WorldWideScience

Sample records for treatment miesaki tkanek

  1. Ropień tkanek miękkich podudzia wywołany przez Salmonella sp. u pacjentki z reumatoidalnym zapaleniem stawów leczonej adalimumabem

    Directory of Open Access Journals (Sweden)

    Magdalena Marek

    2011-04-01

    Full Text Available Stosowanie leków biologicznych, do których zalicza się m.in. przeciwciałaprzeciwko czynnikowi martwicy nowotworów α, może byćzwiązane ze zwiększoną zapadalnością na zakażenia o etiologiibakteryjnej, wirusowej czy grzybiczej.Supresja układu odpornościowego czasami zmienia typowy przebiegkliniczny infekcji w porównaniu z przebiegiem u osób immunokompetentnych.Obserwuje się tendencję do uogólnienia zakażeniai/lub nietypowego, skąpoobjawowego przebiegu.Przedstawiono przypadek 60-letniej kobiety chorej na reumatoidalnezapalenie stawów o agresywnym przebiegu od ok. 12 lat,obciążonej wieloletnią cukrzycą typu 2, leczonej adalimumabem,metotreksatem i prednizonem, przyjętej do szpitala z powodubolesnej zmiany o charakterze naciekowo-zapalnym na bocznejpowierzchni prawego podudzia. Przeprowadzona diagnostykadoprowadziła do rozpoznania ropnia tkanek miękkich prawegopodudzia o etiologii Salmonella sp. (ryc. 1, 2.Etiologia została potwierdzona badaniem bakteriologicznymwydzieliny uzyskanej po chirurgicznym nacięciu ropnia. Zastosowanoantybiotykoterapię zgodną z antybiogramem oraz leczeniemiejscowe (miejscowo działające leki odkażające i regularnawy mia na sączków, uzyskując bardzo dobry efekt kliniczny (ryc. 3.W cza sie diagnostyki i leczenia odstawiono metotreksat i adali -mumab.Powstanie ropnia było prawdopodobnie poprzedzone skąpoobjawowym,ograniczonym jedynie do stanów gorączkowych, zakażeniemSalmonella i bakteriemią. Należy również wziąć pod uwagęmożliwość nosicielstwa i reaktywacji zakażenia w wyniku stosowanychleków immunosupresyjnych. Z powodu wciąż rosnącej liczby chorych stosujących leki biologicznewarto zwrócić uwagę na to, że zakażenia w tej grupie chorychmogą mieć bardzo nietypowy przebieg oraz etiologię.Decyzja o ponownym stosowaniu leku z grupy leków modyfikującychprzebieg choroby, ewentualnie o ponownej kwalifikacji doleczenia biologicznego, będzie podjęta po zako

  2. Stosowanie zabiegów fizjoterapeutycznych u osób uprawiających balet po urazie sportowym oraz przeciążeniach narządu ruchu = The use of physical therapy in people practicing ballet trauma and sports overload the musculoskeletal system

    Directory of Open Access Journals (Sweden)

    Magdalena Michalczak

    2016-07-01

          Słowa kluczowe: przeciążenie tkanek, balet, urazy sportowe. Keywords: overload tissue, ballet, sports injuries.     Streszczenie   Wprowadzenie: Każdy sportowiec poddawany jest obciążeniom. Są to obciążenia psychiczne i fizyczne i wzajemnie ze sobą powiązane. Zmiany stanu wytrenowania i poziomu formy sportowej, a także rozwój sportowy zawodnika to efekt długotrwałych zmian adaptacyjnych w organizmie człowieka pod wpływem treningu. Cel pracy: Ocena jakie zabiegi fizjoterapeutyczne najczęściej stosowane były u pacjentów po przebytym urazie sportowym Materiał i metody: Analizę przeprowadzono na losowo wybranych respondentach z grupy wiekowej od 12 do 38 roku życia, zamieszkałych na terenie województwa lubelskiego. Łącznie badaniem objęto grupę 20 osób. Wyniki: Proces patologii tkanek i urazów sportowych dotyczy 90% ankietowanych. 90% ankietowanych trening zawsze rozpoczyna od rozgrzewki, natomiast 10% badanych odpowiedziało, że czasami nie rozpoczynają treningu od rozgrzewki. Rehabilitacji po przeciążeniu tkanek objętych było 75%, przy czym w przychodni ambulatoryjnej rehabilitowanych jest 60% ankietowanych. W mniejszym stopniu pacjenci korzystają z usprawniania w domu - 10%  badanych. Najczęściej stosowanym zabiegiem była kinezyterapia - 75%. Masaż leczniczy również został uznany za często stosowany zabieg w patofizjologii tkanek - 15%. Rzadziej stosowanymi zabiegami okazały się prądy galwaniczne - 5% oraz ultradźwięki - 5%. U znacznej większości osób ankietowanych – 75% nie występowały choroby współistniejące. Wnioski: W badaniach stwierdzono wysoki odsetek osób, u których występują przeciążenia tkanek oraz urazy stawów, które spowodowane są zbyt częstym i długotrwałym treningom - 90% badanych. U znacznej większości osób badanych nie występowały choroby współistniejące, które mogłyby dodatkowo wpływać na powstawanie urazów tak jak np. osteoporoza - 75% os

  3. Schorzenia w obrębie stawu łokciowego. Łokieć teniststy - schorzenie i współczesne metody leczenia = Diseases within the elbow joint. Tennis elbow - condition and modern methods of treatment

    Directory of Open Access Journals (Sweden)

    Joanna Siminska

    2015-04-01

      Streszczenie   Według najnowszych danych Światowej Organizacji Zdrowia zauważyć należy, iż że wśród wszystkich obrażeń układu mięśniowo-szkieletowego prawie połowa to urazy tkanek miękkich (wraz ze ścięgnami i więzadłami, które często prowadzą one do powstawania przewlekłych dolegliwości  bólowych, ograniczenia ruchomości a  nawet niepełnosprawności. Ciągły rozwój medycyny oraz postęp technologiczny umożliwiają lepsze poznanie schorzeń układu mięśniowo-szkieletowego, ale również znalezienie najlepszych sposobów kompleksowej rehabilitacji. Jednym z obecnie najczęstszych urazów jest zapalenie nadkłykcia bocznego kości ramiennej, popularnie zwane „łokciem tenisisty”. Pacjent z tym schorzeniem zgłasza się z odczuwanym bólem, który  jest spowodowany zwyrodnieniem w okolicy ścięgna prostowników. Omówiono również  najczęstsze urazy, które  dotyczą stawu łokciowego. Obecnie możemy wyróżnić kilka  metod leczenia schorzenia zapalenia nadkłykcia bocznego kości ramiennej m. in. polegające na ostrzykiwaniu miejsca sprawiającego ból: pełną krwią, sterydami oraz płukanymi płytkami krwi. Ponadto możemy stosować także  terapię falami uderzeniowymi oraz zabieg koblacji topaz.   Słowa kluczowe: łokieć tenisisty, leczenie, dolegliwości bólowe nadkłykcia bocznego kości ramiennej. Abstract According to the latest World Health Organization data that should be noted that among all the injuries of the musculoskeletal system, nearly half of the soft tissue injuries (along with the tendons and ligaments, which often lead to the formation of chronic pain disorders, limitation of movable property and even disability. The continuous development of the medicine and technological advances make it possible to better know the conditions of the musculoskeletal system, but also to find the best ways for comprehensive rehabilitation. One of the currently most common injuries is inflammation of the

  4. Choroba zwyrodnieniowa stawów biodrowych - pacjent i problemy funkcjonalne = The hip joint Osteoarthritis - patient and functional problems

    Directory of Open Access Journals (Sweden)

    Piotr Biegański

    2015-08-01

      Streszczenie             Coxarthrosis to przewlekłe schorzenie powodujące destrukcje w obrębie stawu biodrowego i tkanek okołostawowych. Choroba zwyrodnieniowa stawów jest jednym z najczęściej spotykanych schorzeń ortopedycznych i drugim po chorobach układu krążenia powodujące niepełnosprawność. Pacjenci najczęściej borykają się z bólem i sztywnością, które wpływają na spadek możliwości lokomocji, samoobsługi i jakości życia. Stanowi to wyzwanie dla zespołu medycznego, który ma zadanie  utrzymywać sprawność pacjenta jak najdłużej.   Abstract             Coxarthrosis is a chronic illness which makes destruction in the area of joint and tissues surrounding  it. The hip joint Osteoarthritis  is one of the most popular orthopaedic disease and second after  cardiovascular disease causing disability. Patients generally feel pain and stiffness which causes decrease the possibility of locomotion, self-servive and quality of life. It is challenge for medical team to maintain efficiency as long as it is possible.   Słowa kluczowe: coxarthrosis, choroba zwyrodnieniowa stawu biodrowego, ból, problemy funkcjonalne. Key word: coxarthrosis, hip joint osteoarthrosis, pain, functional problems.

  5. Personality does not predict treatment preference, treatment experience does: a study of four complementary pain treatments.

    Science.gov (United States)

    Blasche, Gerhard; Melchart, Herbert; Leitner, Daniela; Marktl, Wolfgang

    2007-10-01

    The aim of the present study was to determine the extent to which personality and treatment experience affect patients' appraisals of 4 complementary treatments for chronic pain. A total of 232 chronic pain patients (164 females, 68 males, average age 56.6 years) visiting a spa clinic in Austria returned a questionnaire on patient characteristics and personality (autonomy, depressiveness, assertiveness, self-control) as well as attitudes towards (i.e. appealing, effective, pleasant) and experience of the treatments. Results were analysed by use of linear regression analysis and confidence intervals. Although all treatments were appraised positively, the passive treatments (thermal water tub baths, classical massage) were favoured more than the active treatments (relaxation training or exercise therapy). Treatment appraisal was not predicted by any of the personality traits but to a large extent by treatment experience. Relaxing, not unpleasant treatments were the most highly esteemed treatments. How strenuous or tiring a treatment was only had a minor effect on its appraisal. Neither do dependent, passive patients prefer passive treatments, nor do conscientious patients prefer active treatments. Instead, the appraisal of treatments that induce specific somatosensory sensations is largely determined by treatment experiences, i.e. what the treatment feels like. Despite the popularity of CAM which encompasses many experientially intensive treatments, treatment experience has to date been a neglected topic of treatment research.

  6. Cholera Treatment

    Science.gov (United States)

    ... Diagnosis and Detection Laboratory Testing for Cholera Treatment Rehydration Therapy Antibiotic Treatment Zinc Treatment Prevention & Control Five ... page for current cholera treatment recommendations. Cholera Treatments Rehydration therapy , meaning prompt restoration of lost fluids and ...

  7. Treatment goals and treatment in exercise therapy.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1994-01-01

    In the present study a quantitative description is given of treatment in exercise therapy according to Cesar and according to Mensendieck. Information was gathered from saurvey on exercise therapy in the Netherlands. Characteristics of treatment are described including treatment goals, emphasis of

  8. Treatment diary for botulinum toxin spasticity treatment

    DEFF Research Database (Denmark)

    Biering-Sørensen, Bo; Iversen, Helle K; Frederiksen, Inge M S

    2017-01-01

    The aim of this study is to develop a treatment diary for patients receiving spasticity treatment including botulinum toxin injection and physiotherapy and/or occupational therapy. The diary focuses on problems triggered by skeletal muscle overactivity; agreed goals for treatment and the patient...

  9. 40 CFR 133.105 - Treatment equivalent to secondary treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Treatment equivalent to secondary treatment. 133.105 Section 133.105 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS SECONDARY TREATMENT REGULATION § 133.105 Treatment equivalent to secondary treatment...

  10. Treatment-refractory anxiety; definition, risk factors, and treatment challenges.

    Science.gov (United States)

    Roy-Byrne, Peter

    2015-06-01

    A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to "pseudo-resistance" (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true "treatment resistance." Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments.

  11. Treatment-refractory anxiety; definition, risk factors, and treatment challenges

    Science.gov (United States)

    Roy-Byrne, Peter

    2015-01-01

    A sizable proportion of psychiatric patients will seek clinical evaluation and treatment for anxiety symptoms reportedly refractory to treatment. This apparent lack of response is either due to “pseudo-resistance” (a failure to have received and adhered to a recognized and effective treatment or treatments for their condition) or to true “treatment resistance.” Pseudo-resistance can be due to clinician errors in selecting and delivering an appropriate treatment effectively, or to patient nonadherence to a course of treatment. True treatment resistance can be due to unrecognized exogenous anxiogenic factors (eg, caffeine overuse, sleep deprivation, use of alcohol or marijuana) or an incorrect diagnosis (eg, atypical bipolar illness, occult substance abuse, attention deficit-hyperactivity disorder). Once the above factors are eliminated, treatment should focus on combining effective medications and cognitive behavioral therapy, combining several medications (augmentation), or employing novel medications or psychotherapies not typically indicated as first-line evidence-based anxiety treatments. PMID:26246793

  12. Incontinence Treatment: Biofeedback

    Science.gov (United States)

    ... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ... Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding ...

  13. Treatment Effects

    DEFF Research Database (Denmark)

    Heckman, James J.; Lopes, Hedibert F.; Piatek, Rémi

    2014-01-01

    This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low-dimensional v......This paper contributes to the emerging Bayesian literature on treatment effects. It derives treatment parameters in the framework of a potential outcomes model with a treatment choice equation, where the correlation between the unobservable components of the model is driven by a low...... to observe the same person in both the treated and untreated states, but it also turns out to be straightforward to implement. Formulae are provided to compute mean treatment effects as well as their distributional versions. A Monte Carlo simulation study is carried out to illustrate how the methodology can...

  14. Long term substitution treatment (maintenance treatment of opioid dependent persons

    Directory of Open Access Journals (Sweden)

    Wirl, Charlotte

    2007-03-01

    Full Text Available Health political background: Methadone substitution treatment in Germany is introduced in 1988 in the framework of a scientific pilot study in North Rhein Westphalia. Recent statistics show that by now a broad offer of substitution treatment exists. From 1 June 2002 to 31 December 2003 113,000 substitution treatments have been recorded as being started of which around 56,000 have been recorded as ongoing treatments by 1 December 2003. Scientific background: Substitution treatment (treatment of opioid-dependent persons using substitution substances is one part of addiction treatment. Its goals are harm reduction and the stabilisation of opioid dependent persons. Integration of opioid-dependent persons in a treatment-setting, reduction of consumption of psychoactive substances, reduction of risk behaviour (primarily related to infectious diseases, decrease of mortality and improvements concerning the social, psychic and physic situation are seen as a success of substitution treatment as maintenance therapy. Research questions: The aim of this HTA report is to investigate which indicators can be used to evaluate the effectiveness of substitution treatment. Based on these indicators an evaluation of the medical, social and economical benefit of substitution treatment - also in relation to abstinence oriented treatment - is carried out. Methods: A systematic literature search was performed in 31 international databases which yielded 2451 articles with publication date between 1995 and February 2005. Results: After a twofold selection process 32 publications were included for assessment and 276 publications were used as background literature. Despite serious restrictions due to selection bias and dropout in most studies focusing on substitution treatment, reduction of consumption of illegal opioids, reduction of risk behaviour, criminal behaviour, mortality and incidence of HIV can be seen as an empirically proven success of substitution treatment

  15. [AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders].

    Science.gov (United States)

    Schlüter-Müller, Susanne

    2017-07-01

    AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in adolescence and emerging adulthood the diagnosis is often delayed. In most cases, specific treatment is only offered late in the course of the disorder and to relatively few individuals. Adolescent Identity Treatment (AIT) is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, a behavior-oriented homeplan and intensive family work is part of AIT.

  16. Multidisciplinary treatment

    International Nuclear Information System (INIS)

    Hayabuchi, Naofumi; Jingu, Kenichi; Matsuura, Keiichi

    1985-01-01

    Multidisciplinary treatment for malignant lymphoma is reported in terms of indication, current status, and outcome of this approach to Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NLH). HD is considered to be most successfully managed with multidisciplinary treatment. Success of treatment of HD in European countries and the US, which has resulted from accurate staging of HD and developments in radiotherapy and chemotherapy, is reviewed in the literature. Problems in the treatment of HD in Japan are presented. A treatment policy for NHL is discussed according to the original site, i.e. lymph nodes, Waldeyer's ring or other sites of tumor involvement. (Namekawa, K.)

  17. [Treatment of chronic bovine endometritis and factors for treatment success].

    Science.gov (United States)

    Feldmann, M; Tenhagen genannt Emming, S; Hoedemaker, M

    2005-01-01

    In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial treatment, n = 28). Before treatment, uterine swabs for bacteriologic examination and blood samples for determination of serum progesterone concentrations were collected. Two weeks following the first treatment, cows were reexamined. In case no clinical cure was diagnosed, treatment was repeated and control cows were treated for the first time with one of the three treatments mentioned above. The four treatment groups did not differ with respect to the clinical cure or reproductive performance. Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P conception rate and a lower pregnancy index were obtained when the treatment was performed following day 42 postpartum (P size had a negative effect on clinical cure over all groups (first treatment clinical cure: 68.2% (small uteri) vs 44.4% (large uteri); P 0.05). Isolation of Arcanobacterium (A.) pyogenes negatively influenced first treatment clinical cure over all treatment groups (79.0% vs 31.5%) and within treatment groups (P conception increased compared with the other treatment groups, when A. pyogenes was detected. Isolation of unspecific bacteria and the presence or absence of a corpus luteum only had minor effects over all and within the PG, AS and C group. Within the AB group, presence of luteal tissue was connected with a

  18. [Headache Treatment].

    Science.gov (United States)

    Diener, Hans Christoph; Holle-Lee, Dagny; Nägel, Steffen; Gaul, Charly

    2017-03-01

    A precondition for the successful treatment of headaches is the correct headache diagnosis. Triptans are effective for attack treatment of migraine and cluster headache. However, there are not effective for the treatment of tension-type headache. For the prevention of frequent episodic migraine betablockers, flunarizine, topiramate and amitriptyline are recommended. For the prevention of chronic migraine evidence is only available for onabotulinumtoxinA and topiramate. For prophylactic treatment of tension-type headaches tricyclic antidepressants are used. In cluster headache verapamil (in combination with steroids) is the most frequently used prophylactic agent. This article focusses on the current acute and prophylactic treatment of common headache syndromes. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Tuberculosis Treatment

    African Journals Online (AJOL)

    Tuberculosis Treatment, Lusaka, Zambia. 1. 2. 2. 3. 3 ... TB treatment has contributed to the steady rise of TB incidence in ... respondents (89.4%) had positive attitude towards TB treatment ..... respondents described feelings of depression, anger and apathy .... Journal of Personality and Social Psychology,. 1979, 37:1-11.

  20. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    Science.gov (United States)

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  1. [Preprosthetic orthodontic treatments

    NARCIS (Netherlands)

    Prahl-Andersen, B.; Prahl, C.; Baat, C. de; Creugers, N.H.J.

    2014-01-01

    The objective of a preprosthetic orthodontic treatment is to position the teeth in such a way that a treatment with (fixed) dental prostheses is made possible or simplified or to affect the result of this treatment positively. Conceivable preprosthetic orthodontic treatments are: correcting primary

  2. Reduction of treatment delivery variances with a computer-controlled treatment delivery system

    International Nuclear Information System (INIS)

    Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

    1997-01-01

    Purpose: To analyze treatment delivery variances for 3-D conformal therapy performed at various levels of treatment delivery automation, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system. Materials and Methods: All external beam treatments performed in our department during six months of 1996 were analyzed to study treatment delivery variances versus treatment complexity. Treatments for 505 patients (40,641 individual treatment ports) on four treatment machines were studied. All treatment variances noted by treatment therapists or quality assurance reviews (39 in all) were analyzed. Machines 'M1' (CLinac (6(100))) and 'M2' (CLinac 1800) were operated in a standard manual setup mode, with no record and verify system (R/V). Machines 'M3' (CLinac 2100CD/MLC) and ''M4'' (MM50 racetrack microtron system with MLC) treated patients under the control of a computer-controlled conformal radiotherapy system (CCRS) which 1) downloads the treatment delivery plan from the planning system, 2) performs some (or all) of the machine set-up and treatment delivery for each field, 3) monitors treatment delivery, 4) records all treatment parameters, and 5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3, so it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments (ports), non-axial and non-coplanar plans, multi-segment intensity modulation, and pseudo-isocentric treatments (and other plans with computer-controlled table motions). Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines, so this analysis

  3. Teaching Treatment Planning.

    Science.gov (United States)

    Seligman, Linda

    1993-01-01

    Describes approach to teaching treatment planning that author has used successfully in both seminars and graduate courses. Clarifies nature and importance of systematic treatment planning, then describes context in which treatment planning seems more effectively taught, and concludes with step-by-step plan for teaching treatment planning.…

  4. Antihypertensive treatment

    DEFF Research Database (Denmark)

    Christensen, Cramer; Mogensen, C E

    1987-01-01

    This study was undertaken to clarify whether antihypertensive treatment has any effect on the rate of progression of kidney disease in patients with incipient diabetic nephropathy. Six insulin-dependent diabetic men with incipient nephropathy (urinary albumin excretion above 15 micrograms....../min and total protein excretion below 0.5 g/24 h) were first given metoprolol (200 mg daily) with the subsequent addition of hydroflumethiazide. At the start of antihypertensive treatment, mean patient age was 32 +/- 4.2 years (SD) and mean duration of diabetes was 18 +/- 1.2 years. The patients were followed...... with repeated measurements of urinary albumin excretion for a mean of 5.4 +/- 3.1 years prior to, and for 4.7 +/- 1.3 years (SD) during treatment. Mean arterial blood pressure declined significantly during treatment, e.g., the values at 6 months before initiation of treatment being compared with values during...

  5. Mandometer Treatment Not Superior to Treatment as Usual for Anorexia Nervosa

    NARCIS (Netherlands)

    van Elburg, Annemarie A.; Hillebrand, Jacquelien J. G.; Huyser, Chaim; Snoek, Maartje; Kas, Martien; Hoek, Hans W.; Adan, Roger A. H.

    Objective: A comparison of the efficacy of a novel treatment method for anorexia nervosa (AN), the Mandometer treatment (MT), with treatment as usual (TAU). Method: During treatment data were collected to determine weight recovery and outcome as assessed by the Morgan Russell Outcome Assessment

  6. Analysis of External Treatment Methods and Technical Characteristics of External Treatment

    Science.gov (United States)

    Zhang, Rui; Miao, Mingsan; Bai, Ming

    2018-01-01

    Chinese medicine external therapy is a treatment method of Chinese medicine with Chinese characteristics. The effect of traditional Chinese medicine external treatment, convenient operation, external treatment and technology has great prospects for development. The traditional Chinese medicine external treatment method and technical characteristics were analyzed.

  7. Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

    2009-01-01

    Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

  8. Gambling Disorder: Exploring Pre-treatment and In-treatment Dropout Predictors. A UK Study.

    Science.gov (United States)

    Ronzitti, Silvia; Soldini, Emiliano; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta

    2017-12-01

    The aim of this study was to identify predictors of treatment dropout in a sample of gamblers attending a specialist clinic for gambling disorder. We analysed data on 846 treatment-seeking pathological gamblers. Firstly, we investigated differences in socio-demographic and clinical variables between treatment completers and pre-treatment dropouts, as well as between treatment completers and during-treatment dropouts. Subsequently, variables were entered into a multinomial logistic regression model to identify significant predictors of pre-treatment and in-treatment dropout. Overall, 44.8% of clients did not complete the treatment: 27.4% dropped out before starting it, while 17.4% dropped out during the treatment. Younger age and use of drugs were associated with pre-treatment dropout, while family history of gambling disorder, a lower PGSI score, and being a smoker were related with in-treatment dropout. Our findings suggest that pre-treatment dropouts differ from in-treatment dropouts, and, thus, further research will benefit from considering these groups separately. In addition, this newly gained knowledge will also be helpful in increasing treatment retention in specific subgroups of problem gamblers.

  9. Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

    Science.gov (United States)

    Lloyd, Belinda; Zahnow, Renee; Barratt, Monica J; Best, David; Lubman, Dan I; Ferris, Jason

    2017-11-01

    Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Osteoporosis treatment

    DEFF Research Database (Denmark)

    Pazianas, Michael; Abrahamsen, Bo

    2016-01-01

    The findings of the Women's Health Initiative study in 2002 marginalized the use of hormone replacement therapy and established bisphosphonates as the first line of treatment for osteoporosis. Denosumab could be used in selected patients. Although bisphosphonates only maintain the structure of bone...... to their benefits/harm ratio. Treatment of osteoporosis is a long process, and many patients will require treatment with more than one type of drug over their lifetime....

  11. Optimizing clozapine treatment

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Damkier, P; Lublin, Henrik

    2011-01-01

    Clozapine treatment remains the gold standard for treatment-resistant schizophrenia, but treatment with clozapine is associated with several side-effects that complicate the use of the drug. This clinical overview aims to provide psychiatrists with knowledge about how to optimize clozapine...... treatment. Relevant strategies for reducing side-effects and increasing the likelihood of response are discussed....

  12. Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia.

    Science.gov (United States)

    Dong, Lu; Soehner, Adriane M; Bélanger, Lynda; Morin, Charles M; Harvey, Allison G

    2018-03-01

    Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Treatment Wetlands

    OpenAIRE

    Dotro, Gabriela; Langergraber, Günter; Molle, Pascal; Nivala, Jaime; Puigagut, Jaume; Stein, Otto; Von Sperling, Marcos

    2017-01-01

    Overview of Treatment Wetlands; Fundamentals of Treatment Wetlands; Horizontal Flow Wetlands; Vertical Flow Wetlands; French Vertical Flow Wetlands; Intensified and Modified Wetlands; Free Water Surface Wetlands; Other Applications; Additional Aspects.

  14. Patients' perceptions, treatment need, and complexity of orthodontic re-treatment

    NARCIS (Netherlands)

    Ren, Yijin; Boxum, Christo; Sandham, John

    The aim of the present study was to investigate the subjective perception and objective treatment need and complexity of patients seeking orthodontic re-treatment. One hundred subjects (66 females, 34 males, age 26.7+/-8.2 years) seeking re-treatment were asked to complete a questionnaire which was

  15. Tuberculosis (TB): Treatment

    Science.gov (United States)

    ... Education & Training Home Conditions Tuberculosis (TB) Tuberculosis: Treatment Tuberculosis: Treatment Make an Appointment Refer a Patient Ask ... or bones is treated longer. NEXT: Preventive Treatment Tuberculosis: Diagnosis Tuberculosis: History Clinical Trials For more than ...

  16. Hyperthermia treatment planning

    International Nuclear Information System (INIS)

    Lagendijk, J.J.W.

    2000-01-01

    The development of hyperthermia, the treatment of tumours with elevated temperatures in the range of 40-44 deg. C with treatment times over 30 min, greatly benefits from the development of hyperthermia treatment planning. This review briefly describes the state of the art in hyperthermia technology, followed by an overview of the developments in hyperthermia treatment planning. It particularly highlights the significant problems encountered with heating realistic tissue volumes and shows how treatment planning can help in designing better heating technology. Hyperthermia treatment planning will ultimately provide information about the actual temperature distributions obtained and thus the tumour control probabilities to be expected. This will improve our understanding of the present clinical results of thermoradiotherapy and thermochemotherapy, and will greatly help both in optimizing clinical heating technology and in designing optimal clinical trials. (author)

  17. Hepatitis C: Treatment

    Science.gov (United States)

    ... Public Home » Hepatitis C » Hepatitis C Treatment Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For ... Enter ZIP code here Enter ZIP code here Hepatitis C Treatment for Veterans and the Public Treatment ...

  18. Cryptosporidium: Treatment

    Science.gov (United States)

    ... lt;/label> Parasites Home Treatment Recommend on Facebook Tweet Share Compartir Most people who have healthy immune systems will recover without treatment. Diarrhea can be managed by drinking plenty of fluids to prevent dehydration. ...

  19. Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers.

    Science.gov (United States)

    Garey, Lorra; Taha, Samar A; Kauffman, Brooke Y; Manning, Kara F; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

    2017-10-01

    Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N=182; 53.3% female; M age =40.67; SD=13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR=0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR=1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Ankle Sprain Treatment

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Ankle Sprain Treatment Page Content Article Body Acute ankle and ... Pediatrics summarizing the treatment phases of rehabilitation for ankle sprain. Phase Summary Description I Phase I treatment involves ...

  1. After Cancer Treatment

    Science.gov (United States)

    ... Better Home Your Health Resources Healthcare Management After Cancer Treatment After Cancer Treatment Share Print From the day you were diagnosed ... of the questions you may have after your cancer treatment ends. Path to well being Will I need ...

  2. Distributed Treatment Systems.

    Science.gov (United States)

    Zgonc, David; Plante, Luke

    2017-10-01

    This section presents a review of the literature published in 2016 on topics relating to distributed treatment systems. This review is divided into the following sections with multiple subsections under each: constituent removal; treatment technologies; and planning and treatment system management.

  3. Inter-treatment compensation of treatment setup variation to enhance the radiotherapeutic ratio

    International Nuclear Information System (INIS)

    Di, Yan; John, Wong; Michalski, Jeff; Pan, Cheng; Frazier, Arthur; Bosch, Walter; Martinez, Alvaro

    1995-01-01

    Purpose: In radiotherapy, treatment setup error has been one of the major causes of dose variation in the treated volume. With the data acquired from on-line electronic portal imaging, it is now possible not only to adjust the patient setup, but also to modify the treatment plan during the course of clinical treatment based on the setup error measured for each individual patient. In this work, daily clinical portal images were retrospectively analyzed to study (1) the number of initial daily portal images required to give adequate prediction of the systematic and random deviations of treatment setup, and (2) the potential therapeutic gain when the inter-treatment planning modification was established using the setup error of each individual patient. Methods and Materials: Only those patients whose treatment positions had not been adjusted during the course of treatment were selected for the retrospective study. Daily portal images of 27 lung, 25 pelvis, and 12 head and neck (h and n) cancer patients were obtained from two independent clinics with similar setup procedures. The anterior-to-posterior field was analyzed for the pelvis and lung treatments, and the right lateral field for the h and n treatments. Between 13 to 30 daily portal images were acquired for each patient and were analyzed using a 2D alignment tool. Systematic and random deviations of the treatment setup were calculated for each individual patient. The statistical confidence on the convergence of both systematic and random deviations with time were tested to determine the number of initial daily portal images needed to predict these deviations. In addition, a mean deviation for each site was also calculated using the setup errors from all patients. Two treatment planning schemes were simulated to evaluate margin design and prescription dose adjustment. Therapeutic scores were quantified in terms of tumor control probability (TCP) and normal tissue complication probability (NTCP). In the first

  4. Cancer treatments

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000901.htm Cancer treatments To use the sharing features on this page, ... or IV. Immunotherapy Immunotherapy is a type of cancer treatment that relies on the body's ability to fight ...

  5. Evidence-based treatment strategies for treatment-resistant bipolar depression: a systematic review

    NARCIS (Netherlands)

    Sienaert, P.; Lambrichts, L.; Dols, A.; De Fruyt, J.

    2013-01-01

    Objectives: Treatment resistance in bipolar depression is a common clinical problem that constitutes a major challenge for the treating clinician as there is a paucity of treatment options. The objective of this paper was to review the evidence for treatment options in treatment-resistant bipolar

  6. Risk factors for treatment default among re-treatment tuberculosis patients in India, 2006.

    Science.gov (United States)

    Jha, Ugra Mohan; Satyanarayana, Srinath; Dewan, Puneet K; Chadha, Sarabjit; Wares, Fraser; Sahu, Suvanand; Gupta, Devesh; Chauhan, L S

    2010-01-25

    Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment. To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients. For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters. 1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%-75% interquartile range 44-117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2-1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1-1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0-1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1-1.6). Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening.

  7. Treatment beliefs underlying intended treatment choices in knee and hip osteoarthritis

    NARCIS (Netherlands)

    Selten, E.M.H.; Geenen, R.; Schers, H.J.; van den Hoogen, F.H.J.; van der Meulen-Dilling, R.G.; Van der Laan, W.H.; Nijhof, M.W.; van den Ende, C.H.M.; Vriezekolk, J.E.

    Purpose Patients’ beliefs about treatment modalities for knee and hip osteoarthritis (OA) will underlie their treatment choices. Based on the Theory of Planned Behavior, it is hypothesized that patients’ beliefs, subjective norm, and perceived behavioral control guide their treatment choices. Also,

  8. Treatment of Epileptic Encephalopathies.

    Science.gov (United States)

    Balestrini, Simona; Sisodiya, Sanjay M

    2017-01-01

    Epileptic encephalopathies represent the most severe epilepsies, with onset in infancy and childhood and seizures continuing in adulthood in most cases. New genetic causes are being identified at a rapid rate. Treatment is challenging and the overall outcome remains poor. Available targeted treatments, based on the precision medicine approach, are currently few. To provide an overview of the treatment of epileptic encephalopathies with known genetic determinants, including established treatment, anecdotal reports of specific treatment, and potential tailored precision medicine strategies. Genes known to be associated to epileptic encephalopathy were selected. Genes where the association was uncertain or with no reports of details on treatment, were not included. Although some of the genes included are associated with multiple epilepsy phenotypes or other organ involvement, we have mainly focused on the epileptic encephalopathies and their antiepileptic treatments. Most epileptic encephalopathies show genotypic and phenotypic heterogeneity. The treatment of seizures is difficult in most cases. The available evidence may provide some guidance for treatment: for example, ACTH seems to be effective in controlling infantile spams in a number of genetic epileptic encephalopathies. There are potentially effective tailored precision medicine strategies available for some of the encephalopathies, and therapies with currently unexplained effectiveness in others. Understanding the effect of the mutation is crucial for targeted treatment. There is a broad range of disease mechanisms underlying epileptic encephalopathies, and this makes the application of targeted treatments challenging. However, there is evidence that tailored treatment could significantly improve epilepsy treatment and prognosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Somatic Treatments in Treatment of Depression During Pregnancy

    Directory of Open Access Journals (Sweden)

    Eylem Ozten

    2015-09-01

    Full Text Available Although some psychotropic drugs are known to be teratogenic no psychotropic drug is of proven safety for treatment of depression during pregnancy. Untreated mood disorders during pregnancy pose significant risks for mother and the newborn. This review focuses on the use of somatic tretments of depression during pregnancy.Electroconvulsive therapy, bright light therapy, transcranial magnetic stimulation and vagal nerve stimulation are relatively safe and effective treatments during pregnancy if steps are taken to decrease potential risks. A clear information related to the somatic treatment should be given to the patient and informed consent should be obtained. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 244-254

  10. [Home treatment--a treatment model of integrated care in Hamburg].

    Science.gov (United States)

    Schöttle, Daniel; Ruppelt, Friederike; Karow, Anne; Lambert, Martin

    2015-03-01

    Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treatment system. We will present the implementation of an "Assertive Community Treatment" embedded into an IC-treatment model in Hamburg and discuss the 3-year-outcomes. The IC-treatment model has been designed for severe mentally ill patients with psychotic disorders. Since May 2007 the model is financed by different health insurances as a managed-care "capitation-model" and its effectiveness gets continuously evaluated. The model proved to be effective in earlier studies were compared with standard care low rates of service disengagement were found as well as significantly improved psychopathology, psychosocial functioning, quality of life, satisfaction with care and adherence, while being cost effective. The rates of involuntary admissions declined to 10% in comparison to the years before. In 2011 the model was specified to the indication "first-episode adolescents and young adults in the age of 12-29" in a government-funded study "Integrated Care in Early Psychosis, ICEP Study". In this study an interdisciplinary team of child, adolescent and adult psychiatrists was implemented and since 2012 it is financed by the involved health insurances throughout an expansion of the §140 SGB V agreement. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Pathways to treatment retention for individuals legally coerced to substance use treatment: the interaction of hope and treatment motivation.

    Science.gov (United States)

    Hampton, Ashley S; Conner, Bradley T; Albert, Dustin; Anglin, M Douglas; Urada, Darren; Longshore, Douglas

    2011-11-01

    Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well. As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California. Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (plead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retention. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Treatment consumption and treatment re-enrollment in GHB-dependent patients in The Netherlands.

    Science.gov (United States)

    van Noorden, Martijn S; Mol, Ton; Wisselink, Jeroen; Kuijpers, Wil; Dijkstra, Boukje A G

    2017-07-01

    The objective of this study was to assess treatment consumption and re-enrollment in treatment in patients with gamma-hydroxybutyrate (GHB)-dependence in Dutch Addiction Treatment Centers (ATCs) in comparison with other addictions. A cohort-study using nationwide administrative data from regular Dutch ATCs associated with the Dutch National Alcohol and Drugs Information System (LADIS), covering an estimated 95% of ATCs. We selected in- and out-patients with alcohol, drug and/or behavioral addictions with a first treatment episode in 2008-2011 and consecutive treatments until 2013 (n=71,679). Patients still in treatment at that date (n=3686; 5.1%), forensic patients (n=1949; 2.7%) and deceased patients (n=570; 0.8%) were excluded, leaving 65,474 patients (91.3%). Of those, 596 (0.9%) patients had GHB dependence. We analyzed number of treatment contacts, treatment duration, admissions and admission duration of the first treatment episode, and re-enrollment (defined as having started a second treatment episode in the study period). GHB-dependent patients showed the highest number of treatment contacts, duration of treatment and chance of being admitted. Re-enrollment rates were 2-5 times higher in GHB-dependent patients than other patients with adjusted HR of other addictions ranging from 0.18 (95% confidence interval [CI]: 0.15-0.21) to 0.53 (95% CI: 0.47-0.61). This study demonstrates high levels of treatment consumption and high rates of treatment re-enrollment in GHB-dependent patients. These findings highlight the urgency of developing effective relapse prevention interventions for GHB-dependent patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, a child with ADHD may fall behind in ... driving infractions. The good news is that effective treatment is available . With the right medical treatment, children ...

  14. Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment.

    Science.gov (United States)

    Nordahl, Håkon; Havnen, Audun; Hansen, Bjarne; Öst, Lars-Göran; Kvale, Gerd

    2018-04-01

    Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  15. Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

    Science.gov (United States)

    Ma, Yunbei; Zhou, Xiao-Hua

    2017-02-01

    For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

  16. First treatment contact for ADHD: predictors of and gender differences in treatment seeking.

    Science.gov (United States)

    Dakwar, Elias; Levin, Frances R; Olfson, Mark; Wang, Shuai; Kerridge, Bradley; Blanco, Carlos

    2014-12-01

    For attention-deficit hyperactivity disorder (ADHD), treatment seeking is a critical first step in treatment initiation and remains insufficiently understood. The aims of this study were to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. Data were drawn from 2001 to 2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions, a two-wave face-to-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism (N=34,653). The lifetime cumulative probability of ADHD treatment seeking was estimated at 55%. Males identifying as African American, with less than 12 years of education, or paranoid personality disorder or in an older cohort (>30 years old) at the time of interview were more likely to experience delays, whereas males with comorbid alcohol dependence, dysthymic disorder, borderline personality disorder, or histrionic personality disorder were less likely. Among females, older age (>44 years) was the only predictor of a delay to first treatment seeking, whereas bipolar disorder was associated with more rapid treatment seeking. Age of onset had opposite effects on treatment-seeking delays by gender; males but not females with early-onset ADHD were more likely to experience treatment-seeking delays. A large proportion of persons with ADHD do not seek treatment. Furthermore, treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry. Future research should explore how to facilitate early access to treatment for individuals with ADHD.

  17. Pharmacological treatment of sexual offenders in German outpatient treatment centers.

    Science.gov (United States)

    Turner, Daniel; Gregório Hertz, Priscilla; Sauter, Julia; Briken, Peer; Rettenberger, Martin

    2018-05-04

    In Germany, depending on a sexual offender's culpability and the severity of the offence, he/she can be placed either in the forensic-psychiatric or the correctional system. Numbers related to the pharmacological treatment of sexual offenders for the correctional system are missing so far. In sexual offenders, the pharmacological treatment of paraphilic disorders is of special importance. The present study aimed at assessing the prevalence of pharmacological sexual offender treatment in German outpatient treatment centers supervising mainly clients from the correctional sector. An online questionnaire was sent to 112 outpatient treatment centers and 21 provided data relevant for the present study. The included institutions reported about a total of 813 sexual offenders, of whom 200 (24.6%) were treated with pharmacological agents, most frequently antipsychotics (14.8%) and selective-serotonin-reuptake-inhibitors (7.1%). Of the total sample, 26.7% of sexual offenders were diagnosed with a paraphilic - mainly with a pedophilic - disorder. Only 2% were treated with androgen-deprivation therapy. Compared with forensic-psychiatric institutions, only a minority of sexual offenders are treated with medication specifically addressing paraphilic symptomatology. However, the prevalence of paraphilic disorders found in the present study suggests that pharmacological treatment of paraphilic fantasies and behaviors could be of great importance in the correctional sector as well.

  18. Finding the Right Treatment for Achalasia Treatment: Risks, Efficacy, Complications.

    Science.gov (United States)

    Moonen, An; Boeckxstaens, Guy

    2016-12-01

    Achalasia is a primary esophageal motor disorder of the esophagus that is characterized by the absence of esophageal peristalsis and a failure of the lower esophageal sphincter (LES) to relax upon swallowing. The defective relaxation leads to symptoms of dysphagia for solids and liquids, regurgitation, aspiration, chest pain, and weight loss. Achalasia is believed to result from a selective loss of enteric inhibitory neurons, most likely due to an autoimmune phenomenon in genetic susceptible individuals. As there is no curative treatment for achalasia, treatment is confined to disruption of the LES to improve bolus passage. The two most commonly used treatment modalities available are the endoscopic pneumodilation (PD) and the surgical laparoscopic Heller myotomy (LHM). A recent European randomized controlled trial showed that both treatment modalities have comparable success rates after a follow-up of at least 5 years. In view of these data, both treatments can be used as an initial therapy in achalasia and the choice should be based on the expertise available. Recently, a new endoscopic technique, peroral endoscopic myotomy (POEM), has been introduced with excellent short-term success rates. However, longer follow-up and data from randomized controlled trials are needed before accepting this technique as a new treatment option for achalasia in clinical practice.

  19. Beyond Fuel Treatment Effectiveness: Characterizing Interactions between Fire and Treatments in the US

    Directory of Open Access Journals (Sweden)

    Kevin Barnett

    2016-10-01

    Full Text Available In the United States, fuel reduction treatments are a standard land management tool to restore the structure and composition of forests that have been degraded by past management. Although treatments can have multiple purposes, their principal objective is to create landscape conditions where wildland fire can be safely managed to help achieve long-term land management goals. One critique is that fuel treatment benefits are unlikely to transpire due to the low probability that treated areas will be burned by a subsequent fire within a treatment’s lifespan, but little quantitative information exists to corroborate this argument. We summarized the frequency, extent, and geographic variation of fire and fuel treatment interactions on federal lands within the conterminous United States (CONUS. We also assessed how the encounters between fuel treatments and fires varied with treatment size, treatment age, and number of times treated. Overall, 6.8% of treatment units evaluated were encountered by a subsequent fire during the study period, though this rate varied among ecoregions across the CONUS. Larger treatment units were more likely to be encountered by a fire, and treatment units were most frequently burned within one year of the most recent treatment, the latter of which is likely because of ongoing maintenance of existing treatments. Our results highlight the need to identify and prioritize additional opportunities to reduce fuel loading and fire risk on the millions of hectares of federal lands in the CONUS that are in need of restoration.

  20. Treatment Fidelity: Its Importance and Reported Frequency in Aphasia Treatment Studies

    Science.gov (United States)

    Hinckley, Jacqueline J.; Douglas, Natalie F.

    2013-01-01

    Purpose: Treatment fidelity is a measure of the reliability of the administration of an intervention in a treatment study. It is an important aspect of the validity of a research study, and it has implications for the ultimate implementation of evidence-supported interventions in typical clinical settings. Method: Aphasia treatment studies…

  1. The Hybrid Treatment Process for mixed radioactive and hazardous waste treatment

    International Nuclear Information System (INIS)

    Ross, W.A.; Kindle, C.H.

    1992-06-01

    This paper describes a new process for treating mixed hazardous and radioactive waste, commonly called mixed waste. The process is called the Hybrid Treatment Process (HTP), so named because it is built on the 20 years of experience with vitrification of wastes in melters, and the 12 years of experience with treatment of wastes by the in situ vitrification (ISV) process. It also uses techniques from several additional technologies. Mixed wastes are being generated by both the US Department of Energy (DOE) and by commercial sources. The wastes are those that contain both a hazardous waste regulated under the US Environmental Protection Agency's (EPA) Resource, Conservation, and Recovery Act (RCRA) regulations and a radioactive waste with source, special nuclear, or byproduct materials. The dual regulation of the wastes increases the complexity of the treatment, handling, and storage of the waste. The DOE is the largest holder and generator of mixed waste. Its mixed wastes are classified as either high-level, transuranic (TRU), or low-level waste (LLW). High-level mixed wastes will be treated in vitrification plants. Transuranic wastes may be disposed of without treatment by obtaining a no-migration variance from the EPA. Lowlevel wastes, however, will require treatment, but treatment systems with sufficient capacity are not yet available to DOE. Various facilities are being proposed for the treatment of low-level waste. The concept described in this paper represents one option for establishing that treatment capacity

  2. Land Treatment Digital Library

    Science.gov (United States)

    Pilliod, David S.; Welty, Justin L.

    2013-01-01

    The Land Treatment Digital Library (LTDL) was created by the U.S. Geological Survey to catalog legacy land treatment information on Bureau of Land Management lands in the western United States. The LTDL can be used by federal managers and scientists for compiling information for data-calls, producing maps, generating reports, and conducting analyses at varying spatial and temporal scales. The LTDL currently houses thousands of treatments from BLM lands across 10 states. Users can browse a map to find information on individual treatments, perform more complex queries to identify a set of treatments, and view graphs of treatment summary statistics.

