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PubMed1979

Structured learning therapy: development and evaluation.

This paper describes the procedures, materials, and evaluation of Structured Learning Therapy, one of several skill training therapies to emerge in recent years. A number of issues are considered in regard to enhanced outcomes for such therapies, particularly means for more successful transfer of newly learned skills from therapy to real-life settings, and prescriptive use of such psycho-educational treatments.

Evaluation Studies as Topic↗
PubMed1998

Migraine therapy: development and testing of a patient preference questionnaire.

OBJECTIVES: To develop and test a patient preference questionnaire in migraine. METHODS: A user-friendly, self-administered questionnaire was developed to assess the relative importance of aspects of migraine therapy to patients. It was tested in a convenience sample of 66 migraineurs. The questionnaire has five sections: patient preference, migraine history, demographics, usual behavior during an attack, and migraine impact on cognition and functionality. It employs a special reverse-ranking technique to quantify preferences. RESULTS: Sixty-six migraineurs participated: 86% were women, 53% had not consulted their doctor about migraine in the previous year; and only 51% took prescribed medication, the majority (52%) at the start of a migraine. "A medication that can be taken any time during a migraine attack" was ranked most important by 20% of the migraineurs, one that decreases pain from the unbearable level in 30 minutes by 17%, and one that relieves pain completely within 2 hours by 15%. Not being able to think or concentrate with severe symptoms was reported by 71%. Optional activities were impeded by migraine in 83% of subjects, but required activities in only 60%. CONCLUSIONS: The patient preference questionnaire is readily completed by subjects and reveals that the dimensions of relief preferred by patients can be addressed by a self-report questionnaire.

Analgesics↗
PubMed2000

Physical properties of new collimator cone system for stereotactic radiation therapy developed in samsung medical center.

PURPOSE: A new collimator cone system has been developed at the Samsung Medical Center that overcomes some of the limitations of present commercially supplied collimator cones. The physical properties of the newly developed cone system are described in this report. METHODS AND MATERIALS: The new cones have relatively larger aperture sizes (3.0-7.0 cm in diameter) and are 16 cm in length. Each new cone is fabricated with cerrobend alloy melted and poured into a stainless steel housing that is permanently fixed to a mounting plate. The mounting plate of the new cone is designed to insert into the wedge mount slot of the gantry head. The mechanical accuracy of the central axis of the cone pointing to the isocenter was tested using film, a steel ball positioned at the isocenter by the mechanical isocenter device. For the evaluation of beam flatness and penumbra, off-axis ratios at 5 cm depth were measured by film dosimetry using polystyrene phantom. RESULTS: The average error of the mechanical isocenter was 0.27 mm (+/- 0.16 mm). The beam flatness was excellent in the central region of the beam, and the average penumbra width was 3.35 mm (+/- 0.25 mm). The new cone design has more clearance between the patient's head and the gantry, and can more easily be removed from the gantry head because it slides in and out of the wedge slot. This facilitates changing cone sizes during one treatment session, and makes the process of double exposure port films easier. CONCLUSIONS: A new collimator cone system for stereotactic radiation therapy has been developed. The mechanical accuracy and physical properties are satisfactory for clinical use, and the new design permits a wider range of clinical applications for stereotactic radiation therapy.

Alloys↗
PubMed1999

[New ways in aerosol therapy. Development of FCKW-free gases-- powder inhalation systems].

New approaches in the field of aerosol therapy are pointing into two directions. In one, chlorofluorocarbons are now beginning to make place for the hydrofluoroalkanes--which are non-destructive of the ozone layer--as propellants for use in metered-dose inhalers. On the other hand, the use and new development of dry powder inhalation devices are on the increase. In the future, systemic pharmacotherapy applied via aerosols will provide an important option for use not only in the field of pneumology, but also, for example, in the treatment of diabetes mellitus and for anticoagulation.

Administration, Inhalation↗
PubMed2002

[Art therapy: development and evaluation of an observation instrument to systematically analyze patients' paintings from oncology and rheumatology].

