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At least 91 records · Page 5Linked to original sources

Predictive and protective autoimmunity in cardiovascular diseases: is vaccination therapy a reality?

The role of the immune system in modulating atherosclerosis has recently been well documented. Studies have revealed that cellular and humoral immunity plays crucial roles in atherogenic plaque formation. This includes macrophages, CD4+ T cells and dendritic cells as well as autoantigens such as oxidized low density lipoprotein (oxLDL), heat shock proteins and beta2-glycoprotein I. Given these recent advances, various modifications of the immune system in experimental models have been proposed as therapeutic strategies, with the potential of inhibiting atherosclerosis progression. These modifications are switching the immune system (CD4+ T cells) from Th1 towards a Th2 anti-inflammatory cytokine secretion, and the induction of protective antibodies both of which may be induced by specific vaccination. Recent identification of specific immunoreactive antigenic epitopes on modified LDL, their successful implementation for immunization and the induction of atheroprotection, supports the idea that active vaccination may emerge as a novel immuno-modulating atheroprotective strategy.

Atherosclerosis↗

Controversies and realities of therapy for varicosis.

Proponents of surgical eradication of varicose veins claim a high cure rate. Proponents of the conservative methods of multiple injections of sclerosing agents claim that this money-saving ambulatory method avoids hospitalization and loss of working time, that the end results are quite satisfactory and that any recurrences can be easily dealt with by reinjections. Both methods are effective. Both have their indications. Many surgeons use sclerotherapy after surgery as complementary therapy. Radical views recommending surgery or injections exclusively are contrary to the principles of good medical care and do injustice to the patient. A simple venographic technic demonstrating the status of the greater saphenous veins is described.

Humans↗

Geriatric paranoia: case report illustrating behavioral management.

Paranoid thinking is a defense mechanism against feelings of inferiority and humiliation. Paranoid behavior serves as a means of getting attention, sympathy and help. A case study of an 81-year-old woman illustrates the nature of geriatric paranoia and the roles of interpersonal relationships, rigid personality, depression, and the impairment of sensory and memory functions. The problem proved to be the effects on the family and neighbors of the patient's verbally expressed paranoid delusions. Treatment consisted of reducing the frequency of these paranoid complaints by means of reality therapy and verbal non-reinforcement.

Aged↗

Six-month follow-up of in-patient experiential cognitive therapy for binge eating disorders.

Treating binge eating disorders is not easy: the disordered eating is usually combined with a patient who is overweight and often obese. As underlined by the current literature, treatment outcome must focus, at a minimum, on the binge eating characterizing this disorder, on weight changes, and preferably also changes in co-morbid psychopathology. To address these issues, cognitive behavioral therapy (CBT) is still considered the best approach. However, if we check the results of follow-up studies, different authors reported some relapse in the frequency of binge eating and small weight gains over the follow-up period. This paper describes the 6-month follow-up outcome of the Experiential Cognitive Therapy (ECT), a multi factorial treatment for binge eating disorders, including virtual reality therapy. These results are compared in a randomized controlled trial (n = 36) with the ones obtained by CBT and nutritional groups only. The results showed that 77% of the ECT group quit binging after 6 months versus 56% for the CBT sample and 22% for the nutritional group sample. Moreover, the ECT sample reported better scores in most psychometric tests including EDI-2 and body image scores.

Adolescent↗

[Experiences of voluntary visitors with nonverbal communication in interaction with confused elderly patients in nursing homes].

20 confused elderly in nursing homes (average age 82), who were socially isolated and dependent of nursing care resulting from dementia and institutional factors, were visited by students of social work and student nurses of the elderly. The voluntary visitors were trained in client-centered therapy, reality orientation, non-verbal communication, sensory training, reinforcing daily functions and occupational therapy. The experiences with verbal and non-verbal communication (visual and hearing contact and touching) and with difficulties with the confused elderly, with feelings and the environmental factors are described. The visiting results in better understanding of the confused elderly and in increasing of supporting relationship. Confusion was ameliorated only in some confused elderly. Recommendations are given for voluntary visitors.

