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At least 721 records · Page 40Linked to original sources
PubMed1995

Scylla and Charybdis. Sexual abuse or 'false memory syndrome'? Therapy-induced 'memories' of sexual abuse.

The increasing importance and frequency of so-called 'false memories' of sexual abuse, which in reality never occurred, occasions a theoretical reflection about therapy-induced 'memories' of sexual abuse. Sexual abuse is first seen to involve a serious loss of psychic structure. As such it has much in common with other, endogenous forms of severe psychic disorders. Drawing upon the (Kleinian) categories of projective identification, projective counter-identification and psychotic personality aspects, together with the Jungian conception of the 'mutual unconsciousness' between therapist and patient, the author presents a psychodynamic hypothesis regarding the origins of 'false memories' or 'recovered memories' of sexual abuse. This is exemplified with two therapy cases involving such memories of abuse.

Adolescent↗
PubMed2006

Selective gene delivery for cancer therapy using cationic liposomes: in vivo proof of applicability.

Targeted gene therapy is essential if cancer treatment is to become a reality with this form of therapy. In the past few years, cationic liposomes, discovered 2 decades ago, and at present, the most commonly used class of transfection reagents, have been tested in various clinical trials for diseases not restricted to cancer. They have been shown to be selective for tumour vascular endothelial cells raising hopes for antiangiogenic and antivascular therapies. They are also capable of being selectively delivered to the lungs and liver when administered intravenously. These vesicles are also being targeted to the tumour in various parts of the body by using advanced liposomal systems such as antibody-antigen and ligand-receptor combinations. This review looks at the state of play in this rapidly growing field.

Animals↗
PubMed1977

Psychological approaches to the treatment of the elderly.

Various psychological approaches to the treatment of elderly patients (including activity and stimulation programmes, reality orientation, environmental approaches and behabiour modification) are discussed with regard to their efficacy and those features that approaches claiming success have in common. The importance of the attitudes of the care staff is discussed, especially in relation to the consistency and intensity of application of treatment programmes. It is argued that the behavioural model is a useful starting point for future progress, and that much of the present literature is comprehensible in this framework.

Aged↗
PubMed1980

Comparison of a reality orientation program for geriatric patients with and without music.

Reality orientation (RO) is a technique used with patients exhibiting confused or disoriented behavior. The purpose of RO is to reverse or halt confusion, social withdrawal, and apathy characteristic of elderly institutionalized patients. The purpose of this study was to compare the effects of a traditional versus music-based RO program. Eight residents of the Chateau de Notre Dame Nursing Home were randomly assigned to experimental and control groups. A pretest was administered to identify any significant differences in RO and behavior functioning between the two groups. The specific goals and objectives for the RO program were then formulated from information gathered on the pretest. The experimental group received two 30-minute music-based RO sessions a week for 8 weeks, while the control group received the same number of traditional RO sessions without music. Upon completion of the treatment, the posttest was administered to each subject. A two-way "mixed effects" analysis of variance was used to analyze the data. A significant interaction (p less than .05) was found between the groups and the treatment condition, with the control group remaining at the same level across trials and the group receiving the music-based RO showing marked improvement.

Aged↗
PubMed1998

[Molecular therapy for human cancer with tumor suppressor p53 gene transfer].

Molecular level approaches have demonstrated that tumor suppressor p53 gene, which is the most commonly mutated gene yet described in human cancers, plays an important role in the pathway of apoptosis triggered by DNA-damaging agents. In addition, defects in apoptosis caused by the inactivation of p53 resulted in resistance to treatment. Human gene therapy has become a reality with the development of effective techniques for delivering the gene to the target cells. These findings suggested a novel approach to cancer therapy with the direct delivery of wild-type p53 gene construct to cancer cells by using an adenoviral vector system. Restoration of wild-type p53 function markedly enhanced the antitumor effect of a common chemotherapeutic agent, cisplatin, in human non-small cell lung cancer cells as well as human colon cancer cells. The application of this technology to human cancer therapy is now in progress.

Apoptosis↗
PubMed1988

Validation therapy with the demented elderly.

This paper describes validation therapy--a method of communicating with disorientated people through the use of specific interactive techniques. It is compared with reality orientation as this is the most widely used therapy for demented patients. The method of evaluating the effects of validation group therapy is included. The authors suggest that validation therapy is an exciting and important therapeutic development which can restore self-worth and ease the stress suffered by elderly people with dementia.

Aged↗
PubMed1997

Vascular gene therapy in the 21st century.

