Sample records for particle therapy review

  1. Particle therapy

    SciTech Connect

    Raju, M.R.

    1993-09-01

    Particle therapy has a long history. The experimentation with particles for their therapeutic application got started soon after they were produced in the laboratory. Physicists played a major role in proposing the potential applications in radiotherapy as well as in the development of particle therapy. A brief review of the current status of particle radiotherapy with some historical perspective is presented and specific contributions made by physicists will be pointed out wherever appropriate. The rationale of using particles in cancer treatment is to reduce the treatment volume to the target volume by using precise dose distributions in three dimensions by using particles such as protons and to improve the differential effects on tumors compared to normal tissues by using high-LET radiations such as neutrons. Pions and heavy ions combine the above two characteristics.

  2. Particle Therapy for Non-Small Cell Lung Tumors: Where Do We Stand? A Systematic Review of the Literature

    PubMed Central

    Wink, Krista C. J.; Roelofs, Erik; Solberg, Timothy; Lin, Liyong; Simone, Charles B.; Jakobi, Annika; Richter, Christian; Lambin, Philippe; Troost, Esther G. C.

    2014-01-01

    This review article provides a systematic overview of the currently available evidence on the clinical effectiveness of particle therapy for the treatment of non-small cell lung cancer and summarizes findings of in silico comparative planning studies. Furthermore, technical issues and dosimetric uncertainties with respect to thoracic particle therapy are discussed. PMID:25401087

  3. Charged Particle Radiation Therapy for Uveal Melanoma: A Systematic Review and Meta-Analysis

    SciTech Connect

    Wang, Zhen, E-mail: Wang.Zhen@mayo.edu [Mayo Clinic, Rochester, Minnesota (United States)] [Mayo Clinic, Rochester, Minnesota (United States); Nabhan, Mohammed [Mayo Clinic, Rochester, Minnesota (United States)] [Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Mayo Clinic, Scottsdale, Arizona (United States)] [Mayo Clinic, Scottsdale, Arizona (United States); Stafford, Scott L.; Petersen, Ivy A.; Foote, Robert L.; Murad, M. Hassan [Mayo Clinic, Rochester, Minnesota (United States)] [Mayo Clinic, Rochester, Minnesota (United States)

    2013-05-01

    Charged particle therapy (CPT) delivered with either protons, helium ions, or carbon ions, has been used to treat uveal melanoma. The present analysis was performed to systematically evaluate the efficacy and adverse effects of CPT for uveal melanoma. We searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and SciVerse Scopus and cross-referenced recent systematic reviews through January 2012. Two independent reviewers identified clinical trials and observational studies of CPT (protons, helium ions, and carbon ions). These reviewers extracted data and assessed study quality. Twenty-seven studies enrolling 8809 uveal melanoma patients met inclusion criteria. The rate of local recurrence was significantly less with CPT than with brachytherapy (odds ratio [OR] = 0.22, 95% confidence interval [CI], 0.21-0.23). There were no significant differences in mortality or enucleation rates. Results were robust in multiple sensitivity analyses. CPT was also associated with lower retinopathy and cataract formation rates. Data suggest better outcomes may be possible with charged particle therapy with respect to local recurrence, retinopathy, and cataract formation rates. The overall quality of the evidence is low, and higher quality comparative effectiveness studies are needed to provide better evidence.

  4. Particle Radiation Therapy: Requiem or Reveille

    PubMed Central

    Alexander, Leslie L.; Goldson, Alfred L.; Alexander, George A.

    1979-01-01

    The 1960s and 1970s witnessed a surge of many institutions devoted to electron therapy. Currently, many facilities are adding or have added particle types of radiation to their armamentarium against cancer. The authors review the concepts, problems, and potentials of this form of therapy. ImagesFigure 1 PMID:423289

  5. Particle therapy for noncancer diseases

    SciTech Connect

    Bert, Christoph; Engenhart-Cabillic, Rita; Durante, Marco [GSI Helmholtzzentrum fuer Schwerionenforschung, Biophysics Department, Planckstrasse 1, 64291 Darmstadt (Germany); Philipps-University Marburg, Center for Radiology, Department of Radiation Therapy, Baldinger Strasse, 35043 Marburg (Germany); GSI Helmholtzzentrum fuer Schwerionenforschung, Biophysics Department, Planckstrasse 1, 64291 Darmstadt (Germany); Technische Universitaet Darmstadt, Institut fuer Festkoerperphysik, Hochschulstrasse 3, 64289 Darmstadt (Germany) and Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe University, Ruth-Moufang-Str. 1, 60438 Frankfurt am Main (Germany)

    2012-04-15

    Radiation therapy using high-energy charged particles is generally acknowledged as a powerful new technique in cancer treatment. However, particle therapy in oncology is still controversial, specifically because it is unclear whether the putative clinical advantages justify the high additional costs. However, particle therapy can find important applications in the management of noncancer diseases, especially in radiosurgery. Extension to other diseases and targets (both cranial and extracranial) may widen the applications of the technique and decrease the cost/benefit ratio of the accelerator facilities. Future challenges in this field include the use of different particles and energies, motion management in particle body radiotherapy and extension to new targets currently treated by catheter ablation (atrial fibrillation and renal denervation) or stereotactic radiation therapy (trigeminal neuralgia, epilepsy, and macular degeneration). Particle body radiosurgery could be a future key application of accelerator-based particle therapy facilities in 10 years from today.

  6. Review of Particle Properties

    Microsoft Academic Search

    K. Hagiwara; K. Hikasa; K. Nakamura; M. Tanabashi; M. Aguilar-Benitez; C. Amsler; R. M. Barnett; P. R. Burchat; C. D. Carone; C. Caso; G. Conforto; O. Dahl; M. Doser; S. Eidelman; J. L. Feng; L. Gibbons; M. Goodman; C. Grab; D. E. Groom; A. Gurtu; K. G. Hayes; K. Honscheid; C. Kolda; M. L. Mangano; D. M. Manley; A. V. Manohar; J. March-Russell; A. Masoni; R. Miquel; K. Mönig; H. Murayama; S. Navas; K. A. Olive; L. Pape; C. Patrignani; A. Piepke; M. Roos; J. Terning; N. A. Törnqvist; T. G. Trippe; P. Vogel; C. G. Wohl; R. L. Workman; W.-M. Yao; B. Armstrong; P. S. Gee; K. S. Lugovsky; S. B. Lugovsky; V. S. Lugovsky; M. Artuso; D. Asner; K. S. Babu; E. Barberio; M. Battaglia; H. Bichsel; O. Biebel; P. Bloch; R. N. Cahn; A. Cattai; R. S. Chivukula; R. D. Cousins; G. Cowan; T. Damour; K. Desler; R. J. Donahue; D. A. Edwards; V. D. Elvira; J. Erler; V. V. Ezhela; W. Fetscher; B. D. Fields; B. Foster; D. Froidevaux; M. Fukugita; T. K. Gaisser; L. Garren; H.-J. Gerber; F. J. Gilman; H. E. Haber; C. Hagmann; J. Hewett; I. Hinchliffe; C. J. Hogan; G. Höhler; P. Igo-Kemenes; J. D. Jackson; K. F. Johnson; D. Karlen; B. Kayser; S. R. Klein; K. Kleinknecht; I. G. Knowles; P. Kreitz; Yu. V. Kuyanov; R. Landua; P. Langacker; L. Littenberg; A. D. Martin; T. Nakada; M. Narain; P. Nason; J. A. Peacock; H. R. Quinn; S. Raby; G. Raffelt; E. A. Razuvaev; B. Renk; L. Rolandi; M. T. Ronan; L. J. Rosenberg; C. T. Sachrajda; A. I. Sanda; S. Sarkar; M. Schmitt; O. Schneider; D. Scott; W. G. Seligman; M. H. Shaevitz; T. Sjöstrand; G. F. Smoot; S. Spanier; H. Spieler; N. J. C. Spooner; M. Srednicki; A. Stahl; T. Stanev; M. Suzuki; N. P. Tkachenko; G. Valencia; K. van Bibber; M. G. Vincter; D. R. Ward; B. R. Webber; M. Whalley; L. Wolfenstein; J. Womersley; C. L. Woody; O. V. Zenin

    2002-01-01

    This biennial Review summarizes much of Particle Physics. Using data from previous editions, plus 2205 new measurements from 667 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed

  7. Review of Particle Physics

    Microsoft Academic Search

    W.-M. Yao; C. Amsler; D. Asner; R. M. Barnett; J. Beringer; P. R. Burchat; C. D. Carone; C. Caso; O. Dahl; G. D'Ambrosio; A. De Gouvea; M. Doser; S. Eidelman; J. L. Feng; T. Gherghetta; M. Goodman; C. Grab; D. E. Groom; A. Gurtu; K. Hagiwara; K. G. Hayes; J. J. Hernández-Rey; K. Hikasa; H. Jawahery; C. Kolda; Y. Kwon; M. L. Mangano; A. V. Manohar; A. Masoni; R. Miquel; K. Mönig; H. Murayama; K. Nakamura; S. Navas; K. A. Olive; L. Pape; C. Patrignani; A. Piepke; G. Punzi; G. Raffelt; J. G. Smith; M. Tanabashi; J. Terning; N. A. Törnqvist; T. G. sTrippe; P. Vogel; T. Watari; C. G. Wohl; R. L. Workman; P. A. Zyla; B. Armstrong; G. Harper; V. S. Lugovsky; P. Schaffner; M. Artuso; K. S. Babu; H. R. Band; E. Barberio; M. Battaglia; H. Bichsel; O. Biebel; P. Bloch; E. Blucher; R. N. Cahn; D. Casper; A. Cattai; A. Ceccucci; D. Chakraborty; R. S. Chivukula; G. Cowan; T. Damour; T. DeGrand; K. Desler; M. A. Dobbs; M. Drees; A. Edwards; D. A. Edwards; V. D. Elvira; J. Erler; V. V. Ezhela; W. Fetscher; B. D. Fields; B. Foster; D. Froidevaux; T. K. Gaisser; L. Garren; H.-J. Gerber; G. Gerbier; L. Gibbons; F. J. Gilman; G. F. Giudice; A. V. Gritsan; M. Grünewald; H. E. Haber; C. Hagmann; I. Hinchliffe; A. Höcker; P. Igo-Kemenes; J. D. JAckson; K. F. Johnson; D. Karlen; B. Kayser; D. Kirkby; S. R. Klein; K. Kleinknecht; I. G. Knowles; R. V. Kowalewski; P. Kreitz; B. Kursche; Yu. V. Kuyanov; O. Lahav; P. Langacker; A. Liddle; Z. Ligeti; T. M. Liss; L. Littenberg; J. C. Liu; K. S. Lugovsky; s. B. Lugovsky; T. Mannel; D. M. Manley; W. J. Marciano; A. D. Martin; D. Milstead; M. Narain; P. Nason; Y. Nir; J. A. Peacock; S. A. Prell; A. Quadt; S. Raby; B. N. Ratcliff; E. A. Razuvaev; B. Renk; P. Richardson; S. Roesler; G. Rolandi; M. T. Ronan; L. J. Rosenberg; C. T. Sachrajda; Y. Sakai; S. Sarkar; M. Schmitt; O. Schneider; D. Scott; T. Sjöstrand; G. F. Smoot; P. Sokolsky; S. Spanier; H. Spieler; A. Stahl; T. Stanev; R. E. Streitmatter; T. Sumiyoshi; N. P. Tkachenko; G. H. Trilling; G. Valencia; K. van Bibber; M. G. Vincter; D. R. Ward; B. R. Webber; J. D. Wells; M. Whalley; L. Wolfenstsein; J. Womersley; C. L. Woody; A. Yamamoto; O. V. Zenin; J. Zhang; R.-Y. Zhu

    2006-01-01

    This biennial Review summarizes much of particle physics. Using data from previous editions, plus 2633 new measurements from 689 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed

  8. Review of Particle Physics

    Microsoft Academic Search

    C. Amsler; M. Doser; M. Antonelli; D. M. Asner; K. S. Babu; H. Baer; H. R. Band; R. M. Barnett; E. Bergren; J. Beringer; G. Bernardi; W. Bertl; H. Bichsel; O. Biebel; P. Bloch; E. Blucher; S. Blusk; R. N. Cahn; M. Carena; C. Caso; A. Ceccucci; D. Chakraborty; M.-C. Chen; R. S. Chivukula; G. Cowan; O. Dahl; G. D'Ambrosio; T. Damour; A. de Gouvêa; T. DeGrand; B. Dobrescu; M. Drees; D. A. Edwards; S. Eidelman; V. D. Elvira; J. Erler; V. V. Ezhela; J. L. Feng; W. Fetscher; B. D. Fields; B. Foster; T. K. Gaisser; L. Garren; H.-J. Gerber; G. Gerbier; T. Gherghetta; G. F. Giudice; M. Goodman; C. Grab; A. V. Gritsan; J.-F. Grivaz; D. E. Groom; M. Grünewald; A. Gurtu; T. Gutsche; H. E. Haber; K. Hagiwara; C. Hagmann; K. G. Hayes; J. J. Hernández-Rey; K. Hikasa; I. Hinchliffe; A. Höcker; J. Huston; P. Igo-Kemenes; J. D. Jackson; K. F. Johnson; T. Junk; D. Karlen; B. Kayser; D. Kirkby; S. R. Klein; I. G. Knowles; C. Kolda; R. V. Kowalewski; P. Kreitz; B. Krusche; Yu. V. Kuyanov; Y. Kwon; O. Lahav; P. Langacker; A. Liddle; Z. Ligeti; C.-J. Lin; T. M. Liss; L. Littenberg; J. C. Liu; K. S. Lugovsky; H. Mahlke; M. L. Mangano; T. Mannel; A. V. Manohar; W. J. Marciano; A. D. Martin; A. Masoni; D. Milstead; R. Miquel; K. Mönig; H. Murayama; K. Nakamura; M. Narain; P. Nason; S. Navas; P. Nevski; Y. Nir; K. A. Olive; L. Pape; C. Patrignani; J. A. Peacock; G. Punzi; A. Quadt; S. Raby; G. Raffelt; B. N. Ratcliff; B. Renk; P. Richardson; S. Roesler; A. Romaniouk; L. J. Rosenberg; C. T. Sachrajda; Y. Sakai; S. Sarkar; F. Sauli; O. Schneider; D. Scott; W. G. Seligman; M. H. Shaevitz; T. Sjöstrand; J. G. Smith; S. Spanier; H. Spieler; A. Stahl; T. Stanev; S. L. Stone; T. Sumiyoshi; M. Tanabashi; J. Terning; M. Titov; N. P. Tkachenko; N. A. Törnqvist; D. Tovey; G. H. Trilling; T. G. Trippe; G. Valencia; K. van Bibber; M. G. Vincter; P. Vogel; D. R. Ward; T. Watari; B. R. Webber; G. Weiglein; J. D. Wells; M. Whalley; A. Wheeler; C. G. Wohl; L. Wolfenstein; J. Womersley; C. L. Woody; R. L. Workman; A. Yamamoto; W.-M. Yao; O. V. Zenin; J. Zhang; R.-Y. Zhu; P. A. Zyla; G. Harper; V. S. Lugovsky; P. Schaffner

    2008-01-01

    This biennial Review summarizes much of particle physics. Using data from previous editions, plus 2778 new measurements from 645 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We also summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed

  9. Basics of particle therapy I: physics

    PubMed Central

    Park, Seo Hyun

    2011-01-01

    With the advance of modern radiation therapy technique, radiation dose conformation and dose distribution have improved dramatically. However, the progress does not completely fulfill the goal of cancer treatment such as improved local control or survival. The discordances with the clinical results are from the biophysical nature of photon, which is the main source of radiation therapy in current field, with the lower linear energy transfer to the target. As part of a natural progression, there recently has been a resurgence of interest in particle therapy, specifically using heavy charged particles, because these kinds of radiations serve theoretical advantages in both biological and physical aspects. The Korean government is to set up a heavy charged particle facility in Korea Institute of Radiological & Medical Sciences. This review introduces some of the elementary physics of the various particles for the sake of Korean radiation oncologists' interest. PMID:22984664

  10. Review of Particle Physics

    NASA Astrophysics Data System (ADS)

    Beringer, J.; Arguin, J.-F.; Barnett, R. M.; Copic, K.; Dahl, O.; Groom, D. E.; Lin, C.-J.; Lys, J.; Murayama, H.; Wohl, C. G.; Yao, W.-M.; Zyla, P. A.; Amsler, C.; Antonelli, M.; Asner, D. M.; Baer, H.; Band, H. R.; Basaglia, T.; Bauer, C. W.; Beatty, J. J.; Belousov, V. I.; Bergren, E.; Bernardi, G.; Bertl, W.; Bethke, S.; Bichsel, H.; Biebel, O.; Blucher, E.; Blusk, S.; Brooijmans, G.; Buchmueller, O.; Cahn, R. N.; Carena, M.; Ceccucci, A.; Chakraborty, D.; Chen, M.-C.; Chivukula, R. S.; Cowan, G.; D'Ambrosio, G.; Damour, T.; de Florian, D.; de Gouvêa, A.; DeGrand, T.; de Jong, P.; Dissertori, G.; Dobrescu, B.; Doser, M.; Drees, M.; Edwards, D. A.; Eidelman, S.; Erler, J.; Ezhela, V. V.; Fetscher, W.; Fields, B. D.; Foster, B.; Gaisser, T. K.; Garren, L.; Gerber, H.-J.; Gerbier, G.; Gherghetta, T.; Golwala, S.; Goodman, M.; Grab, C.; Gritsan, A. V.; Grivaz, J.-F.; Grünewald, M.; Gurtu, A.; Gutsche, T.; Haber, H. E.; Hagiwara, K.; Hagmann, C.; Hanhart, C.; Hashimoto, S.; Hayes, K. G.; Heffner, M.; Heltsley, B.; Hernández-Rey, J. J.; Hikasa, K.; Höcker, A.; Holder, J.; Holtkamp, A.; Huston, J.; Jackson, J. D.; Johnson, K. F.; Junk, T.; Karlen, D.; Kirkby, D.; Klein, S. R.; Klempt, E.; Kowalewski, R. V.; Krauss, F.; Kreps, M.; Krusche, B.; Kuyanov, Yu. V.; Kwon, Y.; Lahav, O.; Laiho, J.; Langacker, P.; Liddle, A.; Ligeti, Z.; Liss, T. M.; Littenberg, L.; Lugovsky, K. S.; Lugovsky, S. B.; Mannel, T.; Manohar, A. V.; Marciano, W. J.; Martin, A. D.; Masoni, A.; Matthews, J.; Milstead, D.; Miquel, R.; Mönig, K.; Moortgat, F.; Nakamura, K.; Narain, M.; Nason, P.; Navas, S.; Neubert, M.; Nevski, P.; Nir, Y.; Olive, K. A.; Pape, L.; Parsons, J.; Patrignani, C.; Peacock, J. A.; Petcov, S. T.; Piepke, A.; Pomarol, A.; Punzi, G.; Quadt, A.; Raby, S.; Raffelt, G.; Ratcliff, B. N.; Richardson, P.; Roesler, S.; Rolli, S.; Romaniouk, A.; Rosenberg, L. J.; Rosner, J. L.; Sachrajda, C. T.; Sakai, Y.; Salam, G. P.; Sarkar, S.; Sauli, F.; Schneider, O.; Scholberg, K.; Scott, D.; Seligman, W. G.; Shaevitz, M. H.; Sharpe, S. R.; Silari, M.; Sjöstrand, T.; Skands, P.; Smith, J. G.; Smoot, G. F.; Spanier, S.; Spieler, H.; Stahl, A.; Stanev, T.; Stone, S. L.; Sumiyoshi, T.; Syphers, M. J.; Takahashi, F.; Tanabashi, M.; Terning, J.; Titov, M.; Tkachenko, N. P.; Törnqvist, N. A.; Tovey, D.; Valencia, G.; van Bibber, K.; Venanzoni, G.; Vincter, M. G.; Vogel, P.; Vogt, A.; Walkowiak, W.; Walter, C. W.; Ward, D. R.; Watari, T.; Weiglein, G.; Weinberg, E. J.; Wiencke, L. R.; Wolfenstein, L.; Womersley, J.; Woody, C. L.; Workman, R. L.; Yamamoto, A.; Zeller, G. P.; Zenin, O. V.; Zhang, J.; Zhu, R.-Y.; Harper, G.; Lugovsky, V. S.; Schaffner, P.

    2012-07-01

    This biennial Review summarizes much of particle physics. Using data from previous editions, plus 2658 new measurements from 644 papers, we list, evaluate, and average measured properties of gauge bosons, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as Higgs bosons, heavy neutrinos, and supersymmetric particles. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as the Standard Model, particle detectors, probability, and statistics. Among the 112 reviews are many that are new or heavily revised including those on Heavy-Quark and Soft-Collinear Effective Theory, Neutrino Cross Section Measurements, Monte Carlo Event Generators, Lattice QCD, Heavy Quarkonium Spectroscopy, Top Quark, Dark Matter, Vcb & Vub, Quantum Chromodynamics, High-Energy Collider Parameters, Astrophysical Constants, Cosmological Parameters, and Dark Matter.A booklet is available containing the Summary Tables and abbreviated versions of some of the other sections of this full Review. All tables, listings, and reviews (and errata) are also available on the Particle Data Group website: http://pdg.lbl.gov/.The 2012 edition of Review of Particle Physics is published for the Particle Data Group as article 010001 in volume 86 of Physical Review D.This edition should be cited as: J. Beringer et al. (Particle Data Group), Phys. Rev. D 86, 010001 (2012).

  11. Comparison of particle-radiation-therapy modalities

    SciTech Connect

    Fairchild, R.G.; Bond, V.P.

    1981-01-01

    The characteristics of dose distribution, beam alignment, and radiobiological advantages accorded to high LET radiation were reviewed and compared for various particle beam radiotherapeutic modalities (neutron, Auger electrons, p, ..pi../sup -/, He, C, Ne, and Ar ions). Merit factors were evaluated on the basis of effective dose to tumor relative to normal tissue, linear energy transfer (LET), and dose localization, at depths of 1, 4, and 10 cm. In general, it was found that neutron capture therapy using an epithermal neutron beam provided the best merit factors available for depths up to 8 cm. The position of fast neutron therapy on the Merit Factor Tables was consistently lower than that of other particle modalities, and above only /sup 60/Co. The largest body of clinical data exists for fast neutron therapy; results are considered by some to be encouraging. It then follows that if benefits with fast neutron therapy are real, additional gains are within reach with other modalities.

  12. Indoor Particles: A Review

    Microsoft Academic Search

    Lance Wallace

    1996-01-01

    This paper reviews studies of particle concentrations and sources in homes and buildings. Three major studies of indoor and outdoor concentrations in U.S. homes are summarized in detail and compared. A number of smaller studies in homes are also briefly summarized. One study of 38 buildings and several smaller studies of buildings are also reviewed.All major studies found that an

  13. Review of Particle Physics

    NASA Astrophysics Data System (ADS)

    Olive, K. A.; Particle Data Group

    2014-08-01

    The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,283 new measurements from 899 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as heavy neutrinos, supersymmetric and technicolor particles, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous tables, figures, formulae, and reviews of topics such as Supersymmetry, Extra Dimensions, Particle Detectors, Probability, and Statistics. Among the 112 reviews are many that are new or heavily revised including those on: Dark Energy, Higgs Boson Physics, Electroweak Model, Neutrino Cross Section Measurements, Monte Carlo Neutrino Generators, Top Quark, Dark Matter, Dynamical Electroweak Symmetry Breaking, Accelerator Physics of Colliders, High-Energy Collider Parameters, Big Bang Nucleosynthesis, Astrophysical Constants and Cosmological Parameters. All tables, listings, and reviews (and errata) are also available on the Particle Data Group website: http://pdg.lbl.gov. Contents Abstract, Contributors, Highlights and Table of ContentsAcrobat PDF (4.4 MB) IntroductionAcrobat PDF (595 KB) Particle Physics Summary Tables Gauge and Higgs bosonsAcrobat PDF (204 KB) LeptonsAcrobat PDF (167 KB) QuarksAcrobat PDF (115 KB) MesonsAcrobat PDF (976 KB) BaryonsAcrobat PDF (384 KB) Searches (Supersymmetry, Compositeness, etc.)Acrobat PDF (120 KB) Tests of conservation lawsAcrobat PDF (383 KB) Reviews, Tables, and Plots Detailed contents for this sectionAcrobat PDF (73 KB) Constants, Units, Atomic and Nuclear PropertiesAcrobat PDF (395 KB) Standard Model and Related TopicsAcrobat PDF (8.37 MB) Astrophysics and CosmologyAcrobat PDF (3.79 MB) Experimental Methods and CollidersAcrobat PDF (3.82 MB) Mathematical Tools of Statistics, Monte Carlo, Group Theory Acrobat PDF (1.77 MB) Kinematics, Cross-Section Formulae, and PlotsAcrobat PDF (3.57 MB) Particle Listings Illustrative key and abbreviationsAcrobat PDF (325 KB) Gauge and Higgs bosonsAcrobat PDF (2.38 MB) LeptonsAcrobat PDF (2.03 MB) QuarksAcrobat PDF (1.51 MB) Mesons: Light unflavored and strangeAcrobat PDF (4.91 MB) Mesons: Charmed and bottomAcrobat PDF (9.03 MB) Mesons: OtherAcrobat PDF (4.03 MB) BaryonsAcrobat PDF (4.54 MB) Miscellaneous searchesAcrobat PDF (3.98 MB) IndexAcrobat PDF (276 KB)

  14. Play therapy: a review

    Microsoft Academic Search

    Maggie L. Porter; Peggy Jessee

    2009-01-01

    This article discusses the current issues in play therapy and its implications for play therapists. A brief history of play therapy is provided along with the current play therapy approaches and techniques. This article also touches on current issues or problems that play therapists may face, such as interpreting children's play, implementing effective techniques, limit setting and how to deal

  15. Play Therapy: A Review

    ERIC Educational Resources Information Center

    Porter, Maggie L.; Hernandez-Reif, Maria; Jessee, Peggy

    2009-01-01

    This article discusses the current issues in play therapy and its implications for play therapists. A brief history of play therapy is provided along with the current play therapy approaches and techniques. This article also touches on current issues or problems that play therapists may face, such as interpreting children's play, implementing…

  16. The Review of Particle Physics

    NSDL National Science Digital Library

    The Particle Physics Group (PDG) is an "international collaboration that reviews particle physics and related areas of Astrophysics, and compiles/analyzes data on particle properties." The Web site features the 2002 publication, The Review of Particle Physics, which is described as "the most cited publication in particle physics during the last decade." Visitors have access to summary tables and conservation laws; reviews, tables, and plots; and particle listings, which list, average, evaluate, and reference various data used. Other features include a link to particle physics information and databases, archives of past reports, and other helpful resources.

  17. Regenerative photonic therapy: Review

    NASA Astrophysics Data System (ADS)

    Salansky, Natasha; Salansky, Norman

    2012-09-01

    After four decades of research of photobiomodulation phenomena in mammals in vitro and in vivo, a solid foundation is created for the use of photobiomodulation in regenerative medicine. Significant accomplishments are achieved in animal models that demonstrate opportunities for photo-regeneration of injured or pathological tissues: skin, muscles and nerves. However, the use of photobiomodulation in clinical studies leads to controversial results while negative or marginal clinical efficacy is reported along with positive findings. A thor ough analysis of requirements to the optical parameters (dosimetry) for high efficacy in photobimodulation led us to the conclusion that there are several misconceptions in the clinical applications of low level laser therapy (LLLT). We present a novel appr oach of regenerative photonic therapy (RPT) for tissue healing and regeneration that overcomes major drawbacks of LLLT. Encouraging clinical results on RPT efficacy are presented. Requirements for RPT approach and vision for its future development for tissue regeneration is discussed.

  18. Advances in charged particle therapy

    NASA Astrophysics Data System (ADS)

    Haberer, Th.

    2002-04-01

    One out of three individuals will be confronted with the diagnosis of cancer in the course of his/her lifetime. Roughly 45% of these patients can be cured. The main treatment modalities to fight against cancer are surgery, radiotherapy and chemotherapy. Whereas systematic approaches like chemotherapy only account for 5% of the cures local approaches like surgery, radiotherapy or combinations of both account for 40% of the successful treatments. These very general numbers clearly point out the relevance of local treatment modalities. Any progress in this area is most welcome. For about 2/3 of cancer patients the disease is localized at the time of diagnosis and therefore is well suited to be successfully treated. Anyhow, in 18% of all patients the local treatment modalities fail, which accounts for 280.000 deaths per year in EC! Radiation therapy could substantially be boosted by making the potential of charged particles available. For the EC 30.000 patients per year are expected to be cured if proton and ion treatment centers of adequate capacity were available.

  19. Gantry for medical particle therapy facility

    DOEpatents

    Trbojevic, Dejan

    2013-04-23

    A particle therapy gantry for delivering a particle beam to a patient includes a beam tube having a curvature defining a particle beam path and a plurality of superconducting, variable field magnets sequentially arranged along the beam tube for guiding the particle beam along the particle path. In a method for delivering a particle beam to a patient through a gantry, a particle beam is guided by a plurality of variable field magnets sequentially arranged along a beam tube of the gantry and the beam is alternately focused and defocused with alternately arranged focusing and defocusing variable field magnets.

  20. Gantry for medical particle therapy facility

    DOEpatents

    Trbojevic, Dejan (Wading River, NY)

    2012-05-08

    A particle therapy gantry for delivering a particle beam to a patient includes a beam tube having a curvature defining a particle beam path and a plurality of fixed field magnets sequentially arranged along the beam tube for guiding the particle beam along the particle path. In a method for delivering a particle beam to a patient through a gantry, a particle beam is guided by a plurality of fixed field magnets sequentially arranged along a beam tube of the gantry and the beam is alternately focused and defocused with alternately arranged focusing and defocusing fixed field magnets.

  1. Hyperpigmentation Therapy: A Review

    PubMed Central

    Desai, Seemal R.

