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PubMed1992

Bone metastases and tumor-induced hypercalcemia.

Tumor-induced hypercalcemia and tumor-induced osteolysis are essentially due to a marked increase in osteoclast-mediated bone resorption, although the kidneys play an important contributory role in the genesis of tumor-induced hypercalcemia. Parathyroid hormone-like protein plays an essential role in tumor-induced hypercalcemia, and maybe in tumor-induced osteolysis, but other factors could also be responsible for the osteoclast activation secondary to the neoplastic infiltration of the skeleton. Treatment of tumor-induced hypercalcemia essentially consists of volume repletion and administration of potent anti-osteolytic drugs. The bisphosphonate pamidronate is particularly useful for that matter and a dose of 1.0 to 1.5 mg/kg can normalize serum calcium in about 90% of hypercalcemic cancer patients. The apparently low response rate of bone metastases to systemic antineoplastic therapy seems to essentially reflect the relative insensitivity of our current methods for assessing response in tumor-induced osteolysis. Newly developed biochemical markers of bone turnover could be particularly useful for that matter. Bisphosphonates are the most potent of the available inhibitors of osteoclast activity. Prolonged administration of oral pamidronate could reduce by almost one half the complications of tumor-induced osteolysis, and repeated bisphosphonate infusions could induce a dramatic relief of bone pain in one third and a sclerosis of lytic lesions in one fourth of the cases. These data must, however, be confirmed in randomized, blinded trials and many questions remain unanswered concerning the optimal therapeutic schemes. Medical therapy of tumor-induced osteolysis by noncytotoxic means has nevertheless become a reality.

Antineoplastic Agents↗
PubMed1989

The concept of neurasthenia and its treatment in Japan.

The term neurasthenia, which had been widely used in Japan before the Second World War, came to be replaced by the term neurosis thereafter. With this change in terminology, there seems to have been a shift in the popular ideas of minor psychiatric disorders towards a more psychological view. Unlike in the West where psychoanalysis was a major contributing factor, in Japan it was Shoma Morita who contributed to this change by questioning the somatic basis of conditions then diagnosed as neurasthenia and by developing the concept shinkeishitsu in the early 1920's, rejecting the concept of neurasthenia. In his theory, the development of shinkeishitsu symptoms is explained in terms of certain psychic dispositions and as a vicious cycle of sensation and attention; he formulated a psychological treatment, Morita therapy, which has been very effective for that condition. With the advent of modernization in this country, doubts have been raised whether this form of psychotherapy will continue to be acceptable to modern Japanese. However, in reality many neurotic patients are still being treated with Morita therapy, although analytically oriented psychotherapy is coming to be practiced more and more in recent years. The indigenous psychotherapies represented by Morita therapy and Naikan therapy have deep-seated roots in Buddhist tradition: its values and ideas have been redefined and reformulated into forms of therapy acceptable to modern Japanese.

Buddhism↗
PubMed2001

Advances in biomedical engineering.

The most visible contributions of biomedical engineering to clinical practice involve instrumentation for diagnosis, therapy, and rehabilitation. Cell and tissue engineering also have emerged as clinical realities. In the next 25 years, advances in electronics, optics, materials, and miniaturization will accelerate development of more sophisticated devices for diagnosis and therapy, such as imaging and virtual surgery. The emerging new field of bioengineering-engineering based in the science of molecular cell biology-will greatly expand the scope of biomedical engineering to tackle challenges in molecular and genomic medicine.

Biocompatible Materials↗
PubMed2000

Behavioral, cognitive, and family therapy for obsessive-compulsive and related disorders.