The technology of gene transfer has developed rapidly and has been applied successfully as pharmacological therapy in animal models of human vascular disease. Human vascular gene therapy has not become a reality although clinical trials are starting. In the next century, gene therapy will find its place in the vascular physicians' armamentarium as new pharmacological targets are defined and new vectors devised for gene transfer. Vascular gene therapy, the use of gene transfer to treat diseases of the vascular system, excites the imagination and captures the public's attention because it promises at a single step almost magically to cure the previously uncurable. The goal has been elusive although the promise remains. What can we look forward to in the 21st century? Will the dream ever be realized or is it a fantasy that will always be out of reach? The sceptics argue that research into pharmacology continues to provide us with powerful drugs for the treatment of vascular disease. Why bother with gene transfer? Could not the same goals be achieved by more conventional means? These questions demand answers and adequate justification. In developing the response, we gain a clear understanding of the potential of gene therapy and thereby define a better set of objectives. Gene therapy in broad terms covers somatic cell and germ line gene therapy. Genetic manipulation of the germ line leads to the development of transgenic animals with specific genes that have been deleted or overexpressed; these animals are useful for the study of gene function. Their organs might also be of use for transplantation into humans. For example, transgenic pigs are being developed for this purpose(1). Although the study of transgenic animals and the field of germ line gene therapy are of great importance for vascular biology, they will not be covered here. This review will address vascular somatic gene therapy and will attempt to focus on potential targets, progress made in the last decade, and the steps needed to achieve clinical application.

Adenoviridae↗
PubMed1997

Gene therapy and ovarian cancer: a review.

OBJECTIVE: To provide the obstetrician-gynecologist with the basic concepts of gene therapy, an overview of cancer gene therapy treatment strategies, and a summary of currently approved human gene therapy protocols for ovarian carcinoma. DATA SOURCES: A computerized search of articles published through December 1995 was performed on the MEDLINE data base. Additional sources were identified through cross-referencing. METHODS OF STUDY SELECTION: All identified references were reviewed with particular attention to their relevance to gene therapy for ovarian cancer. TABULATION, INTEGRATION, AND RESULTS: Each reference was reviewed to determine the relevant contribution to the fundamental science of gene therapy. Particular attention was paid to those studies that offered a rational strategy that might contribute to therapy for ovarian malignancy. CONCLUSION: Advances in molecular biology, immunology, and virology have enabled the concept of gene therapy for neoplastic disorders to become a reality. Given the lack of effective conventional therapy, those patients with recurrent or refractory ovarian cancer should be considered for currently approved investigational gene therapy protocols.

Adjuvants, Immunologic↗
PubMed2005

[Multiple sclerosis: between wish and reality].

The guidelines for the therapy of multiple sclerosis (MS) are unchanged. An acute episode is treated intravenously with high-dosed glucocorticoid. This is usually followed by an immunomodulating basic therapy, although the currently approved preparations for this purpose are only partially effective. During the last ten years, a series of new therapeutic approaches have been developed. The monoclonal antibody natalizumab (Tysabri) was approved for use in the U.S.A. in 2004 and showed good success, but had to be removed from the market in February 2005 because of grave side effects. Up until now, the chemokine receptor antagonist CCR1 has been tested in a pilot study. A clinical phase III study is being planned with MS patients for the interleukin-2 receptor antagonist daclizumab.

Antibodies, Monoclonal↗
PubMed2005

Antibiotic therapy for coronary heart disease: The myth and the reality.

Atherosclerosis is acknowledged as an active inflammatory and thrombotic disease, as opposed to simple degeneration. Infection with microorganisms may contribute to this inflammation and hence the atherosclerotic process. The "infective" hypothesis--first proposed more than a century ago by Virchow--has been revisited in recent years and has implicated numerous microorganisms as potential stimuli. The greatest body of evidence points to Chlamydia pneumoniae, a respiratory pathogen, as the "culprit" microorganism. Consistent finding of bacterial antigens, DNA and occasionally live "viable" organisms within human atherosclerotic plaque support the evidence for the concept linking C. pneumoniae to atherosclerosis. Although original seroepidemiological studies indicated an association, more recent prospective and larger studies suggest that there may be only a weak link between elevated antibodies and immune complexes to C. pneumoniae and coronary heart disease (CHD). Animal models have shown how atherogenesis can be induced by endovascular infection with C. pneumoniae; in vitro studies have explored various immunological and inflammatory pathways linking infection and atherothrombosis. On the basis of this, antibiotic trials have been explored to assess whether there is any role for antichlamydial agents in the treatment of cardiovascular events. Here, we focus on the main antibiotic studies and explores patient criteria and choice, duration of therapy, and whether effects on clinical events could be reduced.

Animals↗
PubMed2006

Antibiotic therapy for coronary heart disease: the myth and the reality.

Atherosclerosis is acknowledged as an active inflammatory and thrombotic disease, as opposed to simple degeneration. Infection with microorganisms may contribute to this inflammation and hence the atherosclerotic process. The "infective" hypothesis - first proposed more than a century ago by Virchow - has been revisited in recent years and has implicated numerous microorganisms as potential stimuli. The greatest body of evidence points to Chlamydia pneumoniae, a respiratory pathogen, as the "culprit" microorganism. Consistent finding of bacterial antigens, DNA and occasionally live "viable" organisms within human atherosclerotic plaque support the evidence for the concept linking C. pneumoniae to atherosclerosis. Although original seroepidemiological studies indicated an association, more recent prospective and larger studies suggest that there may be only a weak link between elevated antibodies and immune complexes to C. pneumoniae and coronary heart disease (CHD). Animal models have shown how atherogenesis can be induced by endovascular infection with C. pneumoniae; in vitro studies have explored various immunological and inflammatory pathways linking infection and atherothrombosis. On the basis of this, antibiotic trials have been explored to assess whether there is any role for antichlamydial agents in the treatment of cardiovascular events. Here, we focus on the main antibiotic studies and explores patient criteria and choice, duration of therapy, and whether effects on clinical events could be reduced.