    2014-01-01

    With an increasing number of multicultural patients and those of different backgrounds presenting in dermatology clinics, issues facing patients with higher Fitzpatrick skin classifications, often referred to as skin of color patients, are on the rise. Knowledge of the diagnostic dilemmas, cutting edge treatment options, and latest clinical research in the diagnosis and management of cutaneous anomalies in skin of color patients is of paramount importance. Of the most common complaints in patients with skin of color is hyperpigmentation. Despite the availability of multiple treatments for the condition, hyperpigmentation continues to present clinical management challenges for dermatologists. Difficulty may be traced to physician or patient reluctance to use certain agents or interventions, failure to identify and avoid contributing factors, and insufficient attention paid to the psychosocial aspects of the disease. This review addresses a variety of issues including the diagnosis and management of hyperpigmentation. PMID:25161755

  2. Hyperpigmentation therapy: a review.

    PubMed

    Desai, Seemal R

    2014-08-01

    With an increasing number of multicultural patients and those of different backgrounds presenting in dermatology clinics, issues facing patients with higher Fitzpatrick skin classifications, often referred to as skin of color patients, are on the rise. Knowledge of the diagnostic dilemmas, cutting edge treatment options, and latest clinical research in the diagnosis and management of cutaneous anomalies in skin of color patients is of paramount importance. Of the most common complaints in patients with skin of color is hyperpigmentation. Despite the availability of multiple treatments for the condition, hyperpigmentation continues to present clinical management challenges for dermatologists. Difficulty may be traced to physician or patient reluctance to use certain agents or interventions, failure to identify and avoid contributing factors, and insufficient attention paid to the psychosocial aspects of the disease. This review addresses a variety of issues including the diagnosis and management of hyperpigmentation. PMID:25161755

  3. Life Review: Implementation, Theory, Research, and Therapy

    ERIC Educational Resources Information Center

    Haber, David

    2006-01-01

    A selective literature review of publications on life review generated ideas on implementation, theory, research, and therapy. The review begins by differentiating life review from reminiscence, and summarizing ways to conduct a life review. A dozen theories that have been influenced by the life review technique are presented, with a focus placed…

  4. Review of Particle Physics

    Microsoft Academic Search

    S. Eidelman; K. G. Hayes; K. A. Olive; M. Aguilar-Benitez; C. Amsler; D. Asner; K. S. Babu; R. M. Barnett; J. Beringer; P. R. Burchat; C. D. Carone; S. Caso; G. Conforto; O. Dahl; G. D'Ambrosio; M. Doser; J. L. Feng; T. Gherghetta; L. Gibbons; M. Goodman; C. Grab; D. E. Groom; A. Gurtu; K. Hagiwara; J. J. Hernández-Rey; K. Hikasa; K. Honscheid; H. Jawahery; C. Kolda; Y. Kwon; M. L. Mangano; A. V. Manohar; J. March-Russell; A. Masoni; R. Miquel; K. Mönig; H. Murayama; K. Nakamura; S. Navas; L. Pape; C. Patrignani; A. Piepke; G. Raffelt; M. Roos; M. Tanabashi; J. Terning; N. A. Törnqvist; T. G. Trippe; P. Vogel; C. G. Wohl; R. L. Workman; W.-M. Yao; P. A. Zyla; B. Armstrong; P. S. Gee; G. Harper; K. S. Lugovsky; V. S. Lugovsky; A. Rom; M. Artuso; E. Barberio; M. Battaglia; H. Bichsel; O. Biebel; P. Bloch; R. N. Cahn; D. Casper; A. Cattai; R. S. Chivukula; G. Cowan; T. Damour; K. Desler; M. A. Dobbs; M. Drees; A. Edwards; D. A. Edwards; V. D. Elvira; J. Erler; V. V. Ezhela; W. Fetscher; B. D. Fields; B. Foster; D. Froidevaux; M. Fukugita; T. K. Gaisser; L. Garren; H.-J. Gerber; G. Gerbier; F. J. Gilman; H. E. Haber; C. Hagmann; J. Hewett; I. Hinchliffe; C. J. Hogan; G. Höhler; P. Igo-Kemenes; J. D. Jackson; K. F. Johnson; D. Karlen; B. Kayser; D. Kirkby; S. R. Klein; K. Kleinknecht; I. G. Knowles; P. Kreitz; Yu. V. Kuyanov; O. Lahav; P. Langacker; A. Liddle; L. Littenberg; D. M. Manley; A. D. Martin; M. Narain; P. Nason; Y. Nir; J. A. Peacock; H. R. Quinn; S. Raby; B. N. Ratcliff; E. A. Razuvaev; B. Renk; G. Rolandi; M. T. Ronan; L. J. Rosenberg; C. T. Sachrajda; Y. Sakai; A. I. Sanda; S. Sarkar; M. Schmitt; O. Schneider; D. Scott; W. G. Seligman; M. H. Shaevitz; T. Sjöstrand; G. F. Smoot; S. Spanier; H. Spieler; N. J. C. Spooner; M. Srednicki; A. Stahl; T. Stanev; M. Suzuki; N. P. Tkachenko; G. H. Trilling; G. Valencia; K. van Bibber; M. G. Vincter; D. R. Ward; B. R. Webber; M. Whalley; L. Wolfenstein; J. Womersley; C. L. Woody; O. V. Zenin; R.-Y. Zhu

    2004-01-01

    A critical review is given of the current status of cosmological nucleosynthesis. In the framework of the standard model with 3 types of relativistic neutrinos, the baryon-to-photon ratio, \\\\eta, corresponding to the inferred primordial abundances of helium-4 and lithium-7 is presently ~2 \\\\sigma below the value implied by the abundance of deuterium. The latter value is also coincident with the

  5. [Proton therapy and particle accelerators].

    PubMed

    Fukumoto, Sadayoshi

    2012-01-01

    Since the high energy accelerator plan was changed from a 40 GeV direct machine to a 12GeV cascade one, a 500 MeV rapid cycling booster synchrotron was installed between the injector linac and the 12 GeV main ring at KEK, National Lab. for High Energy Physics. The booster beams were used not only for injection to the main ring but also for medical use. Their energy was reduced to 250 MeV by a graphite block for clinical trial of cancer therapy. In 1970's, pi(-) or heavy ions were supposed to be promising. Although advantage of protons with Bragg Peak was pointed out earlier, they seemed effective only for eye melanoma at that time. In early 1980's, it was shown that they were effective for deep-seated tumor by Tsukuba University with KEK beams. The first dedicated facility was built at Loma Linda University Medical Center. Its synchrotron was made by Fermi National Accelerator Lab. Since a non-resonant accelerating rf cavity was installed, operation of the synchrotron became much easier. Later, innovation of the cyclotron was achieved. Its weight was reduced from 1,000 ton to 200 ton. Some of the cyclotrons are equipped with superconducting coils. PMID:24592677

  6. Review of Particle Physics, 1998-1999

    E-print Network

    Particle Data Group. Berkeley; Aguilar-Benítez, M; Amsler, Claude; Armstrong, Betty; Babu, K S; Barnett, Richard Michael; Besson, Dave; Biebel, Otmar; Burchat, Patricia R; Cahn, Robert N; Carone, Christopher D; Casas-Serradilla, José Luís; Caso, Carlo; Conforto, Gianni; Crawford, Ronald L; Dahl, Orin; Dalitz, Richard Henry; Damour, Thibault Marie Alban Guillaume; Desler, Kai; Donahue, Richard J; Doser, Michael; Edwards, Donald A; Eidelman, Simon; Erler, Jens; Ezhela, Vladimir V; Fassò, A; Feng, Jonathan L; Fetscher, Wulf; Filimonov, Boris B; Froidevaux, Daniel; Gaisser, Thomas K; Garren, Lynn; Gee, Paul S; Geer, Steve; Gerber, Hans Jürg; Gilman, Frederick J; Goodman, Maury; Grab, C; Groom, Donald E; Gurtu, Atul; Haber, Howard E; Hagiwara, Kaoru; Hagmann, Christian; Hayes, Kenneth G; Hernández, Juan José; Hikasa, Ken Ichi; Hinchliffe, Ian; Hogan, Craig J; Honscheid, Klaus; Höhler, Gerhard; Jackson, John David; James, Frederick E; Johnson, Kurtis F; Karlen, Dean A; Kayser, Boris; Kleinknecht, Konrad; Knowles, Ian G; Kolda, Christopher; Kreitz, Pat; Landua, Rolf; Langacker, Paul; Littenberg, Laurence S; Lugovsky, S B; Mangano, Michelangelo L; Mankov, Serguei; Manley, D Mark; Manohar, Aneesh Vasant; March-Russell, John David; Murayama, Hitoshi; Mönig, Klaus; Nakada, Tatsuya; Nakamura, Kenzo; Nicholson, Flic; Olive, Keith A; Piepke, Andreas; Quinn, Helen R; Raffelt, Georg G; Renk, Burkhard; Ronan, Michael T; Roos, Matts; Rosenberg, Leslie J; Schindler, Rafe H; Schmitt, Michael; Schramm, David N; Scott, Douglas; Shrock, Robert E; Sjöstrand, Torbjörn; Smoot, George F; Spanier, Stefan; Srednicki, Mark A; Stanev, Todor; Suzuki, Mahiko; Tanabashi, Masaharu; Tkachenko, N P; Trippe, Thomas G; Törnqvist, N A; Valencia, German; Van Bibber, Karl; Vogel, Petr; Voss, Rüdiger; Wohl, Charles G; Wolfenstein, Lincoln; Workman, Ronald L; Yao Wei Ming; Youssef, Saul

    1998-01-01

    A comprehensive review of the field of Particle Physics produced by the Particle Data Group (PDG). Includes a compilation/evaluation of data on particle properties, summary tables with best values and limits for particle properties, extensive summari particles, and a long section of reviews, tables, and plots on a wide variety of theoretical and experimental topics of interest to particle and astrophysicists.

  7. Anticoagulation Drug Therapy: A Review

    PubMed Central

    Harter, Katherine; Levine, Michael; Henderson, Sean O.

    2015-01-01

    Historically, most patients who required parenteral anticoagulation received heparin, whereas those patients requiring oral anticoagulation received warfarin. Due to the narrow therapeutic index and need for frequent laboratory monitoring associated with warfarin, there has been a desire to develop newer, more effective anticoagulants. Consequently, in recent years many novel anticoagulants have been developed. The emergency physician may institute anticoagulation therapy in the short term (e.g. heparin) for a patient being admitted, or may start a novel anticoagulation for a patient being discharged. Similarly, a patient on a novel anticoagulant may present to the emergency department due to a hemorrhagic complication. Consequently, the emergency physician should be familiar with the newer and older anticoagulants. This review emphasizes the indication, mechanism of action, adverse effects, and potential reversal strategies for various anticoagulants that the emergency physician will likely encounter. PMID:25671002

  8. Magnetic particle hyperthermia—a promising tumour therapy?

    NASA Astrophysics Data System (ADS)

    Dutz, Silvio; Hergt, Rudolf

    2014-11-01

    We present a critical review of the state of the art of magnetic particle hyperthermia (MPH) as a minimal invasive tumour therapy. Magnetic principles of heating mechanisms are discussed with respect to the optimum choice of nanoparticle properties. In particular, the relation between superparamagnetic and ferrimagnetic single domain nanoparticles is clarified in order to choose the appropriate particle size distribution and the role of particle mobility for the relaxation path is discussed. Knowledge of the effect of particle properties for achieving high specific heating power provides necessary guidelines for development of nanoparticles tailored for tumour therapy. Nanoscale heat transfer processes are discussed with respect to the achievable temperature increase in cancer cells. The need to realize a well-controlled temperature distribution in tumour tissue represents the most serious problem of MPH, at present. Visionary concepts of particle administration, in particular by means of antibody targeting, are far from clinical practice, yet. On the basis of current knowledge of treating cancer by thermal damaging, this article elucidates possibilities, prospects, and challenges for establishment of MPH as a standard medical procedure.

  9. Novel technologies in charged particle therapy

    NASA Astrophysics Data System (ADS)

    Peach, K. J.

    2011-05-01

    Charged Particle Therapy (the use of protons and other light ions such as carbon to treat certain forms of cancer) is experiencing a rapid expansion in many parts of the world, and there are now more than 30 such centres operating in hospitals. The current technologies available use cyclotrons and synchrotrons to deliver the dose to the cancer. While each of these technologies is mature, and capable of treating cancer successfully, there is always room for improvement in technique, to reduce costs, increase throughput and availability and improve outcomes. This talk will discuss some recent development, using both traditional and laser-based accelerator techniques.

  10. Basics of particle therapy II biologic and dosimetric aspects of clinical hadron therapy.

    PubMed

    Rong, Yi; Welsh, James

    2010-12-01

    Besides photons and electrons, high-energy particles like protons, neutrons, ?He ions or heavier ions (C, Ne, etc) have been finding increasing applications in the treatment of radioresistant tumors and tumors located near critical structures. The main difference between photons and hadrons is their different biologic effect and depth-dose distribution. Generally speaking, protons are superior in dosimetric aspects whereas neutrons have advantages in biologic effectiveness because of the high linear energy transfer. In 1946 Robert Wilson first published the physical advantages in dose distribution of ion particles for cancer therapy. Since that time hadronic radiotherapy has been intensively studied in physics laboratories worldwide and clinical application have gradually come to fruition. Hadron therapy was made possible by the advances in accelerator technology, which increases the particles' energy high enough to place them at any depth within the patient's body. As a follow-up to the previous article Introduction to Hadrons, this review discusses certain biologic and dosimetric aspects of using protons, neutrons, and heavy charged particles for radiation therapy. PMID:20395789

  11. Targeted ?-Particle Therapy of Bone Metastases in Prostate Cancer

    PubMed Central

    Jadvar, Hossein; Quinn, David I.

    2013-01-01

    Medical oncology is moving toward personalized and precision treatments. This evolution is spearheaded by ongoing discoveries on the fundamental machinery that controls tumor and hosts microenvironment biological behavior. ?-Particles with their high energy and short range had long been recognized as potentially useful in the treatment of cancer. More than a century after the discovery of radium by the Curies, 223Ra dichloride is now available in the expanding armamentarium of therapies for metastatic castration-resistant prostate cancer. This advance occurs in the context of several other novel therapeutics in advanced prostate cancer that include more effective androgen receptor pathway inhibition, better chemotherapy, and immunotherapy. We present a concise review on the therapeutic use of 223Ra dichloride in this clinically important setting including excerpts on the radium history, physical properties, the alpharadin in symptomatic prostate cancer clinical trial, and practical information on its use in the clinic. It is anticipated that, with the current emergence of 223Ra as a viable form of therapy, interest in and use of ?-particle therapy in the management of cancer will grow. PMID:24212441

  12. Extracorporeal shockwave therapy: a review.

    PubMed

    Chung, Bryan; Wiley, J Preston

    2002-01-01

    Extracorporeal shockwave therapy (ESWT) has been in use for the treatment of tendinopathies since the early 1990s. The exact mechanism by which ESWT relieves tendon-associated pain is not known; however, there is an increasing body of literature that suggests that it can be an effective therapy for patients who have had repeated nonsurgical treatment failures. The highest strength of evidence is shown in randomised controlled trials, of which there are a small number. Reported results for tendinopathies of the shoulder, elbow and heel have shown consistent positive results in favour of ESWT over placebo ESWT in individuals who have failed conservative therapy. These studies provide strong evidence for ESWT as an effective therapy for the treatment of chronic treatment-resistant tendinopathies. There is still much debate over several issues surrounding ESWT that have not been adequately addressed by the literature: high- versus low-energy ESWT, shockwave dosage and number of sessions required for a therapeutic effect. Further research is needed to ascertain the most beneficial protocol for patient care. PMID:12392445

  13. Hepatocellular Carcinoma Radiation Therapy: Review of Evidence and Future Opportunities

    SciTech Connect

    Klein, Jonathan [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Dawson, Laura A., E-mail: laura.dawson@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada)

    2013-09-01

    Hepatocellular carcinoma (HCC) is a leading cause of global cancer death. Curative therapy is not an option for most patients, often because of underlying liver disease. Experience in radiation therapy (RT) for HCC is rapidly increasing. Conformal RT can deliver tumoricidal doses to focal HCC with low rates of toxicity and sustained local control in HCC unsuitable for other locoregional treatments. Stereotactic body RT and particle therapy have been used with long-term control in early HCC or as a bridge to liver transplant. RT has also been effective in treating HCC with portal venous thrombosis. Patients with impaired liver function and extensive disease are at increased risk of toxicity and recurrence. More research on how to combine RT with other standard and novel therapies is warranted. Randomized trials are also needed before RT will be generally accepted as a treatment option for HCC. This review discusses the current state of the literature and opportunities for future research.

  14. Reducing the uncertainties in particle therapy

    NASA Astrophysics Data System (ADS)

    Oancea, C.; Shipulin, K. N.; Mytsin, G. V.; Luchin, Y. I.

    2015-02-01

    The use of fundamental Nuclear Physics in Nuclear Medicine has a significant impact in the fight against cancer. Hadrontherapy is an innovative cancer radiotherapy method using nuclear particles (protons, neutrons and ions) for the treatment of early and advanced tumors. The main goal of proton therapy is to deliver high radiation doses to the tumor volume with minimal damage to healthy tissues and organs. The purpose of this work was to investigate the dosimetric errors in clinical proton therapy dose calculation due to the presence of metallic implants in the treatment plan, and to determine the impact of the errors. The results indicate that the errors introduced by the treatment planning systems are higher than 10% in the prediction of the dose at isocenter when the proton beam is passing directly through a metallic titanium alloy implant. In conclusion, we recommend that pencil-beam algorithms not be used when planning treatment for patients with titanium alloy implants, and to consider implementing methods to mitigate the effects of the implants.

  15. Aspect of Thrombolytic Therapy: A Review

    PubMed Central

    Ali, Md. Ramjan; Salim Hossain, Mohammad; Saiful Islam Arman, Md.; Sarwar Raju, Golam; Dasgupta, Prianka; Noshin, Tasnim Fariha

    2014-01-01

    Thrombolytic therapy, also known as clot busting drug, is a breakthrough treatment which has saved untold lives. It has been used in the clinical area to treat venous and arterial thromboembolic complaints which are a foremost cause of death. In 1761, Morgagni lead the way of thrombolytic therapy. Now day's different types of thrombolytic drugs are currently available in market: alteplase, anistreplase, urokinase, streptokinase, tenecteplase, and so forth. Thrombolytic therapy should be given with maintaining proper care in order to minimize the risk of clinically important bleeding as well as enhance the chances of successfully thrombolysis of clot. These cares include preinfusion care, during the infusion care, and postinfusion care. Besides proper knowledge of contraindication, evolutionary factor, and combination of drug is essential for successful thrombolytic therapy. In these review we discussed about these aspect of thrombolytic therapy. PMID:25574487

  16. Effects of voice therapy: a systematic review.

    PubMed

    Speyer, R

    2008-09-01

    Medical as well as paramedical treatments should be evaluated by scientific methods. This systematic review focuses on the effects of voice therapy, excluding pharmacological or surgical treatments. In general, statistically significant positive but modest and varying therapy effects are found. Many of these effect studies cope with diverse methodological problems. Furthermore, the conclusions of most studies cannot be generalized easily or compared to one another. As a consequence, many issues in the field of effects of voice therapy have yet been unanswered. PMID:17509828

  17. Respiratory motion management in particle therapy

    SciTech Connect

    Rietzel, Eike; Bert, Christoph [Abteilung Biophysik, GSI Helmholtzzentrum fuer Schwerionenforschung, Planckstrasse 1, 64291 Darmstadt (Germany) and Siemens Healthcare Sector, Workflow and Solutions, Particle Therapy, Hofmannstrasse 26, 91052 Erlangen (Germany); Abteilung Biophysik, GSI Helmholtzzentrum fuer Schwerionenforschung, Planckstrasse 1, 64291 Darmstadt (Germany)

    2010-02-15

    Clinical outcomes of charged particle therapy are very promising. Currently, several dedicated centers that use scanning beam technology are either close to clinical use or under construction. Since scanned beam treatments of targets that move with respiration most likely result in marked local over- and underdosage due to interplay of target motion and dynamic beam application, dedicated motion mitigation techniques have to be employed. To date, the motion mitigation techniques, rescanning, beam gating, and beam tracking, have been proposed and tested in experimental studies. Rescanning relies on repeated irradiations of the target with the number of particles reduced accordingly per scan to statistically average local misdosage. Specific developments to prohibit temporal correlation between beam scanning and target motion will be required to guarantee adequate averaging. For beam gating, residual target motion within gating windows has to be mitigated in order to avoid local misdosage. Possibly the most promising strategy is to increase the overlap of adjacent particle pencil beams laterally as well as longitudinally to effectively reduce the sensitivity against small residual target motion. The most conformal and potentially most precise motion mitigation technique is beam tracking. Individual particle pencil beams have to be adapted laterally as well as longitudinally according to the target motion. Within the next several years, it can be anticipated that rescanning as well as beam gating will be ready for clinical use. For rescanning, treatment planning margins that incorporate the full extent of target motion as well as motion induced density variations in the beam paths will result in reduced target conformity of the applied dose distributions. Due to the limited precision of motion monitoring devices, it seems likely that beam gating will be used initially to mitigate interplay effects only but not to considerably decrease treatment planning margins. Then, in the next step, beam gating, based on more accurate motion monitoring systems, provides the possibility to restore target conformity as well as steep dose gradients due to reduced treatment planning margins. Accurate motion monitoring systems will be required for beam tracking. Even though beam tracking has already been successfully tested experimentally, full clinical implementation requires direct feedback of the actual target position in quasireal time to the treatment control system and can be anticipated to be several more years ahead.

  18. review article Anabolic Skeletal Therapy for Osteoporosis

    Microsoft Academic Search

    Monica Girotra; Mishaela R. Rubin; John P. Bilezikian

    2006-01-01

    Antiresorptive agents for osteoporosis are a cornerstone of therapy, but anabolic drugs have recently widened our therapeutic options. By directly stimulating bone formation, anabolic agents reduce fracture incidence by improving bone qualities besides increasing bone mass. In this article, we review the role of anabolic treatment for osteoporosis. The only anabolic agent currently approved in the United States for osteo-

  19. Particle Beam Therapy for Cancer of the Skull Base, Nasal Cavity, and Paranasal Sinus

    PubMed Central

    Fukumitsu, Nobuyoshi

    2012-01-01

    Particle beam therapy has been rapidly developed in these several decades. Proton and carbon ion beams are most frequently used in particle beam therapy. Proton and carbon ion beam radiotherapy have physical and biological advantage to the conventional photon radiotherapy. Cancers of the skull base, nasal cavity, and paranasal sinus are rare; however these diseases can receive the benefits of particle beam radiotherapy. This paper describes the clinical review of the cancer of the skull base, nasal cavity, and paranasal sinus treated with proton and carbon ion beams, adding some information of feature and future direction of proton and carbon ion beam radiotherapy. PMID:23724275

  20. Ozone therapy: A clinical review

    PubMed Central

    Elvis, A. M.; Ekta, J. S.

    2011-01-01

    Ozone (O3) gas discovered in the mid-nineteenth century is a molecule consisting of three atoms of oxygen in a dynamically unstable structure due to the presence of mesomeric states. Although O3 has dangerous effects, yet researchers believe it has many therapeutic effects. Ozone therapy has been utilized and heavily studied for more than a century. Its effects are proven, consistent, safe and with minimal and preventable side effects. Medical O3 is used to disinfect and treat disease. Mechanism of actions is by inactivation of bacteria, viruses, fungi, yeast and protozoa, stimulation of oxygen metabolism, activation of the immune system. Medication forms in a gaseous state are somewhat unusual, and it is for this reason that special application techniques have had to be developed for the safe use of O3. In local applications as in the treatment of external wounds, its application in the form of a transcutaneous O3 gas bath has established itself as being the most practical and useful method, for example at low (sub-atmospheric) pressure in a closed system guaranteeing no escape of O3 into the surrounding air. Ozonized water, whose use is particularly known in dental medicine, is optimally applied as a spray or compress. Diseases treated are infected wounds, circulatory disorders, geriatric conditions, macular degeneration, viral diseases, rheumatism/arthritis, cancer, SARS and AIDS. PMID:22470237

  1. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...false Medical charged-particle radiation therapy system. 892.5050 ...5050 Medical charged-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system is a device...

  2. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...false Medical charged-particle radiation therapy system. 892.5050 ...5050 Medical charged-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system is a device...

  3. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...false Medical charged-particle radiation therapy system. 892.5050 ...5050 Medical charged-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system is a device...

  4. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...false Medical charged-particle radiation therapy system. 892.5050 ...5050 Medical charged-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system is a device...

  5. 21 CFR 892.5050 - Medical charged-particle radiation therapy system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...false Medical charged-particle radiation therapy system. 892.5050 ...5050 Medical charged-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system is a device...

  6. Clinical review: Timing of renal replacement therapy

    PubMed Central

    2011-01-01

    Acute kidney injury is common in intensive care patients and continuous renal replacement therapy is the preferred treatment for this in most centres. Although these techniques have been adopted internationally, there remains significant variation with regard to their clinical application. This is particularly pertinent when one considers that the fundamental questions regarding any treatment, such as initiation, dose and length of treatment, remain a source of debate and have not as yet all been fully answered. In this narrative review we consider the timing of renal replacement therapy, highlighting the relative paucity of high quality data regarding this fundamental question. We examine the role of the usual biochemical criteria as well as conventional clinical indications for commencing renal replacement therapy together with the application of recent classification systems, namely RIFLE and AKIN. We discuss the potential role of biomarkers for acute kidney injury as predictors for the need for renal support and discuss commencing therapy for indications other than acute kidney injury. PMID:21672279

  7. Review of pharmacological therapies in fibromyalgia syndrome

    PubMed Central

    2014-01-01

    This review addresses the current status of drug therapy for the management of fibromyalgia syndrome (FMS) and is based on interdisciplinary FMS management guidelines, meta-analyses of drug trial data, and observational studies. In the absence of a single gold-standard medication, patients are treated with a variety of drugs from different categories, often with limited evidence. Drug therapy is not mandatory for the management of FMS. Pregabalin, duloxetine, milnacipran, and amitriptyline are the current first-line prescribed agents but have had a mostly modest effect. With only a minority of patients expected to experience substantial benefit, most will discontinue therapy because of either a lack of efficacy or tolerability problems. Many drug treatments have undergone limited study and have had negative results. It is unlikely that these failed pilot trials will undergo future study. However, medications, though imperfect, will continue to be a component of treatment strategy for these patients. Both the potential for medication therapy to relieve symptoms and the potential to cause harm should be carefully considered in their administration. PMID:24433463

  8. A Systematic Review of Randomized Controlled Studies of Art Therapy

    ERIC Educational Resources Information Center

    Maujean, Annick; Pepping, Christopher A.; Kendall, Elizabeth

    2014-01-01

    This review article examines current knowledge about the efficacy of art therapy based on the findings of 8 randomized controlled trials (RCTs) conducted with adult populations from 2008-2013 that met a high standard of rigor. Of these studies, all but one reported beneficial effects of art therapy. Review findings suggest that art therapy may…

  9. What’s new in particle therapy accelerator technology

    NASA Astrophysics Data System (ADS)

    Flanz, Jacob B.

    2007-08-01

    Recently, particle therapy has entered a new age. The number of facilities opening and under construction is at an all time high. We are now at an interesting time in the cycle of product development and 'consumer' interest, where; on the one hand, the interest in the technique has encouraged some groups who are working on new ideas; but on the other hand, existing product production, to reduce costs and improve procurement, installation and commissioning time tends to reduce the degree of change that can be considered in a system. This paper summarizes some of the current requirements and directions in particle therapy accelerator technology.

  10. Courseware Review: CONDUIT: Scatter--Particle Scattering.

    ERIC Educational Resources Information Center

    Risley, John S.; Grabel, Lisa

    1983-01-01

    Reviews "Scatter," a software package consisting of three programs designed to help students "see" results of particle scattering and representative concepts difficult to show in introductory laboratories. Includes source, equipment needed, physics level, time involvement, interaction, and nature of programs. Recommends only the first part of the…

  11. Music therapy in pediatric oncology: a review of the literature.

    PubMed

    Hilliard, Russell E

    2006-01-01

    The review of literature provides an overview of both qualitative and quantitative research studies in the area of pediatric oncology music therapy. A total of 12 studies were reviewed. Eight used qualitative and four used quantitative research methods. All articles were published in peer-reviewed journals. This review summarizes the use of music therapy in treating the physical, emotional , social, and developmental needs of children undergoing curative and palliative treatment for cancer. PMID:19442340

  12. A review of novel therapies for melanoma.

    PubMed

    Karimkhani, Chante; Gonzalez, Rene; Dellavalle, Robert P

    2014-08-01

    This review summarizes results from major recent trials regarding novel therapeutic agents in melanoma. The topics discussed include targeted therapy with BRAF (V-RAF murine sarcoma viral oncogene homolog B) inhibitors (vemurafenib and dabrafenib), MEK (mitogen-activated protein kinase kinase) inhibitors (trametinib), bcr-abl/c-kit/PDGF-R inhibitors (imatinib), and angiogenesis inhibitors (bevacizumab and aflibercept), as well as immunotherapy with anti-CTLA-4 (anti-cytotoxic T-lymphocyte antigen-4) antibodies (ipilimumab), anti-PD (anti-programmed death receptor) antibodies (nivolumab and lambrolizumab), and anti-PD-L (anti-programmed death ligand) antibodies. Various combinations of these agents, as well as adjunctive GM-CSF (granulocyte-macrophage colony-stimulating factor), T-VEC (talimogene laherparepvec) oncolytic viruses, and novel chemotherapeutic agents, are also described. Despite the tremendous advances that these novel treatments have created, optimal therapeutic agent selection remains a highly individualized decision. Melanoma therapy has vastly progressed since the days when dacarbazine was the sole option for advanced melanoma patients. The molecular understanding of melanoma pathogenesis has yielded a brighter future for advanced melanoma patients. PMID:24928310

  13. REVIEW Open Access Cell therapy using tolerogenic dendritic cells in

    E-print Network

    Paris-Sud XI, Université de

    REVIEW Open Access Cell therapy using tolerogenic dendritic cells in transplantation Aurélie Moreau with cell therapy using regulatory cells. In our laboratory, as part of a European project, we plan to test the safety of tolerogenic dendritic cell (TolDC) therapy in kidney transplant patients. In this mini

  14. MINI REVIEW MODIFIED ADENOVIRUSES FOR CANCER GENE THERAPY

    E-print Network

    Hemminki, Akseli

    ,2 * 1 Cancer Gene Therapy Group, Rational Drug Design, Biomedicum Helsinki, University of HelsinkiMINI REVIEW MODIFIED ADENOVIRUSES FOR CANCER GENE THERAPY Anna KANERVA 1­3 and Akseli HEMMINKI 1 is an exciting novel approach for treating cancers resistant to currently available therapies. However, currently

  15. Family therapy supervision: A review and critique of the literature

    Microsoft Academic Search

    Craig A. Everett; Barbara J. Koerpel

    1986-01-01

    This article reviews literature related to family therapy supervision which appeared in major journals between 1980 and August, 1985. The authors conclude that the level of theoretical inquiry and research regarding family therapy supervision has not kept pace with broader developments in theory and practice in the field. A selected review of clinical supervision literature from allied disciplines is included

  16. Complementary therapies for reducing body weight: a systematic review

    Microsoft Academic Search

    M H Pittler; E Ernst

    2005-01-01

    The prevalence of obesity is increasing at an alarming rate and a plethora of complementary therapies are on offer claiming effectiveness for reducing body weight. The aim of this systematic review is to critically assess the evidence from randomized controlled trials (RCTs) and systematic reviews of complementary therapies for reducing body weight. Literature searches were conducted on Medline, Embase, Amed,

  17. Glycolic acid peel therapy – a current review

    PubMed Central

    Sharad, Jaishree

    2013-01-01

    Chemical peels have been time-tested and are here to stay. Alpha-hydroxy peels are highly popular in the dermatologist’s arsenal of procedures. Glycolic acid peel is the most common alpha-hydroxy acid peel, also known as fruit peel. It is simple, inexpensive, and has no downtime. This review talks about various studies of glycolic acid peels for various indications, such as acne, acne scars, melasma, postinflammatory hyperpigmentation, photoaging, and seborrhea. Combination therapies and treatment procedure are also discussed. Careful review of medical history, examination of the skin, and pre-peel priming of skin are important before every peel. Proper patient selection, peel timing, and neutralization on-time will ensure good results, with no side effects. Depth of the glycolic acid peel depends on the concentration of the acid used, the number of coats applied, and the time for which it is applied. Hence, it can be used as a very superficial peel, or even a medium depth peel. It has been found to be very safe with Fitzpatrick skin types I–IV. All in all, it is a peel that is here to stay. PMID:24399880

  18. Realizing the potential of the Actinium-225 radionuclide generator in targeted alpha-particle therapy applications

    PubMed Central

    Miederer, Matthias; Scheinberg, David A.; McDevitt, Michael R.