Behavioral therapy and cognitive therapy, individually and combined, are a solid base in any therapy, the goal of which is to decrease the maladaptive behaviors associated with obsessive-compulsive spectrum disorders. Future research into this area involves two branches: (1) better resolution in what components of current treatments are effective and (2) a better understanding of the cause of OCD. The therapies of choice are behavioral therapy and cognitive therapy, but often what is described as behavioral therapy and cognitive therapy varies. Further refinement of the specific components of behavioral therapy and cognitive therapy that directly apply to OCD is needed. The specific components likely include the use of ERP and rational emotive behavioral therapy but often even these therapies can be parceled into smaller discrete parts. Many facets still have not been explored thoroughly (e.g., the extent of exposure to adverse situations needed, ideal length of therapy, time needed for exposure, and the use of virtual reality versus traditional exposures). A better understanding of the biological basis for OCD also would further the field. A better understanding of the basis of this disorder also would help clinicians to treat it with medication and behavioral therapy. Research into how behavioral therapy and cognitive therapy makes neurophysiologic changes would show the effectiveness of the treatment and a biological basis. Such studies could include the use of MR imaging during different stages in behavioral therapy and the use of functional during therapy to observe changes in the brain. Although OCD still is not fully understood, researchers are now beginning to understand how to treat it, and a solid base of empiric data now exists. The authors hope that investigators will continue research toward a better understanding of this disorder so that clinicians can better help their patients.

Behavior Therapy↗
PubMed2005

Stem cells as biological heart pacemakers.

Abnormalities in the pacemaker function of the heart or in cardiac impulse conduction may result in the appearance of a slow heart rate, traditionally requiring the implantation of a permanent electronic pacemaker. In recent years, a number of experimental approaches have been developed in an attempt to generate biological alternatives to implantable electronic devices. These strategies include, initially, a number of gene therapy approaches (aiming to manipulate the expression of ionic currents or their modulators and thereby convert quiescent cardiomyocytes into pacemaking cells) and, more recently, the use of cell therapy and tissue engineering. The latter approach explored the possibility of grafting pacemaking cells, either derived directly during the differentiation of human embryonic stem cells or engineered from mesenchymal stem cells, into the myocardium. This review will describe each of these approaches, focusing mainly on the stem cell strategies, their possible advantages and shortcomings, as well as the avenues required to make biological pacemaking a clinical reality.

Biological Clocks↗
PubMed1996

Growth factors and cytokines in hair follicle development and cycling: recent insights from animal models and the potentials for clinical therapy.

Hair growth disorders, particularly those that lead to hair loss (alopecia), are common and frequently cause significant mental anguish in affected individuals. The mechanisms underlying the majority of these disorders are unknown. However, insights into the specific molecular mechanisms of hair follicle development and cycling have recently been made using animal models, particularly mice that over- or underexpress a specific gene for a growth factor or cytokine. Other animal models have demonstrated that certain growth factors and cytokines can prevent much of the alopecia caused by cancer chemotherapeutic agents. These animal models have confirmed the importance of growth factors and cytokines in hair follicle development and cycling, and have formed the foundation for potential clinical therapy of hair growth disorders, particularly alopecia. Nevertheless, important questions concerning their efficacy, safety and delivery will need to be answered before successful clinical therapy of any hair growth disorder becomes a reality.

Alopecia↗
PubMed1997

Nursing perspectives for intensive care.

Within health care, market forces increasingly determine what services have economic value. For nursing to survive this economic onslaught, nurses must clarify their values and roles. While nurses working in intensive care develop useful technical skills and normally work within a constructive multi-disciplinary team framework, they have a potentially unique contribution to care, focusing on the patient as a whole person rather than intervening to solve a problem. The need for both physiological and psychological care creates a need for holistic values, best achieved through humanistic perspectives. Humanistic nursing places patients as people at the centre of nursing care, as illustrated by the limitations of reality orientation compared with the potentials of validation therapy. Intensive care nurses asserting and developing such patient-centred roles offer a valuable way forward for nursing to develop into the 21st century.

Attitude to Health↗
PubMed1993

Childhood play in normality, pathology, and therapy.

Links are sought between concepts of play pertaining to normal development, pathology, and therapeutic interventions. To this end, the components and functions of play are delineated, the evolution of the concept of play is reviewed, an integrated course for its development is advanced, and a framework and guidelines for its assessment in the clinical context are offered. Issues concerning the role of play in therapy are discussed.

Adolescent↗
PubMed2001

The practical, methodological and ethical dilemmas of conducting focus groups with vulnerable clients.

