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Results for “Reality Therapy”

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At least 631 records · Page 35Linked to original sources
PubMed2004

Gene therapy: how to target the kidney. Promises and pitfalls.

The success of gene therapy strongly depends on an efficient delivery system to allow local transfer and expression of the therapeutic gene in the target organ or tissue. Vector systems have been improved and many show promise. There are two different categories of delivery vehicles: non-viral and viral vectors, both with advantages and disadvantages that must be taken into consideration in view of the final aim. Compared to other solid organs, the kidney offers the main advantage of access by different routes that dictate different sites of transfection. Thus, the choice of the delivery vehicle and administration route has to take account which cells are to be specifically targeted by the gene transfer approach. This concept will be discussed in the first part of the review. Using a gene therapy approach, improvements of renal function and interstitial inflammation have been achieved in experimental models of glomerulonephritis and tubulo-interstitial damage. Gene therapy applied to renal transplantation has shown promising results in rodents, almost controlling acute rejection. Finally, the development of animal models resembling the clinical features of human genetic renal disorders offers a first step towards new treatments among which gene therapy could become reality in the near future. The main findings concerning the suitability of gene therapy for slowing the progression of kidney diseases, and preventing acute renal graft rejection, or treating genetic disorders, are discussed.

Gene Expression↗
PubMed1984

Effects of psychotherapy in schizophrenia: I. Design and implementation of a controlled study.

This article describes a 2-year, multi-hospital study on the effects of psychotherapy for nonchronic schizophrenic patients. The design and methods used to evaluate the relative benefits of exploratory, insight-oriented (EIO) psychotherapy and reality-adaptive, supportive (RAS) psychotherapy when both are provided by experienced therapists against the backdrop of good hospital and psychopharmacological management are presented. Similarities and differences between the two therapies and the therapists are outlined. Special attention is given to the problems in implementing research on long-term psychotherapy. Finally, the strengths and limitations of the present study are discussed.

Adult↗
PubMed1997

[Gene therapy of primary cancers of the liver: hopes and realities].

Many efforts have been devoted to the development of gene therapy for primary liver tumors. This has been hampered by the absence of efficient gene transfer vectors for delivering genes into hepatoma cells in vivo. Also it remains to determine which type of gene has to be used to achieve complete tumor regression. Recent studies have documented improvements obtained using recombinant adenoviral vectors carrying the herpes simplex virus thymidine kinase gene as well as the ability to specifically target gene expression into the tumor cells by using the alpha-fetoprotein gene regulatory sequence. Therefore it seems reasonable to expect the development of clinical protocols in the near future.

Adenoviridae↗
PubMed2002

[Bremen-north working team on pain--an intervention to improve the quality of medical care in a city district as exemplified by pain therapy].

The purpose of an intervention in a city district of Bremen was to reduce the discrepancy between the possibilities and realities of pain therapy. All the important participants were included in measures and actions on several levels and for several target groups for a period of two years. An inquiry revealed a high degree of consent among the medical practitioners. The effect of the intervention was an improvement in the prescription of opioids by those physicians who had already been prescribing them, whereas there was no noticeable change in the behaviour of physicians who had not been prescribing opioids to date. In a second step the intervention was examined for reasons and limitations of its efficacy. In conclusion, this is brought in line with the present state of knowledge on the ways and mechanisms by which new medical advances come to the attention of medical practice. The elements of promising strategies to effect positive changes in health services are pinpointed.

Analgesics, Opioid↗
PubMed1992

Retroviral gene therapy and its application in oncohematology.

A symposium entitled "Foetal and Neonatal Cell Transplantation and Retroviral Gene Therapy" recently organized under the aegis of the Mérieux Foundation in Annecy, France, brought together 100 scientists and clinicians from European countries and the United States. The last day of the meeting focused on retroviral gene therapy in oncohematology. The speakers provided the basis for therapeutic applications of gene transfer and showed practical directions to be followed in the near future. Although it may be mainly restricted to in vitro manipulation of human cells at start, gene therapy is already applicable to the treatment of genetic disorders, cancer, and viral infections. The reality of gene therapy was well illustrated by the nature of the questions raised by clinicians and scientists during the meeting.

Animals↗
PubMed1999

Entering the gene therapy era.

Gene therapy is a new modality with the potential for treating a variety of diseases, inherited or acquired. Although the initial clinical trials, particularly those for cystic fibrosis, have not been successful, the preliminary results of more recent studies of gene therapy for myocardial infarction are encouraging. New plasmids, viral and nonviral vectors, and applications are being developed at a rapid pace. A switch is now inserted in the plasmids so that the therapeutic gene can be turned on and off as needed. A chimeric RNA/DNA oligonucleotide has also been designed so that mutated genes can be converted to normal sequences. These and other novel approaches soon will propel the gene therapy industry into reality. Healthcare providers and educators need to be prepared for the coming of the gene therapy era.

Genetic Therapy↗
PubMed1999

Liver fibrogenesis and the role of hepatic stellate cells: new insights and prospects for therapy.