    2013-01-01

    Alpha particle-emitting isotopes have been proposed as novel cytotoxic agents for augmenting targeted therapy. Properties of alpha particle radiation such as their limited range in tissue of a few cell diameters and their high linear energy transfer leading to dense radiation damage along each alpha track are promising in the treatment of cancer, especially when single cells or clusters of tumor cells are targeted. Actinium-225 (225Ac) is an alpha particle-emitting radionuclide that generates 4 net alpha particle isotopes in a short decay chain to stable 209Bi, and as such can be described as an alpha particle nanogenerator. This article reviews the literature pertaining to the research, development, and utilization of targeted 225Ac to potently and specifically affect cancer. PMID:18514364

  19. Realizing the potential of the Actinium-225 radionuclide generator in targeted alpha particle therapy applications.

    PubMed

    Miederer, Matthias; Scheinberg, David A; McDevitt, Michael R

    2008-09-01

    Alpha particle-emitting isotopes have been proposed as novel cytotoxic agents for augmenting targeted therapy. Properties of alpha particle radiation such as their limited range in tissue of a few cell diameters and their high linear energy transfer leading to dense radiation damage along each alpha track are promising in the treatment of cancer, especially when single cells or clusters of tumor cells are targeted. Actinium-225 (225 Ac) is an alpha particle-emitting radionuclide that generates 4 net alpha particle isotopes in a short decay chain to stable 209 Bi, and as such can be described as an alpha particle nanogenerator. This article reviews the literature pertaining to the research, development, and utilization of targeted 225 Ac to potently and specifically affect cancer. PMID:18514364

  20. Concise Review: Cell Therapy and Tissue Engineering for Cardiovascular Disease

    PubMed Central

    Haraguchi, Yuji; Shimizu, Tatsuya; Yamato, Masayuki

    2012-01-01

    Cardiovascular disease is a major cause of morbidity and mortality, especially in developed countries. Various therapies for cardiovascular disease are investigated actively and are performed clinically. Recently, cell-based regenerative medicine using several cell sources has appeared as an alternative therapy for curing cardiovascular diseases. Scaffold-based or cell sheet-based tissue engineering is focused as a new generational cell-based regenerative therapy, and the clinical trials have also been started. Cell-based regenerative therapies have an enormous potential for treating cardiovascular disease. This review summarizes the recent research of cell sources and cell-based-regenerative therapies for cardiovascular diseases. PMID:23197760

  1. E-Therapy for mental health problems : a systematic review

    Microsoft Academic Search

    Marloes G. Postel; Hein A. de Haan; Cor A. J. De Jong

    2008-01-01

    The widespread availability of the Internet offers opportunities for improving access to therapy for people with mental health problems. There is a seemingly infinite supply of Internet-based interventions available on the World Wide Web. The aim of the present study is to systematically assess the methodological quality of randomized controlled trials (RCTs) concerning e-therapy for mental health problems. Two reviewers

  2. Occupational therapy for community dwelling elderly people: a systematic review

    Microsoft Academic Search

    ESTHER M. J. STEULTJENS; JOOST DEKKER; LEX M. BOUTER; SANDRA JELLEMA; ERICA B. BAKKER; CORNELIA H. M. VAN DEN ENDE

    Objective: occupational therapy might play an important role in maintaining independent living for community dwelling elderly people. The aim of this systematic review is to determine whether occupational therapy improves outcome for people who are ?60 years and are living independently. Methods: an extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH until July 2002 was per- formed. Studies with

  3. Occupational therapy for community dwelling elderly people: a systematic review

    Microsoft Academic Search

    E. M. J. Steultjens; J. Dekker; L. M. Bouter; S. Jellema; E. B. Bakker; C. H. M. van den Ende

    2004-01-01

    OBJECTIVE: Occupational therapy might play an important role in maintaining independent living for community dwelling elderly people. The aim of this systematic review is to determine whether occupational therapy improves outcome for people who are >\\/=60 years and are living independently. METHODS: An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH until July 2002 was performed. Studies with controlled

  4. Systemic therapy for advanced hepatocellular carcinoma: a review

    Microsoft Academic Search

    Anna K Nowak; Pierce K. H Chow; Michael Findlay

    2004-01-01

    Hepatocellular carcinoma (HCC) is a common cause of cancer mortality worldwide. Whilst local treatments are useful in selected patients, they are not suitable for many with advanced disease. Here, we review phase II and III trials for systemic therapy of advanced disease, finding no strong evidence that any chemotherapy, hormonal therapy, or immunotherapy regimen trialled to date benefits survival in

  5. Accelerators for charged particle therapy: PAMELA and related issues

    NASA Astrophysics Data System (ADS)

    Peach, Ken

    2014-05-01

    Cancer is a dreadful disease that will affect one in three people at some point in their life; radiotherapy is used in more than half of all cancer treatment, and contributes about 40% to the successful treatment of cancer. Charged Particle Therapy uses protons and other light ions to deliver the lethal dose to the tumor while being relatively sparing of healthy tissue and, because of the finite range of the particles, is able to avoid giving any dose to vital organs. While there are adequate technologies currently available to deliver the required energies and fluxes, the two main technologies (cyclotrons and synchrotrons) have limitations. PAMELA (the Particle Accelerator for MEdicaL Applications) uses the newly-developed non-scaling Fixed Field Alternating Gradient accelerator concepts to deliver therapeutically relevant beams. The status of the development of the PAMELA conceptual design is discussed.

  6. Research Ethics: Institutional Review Board Oversight of Art Therapy Research

    Microsoft Academic Search

    Sarah P. Deaver

    2011-01-01

    By having their research proposals reviewed and approved by Institutional Review Boards (IRBs), art therapists meet important ethical principles regarding responsibility to research participants. This article provides an overview of the history of human subjects protections in the United States; underlying ethical principles and their application in research practice; and a discussion of concerns nonmedical, post-positivist art therapy researchers need

  7. Gene therapy and uterine leiomyoma: a review

    Microsoft Academic Search

    Ayman Al-Hendy; Salama Salama

    2006-01-01

    Leiomyomas (fibroids) are common estrogen-dependent uterine tumours that cause significant morbidity for women and a substantial economic impact on health delivery systems. Currently, there is no effective medical treatment option for this condition—hysterectomy is the mainstay of management. This is not an attractive choice for many women, especially patients desiring to preserve their fertility potential. Gene therapy is becoming a

  8. Gene therapy and uterine leiomyoma: a review.

    PubMed

    Al-Hendy, Ayman; Salama, Salama

    2006-01-01

    Leiomyomas (fibroids) are common estrogen-dependent uterine tumours that cause significant morbidity for women and a substantial economic impact on health delivery systems. Currently, there is no effective medical treatment option for this condition-hysterectomy is the mainstay of management. This is not an attractive choice for many women, especially patients desiring to preserve their fertility potential. Gene therapy is becoming a clinical reality, with more than 600 clinical trials worldwide. Researchers have recently attempted to develop a gene-therapy-based approach for the ablation of uterine fibroids. The localized nature of this condition and its accessibility using different imaging or endoscopic techniques make it an attractive target for direct delivery of gene-based vectors. Recent work from our laboratory suggests the potential use of a dominant-negative form of estrogen receptor (ER) to inactivate estrogen signalling in leiomyoma cells and induce apoptosis. Our in vivo data in a mouse model demonstrate the ability of an adenovirus-expressing dominant-negative ER to arrest leiomyoma growth. We and others also have described the utility of the herpes simplex virus-thymidine kinase (HSV-TK) plus ganciclovir (GCV) suicide gene-therapy system to effectively eradicate leiomyoma cells by utilizing the bystandard effect phenomena and the high expression of gap-junction protein in these tumours. Further work on rat models will pave the way for future leiomyoma gene-therapy clinical trials and allow the realization of gene therapy as a viable non-surgical option for this common problem in women's health. PMID:16603566

  9. Agonist replacement therapy for cocaine dependence: a translational review

    PubMed Central

    Rush, Craig R; Stoops, William W

    2012-01-01

    Cocaine use disorders are prevalent throughout the world. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. This paper reviews the translational literature, including preclinical experiments, human laboratory studies and clinical trials, to determine whether agonist-replacement therapy is a viable strategy for managing cocaine dependence. Discussion is limited to transporter blockers (i.e., methylphenidate) and releasers (i.e., amphetamine analogs) that are available for use in humans in the hope of impacting clinical research and practice more quickly. The translational review suggests that agonist-replacement therapy, especially monoamine releasers, may be effective for managing cocaine dependence. Future directions for medications development are also discussed because the viability of agonist-replacement therapy for cocaine dependence may hinge on identifying novel compounds or formulations that have less abuse and diversion potential. PMID:22300101

  10. A review of anabolic therapies for osteoporosis

    Microsoft Academic Search

    Ariella Kelman

    2003-01-01

    Osteoporosis results from a loss of bone mass and bone structure such that the bone becomes weak and fractures with very little\\u000a trauma. Until recently, the approved osteoporosis therapies prevented more bone loss by altering osteoclast activity and lifespan.\\u000a Recently, attention has turned away from osteoclast inhibition to agents that can stimulate the osteoblast to form new bone,\\u000a or anabolic

  11. Is EMDR an Exposure Therapy? A Review of Trauma Protocols

    E-print Network

    Susan Rogers; Steven M. Silver

    This article presents the well established theoretical base and clinical practice of exposure therapy for trauma. Necessary requirements for positive treatment results and contraindicated procedures are reviewed. EMDR is contrasted with these requirements and procedures. By the definitions and clinical practice of exposure therapy, the classification of EMDR poses some problems. As seen from the exposure therapy paradigm, its lack of physiological habituation and use of spontaneous association should result in negligible or negative effects rather than the well researched positive outcomes. Possible reasons for the effectiveness of EMDR are discussed, ranging from the fundamental nature of trauma reactions to the nonexposure mechanisms utilized in information processing models. © 2002 John

  12. Outcome Studies on the Efficacy of Art Therapy: A Review of Findings

    Microsoft Academic Search

    Sarah C. Slayton; Jeanne DArcher; Frances Kaplan

    2010-01-01

    In response to a review by Reynolds, Nabors, and Quinlan (2000) of the art therapy literature prior to 1999, this review article identifies studies from 1999–2007 that measured outcomes of art therapy effectiveness with all ages of clinical and nonclinical populations. Although numerous studies blend art therapy with other modalities, this review is limited to studies that isolate art therapy

  13. Pulmonary toxicities from targeted therapies: a review.

    PubMed

    Barber, Nicholas A; Ganti, Apar Kishor

    2011-12-01

    Pulmonary toxicity is rarely seen with most commonly used targeted therapies. The endothelial growth factor receptor (EGFR) small-molecule tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib can cause interstitial lung disease (ILD). BCR-ABL tyrosine kinase inhibitors imatinib and dasatinib can cause pleural effusions. Infusion-related bronchospasm is common with the monoclonal antibodies to EGFR cetuximab and panitumumab, and case reports of bronchiolitis and pulmonary fibrosis have been described. Up to one-sixth of patients taking mammalian target of rapamycin (mTOR) inhibitors get a reversible interstitial pneumonitis. Bevacizumab, the monoclonal antibody to vascular endothelial growth factor (VEGF), has been associated with hemoptysis and pulmonary embolism particularly in patients with squamous cell lung cancer. Infusion-related bronchospasms, acute respiratory distress syndrome (ARDS), and interstitial pneumonitis can be seen with the anti-lymphocyte monoclonal antibodies rituximab, ofatumumab, and alemtuzumab. While most pulmonary toxicities from these therapies are mild and resolve promptly with dose reduction or discontinuation, it is important for the clinician to recognize these potential toxicities when faced with treatment-related complications. Discerning these pulmonary adverse effects may help in making decisions on diagnostic testing and therapy, particularly for those with pulmonary and cardiovascular co-morbidities. PMID:22076388

  14. Newer agents in antiplatelet therapy: a review

    PubMed Central

    Yeung, Jennifer; Holinstat, Michael

    2012-01-01

    Antiplatelet therapy remains the mainstay in preventing aberrant platelet activation in pathophysiological conditions such as myocardial infarction, ischemia, and stroke. Although there has been significant advancement in antiplatelet therapeutic approaches, aspirin still remains the gold standard treatment in the clinical setting. Limitations in safety, efficacy, and tolerability have precluded many of the antiplatelet inhibitors from use in patients. Unforeseen incidences of increased bleeding risk and recurrent arterial thrombosis observed in patients have hampered the development of superior next generation antiplatelet therapies. The pharmacokinetic and pharmacodynamic profiles have also limited the effectiveness of a number of antiplatelet inhibitors currently in use due to variability in metabolism, time to onset, and reversibility. A focused effort in the development of newer antiplatelet therapies to address some of these shortcomings has resulted in a significant number of potential antiplatelet drugs which target enzymes (phosphodiesterase, cyclooxygenase), receptors (purinergic, prostaglandins, protease-activated receptors, thromboxane), and glycoproteins (?IIb?3, GPVI, vWF, GPIb) in the platelet. The validation and search for newer antiplatelet therapeutic approaches proven to be superior to aspirin is still ongoing and should yield a better pharmacodynamic profile with fewer untoward side-effects to what is currently in use today. PMID:22792011

  15. Therapy gloves for patients with rheumatoid arthritis: a review

    PubMed Central

    Troynikov, Olga; Massy-Westropp, Nicola

    2014-01-01

    Rheumatoid arthritis is a chronic inflammatory disease that causes pain, joint stiffness and swelling leading to impaired hand function and difficulty with daily activities. Wearing therapy gloves has been recommended by occupational therapists as one of the alternative treatment methods for rheumatoid arthritis. This study aims to review the available literature on the effects of wearing therapy gloves on patients’ hand function and symptoms as well as to discuss the attributes of gloves that might influence the glove performance. An electronic databases search of MEDLINE, Physiotherapy Evidence Database, Occupational Therapy Systematic Evaluation of Evidence, Wiley Online Library, ScienceDirect and Cochrane Central Register of Controlled Trial was performed. Eight articles met the inclusion criteria, and covered seven clinical trials and one case study. Seven outcome measures were identified from the included studies and were then classified into two categories: hand function and hand symptoms. The hand symptoms such as pain, stiffness and swelling improve substantially when the therapy gloves are used. However, marginal or no improvement in hand function (with the exception of grip strength) linked to the use of therapy gloves is being reported. Further research is needed to quantify the effectiveness of therapy gloves, especially in improvement of hand function and in patients’ interest in wearing therapy gloves. Furthermore, future studies should include parameters which might influence therapy gloves’ performance, such as duration of trials, interface pressure generated by the gloves on the underlying skin and tissue, glove fit and construction, as well as thermophysiological comfort. PMID:25435925

  16. Therapy gloves for patients with rheumatoid arthritis: a review.

    PubMed

    Nasir, Siti Hana; Troynikov, Olga; Massy-Westropp, Nicola

    2014-12-01

    Rheumatoid arthritis is a chronic inflammatory disease that causes pain, joint stiffness and swelling leading to impaired hand function and difficulty with daily activities. Wearing therapy gloves has been recommended by occupational therapists as one of the alternative treatment methods for rheumatoid arthritis. This study aims to review the available literature on the effects of wearing therapy gloves on patients' hand function and symptoms as well as to discuss the attributes of gloves that might influence the glove performance. An electronic databases search of MEDLINE, Physiotherapy Evidence Database, Occupational Therapy Systematic Evaluation of Evidence, Wiley Online Library, ScienceDirect and Cochrane Central Register of Controlled Trial was performed. Eight articles met the inclusion criteria, and covered seven clinical trials and one case study. Seven outcome measures were identified from the included studies and were then classified into two categories: hand function and hand symptoms. The hand symptoms such as pain, stiffness and swelling improve substantially when the therapy gloves are used. However, marginal or no improvement in hand function (with the exception of grip strength) linked to the use of therapy gloves is being reported. Further research is needed to quantify the effectiveness of therapy gloves, especially in improvement of hand function and in patients' interest in wearing therapy gloves. Furthermore, future studies should include parameters which might influence therapy gloves' performance, such as duration of trials, interface pressure generated by the gloves on the underlying skin and tissue, glove fit and construction, as well as thermophysiological comfort. PMID:25435925

  17. review The American Society of Gene & Cell Therapy Molecular Therapy vol. 20 no. 4, 699708 apr. 2012 699

    E-print Network

    Schaffer, David V.

    review© The American Society of Gene & Cell Therapy Molecular Therapy vol. 20 no. 4, 699­708 apr clinical trials for gene therapy of inherited and acquired diseases using first generation AAV2 vectors-related macular degeneration.2 Perhaps the most striking example of successful gene therapy in a clinical setting

  18. STFC 2009 PARTICLE PHYSICS REVIEW -EXPERIMENTS AND EXPERIMENTAL ROLLING GRANTS

    E-print Network

    STFC 2009 PARTICLE PHYSICS REVIEW - EXPERIMENTS AND EXPERIMENTAL ROLLING GRANTS Guidelines A ­ 2009 Review of Experimental Particle Physics Rolling Grants 3 ­ Guidelines for Applicants 1 Procedures.3 Responsive-Mode Posts 7 3.4 Ring-Fenced Posts 7 1 #12;2 4 Requesting Resources 9 4.1 Full Economic Costs 9 4

  19. Review of Fast Monte Carlo Codes for Dose Calculation in Radiation Therapy Treatment Planning

    PubMed Central

    Jabbari, Keyvan

    2011-01-01

    An important requirement in radiation therapy is a fast and accurate treatment planning system. This system, using computed tomography (CT) data, direction, and characteristics of the beam, calculates the dose at all points of the patient's volume. The two main factors in treatment planning system are accuracy and speed. According to these factors, various generations of treatment planning systems are developed. This article is a review of the Fast Monte Carlo treatment planning algorithms, which are accurate and fast at the same time. The Monte Carlo techniques are based on the transport of each individual particle (e.g., photon or electron) in the tissue. The transport of the particle is done using the physics of the interaction of the particles with matter. Other techniques transport the particles as a group. For a typical dose calculation in radiation therapy the code has to transport several millions particles, which take a few hours, therefore, the Monte Carlo techniques are accurate, but slow for clinical use. In recent years, with the development of the ‘fast’ Monte Carlo systems, one is able to perform dose calculation in a reasonable time for clinical use. The acceptable time for dose calculation is in the range of one minute. There is currently a growing interest in the fast Monte Carlo treatment planning systems and there are many commercial treatment planning systems that perform dose calculation in radiation therapy based on the Monte Carlo technique. PMID:22606661

  20. Laser Therapy For Arteriosclerosis: Current Review

    NASA Astrophysics Data System (ADS)

    Dries, David J.; Pollock, Marc E.; Eugene, John

    1987-03-01

    Shortly after the ruby laser was introduced, in 1959, a study for the use of this ruby laser for the in-vitro dissolution of arteriosclerotic plaque was performed.' With subsequent advances in laser technology and with refined delivery techniques, laser applications to the treatment of arteriosclerosis in the coronary arteries and peripheral vascular system is a reality. This report reviews the disease process, arteriosclerosis, and the ef-forts towards laser treatment of this disease. We conclude with a review of the technical barriers to the routine application of laser energy in arteriosclerotic cardiovascular disease and the progress being made to overcome these obstacles.

  1. Low level laser therapy: A review

    Microsoft Academic Search

    Paul R. King

    1989-01-01

    The biological and clinical effects of sub-thermal doses of laser light is an area of some controversy. In this review the published scientific evidence for such effects is examined with particular reference to the physics of the light delivery and dosimetry.

  2. Helicobacter pylori eradication therapy: A review of current trends.

    PubMed

    Olokoba, A B; Obateru, O A; Bojuwoye, M O

    2013-01-01

    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy. PMID:23661891

  3. REVIEWS OF TOPICAL PROBLEMS: The search for dark matter particles

    NASA Astrophysics Data System (ADS)

    Ryabov, Vladimir A.; Tsarev, Vladimir A.; Tskhovrebov, Andrei M.

    2008-11-01

    Evidence of dark matter in the Universe is discussed and the most popular candidates for dark matter particles are reviewed. The review is mainly devoted to numerous experiments, both underway and planned, on the search for dark matter particles. Various experimental methods are discussed, including those involving direct registration of dark matter particles with the detector and those where the products of dark matter decay and annihilation are registered.

  4. Systematic review of antistaphylococcal antibiotic therapy in cystic fibrosis

    Microsoft Academic Search

    Kevin McCaffery; Richard E Olver; Margaret Franklin; Somnath Mukhopadhyay

    1999-01-01

    BACKGROUNDThe respiratory tract in patients with cystic fibrosis is frequently colonised with Staphylococcus aureus. There is great diversity of clinical practice in this area of cystic fibrosis. A systematic review was conducted to study the evidence relating antistaphylococcal therapy to clinical outcome in patients with cystic fibrosis.METHODSA search strategy already evaluated for the study of the epidemiology of cystic fibrosis

  5. Online Video Game Therapy for Mental Health Concerns: A Review

    Microsoft Academic Search

    Nathan Wilkinson; Rebecca P. Ang; Dion H. Goh

    2008-01-01

    Background: There has been research on the use of offline video games for therapeutic purposes but online video game therapy is still fairly under-researched. Online therapeutic interventions have only recently included a gaming component. Hence, this review represents a timely first step toward taking advantage of these recent technological and cultural innovations, particularly for the treatment of special-needs groups such

  6. Occupational therapy for children with cerebral palsy: a systematic review

    Microsoft Academic Search

    Esther M. J. Steultjens; Joost Dekker; Lex M. Bouter; Brigitte L. M. Lambregts; Cornelia H. M. Van Den Ende

    2004-01-01

    Objective: Occupational therapy (OT) for cerebral palsy focuses on the development of skills necessary for the performance of activities of daily living. The aim of this systematic review was to determine whether OT interventions improve outcome for children with cerebral palsy (CP).Methods: An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH was performed. Studies with controlled and uncontrolled designs

  7. Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review

    Microsoft Academic Search

    Kathleen Hempenstall; Turo J. Nurmikko; Robert W. Johnson; Roger P AHern; Andrew S. C. Rice

    2005-01-01

    BackgroundPostherpetic neuralgia (PHN) is a complication of acute herpes zoster, which is emerging as a preferred clinical trial model for chronic neuropathic pain. Although there are published meta-analyses of analgesic therapy in PHN, and neuropathic pain in general, the evidence base has been substantially enhanced by the recent publication of several major trials. Therefore, we have conducted a systematic review

  8. Review of Breast Conservation Therapy: Then and Now

    PubMed Central

    Hoover, Susan; Bloom, Elizabeth; Patel, Sunil

    2011-01-01

    Breast conservation therapy (BCT), which is the marriage of breast conserving surgery and radiation therapy to the breast, has revolutionized the treatment of breast cancer over the last few decades. Surgical direction had seen a heightened interest in the performance of cosmetically superior partial and segmental resections in breast conservation as well as increased demand by patients for breast preservation. The broadening of approaches to delivery of breast irradiation from whole breast to accelerated partial breast has allowed more patients to opt for breast conservation and allowed for what appears to be comparable measurable outcomes in emerging data. As well, the addition of state-of-the-art chemotherapeutic and hormonal therapies has allowed improved outcomes of patients from both local regional recurrence and overall survival standpoints. This paper will provide an overview of BCT and review some of the newest developments in optimizing this therapy for patients with breast cancer from a surgical-, medical-, and radiation-oncology standpoint. PMID:22229101

  9. Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

    PubMed Central

    Lucchetti, Giancarlo; Lucchetti, Alessandra L. Granero; Bassi, Rodrigo M.; Nobre, Marlene Rossi Severino

    2011-01-01

    Spiritism is the third most common religion in Brazil, and its therapies have been used by millions worldwide. These therapies are based on therapeutic resources including prayer, laying on of hands, fluidotherapy (magnetized water), charity/volunteering, spirit education/moral values, and disobsession (spirit release therapy). This paper presents a systematic review of the current literature on the relationship among health outcomes and 6 predictors: prayer, laying on of hands, magnetized/fluidic water, charity/volunteering, spirit education (virtuous life and positive affect), and spirit release therapy. All articles were analyzed according to inclusion/exclusion criteria, Newcastle-Ottawa and Jadad score. At present, there is moderate to strong evidence that volunteering and positive affect are linked to better health outcomes. Furthermore, laying on of hands, virtuous life, and praying for oneself also seem to be associated to positive findings. Nevertheless, there is a lack of studies on magnetized water and spirit release therapy. In summary, science is indirectly demonstrating that some of these therapies can be associated to better health outcomes and that other therapies have been overlooked or poorly investigated. Further studies in this field could contribute to the disciplines of Complementary and Alternative Medicine by investigating the relationship between body, mind, and soul/spirit. PMID:21687790

  10. Systemic Effects of Vaginally Administered Estrogen Therapy: A Review

    PubMed Central

    Krause, Megan; Wheeler, Thomas L.; Richter, Holly E.; Snyder, Thomas E.

    2015-01-01

    Hormone Therapy (HT) was considered the standard of care prior to the publication of the Women’s Health Initiative (WHI). After the study was published, the use of systemic HT dramatically decreased resulting in an increased incidence of menopausal symptoms such as hot flashes, vaginal dryness and dyspareunia experienced by women. Use of vaginal estrogen offers women a unique alternative for relief of these symptoms. This article reviews the systemic effects of vaginally administered estrogen. Effects on serum hormone levels, vasomotor symptoms, lipid profiles and use in women with breast cancer are reviewed. An accompanying review examines the local effects of vaginally administered estrogen. PMID:22453284

  11. Exercise therapy for spondyloarthritis: a systematic review.

    PubMed

    O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona

    2014-07-01

    To evaluate the effects of therapeutic exercise on pain, stiffness, quality of life, physical function, disease activity, health-related fitness and cardiovascular risk factors in adults with spondyloarthritis (SpA). Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to October 2013 using medical subject headings and keywords. This was supplemented by searching conference abstracts and a hand search of reference lists of included studies. Randomised and quasi-randomised studies of adults with SpA in which at least one of the comparison groups received an exercise intervention were included. Outcomes of interest were pain, stiffness, quality of life, physical function and disease activity. Secondary outcomes were health-related fitness and cardiovascular risk factors. Two reviewers independently screened studies for inclusion. Methodological quality was assessed by two reviewers using the Cochrane risk of bias tool and the PEDro scale. Twenty-four studies, involving 1,498 participants, were included. Meta-analyses were not undertaken due to clinical heterogeneity, and this review focuses on qualitative synthesis. Moderate evidence supports exercise interventions in improving physical function, disease activity and chest expansion compared to controls; there is low-level evidence of improved pain, stiffness, spinal mobility and cardiorespiratory function. Supervised group exercise yields better outcomes than unsupervised home exercise. The addition of aerobic components to flexibility programmes improves cardiorespiratory outcomes, but not cardiovascular risk factors. The most effective exercise protocol remains unclear. Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis; effects on other SpA subtypes are unknown. PMID:24549404

  12. Zinc Therapy in Dermatology: A Review

    PubMed Central

    Mahajan, Vikram K.; Mehta, Karaninder S.; Chauhan, Pushpinder S.

    2014-01-01

    Zinc, both in elemental or in its salt forms, has been used as a therapeutic modality for centuries. Topical preparations like zinc oxide, calamine, or zinc pyrithione have been in use as photoprotecting, soothing agents or as active ingredient of antidandruff shampoos. Its use has expanded manifold over the years for a number of dermatological conditions including infections (leishmaniasis, warts), inflammatory dermatoses (acne vulgaris, rosacea), pigmentary disorders (melasma), and neoplasias (basal cell carcinoma). Although the role of oral zinc is well-established in human zinc deficiency syndromes including acrodermatitis enteropathica, it is only in recent years that importance of zinc as a micronutrient essential for infant growth and development has been recognized. The paper reviews various dermatological uses of zinc. PMID:25120566

  13. Particle simulation of plasmas: review and advances

    Microsoft Academic Search

    J P Verboncoeur

    2005-01-01

    Particle simulation of plasmas, employed since the 1960s, provides a self-consistent, fully kinetic representation of general plasmas. Early incarnations looked for fundamental plasma effects in one-dimensional systems with ?102–103 particles in periodic electrostatic systems on computers with ?100 kB memory. Recent advances model boundary conditions, such as external circuits to wave launchers, collisions and effects of particle–surface impact, all in

  14. Mind-body Therapies for Menopausal Symptoms: A Systematic Review

    PubMed Central

    Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

    2010-01-01

    Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

  15. Concise Review: Stem Cell Therapies for Neuropathic Pain

    PubMed Central

    Fortino, Veronica R.; Pelaez, Daniel

    2013-01-01

    Neuropathic pain is a chronic condition that is heterogeneous in nature and has different causes. Different from and more burdensome than nociceptive pain, neuropathic pain more severely affects people's quality of life. Understanding the various mechanisms of the onset and progression of neuropathic pain is important in the development of an effective treatment. Research is being done to replace current pharmacological treatments with cellular therapies that will have longer lasting effects. Stem cells present an exciting potential therapy for neuropathic pain. In this review, we describe the neuroprotective effects of stem cells along with special emphasis on the current translational research using stem cells to treat neuropathic pain. PMID:23572051

  16. Botanical and phytochemical therapy of acne: a systematic review.

    PubMed

    Fisk, Whitney A; Lev-Tov, Hadar A; Sivamani, Raja K

    2014-08-01

    Acne is prevalent among adolescents and adults with significant psychological effects. Standard oral and topical therapies can have significant side effects including skin irritation, gastrointestinal upset, and the development of drug-resistant bacteria. The use of botanicals and phytochemicals in dermatological products is increasingly popular, and many patients are turning to these alternative therapies for treatment of acne. This study aimed to systematically review clinical studies that have investigated the use of botanical agents in the treatment of acne. PubMed and Embase databases were searched in March 2013 for trials assessing botanical therapies in the treatment of acne vulgaris. Data from these trials are presented, and methodology of each study is assessed. Twenty-three trials met inclusion criteria. Interventions included plant extracts, herbal formulations, and phytochemicals. All studies reported favorable results, and several showed equal or superior treatment to standard therapies. No serious adverse events were reported. Few studies were methodologically rigorous. Each botanical was studied in only one or two trials. Botanicals are promising therapies for acne vulgaris although further research is warranted, especially with regard to severe acne and acne resistant to conventional therapy. There is a need for standardized methods for grading acne and assessing therapeutic effects. PMID:25098271

  17. Dose to normal tissues outside the radiation therapy patient's treated volume: a review of different radiation therapy techniques.