AIM: This paper presents some of the practical, methodological and ethical dilemmas that were encountered in a study that used focus groups to elicit the views of women with serious and enduring mental health problems about the services they were receiving. FINDINGS: The dilemmas identified included the time and effort taken to gain access to the women, the role of the researcher as facilitator, communication and interaction in the focus group, accepting the women's reality, and the thin divide between research and therapy. CONCLUSION: The paper concludes with some recommendations for researchers who are planning to use focus groups to elicit the views of vulnerable clients.

Attitude of Health Personnel↗
PubMed2002

Learning lessons.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1996

Predicting dyadic adjustment from general and relationship-specific beliefs.

The cognitive mediation model of human psychological functioning has received increasing attention by researchers studying the role of cognitive variables in relationship distress. This study is an examination of the role of general irrational beliefs, as measured by the Irrational Beliefs Test (IBT; Jones, 1968), and relationship-specific irrational beliefs, as measured by the Relationship Belief Questionnaire (RBQ; Romans & DeBord, 1994), in predicting the perceived quality of relationships by married or cohabiting couples. Results indicated that respondents who reported higher levels of relationship-specific irrational beliefs also reported higher levels of dyadic adjustment; but contrary to expectation, higher levels of general irrational beliefs correlated with lower levels of dyadic adjustment. Implications of these findings are discussed in relation to the depressive realism hypothesis.

Adaptation, Psychological↗
PubMed2003

Developing a virtual reality-based methodology for people with dementia: a feasibility study.

The aim of this study was to examine the feasibility of virtual reality (VR) technology for use by persons with dementia (PWD). Data were obtained directly from six PWD regarding their experiences with a virtual environment (VE) of a large outdoor park. A user-centered method was developed to assess: (a) presence; (b) user inputs; (c) display quality; (d) simulation fidelity; and (e) overall system usability. The extent to which PWD could perform four functional activities in the VE was also investigated (e.g., mailing a letter). In addition, physical and psychological well-being of PWD while interacting with the VE was assessed objectively by recording heart rate during the VR sessions and subjectively with discrete questionnaire items and real-time prompts. Symptom profiles associated with simulator sickness were assessed with an adapted version of the Simulator Sickness Questionnaire. The study found that PWD to some extent experienced presence; perceived that objects were realistic and moved naturally; generally felt in control of the interaction; and demonstrated little difficulty using a joystick for navigation. The study also demonstrated that VR is an appropriate medium for assessing functional behavior within the context of an ecologically valid VE. PWD did not experience any significant increase in symptoms associated with simulator sickness, or detriments to their psychological and physical well-being. These findings demonstrated that it is feasible to work in VEs with PWD.

Aged↗
PubMed2005

Antitubercular inhaled therapy: opportunities, progress and challenges.

Pulmonary tuberculosis remains the commonest form of this disease and the development of methods for delivering antitubercular drugs directly to the lungs via the respiratory route is a rational therapeutic goal. The obvious advantages of inhaled therapy include direct drug delivery to the diseased organ, targeting to alveolar macrophages harbouring the mycobacteria, reduced risk of systemic toxicity and improved patient compliance. Research efforts have demonstrated the feasibility of various drug delivery systems employing liposomes, polymeric microparticles and nanoparticles to serve as inhalable antitubercular drug carriers. In particular, nanoparticles have emerged as a remarkably useful tool for this purpose. While some researchers have preferred dry powder inhalers, others have emphasized nebulization. Beginning with the respiratory delivery of a single antitubercular drug, it is now possible to deliver multiple drugs simultaneously with a greater therapeutic efficacy. More experience and expertise have been observed with synthetic polymers, nevertheless, the possibility of using natural polymers for inhaled therapy has yet to be explored. Several key issues such as patient education, cost of treatment, stability and large scale production of drug formulations, etc. need to be addressed before antitubercular inhaled therapy finds its way from theory to clinical reality.

Administration, Inhalation↗
PubMed1996

Haemodialysis therapy in the elderly.

Haemodialysis therapy in the elderly has become a recognized reality only in the last decade Information collected from restricted statistics often leads to conflicting conclusions. Length of survival may be a useful indicator of the appropriateness of initiating treatment. Survival and important determinants of survival, such as cardiovascular problems, nutritional status and adequacy of dialysis, are addressed in this study and evaluated in 365 elderly patients, treated at a single institution over a 20 year period.

