Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “multimodality”

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 1,567 records · Page 87Linked to original sources
PubMed1999

Multimodal spatial orientation deficits in left-sided visual neglect.

Patients with right-sided temporo-parietal lesions often show contralesional neglect. However, neglect patients may also show spatial-perceptual deficits beyond the bisection and space exploration deficits frequently assessed in the horizontal plane, that is, deficits in the judgment of the subjective visual vertical or horizontal. In a recent study (Kerkhoff, G. & Zoelch, C.. Disorders of visuo-spatial orientation in the frontal plane in patients with visual neglect following right or left parietal lesions. Exp. Brain Res., 1998;122:108-120) we found significant perturbations in the perception of these three visual spatial axes in patients with contralesional neglect from right or left parietal lesions. To examine if this finding extends also to another modality we investigated how neglect patients perform tasks of visual- and tactile-spatial judgments of axis-orientation in the frontal plane. Visual-spatial and tactile-spatial judgments of the subjective vertical, horizontal and a right oblique orientation were obtained from patients with and without neglect as well as from normal subjects. Patients with left neglect showed a significant, contraversive tilt of all three visual-spatial axes (+5.6 degrees to +9.5 degrees, counterclockwise), and of the three tactile-spatial axes as well (+5.2 degrees to +10.5 degrees, counterclockwise). In contrast, right and left hemisphere lesioned control patients without neglect and normal control subjects showed unimpaired visual and tactile-spatial judgments (constant errors: < 1.0 degree). Difference thresholds in the visual-spatial tasks and unsigned errors in the tactile-spatial tasks were selectively elevated in the neglect group in contrast to all other subject groups. Spatial orientation deficits were significantly associated with the severity of clinical neglect (r = 0.55-0.88), and with the patients' ambulation performance (r = 0.45-0.70). Furthermore, crossmodal axis orientation tests in two neglect patients showed a similar counterclockwise tilt of +5 degrees to +15 degrees, suggesting a similar spatial deficit in both modalities. Orientation judgments were significantly aggravated by a 25 degree-tilt of the head to the left, as tested in one neglect patient, while a comparable rightward head-tilt improved spatial judgments in both modalities. This suggests that spatial orientation judgments are significantly modulated by gravitational input in neglect patients. Together these results are interpreted as evidence for multisensory spatial orientation deficits in neglect patients which are modulated by head-position and are related to their accompanying postural impairment.

Adult↗
PubMed1984

Multimodality approaches in the treatment of attention deficit disorders.

This article describes the diagnostic process and various etiologic considerations that underpin the formulation of a comprehensive treatment program for a child with attention deficit disorder and then goes on to describe treatment modalities and strategies. The authors then suggest that the coordinated use of problem-specific treatment modalities is likely to prove more therapeutic and cost-effective than a global treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1991

Tumors of the central nervous system. Improvement in outcome through a multimodality approach.

More children with CNS tumors will continue to be cured of their neoplasms as a result of improved surgical, radiotherapeutic, and chemotherapeutic intervention. The complex problems seen in these patients mandate their treatment at academic centers actively involved in therapeutic investigations and capable of providing comprehensive multidisciplinary care.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Classification of small bowel Crohn's subtypes based on multimodality imaging.

This article has reviewed the imaging features that correspond to and support the classification of patients into clinical subtypes of Crohn's disease. One study showed that radiologic features on barium studies closely correlated with the Crohn's Disease Activity Index, and another study indicated that CT findings changed patient management in up to 29% of cases. Knowledge of the location, severity, and presence of complications assist in providing patients with appropriate treatment options. Reports of radiologic studies in Crohn's disease should include the presence or absence of imaging features that support these different subtypes. An additional advantage of the use of a reproducible imaging classification that emphasizes morphologic features would be improved comparison of the results of different investigators and treatment protocols. Whatever method of radiologic investigation is employed, it should be targeted to answer questions relevant to patient management. The imaging modalities used should be able to classify the small bowel Crohn's subtypes and should be reflected in the radiologists' reports.

Barium Sulfate↗
PubMed2002

Multimodality therapy for esophageal cancer.

Esophageal cancer is undergoing a major shift in its epidemiology. Its incidence is dramatically growing and it more commonly affects younger and healthier patients. Based on the published data, there is no strong evidence to recommend routine preoperative chemotherapy for the treatment of surgically resectable esophageal carcinoma. It might be that a large-scale randomized study-which will be published in the near future-will shed some different light on this subject. The role of preoperative CRT remains undetermined. To settle this issue, larger, clinical, controlled trials are needed. Improvement in the preoperative regimen and use of new drugs should be evaluated. Concomitant CRT should be considered for potential benefit in survival and local control in patients who have localized disease and are candidates for radical non-surgical treatment. Patients with pCR following neoadjuvant therapy have a consistent, substantial survival benefit. Biologic markers can be used to predict response to therapy and might allow designation of treatment based on the individual tumor. Pretreatment staging is necessary for standardization of patients undergoing treatment protocols and for outcome evaluation. Pretreatment staging will be even more important in the future for adjusting treatment to individual patient. Video-assisted thoracoscopy and laparoscopy have been found to be the most accurate lymph node staging techniques.