    PubMed

    Purdy, James A

    2008-11-01

    Radiation therapy treatment planning and delivery capabilities have changed dramatically since the introduction of three-dimensional treatment planning and are continuing to change relatively rapidly in response to the implementation of new advanced technologies. Three-dimensional conformal radiation therapy (3DCRT) is now firmly in place as the standard of practice in clinics around the world. Medical accelerator manufacturers have employed advanced computer technology to produce treatment planning/delivery systems capable of precise shaping of dose distributions via computer-controlled multileaf collimator (MLC) systems, by which the beam fluence is varied optimally to achieve the desired dose distribution. This mode of conformal therapy is referred to as intensity modulated radiation therapy (IMRT), and is capable of generating dose distributions (including concave isodose volumes) that closely conform the prescription dose to the target volume and/or avoid specific sensitive normal structures. The increasing use of IMRT has focused attention on the need to better account for the intra- and inter-fraction spatial uncertainties in the dose delivery process. This has helped spur the development of treatment machines with integrated planar and volumetric advanced imaging capabilities, providing a new treatment modality referred to as image-guided IMRT (IG-IMRT), or simply image-guided radiation therapy (IGRT). In addition, there is a growing interest in replacing x rays with protons because of the physical characteristics of the depth dose curve, which peaks at the end of particle range, and eventually with even heavier charged particles to take advantage of the greater density of energy deposition close to the Bragg peak and hence larger relative biological effectiveness (RBE). Three-dimensional CRT, IMRT and proton beam therapy all provide improved target coverage and lower doses to surrounding normal tissues as compared to the previously used two-dimensional radiation therapy techniques. However, this is achieved at the expense of a greater volume of normal tissue in the irradiated volume receiving some dose and a higher whole body dose (or peripheral dose) to distant normal tissues. The higher whole body dose is a result of the increased x-ray leakage radiation to the patient due to the longer beam-on times associated with IMRT, and also from neutron leakage radiation associated with high energy x-ray beams (>10 MV) and proton beams. Dose distributions for the various CRT techniques and the current status of available data for normal tissues, and whole body dose are reviewed. PMID:18849701

  18. Proton beam therapy for locally advanced lung cancer: A review

    PubMed Central

    Schild, Steven E; Rule, William G; Ashman, Jonathan B; Vora, Sujay A; Keole, Sameer; Anand, Aman; Liu, Wei; Bues, Martin

    2014-01-01

    Protons interact with human tissue differently than do photons and these differences can be exploited in an attempt to improve the care of lung cancer patients. This review examines proton beam therapy (PBT) as a component of a combined modality program for locally advanced lung cancers. It was specifically written for the non-radiation oncologist who desires greater understanding of this newer treatment modality. This review describes and compares photon (X-ray) radiotherapy (XRT) to PBT. The physical differences of these beams are described and the clinical literature is reviewed. Protons can be used to create treatment plans delivering significantly lower doses of radiation to the adjacent organs at risk (lungs, esophagus, and bone marrow) than photons. Clinically, PBT combined with chemotherapy has resulted in low rates of toxicity compared to XRT. Early results suggest a possible improvement in survival. The clinical results of proton therapy in lung cancer patients reveal relatively low rates of toxicity and possible survival benefits. One randomized study is being performed and another is planned to clarify the clinical differences in patient outcome for PBT compared to XRT. Along with the development of better systemic therapy, newer forms of radiotherapy such as PBT should positively impact the care of lung cancer patients. This review provides the reader with the current status of this new technology in treating locally advanced lung cancer. PMID:25302161

  19. EXPOSURE TO CONCENTRATED AMBIENT PARTICLES (CAPS): REVIEW

    EPA Science Inventory

    Epidemiologic studies support a participation of fine particulate matter (PM) with a diameter of 0.1 to 2.5 microm in the effects of air pollution particles on human health. The ambient fine particle concentrator is a recently developed technology that can enrich the mass of ambi...

  20. Omni-directional Display System for Group Activity on Life Review Therapy

    E-print Network

    Boyer, Edmond

    Omni-directional Display System for Group Activity on Life Review Therapy Tomoyuki Honda and Kunio as to trigger a talk. However some observers may perceive upside down images if they sit down opposite on and practices of reminiscence therapy and life review therapy. The concept of the life review is presented

  1. Outcome Studies on the Efficacy of Art Therapy: A Review of Findings

    ERIC Educational Resources Information Center

    Slayton, Sarah; D'Archer, Jeanne; Kaplan, Frances

    2010-01-01

    In response to a review by Reynolds, Nabors, and Quinlan (2000) of the art therapy literature prior to 1999, this review article identifies studies from 1999-2007 that measured outcomes of art therapy effectiveness with all ages of clinical and nonclinical populations. Although numerous studies blend art therapy with other modalities, this review

  2. Underappreciated opportunities for high-density lipoprotein particles in risk stratification and potential targets of therapy.

    PubMed

    Rosenson, Robert S; Davidson, Michael H; Le, Ngoc-Anh; Burkle, Jaime; Pourfarzib, Ray

    2015-02-01

    The inverse relationship between high-density lipoprotein cholesterol (HDL-C) concentrations and coronary heart disease risk is well established. As a result, in recent years there have been significant resources focused on identifying therapies that raise HDL-C and ultimately reduce cardiovascular events. Unfortunately, a number of trials aimed at increasing HDL-C have failed to show improved outcomes, and hence, have cast doubt on the importance of HDL-C as a therapeutic target. HDL-C, however, is only one measure of HDL. HDL levels can also been estimated by quantifying apolipoprotein A-I (apoA-I) levels using enzyme immunoassay or by measuring HDL particle number (HDL-P) using nuclear magnetic resonance spectroscopy (NMR) or ion mobility. While these surrogate measures are correlated, they are not comparable. Lipoprotein-altering therapies have been shown to have different effects on HDL-C, apoA-I and HDL-P and several studies have demonstrated that HDL-P is a stronger predictor of coronary heart disease risk than HDL-C and/or apoA-I. This paper will review available evidence supporting the use of HDL-P as the biomarker of choice to assess the contribution of HDL to cardiovascular risk and as the primary goal of HDL-raising therapies. PMID:25702642

  3. Precise on-line position measurement for particle therapy

    NASA Astrophysics Data System (ADS)

    Actis, O.; Meer, D.; König, S.

    2014-12-01

    An on-line beam position monitoring and regular beam stability tests are of utmost importance for the Quality Assurance (QA) of the patient treatment at any particle therapy facility. The Gantry 2 at the Paul Scherrer Institute uses a strip ionization chamber for the on-line beam position verification. The design of the strip chamber placed in the beam in front of the patient allows for a small beam penumbra in order to achieve a high-quality lateral beam delivery. The position error of 1 mm in a lateral plane (plane perpendicular to the beam direction) can result in a dose inhomogeneity of more than 5%. Therefore the goal of Gantry 2 commissioning was to reach a sub-millimeter level of the reconstruction accuracy in order to bring a dose uncertainty to a level of 1%. In fact, we observed that for beams offered by Gantry 2 signal profiles in a lateral plane can be reconstructed with a precision of 0.1 mm. This is a necessary criterion to perform a reliable patient treatment. The front end electronics and the whole data processing sequence have been optimized for minimizing the dead time in between two consecutive spots to about 2 ms: the charge collection is performed in about 1 ms, read-out takes place in about 100?s while data verification and logging are completed in less than 1 ms.

  4. Review of particle properties. 25th anniversary edition

    SciTech Connect

    Not Available

    1982-04-01

    This review is a reprint of Physics Letters, Vol. IIIB, April 22, 1982, and is an updating through December 1981 of our previous review of particle properties (Particle Data Group (1980)). As in previous editions we have attempted to make the text as complete and self-contained as possible. The results of our compilation are presented in two sections, the Tables of Particle Properties and the Data Card Listings. The Tables summarize the properties of only those particles whose existence is in our judgment experimentally well founded and which have a high probability of standing the test of time. The Data Card Listings give up-to-date information, with references, on all reported particles, whether considered well established or not. The Listings also contain mini-reviews on questions of interest. As in previous editions, we include a section of miscellaneous tables, figures, and formulae. These are aimed at the practicing high energy physics experimentalist. (WHK)

  5. Review of Tumor Dormancy Therapy Using Traditional Oriental Herbal Medicine

    PubMed Central

    Lee, Jong-Ho; Koung, Fan-Pei; Cho, Chong-Kwan; Lee, Yeon-Weol; Yoo, Hwa-Seung

    2013-01-01

    Objective: Standard cancer therapy prolongs survival, but can be detrimental to the quality of life, compromise the immune system, and leave residual disease that can cause recurrence years or decades in the future. Tumor dormancy therapy is a novel therapeutic approach that may improve these shortcomings, promote quality of life, and prolong survival. The aim of this study was to analyze studies on dormancy therapy, especially studies using traditional Oriental herbal medicine, so as to evaluate the efficacy of dormancy therapy with traditional oriental herbal medicine. Methods: We conducted a systematic literature review using Scientific and Technical Information Integration Services (NDSL), PubMed, and RISS. We searched for clinical reports, papers, and books related to tumor metastasis, recurrence, immunotherapy, tumor dormancy, and traditional oriental herbal medicine with anticancer effects. Seventy-nine (79) experimental and clinical articles in both Korean and English were reviewed. This study was conducted from March 1, 2012 to May 31, 2012. Results: This approach, Tumor dormancy therapy, rather than seeking to remove the tumor, includes combination of low-dose chemotherapy, immunotherapy, immunosurveillance, and other methods to stabilize tumor growth and to enhance the host is immunity against disseminated tumor cells and thus to manage cancer as a chronic disease while maintaining quality of life. In particular, integrative use of Oriental herbal medicine has been shown to induce or maintain tumor dormancy, increase the effectiveness of conventional chemotherapy, improve quality of life, and prolong survival. Conclusion: Tumor dormancy therapy is a promising novel therapeutic approach that may be especially effective with Oriental herbal medicine. Further research is needed to determine its potential mechanisms and therapeutic applications.

  6. Effects of therapy for dysphagia in Parkinson's disease: systematic review.

    PubMed

    Baijens, Laura W J; Speyer, Renée

    2009-03-01

    This systematic review explores the effects of dysphagia treatment for Parkinson's disease. The review includes rehabilitative, surgical, pharmacologic, and other treatments. Only oropharyngeal dysphagia is selected for this literature search, excluding dysphagia due to esophageal or gastric disorders. The effects of deep brain stimulation on dysphagia are not included. In general, the literature concerning dysphagia treatment in Parkinson's disease is rather limited. Most effect studies show diverse methodologic problems. Multiple case studies and trials are identified by searching biomedical literature databases PubMed and Embase, and by hand-searching reference lists. The conclusions of most studies cannot be compared with one another because of heterogeneous therapy methods and outcome measures. Further research based on randomized controlled trials to determine the effectiveness of different therapies for dysphagia in Parkinson's disease is required. PMID:18931877

  7. A review of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer.

    PubMed

    Diaby, Vakaramoko; Tawk, Rima; Sanogo, Vassiki; Xiao, Hong; Montero, Alberto J

    2015-05-01

    Breast cancer is a global health concern. In fact, breast cancer is the primary cause of death among women worldwide and constitutes the most expensive malignancy to treat. As health care resources are finite, decisions regarding the adoption and coverage of breast cancer treatments are increasingly being based on "value for money," i.e., cost-effectiveness. As the evidence about the cost-effectiveness of breast cancer treatments is abundant, therefore difficult to navigate, systematic reviews of published systematic reviews offer the advantage of bringing together the results of separate systematic reviews in a single report. As a consequence, this paper presents an overview of systematic reviews of the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer to inform policy and reimbursement decision-making. A systematic review was conducted of published systematic reviews documenting cost-effectiveness analyses of breast cancer treatments from 2000 to 2014. Systematic reviews identified through a literature search of health and economic databases were independently assessed against inclusion and exclusion criteria. Systematic reviews of original evaluations were included only if they targeted breast cancer patients and specific breast cancer treatments (hormone therapy, chemotherapy, and targeted therapy only), documented incremental cost-effectiveness ratios, and were reported in the English language. The search strategy used a combination of these key words: "breast cancer," "systematic review/meta-analysis," and "cost-effectiveness/economics." Data were extracted using predefined extraction forms and qualitatively appraised using the assessment of multiple systematic reviews (AMSTAR) tool. The literature search resulted in 511 bibliographic records, of which ten met our inclusion criteria. Five reviews were conducted in the early-stage breast cancer setting and five reviews in the metastatic setting. In early-stage breast cancer, evidence about trastuzumab value differed by age. Trastuzumab was cost-effective only in women with HER2-positive breast cancer younger than 65 years and over a life-time horizon. The cost-effectiveness of trastuzumab in HER2-positive metastatic breast cancer yielded conflicting results. The same conclusions were reached in comparisons between vinorelbine and taxanes. In both early stage and advanced/metastatic breast cancer, newer aromatase inhibitors (AIs) have proved cost-effective compared to older treatments. This overview of systematic reviews shows that there is heterogeneity in the evidence concerning the cost-effectiveness of hormone therapy, chemotherapy, and targeted therapy for breast cancer. The cost-effectiveness of these treatments depends not only on the comparators but the context, i.e., adjuvant or metastatic setting, subtype of patient population, and perspective adopted. Decisions involving the cost-effectiveness of breast cancer treatments could be made easier and more transparent by better harmonizing the reporting of economic evaluations assessing the value of these treatments. PMID:25893588

  8. Ridge filter design for a particle therapy line

    NASA Astrophysics Data System (ADS)

    Kim, Chang Hyeuk; Han, Garam; Lee, Hwa-Ryun; Kim, Hyunyong; Jang, Hong Suk; Kim, Jeong Hwan; Park, Dong Wook; Jang, Sea Duk; Hwang, Won Taek; Kim, Geun-Beom; Yang, Tae-Keun

    2014-05-01

    The beam irradiation system for particle therapy can use a passive or an active beam irradiation method. In the case of an active beam irradiation, using a ridge filter would be appropriate to generate a spread-out Bragg peak (SOBP) through a large scanning area. For this study, a ridge filter was designed as an energy modulation device for a prototype active scanning system at MC-50 in Korea Institute of Radiological And Medical Science (KIRAMS). The ridge filter was designed to create a 10 mm of SOBP for a 45-MeV proton beam. To reduce the distal penumbra and the initial dose, [DM] determined the weighting factor for Bragg Peak by applying an in-house iteration code and the Minuit Fit package of Root. A single ridge bar shape and its corresponding thickness were obtained through 21 weighting factors. Also, a ridge filter was fabricated to cover a large scanning area (300 × 300 mm2) by Polymethyl Methacrylate (PMMA). The fabricated ridge filter was tested at the prototype active beamline of MC-50. The SOBP and the incident beam distribution were obtained by using HD-810 GaF chromatic film placed at a right triangle to the PMMA block. The depth dose profile for the SOBP can be obtained precisely by using the flat field correction and measuring the 2-dimensional distribution of the incoming beam. After the flat field correction is used, the experimental results show that the SOBP region matches with design requirement well, with 0.62% uniformity.

  9. A systematic review of economic evaluations of therapy in asthma

    PubMed Central

    Bahadori, Katayoun; Quon, Bradley S; Doyle-Waters, Mary M; Marra, Carlo; FitzGerald, J Mark

    2010-01-01

    Background: Asthma’s cost-effectiveness is a major consideration in the evaluation of its treatment options. Our objective was to perform a systematic review of the cost-effectiveness of asthma medications. Methods: We performed a systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, OHE-HEED, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessments Database, NHS Economic Evaluation Database, and Web of Science and reviewed references from key articles between 1990 and Jan 2008. Results: A total of 49 RCTs met the inclusion criteria. Maintenance therapy with inhaled corticosteroids was found to be very cost-effective and in uncontrolled asthmatics patients currently being treated with ICS, the combination of an ICS/LABA represents a safe, cost-effective treatment. The simplified strategy using budesonide and formoterol for maintenance and reliever therapy was also found to be as cost-effective as salmeterol/fluticasone plus salbutamol. Omalizumab was found to be cost-effective. An important caveat with regard to the published literature is the relatively high proportion of economic evaluations which are funded by the manufacturers of specific drug treatments. Conclusion: Future studies should be completed independent of industry support and ensure that the comparator arms within studies should include dosages of drugs that are equivalent. PMID:21437038

  10. TOPICAL REVIEW: Stem cells engineering for cell-based therapy

    NASA Astrophysics Data System (ADS)

    Taupin, Philippe

    2007-09-01

    Stem cells carry the promise to cure a broad range of diseases and injuries, from diabetes, heart and muscular diseases, to neurological diseases, disorders and injuries. Significant progresses have been made in stem cell research over the past decade; the derivation of embryonic stem cells (ESCs) from human tissues, the development of cloning technology by somatic cell nuclear transfer (SCNT) and the confirmation that neurogenesis occurs in the adult mammalian brain and that neural stem cells (NSCs) reside in the adult central nervous system (CNS), including that of humans. Despite these advances, there may be decades before stem cell research will translate into therapy. Stem cell research is also subject to ethical and political debates, controversies and legislation, which slow its progress. Cell engineering has proven successful in bringing genetic research to therapy. In this review, I will review, in two examples, how investigators are applying cell engineering to stem cell biology to circumvent stem cells' ethical and political constraints and bolster stem cell research and therapy.

  11. Review of progress in magnetic particle inspection

    NASA Astrophysics Data System (ADS)

    Eisenmann, David J.; Enyart, Darrel; Lo, Chester; Brasche, Lisa

    2014-02-01

    Magnetic particle inspection (MPI) has been widely utilized for decades, and sees considerable use in the aerospace industry with a majority of the steel parts being inspected with MPI at some point in the lifecycle. Typical aircraft locations inspected are landing gear, engine components, attachment hardware, and doors. In spite of its numerous applications the method remains poorly understood, and there are many aspects of that method which would benefit from in-depth study. This shortcoming is due to the fact that MPI combines the complicated nature of electromagnetics, metallurgical material effects, fluid-particle motion dynamics, and physiological human factors into a single inspection. To promote understanding of the intricate method issues that affect sensitivity, or to assist with the revision of industry specifications and standards, research studies will be prioritized through the guidance of a panel of industry experts, using an approach which has worked successfully in the past to guide fluorescent penetrant inspection (FPI) research efforts.

  12. Physiological Adjustments to Stress Measures Following Massage Therapy: A Review of the Literature

    Microsoft Academic Search

    Albert Moraska; Robin A. Pollini; Karen Boulanger; Marissa Z. Brooks; Lesley Teitlebaum

    2010-01-01

    Use of massage therapy by the general public has increased substantially in recent years. In light of the popularity of massage therapy for stress reduction, a comprehensive review of the peer-reviewed literature is important to summarize the effectiveness of this modality on stress- reactive physiological measures. On-line databases were searched for articles relevant to both massage therapy and stress. Articles

  13. Antibiotic lock therapy: review of technique and logistical challenges

    PubMed Central

    Justo, Julie Ann; Bookstaver, P Brandon

    2014-01-01

    Antibiotic lock therapy (ALT) for the prevention and treatment of catheter-related bloodstream infections is a simple strategy in theory, yet its real-world application may be delayed or avoided due to technical questions and/or logistical challenges. This review focuses on these latter aspects of ALT, including preparation information for a variety of antibiotic lock solutions (ie, aminoglycosides, beta-lactams, fluoroquinolones, folate antagonists, glycopeptides, glycylcyclines, lipopeptides, oxazolidinones, polymyxins, and tetracyclines) and common clinical issues surrounding ALT administration. Detailed data regarding concentrations, additives, stability/compatibility, and dwell times are summarized. Logistical challenges such as lock preparation procedures, use of additives (eg, heparin, citrate, or ethylenediaminetetraacetic acid), timing of initiation and therapy duration, optimal dwell time and catheter accessibility, and risks of ALT are also described. Development of local protocols is recommended in order to avoid these potential barriers and encourage utilization of ALT where appropriate. PMID:25548523

  14. Music Therapy with Children: A Review of Clinical Utility and Application to Special Populations.

    ERIC Educational Resources Information Center

    Yeaw, John David Andrew

    This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…

  15. New developments in treatment planning and verification of particle beam therapy

    PubMed Central

    Schulte, Reinhard W.; Wroe, Andrew J.

    2014-01-01

    Charged particle beam therapy has been used for almost 60 years. During the initial 40 years, the medical use of protons and heavy ions was explored at accelerator laboratories in a limited number of patients and for a limited number of cancerous and non-cancerous disease conditions. After the development of computed tomography and 3D treatment planning, it was time to move charged particle therapy into the clinical realm. This happened in October 1991 when an ocular melanoma patient became the first patient to be treated at Loma Linda University Medical Center in California. Due to the increased awareness of the advantages of charged particle therapy and promising results of single-institution experiences, one currently observes a phase of rapid expansion of proton treatment centers throughout the world. A few of these centers are combined proton/carbon ion facilities. It is very important that the technological evolution of charged particle therapy will continue during this phase of clinical expansion to ensure that the increasing number of patients exposed to therapeutic charged particles will benefit most from the advantageous dose distributions that these particles afford. This report will give an overview of translational research activities related to planning and verification of proton therapy in which the authors have been involved for a number of years. While our activities focus on protons, these developments are to a large degree also applicable to carbon ion therapy. PMID:25520941

  16. Hyperbaric oxygen therapy in acute ischemic stroke: a review.

    PubMed

    Ding, Zheng; Tong, Wesley C; Lu, Xiao-Xin; Peng, Hui-Ping

    2014-08-01

    Stroke, also known as cerebrovascular disease, is a common and serious neurological disease, which is also the fourth leading cause of death in the United States so far. Hyperbaric medicine, as an emerging interdisciplinary subject, has been applied in the treatment of cerebral vascular diseases since the 1960s. Now it is widely used to treat a variety of clinical disorders, especially hypoxia-induced disorders. However, owing to the complex mechanisms of hyperbaric oxygen (HBO) treatment, the therapeutic time window and the undefined dose as well as some common clinical side effects (such as middle ear barotrauma), the widespread promotion and application of HBO was hindered, slowing down the hyperbaric medicine development. In August 2013, the US Food and Drug Administration declared artery occlusion as one of the 13 specific indications for HBO therapy. This provides opportunities, to some extent, for the further development of hyperbaric medicine. Currently, the mechanisms of HBO therapy for ischemic stroke are still not very clear. This review focuses on the potential mechanisms of HBO therapy in acute ischemic stroke as well as the time window. PMID:25337089

  17. Drug therapy of dementia in elderly patients. A review.

    PubMed

    Olsen, Carsten Emil; Poulsen, Henrik Day; Lublin, Henrik K F

    2005-01-01

    Today drug therapy of dementia in elderly patients is possible. Owing to a huge increase in the number of elderly people throughout the Western world in the coming years, evidence-based treatment of dementia in this group is needed. The article reviews double-blind, randomized trials on the effect in dementia of donepezil, galantamine, rivastigmine and memantine up to 2003. A total of 27 studies were included. Donepezil, galantamine, rivastigmine and memantine improve cognition and the global level of functioning in mild to moderate Alzheimer's disease (AD). Most evidence exists for donepezil and galantamine. The effect of rivastigmine is best documented in Lewy body dementia (LB). Galantamine, memantine and donepezil may improve cognition in vascular dementia (VD). Galantamine may improve behavioural psychological symptoms of dementia (BPSD). No solid evidence for drug therapy in severe dementia exists. Elderly patients with mild to moderate AD should be offered drug therapy. One should also consider expanding the indication of dementia treatment to LB and VD. An international consensus on what primary efficacy variables to use is needed. PMID:16195103

  18. Clinical review: Prevention and therapy of vasospasm in subarachnoid hemorrhage

    PubMed Central

    Keyrouz, Salah G; Diringer, Michael N

    2007-01-01

    Vasospasm is one of the leading causes of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Radiographic vasospasm usually develops between 5 and 15 days after the initial hemorrhage, and is associated with clinically apparent delayed ischemic neurological deficits (DID) in one-third of patients. The pathophysiology of this reversible vasculopathy is not fully understood but appears to involve structural changes and biochemical alterations at the levels of the vascular endothelium and smooth muscle cells. Blood in the subarachnoid space is believed to trigger these changes. In addition, cerebral perfusion may be concurrently impaired by hypovolemia and impaired cerebral autoregulatory function. The combined effects of these processes can lead to reduction in cerebral blood flow so severe as to cause ischemia leading to infarction. Diagnosis is made by some combination of clinical, cerebral angiographic, and transcranial doppler ultrasonographic factors. Nimodipine, a calcium channel antagonist, is so far the only available therapy with proven benefit for reducing the impact of DID. Aggressive therapy combining hemodynamic augmentation, transluminal balloon angioplasty, and intra-arterial infusion of vasodilator drugs is, to varying degrees, usually implemented. A panoply of drugs, with different mechanisms of action, has been studied in SAH related vasospasm. Currently, the most promising are magnesium sulfate, 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, nitric oxide donors and endothelin-1 antagonists. This paper reviews established and emerging therapies for vasospasm. PMID:17705883

  19. Light-based therapy on wound healing?:?a review

    NASA Astrophysics Data System (ADS)

    Pik Suan, Lau; Bidin, Noriah; Cherng, Chong Jia; Hamid, Asmah

    2014-08-01

    Wound healing is a complex matrix and overlapping process. In order to accelerate the healing process and minimize bacterial infection, light-based therapy was applied to stimulate bio-reaction to improve healing. The aim of this paper is to review the effects induced by light source (laser and incoherent light like LED) on different biological targets. The light-based therapy techniques were categorized according to the wavelength, energy density, type of irradiance and activity of tissues in the healing process. Out of 80 cases, 77% were animal studies, 5% were human studies and 18% were cell studies. Around 75% of light-based therapy has an advantage on tissue interaction and 25% has no effect or inhibition on the healing process. The appropriate dose appears to be between 1 and 5?J cm?2. At shorter wavelength, photobiostimulation would be effective with a high frequently administrated low-energy dose. On the other hand, for longer wavelength it is the reverse, i.e., more effective with a low frequent treated schedule and a high-energy dose.

  20. Hyperbaric Oxygen Therapy in Acute Ischemic Stroke: A Review

    PubMed Central

    Ding, Zheng; Tong, Wesley C.; Lu, Xiao-Xin; Peng, Hui-Ping

    2014-01-01

    Stroke, also known as cerebrovascular disease, is a common and serious neurological disease, which is also the fourth leading cause of death in the United States so far. Hyperbaric medicine, as an emerging interdisciplinary subject, has been applied in the treatment of cerebral vascular diseases since the 1960s. Now it is widely used to treat a variety of clinical disorders, especially hypoxia-induced disorders. However, owing to the complex mechanisms of hyperbaric oxygen (HBO) treatment, the therapeutic time window and the undefined dose as well as some common clinical side effects (such as middle ear barotrauma), the widespread promotion and application of HBO was hindered, slowing down the hyperbaric medicine development. In August 2013, the US Food and Drug Administration declared artery occlusion as one of the 13 specific indications for HBO therapy. This provides opportunities, to some extent, for the further development of hyperbaric medicine. Currently, the mechanisms of HBO therapy for ischemic stroke are still not very clear. This review focuses on the potential mechanisms of HBO therapy in acute ischemic stroke as well as the time window. PMID:25337089

  1. Occupational therapy and return to work: a systematic literature review

    PubMed Central

    2011-01-01

    Background The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was to be able to select the most efficient OTI. Methods A systematic literature review of peer-reviewed papers was conducted using electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo). The search focussed on randomised controlled trials and cohort studies published in English from 1980 until September 2010. Scientific validity of the studies was assessed. Results Starting from 1532 papers with pertinent titles, six studies met the quality criteria. Results show systematic reviewing of OTIs on RTW was challenging due to varying populations, different outcome measures, and poor descriptions of methodology. There is evidence that OTIs as part of rehabilitation programs, increase RTW rates, although the methodological evidence of most studies is weak. Conclusions Analysis of the selected papers indicated that OTIs positively influence RTW; two studies described precisely what the content of their OTI was. In order to identify the added value of OTIs on RTW, studies with well-defined OT intervention protocols are necessary. PMID:21810228

  2. Estrogen Therapy and Cognition: A Review of the Cholinergic Hypothesis

    PubMed Central

    Gibbs, Robert B.

    2010-01-01

    The pros and cons of estrogen therapy for use in postmenopausal women continue to be a major topic of debate in women’s health. Much of this debate focuses on the potential benefits vs. harm of estrogen therapy on the brain and the risks for cognitive impairment associated with aging and Alzheimer’s disease. Many animal and human studies suggest that estrogens can have significant beneficial effects on brain aging and cognition and reduce the risk of Alzheimer’s-related dementia; however, others disagree. Important discoveries have been made, and hypotheses have emerged that may explain some of the inconsistencies. This review focuses on the cholinergic hypothesis, specifically on evidence that beneficial effects of estrogens on brain aging and cognition are related to interactions with cholinergic projections emanating from the basal forebrain. These cholinergic projections play an important role in learning and attentional processes, and their function is known to decline with advanced age and in association with Alzheimer’s disease. Evidence suggests that many of the effects of estrogens on neuronal plasticity and function and cognitive performance are related to or rely upon interactions with these cholinergic projections; however, studies also suggest that the effectiveness of estrogen therapy decreases with age and time after loss of ovarian function. We propose a model in which deficits in basal forebrain cholinergic function contribute to age-related changes in the response to estrogen therapy. Based on this model, we propose that cholinergic-enhancing drugs, used in combination with an appropriate estrogen-containing drug regimen, may be a viable therapeutic strategy for use in older postmenopausal women with early evidence of mild cognitive decline. PMID:20019127

  3. Static Magnetic Field Therapy: A Critical Review of Treatment Parameters

    PubMed Central

    Wahbeh, Helané; Harling, Noelle; Connelly, Erin; Schiffke, Heather C.; Forsten, Cora; Gregory, William L.; Markov, Marko S.; Souder, James J.; Elmer, Patricia; King, Valerie

    2009-01-01

    Static magnetic field (SMF) therapy, applied via a permanent magnet attached to the skin, is used by people worldwide for self-care. Despite a lack of established SMF dosage and treatment regimens, multiple studies are conducted to evaluate SMF therapy effectiveness. Our objectives in conducting this review are to:(i) summarize SMF research conducted in humans; (ii) critically evaluate reporting quality of SMF dosages and treatment parameters and (iii) propose a set of criteria for reporting SMF treatment parameters in future clinical trials. We searched 27 electronic databases and reference lists. Only English language human studies were included. Excluded were studies of electromagnetic fields, transcranial magnetic stimulation, magnets placed on acupuncture points, animal studies, abstracts, posters and editorials. Data were extracted on clinical indication, study design and 10 essential SMF parameters. Three reviewers assessed quality of reporting and calculated a quality assessment score for each of the 10 treatment parameters. Fifty-six studies were reviewed, 42 conducted in patient populations and 14 in healthy volunteers. The SMF treatment parameters most often and most completely described were site of application, magnet support device and frequency and duration of application. Least often and least completely described were characteristics of the SMF: magnet dimensions, measured field strength and estimated distance of the magnet from the target tissue. Thirty-four (61%) of studies failed to provide enough detail about SMF dosage to permit protocol replication by other investigators. Our findings highlight the need to optimize SMF dosing parameters for individual clinical conditions before proceeding to a full-scale clinical trial. PMID:18955243

  4. TOPICAL REVIEW: Radiation reaction of point particles in curved spacetime

    NASA Astrophysics Data System (ADS)

    Poisson, Eric

    2004-08-01

    This review is concerned with the motion of a point scalar charge, a point electric charge and a point mass in a specified background spacetime. In each of these three cases the particle produces a field that behaves as outgoing radiation in the wave zone, and therefore removes energy from the particle. In the near zone, the field acts on the particle and gives rise to a self-force that prevents the particle from moving on a geodesic of the background spacetime. The self-force contains both conservative and dissipative terms, and the latter are responsible for the radiation reaction. The work done by the self-force matches the energy radiated away by the particle. The field's action on the particle is difficult to calculate because of its singular behaviour: the field diverges at the position of the particle. But Detweiler and Whiting have given a prescription to unambiguously isolate the field's singular part; their singular field obeys the same wave equation as the original field and it can be shown not to exert a force on the particle. What remains after subtraction is a smooth field that is fully responsible for the self-force. Because this field satisfies a homogeneous wave equation, it can be thought of as a free (radiative) field that interacts with the particle; it is this interaction that gives rise to the self-force. The mathematical tools required to derive the equations of motion of a point scalar charge, a point electric charge and a point mass in a specified background spacetime are developed here from scratch. The review begins with a discussion of the basic theory of bitensors and some of its applications. It continues with a thorough discussion of Green's functions in curved spacetime. It concludes with a detailed derivation of each of the three equations of motion.