Animals↗
PubMed2006

Autophagy and mistargeting of therapeutic enzyme in skeletal muscle in Pompe disease.

Enzyme replacement therapy (ERT) became a reality for patients with Pompe disease, a fatal cardiomyopathy and skeletal muscle myopathy caused by a deficiency of glycogen-degrading lysosomal enzyme acid alpha-glucosidase (GAA). The therapy, which relies on receptor-mediated endocytosis of recombinant human GAA (rhGAA), appears to be effective in cardiac muscle, but less so in skeletal muscle. We have previously shown a profound disturbance of the lysosomal degradative pathway (autophagy) in therapy-resistant muscle of GAA knockout mice (KO). Our findings here demonstrate a progressive age-dependent autophagic buildup in addition to enlargement of glycogen-filled lysosomes in multiple muscle groups in the KO. Trafficking and processing of the therapeutic enzyme along the endocytic pathway appear to be affected by the autophagy. Confocal microscopy of live single muscle fibers exposed to fluorescently labeled rhGAA indicates that a significant portion of the endocytosed enzyme in the KO was trapped as a partially processed form in the autophagic areas instead of reaching its target--the lysosomes. A fluid-phase endocytic marker was similarly mistargeted and accumulated in vesicular structures within the autophagic areas. These findings may explain why ERT often falls short of reversing the disease process and point toward new avenues for the development of pharmacological intervention.

Age Factors↗
PubMed1998

[Nephrology in the first decade of the twenty-first century].

Although prophecy in medicine is extremely difficult, I do not expect, that xenotransplantation will become reality in the first decade of the 21th century. However I expect introduction of safer and more effective immunosuppressive agents or even induction of selective immunologic tolerance in kidney transplant patients. I expect a significant decline in the number of uraemic patients with diabetic or hypertensive nephropathies, thanks to better prevention and treatment of these pathological states. I predict intensification of studies of renal fibroblasts responsible for progression and loss of renal parenchyma in nephropathies of different etiology. Gene therapy will become a reality both in inborn and acquired nephropathies although safety of this kind of therapy remains to be established. Finally I expect essential improvement of therapy in clinical settings induced by abnormal homeostatic function of the kidneys mostly thanks to our better understanding of the molecular background of this function.

Forecasting↗
PubMed1996

Gene therapy approaches for inherited and acquired lung diseases.

Gene therapy is the treatment of any disorder or pathophysiologic state based upon the transfer of genetic information. The lung represents a major target of gene therapy for the treatment of genetic disorders such as cystic fibrosis and alpha 1-antitrypsin deficiency. Other diseases are also being targeted, including pulmonary inflammation, surfactant deficiency, pulmonary hypertension, lung cancer, and malignant mesothelioma. This review will examine some general concepts regarding gene transfer and gene therapy, provide an overview of the current vectors being developed to achieve safe and efficient gene transfer, and summarize the ongoing work to apply this new technology to the treatment of both inherited and acquired pulmonary diseases. Although tremendous progress has been made in the ability to successfully transfer genes to cells, there are several unresolved problems limiting the clinical application of this technology to human pulmonary disease. However, as vector technology evolves, gene therapy may become a reality for a number of lung diseases.

Animals↗
PubMed1994

Reducing fear in cancer survivors.

As more patients come to survive cancer, controlling their fear of its recurrence and minimising anxiety are important in re-establishing their quality of life. Combinations of therapies that acknowledge existential realities, encourage expression of feelings, identify irrational thoughts and promote self-helping behaviours are needed.

Cognitive Behavioral Therapy↗
PubMed1993

Working with Jewish ultra-orthodox patients: guidelines for a culturally sensitive therapy.

The epistemological gap between the medical reality of mental health practitioners and the sacred reality of their Jewish ultra-orthodox patients poses a major challenge for therapy. Based on our work with psychiatric patients from the ultra-orthodox community of northern Jerusalem, we propose a set of guidelines to cope with this challenge. Basically, we seek to incorporate religiously congruent elements, composed of metaphoric images, narratives and actions, into the wide range of our "secular" treatment modalities in order to respond to the patient's suffering, often expressed through distinctively religious idioms of distress. This endeavor calls for "a temporary suspension of disbelief" on both sides. The guidelines presented include three sets of factors which appear pertinent to working with ultra-orthodox patients. The first set is contextual in nature, dealing with the image of the clinic and its physical setting; the second discusses the necessary role requisites of the therapists; and the third one, accorded a central importance, deals on various levels with the therapeutic interventions administered in terms of form and content. Several case vignettes are presented to illustrate three classes of religiously informed interventions: healing rituals, dream interpretation, and the use of culturally congruent metaphors and stories. In the concluding part we discuss ethical and instrumental issues that the proposed therapeutic guidelines may raise.

Acculturation↗