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At least 595 records · Page 33Linked to original sources
PubMed1981

Fulminant spontaneous acute bacterial peritonitis in maintenance hemodialysis.

Two patients on maintenance hemodialysis therapy developed fulminant spontaneous acute bacterial peritonitis (S.A.B.P.). Both had positive blood cultures and died within a few hours despite intensive antibiotic and supportive therapy. No intra-abdominal source of the peritonitis was found in either case. Though septicemia is an important cause of death in the hemodialyzed patient, this form of presentation (S.A.B.P.) has not been previously reported.

Adult↗
PubMed1993

Antibodies developing against a single recombinant interferon protein may neutralize many other interferon-alpha subtypes.

Three hepatitis C patients out of 15 who received recombinant interferon-alpha 2a (rIFN-alpha 2a) therapy developed high levels of neutralizing antibody coincident with clinical relapse. On analysis, antibodies in their sera were found to also produce some neutralization of lymphoblastoid IFN. Purified lymphoblastoid IFN was separated chromatographically into 10 fractions, each containing one or two IFN-alpha subtypes, and these were used individually to examine the subtype specificity of the neutralizing antibodies in the patients' sera. All three sera neutralized all the subtypes present in the 10 lymphoblastoid IFN fractions. These findings may explain why some patients who develop antibody-mediated resistance to treatment with rIFN-alpha 2 preparations are unable to respond again when treated instead with a human cell derived preparation containing many IFN-alpha subtypes.

Antibody Specificity↗
PubMed2006

New directions for neurodegenerative disease therapy: using chemical compounds to boost the formation of mutant protein inclusions.

Neurodegenerative diseases such as Huntington's, Parkinson's and Alzheimer's diseases are marked by neuronal accumulation of toxic misfolded protein. Developing therapies for these misfolding diseases requires finding chemical compounds that can either clear toxic misfolded protein, or can protect neurons from their impact. Such compounds could not only provide the starting points for potential drugs, but could also provide valuable research tools for untangling the complexities of the disease process. Until now, chemical screens for these diseases have focused on finding compounds that prevent aggregation of mutant protein. We recently published a compound, B2, which promotes the formation of large inclusions by mutant Huntingtin and alpha-synuclein, while rescuing some of the toxic effects of these proteins. As inclusions were long believed to be toxic to cells, this contradicts previous therapeutic approaches. At the same time, the results support growing evidence for the protective effects of inclusions. In this review, we discuss these results, and place them in the context of ongoing therapeutic discovery efforts for Huntington's disease and other neurodegenerative diseases.

Humans↗
PubMed1998

Recent developments in reading therapy: a review of the literature.

This paper defines the term 'reading therapy' and discusses its early development in the United Kingdom and the USA. A review of the recent literature in the field is followed by some recommendations on the implementation of reading therapy in health and community care libraries.

Bibliotherapy↗
PubMed2004

Follow-up of cases with false-negative pathologic sentinel nodes in breast cancer.

BACKGROUND: The clinical practice of sentinel lymph node biopsy for breast cancer patients started in 1999 in our hospital, to obviate unnecessary axillary lymph node dissection. The present study examines the pathological false-negative cases on intraoperative sentinel lymph node investigations and evaluates their outcomes. METHODS: The subjects consisted of 183 cases with clinically node-negative breast cancer who had undergone sentinel node biopsy. When the sentinel node was noted to contain malignant cells intraoperatively, a complete axillary lymph node dissection was performed subsequently. The patients with tumor free sentinel nodes underwent no further axillary surgery. The pathological false-negative cases in this series were defined as patients with lymph node involvement which was revealed postoperatively, despite negative intraoperative sentinel node examinations. After these surgeries and/or adjuvant therapies, interval clinical evaluations were performed for all patients. RESULTS: Intraoperative diagnosis of the sentinel node was 96.2% accurate compared with the results of permanent sections. There were six pathological false-negative cases, a false-negative rate of 4.1%, all of which had only micrometastasis. Five cases received systemic adjuvant therapy and have been disease-free, however, one patient who refused further therapy developed infraclavicular lymph node metastasis two years after surgery. CONCLUSIONS: In the management of the patients with postoperatively revealed sentinel node micrometastasis, systemic adjuvant therapies might reduce local relapse without secondary lymph node dissection.