  3. Accelerated treatment protocols: full arch treatment with interim and definitive prostheses.

    Science.gov (United States)

    Drago, Carl

    2012-01-01

    With the advent of titanium, root form implants and osseointegration, dental treatment has undergone a metamorphosis in recent years. These new techniques enable dentists to provide anchorage for various kinds of prostheses that improve masticatory function, esthetics, and comfort for patients. Implant treatment protocols have been improved relative to implant macro- and micro-geometries, surgical and prosthetic components, and treatment times. Over the past 20 years, immediate occlusal function (also known as loading) has been established as a predictable treatment modality, provided certain specific criteria are met. In many cases, edentulous patients, crippled by the loss of their teeth, can undergo outpatient surgical and prosthetic procedures and return to a masticatory function that is near normal--sometimes after only one day of surgical and prosthetic treatment. This treatment option is also available for patients with advanced, generalized periodontal disease. Computer-assisted design/Computer-assisted manufacturing (CAD/CAM) has transformed how dental prostheses are made, offering improved accuracy, longevity, and biocompatibility; along with reduced labor costs and fewer complications than casting technologies. This article reviews the principles associated with immediate occlusal loading and illustrates one specific accelerated prosthodontic treatment protocol used to treat edentulous and partially edentulous patients with interim and definitive prostheses.

  4. Treatment preference in hypochondriasis.

    Science.gov (United States)

    Walker, J; Vincent, N; Furer, P; Cox, B; Kjernisted, K

    1999-12-01

    Promising cognitive-behavioral and medication treatments for hypochondriasis are in the early stages of evaluation. Little is known about the treatment preferences and opinions of individuals seeking help for this problem. In this exploratory study, 23 volunteers from the community with a DSM-IV diagnosis of hypochondriasis were recruited through a newspaper advertisement. Participants were presented with a survey which included balanced descriptions of both a medication and a cognitive-behavioral treatment for intense illness concerns (hypochondriasis). The brief descriptions of the treatments discussed the time commitment required as well as the major advantages and disadvantages of each. Results showed that, relative to medication treatment, cognitive-behavioral treatment was predicted to be more effective in both the short and long terms and was rated as more acceptable. Psychological treatment was indicated as the first choice by 74% of respondents, medication by 4%, and 22% indicated an equal preference. Forty-eight percent of respondents would only accept the psychological treatment.

  5. Endovascular treatment of acute basilar artery occlusion: time to treatment is crucial

    International Nuclear Information System (INIS)

    Dorňák, T.; Herzig, R.; Kuliha, M.; Havlíček, R.; Školoudík, D.; Šaňák, D.; Köcher, M.; Procházka, V.; Lacman, J.; Charvát, F.; Krajina, A.

    2015-01-01

    Aim: To evaluate the safety and efficacy of multimodal endovascular treatment (EVT) of acute basilar artery occlusion (BAO), including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT], to compare particular EVT techniques and identify predictors of clinical outcome. Materials and methods: This retrospective, multi-centre study comprised 72 acute ischaemic stroke patients (51 males; mean age 59.1 ± 13.3 years) with radiologically confirmed BAO. The following data were collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, localization of occlusion, time to therapy, recanalization rate, post-treatment imaging findings. Thirty- and 90-day outcomes were evaluated using the modified Rankin scale with a good clinical outcome defined as 0–3 points. Results: Successful recanalization was achieved in 94.4% patients. Stepwise binary logistic regression analysis identified the presence of arterial hypertension (OR = 0.073 and OR = 0.067, respectively), National Institutes of Health Stroke Scale (NIHSS) at the time of treatment (OR = 0,829 and OR = 0.864, respectively), and time to treatment (OR = 0.556 and OR = 0.502, respectively) as significant independent predictors of 30- and 90-day clinical outcomes. Conclusion: Data from this multicentre study showed that multimodal EVT was an effective recanalization method in acute BAO. Bridging therapy shortens the time to treatment, which was identified as the only modifiable outcome predictor. - Highlights: • Various treatments are being used in recanalization of basilar artery occlusion. • Multimodal endovascular treatment is an effective recanalization method. • Time-to-treatment is the only modifiable outcome predictor. • Bridging therapy shortens time-to-treatment. • Arterial hypertension, neurologic deficit are associated with poor outcome

  6. Adjunctive steroid treatment

    DEFF Research Database (Denmark)

    Korshin, André; Køster-Rasmussen, Rasmus; Meyer, Christian N

    2007-01-01

    Our objective was to evaluate local guidelines regarding early steroid treatment in adult community acquired bacterial meningitis, and assess the actual treatment given and its correlation to clinical outcome. Patient outcome was obtained retrospectively from the medical records of 210 adults...... admitted to 47 hospitals in Denmark during 2002-2004 (population 5.4 million) and was combined with results from a questionnaire regarding treatment guidelines in these hospitals. In 36 of 47 departments responding to the questionnaire, 21 recommended early steroid treatment, but none did so initially...... during 2002. Early steroid treatment was given to 15% of patients and was given more often when recommended locally (41% vs 11%, OR=5.7 (2.4-13.5)). Unfavourable outcome was demonstrated rarely in patients treated with early steroids compared to the non-steroid group (17% vs 42%, p

  7. Waste treatment

    International Nuclear Information System (INIS)

    Davies, D.; Hooper, E.W.

    1981-01-01

    In the treatment of wastes, such as liquid radioactive effluents, it is known to remove radionuclides by successive in situ precipitation of cobalt sulphide, an hydroxide, barium sulphate and a transition element ferrocyanide, followed by separation of the thereby decontaminated effluent. In this invention, use is made of precipitates such as obtained above in the treatment of further fresh liquid radioactive effluent, when it is found that the precipitates have additional capacity for extracting radionuclides. The resulting supernatant liquor may then be subjected to a further precipitation treatment such as above. Decontamination factors for radionuclides of Ce, Ru, Sr and Cs have been considerably enhanced. (author)

  8. Neuroimaging in aphasia treatment research: Standards for establishing the effects of treatment

    Science.gov (United States)

    Kiran, Swathi; Ansaldo, Ana; Bastiaanse, Roelien; Cherney, Leora R.; Howard, David; Faroqi-Shah, Yasmeen; Meinzer, Marcus; Thompson, Cynthia K

    2012-01-01

    The goal of this paper is to discuss experimental design options available for establishing the effects of treatment in studies that aim to examine the neural mechanisms associated with treatment-induced language recovery in aphasia, using functional magnetic resonance imaging (fMRI). We present both group and single-subject experimental or case-series design options for doing this and address advantages and disadvantages of each. We also discuss general components of and requirements for treatment research studies, including operational definitions of variables, criteria for defining behavioral change and treatment efficacy, and reliability of measurement. Important considerations that are unique to neuroimaging-based treatment research are addressed, pertaining to the relation between the selected treatment approach and anticipated changes in language processes/functions and how such changes are hypothesized to map onto the brain. PMID:23063559

  9. The impact of treatment complexity and computer-control delivery technology on treatment delivery errors

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; Lash, Kathy L.; Matrone, Gwynne M.; Volkman, Susan K.; McShan, Daniel L.; Kessler, Marc L.; Lichter, Allen S.

    1998-01-01

    Purpose: To analyze treatment delivery errors for three-dimensional (3D) conformal therapy performed at various levels of treatment delivery automation and complexity, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system (CCRS). Methods and Materials: All treatment delivery errors which occurred in our department during a 15-month period were analyzed. Approximately 34,000 treatment sessions (114,000 individual treatment segments [ports]) on four treatment machines were studied. All treatment delivery errors logged by treatment therapists or quality assurance reviews (152 in all) were analyzed. Machines 'M1' and 'M2' were operated in a standard manual setup mode, with no record and verify system (R/V). MLC machines 'M3' and 'M4' treated patients under the control of the CCRS system, which (1) downloads the treatment delivery plan from the planning system; (2) performs some (or all) of the machine set up and treatment delivery for each field; (3) monitors treatment delivery; (4) records all treatment parameters; and (5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3; therefore, it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments, nonaxial and noncoplanar plans, multisegment intensity modulation, and pseudoisocentric treatments studied for a 6-month period (505 patients) concurrent with the period in which the delivery errors were obtained. Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines; therefore, this analysis does not depend on fixed therapist staff on particular

  10. [Management of opioid maintenance treatments when analgesic treatments are required].

    Science.gov (United States)

    Laprevote, Vincent; Geoffroy, Pierre A; Rolland, Benjamin; Leheup, Benoît F; Di Patrizio, Paolo; Cottencin, Olivier; Schwan, Raymund

    2013-01-01

    Opioid maintenance treatments (OMT) reduce illicit opiate use and its associated risks. They are often prescribed on a long-term basis. Physiological changes induced by long-term OMT may cause hyperalgesia and cross-tolerance to opioid agonists, which suggests that the dosage of analgesic treatment should be modified in cases of acute pain, especially when an opioid-based analgesia is required. When treatment with analgesics is necessary, OMT must be maintained, except in exceptional cases. If a split-dosing schedule is temporarily employed during OMT, the daily dosage should not be increased for analgesic purposes. Analgesic treatment must be managed differently in case of treatment with buprenorphine or methadone. With buprenorphine, non-opioid analgesics should be introduced first, if possible. If this strategy is inefficient or contraindicated, a temporary or definitive switch to methadone should be considered. In the case of methadone-based OMT, opioid analgesics should be added directly and the dosage should be adapted according to the level of pain reported by the patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Treatment 2.0: catalyzing the next phase of treatment, care and support.

    Science.gov (United States)

    Duncombe, Chris; Ball, Andrew; Passarelli, Carlos; Hirnschall, Gottfried

    2013-01-01

    This review provides an update on the WHO/UNAIDS Treatment 2.0 strategy by reviewing the documents and technical updates issued under the initiative. Launched in 2010, this global initiative provides a framework for the continued scale-up of access to HIV care and treatment. WHO has prioritized once daily fixed-dose combination as the preferred antiretroviral (ARV) regimen to initiate HIV treatment, paving the way for programmatic simplification, with reduced toxicity and improved adherence. WHO also recommends the use of point-of-care diagnostics, with CD4 cell count technologies being implemented in the field and progress towards improving access to simplified viral load testing. The strategy also seeks mechanisms that can contribute to reducing treatment costs, such as pooled commodity procurement and public health-oriented licensing approaches. Improved service delivery, specifically through decentralization, task shifting, integration and community mobilization also has the potential to reduce costs and improve access. Support to countries has been provided through the timely release of a series of programmatic and technical updates on specific treatment-related topics. The Treatment 2.0 strategy articulates how innovation and greater efficiency can make HIV care and treatment more accessible and affordable, and guide treatment and prevention scale-up.

  12. Effects of unplanned treatment interruptions on HIV treatment failure– results from TAHOD

    Science.gov (United States)

    Jiamsakul, Awachana; Kerr, Stephen J.; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L. H.; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

    2016-01-01

    Objectives Treatment interruptions (TI) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Methods Patients initiating cART between 2006-2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Co-variables with p30 days were associated with failure (31-180 days HR=2.66, 95%CI (1.70-4.16); 181-365 days HR=6.22, 95%CI (3.26-11.86); and >365 days HR=9.10, 95% CI (4.27-19.38), all pfailure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. PMID:26950901

  13. MO-G-BRE-04: Automatic Verification of Daily Treatment Deliveries and Generation of Daily Treatment Reports for a MR Image-Guided Treatment Machine

    International Nuclear Information System (INIS)

    Yang, D; Li, X; Li, H; Wooten, H; Green, O; Rodriguez, V; Mutic, S

    2014-01-01

    Purpose: Two aims of this work were to develop a method to automatically verify treatment delivery accuracy immediately after patient treatment and to develop a comprehensive daily treatment report to provide all required information for daily MR-IGRT review. Methods: After systematically analyzing the requirements for treatment delivery verification and understanding the available information from a novel MR-IGRT treatment machine, we designed a method to use 1) treatment plan files, 2) delivery log files, and 3) dosimetric calibration information to verify the accuracy and completeness of daily treatment deliveries. The method verifies the correctness of delivered treatment plans and beams, beam segments, and for each segment, the beam-on time and MLC leaf positions. Composite primary fluence maps are calculated from the MLC leaf positions and the beam-on time. Error statistics are calculated on the fluence difference maps between the plan and the delivery. We also designed the daily treatment delivery report by including all required information for MR-IGRT and physics weekly review - the plan and treatment fraction information, dose verification information, daily patient setup screen captures, and the treatment delivery verification results. Results: The parameters in the log files (e.g. MLC positions) were independently verified and deemed accurate and trustable. A computer program was developed to implement the automatic delivery verification and daily report generation. The program was tested and clinically commissioned with sufficient IMRT and 3D treatment delivery data. The final version has been integrated into a commercial MR-IGRT treatment delivery system. Conclusion: A method was developed to automatically verify MR-IGRT treatment deliveries and generate daily treatment reports. Already in clinical use since December 2013, the system is able to facilitate delivery error detection, and expedite physician daily IGRT review and physicist weekly chart

  14. Treatment Response to an Intensive Summer Treatment Program for Adolescents with ADHD

    Science.gov (United States)

    Sibley, Margaret H.; Smith, Bradley H.; Evans, Steven W.; Pelham, William E.; Gnagy, Elizabeth M.

    2012-01-01

    Objective: There are presently almost no empirically validated treatments for adolescents with ADHD. However, in childhood, behavioral treatments for ADHD typically include behavioral parent training, classroom interventions, and intensive child-directed interventions. Method: The present investigation examines treatment gains following an 8-week…

  15. Water Treatment Group

    Data.gov (United States)

    Federal Laboratory Consortium — This team researches and designs desalination, water treatment, and wastewater treatment systems. These systems remediate water containing hazardous c hemicals and...

  16. Preventive Migraine Treatment

    Science.gov (United States)

    Silberstein, Stephen D.

    2015-01-01

    Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

  17. Endoscopic root canal treatment.

    Science.gov (United States)

    Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

    2009-10-01

    To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

  18. Treatment of thyroid cancer

    International Nuclear Information System (INIS)

    Voronetskij, I.B.

    1990-01-01

    Peculiarities of thyroid cancer, producing direct influence on selection of treatment procedure are enumerated. It is shown that surgical treatment is the determining way of treatment, which is supplemented with hormonotherapy in case of differentiated forms of the tumor. In case of anaplasia cancer, sarcomas, propagation of tumor beyond the limits of the organ, inoperable processes, treatment of recurrences and functional inactivity of bone metastases the remote control gamma-therapy should be performed. Therapy by radioactive iodine is shown for the treatment of remote iodine-concentrating metastases for devitalization of residual thyroid tissue after thyroidectomy

  19. Hazardous Waste Treatment Facility and skid-mounted treatment systems at Los Alamos

    International Nuclear Information System (INIS)

    Lussiez, G.W.; Zygmunt, S.J.

    1994-01-01

    To centralize treatment, storage, and areas for hazardous wastes, Los Alamos National Laboratory has designed a 1115 m2 hazardous waste treatment facility. The facility will house a treatment room for each of four kinds of wastes: nonradioactive characteristic wastes, nonradioactive listed wastes, radioactive characteristic wastes, and radioactive listed wastes. The facility will be used for repacking labpacks; bulking small organic waste volumes; processing scintillation vials; treating reactives such as lithium hydride and pyrophoric uranium; treating contaminated solids such as barium sand; treating plating wastes and other solutions with heavy metals and oxidizing organics: Separate treatment rooms will allow workers to avoid mixing waste types and prevent cross-contamination. The ventilation air from the treatment areas may contain hazardous or radioactive dust. Gas may also leak from process equipment. The gas treatment process includes separating solids and gases and neutralization or adsorption of the hazardous gases. The ventilation air from each room will first be filtered before being scrubbed in a common gas caustic scrubber on an outside pad. There are two levels of exhaust in each treatment room, one for heavy gases and another for light gases. Several features help mitigate or eliminate hazards due to spills and releases: each treatment room is sealed and under slight negative pressure; each room has its own HEPA filtration; to avoid mixing of incompatible wastes and reagents, portable individual spill-containment trays are used for skids, to limit the danger of spills, the waste is directly transferred from outside storage to the treatment room; to mitigate the consequences of a gas release in the room, mobile hoods are connected to the exhaust-air treatment system; the floor, walls, ceilings, fixtures, ducts, and piping are made of acid-resistant material or are coated

  20. Treatment Option Overview (Kaposi Sarcoma)

    Science.gov (United States)

    ... Treatment Childhood Vascular Tumors Treatment Research Kaposi Sarcoma Treatment (PDQ®)–Patient Version General Information About Kaposi Sarcoma ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  1. Domestic Violence Offender Treatment and Multidisciplinary Treatment Teams: The Role of "Treatment" Victim Advocates.

    Science.gov (United States)

    Richards, Tara N; Gover, Angela R

    2018-03-01

    In Colorado, "treatment victim advocates" (TVAs) serve alongside providers and probation/parole officers on "multidisciplinary treatment teams" (MTTs) to oversee domestic violence offender's treatment. Although this model provides an opportunity for victim safety concerns to be heard, the utility of using victim advocates as advisors regarding interventions for domestic violence offenders has yet to be studied. Using survey data and narrative responses from TVAs ( N = 37), the current study examines the challenges and opportunities TVAs face while serving on MTTs. Results suggest that, overall, TVAs are successful in communicating with other members of the MTT, are confident that their perspectives are valued in the offender decision-making process, and are able to provide a wide variety of services and referrals to the victims with whom they are engaged. Implications and recommendations for the Colorado model as well as correctional professionals managing domestic violence offenders internationally are presented and discussed.

  2. Association between root resorption incident to orthodontic treatment and treatment factors.

    Science.gov (United States)

    Motokawa, Masahide; Sasamoto, Tomoko; Kaku, Masato; Kawata, Toshitsugu; Matsuda, Yayoi; Terao, Akiko; Tanne, Kazuo

    2012-06-01

    The purpose of this study was to clarify the prevalence and degree of root resorption induced by orthodontic treatment in association with treatment factors. The files of 243 patients (72 males and 171 females) aged 9-51 years were randomly selected from subjects treated with multi-bracket appliances. The severity of root resorption was classified into five categories on radiographs taken before and after treatment. The subjects were divided into extraction (n = 113 patients, 2805 teeth) and non-extraction (n = 130 patients, 3616 teeth) groups and surgical (n = 56 patients, 1503 teeth) and non-surgical treatment (n = 187 patients, 4918 teeth) groups. These subjects were also divided into two or three groups based on the duration of multiloop edgewise archwire (MEAW) treatment, elastic use, and total treatment time: 0 month (T1; n = 184 patients, 4831 teeth), range 1-6 months (T2; n = 37 patients, 994 teeth), more than 6 months (T3; n = 22 patients, 596 teeth); range 0-6 months (n = 114 patients, 3016 teeth) more than 6 months (n = 129 patients, 3405 teeth); range 1-30 months (n = 148 patients, 3913 teeth) and more than 30 months (n = 95 patients, 2508 teeth). The prevalence of overall and severe root resorption evaluated by the number of subjects and teeth was compared with a chi-square test. A Student's t-test for unpaired data was used to determine any statistically significant differences. The prevalence of severe root resorption based on the number of teeth was significantly higher in the group with extractions (P root resorption (P root resorption was not significantly different between the subjects treated with or without surgery, but there was a significant increase when treatment time was prolonged (P root movement of the upper central incisors and the distance from their root apices to the cortical bone surface (P root resorption. These results indicate that orthodontic treatment with extractions, long-term use of a MEAW appliance and elastics, treatment

  3. The complex treatment of acute pancreatitis using miniinvasive surgical treatment

    Directory of Open Access Journals (Sweden)

    G. I. Ohrimenko

    2015-06-01

    Full Text Available Nowadays methods used in acute pancreatitis diagnostic do not allow to find the most optimal indications, terms of surgical drainage approaches in surgical treatment of acute pancreatitis. Aim. In order to develop optimal diagnostic and treatment algorithm 316 patients took part in the study. Methods and results. Surgery outcomes were assessed by the next methods: ultrasound, computed tomography. We determined that destructive changes in pancreas in group of sterile pancreatic necrosis were limited. In cases of infected pancreatic necrosis the damage was spread and the disease course was septic. That’s why the operative treatment in cases of sterile pancreatitis has to be used with strict indications such as fermentative peritonitis, acute liquid formations, acute pseudocysts. Conclusion. In such cases miniinvasive surgery is mainly used while in the cases of infected pancreatic necrosis we ought to choose open surgery treatment.

  4. Validation of the Treatment Motivation Scales for forensic outpatient treatment (TMS-F)

    NARCIS (Netherlands)

    Drieschner, Klaus H.; Boomsma, Anne

    The validity of the Treatment Motivation Scales for outpatient offender treatment (TMS-F), a self-report questionnaire with scales for the motivation of patients to engage in the treatment and six cognitive and emotional determinants of this motivation, is evaluated in two studies. In Study 1 (N =

  5. Treatment Options for Retinoblastoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other places in the body. Treatment Option Overview Key Points There are different types of ...

  6. Treatment of Functional Constipation

    Directory of Open Access Journals (Sweden)

    H Karami

    2014-04-01

    Full Text Available Childhood constipation is ofton a long_term problem requiring treatment over months or years. There is no single treatment metod for constipation and many children do not respond and continue to have chronic problems. Treatment is consisted of: Disimpaction,Drug adminstration , Diet modilation, and behaverial therapy. It is necessary in all cases that not responding to conventional therapy, un diagnosed organic causes, non proper drug, short course therapy, behaverial disorder and withholding should be considered. Internal anal achalasia, Neural tube defect, Neurointestinal dysplasia. and food allergy are the most important predisposing factors in treatment failer . PEG is drug of choice for treatment and therapy must be continued for several months or years. Psycologic consulting should be considered in patients with severe behaverial disorder.   Key words: Children, Functional Constipation, Treatment.

  7. Treatment of attention deficit hyperactivity disorder in children: Predictors of treatment outcome

    NARCIS (Netherlands)

    van der Oord, S.; Prins, P.J.M.; Oosterlaan, J.; Emmelkamp, P.M.G.

    2008-01-01

    Objective: The present study investigated the predictive power of anxiety, IQ, severity of ADHD and parental depression on the outcome of treatment in children with ADHD. Method: Fifty children with ADHD (ages 8-12) were randomized to a 10-week treatment of methylphenidate or to a treatment of

  8. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... Breast Cancer > Breast Cancer: Treatment Options Request Permissions Breast Cancer: Treatment Options Approved by the Cancer.Net Editorial ... can be addressed as quickly as possible. Recurrent breast cancer If the cancer does return after treatment for ...

  9. Inventtional treatment of varicocele

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2016-09-15

    Varicocele is a dilatation of the veins in the pampiniform plexus and manifests as mass-effect, pain, testicular atrophy, or male infertility. Traditionally, surgical treatment has been the mainstay of treatment of varicocele, while interventional treatment, which is endovascular embolization of the testicular vein, has been gaining popularity recently. In this review, diagnosis of the disease, indications and procedure details of interventional treatment, results, and complications are discussed.

  10. Wastewater Treatment Plants

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — The actual treatment areas for municipal, industrial, and semi-public wastewater treatment facilities in Iowa for the National Pollutant Discharge Elimination System...

  11. Working during cancer treatment

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000834.htm Working during cancer treatment To use the sharing features on this page, ... JavaScript. Many people continue to work throughout their cancer treatment. Cancer, or the side effects of treatment, may ...

  12. NIAAA Alcohol Treatment Navigator

    Science.gov (United States)

    ... What to Know About Alcohol Treatment What Is Alcohol Use Disorder (AUD)? What Types of Alcohol Treatment Are Available? ... What to Know About Alcohol Treatment What is alcohol use disorder (AUD)? A health condition that can improve with ...

  13. Research Areas: Treatment

    Science.gov (United States)

    The development of more effective and less toxic treatments is fundamental to improving outcomes for patients with cancer. NCI is leading efforts on several fronts to develop and evaluate new cancer treatments.

  14. Lifetime treatment contact and delay in treatment seeking after first onset of a mental disorder

    NARCIS (Netherlands)

    ten Have, M.; de Graaf, R.; van Dorsselaer, S.; Beekman, A.T.F.

    2013-01-01

    Objective: This study examined lifetime treatment contact and delays in treatment seeking, including rates for receipt of helpful treatment, after the onset of specific mental disorders and evaluated factors that predicted treatment seeking and delays in treatment seeking. Methods: Data were from

  15. Equal treatment of shareholders

    Directory of Open Access Journals (Sweden)

    Arsić Zoran

    2014-01-01

    Full Text Available Equal treatment of shareholders is regulated in Art.269 of Company Act (2011 of Republic of Serbia. Equal treatment of shareholders means that all shareholders are to be treated equally under same circumstances. Obligation to treat all shareholders equally rests on all company bodies, predominantly general meeting. The standard whether an action violates the principle of equal treatment of all shareholders regarding the main rights of shareholders (such as voting right etc. is the nominal value of shares, or the equal treatment per person regarding ancillary rights (such as right to speak in shareholders' meeting etc.. Any action deviating from this standard is unlawful if the unequal treatment is not justified on the facts. If the principle of equal treatment is violated by general meeting resolution, such resolution may be annulled by the court.

  16. Atrial Fibrillation: Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Treatment Past Issues / Winter 2015 Table of Contents Treatment for atrial fibrillation depends on how often you have symptoms, how ...

  17. Anaerobic treatment techniques

    International Nuclear Information System (INIS)

    Boehnke, B.; Bischofsberger, W.; Seyfried, C.F.

    1993-01-01

    This practical and theoretical guide presents the current state of knowledge in anaerobic treatment of industrial effluents with a high organic pollutant load and sewage sludges resulting from the treatment of municipal and industrial waste water. Starting from the microbiological bases of anaerobic degradation processes including a description and critical evaluation of executed plants, the book evolves the process-technical bases of anaerobic treatment techniques, derives relative applications, and discusses these with reference to excuted examples. (orig./UWA). 232 figs [de

  18. Cholesterol - drug treatment

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000314.htm Cholesterol - drug treatment To use the sharing features on ... treatment; Hardening of the arteries - statin Statins for Cholesterol Statins reduce your risk of heart disease, stroke, ...

  19. Intensive treatment models and coercion

    DEFF Research Database (Denmark)

    Ohlenschlaeger, Johan; Thorup, Anne; Petersen, Lone

    2007-01-01

    . Hospital-based Rehabilitation, an intensified inpatient treatment model, Integrated Treatment, an intensified model of Assertive Community Treatment, and standard treatment were compared for patients with first-episode schizophrenia-spectrum disorders. Ninety-four patients with first-episode schizophrenia......Little evidence exists concerning the optimal treatment for patients with first-episode schizophrenia-spectrum disorders and the effect on traditional outcomes. The aim was to investigate whether optimal treatment models have an effect on the level of use of coercion and on traditional outcomes......-spectrum disorders estimated to benefit from long-term hospitalization were included consecutively from the Copenhagen OPUS-trial and randomized to the three treatment models. At 1-year follow-up, Hospital-based Rehabilitation and Integrated Treatment had better scores on symptoms in the negative dimension...

  20. [Treatment and prevention of cancer treatment related oral mucositis].

    Science.gov (United States)

    Ruiz-Esquide, Gonzalo; Nervi, Bruno; Vargas, Alex; Maíz, Alberto

    2011-03-01

    One of the most common and troublesome complications of modern intensive anticancer treatments is oral mucositis. The purpose of this review is to summarize current evidence and clinical guidelines regarding its prevention and therapy. The use of keratinocyte growth factor-1, supplementary glutamine and other recently developed treatment modalities are discussed. The injury of the oral mucosa caused by antineoplastic agents promotes the local expression of multiple pro-inflammatory and pro-apoptotic molecules and eventually leads to the development of ulcers. Such lesions predispose patients to several infectious and nutritional complications. Also, they lead to modification of treatment schedules, potentially affecting overall prognosis. Local cryotherapy with ice chips and phototherapy with low energy laser may be useful as preventive measures. Mouthwashes with allopurinol and phototherapy with low energy laser can be used as treatment. In radiotherapy, special radiation administration techniques should be used to minimize mucosal injury. Pain control should always be optimized, with the use of patient controlled analgesia and topical use of morphine. Supplemental glutamine should not be used outside of research protocols. Lastly, thorough attention should be paid to general care and hygiene measures.

  1. Radiation treatment of benign diseases

    International Nuclear Information System (INIS)

    Reitan, J.B.; Flatby, J.; Backe, S.; Lundgren, L.

    1984-01-01

    The report deals with an estimation of the volume of radiation treatment of benign diseases in Norway and gives a survey of the subjective opinion of patients regarding the result of the treatment. Reported subjective recovery after radiation treatment seems to be at the same level as recovery without treatment. For an indication of the objective effect of radiation treatment of benign diseases, the subjective effect of this treatment has to be compared with objective findings

  2. Life After Breast Cancer Treatment

    Science.gov (United States)

    ... know what to expect after treatment ends. Emotional effects of treatment The last day of treatment It is normal to have different feelings, emotions and fears after treatment ends. Not everyone feels ...

  3. Does phasic trauma treatment make patients with dissociative identity disorder treatment more dissociative?

    Science.gov (United States)

    Brand, Bethany; Loewenstein, Richard J

    2014-01-01

    Proponents of the iatrogenic model of the etiology of dissociative identity disorder (DID) have expressed concern that treatment focused on direct engagement and interaction with dissociated self-states harms DID patients. However, empirical data have shown that this type of DID treatment is beneficial. Analyzing data from the prospective Treatment of Patients With Dissociative Disorders (TOP DD) Study, we test empirically whether DID treatment is associated with clinically adverse manifestations of dissociated self-states: acting so differently that one feels like different people, hearing voices, and dissociative amnesia. We show that, over the course of the study, there were significant decreases in feeling like different people and hearing voices. These results indicate that this form of DID treatment does not lead to symptomatic worsening in these dimensions, as predicted by the iatrogenic model. Indeed, treatment provided by TOP DD therapists reduced, rather than increased, the extent to which patients experienced manifestations of pathological dissociation. Because severe symptomatology and impairment are associated with DID, iatrogenic harm may come from depriving DID patients of treatment that targets DID symptomatology.

  4. Towards personalizing treatment for depression : developing treatment values markers.

    Science.gov (United States)

    Wittink, Marsha N; Morales, Knashawn H; Cary, Mark; Gallo, Joseph J; Bartels, Stephen J

    2013-01-01

    While 'personalized medicine' commonly refers to genetic markers or profiles associated with pharmacological treatment response, tailoring treatments to patient preferences and values is equally important. To describe and demonstrate a method to develop 'values markers,' or profiles based on the relative importance of attributes of depression treatment. Discrete choice analysis was used to assess individuals' relative preferences for features of depression treatment. Preference profiles were developed using latent profile analysis. Eighty-six adults participating in an internet-based discrete choice questionnaire. Participants were presented with two depression scenarios representing mild and severe depression. For each scenario, they were asked to compare 18 choice sets based on the type of medication side effect (nausea, dizziness, and sexual dysfunction) and severity (mild, moderate, and severe); and for counseling frequency (once per week or every other week) and provider setting (the office of a mental health professional, primary care doctor, or spiritual counselor). Three profiles were identified: profile 1 was associated with a preference for counseling and an avoidance of medication side effects; profile 2 with an avoidance of strong medication side effects and for receiving counseling in medical settings; and profile 3 with a preference for medication over counseling. When presented with a severe depression scenario, there was a higher prevalence for profile 1 and patients were more likely to prefer mental health over primary care and spiritual settings. Values markers may provide a foundation for personalized medicine, and reflect current initiatives emphasizing patient-centered care. Next steps should assess whether values markers are predictive of treatment initiation and adherence.

  5. Prostate cancer - treatment

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000403.htm Prostate cancer - treatment To use the sharing features on this page, ... drugs is recommended. References National Cancer Institute. Prostate cancer treatment (PDQ): Stages of prostate cancer. Updated July 31, ...

  6. Nasal Wash Treatment

    Science.gov (United States)

    ... Medications Alternative Therapies Nasal Wash Treatment Nasal Wash Treatment Make an Appointment Ask a Question Refer Patient The Centers for Disease Control (CDC) guidelines for preparing water used in a nasal wash are listed below. Many ...

  7. Modeling Vertical Flow Treatment Wetland Hydraulics to Optimize Treatment Efficiency

    Science.gov (United States)

    2011-03-24

    be forced to flow in a 90 serpentine manner back and forth as it moves upward through the wetland (think waiting in line at Disneyland ). This...Flow Treatment Wetland Hydraulics to Optimize Treatment Efficiency 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR

  8. Extracorporeal Treatment for Lithium Poisoning

    DEFF Research Database (Denmark)

    Decker, Brian S; Goldfarb, David S; Dargan, Paul I

    2015-01-01

    The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxico......The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical...... extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li...... treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity...

  9. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder

    Directory of Open Access Journals (Sweden)

    Fresno David

    2007-10-01

    Full Text Available Abstract Background Manic-depression or bipolar disorder (BD is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole for the treatment of acute mania. These could also be useful in the treatment of bipolar depression, but only limited data exists so far to support the use of quetiapine monotherapy or the olanzapine-fluoxetine combination. Some, but not all, anticonvulsants possess a broad spectrum of effectiveness, including mixed dysphoric and rapid-cycling forms. Lamotrigine may be effective in the treatment of depression but not mania. Antidepressant use is controversial. Guidelines suggest their cautious use in combination with an antimanic agent, because they are supposed to induce switching to mania or hypomania, mixed episodes and rapid cycling. Conclusion The first-line psychosocial intervention in BD is psychoeducation, followed by cognitive-behavioral therapy. Other treatment options include Electroconvulsive therapy and transcranial magnetic stimulation. There is a gap between the evidence base, which comes mostly from monotherapy trials, and clinical practice, where complex treatment regimens are the rule.

  10. Bell's Palsy Treatment

    Science.gov (United States)

    ... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms Bell's Palsy Treatment Bell's Palsy Treatment Leer en Español: Tratamiento de la parálisis ...

  11. Treatment Option Overview (Ewing Sarcoma)

    Science.gov (United States)

    ... Ewing Sarcoma Treatment Osteosarcoma Treatment Research Ewing Sarcoma Treatment (PDQ®)–Patient Version General Information About Ewing Sarcoma ... started or in another part of the body. Treatment Option Overview Key Points There are different types ...

  12. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  13. Improved process for the treatment of bituminous materials. [two heat treatments

    Energy Technology Data Exchange (ETDEWEB)

    1947-04-30

    A continuous process for recovering valuable hydrocarbon oils from solid minerals adapted to produce such oils upon application of heat, consists of reducing the raw minerals to a powder, suspending the powdered minerals in a gaseous medium and subjecting the suspension thus formed to heat treatment in a primary reaction zone, followed by heat treatment in a secondary reaction zone separate from the primary reaction zone. The temperature during the second of said treatments being substantially higher than that of the first.

  14. Treatment of Gas

    Science.gov (United States)

    ... Funding IFFGD Symposium reports Industry Council Contact Us Treatment of Gas You are here: Home Symptoms & Causes Intestinal Gas ... Controlling Intestinal Gas Foods That May Cause Gas Treatment of Gas Tips on Controlling Gas Adapted from IFFGD Publication # ...

  15. Patient-Treatment Matching Improves Compliance of Alcoholics in Outpatient Treatment

    DEFF Research Database (Denmark)

    Nielsen, Anette Søgaard; Nielsen, Bent; Wraae, Olaf

    1998-01-01

    curves. The consequence of compliance for long-term prognosis was described by means of the Addiction Severity Index. The form of treatment in itself had no importance for compliance. However, correct matching of a patient and a treatment structure resulted in a compliance rate of 63% as opposed to 38...

  16. Integrated nonthermal treatment system study

    International Nuclear Information System (INIS)

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs

  17. Integrated nonthermal treatment system study

    Energy Technology Data Exchange (ETDEWEB)

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  18. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Finder Getting Treatment Without treatment, a child with ADHD may fall behind in school and continue having trouble with friendships. Family life ... speak. Contents What is ADHD? How Common is ADHD? Common Signs and Symptoms Getting Treatment Supporting School Success The Teenage Years Working ... Connect ...

  19. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ability to pay attention and control their behavior. The right care can help them grow, learn, and ... and help the child function at a normal level. Treatment may include ...

  20. Waste Water Treatment Unit

    International Nuclear Information System (INIS)

    Ramadan, A.E.K.

    2004-01-01

    A wastewater treatment plant to treat both the sanitary and industrial effluent originated from process, utilities and off site units of the refinery is described. The purpose is to obtain at the end of the treatment plant, a water quality that is in compliance with contractual requirements and relevant environmental regulations. first treatment (pretreatment). Primary de-oiling, Equalization, Neutralization, Secondary de-oiling. Second treatment (Biological), The mechanism of BOD removal, Biological flocculation, Nutrient requirements, Nitrification, De-nitrification, Effect of temperature, Effect of ph, Toxicity

  1. [Psychiatric treatment sentences.

    DEFF Research Database (Denmark)

    Stevens, Hanne; Nordentoft, Merete; Agerbo, Esben

    2010-01-01

    INTRODUCTION: Previous Danish studies of the increasing number of sentences to psychiatric treatment (SPT) have compared prevalent populations of persons undergoing treatment with incident measures of reported crimes. Examining the period 1990-2006, we studied incident sentences, taking the type...

  2. Treatment versus proportionality

    DEFF Research Database (Denmark)

    Sorensen, David Woodrow Mattson

    2010-01-01

    Persons suffering from mental illness, retardation or other disturbances who commit crimes in Denmark cannot be punished, but are instead sentenced to treatment. In the past, these sentences were always indeterminate, meaning that treatment regimens were only terminated when psychiatrists judged ...

  3. Hazardous waste treatment facility and skid-mounted treatment systems at Los Alamos

    International Nuclear Information System (INIS)

    Lussiez, G.W.; Zygmunt, S.J.

    1993-01-01

    To centralize treatment, storage, and staging areas for hazardous wastes, Los Alamos National Laboratory has designed a 12,000-ft 2 hazardous waste treatment facility. The facility will house a treatment room for each of four kinds of wastes: nonradioactive characteristic wastes, nonradioactive listed wastes radioactive characteristic wastes, and radioactive listed wastes. The facility will be used for repacking labpacks, bulking small organic waste volumes, processing scintillation vials, treating reactives such as lithium hydride and pyrophoric uranium, treating contaminated solids such as barium sand, and treating plating wastes. The treated wastes will then be appropriately disposed of. This report describes the integral features of the hazardous waste treatment facility

  4. Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

    Directory of Open Access Journals (Sweden)

    Preuss UW

    2012-05-01

    Full Text Available Ulrich W Preuss,1 Jörg Zimmermann,2,3 Gabriele Schultz,2 Anna Watzke,2 Peggy Schmidt,4 Bärbel Löhnert,5 Michael Soyka2,61Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg, Halle, Germany; 2Ev Krankenhaus Bethanien GmbH, Fachklinik Gristower Wiek, Johanna-Odebrecht-Stiftung, Germany; 3Karl-Jaspers-Klinik, Fachkrankenhaus für Psychiatrie und Psychotherapie, Psychiatrieverbund Oldenburger Land, Germany; 4Department of Psychiatry, Ludwig-Maximilians-Universität Munich, Germany; 5Klientenzentrierte Problemberatung, Dachau/Munich, Germany; 6Privatklinik Meiringen, Meiringen, Switzerland Background: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.Methods: A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncompleters for any reason.Results: A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be

  5. Treatment of malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Yusa, Toshikazu

    2007-01-01

    In Japan, it is predicted that mesothelioma will rapidly increase in the future. Malignant pleural mesothelioma that accounts for approximately 90% of mesothelioma as a whole has a median survival time of approximately nine months which is considered a poor prognosis. As for the treatment of this disease, extrapleural pneumonectomy or pleurectomy/decortication are available for those patients who can be surgically operated on. However, since a complete cure rate is low when only surgical treatment is performed, generally a multimodality treatment is performed wherein chemotherapy and/or radiotherapy are combined. For chemotherapy, a large-scale randomized phase III study demonstrated that a treatment using two agents: pemetrexed, which is a new multitargeted antifolate, and cisplatin is effective. Pemetrexed will be the drug of first choice for mesothelioma in the future. As other treatment methods, chemohyperthermia, treatments using various kinds of cytokines and angiogenesis inhibitors, genetic treatment and photodynamic therapy have been attempted. The current treatment results for this disease are very poor, and there has been a strong demand for establishing an effective treatment method. (author)

  6. Diagnosis and treatment of haemorrhoids

    DEFF Research Database (Denmark)

    Buntzen, Steen; Christensen, Peter Quist; Khalid, Ali

    2013-01-01

    These guidelines provide a review of diagnosis, conservative and surgical treatment of haemorrhoids with primary focus on the surgical treatment. In symptomatic hemorrhoids it is recommended, that conservative treatment is used as basic treatment regardless of grading. The vast majority of grade II...

  7. Presolidification treatment of decontamination wastes

    International Nuclear Information System (INIS)

    Habayeb, M.A.

    1982-02-01

    Unsatisfactory leaching performance of several solidified decontamination solutions indicated a need for presolidification treatments to reduce the water sensitivity of the active chemicals. Chemical treatments examined in this work include pH adjustment, precipitation and oxidation-reduction reactions. The reactions involved in these treatments are discussed. The most suitable presolidification treatment for each decontamination solution has been identified. Further research is needed to test the effectivenss of these treatments

  8. Assessing self-determined motivation for addiction treatment: validity of the Treatment Entry Questionnaire.

    Science.gov (United States)

    Urbanoski, Karen A; Wild, T Cameron

    2012-07-01

    Although legal, formal, and informal social controls are frequently used to pressure individuals to enter treatment, motivational consequences of using these tactics have been neglected. Self-determination theory (SDT) provides a useful perspective for understanding client experiences of social controls and highlights the importance of self-determined motivation for long-term behavior change. This study assessed the construct validity of the Treatment Entry Questionnaire (TEQ), a brief scale derived from SDT to measure identified, introjected, and external treatment motivation. Two independent samples of clients entering Canadian residential and outpatient treatment completed TEQ items (ns = 529 and 623). Exploratory and confirmatory factor analyses supported a 9-item version of the scale, with 3 factors aligning with SDT motivational subtypes. Subscales showed high internal consistency and correlated as expected with social controls and perceived coercion at treatment entry. The TEQ-9 is a valid option for assessing self-determined motivation in clinical practice and evaluating coerced addiction treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. PRE-FEASIBILITY STUDY FOR TREATMENT WETLAND APPLICATION FOR WASTEWATER TREATMENT IN DISPERSED DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Magdalena Gajewska

    2016-07-01

    Full Text Available The aim of the paper is to present the conducted analyses of pre-feasibility study of different approaches for wastewater management in a settlement of 180 persons. In the assessment both technical and economic aspects were analyzed. The costs were calculated for three different and, at the same time, most popular as well as possible technical solutions like: (i construction of local wastewater treatment plant with gravitational and pressurized networks, (ii construction of single family wastewater treatment plants, (iii construction of sealed septic tanks. Carried out analyses of investment and maintenance costs revealed that at the stage of construction the most expensive is local sewer network with treatment plant, while the construction of a single family treatment plant has similar cost regardless of the technology used. When the long term operation and investment cost are accounted the most economical reasonable solution is the application of wetland treatment for household wastewater treatment.

  10. Cradle Cap: Treatment

    Science.gov (United States)

    Cradle cap Treatment Cradle cap usually doesn't require medical treatment. It clears up on its own within a few months. In the meantime, wash ... tips can help you control and manage cradle cap. Gently rub your baby's scalp with your fingers ...

  11. Nonpharmacological treatment of epilepsy

    Directory of Open Access Journals (Sweden)

    V S Saxena

    2011-01-01

    Full Text Available Nonpharmacological treatment of epilepsy includes surgery, vagal nerve stimulation, ketogenic diet, and other alternative/complementary therapies, e.g., yoga, Ayurveda, electroencephalography (EEG biofeedback technique, aerobic exercise, music therapy, transcranial magnetic stimulation, acupuncture, and herbal remedies (traditional Chinese medicine. Alternative therapies, despite the term, should not be considered as an alternative to antiepileptic medication; they complement accepted drug treatment. Alternative therapies like yoga, through techniques that relax the body and mind, reduce stress, improve seizure control, and also improve quality of life. Ketogenic diet is a safe and effective treatment for intractable epilepsies; it has been recommended since 1921. The diet induces ketosis, which may control seizures. The most successful treatment of epilepsy is with modern antiepileptic drugs, which can achieve control of seizures in 70-80% cases. Patients opt for alternative therapies because they may be dissatisfied with antiepileptic drugs due to their unpleasant side effects, the long duration of treatment, failure to achieve control of seizures, cultural beliefs and, in the case of women, because they wish to get pregnant Surgical treatment may lead to physical and psychological sequelae and is an option only for a minority of patients. This article presents supportive evidence from randomized controlled trials done to assess the benefit of non-pharmacological treatment.

  12. Oral health: orthodontic treatment.

    Science.gov (United States)

    Martonffy, Andrea Ildiko

    2015-01-01

    Improper tooth alignment due to crowding, malocclusion, and missing teeth can cause difficulties with eating and speech, and premature wear. It is estimated that more than 20% of children would benefit from orthodontic treatment to correct these conditions, many of which will persist into adulthood if not corrected. Orthodontic care is gaining popularity among adults for similar concerns, as well as for correction of cosmetic issues. The psychological effects of malocclusion should not be ignored. The American Association of Orthodontists recommends that all children undergo evaluation at the first recognition of an orthodontic condition and no later than age 7 years. Some children will need early treatment to help eliminate developing conditions and improve the foundations of the bite, which can ease later treatment in adolescence. For others, treatment in adolescence without early treatment is recommended. Standard cemented braces or clear, removable aligners may be used, depending on the patient's corrective needs. Average treatment time is approximately 2 years; this may be shortened by the use of accelerative techniques. Routine preventive dental care should be continued during the treatment period. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  13. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Swanson, J.L.; Ross, W.A.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  14. 75 FR 4227 - Phytosanitary Treatments; Location of and Process for Updating Treatment Schedules

    Science.gov (United States)

    2010-01-26

    ... phases of water and, as used in treatments, are thus a mixture of air and water. As the regulations... in how the terms ``approve,'' ``authorize,'' and ``certify'' are used in the existing treatment... term monitor, a term used in the general treatment requirements. The commenter stated that readers...

