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At least 109 records · Page 6Linked to original sources
PubMed1977

[Evaluation of the therapeutic performance of an integral program of neuroses as applied to an outpatient clinic].

1. During 1976, it was evaluated the treatment of 45 cases of neurosis, carried out by monitors (D4) of the External Consultation of Barros Luco-Trudeau Hospital. 2. It is emphasized that the cost of the program in terms of professional hours and economic resources is low. 3. From 156 patients referred to therapy, 88 deserted (56,4%); 23 attend without finishing therapy (14,7%), and 45 completed it (28,8%). 4. It seems important to carry out studies about the factors that influence the desertion to the psychotherapy offered by our psychiatric services. To establish comparisons between the attendance to the group therapy, and also between the attendance to the group therapy carried out by professionals and carried out by monitors. 5. In the patients that complete therapy (12 sessions of 1,5 hours, once a week) the total improvement is 79,1%, the partial, 11,3%, and there is no modification in 9,3%.

Chile↗
PubMed1980

Combined treatment of pediatric medulloblastoma. A review of an integrated program )two-arm chemotherapy trial).

29 out of 34 consecutive patients of pediatric age, operated upon for posterior fossa medulloblastoma, were divided into 2 groups according to the chemotherapeutic treatment (intrathecal methotrexate or intravenous cyclophosphamide) received at random after surgery and radiation treatment. The modalities of irradiation and chemotherapy are described. 9 patients have not yet shown a local recurrence and are alive at varous intervals after surgery. Only 1 patient with local recurrence is still alive 31 months after the primary operation. The mean actuarial survival of the whole series of patients is about 38 months. Differences between the two groups, concerning either the survival rate till local recurrence, or the general and neurologic conditions of survival, are not statistically significant. Hematologic toxicity was more pronounced in the group treated with cyclophosphamide, whereas late neurologic sequelae were a more prominent feature of the intrathecal methotrexate trial.

Brain Neoplasms↗
PubMed1980

[An integrated program for psychosis].

The reciprocal balance between the cognitive normal awareness of reality and the cognitive psychotic awareness of reality in schizophrenia, is proposed, on the basis of the structural psychopathological theory of psychoses of the author. This balance points to the dominance of the operant conditioning of psychotic reality over normal reality during the invasion period of the disease, an equilibrium of both aspects during the steady period, and a dominance of normal reality during the residual period. A comprehensive program for secondary and terciary prevention of schizophrenia is outlined, with five levels of function delegation: D1, psychiatrists and psychologists; D2, nurses and social workers; D3, auxiliary nurses; D4, family co-therapist; D5, patients and other relatives. The functions delegated to D5 include the recognition of symptoms, causes and course, and attitudes conducing to secondary handicaps in patients. To D4, are delegate the administration of psychotropic drugs at home and technique for reinforcing normal reality. To D3, are delegated notions on epidemiology, the supervision of the psychopharmacological treatment and of reinforcement programs for normal reality, attitudes and its change, and notions of urgencies in psychosis. The D2 and D1 levels indicate treatment at all levels and treat the more complicated cases in institutions. The efficacy of the program in 36 cases, after a year, indicates a reduction of acute psychotic productivity from 72 to 6% of the patients, and a rate of hospitalization of only 8%.

Adult↗
PubMed1977

"Blood and guts": one component of an integrated program in biologic sciences as applied to medicine.

The 3-year medical school program at McMaster University encourages an approach to learning a physician can apply throughout his or her career. The program has four phases and provides early exposure to relevant clinical material. In phase 3, the basic science phase, the structure and function of organ systems in health and disease are studied. Understanding the mechanisms of disease in order to be able to relate clinical symptoms and signs to physiologic and pathologic processes is emphasized. The four 10-week units deal with groups of organ systems. The "blood and guts" unit teaches the student hematology and gastroenterology through a variety of problem-based methods. Specialists in the relevant scientific disciplines influence selection and construction of the problems presented. The students are evaluated by the faculty tutor on their accomplishment of specific objectives related to their competence in solving biomedical problems.

Curriculum↗
PubMed1997

[Analysis of experience in an integrated program of hospital rheumatological service and primary care].

BACKGROUND: In order to improve the health quality at the Primary care level, the Catalonian Health Authority (Servei Catala de la Salut) has begun a reform of the medical and surgical specialties. In this reform process the Hospital del Mar, Barcelona, Spain, has taken part in the incorporation of several medical and surgical hospital specialists to primary care within its influence area. In this study, we describe the results of the collaboration between Hospital health care and Primary care on rheumatic complaints during one year. METHODS: We carried out a descriptive study of some clinical and epidemiological variables of the population visited during one year (1995), at the Primary care level by the Rheumatologist. Our area has a population of 90,612 people, and its located in Barcelona City, Ciutat Vella Variables of study were collected during the period of time between January and December 1995. The following variables were recorded: age, gender, referral cause, rheumatologic diagnosis, intra-articular and peri-articular corticosteroid injections perform, techniques used for the diagnosis of rheumatic disease, follow-up level Data were statistically analyzed. RESULTS: Visits performed were 2,668 on 1,384 patients. Fifty-two percent were first visits, 48% were follow-up visits (Ratio first visits Nolfow-up visits: 0.57). Fifty-one percent of the patients were > 65 years old. Unspecific polyarthralgias, chronic low back pain, gonalgia and pathology of the shoulder were the most frequent complaints (> 50%). Osteoarthritis and soft-tissue diseases were the most frequent diagnosis with a percentage of 41% and 30.7%, respectively. Connective tissue diseases and spondyloarthropathies had account for 3.8% of global diagnosis. X-ray film has been the commonest technique used for the diagnosis of rheumatic diseases (80.5%). The waiting list for first visit initially has been 5 weeks, and at the end of study it has been 3 weeks. Ten percent of patients had been referred to the Hospital. CONCLUSIONS: Collaboration between Hospital care rheumatology and Primary care, improves the diagnostic quality, as well as it decreases the waiting list and allows the patients' control at the most appropriate care level.

Adolescent↗
PubMed1999

Native American medicine in the treatment of chronic illness: developing an integrated program and evaluating its effectiveness.

Traditional Native American healing practices are increasingly sought after by Native Americans as well as non-Natives. A series of meetings between traditional Native American healers and the author resulted in dialogues on the Native American worldview and biomedicine. Recommendations arose for how Native American treatment should proceed in the modern world and how to effectively introduce interested non-Natives to Native American healing practices. An approach for bridging cultures to facilitate the interaction of non-Natives with traditional healers was developed. A total of 116 patients were treated by the author in conjunction with traditional Native American healers. More than 80% of patients showed significant, persistent benefits from a time-intensive treatment program. A comparison group consisting of patients from the author's emergency room practice had significantly lower rates of improvement. An intensive program inspired by Native American practices lasting 7 to 10 days can achieve both health benefits and improved cost-effectiveness in the treatment of chronic physical illness. The treatment philosophy underlying this approach is best described as a dynamic energy system. Within this theoretical framework, physical illness, which is viewed as simultaneously spiritual, mental, and physical, can be treated by counseling and ceremony. Due to the interaction and hierarchical nature of these levels, intervention at any one level affects the others.

Chronic Disease↗