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PubMed2006

[Therapeutic effect of acupuncture on allergic rhinitis and its effects on immunologic function].

OBJECTIVE: To compare therapeutic effects of acupuncture and auricular point pressing therapy on allergic rhinitis. METHODS: One hundred and fifty cases were randomly divided into an acupuncture group, an auricular point pressing group and a medication control group, 50 cases in each group. The acupuncture group were treated with acupuncture for 6 consecutive days, once each day, with an interval of one day; and the auricular point pressing group were alternatively treated twice each week; the medication group were treated with oral administration of western medicine saitezan, once daily, 10 mg once. They were treated for 4 weeks, and the short-term and long-term therapeutic effects, and effects on serum immunological indexes were compared among the three groups. RESULTS: The acupuncture group and the auricular point pressing group in the short-term therapeutic effect and improvement of cumulative scores of symptoms and signs, and the long-term total therapeutic effect and the improvement of cumulative scores of symptoms and signs were better than the medication group (P<0.01, P<0.05), with no significant differences between the acupuncture group and the auricular point pressing group. Serum IgE, IL-4 contents decreased and IFN-gamma level did not significantly change in the three groups. CONCLUSION: Acupuncture and auricular pressing therapy in improvement of symptoms and signs are better than the medication, and the therapeutic effect is carried out by inhibiting the differentiation from Th cells to Th2 cells, adjusting the imbalance of Th1/Th2 cells and decrease the synthesis of IgE to inhibit allergic rhinitis.

Acupuncture Points↗
PubMed2006

[Comparison of therapeutic effects between normal acupuncture and shallow needling with short-needle on periarthritis of shoulder].

OBJECTIVE: To compare therapeutic effects between normal acupuncture and shallow needling with short-needle, and search for therapeutic tool and method easy to be accepted by the patient of periarthritis of shoulder. METHODS: One hundred and fifty-two cases of periarthritis of shoulder were randomly divided into 2 groups. They were treated by normal acupuncture and shallow needling with short-needle, respectively. The two groups were same in acupoints selected and the therapeutic course, and their therapeutic effects and the accepting degrees of the patient were investigated. RESULTS: The cured rate was 67.1% in the normal acupuncture group and 69.7% in the shallow needling with short-needle group, with no significant difference between the two groups (P>0.05). CONCLUSION: Normal acupuncture and shallow needling with short-needle have similar therapeutic effect on periarthritis of shoulder, but the shallow needling with short-needle can obviously relieve the pain and mental fear in treatment, easy to be accepted.

Acupuncture Therapy↗
PubMed2007

Therapeutic potential of 90Y- and 131I-labeled anti-CD20 monoclonal antibody in treating non-Hodgkin's lymphoma with pulmonary involvement: a Monte Carlo-based dosimetric analysis.

UNLABELLED: Pulmonary involvement is common in patients with non-Hodgkin's lymphoma (NHL). (90)Y- and (131)I-anti-CD20 antibodies (ibritumomab tiuxetan and tositumomab, respectively) have been approved for the treatment of refractory low-grade follicular NHL. In this work, we used Monte Carlo-based dosimetry to compare the potential of (90)Y and (131)I, based purely on their emission properties, in targeted therapy for NHL lung metastases of various nodule sizes and tumor burdens. METHODS: Lung metastases were simulated as spheres, with radii ranging from 0.2 to 5.0 cm, which were randomly distributed in a voxelized adult male lung phantom. Total tumor burden was varied from 0.2 to 1,641 g. Tumor uptake and retention kinetics of the 2 radionuclides were assumed equivalent; a uniform distribution of activity within tumors was assumed. Absorbed dose to tumors and lung parenchyma per unit activity in lung tumors was calculated by a Monte Carlo-based system using the MCNP4B package. Therapeutic efficacy was defined as the ratio of mean absorbed dose in the tumor to that in normal lung. Dosimetric analysis was also performed for a lung-surface distribution of tumor nodules mimicking pleural metastatic disease. RESULTS: The therapeutic efficacy of both (90)Y and (131)I declined with increasing tumor burden. In treating tumors with radii less than 2.0 cm, (131)I targeting was more efficacious than (90)Y targeting. (90)Y yielded a broader distribution of tumor absorbed doses, with the minimum 54.1% lower than the average dose; for (131)I, the minimum absorbed dose was 33.3% lower than the average. The absorbed dose to normal lungs was reduced when the tumors were distributed on the lung surface. For surface tumors, the reductions in normal-lung absorbed dose were greater for (90)Y than for (131)I, but (131)I continued to provide a greater therapeutic ratio across different tumor burdens and sizes. CONCLUSION: Monte Carlo-based dosimetry was performed to compare the therapeutic potential of (90)Y and (131)I targeting of lung metastases in NHL patients. (131)I provided a therapeutic advantage over (90)Y, especially in tumors with radii less than 2.0 cm and at lower tumor burdens. For both (90)Y- and (131)I-labeled antibodies, treatment is more efficacious when applied to metastatic NHL cases with lower tumor burdens. (131)I has advantages over (90)Y in treating smaller lung metastases.