  15. Optical treatment of amblyopia in astigmatic children: the sensitive period for successful treatment.

    Science.gov (United States)

    Harvey, Erin M; Dobson, Velma; Clifford-Donaldson, Candice E; Miller, Joseph M

    2007-12-01

    To compare the effectiveness of eyeglass treatment of astigmatism-related amblyopia in children younger than 8 years (range, 4.75-7.99 years) versus children 8 years of age and older (range, 8.00-13.53 years) over short (6-week) and long (1-year) treatment intervals. Prospective, interventional, comparative case-control study. Four hundred forty-six nonastigmatic (right and left eye, or =1.00 D) Native American (Tohono O'odham) children in kindergarten or grades 1 through 6. Eyeglass correction of refractive error, prescribed for full-time wear, in astigmatic children. Amount of change in mean right-eye best-corrected letter visual acuity for treated astigmatic children versus untreated, age-matched nonastigmatic children after short (6-week) and long (1-year) treatment intervals. Astigmatic children had significantly reduced mean best-corrected visual acuity at baseline compared to nonastigmatic children. Astigmats showed significantly greater improvement in mean best-corrected visual acuity (0.08 logarithm of the minimum angle of resolution [logMAR] unit; approximately 1 line), than the nonastigmatic children (0.01 logMAR unit) over the 6-week treatment interval. No additional treatment effect was observed between 6 weeks and 1 year. Treatment effectiveness was not dependent on age group ( or =8 years) and was not influenced by previous eyeglass treatment. Despite significant improvement, mean best-corrected visual acuity in astigmatic children remained significantly poorer than in nonastigmatic children after 1 year of eyeglass treatment, even when analyses were limited to results from highly compliant children. Sustained eyeglass correction results in significant improvement in best-corrected visual acuity in astigmatic children, including those previously believed to be beyond the sensitive period for successful treatment.

  16. Interferon Treatment of Multiple Sclerosis

    OpenAIRE

    Alajbegovic, Azra; Deljo, Dervis; Alajbegovic, Salem; Djelilovic-Vranic, Jasminka; Todorovic, Ljubica; Tiric-Campara, Merita

    2012-01-01

    Introduction: In the treatment of Multiple Sclerosis (MS) differ: treatment of relapse, treatment slow the progression of the disease (immunomodulators and immunosuppression), and symptomatic treatment. The aim: The aim of this study is to analyze the application of interferon therapy in the treatment of MS-E: Process the disease, patients with multiple sclerosis who have passed the commission for multiple sclerosis at the Neurology Clinic of Clinical Center of Sarajevo University as a refere...

  17. [Strongyloidosis. Part IX. Treatment].

    Science.gov (United States)

    Soroczan, Wiesław

    2002-01-01

    The treatment of chronic and massive (uncomplicated) and severe (complicated) disseminated strongyloidosis, was presented from the historical point of view. The sequence of achievements in regard of treatment of the gentian violet, dithiazine iodide, benzimidazoles (thiabendazole, mebendazole, albendazole, cambendazole), ivermectin and cyclosporin A, was described. The recommendations for treatment of strongyloidosis are also given.

  18. Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

    Science.gov (United States)

    Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

    2015-06-01

    The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

  19. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  20. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

    Science.gov (United States)

    Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

    2009-02-01

    A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

  1. Duration of orthognathic-surgical treatment.

    Science.gov (United States)

    Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

    2017-07-01

    The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

  2. Treatment for Acquired Apraxia of Speech: Examination of Treatment Intensity and Practice Schedule

    Science.gov (United States)

    Wambaugh, Julie L.; Nessler, Christina; Cameron, Rosalea; Mauszycki, Shannon C.

    2013-01-01

    Purpose: The authors designed this investigation to extend the development of a treatment for acquired apraxia of speech (AOS)--sound production treatment (SPT)--by examining the effects of 2 treatment intensities and 2 schedules of practice. Method: The authors used a multiple baseline design across participants and behaviors with 4 speakers with…

  3. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Ross, W.A.; Swanson, J.L.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these wastes (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  4. Canadian Treatment Guidelines on Psychosocial Treatment of Schizophrenia in Children and Youth.

    Science.gov (United States)

    Lecomte, Tania; Abidi, Sabina; Garcia-Ortega, Iliana; Mian, Irfan; Jackson, Kevin; Jackson, Kim; Norman, Ross

    2017-09-01

    A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth. New treatments were also considered when recent meta-analyses suggested their usefulness. The children and youth psychosocial guidelines include many cross-sectional recommendations in terms of clinical and interpersonal skills needed to work with this clientele, setting and collaboration issues and needed adaptations for specific subpopulations. In terms of specific treatments, the treatments most strongly recommended are family intervention and cognitive behavior therapy. Also recommended, although with different degrees of support, are supported employment/supported education programs, patient education, cognitive remediation, and social skills training. Novel and upcoming psychosocial treatments are also briefly discussed. These novel Canadian guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.

  5. Telemedicine of family-based treatment for adolescent anorexia nervosa: A protocol of a treatment development study.

    Science.gov (United States)

    Anderson, Kristen E; Byrne, Catherine; Goodyear, Alexandria; Reichel, Ryan; Le Grange, Daniel

    2015-01-01

    Family-based treatment is an efficacious treatment available for adolescents with anorexia nervosa. Yet the implementation of this treatment, at least in the United States, is challenging due to a limited number of trained family-based treatment therapists and the concentration of these therapists in a limited number of urban centers. The use of telemedicine in the delivery of family-based treatment can increase access to this therapy for this patient population. This two-year treatment development study (December 2013-November 2015) follows a two-wave iterative case series design. The study is ongoing and addresses the treatment needs of families in remote, rural, or underrepresented parts of the United States by delivering family-based treatment via telemedicine (video chat). The first six months of the study was dedicated to selecting a cloud-based secure telemedicine portal for use with participants. Recruitment for the first of two consecutive case series (N = 5) began during month seven. After these five patients completed treatment, a systematic review of treatment via feedback from participants and therapists related to the delivery of this model and use of technology was completed. A second wave of recruitment is underway (N = 5). At the end of both waves (N = 10), and after a second review of treatment, we should be able to establish the feasibility and acceptability of family-based treatment delivered via telemedicine for this patient population. This study is the first attempt to deliver family-based treatment for adolescents with anorexia nervosa via telemedicine. If delivering family-based treatment in this format is feasible, it will provide access to an evidence-based treatment for families heretofore unable to participate in specialist treatment for their child's eating disorder.

  6. Psychological treatments for gambling disorder

    Directory of Open Access Journals (Sweden)

    Rash CJ

    2014-10-01

    Full Text Available Carla J Rash, Nancy M Petry Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA Abstract: This review discusses the research evidence for psychological treatment of gambling disorder. Several treatment options for gamblers have been explored, ranging from self-help and peer support, to brief and motivational interventions, to more intensive therapy approaches. Involvement in peer support programs seems to be optimal when combined with professional treatment; however, engagement and retention in peer support is limited. Self-directed interventions appear to benefit some gamblers; however, the involvement of therapist support, either in person or by telephone, may bolster these effects and such support need not be extensive. These self-directed options reduce the barriers associated with treatment-seeking, and may reach a wider range of gamblers than professionally delivered treatments alone. Brief and motivational approaches similarly may extend treatment options to more gamblers, namely at-risk and problem gamblers and those not seeking treatment. Of more extensive therapies, no consistent benefit of one approach emerges, although cognitive–behavioral interventions have been most often applied. Overall, several treatments have been developed for gambling disorder and results are promising, but variability in findings suggests a need for further systematic evaluation. Keywords: gambling treatment, cognitive behavioral treatment, brief interventions, pathological gambling, problem gambling, behavioral addictions

  7. THE METHODS OF CHOLEDOCHOLITHIASIS TREATMENT

    Directory of Open Access Journals (Sweden)

    N. V. Merzlikin

    2015-01-01

    Full Text Available The methods of choledocholithiasis treatment, which are currently used in clinics of the Russian Federa-tion, has been presented. The problems of diagnosis and treatment of gallstones (GSD in individuals of different age groups are spotlighted. In the study of treatment of cholelithiasis and choledocholithiasis, including arising complications, it can be concluded that so far the ideal method of treatment of this pa-thology has not been found. Up to now, the majority of doctor’s main treatment is surgical removal of gall stones by some method or other.This article also considers a conservative approach (drug: antispasmodics (selective and nonselective, and non-pharmacological: treatment, diet, describes the criteria and assessment of the effectiveness of therapeutic interventions that help in the question of further treatment: the continuation of drug therapy or assignment of surgical treatment. Invasive techniques that are covered in the article, namely, a tech-nique of remote and endoscopic lithotripsy, are high-tech and in demand at the moment, which, along with high efficiency removal of a stone, reduced the number and severity of postoperative complications. Additionally, in the analysis of the features of a particular method of treatment, advantages and disadvantages of different treatment methods are described, indications and contraindications (absolute and relative together with complications, possible outcomes, and further prognosis are high-lighted. 

  8. Treatment accuracy of hypofractionated spine and other highly conformal IMRT treatments

    International Nuclear Information System (INIS)

    Sutherland, B.; Hanlon, P.; Charles, P.

    2011-01-01

    Full text: Spinal cord metastases pose difficult challenges for radiation treatment due to tight dose constraints and a concave PTY. This project aimed to thoroughly test the treatment accuracy of the Eclipse Treatment Planning System (TPS) for highly modulated IMRT treatments, in particular of the thoracic spine, using an Elekta Synergy Linear Accelerator. The increased understanding obtained through different quality assurance techniques allowed recommendations to be made for treatment site commissioning with improved accuracy at the Princess Alexandra Hospital (PAH). Three thoracic spine IMRT plans at the PAH were used for data collection. Complex phantom models were built using CT data, and fields simulated using Monte Carlo modelling. The simulated dose distributions were compared with the TPS using gamma analysis and DYH comparison. High resolution QA was done for all fields using the MatriXX ion chamber array, MapCHECK2 diode array shifted, and the EPlD to determine a procedure for commissioning new treatment sites. Basic spine simulations found the TPS overestimated absorbed dose to bone, however within spinal cord there was good agreement. High resolution QA found the average gamma pass rate of the fields to be 99.1 % for MatriXX, 96.5% for MapCHECK2 shifted and 97.7% for EPlD. Preliminary results indicate agreement between the TPS and delivered dose distributions higher than previously believed for the investigated IMRT plans. The poor resolution of the MatriXX, and normalisation issues with MapCHECK2 leads to probable recommendation of EPlD for future IMRT commissioning due to the high resolution and minimal setup required.

  9. Global response to HIV: treatment as prevention, or treatment for treatment?

    NARCIS (Netherlands)

    Sigaloff, Kim C. E.; Lange, Joep M. A.; Montaner, Julio

    2014-01-01

    The concept of "treatment as prevention" has emerged as a means to curb the global HIV epidemic. There is, however, still ongoing debate about the evidence on when to start antiretroviral therapy in resource-poor settings. Critics have brought forward multiple arguments against a "test and treat"

  10. Generic phytosanitary irradiation treatments

    International Nuclear Information System (INIS)

    Hallman, Guy J.

    2012-01-01

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. - Highlights: ► The history of phytosanitary irradiation (PI) treatments is given. ► Generic PI treatments in use today are discussed. ► Suggestions for future research are presented. ► A dose of 250 Gy for most insects may suffice.

  11. Adding an Internet-delivered treatment to an efficacious treatment package for opioid dependence.

    Science.gov (United States)

    Christensen, Darren R; Landes, Reid D; Jackson, Lisa; Marsch, Lisa A; Mancino, Michael J; Chopra, Mohit P; Bickel, Warren K

    2014-12-01

    To examine the benefit of adding an Internet-delivered behavior therapy to a buprenorphine medication program and voucher-based motivational incentives. A block-randomized, unblinded, parallel, 12-week treatment trial was conducted with 170 opioid-dependent adult patients (mean age = 34.3 years; 54.1% male; 95.3% White). Participants received an Internet-based community reinforcement approach intervention plus contingency management (CRA+) and buprenorphine or contingency management alone (CM-alone) plus buprenorphine. The primary outcomes, measured over the course of treatment, were longest continuous abstinence, total abstinence, and days retained in treatment. Compared to those receiving CM-alone, CRA+ recipients exhibited, on average, 9.7 total days more of abstinence (95% confidence interval [CI = 2.3, 17.2]) and had a reduced hazard of dropping out of treatment (hazard ratio = 0.47; 95% CI [0.26, 0.85]). Prior treatment for opioid dependence significantly moderated the additional improvement of CRA+ for longest continuous days of abstinence. These results provide further evidence that an Internet-based CRA+ treatment is efficacious and adds clinical benefits to a contingency management/medication based program for opioid dependence.

  12. Decision making in treatment strategy of AVMs. Treatment board system at Tohoku University

    International Nuclear Information System (INIS)

    Jokura, Hidefumi; Yoshimoto, Takashi

    1999-01-01

    Treatment of some large, deep-seated arteriovenous malformations is still a challenge to neurosurgeons. The recent development of non-invasive imaging modalities has increased the chance of finding asymptomatic AVM's, for which evaluation for treatment is more complicated than in symptomatic cases. Currently there are 3 major treatment options for AVM: microsurgical removal, radiosurgery, and intravascular embolization. It is not easy to choose the best single modality or combination of modalities for individual patients, who have different types of onset, neurological deficits, size and location, and social background. After the installation of the Gamma Knife in November 1991, we established an 'AVM Treatment Board.' It comprises vascular neurosurgeons, endovascular neurosurgeons, and radio-neurosurgeons, and meetings are held twice a month. Every AVM case referred to us is presented to the board, and treatment strategy is selected after a discussion among experts who know the advantages and drawbacks of each treatment modality. We describe this board system in detail and emphasize the importance of gathering expertise in decision making. (author)

  13. Wastewater treatment

    Directory of Open Access Journals (Sweden)

    Ranđel N. Kitanović

    2013-10-01

    Full Text Available Quality of life on Earth in the future will largely depend on the amount of safe water. As the most fundamental source of life, water is relentlessly consumed and polluted. To halt this trend, many countries are taking extensive measures and investing substantial resources in order to stop the contamination of water and return at least tolerably good water quality to nature. The goal of water purification is to obtain clean water with the sewage sludge as a by-product. Clean water is returned to nature, and further treatment of sludge may be subject to other procedures. The conclusion of this paper is simple. The procedure with purified water is easily achievable, purified water is discharged into rivers, lakes and seas, but the problem of further treatment of sludge remains. This paper presents the basic methods of wastewater treatment and procedures for processing the products from contaminated water. The paper can serve as a basis for further elaboration. Water Pollution In order to ensure normal life of living creatures, the water in which they live or the water they use must have a natural chemical composition and natural features. When, as a result of human activities, the chemical composition of water and the ratio of its chemical elements significantly change, we say that water is polluted. When the pollutants come from industrial plants, we are talking about industrial wastewater, and when they come from households and urban areas, we are talking about municipal wastewater. Both contain a huge amount of pollutants that eventually end up in rivers. Then, thousands of defenseless birds, fish and other animals suffer, and environmental consequences become immeasurable. In addition, the waste fed to the water often ends up in the bodies of marine animals, so they can return to us as food. Thermal water pollution also has multiple effects on the changes in the wildlife composition of aquatic ecosystems. Polluted water can be purified by

  14. Management and treatment outcomes of patients enrolled in MDR-TB treatment in Viet Nam.

    Science.gov (United States)

    Phuong, N T M; Nhung, N V; Hoa, N B; Thuy, H T; Takarinda, K C; Tayler-Smith, K; Harries, A D

    2016-03-21

    The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009. To document the annual numbers of patients enrolled for multidrug-resistant tuberculosis (MDR-TB) treatment during 2010-2014 and to determine characteristics and treatment outcomes of patients initiating treatment during 2010-2012. A retrospective cohort study using national reports and data from the national electronic data system for drug-resistant TB. The number of patients enrolled annually for MDR-TB treatment increased from 97 in 2010 to 1522 in 2014. The majority of patients were middle-aged men who had pulmonary disease and had failed a retreatment regimen; 77% had received ⩾2 courses of TB treatment. Favourable outcomes (cured and treatment completed) were attained in 73% of patients. Unfavourable outcomes included loss to follow-up (12.5%), death (8%) and failure (6.3%). Having had ⩾2 previous treatment courses and being human immunodeficiency virus-positive were associated with unfavourable outcomes. Increasing numbers of patients are being treated for MDR-TB each year with good treatment outcomes under national programme management in Viet Nam. However, there is a need to increase case detection-currently at 30% of the estimated 5100 MDR-TB cases per year, reduce adverse outcomes and improve monitoring and evaluation.

  15. Adherence to Polyethylene Glycol Treatment in Children with Functional Constipation Is Associated with Parental Illness Perceptions, Satisfaction with Treatment, and Perceived Treatment Convenience.

    Science.gov (United States)

    Koppen, Ilan Jasper Nader; van Wassenaer, Elsa A; Barendsen, Rinse W; Brand, Paul L; Benninga, Marc A

    2018-05-10

    To assess treatment adherence in children with functional constipation and to evaluate the association with parental beliefs about medication, illness perceptions, treatment satisfaction, and satisfaction with information about medication. A cross-sectional survey was administered among parents of children with functional constipation treated with polyethylene glycol. Adherence was measured via the Medication Adherence Report Scale (MARS-5, score 5-25), with greater scores indicating better adherence (scores ≥23 were defined as adherent). Beliefs about medication, illness perceptions, satisfaction with treatment, and satisfaction with information about treatment were measured with the Beliefs about Medication Questionnaire, the Brief Illness Perception Questionnaire, the Treatment Satisfaction Questionnaire for Medication (TSQM), and the Satisfaction with Information about Medication Questionnaire. Associations between the questionnaire scores and adherence (MARS-5 score as a continuous variable) were analyzed with regression analyses. In total, 43 of 115 included children (37%) were adherent (MARS-5 ≥23). Spearman rank correlation test revealed a statistically significant correlation between TSQM-convenience, TSQM-satisfaction, Brief Illness Perception Questionnaire question 8 (emotions), and the MARS-5 score (r s 0.342, P = .000; r s 0.258, P = .006; r s -0.192, P = .044), which suggests that parental perceived treatment convenience, satisfaction with treatment, and illness perceptions may affect adherence in children with functional constipation. In the hierarchical multivariate regression model, 22% of the variability of the MARS-5 score could be explained by the selected predictors. The TSQM-convenience score contributed the most to the model (β: 0.384, P = .000). Parents reported low adherence rates in their children with functional constipation. Treatment inconvenience, dissatisfaction with treatment, and the emotional impact of

  16. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

    DEFF Research Database (Denmark)

    von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

    2016-01-01

    Objective: While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome......-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results: In total, 1033 respondents answered the survey. The majority of treatment beliefs...... and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy...

  17. Treatment of mastitis during lactation.

    Science.gov (United States)

    Pyörälä, S

    2009-04-01

    Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

  18. Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

    Science.gov (United States)

    Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

    2011-01-01

    Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048

  19. Emerging from Depression: Treatment of Adolescent Depression Using the Major Treatment Models of Adult Depression.

    Science.gov (United States)

    Long, Kathleen M.

    Noting that adolescents who commit suicide are often clinically depressed, this paper examines various approaches in the treatment of depression. Major treatment models of adult depression, which can be directly applied to the treatment of the depressed adolescent, are described. Major treatment models and selected research studies are reviewed in…

  20. Portable treatment systems study

    Energy Technology Data Exchange (ETDEWEB)

    Sherick, M.J.; Schwinkendorf, W.E.; Bechtold, T.E.; Cole, L.T.

    1997-03-01

    In developing their Site Treatment Plans (STPs), many of the Department of Energy installations identified some form of portable treatment, to facilitate compliant disposition of select mixed low-level wastestreams. The Environmental Management Office of Science and Technology requested that a systems study be performed to better define the potential role of portable treatment with respect to mixed low-level waste, highlight obstacles to implementation, and identify opportunities for future research and development emphasis. The study was performed by first establishing a representative set of mixed waste, then formulating portable treatment system concepts to meet the required processing needs for these wastes. The portable systems that were conceptualized were evaluated and compared to a fixed centralized treatment alternative. The system evaluations include a life-cycle cost analysis and an assessment of regulatory, institutional, and technical issues associated with the potential use of portable systems. The results of this study show that when all costs are included, there are no significant cost differences between portable systems and fixed systems. However, it is also emphasized that many uncertainties exist that could impact the cost of implementing portable treatment systems. Portable treatment could be made more attractive through private sector implementation, although there is little economic incentive for a commercial vendor to develop small, specialized treatment capabilities with limited applicability. Alternatively, there may also be valid reasons why fixed units cannot be used for some problematic wastestreams. In any event, there are some site-specific problems that still need to be addressed, and there may be some opportunity for research and development to make a positive impact in these areas.

  1. Portable treatment systems study

    International Nuclear Information System (INIS)

    Sherick, M.J.; Schwinkendorf, W.E.; Bechtold, T.E.; Cole, L.T.

    1997-03-01

    In developing their Site Treatment Plans (STPs), many of the Department of Energy installations identified some form of portable treatment, to facilitate compliant disposition of select mixed low-level wastestreams. The Environmental Management Office of Science and Technology requested that a systems study be performed to better define the potential role of portable treatment with respect to mixed low-level waste, highlight obstacles to implementation, and identify opportunities for future research and development emphasis. The study was performed by first establishing a representative set of mixed waste, then formulating portable treatment system concepts to meet the required processing needs for these wastes. The portable systems that were conceptualized were evaluated and compared to a fixed centralized treatment alternative. The system evaluations include a life-cycle cost analysis and an assessment of regulatory, institutional, and technical issues associated with the potential use of portable systems. The results of this study show that when all costs are included, there are no significant cost differences between portable systems and fixed systems. However, it is also emphasized that many uncertainties exist that could impact the cost of implementing portable treatment systems. Portable treatment could be made more attractive through private sector implementation, although there is little economic incentive for a commercial vendor to develop small, specialized treatment capabilities with limited applicability. Alternatively, there may also be valid reasons why fixed units cannot be used for some problematic wastestreams. In any event, there are some site-specific problems that still need to be addressed, and there may be some opportunity for research and development to make a positive impact in these areas

  2. Addic tion treatment

    African Journals Online (AJOL)

    2009-01-29

    Jan 29, 2009 ... it does leave the profitability and viability of the more orthodox treatment centres at risk, and they now often seek improved income streams by sourcing patients from abroad. This effectively subsidises local patients whose treatment intervention is remunerated by discounted medical aid rates. South Africa is ...

  3. Duration of surgical-orthodontic treatment.

    Science.gov (United States)

    Häll, Birgitta; Jämsä, Tapio; Soukka, Tero; Peltomäki, Timo

    2008-10-01

    To study the duration of surgical-orthodontic treatment with special reference to patients' age and the type of tooth movements, i.e. extraction vs. non-extraction and intrusion before or extrusion after surgery to level the curve of Spee. The material consisted files of 37 consecutive surgical-orthodontic patients. The files were reviewed and gender, diagnosis, type of malocclusion, age at the initiation of treatment, duration of treatment, type of tooth movements (extraction vs. non-extraction and levelling of the curve of Spee before or after operation) and type of operation were retrieved. For statistical analyses two sample t-test, Kruskal-Wallis and Spearman rank correlation tests were used. Mean treatment duration of the sample was 26.8 months, of which pre-surgical orthodontics took on average 17.5 months. Patients with extractions as part of the treatment had statistically and clinically significantly longer treatment duration, on average 8 months, than those without extractions. No other studied variable seemed to have an impact on the treatment time. The present small sample size prevents reliable conclusions to be made. However, the findings suggest, and patients should be informed, that extractions included in the treatment plan increase chances of longer duration of surgical-orthodontic treatment.

  4. Radiation treatment of foodstuffs

    International Nuclear Information System (INIS)

    Luther, T.; Huebner, G.

    1990-10-01

    In addition to fundamental demands on radiation and safety engineering of irradiation facilities, the necessity arises to optimize irradiation conditions by using facilities to capacity and thus reducing irradiation costs. The following subjects are dealt with in detail: rehabilitation of a pilot plant for radiation treatment of onions; examination of radiation resistance of components and equipment parts of food irradiation facilities; chemical dosimetry; relative measurement of the intensity of radioactive sources; thermo- and chemiluminescence to prove irradiation of foodstuffs; radiation induced sprout inhibition of potatoes; laboratory tests of delayed maturation of tomatoes; radiation treatment of strawberries; radiation treatment of forage; radiation induced sprout inhibition of acid-treated onions; radiation treatment of starch and potatoe products; radiation treatment of cosmetics; the universal radiation source UNI 88/26 for gamma irradiation facilities; microbiological aspects of food irradiation, and introduction of chicken irradiation on an industrial scale. (BBR) [de

  5. Emerging treatments in alopecia.

    Science.gov (United States)

    Falto-Aizpurua, Leyre; Choudhary, Sonal; Tosti, Antonella

    2014-12-01

    Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules. We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia. Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.

  6. Mandatory neurotechnological treatment: ethical issues.

    Science.gov (United States)

    Focquaert, Farah

    2014-02-01

    What if neurofeedback or other types of neurotechnological treatment, by itself or in combination with behavioral treatment, could achieve a successful "rewiring" of the psychopath's brain? Imagine that such treatments exist and that they provide a better long-term risk-minimizing strategy compared to imprisonment. Would it be ethical to offer such treatments as a condition of probation, parole, or (early) prison release? In this paper, I argue that it can be ethical to offer effective, non-invasive neurotechnological treatments to offenders as a condition of probation, parole, or (early) prison release provided that: (1) the status quo is in no way cruel, inhuman, degrading, or in some other way wrong, (2) the treatment option is in no way cruel, inhuman, degrading, or in some other way wrong, (3) the treatment is in the best interests of the offender, and (4) the offender gives his/her informed consent.

  7. Herbal Treatment in Menopause

    Directory of Open Access Journals (Sweden)

    Cigdem Gun

    2015-12-01

    Full Text Available The digest has been prepared to review available clinical evidence on herbs used in treatment of menopause symptoms. Effectiveness of Humulus lupulus, Vitex agnus-castus, Dioskorea vilosa, Linum usitatissimum, Pinus pinaster, cruciferous vegetables, Cimicifuga racemosa L., Angelica sinensis, Oenothera biennis L., Hypericum perforatum L., Panax ginseng, Ginkgo biloba, Glycine soja, Trifolium pratense and Piper methysticum herbs were assessed for treatment of menopausal symptoms in the studies. Herbs used as alternative supplementary treatment for menopause symptoms have been found to have a limited effect. Thus more studies are warranted to assess effectiveness of herbal treatments for menopausal symptoms. [Archives Medical Review Journal 2015; 24(4.000: 520-530

  8. Treatment efficacy, treatment failures and selection of macrolide resistance in patients with high load of Mycoplasma genitalium during treatment of male urethritis with josamycin.

    Science.gov (United States)

    Guschin, Alexander; Ryzhikh, Pavel; Rumyantseva, Tatiana; Gomberg, Mikhail; Unemo, Magnus

    2015-02-03

    Azithromycin has been widely used for Mycoplasma genitalium treatment internationally. However, the eradication efficacy has substantially declined recent decade. In Russia, josamycin (another macrolide) is the recommended first-line treatment for M. genitalium infections, however, no data regarding treatment efficacy with josamycin and resistance in M. genitalium infections have been internationally published. We examined the M. genitalium prevalence in males attending an STI clinic in Moscow, Russia from December 2006 to January 2008, investigated treatment efficacy with josamycin in male urethritis, and monitored the M. genitalium DNA eradication dynamics and selection of macrolide resistance in M. genitalium during this treatment. Microscopy and real-time PCRs were used to diagnose urethritis and non-viral STIs, respectively, in males (n = 320). M. genitalium positive patients were treated with recommended josamycin regimen and treatment efficacy was monitored using quantitative real-time PCR. Macrolide resistance mutations were identified using sequencing of the 23S rRNA gene. Forty-seven (14.7%) males were positive for M. genitalium only and most (85.1%) of these had symptoms and signs of urethritis. Forty-six (97.9%) males agreed to participate in the treatment efficacy monitoring. All the pre-treatment M. genitalium specimens had wild-type 23S rRNA. The elimination of M. genitalium DNA was substantially faster in patients with lower pre-treatment M. genitalium load, and the total eradication rate was 43/46 (93.5%). Of the six patients with high pre-treatment M. genitalium load, three (50%) remained positive post-treatment and these positive specimens contained macrolide resistance mutations in the 23S rRNA gene, i.e., A2059G (n = 2) and A2062G (n = 1). M. genitalium was a frequent cause of male urethritis in Moscow, Russia. The pre-treatment M. genitalium load might be an effective predictor of eradication efficacy with macrolides (and possibly

  9. The treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Klopper, J.F.

    1991-01-01

    The clinical picture of hyperthyroidism varies considerably and the diagnosis can easily be missed. The treatment of hyperthyroidism needs to be individualized, taking the patient's condition and preferences into account. There are three possible methods of treating hyperthyroidism, namely, medical treatment, including the use of beta-blockers and other antithyroid medications; surgery, and radio-iodine treatment. These three methods are briefly discussed. 3 refs., 3 tabs

  10. Surgical treatment of brain metastases - a review. Part 2. Results of treatment

    International Nuclear Information System (INIS)

    Wronski, M.; Czernicki, Z.

    1994-01-01

    Results of treatment of most frequent brain metastases from nonsmall cell lung cancer, breast cancer, malignant melanoma and kidney tumors are discussed. Also efficacy of surgical treatment, chemotherapy, radiotherapy and radiosurgery is analyzed

  11. Treatment of mastitis during lactation

    Directory of Open Access Journals (Sweden)

    Pyörälä S

    2009-04-01

    Full Text Available Abstract Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

  12. TECHNOLOGICAL PROCESS ASSESSMENT OF THE DRINKING WATER TREATMENT AT TARGU-MURES WATER TREATMENT PLANT

    Directory of Open Access Journals (Sweden)

    CORNELIA DIANA HERTIA

    2011-03-01

    Full Text Available This paper intends to assess the technological process of obtaining drinking water at Targu-Mures water treatment plant. The assessment was performed before changing the technological process and four months were chosen to be analized during 2008: January, April, July and October for its efficiency analysis on treatment steps. Mures River is the water source for the water treatment plant, being characterized by unsteady flow and quality parameters with possible important variability in a very short period of time. The treatment technological process is the classic one, represented by coagulation, sedimentation, filtration and disinfection, but also prechlorination was constantly applied as additional treatment during 2008. Results showed that for the measured parameters, raw water at the water treatment plant fits into class A3 for surface waters, framing dictated by the bacterial load. The treatment processes efficiency is based on the performance calculation for sedimentation, filtration, global and for disinfection, a better conformation degree of technological steps standing out in January in comparison to the other three analyzed months. A variable non-compliance of turbidity and residual chlorine levels in the disinfected water was observed constantly. Previous treatment steps managed to maintain a low level of oxidisability, chlorine consumption and residual chlorine levels being also low. 12% samples were found inconsistent with the national legislation in terms of bacteriological quality. Measures for the water treatment plant retechnologization are taken primarily for hyperchlorination elimination, which currently constitutes a discomfort factor (taste, smell, and a generating factor of chlorination by-products.

  13. Surgical Treatment of Tattoo Complications.

    Science.gov (United States)

    Sepehri, Mitra; Jørgensen, Bo

    2017-01-01

    With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

  14. 7 CFR 305.5 - Treatment requirements.

    Science.gov (United States)

    2010-01-01

    ... inside of the treatment enclosure to uniformly distribute gas throughout the enclosure. The circulation... 7 Agriculture 5 2010-01-01 2010-01-01 false Treatment requirements. 305.5 Section 305.5... SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS Chemical Treatments § 305.5 Treatment...

  15. Involuntary admission may support treatment outcome and motivation in patients receiving assertive community treatment.

    Science.gov (United States)

    Kortrijk, Hans Erik; Staring, A B P; van Baars, A W B; Mulder, C L

    2010-02-01

    Patients with severe mental illness who are treated in assertive community treatment (ACT) teams are sometimes involuntarily admitted when they are dangerous to themselves or others, and are not motivated for treatment. However, the consequences of involuntary admission in terms of psychosocial outcome and treatment motivation are largely unknown. We hypothesized that involuntary admission would improve psychosocial outcome and not adversely affect their treatment motivation. In the context of routine 6-monthly outcome monitoring in the period January 2003-March 2008, we used the Health of the Nation Outcome Scales (HoNOS) and a motivation-for-treatment scale to assess 260 severely mentally ill patients at risk for involuntary admission. Mixed models with repeated measures were used for data analyses. During the observation period, 77 patients (30%) were involuntarily admitted. Relative to patients who were not involuntarily admitted, these patients improved significantly in HoNOS total scores (F = 17,815, df = 1, p < 0.001) and in motivation for treatment (F = 28.139, df = 1, p < 0.001). Patients who were not involuntarily admitted had better HoNOS and motivation scores at baseline, but did not improve. Involuntary admission in the context of ACT was associated with improvements in psychosocial outcome and motivation for treatment. There are no indications that involuntary admission leads to deterioration in psychosocial outcome or worsening of motivation for treatment.

  16. Patient Characteristics Associated with HCV Treatment Adherence, Treatment Completion, and Sustained Virologic Response in HIV Coinfected Patients

    Directory of Open Access Journals (Sweden)

    Glenn Wagner

    2011-01-01

    Full Text Available Background. Hepatitis C (HCV treatment efficacy among HIV patients is limited by poor treatment adherence and tolerance, but few studies have examined the psychosocial determinants of treatment adherence and outcomes. Methods. Chart abstracted and survey data were collected on 72 HIV patients who had received pegylated interferon and ribavirin to assess correlates of treatment adherence, completion, and sustained virologic response (SVR. Results. Nearly half (46% the sample had active psychiatric problems and 13% had illicit drug use at treatment onset; 28% reported <100% treatment adherence, 38% did not complete treatment (mostly due to virologic nonresponse, and intent to treat SVR rate was 49%. Having a psychiatric diagnosis was associated with nonadherence, while better HCV adherence was associated with both treatment completion and SVR. Conclusions. Good mental health may be an indicator of HCV treatment adherence readiness, which is in turn associated with treatment completion and response, but further research is needed with new HCV treatments emerging.

  17. Wastewater sludge treatment at selected wastewater treatment plants of the region Banska Bystrica

    International Nuclear Information System (INIS)

    Samesova, D.; Mitterpach, J.; Martinkova, A.

    2014-01-01

    The management of sewage sludges in water treatment plants of Banska Bystrica region. The paper deals with the problems of sewage sludge in wastewater treatment plants, its origin and possibilities how to use it in accordance with the current legislation of the Slovak Republic. We described radioactive pollution of sewage sludges. The paper consists of review of sludge production and its usage in the Slovak Republic and in selected states of the European Union. The paper deals with the sludge treatment in selected wastewater treatment plants in Banska Bystrica region in the context of biogas production and its usage by the help of the electricity and heat production. (authors)

  18. The Impact of Early Substance Use Disorder Treatment Response on Treatment Outcomes Among Pregnant Women With Primary Opioid Use.

    Science.gov (United States)

    Tuten, Michelle; Fitzsimons, Heather; Hochheimer, Martin; Jones, Hendree E; Chisolm, Margaret S

    2018-03-13

    This study examined the impact of early patient response on treatment utilization and substance use among pregnant participants enrolled in substance use disorder (SUD) treatment. Treatment responders (TRs) and treatment nonresponders (TNRs) were compared on pretreatment and treatment measures. Regression models predicted treatment utilization and substance use. TR participants attended more treatment and had lower rates of substance use relative to TNR participants. Regression models for treatment utilization and substance use were significant. Maternal estimated gestational age (EGA) and baseline cocaine use were negatively associated with treatment attendance. Medication-assisted treatment, early treatment response, and baseline SUD treatment were positively associated with treatment attendance. Maternal EGA was negatively associated with counseling attendance; early treatment response was positively associated with counseling attendance. Predictors of any substance use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline cocaine use. The single predictor of any substance use at 2 months was early treatment nonresponse. Predictors of opioid use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline SUD treatment. Predictors of opioid use at 2 months were early treatment nonresponse, and baseline cocaine and marijuana use. Predictors of cocaine use at 1 month were early treatment nonresponse, baseline cocaine use, and baseline SUD treatment. Predictors of cocaine use at 2 months were early treatment nonresponse and baseline cocaine use. Early treatment response predicts more favorable maternal treatment utilization and substance use outcomes. Treatment providers should implement interventions to maximize patient early response to treatment.

  19. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

    Directory of Open Access Journals (Sweden)

    Huas Dominique

    2010-08-01

    Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

  20. Comparison of pre-treatment and post-treatment use of selenium in retinal ischemia reperfusion injury

    Directory of Open Access Journals (Sweden)

    Alper Yazici

    2015-04-01

    Full Text Available AIM: To investigate the effects of selenium in rat retinal ischemia reperfusion (IR model and compare pre-treatment and post-treatment use. METHODS: Selenium pre-treatment group (n=8 was treated with intraperitoneal (i.p. selenium 0.5 mg/kg for 7d and terminated 24h after the IR injury. Selenium post-treatment group (n=8 was treated with i.p. selenium 0.5 mg/kg for 7d after the IR injury with termination at the end of the 7d period. Sham group (n=8 received i.p. saline injections identical to the selenium volume for 7d with termination 24h after the IR injury. Control group (n=8 received no intervention. Main outcome measures were retina superoxide dismutase (SOD, glutathione (GSH, total antioxidant status (TAS, malondialdehyde (MDA, DNA fragmentation levels, and immunohistological apoptosis evaluation. RESULTS: Compared to the Sham group, selenium pre-treatment had a statistical difference in all parameters except SOD. Post-treatment selenium also resulted in statistical differences in all parameters except the MDA levels. When comparing selenium groups, the pre-treatment selenium group had a statistically higher success in reduction of markers of cell damage such as MDA and DNA fragmentation. In contrast, the post-selenium treatment group had resulted in statistically higher levels of GSH. Histologically both selenium groups succeeded to limit retinal thickening and apoptosis. Pre-treatment use was statistically more successful in decreasing apoptosis in ganglion cell layer compared to post-treatment use. CONCLUSION: Selenium was successful in retinal protection in IR injuries. Pre-treatment efficacy was superior in terms of prevention of tissue damage and apoptosis.

  1. Wastewater Characteristics, Treatment and Disposal

    OpenAIRE

    Von Sperling, Marcos

    2007-01-01

    "Wastewater Characteristics, Treatment and Disposal is the first volume in the series Biological Wastewater Treatment, presenting an integrated view of water quality and wastewater treatment. The book covers the following topics: wastewater characteristics (flow and major constituents) impact of wastewater discharges to rivers and lakes overview of wastewater treatment systems complementary items in planning studies. This book, with its clear and practical approach, lays the foundations f...

  2. Basic Principles of Wastewater Treatment

    OpenAIRE

    Von Sperling, Marcos

    2007-01-01

    "Basic Principles of Wastewater Treatment is the second volume in the series Biological Wastewater Treatment, and focusses on the unit operations and processes associated with biological wastewater treatment. The major topics covered are: microbiology and ecology of wastewater treatment reaction kinetics and reactor hydraulics conversion of organic and inorganic matter sedimentation aeration The theory presented in this volume forms the basis upon which the other books...

  3. Improving Treatment Adherence in Bipolar Disorder: A Review of Current Psychosocial Treatment Efficacy and Recommendations for Future Treatment Development

    Science.gov (United States)

    Gaudiano, Brandon A.; Weinstock, Lauren M.; Miller, Ivan W.

    2008-01-01

    Treatment adherence is a frequent problem in bipolar disorder, with research showing that more than 60% of bipolar patients are at least partially nonadherent to medications. Treatment nonadherence is consistently predictive of a number of negative outcomes in bipolar samples, and the discontinuation of mood stabilizers places these patients at…

  4. Influences of mechanical pre-treatment on the non-biological treatment of municipal wastewater by forward osmosis

    DEFF Research Database (Denmark)

    Hey, Tobias; Zarebska, Agata; Bajraktari, Niada

    2016-01-01

    municipal wastewater treatment without the biological treatment step, including the effects of different pre-treatment configurations, e.g., direct membrane filtration before forward osmosis. Forward osmosis was tested using raw wastewater and wastewater subjected to different types of mechanical pre-treatment......, e.g., microsieving and microfiltration permeation, as a potential technology for municipal wastewater treatment. Forward osmosis was performed using thin-film-composite, Aquaporin Inside(TM) and HTI membranes with NaCl as the draw solution. Both types of forward osmosis membranes were tested......-sized wastewater treatment plants....

  5. Stroke Prevention & Treatment: Diet & Nutrition

    Science.gov (United States)

    ... Prevention & Treatment: Diet & Nutrition Stroke Prevention & Treatment: Diet & Nutrition A healthy diet can reduce your risk for ... Treatment How does a stroke affect eating and nutrition? Stroke can devastate a person's nutritional health because ...

  6. Treatment Options for Wilms Tumor

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... come back) after it has been treated. Treatment Option Overview Key Points There are different types of ...

  7. Treatment Options for Myelodysplastic Syndromes

    Science.gov (United States)

    ... special light. Certain factors affect prognosis and treatment options. The prognosis (chance of recovery) and treatment options ... age and general health of the patient. Treatment Option Overview Key Points There are different types of ...

  8. Treatment Option Overview (Prostate Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  9. Treatment Option Overview (Myelodysplastic Syndromes)

    Science.gov (United States)

    ... special light. Certain factors affect prognosis and treatment options. The prognosis (chance of recovery) and treatment options ... age and general health of the patient. Treatment Option Overview Key Points There are different types of ...

  10. Treatment Option Overview (Esophageal Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  11. Treatment Option Overview (Childhood Rhabdomyosarcoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  12. Treatment Option Overview (Penile Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  13. Treatment Option Overview (Vulvar Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  14. Treatment Option Overview (Pancreatic Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  15. Treatment Option Overview (Adrenocortical Carcinoma)

    Science.gov (United States)

    ... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  16. Treatment Options for Childhood Rhabdomyosarcoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  17. Treatment Options for Kaposi Sarcoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  18. Treatment Options for Childhood Craniopharyngioma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the brain where it was first found. Treatment Option Overview Key Points There are different types of ...

  19. Optimizing patient treatment decisions in an era of rapid technological advances: the case of hepatitis C treatment.

    Science.gov (United States)

    Liu, Shan; Brandeau, Margaret L; Goldhaber-Fiebert, Jeremy D

    2017-03-01

    How long should a patient with a treatable chronic disease wait for more effective treatments before accepting the best available treatment? We develop a framework to guide optimal treatment decisions for a deteriorating chronic disease when treatment technologies are improving over time. We formulate an optimal stopping problem using a discrete-time, finite-horizon Markov decision process. The goal is to maximize a patient's quality-adjusted life expectancy. We derive structural properties of the model and analytically solve a three-period treatment decision problem. We illustrate the model with the example of treatment for chronic hepatitis C virus (HCV). Chronic HCV affects 3-4 million Americans and has been historically difficult to treat, but increasingly effective treatments have been commercialized in the past few years. We show that the optimal treatment decision is more likely to be to accept currently available treatment-despite expectations for future treatment improvement-for patients who have high-risk history, who are older, or who have more comorbidities. Insights from this study can guide HCV treatment decisions for individual patients. More broadly, our model can guide treatment decisions for curable chronic diseases by finding the optimal treatment policy for individual patients in a heterogeneous population.

  20. Biological treatment of Crohn's disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Bjerrum, Jacob Tveiten; Seidelin, Jakob Benedict

    2012-01-01

    Introduction of biological agents for the treatment of Crohn's disease (CD) has led to a transformation of the treatment paradigm. Several biological compounds have been approved for patients with CD refractory to conventional treatment: infliximab, adalimumab and certolizumab pegol (and...... natalizumab in several countries outside the European Union). However, despite the use of biologics for more than a decade, questions still remain about the true efficacy and the best treatment regimens - especially about when to discontinue treatment. Furthermore, a need for optimizing treatment...... with biologics still exists, as 20-40% of patients with CD (depending on selection criteria) do not have any relevant response to the current biological agents (i.e. primary failures). A better patient selection might maximize the clinical outcome while minimizing the complications associated with this type...

  1. Cyberknife stereotactic treatment

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    The topic discussed included, among others, the following: cyberknife capabilities; autonomous robotics; continuous image guidance; flexible robotics maneuverability; Dynamic motion targeting; intelligent patient positioning; 4D treatment optimization and planning system; X-ray sources; robotic manipulator; linear accelerator; MultiPlan treatment planning system; radiosurgery vs radiotherapy; radiation system delivery comparison; simplified contouring; plan optimization; QA and commissioning. (P.A.)

  2. Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique.

    Science.gov (United States)

    Brodin, N Patrik; Munck af Rosenschöld, Per; Blomstrand, Malin; Kiil-Berthlesen, Anne; Hollensen, Christian; Vogelius, Ivan R; Lannering, Birgitta; Bentzen, Søren M; Björk-Eriksson, Thomas

    2014-04-01

    We investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy. We included 17 pediatric medulloblastoma patients to represent the variability in tumor location relative to the hippocampal region. Treatment plans were generated using 3D conformal radiotherapy, hippocampal sparing intensity-modulated radiotherapy, and spot-scanned proton therapy, using 3 different treatment margins for the conformal tumor boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques. Mean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment margins (P < .05). The largest risk reduction, however, was seen when applying hippocampal sparing proton therapy-the estimated risk of impaired task efficiency (95% confidence interval) was 92% (66%-98%), 81% (51%-95%), and 50% (30%-70%) for 3D conformal radiotherapy, intensity-modulated radiotherapy, and proton therapy, respectively, for the smallest boost margin and 98% (78%-100%), 90% (60%-98%), and 70% (39%-90%) if boosting the whole posterior fossa. Also, the distance between the closest point of the planning target volume and the center of the hippocampus can be used to predict mean hippocampal dose for a given treatment technique. We estimate a considerable clinical benefit of hippocampal sparing radiotherapy. In choosing treatment margins, the tradeoff between margin size and risk of neurocognitive impairment quantified here should be considered.