Chemotherapy, Adjuvant↗
PubMed2002

The role of laparoscopy in the multimodality treatment of colorectal cancer.

Ten years after the first reports of laparoscopic techniques in colorectal surgery the precise role for these approaches in future colorectal practice as still to be defined. However, it seems most unlikely that the application is going to disappear. Laparoscopic colectomy is undoubtedly a complex. time-consuming procedure and it is clear that the technique is intolerant of difficult cases and will likely remain thus. Therefore. the potential advantages of laparoscopy do not as yet appear to be attainable across the board in colorectal resection. Such generalized advantage may, however, be tantalizingly close. Although many studies have failed to show major benefits for laparoscopy in terms of postoperative recovery, it must be remembered that most of these have been of insufficient statistical power to settle the issue. What is clear to all involved in the field is that very many patients do gain major benefit from the minimally invasive approach. The challenge for the future lies in developing the technology to such a point that these benefits for patients are more reproducible. The requirement for a significant abdominal incision to deliver an intact specimen represents a significant hurdle in this regard. The importance of pathological staging for colorectal cancer at present mandates retrieval of an intact specimen. It is of course possible that radiological staging may develop to such a point that surgeons need only remove the lesion with minimal attention to lymphadenectomy. Alternatively, new adjuvant therapies may arrive that, by virtue of increased efficacy and low side-effect profiles, may be applicable to all but the earliest lesions. Finally, increasing health awareness and application of screening programs may lead to a preponderance of large polyps and preinvasive lesions for which a more limited resection may be appropriate. Obviously these scenarios remain almost entirely speculative. However, the trend towards less invasive local therapy for colorectal cancer seems inexorable, and we firmly believe that laparoscopy will come to play an increasing role. Finally, we suggest that the oncological safety of laparoscopy is of less concern than was the case some years ago. The specter of port-site metastasis, once so alarming, has faded. It is now apparent from all of the larger scale studies that port-site metastases are not a significant issue in the presence of adequate training and laparoscopic skills. Almost without exception, the accumulating evidence seems to point to equivalence in terms of disease-specific recurrence and survival between patients treated using conventional and laparoscopic techniques. We foresee these findings being confirmed by the North American and European trials.

Colectomy↗
PubMed1980

Multimodal therapy.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1988

Multimodal approach to screening for ovarian cancer.

1010 postmenopausal women were recruited for an ovarian cancer screening programme incorporating serum CA-125 measurement and vaginal examination as initial tests and real-time ultrasonography as a secondary procedure in selected cases. The normal range for serum CA-125 in postmenopausal women was established. The specificity for ovarian cancer of serum CA-125 measurement and vaginal examination were 97.0% and 97.3%, respectively. The combinations of serum CA-125 measurement with ultrasound and vaginal examination with ultrasound achieved specificities of 99.8% and 99.0%, respectively. 100% specificity was achieved by serum CA-125 measurement with vaginal examination and by the combination of all three tests. The findings indicate that no individual screening test has acceptable specificity for ovarian cancer in postmenopausal women. However, the combination of CA-125 measurement with ultrasound did achieve acceptable specificity and offers the most hope of a specific and sensitive method for early detection.

Aged↗
PubMed1984

Improved survival in neuroblastoma using multimodality therapy.

One hundred and thirty-six patients with neuroblastoma have been treated at our center from 1970 to 1982, using various combinations of surgery, radiation therapy, and chemotherapy. Choice of therapy was individualized but depended primarily on age and stage. The overall disease-free survival was 60% (minimum follow-up of one year). Patients with stage I disease and younger patients with stage II disease usually received less intensive therapy and fared extremely well (100% survival). Patients with stage III disease and older patients with stage II disease also did extremely well (survival of 85% and 90%, respectively). These patients may have benefited from intensive treatment with all three modalities. Patients under one year of age with stage IV neuroblastoma were treated with surgery and multiagent chemotherapy, and 92% (11/12) survived free of disease. Patients over one year old with stage IV disease represented the only group for which therapy was unsuccessful (10% survival). With combination approaches and with more effective multiagent chemotherapeutic regimens, a real impact on the survival of older stage II patients, stage III patients, and younger stage IV patients appears to have been made. However, older stage IV patients are rarely cured with conventional therapy, and better approaches will be needed for this group.

Adolescent↗