Adult↗
PubMed1991

[Guidelines for interaction by the therapeutic team in inpatient treatment of patients with chronic neurotic disorders].

In treatment of in-patients with chronic neurotic disorders we tried both to reduce distress in the therapeutic team (doctors, nurses, other therapists) as usually caused by those patients, and to improve outcome of treatment. Therefore, three to five guidelines on how to deal with the patient were given to the therapeutic team, and illustrated by possible literal statements to the patient. The guidelines aimed at a general interactional approach to the patient and did not determine specific therapeutic interventions. They were set up following principles of Brief Therapy as developed at the Mental Research Institute in Palo Alto. Results of our intervention in treatment of ten patients are reported. The therapeutic team rated the guidelines generally as positive. The therapeutic outcome varied greatly. A comparison with a matched pair control group showed a favourable tendency. Initial ratings by the team of the prescriptions predicted eventual improvement of the patients.

Adult↗
PubMed1991

Diagnostic peritoneal lavage as an indicator for therapeutic surgery.

Diagnostic peritoneal lavage (DPL) has been reported to be extremely accurate in identifying intra-abdominal injury. Many studies, however, fail to indicate clearly if the procedure is helpful in determining which patients require truly therapeutic surgical intervention, because not all injuries need such surgery. In this study the authors reviewed the charts of 174 patients with blunt abdominal trauma and, by applying strict criteria to define a therapeutic laparotomy, sought to determine, retrospectively, whether DPL was useful for indicating the need for therapeutic surgery. Although 94% of patients with positive findings from DPL underwent a laparotomy, only 65% underwent one that was clearly of therapeutic value. Although other factors may have partially contributed to the discrepancy between these results and those generally referred to in the trauma literature, this study suggests that criteria providing a strict definition of a therapeutic laparotomy must be universally applied when analysing the value of DPL.

Abdominal Injuries↗
PubMed1990

Prophylactic and therapeutic effects of oral administration of amphotericin B in mycosis associated with hematologic diseases. Study Group of Mycosis in Hematologic Disease.

The prophylactic and therapeutic effects of the oral administration of amphotericin B (AMPH) to patients with deep mycosis associated with hematologic diseases were evaluated in an investigation including determination of serum concentrations of the antibiotic. Prophylactic effects were examined in 111 subjects, and the efficacy rates averaged 83.8% at daily doses from 1,200 to 4,800 mg. The efficacy was significantly higher at a dose of 2,400 mg/day than at a dose of 1,200 mg/day (P less than 0.05). The efficacy rate tended to be higher when the length of administration period was 1 month or more. The percentage of the number of days of fever by neutrophil count was significantly less at a daily dose of 2,400 mg than at 1,200 mg in patients with neutrophil count of 1,000 cells/mm3 or less (P less than 0.001). The safety was evaluated in 131 subjects, and adverse effects were found in only 2 cases of nausea for an incidence rate of 1.5%. Therapeutic effects were studied in 12 cases, and efficacy rates averaged 58.3% at daily doses from 2,400 to 7,200 mg. Adverse effects consisted of 1 case of diarrhea among 15 subjects who were evaluated for the safety for an incidence rate of 6.7%. The serum concentrations of the antibiotic were examined in 60 of the prophylactic and therapeutic subjects. Average concentrations of AMPH at 4 hours after the first daily dose of 1,200, 2,400 and 4,800 mg were 0.040, 0.053 and 0.078 micrograms/ml, respectively. Concentrations gradually increased thereafter and reached averages of 0.089, 0.090 and 0.132 micrograms/ml, respectively, for the 3 dose levels on the 7th day. These results indicated that there were no serious adverse effects and serum concentrations were above the Candida MIC values at daily prophylactic and therapeutic doses of 1,200 to 7,200 mg of AMPH. Based on these findings, this drug can be expected to show prophylactic and therapeutic effects with safety in cases of deep mycosis.