Adult↗
PubMed2001

Epstein-Barr virus-related lymphoproliferative disease complicating childhood acute lymphoblastic leukemia: no recurrence after unrelated donor bone marrow transplantation.

A 16-year-old boy in complete remission of ALL, undergoing oral maintenance therapy, developed intestinal perforation related to EBV-associated lymphoproliferative disease (LPD). He was successfully managed with surgical resection, acyclovir, immunoglobulins and discontinuation of maintenance therapy. Leukemic marrow relapse occurred 3 months later, treated by polychemotherapy followed by unmanipulated BMT from a matched unrelated EBV seropositive donor. Donor lymphocytes were infused twice after transplant because of delayed immunologic recovery and severe CMV colitis. This was followed by acute GVHD requiring prolonged immunosuppressive treatment. Despite intensive and prolonged immunosuppression, recurrence of LPD was not observed. Following EBV-related LPD, allogeneic BMT can be performed if indicated. Selection of an EBV seropositive donor is of major importance for the prevention of LPD recurrence as the recipient may be protected by passive transfer of EBV-specific cytotoxic T cells.

Adolescent↗
PubMed2005

High-dose factor VIII inhibits factor VIII-specific memory B cells in hemophilia A with factor VIII inhibitors.

Hemophilia A in its severe form is a life-threatening hemorrhagic disease that is caused by mutations in the factor VIII (FVIII) gene (symbol F8). About 25% of patients who receive replacement therapy develop neutralizing antibodies that inhibit the function of substituted FVIII. Long-term application of high doses of FVIII has evolved as an effective therapy to eradicate the antibodies and to induce long-lasting immune tolerance. Little is known, however, about the immunologic mechanisms that cause the down-modulation of anti-FVIII antibodies by high doses of FVIII. We report that high doses of FVIII inhibit the restimulation of FVIII-specific memory B cells and their differentiation into antibody-secreting plasma cells in vitro and in vivo in a murine model of hemophilia A. The inhibition of memory B-cell responses is irreversible and not mediated by FVIII-specific T cells. Furthermore, it seems to involve the activation of caspases. We conclude that the inhibition of FVIII-specific memory B cells might be an early event in the down-modulation of anti-FVIII antibodies in patients with hemophilia A who receive high doses of FVIII.

Animals↗
PubMed1981

Family therapy--an attempt to integrate models and modes into a structure of developing phases of therapy.

There is a need experienced by most practitioners of family therapy to impose order and structure upon the considerable range of concepts currently used in the family process approach. This paper suggests a possible structure utilizing five phases which characteristically unfold during the treatment process. The structure provides a rationale so that seemingly divergent techniques of therapy may be seen to be appropriate to particular phases of therapy, rather than mutually contradictory or exclusive. The article further attempts to demonstrate that certain conceptual models and the techniques that arise from them, are called into play depending upon the nature of the family in treatment.

Adult↗
PubMed1996

[New development of endocrine therapy in prostate cancer].

Indication and new agents for endocrine therapy in prostate cancer were outlined, and new development of endocrine therapy was reviewed in terms of total androgen blockade (TAB) for advanced disease and localized disease as neoadjuvant setting, and antiandrogen withdrawal syndrome. TAB is considered to be useful in the treatment of patients with advanced prostate cancer, particularly those with minimal disease and good performance status. Neoadjuvant TAB therapy before radical prostatectomy may decrease cancer positive surgical margins. However, long-term follow-up data are required to determine the impact on survival. Antiandrogen withdrawal seems to be therapeutically efficacious for patients with hormone-refractory prostate cancer, with a response rate of about 20%. Therefore, antiandrogen withdrawal should be tried before initiating therapy for hormone-refractory prostate cancer.

Aged↗
PubMed1988

Developing community occupational therapy services in Canada.

International trends in health care point to increasing development of community services. However, the majority of occupational therapists work in institutional settings. A study, between 1985 and 1987, defined and created a profile of existing community occupational therapy services across Canada, and identified the processes and strategies which led to the development of these services. One hundred and eighty nine (189) services, including home care, other salaried services, and private or consulting services were identified. A national sample of community occupational therapy program developers described processes and strategies from which the author suggests a general "ripple effect" strategy to enhance the occupational therapy contribution to the community.