INTRODUCTION: Art therapies have been established methods in oncology for many years. To what extent patients' pictures can be systematically described, and what connections to various illnesses are possibly thereby revealed, has been discussed in various specialized medical fields for over a hundred years. The following paper first presents insight into the present stand of research and then presents the results of the study. QUESTION: Are systematic analyses of pictures possible with the use of the instrument we have developed? Are pictorial differences evident within the researched group? METHOD: A previously developed instrument was submitted for expert questioning for the purpose of the study. The instrument that had been modified on the basis of these results could then be used in the study to interpret 162 pictures. Four different raters, three of whom were acquainted with neither the patients nor the pictures, interpreted these pictures independently of one another. RESULTS: The evaluation of the expert interpretations shows that this newly developed instrument is suitable for the differentiated description of patients' pictures. First important indications were drawn in regard to the pictorial differences between the two examined groups of cancer patients and patients with chronic polyarthritis. CONCLUSION: Systematic picture analyses are possible. A further analysis of the expert interpretations is necessary to clarify questions raised by the pictorial differences found in the various diagnostic groups.

Adult↗
PubMed2006

Behavior therapy for depression in drug dependence (BTDD): results of a stage Ia therapy development pilot.

Limited access to positive reinforcers is a central feature in behavioral formulations of substance use and depression, and evidence suggests both disorders share similar environmental contexts. The Behavioral Therapy for Depression in Drug Dependence (BTDD) was developed to target the density of potential reinforcers in a patient's environment to reduce both depression and illicit substance use using therapeutic techniques from three operant based treatment programs, Community Reinforcement Approach, Changing Reinforcement Events, and Treatment-plan Contingency Management. Results of an uncontrolled Stage Ia trial (n = 29), indicated 48% of the participants demonstrated at least a 50% reduction in baseline depression scores during the 16-session treatment program. Those designated as treatment responders completed more out-of-session behavioral activities, attended more treatment sessions, and demonstrated less benzodiazepine use during the program than non-responders. There were no changes in opiate and cocaine use. BTDD may be a useful adjunct to methadone maintenance for treating comorbid depressive disorders.

Behavior Therapy↗
PubMed1995

Analysis of breakthrough pain in 50 patients treated with intrathecal morphine infusion therapy. Development of tolerance or infusion system malfunction.

Fifty patients with intractable benign pain were treated with intrathecal morphine (IT-MS) infusion therapy. Median follow-up was 39 months (range 5-70). Breakthrough pain was reported in 45 (90%) patients in 75 outpatient clinic events. A diagnostic algorithm was developed to evaluate and efficiently treat these patients. A programmed bolus (50% of daily dose) identified that 50 (67%) breakthrough events where due to partial tolerance to the IT-MS. Radiographic survey of the catheters identified malfunctions in 11 patients. Attempts to withdraw CSF from the side-port demonstrated obstruction in 7 due to kinking not seen on X-rays. Side-port myelography demonstrated scarring that obstructed the flow of morphine to the spinal cord in 2 patients. Benefits were regained after all surgical catheter corrections. In total, partial tolerance was seen in 23 patients (46%) during 50 (67%) breakthrough events, 15 patients (30%) required 22 catheter revisions during 27% of breakthrough events and 2 patients had progressive disease. True tolerance was encountered in only 5 patients (10%) during 5 (7%) breakthrough pain events.

Adult↗
PubMedDate not supplied

Developing therapy for acute ischemic stroke.

Currently, the only therapy approved for the treatment of acute ischemic stroke is intravenous recombinant tissue-type plasminogen activator (rt-PA) initiated within 3 hours of symptom onset. This therapy is only used in a very small percentage of stroke patients even in experienced centers. There have been many other clinical trials of thrombolytic drugs beyond the 3-hour time window and neuroprotective drugs, but none of these trials have been positive. There are many potential explanations for these unsuccessful stroke trials and many valuable lessons have been learned. Using imagging technology such as diffusion/perfusion magnetic resonance imaging (MRI) and perfusion computerised tomography (CT) will likely enhance the enhances for success in future acute stroke trials when combined with appropriate trial design and patient selection. Developing new acute stroke therapies will be a difficult but necessary task to meet the large unmet need for this important and under treated disorder.

Acute Disease↗
PubMed2004

IL-18 gene therapy develops Th1-type immune responses in Leishmania major-infected BALB/c mice: is the effect mediated by the CpG signaling TLR9?