Administration, Oral↗
PubMed1990

[Improvement in alveolar macrophage function after therapeutic lung lavage in pulmonary alveolar proteinosis].

Alveolar macrophage (AM) function was investigated in 4 cases of pulmonary alveolar proteinosis (PAP). Therapeutic bronchoalveolar lavage (BAL) with a flexible bronchofiberscope was done 7-13 times during periods of 4-24 weeks. In the initial BAL, the total cell count was only 0.18-0.92 x 10(5)/ml. Also low AM, lymphocytosis and eosinophilia values were noted. The phagocytic activity of AM was only 3-14% and nitroblue tetrazonium (NBT) reduction of AM was under 5% before therapeutic BAL. However, the phagocytic activity was from 25-63% and NBT reduction from 15-35% after therapeutic BAL, AM function with periods of remission of PAP was normal but AM function decreased during relapse and exacerbation of PAP. After therapeutic BAL, two patients have been in remission for three years, one patient with incomplete restoration of AM function relapsed after one year, and one patient without restoration of AM function showed further deterioration after developing pulmonary tuberculosis. These findings indicate that the defect in AM function found in PAP is reversible with therapeutic BAL, and that the severity of PAP is closely associated with AM function.

Adult↗
PubMed1990

Therapeutic drug monitoring (TDM): an aid to anti-epileptic drug (AED) therapy in Zimbabwe: a review.

Therapeutic drug monitoring as an aid to maximal anti-epileptic drug therapy in Zimbabwe was reviewed. The rationale behind therapeutic drug monitoring is that the therapeutic response to most anti-epileptic drugs correlates with the concentration in the blood rather than with the dose and that within an optimum therapeutic range, the majority of patients experience maximum benefit with minimum toxicity. This review highlights the fact that therapeutic drug monitoring is required to optimise anti-epileptic drug therapy because it is a predictor of drug compliance; it is ideal for dosage adjustment: it is a good indicator for confirming clinical diagnosis of intoxication and in poly-pharmacy it can be used to identify a culprit compound and in pregnancy and paediatric populations it is ideal for dosage individualization since changes are rapid. TDM of AED is recommended in the 'intractable' seizure group for our setting.

Anticonvulsants↗
PubMed1989

[Therapeutic effectiveness of lidocaine in patients with ventricular arrhythmias estimated relative to measurements of drug concentration in serum].

Therapeutic effectiveness of lidocaine intravenous infusions preceded by an initial intravenous dose was studied in 29 patients with ventricular arrhythmias in a course of ischemic heart disease admitted to CCU. Clinical effects were evaluated in correlation with obtained lidocaine concentrations and basic pharmacokinetic parameters. Regression of cardiac arrhythmias was stated in 23 patients (79.3%), inclusive of all acute MI cases. Partial therapeutic effect was observed in 4 patients (13.8%) and no effect in 2 (6.9%). In 12 patients (52.2%) with stated regression of ventricular arrhythmias the full therapeutic effect was observed after initial dose administration. Serum drug concentrations were above the lower limit of the therapeutic range in all cases. Side effects were observed in 3 cases with high serum lidocaine levels caused by impaired drug metabolism or elimination due to the patient's clinical state. Correlation between the infusion rate and obtained stationary condition of drug concentration within therapeutic range seemed to be highly effective in management of ventricular premature beats caused by acute myocardial ischemia but less effective in cases of ischemic and postinfarction cardiomyopathy with heart failure.