  5. Heavy Charged Particle Radiobiology: Using Enhanced Biological Effectiveness and Improved Beam Focusing to Advance Cancer Therapy

    PubMed Central

    Allen, Christopher; Borak, Thomas B.; Tsujii, Hirohiko; Nickoloff, Jac A.

    2011-01-01

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and ?-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation. PMID:21376738

  6. Adherence to Cognitive Behavioral Therapy for Insomnia: A Systematic Review

    PubMed Central

    Matthews, Ellyn E.; Arnedt, J. Todd; McCarthy, Michaela S.; Cuddihy, Leisha J.; Aloia, Mark S.

    2013-01-01

    Summary Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive Behavioral Therapy for Insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to (1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, (2) discuss measurement issues, and (3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts. PMID:23602124

  7. Implications of technology in music therapy practice and research for music therapy education: a review of literature.

    PubMed

    Crowe, Barbara J; Rio, Robin

    2004-01-01

    This article reviews the use of technology in music therapy practice and research for the purpose of providing music therapy educators and clinicians with specific and accurate accounts of the types and benefits of technology being used in various settings. Additionally, this knowledge will help universities comply with National Association of Schools of Music requirements and help to standardize the education and training of music therapists in this rapidly changing area. Information was gathered through a literature review of music therapy and related professional journals and a wide variety of books and personal communications. More data were gathered in a survey requesting information on current use of technology in education and practice. This solicitation was sent to all American Music Therapy Association approved universities and clinical training directors. Technology applications in music therapy are organized according to the following categories: (a) adapted musical instruments, (b) recording technology, (c) electric/electronic musical instruments, (d) computer applications, (e) medical technology, (f) assistive technology for the disabled, and (g) technology-based music/sound healing practices. The literature reviewed covers 177 books and articles from a span of almost 40 years. Recommendations are made for incorporating technology into music therapy course work and for review and revision of AMTA competencies. The need for an all-encompassing clinical survey of the use of technology in current music therapy practice is also identified. PMID:15762835

  8. A Review on Vital Pulp Therapy in Primary Teeth

    PubMed Central

    Parisay, Iman; Ghoddusi, Jamileh; Forghani, Maryam

    2015-01-01

    Maintaining deciduous teeth in function until their natural exfoliation is absolutely necessary. Vital pulp therapy (VPT) is a way of saving deciduous teeth. The most important factors in success of VPT are the early diagnosis of pulp and periradicular status, preservation of the pulp vitality and proper vascularization of the pulp. Development of new biomaterials with suitable biocompatibility and seal has changed the attitudes towards preserving the reversible pulp in cariously exposed teeth. Before exposure and irreversible involvement of the pulp, indirect pulp capping (IPC) is the treatment of choice, but after the spread of inflammation within the pulp chamber and establishment of irreversible pulpitis, removal of inflamed pulp tissue is recommended. In this review, new concepts in preservation of the healthy pulp tissue in deciduous teeth and induction of the reparative dentin formation with new biomaterials instead of devitalization and the consequent destruction of vital tissues are discussed. PMID:25598803

  9. Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example

    ERIC Educational Resources Information Center

    Silverman, Michael J.

    2008-01-01

    This article presents a review of nonverbal literature relating to therapy, music, autism, and music therapy. Included is a case study of a woman with autism who was nonverbal. The case highlights and analyzes behaviors contextually. Interpretations of communication through the music therapy, musical interactions, and the rapport that developed…

  10. Online therapy: review of relevant definitions, debates, and current empirical support.

    PubMed

    Rochlen, Aaron B; Zack, Jason S; Speyer, Cedric

    2004-03-01

    The current article reviews the most recent literature addressing the definitions, ethical considerations, and potential strengths and limitations of online therapy. In addition, a framework is provided for how to conceptualize and categorize different aspects of online therapy for research purposes. Relevant studies of both online and face-to-face therapy as well as suggestions for future research are outlined. PMID:14981791

  11. Do Video Reviews of Therapy Sessions Help People with Mild Intellectual Disabilities Describe Their Perceptions of Cognitive Behaviour Therapy?

    ERIC Educational Resources Information Center

    Burford, B.; Jahoda, A.

    2012-01-01

    Background: This study examined the potential of a retrospective video reviewing process [Burford Reviewing Process (BRP)] for enabling people with intellectual disabilities to describe their experiences of cognitive behaviour therapy (CBT). It is the first time that the BRP, described in this paper, has been used with people with intellectual…

  12. Bronchopulmonary hygiene physical therapy in bronchiectasis and chronic obstructive pulmonary disease: A systematic review

    Microsoft Academic Search

    Arthur Jones; Brian H. Rowe

    2000-01-01

    OBJECTIVES: This study had two objectives: (1) to examine the effects of bronchopulmonary hygiene physical therapy on patients with chronic obstructive pulmonary disease and bronchiectasis: (2) to determine any differences between manual and mechanical techniques for bronchopulmonary hygiene physical therapy.DESIGN: The study design was a systematic review of the literature that used an exhaustive search for trials and review methods

  13. Do cognitive behaviour therapies validate cognitive models of mood disorders? a review of the empirical evidence

    Microsoft Academic Search

    Tian P. S. Oei; Michael L. Free

    1995-01-01

    The efficacy of Cognitive Behaviour Therapy (CBT) in the treatment of depression is now established. However, explanations for the efficacy of CBT are mixed. The evidence needed to support the explanation advanced by cognitive theory is lacking. This paper critically reviews the available empirical evidence. Forty-four outcome or process studies of therapy with depression are reviewed and 21 of these

  14. The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies

    Microsoft Academic Search

    Yusuf Ziya Tatli; Sameer Kapasi

    2009-01-01

    This article presents a review of conservative therapies for plantar fasciitis pain reduction with a discussion of steroid\\u000a therapy risks. The therapies reviewed include orthoses, stretching, extracorporeal shockwave, BTX-A, and corticosteroid injection\\/iontophoresis.\\u000a These modes were included based on the availability of double blinded randomized controlled trials. We noted the following\\u000a findings. Orthoses, regardless of type, can improve pain levels. Plantar

  15. The effectiveness of art therapy in the treatment of traumatized adults: a systematic review on art therapy and trauma.

    PubMed

    Schouten, Karin Alice; de Niet, Gerrit J; Knipscheer, Jeroen W; Kleber, Rolf J; Hutschemaekers, Giel J M

    2015-04-01

    Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The aim of this systematic review is to identify and evaluate empirical evidence of the effectiveness of art therapy for trauma treatment. As a result of the systematic review, six controlled, comparative studies on art therapy for trauma in adult patients were found. In half of the included studies, a significant decrease in psychological trauma symptoms was found in the treatment groups, and one study reported a significant decrease in depression. Although there are limitations in the number of included studies, the number of participants, the heterogeneity of included studies, and their methodological quality, the results contribute to insight into the effectiveness of art therapy in trauma treatment and form an evidence base for the urgent need for further research on art therapy and trauma treatment. PMID:25403446

  16. Antipsychotic Therapy During Early and Late Pregnancy. A Systematic Review

    PubMed Central

    Gentile, Salvatore

    2010-01-01

    Objective: Both first- (FGAs) and second-generation antipsychotics (SGAs) are routinely used in treating severe and persistent psychiatric disorders. However, until now no articles have analyzed systematically the safety of both classes of psychotropics during pregnancy. Data sources and search strategy: Medical literature information published in any language since 1950 was identified using MEDLINE/PubMed, TOXNET, EMBASE, and The Cochrane Library. Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from companies developing drugs. Search terms were pregnancy, psychotropic drugs, (a)typical-first-second-generation antipsychotics, and neuroleptics. A separate search was also conducted to complete the safety profile of each reviewed medication. Searches were last updated on July 2008. Data selection: All articles reporting primary data on the outcome of pregnancies exposed to antipsychotics were acquired, without methodological limitations. Conclusions: Reviewed information was too limited to draw definite conclusions on structural teratogenicity of FGAs and SGAs. Both classes of drugs seem to be associated with an increased risk of neonatal complications. However, most SGAs appear to increase risk of gestational metabolic complications and babies large for gestational age and with mean birth weight significantly heavier as compared with those exposed to FGAs. These risks have been reported rarely with FGAs. Hence, the choice of the less harmful option in pregnancy should be limited to FGAs in drug-naive patients. When pregnancy occurs during antipsychotic treatment, the choice to continue the previous therapy should be preferred. PMID:18787227

  17. Tutorial for writing systematic reviews for the Brazilian Journal of Physical Therapy (BJPT).

    PubMed

    Mancini, Marisa C; Cardoso, Jefferson R; Sampaio, Rosana F; Costa, Lucíola C M; Cabral, Cristina M N; Costa, Leonardo O P

    2014-01-01

    Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design. PMID:25590440

  18. Tutorial for writing systematic reviews for the Brazilian Journal of Physical Therapy (BJPT)

    PubMed Central

    Mancini, Marisa C.; Cardoso, Jefferson R.; Sampaio, Rosana F.; Costa, Lucíola C. M.; Cabral, Cristina M. N.; Costa, Leonardo O. P.

    2014-01-01

    Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design. PMID:25590440

  19. Bacteriophage therapy for safeguarding animal and human health: a review.

    PubMed

    Tiwari, Ruchi; Dhama, Kuldeep; Kumar, Amit; Rahal, Anu; Kapoor, Sanjay

    2014-02-01

    Since the discovery of bacteriophages at the beginning of the 19th century their contribution to bacterial evolution and ecology and use in a variety of applications in biotechnology and medicine has been recognized and understood. Bacteriophages are natural bacterial killers, proven as best biocontrol agents due to their ability to lyse host bacterial cells specifically thereby helping in disease prevention and control. The requirement of such therapeutic approach is straight away required in view of the global emergence of Multidrug Resistant (MDR) strains of bacteria and rapidly developing resistance to antibiotics in both animals and humans along with increasing food safety concerns including of residual antibiotic toxicities. Phage typing is a popular tool to differentiate bacterial isolates and to identify and characterize outbreak-associated strains of Salmonella, Campylobacter, Escherichia and Listeria. Numerous methods viz. plaque morphology, ultracentrifugation in the density gradient of CsCl2, and random amplified polymorphic DNA (RAPD) have been found to be effective in detection of various phages. Bacteriophages have been isolated and recovered from samples of animal waste products of different livestock farms. High titer cocktails of broad spectrum lytic bacteriophages are usually used for clinical trial for assessing their therapeutic efficacy against antibiotic unresponsive infections in different animals. Bacteriophage therapy also helps to fight various bacterial infections of poultry viz. colibacillosis, salmonellosis and listeriosis. Moreover, the utility of phages concerning biosafety has raised the importance to explore and popularize the therapeutic dimension of this promising novel therapy which forms the topic of discussion of the present review. PMID:24897784

  20. A review of hormonal therapy for female pattern (androgenic) alopecia.

    PubMed

    Scheinfeld, Noah

    2008-01-01

    Female pattern hair loss (female androgenetic alopecia) is a common, but puzzling, condition in women. Approximately 10 percent of pre-menopausal women show evidence of androgenetic alopecia. Age increases the incidence and 50-75 percent of women 65 years or older suffer from this condition. Only 2 percent topical mindoxidil is approved for treating female androgenetic alopecia. Reviews suggest that anti-hormonal therapy (e.g. cyproterone acetate, spironolactone) is helpful in treating female pattern alopecia in some women who have normal hormone levels. The use of hormonal therapies is most extensively studied in post-menopausal women. Several studies have suggested that cyproterone acetate with or without ethinyl estradiol and spironolactone can ameliorate female androgenetic alopecia in women with normal hormone levels, but larger controlled studies need to be done. Flutamide was found to be more effective than spironolactone or cyproterone in one study. Testosterone conversion inhibitors have been tried in post-menopausual women with normal hormone levels to treat alopecia. No study has shown that 1 mg of finasteride effectively treats female androgenetic alopecia but doses of 2.5 and 5 mg finasteride have helped some women in a few open studies. One case report notes the utility of dutasteride after finasteride failed. The role and place of anti-androgentic agents in female androgenetic alopecia in both pre and post-menopausal women remains to be fully defined. The need for effective agents is highlighted by the paucity of effective treatments and the substantial psychosocial impact of alopecia on women. PMID:18627703

  1. Treating Addiction with Tunes: A Systematic Review of Music Therapy for the Treatment of Patients with Addictions

    Microsoft Academic Search

    Kara L. Mays; David L. Clark; Adam J. Gordon

    2008-01-01

    Music therapy is the use of musical interventions in a therapeutic setting to accomplish health-related goals. Descriptions of music therapy exist in the peer-reviewed literature and indicate potential use of music therapy in treatment of patients with addiction disorders. This systematic review describes and compares the types of music therapy demonstrated in the literature and evaluates the evidence that music

  2. Nanotechnology in Corneal Neovascularization Therapy—A Review

    PubMed Central

    Gonzalez, Lilian; Loza, Raymond J.; Han, Kyu-Yeon; Sunoqrot, Suhair; Cunningham, Christy; Purta, Patryk; Drake, James; Jain, Sandeep; Hong, Seungpyo

    2013-01-01

    Abstract Nanotechnology is an up-and-coming branch of science that studies and designs materials with at least one dimension sized from 1–100?nm. These nanomaterials have unique functions at the cellular, atomic, and molecular levels.1 The term “nanotechnology” was first coined in 1974.2 Since then, it has evolved dramatically and now consists of distinct and independent scientific fields. Nanotechnology is a highly studied topic of interest, as nanoparticles can be applied to various fields ranging from medicine and pharmacology, to chemistry and agriculture, to environmental science and consumer goods.3 The rapidly evolving field of nanomedicine incorporates nanotechnology with medical applications, seeking to give rise to new diagnostic means, treatments, and tools. Over the past two decades, numerous studies that underscore the successful fusion of nanotechnology with novel medical applications have emerged. This has given rise to promising new therapies for a variety of diseases, especially cancer. It is becoming abundantly clear that nanotechnology has found a place in the medical field by providing new and more efficient ways to deliver treatment. Ophthalmology can also stand to benefit significantly from the advances in nanotechnology research. As it relates to the eye, research in the nanomedicine field has been particularly focused on developing various treatments to prevent and/or reduce corneal neovascularization among other ophthalmologic disorders. This review article aims to provide an overview of corneal neovascularization, currently available treatments, and where nanotechnology comes into play. PMID:23425431

  3. Thermal modelling using discrete vasculature for thermal therapy: a review

    PubMed Central

    Kok, H.P.; Gellermann, J.; van den Berg, C.A.T.; Stauffer, P.R.; Hand, J.W.; Crezee, J.

    2013-01-01

    Reliable temperature information during clinical hyperthermia and thermal ablation is essential for adequate treatment control, but conventional temperature measurements do not provide 3D temperature information. Treatment planning is a very useful tool to improve treatment quality and substantial progress has been made over the last decade. Thermal modelling is a very important and challenging aspect of hyperthermia treatment planning. Various thermal models have been developed for this purpose, with varying complexity. Since blood perfusion is such an important factor in thermal redistribution of energy in in vivo tissue, thermal simulations are most accurately performed by modelling discrete vasculature. This review describes the progress in thermal modelling with discrete vasculature for the purpose of hyperthermia treatment planning and thermal ablation. There has been significant progress in thermal modelling with discrete vasculature. Recent developments have made real-time simulations possible, which can provide feedback during treatment for improved therapy. Future clinical application of thermal modelling with discrete vasculature in hyperthermia treatment planning is expected to further improve treatment quality. PMID:23738700

  4. Ridge Preservation for Implant Therapy: a Review of the Literature

    PubMed Central

    Tomlin, Elizabeth M; Nelson, Shelby J; Rossmann, Jeffrey A

    2014-01-01

    Healing of the extraction socket after tooth removal involves retention of the blood clot followed by a sequence of events that lead to changes in the alveolar process in a three dimensional fashion. This normal healing event results in a minimal loss of vertical height (around 1 mm), but a substantial loss of width in the buccal-lingual plane (4-6 mm). During the first three months following extraction that loss has been shown to be significant and may result in both a hard tissue and soft tissue deformity affecting the ability to restore the site with acceptable esthetics. Procedures that reduce the resorptive process have been shown to be predictable and potentially capable of eliminating secondary surgery for site preparation when implant therapy is planned. The key element is prior planning by the dental therapist to act at the time of extraction to prevent the collapse of the ridge due to the loss of the alveolus. Several techniques have been employed as ridge preservation procedures involving the use of bone grafts, barrier membranes and biologics to provide a better restorative outcome. This review will explore the evidence behind each technique and their efficacy in accomplishing site preparation. The literature does not identify a single technique as superior to others; however, all accepted therapeutic procedures for ridge preservation have been shown to be more effective than blood clot alone in randomized controlled studies. PMID:24893595

  5. Biofield therapies and cancer-related symptoms: a review.

    PubMed

    Gonella, Silvia; Garrino, Lorenza; Dimonte, Valerio

    2014-10-01

    Patients with cancer can experience several treatment-related symptoms, and conventional care focuses primarily on cure and survival without a holistic approach to disease. Subsequently, an increasing number of patients are accustomed to complementary modalities to improve well-being. Biofield therapies (BTs) are complementary and alternative medicine (CAM) modalities based on the philosophy that humans have an energetic dimension. Physical and psychological symptoms may cause imbalance, and BTs are believed to balance disturbance in the energy field. This article provides a study review of the main BTs (i.e., therapeutic touch, healing touch, and Reiki) in the treatment of cancer-related symptoms. Although BTs are among the most ancient healing practices, data on their effectiveness are poor and additional multicenter research with larger samples are necessary. BTs may eventually become an autonomous field of nursing activity and allow professionals to build a relationship with the patient, thereby improving motivation. The idea that this method can be self-managed and may effectively reduce pain for patients with cancer can improve satisfaction challenges experienced by the current healthcare system. PMID:25253110

  6. "Wilderness Therapy: Foundations, Theory and Research," by Jennifer Davis-Berman & Dene S. Berman [Book Review].

    ERIC Educational Resources Information Center

    Swiderski, Michael J.; Mitten, Denise

    1994-01-01

    Two reviewers present divergent points of view concerning a book that provides a comprehensive overview of the field of wilderness therapy. The first reviewer sees the book as valuable in bridging the gap between the mental health profession and outdoor experiential education, whereas the second reviewer suggests that the book gives ambiguous…

  7. Electron beam ion sources for use in second generation synchrotrons for medical particle therapy.

    PubMed

    Zschornack, G; Ritter, E; Schmidt, M; Schwan, A

    2014-02-01

    Cyclotrons and first generation synchrotrons are the commonly applied accelerators in medical particle therapy nowadays. Next generation accelerators such as Rapid Cycling Medical Synchrotrons (RCMS), direct drive accelerators, or dielectric wall accelerators have the potential to improve the existing accelerator techniques in this field. Innovative accelerator concepts for medical particle therapy can benefit from ion sources which meet their special requirements. In the present paper we report on measurements with a superconducting Electron Beam Ion Source, the Dresden EBIS-SC, under the aspect of application in combination with RCMS as a well proven technology. The measurements indicate that this ion source can offer significant advantages for medical particle therapy. We show that a superconducting EBIS can deliver ion pulses of medically relevant ions such as protons, C(4 +) and C(6 +) ions with intensities and frequencies required for RCMS [S. Peggs and T. Satogata, "A survey of Hadron therapy accelerator technology," in Proceedings of PAC07, BNL-79826- 2008-CP, Albuquerque, New Mexico, USA, 2007; A. Garonna, U. Amaldi et al., "Cyclinac medical accelerators using pulsed C(6 +)/H2(+) ion sources," in Proceedings of EBIST 2010, Stockholm, Sweden, July 2010]. Ion extraction spectra as well as individual ion pulses have been measured. For example, we report on the generation of proton pulses with up to 3 × 10(9) protons per pulse and with frequencies of up to 1000 Hz at electron beam currents of 600 mA. PMID:24593601

  8. Dose- and LET-painting with particle therapy.

    PubMed

    Bassler, Niels; Jäkel, Oliver; Søndergaard, Christian Skou; Petersen, Jørgen B

    2010-10-01

    Tumour hypoxia is one of the limiting factors in obtaining tumour control in radiotherapy. The high-LET region of a beam of heavy charged particles such as carbon ions is located in the distal part of the Bragg peak. A modulated or spread out Bragg peak (SOBP) is a weighted function of several Bragg peaks at various energies, which however results in a dilution of the dose-average LET in the target volume. Here, we investigate the possibility to redistribute the LET by dedicated treatment plan optimisation, in order to maximise LET in the target volume. This may be a strategy to potentially overcome hypoxia along with dose escalation or dose painting. The high-LET region can be shaped in very different ways, while maintaining the distribution of the absorbed dose or biological effective dose. Treatment plans involving only carbon ion beams, show very different LET distributions depending on how the fields are arranged. Alternatively, a LET boost can be applied in multi-modal treatment planning, such as combining carbon ions with protons and/or photons. For such mixed radiation modalities, significant "LET boosts" can be achieved at nearly arbitrary positions within the target volume. Following the general understanding of the relationship between hypoxia, LET and the oxygen enhancement ratio (OER), we conclude, that an additional therapeutic advantage can be achieved by confining the high-LET part of the radiation in hypoxic compartments of the tumour, and applying low-LET radiation to the normoxic tissue. We also anticipate that additional advantages may be achieved by deliberate sparing of normal tissue from high LET regions. Consequently, treatment planning based on simultaneous dose and LET optimisation has a potential to achieve higher tumour control and/or reduced normal tissue control probability (NTCP). PMID:20831510

  9. Nuclear and particle physics, astrophysics and cosmology (NPAC) capability review

    SciTech Connect

    Redondo, Antonio [Los Alamos National Laboratory

    2010-01-01

    The present document represents a summary self-assessment of the status of the Nuclear and Particle Physics, Astrophysics and Cosmology (NPAC) capability across Los Alamos National Laboratory (LANL). For the purpose of this review, we have divided the capability into four theme areas: Nuclear Physics, Particle Physics, Astrophysics and Cosmology, and Applied Physics. For each theme area we have given a general but brief description of the activities under the area, a list of the Laboratory divisions involved in the work, connections to the goals and mission of the Laboratory, a brief description of progress over the last three years, our opinion of the overall status of the theme area, and challenges and issues.

  10. Internal radiotherapy techniques using radiolanthanide praseodymium-142: a review of production routes, brachytherapy, unsealed source therapy.

    PubMed

    Bakht, Mohamadreza K; Sadeghi, Mahdi

    2011-10-01

    Radionuclides of rare earth elements are gaining importance as emerging therapeutic agents in nuclear medicine. ?(-)-particle emitter 142Pr [T (1/2) = 19.12 h, E(-)? = 2.162 MeV (96.3%), E? = 1575 keV (3.7%)] is one of the praseodymium-141 (100% abundant) radioisotopes. Production routes and therapy aspects of 142Pr will be reviewed in this paper. However, 142Pr produces via 141Pr(n, ?) 142Pr reaction by irradiation in a low-fluence reactor; 142Pr cyclotron produced, could be achievable. 142Pr due to its high ?(-)-emission and low specific gamma ?-emission could not only be a therapeutic radionuclide, but also a suitable radionuclide in order for biodistribution studies. Internal radiotherapy using 142Pr can be classified into two sub-categories: (1) unsealed source therapy (UST), (2) brachytherapy. UST via 142Pr-HA and 142Pr-DTPA in order for radiosynovectomy have been proposed. In addition, 142Pr Glass seeds and 142Pr microspheres have been utilized for interstitial brachytherapy of prostate cancer and intraarterial brachytherapy of arteriovenous malformation, respectively. PMID:21720780

  11. Range assessment in particle therapy based on prompt ?-ray timing measurements

    NASA Astrophysics Data System (ADS)

    Golnik, Christian; Hueso-González, Fernando; Müller, Andreas; Dendooven, Peter; Enghardt, Wolfgang; Fiedler, Fine; Kormoll, Thomas; Roemer, Katja; Petzoldt, Johannes; Wagner, Andreas; Pausch, Guntram

    2014-09-01

    Proton and ion beams open up new vistas for the curative treatment of tumors, but adequate technologies for monitoring the compliance of dose delivery with treatment plans in real time are still missing. Range assessment, meaning the monitoring of therapy-particle ranges in tissue during dose delivery (treatment), is a continuous challenge considered a key for tapping the full potential of particle therapies. In this context the paper introduces an unconventional concept of range assessment by prompt-gamma timing (PGT), which is based on an elementary physical effect not considered so far: therapy particles penetrating tissue move very fast, but still need a finite transit time—about 1-2 ns in case of protons with a 5-20 cm range—from entering the patient’s body until stopping in the target volume. The transit time increases with the particle range. This causes measurable effects in PGT spectra, usable for range verification. The concept was verified by proton irradiation experiments at the AGOR cyclotron, KVI-CART, University of Groningen. Based on the presented kinematical relations, we describe model calculations that very precisely reproduce the experimental results. As the clinical treatment conditions entail measurement constraints (e.g. limited treatment time), we propose a setup, based on clinical irradiation conditions, capable of determining proton range deviations within a few seconds of irradiation, thus allowing for a fast safety survey. Range variations of 2 mm are expected to be clearly detectable.

  12. Sinonasal Malignancies and Charged Particle Radiation Treatment: A Systematic Literature Review

    PubMed Central

    Cianchetti, Marco; Amichetti, Maurizio

    2012-01-01

    Background. Paranasal and nasal cavity malignancies are rare tumors that frequently present at advanced stages. Tumor extension and anatomic complexity pose a challenge for their treatment. Due to their peculiar physical and biological properties particle radiation therapy, i.e. protons and ions can have a role in their management. We performed a systematic literature review to gather clinical evidence about their use to treat sinonasal malignancies. Materials and Methods. We searched the browsers PubMed and Medline as well as specific journals and conference proceedings. Inclusion criteria were: at least 10 patients, English language, reporting outcome and/or toxicity data. Results. We found six studies with data on clinical outcome. Carbon and helium ions were each used in one study, protons in four. Toxicity was specifically described in five studies. One reported acute toxicity of carbon ions, one dealt with brain toxicity from both carbon ions and protons. Three papers reported on visual toxicity: one from carbon ions, one from protons and one from both. Specific data were extracted and compared with the most pertinent literature. Conclusion. Particle radiation therapy is in its early phase of development. Promising results achieved so far must be confirmed in further studies. PMID:22693516

  13. Review: phage therapy: a modern tool to control bacterial infections.

    PubMed

    Qadir, Muhammad Imran

    2015-01-01

    The evolution of antibiotic-resistant in bacteria has aggravated curiosity in development of alternative therapy to conventional drugs. One of the emerging drugs that can be used alternative to antibiotics is bacteriophage therapy. The use of living phages in the cure of lethal infectious life threatening diseases caused by Gram positive and Gram negative bacteria has been reported. Another development in the field of bacteriophage therapy is the use of genetically modified and non replicating phages in the treatment of bacterial infection. Genetically engineered bacteriophages can be used as adjuvant along with antibiotic therapy. Phages encoded with lysosomal enzymes are also effectual in the treatment of infectious diseases. PMID:25553704

  14. Electroconvulsive therapy during pregnancy: a systematic review of case studies.

    PubMed

    Leiknes, Kari Ann; Cooke, Mary Jennifer; Jarosch-von Schweder, Lindy; Harboe, Ingrid; Høie, Bjørg

    2015-02-01

    This study aims to explore practice, use, and risk of electroconvulsive therapy (ECT) in pregnancy. A systematic search was undertaken in the databases Medline, Embase, PsycINFO, SveMed and CINAHL (EBSCO). Only primary data-based studies reporting ECT undertaken during pregnancy were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria and extracted detailed use, practice, and adverse effects data from full text retrieved articles. Studies and extracted data were sorted according to before and after year 1970, due to changes in ECT administration over time. A total of 67 case reports were included and studies from all continents represented. Altogether, 169 pregnant women were identified, treated during pregnancy with a mean number of 9.4 ECTs, at mean age of 29 years. Most women received ECT during the 2nd trimester and many were Para I. Main diagnostic indication in years 1970 to 2013 was Depression/Bipolar disorder (including psychotic depression). Missing data on fetus/child was 12 %. ECT parameter report was often sparse. Both bilateral and unilateral electrode placement was used and thiopental was the main anesthetic agent. Adverse events such as fetal heart rate reduction, uterine contractions, and premature labor (born between 29 and 37 gestation weeks) were reported for nearly one third (29 %). The overall child mortality rate was 7.1 %. Lethal outcomes for the fetus and/or baby had diverse associations. ECT during pregnancy is advised considered only as last resort treatment under very stringent diagnostic and clinical indications. Updated international guidelines are urgently needed. PMID:24271084

  15. Laser-driven beam lines for delivering intensity modulated radiation therapy with particle beams

    PubMed Central

    Hofmann, Kerstin M; Schell, Stefan; Wilkens, Jan J

    2012-01-01

    Abstract Laser-accelerated particles are a promising option for radiation therapy of cancer by potentially combining a compact, cost-efficient treatment unit with the physical advantages of charged particle beams. To design such a treatment unit we consider different dose delivery schemes and analyze the necessary devices in the required particle beam line for each case. Furthermore, we point out that laser-driven treatment units may be ideal tools for motion adaptation during radiotherapy. Reasons for this are the potential of a flexible gantry and the time structure of the beam with high particle numbers in ultrashort bunches. One challenge that needs to be addressed is the secondary radiation produced in several beam line elements. (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) PMID:22930653

  16. Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder

    Microsoft Academic Search

    Richard Harrington; Jane Whittaker; Philip Shoebridge; Fiona Campbell

    1998-01-01

    Objective: To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder. Design: Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder. Main outcome measure: Remission from depressive disorder. Results: The rate of remission from depressive disorder was

  17. Diversity and Social Justice Issues in Family Therapy Literature: A Decade Review

    Microsoft Academic Search

    Iva Kosutic; Teresa McDowell

    2008-01-01

    In this paper, we report on our (a) review of diversity and social justice issues as represented across articles published in five family therapy journals between 1995 and 2005, and (b) in-depth analysis of the content of diversity and social justice related articles in one of the five journals (the Journal of Marital and Family Therapy [JMFT]) during the same

  18. Family Therapy for Drug Abuse: Review and Updates 2003-2010

    ERIC Educational Resources Information Center

    Rowe, Cynthia L.