IL-18 regulates either Th1 or Th2 responses depending on the cytokine microenvironment. Administration of recombinant IL-18 (rIL-18) alone does not promote Th1 response, but rather induces Th2 response and exacerbates Leishmania major infection in susceptible BALB/c mice. Here, we treated BALB/c mice with an IL-18-expressing plasmid by using a gene gun weekly after L. major infection. This gene therapy resulted in improved pathogenic process and preferential induction of Th1 responses by inducing the expression of IL-12 p40, but treatment with rIL-18 did not. Notably, simultaneous administration of rIL-18 with an empty plasmid vector rendered BALB/c mice resistant to the infection, despite the fact that treatment with either rIL-18 alone or the plasmid vector alone did not influence the susceptibility. The synergistic role of the vector with rIL-18 was found to depend on CpG motifs, which enhanced expression of proinflammatory cytokines, especially IL-12, from APCs through Toll-like receptor (TLR) 9 ligation. Treatment with methylated plasmid vector in which CpG was disrupted could no longer prevent the disease development in coadministration with rIL-18. Taken together, IL-18 gene therapy was shown to develop Th1-type protective immunity in L. major-infected BALB/c mice without the requirement of exogenous IL-12, probably via CpG-TLR9 signaling pathway.

Animals↗
PubMed2001

[Leukemogenesis and new therapy development: the example of chronic myelogenous leukemia].

During the past ten years, the improvements of our understanding of cellular signal transduction pathways provide new targets for drug therapies. Chronic myeloid leukemia (CML), a malignant hematopoietic stem cell disorder, is characterised by an acquired genetic abnormality: the Philadelphia chromosome (Ph) and its molecular counterpart, the oncogene BCR-ABL. The latter, which is translated in an active BCR-ABL protein, exhibited a deregulated tyrosine kinase activity inducing malignant transformation. Produced from the 2-phenylaminopyrimidine class, a novel synthetic inhibitor, identified as CGP57148 (STI571), inhibits tyrosine kinase activity of c-ABL, BCR-ABL, PDGF-R and c-kit at micromolar concentrations. It suppresses the proliferation of the majority of BCR-ABL positive cell lines. The phases I-II clinical trials in CML have demonstrated promising results, especially in the chronic phase of the disease. STI571 is an original therapeutic approach which may be used as a model for the development of other drugs in cancer.

Animals↗
PubMed1995

Developing therapies for Alzheimer's disease.

With the greying of the population, many more people will suffer from senile dementia, placing an enormous burden on families and on health provision. Alzheimer's disease, by far the most common form of dementia, is a complex disease, whose causes are still poorly understood despite a recent mushrooming in research. Many drugs are being developed that may provide symptomatic relief or slow down deterioration, but preventive therapies still seem a long way off.

Acetylcholine↗
PubMed1992

Surfactant replacement therapy: development of criteria for appropriate use. Ohio State University Hospitals.

At The Ohio State University (OSU) Hospitals, DUE criteria were established when colfosceril palmitate, a synthetic surfactant, was added to the formulary in January 1991. The DUE criteria were designed to assure appropriate drug use, educate physicians, and establish an effective way to monitor drug use and patient outcome (ie, response rate and complications). The criteria include a mechanism for evaluation and modification of the guidelines, as necessary. In addition, a review process will be used to determine the therapy's cost effectiveness and to serve as a guideline for making recommendations on other surfactant formulations as they become available.

Cost-Benefit Analysis↗
PubMed2026

New approaches to uncover COPD pathobiology and develop therapies.

Chronic obstructive pulmonary disease (COPD) was the third leading cause of global mortality in 2011 but receives limited attention and research funding. This Review describes the current knowledge on COPD risk factors, including genetic and epigenetic determinants and their interactions with the microbiome and environmental exposures. Preclinical models are being refined and single-cell transcriptomic, metabolomic, and proteomic technologies are being implemented to investigate the molecular mechanisms of disease progression. Patient cohorts to define biomarkers of early disease and the latest approaches to diagnose pre-COPD are essential to accelerate the development of novel and effective therapeutic interventions and translate new findings into clinical trials. This Review is a summary of topics covered by a symposium organized by the COPD-iNET consortium, an international network of researchers who have established a platform that facilitates collaboration of this multidisciplinary group of preclinical, translational, and clinical researchers.

Humans↗