Aged↗
PubMed1989

Fundamental and practical aspects of therapeutic uses of pulsed electromagnetic fields (PEMFs).

The beneficial therapeutic effects of selected low-energy, time-varying magnetic fields, called PEMFs, have been documented with increasing frequency since 1973. Initially, this form of athermal energy was used mainly as a salvage for patients with long-standing juvenile and adult nonunions. Many of these individuals were candidates for amputation. Their clearly documented resistance to the usual forms of surgical treatment, including bone grafting, served as a reasonable control in judging the efficacy of this new therapeutic method, particularly when PEMFs were the sole change in patient management. More recently, the biological effectiveness of this approach in augmenting bone healing has been confirmed by several highly significant double-blind and controlled prospective studies in less challenging clinical circumstances. Furthermore, double-blind evidence of therapeutic effects in other clinical disorders has emerged. These data, coupled with well-controlled laboratory findings on pertinent mechanisms of action, have begun to place PEMFs on a therapeutic par with surgically invasive methods but at considerably less risk and cost. As a result of these clinical observations and concerns about electromagnetic "pollution", interactions of nonionizing electromagnetic fields with biological processes have been the subject of increasing investigational activity. Over the past decade, the number of publications on these topics has risen exponentially. They now include textbooks, speciality journals, regular reviews by government agencies, in addition to individual articles, appearing in the wide spectrum of peer-reviewed, scientific sources. In a recent editorial in Current Contents, the editor reviews the frontiers of biomedical engineering focusing on Science Citation Index methods for identifying core research endeavors. Dr. Garfield chose PEMFs from among other biomedical engineering efforts as an example of a rapidly emerging discipline. Three new societies in the bioelectromagnetics, bioelectrochemistry, and bioelectrical growth and repair have been organized during this time, along with a number of national and international committees and conferences. These activities augment a continuing interest by the IEEE in the U.S. and the IEE in the U.K. This review focuses on the principles and practice behind the therapeutic use of "PEMFs". This term is restricted to time-varying magnetic field characteristics that induce voltage waveform patterns in bone similar to those resulting from mechanical deformation. These asymmetric, broad-band pulses affect a number of biologic processes athermally. Many of these processes appear to have the ability to modify selected pathologic states in the musculoskeletal and other systems.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1988

[Vertebral tuberculosis in Gabon. Anatomo-clinical aspects, diagnostic and therapeutic problems, 107 cases from 1976 to 1986].

This retrospective study covers a period of 10.5 years (february 1976 to november 1986). It concerns 107 patients who contracted tuberculous spondylitis and originated from different provinces of Gabon. The authors report their experiences in order to emphasize the frequency of the disease, diagnostic and therapeutic problems. In Gabon, tuberculosis of the spine occupies the third position (3%), after the pulmonary form (90%) and ganglionic form (3.8%). In also represents 83.6% of the osteoarticular tuberculosis. The average age is 22 years, 55% of the patients were less than 20 years. The zone of maximum predilection, in decreasing order, is thoracic spine (36.4%), lumbar spine (33.6%), thoraco-lumbar region (10.3%). The 107 patients totalized 257 vertebral bodies destroyed (an average of 2.4 bodies per patients). On the clinical field the sick seek advice at an advance stage of the disease with gibbosity (38.3%) and neurologic deficits (21.5%). The diagnosis proof often followed the therapeutic results. There were three therapeutic modalities: medical (all patients), surgical (6 patients) and orthopedic (44 patients). The therapeutic indications improved with the available of more material and qualified staff. In children the treatment remains classic. The authors discuss the surgical indications in adults. The therapeutic results in patients treated and followed for over one year were satisfactory. Unfortunately, most patients were lost to follow-up. They suggest public health means of decreasing the frequency of the disease.

