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At least 145 records · Page 8Linked to original sources
PubMed1995

Between sacred and medical realities: culturally sensitive therapy with Jewish ultra-orthodox patients.

One disconcerting aspect of the role of culture in shaping human suffering is the gap between the explanatory models of therapists and patients in multicultural settings. This gap is particularly noted in working with Jewish ultra-orthodox psychiatric patients whose idioms of distress are often derived from a sacred reality not easily reconcilable with psychomedical reality. To meet the challenge to therapeutic efficacy that this incompatibility may pose, we propose a culturally sensitive therapy based on strategic principles that focus on the patient's mythic world and religious idioms of distress as the kernel of therapeutic interventions. Using one case of post-traumatic stress disorder (PTSD) as illustration, we seek to show how the religious symbols through which the patient's distress was articulated may be manipulated to effect cure. The case highlights the narrative quality of both illness construction and self-reconstruction.

History, 20th Century↗
PubMed1993

Reality orientation and validation therapy. Dementia, depression, and functional status.

1. This study shows that Reality Orientation (RO) and Validation Therapy have no significant impact on mental status, level of depression, or functional status. 2. Gerontological nurses, administrators, specialists, and practitioners must carefully evaluate and compare all relevant research studies on therapies before implementing therapies in long-term care settings. 3. Gerontological nurse researchers and staff must be aware of the difficulties arising in long-term research: sampling difficulties, patients' behavioral and physical factors, and environmental, staff, and financial resources.

Aged↗
PubMed2004

Male sexual dysfunctions: immersive virtual reality and multimedia therapy.

The study describes a therapeutic approach using psycho-dynamic psychotherapy integrating virtual environment (VE) for resolving impotence or better erectile dysfunction (ED) of presumably psychological or mixed origin and premature ejaculation (PE). The plan for therapy consists of 12 sessions (15 if a sexual partner was involved) over a 25-week period on the ontogenetic development of male sexual identity, and the methods involved the use of a laptop PC, joystick, Virtual Reality (VR) helmet with miniature television screen showing a new specially-designed CD-ROM programs using Virtools with Windows 2000 and an audio CD. This study was composed of 30 patients, 15 (10 suffering from ED and 5 PE) plus 15 control patients (10 ED and 5 PE), that underwent the same therapeutic protocol but used an old VR helmet to interact with the old VE using a PC Pentium 133 16 Mb RAM. We also compared this study with another study we carried out on 160 men affected by sexual disorders, underwent the same therapeutic protocol, but treated using a VE created (in Superscape VRT 5.6) using always Windows 2000 with portable tools. Comparing the groups of patients affected by ED and PE, there emerged a significant positive results value without any important differences among the different VE used. However, we had a % increase of undesirable physical reactions during the more realistic 15-minute VR experience using Virtools development kit. Psychotherapy alone normally requires long periods of treatment in order to resolve sexual dysfunctions. Considering the particular way in which full-immersion VR involves the subject who experiences it (he is totally unobserved and in complete privacy), we hypothesise that this methodological approach might speed up the therapeutic psycho-dynamic process, which eludes cognitive defences and directly stimulates the subconscious, and that better results could be obtained in the treatment of these sexual disorders. This method can be used by any psychotherapist and it can be used alone or associated with pharmacotherapy prescribed by the urologist/andrologist as part of a therapeutic alliance.

CD-ROM↗
PubMed1995

Intranasal insulin therapy: the clinical realities.