  3. Treatment of textiles industrial wastewater by electron beam and biological treatment (sbr)

    International Nuclear Information System (INIS)

    Khomsaton Abu Bakar; Khairul Zaman Mohd Dahlan; Zulkafli Ghazali; Ting Teo Ming

    2008-08-01

    Study of treating textiles industrial wastewater with combined of electron beam and Tower Style Biological Treatment (TSB) was investigated in Korea. In this project, textiles wastewater was also treated with electron beam, but hybrid with Sequencing Batch Reactor (SBR). The purpose of this research is to develop combined electron beam treatment with existing biological treatment facility (SBR), of textile industries in Malaysia. The objectives of this project are to determine the effective irradiation parameter for treatment and to identify effective total retention time in SBR system. To achieve the objective, samples fill in polypropyle tray were irradiated at 1 MeV, 20 mA and 1 MeV ,5 mA at doses 11, 20, 30, 40 and 50 kGy respectively. Raw effluent and two series of irradiated effluent at 1 MeV 20 mA (11, 20, 30, 40 and 50 kGy) and 1 MeV 5 mA (11, 20, 30, 40 and 50 kGy) were then treated in SBR system. Samples were analysed at 6, 14 and 20 hrs after aeration in the SBR. The results show that, average reduction in BOD was about 2-11% after irradiated at 5 mA, and the percentage increased to 21-73% after treatment in SBR system. At 20 mA, BOD reduced to 7-29% during irradiation and the value increased to 57-87% after treatment in SBR system. (Author)

  4. Changes in different organic matter fractions during conventional treatment and advanced treatment

    Institute of Scientific and Technical Information of China (English)

    Chao Chen; Xiaojian Zhang; Lingxia Zhu; Wenjie He; Hongda Han

    2011-01-01

    XAD-8 resin isolation of organic matter in water was used to divide organic matter into the hydrophobic and hydrophilic fractions.A pilot plant was used to investigate the change in both fractions during conventional and advanced treatment processes.The treatment of hydrophobic organics (HPO), rather than hydrophilic organicas (HPI), should carry greater emphasis due to HPO's higher trihalomethane formation potential (THMFP) and haloacetic acid formation potential (HAAFP).The removal of hydrophobic matter and its transmission into hydrophilic matter reduced ultimate DBP yield during the disinfection process.The results showed that sand filtration, ozonation, and biological activated carbon (BAC) filtration had distinct influences on the removal of both organic fractions.Additionally, the combination of processes changed the organic fraction proportions present during treatment.The use of ozonation and BAC maximized organic matter removal efficiency, especially for the hydrophobic fraction.In sum, the combination of pre-ozonation,conventional treatment, and O3-BAC removed 48% of dissolved organic carbon (DOC), 60% of HPO, 30% of HPI, 63% of THMFP,and 85% of HAAFP.The use of conventional treatment and O3-BAC without pre-ozonation had a comparable performance, removing 51% of DOC, 56% of HPO, 45% of HPI, 61% of THMFP, and 72% of HAAFP.The effectiveness of this analysis method indicated that resin isolation and fractionation should be standardized as an applicable test to help assess water treatment process efficiency.

  5. Predicting Treatment Response for Oppositional Defiant and Conduct Disorder Using Pre-treatment Adrenal and Gonadal Hormones.

    Science.gov (United States)

    Shenk, Chad E; Dorn, Lorah D; Kolko, David J; Susman, Elizabeth J; Noll, Jennie G; Bukstein, Oscar G

    2012-12-01

    Variations in adrenal and gonadal hormone profiles have been linked to increased rates of oppositional defiant disorder (ODD) and conduct disorder (CD). These relationships suggest that certain hormone profiles may be related to how well children respond to psychological treatments for ODD and CD. The current study assessed whether pre-treatment profiles of adrenal and gonadal hormones predicted response to psychological treatment of ODD and CD. One hundred five children, 6 - 11 years old, participating in a randomized, clinical trial provided samples for cortisol, testosterone, dehydroepiandrosterone, and androstenedione. Diagnostic interviews of ODD and CD were administered up to three years post-treatment to track treatment response. Group-based trajectory modeling identified two trajectories of treatment response: 1) a High-response trajectory where children demonstrated lower rates of an ODD or CD diagnosis throughout follow-up, and 2) a Low-response trajectory where children demonstrated higher rates of an ODD or CD diagnosis throughout follow-up. Hierarchical logistic regression predicting treatment response demonstrated that children with higher pre-treatment concentrations of testosterone were four times more likely to be in the Low-response trajectory. No other significant relationship existed between pre-treatment hormone profiles and treatment response. These results suggest that higher concentrations of testosterone are related to how well children diagnosed with ODD or CD respond to psychological treatment over the course of three years.

  6. Cyanobacteria, Toxins and Indicators: Field Monitoring,Treatment Facility Monitoring and Treatment Studies

    Science.gov (United States)

    This presentation is a compilation of harmful algal bloom (HAB) related field monitoring data from the 2015 bloom season, treatment plant monitoring data from the 2013 and 2014 bloom seasons, and bench-scale treatment study data from 2015.

  7. Cancer treatment: dealing with pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000827.htm Cancer treatment - dealing with pain To use the sharing features ... test, can cause pain. Treatment. Many types of cancer treatments can cause pain, including chemotherapy , radiation , and surgery. ...

  8. HPA axis response to psychological stress and treatment retention in residential substance abuse treatment: a prospective study.

    Science.gov (United States)

    Daughters, Stacey B; Richards, Jessica M; Gorka, Stephanie M; Sinha, Rajita

    2009-12-01

    Substance abuse treatment programs are often characterized by high rates of premature treatment dropout, which increases the likelihood of relapse to drug use. Negative reinforcement models of addiction emphasize an individual's inability to tolerate stress as a key factor for understanding poor substance use treatment outcomes, and evidence indicates that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis contributes to an individual's inability to respond adaptively to stress. The aim of the current study was to examine whether HPA axis response to stress is predictive of treatment retention among a sample of drug users in residential substance abuse treatment. Prospective study assessing treatment retention among 102 individuals enrolled in residential substance abuse treatment. Participants completed two computerized stress tasks, and HPA axis response to stress was measured via salivary cortisol at five time points from baseline (pre-stress) to 30 min post-stress exposure. The main outcome measures were treatment dropout (categorical) and total number of days in treatment (continuous). A significantly higher salivary cortisol response to stress was observed in treatment dropouts compared to treatment completers. Further, Cox proportional hazards survival analyses indicated that a higher peak cortisol response to stress was associated with a shorter number of days to treatment dropout. Results indicate that a higher salivary cortisol level in response to stress is associated with an inability to remain in substance abuse treatment. These findings are the first to document a biological marker of stress as a predictor of substance abuse treatment dropout, and support the development and implementation of treatments targeting this vulnerability.

  9. Extracorporeal treatment for thallium poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

    2012-01-01

    The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl).......The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

  10. The Survey of Treatment Entry Pressures (STEP): identifying client's reasons for entering substance abuse treatment.

    Science.gov (United States)

    Dugosh, Karen Leggett; Festinger, David S; Lynch, Kevin G; Marlowe, Douglas B

    2014-10-01

    Systematically identifying reasons that clients enter substance abuse treatment may allow clinicians to immediately focus on issues of greatest relevance to the individual and enhance treatment engagement. We developed the Survey of Treatment Entry Pressures (STEP) to identify the specific factors that precipitated an individual's treatment entry. The instrument contains 121 items from 6 psychosocial domains (i.e., family, financial, social, medical, psychiatric, legal). The current study examined the STEP's psychometric properties. A total of 761 participants from various treatment settings and modalities completed the STEP prior to treatment admission and 4-7 days later. Analyses were performed to examine the instrument's psychometric properties including item response rates, test-retest reliability, internal consistency, and factor structure. The items displayed adequate test-retest reliability and internal consistency within each psychosocial domain. Generally, results from exploratory and confirmatory factor analyses support a 2-factor structure reflecting type of reinforcement schedule. The study provides preliminary support for the psychometric properties of the STEP. The STEP may provide a reliable way for clinicians to characterize and capitalize on a client's treatment motivation early on which may serve to improve treatment retention and therapeutic outcomes. © 2014 Wiley Periodicals, Inc.

  11. Computer-controlled 3-D treatment delivery

    International Nuclear Information System (INIS)

    Fraass, Benedick A.

    1995-01-01

    Purpose/Objective: This course will describe the use of computer-controlled treatment delivery techniques for treatment of patients with sophisticated conformal therapy. In particular, research and implementation issues related to clinical use of computer-controlled conformal radiation therapy (CCRT) techniques will be discussed. The possible/potential advantages of CCRT techniques will be highlighted using results from clinical 3-D planning studies. Materials and Methods: In recent years, 3-D treatment planning has been used to develop and implement 3-D conformal therapy treatment techniques, and studies based on these conformal treatments have begun to show the promise of conformal therapy. This work has been followed by the development of commercially-available multileaf collimator and computer control systems for treatment machines. Using these (and other) CCRT devices, various centers are beginning to clinically use complex computer-controlled treatments. Both research and clinical CCRT treatment techniques will be discussed in this presentation. General concepts and requirements for CCRT will be mentioned. Developmental and clinical experience with CCRT techniques from a number of centers will be utilized. Results: Treatment planning, treatment preparation and treatment delivery must be approached in an integrated fashion in order to clinically implement CCRT treatment techniques, and the entire process will be discussed. Various CCRT treatment methodologies will be reviewed from operational, dosimetric, and technical points of view. The discussion will concentrate on CCRT techniques which are likely to see rather wide dissemination over the next several years, including particularly the use of multileaf collimators (MLC), dynamic and segmental conformal therapy, conformal field shaping, and other related techniques. More advanced CCRT techniques, such as the use of individualized intensity modulation of beams or segments, and the use of computer

  12. Surgical treatment for mandibular osteoradionecrosis. Stepwise surgical treatment before wide resection

    International Nuclear Information System (INIS)

    Aoki, Shinjiro; Hirota, Makoto; Saito, Tomokatsu; Watanuki, Kei; Matsui, Yoshiro; Fujita, Kiyohide

    2006-01-01

    A method corresponding to the state of progress of necrosis is necessary for the treatment of mandibular osteoradionecrosis considering the healing conditions of the original focus. We devised a three-step treatment method that combined active application of platelet rich plasma (PRP) with particulate cancellous bone marrow (PCBM) with resolutive treatment using external skeletal fixation, as a step preceding wide segmental mandibulectomy and vascularized free combination flap graft when bone necrosis progressed. From January 2002 until December 2004, 14 patients (12 patients of oral cancer and 2 patients of mesopharygeal cancer) in whom mandibular osteoradionecrosis developed after radiation therapy, were treated. First step: when only alveolectomy is done, the wound is closed with a mucosal flap after PRP is applied to the bone surface as there is little sequestration. Second step: when sequestrectomy spreads to the central part of the mandible, PCBM is transplanted in addition to PRP, and the wound is closed by a local skin flap. Third step: when bone defect is segmental, any issue with soft tissue is first resolved and bone grafting is performed after that, while holding the remaining bone in position by using an external skeletal fixation device. A decrease in exposure of bone surface and alleviation of pain symptoms were achieved in all cases by treatment with the first step. However, outer cortical bone necrosis relapsed. The outcome of the second and third step treatment was good, and bone regeneration was achieved in 8 cases where PRP and transplantation of PCBM were done. Two cases suffered an infection, and curettage or retransplantation of PCBM was necessary. It is suggested that improvement of blood circulation and resolution of soft tissue are important for treatment of osteoradionecrosis. Therefore, waiting for resolution of the soft tissue using external skeletal fixation was effective, and PRP was useful in the healing process. (author)

  13. Cancer treatment - preventing infection

    Science.gov (United States)

    ... Radiation - preventing infection; Bone marrow transplant - preventing infection; Cancer treatment - immunosuppression ... this is a short-lived side effect of cancer treatment. Your provider may give you medicines to help ...

  14. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  15. [Eating Disorder Treatment in Iceland - Treatment adherence, psychiatric co-morbidities and factors influencing drop-out].

    Science.gov (United States)

    Gunnarsdottir, Gudrun Mist; Palsson, Sigurdur Pall; Thorsteinsdottir, Gudlaug

    2015-05-01

    Treatment adherence in patients with eating disorders (ED) in Iceland is unknown. The aim of the study was to investigate treatment drop-out and explore factors that influence premature termination of treatment in a specialized ED treatment unit, at the University Hospital of Iceland, during the period of September 1, 2008 - May 1, 2012. The study is retrospective and naturalistic. Hospital records of referred patients were examined. Those meeting the ICD 10 criteria of anorexia nervosa (AN) (F50.0, F50.1), bulimia nervosa (BN) (F50.2, F50.3) and eating disorder not otherwise specified (EDNOS) (F50.9) were included. The total sample was 260 and 182 patients met inclusion criteria. No-shows were 7%. Drop-out was defined as premature termination of treatment without formal discharge. The sample consisted of 176 women and 6 men, mean age 26.3 years. BN was diagnosed in 52.7% of patients, EDNOS in 36.8% AN in 10.4%. 74.7% had one or more co-morbid psychiatric diagnosis. Anxiety- and/or depression were diagnosed in 72.5%, Attention hyperactivity deficiency disorder in 15.4% and personality disorders in 8.2%. Lifetime prevalence of substance use disorders (SUDs) was 30.8%. Drop-out from treatment occurred in 54.4% of cases (with approximately 1/3 returning to treatment), 27.5% finished treatment and 18.1% were still in treatment at the end of the follow up period. Treatment adherence was significantly higher in patients who had a university degree, in those who had themselves taken the initiative to seek ED treatment and in those with higher anxiety scores at assessment. AN patients did better than other ED patients while patients with SUDs showed a tendency for higher drop-out (p=0.079). The drop-out rates were similar to what has been reported from other western countries. Follow-up time was longer and AN patient did better than expected. Higher education, initiative in seeking treatment and higher anxiety scores on questionnaires were protective.

  16. Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.

    Science.gov (United States)

    Moulding, Richard; Nedeljkovic, Maja; Kyrios, Michael; Osborne, Debra; Mogan, Christopher

    2017-01-01

    The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. A 12-week group programme delivered in a community setting was effective for helping with

  17. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... and drug addiction, and more driving infractions. The good news is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ...

  18. Biosorption treatment of brackish water

    International Nuclear Information System (INIS)

    Rizwan, M.; Ali, M.; Tariq, M.I.; Rehman, F.U.; Karim, A.; Makshoof, M.; Farooq, R.

    2010-01-01

    Biosorptivity of different agricultural wastes have been evaluated for the treatment of brackish water and a new method, based on the principle of bio-sorption has been described. Wastes of the Saccharum officinarum, Moringa oleifera, Triticum aestivcum and Oryza sativa have been used in raw forms as well as after converting them into ash and activated carbon as biosorbents for treatment of brackish water in this study. Samples of brackish water have been analyzed before and after treatment for quality control parameters of water. A significant Improvement has been observed in quality control parameters of water after treatment. pH of the water samples slightly increased from 7.68 to 7.97 with different treatments. A substantial decrease in conductivity,. TDS, TH, concentrations of cations and anions was observed in the samples of brackish water after treatment with different biosorbents. (author)

  19. Mechanical Treatment: Material Recovery Facilities

    DEFF Research Database (Denmark)

    Christensen, Thomas Højlund; Bilitewski, B.

    2011-01-01

    A wide variety of mechanical treatment unit processes, including manual sorting, is described in Chapter 7.1. These unit processes may be used as a single separate operation (e.g. baling of recyclable cardboard) or as a single operation before or after biological and thermal treatment processes (e.......g. shredding prior to incineration or screening after composting). The mechanical treatment unit process is in the latter case an integrated part of the overall treatment usually with the purpose of improving the quality of the input material, or the efficiency or stability of the biological or thermal process......, or improving the quality of the output material. Examples hereof appear in the chapters on biological and thermal treatment. Mechanical treatment unit processes may also appear at industries using recycled material as part of their feedstock, for example, for removing impurities and homogenizing the material...

  20. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules

    International Nuclear Information System (INIS)

    Groome, Patti A.; O'Sullivan, Brian; Mackillop, William J.; Jackson, Lynda D.; Schulze, Karleen M.Math.; Irish, Jonathan C.; Warde, Padraig R.; Schneider, Ken M.; Mackenzie, Robert G.; Hodson, D. Ian; Hammond, J. Alex; Gulavita, Sunil P.P.; Eapen, Libni J.; Dixon, Peter F. M.B.; Bissett, Randy J.

    2006-01-01

    Purpose: This population-based study describes the treatment of early glottic cancer in Ontario, Canada and assesses whether treatment variations were associated with treatment effectiveness. Methods and Materials: We studied 491 T1N0 and 213 T2N0 patients. Data abstracted from charts included age, sex, stage, treatment details, disease control, and survival. Results: The total dose ranged from 50 to 70 Gy, and the daily dose ranged from 1.9 to 2.8 Gy. In 90%, treatment duration was between 25 and 50 days. Field sizes, field reductions, beam arrangement, and beam energy varied. Late treatment breaks occurred in 13.6% of T1N0 and 27.1% of T2N0 cases. Local control was comparable to other reports for T1N0 (82% at 5 years), but was only 63.2% in T2N0. Variables associated with local failure in T1N0 were age less than 49 years (relative risk [RR], 3.21; 95% confidence interval [CI], 1.49-6.90) and >3 treatment interruption days (RR, 2.43; 95% CI, 1.00-5.91). In T2N0, these were field reduction (RR, 2.33; 95% CI, 1.23-4.42) and late treatment breaks (RR, 2.19; 95% CI, 1.09-4.41). Conclusion: Some aspects of treatment for early glottic cancer were associated with worse local control. Problems with protracted treatment are of particular concern, underscoring the need for randomized studies to intensify radiotherapy

  1. Sewage Treatment

    Science.gov (United States)

    1991-01-01

    Stennis Space Center's aquaculture research program has led to an attractive wastewater treatment for private homes. The system consists of a septic tank or tanks for initial sewage processing and a natural secondary treatment facility for further processing of septic tanks' effluent, consisting of a narrow trench, which contains marsh plants and rocks, providing a place for microorganisms. Plants and microorganisms absorb and digest, thus cleansing partially processed wastewater. No odors are evident and cleaned effluent may be discharged into streams or drainage canals. The system is useful in rural areas, costs about $1,900, and requires less maintenance than mechanical systems.

  2. Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment

    Science.gov (United States)

    Khourdaji, Iyad; Parke, Jacob; Burks, Frank

    2015-01-01

    Radiation therapy (RT), external beam radiation therapy (EBRT), brachytherapy (BT), photon beam therapy (PBT), high intensity focused ultrasound (HIFU), and cryotherapy are noninvasive treatment options for pelvic malignancies and prostate cancer. Though effective in treating cancer, urethral stricture disease is an underrecognized and poorly reported sequela of these treatment modalities. Studies estimate the incidence of stricture from BT to be 1.8%, EBRT 1.7%, combined EBRT and BT 5.2%, and cryotherapy 2.5%. Radiation effects on the genitourinary system can manifest early or months to years after treatment with the onus being on the clinician to investigate and rule-out stricture disease as an underlying etiology for lower urinary tract symptoms. Obliterative endarteritis resulting in ischemia and fibrosis of the irradiated tissue complicates treatment strategies, which include urethral dilation, direct-vision internal urethrotomy (DVIU), urethral stents, and urethroplasty. Failure rates for dilation and DVIU are exceedingly high with several studies indicating that urethroplasty is the most definitive and durable treatment modality for patients with radiation-induced stricture disease. However, a detailed discussion should be offered regarding development or worsening of incontinence after treatment with urethroplasty. Further studies are required to assess the nature and treatment of cryotherapy and HIFU-induced strictures. PMID:26494994

  3. Treatment of Urethral Strictures from Irradiation and Other Nonsurgical Forms of Pelvic Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Iyad Khourdaji

    2015-01-01

    Full Text Available Radiation therapy (RT, external beam radiation therapy (EBRT, brachytherapy (BT, photon beam therapy (PBT, high intensity focused ultrasound (HIFU, and cryotherapy are noninvasive treatment options for pelvic malignancies and prostate cancer. Though effective in treating cancer, urethral stricture disease is an underrecognized and poorly reported sequela of these treatment modalities. Studies estimate the incidence of stricture from BT to be 1.8%, EBRT 1.7%, combined EBRT and BT 5.2%, and cryotherapy 2.5%. Radiation effects on the genitourinary system can manifest early or months to years after treatment with the onus being on the clinician to investigate and rule-out stricture disease as an underlying etiology for lower urinary tract symptoms. Obliterative endarteritis resulting in ischemia and fibrosis of the irradiated tissue complicates treatment strategies, which include urethral dilation, direct-vision internal urethrotomy (DVIU, urethral stents, and urethroplasty. Failure rates for dilation and DVIU are exceedingly high with several studies indicating that urethroplasty is the most definitive and durable treatment modality for patients with radiation-induced stricture disease. However, a detailed discussion should be offered regarding development or worsening of incontinence after treatment with urethroplasty. Further studies are required to assess the nature and treatment of cryotherapy and HIFU-induced strictures.

  4. Greywater Treatment and Reuse

    Directory of Open Access Journals (Sweden)

    Gökhan Ekrem ÜSTÜN

    2015-07-01

    Full Text Available The aim of this study, to examine grey water treatment and reuse. For this aim, previous literature studies been research on and interpreted. Project began with study of physical, chemical and biological characteristics of the gray water. At the second part; grey water treatment and reuse were examined. At the third part; the technologies used for the methods treatment of gray water were explained. Then from costs and previous studies about grey water reuse were mentioned.

  5. Ebola vaccine and treatment.

    Science.gov (United States)

    Takada, Ayato

    2015-01-01

    Filoviruses (Ebola and Marburg viruses) cause severe hemorrhagic fever in humans and nonhuman primates. No effective prophylaxis or treatment for filovirus diseases is yet commercially available. The recent outbreak of Ebola virus disease in West Africa has accelerated efforts to develop anti-Ebola virus prophylaxis and treatment, and unapproved drugs were indeed used for the treatment of patients during the outbreak. This article reviews previous researches and the latest topics on vaccine and therapy for Ebola virus disease.

  6. Combination treatment of neuropathic pain

    DEFF Research Database (Denmark)

    Holbech, Jakob Vormstrup; Jung, Anne; Jonsson, Torsten

    2017-01-01

    BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combin...

  7. Treatment consumption and treatment re-enrollment in GHB-dependent patients in the Netherlands

    OpenAIRE

    Noorden, M.S. van; Mol, T.; Wisselink, J.; Kuijpers, W.G.T.; Dijkstra, B.A.G.

    2017-01-01

    Background: The objective of this study was to assess treatment consumption and re-enrollment in treatment in patients with gamma-hydroxybutyrate (GHB)-dependence in Dutch Addiction Treatment Centers (ATCs) in comparison with other addictions. Methods: A cohort-study using nationwide administrative data from regular Dutch ATCs associated with the Dutch National Alcohol and Drugs Information System (LADIS), covering an estimated 95% of ATCs. We selected in- and out-patients with alcohol, drug ...

  8. Generic phytosanitary irradiation treatments

    Energy Technology Data Exchange (ETDEWEB)

    Hallman, Guy J [United States Department of Agriculture, Agricultural Research Service, Weslaco, TX (United States)

    2013-01-15

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies. (author)

  9. Generic phytosanitary irradiation treatments

    Science.gov (United States)

    Hallman, Guy J.

    2012-07-01

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies.

  10. Efficacy of Combined Treatment with Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment for Parkinson's Disease.

    Science.gov (United States)

    Cho, Seung-Yeon; Lee, Young-Eun; Doo, Kyeong-Hee; Lee, Ji-Hyun; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Kim, Ho; Rhee, Hak Young; Park, Hi-Joon; Park, Seong-Uk

    2018-01-01

    The aim of this study was to evaluate the efficacy of acupuncture and bee venom acupuncture (BVA) for idiopathic Parkinson's disease (IPD) through a sham-controlled trial. We also investigated whether there is a sustained therapeutic effect by completing follow-up assessments after treatment completion. A single center, double-blind, three-armed randomized controlled trial. This study was performed at a university hospital in Seoul, Republic of Korea. Seventy-three (73) patients with IPD were the subjects. They were randomly assigned to the active treatment group, sham treatment group, or conventional treatment group. The active treatment group received acupuncture and BVA and the sham group received sham acupuncture and normal saline injections, twice a week for 12 weeks. The conventional treatment group maintained anti-parkinsonian drugs without additional intervention. The Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III score, postural instability and gait disturbance (PIGD) score, gait speed and number, Parkinson's Disease Quality of Life Questionnaire, Beck Depression Inventory, and postural stability at baseline and at 12, 16, and 20 weeks. Sixty-three (63) patients provided a complete data of assessments, including a final follow-up. After 12 weeks of treatment, a significant difference was observed between the active treatment group and the conventional treatment group. After the end of the treatment, the treatment effects were maintained significantly in the active treatment group only. It is suggested that the combined treatment of acupuncture and BVA might be safe and useful adjunctive treatment for patients with IPD.

  11. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    Science.gov (United States)

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.

  12. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

    Science.gov (United States)

    von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

    2016-01-01

    Objective While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome as measured by glycated hemoglobin (HbA1c) level, blood pressure, and lipid profile. Research design and methods This was a large-scale cross-sectional, registry-based study involving a well-defined type 2 diabetes population, in the county of Funen, Denmark. Registry data were combined with a 27-item self-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results In total, 1033 respondents answered the survey. The majority of treatment beliefs and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy were factors positively associated with HbA1c levels, s-cholesterol, and low-density lipoprotein. Conversely, infrequent self-measured blood glucose was associated with a significantly higher likelihood of having a blood pressure below 130/80 mm Hg. Perceived low treatment efficacy was the only health belief associated with poorer levels of health outcome other than HbA1c. Conclusions Health behaviors were stronger predictors for health outcomes than treatment beliefs. Self-reported adherence to either the treatment regimen or general medical advice most consistently predicted both glycemic control and cardiovascular risk factors. PMID:27110367

  13. Treatment Option Overview (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

  14. Hairy Cell Leukemia Treatment Option Overview

    Science.gov (United States)

    ... or a swollen spleen. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... cell leukemia has not responded to treatment. Treatment Option Overview Key Points There are different types of ...

  15. Treatment Option Overview (Myelodysplastic/Myeloproliferative Neoplasms)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ...

  16. Treatment Options for Gastrointestinal Carcinoid Tumors

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... body. Has not gotten better with treatment. Treatment Option Overview Key Points There are different types of ...

  17. Treatment Readiness as a Determinant of Treatment Participation in a Prison-Based Rehabilitation Program: An Exploratory Study.

    Science.gov (United States)

    Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul

    2017-06-01

    The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.

  18. Pharmaceutical wastewater treatment by internal micro-electrolysis--coagulation, biological treatment and activated carbon adsorption.

    Science.gov (United States)

    Wang, Kangle; Liu, Suiqing; Zhang, Qiang; He, Yiliang

    2009-12-01

    Treatment of pharmaceutical wastewater by the combined process of internal micro-electrolysis and coagulation, biological treatment and activated carbon adsorption was studied. Internal micro-electrolysis and coagulation served as the pretreatment for the wastewater before biological treatment to reduce the contaminants' toxicity to microbes and improve the biodegradability of wastewater to guarantee the smooth operation of the biological process. Biological treatment was the main body of the whole process which took an unparalleled role in removing COD (chemical oxygen demand). Activated carbon adsorption was adopted as the post-treatment process to further remove the remaining non-biodegradable particles. Results showed that the removal rates of COD and S2- (sulphide ion) by pretreatment were 66.9% and 98.9%, respectively, and the biodegradability, as measured by the ratio of biodegradable COD to initial COD, of the wastewater was greatly improved from 0.16 +/- 0.02 to 0.41 +/- 0.02. The overall removal rate of COD in the wastewater achieved by this combined treatment process was up to 96%, and the effluent COD met the Chinese tertiary discharge standard (GB 8978-1996).

  19. Endovascular treatment in pregnancy

    International Nuclear Information System (INIS)

    Ishii, Akira; Miyamoto, Susumu

    2013-01-01

    There is an increased risk of stroke during pregnancy and the puerperium. Decisions should be made immediately upon transfer to each institution, particularly with respect to when and how to treat the patient. This review highlights the feasibility of endovascular treatment in pregnancy. Most of the pharmaceutical agents and therapeutic devices used in clinical practice can be utilized in pregnant patients. Comprehensive information on the benefits and risks of treatment should be explained to the patient and her family, with particular attention to the safety of the mother and fetus. Radiation exposure to the fetus is also a concern; the hazard can be minimized with optimal protection. Several studies have demonstrated that conventional procedures do not cause serious radiation exposure exceeding the threshold of safety to the fetus. Endovascular therapy can be safely performed for the treatment of acute stroke as in non-pregnant patients with adequate attention to pharmaceutical agents and shielding from radiation. In contrast to therapy for acute stroke, preventive endovascular treatment for asymptomatic lesions remains controversial. Several conditions, such as cerebral aneurysms and arteriovenous malformations, are known to bleed more frequently in pregnancy, but whether the benefits of preventive treatment outweigh the associated risks is unknown. The decision for preventive treatment should be carefully made on a case-by-case basis after extensive discussion with the patient. (author)

  20. [Oligometastasized colorectal cancer-modern treatment strategies].

    Science.gov (United States)

    Binnebösel, M; Lambertz, A; Dejong, K; Neumann, U P

    2018-06-05

    The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.

  1. Treatment of Adolescents with Anorexia Nervosa.

    Science.gov (United States)

    Patel, Dilip R.; Pratt, Helen D.; Greydanus, Donald E.

    2003-01-01

    Reviews research on the treatment of adolescents with anorexia nervosa, including the general approach, treatment setting, treatment of medical complications, nutritional management, psychopharmacotherapy, psychotherapy, treatment efficacy and outcome studies, comparison studies, and prevention programs. (EV)

  2. Municipal wastewater treatment in Mexico: current status and opportunities for employing ecological treatment systems.

    Science.gov (United States)

    Zurita, Florentina; Roy, Eric D; White, John R

    2012-06-01

    The aim of this paper is to evaluate the current status of municipal wastewater (MWW) treatment in Mexico, as well as to assess opportunities for using ecological treatment systems, such as constructed wetlands. In 2008, Mexico had 2101 MWW treatment plants that treated only 84 m3/s of wastewater (208 m3/s ofMWW were collected in sewer systems). Unfortunately, most treatment plants operate below capacity owing to a lack of maintenance and paucity of properly trained personnel. The main types of treatment systems applied in Mexico are activated sludge and waste stabilization ponds, which treat 44.3% and 18% of the MWW collected, respectively. As in many other developing nations around the world, there is a great need in Mexico for low-cost, low-maintenance wastewater treatment systems that are both economically and environmentally sustainable. In 2005, 24.3 million Mexicans lived in villages of less than 2500 inhabitants and 14.1 million lived in towns with 2500-15,000 inhabitants. An opportunity exists to extend the use of ecological treatment systems to these low population density areas and considerably increase the percentage of MWW that is treated in Mexico. Small-scale and medium-size constructed wetlands have been built successfully in some states, primarily during the past five years. Several barriers need to be overcome to increase the adoption and utilization of ecological wastewater technology in Mexico, including: a lack of knowledge about this technology, scarce technical information in Spanish, and the government's concentration on constructing MWW treatment plants solely in urban areas.

  3. Laser treatment of infantile hemangiomas

    Directory of Open Access Journals (Sweden)

    Michelle Si Ying Ng

    2017-01-01

    Full Text Available Infantile hemangiomas (IHs are the most common benign soft tissue tumor of infancy and childhood. Many patients seek early treatment to halt progression of tumor growth and accelerate regression to achieve quick resolution with good cosmetic outcomes. We reviewed literature through PubMed search on the treatment strategies for IH and share our experience in the field of laser treatment of IH. Treatment strategies for IH include both pharmacological, laser, and surgical interventions depending on the stage and severity of the lesion. Various laser beams have been attempted with varying effects and effectiveness. The 595-nm pulsed dye laser therapy has been most widely utilized owing to its great efficacy but minimal adverse effects. It works by targeting oxyhemoglobin chromophore in blood vessels located within the dermis, causing photothermal damage of these target vessels stimulating quick involution without damaging surrounding healthy skin. It is especially useful in treating ulcerated superficial facial hemangiomas that necessitate rapid healing to avoid unsightly scarring. It has a good safety profile but small risk of epidermal burn, blistering, postinflammatory pigment changes, and scarring remains in those with darker skin types treated with higher fluences and short-pulsed duration. Combination treatment with 1064 nm neodymium-doped yttrium aluminum garnet laser, oral propranolol, and even corticosteroids remains an option, especially in treatment of deep, large, and functionally threatening IH. Careful consideration in consultation with the child's parents given the complexities and potential complications surrounding treatment should always be considered. Laser treatment remains an appropriate treatment for rapidly growing IH in exposed locations at early presentation.

  4. Optimal Treatment of Symptomatic Hemorrhoids

    Science.gov (United States)

    Kim, Soung-Ho

    2011-01-01

    Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Other non-surgical treatments, such as infrared photocoagulation, injection sclerotherapy and rubber band ligation have been used to fixate the hemorrhoid's cushion. If non-surgical treatment has no effect, surgical treatments, such as a hemorrhoidectomy, procedure for prolapsed hemorrhoids, and transanal hemorrhoidal dearterialization are used. PMID:22259741

  5. Getting Treatment for ADHD

    Science.gov (United States)

    ... Toggle search Toggle navigation Quick Links Family Resources ADHD Resource Center Resource Centers Obsessive Compulsive Disorder Resource ... Finder Getting Treatment Without treatment, a child with ADHD may fall behind in school and continue having ...

  6. HIV Treatment: The Basics

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Treatment: The Basics Last Reviewed: March 22, 2018 ...

  7. Chronic Myeloproliferative Neoplasms Treatment

    Science.gov (United States)

    ... Treatment for information on diagnosis , staging , and treatment. Polycythemia Vera Key Points Polycythemia vera is a disease ... blood tests are used to diagnose polycythemia vera. Polycythemia vera is a disease in which too many ...

  8. Treatment credibility, expectancy, and preference: Prediction of treatment engagement and outcome in a randomized clinical trial of hatha yoga vs. health education as adjunct treatments for depression.

    Science.gov (United States)

    Uebelacker, Lisa A; Weinstock, Lauren M; Battle, Cynthia L; Abrantes, Ana M; Miller, Ivan W

    2018-06-02

    Hatha yoga may be helpful for alleviating depression symptoms. The purpose of this analysis is to determine whether treatment program preference, credibility, or expectancy predict engagement in depression interventions (yoga or a control class) or depression symptom severity over time. This is a secondary analysis of a randomized controlled trial (RCT) of hatha yoga vs. a health education control group for treatment of depression. Depressed participants (n = 122) attended up to 20 classes over a period of 10 weeks, and then completed additional assessments after 3 and 6 months. We assessed treatment preference prior to randomization, and treatment credibility and expectancy after participants attended their first class. Treatment "concordance" indicated that treatment preference matched assigned treatment. Treatment credibility, expectancy, and concordance were not associated with treatment engagement. Treatment expectancy moderated the association between treatment group and depression. Depression severity over time differed by expectancy level for the yoga group but not for the health education group. Controlling for baseline depression, participants in the yoga group with an average or high expectancy for improvement showed lower depression symptoms across the acute intervention and follow-up period than those with a low expectancy for improvement. There was a trend for a similar pattern for credibility. Concordance was not associated with treatment outcome. This is a secondary, post-hoc analysis and should be considered hypothesis-generating. Results suggest that expectancy improves the likelihood of success only for a intervention thought to actively target depression (yoga) and not a control intervention. Copyright © 2018. Published by Elsevier B.V.

  9. Microalgal biofilms for wastewater treatment

    NARCIS (Netherlands)

    Boelee, N.C.

    2013-01-01

    The objective of this thesis was to explore the possibilities of using microalgal biofilms for the treatment of municipal wastewater, with a focus on the post-treatment of municipal wastewater effluent. The potential of microalgal biofilms for wastewater treatment was first investigated using a

  10. Treatment of ventriculostomy-related infections

    DEFF Research Database (Denmark)

    Gerner-Smidt, P; Stenager, E; Kock-Jensen, C

    1988-01-01

    The results of the treatment of 15 cases of ventriculitis related to the use of external ventricular drainage are presented. A review of the literature on the treatment of cerebrospinal fluid shunt infections combined with our data suggest the following treatment of ventriculostomy-related ventri...

  11. [Local treatment of liver tumors

    DEFF Research Database (Denmark)

    Pless, T.K.; Skjoldbye, Bjørn Ole

    2008-01-01

    Local treatment of non-resectable liver tumors is common. This brief review describes the local treatment techniques used in Denmark. The techniques are evaluated according to the evidence in literature. The primary local treatment is Radiofrequency Ablation of both primary liver tumors and liver...

  12. Electrochemical treatment of graphite

    International Nuclear Information System (INIS)

    Podlovilin, V.I.; Egorov, I.M.; Zhernovoj, A.I.

    1983-01-01

    In the course of investigating various modes of electroche-- mical treatment (ECT) it has been found that graphite anode treatment begins under the ''glow mode''. A behaviour of some marks of graphite with the purpose of ECT technique development in different electrolytes has been tested. Electrolytes have been chosen of three types: highly alkaline (pH 13-14), neutral (pH-Z) and highly acidic (pH 1-2). For the first time parallel to mechanical electroerosion treatment ECT graphite and carbon graphite materials previously considered chemically neutral is proposed. ECT of carbon graphite materials has a number of advantages as compared with electroerrosion and mechanical ones this is treatment rate and purity (ronghness) of the surface. A sMall quantity of sludge (6-8%) under ECT is in highly alkali electrolytes

  13. Wastewater Treatment in Greenland

    DEFF Research Database (Denmark)

    Gunnarsdottir, Ragnhildur

    treatment in these regions. However, designing, constructing and operating wastewater collection systems in the Arctic is challenging because of e.g. permafrost conditions, hard rock surfaces, freezing, limited quantity of water and high costs of electricity, fuel and transportation, as well as a settlement...... or water saving toilets. This opens up for co-treatment of organic waste fractions. Freezing and thawing has also been recognised as being a cost-effective wastewater treatment method in cold regions. Thus it was chosen to concentrate on the effect of the mentioned processes, namely freezing, anaerobic...... spreading of nutrients, diseases and potential pollution issues. Due to the above mentioned challenges alternative treatment methods are needed, especially in small and remotely located communities. Decentralized solutions are well suited for Greenland. Ideal solutions should reduce the need for expensive...

  14. Thermal plasma waste treatment

    International Nuclear Information System (INIS)

    Heberlein, Joachim; Murphy, Anthony B

    2008-01-01

    Plasma waste treatment has over the past decade become a more prominent technology because of the increasing problems with waste disposal and because of the realization of opportunities to generate valuable co-products. Plasma vitrification of hazardous slags has been a commercial technology for several years, and volume reduction of hazardous wastes using plasma processes is increasingly being used. Plasma gasification of wastes with low negative values has attracted interest as a source of energy and spawned process developments for treatment of even municipal solid wastes. Numerous technologies and approaches exist for plasma treatment of wastes. This review summarizes the approaches that have been developed, presents some of the basic physical principles, provides details of some specific processes and considers the advantages and disadvantages of thermal plasmas in waste treatment applications. (topical review)

  15. The effectiveness of stuttering treatments in Germany.

    Science.gov (United States)

    Euler, Harald A; Lange, Benjamin P; Schroeder, Sascha; Neumann, Katrin

    2014-03-01

    Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable

  16. Microwave heat treatment as a substitute for conventional treatment of palm oil fruits

    International Nuclear Information System (INIS)

    Mujahid H Al-Fayadh; Nor Azura Masabbir Ali

    1996-01-01

    Microwave energy has become a sound method of heat treatment because of its high penetration power, cleanliness and possible economic significance. In this research, microwave heat was used as a substitute for conventional blanching method of palm oil fruits. Microwave treatment at 2450 MHz and 800 watts gave very close color and frn,frying characteristics to oil of blanched fruits after one minute exposure time. However, five minutes of microwave heat gave severe husk oil discoloration after 49 hours of deep frying, compared to all oils extracted from fruits treated by either low, microwave exposure time or conventional steam treatment. Kernel oil, after five minutes of microwave treatment, was less discolored than both steam or microwave-treated fruits for one minute. More carotenes and discoloration compounds may be contributed to discoloration during microwave treatments. Oil chemical constants of both husk and kernel oils treated by microwave heat were close to those treated by conventional heat. Further research is needed to investigate detailed oil characteristics and evaluate the feasibility study for using microwave energy, as a substitute for conventional heat in palm oil industry

  17. Treatment Seeking for Alcohol Use Disorders : Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; Ten Have, Margreet; Van Den Brink, Wim; Vollebergh, Wilma; De Graaf, Ron

    2016-01-01

    Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization

  18. Perspectives of addiction treatment providers

    African Journals Online (AJOL)

    Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the ...

  19. Smartphone and Mobile Application Utilization Prior to and Following Treatment Among Individuals Enrolled in Residential Substance Use Treatment

    Science.gov (United States)

    Dahne, Jennifer; Lejuez, C. W.

    2015-01-01

    Background Following completion of substance use treatment, it is crucial for patients to continue to utilize skills learned in treatment for optimal treatment outcomes. Mobile applications (apps) on smartphones offer a unique platform to promote utilization of evidence-based skills following completion of substance use treatment. Despite the promise of mobile apps and smartphones for treatment delivery, it remains unknown whether patients in substance use treatment in the United States have access to smartphones and utilize mobile apps on smartphones. The present study sought to determine smartphone utilization among individuals enrolled in one residential substance use treatment center in the U.S catering specifically to low-income adults. Methods Participants included 251 individuals at a residential substance use treatment center in Washington DC admitted to the center between March, 2014 and January, 2015. During the intake process, participants completed interviewer-administered demographics and psychiatric questionnaires as well as a self-report of technology utilization. Results Results indicated that the majority of patients in this residential substance use treatment center owned mobile phones prior to treatment entry (86.9%) and expected to own mobile phones after leaving treatment (92.6%). Moreover, the majority of these phones were (68.5%) or will be smartphones (72.4%) on which patients reported utilizing mobile applications (Prior to treatment: 61.3%; Post treatment: 64.3%) and accessing the internet (Prior to treatment: 61.3%; Post treatment: 65.9%). Conclusions Mobile phone and smartphone ownership among this sample were comparable to ownership among U.S. adults broadly. Findings suggest that smartphones and mobile apps may hold clinical utility for fostering continued use of treatment skills following substance use treatment completion. PMID:26231698

  20. Current treatment of Graves' disease

    International Nuclear Information System (INIS)

    Harada, T.; Shimaoka, K.; Mimura, T.; Ito, K.

    1987-01-01

    In this review we have described the rationale for the appropriate treatment of patients with Graves' disease. Because the etiology of this disorder remains obscure, its management remains controversial. Since antithyroid drugs and radioiodine became readily available in the early 1950s, they have been widely used for the treatment of thyrotoxicosis, and the number of cases treated surgically has markedly decreased. However, almost four decades of experience have disclosed an unexpectedly high incidence of delayed hypothyroidism after radioiodine treatment and a low remission rate after antithyroid therapy. As a result, surgery is again being advocated as the treatment of choice. The three modalities of treatment have different advantages and disadvantages, and selection of treatment is of importance. In principle, we believe that for most patients a subtotal thyroidectomy should be performed after the patient has been rendered euthyroid by antithyroid drugs. We attempt to leave a thyroid remnant of 6 to 8 gm.36 references

  1. Rape: psychopathology, theory and treatment.

    Science.gov (United States)

    Gannon, Theresa A; Collie, Rachael M; Ward, Tony; Thakker, Jo

    2008-07-01

    Whether treatment programs are effective at rehabilitating rapists is yet to be determined empirically. From a scientist-practitioner perspective, treatment should be based on an empirical understanding of rape and rapists, and evidence-based knowledge of treatment outcome with rapists. In this paper we comprehensively review the characteristics of rapists, etiological features implicated in the commission of rape, and relevant treatment outcome research. We pay particular attention to contemporary knowledge about the core vulnerabilities and features required to understand and treat rapists effectively, and, where possible, highlight similarities and differences between rapists, child molesters and non-sexual violent offenders. We use an epistemological framework to (a) critique the various etiological accounts of rape available and (b) help guide professionals' use of such knowledge in both treatment design and evaluation. Gaps in the understanding of rapists' characteristics and etiological features are highlighted, as are discrepancies between current knowledge and treatment approaches. We conclude by highlighting areas for future research and practice innovation.

  2. Salivary Gland Cancer Treatment

    Science.gov (United States)

    ... A to Z List of Cancer Drugs Complementary & Alternative Medicine (CAM) Questions to Ask about Your Treatment Research ... Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to Cancer Self Image & ...

  3. IV treatment at home

    Science.gov (United States)

    ... Other IV treatments you may receive after you leave the hospital include: Treatment for hormone deficiencies Medicines for severe nausea that cancer chemotherapy or pregnancy may cause Patient-controlled analgesia (PCA) for pain (this is IV ...

  4. Antimicrobial Treatments and Efficacy

    Science.gov (United States)

    To limit exposure to indoor biological contamination a risk-management approach which employs various antimicrobial treatments can effectively control contaminants and reduce exposure. Antimicrobial treatment of biological contaminants, especially mold in buildings, it is often n...

  5. Health Issues and Treatments

    Science.gov (United States)

    ... About Us Information For… Media Policy Makers Health Issues & Treatments Language: English (US) Español (Spanish) Recommend on ... people with spina bifida are exactly alike. Health issues and treatments for people with spina bifida will ...

  6. Patient-relevant treatment goals in psoriasis.

    Science.gov (United States)

    Blome, Christine; Gosau, Ramona; Radtke, Marc A; Reich, Kristian; Rustenbach, Stephan J; Spehr, Christina; Thaçi, Diamant; Augustin, Matthias

    2016-03-01

    Patient-oriented care requires therapeutic decisions to agree with the patients' treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % "quite" or "very" important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2-77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3-54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.

  7. ESCHARS TREATMENT

    Directory of Open Access Journals (Sweden)

    Cioc Liliana

    2012-02-01

    Full Text Available This article carry out a modern research and principles of the main solutions for the treatment of eschars, including cleaning solutions for wound debridement, dressings, antibiotics, surgery and adjuvant therapies. The approach taken to achieve the research is justified by the fact that, despite current interest and progress in medicine, surgery, medical care and education for self-care, pressure sores remain a major cause of morbidity and mortality, affecting in particular, people with prolonged immobilization and the elderly. The conclusions of the paper are oriented towards to analysis of the efficiency of each treatment solutions presented in active control eschars and negative effects they generate.

