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PubMed1996

Group therapy as an effective treatment modality for people of color.

The unique benefits for group therapy are examined with special emphasis on the treatment of blacks and Latinos. Because of racial prejudice, economic exploitation, and negative stereotypes, group forces have been especially detrimental to the personality development of people of color. The group therapist attempts to harness these powerful group forces and use them therapeutically, thus enabling people of color to relate better to others while retaining their own autonomy. Racial differences can intensely affect diagnosis, transference, countertransference, and the "real relationship." Distinctions between cultural and functional paranoia are particularly relevant in interracial groups. Implications for training group therapists are also explored.

Black or African American↗
PubMed1999

Light relief: the case for ocular light therapy.

Ocular Light Therapy is emerging as a significant form of therapy, particularly in psychological and psychosomatic disorders. OLT involves the projection of light through colour filters to the eyes of the client, with consequent photocurrent stimulation of cortical and hypothalamic systems.

Color Therapy↗
PubMed2001

Light therapy for seasonal affective disorder in primary care: randomised controlled trial.

BACKGROUND: Studies of light therapy have not been conducted previously in primary care. AIMS: To evaluate light therapy in primary care. METHOD: Fifty-seven participants with seasonal affective disorder were randomly allocated to 4 weeks of bright white or dim red light. Baseline expectations for treatment were assessed. Outcome was assessed with the Structured Interview Guide for the Hamilton Depression Scale, Seasonal Affective Disorder Version. RESULTS: Both groups showed decreases in symptom scores of more than 40%. There were no differences in proportions of responders in either group, regardless of the remission criteria applied, with around 60% (74% white light, 57% red light) meeting broad criteria for response and 31% (30% white light, 33% red light) meeting strict criteria. There were no differences in treatment expectations. CONCLUSIONS: Primary care patients with seasonal affective disorder improve after light therapy, but bright white light is not associated with greater improvements.

Adolescent↗
PubMed1996

[Ureteral jet in patients with benign prostatic hypertrophy: prognostic evaluation during single and combined therapy].

By color-Doppler ultrasound it's possible to visualize urine flow jet from ureter into the bladder. Aim of the study was to evaluate of ureteral jet in patients with benign prostatic hyperplasia before, during and after with one or two drugs medical therapy. Thirteen patients, aged 51-63 years, were studied; they were not affected by metabolic, hepatic, renal diseases and by prostate inflammation. Eco color Doppler p.w. (Toshiba SSA 270A) with a convex probe of 3.5 MHz was used. A transabdominal ultrasound study was performed, prostate volume measured and ureteral jet visualized before and along treatment (at six months interval) with Finasteride and at the end of treatment. Successively, in four patients, with relapse of prostatic synptomatology, a transabdominal ultrasound study was performed, before and along a treatment with Finasteride, 5 mg/die (Finastid, Neopharmed) and Terazosin hydrochloride, 5 mg/die (Teraprost, Malesci), and at the end of treatment.

Adrenergic alpha-Antagonists↗
PubMed1995

Vaginal color Doppler assessment of uterine artery impedance correlates with immunohistochemical markers of endometrial receptivity required for the implantation of an embryo.

OBJECTIVE: To investigate the correlation between uterine artery impedance with immunohistochemical histologic, and ultrasonographic markers of uterine receptivity. DESIGN: A prospective study of subfertile women undergoing a frozen embryo replacement cycle. SETTING: A tertiary infertility clinic. PATIENTS: The study was based on 86 patients who had failed to become pregnant during a standard IVF treatment cycle and who had at least two good quality embryos cryopreserved. INTERVENTIONS: All patients had pituitary desensitization with the GnRH analogue buserelin acetate, followed by E2 and P replacement therapy. Vaginal color Doppler images of both uterine arteries were obtained on days 7, 14, and 21 of the first (trial) cycle. On day 21, an endometrial biopsy was taken for dating a 24-kd protein, placental protein 14, and E2 receptor assessment. After a menstrual bleed had been induced, administration of estrogen and P was reinstituted and embryos transferred to the uterus on the 3rd or 4th day of P administration. MAIN OUTCOME MEASURES: The mean pulsatility index of the left and right uterine arteries, a semiquantitative score of endometrial 24-kd protein, PP14, and E2 receptor assessment, endometrial histologic dating, and pregnancy outcome. RESULTS: Nineteen of 76 patients who had a successful ET became pregnant. The pulsatility index on day 14 of both the trial and ET cycles was significantly lower in those who achieved pregnancy as compared with those who did not conceive: 2.65 (range 1.3 to 3.4) versus 3.85 (1.8 to 6.8) and 2.85 (1.4 to 3.6) versus 4.15 (2.1 to 6.8), respectively. There were significant correlations between pulsatility index and 24-kd protein, E2 receptor, and endometrial histology but not with PP14 and endometrial thickness. CONCLUSIONS: Uterine artery impedance has a significant correlation with biochemical markers of uterine receptivity and accurately predicts the probability of pregnancy in frozen embryo replacement cycles. It is a useful method for assessing uterine receptivity in assisted conception programs.