Canada↗
PubMed1989

Iron deficiency anemia: adverse effects on infant psychomotor development.

In a double-blind, placebo-control prospective cohort study of 196 infants from birth to 15 months of age, assessment was made at 12 months of age of the relationship between iron status and psychomotor development, the effect of a short-term (10-day) trial of oral iron vs placebo, and the effect of long-term (3 months) oral iron therapy. Development was assessed with the mental and psychomotor indices and the infant behavior record of the Bayley Scales of Infant Development in 39 anemic, 30 control, and 127 nonanemic iron-deficient children. Anemic infants had significantly lower Mental and Psychomotor Developmental Index scores than control infants or nonanemic iron-deficient infants (one-way analysis of variance, P less than .0001). Control infants and nonanemic iron-deficient infants performed comparably. No difference was noted between the effect of oral administration of iron or placebo after 10 days or after 3 months of iron therapy. Among anemic infants a hemoglobin concentration less than 10.5 g/dL and duration of anemia of greater than 3 months were correlated with significantly lower motor and mental scores (P less than .05). Anemic infants failed specifically in language capabilities and body balance-coordination skills when compared with controls. These results, in a design in which intervening variables were closely controlled, suggest that when iron deficiency progresses to anemia, but not before, adverse influences in the performance of developmental tests appear and persist for at least 3 months despite correction of anemia with iron therapy. If these impairments prove to be long standing, prevention of iron deficiency anemia in early infancy becomes the only way to avoid them.

Anemia, Hypochromic↗
PubMed1994

Developmental formulation and psychotherapy of borderline adolescents.

Treatment of the borderline adolescent requires a highly sophisticated, multimodal treatment formulation that is based on a developmental, psychodynamic formulation of the patient and family system. The therapeutic model chosen must fit the case as well as possible, but, of necessity, may change as the patient grows and develops. It is of utmost importance to understand the patient's process of growth and development and the utilization of each particular model of psychotherapy chosen. Therapeutic techniques should derive from the model(s) of treatment and should constantly be analyzed during the course of psychotherapy with these very difficult patients. The case example illustrates the treatment of a borderline personality patient who, in Goldstein and Jones's model, initially was in Group IV, the withdrawn and socially isolated group, but as therapy developed, fell into Group II in her defiance, disrespectful stance toward her mother, belligerance, and antagonism both in the family and in therapy. She progressively was able to relinquish her defensive stance of denial, projection, and splitting, and became more aware of her affect. As she progressed in therapy, her mood shifted from states of anger to states of depression and self-consciousness and her treatment was facilitated by use of pharmacotherapeutic agents and a very close-knit outpatient team. It is important to emphasize the value of a close-knit working outpatient team in the psychotherapy.

Adolescent↗
PubMed1993

Successful bone marrow transplantation in children with severe aplastic anemia using HLA-partially matched family donors.

Bone marrow transplantation (BMT) using HLA-partially matched family donors has produced disappointing results (25-30% of long-term survivors) in patients with severe aplastic anemia. We describe two children affected by severe aplastic anemia, not responsive to immunosuppressive therapy, who underwent allogeneic bone marrow transplantation using a HLA-partially matched family donor. Both cases presented 2 first class HLA-antigens (A and B) disparity between donor and recipient. The pretransplant conditioning regimen consisted of cyclophosphamide, thoracoabdominal irradiation, cytosine-arabinoside, and antilymphocyte globulin. As graft versus host disease (GVHD) prophylaxis, Cyclosporine-A was administered at usual dosages for 6 months. A full marrow engraftment was observed in both cases. Only grade I acute GVHD, promptly responsive to corticosteroid therapy, developed with no chronic GVHD. Five months after transplant, both children progressively developed hypertension, renal function impairment, thrombocytopenia, and severe normochromic anemia, with erythropoietin serum levels lower than expected for the haematocrit. After antihypertension treatment and supportive therapy, the clinical picture progressively improved, while treatment with recombinant human erythropoietin completely corrected the long-lasting anemia. The two children are alive and well 28 months after the transplant, with a Karnofsky score of 100% and a normal peripheral blood count. The authors suggest that, once immunosuppressive therapy has failed, BMT from donors other than HLA-identical sibling is a feasible approach in children affected by severe aplastic anemia, not having an HLA-identical donor.