  8. Integrated, exposure-based treatment for PTSD and comorbid substance use disorders: Predictors of treatment dropout.

    Science.gov (United States)

    Szafranski, Derek D; Snead, Alexandra; Allan, Nicholas P; Gros, Daniel F; Killeen, Therese; Flanagan, Julianne; Pericot-Valverde, Irene; Back, Sudie E

    2017-10-01

    High rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD) have been noted in veteran populations. Fortunately, there are a number of evidence-based psychotherapies designed to address comorbid PTSD and SUD. However, treatments targeting PTSD and SUD simultaneously often report high dropout rates. To date, only one study has examined predictors of dropout from PTSD/SUD treatment. To address this gap in the literature, this study aimed to 1) examine when in the course of treatment dropout occurred, and 2) identify predictors of dropout from a concurrent treatment for PTSD and SUD. Participants were 51 male and female veterans diagnosed with current PTSD and SUD. All participants completed at least one session of a cognitive-behavioral treatment (COPE) designed to simultaneously address PTSD and SUD symptoms. Of the 51 participants, 22 (43.1%) dropped out of treatment prior to completing the full 12 session COPE protocol. Results indicated that the majority of dropout (55%) occurred after session 6, with the largest amount of dropout occurring between sessions 9 and 10. Results also indicated a marginally significant relationship between greater baseline PTSD symptom severity and premature dropout. These findings highlight inconsistencies related to timing and predictors of dropout, as well as the dearth of information noted about treatment dropout within PTSD and SUD literature. Suggestions for procedural changes, such as implementing continual symptom assessments during treatment and increasing dialog between provider and patient about dropout were made with the hopes of increasing consistency of findings and eventually reducing treatment dropout. Published by Elsevier Ltd.

  9. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Compulsive Disorder Resource Center Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, a child ... ADHD. They know that biological substances in the brain, such as dopamine and norepinephrine, play a role ...

  10. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Toggle search Toggle navigation Quick Links Family Resources ADHD Resource Center Resource Centers Obsessive Compulsive Disorder Resource ... Finder Getting Treatment Without treatment, a child with ADHD may fall behind in school and continue having ...

  11. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Resources Support AACAP Medical Students and Residents Toggle Child Psychiatry Residents (Fellows) Early Career Psychiatrists Medical Student ... Centers Obsessive Compulsive Disorder Resource Center Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, ...

  12. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Resource Center Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, a child with ADHD ... can help the child identify his or her strengths and build on them. Therapy can also help ...

  13. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... also have higher rates of cigarette and drug addiction, and more driving infractions. The good news is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ability ...

  14. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ... to pay attention and control their behavior. The right care can help them grow, learn, and feel ...

  15. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Compulsive Disorder Resource Center Youth Resources Child and Adolescent Psychiatrist Finder Getting Treatment Without treatment, a child ... ADHD will continue to benefit from it as teenagers. In fact, many adults with ADHD also find ...

  16. 40 CFR 141.809 - Supplemental treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Supplemental treatment. 141.809... treatment. (a) Any supplemental drinking water treatment units installed onboard existing or new aircraft... the manufacturer's plans and specifications and FAA requirements. (b) Water supplemental treatment and...

  17. Features of Islamic Health-Treatment Doctrine

    Directory of Open Access Journals (Sweden)

    Ali Reza Alinouri

    2015-03-01

    Full Text Available Islam has particular style and doctrine about health and treatment that makes it different from other treatment methods. The aim of this article is studying the principles and methods of Islamic health treatment and the attitudes of this religion toward appearance of disease caused by material or immaterial factors. This article is review type and it is presented by descriptive analysis method from religious sources. Islam is a religion which is oriented towards health with health-treatment features, priority of prevention over treatment by reforming nutritional principles, tolerance of disease and avoidance of taking medicine if the disease is not sever, paying attention to spiritual causes of illness in addition to physical factors and necessity of treatment as a Divine Will and avoidance of treatment by Haraam because God has not placed healing in Haraam. These features have made Islamic health - treatment doctrine as unique.

  18. Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2016-01-01

    This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The

  19. Treatment approaches and antibiotic use for emergency dental treatment in Turkey

    Directory of Open Access Journals (Sweden)

    Kaptan RF

    2013-11-01

    Full Text Available Rabia Figen Kaptan,1 Faruk Haznedaroglu,2 Fatima Betul Basturk,3 Mehmet Baybora Kayahan11Department of Endodontics, Yeditepe University, 2Department of Endodontics, Istanbul University, 3Department of Endodontics, Marmara University, Istanbul, TurkeyAbstract: The purpose of this study was to gather information about Turkish general dental practitioners' treatment approaches towards endodontic emergencies, antibiotic-prescribing habits, and their participation in lifelong learning programs. Questionnaires were given to dentists who attended the 16th National Congress organized by the Turkish Dental Association. From 1,400 questionnaires distributed, 589 (43% were deemed usable in this study. This survey dealt with questions that were subdivided into two main topics: dental emergency treatment approaches, and antibiotic prescription and information on lifelong learning program participation. The statistical analysis was conducted with a Χ2 test at a significance level of P<0.05. For irreversible pulpitis cases in vital teeth, most of the dental practitioners (65.3% preferred single-visit root canal treatments. For teeth presenting a periapical lesion, the preferred treatment approach was root canal treatment (91.5%. The rate of prescription of analgesics and antibiotics was 21.7% in untreated acute apical periodontitis cases and 41% in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin–clavulanate (61.8% and amoxicillin (46.5%. There was a tendency for practitioners to attend congresses as their years of professional practice increased (P<0.0001. There have been discrepancies between taught and observed practice. Educational initiatives are needed to prevent inappropriate prescription of antibiotics.Keywords: antibiotic prescription, endodontic emergency, survey, Turkey

  20. Effect of Ultrasonic Treatment Combined with Peracetic Acid Treatment Reduces Decay and Maintains Quality in Loquat Fruit

    Directory of Open Access Journals (Sweden)

    Chen Ling

    2018-01-01

    Full Text Available The effects of ultrasonic treatment (UT, 400 watts for 6 min combined with peracetic acid (PA, 0.4% (W/W treatment on fruit decay, browning, and quality and physiological changes in loquat fruit stored at 20°C were investigated. The results showed that treatment with UT or PA alone significantly reduced both decay and browning index in loquat fruit compared with the control. The combined treatment was more effective in decreasing decay and browning index and maintaining higher quality parameters than UT or PA treatment alone. Loquat fruits treated with the combined treatment maintained higher activities of polyphenol oxidase (PPO and peroxidase (POD than those treated with other treatments. In addition, UT combined with PA treatment significantly reduced the increase of firmness and increased fruit extractable juice, total soluble solid (TSS, and ascorbic acid content in loquat fruit. Moreover, the contents of total phenolics and total flavonoids were enhanced by the combination of UT and PA treatment. The combination of UT and PA treatment could be a useful method to reduce decay and browning in loquat fruit stored at room temperature, which has potential for application in the loquat industry.

  1. Treatments for Sleep Changes

    Science.gov (United States)

    ... Contributing medical factors Non-drug strategies Medications Common sleep changes Many people with Alzheimer’s experience changes in ... at night. Subscribe now Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep ...

  2. Efficiency of combined treatment and conventional physical treatment in bilateral knee arthrosis

    Directory of Open Access Journals (Sweden)

    Samir Bojičić

    2013-04-01

    Full Text Available Introduction: Degenerative joint disease, which is standardized in Europe by the name of arthrosis or osteoarthrosis, while in the Anglo-Saxon literature is in use for a long time by the name of osteoarthritis (OA although this is not a classical inflammation,is the most common joint disease in general and the most common cause of functional damage of the musculoskeletal system. Recently, the term osteoarthritisappears more frequently in domestic literature. Arthroses are degenerative joint diseases with progressive character, also one of the most frequent diseases in orthopedics. The disease fi rst affects the articular cartilage, then the bony edges of the articular surfaces, and then the articular lining.Methods: Retrospective analysis and evaluation of data of treated patients, with the "Praxis" physical treatment during the period of time from 2000 to the end of 2010 on a sample of 79 patients,valorized the efficacy of Praxis treatment. The  correlation of these results, with valorisation of the efficacy of standard physical treatment in clinics D.Z. " Novi Grad " on a sample of 81 patients, during the period of time from 2000 to the end of 2010, a statistical analysis was performed for comparing the effi cacy of the two methods.Results: There is a functional difference after therapy of bilateral gonarthrosis in clinics D.Z. "Novi Grad" and "Praxis" with statistical reliability.Conclusion: A combined approach in the treatment of knee arthrosis has a wider range of treatment procedures, comprehensively approaches to the problem and gives better results, so we can say that this method has priority compared to the standard approach to the knee arthrosis treatment.

  3. Computerized radiation treatment planning

    International Nuclear Information System (INIS)

    Laarse, R. van der.

    1981-01-01

    Following a general introduction, a chain consisting of three computer programs which has been developed for treatment planning of external beam radiotherapy without manual intervention is described. New score functions used for determination of optimal incidence directions are presented and the calculation of the position of the isocentre for each optimum combination of incidence directions is explained. A description of how a set of applicators, covering fields with dimensions of 4 to 20 cm, for the 6 to 20 MeV electron beams of a MEL SL75-20 linear accelerator was developed, is given. A computer program for three dimensional electron beam treatment planning is presented. A microprocessor based treatment planning system for the Selectron remote controlled afterloading system for intracavitary radiotherapy is described. The main differences in treatment planning procedures for external beam therapy with neutrons instead of photons is discussed. A microprocessor based densitometer for plotting isodensity lines in film dosimetry is described. A computer program for dose planning of brachytherapy is presented. Finally a general discussion about the different aspects of computerized treatment planning as presented in this thesis is given. (Auth.)

  4. Hyperthyroidism: diagnosis and treatment.

    Science.gov (United States)

    Reid, Jeri R; Wheeler, Stephen F

    2005-08-15

    The proper treatment of hyperthyroidism depends on recognition of the signs and symptoms of the disease and determination of the etiology. The most common cause of hyperthyroidism is Graves' disease. Other common causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications. The diagnostic workup begins with a thyroid-stimulating hormone level test. When test results are uncertain, measuring radionuclide uptake helps distinguish among possible causes. When thyroiditis is the cause, symptomatic treatment usually is sufficient because the associated hyperthyroidism is transient. Graves' disease, toxic multinodular goiter, and toxic adenoma can be treated with radioactive iodine, antithyroid drugs, or surgery, but in the United States, radioactive iodine is the treatment of choice in patients without contraindications. Thyroidectomy is an option when other treatments fail or are contraindicated, or when a goiter is causing compressive symptoms. Some new therapies are under investigation. Special treatment consideration must be given to patients who are pregnant or breastfeeding, as well as those with Graves' ophthalmopathy or amiodarone-induced hyperthyroidism. Patients' desires must be considered when deciding on appropriate therapy, and dose monitoring is essential.

  5. Electrochemical treatment of graphite

    Energy Technology Data Exchange (ETDEWEB)

    Podlovilin, V.I.; Egorov, I.M.; Zhernovoj, A.I.

    1983-01-01

    In the course of investigating various modes of electrochemical treatment (ECT) it has been found that graphite anode treatment begins under the ''glow mode''. A behaviour of some marks of graphite with the purpose of ECT technique development in different electrolytes has been tested. Electrolytes have been chosen of three types: highly alkaline (pH 13-14), neutral (pH-Z) and highly acidic (pH 1-2). For the first time parallel to mechanical electroerosion treatment, ECT of graphite and carbon graphite materials previously considered chemically neutral is proposed. ECT of carbon graphite materials has a number of advantages as compared with electroerrosion and mechanical ones with respect to the treatment rate and purity (ronghness) of the surface. A small quantity of sludge (6-8%) under ECT is in highly alkali electrolytes.

  6. Friction Surface Treatment Selection: Aggregate Properties, Surface Characteristics, Alternative Treatments, and Safety Effects

    Science.gov (United States)

    2017-07-01

    This study aimed to evaluate the long term performance of the selected surface friction treatments, including high friction surface treatment (HFST) using calcined bauxite and steel slag, and conventional friction surfacing, in particular pavement pr...

  7. A test of faith in God and treatment: the relationship of belief in God to psychiatric treatment outcomes.

    Science.gov (United States)

    Rosmarin, David H; Bigda-Peyton, Joseph S; Kertz, Sarah J; Smith, Nasya; Rauch, Scott L; Björgvinsson, Thröstur

    2013-04-25

    Belief in God is very common and tied to mental health/illness in the general population, yet its relevance to psychiatric patients has not been adequately studied. We examined relationships between belief in God and treatment outcomes, and identified mediating mechanisms. We conducted a prospective study with n=159 patients in a day-treatment program at an academic psychiatric hospital. Belief in God, treatment credibility/expectancy, emotion regulation and congregational support were assessed prior to treatment. Primary outcomes were treatment response as well as degree of reduction in depression over treatment. Secondary outcomes were improvements in psychological well-being and reduction in self-harm. Belief in God was significantly higher among treatment responders than non-responders F(1,114)=4.81, pGod and reductions in depression. No variables mediated relationships to other outcomes. Religious affiliation was also associated with treatment credibility/expectancy but not treatment outcomes. Belief in God, but not religious affiliation, was associated with better treatment outcomes. With respect to depression, this relationship was mediated by belief in the credibility of treatment and expectations for treatment gains. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... news is that effective treatment is available . With the right medical treatment, children with ADHD can improve their ability to pay attention and control their behavior. The right care can help them grow, learn, and feel ...

  9. HIV: Treatment and Comorbidity

    NARCIS (Netherlands)

    C. Rokx (Casper)

    2016-01-01

    markdownabstractClinicians worldwide strive to improve HIV care for their patients. Antiretroviral therapy prevents HIV related mortality and is lifelong. A clinical evaluation of these treatment strategies is necessary to identify strategies that may jeopardize treatment effectiveness and patient

  10. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... the sensitive fraction of the commensal flora.Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were...... (how frequently antibiotics are alternated in a sequential treatment) of the two drugs was dependent upon the order in which the two drugs were used.Conclusion: Sequential treatment was more effective in preventing the growth of resistant strains when compared to the combination treatment. The cycling...

  11. Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Changing the Conversation.

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    This report is the result of five expert panels and six regional public hearings around the country that focused on key persistent issues that have characterized discussions of substance abuse over the years: closing the treatment gap; reducing stigma and changing attitudes; improving and strengthening treatment systems; connecting services and…

  12. Radiation treatment of polymethyl methacrylate

    International Nuclear Information System (INIS)

    Knizhnik, E.I.; Onisko, A.D.

    1979-01-01

    The well-known methods of radiation treatment of polymethylmethacrylate (PMMA) are reviewed. Described is a new method of the production of decorative articles with the drawing inside the volume. This method permits to obtain the original ''dendritic'' drawing by electron treatment of PMMA. Presented are the technique which permits to obtain the drawing with the increased density of lines and the ways of changing the deposition depth, the drawing volume and the treatment duration. Shown is the possibility of the radiation treatment application for the increase of the specific volume resistance of PMMA

  13. Struniak w okolicy kości krzyżowej u 47 – letniej pacjentki – opis przypadku = Chordoma in the sacral spine in an 47-year-old woman – case report

    Directory of Open Access Journals (Sweden)

    Kamila Woźniak

    2016-09-01

    • 2.        Katedra i Klinika Rehabilitacji, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu     Streszczenie   Struniaki (łac. chordoma są rzadkimi, histologicznie łagodnymi, lecz klinicznie złośliwymi nowotworami szkieletu osiowego. Mogą powstać w dowolnym miejscu w linii środkowej ciała, gdzie istniała struna grzbietowa (np. stok, nosogardziel, siodło i okolica okołosiodłowa, otwór wielki kręgi i okolica krzyżowo-ogonowa. Struniaki to wolno rosnące nowotwory, wykazujące miejscową agresywność w stosunku do kości i tkanek miękkich. Struniaka po raz pierwszy opisał w 1856 roku Virchow i Luschke. Z kolei w 1858 roku Muller stwierdził, że nowotwór może pochodzić z pozostałości embrionalnych prymitywnej struny grzbietowej tzw. chorda dorsalis. Autorzy przedstawiają opis przypadku klinicznego leczonego operacyjne w Klinice Neurochirurgii, Neurotraumatologii i Neurochirurgii Dziecięcej Szpitala Uniwersyteckiego nr 1 im. dr A. Jurasza w Bydgoszczy z rozpoznanym w badaniu histopatologicznym struniakiem.   Słowa kluczowe: struniak, chrodoma, nowotwór, szkielet osiowy, neurochirurgia.     Abstract   Chordomas are rare, histologically benign but clinically malignant tumors of the axial skeleton. They can occur anywhere in the midline of the body where there notochord (clivus, nasopharynx, saddle and surroundings parasellar, the foramen vertebrae and surroundings sacral area. Chordomas are slow-growing cancer, showing local aggressiveness relative to bone and soft tissue. Chordoma was first described in 1856 by Virchow and Luschke. In turn, in 1858 Muller found that the cancer can come from embryonic remnants of the primitive notochord called chorda dorsalis. The authors present a clinical case operating treated in the Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery, Dr Antoni Jurasz University Hospital No.1 in Bydgoszcz histopathological diagnosed

  14. Zespół Melkerssona‑Rosenthala jako przyczyna nawracającego porażenia nerwu twarzowego u 10‑letniej dziewczynki

    Directory of Open Access Journals (Sweden)

    Dorota Szałowska

    2012-11-01

    Full Text Available Nerw twarzowy jest siódmym, parzystym nerwem czaszkowym. Patogeneza schorzeń nerwu VII jest ściśle związana z jego przebiegiem. W każdej grupie wiekowej może wystąpić porażenie nerwu twarzowego – ośrod‑ kowe lub obwodowe. Wśród najczęstszych przyczyn porażenia nerwu VII wymienia się: porażenie idiopatycz‑ ne, porażenie pourazowe, porażenie po infekcji wirusowej, przejście stanu zapalnego na pień nerwu VII ze struktur ucha środkowego, zmiany nowotworowe, a także naczyniowe na przebiegu samego nerwu. Zespół Melkerssona‑Rosenthala jest rzadką przyczyną nawracającego porażenia nerwu twarzowego i choć występu‑ je zazwyczaj między 20. a 30. rokiem życia, to jego wczesne objawy mogą pojawić się w każdym wieku. Występowanie tego zespołu opisywane jest także w populacji pediatrycznej. W nieustalonej do końca etiolo‑ gii zespołu bierze się pod uwagę między innymi czynniki infekcyjne, alergiczne, immunologiczne i genetyczne. W zespole Melkerssona‑Rosenthala występuje charakterystyczna triada objawów klinicznych: nawracający obrzęk tkanek miękkich twarzy, porażenie nerwu twarzowego i bruzdy (pofałdowania na powierzchni języka (lingua plicata. Postać zespołu Melkerssona‑Rosenthala z pełną triadą wymienionych objawów występuje rzadko, najczęściej spotykane są postacie niepełne czy monosymptomatyczne. W pracy przedstawiono przy‑ padek 10‑letniej dziewczynki z nawracającym porażeniem nerwu twarzowego, bruzdami na języku i obrzę‑ kiem wargi, u której na podstawie badania przedmiotowego i podmiotowego rozpoznano zespół Melkersso‑ na‑Rosenthala. Zaostrzeniom choroby towarzyszyły nawracające zakażenia wirusem Herpes simplex.

  15. Ocena sprawności funkcjonalnej chorych na reumatoidalne zapalenie stawów na podstawie funkcjonalnego testu z wystandaryzowanym wyposażeniem

    Directory of Open Access Journals (Sweden)

    Grażyna Bączyk

    2011-02-01

    Full Text Available Reumatoidalne zapalenie stawów (RZS jest przewlekle postępującymprocesem zapalnym błony maziowej, doprowadzającym doniszczenia tkanek stawowych i okołostawowych, w wyniku czegodochodzi do zniekształceń i upośledzenia funkcji stawów, co w konsekwencjiprowadzi do trwałego kalectwa. Celem badań była ocenasprawności funkcjonalnej chorych na RZS. Materiały i metody: Grupę badaną stanowiło 120 chorych na reumatoidalnezapalenie stawów leczonych w poradni reumatologicznejw Poznaniu. Kobiety stanowiły 75% badanych. Średnia wiekubadanych to 52,15 roku (SD 12,73. Średni czas trwania chorobywynosił 13,47 roku, (SD 8,62 (tab. I.Objawy ze strony układu kostno-stawowego oceniano wg następującychzasad: czas trwania sztywności porannej, natężenie bólu wgskali VAS, bolesność uciskowa stawów z wykorzystaniem RitchieArticular Index, siła mięśniowa ręki na podstawie siły chwytu. Dooceny sprawności funkcjonalnej chorych wykorzystano funkcjonalnytest z wystandaryzowanym wyposażeniem (tab. II. Wyniki: Około 60% kobiet i 40% mężczyzn nie było zdolnych dowykonania takiego zadania, jak otwieranie słoika. Wykonanie większościzadań wymagało od badanych zastosowania pewnego rodzajupomocy technicznej albo wykonanie danej czynności odbywało siępowoli czy też z pomocą drugiej osoby (tab. III. Wnioski: Złe wyniki oceny funkcjonowania chorych na reumatoidalnezapalenie stawów, niezależnie od płci, świadczą o ograniczeniumożliwości wykonywania podstawowych aktywności życiowych.Wiązało się to z bólem stawów, czasem trwania objawu sztywnościporannej oraz słabą siłą mięśniową rąk.

  16. Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.

    Science.gov (United States)

    Liu, Shi; Wu, Yu; Wooten, H Omar; Green, Olga; Archer, Brent; Li, Harold; Yang, Deshan

    2016-03-08

    A software tool is developed, given a new treatment plan, to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in our clinic. The predicted treatment delivery time and the assessment of plan complexities could also be useful to aid treatment planning. A patient's total treatment delivery time, not including time required for localization, is modeled as the sum of four components: 1) the treatment initialization time; 2) the total beam-on time; 3) the gantry rotation time; and 4) the multileaf collimator (MLC) motion time. Each of the four components is predicted separately. The total beam-on time can be calculated using both the planned beam-on time and the decay-corrected dose rate. To predict the remain-ing components, we retrospectively analyzed the patient treatment delivery record files. The initialization time is demonstrated to be random since it depends on the final gantry angle of the previous treatment. Based on modeling the relationships between the gantry rotation angles and the corresponding rotation time, linear regression is applied to predict the gantry rotation time. The MLC motion time is calculated using the leaves delay modeling method and the leaf motion speed. A quantitative analysis was performed to understand the correlation between the total treatment time and the plan complexity. The proposed algorithm is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82%, and the maximal prediction error 0.89 min or 7.88%. The analysis has shown the correlation between the plan modulation (PM) factor and the total treatment delivery time, as well as the treatment delivery duty cycle. A possibility has been identified to significantly reduce MLC motion time by optimizing the positions of closed MLC pairs. The accuracy of

  17. Evaluation of advanced wastewater treatment systems for water reuse in the era of advanced wastewater treatment

    Science.gov (United States)

    Kon, Hisao; Watanabe, Masahiro

    This study focuses on effluent COD concentration from wastewater treatment in regards to the reduction of pathogenic bacteria and trace substances in public waters. The main types of secondary wastewater treatment were conventional activated sludge processes. Recently, however, advance wastewater treatment processes have been developed aimed at the removal of nitrogen and phosphorus, and the effluent quality of these processes was analyzed in this study. Treatment processes for water reclamation that make effluent to meet the target water quality for reuse purposes were selected and also optimum design parameters for these processes were proposed. It was found that the treatment cost to water reclamation was greatly affected by the effluent COD of the secondary treatment. It is important to maintain low COD concentration in the secondary treated effluent. Therefore, it is considered that adequate cost benefits would be obtained by achieving target COD quality through shifting from a conventional activated sludge process to an advanced treatment process.

  18. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... Demand Maintenance of Certification and Lifelong Learning Modules Online CME Pathways ... Treatment Without treatment, a child with ADHD may fall behind in school and continue having trouble with friendships. Family life may also suffer. Untreated ADHD can ...

  19. Advanced wastewater treatment system (SEADS)

    International Nuclear Information System (INIS)

    Dunn, J.

    2002-01-01

    'Full text:' This presentation will describe the nature, scope, and findings of a third-party evaluation of a wastewater treatment technology identified as the Advanced Wastewater Treatment System Inc.'s Superior Extended Aerobic Digester System (SEADS). SEADS is an advanced miniaturized wastewater treatment plant that can meet advanced wastewater treatment standards for effluent public reuse. SEADS goes beyond primary and secondary treatment operations to reduce nutrients such as nitrogen and phosphorus, which are typically found in excessive quantities in traditional wastewater treatment effluent. The objective of this evaluation will be to verify the performance and reliability of the SEADS to treat wastewater from a variety of sources, including domestic wastewater and commercial industrial wastewater. SEADS utilizes remote telemetry equipment to achieve added reliability and reduces monitoring costs as compared to many package wastewater treatment plants. The evaluation process will be overseen and coordinated by the Environmental Technology Evaluation Center (EvTEC), a program of the Civil Engineering Research Foundation (CERF), the research and technology transfer arm of the American Society of Civil Engineers (ASCE). EvTEC is a pilot program evaluating innovative environmental technologies under the US Environmental Protection Agency's (USEPA) Environmental Technology Verification (ETV) Program. Among other performance issues, the SEADS technology evaluation will address its ability to treat low flows-from remote individual and clustered housing applications, and individual commercial applications in lieu of a main station conventional wastewater treatment plant. The unneeded reliance on particular soil types for percolation and the improved effluent water quality over septic systems alone look to make these types of package treatment plants a viable option for rural communities, small farms, and other low-flow remote settings. Added benefits to be examined

  20. Factors Associated with Effectiveness of Treatment and Reproductive Outcomes in Patients with Thin Endometrium Undergoing Estrogen Treatment

    Directory of Open Access Journals (Sweden)

    Si-Miao Liu

    2015-01-01

    Conclusions: Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful (i.e., achieves an EMT ≥8 mm are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.

  1. 40 CFR 35.2101 - Advanced treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Advanced treatment. 35.2101 Section 35... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2101 Advanced treatment. Projects proposing advanced treatment shall be awarded grant assistance only after the project has been...

  2. Internet gaming disorder treatment: a review of definitions of diagnosis and treatment outcome.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H

    2014-10-01

    Internet gaming disorder (IGD) is a new disorder currently positioned in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Few clinical studies report that psychological and pharmacological interventions can significantly reduce the severity of IGD symptomatology. The aim of this review was to assess current knowledge of the short- and long-term benefits of IGD interventions. This review presents a systematic evaluation of definitions of diagnosis and treatment outcomes employed in IGD treatment studies, including an assessment of goodness of fit with the DSM-5 classification. A computer database search of Academic Search Premier, PubMed, PsychINFO, ScienceDirect, Web of Science, and Google Scholar was conducted to identify all available research evidence on Internet gaming disorder treatment (N = 8 studies). Diagnostic and treatment outcome parameters were systematically evaluated. Several weaknesses of IGD treatment literature were identified. Only 2 treatment studies have employed an equivalent method of diagnosis for IGD. Studies have not assessed formative change in diagnostic status at posttreatment or follow-up. Duration of follow-up has been inadequate to assess relapse and remission. Posttreatment assessment has been predominantly limited to IGD symptomatology, comorbidity, and frequency of gaming behavior. Currently, there is insufficient evidence to warrant suggestion that trialled IGD interventions confer a long-term therapeutic benefit. Several improvements to study design and reporting are proposed to guide future studies of IGD. © 2014 Wiley Periodicals, Inc.

  3. Estimation of treatment preference effects in clinical trials when some participants are indifferent to treatment choice

    Directory of Open Access Journals (Sweden)

    Stephen D. Walter

    2017-02-01

    Full Text Available Abstract Background In the two-stage randomised trial design, a randomly sampled subset of study participants are permitted to choose their own treatment, while the remaining participants are randomised to treatment in the usual way. Appropriate analysis of the data from both arms of the study allows investigators to estimate the impact on study outcomes of treatment preferences that patients may have, in addition to evaluating the usual direct effect of treatment. In earlier work, we showed how to optimise this design by making a suitable choice of the proportion of participants who should be assigned to the choice arm of the trial. However, we ignored the possibility of some participants being indifferent to the treatments under study. In this paper, we extend our earlier work to consider the analysis of two-stage randomised trials when some participants have no treatment preference, even if they are assigned to the choice arm and allowed to choose. Methods We compare alternative characterisations of the response profiles of the indifferent or undecided participants, and derive estimates of the treatment and preference effects on study outcomes. We also present corresponding test statistics for these parameters. The methods are illustrated with data from a clinical trial contrasting medical and surgical interventions. Results Expressions are obtained to estimate and test the impact of treatment choices on study outcomes, as well as the impact of the actual treatment received. Contrasts are defined between patients with stated treatment preferences and those with no preference. Alternative assumptions concerning the outcomes of undecided participants are described, and an approach leading to unbiased estimation and testing is identified. Conclusions Use of the two-stage design can provide important insights into determinants of study outcomes that are not identifiable with other designs. The design can remain attractive even in the presence of

  4. Treatment simulation approaches for the estimation of the distributions of treatment quality parameters generated by geometrical uncertainties

    International Nuclear Information System (INIS)

    Baum, C; Alber, M; Birkner, M; Nuesslin, F

    2004-01-01

    Geometric uncertainties arise during treatment planning and treatment and mean that dose-dependent parameters such as EUD are random variables with a patient specific probability distribution. Treatment planning with highly conformal treatment techniques such as intensity modulated radiation therapy requires new evaluation tools which allow us to estimate this influence of geometrical uncertainties on the probable treatment dose for a planned dose distribution. Monte Carlo simulations of treatment courses with recalculation of the dose according to the daily geometric errors are a gold standard for such an evaluation. Distribution histograms which show the relative frequency of a treatment quality parameter in the treatment simulations can be used to evaluate the potential risks and chances of a planned dose distribution. As treatment simulations with dose recalculation are very time consuming for sufficient statistical accuracy, it is proposed to do treatment simulations in the dose parameter space where the result is mainly determined by the systematic and random component of the geometrical uncertainties. Comparison of the parameter space simulation method with the gold standard for prostate cases and a head and neck case shows good agreement as long as the number of fractions is high enough and the influence of tissue inhomogeneities and surface curvature on the dose is small

  5. Treatment progress of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Dou Kou

    2016-05-01

    Full Text Available Diabetic retinopathy(DR,which can cause blindness, is a serious eye diseases. Diabetic macular edema(DME, often causes irreversible vision loss, can occur in any period of DR. The treatment of DME, including laser photocoagulation, anti-inflammatory therapy, anti-VEGF therapy and surgical treatment have made great progress in recent years as the researches on the pathogenesis deepening. The innovation of minimally invasive technique also proved the surgical treatment more convenience. The joint application of a variety of treatments, also become the main trend of treatment. A review of the present status and progress of the treatment was made in this paper.

  6. The challenges of amblyopia treatment

    Directory of Open Access Journals (Sweden)

    Gail D.E. Maconachie

    2015-12-01

    Full Text Available The treatment of amblyopia, particularly anisometropic (difference in refractive correction and/or strabismic (turn of one eye amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report.

  7. Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

    2012-01-01

    Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

  8. 40 CFR 133.102 - Secondary treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Secondary treatment. 133.102 Section... TREATMENT REGULATION § 133.102 Secondary treatment. The following paragraphs describe the minimum level of effluent quality attainable by secondary treatment in terms of the parameters—BOD5, SS and pH. All...

  9. Current obesity drug treatment

    Directory of Open Access Journals (Sweden)

    Marcio C. Mancini

    2006-03-01

    Full Text Available Pharmacological treatment of obesity is an area of sudden changes,development of new drugs and treatment propositions. This articlepresents information on physiological agents that are currentlybeing used as well as drugs that were widely used but are nomore available.

  10. Treatment strategies in mastocytosis

    DEFF Research Database (Denmark)

    Siebenhaar, Frank; Akin, Cem; Bindslev-Jensen, Carsten

    2014-01-01

    Treatment recommendations for mastocytosis are based mostly on expert opinion rather than evidence obtained from controlled clinical trials. In this article, treatment options for mastocytosis are presented, with a focus on the control of mediator-related symptoms in patients with indolent disease....

  11. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.Results: Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency...... frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes.......Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...

  12. Treatment of personality disorder.

    Science.gov (United States)

    Bateman, Anthony W; Gunderson, John; Mulder, Roger

    2015-02-21

    The evidence base for the effective treatment of personality disorders is insufficient. Most of the existing evidence on personality disorder is for the treatment of borderline personality disorder, but even this is limited by the small sample sizes and short follow-up in clinical trials, the wide range of core outcome measures used by studies, and poor control of coexisting psychopathology. Psychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions. The synergistic or antagonistic interaction of psychotherapies and drugs for treating personality disorder should be studied in conjunction with their mechanisms of change throughout the development of each. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Factors affecting ionizing radiation phytosanitary treatments, and implications for research and generic treatments

    Science.gov (United States)

    Phytosanitary irradiation (PI) treatments are promising measures to overcome quarantine barriers to trade and are currently used in several countries. Although PI has advantages compared with other treatments, one disadvantage bedevils research approval/application: organisms may remain alive afte...

  14. Fate of oestrogens during anaerobic blackwater treatment with micro-aerobic post-treatment

    NARCIS (Netherlands)

    Mes, de T.Z.D.; Kujawa-Roeleveld, K.; Zeeman, G.; Lettinga, G.

    2007-01-01

    The fate of oestrone (E1), 17b-oestradiol (E2) and 17a-ethynyloestradiol (EE2) was investigated in a concentrated blackwater treatment system consisting of an UASB septic tank, with micro-aerobic post-treatment. In UASB septic tank effluent a (natural) total concentration of 4.02 mg/L E1 and 18.69

  15. Percutaneous treatment of liver hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan; Oezmen, Mustafa N

    1999-10-01

    Hydatic disease caused by Echinococcus granulosus is an endemic disease and an important public health problem in some countries of the world. The results of surgical treatment are associated with a high rate of mortality, morbidity, postoperative recurrence and a long period of hospital stay and the medical treatment results are still controversial. Although the percutaneous aspiration and treatment of liver hydatid cysts were considered to be contraindicated due to risks of anaphylactic shock and dissemination of clear-crystal fluid into the abdomen, several reports of successful percutaneous treatment of liver hydatid cysts have been published in the literature. Today, percutaneous treatment of liver hydatid cysts is the most effective and reliable treatment procedure in the selected cases. In this review, indications, contraindications, method and techniques, healing criteria, complications, results and importance of the percutaneous treatment of liver hydatid cysts are discussed.

  16. Percutaneous treatment of liver hydatid cysts

    International Nuclear Information System (INIS)

    Akhan, Okan; Oezmen, Mustafa N.

    1999-01-01

    Hydatic disease caused by Echinococcus granulosus is an endemic disease and an important public health problem in some countries of the world. The results of surgical treatment are associated with a high rate of mortality, morbidity, postoperative recurrence and a long period of hospital stay and the medical treatment results are still controversial. Although the percutaneous aspiration and treatment of liver hydatid cysts were considered to be contraindicated due to risks of anaphylactic shock and dissemination of clear-crystal fluid into the abdomen, several reports of successful percutaneous treatment of liver hydatid cysts have been published in the literature. Today, percutaneous treatment of liver hydatid cysts is the most effective and reliable treatment procedure in the selected cases. In this review, indications, contraindications, method and techniques, healing criteria, complications, results and importance of the percutaneous treatment of liver hydatid cysts are discussed

  17. Treatment Options for Extrahepatic Bile Duct Cancer

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with bile duct cancer. Different types of treatments are available ...

  18. Treatment Option Overview (Extrahepatic Bile Duct Cancer)

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with bile duct cancer. Different types of treatments are available ...

  19. Treatment goals in psoriasis routine care.

    Science.gov (United States)

    Radtke, M A; Reich, K; Spehr, C; Augustin, Matthias

    2015-07-01

    The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.

  20. In-treatment cigarette demand among treatment-seeking smokers with depressive symptoms.

    Science.gov (United States)

    Weidberg, S; Vallejo-Seco, G; González-Roz, A; García-Pérez, Á; Secades-Villa, R

    2018-07-01

    Despite previous evidence supporting the use of the Cigarette Purchase Task (CPT) as a valid tool for assessing smoking reinforcement, research assessing how environmental changes affect CPT performance is scarce. This study addressed for the first time the differential effect of treatment condition [Cognitive Behavioral Treatment (CBT) + Behavioral Activation (BA) versus CBT + BA + Contingency Management (CM)] on cigarette demand among treatment seeking smokers with depressive symptoms. It also sought to assess whether reductions in smoking consumption arranged over the course of an intervention for smoking cessation impact on in-treatment cigarette demand. Participants were 92 smokers with depressive symptoms from a randomized clinical trial that received eight weeks of either CBT + BA or CBT + BA + CM. Individuals completed the CPT 8 times; the first during the intake visit and the remaining 7 scheduled once a week in midweek sessions. Cotinine samples were collected in each session. Participants receiving CBT + BA + CM showed higher reduction in cigarette demand across sessions than participants receiving CBT + BA, although this comparison was only significant for the intensity index (p = .004). Cotinine was positively related to cigarette demand (all p values demand reductions (all p values demand. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Dengue fever: diagnosis and treatment.

    Science.gov (United States)

    Wiwanitkit, Viroj

    2010-07-01

    Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

  2. Getting Treatment for ADHD

    Medline Plus

    Full Text Available ... They also have higher rates of cigarette and drug addiction, and more driving infractions. The good news is that effective treatment is available . With the right medical treatment, children ... and develop new drugs for ADHD. It is important to confer with ...

  3. [Esthetic treatment of varicosities].

    Science.gov (United States)

    Vin, F

    2000-06-01

    Telangiectasia is dilatation of the subpapillary venous plexus of the epidermis of the lower limbs, which can lead to aesthetic embarrassment. Before treating telangiectasia, patient history and clinical examination help establishing its origin. It can be with isolated, associated reticular drainage veins, or be part of superficial venous insufficiency. Several types of treatment have been proposed. Microsclerotherapy is the most effective and least costly. Muller's phlebectomy can be performed when telangiectasia is fed by large reticular veins, either afferent or efferent. Treatment by laser and pulsed light appear best reserved to treatment of finer venous dilatations, either complementary or after failure of sclerotherapy.

  4. [Treatment of selective mutism].

    Science.gov (United States)

    Melfsen, Siebke; Warnke, Andreas

    2007-11-01

    Selective mutism is a communication disorder of childhood in which the child does not speak in specific social situations despite the ability to speak in other situations. A literature review was completed in order to provide practical guidelines for the assessment and treatment of children with selective mutism. There are many different behavioral approaches in the treatment of this disorder, e.g. contingency management, shaping, stimulus fading, escape-avoidance, self-modeling, learning theory approaches. A clearer diagnostic understanding of the disorder as part of anxiety or oppositional disorders needs to be realized prior to generalize an effective treatment for this disorder.

  5. WASTE TREATMENT BUILDING SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    F. Habashi

    2000-06-22

    The Waste Treatment Building System provides the space, layout, structures, and embedded subsystems that support the processing of low-level liquid and solid radioactive waste generated within the Monitored Geologic Repository (MGR). The activities conducted in the Waste Treatment Building include sorting, volume reduction, and packaging of dry waste, and collecting, processing, solidification, and packaging of liquid waste. The Waste Treatment Building System is located on the surface within the protected area of the MGR. The Waste Treatment Building System helps maintain a suitable environment for the waste processing and protects the systems within the Waste Treatment Building (WTB) from most of the natural and induced environments. The WTB also confines contaminants and provides radiological protection to personnel. In addition to the waste processing operations, the Waste Treatment Building System provides space and layout for staging of packaged waste for shipment, industrial and radiological safety systems, control and monitoring of operations, safeguards and security systems, and fire protection, ventilation and utilities systems. The Waste Treatment Building System also provides the required space and layout for maintenance activities, tool storage, and administrative facilities. The Waste Treatment Building System integrates waste processing systems within its protective structure to support the throughput rates established for the MGR. The Waste Treatment Building System also provides shielding, layout, and other design features to help limit personnel radiation exposures to levels which are as low as is reasonably achievable (ALARA). The Waste Treatment Building System interfaces with the Site Generated Radiological Waste Handling System, and with other MGR systems that support the waste processing operations. The Waste Treatment Building System interfaces with the General Site Transportation System, Site Communications System, Site Water System, MGR

  6. WASTE TREATMENT BUILDING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    Habashi, F.

    2000-01-01

    The Waste Treatment Building System provides the space, layout, structures, and embedded subsystems that support the processing of low-level liquid and solid radioactive waste generated within the Monitored Geologic Repository (MGR). The activities conducted in the Waste Treatment Building include sorting, volume reduction, and packaging of dry waste, and collecting, processing, solidification, and packaging of liquid waste. The Waste Treatment Building System is located on the surface within the protected area of the MGR. The Waste Treatment Building System helps maintain a suitable environment for the waste processing and protects the systems within the Waste Treatment Building (WTB) from most of the natural and induced environments. The WTB also confines contaminants and provides radiological protection to personnel. In addition to the waste processing operations, the Waste Treatment Building System provides space and layout for staging of packaged waste for shipment, industrial and radiological safety systems, control and monitoring of operations, safeguards and security systems, and fire protection, ventilation and utilities systems. The Waste Treatment Building System also provides the required space and layout for maintenance activities, tool storage, and administrative facilities. The Waste Treatment Building System integrates waste processing systems within its protective structure to support the throughput rates established for the MGR. The Waste Treatment Building System also provides shielding, layout, and other design features to help limit personnel radiation exposures to levels which are as low as is reasonably achievable (ALARA). The Waste Treatment Building System interfaces with the Site Generated Radiological Waste Handling System, and with other MGR systems that support the waste processing operations. The Waste Treatment Building System interfaces with the General Site Transportation System, Site Communications System, Site Water System, MGR

  7. Modeling Hepatitis C treatment policy.

    Energy Technology Data Exchange (ETDEWEB)

    Kuypers, Marshall A.; Lambert, Gregory Joseph; Moore, Thomas W.; Glass, Robert John,; Finley, Patrick D.; Ross, David; Chartier, Maggie

    2013-09-01

    Chronic infection with Hepatitis C virus (HCV) results in cirrhosis, liver cancer and death. As the nations largest provider of care for HCV, US Veterans Health Administration (VHA) invests extensive resources in the diagnosis and treatment of the disease. This report documents modeling and analysis of HCV treatment dynamics performed for the VHA aimed at improving service delivery efficiency. System dynamics modeling of disease treatment demonstrated the benefits of early detection and the role of comorbidities in disease progress and patient mortality. Preliminary modeling showed that adherence to rigorous treatment protocols is a primary determinant of treatment success. In depth meta-analysis revealed correlations of adherence and various psycho-social factors. This initial meta-analysis indicates areas where substantial improvement in patient outcomes can potentially result from VA programs which incorporate these factors into their design.

  8. Psychological Treatments for Binge Eating Disorder

    Science.gov (United States)

    Gredysa, Dana M.; Altman, Myra; Wilfley, Denise E.

    2012-01-01

    Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy. Predictors and moderators of treatment response, such as weight and shape concerns, are highlighted and a stepped-care model proposed. Future directions include expanding the adoption of efficacious treatments in clinical practice, testing adapted treatments in diverse samples (e.g., minorities and youth), improving treatment outcomes for nonresponders, and developing efficient and cost-effective stepped-care models. PMID:22707016

  9. [Conservative treatment of hyperthyroidism (author's transl)].

    Science.gov (United States)

    Schumm, P M; Usadel, K H; Schulz, F; Schumann, J; Schöffling, K

    1981-01-09

    Antithyroid medication was given to 158 patients with hyperthyroidism over a period of 3 to 60 months. After cessation of therapy patients were followed up for 18 to 90 months. Permanent euthyroidism was seen in 70 patients (44.3%) after stopping treatment, however, 88 patients (55.7%) showed recurrence of hyperthyroidism occurring 1 to 56 months after ceasing treatment. In more than 50% recurrence of hyperthyroidism was within the first 3 months and in almost 80% within the first year after end of treatment. There was no connection either between the length of thyrostatic treatment and the recurrence rate or between the length of treatment and recurrence time. Comparison of patients with and without recurrence according to various parameters prior, during and after thyrostatic treatment indicates that there is a high risk of recurrence in patients with 1) nodular and (or) large goitres, 2) marked clinical symptomatology and delayed attainment of a euthyroid state after starting conservative treatment, and 3) the symptom of sweating remaining uninfluenced by antithyroid treatment.

  10. Treatment of Dry Eye Disease.

    Science.gov (United States)

    Marshall, Leisa L; Roach, J Michael

    2016-02-01

    Review of the etiology, clinical manifestations, and treatment of dry eye disease (DED). Articles indexed in PubMed (National Library of Medicine), Iowa Drug Information Service (IDIS), and the Cochrane Reviews and Trials in the last 10 years using the key words "dry eye disease," "dry eye syndrome," "dry eye and treatment." Primary sources were used to locate additional resources. Sixty-eight publications were reviewed, and criteria supporting the primary objective were used to identify useful resources. The literature included practice guidelines, book chapters, review articles, original research articles, and product prescribing information for the etiology, clinical manifestations, diagnosis, and treatment of DED. DED is one of the most common ophthalmic disorders. Signs and symptoms of DED vary by patient, but may include ocular irritation, redness, itching, photosensitivity, visual blurring, mucous discharge, and decreased tear meniscus or break-up time. Symptoms improve with treatment, but the condition is not completely curable. Treatment includes reducing environmental causes, discontinuing medications that cause or worsen dry eye, and managing contributing ocular or systemic conditions. Most patients use nonprescription tear substitutes, and if these are not sufficient, other treatment is prescribed. These treatments include the ophthalmic anti-inflammatory agent cyclosporine, punctal occlusion, eye side shields, systemic cholinergic agents, and autologous serum tears. This article reviews the etiology, symptoms, and current therapy for DED.