Hepatic fibrosis is a wound-healing response to chronic liver injury, which if persistent leads to cirrhosis and liver failure. Exciting progress has been made in understanding the mechanisms of hepatic fibrosis. Major advances include: (i) characterization of the components of extracellular matrix (ECM) in normal and fibrotic liver; (ii) identification of hepatic stellate cells as the primary source of ECM in liver fibrosis; (iii) elucidation of key cytokines, their cellular sources, modes of regulation, and signalling pathways involved in liver fibrogenesis; (iv) characterization of key matrix proteases and their inhibitors; (v) identification of apoptotic mediators in stellate cells and exploration of their roles during the resolution of liver injury. These advances have helped delineate a more comprehensive picture of liver fibrosis in which the central event is the activation of stellate cells, a transformation from quiescent vitamin A-rich cells to proliferative, fibrogenic and contractile myofibroblasts. The progress in understanding fibrogenic mechanisms brings the development of effective therapies closer to reality. In the future, targeting of stellate cells and fibrogenic mediators will be a mainstay of antifibrotic therapy. Points of therapeutic intervention may include: (i) removing the injurious stimuli; (ii) suppressing hepatic inflammation; (iii) down-regulating stellate cell activation; and (iv) promoting matrix degradation. The future prospects for effective antifibrotic treatment are more promising than ever for the millions of patients with chronic liver disease worldwide.

Animals↗
PubMed1995

Virtual reality for physically disabled people.

This paper demonstrates how physically disabled people can benefit from the innovative virtual reality techniques. Several specific examples show the applicability of virtual reality to the therapy and rehabilitation of people with various disabilities. In addition, the paper describes how physicians can use virtual reality as an advanced visualization tool for the diagnosis of physical disabilities. Finally, possible display techniques and input devices for diagnosis and rehabilitation purposes are discussed briefly.

Attitude of Health Personnel↗
PubMed2000

Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study.

OBJECTIVE: The pain experienced by burn patients during physical therapy range of motion exercises can be extreme and can discourage patients from complying with their physical therapy. We explored the novel use of immersive virtual reality (VR) to distract patients from pain during physical therapy. SETTING: This study was conducted at the burn care unit of a regional trauma center. PATIENTS: Twelve patients aged 19 to 47 years (average of 21% total body surface area burned) performed range of motion exercises of their injured extremity under an occupational therapist's direction. INTERVENTION: Each patient spent 3 minutes of physical therapy with no distraction and 3 minutes of physical therapy in VR (condition order randomized and counter-balanced). OUTCOME MEASURES: Five visual analogue scale pain scores for each treatment condition served as the dependent variables. RESULTS: All patients reported less pain when distracted with VR, and the magnitude of pain reduction by VR was statistically significant (e.g., time spent thinking about pain during physical therapy dropped from 60 to 14 mm on a 100-mm scale). The results of this study may be examined in more detail at www.hitL.washington.edu/projects/burn/. CONCLUSIONS: Results provided preliminary evidence that VR can function as a strong nonpharmacologic pain reduction technique for adult burn patients during physical therapy and potentially for other painful procedures or pain populations.

Adolescent↗
PubMedDate not supplied

Beta-blocker therapy and severe heart failure: myth or reality?

The medical management of heart failure has undergone remarkable progress in the past 10 years. The paradigm shift is toward long-term reparative strategies that help in altering the biologic properties of the failing heart. Together with angiotensin-converting enzyme inhibitors, beta blockers have emerged as standard therapy for heart failure, especially for patients with mild to moderate heart failure. Since most of the clinical trials demonstrating the benefits of betablockers have been done in patients with mild to moderate heart failure, some controversy exists about the utility of beta-blocking agents in patients with advanced heart failure. This review will summarize the rationale and the use of beta blockers, a very challenging therapeutic strategy, in patients with severe heart failure.

Adrenergic beta-Antagonists↗
PubMed1992

Cystic fibrosis and pulmonary involvement from multiple perspectives.

The pulmonary involvement in cystic fibrosis (CF) is discussed from several perspectives including historical, current treatment, and possible future therapies. The clinical realities that have limited and frustrated the successful control of the pulmonary progression are reviewed. A variety of pending new therapies are briefly presented including antiinflammatory agents, protease inhibitors, ion transport inhibitors, antiviscosity agents, chloride channel modifiers, and immunomodifiers. An appeal is made for more effective down-regulation of the overstimulated local and systemic immune responses to the chronic inflammatory processes. More attention needs to be paid to improvement of current methods of aerosol administration that will be of critical importance for living cell/viral/gene/liposome delivery. Other means of buying additional survival time are urgently needed such as improvements in lung transplantation and better treatment of cor pulmonale. The explosion of molecular genetics progress in CF basic research is an exciting and encouraging dynamic that may lead to a cure for patients with CF in spite of the more than 200 known genetic variations known to date. The survival of CF patients has increased 1 year for 1 year during the past 10 years and now is 29.4 years in 1991. If this progress can be maintained, the hope is that advances in molecular genetics and cell electrophysiology can soon be brought to clinical application in an effective fashion. A magnificent choice of new treatment directions is becoming available, leading to very realistic hope and optimism for the future for patients with CF.

Cystic Fibrosis↗
PubMed2005

The physical, emotional and interpersonal impact of HAART: exploring the realities of HIV seropositive individuals on combination therapy.

The purpose of this qualitative study was to understand the impact of HAART on the lives of HIV seropositive men and women. The data demonstrate that the demands of these treatments are substantial, but that renewed health and hope for the future due to the implementation of HAART often overshadows the stress of the treatments on the physical, emotional and social well-being of the individuals. Practitioners should be keenly aware of the struggles faced by those on HAART, and provide multidimensional support to assure maximum effectiveness of these treatments in light of the realities of their clients' lives.

Adult↗