Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THERAPEUTICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed2003

Therapeutic community treatment of personality disorder: service use and mortality over 3 years' follow-up.

BACKGROUND: A number of studies have demonstrated reductions in the utilisation of psychiatric services, especially acute in-patient admissions, following therapeutic community treatment of personality disorder. These studies have, however, been of limited duration (1 year) and follow-up has not always been complete. AIMS: To identify hospital admissions before and after therapeutic community treatment of personality disorder. METHOD: A naturalistic clinical cohort of patients admitted between January 1993 and December 1995 was followed up for 3 years. All subjects were traced to their current consultant psychiatrist, general practitioner or death. RESULTS: All patients were traced at 3-year follow-up. The significant reduction in in-patient admissions seen in the first year was maintained over 3 years. Those with the poorest outcomes, suicide, accidental death or prolonged admission were all in the quartile with the shortest admissions (under 42 days) to the therapeutic community. CONCLUSIONS: Previously reported reductions in psychiatric admissions following therapeutic community treatment of personality disorder are maintained over 3 years.

Adolescent↗
PubMed2002

Lack of therapeutic interchangeability of HMG-CoA reductase inhibitors.

OBJECTIVE: To review relevant literature and provide an opinion on the class effect of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins). DATA SOURCES: Primary and review articles were identified by MEDLINE search (1990-July 2002). STUDY SELECTION AND DATA EXTRACTION: Editorials, studies, and review articles related to the class effect or therapeutic interchangeability of statins were reviewed. Also included was information that is relevant to this topic. DATA SYNTHESIS: Although statins share common main actions, they may have clinically important differences in terms of efficacy and safety. At fixed or allowable dosages, rosuvastatin, atorvastatin, and simvastatin produced greater low-density lipoprotein cholesterol-lowering effects compared with other statins. Some statins have shown reduction in either cardiovascular and/or total mortality. Statins also differ in their structure, pharmacokinetics, potency, and rate of metabolism, any or all of which may have clinical significance. Although inconclusive, subtle differences in nonlipid effects of some statins may have contributed to positive benefits observed in clinical studies. As a result of drug-related deaths, cerivastatin was withdrawn voluntarily from the market, which may raise the question whether there is therapeutic interchangeability (due to class effect) among statins. CONCLUSIONS: Despite the competition for market share and strategies attempting to identify differences in therapeutic value, few head-to-head comparisons between statins have been performed. The limited, available data suggest that statins are not therapeutically interchangeable.

Drug Interactions↗
PubMed2006

Arteriovenous malformations of the body and extremities: analysis of therapeutic outcomes and approaches according to a modified angiographic classification.

PURPOSE: To propose a modified angiographic classification for peripheral arteriovenous malformations (AVMs) and to determine its value for assessing therapeutic outcomes and approaches to ethanol embolization of AVMs in the body and extremities. METHODS: AVMs of the trunk and extremities were categorized according to the angiographic morphology of the nidus: type I (arteriovenous fistulae), type II (arteriolovenous fistulae), type IIIa (arteriolovenulous fistulae with non-dilated fistula), and type IIIb (arteriolovenulous fistulae with dilated fistula). Sixty-six patients (41 women; mean age 28.3 years, range 5-53) with inoperable AVMs in the body and extremities who underwent staged ethanol embolizations were retrospectively analyzed. Therapeutic outcomes and approaches were evaluated according the above classification system. RESULTS: The 66 AVMs were composed of 30 (45%) type IIIb, 13 (20%) type II, 12 (18%) mixed types IIIa and IIIb, 9 (14%) mixed types II and IIIb, and 2 (3%) type IIIa. Ethanol embolization was most effective for type II (100%), and more effective for type IIIb (83%) than for type IIIa or mixed types (< or = 50%). Despite the use of the transarterial approach, direct puncture and transvenous approaches were more relevant for treating type II AVMs. Only the transarterial approach was used for treating type IIIa; both direct puncture and transarterial approaches were used for treating the other types. CONCLUSION: The described angiographic classification provides considerable information concerning the characteristics of AVMs in the body and extremities, the optimal therapeutic approach, and the likely therapeutic outcome.

Adolescent↗
PubMed1984

Treatment collaboration of methadone maintenance programs and therapeutic communities.

Although they developed from different backgrounds, therapeutic communities and methadone maintenance programs became major treatments of heroin abuse in the 1970s. Research published in the last 5 years demonstrates that therapeutic communities are associated with long-lasting improvements in functioning for the few drug abusers who stay in treatment at least 3 months. A principal limitation of this modality is that few patients remain in treatment long enough to acquire the changed values that produce long-lasting effects. Research on methadone maintenance continues to show that this treatment produces immediate decreases in criminality and drug abuse; however, patients who taper off of maintenance are prone to relapse. The aspects of treatment that appear to prevent relapse include minimizing withdrawal symptoms during tapering and providing support during and after completing maintenance. The strengths of these two treatment modalities can be combined to enable narcotic addicts to taper off of methadone maintenance in a therapeutic community and remain drug-free. Several other clinical, administrative, and research collaborations could be beneficial, pooling the medical/technical expertise of maintenance programs with the intensity of therapeutic community treatment.