    2012-01-01

    Just 15 years ago, Liddle and Dakof ("Journal of Marital and Family Therapy," 1995; 21, 511) concluded, based on the available evidence, that family therapy represented a "promising, but not definitive" approach for the treatment of drug problems among adolescents and adults. Seven years later, Rowe and Liddle (2003) review described considerable…

  19. Maintaining clarity: Review of maintenance therapy in non-small cell lung cancer

    PubMed Central

    Dearing, Kristen R; Sangal, Ashish; Weiss, Glen J

    2014-01-01

    The purpose of this article is to review the role of maintenance therapy in the treatment of advanced non-small cell lung cancer (NSCLC). A brief overview about induction chemotherapy and its primary function in NSCLC is provided to address the basis of maintenance therapies foundation. The development of how maintenance therapy is utilized in this population is discussed and current guidelines for maintenance therapy are reviewed. Benefits and potential pitfalls of maintenance therapy are addressed, allowing a comprehensive review of the achieved clinical benefit that maintenance therapy may or may not have on NSCLC patient population. A review of current literature was conducted and a table is provided comparing the results of various maintenance therapy clinical trials. The table includes geographical location of each study, the number of patients enrolled, progression free survival and overall survival statistics, post-treatment regimens and if molecular testing was conducted. The role of molecular testing in relation to therapeutic treatment options for advanced NSCLC patients is discussed. A treatment algorithm clearly depicts first line and second line treatment for management of NSCLC and includes molecular testing, maintenance therapy and the role clinical trials have in treatment of NSCLC. This treatment algorithm has been specifically tailored and developed to assist clinicians in the management of advanced NSCLC. PMID:24829857

  20. Adherence to Antiretroviral Therapy for Pediatric HIV Infection: Review of the Literature and Recommendations for Research

    Microsoft Academic Search

    Ric G. Steele; Dennis Grauer

    2003-01-01

    This review described and compared empirical investigations of adherence to pediatric antiretroviral therapy (ART) and predictors\\/correlates of adherence with regard to methodology and outcome. Thirteen empirical studies of children's adherence to ART, conducted between the years 1981 and 2002 were identified. Investigations varied by age of participant, drug therapy regimen, method of adherence assessment, and by the reporting of predictors\\/correlates

  1. Systemic Therapy of Metastatic Breast Cancer: A Review of the Current Trends

    Microsoft Academic Search

    Sewa S. Legha; George R. Blumenschein

    1982-01-01

    This papier reviews the different options of systemic therapy available for the management of patients with metastatic breast cancer. Endocrine therapy with tamoxifen, aminoglutethimide, progestins or androgens are useful for approximately one half of the patients either before or after chemotherapy. Combination chemotherapy is effective in approximately 75% of the patients and offers the best palliation for the majority of

  2. Physical Therapy Program Review, State University System of Florida. Consultant's Report and Recommendations.

    ERIC Educational Resources Information Center

    Bork, Christopher E.

    This report reviews the degree programs in physical therapy offered by five State University System of Florida (SUS) institutions. The evaluation is based on self-study reports submitted by the universities, site visits, interviews, and school records. The report includes an overview of the physical therapy profession, system-wide analysis and…

  3. Effectiveness of Physiotherapy, Occupational Therapy, and Speech Pathology for People with Huntington's Disease: A Systematic Review

    Microsoft Academic Search

    Belinda Bilney; Meg E. Morris; Alison Perry

    2003-01-01

    This review provides a summary of the current literature examining the outcomes of physiotherapy, occupational therapy, and speech pathology interventions for people with Huntington's disease. The literature was retrieved via a systematic search using a combination of key words that included Huntington's disease, physiotherapy, occu- pational therapy, and speech pathology. The electronic databases for Medline, Embase, CINAHL, Cochrane Controlled Trials

  4. Emotionally Focused Couples Therapy: A Review of the Literature.

    ERIC Educational Resources Information Center

    Messer, Larry D., Jr.

    Emotionally Focused Therapy (EFT) is an approach for working with couples that focuses on the negative interaction cycles perpetuated by deep-seated emotional vulnerabilities. This therapy attempts to alleviate distress by intervening on an emotional level in order to promote more caring interactions that can enhance relationships. Proponents…

  5. Eurythmy Therapy in clinical studies: a systematic literature review

    Microsoft Academic Search

    Arndt Büssing; Thomas Ostermann; Magdalena Majorek; Peter F Matthiessen

    2008-01-01

    BACKGROUND: We aimed to overview the current literature on eurythmy therapy (EYT) which is an integral part of Anthroposophic Medicine. EYT can be described as a movement therapy in which speech movements are transposed into exercises which address the patient's capability to soul expression and strengthen his salutogenetic resources. METHODS: We searched several databases such as Cochrane, EMBASE, NCCAM, NLM,

  6. PEREGRINE: An all-particle Monte Carlo code for radiation therapy

    SciTech Connect

    Hartmann Siantar, C.L.; Chandler, W.P.; Rathkopf, J.A.; Svatos, M.M.; White, R.M.

    1994-09-01

    The goal of radiation therapy is to deliver a lethal dose to the tumor while minimizing the dose to normal tissues. To carry out this task, it is critical to calculate correctly the distribution of dose delivered. Monte Carlo transport methods have the potential to provide more accurate prediction of dose distributions than currently-used methods. PEREGRINE is a new Monte Carlo transport code developed at Lawrence Livermore National Laboratory for the specific purpose of modeling the effects of radiation therapy. PEREGRINE transports neutrons, photons, electrons, positrons, and heavy charged-particles, including protons, deuterons, tritons, helium-3, and alpha particles. This paper describes the PEREGRINE transport code and some preliminary results for clinically relevant materials and radiation sources.

  7. The "coming of age" of couple therapy: a decade review.

    PubMed

    Johnson, S; Lebow, J

    2000-01-01

    This article overviews significant developments in couple therapy over the last decade. Key trends include: (1) couple therapy becoming firmly established as the accepted treatment of choice for couple problems, (2) the blossoming of the science of relationships, (3) strong evidence supporting the effectiveness of couple therapy both for relationship problems and DSM disorders, (4) greater understanding of the ramifications of gender, (5) new respect for the diversity of family forms, (6) increased accent on the role of emotion, (7) the influence of postmodernism, (8) greater recognition of couple violence, and (9) the move toward integration across models of treatment. PMID:10685349

  8. A review of research and methods used to establish art therapy as an effective treatment method for traumatized children

    Microsoft Academic Search

    Leslie G. Eaton; Kimberly L. Doherty; Rebekah M. Widrick

    2007-01-01

    Art therapy uses creative expression to provide individuals with a safe outlet for expressing thoughts and emotions to successfully facilitate recovery from psychological distress. The present study reviews the efficacy of art therapy as a method for treating traumatized children. Published, peer-reviewed literature that focused exclusively on the use of art therapy for treating children who had experienced a traumatic

  9. [Creative therapy options for patients with dementia--a systematic review].

    PubMed

    Schmitt, B; Frölich, L

    2007-12-01

    The specifics of creative therapies aim at activating the creative potential of the patients in the sense of acceptance, orientation and coping with their illness "dementia" and at improving their quality of life. Creative therapies in the treatment of dementia offer the advantage of working with these patients, whose cognition and often also verbal communication skills are affected in a nonverbal way. This article presents a systematic review of studies and case studies, which could be found on the subject of the implementation of active creative therapies "music-, art-, drama- and dance-therapy" within the following databases (05/05): Medline, Psyndex Plus, PsychInfo and Cochrane. The search terms used were: "Creativ* and therapy and dementia and (stud*)", "Dance therapy and dementia", "Music therapy and dementia", "Drama therapy and dementia" and "Art therapy and dementia". As a result of this search we found seven quantitative evaluated controlled studies, three prae-post comparisons and three qualitative evaluated studies which have been finished since 1998. All of these studies included groups of at least three participants. Further reviews are mentioned in this article. This survey of studies on creative therapies for patients with dementia shows positive effects like the improvement of interaction skills. The data supplied thus supports the approach of using creative therapies in order to help patients accept dementia as their illness and finally to cope with it. The methodical approach to the registration of the therapies' effects and process-orientated contents of the therapy create a field of tension, leading to the request for a further development and validation of instruments, which allow the quantitative evaluation of parameters like liveliness, agility and interaction skills. PMID:17443437

  10. Multiple myeloma maintenance therapy: A review of the pharmacologic treatment.

    PubMed

    Shank, Brandon R; Brown, Victoria T; Schwartz, Rowena N

    2015-02-01

    Over the last decade, numerous drug therapies have emerged for the treatment of multiple myeloma including immunomodulating agents namely thalidomide, lenalidomide, and pomalidomide and proteasome inhibitors namely bortezomib and carfilzomib. These agents have transformed the treatment of multiple myeloma and the role of high-dose chemotherapy followed by stem cell transplantation in the treatment of the disease. There are now studies that evaluate the use of drug therapy as maintenance following autologous stem cell transplantation; these studies have shown improvements in surrogate endpoints such as progression-free survival. Studies that have evaluated thalidomide or lenalidomide maintenance therapy have demonstrated an overall survival (OS) benefit in individuals with multiple myeloma who received high-dose chemotherapy followed by stem cell transplantation. A meta-analysis of thalidomide maintenance therapy did show a possible late survival benefit. The use of dexamethasone, thalidomide, lenalidomide, or combination bortezomib with thalidomide in patients who did not undergo transplantation demonstrated progression-free survival benefit; although there was no OS advantage for these agents in this population. There are a number of important considerations when selecting a drug therapy strategy for maintenance therapy which includes practical considerations such as route of administration and frequency of administration. Additionally, patient-specific elements such as potential toxicities, end-organ function, quality of life, cytogenetics, and previous treatment should be considered. Additional studies are needed to elicit the timing for initiation and duration of maintenance therapy, determine the role of cytogenetics, further characterize possible resistance patterns, and determine the combinations necessary to achieve an optimal increase in OS. Until more data are available, the risks and benefits should be evaluated on a patient-specific basis when deciding to initiate maintenance therapy or observation. PMID:24395544

  11. Problem-Solving Therapy for Depression in Adults: A Systematic Review

    ERIC Educational Resources Information Center

    Gellis, Zvi D.; Kenaley, Bonnie

    2008-01-01

    Objectives: This article presents a systematic review of the evidence on problem-solving therapy (PST) for depressive disorders in noninstitutionalized adults. Method: Intervention studies using randomized controlled designs are included and methodological quality is assessed using a standard set of criteria from the Cochrane Collaborative Review

  12. Behavioral Marital Therapy (BMT) for Alcoholics and Wives: Review of Literature and a Proposed Research Program.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Cutter, Henry S. G.

    After describing a social learning formulation of the male alcoholic's marriage, this paper reviews the few studies of behavioral marital therapy (BMT) for alcoholics and their wives. Although none of these studies are as rigorous as one might wish and many of them are merely case studies, a review of the literature shows that behavioral marital…

  13. Review: engineering particles using the aerosol-through-plasma method

    SciTech Connect

    Phillips, Jonathan [Los Alamos National Laboratory; Luhrs, Claudia C [UNM; Richard, Monique [TEMA

    2009-01-01

    For decades, plasma processing of materials on the nanoscale has been an underlying enabling technology for many 'planar' technologies, particularly virtually every aspect of modern electronics from integrated-circuit fabrication with nanoscale elements to the newest generation of photovoltaics. However, it is only recent developments that suggest that plasma processing can be used to make 'particulate' structures of value in fields, including catalysis, drug delivery, imaging, higher energy density batteries, and other forms of energy storage. In this paper, the development of the science and technology of one class of plasma production of particulates, namely, aerosol-through-plasma (A-T-P), is reviewed. Various plasma systems, particularly RF and microwave, have been used to create nanoparticles of metals and ceramics, as well as supported metal catalysts. Gradually, the complexity of the nanoparticles, and concomitantly their potential value, has increased. First, unique two-layer particles were generated. These were postprocessed to create unique three-layer nanoscale particles. Also, the technique has been successfully employed to make other high-value materials, including carbon nanotubes, unsupported graphene, and spherical boron nitride. Some interesting plasma science has also emerged from efforts to characterize and map aerosol-containing plasmas. For example, it is clear that even a very low concentration of particles dramatically changes plasma characteristics. Some have also argued that the local-thermodynamic-equilibrium approach is inappropriate to these systems. Instead, it has been suggested that charged- and neutral-species models must be independently developed and allowed to 'interact' only in generation terms.

  14. Particle selection and beam collimation system for laser-accelerated proton beam therapy.

    PubMed

    Luo, Wei; Fourkal, Eugene; Li, Jinsheng; Ma, Chang-Ming

    2005-03-01

    In a laser-accelerated proton therapy system, the initial protons have broad energy and angular distributions, which are not suitable for direct therapeutic applications. A compact particle selection and collimation device is needed to deliver small pencil beams of protons with desired energy spectra. In this work, we characterize a superconducting magnet system that produces a desired magnetic field configuration to spread the protons with different energies and emitting angles for particle selection. Four magnets are set side by side along the beam axis; each is made of NbTi wires which carry a current density of approximately 10(5) A/cm2 at 4.2 K, and produces a magnetic field of approximately 4.4 T in the corresponding region. Collimation is applied to both the entrance and the exit of the particle selection system to generate a desired proton pencil beam. In the middle of the magnet system, where the magnetic field is close to zero, a particle selection collimator allows only the protons with desired energies to pass through for therapy. Simulations of proton transport in the presence of the magnetic field show that the selected protons have successfully refocused on the beam axis after passing through the magnetic field with the optimal magnet system. The energy spread for any given characteristic proton energy has been obtained. It is shown that the energy spread is a function of the magnetic field strength and collimator size and reaches the full width at half maximum of 25 MeV for 230 MeV protons. Dose distributions have also been calculated with the GEANT3 Monte Carlo code to study the dosimetric properties of the laser-accelerated proton beams for radiation therapy applications. PMID:15839352

  15. The Current Status and Future Directions of Heavy Charged Particle Therapy in Medicine

    NASA Astrophysics Data System (ADS)

    Levy, Richard P.; Blakely, Eleanor A.; Chu, William T.; Coutrakon, George B.; Hug, Eugen B.; Kraft, Gerhard; Tsujii, Hirohiko

    2009-03-01

    As aggressive, 3D-conformal treatment has become the clearly accepted goal of radiation oncology, heavy charged-particle treatment with protons and heavier ions has concurrently and relentlessly ascended to the forefront. Protons and helium nuclei, with relatively low linear-energy-transfer (LET) properties, have consistently been demonstrated to be beneficial for aggressive (high-dose) local treatment of many types of tumors. Protons have been applied to the majority of solid tumors, and have reached a high degree of general acceptance in radiation oncology after three decades and 55,000 patients treated. However, some 15% to 20% of tumor types have proven resistant to even the most aggressive low-LET irradiation. For these radio-resistant tumors, treatment with heavier ions (e.g., carbon) offers great potential benefit. These high-LET particles have increased relative biological effectiveness (RBE) that reaches its maximum in the Bragg peak. Irradiation with these heavier ions offers the unique combination of excellent 3D-dose distribution and increased RBE. We are presently witnessing several, important parallel developments in particle therapy. Protons will likely continue their exponential growth phase, and more compact design systems will make protons available to a larger patient population—thus becoming the "heavy charged particle of choice" for Cancer Centers with limited financial resources. In parallel, major academic efforts will further advance the field of heavier ion therapy, exploring all opportunities for particle treatment and continuing the search for the ideal particle(s) for specific tumors. The future of ion therapy will be best realized by clinical trials that have ready access to top-quality delivery of both protons and heavier ions that can be accurately shaped for treatment of a specific pathology, and which will permit direct randomized-trial comparison of the effectiveness of the various ions for different diseases. Optimal results will require: (1) sophisticated target delineation that integrates CT, MRI and PET imaging; (2) reliable RBE modeling algorithms; (3) efficient beam-scanning technology that compensates for organ movements; (4) online beam control proximal to and within the patient; and (5) better understanding of dose-fractionation parameters. The current status and the anticipated future directions of the role of particle therapy in medicine is a complex subject that involves a very intimate interplay of radiobiology, accelerator physics and radiation oncology. The intention of this relatively brief manuscript is to describe the underlying principles, present the historical developments, highlight the clinical results, focus on the technical advances, and suggest likely future directions. We have also attempted to present a balanced, consensus view of the past achievements and current strategies in particle therapy, in a manner of interest both to long-term experts and to educated newcomers to this field.

  16. An improved Monte Carlo (MC) dose simulation for charged particle cancer therapy

    NASA Astrophysics Data System (ADS)

    Ying, C. K.; Kamil, W. A.; Shuaib, I. L.; Matsufuji, Naruhiro

    2014-02-01

    Heavy-particle therapy such as carbon ion therapy are more popular nowadays because of the nature characteristics of charged particle and almost no side effect to patients. An effective treatment is achieved with high precision of dose calculation, in this research work, Geant4 based Monte Carlo simulation method has been used to calculate the radiation transport and dose distribution. The simulation have the same setting with the treatment room in Heavy Ion Medical Accelerator, HIMAC. The carbon ion beam at the isocentric gantry nozzle for the therapeutic energy of 290 MeV/u was simulated, experimental work was carried out in National Institute of Radiological Sciences, NIRS, Chiba, Japan by using the HIMAC to confirm the accuracy and qualities dose distribution by MC methods. The Geant4 based simulated dose distribution were verified with measurements for Bragg peak and spread out Bragg peak (SOBP) respectively. The verification of results shows that the Bragg peak depth-dose and SOBP distributions in simulation has good agreement with measurements. In overall, the study showed that Geant4 based can be fully applied in the heavy-ion therapy field for simulation, further works need to be carry on to refine and improve the Geant4 MC simulations.

  17. Ozone therapy in dentistry. A brief review for physicians.

    PubMed

    Domb, William C

    2014-10-31

    The 21(st) century dental practice is quite dynamic. New treatment protocols and new materials are being developed at a rapid pace. Ozone dental therapy falls into the category of new treatment protocols in dentistry, yet ozone is not new at all. Ozone therapy is already a major treatment modality in Europe, South America and a number of other countries. What is provided here will not be an exhaustive scientific treatise so much as a brief general introduction into what dentists are now doing with ozone therapies and the numerous oral/systemic links that make this subject so important for physicians so that, ultimately, they may serve their patients more effectively and productively. PMID:25363268

  18. Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

    Microsoft Academic Search

    Esther MJ Steultjens; Joost Dekker; Lex M Bouter; Chantal J Leemrijse; Cornelia HM van den Ende

    2005-01-01

    Objective: To summarize the research evidence available from systematic reviews of the efficacy of occupational therapy (OT) for practitioners, researchers, purchasing organizations and policy-makers.Data source: The search for systematic reviews was conducted in PubMed and the Cochrane Library (October 2004).Methods: The reviews included were those that utilized a systematic search for evidence with regard to OT for specific patient groups.

  19. Sensory Integration Therapy for Autism Spectrum Disorders: A Systematic Review

    ERIC Educational Resources Information Center

    Lang, Russell; O'Reilly, Mark; Healy, Olive; Rispoli, Mandy; Lydon, Helena; Streusand, William; Davis, Tonya; Kang, Soyeon; Sigafoos, Jeff; Lancioni, Giulio; Didden, Robert; Giesbers, Sanne

    2012-01-01

    Intervention studies involving the use of sensory integration therapy (SIT) were systematically identified and analyzed. Twenty-five studies were described in terms of: (a) participant characteristics, (b) assessments used to identify sensory deficits or behavioral functions, (c) dependent variables, (d) intervention procedures, (e) intervention…

  20. Occupational therapy for rheumatoid arthritis: A systematic review

    Microsoft Academic Search

    Esther M. J. Steultjens; Joost Dekker; Lex M. Bouter; Dirkjan van Schaardenburg; Marie-Antoinette H. van Kuyk; Cornelia H. M. van den Ende

    2002-01-01

    Patients with rheumatoid arthritis (RA) show a reduction in physical capacities compared with healthy persons. Symptoms such as pain, fatique, stiffness, and decreased muscle strength cause difficulties with daily activities such as grooming and dressing, cooking a meal, cleaning, shopping, work, and leisure activities. The physical, personal, familial, social, and vocational consequences of RA are extensive. Occupational therapy (OT) is

  1. Analytic Review: Thrombolytic Therapy in Acute Myocardial Infarction

    Microsoft Academic Search

    Peter L. Zwerner; Joel M. Gore

    1986-01-01

    The salvage of myocardium in the setting of acute myocardial infarction has long been a goal of physicians involved in the care of patients with coronary artery disease. Understanding the role of thrombosis in the pathogenesis of acute myocardial infarction has led the way to an entirely new approach to the treatment of this entity. Thrombolytic therapy has now become

  2. Water-soluble core/shell nanoparticles for proton therapy through particle-induced radiation

    NASA Astrophysics Data System (ADS)

    Park, Jeong Chan; Jung, Myung-Hwan; Kim, Maeng Jun; Kim, Kye-Ryung

    2015-02-01

    Metallic nanoparticles have been used in biomedical applications such as magnetic resonance imaging (MRI), therapy, and drug delivery systems. Metallic nanoparticles as therapeutic tools have been demonstrated using radio-frequency magnetic fields or near-infrared light. Recently, therapeutic applications of metallic nanomaterials combined with proton beams have been reported. Particle-induced radiation from metallic nanoparticles, which can enhance the therapeutic effects of proton therapy, was released when the nanoparticles were bombarded by a high-energy proton beam. Core/shell nanoparticles, especially Au-coated magnetic nanoparticles, have drawn attention in biological applications due to their attractive characteristics. However, studies on the phase transfer of organic-ligand-based core/shell nanoparticles into water are limited. Herein, we demonstrated that hydrophobic core/shell structured nanomaterials could be successfully dispersed in water through chloroform/surfactant mixtures. The effects of the core/shell nanomaterials and the proton irradiation on Escherichia coli (E. coli) were also explored.

  3. Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis

    Microsoft Academic Search

    Marianne Canonico; Geneviève Plu-Bureau; Gordon D O Lowe; Pierre-Yves Scarabin

    2008-01-01

    Objective To assess the risk of venous thromboembolism in women using hormone replacement therapy by study design, characteristics of the therapy and venous thromboembolism, and clinical background.Design Systematic review and meta-analysis.Data sources Medline.Studies reviewed Eight observational studies and nine randomised controlled trials.Inclusion criteria Studies on hormone replacement therapy that reported venous thromboembolism.Review measures Homogeneity between studies was analysed using ?2

  4. Research Ethics: Institutional Review Board Oversight of Art Therapy Research

    ERIC Educational Resources Information Center

    Deaver, Sarah P.

    2011-01-01

    By having their research proposals reviewed and approved by Institutional Review Boards (IRBs), art therapists meet important ethical principles regarding responsibility to research participants. This article provides an overview of the history of human subjects protections in the United States; underlying ethical principles and their application…

  5. Integrative Care Therapies and Pain in Hospitalized Children and Adolescents: A Retrospective Database Review

    PubMed Central

    Luberto, Christina M.; Bogenschutz, Lois H.; Pelley, Terri J.; Dusek, Jeffrey

    2014-01-01

    Abstract Background: Complementary or integrative care therapies are promising adjunctive approaches to pain management for pediatric inpatients that are currently underused and understudied. The purpose of this study was to examine the potential benefits of integrative care therapies delivered to hospitalized children and adolescents at a large Midwestern academic pediatric medical center over a 1-year period. Methods: A retrospective chart review of an inpatient clinical database maintained by integrative care therapists over a 1-year period was used for the current study. Pre/post pain and relaxation scores associated with the delivery of inpatient integrative care therapies (primarily massage therapy and healing touch) were examined. Results: Five-hundred nineteen hospitalized children and adolescents were treated by integrative care therapists for primarily pain or anxiety needs. Patients had a mean age of 10.2 years (standard deviation, 7.0), 224 were female (43%), 383 were white (74%), and most (393 [77%]) received massage therapy. Mean pain and relaxation scores decreased significantly from pre- to post-therapy across all demographic and clinical subgroups (p?.001). Conclusions: Although integrative care therapies are increasingly requested and offered in children's hospitals, provision of these approaches is driven primarily by consumer demand rather than evidence-informed practice. Future controlled studies should examine the incremental effects of integrative care therapies as an adjunct to conventional treatment, assess how these therapies work mechanistically, and determine whether they improve outcomes, such as pain and cost, for hospitalized children and adolescents. PMID:24175871

  6. Efficacy of estrogen therapy in patients with intrauterine adhesions: systematic review.

    PubMed

    Johary, Jolinda; Xue, Min; Zhu, Xiaogang; Xu, Dabao; Velu, Prasad Palani

    2014-01-01

    Hysteroscopic adhesiolysis has become the preferred option for management of intrauterine adhesions (IUA). Use of estrogen as perioperative adjuvant therapy has been suggested for preventing recurrent adhesions. The primary objective of this article was to review the literature for evidence of the efficacy of estrogen therapy in the management of IUA. All eligible studies were identified using computerized databases (PubMed, Scopus. and Web of Science) from their earliest publication date to July 2013. Additional relevant articles were identified from citations in these publications. Twenty-six studies were identified that reported use of hormone therapy as ancillary treatment after adhesiolysis. Of these studies, 19 used at least one of the following methods: intrauterine device, Foley catheter, hyaluronic acid gel, or amnion graft, in addition to hormone therapy as ancillary treatment. In 7 studies, hormone therapy was used as a single ancillary treatment. In 2 studies, no adjunctive therapy was used after adhesiolysis. Meta-analysis could not be performed because of the differences in treatment methods in these articles. There was a wide range of reported menstrual and fertility outcomes. Better menstrual and fertility outcomes were associated with use of estrogen in combination with other methods of ancillary treatment. At present, hormone therapy, in particular estrogen therapy, is beneficial in patients with IUA, regardless of stage of adhesions. However, estrogen therapy needs to be combined with ancillary treatment to obtain maximal outcomes, in particular in patients with moderate to severe IUA. PMID:23933351

  7. Physical Therapy Interventions for Degenerative Lumbar Spinal Stenosis: A Systematic Review

    PubMed Central

    Macedo, Luciana Gazzi; Hum, Abraham; Kuleba, Laura; Mo, Joey; Truong, Linda; Yeung, Mankeen

    2013-01-01

    Background Physical therapy is commonly prescribed for patients with lumbar spinal stenosis (LSS); however, little is known about its effectiveness. Purpose The purpose of this study was to systematically review randomized controlled trials (RCTs), controlled trials, and cohort studies evaluating the effectiveness of physical therapy for LSS. Data Sources Studies were searched on electronic databases to January 2012. Study Selection Inclusion criteria were: clinical diagnosis of LSS with confirmatory imaging, evaluation of physical therapy treatment, presence of a comparison group, and outcomes of pain, disability, function, or quality of life. Data Extraction Outcomes were extracted and, when possible, pooled using RevMan 5, a freely available review program from the Cochrane Library. Data Synthesis Ten studies were included: 5 RCTs, 2 controlled trials, 2 mixed-design studies, and 1 longitudinal cohort study. Pooled effects of 2 studies revealed that the addition of a physical therapy modality to exercise had no statistically significant effect on outcome. Pooled effects results of RCTs evaluating surgery versus physical therapy demonstrated that surgery was better than physical therapy for pain and disability at long term (2 years) only. Other results suggested that exercise is significantly better than no exercise, that cycling and body-weight–supported treadmill walking have similar effects, and that corsets are better than no corsets. Limitations The limitations of this review include the low quality and small number of studies, as well as the heterogeneity in outcomes and treatments. Conclusions No conclusions could be drawn from the review regarding which physical therapy treatment is superior for LSS. There was low-quality evidence suggesting that modalities have no additional effect to exercise and that surgery leads to better long-term (2 years) outcomes for pain and disability, but not walking distance, than physical therapy in patients with LSS. PMID:23886845

  8. Adverse effects of unconventional therapies in the elderly: A systematic review of the recent literature

    Microsoft Academic Search

    E. Ernst

    2002-01-01

    Unconventional therapies are increasingly popular, not least in populations of elderly individuals. This review summarizes\\u000a the evidence regarding the risk unconventional therapies may entail for the elderly. Computerized literature searches were\\u000a performed to locate all reports with original data on this topic. Most of the evidence found was anecdotal by nature and thus\\u000a has obvious limitations. The results show that

  9. Hydroxyurea therapy contributes to infertility in adult men with sickle cell disease: a review.

    PubMed

    DeBaun, Michael R

    2014-12-01

    Hydroxyurea therapy, a chemotherapeutic agent, is the only US FDA approved therapy for the prevention of vaso-occlusive pain in sickle cell disease (SCD). The National Institutes of Health has sponsored two Phase III randomized, placebo-controlled trials, initially in adults, and subsequently in children with sickle cell anemia (SCA). Despite the overwhelming evidence that hydroxyurea therapy is beneficial to children and adults with SCA, individuals with SCA and their families express reservations about its use, in part because of the concerns about fertility, particularly in men. As adolescent boys with SCD are now expected to reach their reproductive years, a new concern is emerging about the role of hydroxyurea therapy as a barrier to their progeny. This review will systemically evaluate compromised fertility in men with SCD, and the evidence that hydroxyurea therapy is associated with further decreasing fertility in men with SCD. PMID:25242414

  10. Review of the results of the in vivo dosimetry during total skin electron beam therapy

    PubMed Central

    Guidi, Gabriele; Gottardi, Giovanni; Ceroni, Paola; Costi, Tiziana

    2013-01-01

    This work reviews results of in vivo dosimetry (IVD) for total skin electron beam (TSEB) therapy, focusing on new methods, data emerged within 2012. All quoted data are based on a careful review of the literature reporting IVD results for patients treated by means of TSEB therapy. Many of the reviewed papers refer mainly to now old studies and/or old guidelines and recommendations (by IAEA, AAPM and EORTC), because (due to intrinsic rareness of TSEB-treated pathologies) only a limited number of works and reports with a large set of numerical data and proper statistical analysis is up-to-day available in scientific literature. Nonetheless, a general summary of the results obtained by the now numerous IVD techniques available is reported; innovative devices and methods, together with areas of possible further and possibly multicenter investigations for TSEB therapies are highlighted. PMID:24936333

  11. [Extracorporeal shockwave therapy (ESWT) in orthopedic indications: a selective review].

