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Results for “Therapeutic Situation”

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At least 19 recordsLinked to original sources
PubMed2005

[The changing etiology and therapeutic situation of atherosclerotic renal artery stenosis].

OBJECTIVE: To determine whether the etiology of renal artery stenosis changed. To investigate the clinical characteristics and current therapeutic situation of atherosclerotic renal artery stenosis (ARAS). METHODS: Retrospective analysis was performed in 144 cases of renal artery stenosis diagnosed by angiography (> or = 50% luminal narrowing) from 1979 to 2003. Eighty-seven of them were diagnosed as ARAS by special characteristics of angiography and clinical features. The clinical data of ARAS was compared with RAS caused by other diseases. RESULTS: The proportion of ARAS in all RAS was 60.4%. The proportion of ARAS was 28.9% during the period of 1980 to 1990 and 71.7% from the year of 1991 to 2003, respectively. The prevalence of hypertension was 90.8% among ARAS patients. Newly-progressive hypertension was more common among ARAS patients compared with RAS patients with other causes (37.9% vs 21.0%, P = 0.044). Renal dysfunction were more commonly seen among ARAS than non-ARAS patients in those with the same degree of stenosis (11.2% vs 6.9% for stenosis 50%-74%, P = 0.038; 35.8% vs 15.4% for stenosis > or = 75%, P = 0.046). Among ARAS cases, 60.9% were managed with antihypertensive agents only, 18.8% were managed by angioplasty with or without stents. After 1990, the improvement rate of blood pressure rose significantly but not for renal function. The improvement rate of blood pressure by angioplasty was similar with that by medication (84.1% vs 92.6% for stenosis 50%-74%, P = 0.39; 76.6% vs 80.1% for stenosis > or = 75%, P = 0.61). And the improvement or stable rate of renal function was not different (85.4% vs 85.7% for stenosis 50%-74%, P = 0.91; 77.8% vs 76.9% for stenosis > or = 75%, P = 0.83). CONCLUSION: ARAS is the predominant cause of RAS nowadays in stead of Takayasu arteritis. Medication is the mostly used management for ARAS, though more angioplasty with or without stents appear. The effect of medication for ARAS has improved since 1990. Most cases of ARAS could achieve ideal blood pressure control and similar renal function protection with either rational medication or angioplasty.

Adult↗
PubMed1989

[Suicide of the schizophrenic patient and its relation to the therapeutic situation].

The relationship between the course of illness and the therapeutic circumstances was investigated in 6 cases of schizophrenic patients who had committed suicide. All patients committed suicide following repeated stationary treatments with only partial remission. More than previously reported in the literature insufficient treatment on one side and a breakdown of the therapeutic relationship to the doctor with the following repulsion and hopelessness on the other side appear to determine the suicidal dynamics in the context of a multidimensional concept of suicide: If insufficient therapeutic efficacy disappoints doctor and patient and if the patient cannot fulfill rehabilitation requirements, he is often given up and then gives up himself. From that, suicideprophylactic aspects should be derived.

Adult↗
PubMed1993

[Sexual relations in therapeutic situations].

Patients who feel sexually violated by their therapists may complain to the health authorities. During recent years there has been an increasing number of such complaints. 15 cases were under investigation at the Directorate of Health in July 1992. Most of the doctors and psychologists involved had long therapeutic experience. The sexual contacts were of highly divergent types. In the majority of cases the therapists lacked the capacity to draw clear borderlines between professional and private life. Some of the therapists had a tendency to belittle the contacts. Sexual contact between patient and therapist has a detrimental effect upon the relationship and the mental functioning of the patients. Therapists acquainted with colleagues' sexual violations should react swiftly. Too lenient and permissive ethical and social attitudes towards sexual relationships between therapist and patient may be conducive to further abuse. It is important to incorporate the study and discussion of these problems into both the basic and postgraduate education of therapists. Therapists who have violated the norms for decent behaviour need professional support.

Adult↗
PubMed1997

What are ago-antagonistic couples? Their role in normal and pathological situations. Therapeutical consequences.

Two classes of steroid hormones are successively produced following a microbial infection stress in rat and man. First there are those of attenuation and acceptation, the glucocorticoids and progestins, which correspond to the temporization phase of reaction to stress. Secondly, there are those of rejection or creative reinforcement, namely the adrenal androgens converted in certain circumstances to estrogens by aromatization, which are necessary to fight against or accept the stressor. We suggest that these two classes of signal carrier molecules function as agonistic-antagonistic couples which work to prevent the organism from going too far in the direction of attenuation-acceptation or, on the contrary, in the direction of rejection-reinforcement. The presence of agonistic-antagonistic couples can be identified as regulating numerous other steps in the signal networks. Dysfunctions of such couples result in pathological situations, characterized by an imbalance in the concentration and correspondingly in the biological activity of one of the partners due to a change in the 'equilibrium constant' of the ago-antagonistic couple, changes in the level of synthesis or catabolism of one of the partners, the presence in adequate time and location of the partners, or the deficiency of the receptor of at least one of the partners. Different 'paradoxical' therapeutical strategies are envisaged to reequilibrate the imbalance.

Animals↗