Combined Modality Therapy↗
PubMed1999

Power Doppler sonography of hepatocellular carcinoma treated by transcatheter arterial chemoembolization. Assessment of the therapeutic effect.

PURPOSE: To evaluate the usefulness of power Doppler sonography (PDS) in assessing the therapeutic effect of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). MATERIAL AND METHODS: TACE was performed in 43 patients (48 lesions) with HCC. All patients were examined with both PDS and color Doppler sonography (CDS) to assess the therapeutic results 1 week after TACE. Follow-up hepatic angiography was performed in 39 patients 3-4 months after TACE and then CT after iodized oil reinjection was also performed 3-4 weeks after a repeat TACE; in the remaining 4 patients, hepatectomy was performed within one month after chemoembolization and histologic study was undertaken to confirm the Doppler findings. RESULTS: Determination of therapeutic results with PDS and CDS were in agreement with those of follow-up findings in 37 and 29 of the 48 lesions, respectively. There was a significant difference in overall accuracy (p=0.038) between PDS and CDS results. CONCLUSION: PDS is more effective than CDS for evaluating changes in tumor vascularity after TACE. PDS may also replace angiography in assessing the therapeutic effects of TACE for HCCs, except in deep-seated areas.

Aged↗
PubMed1980

An eclectic therapeutic community for the treatment of addiction.

The Eclectic Therapeutic Community described in this report is a modification of a Jonesian Therapeutic Community to fit the immature character defenses of many addicted patients. The program emphasizes structures; that is, rules, policies, staff roles, therapeutic forums, program phases, and clear expectations to create living and learning situations in which addicts can model after staff and senior residents in the program. This modeling results in a development of a new perceptual style so that the addict patient is better able to clearly perceive his own behavior and the behaviors of others when involved in an emotional situation. The structures also protect the staff and patients against externalization and narcissistic injury. The program has developed out of consideration of recent psychoanalytic work with borderline and narcissistic personalities. A Gestalt therapeutic approach is employed because of its focus on perception of here and now social learning situations, ease of communication of the basic concepts and techniques, and most importantly because it focuses on clear perception when emotional.

Gestalt Therapy↗
PubMed2026

Cellular Recovery and Therapeutic Rechallenge After Cancer Therapy-Induced Kidney Injury: Mechanistic Insights and Clinical Implications.

Cancer therapy-related acute kidney injury has become an increasingly common challenge as modern treatments prolong survival and increase exposure to potentially nephrotoxic therapies. Decisions regarding therapeutic rechallenge have relied on normalizing serum creatinine and recovering estimated glomerular filtration rate, despite growing evidence that biochemical recovery does not necessarily indicate restoration of kidney integrity or resilience. In this review, we propose biological kidney recovery as a conceptual framework that integrates mechanisms of kidney injury and repair (adaptive and maladaptive) with emerging biomarkers and therapeutic rechallenge. We first summarize the distinct mechanisms of kidney injury induced by platinum-based chemotherapy, immune checkpoint inhibitors, and vascular endothelial growth factor pathway inhibitors, highlighting how these differences influence subsequent repair. We then discuss the cellular and metabolic processes underlying adaptive repair, the transition to maladaptive remodeling, and current approaches for assessing biological recovery through pathology, biomarkers, and multi-omics technologies. Finally, we present a practical framework for individualized therapeutic rechallenge based on an integrated assessment of kidney-, tumor-, and patient-related factors and outline future directions for precision onco-nephrology. By shifting the focus from filtration alone to biological recovery, this framework enables more informed therapeutic rechallenge aimed at preserving both oncologic efficacy and long-term kidney health.

Humans↗
PubMed1996

Formulary management: antibiotics and therapeutic interchange.

A well-managed formulary provides pharmacy managers with opportunities for decreasing drug expenditures. Therapeutic interchange constitutes one of the many programs under a formulary system which may yield cost savings as improved patient outcomes. The process of therapeutic interchange is described and compared with therapeutic substitution and generic substitution. A procedure for developing and implementing a therapeutic interchange program is presented with case studies.

Anti-Bacterial Agents↗
PubMed1983

Quality analysis in therapeutic recreation curricula.