Aged↗

Boron neutron capture therapy for cancer. Realities and prospects.

Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when a stable isotope, boron-10 (10B), is irradiated with low-energy thermal neutrons (nth) to yield (4He) alpha-particles and 7Li nuclei (10B+nth-->[11B]-->4He+7Li+2.31 MeV). The success of BNCT as a tumoricidal modality is dependent on the delivery of a sufficient quantity of 10B and nth to individual cancer cells to sustain a lethal 10B(n, alpha) 7Li reaction. The current review covered the radiobiologic considerations on which BNCT is based, including a brief discussion of microdosimetry and normal tissue tolerance. The development of tumor-localizing boron compounds was discussed, including the sulfhydryl-containing polyhedral borane, sodium borocaptate (Na2B12H11SH), and boronophenylalanine (BPA), both of which are currently being used clinically in Japan as capture agents for malignant brain tumors and melanomas, respectively. Compounds currently under evaluation, such as boronated porphyrins, nucleosides, liposomes, and monoclonal antibodies (MoAbs), were also considered. Nuclear reactors have been used as the exclusive source of neutrons for BNCT. The use of low-energy (0.025 eV) thermal neutrons and higher-energy (1-10,000 eV) epithermal beams, beam optimization, and possible alternative neutron sources (accelerators) were also discussed. Clinical studies performed in the United States during the 1950s and 1960s for the treatment of malignant brain tumors were reviewed. Current studies in Japan and future studies in Europe and the United States concerning the treatment of glioblastomas and melanomas by BNCT were discussed, as were critical issues that must be addressed if BNCT is ever to be a useful therapeutic modality.

Boron Neutron Capture Therapy↗

[A model experiment with a specialty clinic for geriatrics with an open psychosomatic unit].

Report on a current exemplary test in which "animators and multiplicators" are being trained in a specialized course. The intention is to employ the trainees as voluntary lay assistants in a geriatric clinic. In the same clinic programs have been established aiming at the reduction of expenses for drug therapy by making extensive use of motion therapy, musical therapy, reality training, creativity training, autogenic training.

Aged↗

New methods of psychiatric treatment.

There have recently been many innovations in the field of psychiatric therapy. Many of the new techniques challenge some of the underlying assumptions of conventional psychiatry. Some methods, such as reality therapy and behavior therapy, attack the symptom directly, rather than assuming there is an underlying disorder which must be treated. Another, crisis therapy, stresses brief intervention aimed at rapidly reestablishing previous levels of function, with relatively little concern for insight into developmental causes. Or, as in family therapy, the pattern of family interaction rather than the individual may be the primary object of study and treatment. Each of the new methods of treatment has certain advantages as well as disadvantages. They have stimulated psychiatry to explore innovative methods and should make it possible eventually to incorporate in the treatment of each individual those techniques which will most effectively meet his needs.

Behaviorism↗

The Iowa therapeutic community model of chemical dependency treatment.

A model of inpatient chemical dependency treatment used in several facilities in Iowa is described. Through combining 12 Step, Therapeutic Community and Reality Therapy concepts, the issues of denial, control, and self centeredness are addressed in developmental phases. Individualizing the program through multidisciplinary input is explained in terms of identifying hindrances in perceiving reality and assisting the patients reduce resistance in a downhill process of increasing wholeness and growth.

Adult↗

The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy.

