresented in the music therapy...

  9. Obesity: Pathophysiology and Intervention

    Directory of Open Access Journals (Sweden)

    Yi Zhang

    2014-11-01

    Full Text Available Obesity presents a major health hazard of the 21st century. It promotes co-morbid diseases such as heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. Excessive energy intake, physical inactivity, and genetic susceptibility are main causal factors for obesity, while gene mutations, endocrine disorders, medication, or psychiatric illnesses may be underlying causes in some cases. The development and maintenance of obesity may involve central pathophysiological mechanisms such as impaired brain circuit regulation and neuroendocrine hormone dysfunction. Dieting and physical exercise offer the mainstays of obesity treatment, and anti-obesity drugs may be taken in conjunction to reduce appetite or fat absorption. Bariatric surgeries may be performed in overtly obese patients to lessen stomach volume and nutrient absorption, and induce faster satiety. This review provides a summary of literature on the pathophysiological studies of obesity and discusses relevant therapeutic strategies for managing obesity.

  10. [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.

  11. Therapeutic physical exercise in neural injury: friend or foe?

    Science.gov (United States)

    Park, Kanghui; Lee, Seunghoon; Hong, Yunkyung; Park, Sookyoung; Choi, Jeonghyun; Chang, Kyu-Tae; Kim, Joo-Heon; Hong, Yonggeun

    2015-12-01

    [Purpose] The intensity of therapeutic physical exercise is complex and sometimes controversial in patients with neural injuries. This review assessed whether therapeutic physical exercise is beneficial according to the intensity of the physical exercise. [Methods] The authors identified clinically or scientifically relevant articles from PubMed that met the inclusion criteria. [Results] Exercise training can improve body strength and lead to the physiological adaptation of skeletal muscles and the nervous system after neural injuries. Furthermore, neurophysiological and neuropathological studies show differences in the beneficial effects of forced therapeutic exercise in patients with severe or mild neural injuries. Forced exercise alters the distribution of muscle fiber types in patients with neural injuries. Based on several animal studies, forced exercise may promote functional recovery following cerebral ischemia via signaling molecules in ischemic brain regions. [Conclusions] This review describes several types of therapeutic forced exercise and the controversy regarding the therapeutic effects in experimental animals versus humans with neural injuries. This review also provides a therapeutic strategy for physical therapists that grades the intensity of forced exercise according to the level of neural injury.

  12. Reflections on relevance: Psychotherapy and Psychosomatics in 2004.

    Science.gov (United States)

    Balon, Richard

    2005-01-01

    Relevance of an article is a highly desirable yet hardly predictable quality at the time of its publication. Article relevance is frequently measured by the impact factor of the journal where the article is published. Furthermore, impact factor, citation index and citation analysis are used as a measure of research progress and scientific wealth of a nation. The wisdom and significance of this approach to