Within the last several years therapeutic recreation has witnessed an increasing concern over the quality of professional preparation programs. Unfortunately, few efforts have really focused on improving the depth of preparation although the scope of preparation is fairly well documented by accreditation criteria. Quality analysis elucidates curricula by considering: (1) the depth of competence desired, (2) the barriers to acquiring said knowledge and (3) who is responsible for disseminating the knowledge to students. Furthermore, quality analysis relative to therapeutic recreation curricula currently requires consideration of material from other disciplines and therapeutic recreation's unique perspective on traditional areas of learning. A competency cluster including knowledge related to anatomy, physiology, disabilities and limitations imposed by the disabling conditions and medical terminology was used as an example of quality analysis. Quality analysis revealed that the aforesaid competency cluster is not presently being transmitted adequately to students and that therapeutic recreation educators' need to assume more responsibility for disseminating knowledge related to the competencies discussed.

Competency-Based Education↗
PubMed1983

Data-based research in therapeutic recreation: state of the art.

During difficult financial times, it is critical not only to evaluate therapeutic recreation programs and document client progress but also to disseminate objective program data to therapeutic recreation and other practitioners. The purpose of this state-of-the-art research inquiry was to provide the therapeutic recreation discipline and other related helping professions with an accurate and current assessment of empirically based research concerning the provision of recreation for special populations. Eight professional journals in recreation, special education, and psychology from 1977 (the year of PL 94-142) through the current literature were reviewed. Articles using a data-based research methodology in the area of recreation/leisure for special populations were identified. Articles were analyzed according to target population, subject age, purpose of study, and research design. Of the 83 data-based research reports found, 40 studies addressed the mentally retarded population, 26 involved children (birth to 13 years), and the case study (23) and survey (23) research designs were most prevalent. A plea for future data-based research by therapeutic recreation professionals to improve services is made.

Evaluation Studies as Topic↗
PubMed1985

Creating a positive work environment for therapeutic recreation personnel.

It is the role of management in therapeutic recreation to create a working environment where personnel can accomplish their duties; create and maintain relationships; and work together harmoniously and creatively to obtain the organization's mission or purpose. This is an awesome job and therapeutic recreation managers are at times confronted with low-morale environments. Yet, there are strategies which can be employed to create positive working environments. Yet, there are strategies which can be employed to create positive working environments for therapeutic recreation personnel. These transformation techniques are: acknowledging negativity, identifying the positives, being available, providing positive recognition, avoiding negative game playing, refraining from negative conversation, avoiding putdowns, and using positive and effective communication. A successful therapeutic recreation supervisor can bring about positive change in the work environment so that staff members can rise to new levels of performance and self-esteem.

Humans↗
PubMed1985

Performance appraisal system for therapeutic recreation.

Therapeutic Recreation professionals continually strive for effective performance standards for their clients. In addition to standards for clients, Therapeutic Recreation Specialists must also develop performance standards for themselves to meet the continual challenge of accountability in the 80's. This paper identifies the need to develop a performance appraisal system as well as the benefits. The elements of the standards include: specificity, observability, measurability, attainment and mutual determination. The paper also reviews the process of assignment of relative weights, categories of review and detailed standards for the Director of Therapeutic Recreation and Therapeutic Recreation Specialist at the Rehabilitation Institute of Detroit.

Employee Performance Appraisal↗
PubMed1984

Third party reimbursement: is therapeutic recreation too late?

The Social Security Amendments of 1983 have brought added concerns about the feasibility of securing third-party reimbursement for therapeutic recreation services. Retrospective, cost-based reimbursement is compared with prospective payment systems, and potential impacts on therapeutic recreation services are explored. Present status of third-party reimbursement for therapeutic recreation is outlined, and suggestions are offered for therapeutic recreation managers to utilize in responding to the changing health care industry.

Insurance, Health, Reimbursement↗
PubMed1985

The dilemma of an unresolved philosophy in therapeutic recreation.

The therapeutic recreation profession is at a major crossroads. The demands of a society concerned with accountability, cost-effectiveness, productivity and reduced governmental support, on the one hand, and the quality of life on the other, provide a context for understanding the dilemma facing the field. Therapeutic recreators are being called upon to make decisions about the future direction of the field, including the choice of professional organizations. Without a strong philosophical foundation, choices that are made are likely to be based primarily on external influences. A solid professional philosophy will increase our security with our unique professional capabilities and will enhance our ability to be responsive to changing societal conditions. Various philosophical positions and some of their implications for therapeutic recreation are discussed. Therapeutic recreation professionals are encouraged to further explore the philosophical premises which guide their professional and organizational decisions.

Leisure Activities↗
PubMedDate not supplied

[Therapeutic touch].