Anemia, Aplastic↗
PubMed2004

Effects of motor and sensory stimulation in stroke patients with long-lasting dysphagia.

Dysphagia is a common poststroke symptom with negative effects on recovery and rehabilitation. However, the orofacial regulation therapy, developed by Castillo Morales, comprising body regulation and orofacial regulation in combination with a palatal plate application has shown promising results in stroke patients. This therapy is based not only on muscle exercises but also on an improvement of the entire sensory-motor reflex arc involved in normal deglutition, and on the knowledge that the function of face and oropharynx at deglutition is closely interrelated with the entire body posture as well as with appropriate breathing. The treatment concept is relatively unknown to caregivers, partly due to lack of scientific evaluation of treatment results. The present investigation aimed to assess the effect of motor and sensory stimulation in stroke patients with dysphagia persisting for more than six months. Seven patients were evaluated with respect to orofacial and pharyngeal motility and sensory function before and two weeks after a five-week treatment period. The evaluation comprised a swallowing capacity test, a meal observation test, clinical examination of oral motor and sensory function, a velopharyngeal closure test, and videofluoroscopy. In addition, the symptoms were scored by the patients. An overall single-blind estimation showed objective and self-assessed swallowing improvement in all seven patients. Kappa coefficients are calculated on all reliability data, both inter- and intrarater reliabilities. Sensory and motor stimulation seems to be a promising therapy in stroke patients with long-lasting and persistent oropharyngeal dysphagia.

Aged↗
PubMed2003

Stable molecular remission induced by imatinib mesylate (STI571) in a patient with CML lymphoid blast crisis relapsing after allogeneic stem cell transplantation.

We report the response to the ABL kinase inhibitor imatinib mesylate (STI571) in a patient with chronic myeloid leukemia (CML) who relapsed twice after dose-reduced allogeneic stem cell transplantation (alloSCT) for B lymphoid blast crisis (BC) and failed to develop an antileukemic response despite grade 3 graft-versus-host disease (GvHD). Complete hematologic, cytogenetic and molecular responses were achieved within 9 weeks of therapy and are maintained after 27 months. Extensive chronic skin GvHD necessitating immunosuppressive therapy developed after 14 months. This case illustrates the ability of imatinib to induce sustained hematologic and molecular remissions in some patients relapsing with advanced stage CML after alloSCT.

Adult↗
PubMed2002

Signaling pathways in vascular development.

The vasculature is one of the most important and complex organs in the mammalian body. The first functional organ to form during embryonic development, the intricately branched network of endothelial and supporting periendothelial cells is essential for the transportation of oxygen and nutrients to and the removal of waste products from the tissues. Serious disruptions in the formation of the vascular network are lethal early in post-implantation development, while the maintenance of vessel integrity and the control of vessel physiology and hemodynamics have important consequences throughout embryonic and adult life. A full understanding of the signaling pathways of vascular development is important not just for understanding normal development but because of the importance of reactivation of angiogenic pathways in disease states. Clinically there is a need to develop therapies to promote new blood vessel formation in situations of severe tissue ischemia, such as coronary heart disease. In addition, there is considerable interest in developing angiogenic inhibitors to block the new vessel growth that solid tumors promote in host tissue to enhance their own growth. Already studies on the signaling pathways of normal vascular development have provided new targets for therapeutic intervention in both situations. Further understanding of the complexities of the pathways should help refine such strategies.

Animals↗
PubMed1982

Cognitive group psychotherapy of depression: the close-ended group.

One of the most important recent contributions to the understanding and treatment of depression is that of the cognitive theory and cognitive-behavior therapy developed by A. T. Beck. This paper describes the rationale and the technique of a short-term group psychotherapy based on Beck's Cognitive Therapy. The therapy was conducted with small closed-membership groups of patients with major depressive illness who were participating in a treatment-outcome study. Details of the role induction, session structure, roles of therapist and cotherapist, phases of group treatment course, and possible effectiveness are discussed. The technique presented here includes two individual cognitive sessions for purposes of role induction and establishing a therapeutic relationship before the first group session. We make use of flipcharts and a blackboard to illustrate various cognitive techniques, highly structured sessions with specific individualized agendas, defined therapist and cotherapist roles. The usual phases in a 15-session group course are described and our present experience of the techniques effectiveness are discussed.

Cognition↗