Aged↗
PubMed1985

Environmental management of senile dementia.

A model is described of social activity in club settings geared to the needs of demented and cognitively impaired old people living in the community. As well as reality orientation, guided social interaction, physical activity, dance therapy and craftsmanship, important elements include transport, home assessment and follow-up visits. Parallel support groups for spouses are essential to the complete program, which coordinates planning with local authority agencies. The complex also includes educational programs for staff, professionals and the public. This design is seen as an on-going neighborhood project in which at focal points of the week, the patient enters a meaningful social environment with which he can cope.

Aged↗
PubMed2004

Rehabilitation of the wandering seriously mentally ill (WSMI) women-The Banyan experience.

Started in 1993, in a small way, by a social worker as a response to the growing destitution of mentally ill women and with the objective of giving shelter, treatment and mainstreaming them, The Banyan has so far given 'Adaikalam' (refuge) to 413 women, of whom 252 have been rehabilitated. The entire care process starts from the time the women are picked from the streets in a disheveled and deranged state and brought to the home after much difficulty. On arrival they are spruced up and clinically assessed by a psychiatrist and put on medication. Slowly and steadily they return to the world of reality. Simultaneously, the inmates are put through various therapies like individual counseling, music, art, yoga, and vocational training. Finally, the address of the inmates is traced, and a team from The Banyan accompanies them, and they are rehabilitated. The family is enlightened about the illness, the woman's stay at The Banyan, need for continuous medication. The Banyan is a lifetime service provider of medicines, keeping track by regular follow up and above all a friend to whom they can seek any help at any time. The role played by the social workers is so vital that the success of the programme hinges on their repertoire of skill and commitment.

Adult↗
PubMed2026

Metal-Organic Framework-Based and Metal-Organic Framework-Derived Nanomaterials for Cancer Theranostics and Antibacterial Applications: Advances, Challenges, and Perspectives.

Metal-organic frameworks (MOFs), constructed through coordination-driven self-assembly of metal ions/clusters and organic linkers, have emerged as a uniquely versatile class of porous nanomaterials with broad biomedical potential. Despite substantial clinical progress, both oncological treatment and antimicrobial intervention remain constrained by inadequate tumor-targeting selectivity, multidrug resistance, immunosuppressive tumor microenvironments, and the global proliferation of antibiotic-resistant pathogens, limitations that conventional nanocarrier platforms have addressed only in part. MOF-based and MOF-derived nanomaterials, distinguished by tunable pore architecture, structurally and compositionally adaptable metal nodes, high surface areas, and stimulus-responsive degradability, offer a rational framework for overcoming these barriers. This review systematically examines the synthetic strategies underlying MOF-based and MOF-derived nanomaterials, including pyrolysis, chemical etching, composite modification, and functional group introduction, and their structural determinants of performance. In cancer theranostics, we critically evaluate their roles as multimodal imaging contrast agents, stimulus-responsive drug delivery carriers, and platforms for combination therapies encompassing photodynamic, photothermal, chemodynamic, and immunomodulatory modalities. In antibacterial applications, we analyze the mechanistic basis of MOF-based and MOF-derived activity, including physical membrane disruption, reactive oxygen species-mediated oxidative stress, and sustained metal ion release, alongside strategies targeting biofilm formation and antibiotic resistance. Multifunctional platforms that concurrently integrate cancer theranostic and antibacterial capabilities are further discussed. This review also addresses the principal barriers to clinical translation, encompassing large-scale manufacturing, long-term biosafety, and regulatory approval, and proposes future directions incorporating artificial intelligence-assisted design and materials genomics, underscoring the transformative potential of MOF-based and MOF-derived nanomaterials as next-generation precision nanomedicines. This review establishes a unified mechanistic framework grounded in the intrinsic physicochemical properties of MOF-derived nanomaterials, systematically integrating their applications in cancer theranostics and antibacterial therapy. Critically, it bridges fundamental advances with translational reality by incorporating a rigorous assessment of regulatory pathways, scalable manufacturing constraints, and clinical implementation barriers, and offers a comprehensive, practice-oriented reference for the rational design and responsible translation of MOF-based and MOF-derived nanomaterials.

Theranostic Nanomedicine↗