  11. Endodontic treatment in geriatric patients

    Directory of Open Access Journals (Sweden)

    Milly Armilya Andang

    2007-11-01

    Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

  12. Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media.

    Science.gov (United States)

    Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George

    2008-01-01

    Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

  13. Treatment of gonorrhoea in Auckland, New Zealand: marked variation in prescriber adherence to treatment guidelines.

    Science.gov (United States)

    Forster, Rose; Ng, Diana; Upton, Arlo; Franklin, Rick; Thomas, Mark

    2017-06-01

    The relentless emergence and spread of strains of Neisseria gonorrhoeae that are resistant to many antimicrobial agents has led to frequent changes in treatment guidelines, with a consequent risk that prescribers may not be aware of current guidelines. To determine the proportion of patients with gonorrhoea who were treated with a regimen consistent with the New Zealand Sexual Health Society (NZSHS) guidelines. We audited the treatment given to adult patients with laboratory-proven gonorrhoea in Auckland, New Zealand, during the first 6 months of 2015. Treatment compliant with the current NZSHS guidelines was administered in only 65% (458/706) episodes overall. Guideline-compliant treatment was much more likely to be prescribed for patients who presented to a sexual health clinic (89%) than for patients who presented to either a general practice or other community clinic (52%) or to a hospital (56%) (P Auckland region. Improved compliance with treatment guidelines, particularly in patients who present either to general practice or to hospitals, is necessary to maintain the efficacy of current treatment regimens. © 2017 Royal Australasian College of Physicians.

  14. Sperm Cryopreservation before Testicular Cancer Treatment and Its Subsequent Utilization for the Treatment of Infertility

    Directory of Open Access Journals (Sweden)

    Jana Žáková

    2014-01-01

    Full Text Available Aims. In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. Methods. Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5% was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. Results. A total of 557 men have decided to freeze their semen before cancer treatment. Azoospermia was diagnosed in 34 men (6.1%, and semen was cryopreserved in 532 patients. Seminoma was diagnosed in 283 men (54.1% and nonseminomatous germ cell tumors in 240 men (45.9%. 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8% pregnancy rate. Conclusion. The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.

  15. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

    Science.gov (United States)

    Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

    2017-03-01

    One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Treatment of painful diabetic peripheral neuropathy.

    Science.gov (United States)

    Rosenberg, Casandra J; Watson, James C

    2015-02-01

    Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. To discuss current treatment recommendations for painful diabetic peripheral neuropathy. Literature review. Systematic review of the literature discussing treatment of painful diabetic peripheral neuropathy. Existing treatment guidelines were studied and compared. Painful diabetic peripheral neuropathy occurs in about one in six people with diabetes. This condition impairs quality of life and increases healthcare costs. Treatment recommendations exist, but individual patient therapy can require a trial-and-error approach. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. Adequate medication titration and a reasonable trial period should be allowed. The treatment of painful diabetic peripheral neuropathy can be challenging, but effective management can improve patient's quality of life. Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. © The International Society for Prosthetics and Orthotics 2014.

  17. Treatment planning optimization for linear accelerator radiosurgery

    International Nuclear Information System (INIS)

    Meeks, Sanford L.; Buatti, John M.; Bova, Francis J.; Friedman, William A.; Mendenhall, William M.

    1998-01-01

    Purpose: Linear accelerator radiosurgery uses multiple arcs delivered through circular collimators to produce a nominally spherical dose distribution. Production of dose distributions that conform to irregular lesions or conformally avoid critical neural structures requires a detailed understanding of the available treatment planning parameters. Methods and Materials: Treatment planning parameters that may be manipulated within a single isocenter to provide conformal avoidance and dose conformation to ellipsoidal lesions include differential arc weighting and gantry start/stop angles. More irregular lesions require the use of multiple isocenters. Iterative manipulation of treatment planning variables can be difficult and computationally expensive, especially if the effects of these manipulations are not well defined. Effects of treatment parameter manipulation are explained and illustrated. This is followed by description of the University of Florida Stereotactic Radiosurgery Treatment Planning Algorithm. This algorithm organizes the manipulations into a practical approach for radiosurgery treatment planning. Results: Iterative treatment planning parameters may be efficiently manipulated to achieve optimal treatment plans by following the University of Florida Treatment Planning Algorithm. The ability to produce conformal stereotactic treatment plans using the algorithm is demonstrated for a variety of clinical presentations. Conclusion: The standard dose distribution produced in linear accelerator radiosurgery is spherical, but manipulation of available treatment planning parameters may result in optimal dose conformation. The University of Florida Treatment Planning Algorithm organizes available treatment parameters to efficiently produce conformal radiosurgery treatment plans

  18. Process waste treatment system upgrades: Clarifier startup at the nonradiological wastewater treatment plant

    International Nuclear Information System (INIS)

    Lucero, A.J.; McTaggart, D.R.; Van Essen, D.C.; Kent, T.E.; West, G.D.; Taylor, P.A.

    1998-07-01

    The Waste Management Operations Division at Oak Ridge National Laboratory recently modified the design of a reactor/clarifier at the Nonradiological Wastewater Treatment Plant, which is now referred to as the Process Waste Treatment Complex--Building 3608, to replace the sludge-blanket softener/clarifier at the Process Waste Treatment Plant, now referred to as the Process Waste Treatment Complex-Building 3544 (PWTC-3544). This work was conducted because periodic hydraulic overloads caused poor water-softening performance in the PWTC-3544 softener, which was detrimental to the performance and operating costs of downstream ion-exchange operations. Over a 2-month time frame, the modified reactor/clarifier was tested with nonradiological wastewater and then with radioactive wastewater to optimize softening performance. Based on performance to date, the new system has operated more effectively than the former one, with reduced employee radiological exposure, less downtime, lower costs, and improved effluent quality

  19. Treatment Option Overview (Chronic Myelogenous Leukemia)

    Science.gov (United States)

    ... ALL Treatment Childhood AML Treatment Research Chronic Myelogenous Leukemia Treatment (PDQ®)–Patient Version General Information About Chronic Myelogenous Leukemia Go to Health Professional Version Key Points Chronic ...

  20. [Relevance between expectations before treatment, new symptoms and satisfaction after treatment in patients with pelvic organ prolapse].

    Science.gov (United States)

    Wang, Yu; Han, Jinsong; Zhang, Kun; Zhu, Fuli; Yang, Junfang; Wang, Yiting

    2015-09-01

    To investigate the relevance between expectations before treatment, new symptoms and satisfaction after treatment of the pelvic organ prolapse (POP) patients. Made a collection of 75 cases of POP patients at Peking University Third Hospital, who were affected by the POP symptoms and came to our clinic for treatment from January to December in 2013. Prospectively investigate the patients' expectations before treatment, which were the most troubling symptoms to be solved. According to treatment we divided the patients into surgery and pessary groups. Two groups were followed up with the degree to achieve the desired goals using patient global impression of improvement (PGI-I), new symptoms and satisfaction after treatment, try to find the relevance between expectations before treatment, new symptoms and satisfaction after treatment. There were 47 (63%, 47/75) patients in the surgical group and 28 (37%, 28/75) patients in the pessary group. The top three problems for patients were friction when walking (25%, 19/75), dysuria (23%, 17/75) and the feeling of vaginal prolapse (19%, 14/75). The follow-up rate was of 93% (70/75), follow-up time was (5 ± 4) months. Satisfaction score after treatment of surgical group was higher than that of pessary group [(4.9 ± 0.4) versus (4.0 ± 1.3) scores, P satisfaction scores was relevant (P = 0.021). The availability of new symptoms and satisfaction scores was relevant (P = 0.001). When achieving higher expectations to the treatment and no more new symptoms, the satisfaction score after treatment is higher.

  1. Treatment of Olive Mill Wastewater and the Use of Polyphenols Obtained After Treatment

    Directory of Open Access Journals (Sweden)

    Semih Otles

    2012-04-01

    Full Text Available Olive mill wastes are signicant environmental problem especially in Mediterranean areas where they are generated in huge quantities in a short period of time. They are phytotoxic materials because of their high phenol, lipid and organic acid concentrations, but these wastes also contain valuable resources that could be recycled such as a large proportion of organic matter and a wide range of nutrients. The effluent from olive oil mills contains a large amount of polyphenols that have antioxidant properties. The market value of these antioxidants is high and they are commonly used in the food, cosmetics, pharmaceutics and chemical industries. For the management of olive mill wastewater (OMW and other olive residues, various treatment methods can be used. Many scientists work on more efficient and cheaper treatment alternatives. Due to the great variety of compounds in the waste, several technologies to remove the harmful compounds for the environment should be used single or together. Some of the most used OMW treatments are drying / evaporation, forced evaporation, thermal treatment, centrifugation-ultraltration, electrocoagulation, composting, lagooning, adsorption, powdered activated carbon, filtration, sand filtration, membrane filtration, ultrafiltration, precipitation / flocculation, distillation, electrolysis, co-composting, advanced oxidation processes (AOPs such as ozonation, hydrogen peroxide / ferrous iron oxidation (the so-called Fentons reagent. Several OMW treatment technologies have been developed aiming at the removal of the main toxic organic compounds. A lot of factors must be considered to choose the treatment methods among them the investment, required area, specic training of the workers, noise and odour emissions and seasonality of production.

  2. Online Adaptive Hyperthermia Treatment Planning During Locoregional Heating to Suppress Treatment-Limiting Hot Spots.

    Science.gov (United States)

    Kok, H Petra; Korshuize-van Straten, Linda; Bakker, Akke; de Kroon-Oldenhof, Rianne; Geijsen, Elisabeth D; Stalpers, Lukas J A; Crezee, Johannes

    2017-11-15

    Adequate tumor temperatures during hyperthermia are essential for good clinical response, but excessive heating of normal tissue should be avoided. This makes locoregional heating using phased array systems technically challenging. Online application of hyperthermia treatment planning could help to improve the heating quality. The aim of this study was to evaluate the clinical benefit of online treatment planning during treatment of pelvic tumors heated with the AMC-8 locoregional hyperthermia system. For online adaptive hyperthermia treatment planning, a graphical user interface was developed. Electric fields were calculated in a preprocessing step using our in-house-developed finite-difference-based treatment planning system. This allows instant calculation of the temperature distribution for user-selected phase-amplitude settings during treatment and projection onto the patient's computed tomographic scan for online visualization. Online treatment planning was used for 14 treatment sessions in 8 patients to reduce the patients' reports of hot spots while maintaining the same level of tumor heating. The predicted decrease in hot spot temperature should be at least 0.5°C, and the tumor temperature should decrease less than 0.2°C. These predictions were compared with clinical data: patient feedback about the hot spot and temperature measurements in the tumor region. In total, 17 hot spot reports occurred during the 14 sessions, and the alternative settings predicted the hot spot temperature to decrease by at least 0.5°C, which was confirmed by the disappearance of all 17 hot spot reports. At the same time, the average tumor temperature was predicted to change on average -0.01°C (range, -0.19°C to 0.34°C). The measured tumor temperature change was on average only -0.02°C (range, -0.26°C to 0.31°C). In only 2 cases the temperature decrease was slightly larger than 0.2°C, but at most it was 0.26°C. Online application of hyperthermia treatment planning is

  3. Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

    Science.gov (United States)

    Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

    2017-09-01

    Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional

  4. Processes underlying treatment success and failure in assertive community treatment.

    Science.gov (United States)

    Stull, Laura G; McGrew, John H; Salyers, Michelle P

    2012-02-01

    Processes underlying success and failure in assertive community treatment (ACT), a widely investigated treatment model for persons with severe mental illness, are poorly understood. The purpose of the current study was to examine processes in ACT by (1) understanding how consumers and staff describe the processes underlying treatment success and failure and (2) comparing processes identified by staff and consumers. Investigators conducted semi-structured interviews with 25 staff and 23 consumers from four ACT teams. Both staff and consumers identified aspects of the ACT team itself as the most critical in the process of consumer success. For failure, consumers identified consumer characteristics as most critical and staff identified lack of social relationships. Processes underlying failure were not viewed as merely the opposite of processes underlying success. In addition, there was notable disagreement between staff and consumers on important processes. Findings overlap with critical ingredients identified in previous studies, including aspects of the ACT team, social involvement and employment. In contrast to prior studies, there was little emphasis on hospitalizations and greater emphasis on not abusing substances, obtaining wants and desires, and consumer characteristics.

  5. Treatment of cachexia in oncology

    Directory of Open Access Journals (Sweden)

    E M Tazi

    2010-01-01

    Full Text Available Background: Cachexia is a complex metabolic syndrome associated with many chronic or end-stage diseases, especially cancer, and is characterized by loss of muscle with or without loss of fat mass. The management of cachexia is a complex challenge that should address the different causes underlying this clinical event with an integrated or multimodal treatment approach targeting the different factors involved in its pathophysiology. Aims and Objectives : The purpose of this article was to review the current medical treatment of cancer-related cachexia, in particular focusing on combination therapy and ongoing research. Results : Among the treatments proposed in the literature for cancer-related cachexia, some proved to be ineffective, namely, cyproheptadine, hydrazine, metoclopramide, and pentoxifylline. Among effective treatments, progestagens are currently considered the best available treatment option for cancer-related cachexia, and they are the only drugs approved in Europe. Drugs with a strong rationale that have failed or have not shown univocal results in clinical trials so far include eicosapentaenoic acid, cannabinoids, bortezomib, and anti-TNF-alpha MoAb. Several emerging drugs have shown promising results but are still under clinical investigation (thalidomide, selective cox-2 inhibitors, ghrelin mimetics, insulin, oxandrolone, and olanzapine. Conclusions : To date, despite several years of coordinated efforts in basic and clinical research, practice guidelines for the prevention and treatment of cancer-related muscle wasting are lacking, mainly because of the multifactorial pathogenesis of the syndrome. From all the data presented, one can speculate that one single therapy may not be completely successful in the treatment of cachexia. From this point of view, treatments involving different combinations are more likely to be successful.

  6. Treatment of Established Status Epilepticus.

    Science.gov (United States)

    Falco-Walter, Jessica J; Bleck, Thomas

    2016-04-25

    Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early status epilepticus, treatment after benzodiazepine failure (established status epilepticus (ESE)) is incompletely studied. Effective treatment of ESE is critical as morbidity and mortality increases dramatically the longer convulsive status epilepticus persists. Phenytoin/fosphenytoin, valproic acid, levetiracetam, phenobarbital, and lacosamide are the most frequently prescribed antiseizure medications for treatment of ESE. To date there are no class 1 data to support pharmacologic recommendations of one agent over another. We review each of these medications, their pharmacology, the scientific evidence in support and against each in the available literature, adverse effects and safety profiles, dosing recommendations, and limitations of the available evidence. We also discuss future directions including the established status epilepticus treatment trial (ESETT). Substantial further research is urgently needed to identify these patients (particularly those with non-convulsive status epilepticus), elucidate the most efficacious antiseizure treatment with head-to-head randomized prospective trials, and determine whether this differs for convulsive vs. non-convulsive ESE.

  7. The challenges of amblyopia treatment.

    Science.gov (United States)

    Maconachie, Gail D E; Gottlob, Irene

    2015-12-01

    The treatment of amblyopia, particularly anisometropic (difference in refractive correction) and/or strabismic (turn of one eye) amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  8. The Treatment of Neuromyelitis Optica

    Science.gov (United States)

    Kowarik, Markus C.; Soltys, John; Bennett, Jeffrey L.

    2014-01-01

    Neuromyelitis optica (NMO) is an autoimmune disorder of the central nervous system directed against astrocytes. Initially diagnosed in individuals with monophasic or relapsing optic neuritis and transverse myelitis, NMO is now recognized as a demyelinating disorder with pleiotropic presentations due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 in the majority of individuals. As visual impairment and neurologic dysfunction in NMO are commonly severe, aggressive treatment of relapses and prophylactic immunomodulatory therapy are the focus of treatment. Although there are no approved treatments for NMO, medications and therapeutic interventions for acute and chronic treatment have been the subject of retrospective study and case reports. The goal of this review is to familiarize the reader with biologic and clinical data supporting current treatments in NMO and highlight future strategies based on advancements in our understanding of NMO pathogenesis. PMID:24531318

  9. TB treatment in a chronic complex emergency: treatment outcomes and experiences in Somalia.

    Science.gov (United States)

    Liddle, Karin Fischer; Elema, Riekje; Thi, Sein Sein; Greig, Jane; Venis, Sarah

    2013-11-01

    Médecins Sans Frontières (MSF) provides TB treatment in Galkayo and Marere in Somalia. MSF international supervisory staff withdrew in 2008 owing to insecurity but maintained daily communication with Somali staff. In this paper, we aimed to assess the feasibility of treating TB in a complex emergency setting and describe the programme adaptations implemented to facilitate acceptable treatment outcomes. Routinely collected treatment data from 2005-2012 were retrospectively analysed. In multivariate analyses, factors associated with successful outcome (cure or completion versus failure, death and default) were assessed, including the presence of international supervisory staff. Informal interviews were conducted with Somali staff regarding programmatic factors affecting patient management and perceived reasons for default. In total, 6167 patients were admitted (34.8% female; median age 24.0 years [IQR 13.0-38.0 years]). Treatment success was 79% (programme range 69-87%). Presence of international staff did not improve outcomes (adjusted OR 0.85, 95% CI 0.66-1.09; p=0.27). Perceived reasons for default included being away from family, nomadic group, insecurity, travel cost, need to return to grazing land or feeling better. Despite the challenges, a high percentage of patients were successfully treated. Treatment outcomes were not adversely affected by withdrawal of international supervisory staff.

  10. Impact of pre-treatment technologies on soil aquifer treatment

    Directory of Open Access Journals (Sweden)

    A. Besançon

    2017-03-01

    Full Text Available This study investigates the impact of pre-treatment options on the performances of soil columns simulating soil aquifer treatment (SAT. For this purpose a conventional activated sludge (CAS process, a membrane bioreactor (MBR and vertical flow reed beds were used as single units or in combination before SAT. The influent and effluent from each treatment train were monitored over three successive 6-month periods, corresponding to changes in the operational conditions of the MBR and CAS units from 6 days' sludge retention time (SRT to 12 and 20 days. All the columns acted as efficient polishing steps for solids and bacteria. The column receiving effluent from the CAS system running at 6 days' SRT also presented high total nitrogen and total phosphorus removals, but this column was also associated with the lowest infiltration rates over that period. While the quality of the effluent from the column following the CAS process increased over 18 months of operation, the effluent quality of the columns receiving MBR effluent degraded. No correlations were found between variations in SRT of the MBR and CAS processes and the columns' performances. Overall, all columns, except the one receiving CAS effluent, underwent a reduction in infiltration rate over 18 months.

  11. Effectiveness of a pre-treatment snack on the uptake of mass treatment for schistosomiasis in Uganda

    DEFF Research Database (Denmark)

    Muhumuza, Simon; Olsen, Annette; Katahoire, Anne

    2014-01-01

    -treatment snack on uptake of mass treatment.Methods and Findings:In a cluster randomized trial carried out in Jinja district, Uganda, 12 primary schools were randomized into two groups; one received education messages for schistosomiasis prevention for two months prior to mass treatment, while the other......, in addition to the education messages, received a pre-treatment snack shortly before mass treatment. Four weeks after mass treatment, uptake of praziquantel was assessed among a random sample of 595 children in the snack schools and 689 children in the non-snack schools as the primary outcome. The occurrence...... of side effects and the prevalence and mean intensity of Schistosoma mansoni infection were determined as the secondary outcomes. Uptake of praziquantel was higher in the snack schools, 93.9% (95% CI 91.7%-95.7%), compared to that in the non-snack schools, 78.7% (95% CI 75.4%-81.7%) (p = 0...

  12. [Diagnostics and treatment of phenylketonuria].

    Science.gov (United States)

    Bayat, Allan; Møller, Libeth Birk; Lund, Allan Meldgaard

    2015-02-16

    Primary phenylalanine hydroxylase deficiency, also known as phenylketonuria, results in accumulation of phenylalanine in the blood. Early identification and treatment prevents the majority of clinical sequelae to the disease, but psychological and neurodevelopmental problems can occur in some patients. This article reviews the symptoms, diagnosis, classification and strategies of treatment and management of phenylketonuria. Finally we review new pharmacological and non-pharmaco-logical means of treatment.

  13. Treatment Strategies for Chronic Cases

    Directory of Open Access Journals (Sweden)

    Susan M Lord

    2003-01-01

    Full Text Available The treatment of chronic somatic pain, including pain referred to the head, neck, shoulder girdle and upper limb from somatic structures, is addressed. Levels of evidence for the various treatments that have been prescribed for chronic whiplash associated disorders are considered. The challenge to find a treatment strategy for chronic pain after whiplash that completely relieves the condition and prevents its sequelae is reviewed.

  14. Radioiodine treatment for malignant thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-12-15

    Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

  15. The Hybrid Treatment Process for treatment of mixed radioactive and hazardous wastes

    International Nuclear Information System (INIS)

    Ross, W.A.; Kindle, C.H.

    1992-04-01

    This paper describes a new process for treating mixed hazardous and radioactive waste, commonly called mixed waste. The process is called the Hybrid Treatment Process (HTP), so named because it is built on the 20 years of experience with vitrification of wastes in melters, and the 12 years of experience with treatment of wastes by the in situ vitrification (ISV) process

  16. Assessment and Treatment of Pain during Treatment of Buruli Ulcer.

    Directory of Open Access Journals (Sweden)

    Janine de Zeeuw

    Full Text Available Buruli ulcer (BU is described as a relatively painless condition; however clinical observations reveal that patients do experience pain during their treatment. Knowledge on current pain assessment and treatment in BU is necessary to develop and implement a future guideline on pain management in BU.A mixed methods approach was used, consisting of information retrieved from medical records on prescribed pain medication from Ghana and Benin, and semi-structured interviews with health care personnel (HCP from Ghana on pain perceptions, assessment and treatment. Medical records (n = 149 of patients treated between 2008 and 2012 were collected between November 2012 and August 2013. Interviews (n = 11 were audio-taped, transcribed verbatim and qualitatively analyzed.In 113 (84% of the 135 included records, pain medication, mostly simple analgesics, was prescribed. In 48% of the prescriptions, an indication was not documented. HCP reported that advanced BU could be painful, especially after wound care and after a skin graft. They reported not be trained in the assessment of mild pain. Pain recognition was perceived as difficult, as patients were said to suppress or to exaggerate pain, and to have different expectations regarding acceptable pain levels. HCP reported a fear of side effects of pain medication, shortage and irregularities in the supply of pain medication, and time constraints among medical doctors for pain management.Professionals perceived BU disease as potentially painful, and predominantly focused on severe pain. Our study suggests that pain in BU deserves attention and should be integrated in current treatment.

  17. [Classification and treatment of endoleaks after endovascular treatment of abdominal aortic aneurysms].

    Science.gov (United States)

    Pitton, M B; Schmiedt, W; Neufang, A; Düber, C; Thelen, M

    2005-01-01

    This article describes the classification of endoleaks after endovascular treatment of abdominal aortic aneurysms, thereby summarizing the most important problems of this endovascular technique. The correct classification of endoleaks is a prerequisite for interdisciplinary discussion. It is indispensable for professional reporting of the pathological findings and for the decision making as to the adequate treatment of endoleaks. Irrespective of the types of stent graft and property of the material, five endoleak types are defined in the literature: leakage at the anchor sites (type I); leakage due to collateral arteries (type II); defective stent grafts (type III); leakage due to porosity of the graft material (type IV); and endotension (type V). The causes of endoleaks are discussed and treatment options are reviewed for the diverse pathologic findings.

  18. Classification and treatment of endoleaks after endovascular treatment of abdominal aortic aneurysms

    International Nuclear Information System (INIS)

    Pitton, M.B.; Thelen, M.; Schmiedt, W.; Neufang, A.; Dueber, C.

    2005-01-01

    This article describes the classification of endoleaks after endovascular treatment of abdominal aortic aneurysms, thereby summarizing the most important problems of this endovascular technique. The correct classification of endoleaks is a prerequisite for interdisciplinary discussion. It is indispensable for professional reporting of the pathological findings and for the decision making as to the adequate treatment of endoleaks. Irrespective of the types of stent graft and property of the material, five endoleak types are defined in the literature: leakage at the anchor sites (type I); leakage due to collateral arteries (type II); defective stent grafts (type III); leakage due to porosity of the graft material (type IV); and endotension (type V). The causes of endoleaks are discussed and treatment options are reviewed for the diverse pathologic findings. (orig.)

  19. Ayurvedic treatments for diabetes mellitus

    Science.gov (United States)

    Sridharan, Kalpana; Mohan, Roshni; Ramaratnam, Sridharan; Panneerselvam, Deepak

    2013-01-01

    Background Patients with diabetes frequently use complimentary and alternative medications including Ayurvedic medications and hence it is important to determine their efficacy and safety. Objectives To assess the effects of Ayurvedic treatments for diabetes mellitus. Search methods We searched The Cochrane Library (issue 10, 2011), MEDLINE (until 31 August 2011), EMBASE (until 31 August 2011), AMED (until 14 October 2011), the database of randomised trials from South Asia (until 14 October 2011), the database of the grey literature (OpenSigle, until 14 October 2011) and databases of ongoing trials (until 14 October 2011). In addition we performed hand searches of several journals and reference lists of potentially relevant trials. Selection criteria We included randomized trials of at least two months duration of Ayurvedic interventions for diabetes mellitus. Participants of both genders, all ages and any type of diabetes were included irrespective of duration of diabetes, antidiabetic treatment, comorbidity or diabetes related complications. Data collection and analysis Two authors independently extracted data. Risk of bias of trials was evaluated as indicated in the Cochrane Handbook for Systematic Reviews of Intervention. Main results Results of only a limited number of studies could be combined, in view of different types of interventions and variable quality of data. We found six trials of proprietary herbal mixtures and one of whole system Ayurvedic treatment. These studies enrolled 354 participants ( 172 on treatment, 158 on controls, 24 allocation unknown). The treatment duration ranged from 3 to 6 months. All these studies included adults with type 2 diabetes mellitus. With regard to our primary outcomes, significant reductions in glycosylated haemoglobin A1c (HbA1c), fasting blood sugar (FBS) or both were observed with Diabecon, Inolter and Cogent DB compared to placebo or no additional treatment, while no significant hypoglycaemic response was found

  20. Renovascular hypertension - imaging and treatment

    International Nuclear Information System (INIS)

    Brkljačić, B.

    2015-01-01

    Full text: Imaging is very important in diagnosing renovascular hypertension (RVHT). The role of color duplex Doppler, CT angiography, MR angiography and DS angiography will be presented, advantages and disadvantages discussed. The treatment of RVHT can be medical, surgical or endovascular. Endovascular treatment is a domain of vascular interventional radiology; endovascular treatment of renovascular hypertension consists of PTA alone or PTA and stenting of renal arteries in patients who have haemodynamically significant stenosis of renal artery due to fibromuscular dysplasia or atherosclerosis. Atherosclerotic renal artery stenosis results in increased production of renin, angiotensin II, aldosterone; plasma rennin activity of is increased in renal vein of ischemic kidney that retains sodium and water. Atherosclerotic lesions are typically ostial. Long-standing hypertension damages intrarenal vessels of unprotected kidney. Hypertension and renal failure may persist after removal of stenotic kidney. It usually affects older people. Fibromuscular dysplasia is non-atherosclerotic, is more common in women, occurs at younger age (average 35 yrs). Treatment of choice is PTA alone. Results are much better than in atherosclerotic RAS, where PTA + stenting are indicated. Endovascular treatment may result in complications, minor local or major complications, mostly related to the interventional technique. While PTA for the treatment of FMD is clearly indicated, the conflicting data exist over years regarding indications, benefits, complications and advantages of PTA / stent over medical therapy for treatment of atherosclerotic renovascular hypertension. Although 25-30% of patients with impaired renal function can recover glomerular filtration after revascularization, many have no apparent change in kidney function and 19-25% experience a significant loss of kidney function, some as a result of atheroemboli. The results of ASTRAL, STAR and CORAL studies will be presented

  1. [Nocturnal polyuria, treatment with desmopressin].

    Science.gov (United States)

    Zachoval, R; Krhut, J; Šottner, O; Hanuš, T; Martan, A; Horčička, L; Feyereisl, J; Halaška, M; Švabík, K; Krofta, L

    2013-08-01

    Nonpharmacologic and especially pharmacologic treatment options are available for nocturnal polyuria. Desmopressin represents the basis of pharmacologic treatment. Desmopressin acetate is a synthetic analogue of arginine vasopressin with high affinity to V2 receptors with antidiuretic effect. It is the only medicament currently registered for antidiuretic treatment. Desmopressin has not any relevant affinity to V1 receptors, and therefore there is no hypertensive effect in contrary to natural vasopressin. Desmopressin use before a bedtime leads to reduced production of urine during a sleep, therefore time between desires to void is prolonged and number of nocturia is reduced. Clinical effect, in a meaning of reduced urine production and increased osmolality of urine, lasts approximately 8-12 hours. In the treatment of nocturnal polyuria desmopressin is used orally one hour before a bedtime. It is essential to titrate an ideal dose, the initial dose is 60 µg of MELT formula (fast melting oral formulation) and it can be increased according to the clinical effect up to the maximal recommended daily dose 240 µg. Patients treated with desmopressin should cut down a fluid intake 1 hour before and 8 hours after the use of desmopressin. Total number of adverse events connected withdesmopressin treatment in clinical studies was higher compared to placebo but the side effects were mostly mild. The most common adverse events were headaches, nausea, diarrhoea, abdominal pain, dry mouth and hyponatremia both in the short-term and long-term clinical trials. Hyponatremia was observed mainly in patients over 65 year of age. Therefore treatment with desmopressin should not be commended in patients over 65 year of age without close monitoring of the natrium level in serum and all patients should be informed about the first symptoms of hyponatremia - headache, nausea and insomnia. According to Evidence Based Medicine, the level of evidence for treatment of nocturnal polyuria with

  2. Emerging treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Aboubakr Elnashar

    2015-06-01

    Full Text Available Current treatment of endometriosis is mainly based on surgery and ovarian suppressive agents (oral contraceptives, progestins, GnRh agonist and androgenic agents. Hormonal treatments are often associated with unwanted effects, delayed conception and recurrence of disease and symptoms when stopped. For these reasons, new drugs that aim new targets are required to cause regression of the disease & symptoms without adverse hypo-estrogenic effects. This review aims to provide an update on the new drugs used for treatment of endometriosis. These include the levonorgestrel-releasing intrauterine device, GnRH antagonists, aromatase inhibitors, selective estrogen-receptor modulators, progesterone antagonist, selective progesterone receptor modulators, angiogenesis inhibitors, and immunomodulatory drugs.

  3. Mixed waste treatment model: Basis and analysis

    International Nuclear Information System (INIS)

    Palmer, B.A.

    1995-09-01

    The Department of Energy's Programmatic Environmental Impact Statement (PEIS) required treatment system capacities for risk and cost calculation. Los Alamos was tasked with providing these capacities to the PEIS team. This involved understanding the Department of Energy (DOE) Complex waste, making the necessary changes to correct for problems, categorizing the waste for treatment, and determining the treatment system requirements. The treatment system requirements depended on the incoming waste, which varied for each PEIS case. The treatment system requirements also depended on the type of treatment that was desired. Because different groups contributing to the PEIS needed specific types of results, we provided the treatment system requirements in a variety of forms. In total, some 40 data files were created for the TRU cases, and for the MLLW case, there were 105 separate data files. Each data file represents one treatment case consisting of the selected waste from various sites, a selected treatment system, and the reporting requirements for such a case. The treatment system requirements in their most basic form are the treatment process rates for unit operations in the desired treatment system, based on a 10-year working life and 20-year accumulation of the waste. These results were reported in cubic meters and for the MLLW case, in kilograms as well. The treatment system model consisted of unit operations that are linked together. Each unit operation's function depended on the input waste streams, waste matrix, and contaminants. Each unit operation outputs one or more waste streams whose matrix, contaminants, and volume/mass may have changed as a result of the treatment. These output streams are then routed to the appropriate unit operation for additional treatment until the output waste stream meets the treatment requirements for disposal. The total waste for each unit operation was calculated as well as the waste for each matrix treated by the unit

  4. Treatment Options

    Science.gov (United States)

    ... one that is tailored to your symptoms. article Protecting your eyesight when taking Plaquenil Some lupus treatments have the potential for eye health side-effects. Know the warning signs. article ​ ...

  5. Treatment of Helicobacter Pylori in Children

    Directory of Open Access Journals (Sweden)

    F Famouri

    2014-04-01

    Full Text Available Childrenwith Helicobacter infection need treatment. The aim of treatment is elimination of H.Pylori. Most patients with this infection are asymptomatic and without peptic disease. Treatment and management of these patients are controversy. Conventional Treatment: The best treatment for H. pylori eradication regimens should have cure rates of at least 80%, be without major side effects, and induce minimal bacterial resistance. Antibiotics alone have not achieved this. Luminal acidity influences both the effectiveness of some antimicrobial agents and the survival of the bacteri; thus antibiotics have been combined with acid suppression such as proton pump inhibitors (PPIs, bismuth, or H2 antagonists. The “classic” regimen is treatment twice daily for 7 days with a PPI and clarithromycin plus either amoxicillin or metronidazole Bismuth has been used in the treatment of peptic ulcer disease and 1 part o quadruple therapy for H.Pylori but compliance of children for it is low.   Sequential Therapy  Sequential therapyinvolves dual therapy with a PPI and amoxicillin for 5 days followed sequentially by clarithromycin, Tinidazole and omeperazole for 5 days or other triple therapy for 7 days. This treatment has had 97% efficacy.   Adjunctive Therapies A number of studies have showed the potential benefits of probiotic therapy in H. pylori treatment regimens.Consumption of these drugs accompanied with other medications increase H.Pylori eradication.    

  6. Immunotherapy in multimodality treatment

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Application of immunotherapy for treatment of oncologic patients is considered. Monoclonal antibodies (MCA) are used for immunotherapy both independently and as carriers of various toxins, chemopreparations and radioactive isotopes. It is shown that immunotherapy should be considered as one of additional methods of multimodulity treatment of patients with malignant tumors

  7. Acceptability of psychological treatment to Chinese- and Caucasian-Australians: Internet treatment reduces barriers but face-to-face care is preferred.

    Science.gov (United States)

    Choi, Isabella; Sharpe, Louise; Li, Stephen; Hunt, Caroline

    2015-01-01

    Internet treatments have the potential to improve access, especially for cultural groups who face considerable treatment barriers. This study explored the perceived barriers and likelihood of using Internet and face-to-face treatments for depression among Chinese and Caucasian Australian participants. Three-hundred ninety-five (289 Chinese, 106 Caucasian) primary care patients completed a questionnaire about depression history, previous help-seeking, perceived barriers to Internet and face-to-face treatment, and likelihood of using either treatment for depressive symptoms. Internet treatment reduced perceived barriers (including stigma, lack of motivation, concerns of bringing up upsetting feelings, time constraints, transport difficulties, and cost) for both groups to a similar degree, except for time constraints. There were heightened concerns about the helpfulness, suitability, and confidentiality of Internet treatments. Chinese participants and individuals with a probable depression history reported increased perceived barriers across treatments. Both Chinese and Caucasian groups preferred face-to-face treatment across depression severity. However, when age was controlled, there were no significant concerns about Internet treatment, and face-to-face treatment was only preferred for severe depression. Only 12 % of the entire sample refused to try Internet treatment for depression. Endorsement of perceived Internet treatment barriers (including concerns of bringing up upsetting feelings, that treatment would be unhelpful or unsuitable, lack of motivation, cost, cultural sensitivity, and confidentiality) reduced the likelihood to try Internet treatments. Internet treatment reduced perceived treatment barriers across groups, with encouraging support for Internet treatment as an acceptable form of receiving help. Negative concerns about Internet treatment need to be addressed to encourage use.

  8. Disease-modifying treatments for early and advanced multiple sclerosis: a new treatment paradigm.

    Science.gov (United States)

    Giovannoni, Gavin

    2018-06-01

    The treatment of multiple sclerosis is evolving rapidly with 11 classes of disease-modifying therapies (DMTs). This article provides an overview of a new classification system for DMTs and treatment paradigm for using these DMTs effectively and safely. A summary of research into the use of more active approaches to early and effective treatment of multiple sclerosis with defined treatment targets of no evident disease activity (NEDA). New insights are discussed that is allowing the field to begin to tackle more advanced multiple sclerosis, including people with multiple sclerosis using wheelchairs. However, the need to modify expectations of what can be achieved in more advanced multiple sclerosis are discussed; in particular, the focus on neuronal systems with reserve capacity, for example, upper limb, bulbar and visual function. The review describes a new more active way of managing multiple sclerosis and concludes with a call to action in solving the problem of slow adoption of innovations and the global problem of untreated, or undertreated, multiple sclerosis.

  9. Evolution of Facial Aesthetic Treatment Over Five or More Years: A Retrospective Cross-sectional Analysis of Continuous OnabotulinumtoxinA Treatment.

    Science.gov (United States)

    Carruthers, Alastair; Sadick, Neil; Brandt, Frederic; Trindade de Almeida, Ada Regina; Fagien, Steve; Goodman, Greg J; Raspaldo, Herve; Smith, Kevin; Darmody, Sarah; Gallagher, Conor J; Street, James; Romagnano, Linda

    2015-06-01

    Little information exists on how facial aesthetic treatments are incorporated into aesthetic regimens. Assess the evolution of facial aesthetic treatments in patients receiving long-term continuous onabotulinumtoxinA treatment. This international retrospective chart review included patients with ≥5 years of continuous onabotulinumtoxinA treatments including ≥1 glabellar lines treatment/year. Charts were reviewed for facial areas treated, number of treatments, doses/treatment visit, concomitant aesthetic procedures, and onabotulinumtoxinA-related adverse events. Data were collected from 5,112 onabotulinumtoxinA treatment sessions for 194 patients over an average of 9.1 years. Dosing was relatively stable over time; however, interinjection intervals increased. Glabellar lines' treatment temporally preceded crow's feet lines and forehead lines' treatment. A majority of patients (85%) also received treatment with fillers. Cumulative increases in onabotulinumtoxinA treatments occurred over time and by facial area corresponding with increases in treatments with injectable fillers, energy-based devices, and prescription topical creams. The longer the patients were treated, the younger they perceived themselves to look. Rates of adverse events were low. OnabotulinumtoxinA treatment evolved over time, coinciding with growth of the facial aesthetics market. Additional treatment modalities were added as complements to onabotulinumtoxinA. Long-term continuous onabotulinumtoxinA injections are an important component of contemporary facial aesthetic treatment regimens.

  10. In-Office Bleaching During Orthodontic Treatment.

    Science.gov (United States)

    Gomes, Mauricio Neves; Dutra, Hélio; Morais, Alexandre; Sgura, Ricardo; Devito-Moraes, André Guaraci

    2017-04-01

    To demonstrate that it is possible to pursue teeth whitening treatment protocols during orthodontic treatment with no esthetic loss. Many patients undergoing orthodontic treatment desire to have a straight and well aligned dentition, but also whiter teeth. For many years, it was believed that carrying out a whitening treatment with positioned orthodontic brackets in place would result in localized spots on the enamel labial surfaces of teeth. However, a deeper understanding of the bleaching process suggests that the oxidation caused by products, which results from hydrogen peroxide decomposition, are able to diffuse peripherally into the tooth structure and reach even that under the cemented brackets. Two in-office-bleaching treatments were performed in patients using orthodontic fixed braces in two or three 40-minute sessions using a 35% hydrogen peroxide. In-office bleaching is possible and effective, even with orthodontic brackets in position. The teeth were successfully bleached despite the presence of brackets. All biological criteria have been fulfilled satisfying patients' expectations of aligned and whitened teeth in less time than if treatments had been performed separately, with satisfactory results and no esthetic loss. The whitening of teeth is possible during orthodontic treatment with fixed braces without any esthetic loss. The in-office bleaching treatment with brackets in position also may act as a motivation factor, preventing patient withdrawal or treatment interruption. Therefore, at the end of the orthodontic treatment, the patient is able to display an aligned, functional and whitened smile. (J Esthet Restor Dent 29:83-92, 2017). © 2016 Wiley Periodicals, Inc.

  11. Treatment Intensity and Childhood Apraxia of Speech

    Science.gov (United States)

    Namasivayam, Aravind K.; Pukonen, Margit; Goshulak, Debra; Hard, Jennifer; Rudzicz, Frank; Rietveld, Toni; Maassen, Ben; Kroll, Robert; van Lieshout, Pascal

    2015-01-01

    Background: Intensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population. Aim: To investigate the effects of treatment intensity on outcome…

  12. Primary treatment of diabetic macular edema

    OpenAIRE

    Ranchod, Tushar; Fine,Stuart

    2009-01-01

    Tushar M Ranchod, Stuart L FineScheie Eye Institute, Department, of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USAAbstract: Diabetic macular edema (DME) is a leading cause of vision loss in older Americans. Thermal laser treatment remains the mainstay of treatment for DME. Recently, alternative primary treatments for DME have been evaluated. These treatments include intravitreal injections of steroids as well as pharmaceuticals containing antibodies against vascular endothel...

  13. Associations between nutritional status, weight loss, radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients.

    Science.gov (United States)

    Hill, Amanda; Kiss, Nicole; Hodgson, Belinda; Crowe, Timothy C; Walsh, Adam D

    2011-02-01

    Patients with gastrointestinal cancers are susceptible to nutritional deterioration which may be compounded by radiotherapy treatment toxicities. This study aimed to determine whether nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy were associated with treatment toxicity and outcomes in gastrointestinal cancer patients. Seventy-three gastrointestinal cancer patients receiving curative radiotherapy underwent medical record audits assessing body weight, radiotherapy toxicity, unplanned treatment breaks or hospital admissions and completion of prescribed treatment/s. Nutritional status was assessed in a subset of patients (n = 11) using the Patient-Generated Subjective Global Assessment tool. Seventy-five percent of patients lost weight throughout radiotherapy. Weight loss was significantly greater in patients experiencing unplanned radiotherapy breaks (-3.1% vs -1.6%, p nutritional status during radiotherapy (as measured by weight loss) may be associated with poorer short-term treatment outcomes in gastrointestinal cancer patients. Patient numbers were too small to definitively determine the effect of nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy (defined by PG-SGA) on treatment outcomes. Further research is required to investigate this in larger, longer-term studies. Copyright © 2010. Published by Elsevier Ltd.

  14. HORMONAL TREATMENT IN UROGYNECOLOGY

    Directory of Open Access Journals (Sweden)

    Adolf Lukanović

    2018-02-01

    Full Text Available Background. Hormonal treatment in urogynecology is based on the knowledge, that urinary and reproductive tracts have common embriologic origin and are also linked anatomically and functionally. Both systems are functioning and changing due to sex steroids influence. Decreased estrogen concentrations are connected to metabolic and trophic changes in all organs with estrogen receptors, i.e. also in urogenital tract. Atrophy of urogenital system in postmenopause is a common causative factor for stress urinary incontinence (SUI and urge incontinence (UUI. In both estrogen replacement treatment have been introduced, but meta-analyses of the available literature indicate that estrogen therapy is effective only if given vaginaly. Recurrent urinary tract infections (RUTI occur in postmenopause often as a consequence of structural changes in urinary and reproductive tract to lowered immune protection and colonization with eneterobacteria. In RUTI too, estrogen replacement treatment have been used with the results similar to those with SUI and UUI. Effectiveness of estrogen treatment was evident only in topically applied vaginaly, while oral administration has the same effectiveness as placebo. Conclusions. Structural changes in urogenital tract in postmenopause are the results of estrogen depletion. Estrogen replacement is effective in cases of SUI, UUI and RUTI if it is applied topicaly, the efffect being influenced by the type of estrogen used and duration of treatment.

  15. Current calibration, treatment, and treatment planning techniques among institutions participating in the Children's Oncology Group

    International Nuclear Information System (INIS)

    Urie, Marcia; FitzGerald, T.J.; Followill, David; Laurie, Fran; Marcus, Robert; Michalski, Jeff

    2003-01-01

    Purpose: To report current technology implementation, radiation therapy physics and treatment planning practices, and results of treatment planning exercises among 261 institutions belonging to the Children's Oncology Group (COG). Methods and Materials: The Radiation Therapy Committee of the newly formed COG mandated that each institution demonstrate basic physics and treatment planning abilities by satisfactorily completing a questionnaire and four treatment planning exercises designed by the Quality Assurance Review Center. The planning cases are (1) a maxillary sinus target volume (for two-dimensional planning), (2) a Hodgkin's disease mantle field (for irregular-field and off-axis dose calculations), (3) a central axis blocked case, and (4) a craniospinal irradiation case. The questionnaire and treatment plans were submitted (as of 1/30/02) by 243 institutions and completed satisfactorily by 233. Data from this questionnaire and analyses of the treatment plans with monitor unit calculations are presented. Results: Of the 243 clinics responding, 54% use multileaf collimators routinely, 94% use asymmetric jaws routinely, and 13% use dynamic wedges. Nearly all institutions calibrate their linear accelerators following American Association of Physicists in Medicine protocols, currently 16% with TG-51 and 81% with TG-21 protocol. Treatment planning systems are relied on very heavily for all calculations, including monitor units. Techniques and results of each of the treatment planning exercises are presented. Conclusions: Together, these data provide a unique compilation of current (2001) radiation therapy practices in institutions treating pediatric patients. Overall, the COG facilities have the equipment and the personnel to perform high-quality radiation therapy. With ongoing quality assurance review, radiation therapy compliance with COG protocols should be high

  16. Treatment Options by Stage (Pancreatic Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  17. Treatment Options by Stage (Esophageal Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  18. Treatment Options by Stage (Vulvar Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  19. Treatment Options by Stage (Penile Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  20. Treatment Options for Non-Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... lymphoma may come back as indolent lymphoma. Treatment Option Overview Key Points There are different types of ...

  1. Treatment Options by Stage (Prostate Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  2. Treatment Options by Stage (Adrenocortical Carcinoma)

    Science.gov (United States)

    ... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  3. Treatment Options for Childhood Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

  4. Treatment Options for Adult Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  5. Treatment Option Overview (Small Intestine Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  6. Treatment Option Overview (Adult Hodgkin Lymphoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  7. Treatment Option Overview (Merkel Cell Carcinoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... common for Merkel cell carcinoma to recur. Treatment Option Overview Key Points There are different types of ...