Adolescent↗
PubMed1987

[Clinico-diagnostic, therapeutic and prognostic studies of Wilson-Konovalov disease. The results of 25 years' experience].

The author's 25 years experience in clinical, diagnostic, therapeutic and prognostic study of 24 patients with Wilson-Konovalov's disease (hepatilenticular degeneration) is presented. The great diagnostic importance of copper metabolism (plasma copper level, urine copper), plasma ceruloplasmin concentration, histochemical and quantitative determination of copper in liver cells (after a liver biopsy) is pointed out. These are of special importance in young patients (under 25 years) and in children with chronic parenchymal liver disease. In 1/4 of the patients the early stage of the disease resembled chronic active hepatitis (predominantly liver type of the disease). The basic therapeutic drug is D-penicillamine hydrochloride and when it is not tolerated the drug Trien may be used. Very good therapeutic results and considerable improvement of prognosis, social and working rehabilitation of the patients have been achieved. The preconditions for good therapeutic and prognostic results are the early discovery, exact diagnosis and prolonged purposeful pathogenetic treatment (chelatory and hepatoprotective). Zinc sulfate and potassium sulfide are only secondary therapeutic means in patients with hepatolenticular degeneration.

Adolescent↗
PubMed1986

Therapeutic misadventure. An 11-year study from a metropolitan coroner's office.

"Therapeutic misadventure" and its alternative forms is a controversial, though necessary, manner of ruling deaths that result from unexpected complications of medical procedures. Such cases must be brought to the attention of the medical-legal office so that they are thoroughly investigated and documented, and so that appropriate and consistent rulings are made. While it is not generally agreed that a ruling of therapeutic misadventure implies medical negligence, a number of such cases do become the bases for litigation. During an 11-year period in a metropolitan coroner's office that examines about 2,000 cases yearly, 44 cases were ruled therapeutic misadventure, an incidence of 0.46%. A recent increase in such cases is probably the result of improved case finding and investigation. The largest category was that of surgical complications, followed, in order, by complications of anesthesia and of therapeutic and diagnostic procedures, and by drug reaction. No case occurred in ambulatory surgery. There apparently has been a low incidence of attendant lawsuits. The study of cases of therapeutic misadventure is potentially of great value in identifying outcomes and trends, and for the prevention of such cases in the future.

Adolescent↗
PubMed1986

[Therapeutic interventions in sexual child abuse].

This article describes the steps in a therapeutic crisis intervention in cases of intrafamilial child sexual abuse. It is outlined how the form and organisation of the intervention can in itself be highly therapeutic or very harmful. Taking to children, physical examination, coordination of professionals, the disclosure with parents and a family meeting are described as part of an overall therapeutic approach in the disclosure of the abuse. The described therapeutic crisis intervention attempts to take into account paediatric-medical routine and does not refer to any specialist therapeutic techniques in order to enable any child health professional who dares to face the issue of child sexual abuse to undertake the intervention.

Child↗
PubMed1979

Cardiorespiratory monitoring in postoperative patients: II. Quantitative therapeutic indices as guides to therapy.

Immediate (proximate) and late (optimal) therapeutic goals for critically ill postoperative general surgical patients were based on the frequency distributions of cardiorespiratory data of the survivors immediately after resuscitation and in the late stage of shock, respectively. An algorithm was developed which expresses in quantitative terms the distance from observed values for each variable to both of these therapeutic goals. Further, composite indices were also made of related cardiorespiratory variables that reflect the important aspects of acute circulatory failure and its therapy; i.e., volume, flow, tissue perfusion, oxygen transport, and bodily response to stress. The therapeutic indices of nonsurvivors were found to have greater mean deficits that survivors (p less than 0.05) during all but the middle stage of shock. The therapeutic indices greatly aid in the organization and display of monitored cardiorespiratory variables by expressing the circulatory defects in easily understood indices that can be related to therapeutic interventions. Moreover, the interactions of the various aspects of cardiorespiratory function before and after therapy may be easily observed.

Cardiovascular System↗
PubMedDate not supplied

[Failures of standardized treatments in pulmonary tuberculosis. Possibilities of prevention and therapeutic recovery].