To evaluate metabolic control and safety parameters (hypoglycaemia frequency and nasal mucosa physiology), 31 insulin-dependent diabetic patients were treated with intranasal insulin at mealtimes for 1 month and with subcutaneous fast-acting insulin at meals for another month in an open, crossover randomized trial. During both treatment periods the patients were treated with intermediate-acting insulin at bedtime. Six of the patients were withdrawn from the study during intranasal insulin therapy due to metabolic dysregulation. Serum insulin concentrations increased more rapidly and decreased more quickly during intranasal as compared with subcutaneous insulin administration. Metabolic control deteriorated, as assessed by haemoglobin A1c concentrations, slightly but significantly after intranasal as compared with subcutaneous insulin therapy. The bioavailability of intranasally applied insulin was low, since intranasal insulin doses were approximately 20 times higher than subcutaneous doses. The frequency of hypoglycaemia was similar during intranasal and subcutaneous insulin therapy, and nasal mucosa physiology was unaffected after intranasal insulin. We conclude that due to low bioavailability and to a high rate of therapeutic failure, intranasal insulin treatment is not a realistic alternative to subcutaneous insulin injections at the present time.

Administration, Intranasal↗
PubMed1991

Neonatology in the 1990's: surfactant replacement therapy becomes a reality.

It has been more than 35 years since the lung was discovered to be lined with a layer of surface-active material that is important in lung stability and mechanics of respiration. The absence of this "anti-atelectasis" factor was proposed by Avery and Mead in 1959 to be the cause of hyaline membrane disease of premature infants. An indepth historical review of pulmonary surfactant by Tierney was recently published. In the years since 1959, there has been an exhaustive amount of research aimed at elucidating the structure and function of pulmonary surfactant, the ultimate goal being a safe and effective exogenous surfactant for the treatment of the Respiratory Distress Syndrome (RDS). The days of surfactant research are far from over, but the era of surfactant replacement therapy is now upon us. The practitioner needs to be knowledgeable about surfactant and aware of his or her role in surfactant therapy for premature infants. The following is intended to clarify some of the important issue of surfactant replacement.

Humans↗
PubMed1997

[Estrogen replacement therapy: myth or reality?].

Before 50, women are protected against cardio-vascular diseases, and this protection disappears after this age. There are some strong epidemiologic arguments to attribute this loss of protection to the menopause. The ways of action of this hormonal shortage are still being discussed. Hypercholesterolemia seems to be a less important factor than with men, but signs of insulin resistance (hypertriglyceridemia, hypoHDLemia, androïd morphotype) play an important part. Estrogen HRT lowers coronarien risk, but published results are optimized by good health effect. Progestins do no affect results. The ways of action of estrogens are multiple. Some molecules and ways of administration have deleterious effects, the consequences of which are not known, in particular among patients with risk factors who would be the first to benefit from a preventive effect.

Coronary Disease↗
PubMed1987

Reality orientation and reminiscence therapy. A controlled cross-over study of elderly confused people.

We compared reality orientation with reminiscence therapy for elderly people in a large residential home, using a controlled cross-over design. Both kinds of therapy group were enjoyed by both staff and residents, and enabled staff to get to know moderately and severely confused residents. The group that received reality orientation followed by reminiscence therapy showed improvement in cognitive and behavioural measures which was not found in the other two groups. It may be important to use reality orientation techniques with confused residents before involving them in a reminiscence group.

Aged↗
PubMed2004

Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear.

