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At least 811 records · Page 45Linked to original sources
PubMed2006

Cardiac cell-repair therapy: clinical issues.

The possibility that cardiac cell-repair therapy might become a clinical reality is a challenge worthy of the current state of technological and scientific expertise at the start of the 21(st) century. The success of preclinical and early clinical studies is a strong inducement to move ahead with larger clinical trials, but caution is warranted given our lack of understanding of the potential mechanisms by which cell-repair therapy exerts a benefit on ventricular function, perfusion, and infarct size, irrespective of the type of cell, method, site, and disease entity. There are multiple clinical, mechanistic, and safety questions requiring answers, and these will be forthcoming only if the design of clinical trials is carefully tailored to answer specific questions. These questions, in turn, will require the use of different and multiple end points, depending on the specific issue and study. Accordingly, this review addresses the limitations of current clinical studies, the design of future trials, and the concept of a hierarchical series of end points that might provide answers to a host of different questions. Clinical and basic scientists need to approach the next generation of trials in partnership.

Animals↗
PubMed2005

A review of gene therapy for haematological disorders.

Gene therapy aims to correct the disease process by restoring, modifying or enhancing cellular functions through the introduction of a functional gene into a target cell. Whilst the concept of gene therapy is simple, the practical reality of translating this new technology to the clinic has proven to be more difficult than first imagined. Recent progress in gene transfer technology has shown impressive clinical success in infants with immunodeficiency. However, two of these children have subsequently developed leukaemia as a result of insertional mutagenesis, thus, raising important questions about the safety of genetic therapeutics. This article reviews the current status of gene therapy and outlines the challenges faced by this emerging technology that holds so much promise for many suffering from catastrophic disorders.

Animals↗
PubMed2003

Molecular basis of atrial fibrillation: a dream or a reality?

AF is a difficult disease to treat because of the numerous (ischemic, metabolic, inflammatory, structural) mechanisms contributing to its etiology. AF persistence requires both an adequate tissue substrate for reentrant activity and triggers to initiate the arrhythmia. In a few interesting instances, AF may have a monogenic cause. Although there are common electrophysiologic characteristics of myocytes from a variety of AF models and clinical presentations, it is unrealistic to expect that all patients will respond equally to the same interventions. Thus, patients with AF of an inflammatory etiology may respond better to anti-inflammatory therapies, whereas those with enlarged atria secondary to valvular disease may require surgery. Some may respond better to ablation than others. However, the heterogeneity of the substrate does not negate the value of searching for the underlying molecular mechanisms. As we begin to comprehend these mechanisms in greater detail, the dream of using individualized rational therapies will come closer to reality.

Animals↗
PubMedDate not supplied

[Questionable methods in cancer therapy].

Although alternative and complementary therapies are a well known, spread reality, and many alternative cancer cure were generally found ineffective in clinical trials, oncologists don't care of them. While some therapies, such as spiritual healing and relaxation, are low risk if they don't delay effective conventional methods, herbal remedies showed potential adverse reactions. Oncologists should be aware of these products and question patients on their use of them.

Complementary Therapies↗
PubMed1997

Computer assisted therapy for multiple sclerosis and spinal cord injury patients application of virtual reality.

For patients with multiple sclerosis and spinal cord injury, virtual reality systems provide new methods of assistance with dysmetria, tremor, spasticity, and weakness. Robust mechanisms exist within the central nervous system to produce neuroplastic adaptive responses operative in retraining motor activities. Haptic systems cued by the patient's visual environment can produce force corridors to guide a patient's wrist and hand in the performance of specific tasks. Such haptic application can substantially reduce motor instability and improve performance. Preliminary clinical approaches, using video tremor tracking and manual force application, indicate the extent of the expected improvements attainable with this approach. Refinement of these techniques is proceeding to development of VR systems that will allow more extensive application to the problems of dysmetria, more general instances of tremor, spasticity, and weakness.

Humans↗
PubMed1997

Prevention of vein graft failure: potential applications for gene therapy.