    PubMed

    Fritze, J

    1998-10-01

    A search of Medline concerning the efficacy of shock wave therapy for pseudarthritis (nonunion), calcifying tendinitis of the shoulder, lateral epicondylitis and painful heel identified 25 publications describing 31 investigations. These investigations cannot be accepted as confirmative. The effects in pseudarthritis appear most promising but the cases reported need a reanalysis and thorough description before efficacy can be accepted as granted. Moreover, the indication as well as the stimulus parameters have to be specified and standardized. Published data on the other indications justify prospective, randomized, double-blind, placebo-controlled (sham treatment) trials to confirm efficacy where again the procedure and dosing of shock wave therapy need data-based, rational standardization. PMID:9816990

  12. Literature Review on LINACs and FFAGs for Hadron Therapy

    NASA Astrophysics Data System (ADS)

    Verdú-Andrés, Silvia; Amaldi, Ugo; Faus-Golfe, Ángeles

    The document summarizes the recent papers, presentations and other public information on Radio-Frequency (RF) Linear Accelerators (linacs) and Fixed-Field Alternating-Gradient (FFAG) accelerators for hadron therapy. The main focus is on technical aspects of these accelerators. This report intends to provide a general overview of the state-of-the-art in those accelerators which could be used in short and middle-term for treating cancer.

  13. Silicone-Based Scar Therapy: A Review of the Literature

    Microsoft Academic Search

    Demetris StavrouOren; Oren Weissman; Eyal Winkler; Lior Yankelson; Eran Millet; Oren Paul Mushin; Alon Liran; Joseph Haik

    2010-01-01

    Hypertrophic and keloid scars still are among the banes of plastic surgery. In the treatment arsenal at the disposal of the\\u000a plastic surgeon, topical silicone therapy usually is considered the first line of treatment or as an adjuvant to other treatment\\u000a methods. Yet, knowledge concerning its mechanisms of action, clinical efficacy, and possible adverse effects is rather obscure\\u000a and sometimes

  14. A review on photoneutrons characteristics in radiation therapy with high-energy photon beams

    PubMed Central

    Naseri, Alireza; Mesbahi, Asghar

    2010-01-01

    In radiation therapy with high-energy photon beams (E > 10 MeV) neutrons are generated mainly in linacs head thorough (?,n) interactions of photons with nuclei of high atomic number materials that constitute the linac head and the beam collimation system. These neutrons affect the shielding requirements in radiation therapy rooms and also increase the out-of-field radiation dose of patients undergoing radiation therapy with high-energy photon beams. In the current review, the authors describe the factors influencing the neutron production for different medical linacs based on the performed measurements and Monte Carlo studies in the literature. PMID:24376940

  15. Ocular Surface Alterations and Topical Antiglaucomatous Therapy: A Review

    PubMed Central

    Actis, Alessandro G; Rolle, Teresa

    2014-01-01

    Ocular Surface Disease (OSD) is prevalent among medically treated patients with glaucoma. This is basically related to three key-points: OSD and glaucoma are both prevalent in elderly and are common comorbidities in the same patient; the role of the active ingredient of the medical antiglaucomatous therapy; the role of the preservative agent of this medical therapy. Considering the actual state of literature we can state that the active glaucoma agent have a role in OSD, but the main cause seems to be the preservative agent, in particular referring to benzalkonium chloride, BAK. In the clinical evaluation of dry eye patients there is no actually established gold standard. Since the ocular surface injury not only causes dry eye, red eye, eye itching, photophobia and other discomforts, but also increases the risk of failure of glaucoma surgery in patients, it becomes fundamental a complete and good clinical evaluation of OSD (considering Schirmer’s test, tear breakup time, corneal and conjunctival staining) together with a good evaluation of patients’ quality of life (with validated questionnaires). Development of complex preparations, preservative-free and/or novel preservative preparations for glaucoma therapy could provide a promising approach in the prevention of ocular surface injuries. PMID:25317218

  16. Injection therapy and denervation procedures for chronic low-back pain: a systematic review

    PubMed Central

    Kuijpers, Ton; Rubinstein, Sidney M.; van Middelkoop, Marienke; Ostelo, Raymond; Verhagen, Arianne; Koes, Bart W.; van Tulder, Maurits W.

    2010-01-01

    Injection therapy and denervation procedures are commonly used in the management of chronic low-back pain (LBP) despite uncertainty regarding their effectiveness and safety. To provide an evaluation of the current evidence associated with the use of these procedures, a systematic review was performed. Existing systematic reviews were screened, and the Cochrane Back Review Group trial register was searched for randomized controlled trials (RCTs) fulfilling the inclusion criteria. Studies were included if they recruited adults with chronic LBP, evaluated the use of injection therapy or denervation procedures and measured at least one clinically relevant outcome (such as pain or functional status). Two review authors independently assessed studies for eligibility and risk of bias (RoB). A meta-analysis was performed with clinically homogeneous studies, and the GRADE approach was used to determine the quality of evidence. In total, 27 RCTs were included, 14 on injection therapy and 13 on denervation procedures. 18 (66%) of the studies were determined to have a low RoB. Because of clinical heterogeneity, only two comparisons could be pooled. Overall, there is only low to very low quality evidence to support the use of injection therapy and denervation procedures over placebo or other treatments for patients with chronic LBP. However, it cannot be ruled out that in carefully selected patients, some injection therapy or denervation procedures may be of benefit. PMID:20424870

  17. Anterior pituitary hormone replacement therapy—a clinical review

    Microsoft Academic Search

    Christoph J. Auernhammer; George Vlotides

    2007-01-01

    This clinical review summarizes current approaches to diagnosis and treatment of anterior pituitary hormone deficiency. The\\u000a diagnostic value of endocrine function tests and replacement strategies for hydrocortisone, thyroxine, sex steroids, and growth\\u000a hormone replacement are reviewed. Female androgen deficiency syndrome and the current role of DHEA and testosterone replacement\\u000a in women are also discussed.

  18. Music therapy services in pediatric oncology: a national clinical practice review.

    PubMed

    Tucquet, Belinda; Leung, Maggie

    2014-01-01

    This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed. PMID:25027188

  19. Algorithms for the optimization of RBE-weighted dose in particle therapy.

    PubMed

    Horcicka, M; Meyer, C; Buschbacher, A; Durante, M; Krämer, M

    2013-01-21

    We report on various algorithms used for the nonlinear optimization of RBE-weighted dose in particle therapy. Concerning the dose calculation carbon ions are considered and biological effects are calculated by the Local Effect Model. Taking biological effects fully into account requires iterative methods to solve the optimization problem. We implemented several additional algorithms into GSI's treatment planning system TRiP98, like the BFGS-algorithm and the method of conjugated gradients, in order to investigate their computational performance. We modified textbook iteration procedures to improve the convergence speed. The performance of the algorithms is presented by convergence in terms of iterations and computation time. We found that the Fletcher-Reeves variant of the method of conjugated gradients is the algorithm with the best computational performance. With this algorithm we could speed up computation times by a factor of 4 compared to the method of steepest descent, which was used before. With our new methods it is possible to optimize complex treatment plans in a few minutes leading to good dose distributions. At the end we discuss future goals concerning dose optimization issues in particle therapy which might benefit from fast optimization solvers. PMID:23257239

  20. Algorithms for the optimization of RBE-weighted dose in particle therapy

    NASA Astrophysics Data System (ADS)

    Horcicka, M.; Meyer, C.; Buschbacher, A.; Durante, M.; Krämer, M.

    2013-01-01

    We report on various algorithms used for the nonlinear optimization of RBE-weighted dose in particle therapy. Concerning the dose calculation carbon ions are considered and biological effects are calculated by the Local Effect Model. Taking biological effects fully into account requires iterative methods to solve the optimization problem. We implemented several additional algorithms into GSI's treatment planning system TRiP98, like the BFGS-algorithm and the method of conjugated gradients, in order to investigate their computational performance. We modified textbook iteration procedures to improve the convergence speed. The performance of the algorithms is presented by convergence in terms of iterations and computation time. We found that the Fletcher-Reeves variant of the method of conjugated gradients is the algorithm with the best computational performance. With this algorithm we could speed up computation times by a factor of 4 compared to the method of steepest descent, which was used before. With our new methods it is possible to optimize complex treatment plans in a few minutes leading to good dose distributions. At the end we discuss future goals concerning dose optimization issues in particle therapy which might benefit from fast optimization solvers.

  1. Phototherapy, Photodynamic therapy and Photophoresis in the Treatment of Connective-Tissue Diseases: A Review.

    PubMed

    Gordon Spratt, E A; Gorcey, L V; Soter, N A; Brauer, J A

    2014-11-15

    Connective-tissue disorders, which include lupus erythematosus, morphea/scleroderma, and dermatomyositis, are characterized by cutaneous manifestations that are sometimes resistant to conventional therapy. Light treatments, which include phototherapy, photodynamic therapy, and photopheresis, are routinely utilized in the treatment of dermatologic conditions and may provide unique mechanisms of action in the treatment of these connective-tissue disorders. The objective of this study is to conduct a review of the literature that describes the use of phototherapy, photodynamic therapy and photopheresis in the treatment of lupus erythematosus, morphea/scleroderma, and dermatomyositis. A MEDLINE search was conducted to find articles that discussed treatment of connective-tissue diseases with light therapies and greater than 30 publications that discussed light therapy for these diseases were identified. These ranged in design from case reports to randomized, prospective trials. Study outcomes and details were summarized and presented within each connective-tissue disease by light therapy modality, which include phototherapy, photodynamic therapy and photopheresis. Although there is a known association between photosensitivity and connective-tissue diseases, light therapies, when used appropriately, may be legitimate therapeutic options for recalcitrant cutaneous manifestations in lupus erythematosus, morphea/scleroderma, and dermatomyositis. This article is protected by copyright. All rights reserved. PMID:25400115

  2. A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients

    PubMed Central

    Carr, Catherine; Odell-Miller, Helen; Priebe, Stefan

    2013-01-01

    Background and Objectives There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported. Review Methods A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis. Results 98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions. Conclusions No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to develop specific music therapy models for this patient group that can be tested in experimental studies. PMID:23936399

  3. Eurythmy Therapy in clinical studies: a systematic literature review

    PubMed Central

    Büssing, Arndt; Ostermann, Thomas; Majorek, Magdalena; Matthiessen, Peter F

    2008-01-01

    Background We aimed to overview the current literature on eurythmy therapy (EYT) which is an integral part of Anthroposophic Medicine. EYT can be described as a movement therapy in which speech movements are transposed into exercises which address the patient's capability to soul expression and strengthen his salutogenetic resources. Methods We searched several databases such as Cochrane, EMBASE, NCCAM, NLM, DIMDI, CAMbase, and Medline for case-control studies, cohort studies and randomised controlled trials on the treatment effects of EYT in a clinical setting. In a second search we included journal databases from Karger, Kluwer, Springer, Thieme, and Merkurstab archive. Results We found 8 citations which met the inclusion criterion: 4 publications referring to a prospective cohort study without control group (the AMOS study), and 4 articles referring to 2 explorative pre-post studies without control group, 1 prospective, non-randomized comparative study, and 1 descriptive study with a control group. The methodological quality of studies ranged in from poor to good, and in sample size from 5 to 898 patients. In most studies, EYT was used as an add-on, not as a mono-therapy. The studies described positive treatment effects with clinically relevant effect sizes in most cases. Conclusion Indications, study designs and the usage of additional treatments within the identified studies were quite heterogeneous. Despite of this, EYT can be regarded as a potentially relevant add-on in a therapeutic concept, although its specific relevance remains to be clarified. Well performed controlled studies on this unique treatment are highly recommended. PMID:18377647

  4. Method for the systematic reviews on occupational therapy and driving and community mobility for older adults.

    PubMed

    Arbesman, Marian; Lieberman, Deborah; Berlanstein, Debra R

    2014-01-01

    Systematic reviews of literature relevant to driving and community mobility for older adults are important to the practice of occupational therapy. We describe the four questions that served as the focus for the systematic reviews of the effectiveness of occupational therapy assessments and interventions for driving and community mobility for older adults. We include the background for the reviews; the process followed for each question, including search terms and search strategy; the databases searched; and the methods used to summarize and critically appraise the literature. The final number of articles included in each systematic review, a summary of the themes of the results, the strengths and limitations of the findings, and the implications for practice, education, and research are presented. PMID:25397760

  5. Method for the evidence-based reviews on occupational therapy and stroke.

    PubMed

    Arbesman, Marian; Lieberman, Deborah; Berlanstein, Debra R

    2015-01-01

    Evidence-based reviews of the literature relevant to adults with stroke are important to the practice of occupational therapy. We describe the four questions that served as the focus for the evidence-based reviews of the effectiveness of occupational therapy interventions for adults with stroke. The questions include occupation- and activity-based interventions to improve occupational performance and social participation after stroke, as well as interventions for motor, cognitive, and psychological and emotional impairments after stroke. We include the background for the reviews; the process followed for addressing each question, including search terms and search strategy; the databases searched; and the methods used to summarize and critically appraise the literature. The final number of articles included in each evidence-based review; a summary of the themes of the results; the strengths and limitations of the findings; and implications for practice, education, and research are presented. PMID:25553741

  6. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

    PubMed Central

    Kumar, Saravana; Beaton, Kate; Hughes, Tricia

    2013-01-01

    Introduction The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. Methods A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Results Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as mobilization), standard medical care, and acupuncture. Conclusion There is an emerging body of evidence, albeit small, that supports the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. Due to common methodological flaws in the primary research, which informed the systematic reviews, recommendations arising from this evidence base should be interpreted with caution. PMID:24043951

  7. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review

    PubMed Central

    2011-01-01

    Background Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness. Methods A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria. Results A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity. Discussion Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented. Conclusion There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended. PMID:21923933

  8. Systematic reviews of complementary therapies - an annotated bibliography. Part 1: Acupuncture

    PubMed Central

    Linde, Klaus; Vickers, Andrew; Hondras, Maria; ter Riet, Gerben; Thormählen, Johannes; Berman, Brian; Melchart, Dieter

    2001-01-01

    Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with acupuncture. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of acupuncture; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. Results From a total of 48 potentially relevant reviews preselected in a screeening process 39 met the inclusion criteria. 22 were on various pain syndromes or rheumatic diseases. Other topics addressed by more than one review were addiction, nausea, asthma and tinnitus. Almost unanimously the reviews state that acupuncture trials include too few patients. Often included trials are heterogeneous regarding patients, interventions and outcome measures, are considered to have insufficient quality and contradictory results. Convincing evidence is available only for postoperative nausea, for which acupuncture appears to be of benefit, and smoking cessation, where acupuncture is no more effective than sham acupuncture. Conclusions A large number of systematic reviews on acupuncture exists. What is most obvious from these reviews is the need for (the funding of) well-designed, larger clinical trials. PMID:11513758

  9. Systematic reviews of complementary therapies – an annotated bibliography. Part 2: Herbal medicine

    PubMed Central

    Linde, Klaus; ter Riet, Gerben; Hondras, Maria; Vickers, Andrew; Saller, Reinhard; Melchart, Dieter

    2001-01-01

    Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with herbal medicine. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of herbal medicines; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pre-tested form and summarized descriptively. Results From a total of 79 potentially relevant reviews pre-selected in the screening process 58 met the inclusion criteria. Thirty of the reports reviewed ginkgo (for dementia, intermittent claudication, tinnitus, and macular degeneration), hypericum (for depression) or garlic preparations (for cardiovascular risk factors and lower limb atherosclerosis). The quality of primary studies was criticized in the majority of the reviews. Most reviews judged the available evidence as promising but definitive conclusions were rarely possible. Conclusions Systematic reviews are available on a broad range of herbal preparations prescribed for defined conditions. There is very little evidence on the effectiveness of herbalism as practised by specialist herbalists who combine herbs and use unconventional diagnosis. PMID:11518548

  10. Adverse events of auricular therapy: a systematic review.

    PubMed

    Tan, Jing-Yu; Molassiotis, Alexander; Wang, Tao; Suen, Lorna K P

    2014-01-01

    The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient's safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved. PMID:25435890

  11. Adverse Events of Auricular Therapy: A Systematic Review

    PubMed Central

    Molassiotis, Alexander; Wang, Tao; Suen, Lorna K. P.

    2014-01-01

    The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient's safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved. PMID:25435890

  12. Outcome of type III Gaucher disease on enzyme replacement therapy: Review of 55 cases

    Microsoft Academic Search

    E. H. Davies; A. Erikson; T. Collin-Histed; E. Mengel; A. Tylki-Szymanska; A. Vellodi

    2007-01-01

    Summary  The European Task Force for Neuronopathic Gaucher Disease (NGD) met in 2006 to review its 2001 guidelines. Fifty-five patients\\u000a from five European countries were reviewed; 29 were male and 26 female. The majority of the patients were homozygous for the\\u000a L444P mutation. All had been on enzyme replacement therapy (ERT). However, there was considerable variation in the dose of\\u000a ERT,

  13. Usage of complementary therapies in rheumatology: A systematic review

    Microsoft Academic Search

    E. Ernst

    1998-01-01

    Complementary medicine (CM) is more popular than ever before. Rheumatology patients seem particularly keen to try CM. In this paper, surveys on rheumatology patients' use of CM are reviewed. The issues of perceived effectiveness, safety and costs are also addressed. In addition surveys of doctors' attitudes towards CM in rheumatology are summarised. Fourteen surveys on patients' use of CM and

  14. Triple antiplatelet therapy for preventing vascular events: a systematic review and meta-analysis

    PubMed Central

    2010-01-01

    Background Dual antiplatelet therapy is usually superior to mono therapy in preventing recurrent vascular events (VEs). This systematic review assesses the safety and efficacy of triple antiplatelet therapy in comparison with dual therapy in reducing recurrent vascular events. Methods Completed randomized controlled trials investigating the effect of triple versus dual antiplatelet therapy in patients with ischaemic heart disease (IHD), cerebrovascular disease or peripheral vascular disease were identified using electronic bibliographic searches. Data were extracted on composite VEs, myocardial infarction (MI), stroke, death and bleeding and analysed with Cochrane Review Manager software. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using random effects models. Results Twenty-five completed randomized trials (17,383 patients with IHD) were included which involving the use of intravenous (iv) GP IIb/IIIa inhibitors (abciximab, eptifibatide, tirofiban), aspirin, clopidogrel and/or cilostazol. In comparison with aspirin-based therapy, triple therapy using an intravenous GP IIb/IIIa inhibitor significantly reduced composite VEs and MI in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) (VE: OR 0.69, 95% CI 0.55-0.86; MI: OR 0.70, 95% CI 0.56-0.88) and ST elevation myocardial infarction (STEMI) (VE: OR 0.39, 95% CI 0.30-0.51; MI: OR 0.26, 95% CI 0.17-0.38). A significant reduction in death was also noted in STEMI patients treated with GP IIb/IIIa based triple therapy (OR 0.69, 95% CI 0.49-0.99). Increased minor bleeding was noted in STEMI and elective percutaneous coronary intervention (PCI) patients treated with GP IIb/IIIa based triple therapy. Stroke events were too infrequent for us to be able to identify meaningful trends and no data were available for patients recruited into trials on the basis of stroke or peripheral vascular disease. Conclusions Triple antiplatelet therapy based on iv GPIIb/IIIa inhibitors was more effective than aspirin-based dual therapy in reducing VEs in patients with acute coronary syndromes (STEMI and NSTEMI). Minor bleeding was increased among STEMI and elective PCI patients treated with a GP IIb/IIIa based triple therapy. In patients undergoing elective PCI, triple therapy had no beneficial effect and was associated with an 80% increase in transfusions and an eightfold increase in thrombocytopenia. Insufficient data exist for patients with prior ischaemic stroke and peripheral vascular disease and further research is needed in these groups of patients. PMID:20553581

  15. A Monte Carlo tool for raster-scanning particle therapy dose computation

    NASA Astrophysics Data System (ADS)

    Jelen, U.; Radon, M.; Santiago, A.; Wittig, A.; Ammazzalorso, F.

    2014-03-01

    Purpose of this work was to implement Monte Carlo (MC) dose computation in realistic patient geometries with raster-scanning, the most advanced ion beam delivery technique, combining magnetic beam deflection with energy variation. FLUKA, a Monte Carlo package well-established in particle therapy applications, was extended to simulate raster-scanning delivery with clinical data, unavailable as built-in feature. A new complex beam source, compatible with FLUKA public programming interface, was implemented in Fortran to model the specific properties of raster-scanning, i.e. delivery by means of multiple spot sources with variable spatial distributions, energies and numbers of particles. The source was plugged into the MC engine through the user hook system provided by FLUKA. Additionally, routines were provided to populate the beam source with treatment plan data, stored as DICOM RTPlan or TRiP98's RST format, enabling MC recomputation of clinical plans. Finally, facilities were integrated to read computerised tomography (CT) data into FLUKA. The tool was used to recompute two representative carbon ion treatment plans, a skull base and a prostate case, prepared with analytical dose calculation (TRiP98). Selected, clinically relevant issues influencing the dose distributions were investigated: (1) presence of positioning errors, (2) influence of fiducial markers and (3) variations in pencil beam width. Notable differences in modelling of these challenging situations were observed between the analytical and Monte Carlo results. In conclusion, a tool was developed, to support particle therapy research and treatment, when high precision MC calculations are required, e.g. in presence of severe density heterogeneities or in quality assurance procedures.

  16. Advances in 4D treatment planning for scanned particle beam therapy - report of dedicated workshops.

    PubMed

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-12-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue. PMID:24354749

  17. Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data

    PubMed Central

    2005-01-01

    Although music therapy is an established allied health profession and is used with increasing frequency in the treatment of those with a terminal illness, there is a real dearth of empirical research literature supporting the use of music therapy in end-of-life care. This article reviews the empirical studies found in the literature and documents the emergence of an evidenced-based approach to the use of music therapy in hospice and palliative care. A total of 11 studies are reviewed; of these, six show significant differences supporting the use of music therapy in this area. Dependent variables positively affected by music therapy include pain, physical comfort, fatigue and energy, anxiety and relaxation, time and duration of treatment, mood, spirituality and quality of life. Guidelines for future research are considered, and variables that need to be controlled are presented. The need to create an evidence-based approach to hospice and palliative care music therapy is articulated, and future researchers are empowered to continue to conduct investigations among this population. PMID:15937557

  18. Personalized therapy for urothelial cancer: review of the clinical evidence

    PubMed Central

    Guancial, Elizabeth A.; Chowdhury, Dipanjan; Rosenberg, Jonathan E.

    2012-01-01

    Despite a detailed understanding of the molecular aberrations driving the development of urothelial cancers, this knowledge has not translated into advances for the treatment of this disease. Urothelial cancers are chemosensitive, and platinum-based combination chemotherapy remains the standard of care for advanced disease, as well as neoadjuvant and adjuvant therapy for locally advanced disease. However, nearly half of patients who undergo resection of locally advanced urothelial cancer will relapse and eventually develop platinum-resistant disease. Clinical trials of targeted agents against angiogenesis and growth factors, as well as novel chemotheraputics, have generally been unsuccessful in urothelial cancers. Improvements in the theraputic arsenal for urothelial cancer depend upon identification of new targets and strategies to overcome platinum resistance. PMID:22754656

  19. Leech therapy for epidermoid cysts and review of the literature

    PubMed Central

    Rasi, Abbas; Faghihi, Alireza; Jalali, Mirhadi Aziz; Zamanian, Abbas; Ghaffarpour, Gholamhossein

    2014-01-01

    Hirudo medicinalis sucks blood directly through the external mammalian skin. We recently observed a healthy 64-year-old Iranian man, who presented with numerous asymptomatic multilobular oval-to-round well-defined 0.5 to 1.5 cm cystic lesions with central umbilication (central black eschar) over the upper portion of his chest. We made the diagnosis of epidermoid cyst, giant comedone and leech bite on the basis of the constellation of clinical features. The patient was treated with oral ciprofloxacin at a dose of 2 g daily, and 2% topical erythromycin solution. Despite improvement, the evidence of cystic lesions persisted. There was no history of similar lesions in any other family member. There was no history of trauma. The patient was not using any topical or systemic medication. Two weeks before his visit, he had a history of leech therapy under the supervision of a general practitioner. His medical history was significant for leech therapy of the lesions, five days previously. He was followed up for another two weeks and after disappearance of the inflammation, with the patient under local anesthesia, the well-circumscribed mass was completely evacuated with a sharp curette and comedone extractor. The patient was subsequently lost to follow-up. Conclusion: Considering the efficacy of leeches, it would be favorable to breed a germ-free leech. In Iran, the use of the leeches in surgery, in recent years, has been infrequent. It appears that the positive effects of this ancient remedy may now be explained through scientific methods, promising potentially even more uses of this admirable creature in medicine. PMID:24804186

  20. Proton therapy in lung cancer: Clinical outcomes and technical issues. A systematic review

    Microsoft Academic Search

    Lamberto Widesott; Maurizio Amichetti; Marco Schwarz

    2008-01-01

    Background and purpose. To determine whether, according to the currently available literature, proton therapy (PT) has a role in the treatment of non-small-cell lung cancer (NSCLC), to assess its safety and efficacy and to evaluate the main technical issues specifically related to this treatment technique. Materials and methods. During March 2007, two independent researchers conducted a systematic review of the

  1. Proton therapy in lung cancer: Clinical outcomes and technical issues. A systematic review

    Microsoft Academic Search

    Lamberto Widesott; Maurizio Amichetti; Marco Schwarz

    Background and purpose. To determine whether, according to the currently available literature, proton therapy (PT) has a role in the treatment of non-small-cell lung cancer (NSCLC), to assess its safety and efficacy and to evaluate the main technical issues specifically related to this treatment technique. Materials and methods. During March 2007, two independent researchers conducted a systematic review of the

  2. Multisystemic Therapy for Child Non-Externalizing Psychological and Health Problems: A Preliminary Review

    ERIC Educational Resources Information Center

    Pane, Heather T.; White, Rachel S.; Nadorff, Michael R.; Grills-Taquechel, Amie; Stanley, Melinda A.

    2013-01-01

    Multisystemic therapy (MST) is effective for decreasing or preventing delinquency and other externalizing behaviors and increasing prosocial or adaptive behaviors. The purpose of this project was to review the literature examining the efficacy of MST for other child psychological and health problems reflecting non-externalizing behaviors,…

  3. Impact of physical therapy for Parkinson's disease: A critical review of the literature

    Microsoft Academic Search

    G. Kwakkel; C. J. T. de Goede; E. E. H. van Wegen

    2007-01-01

    A systematic review of the literature found 23 randomized clinical trials reflecting specific core areas of physical therapy (PT), that is, transfer, posture, balance, reaching and grasping, gait, and physical condition. All studies were of moderate methodological quality. Important limitations of the studies were: (1) insufficient statistical power (type II error); (2) poor methodological quality due to inadequate randomization and

  4. Effectiveness of physical therapy interventions for children with cerebral palsy: A systematic review

    Microsoft Academic Search

    Heidi Anttila; Ilona Autti-Rämö; Jutta Suoranta; Marjukka Mäkelä; Antti Malmivaara

    2008-01-01

    BACKGROUND: To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). METHODS: A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality

  5. Cognitive-Behavioral Therapy for Somatization and Symptom Syndromes: A Critical Review of Controlled Clinical Trials

    Microsoft Academic Search

    Kurt Kroenke; Ralph Swindle

    2000-01-01

    Objective: Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioral therapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. Methods: A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of

  6. Pelvic Floor Physical Therapy for Lifelong Vaginismus: A Retrospective Chart Review and Interview Study

    Microsoft Academic Search

    Elke Doris Reissing; Heather Lynne Armstrong; Caroline Allen

    2012-01-01

    Pelvic floor physical therapy (PT) is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or were not differentiated from women with acquired vaginismus and\\/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on PT interventions, course, and outcome in women who

  7. Effectiveness of Solution-Focused Brief Therapy: A Systematic Qualitative Review of Controlled Outcome Studies

    ERIC Educational Resources Information Center

    Gingerich, Wallace J.; Peterson, Lance T.

    2013-01-01

    Objective: We review all available controlled outcome studies of solution-focused brief therapy (SFBT) to evaluate evidence of its effectiveness. Method: Forty-three studies were located and key data abstracted on problem, setting, SFBT intervention, design characteristics, and outcomes. Results: Thirty-two (74%) of the studies reported…

  8. Assessment in Marriage and Family Therapy: A Review of Clinical Updates for Family Therapists

    Microsoft Academic Search

    Deborah C. Bailey

    2012-01-01

    This article presents information from an integrative literature review that examined assessment processes presented to marriage and family therapists in Clinical Updates for Family Therapists, Volumes 1 (2005), 2 (2006), and 3 (2007). The study was based on the concern that marriage and family therapy is losing its systemic relational focus as practitioners must comply with diagnosis models using the

  9. The child's participation in family therapy: A review and a model

    Microsoft Academic Search

    Claude Villeneuve; Catherine LaRoche

    1993-01-01

    A major gap in family therapy, the treatment of children and adults together, is addressed. The literature on the children's participation is reviewed and a model which systematizes their involvement is presented. The full participation of the child necessitates the use of play. To create a context of play without alienating the rest of the family, action-promoting methods are used.

  10. Androgen deprivation therapy for prostate cancer—review of indications in 2010

    PubMed Central

    Quon, H.; Loblaw, D.A.

    2010-01-01

    The discovery of androgen deprivation therapy (adt) has been one of the most important advances in the treatment of prostate cancer. Here, the indications for the use of adt are reviewed, together with the data supporting each indication. The settings for adt use include cytoreduction; combined adt and radiotherapy; pathologic node-positive disease; and recurrent, metastatic, or progressive prostate cancer. PMID:20882131

  11. Medical Therapy for Benign Prostatic Hyperplasia: A Review of the Literature

    Microsoft Academic Search

    G. M. Clifford; R. D. T. Farmer

    2000-01-01

    Objective: To review the existing evidence regarding the efficacy and safety of medical therapy for lower urinary tract symptoms (LUTS) indicative of benign prostatic hyperplasia (BPH). To assess randomised controlled trials investigating the six ?–adrenergic receptor antagonists (?–blockers), prazosin, alfuzosin, indoramin, terazosin, doxazosin, and tamsulosin, that benefit patients by relaxing prostatic smooth muscle, and the anti–androgen, finasteride, that mediates its

  12. UCLA and Fred Hutchinson scientists review menopausal hormone therapy and breast cancer risk

    Cancer.gov

    In the past decade, results from large prospective cohort studies and the Women's Health Initiative (WHI) randomized placebo-controlled hormone therapy trials have substantially changed thoughts about how estrogen alone and estrogen plus progestin influence the risk of breast cancer, according to a review published March 15 in the Journal of The National Cancer Institute.