BACKGROUND: Traditional pharmacological approaches to treating psychiatric disorders focus on correcting presumed biochemical abnormalities. However, some disorders, particularly the anxiety-related disorders exemplified by specific phobia, have an emotional learning component to them that can be facilitated with psychotherapy. OBJECTIVE: To determine whether D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor that has previously been shown to improve extinction of fear in rodents, will also improve extinction of fear in human phobic patients undergoing behavioral exposure therapy. DESIGN: Randomized, double-blind, placebo-controlled trial examining DCS vs placebo treatment in combination with a precisely controlled exposure paradigm. SETTING: Participants were recruited from the general community to a research clinic. PARTICIPANTS: Twenty-eight subjects with acrophobia diagnosed by the Structured Clinical Interview for DSM-IV were enrolled. INTERVENTIONS: After we obtained pretreatment measures of fear, subjects were treated with 2 sessions of behavioral exposure therapy using virtual reality exposure to heights within a virtual glass elevator. Single doses of placebo or DCS were taken prior to each of the 2 sessions of virtual reality exposure therapy. Subjects, therapists, and assessors were blind to the treatment condition. Subjects returned at 1 week and 3 months posttreatment for measures to determine the presence and severity of acrophobia symptoms. MAIN OUTCOME MEASURES: Included were measures of acrophobia within the virtual environment, measures of acrophobia in the real world, and general measures of overall improvement. An objective measure of fear, electrodermal skin fluctuation, was also included during the virtual exposure to heights. Symptoms were assessed by self-report and by independent assessors at approximately 1 week and 3 months posttreatment. RESULTS: Exposure therapy combined with DCS resulted in significantly larger reductions of acrophobia symptoms on all main outcome measures. Subjects receiving DCS had significantly more improvement compared with subjects receiving placebo within the virtual environment (1 week after treatment, P</=.001; 3 months later, P</=.05). Subjects receiving DCS also showed significantly greater decreases in posttreatment skin conductance fluctuations during the virtual exposure (P</=.05). Additionally, subjects receiving DCS had significantly greater improvement compared with subjects receiving placebo on general measures of real-world acrophobia symptoms (acrophobia avoidance [P</=.02], acrophobia anxiety [P</=.01], attitudes toward heights [P</=.04], clinical global improvement [P</=.01], and number of self-exposures to real-world heights [P</=.01]); the improvement was evident early in treatment and was maintained at 3 months. CONCLUSION: These pilot data provide initial support for the use of acute dosing of DCS as an adjunct to exposure-based psychotherapy to accelerate the associative learning processes that contribute to correcting psychopathology.

Adult↗
PubMed2006

Adult stem cell therapy: dream or reality?

Adult stem cells may be an invaluable source of plastic cells for tissue regeneration. The bone marrow contains different subpopulations of adult stem cells easily accessible for transplantation. However the therapeutic value of adult stem cell is a question of debate in the scientific community. We have investigated the potential benefits of adult hematopoietic stem cell transplantation in animal models of demyelinating and motor neuron diseases. Our results suggest that transplantation of HSC have direct and indirect neuroregenerative and neuroprotective effects.

Animals↗
PubMed1978

Pragmatic realities in uremia therapy.

The present status and future prospects of uremia therapy in the United States are reviewed. Approximately 3500 renal transplants were done in 1976 as compared to 3700 in 1975. Functional two-year survival of grafts has not changed recently (40 to 45 per cent for cadaver donors; 70 to 75 per cent for siblings), but patient survival with cadaver grafts continues to improve (now 65 per cent at two years). Patients on hemodialysis in facilities are increasing rapidly. Only 13 per cent are on home dialysis, as compared with nearly 40 per cent five years ago. Home patients do at least as well as those in centers (80 per cent two-year survival) and cost 40 per cent less. Physician bias probably explains the trend to center dialysis, but pending legislation may provide new incentives for home treatment. Prospects for technical advances are good, but a greater federal investment in research and development is needed. Dollars saved on the center dialysis could be used for this purpose.

Attitude of Health Personnel↗
PubMed2002

Adoptive cellular therapy: a therapeutic reality?

The past decade has seen numerous lines of evidence emerging that suggest human malignancies may be sensitive to the effects of cellular immunotherapy. An increasing understanding of the nature of the effector cells and their target antigens is now leading to more focused efforts to harness these responses for therapeutic benefit. However, clinical application has proven more challenging than initially envisaged. Advances in the setting of allogeneic stem cell transplantation now allow attempts to augment both immunological recovery and anti-tumour activity. Some of the most attractive targets here are allospecific rather than truly tumour-specific. Application outside of this setting is based on attempts to delineate further tumour-specific or, increasingly, tumour-selective targets. This review summarizes these developments and highlights some of the issues that remain to be resolved.

Animals↗