The use of gene therapy in the clinical setting is believed to be a realistic option for the future. Many clinical trials are underway for treatment of disorders as diverse as cancer, peripheral vascular disease, and numerous monogenic disease. However, gene therapy for vein graft failure may be more distant due to the highly complex, multifactorial aetiology of the disease. Although many of the cellular mechanisms involved in vein graft failure have been reported, important barriers still need to be overcome before gene therapy could become a clinical reality. Further understanding of the molecular mechanisms involved in graft failure will lead to the identification of appropriate therapeutic genes. Moreover, limitations in the current delivery systems need to be overcome to allow efficient, safe delivery and expression of transgenes for the required length of time in vivo. However, currently available gene delivery vectors are extremely useful tools to help in our understanding of vein graft failure. In this review, we address the issues surrounding gene therapy with particular emphasis on its future potential to ameliorate long term vein graft occlusion.

Gene Transfer Techniques↗
PubMed1996

The continuing evolution of the nation's blood supply system.

The nation's blood supply system has undergone major change during the last decade. As a result, the blood supply is extremely safe. To accomplish this, the centers that supply most of nation's blood have made extensive changes in their regulatory affairs and quality assurance programs, personnel, or organizational structure, process control systems, computer and data management systems, and overall philosophy. The emphasis on a medical and patient focused organizational culture has been replaced by a more manufacturing and business culture. Research in transfusion medicine and related fields is bringing potential new transfusion therapies and blood components closer to reality. The blood system and the organizations and people who compose it must continue to evolve in ways to implement these new therapies.

Blood Banks↗
PubMed1983

Process, structure and world views: toward an integrated view of systemic models in family therapy.

Therapeutic modalities centered in interpersonal processes, in structural phenomena, and in reality constructions--the three care orientations in the field of family therapy--are here defined as mutually nonexclusive "translations" of the systemic paradigm into clinical practice. This definition does not attempt to blur the distinctions among these models but seeks to show their common denominator and thus expands the conceptual and clinical repertoire of the systems-oriented family therapist.

Family↗
PubMed2003

Gene therapy for pituitary tumors: from preclinical models to clinical implementation.

Gene therapy, which entails the use of nucleic acids as drugs, is a new approach to treat disease. Gene therapy has been successfully implemented in several preclinical animal models, including several paradigms of experimental pituitary tumors. In spite of these successes, several critical issues need to be addressed before gene therapy can become a clinical reality for the treatment of pituitary tumors. These include the development of safer and more effective gene delivery vectors, the uncovering of novel therapeutic targets, the development of molecular switches which will allow turning therapeutic transgene expression "on" and "off" as and when it is needed, and the ability to scale up the vector preparations devoid of any putative contaminants. There are still many basic science developments that must take place in order to allow this new therapeutic technology to make its way successfully into the clinical arena to treat pituitary disease. We envisage these developments taking place within the next five years, gene therapy for pituitary tumors will then form part of the armamentarium available to better treat and manage pituitary tumors.

Adenoviridae↗
PubMed1991

[The confused and the demented patient as a problem in neuro-rehabilitation. Old-age rehabilitation].

Organic psychosyndromes may be classified 1) by the state of vigilance (agitated or reduced), 2) by the progress in time (episodic versus progressive), 3) by the presence or absence of brain-local or vegetative accompanying phenomena, 4) by etiology. The most frequent forms are: multi-infarct-dementia and primary degenerative dementia of Alzheimer's type. We must be aware that this didactic differential diagnosis in reality mostly shows overlapping criteria. Either more to the one side or more to the other. Etiological therapy (as well "vasoactive" as "nootropic") should in most cases be combined with therapy of underlying internistic (cardiac for example) and accompanying (infection for example) symptoms. Depression as a special frequent dimension needs special attention. Furthermore there are complex therapeutic possibilities in the social, recreative, psychologic, rehabilitative, psychotherapeutic etc. field. Relatives need to be treated concommitantly. Only thus scientific as well as human implications for rehabilitation can meet.

Aged↗