In the advanced stages of dementia of the Alzheimer's type (DAT), affected persons present body language and various behaviours expressing discomfort: shouting, agitation, irritability, aggressiveness, tense movements. Nursing, up until now, has had few available means to ease this discomfort. The authors of the following article have conducted an experimental study measuring the alleviating effects of therapeutic touch on the discomfort of persons in the advanced stages of DAT. Experimental group subjects (n = 16) received 5 sessions of therapeutic touch lasting 12.4 minutes. Control group subjects (n = 11) received 5 sessions of simple presence lasting 10.3 minutes. The authors measured subject discomfort levels using the Discomfort Scale for Dementias of the Alzheimer's Type (DS-DAT). Results show that discomfort levels of persons in the advanced stages of DAT decreased significantly after 5 therapeutic touch sessions, becoming significantly lower than levels in the control group. If care was focused on the whole person and his or her comfort, tools like therapeutic touch would become available to nurses, allowing them to enhance the quality of life of the people in their care.

Aged↗
PubMed2002

Misoprostal use for therapeutic abortion in Siriraj Hospital: the year 2000.

OBJECTIVE: To evaluate the efficacy and the adverse effects of misoprostal usage for therapeutic abortion in Siriraj Hospital. STUDY DESIGN: Cross-sectional, descriptive study. MATERIAL AND METHOD: A consecutive series of 101 therapeutic abortions was performed in the Department of Obstetrics & Gynecology, Siriraj Hospital in the year 2000. The patients were interviewed for general information and registered, as well as in-patient data. Any adverse events were recorded and collected from the inpatient record file. All data were analyzed statistically. RESULTS: 42 therapeutic abortions were conducted in association with misoprostal usage. Misoprostal was used for cervical ripening in 8 patients with a good outcome. 31 therapeutic abortions were induced by misoprostal alone regimen. A higher success rate (74.1%) was correlated with higher gestational age. 27 out of 31 cases were second trimester abortion. The induction to abortion interval was 18.0+/-10.5 hours (range 5-48). No factor, including age, weight, total dose of misoprostal use, nulliparity and viability of the fetus, could be demonstrated to affect the misoprostal activity defined by induction to abortion interval. There was no serious adverse event, except for severe abdominal cramping (26.2%) and fever (14.3%). CONCLUSION: Misoprostal alone can be used with caution for abortion induction especially in second trimester abortion.

Abortifacient Agents, Nonsteroidal↗
PubMed1992

Therapeutic interchange of cefazolin with metronidazole for cefoxitin.

The effects on patient outcome and drug therapy costs of a therapeutic interchange program using a cefazolin and metronidazole combination in place of cefoxitin were studied. A therapeutic interchange program was initiated in which the pharmacy department automatically replaced orders for cefoxitin with orders for a cefazolin and metronidazole combination. Data were compared for 100 consecutive patients who received cefoxitin before initiation of the program and the first 100 patients who received cefazolin and metronidazole as part of the program. The impact of the program on therapeutic efficacy, adverse effects associated with therapy, and drug therapy costs was assessed. The two patient groups were similar in age, gender, and white blood cell count. The failure rates for treatment or prophylaxis of infection did not significantly differ between the groups. Duration of therapy and incidence of adverse effects did not significantly differ between the groups. The average cost saving was +72 per patient for treatment with cefazolin and metronidazole instead of cefoxitin. A program for therapeutic interchange of cefazolin and metronidazole in place of cefoxitin demonstrated equivalent efficacy and adverse effects, as well as considerable cost savings.

British Columbia↗
PubMedDate not supplied

[Therapeutic interchange between angiotensin II receptor blockers in institutionalized elderly patients. Implimenting a protocol].

OBJECTIVE: To assess the effectiveness of a therapeutic interchange protocol for angiotensin II receptor blockers (ARB's) in the maintenance of blood pressure levels for institutionalized elderly patients diagnosed with hypertension. METHODS: A new protocol was discussed by the Pharmacy and Therapeutics Committee, and its implementation by the Pharmacy Department was authorized. The protocol specifies equivalent doses between drugs and the patients' clinical follow-up. Criteria used in the assessment includes: need to change dosage for an ARB included in the Pharmacotherapeutic Guide, and blood pressure changes after drug interchange. RESULTS: In the absence of hepatic insufficiency, the protocol may replace the standard doses of any drugs within this group with losartan 50 mg daily. If needed, the dose of losartan may be increased to 100 mg daily divided into two doses. Eighteen patients, which represent 10% of all interchange operations carried out by the Pharmacy Department, were included in this study. Blood pressures both before and after the interchange process show no major differences between them. Only two patients required an increase in the dose of losartan. CONCLUSION: The implementation of a therapeutic interchange protocol as agreed upon by the Pharmacy and Therapeutics Committee allows the clinical follow-up of patients and therefore facilitates an evaluation of the process. This ARB interchange protocol, as suggested for the institutionalized elderly population setting, has proven effective in maintaining anti-hypertensive activity.

Aged↗