  8. Treatment Option Overview (Childhood Hodgkin Lymphoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

  9. Treatment Options for AIDS-Related Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... nervous system is not primary CNS lymphoma. Treatment Option Overview Key Points There are different types of ...

  10. Treatment Options for Renal Cell Cancer

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  11. Treatment Options by Stage (Gastric Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... such as the liver or lymph nodes . Treatment Option Overview Key Points There are different types of ...

  12. Treatment Options by Stage (Thyroid Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  13. Treatment Options for Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... of blast cells increases after a remission . Treatment Option Overview Key Points There are different types of ...

  14. Research on the sewage treatment in high altitude region based on Lhasa Sewage Treatment Plant

    Science.gov (United States)

    Xu, Jin; Li, Shuwen

    2017-12-01

    Sewage treatment is of great significance to enhance environmental quality, consolidate pollution prevention and ecological protection, and ensure sustainable economic and social development in high altitude region. However, there are numerous difficulties in sewage treatment due to the alpine climate, the relatively low economic development level, and the backward operation and management styles, etc. In this study, the characteristics of influent quality in the sewage treatment plant in Lhasa are investigated by analysing the influent BOD5/COD and BOD5/TN, comparing key indexes recorded from 2014 to 2016 with the hinterland. Results show that the concentration of influent COD, BOD5, NH3-N and SS in the Lhasa sewage treatment plant, in which the sewage belongs to low-concentration urban sewage, is smaller than that in the domestic sewage treatment plants in the mainland. The concentration ratio of BOD5/COD and BOD5/TN is below 0.4 and 4, which indicates that the biodegradation is poor and the carbon sources are in bad demand. The consequences obtained play a vital role in the design, operation and management of sewage treatment plants in high altitude region.

  15. Wastewater Treatment

    Science.gov (United States)

    ... day before releasing it back to the environment. Treatment plants reduce pollutants in wastewater to a level nature can handle. Wastewater is used water. It includes substances such as human waste, food ...

  16. Predicting therapy success for treatment as usual and blended treatment in the domain of depression.

    Science.gov (United States)

    van Breda, Ward; Bremer, Vincent; Becker, Dennis; Hoogendoorn, Mark; Funk, Burkhardt; Ruwaard, Jeroen; Riper, Heleen

    2018-06-01

    In this paper, we explore the potential of predicting therapy success for patients in mental health care. Such predictions can eventually improve the process of matching effective therapy types to individuals. In the EU project E-COMPARED, a variety of information is gathered about patients suffering from depression. We use this data, where 276 patients received treatment as usual and 227 received blended treatment, to investigate to what extent we are able to predict therapy success. We utilize different encoding strategies for preprocessing, varying feature selection techniques, and different statistical procedures for this purpose. Significant predictive power is found with average AUC values up to 0.7628 for treatment as usual and 0.7765 for blended treatment. Adding daily assessment data for blended treatment does currently not add predictive accuracy. Cost effectiveness analysis is needed to determine the added potential for real-world applications.

  17. Medical Treatment for Uterine Myomas

    Directory of Open Access Journals (Sweden)

    Ming-Hui Cheng

    2008-03-01

    Full Text Available Uterine myomas are the most common benign tumors in the female reproductive tract. Most women with myomas are asymptomatic. Therefore, expectant observation and follow-up are often recommended for these myoma patients. However, myomas may cause menstrual symptoms, pelvic pain, pressure complaints, subfer-tility or pregnancy-related complications, with resultant requests for a definitive treatment. The management of myomas has become multidisciplinary in the past 20 years. Basically, the choice of treatment depends on the patient's age, the reason for treatment, the issue of fertility preservation, and the patient's preference. The treatment spectrum includes an expectant management, medical therapy, surgical intervention, uterine artery embolization or ablative techniques. Medical therapy is an option for women with symptomatic myomas who prefer non-surgical treatment, consider fertility preservation, or expect a less aggressive operation after shrinkage of the uterine volume. This review will summarize the recent well-documented drugs for the management of uterine myomas.

  18. [Treatment of patients with osteoarthritis].

    Science.gov (United States)

    Vargas Negrín, Francisco; Medina Abellán, María D; Hermosa Hernán, Juan Carlos; de Felipe Medina, Ricardo

    2014-01-01

    The therapeutic management of patients with osteoarthritis aims to decrease pain and inflammation, improve physical function, and to apply safe and effective treatments. A patient-centered approach implies the active participation of the patient in the design of the treatment plan and in timely and informed decision-making at all stages of the disease. The nucleus of treatment is patient education, physical activity and therapeutic exercise, together with weight control in overweight or obese patients. Self-care by the individual and by the family is fundamental in day-to-day patient management. The use of physical therapies, technical aids (walking sticks, etc.) and simple analgesics, opium alkaloids, and antiinflammatory drugs have demonstrated effectiveness in controlling pain, improving physical function and quality of life and their use is clearly indicated in the treatment of osteoarthritis. Conservative surgery and joint replacement is indicated when treatment goals are not achieved in specific patients. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  19. Psychodynamic Treatment of the Criminal Offender: Making the Case for Longer-Term Treatment in a Longer-Term Setting.

    Science.gov (United States)

    Mulay, Abby L; Kelly, Elspeth; Cain, Nicole M

    2017-01-01

    In recent years, prisons and jails have become de facto psychiatric hospitals, responsible for the care and treatment of individuals with serious mental illness. Historically, cognitive-behaviorally informed therapeutic approaches have been the treatment of choice among mental health practitioners in correctional settings. However, inmate-clients often present with complex diagnostic issues that are arguably better served by long-term treatment options, such as psychodynamic psychotherapy. We first review the nature of psychotherapy in the correctional setting, as well as treatment barriers and challenges faced by both mental health providers and inmate-clients. We then review treatment studies that examine the efficacy of various therapeutic techniques in correctional/forensic contexts. Finally, we argue that, due to the complex nature of psychopathology, average length of time incarcerated, and treatment issues that arise in this multifaceted and challenging setting, mental health treatment providers should consider providing psychodynamic treatment modalities when working with incarcerated individuals. We also argue that more research is needed to examine the efficacy of these treatment approaches with inmate-clients.

  20. Development of independent MU/treatment time verification algorithm for non-IMRT treatment planning: A clinical experience

    Science.gov (United States)

    Tatli, Hamza; Yucel, Derya; Yilmaz, Sercan; Fayda, Merdan

    2018-02-01

    The aim of this study is to develop an algorithm for independent MU/treatment time (TT) verification for non-IMRT treatment plans, as a part of QA program to ensure treatment delivery accuracy. Two radiotherapy delivery units and their treatment planning systems (TPS) were commissioned in Liv Hospital Radiation Medicine Center, Tbilisi, Georgia. Beam data were collected according to vendors' collection guidelines, and AAPM reports recommendations, and processed by Microsoft Excel during in-house algorithm development. The algorithm is designed and optimized for calculating SSD and SAD treatment plans, based on AAPM TG114 dose calculation recommendations, coded and embedded in MS Excel spreadsheet, as a preliminary verification algorithm (VA). Treatment verification plans were created by TPSs based on IAEA TRS 430 recommendations, also calculated by VA, and point measurements were collected by solid water phantom, and compared. Study showed that, in-house VA can be used for non-IMRT plans MU/TT verifications.

  1. Dermatological laser treatment

    International Nuclear Information System (INIS)

    Moerk, N.J.; Austad, J.; Helland, S.; Thune, P.; Volden, G.; Falk, E.

    1991-01-01

    The article reviews the different lasers used in dermatology. Special emphasis is placed on the treatment of naevus flammeus (''portwine stain'') where lasers are the treatment of choice. Argon laser and pulsed dye laser are the main lasers used in vascular skin diseases, and the article focuses on these two types. Copper-vapour laser, neodymium-YAG laser and CO 2 laser are also presented. Information is provided about the availability of laser technology in the different health regions in Norway. 5 refs., 2 figs

  2. Image guided prostate cancer treatments

    Energy Technology Data Exchange (ETDEWEB)

    Bard, Robert L. [Bard Cancer Center, Biofoundation for Angiogenesis Research and Development, New York, NY (United States); Fuetterer, Jurgen J. [Radboud Univ. Nijmegen, Medical Centre (Netherlands). Dept. of Radiology; Sperling, Dan (ed.) [Sperling Prostate Center, Alpha 3TMRI, New York, NY (United States)

    2014-07-01

    Systematic overview of the application of ultrasound and MRI in the diagnosis and treatment of diseases of the lower urinary tract. Detailed information on image-guided therapies, including focused ultrasound, photodynamic therapy, and microwave and laser ablation. Numerous high-quality illustrations based on high-end equipment. Represents the state of the art in Non Invasive Imaging and Minimally Invasive Ablation Treatment (MIAT). Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively

  3. Treatment of severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Praznik Ivan

    2014-01-01

    Full Text Available Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or other organ systems. The severe form of the disease occurs in 10-20% of cases, and usually requires prolonged hospitalization due to a frequent local and systemic complications. Additionally, considerable mortality despite diagnostic and therapeutic advances, makes this disease a serious health problem nowadays. The aim of this study was to conduct a review of randomized controlled trials to determine differences in the efficiency between standard methods of treatment for severe acute pancreatitis and new treatment ways in terms of decreased mortality. Search of the 'Medline' database of original scientific papers and systematic review articles was made, using a combination of the following keywords: acute pancreatitis, treatment, mortality. In total 914 papers were found, published in the last 13 years; 14 of 64 randomized controlled clinical trials met the selection criteria and were eligible for inclusion. From a total of 16 papers, the conservative treatment was related to 11, which includes some of the new treatment methods, while the effects of new methods of treatment have been the subject of research in the four studies. Combined endoscopic and surgical treatment was applied in only one study. The largest sample of 290 patients was included in the study with platelet activation factor antagonist, while the smallest sample of 22 patients was used in the study that compared total parenteral with enteral nutrition. Continuous regional arterial infusion of protease inhibitors in combination with antibiotics, intravenous supplementation of alanyl-glutamine dipeptide and the early, high-volume continuous veno-venous hemofiltration showed the best results in the treatment of patients with severe acute pancreatitis. Also, the use of low molecular weight heparin and enteral nutrition significantly reduced mortality.

  4. Chemotherapeutic treatment of naturally acquired generalized demodicosis.

    Science.gov (United States)

    Folz, S D; Kratzer, D D; Conklin, R D; Nowakowski, L H; Kakuk, T J; Rector, D L

    1983-08-01

    Fifty-two dogs naturally parasitized with Demodex canis and having the generalized form of the disease were utilized to evaluate the efficacy and safety of single or multiple topical treatments with a liquid concentrate formulation of amitraz. Ten dogs (5 treated, 5 controls) were utilized to evaluate a single treatment. A single topical treatment with the miticide did not significantly reduce the incidence of dogs with mites, however, significant clinical improvement resulted. Side-effects were not observed after treatment. Forty-two dogs (26 treated, 16 controls) were utilized to evaluate multiple topical treatments with the liquid concentrate. A series of 3-6 treatments was applied topically at 14-day intervals. The dogs treated with the miticide received an average of 4.5 topical treatments. All (100%) of the dogs responded clinically, and the mean rate of improvement at four weeks post-treatment was 99.1%. Most dogs (96.2%) were cleared of mites after 3-6 treatments, and Mitaban did not cause any dermatologic, ocular, or other clinical side-effects. Multiple treatments with the liquid concentrate were highly efficacious and safe for treatment of generalized demodicosis. Control dogs did not improve clinically and retained mite populations.

  5. Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

    Directory of Open Access Journals (Sweden)

    Shekarchizadeh Hajar

    2012-06-01

    Full Text Available Abstract Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810 in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%, more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education, and employed (>70%. The most commonly reported main drugs of abuse prior to MMT entry were opium (69% and crystalline heroin (24%. The patients’ lifetime drug experience included opium (92%, crystalline heroin (28%, cannabis (16%, amphetamines (15%, and other drugs (33%. Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.

  6. Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

    Science.gov (United States)

    2012-01-01

    Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT) is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810) in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%), more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education), and employed (>70%). The most commonly reported main drugs of abuse prior to MMT entry were opium (69%) and crystalline heroin (24%). The patients’ lifetime drug experience included opium (92%), crystalline heroin (28%), cannabis (16%), amphetamines (15%), and other drugs (33%). Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men. PMID:22676557

  7. The influence of location of local anesthesia and complexity/duration of restorative treatment on children's behavior during dental treatment.

    Science.gov (United States)

    Davidovich, Esti; Wated, Alham; Shapira, Joseph; Ram, Diana

    2013-01-01

    The purpose of this study was to investigate whether the region of local anesthetic injection and the complexity and duration of restorative treatment were associated with children's behavior during and immediately after dental treatment. This study examined 90 children, divided into two age groups (2-3.5 years old and >3.5-5.5 years old), who underwent dental treatment while lightly sedated. The region of local anesthesia (maxillary infiltration or mandibular block), complexity and duration of treatment, and behavior during and after treatment were assessed. Children's behavior during and after dental treatment, within and between age groups, was not found to be associated with the region of local anesthesia or complexity of treatment. For both age groups, more children exhibited negative behaviors during treatment when procedures exceeded 30 minutes. For younger children, more negative behaviors were also observed after longer vs shorter procedures. Treatment duration, not the region of local anesthesia or complexity of treatment, was associated with children's behavior during and after dental procedures.

  8. Pregnancy after definitive treatment for Graves' disease--does treatment choice influence outcome?

    Science.gov (United States)

    Elston, Marianne S; Tu'akoi, Kelson; Meyer-Rochow, Goswin Y; Tamatea, Jade A U; Conaglen, John V

    2014-08-01

    Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement. Retrospective chart review of women who had undergone definitive treatment for Graves' disease at a tertiary hospital and subsequently had one or more pregnancies. A total of 29 women were identified, each of whom had at least one pregnancy since receiving definitive treatment for Graves' disease: there were a total of 49 pregnancies (22 in the surgical group and 27 in the radioiodine group). Both groups had high rates of hypothyroidism documented during pregnancy (47 and 50%, respectively). The surgical group was more likely to be euthyroid around the time of conception. Less than half of the women were referred to an endocrinologist or had TRAb measured during pregnancy. Neonatal thyroid function was measured in one-third of live births. One case of neonatal thyrotoxicosis was identified. Adherence to the current American Thyroid Association guidelines is poor. Further education of both patients and clinicians is important to ensure that treatment of women during pregnancy after definitive treatment follows the currently available guidelines. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  9. Clinical treatment planning optimization by Powell's method for gamma unit treatment system

    International Nuclear Information System (INIS)

    Yan Yulong; Shu Huazhong; Bao Xudong; Luo Limin; Bai Yi

    1997-01-01

    Purpose: This article presents a new optimization method for stereotactic radiosurgery treatment planning for gamma unit treatment system. Methods and Materials: The gamma unit has been utilized in stereotactic radiosurgery for about 30 years, but the usual procedure for a physician-physicist team to design a treatment plan is a trial-and-error approach. Isodose curves are viewed on two-dimensional computed tomography (CT) or magnetic resonance (MR) image planes, which is not only time consuming but also seldom achieves the optimal treatment plan, especially when the isocenter weights are regarded. We developed a treatment-planning system on a computer workstation in which Powell's optimization method is realized. The optimization process starts with the initial parameters (the number of iso centers as well as corresponding 3D iso centers' coordinates, collimator sizes, and weight factors) roughly determined by the physician-physicist team. The objective function can be changed to consider protection of sensitive tissues. Results: We use the plan parameters given by a well-trained physician-physicist team, or ones that the author give roughly as the initial parameters for the optimization procedure. Dosimetric results of optimization show a better high dose-volume conformation to the target volume compared to the doctor's plan. Conclusion: This method converges quickly and is not sensitive to the initial parameters. It achieves an excellent conformation of the estimated isodose curves with the contours of the target volume. If the initial parameters are varied, there will be a little difference in parameters' configuration, but the dosimetric results proved almost to be the same

  10. Specific phobias in youth: a randomized controlled trial comparing one-session treatment to a parent-augmented one-session treatment.

    Science.gov (United States)

    Ollendick, Thomas H; Halldorsdottir, Thorhildur; Fraire, Maria G; Austin, Kristin E; Noguchi, Ryoichi J P; Lewis, Krystal M; Jarrett, Matthew A; Cunningham, Natoshia R; Canavera, Kristin; Allen, Kristy B; Whitmore, Maria J

    2015-03-01

    Examine the efficacy of a parent-augmented One-Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. A total of 97 youth (ages 6-15, 51.5% female, 84.5% White) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semistructured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, posttreatment, and 1month and 6months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at posttreatment and 1-month follow-up. At 6-month follow-up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted. Copyright © 2014. Published by Elsevier Ltd.

  11. Hyperdosed radiotherapy in cancer treatment

    International Nuclear Information System (INIS)

    Machidon, Vasile; Jovmir, Vasile; Stanislav, Anastasia; Scurtu, Elena; Gazibar, Valeria; Lungu, Viorica

    2010-01-01

    The results of 328 patients with metastasizing breast cancer (BCM) are presented in the article. The distant metastases development in 4,5 % from the lot, which received the neoadjuvant treatment, is a high assurance in argumentation of preoperative hyperdosed X-ray therapy in breast cancer treatment. 15,8% from 100% - that is the significance of hyper dosed X-ray therapy versus classic X-ray therapy used preoperative in case of metastasizing breast cancer. The obtained data can not deny the efficacy of hyperdosed X-ray therapy in preoperative treatment of breast cancer. The hyperdosed X-ray therapy in the present moment remains current in the treatment of breast cancer and different localized cancers. (authors)

  12. Life cycle assessment comparing the treatment of surplus activated sludge in a sludge treatment reed bed system with mechanical treatment on centrifuge

    DEFF Research Database (Denmark)

    Larsen, Julie Dam; Hoeve, Marieke ten; Nielsen, Steen

    2018-01-01

    or the centrifuge and terminated by land application of the final sludge product. The environmental impacts caused by the sludge treatment reed bed system strategy were comparable to or lower than those caused by the mechanical sludge treatment method. The impacts on climate change were the same for all...

  13. Telemedical Treatment of Diabetic Foot Ulcers

    DEFF Research Database (Denmark)

    Clemensen, Jane; Larsen, Simon Bo

    2007-01-01

    Telemedicine allows for remote treatment and access to medical experts no matter where the location of the patient. This enables the monitoring and treatment of conditions like diabetes from one location via video consultations......Telemedicine allows for remote treatment and access to medical experts no matter where the location of the patient. This enables the monitoring and treatment of conditions like diabetes from one location via video consultations...

  14. Negotiating access to medical treatment and the making of patient citizenship: the case of hepatitis C treatment.

    Science.gov (United States)

    Rhodes, Tim; Harris, Magdalena; Martin, Anthea

    2013-09-01

    Drawing on qualitative interview accounts with people who have injected drugs, we deploy ideas of biological and therapeutic citizenship to explore how the negotiation of access to hepatitis C treatment enacts patient citizenship potential. We find that the patient citizenship made through hepatitis C treatment divides those who are deserving from those who are not, largely in relation to their presentations of self-control, responsibility and recovery regarding drug use. Accessing treatment requires that patients negotiate their entitlement by reflexively producing the patient citizen role expected of them. In this context of rationed treatment expectation, access to treatment is constructed in relation to gratitude rather than entitlement. Rationed treatment expectation also interplays with a utilitarian approach to hepatitis C expertise. Accounts of the bio-effects of hepatitis C and its treatment as uncertain further weaken the potential for shared illness identity and biosocial membership as well as contributing to treatment delay. We conclude that the construction of hepatitis C treatment as a negotiation of 'recovery towards normality' positions people who continue to use or inject drugs as beyond patient citizenship. Our findings underscore the situated limits of therapeutic and biological citizenship, emphasising that these processes are unavoidably forces of governance. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd. Published by John Wiley & Sons Ltd.

  15. Antifungal treatment for invasive Candida infections: a mixed treatment comparison meta-analysis

    Directory of Open Access Journals (Sweden)

    Nachega Jean B

    2009-06-01

    Full Text Available Objectives Invasive fungal infections are a major cause of mortality among patients at risk. Treatment guidelines vary on optimal treatment strategies. We aimed to determine the effects of different antifungal therapies on global response rates, mortality and safety. Methods We searched independently and in duplicate 10 electronic databases from inception to May 2009. We selected any randomized trial assessing established antifungal therapies for confirmed cases of invasive candidiasis among predominantly adult populations. We performed a meta-analysis and then conducted a Bayesian mixed treatment comparison to differentiate treatment effectiveness. Sensitivity analyses included dosage forms of amphotericin B and fluconazole compared to other azoles. Results Our analysis included 11 studies enrolling a total of 965 patients. For our primary analysis of global response rates, we pooled 7 trials comparing azoles to amphotericin B, Relative Risk [RR] 0.87 (95% Confidence Interval [CI], 0.78–0.96, P = 0.007, I2 = 43%, P = 0.09. We also pooled 2 trials of echinocandins versus amphotericin B and found a pooled RR of 1.10 (95% CI, 0.99–1.23, P = 0.08. One study compared anidulafungin to fluconazole and yielded a RR of 1.26 (95% CI, 1.06–1.51 in favor of anidulafungin. We pooled 7 trials assessing azoles versus amphotericin B for all-cause mortality, resulting in a pooled RR of 0.88 (95% CI, 0.74–1.05, P = 0.17, I2 = 0%, P = 0.96. Echinocandins versus amphotericin B (2 trials for all-cause mortality resulted in a pooled RR of 1.01 (95% CI, 0.84–1.20, P = 0.93. Anidulafungin versus fluconazole resulted in a RR of 0.73 (95% CI, 0.48–1.10, P = 0.34. Our mixed treatment comparison analysis found similar within-class effects across all interventions. Adverse event profiles differed, with amphotericin B exhibiting larger adverse event effects. Conclusion Treatment options appear to offer preferential effects on response rates and mortality. When

  16. Treatment seeking behaviour and prevalence of treatment delay among malaria patients along Thailand-Myanmar border in Tak province

    Directory of Open Access Journals (Sweden)

    Krit Sonkong

    2015-04-01

    Full Text Available Objective: To investigate treatment seeking behaviour and the prevalence of treatment delay of malaria patients. Methods: A cross-sectional study was conducted with malaria patients along the ThailandMyanmar border in Tak province, Thailand. Results: Most of patients (70.0% were treated for fever before receiving treatment at a malaria clinic or public hospital. The sources of initial treatments were self-treatment (64.0%, malaria clinics (20.0%, public hospital (11.0%, sub-district health promotion hospital (3.3%, and malaria posts (1.1%. Prevalence of patients delayed more than one day after onset of symptoms was 79.4%, but doctor delay of more than one day occurred in only 1.3%. The prevalence of treatment delay (total delay of more than one day was 79.6%. Patient delay and treatment delay were found to be significantly higher among hill tribe than Thai subjects (P=0.004 and 0.003, respectively but, there was no significant association between ethnicity and doctor delay (P=0.669. Conclusion: Patient delay in seeking treatment is a major problem along the ThailandMyanmar border in Tak province, especially in hill tribe people. Self-treatment accounted for most of initial treatment sought by patients.

  17. The function of advanced treatment process in a drinking water treatment plant with organic matter-polluted source water.

    Science.gov (United States)

    Lin, Huirong; Zhang, Shuting; Zhang, Shenghua; Lin, Wenfang; Yu, Xin

    2017-04-01

    To understand the relationship between chemical and microbial treatment at each treatment step, as well as the relationship between microbial community structure in biofilms in biofilters and their ecological functions, a drinking water plant with severe organic matter-polluted source water was investigated. The bacterial community dynamics of two drinking water supply systems (traditional and advanced treatment processes) in this plant were studied from the source to the product water. Analysis by 454 pyrosequencing was conducted to characterize the bacterial diversity in each step of the treatment processes. The bacterial communities in these two treatment processes were highly diverse. Proteobacteria, which mainly consisted of beta-proteobacteria, was the dominant phylum. The two treatment processes used in the plant could effectively remove organic pollutants and microbial polution, especially the advanced treatment process. Significant differences in the detection of the major groups were observed in the product water samples in the treatment processes. The treatment processes, particularly the biological pretreatment and O 3 -biological activated carbon in the advanced treatment process, highly influenced the microbial community composition and the water quality. Some opportunistic pathogens were found in the water. Nitrogen-relative microorganisms found in the biofilm of filters may perform an important function on the microbial community composition and water quality improvement.

  18. Objectification of Orthodontic Treatment Needs: Does the Classification of Malocclusions or a History of Orthodontic Treatment Matter?

    Science.gov (United States)

    Kozanecka, Anna; Sarul, Michał; Kawala, Beata; Antoszewska-Smith, Joanna

    2016-01-01

    Orthodontic classifications make it possible to give an accurate diagnosis but do not indicate an objective orthodontic treatment need. In order to evaluate the need for treatment, it is necessary to use such indicators as the IOTN. The aim of the study was to find (i) relationships between individual diagnosis and objective recommendations for treatment and (ii) an answer to the question whether and which occlusal anomalies play an important role in the objectification of treatment needs. Two hundred three 18-year-old adolescents (104 girls, 99 boys) were examined. In order to recognize occlusal anomalies, the classifications proposed by Orlik-Grzybowska and Ackerman-Proffit were used. The occlusal anomalies were divided into three categories: belonging to both classifications, typical of OrlikGrzybowska classification and typical of Ackerman-Proffit classification. In order to determine the objective need for orthodontic treatment, the Dental Health Component (DHC) of the IOTN was used. The occurrence of the following malocclusions covered by both classifications, namely abnormal overjet, crossbite and Angle's class, had a statistically significant (p 3). As for the classification by Orlik-Grzybowska, dental malpositions and canine class significantly affected the need for orthodontic treatment, while in the case of the Ackerman-Proffit scheme, it was asymmetry and crowding. There was no statistically significant correlation between past orthodontic treatment and current orthodontic treatment need. IOTN may be affected by a greater number of occlusal anomalies than it was assumed. Orthodontic treatment received in the past slightly reduces the need for treatment in 18-year-olds.

  19. Treatment decision-making processes in the systemic treatment of ovarian cancer: review of the scientific evidence.

    Science.gov (United States)

    Luketina, Hrvoje; Fotopoulou, Christina; Luketina, Ruzica-Rosalia; Pilger, Adak; Sehouli, Jalid

    2012-09-01

    The systemic treatment of epithelial ovarian cancer (OC) is one of the cornerstones in the multimodal management of advanced OC in both primary and recurrent stages of this disease. In most situations various treatment options are available but only few data exists about the treatment decision-making process. Therefore, we conducted a review of the current literature regarding the decision-making process concerning the systemic therapy in patients with advanced ovarian cancer. The electronic database MEDLINE (PubMed) was systematically reviewed for studies that evaluate the treatment decision-making processes in patients with advanced OC. The PubMed database was searched in detail for all titles and abstracts of potentially relevant studies published between 1995 and 2011. An initial search identified 15 potentially relevant studies, but only seven met all inclusion criteria. Factors that influence treatment decisions in patients with OC include not only rational arguments and medical reasons, but also individual attitudes, fears, existential questions, various projections resulting from the physician patient relationship and the social environment. The physician's personal experience with OC treatment seems to be an important factor, followed by previous personal experience with medical issues, and the fear of side-effects and future metastases. Family and self-support organisations also seem to play a significant role in the treatment decision-making process. This review underlines the need for more research activities to explore the treatment decision-making process to enable the best individual support for patients in treatment decision-making. It is a challenge for clinicians to determine the individual information needs of women with OC and to involve them during the decision-making process to the extent they wish.

  20. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product ... and should not stop or delay their conventional treatment. Category: Scam Watch Health Download File Related Videos ...

  1. Low-level-waste-treatment handbook

    International Nuclear Information System (INIS)

    Clinton, S.D.; Goeller, H.E.; Holladay, D.W.; Donaldson, T.L.

    1982-01-01

    The initial draft of the Low-Level Waste Treatment Handbook has been prepared and submitted to the DOE Low-Level Waste Management Program for review and comment. A revised draft is scheduled to be delivered to DOE Headquarters in December 1982. The Handbook is designed to be useful to all individuals and groups concerned with low-level wastes. It is one of several volumes that will ultimately comprise a Low-Level Waste Technology Handbook. The objective of the Low-Level Waste Treatment Handbook is to present an overview of current practices related to the segregation, classification, volume reduction, solidification, handling, packaging, and transportation of LLW for disposal in a shallow land burial facility. The Handbook is intended to serve as a guide to individuals interested in the treatment and handling of low-level radioactive waste. The Handbook will not explicitly tell the user how to design and operate LLW treatment facilities, but rather will identify (1) kinds of information required to evaluate the options, (2) methods that may be used to evaluate these options, and (3) limitations associated with the selection of the treatment options. The focus of the Handbook is providing guidance on how to do waste treatment for disposal by shallow land burial

  2. Treatment of Established Status Epilepticus

    Science.gov (United States)

    Falco-Walter, Jessica J.; Bleck, Thomas

    2016-01-01

    Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early status epilepticus, treatment after benzodiazepine failure (established status epilepticus (ESE)) is incompletely studied. Effective treatment of ESE is critical as morbidity and mortality increases dramatically the longer convulsive status epilepticus persists. Phenytoin/fosphenytoin, valproic acid, levetiracetam, phenobarbital, and lacosamide are the most frequently prescribed antiseizure medications for treatment of ESE. To date there are no class 1 data to support pharmacologic recommendations of one agent over another. We review each of these medications, their pharmacology, the scientific evidence in support and against each in the available literature, adverse effects and safety profiles, dosing recommendations, and limitations of the available evidence. We also discuss future directions including the established status epilepticus treatment trial (ESETT). Substantial further research is urgently needed to identify these patients (particularly those with non-convulsive status epilepticus), elucidate the most efficacious antiseizure treatment with head-to-head randomized prospective trials, and determine whether this differs for convulsive vs. non-convulsive ESE. PMID:27120626

  3. Musical hallucinations: review of treatment effects

    Directory of Open Access Journals (Sweden)

    Jan eCoebergh

    2015-06-01

    Full Text Available AbstractBackground: Despite an increased scientific interest in musical hallucinations throughout the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare.Objective: To review the effects of published treatment methods for musical hallucinations.Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analysed the treatment results in relation to the aetiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion and other pathology, epilepsy or intoxication.Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct aetiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g. more acoustic stimulation are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being more helpful than antiepileptics (which are still better than antipsychotics. The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication is the main aetiological factor, it is important to stop or switch the

  4. Evaluation of Chlorine Treatment Levels for Inactivation of Human Norovirus and MS2 Bacteriophage during Sewage Treatment.

    Science.gov (United States)

    Kingsley, David H; Fay, Johnna P; Calci, Kevin; Pouillot, Régis; Woods, Jacquelina; Chen, Haiqiang; Niemira, Brendan A; Van Doren, Jane M

    2017-12-01

    This study examined the inactivation of human norovirus (HuNoV) GI.1 and GII.4 by chlorine under conditions mimicking sewage treatment. Using a porcine gastric mucin-magnetic bead (PGM-MB) assay, no statistically significant loss in HuNoV binding (inactivation) was observed for secondary effluent treatments of ≤25 ppm total chlorine; for both strains, 50 and 100 ppm treatments resulted in ≤0.8-log 10 unit and ≥3.9-log 10 unit reductions, respectively. Treatments of 10, 25, 50, and 100 ppm chlorine inactivated 0.31, 1.35, >5, and >5 log 10 units, respectively, of the norovirus indicator MS2 bacteriophage. Evaluation of treatment time indicated that the vast majority of MS2 and HuNoV inactivation occurred in the first 5 min for 0.2-μm-filtered, prechlorinated secondary effluent. Free chlorine measurements of secondary effluent seeded with MS2 and HuNoV demonstrated substantial oxidative burdens. With 25, 50, and 100 ppm treatments, free chlorine levels after 5 min of exposure ranged from 0.21 to 0.58 ppm, from 0.28 to 16.7 ppm, and from 11.6 to 53 ppm, respectively. At chlorine treatment levels of >50 ppm, statistically significant differences were observed between reductions for PGM-MB-bound HuNoV (potentially infectious) particles and those for unbound (noninfectious) HuNoV particles or total norovirus particles. While results suggested that MS2 and HuNoV (measured as PGM-MB binding) behave similarly, although not identically, both have limited susceptibility to chlorine treatments of ≤25 ppm total chlorine. Since sewage treatment is performed at ≤25 ppm total chlorine, targeting free chlorine levels of 0.5 to 1.0 ppm, these results suggest that traditional chlorine-based sewage treatment does not inactivate HuNoV efficiently. IMPORTANCE HuNoV is ubiquitous in sewage. A receptor binding assay was used to assess inactivation of HuNoV by chlorine-based sewage treatment, given that the virus cannot be routinely propagated in vitro Results reported here

  5. [Treatment Strategy for Liver Metastasis of Colorectal Cancer - Including Treatment for Oligometastasis].

    Science.gov (United States)

    Sato, Takeo; Nakamura, Takatoshi; Yamanashi, Takahiro; Miura, Hirohisa; Tsutsui, Atsuko; Shimazu, Masashi; Watanabe, Masahiko

    2017-10-01

    The mainstay of treatment for metastatic colorectal cancer is surgery. Therefore, colorectal cancer metastasis is distinctive, compared to other cancer types in which chemotherapy is the main treatment. Initially, Japan experienced medical druglag compared with western countries. However, the use of oxaliplatin for unresectable recurrent metastatic colorectal cancer became available in Japan, as well as in western countries, in 2005. We have since shifted chemotherapeutic regimens from monotherapy to combination therapy with molecular targeted agents. The combination therapy has rapidly become a standard therapy for unresectable metastatic colorectal cancer, and prognosis has dramatically increased for patients with this condition. Herein, we describe the treatment of liver metastasis of colorectal cancer, and surgery and adjuvant or neoadjuvant therapy options for resectable cancer. Furthermore, we focus on conversion therapy for unresectable cancer.

  6. Principled Missing Data Treatments.

    Science.gov (United States)

    Lang, Kyle M; Little, Todd D

    2018-04-01

    We review a number of issues regarding missing data treatments for intervention and prevention researchers. Many of the common missing data practices in prevention research are still, unfortunately, ill-advised (e.g., use of listwise and pairwise deletion, insufficient use of auxiliary variables). Our goal is to promote better practice in the handling of missing data. We review the current state of missing data methodology and recent missing data reporting in prevention research. We describe antiquated, ad hoc missing data treatments and discuss their limitations. We discuss two modern, principled missing data treatments: multiple imputation and full information maximum likelihood, and we offer practical tips on how to best employ these methods in prevention research. The principled missing data treatments that we discuss are couched in terms of how they improve causal and statistical inference in the prevention sciences. Our recommendations are firmly grounded in missing data theory and well-validated statistical principles for handling the missing data issues that are ubiquitous in biosocial and prevention research. We augment our broad survey of missing data analysis with references to more exhaustive resources.

  7. Ketosis treatment in lactating dairy cattle.

    Science.gov (United States)

    Gordon, Jessica L; Leblanc, Stephen J; Duffield, Todd F

    2013-07-01

    This article provides an update on ketosis treatment regimens. The ketosis treatment literature is reviewed and the findings are summarized. Current treatment recommendations and areas for future research are provided. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Treatment of Tourette Syndrome with Cannabinoids

    Directory of Open Access Journals (Sweden)

    Kirsten R. Müller-Vahl

    2013-01-01

    Full Text Available Cannabinoids have been used for hundred of years for medical purposes. To day, the cannabinoid delta-9-tetrahydrocannabinol (THC and the cannabis extract nabiximols are approved for the treatment of nausea, anorexia and spasticity, respectively. In Tourette syndrome (TS several anecdotal reports provided evidence that marijuana might be effective not only in the suppression of tics, but also in the treatment of associated behavioural problems. At the present time there are only two controlled trials available investigating the effect of THC in the treatment of TS. Using both self and examiner rating scales, in both studies a significant tic reduction could be observed after treatment with THC compared to placebo, without causing significant adverse effects. Available data about the effect of THC on obsessive-compulsive symptoms are inconsistent. According to a recent Cochrane review on the efficacy of cannabinoids in TS, definite conclusions cannot be drawn, because longer trials including a larger number of patients are missing. Notwithstanding this appraisal, by many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.

  9. Does CPAP treatment affect the voice?

    Science.gov (United States)

    Saylam, Güleser; Şahin, Mustafa; Demiral, Dilek; Bayır, Ömer; Yüceege, Melike Bağnu; Çadallı Tatar, Emel; Korkmaz, Mehmet Hakan

    2016-12-20

    The aim of this study was to investigate alterations in voice parameters among patients using continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea syndrome. Patients with an indication for CPAP treatment without any voice problems and with normal laryngeal findings were included and voice parameters were evaluated before and 1 and 6 months after CPAP. Videolaryngostroboscopic findings, a self-rated scale (Voice Handicap Index-10, VHI-10), perceptual voice quality assessment (GRBAS: grade, roughness, breathiness, asthenia, strain), and acoustic parameters were compared. Data from 70 subjects (48 men and 22 women) with a mean age of 44.2 ± 6.0 years were evaluated. When compared with the pre-CPAP treatment period, there was a significant increase in the VHI-10 score after 1 month of treatment and in VHI- 10 and total GRBAS scores, jitter percent (P = 0.01), shimmer percent, noise-to-harmonic ratio, and voice turbulence index after 6 months of treatment. Vague negative effects on voice parameters after the first month of CPAP treatment became more evident after 6 months. We demonstrated nonsevere alterations in the voice quality of patients under CPAP treatment. Given that CPAP is a long-term treatment it is important to keep these alterations in mind.

  10. Pasireotide for the treatment of acromegaly.

    Science.gov (United States)

    Wildemberg, Luiz Eduardo; Gadelha, Mônica R

    2016-01-01

    Acromegaly is a chronic disease with high morbidity and enhanced mortality if left untreated. Treatment options include surgery, medical therapy (somatostatin analogues (SA), dopamine agonists (DA) and growth hormone receptor antagonists) and radiotherapy. Despite these treatment options, "real-life" studies have shown that approximately 50% of patients are not controlled. In this scenario, a next-generation SA, pasireotide, has recently been approved for the treatment of acromegaly. 1) pasireotide's pharmacokinetics and pharmacodynamics; 2) pasireotide's anti-secretory and anti-proliferative effects, from preclinical studies up to phase III clinical trials; and 3) the adverse effects of pasireotide, focusing on hyperglycemia; 4) biomarkers of response to SA treatment. surgery is the primary treatment for most patients with acromegaly; however, approximately half of them will need adjuvant therapy. At present, the decision of this adjuvant treatment is made on a "trial-and-error" fashion. Nevertheless, in recent years, efforts have been made to establish biomarkers for the response to drugs involved in the treatment of acromegaly, which will change the treatment of acromegaly towards a more personalized therapeutic decision-making process. In the near future, the establishment of pasireotide response biomarkers will allow us to identify good candidates for first-line medical monotherapy with pasireotide.

  11. Depression Treatment

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Depression Treatment Recommend on Facebook Tweet Share Compartir On ... How Do I Know if I Am Experiencing Depression? The following questions may help you determine if ...

  12. Rotavirus Treatment

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Rotavirus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Rotavirus Home About Rotavirus Symptoms Transmission Treatment Photos Vaccination ...

  13. Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.

    Science.gov (United States)

    Haile, Demewoz; Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

    2016-01-01

    Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95

  14. Thermal treatment for TRU waste sorting

    International Nuclear Information System (INIS)

    Sasaki, Toshiki; Aoyama, Yoshio; Yamashita, Toshiyuki

    2009-03-01

    A thermal treatment that can automatically unpack TRU waste and remove hazardous materials has been developed to reduce the risk of radiation exposure and save operation cost. The thermal treatment is a process of removing plastic wrapping and hazardous material from TRU waste by heating waste at 500 to 700degC. Plastic wrappings of simulated wastes were removed using a laboratory scale thermal treatment system. Celluloses and isoprene rubbers that must be removed from waste for disposal were pyrolyzed by the treatment. Although the thermal treatment can separate lead and aluminum from the waste, a further technical development is needed to separate lead and aluminum. A demonstration scale thermal treatment system that comprises a rotary kiln with a jacket water cooler and a rotating inner cage for lead and aluminum separation is discussed. A clogging prevention system against zinc chloride, a lead and aluminum accumulation system, and a detection system for spray cans that possibly cause explosion and fire are also discussed. Future technology development subjects for the TRU waste thermal treatment system are summarized. (author)

  15. Longitudinal predictors of addictions treatment utilization in treatment-naïve adults with alcohol use disorders.

    Science.gov (United States)

    Ilgen, Mark A; Price, Amanda M; Burnett-Zeigler, Inger; Perron, Brian; Islam, Khairul; Bohnert, Amy S B; Zivin, Kara

    2011-01-15

    Despite the substantial prevalence of alcohol use disorders (AUDs), prior research indicates that most people with AUDs never utilize either formal or informal treatment services. Several prior studies have examined the characteristics of individuals with AUDs who receive treatment; however, limited longitudinal data are available on the predictors of receiving AUD services in treatment-naive individuals with AUDs. This study utilized data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to identify adults in Wave 1 who met criteria for an AUD within the last 12 months and reported no prior lifetime alcohol treatment (N = 2760). These individuals were surveyed again at Wave 2, approximately 3-4 years later (N = 2170). This study examined the Wave 1 demographic and psychiatric conditions that were associated with receipt of AUD treatment services between Waves 1 and 2. In multivariable analyses, use of AUD treatment services between Waves 1 and 2 was significantly more likely among those who were male, non-Caucasian, younger, had lower income, and who had health insurance. Additionally, those who met criteria for a baseline drug use disorder, anxiety disorder or a personality disorder were more likely to receive AUD treatment. Treatment was more often utilized in those who had more severe baseline psychopathology and in those with fewer economic resources. These findings highlight the need to broaden the types of care available to individuals with AUDs to increase the appeal of AUD services. Published by Elsevier Ireland Ltd.

  16. Motivation and treatment credibility predict alliance in cognitive behavioral treatment for youth with anxiety disorders in community clinics.

    Science.gov (United States)

    Fjermestad, K W; Lerner, M D; McLeod, B D; Wergeland, G J H; Haugland, B S M; Havik, O E; Öst, L-G; Silverman, W K

    2017-11-16

    We examined whether motivation and treatment credibility predicted alliance in a 10-session cognitive behavioral treatment delivered in community clinics for youth anxiety disorders. Ninety-one clinic-referred youths (mean age  = 11.4 years, standard deviation = 2.1, range 8-15 years, 49.5% boys) with anxiety disorders-rated treatment motivation at pretreatment and perceived treatment credibility after session 1. Youths and therapists (YT) rated alliance after session 3 (early) and session 7 (late). Hierarchical linear models were applied to examine whether motivation and treatment credibility predicted YT early alliance, YT alliance change, and YT alliance agreement. Motivation predicted high early YT alliance, but not YT alliance change or alliance agreement. Youth-rated treatment credibility predicted high early youth alliance and high YT positive alliance change, but not early therapist alliance or alliance agreement. Conclusion Efforts to enhance youth motivation and treatment credibility early in treatment could facilitate the formation of a strong YT alliance. © 2017 Wiley Periodicals, Inc.

  17. Day-care treatment for multiple drug abusing adolescents: social factors linked with completing treatment.

    Science.gov (United States)

    Feigelman, W

    1987-01-01

    By identifying some of the social correlates linked with completing day-care drug abuse treatment, the present study has sought to broaden understanding of how drug rehabilitations are effected. As the findings have demonstrated, completing care is a result of a complex array of causes and their interaction. The disposition of the entering patient (i.e., their determination and other strengths) has a great bearing on treatment outcome. It is also a result of the patient's family, their motivations, resources and perseverance in enduring a long course of demanding therapeutic interventions. In addition, it is the product of meanings shared and transmitted between the patient's family and the treatment staff. Patients and their families project positive attitudes about the value of the therapeutic enterprise as well as a compliant demeanor. As staff recognize that patients and parents are acting cooperatively, then such perceptions tend to create self-fulfilling prophecies. The data has established that older adolescent patients are more likely to possess the motivational resources needed for program completion than younger patients. Apparently, self-referred patients are also more inclined to meet the demands of program requirements than those referred by the courts or other outside social agencies, although the differences fell short of the .05 level of statistical significance. Those completing the program are less likely to be diagnosed as depressed at intake. Parental characteristics comprise another group of variables that are related to treatment completion. Parents of higher occupational rank, who have had mental health care for themselves, and who are of Jewish ethnicity appear to possess useful strengths for meeting program challenges. The pattern of spouse mutuality in dealing with a child's needs as it exists preceding and during treatment seems to be another useful asset for successfully getting through this form of treatment. While parents with the

  18. Treatment Satisfaction in Multiple Sclerosis

    OpenAIRE

    Glanz, Bonnie I.; Musallam, Alexander; Rintell, David J.; Chitnis, Tanuja; Weiner, Howard L.; Healy, Brian C.

    2014-01-01

    Background: Disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) are associated with inconvenient methods of administration, significant side effects, and low adherence rates. This study was undertaken to compare treatment satisfaction in MS patients treated with interferon beta-1a intramuscular (IFNβ-1a IM), interferon beta-1a subcutaneous (IFNβ-1a SC), glatiramer acetate (GA), and natalizumab (NTZ), and to examine the associations between treatment satisfaction ra...

  19. Childhood vitiligo: Treatment paradigms

    Directory of Open Access Journals (Sweden)

    Amrinder Jit Kanwar

    2012-01-01

    Full Text Available Childhood vitiligo differs from the adults by showing a higher incidence in females, segmental vitiligo being more common and less frequent association with other systemic autoimmune and endocrine disorders.Childhood vitiligo is often associated with a marked psychosocial and long lasting effect on the self-esteem of the affected children and their parents, hence an adequate treatment is very essential. Treatment of vitiligo is indeed a tough challenge for the dermatologists′ more so in the background of childhood vitiligo. Although multiple therapeutic modalities are available in the therapeutic armamentarium, not all can be used in children. This brief report updates regarding various therapies available in the treatment of childhood vitiligo.