Adult↗
PubMed2004

Color of culprit lesion at 6 months after plain old balloon angioplasty versus stenting in patients with acute myocardial infarction.

BACKGROUND: Although the healing process of disrupted yellow plaques at myocardial infarction (MI) culprit lesions has been reported, the effect of stenting on this process has not been clarified. Stenting has been reported to deteriorate the endothelial function after percutaneous coronary intervention (PCI). Therefore, we compared the angioscopic morphology of culprit lesions at 6 months after plain old balloon angioplasty (POBA) and stenting to clarify the effect of stenting on the healing of disrupted culprit plaques of acute MI. METHODS: Patients with acute MI who had yellow culprit plaque, successful reperfusion therapy with POBA (n = 21) or stenting (n = 22), and a successful 6-month follow-up angioscopic examination were included in this study. Oral ticlopidine (200 mg/day) was administered for 3 to 6 months after stenting. RESULTS: At 6 months after reperfusion therapy, the color of the culprit lesion became white in significantly more patients treated with stenting than treated with POBA (50% vs 14%; P = .01). However, the prevalence of thrombus appeared to be higher in patients treated with stenting than in patients treated with POBA (27% vs 5%; P = .04). Although there was some difference in the patients' characteristics in the groups, logistic regression analysis revealed no significant influence of those factors on the color of or on the prevalence of thrombus at the culprit lesion. CONCLUSIONS: Coronary stenting in patients with acute MI leads to the disappearance of yellow color at a significantly higher rate than POBA; however, whether it stabilizes the plaque requires further investigation.

Angioplasty, Balloon, Coronary↗
PubMed1995

Effect of psychological treatment on cognitive bias in generalized anxiety disorder.

Measures of attention and implicit memory for threatening words were obtained from anxious patients before and after psychological treatment, and compared with data from non-anxious control Ss collected over the same period. Findings confirmed the expectation that the presence of threatening distractors would be associated with greater interference with the performance of anxious patients than with that of controls, in both color-naming and attentional search tasks, but failed to confirm the previous finding of related differences in priming on a word completion task. Treatment significantly reduced selective interference effects in anxious patients, and abolished evidence of differences between the treated patients and controls. It is suggested that cognitive bias effects in anxiety may either depend on state factors alone, or may represent a more enduring individual difference that becomes apparent only when vulnerable individuals are primed by mood state or stressful events.

Adult↗
PubMed1992

[The color Doppler-guided compression therapy of a large false aneurysm of the femoral artery following left heart catheterization].

A ventrally located false aneurysm (7 x 5.2 x 3.4 cm) of the right common femoral artery occurred, after left-heart catheterization by the Judkins technique via this artery, in an 83-year-old woman with aortic valve stenosis. Colour Doppler sonography demonstrated a puncture canal (neck of the aneurysm) filling in both systole and diastole, as well as turbulent flow within the aneurysm. Flow into the aneurysm was considerably reduced when the transducer head compressed the aneurysm, while flow continued in the femoral artery and vein. This compression, maintained for 25 min, completely thrombosed the puncture canal and aneurysm so that no vascular surgery was required.

Aged↗
PubMed1996

[The color Doppler-guided compression therapy of pseudoaneurysms. The authors' own experiences and a review of the literature].

PURPOSE: The common use of interventional angiographic techniques and the sensitive detection of this vascular complication by ultrasound are major factors contributing to the increasing incidence of femoral artery pseudoaneurysms. ultrasound-guided compression repair of femoral artery pseudoaneurysms was prospectively evaluated. MATERIAL AND METHODS: 11 femoral artery pseudoaneurysms were detected in 10 patients who ranged from 45 to 79 years of age. In one patient two ipsilateral pseudoaneurysms occurred. All patients were considered to be candidates for ultrasound-guided compression repair. RESULTS: Successful compression repair was achieved in 9 of 11 pseudoaneurysms (82%) with a mean diameter of 2.2 +/- 1.0 cm. In two recurrent lesions (22%) definitive thrombosis required a second treatment. Compression was maintained between 10 and 40 minutes (mean 22 +/- 11 minutes). No complications have been observed. CONCLUSIONS: Ultrasound-guided compression repair provides an efficient, noninvasive and safe treatment of femoral artery pseudoaneurysms. More than 80% of pseudoaneurysms can be occluded successfully. In recurrent lesions a second attempt is valuable.