The goal of this study was to determine if virtual reality graded exposure therapy (VRGET) was equally efficacious, more efficacious, or less efficacious, than imaginal exposure therapy in the treatment of fear of flying. Thirty participants (Age = 39.8 +/- 9.7) with confirmed DSM-IV diagnosis of specific phobia fear of flying were randomly assigned to one of three groups: VRGET with no physiological feedback (VRGETno), VRGET with physiological feedback (VRGETpm), or systematic desensitization with imaginal exposure therapy (IET). Eight sessions were conducted once a week. During each session, physiology was measured to give an objective measurement of improvement over the course of exposure therapy. In addition, self-report questionnaires, subjective ratings of anxiety (SUDs), and behavioral observations (included here as flying behavior before beginning treatment and at a three-month posttreatment followup) were included. In the analysis of results, the Chi-square test of behavioral observations based on a three-month posttreatment followup revealed a statistically significant difference in flying behavior between the groups [chi(2) (4) = 19.41, p < 0.001]. Only one participant (10%) who received IET, eight of the ten participants (80%) who received VRGETno, and ten out of the ten participants (100%) who received VRGETpm reported an ability to fly without medication or alcohol at three-month followup. Although this study included small sample sizes for the three groups, the results showed VRGET was more effective than IET in the treatment of flying. It also suggests that physiological feedback may add to the efficacy of VR treatment.

Adult↗

Photodynamic therapy: a clinical reality in the treatment of cancer.

Photodynamic therapy (PDT) is a minimally invasive treatment with great promise in malignant disease. It can be applied before, or after, chemotherapy, ionising radiation, or surgery, without compromising these treatments or being compromised itself. Unlike radiotherapy and surgery, it can be repeated many times at the same site. Response rates and the durability of response with PDT are as good as, or better than, those with standard locoregional treatments. Furthermore, there is less morbidity and better functional and cosmetic outcome. PDT is valuable for premalignant conditions such as mucosal dysplasia and carcinoma-in-situ. The excellent cosmetic outcome makes it valuable for skin lesions and for lesions of the head, neck, and oral cavity, where another advantage is that it has negligible effects on underlying functional structures. With endoscopic delivery of light to hollow structures, PDT has been successful in the treatment of early gastrointestinal cancers, such as oesophageal cancer, and lung cancer. The superficial effects of PDT can be exploited in the treatment of large areas such as the pleura and peritoneum, where curative radiation doses cannot be tolerated by underlying normal tissue. PDT is an ideal adjuvant therapy when surgical resection of solid tumours might leave behind residual microscopic disease. Interstitial light delivery, where light is fed directly into solid tumours, allows PDT to be used for large, buried tumours that would otherwise require extensive surgical resection.

Clinical Trials as Topic↗

Development of virtual environment for treating acrophobia.

Virtual Reality (VR) is a new technology that makes humans communicate with computer. It allows the user to see, hear, feel and interact in a three-dimensional virtual world created graphically. Virtual Reality Therapy (VRT), based on this sophisticated technology, has been recently used in the treatment of subjects diagnosed with acrophobia, a disorder that is characterized by marked anxiety upon exposure to heights, avoidance of heights, and a resulting interference in functioning. Conventional virtual reality system for the treatment of acrophobia has a limitation in scope that it is based on over-costly devices or somewhat unrealistic graphic scene. The goal of this study was to develop a inexpensive and more realistic virtual environment for the exposure therapy of acrophobia. We constructed two types virtual environment. One is constituted a bungee-jump tower in the middle of a city. It includes the open lift surrounded by props beside tower that allowed the patient to feel sense of heights. Another is composed of diving boards which have various heights. It provides a view of a lower diving board and people swimming in the pool to serve the patient stimuli upon exposure to heights.

Altitude↗

Occupational therapy in long term psychiatry: what's new?

This paper summarizes the results of a survey of the role of occupational therapy in provincial psychiatric hospitals in Ontario. Occupational therapy was found to provide major programming in three areas: 1) functional skills assessment and training, 2) life skills assessment and training and, 3) self awareness and personal growth. Subjects used a variety of frames of reference, but models based upon Glasser's Reality Therapy predominated. A complementary relationship was found between occupational therapy and vocational and recreational services, with occupational therapy playing a clinical or therapeutic role, while vocational and recreational services provided normalizing experiences. A comparison of occupational therapy programming in the institutions surveyed, with programming reported in the recent occupational therapy literature indicated that techniques and media utilized paralleled those used in acute and community psychiatric programs.

Hospital Departments↗