  20. New treatments for gout.

    Science.gov (United States)

    Mapa, Janet B; Pillinger, Michael H

    2010-05-01

    Gout is a commonly occurring medical condition that can lead to significant morbidity. Therapies available for the treatment of both acute and chronic gouty arthritis have not changed significantly since the 1960s. Although these treatments are well established, they are often contraindicated in the presence of various different comorbidities, including diabetes, renal insufficiency, hypertension and gastrointestinal disease, all of which can occur frequently in patients with gout. Therefore, new treatments are needed. This review describes recent advances in therapeutics for gout, including drugs designed to reduce levels of urate and to inhibit acute or chronic inflammation. While some of these strategies are currently available, others are undergoing regulatory evaluation or are at earlier stages of development.

  1. Role of radiation treatment in craniopharyngioma

    Energy Technology Data Exchange (ETDEWEB)

    Chin, H.W.; Maruyama, Y.; Young, B.

    1983-12-01

    The long natural course of craniopharyngioma and short-term follow-up period in many reports make comparison of various treatment results difficult. Some patients may enjoy virtually symptom-free lives despite known recurrence. Some patients with recurrence may have a good response to retreatment. Such unpredictable behavior and treatment responses have led to considerable disparity in clinical reports concerning the best treatment method. Treatments using surgery alone and/or low dose postoperative radiation treatment could prolong survival time, but may not prevent recurrence leading to ultimate failure. High dose postoperative radiotherapy following radical surgery should be an ideal approach in dealing with this tumor.

  2. Systematic review of catatonia treatment

    Directory of Open Access Journals (Sweden)

    Pelzer ACM

    2018-01-01

    Full Text Available Anne CM Pelzer,1 Frank MMA van der Heijden,2 Erik den Boer3 1Department of Psychiatry, Reinier van Arkel, ‘s-Hertogenbosch, 2Department of Psychiatry, Vincent van Gogh Institute for Psychiatry, Venlo, 3Department of Psychiatry, GGzE, Eindhoven, the Netherlands Objective: To investigate the evidence-based treatment of catatonia in adults. The secondary aim is to develop a treatment protocol. Materials and methods: A systematic review of published treatment articles (case series, cohort or randomized controlled studies which examined the effects of particular interventions for catatonia and/or catatonic symptoms in adult populations and used valid outcome measures was performed. The articles for this review were selected by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE and PSYCHINFO. Results: Thirty-one articles met the inclusion criteria. Lorazepam and electroconvulsive therapy (ECT proved to be the most investigated treatment interventions. The response percentages in Western studies varied between 66% and 100% for studies with lorazepam, while in Asian and Indian studies, they were 0% and 100%. For ECT, the response percentages are 59%–100%. There does not seem to be evidence for the use of antipsychotics in catatonic patients without any underlying psychotic disorder. Conclusion: Lorazepam and ECT are effective treatments for which clinical evidence is found in the literature. It is not possible to develop a treatment protocol because the evidence for catatonia management on the basis of the articles reviewed is limited. Stringent treatment studies on catatonia are warranted. Keywords: review, catatonia, therapeutics, electroconvulsive therapy, benzodiazepines, lorazepam, ECT

  3. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.

    Science.gov (United States)

    Kemler, Ellen; van de Port, Ingrid; Backx, Frank; van Dijk, C Niek

    2011-03-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of taping the ankle. The purpose of this review is to evaluate the effectiveness of ankle braces as a treatment for acute ankle sprains compared with other types of functional treatments such as ankle tape and elastic bandages. A computerized literature search was conducted using PubMed, EMBASE, CINAHL and the Cochrane Clinical Trial Register. This review includes randomized controlled trials in English, German and Dutch, published between 1990 and April 2009 that compared ankle braces as a treatment for lateral ankle sprains with other functional treatments. The inclusion criteria for this systematic review were (i) individuals (sports participants as well as non-sports participants) with an acute injury of the ankle (acute ankle sprains); (ii) use of an ankle brace as primary treatment for acute ankle sprains; (iii) control interventions including any other type of functional treatment (e.g. Tubigrip™, elastic wrap or ankle tape); and (iv) one of the following reported outcome measures: re-injuries, symptoms (pain, swelling, instability), functional outcomes and/or time to resumption of sports, daily activities and/or work. Eight studies met all inclusion criteria. Differences in outcome measures, intervention types and patient characteristics precluded pooling of the results, so best evidence syntheses were conducted. A few individual studies reported positive outcomes after treatment with an ankle brace compared with other functional methods, but our best evidence syntheses only demonstrated a better treatment result in terms of functional outcome. Other studies have suggested that ankle brace treatment is a more cost-effective method, so the use of braces after acute

  4. A comparative review of the options for treatment of erectile dysfunction: which treatment for which patient?

    Science.gov (United States)

    Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios G

    2005-01-01

    The field of erectile dysfunction (ED) has been revolutionised over the last two decades. Several treatment options are available today, most of which are associated with high efficacy rates and favourable safety profiles. A MEDLINE search was undertaken in order to evaluate all currently available data on treatment modalities for ED. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first-choice of most physicians and patients for the treatment of ED. PDE5 inhibitors have differences in their pharmacological profiles, the most obvious being the long duration of action of tadalafil, but there are no data supporting superiority for any one of them in terms of efficacy or safety. Sublingual apomorphine has limited efficacy compared with the PDE5 inhibitors, and its use is limited to patients with mild ED. Treatment failures with oral drugs may be due to medication, clinician and patient issues. The physician needs to address all of these issues in order to identify true treatment failures. Patients who are truly unresponsive to oral drugs may be offered other treatment options.Intracavernous injections of alprostadil alone, or in combination with other vasoactive agents (papaverine and phentolamine), remain an excellent treatment option, with proven efficacy and safety over time. Topical pharmacotherapy is appealing in nature, but currently available formulations have limited efficacy. Vacuum constriction devices may be offered mainly to elderly patients with occasional intercourse attempts, as younger patients show limited preference because of the unnatural erection that is associated with this treatment modality. Penile prostheses are generally the last treatment option offered, because of invasiveness, cost and non-reversibility; however, they are associated with high satisfaction rates in properly selected patients. All treatment options are associated with particular strengths and weaknesses. A patient

  5. Treatment Options by Stage (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

  6. Treatment modalities of palatal impacted canines

    OpenAIRE

    Dimova, Cena; Papakoca, Kiro; Ristoska, Sonja; Kovacevska, Ivona

    2012-01-01

    Introduction: The orthodontic treatment of impacted maxillary canine remains a challenge to today’s clinicians. The treatment of this clinical entity usually involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The impacted palatal canine requires a combination of both treatment modalities: orthodontic management and oral surgical treatment. Two types of approach are commonly used: simple exposure, or exposure with brac...

  7. Statistical aspects of optimal treatment assignment

    OpenAIRE

    van der Linden, Willem J.

    1980-01-01

    The issues of treatment assignment is ordinarily dealt with within the framework of testing aptitude treatment interaction (ATI) hypothesis. ATI research mostly uses linear regression techniques, and an ATI exists when the aptitude treatment (AT) regression lines cross each other within the relevant interval of the aptitude variable. Consistent with this approach is the use of the points of interaction of AT regression lines as treatment-assignment rule. The replacement of such rules by monot...

  8. Technologies 1995: environment and wastes treatment

    International Nuclear Information System (INIS)

    Anon.

    1995-03-01

    From new technical or scientific developments, new products launching, and markets evolutions, this catalog gives informations selection on research and development projects, new fabrication processes, activities and plants strategies, licences or technology transfers opportunities. The covered fields are: atmospheric pollution controls, water and liquid wastes treatment, polluted soils treatments, noise and odors treatments, municipal and industrial wastes treatments (metal, plastic, paper, glass), clean materials and technologies, radioactive wastes, and european cooperation programs. (A.B.)

  9. Treatment options for Primary CNS Lymphoma.

    Science.gov (United States)

    Laghari, Altaf Ali; Ahmed, Syed Ijlal; Jabbar, Adnan; Shamim, Muhammad Shahzad

    2018-03-01

    Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.

  10. Autonomous and controlled motivation for eating disorders treatment: baseline predictors and relationship to treatment outcome.

    Science.gov (United States)

    Carter, Jacqueline C; Kelly, Allison C

    2015-03-01

    This study aimed to identify baseline predictors of autonomous and controlled motivation for treatment (ACMT) in a transdiagnostic eating disorder sample, and to examine whether ACMT at baseline predicted change in eating disorder psychopathology during treatment. Participants were 97 individuals who met DSM-IV-TR criteria for an eating disorder and were admitted to a specialized intensive treatment programme. Self-report measures of eating disorder psychopathology, ACMT, and various psychosocial variables were completed at the start of treatment. A subset of these measures was completed again after 3, 6, 9, and 12 weeks of treatment. Multiple regression analyses showed that baseline autonomous motivation was higher among patients who reported more self-compassion and more received social support, whereas the only baseline predictor of controlled motivation was shame. Multilevel modelling revealed that higher baseline autonomous motivation predicted faster decreases in global eating disorder psychopathology, whereas the level of controlled motivation at baseline did not. The current findings suggest that developing interventions designed to foster autonomous motivation specifically and employing autonomy supportive strategies may be important to improving eating disorders treatment outcome. The findings of this study suggest that developing motivational interventions that focus specifically on enhancing autonomous motivation for change may be important for promoting eating disorder recovery. Our results lend support for the use of autonomy supportive strategies to strengthen personally meaningful reasons to achieve freely chosen change goals in order to enhance treatment for eating disorders. One study limitation is that there were no follow-up assessments beyond the 12-week study and we therefore do not know whether the relationships that we observed persisted after treatment. Another limitation is that this was a correlational study and it is therefore important

  11. Refinement of the basic treatment equivalent model to reflect radiotherapy treatment throughput using Australasian data

    International Nuclear Information System (INIS)

    Delaney, G.; Gebski, V.; Sydney University, NSW; Lunn, A.D.; Open University, Milton Keynes,; Oxford University, Oxford,; Lunn, M.; Oxford University, Oxford,

    1999-01-01

    The present study aims to develop a more sensitive basic treatment equivalent (BTE) model that still measures linear accelerator throughput and considers some of the shortcomings of the previous model. All radiation oncology departments in Australia and New Zealand were invited to participate. Departments were asked to time with a stopwatch all episodes of radiotherapy treatment over a 4-week period. Data collected for each treatment fraction included treatment intent, tumour site, patient age, Eastern Cooperative Oncology Group (ECOG) performance status, number of fields used, number of wedges used, number of junctions, number of shielding blocks used, whether the treatment was the first fraction, the use of general anaesthesia and whether port films or electronic portal imaging was used. Twenty-six departments of radiation oncology (70%) participated in this trial. A total of 7929 fractions of treatment, administered to 2424 patients, were timed. The factors found to most significantly impact on treatment duration on multivariate analysis were the type of fraction (first fraction was longer than subsequent fractions), type of beam (electrons were quicker than photons, which were quicker than mixed), number of fields, number of shields, number of junctions, number of port films and performance status (ECOG 2). The age of the patient, number of compensators and the sex of the patient were not significant. The relationships between factors were assessed, and models of measuring linear accelerator throughput which consider complexity corrections were derived. It is possible to show that linear accelerator throughput is poorly measured by just considering numbers of patients or fields treated per unit time; and that other factors that impact on treatment duration must be considered. A more sensitive model of patient throughput is suggested; but even when a large number of factors are considered, some insensitivity still remains in the model. Copyright (1999) Blackwell

  12. Radwaste treatment and disposal

    International Nuclear Information System (INIS)

    Ehn, L.; Breza, M.; Pekar, A.

    2000-01-01

    In this lecture is given the basic information, that is concerning on the RAW treatment and long term disposal of the treated RAW in repository at Mochovce. Then here is given the basic technical and technological information, that is concerning bituminization, plant, the vitrification unit, center for the RAW-treatment (BSC) and repository at Mochovce. (authors)

  13. Targeted treatment in early rheumatoid arthritis

    NARCIS (Netherlands)

    Klarenbeek, Naomi Bertine

    2013-01-01

    With the implementation of new treatment options, including biologicals and the early, agressive start of target-steered treatment the outlook for rheumatoid arthritis patients improved considerably the past decades. This thesis describes several aspects of modern rheumatoid arthritis treatment from

  14. Assertive Community Treatment in the Netherlands

    NARCIS (Netherlands)

    M.D. van Vugt (Maaike)

    2015-01-01

    markdownabstract__Abstract__ __Introduction: __ Assertive Community Treatment is a model for care and treatment of patients with the most severe mental illness in the community. Key principles of Assertive Community Treatment (ACT) are: integration of services, low patient–staff ratio, locus of

  15. PREVALENCE OF MULTIPLE ADDICTIONS AND CURRENT TREATMENT BY DRUG TREATMENT CENTRES IN DURBAN, SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Keen, Helen

    2015-09-01

    Full Text Available Substance-use disorders (SUD cause severe problems both globally and locally. Research suggests that multiple addictions create a more complex illness. This study investigated whether in-patients admitted for SUD at three drug treatment centres in Durban, South Africa had other, undiagnosed addictions. It utilised a three-phase concurrent mixed-methods design and initially screened for gambling and sex addiction. Results showed that, of the sample of 123 participants, 54% had either sex or gambling and 24% had both addictions which current treatment programmes neither assessed for nor treated. Recommendations include suggestions to update current assessment and treatment approaches and the need to train professional staff at drug treatment centres.

  16. Considering patient values and treatment preferences enhances patient involvement in rectal cancer treatment decision making.

    Science.gov (United States)

    Kunneman, Marleen; Marijnen, Corrie A M; Baas-Thijssen, Monique C M; van der Linden, Yvette M; Rozema, Tom; Muller, Karin; Geijsen, Elisabeth D; Stiggelbout, Anne M; Pieterse, Arwen H

    2015-11-01

    The shared decision making (SDM) model states that patients' values and preferences should be clarified to choose a strategy that best fits the patient. This study aimed to assess whether values and preferences of rectal cancer patients are voiced and considered in deciding about preoperative radiotherapy (PRT), and whether this makes patients feel more involved in treatment decision making. Pre-treatment consultations of radiation oncologists and patients eligible for PRT were audiotaped (N=90). Tapes were transcribed and coded to identify patients' values and treatment preferences. Patients filled in a post-consultation questionnaire on their perceived involvement in decision making (N=60). Patients' values were voiced for 62/611 of benefits/harms addressed (10%), in 38/90 consultations (42%; maximum 4 values per consultation), and most often related to major long-term treatment outcomes. Patients' treatment preferences were discussed in 20/90 consultations (22%). In 16/90 consultations (18%), the oncologists explicitly indicated to consider patients' values or preferences. Patients perceived a significantly more active role in decision making if their values or preferences had been voiced or considered. Patients' values and treatment preferences are voiced or considered in a minority of consultations. If they are, this increases patients' perceived involvement in the decision making process. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Treatment Deployment Evaluation Tool

    International Nuclear Information System (INIS)

    M. A. Rynearson; M. M. Plum

    1999-01-01

    The U.S. Department of Energy (DOE) is responsible for the final disposition of legacy spent nuclear fuel (SNF). As a response, DOE's National Spent Nuclear Fuel Program (NSNFP) has been given the responsibility for the disposition of DOE-owned SNF. Many treatment technologies have been identified to treat some forms of SNF so that the resulting treated product is acceptable by the disposition site. One of these promising treatment processes is the electrometallurgical treatment (EMT) currently in development; a second is an Acid Wash Decladding process. The NSNFP has been tasked with identifying possible strategies for the deployment of these treatment processes in the event that a treatment path is deemed necessary. To support the siting studies of these strategies, economic evaluations are being performed to identify the least-cost deployment path. This model (tool) was developed to consider the full scope of costs, technical feasibility, process material disposition, and schedule attributes over the life of each deployment alternative. Using standard personal computer (PC) software, the model was developed as a comprehensive technology economic assessment tool using a Life-Cycle Cost (LCC) analysis methodology. Model development was planned as a systematic, iterative process of identifying and bounding the required activities to dispose of SNF. To support the evaluation process, activities are decomposed into lower level, easier to estimate activities. Sensitivity studies can then be performed on these activities, defining cost issues and testing results against the originally stated problem

  18. [Verruca planae Chinese medicine treatment].

    Science.gov (United States)

    Chen, Hai-Ming

    2008-08-01

    Flat wart on the effectiveness of TCM treatment. Outpatients will be by the "People's Republic of China Chinese medicine industry standards, TCM diagnosis of dermatological diseases efficacy standards, Chen Hou State Administration of Traditional Chinese Medicine 1994-06-28 approved, 1995-01-01 implementation". Randomly divided into two groups. Treatment and control groups. Treatment groups treated with Chinese herbs. The control group were treated with WM. Since the preparation of the unification formula ointment, cuboiling method. Chinese herbal medicine preparation by my hospital room Producer. 5 g pre pack, after treatment for 30 days, clinical observation. The group of Chinese medicine is better than western medicine (86.7% vs 71.7% , P < 0.05). Chinese medicine has some effect flat wart.

  19. Antipsychotic Polypharmacy in a Treatment-Refractory Schizophrenia Population Receiving Adjunctive Treatment With Electroconvulsive Therapy

    DEFF Research Database (Denmark)

    Kristensen, Diana; Hageman, Ida; Bauer, Jeanett

    2013-01-01

    Antipsychotic polypharmacy (APP) is frequent, but its pattern is unknown in treatment-refractory schizophrenia-spectrum patients receiving electroconvulsive therapy (ECT).......Antipsychotic polypharmacy (APP) is frequent, but its pattern is unknown in treatment-refractory schizophrenia-spectrum patients receiving electroconvulsive therapy (ECT)....

  20. Statistical aspects of optimal treatment assignment

    NARCIS (Netherlands)

    van der Linden, Willem J.

    The issues of treatment assignment is ordinarily dealt with within the framework of testing aptitude treatment interaction (ATI) hypothesis. ATI research mostly uses linear regression techniques, and an ATI exists when the aptitude treatment (AT) regression lines cross each other within the relevant

  1. Interferon-α treatment in systemic mastocytosis

    DEFF Research Database (Denmark)

    Bjerrum, Ole Weis

    2011-01-01

    classification need treatment. This review on interferon treatment in systemic mastocytosis documents an effect of this biological agent in some patients with mastocytosis. However, the place of interferon-a, as mono- or combination therapy, in the treatment algorithm may only be definitely established...

  2. Balancing treatment allocations by clinician or center in randomized trials allows unacceptable levels of treatment prediction.

    Science.gov (United States)

    Hills, Robert K; Gray, Richard; Wheatley, Keith

    2009-08-01

    Randomized controlled trials are the standard method for comparing treatments because they avoid the selection bias that might arise if clinicians were free to choose which treatment a patient would receive. In practice, allocation of treatments in randomized controlled trials is often not wholly random with various 'pseudo-randomization' methods, such as minimization or balanced blocks, used to ensure good balance between treatments within potentially important prognostic or predictive subgroups. These methods avoid selection bias so long as full concealment of the next treatment allocation is maintained. There is concern, however, that pseudo-random methods may allow clinicians to predict future treatment allocations from previous allocation history, particularly if allocations are balanced by clinician or center. We investigate here to what extent treatment prediction is possible. Using computer simulations of minimization and balanced block randomizations, the success rates of various prediction strategies were investigated for varying numbers of stratification variables, including the patient's clinician. Prediction rates for minimization and balanced block randomization typically exceed 60% when clinician is included as a stratification variable and, under certain circumstances, can exceed 80%. Increasing the number of clinicians and other stratification variables did not greatly reduce the prediction rates. Without clinician as a stratification variable, prediction rates are poor unless few clinicians participate. Prediction rates are unacceptably high when allocations are balanced by clinician or by center. This could easily lead to selection bias that might suggest spurious, or mask real, treatment effects. Unless treatment is blinded, randomization should not be balanced by clinician (or by center), and clinician-center effects should be allowed for instead by retrospectively stratified analyses. © 2009 Blackwell Publishing Asia Pty Ltd and Chinese

  3. Treatment of skeletal class II in a growing patient using two-phase treatment

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Neela

    2018-01-01

    Full Text Available This case was submitted to the board under category II for the Indian Board of Orthodontics examination, November 2016. The summary of the treatment, various records, treatment progress, and critical appraisal are reprinted here with minimal editing and reformatting and hence that the presentation resembles the actual documents submitted to the board.

  4. Wavefront-Guided and Wavefront-Optimised Laser Treatments

    Directory of Open Access Journals (Sweden)

    Canan Aslı Utine

    2012-12-01

    Full Text Available Optical aberrations of the eye are the errors of the optical system that limit the resolution, contrast and amount of detail in the image formed on the retina. Wavefront technology allows us to measure these optical aberrations, calculate mathematically, and transfer this information into excimer laser system to perform customized treatment on the cornea. Two treatment algorithms developed to create low aberration-corneal profile are wavefront-optimised (WF-O and wavefront-guided (WF-G treatments. WF-O treatment, aims not to increase the existing spherical aberration while treatment is based on manifest refractive error as in conventional laser treatments. By increasing the number of laser spots applied peripherally in order to optimize the corneal asphericity, the preoperative central:peripheral keratometry ratio is preserved and optic zone shrinkage is prevented. On the other hand, WF-G treatment is based on aberrometry measurements and aims to correct the existing high-order aberrations in the eye. Thus, retinal image with high spatial details can be achieved. However, presence of postoperative defocus can abolish the successful results obtained with WF-G treatment. Clinical randomized controlled trials showed that in patients with preoperative RMS value of <0.3 μm, higher order aberration outcomes are similar after WF-G and WF-O treatments, but WF-G treatment yields better results when it is ≥0.4 μm. In normal eyes, very limited visual advantage can be achieved with WF-G treatment and preservation of asphericity value with WF-O treatment carries greater importance. On the other hand, in case of high astigmatism or higher order aberrations other than spherical aberration, decreasing aberrations with WF-G treatment becomes more important. In this study, we aimed to make a comparative analysis of characteristics and outcomes of the two treatment algorithms. (Turk J Ophthalmol 2012; 42: 474-8

  5. [Modern treatment of type B dissections

    DEFF Research Database (Denmark)

    Klitfod, L.; Baekgaard, N.; Just, S.

    2008-01-01

    Rapid classification is essential in the management of aortic dissections, as Type A dissections require surgery, while the optimal treatment of Type B dissections is controversial. Medical treatment with antihypertensive medication and analgesics has so far been the main treatment of uncomplicated...... Type B dissections, while surgery has been reserved for complications and persistent pain in spite of medical treatment. Endovascular techniques are less invasive than open repair and show promising early results Udgivelsesdato: 2008/9/8...

  6. Modelling of treatment couch top with prowess panther treatment planning system for external beam radiotherapy

    International Nuclear Information System (INIS)

    Owusu-Agyapong, Linus

    2016-07-01

    The aim of this work is to evaluate the attenuation effects of a treatment couch and to alternatively model the couch top material with a Prowess Panther treatment planning system which does not support couch top modelling. The Hounsfield Unit classification of the couch structure was determined using a PMMA phantom by comparing ion chamber measurements with the dose forecasted by the treatment planning system (TPS). The transmission factor (TF) of the couch top was determined and was used as a TF for a treatment accessory that represented the treatment couch in the TPS. A treatment plan was done for various angles with and without the interference of the couch top and a simulated treatment was done using the PMMA phantom. Ion chamber measurement were made and compared with dose predicted by the TPS to evaluate the accuracy of the couch top modelling in the treatment planning system TPS. These investigations were done for various field sizes. The ideal set of HU for the couch was established to be -674. The measured TF was 0.956042 and the TPS calculated Transmission factor was 0.951456. The percentage difference between the measured and calculated TFs was 0.48% and this agrees perfectly with the IAEA recommended tolerance of 2%. Relative attenuation measurements were as high as 54.16% and as low as 0.63% for the beams that exited the couch before interacting with the phantom. In comparing couch modelling by couch simulation and couch TF insert, it was observed that the normalized doses were the same for 5×5 square field but deviated approximately 1% for the other field sizes. The highest deviation was observed at 10×10 square field. This study demonstrates that the couch simulation method of couch modelling is the best method that can be used to account for the effect of the treatment couch top on intersecting posterior beam fields. Thus, the attenuation effects of the treatment couch was effectively evaluated and the couch top material accurately modelled in

  7. Phenomenology and treatment of selective mutism.

    Science.gov (United States)

    Kumpulainen, Kirsti

    2002-01-01

    Selective mutism is a multidimensional childhood disorder in which, according to the most recent studies, biologically mediated temperament and anxiety components seem to play a major role. Several psychotherapy methods have been reported in case studies to be useful, but the disorder is commonly seen to be resistant to change, particularly in cases of long duration. Currently, behaviour modification and other cognitive methods, together with cooperation with the family and the school personnel, are recommended in the treatment of selective mutism. Selective serotonin reuptake inhibitors and selective monoamine oxidase inhibitors have also been reported to be helpful when treating children with selective mutism. At the moment, pharmacotherapy cannot be recommended as the treatment of first choice but if other methods of treatment are not helpful, medication can be included in the treatment scheme. Comprehensive evaluation and treatment of possible primary and comorbid problems that require treatment are also essential.

  8. Concurrent Electroconvulsive Therapy and Bupropion Treatment.

    Science.gov (United States)

    Takala, Christopher R; Leung, Jonathan G; Murphy, Lauren L; Geske, Jennifer R; Palmer, Brian A

    2017-09-01

    Bupropion is associated with a dose-dependent increased risk of seizures. Use of concomitant bupropion and electroconvulsive therapy (ECT) remains controversial because of an increased risk of prolonged seizures. This is the first systematic evaluation of the effect of bupropion on ECT. A case group (n = 119), patients treated with concomitant ECT and bupropion, was compared with an age and gender frequency-matched control group (n = 261), treated with only ECT. Electroconvulsive therapy treatment data including seizure length, number of treatments, and concurrent medications were extracted. Longitudinal mixed models examined ECT versus ECT + bupropion group differences over the course of treatments measured by seizure duration (electroencephalogram [EEG] and motor). Multivariable models examined the total number of treatments and first and last seizure duration. All models considered group differences with ECT treatment measures adjusted for age, gender, benzodiazepine treatment, lead placement, and setting. Electroconvulsive therapy treatment with bupropion led to shorter motor seizure duration (0.047) and EEG seizure duration (P = 0.001). The number of ECT treatments (7.3 vs 7.0 treatments; P = 0.23), respectively, or the probability of a prolonged seizure (P = 0.15) was not significantly different. Benzodiazepine use was significantly more common in control subjects (P = 0.01). This is a retrospective analysis limited in part by unavailable variables (seizure threshold, nature of EEG and motor seizure monitoring, type of ECT device, dosing and formulation of bupropion, and duration of the current depressive illness). This study revealed a significantly shorter duration in seizure length with ECT + concomitant bupropion, but not in the number of required treatments in those treated compared with ECT without bupropion. There remains a critical need to reevaluate the efficacy of concomitant use of psychotropic medications + ECT.

  9. Overview of manure treatment in France.

    Science.gov (United States)

    Loyon, L

    2017-03-01

    Manure treatment becomes a focal issue in relation to current EU and national policies on environmental, climate and renewable energy matters. The objective of this desk study was to collect all available data on the treatment of manure from cattle, pig and poultry farms for an overview of manure treatment in France. Specific surveys in 2008 showed that 12% of pig farms, 11% of poultry farms and 7.5% of cattle farms was concerned by manure treatment. Taken together, the treatment of pig, poultry and cattle manure accounted for 13.6milliontons corresponding to 11.3% of the total annual tonnage (120milliontons). The main processes, mostly applied on the farm, were composting (8.5milliontons), aerobic treatment (2.9milliontons of pig slurry) and anaerobic digestion (1milliontons). Other manure treatments, including physical-chemical treatment, were less frequent (0.4million of m 3 ). Treated manure was mainly used to fertilize the soil and crops on the farm concerned. Manure treatment can thus be considered to be underused in France. However, anaerobic digestion is expected to expand to reach the European target of 20% of energy from renewable sources. Nevertheless, this expansion will depend on overcoming the constraint requiring registration or normalization of the use of the digestate as fertilizer. Thus, to avoid penalizing farmers, the further development or creation of collective processing platforms is recommended, combined with an N recovery process that will enable the production of organic amendments and fertilizers in an easy marketable form. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Endoscopic treatment of prepatellar bursitis.

    Science.gov (United States)

    Huang, Yu-Chih; Yeh, Wen-Lin

    2011-03-01

    Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory.

  11. Psychological Treatment

    Science.gov (United States)

    ... cognitive-behavioral therapy ), relaxation therapy , hypnotherapy , and biofeedback therapy . Psychological treatments can also be combined. Review of well- ... Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics ... Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online ...

  12. Intermediate treatments

    Science.gov (United States)

    John R. Jones; Wayne D. Shepperd

    1985-01-01

    Intermediate treatments are those applied after a new stand is successfully established and before the final harvest. These include not only intermediate cuttings - primarily thinning - but also fertilization, irrigation, and protection of the stand from damaging agents.

  13. Building 107 for surface treatment

    CERN Multimedia

    Brice, Maximilien

    2018-01-01

    A brand new state-of-the-art building hosting laboratories for the surface treatment of vacuum equipment and workshops for the manufacturing and treatment of printed circuit boards was completed in 2017.

  14. Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

    Science.gov (United States)

    Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

    2018-04-01

    To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

  15. Microwave treatment of BPH: still an option?

    NARCIS (Netherlands)

    de la Rosette, J. J.

    1994-01-01

    Surgery, the gold standard in the treatment of benign prostatic hyperplasia (BPH), is presently performed in the majority of patients who receive treatment. An increasing number of alternative options recently became available for treatment of BPH and especially minimal invasive treatment

  16. Implicit and Explicit Attitudes Toward Spiders : Sensitivity to Treatment and Predictive Value for Generalization of Treatment Effects

    NARCIS (Netherlands)

    Huijding, Jorg; de Jong, Peter J.

    This study tested whether high spider fearful individuals' implicit and explicit attitudes toward spiders are sensitive to exposure treatment, and whether post-treatment implicit and/or explicit attitudes are related to the generalization of treatment effects. Self-reported explicit and implicit

  17. A Distributive Model of Treatment Acceptability

    Science.gov (United States)

    Carter, Stacy L.

    2008-01-01

    A model of treatment acceptability is proposed that distributes overall treatment acceptability into three separate categories of influence. The categories are comprised of societal influences, consultant influences, and influences associated with consumers of treatments. Each of these categories are defined and their inter-relationships within…

  18. ATOPIC DERMATITIS: NEW ASPECTS OF TREATMENT

    Directory of Open Access Journals (Sweden)

    D. Sh. Macharadze

    2013-01-01

    Full Text Available Atopic dermatitis is a chronic inflammatory cutaneous disease, which demands a prolonged treatment. A modern views on the main approaches to treatment of atopic dermatitis in children and adults are analyzed in this article. The treatment is based on the permanent use of emollients in order to achieve an anti-inflammatory effect — topical calcineurin inhibitors (tacrolimus and pimecrolimus, and short courses (5 days of topical corticosteroids during relapses. For the 10-year period of topical calcineurin inhibitors usage in treatment of atopic dermatitis a great amount of experimental and clinical data have been accumulated. Two the most important changes and additions in the treatment of atopic dermatitis in recent times were related to a new hypothesis of proactive therapy with the use of topical tacrolimus and closing of «black box» warnings, associated to malignization risk due to the long-term usage of topical calcineurin inhibitors. Since atopic dermatitis is characterized by relapsing course, nowadays topical tacrolimus should be considered the most appropriate treatment approach, both in adults and children. The results of investigations confirmed more than 6-times decrease in relapse rate, as well as the significant improvement of quality of life, when the above-mentioned treatment scheme is used, both in children and adults.Key words: children, atopic dermatitis, emollients, treatment, tacrolimus.

  19. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments - United States, 2015-2017.

    Science.gov (United States)

    DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S

    2018-04-06

    Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).

  20. 3D treatment planning systems.

    Science.gov (United States)

    Saw, Cheng B; Li, Sicong

    2018-01-01

    Three-dimensional (3D) treatment planning systems have evolved and become crucial components of modern radiation therapy. The systems are computer-aided designing or planning softwares that speed up the treatment planning processes to arrive at the best dose plans for the patients undergoing radiation therapy. Furthermore, the systems provide new technology to solve problems that would not have been considered without the use of computers such as conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). The 3D treatment planning systems vary amongst the vendors and also the dose delivery systems they are designed to support. As such these systems have different planning tools to generate the treatment plans and convert the treatment plans into executable instructions that can be implemented by the dose delivery systems. The rapid advancements in computer technology and accelerators have facilitated constant upgrades and the introduction of different and unique dose delivery systems than the traditional C-arm type medical linear accelerators. The focus of this special issue is to gather relevant 3D treatment planning systems for the radiation oncology community to keep abreast of technology advancement by assess the planning tools available as well as those unique "tricks or tips" used to support the different dose delivery systems. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  1. Recidivism after treatment in a forensic youth-psychiatric setting: the effect of treatment characteristics

    NARCIS (Netherlands)

    van der Put, C.E.; Asscher, J.J.; Stams, G.J.J.M.; van der Laan, P.H.; Breuk, R.; Jongman, E.; Doreleijers, T.

    2013-01-01

    The aim of this study was to examine the effect of treatment characteristics on recidivism in a forensic youth-psychiatric outpatient clinic. The treatment offered comprised functional family therapy (FFT), individual cognitive behavioural therapy (CBT), or CBT in combination with parent training.

  2. Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART Clients in Bale Zone Hospitals, South Eastern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Demewoz Haile

    Full Text Available Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia.Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure.The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30 per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73].Similarly, lower CD4 count (<100 m3/dl at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84.Bedridden [AHR = 5.02; 95% CI: (1.98-12.73] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of

  3. Treatment of Schizoaffective Disorder

    OpenAIRE

    Cascade, Elisa; Kalali, Amir H.; Buckley, Peter

    2009-01-01

    In this article, we investigate the range of treatments prescribed for schizoaffective disorder. The data show that the majority of those treated, 87 percent, receive two or more pharmaceutical classes. From a therapeutic class perspective, 93 percent of schizoaffective disorder patients receive an antipsychotic, 48 percent receive a mood disorder treatment, and 42 percent receive an antidepressant. An expert commentary is also included.

  4. Atraumatic restorative treatment in atypical cavities

    Directory of Open Access Journals (Sweden)

    Letícia Simino Carvalho

    2009-10-01

    Full Text Available The atraumatic restorative treatment has been widely divulged among professionals in the area of Pediatric Dentistry. This restorative technique is included in the philosophy of Minimal Intervention and is considered one of the most conservative treatments, because only the layer of infected dentin caries is removed. Moreover, the atraumatic restorative treatment has been shown to be less painful than conventional approaches, and local anesthesia is rarely required. After the removal of the infected dentin, the cavities are filled with glass ionomer cement, a material that has antimicrobial capacity, good marginal sealing and constant fluorine release and recharge. In spite of the increasing number of studies about atraumatic restorative treatment, only studies related to restorations in occlusal cavities have shown scientific evidences about the technique. The aim of this study was to evaluate the feasibility of atraumatic restorative treatment in cavities with 3 or more surfaces involved, by means of a clinical case report of a patient with extensive dstruction in primary teeth, who was submitted to atraumatic restorative treatment, and observe the result of the treatment after one year of clinical and radiographic control.

  5. Dry mouth during cancer treatment

    Science.gov (United States)

    ... gov/ency/patientinstructions/000032.htm Dry mouth during cancer treatment To use the sharing features on this page, please enable JavaScript. Some cancer treatments and medicines can cause dry mouth. Symptoms you ...

  6. Transient thyrotoxicosis during nivolumab treatment

    NARCIS (Netherlands)

    van Kooten, M. J.; van den Berg, G.; Glaudemans, A. W. J. M.; Hiltermann, T. J. N.; Groen, H. J. M.; Rutgers, A.; Links, T. P.

    Two patients presented with transient thyrotoxicosis within 2-4 weeks after starting treatment with nivolumab. This thyrotoxicosis turned into hypothyroidism within 6-8 weeks. Temporary treatment with a beta blocker may be sufficient.

  7. Treatment decisions under ambiguity.

    Science.gov (United States)

    Berger, Loïc; Bleichrodt, Han; Eeckhoudt, Louis

    2013-05-01

    Many health risks are ambiguous in the sense that reliable and credible information about these risks is unavailable. In health economics, ambiguity is usually handled through sensitivity analysis, which implicitly assumes that people are neutral towards ambiguity. However, empirical evidence suggests that people are averse to ambiguity and react strongly to it. This paper studies the effects of ambiguity aversion on two classical medical decision problems. If there is ambiguity regarding the diagnosis of a patient, ambiguity aversion increases the decision maker's propensity to opt for treatment. On the other hand, in the case of ambiguity regarding the effects of treatment, ambiguity aversion leads to a reduction in the propensity to choose treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Alopecia areata: Treatment options

    Directory of Open Access Journals (Sweden)

    E. Kasumagić-Halilović

    2006-02-01

    Full Text Available Alopecia areata (AA is a common cause of reversible hair loss afflictingapproximately1-2%ofthegeneralpopulation. It commonly present as round patches of hair loss which can be the firstmanifestationofamoreseverealopecia totalis or universalis. The cause of AA is unknown although most evidence supports the hypothesis that AA is an immunologically mediated disease. Treatment of AA may be divided into four different categories of widely accepted therapeutic modalities: immune inhibitors (steroid or psoralen and UVA light- PUVA, topicalsensitizers (squaric acid dibutylester and diphenylcyclopropenone, non-specificirritants(anthralinandthevasodilatator minoxidil. Improved future treatments may be immunosuppressive or immunomodulatory or they may otherwise protect hair follicles from the injurious effects of inflammation.Theaimofthisarticleistoreviewavailable data on current and potential agents for the treatment of AA.

  9. Is Coersive Treatment of Offenders Morally Acceptable?

    DEFF Research Database (Denmark)

    Ryberg, Jesper

    2015-01-01

    Is it morally acceptable to instigate criminal offenders to participate in rehabilitative treatment by offering treatment in return for early release from prison? Some theorists have supported such treatment schemes by pointing to the beneficial consequences that follow from the treatment. Others...

  10. Treatment intensity and childhood apraxia of speech

    NARCIS (Netherlands)

    Namasivayam, Aravind K.; Pukonen, Margit; Goshulak, Debra; Hard, Jennifer; Rudzicz, Frank; Rietveld, Toni; Maassen, Ben; Kroll, Robert; van Lieshout, Pascal

    BackgroundIntensive treatment has been repeatedly recommended for the treatment of speech deficits in childhood apraxia of speech (CAS). However, differences in treatment outcomes as a function of treatment intensity have not been systematically studied in this population. AimTo investigate the

  11. Treatment actions and treatment failure: case studies in the response to severe childhood febrile illness in Mali

    Directory of Open Access Journals (Sweden)

    Ellis Amy A

    2012-11-01

    Full Text Available Abstract Background Appropriate home management of illness is vital to efforts to control malaria. The strategy of home management relies on caregivers to recognize malaria symptoms, assess severity and promptly seek appropriate care at a health facility if necessary. This paper examines the management of severe febrile illness (presumed malaria among children under the age of five in rural Koulikoro Region, Mali. Methods This research examines in-depth case studies of twenty-five households in which a child recently experienced a severe febrile illness, as well as key informant interviews and focus group discussions with community members. These techniques were used to explore the sequence of treatment steps taken during a severe illness episode and the context in which decisions were made pertaining to pursing treatments and sources of care, while incorporating the perspective and input of the mother as well as the larger household. Results Eighty-one participants were recruited in 25 households meeting inclusion criteria. Children's illness episodes involved multiple treatment steps, with an average of 4.4 treatment steps per episode (range: 2–10. For 76% of children, treatment began in the home, but 80% were treated outside the home as a second recourse. Most families used both traditional and modern treatments, administered either inside the home by family members, or by traditional or modern healers. Participants’ stated preference was for modern care, despite high rates of reported treatment failure (52%, n=12, however, traditional treatments were also often deemed appropriate and effective. The most commonly cited barrier to seeking care at health facilities was cost, especially during the rainy season. Financial constraints often led families to use traditional treatments. Conclusions Households have few options available to them in moments of overlapping health and economic crises. Public health research and policy should focus on

  12. Carbon Footprint Analyses of Mainstream Wastewater Treatment Technologies under Different Sludge Treatment Scenarios in China

    Directory of Open Access Journals (Sweden)

    Chunyan Chai

    2015-03-01

    Full Text Available With rapid urbanization and infrastructure investment, wastewater treatment plants (WWTPs in Chinese cities are putting increased pressure on energy consumption and exacerbating greenhouse gas (GHG emissions. A carbon footprint is provided as a tool to quantify the life cycle GHG emissions and identify opportunities to reduce climate change impacts. This study examined three mainstream wastewater treatment technologies: Anaerobic–Anoxic–Oxic (A–A–O, Sequencing Batch Reactor (SBR and Oxygen Ditch, considering four different sludge treatment alternatives for small-to-medium-sized WWTPs. Following the life cycle approach, process design data and emission factors were used by the model to calculate the carbon footprint. Results found that direct emissions of CO2 and N2O, and indirect emissions of electricity use, are significant contributors to the carbon footprint. Although sludge anaerobic digestion and biogas recovery could significantly contribute to emission reduction, it was less beneficial for Oxygen Ditch than the other two treatment technologies due to its low sludge production. The influence of choosing “high risk” or “low risk” N2O emission factors on the carbon footprint was also investigated in this study. Oxygen Ditch was assessed as “low risk” of N2O emissions while SBR was “high risk”. The carbon footprint of A–A–O with sludge anaerobic digestion and energy recovery was more resilient to changes of N2O emission factors and control of N2O emissions, though process design parameters (i.e., effluent total nitrogen (TN concentration, mixed-liquor recycle (MLR rates and solids retention time (SRT and operation conditions (i.e., nitrite concentration are critical for reducing carbon footprint of SBR. Analyses of carbon footprints suggested that aerobic treatment of sludge not only favors the generation of large amounts of CO2, but also the emissions of N2O, so the rationale of reducing aerobic treatment and

  13. Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

    Directory of Open Access Journals (Sweden)

    Chien WT

    2013-09-01

    Full Text Available Wai Tong Chien, Annie LK Yip School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Abstract: During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients' needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have

  14. Treatment of imprisoned drug users

    OpenAIRE

    Koňák, Tomáš

    2015-01-01

    The main goal of the theoretical part of submitted theses is to describe the field of specialized treatment of imprisoned drug users. The author's emphasis is to put the specialized treatment to a broader frame of the Risk-needs theory as well as to the frame of physical diseases and mental disorders that are often associated with addiction or drug abuse. Different kinds of specialized interventions that are usually used for treatment of imprisoned drug users in different countries are descri...

  15. Treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    Fischer-Rasmussen, W

    1990-01-01

    This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long......-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy...

  16. Sludge pumping in water treatment

    International Nuclear Information System (INIS)

    Solar Manuel, M. A.

    2010-01-01

    In water treatment processes is frequent to separate residual solids, with sludge shape, and minimize its volume in a later management. the technologies to applicate include pumping across pipelines, even to long distance. In wastewater treatment plants (WWTP), the management of these sludges is very important because their characteristics affect load losses calculation. Pumping sludge can modify its behavior and pumping frequency can concern treatment process. This paper explains advantages and disadvantages of different pumps to realize transportation sludge operations. (Author) 11 refs.

  17. Turkey Psoriasis Treatment Guide-2016

    Directory of Open Access Journals (Sweden)

    Melih Akyol

    2016-08-01

    Full Text Available Psoriasis is a common, chronic, recurrent, inflammatory disease of the skin with unknown etiology. In addition to skin involvement, joint involvement is often seen in psoriasis; however as comorbidities including metabolic syndrome, cardiovascular diseases, psychological/psychiatric disorders and inflammatory bowel disease accompany psoriasis, the inflammatory process underlying has been shown to damage several organs. It is also known that the risk of mortality is increased in patients with severe psoriasis. What’s more, psoriasis significantly affects the patients quality of life. According to physical/psychological examinations, the quality of life is affected from psoriasis as much as other chronic diseases like cancer or diabetes. Psoriasis leads to massive performance loss because of time and work loss at business and daily life as a result of either disease itself or its treatment. Psoriasis has several treatment modalities either topical or systemic. Topical treatment is sufficient and successful for mild psoriasis but early systemic therapy is recommended for moderate and severe psoriasis to prevent comorbidites due to increased inflammatory effect and to manage psoriatic arthritis. Topical treatment is usually applied alone for mild cases and in combination with systemic therapy or phototherapy for moderate or severe cases. Indications for the systemic therapy includes erythrodermic psoriasis, generalized pustular psoriasis, psoriatic arthritis and moderate-severe plaque psoriasis that causes serious decrease at quality of life which is irresponsive-incompatible to topical modalities or phototherapy. As the role of the immunology in pathophysiology of psoriasis is better understood, new generation of biological therapies affecting molecular mechanisms which take role at onset of psoriasis have been developed. Today, cyclosporine, methotrexate, and acitretin are used systemically; etanercept, infliximab, adalimumab or ustekinumab are

  18. Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment.

    Science.gov (United States)

    Kim, Jung Eun; Kim, Hyun Jeong; Lew, Bark-Lynn; Lee, Kyung Ho; Hong, Seung Phil; Jang, Yong Hyun; Park, Kui Young; Seo, Seong Jun; Bae, Jung Min; Choi, Eung Ho; Suhr, Ki Beom; Lee, Seung Chul; Ko, Hyun Chang; Park, Young Lip; Son, Sang Wook; Seo, Young Jun; Lee, Yang Won; Cho, Sang Hyun; Park, Chun Wook; Roh, Joo Young

    2015-10-01

    Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.

  19. 34 CFR 101.114 - Expeditious treatment.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Expeditious treatment. 101.114 Section 101.114 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF... § 101.114 Expeditious treatment. Requests for expeditious treatment of matters pending before the...

  20. The Psychological Impact of IVF Treatment

    NARCIS (Netherlands)

    C. de Klerk (Cora)

    2008-01-01

    textabstractIVF treatment requires the woman to undergo several invasive procedures, which are repeated in subsequent treatment cycles. In addition to the physical burden, the threat of treatment failure confronts the couple with the possibility that they have to give up hope to have a child of