Aged↗
PubMed1996

Color duplex-guided compression therapy for postcatheterization pseudoaneurysms in a community hospital.

Diagnostic or therapeutic arterial catheterization may be complicated by postcatheterization pseudoaneurysm. Pseudoaneurysms have generally been treated surgically, but more recently, encouraging results with duplex-guided compression therapy (DGCT) of pseudoaneurysms have been reported from university hospitals. We reviewed our experience with DGCT to assess the applicability of DGCT in a community hospital setting. Sixty-two patients presented with 63 symptomatic postcatheterization pseudoaneurysms between January 1, 1990, and December 31, 1993. Prior to October 28, 1991, all pseudoaneurysms were treated surgically. Subsequently we initiated DGCT as primary treatment for pseudoaneurysms, reserving surgery for DGCT failures and unstable patients. DGCT patients were indistinguishable from primary surgery patients, and the number of pseudoaneurysms treated did not appear to increase during the study period. DGCT was initially successful in 27 (75%) of 36 patients. Three pseudoaneurysms recurred, yielding cumulative success in 24 (67%) of 36 patients. Three of 12 DGCT failures were due to patient intolerance. DGCT was unsuccessful in three of four intra-aortic balloon pump (IABP)-associated pseudoaneurysms. There was some variation in pseudoaneurysm volume between the successful and failed groups, and a trend toward failure with larger pseudoaneurysm was not significant (13 vs. 6 cm3, p > or = 0.25). DGCT failure appears more likely in post-IABP pseudoaneurysms and possibly with larger pseudoaneurysms. Anticoagulation, type of procedure (exclusive of IABP), obesity, and other patient characteristics examined did not appear to predict success or failure of DGCT. Treatment was reserved for symptomatic patients throughout the period of study and there was no evidence that patients were more likely to be treated for pseudoaneurysms after DGCT was initiated. We conclude that DGCT is usually successful and is appropriate primary treatment for all symptomatic postcatheterization pseudoaneurysms in stable patients.

Adult↗
PubMed1995

A follow-up study of cognitive bias in generalized anxiety disorder.

Patients with generalized anxiety disorder (GAD) without concurrent depression (n = 11) and normal controls (n = 17) were tested twice, about 2 months apart, on a modified Stroop colour-naming task, which presented anxiety-related, depression-related and neutral words in masked and unmasked exposure conditions. GAD patients received cognitive behaviour therapy in the test-retest interval, and were also retested at follow-up, about 20 months after initial testing. GAD patients showed interference in colour-naming negative words across both masked and unmasked conditions before treatment, but not post-treatment, compared with controls. Reduced interference effects of masked threat words over time correlated with reduced ratings of anxious thoughts at post-treatment, and at follow-up, in GAD patients. Thus, the preconscious bias for threat information in GAD appears to vary over time in association with changes in anxious thoughts and worries.

Adolescent↗
PubMed1998

The topographic distribution of the first sites of diabetic retinal neovascularization.

PURPOSE: To examine the topographic distribution of the origin of diabetic retinal neovascularization. METHODS: The eyes of 3,121 patients with background diabetic retinopathy were investigated. These patients were volunteers in systemic medical therapy experiments. Color stereo photographs were obtained annually. The first retinal neovascularization sites were identified and the distances from the optic nerve measured. RESULTS: In 1 year, neovascularization originated in 282 eyes. The superotemporal quadrant, at 6 mm from the optic disk, was the most frequent initial site. CONCLUSIONS: The first retinal neovascularization sites cluster around specific anatomic foci. This information should influence retinopathy monitoring protocols.

Clinical Trials as Topic↗
PubMed1998

Conservative therapy of adnexal torsion employing color Doppler sonography.

STUDY OBJECTIVE: To ascertain if color Doppler sonography (CDS) can detect viability of adnexa in torsion. DESIGN: Concurrent, nonrandomized study (Canadian Task Force classification II-2). SETTING: Tertiary medical care center in a university hospital. PATIENTS: Twenty-seven women suspected of having torsion of the ovary in which a benign tumor was present. INTERVENTIONS: Color Doppler sonography of the ovarian pedicle suggested torsion. Laparoscopy or laparotomy was performed in 19 patients and confirmed the diagnosis. MEASUREMENTS AND MAIN RESULTS: We identified a twisted vascular pedicle of the ovarian tumor by CDS in 24 (88%) of 27 women. Pedicle arterial and venous blood flow was observed in 10 women; pathology specimens revealed normal tissue, edema with congestion, or early hemorrhage. In all nine in whom only arterial blood flow or no blood flow was observed, pathology revealed hemorrhagic necrosis. In five women with arterial and venous blood flow the tumor was managed conservatively, either by detorsion or cystectomy, after which no embolism or tumor recurrence was seen at follow-up ultrasonography. Normal follicular development and ovulation occurred in these patients. CONCLUSION: For women of childbearing age in whom torsion of benign adnexal tumors is suspected, CDS should be performed to confirm the diagnosis and ascertain whether or not pedicle arterial and venous blood flow is present. If such blood flow is detected, the adnexa is considered to be viable and detorsion or cystectomy may be performed, thus preserving the ovary. It is recommended that further studies with a larger group be undertaken to provide a basis for statistical analysis.