In view of a better knowledge of therapeutic failures in operational conditions four groups of patients were analyzed, which included a total of 1511 patients, both new cases and patients re-admitted for tuberculosis of the pulmonary apparatus, that had been treated according to standardized regimens. In three of these groups failures had been recorded at a rate of 3,9% intra-therapeutic failures and 7,6% post-therapeutic ones in the first 18 months after completing the therapy. Out of the four groups a lot was selected, which included 127 cases of therapy failure. This lot was studied under the aspect of causes of the failure and of the possibilities for recovery. The major causes of the failure were non-cooperation of patients (in 48% of the cases), the initial severity of the lesions, associated diseases, the re-admittance, the secondary resistance. Recovery of the intra-therapeutic failures was possible in 46% of the cases, and of patients with post-therapeutic failure in 72% of the cases. On the basis of an analysis of risk factors a series of proposals are made for preventing such failures.

Adolescent↗
PubMed1983

Therapeutic and prognostic value of initial chromosomal findings at the blastic phase of Ph1-positive chronic myeloid leukemia.

To assess parameters of therapeutic response and of survival after the onset of the blastic phase (BP) in 64 patients with Ph1-positive chronic myeloid leukemia (CML), a number of clinical, hematologic, and cytogenetic data at the BP were evaluated. Among 10 parameters checked, only the chromosomal findings correlated with the therapeutic response and survival after the onset of the BP. The patients were divided into three groups on the basis of the chromosome findings in the bone marrow, blood, and spleen: (1) those with only a Ph1 (PP), (2) those having two types of clones, i.e., one clone with only a Ph1 and another with additional karyotypic changes (AP), and (3) those with only abnormal clones in addition to the Ph1 (AA). The number of patients in each group was 29 in PP, 15 in AP, and 20 in AA. The results were as follows. (1) The percentage of patients with a good therapeutic response was 79% (23/29) in PP, 53% (8/15) in AP, and 30% (6/20) in AA. (2) The median survival after the onset of the BP was 171 days (5.7 mo) in PP, 146 days (4.9 mo) in AP, and 74 days (2.5 mo) in AA. Statistically, there was a significant difference between the AA and the other two groups (p less than 0.05). For further study, the AA and AP patients were divided into 4 subgroups each: those with 48 or more chromosomes, those with 47 chromosomes, those with pseudodiploidy, and those with hypodiploidy. A subgroup with 48 or more chromosomes in the AA patients had a very short survival (median, 25 days; 0.8 mo) and a poor therapeutic response (1/9, 11%). Our observations suggest that the lack of a clone with only a Ph1 (AA), particularly with more than 48 chromosomes, at the acute crisis or shortly after the onset of the BP indicates an unfavorable therapeutic response and a poor prognosis after the onset of the BP.

Adolescent↗
PubMed1984

[A new research method in psychiatry: the therapeutic companion].

In this paper, the profile of the therapeutic companion (T.C.) is drawn. This is a person, not necessarily a psychologist, who has been especially trained to cooperate in a psychiatric therapeutic equipment from a complementary position to the therapist in charge (T. Ch.). His function is to accomplish the therapist's instructions which mainly aim to contain the patient's anxiety and to give him pertinent responses to this symptomatic behavior. The link T. C.-T. Ch. is examined; a fluid communication between the parties and permanent supervision of the T.C.'s work is strongly recommended for a satisfactory therapeutic work. The indications for the inclusion of the T. C. comprise psychotic decompensations in border-line patients, acute psychosis and suicidal or aggressive behavior toward others. Special emphasis is laid on the research possibilities of this procedure: "natural" observations can be made and corroboration of hypothesis about therapeutic conduct can be attained. In respect to the number of T. C. to employ in each case. It depends on the patient's pathology. Not always, though, the theoretical convenience of only one T. C. all the time for some cases is feasible, due to the emotional strain of the task. The probability of a betterment of the therapeutic efficiency, together with the diminishment of time and cost of internment are some of the advantages of this approach.

Humans↗