Abdomen, Acute↗
PubMed1999

A review of the management of 323 consecutive patients seen in a specific learning difficulties clinic.

Visual correlates of specific learning difficulties (SpLD) include: binocular instability, low amplitude of accommodation, and Meares-Irlen Syndrome. Meares-Irlen Syndrome describes asthenopia and perceptual distortions which are alleviated by using individually prescribed coloured filters. Data from 323 consecutive patients seen over a 15 month period in an optometric clinic specialising in SpLD are reviewed. Visual symptoms and headaches were common. 48% of patients were given a conventional optometric intervention (spectacles, orthoptic exercises) and 50% were issued with coloured filters, usually for a trial period. 40% of those who were given orthoptic exercises were later issued with coloured overlays. 32% of those who were issued with coloured overlays were ultimately prescribed Precision Tinted lenses. Approximately half the sample were telephoned more than a year after the last clinical appointment. More than 70% of those who were prescribed Precision Tints were still wearing them daily, and results for this intervention compared favourably with data for non-tinted spectacles. The data suggest that many people with SpLD need optometric care and that the optometrist needs to be skilled in orthoptic techniques and cognisant of recent research on coloured filters.

Accommodation, Ocular↗
PubMed2002

Benefit of coloured lenses for age-related macular degeneration.

PURPOSE: To evaluate and compare the functional and perceived benefits of wearing coloured lenses by patients with age-related macular degeneration (ARMD). METHOD: Ten subjects with early ARMD and five elderly controls wore a selection of NoIR wrap-around coloured lenses (yellow 29.7% light transmission, orange 22.9%, red 16.8% and grey 10.3%), each for a duration of 7 days. Contrast sensitivity, colour vision, visual acuity, the effect of glare and peripheral sensitivity were measured for each lens and compared with a control (no lens) condition. Subjective ratings of visual performance were also scored. RESULTS: Compared with the no filter condition, red and grey lenses reduced contrast sensitivity whereas yellow and orange lenses increased contrast sensitivity. These objective changes were supported by subjective ratings in subjects with ARMD. Grey lenses reduced the loss of contrast sensitivity usually suffered in the presence of glare, whereas visual acuity and peripheral sensitivity decreased with red lenses. Colour vision became distorted with red lenses in control subjects, but was relatively unaffected by the use of coloured lenses in subjects with ARMD. CONCLUSIONS: The subjective benefit of coloured lenses appears to be due to a minor enhancement of contrast sensitivity.

Aged↗
PubMed1999

Comparison of the efficacy of conventional special blue light phototherapy and fiberoptic phototherapy in the management of neonatal hyperbilirubinaemia.

The efficacy and usefulness of two types of phototherapy differing in the source, wavelength and irradiance of the light, conventional phototherapy consisting of special blue light and fiberoptic phototherapy, were compared in a relatively larger series of term newborns with non-haemolytic and more significant hyperbilirubinaemia than those in previous studies. In total, 108 newborns were allocated sequentially to receive either conventional phototherapy consisting of five special blue lamps or fiberoptic phototherapy. The average spectral irradiance measured at the skin surface level of newborns during the study period was significantly greater in the conventional phototherapy group. The special blue lamp of the conventional phototherapy unit had an emission spectrum almost identical to the bilirubin absorption spectrum, whereas the tungsten-halogen lamp of the fiberoptic phototherapy had a broad emission through the blue and green wavelengths (mainly in the green spectrum). Phototherapy was more effective in the conventional phototherapy group; the duration of exposure to phototherapy (h) was significantly shorter, and the overall bilirubin decline rate (as micromol/l/h and %/h) was significantly greater in the conventional phototherapy group. According to the nursing personnel, fiberoptic phototherapy was more comfortable than the conventional phototherapy frame because of the easier accessibility and handling of the infants during phototherapy. They complained of giddiness, nausea, glare, temporary blurring of vision and difficulty in detecting the skin colour changes of newborns with the blue light of the conventional phototherapy unit. Conventional phototherapy consisting of special blue fluorescent lamps with approximately twofold higher irradiance and an emission spectrum almost identical to the bilirubin absorption spectrum is preferable to fiberoptic phototherapy in the standard treatment of term newborns with non-haemolytic hyperbilirubinaemia.

Color Therapy↗