  13. Effectiveness of Massage Therapy for Chronic, NonMalignant Pain: A Review

    Microsoft Academic Search

    Jennie C. I. Tsao

    2007-01-01

    Previous reviews of massage therapy for chronic, non-malignant pain have focused on discrete pain conditions. This article aims to provide a broad overview of the literature on the effectiveness of massage for a variety of chronic, non-malignant pain complaints to identify gaps in the research and to inform future clinical trials. Computerized databases were searched for relevant studies including prior

  14. Child-Centered Play Therapy in the Schools: Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Ray, Dee C.; Armstrong, Stephen A.; Balkin, Richard S.; Jayne, Kimberly M.

    2015-01-01

    The authors conducted a meta-analysis and systematic review that examined 23 studies evaluating the effectiveness of child centered play therapy (CCPT) conducted in elementary schools. Meta-analysis results were explored using a random effects model for mean difference and mean gain effect size estimates. Results revealed statistically significant…

  15. Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis

    Microsoft Academic Search

    Richard A Malthaner; Rebecca KS Wong; R Bryan Rumble; Lisa Zuraw

    2004-01-01

    BACKGROUND: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.

  16. Pharmacological therapy used in the elimination of Helicobacter pylori infection: A review

    PubMed Central

    dos Santos, Ariolana A; Carvalho, Adriana A

    2015-01-01

    The optimal therapy for Helicobacter pylori (H. pylori) infection should combine a high cure rate and a short treatment duration with a favorable side-effect profile and should maintain a low cost. Several strategies have been proposed to increase the H. pylori eradication rate, including the extension of the treatment duration to 14 d, the use of a four-drug regimen (quadruple, sequential, and concomitant treatments), and the use of novel antibiotics, such as levofloxacin. However, triple therapy remains the most widely accepted first-line treatment regimen in Brazil and the United States and throughout Europe. Because this therapy is limited by resistance to clarithromycin, other therapeutic regimens have been investigated worldwide. This review describes the current literature involving studies directly comparing these different therapies and their efficacies. PMID:25574087

  17. A systematic review comparing cognitive-behavioral therapy and contingency management for cocaine dependence.

    PubMed

    Farronato, Nadine S; Dürsteler-Macfarland, Kenneth M; Wiesbeck, Gerhard A; Petitjean, Sylvie A

    2013-01-01

    The main objective of this review was to compare the effectiveness of cognitive-behavioral therapy and contingency management for cocaine dependence. Contingency management alone reliably reduced cocaine use during active treatment in all cited trials, whereas the positive effect of cognitive-behavioral therapy emerged after treatment in 3 of 5 trials. Synergistic effects of the combination of contingency management plus cognitive-behavioral therapy are shown in 2 trials, but another 3 trials found no additive effects. Positive, rapid, and enduring effects on cocaine use are reliably seen with contingency management interventions, whereas measurable effects of cognitive-behavioral therapy emerge after treatment and are not as reliable as effects with contingency management. PMID:24074193

  18. Adequate margin definition for scanned particle therapy in the incidence of intrafractional motion

    NASA Astrophysics Data System (ADS)

    Knopf, Antje-Christin; Boye, Dirk; Lomax, Antony; Mori, Shininchiro

    2013-09-01

    Advanced 4D dose calculations (4DDCs) for scanned particle therapy show that in the incidence of motion, it is insufficient to use target contours defined on one reference CT phase. ICRU Report 62 (ICRU 1999 ICRU Report 62 (Bethesda, MD: ICRU)) advises that variations in size, shape and position of CTVs relative to anatomic reference points have to be considered for internal target volumes (ITVs). In addition to geometrical margin adaption, changes of water equivalent path length have to be considered for particle therapy. Different ITV concepts have been applied to six representative patients (liver and lung indications) based on 4DCT. Geometrical ITVs (gITV) were calculated by combining deformed CTVs over all motion phases. To take into account path length changes, range adapted ITVs (raITV) were established as the union of range adapted CTVs in all phases. For gated delivery, gat_gITVs and gat_raITVs were calculated. Extensive 4DDCs have been performed for two exemplary patients to illustrate that neither re-scanning nor gating can sufficiently compensate for motion effects if no appropriate margins are employed and to evaluate the effectiveness of gITVs and raITVs. CTVs significantly differ from gITVs and raITVs in size (up to a factor 2 in volume). But also raITVs and gITVs differ significantly in size and are spatially displaced, particularly for lung patients. raITVs show a strong field dependence in shape. All volumes are reduced in size when gating is applied and considered during margin adaption. 4D dose distributions show big improvements when gITV or raITV are used compared to CTVs. However, the use of either gITVs or raITVs do not result in significant differences. If raITVs are used, slightly better target coverage is gained at the cost of more healthy tissue exposure. Our results emphasize that adapted target volumes have to be used for scanned particle therapy in the presence of motion. However, even though gITVs and raITVs differ significantly in shape and size, this difference does not necessarily translate into significant differences in the resultant 4D dose distributions.

  19. Preclinical investigations towards the first spacer gel application in prostate cancer treatment during particle therapy at HIT

    PubMed Central

    2013-01-01

    Background The application of spacer gel represents a promising approach to reliably spare the rectal frontal wall during particle therapy (IJROBP 76:1251-1258, 2010). In order to qualify the spacer gel for the clinical use in particle therapy, a variety of measurements were performed in order to ensure the biological compatibility of the gel, its physical stability during and after the irradiation, and a proper definition of the gel in terms of the Hounsfield Unit (HU) values for the treatment planning system. The potential for the use of the spacer gel for particle therapy monitoring with off-line Positron Emission Tomography (PET) was also investigated. Results The spacer gel implanted to the prostate patient in direct neighbourhood to the clinical target volume does not interfere with the particle therapy treatment planning procedure applied at Heidelberg Ion Beam Therapy Centre (HIT). The performed measurements show that Bragg-peak position of the particles can be properly predicted on the basis of computed tomography imaging with the treatment planning system used at HIT (measured water equivalent path length of 1.011 ±0.011 (2?), measured Hounsfield Unit of 28.9 ±6.1 (2?)). The spacer gel samples remain physically unchanged after irradiation with a dose exceeding the therapeutic dose level. The independently measured Bragg-Peak position does not change within the time interval of 10 weeks. Conclusions As a result of the presented experiments, the first clinical application of spacer gel implant during prostate cancer treatment with carbon ions and protons was possible at HIT in 2012. The reported pre-clinical investigations demonstrate that use of spacer gel is safe in particle therapy in presence of therapy target motion and patient positioning induced particle range variations. The spacer gel injected between prostate and rectum enlarge the distance between both organs, which is expected to clinically significantly decrease the undesirable exposure of the most critical organ at risk, i.e. rectal frontal wall. Further research on the composition of spacer gel material might lead to additional clinical benefits by validation of particle therapy of prostate via post-therapeutic PET-imaging or by patient positioning based on the gel as a radio-opaque marker. PMID:23742233

  20. A review and update on melanocyte stimulating hormone therapy: afamelanotide.

    PubMed

    Fabrikant, Jordan; Touloei, Khasha; Brown, Stuart M

    2013-07-01

    Afamelanotide ([Nle4-D-Phe7]-alpha-MSH) is an analog of alpha-melanocyte stimulating hormone given as a subcutaneous injection. Afamelanotide is currently undergoing phase II and III trials in Europe and the US for skin diseases including vitiligo, erythropoietic protoporphyria, polymorphic light eruption and prevention of actinic keratoses in organ transplant recipients. Unregulated analogs and chemicals are being sold online ahead of formal approval. A number of counterfeit chemicals, 'Melanotans' are being sold for tanning purposes. Currently, afamelanotide is already on the market in Italy and Switzerland for patients with erythropoietic protoporphyria. This paper will review the current literature on this promising compound. PMID:23884489

  1. The Effect of Orthodontic Therapy on Periodontal Health: A Review of the Literature

    PubMed Central

    Alfuriji, Samah; Alhazmi, Nora; Alhamlan, Nasir; Al-Ehaideb, Ali; Alruwaithi, Moatazbellah; Alkatheeri, Nasser; Geevarghese, Amrita

    2014-01-01

    Objectives. This review aims to evaluate the effect of orthodontic therapy on periodontal health. Data. Original articles that reported on the effect of orthodontic therapy on periodontal health were included. The reference lists of potentially relevant review articles were also sought. Sources. A literature search was conducted using the databases, Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. The search was carried out by using a combined text and the MeSH search strategies: using the key words in different combinations: “periodontal disease,” “orthodontics” and “root resorption.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Articles published only in English language were included. Letters to the Editor, historical reviews and unpublished articles were not sought. Conclusions. Within the limitations of the present literature review, it was observed that there is a very close inter-relationship between the periodontal health and the outcome of orthodontic therapy. PMID:24991214

  2. Improvement of extraction efficiency from a compact synchrotron for proton beam therapy by applying particle tracking analysis

    NASA Astrophysics Data System (ADS)

    Ebina, Futaro; Umezawa, Masumi; Hiramoto, Kazuo

    2013-04-01

    Various types of synchrotrons are used for particle beam therapy. In particle beam therapy, especially in proton beam therapy, downsizing of the accelerator system is a major concern. A compact synchrotron dedicated for proton beam therapy is presented. The synchrotron is horizontally weakly focusing and consists of 4 H-type zerogradient dipole magnets and 4 quadrupole magnets. The circumference of the ring is a little shorter than 18 m, and the energies are up to 230MeV. Beam extraction from the synchrotron is performed by RF-driven slow extraction technology. Two sextupole magnets set in adjacent straight sections form a horizontal separatrix which is fixed during the beam extraction. Horizontal RF voltage excites betatron oscillation of the circulating beam, and protons exceeding the separatrix are extracted by an electrostatic deflector and a horizontal septum dipole magnet. To achieve adequately high extraction efficiency, the relationship between the extraction efficiency and the horizontal chromaticity of the ring is analyzed by particle tracking simulation. The horizontal chromaticity with maximum extraction efficiency is half of the theoretical value because of the distortion of the horizontal separatrix for the extraction. With this chromaticity, the spiral-step of the extracted particle is independent of the momentum deviation of the particle, and the separatrix across the electrostatic septum electrodes is superpositioned.

  3. Surrogate-driven deformable motion model for organ motion tracking in particle radiation therapy

    NASA Astrophysics Data System (ADS)

    Fassi, Aurora; Seregni, Matteo; Riboldi, Marco; Cerveri, Pietro; Sarrut, David; Battista Ivaldi, Giovanni; Tabarelli de Fatis, Paola; Liotta, Marco; Baroni, Guido

    2015-02-01

    The aim of this study is the development and experimental testing of a tumor tracking method for particle radiation therapy, providing the daily respiratory dynamics of the patient’s thoraco-abdominal anatomy as a function of an external surface surrogate combined with an a priori motion model. The proposed tracking approach is based on a patient-specific breathing motion model, estimated from the four-dimensional (4D) planning computed tomography (CT) through deformable image registration. The model is adapted to the interfraction baseline variations in the patient’s anatomical configuration. The driving amplitude and phase parameters are obtained intrafractionally from a respiratory surrogate signal derived from the external surface displacement. The developed technique was assessed on a dataset of seven lung cancer patients, who underwent two repeated 4D CT scans. The first 4D CT was used to build the respiratory motion model, which was tested on the second scan. The geometric accuracy in localizing lung lesions, mediated over all breathing phases, ranged between 0.6 and 1.7?mm across all patients. Errors in tracking the surrounding organs at risk, such as lungs, trachea and esophagus, were lower than 1.3?mm on average. The median absolute variation in water equivalent path length (WEL) within the target volume did not exceed 1.9?mm-WEL for simulated particle beams. A significant improvement was achieved compared with error compensation based on standard rigid alignment. The present work can be regarded as a feasibility study for the potential extension of tumor tracking techniques in particle treatments. Differently from current tracking methods applied in conventional radiotherapy, the proposed approach allows for the dynamic localization of all anatomical structures scanned in the planning CT, thus providing complete information on density and WEL variations required for particle beam range adaptation.

  4. Surrogate-driven deformable motion model for organ motion tracking in particle radiation therapy.

    PubMed

    Fassi, Aurora; Seregni, Matteo; Riboldi, Marco; Cerveri, Pietro; Sarrut, David; Ivaldi, Giovanni Battista; de Fatis, Paola Tabarelli; Liotta, Marco; Baroni, Guido

    2015-02-21

    The aim of this study is the development and experimental testing of a tumor tracking method for particle radiation therapy, providing the daily respiratory dynamics of the patient's thoraco-abdominal anatomy as a function of an external surface surrogate combined with an a priori motion model. The proposed tracking approach is based on a patient-specific breathing motion model, estimated from the four-dimensional (4D) planning computed tomography (CT) through deformable image registration. The model is adapted to the interfraction baseline variations in the patient's anatomical configuration. The driving amplitude and phase parameters are obtained intrafractionally from a respiratory surrogate signal derived from the external surface displacement. The developed technique was assessed on a dataset of seven lung cancer patients, who underwent two repeated 4D CT scans. The first 4D CT was used to build the respiratory motion model, which was tested on the second scan. The geometric accuracy in localizing lung lesions, mediated over all breathing phases, ranged between 0.6 and 1.7?mm across all patients. Errors in tracking the surrounding organs at risk, such as lungs, trachea and esophagus, were lower than 1.3?mm on average. The median absolute variation in water equivalent path length (WEL) within the target volume did not exceed 1.9?mm-WEL for simulated particle beams. A significant improvement was achieved compared with error compensation based on standard rigid alignment. The present work can be regarded as a feasibility study for the potential extension of tumor tracking techniques in particle treatments. Differently from current tracking methods applied in conventional radiotherapy, the proposed approach allows for the dynamic localization of all anatomical structures scanned in the planning CT, thus providing complete information on density and WEL variations required for particle beam range adaptation. PMID:25615399

  5. Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review.

    PubMed

    Speyer, Renée; Baijens, Laura; Heijnen, Mariëlle; Zwijnenberg, Iris

    2010-03-01

    Medical and paramedical treatments should be evaluated according to current standards of evidence-based medicine. Evaluation of therapy in oropharyngeal dysphagia fits into this growing interest. A systematic review is given of the literature on the effects of therapy in oropharyngeal dysphagia carried out by speech therapists. Thus, the review excludes reports of surgical or pharmacological treatments. The literature search was performed using the electronic databases PubMed and Embase. All available inclusion dates up to November 2008 were used. The search was limited to English, German, French, Spanish, and Dutch publications. MESH terms were supplemented by using free-text words (for the period after January 2005). Fifty-nine studies were included. In general, statistically significant positive therapy effects were found. However, the number of papers was rather small. Moreover, diverse methodological problems were found in many of these studies. For most studies, the conclusions could not be generalized; comparison was hindered by the range of diagnoses, types of therapies, and evaluation techniques. Many questions remain about the effects of therapy in oropharyngeal dysphagia as performed by speech and language therapists. Although some positive significant outcome studies have been published, further research based on randomized controlled trials is needed. PMID:19760458

  6. Anticoagulant therapy in patients undergoing dental interventions: a critical review of the literature and current perspectives.

    PubMed

    Isola, G; Matarese, G; Cordasco, G; Rotondo, F; Crupi, A; Ramaglia, L

    2015-02-01

    Patients treated with oral anticoagulant therapy (OAT) represent an issue to the dentist, as an increasing number of people are using anticoagulant drugs for cardiovascular disease. The choice of an eventual suspension or continuation of anticoagulant therapy is important when considering an efficient management of the patient. Patients in anticoagulant therapy and requiring dental procedures sometimes represent therapeutic concerns especially concerning the suspension of the anticoagulant treatment. At the moment there is no consensus among international experts of a possible discontinuation of therapy before invasive dental procedures. In this paper, the authors try to focus on this topic through a critical review of the literature. Most of the studies suggest the continuation of the anticoagulant treatment with heparin before invasive oral surgical interventions. Based on the data of the literature, two rules must be adopted in clinical practice: 1) maintenance of anticoagulation related to the international normalized ratio (INR); 2) local application of antifibrinolytic agents to ensure a proper hemostatic process. Given the widespread use of anticoagulant drugs in cardiovascular disease, dentists must often face the problem of the therapy and, since there is no consensus on the management of these patients, the authors propose, after a thorough critical review of the literature, the implementation of a multiphase protocol of surgical approach to be implemented with safety in daily clinical practice. PMID:25660591

  7. Massage therapy for essential hypertension: a systematic review.

    PubMed

    Xiong, X J; Li, S J; Zhang, Y Q

    2015-03-01

    Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); P<0.0001) and diastolic BP (MD: -3.63 (-6.18, -1.09); P=0.005); massage appears beneficial for reducing SBP (MD: -3.47 (-5.39, -1.56); P=0.0004) for hypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future. PMID:24990417

  8. May-Thurner syndrome: case report and review of the literature involving modern endovascular therapy.

    PubMed

    Moudgill, Neil; Hager, Eric; Gonsalves, Carin; Larson, Robert; Lombardi, Joseph; DiMuzio, Paul

    2009-01-01

    May-Thurner syndrome is a rare clinical entity involving venous obstruction of the left lower extremity. Obstruction occurs secondary to compression of the left common iliac vein between the right common iliac artery and the underlying vertebral body. Current management largely involves endovascular therapy. A review was conducted of six studies containing at least five patients with May-Thurner syndrome treated by endovascular therapy. We compiled data on 113 patients, analyzing patient demographics, treatment details, and outcome. An 18-year-old female presented 1 week after the onset of left lower extremity pain and swelling. Duplex ultrasonography revealed extensive left-sided deep venous thrombosis (DVT). Thrombolysis followed by iliac vein stent placement restored patency to the venous system, with subsequent resolution of symptoms. Review of 113 patients revealed that the majority were females (72%) presenting with DVT (77%), most of which was acute in onset (73%). Therapy consisted of catheter-directed thrombolysis and subsequent stent placement in the majority of patients, resulting in a mean technical success of 95% and a mean 1-year patency of 96%. Endovascular therapy is the current mainstay of treatment for May-Thurner syndrome. Review of the current literature supports treatment via catheter-directed thrombolysis followed by stent placement with good early results. PMID:19909680

  9. Management and therapy of vasovagal syncope: A review

    PubMed Central

    Aydin, Muhammet Ali; Salukhe, Tushar V; Wilke, Iris; Willems, Stephan

    2010-01-01

    Vasovagal syncope is a common cause of recurrent syncope. Clinically, these episodes may present as an isolated event with an identifiable trigger, or manifest as a cluster of recurrent episodes warranting intensive evaluation. The mechanism of vasovagal syncope is incompletely understood. Diagnostic tools such as implantable loop recorders may facilitate the identification of patients with arrhythmia mimicking benign vasovagal syncope. This review focuses on the management of vasovagal syncope and discusses the non-pharmacological and pharmacological treatment options, especially the use of midodrine and selective serotonin reuptake inhibitors. The role of cardiac pacing may be meaningful for a subgroup of patients who manifest severe bradycardia or asystole but this still remains controversial. PMID:21160608

  10. Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis

    PubMed Central

    Marti, Christophe; John, Gregor; Konstantinides, Stavros; Combescure, Christophe; Sanchez, Olivier; Lankeit, Mareike; Meyer, Guy; Perrier, Arnaud

    2015-01-01

    Aim Thrombolytic therapy induces faster clot dissolution than anticoagulation in patients with acute pulmonary embolism (PE) but is associated with an increased risk of haemorrhage. We reviewed the risks and benefits of thrombolytic therapy in the management of patients with acute PE. Methods and results We systematically reviewed randomized controlled studies comparing systemic thrombolytic therapy plus anticoagulation with anticoagulation alone in patients with acute PE. Fifteen trials involving 2057 patients were included in our meta-analysis. Compared with heparin, thrombolytic therapy was associated with a significant reduction of overall mortality (OR; 0.59, 95% CI: 0.36–0.96). This reduction was not statistically significant after exclusion of studies including high-risk PE (OR; 0.64, 95% CI: 0.35–1.17). Thrombolytic therapy was associated with a significant reduction in the combined endpoint of death or treatment escalation (OR: 0.34, 95% CI: 0.22–0.53), PE-related mortality (OR: 0.29; 95% CI: 0.14–0.60) and PE recurrence (OR: 0.50; 95% CI: 0.27–0.94). Major haemorrhage (OR; 2.91, 95% CI: 1.95–4.36) and fatal or intracranial bleeding (OR: 3.18, 95% CI: 1.25–8.11) were significantly more frequent among patients receiving thrombolysis. Conclusions Thrombolytic therapy reduces total mortality, PE recurrence, and PE-related mortality in patients with acute PE. The decrease in overall mortality is, however, not significant in haemodynamically stable patients with acute PE. Thrombolytic therapy is associated with an increase of major and fatal or intracranial haemorrhage. PMID:24917641

  11. A systematic review of dental disease in patients undergoing cancer therapy

    PubMed Central

    Napeñas, Joel J.; Hodgson, Brian D.; Stokman, Monique A.; Mathers-Stauffer, Vickie; Elting, Linda S.; Spijkervet, Fred K. L.; Brennan, Michael T.

    2010-01-01

    Introduction This purpose of this systematic review was to evaluate the literature and update our current understanding of the impact of present cancer therapies on the dental apparatus (teeth and periodontium) since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies. Review method A systematic literature search was conducted with assistance from a research librarian in the databases MEDLINE/PubMed and EMBASE for articles published between 1 January 1990 and 31 December 2008. Each study was independently assessed by two reviewers. Taking into account predetermined quality measures, a weighted prevalence was calculated for the prevalence of dental caries, severe gingival disease, and dental infection. Data on DMFT/dmft, DMFS/dmfs, plaque, and gingival indexes were also gathered. The level of evidence, recommendation, and guideline (if possible) were given for published preventive and management strategies. Results Sixty-four published papers between 1990 and 2008 were reviewed. The weighted overall prevalence of dental caries was 28.1%. The overall DMFT for patients who were post-antineoplastic therapy was 9.19 (SD, 7.98; n?=?457). The overall plaque index for patients who were post-antineoplastic therapy was 1.38 (SD, 0.25; n?=?189). The GI for patients who were post-chemotherapy was 1.02 (SD, 0.15; n?=?162). The weighted prevalence of dental infections/abscess during chemotherapy was reported in three studies and was 5.8%. Conclusions Patients who were post-radiotherapy had the highest DMFT. The use of fluoride products and chlorhexidine rinses are beneficial in patients who are post-radiotherapy. There continues to be lack of clinical studies on the extent and severity of dental disease that are associated with infectious complications during cancer therapy. PMID:20449756

  12. Targeted therapy in her2-positive metastatic breast cancer: a review of the literature

    PubMed Central

    Zhu, X.; Verma, S.

    2015-01-01

    Breast tumours positive for her2 (human epidermal growth factor receptor 2) represent approximately 20% of all breast cancer cases and are associated with an aggressive natural history. The advent of targeted anti-her2 therapies has dramatically improved disease control and survival in patients with metastatic her2-positive breast cancer. Targeted agents are now considered the standard of care in the first-line setting and beyond. The present review summarizes the currently available data on targeted anti-her2 therapies from completed randomized phase iii clinical trials and briefly discusses emerging advances that will address unmet needs in metastatic her2-positive breast cancer.

  13. Negative Pressure Wound Therapy – A Review of its Uses in Orthopaedic Trauma

    PubMed Central

    Putnis, Sven; Khan, Wasim S; Wong, James M.-L

    2014-01-01

    The use of Negative Pressure Wound Therapy (NPWT) for complex and large wounds has increased in popularity over the past decade. Modern NPWT systems consisting of an open pore foam sponge, adhesive dressing and a vacuum pump producing negative pressure have been used as an adjunct to surgical debridement to treat tissue defects around open fractures and chronic, contaminated wounds. Other uses include supporting skin grafts and protecting wounds at risk of breaking down. This review outlines the current and emerging indications for negative pressure wound therapy in Orthopaedic trauma and the existing preclinical and clinical evidence base for its use. PMID:25067967

  14. FUNCTIONAL PROTEOME OF MACROPHAGE CARRIED NANOFORMULATED ANTIRETROVIRAL THERAPY DEMONSTRATES ENHANCED PARTICLE CARRYING CAPACITY

    PubMed Central

    Martinez-Skinner, Andrea L.; Veerubhotla, Ram S.; Liu, Han; Xiong, Huangui; Yu, Fang; McMillan, JoEllyn M.; Gendelman, Howard E.

    2013-01-01

    Our laboratory has pioneered the development of long-acting nanoformulations of antiretroviral therapy (nanoART). NanoART serves to improve drug compliance, toxicities, and access to viral reservoirs. These all function to improve treatment of human immunodeficiency virus (HIV) infection. Formulations are designed to harness the carrying capacities of mononuclear phagocytes (MP; monocytes and macrophages) and to use these cells as Trojan horses for drug delivery. Such a drug distribution system limits ART metabolism and excretion while facilitating access to viral reservoirs. Our prior works demonstrated a high degree of nanoART sequestration in macrophage recycling endosomes with broad and sustained drug tissue biodistribution and depots with limited untoward systemic toxicities. Despite such benefits, the effects of particle carriage on the cells’ functional capacities remained poorly understood. Thus, we employed pulsed stable isotope labeling of amino acids in cell culture to elucidate the macrophage proteome and assess any alterations in cellular functions that would affect cell-drug carriage and release kinetics. NanoART-MP interactions resulted in the induction of a broad range of activation-related proteins that can enhance phagocytosis, secretory functions, and cell migration. Notably, we now demonstrate that particle-cell interactions serve to enhance drug loading while facilitating drug tissue depots and transportation. PMID:23544708

  15. Functional proteome of macrophage carried nanoformulated antiretroviral therapy demonstrates enhanced particle carrying capacity.

    PubMed

    Martinez-Skinner, Andrea L; Veerubhotla, Ram S; Liu, Han; Xiong, Huangui; Yu, Fang; McMillan, JoEllyn M; Gendelman, Howard E

    2013-05-01

    Our laboratory developed long-acting nanoformulations of antiretroviral therapy (nanoART) to improve drug compliance, reduce toxicities, and facilitate access of drug to viral reservoirs. These all function to inevitably improve treatment of human immunodeficiency virus (HIV) infection. Formulations are designed to harness the carrying capacities of mononuclear phagocytes (MP; monocytes and macrophages) and to use these cells as Trojan horses for drug delivery. Such a drug distribution system limits ART metabolism and excretion while facilitating access to viral reservoirs. Our prior works demonstrated a high degree of nanoART sequestration in macrophage recycling endosomes with broad and sustained drug tissue biodistribution and depots with limited untoward systemic toxicities. Despite such benefits, the effects of particle carriage on the cells' functional capacities remained poorly understood. Thus, we employed pulsed stable isotope labeling of amino acids in cell culture to elucidate the macrophage proteome and assess any alterations in cellular functions that would affect cell-drug carriage and release kinetics. NanoART-MP interactions resulted in the induction of a broad range of activation-related proteins that can enhance phagocytosis, secretory functions, and cell migration. Notably, we now demonstrate that particle-cell interactions serve to enhance drug loading while facilitating drug tissue depots and transportation. PMID:23544708

  16. Breast cancer pain management - A review of current & novel therapies

    PubMed Central

    Satija, Aanchal; Ahmed, Syed Mehmood; Gupta, Rahul; Ahmed, Arif; Rana, Shiv Pratap Singh; Singh, Suraj Pal; Mishra, Seema; Bhatnagar, Sushma

    2014-01-01

    Breast cancer is one of the most prevalent cancers amongst women in the world. Unfortunately, even after adequate treatment, some patients experience severe pain either due to disease progression or due to treatment related side effects. The persistent pain causes a negative physical and psychosocial impact on patients’ lives. Current rational pain management is patient-centred and requires a thorough psychological assessment. Usually adequate analgesia is achieved by adopting the WHO's three step analgesic ladder. As the disease progresses, the pain experienced by the patient also increases. This necessitates the administration of opioids and adjuvant analgesics to the breast cancer patients experiencing severe pain. However, opioid use is associated with intolerable side effects like constipation, nausea, vomiting, fear of dependence, and tolerance. Concomitant medications are required to combat these unacceptable side effects. Adjuvant analgesics need to be added to provide adequate and satisfactory analgesia. These factors worsen the psychological state of patients and deteriorate their quality of life. Hence, there is a need to develop therapeutic modalities to provide adequate analgesia with minimum side effects. This review article focuses on the current treatments available for cancer pain management, their limitations, and novel targets and non-pharmacological measures under investigation which have the potential to produce a radical change in pain management measures for the breast cancer patients. PMID:24718395

  17. Stem cell therapy – Hype or hope? A review

    PubMed Central

    Nadig, Roopa R

    2009-01-01

    While the regeneration of a lost tissue is known to mankind for several years, it is only in the recent past that research on regenerative medicine/dentistry has gained momentum and eluded the dramatic yet scientific advancements in the field of molecular biology. The growing understanding of biological concepts in the regeneration of oral/dental tissues coupled with experiments on stem cells is likely to result in a paradigm shift in the therapeutic armamentarium of dental and oral diseases culminating in an intense search for “biological solutions to biological problems.” Stem cells have been successfully isolated from variety of human tissues including orofacial tissues. Initial evidence from pioneering studies has documented the likely breakthrough that stem cells offer for various life-threatening diseases that have so far defeated modern medical care. The evidence gathered so far has propelled many elegant studies exploring the role of stem cells and their manifold dental applications. This review takes you on a sojourn of the origin of stem cells, their properties, characteristics, current research, and their potential applications. It also focuses on the various challenges and barriers that we have to surmount before translating laboratory results to successful clinical applications heralding the dawn of regenerative dentistry. PMID:20543921

  18. YAP/TAZ for cancer therapy: Opportunities and challenges (Review).

    PubMed

    Guo, Liwen; Teng, Lisong

    2015-04-01

    YAP (Yes-associated protein) and its paralog TAZ (transcriptional co-activator with PDZ-binding motif) are the main downstream effectors of the Hippo signaling pathway. This pathway is an evolutionally conserved signal cascade, which plays pivotal roles in organ size control and tumorigenesis from Drosophila to mammals. Functionally, when the Hippo pathway is activated, YAP and TAZ will be sequestered in the cytoplasm and degraded. Conversely, when the Hippo pathway is deactivated, YAP and TAZ will translocate into nucleus and promote transcription of downstream genes by forming complexes with transcription factors, such as transcriptional enhancer factors (TEF; also referred to as TEAD), runt-domain transcription factors (Runx) and others. Most of these transcription factors belong to growth promoting or apoptosis-inhibition genes. It has been reported that the deactivation of the Hippo pathway, as well as up-regulation of YAP and TAZ was observed in many human cancers with a high frequency, which suggests that the Hippo pathway may be a potent target for developing anticancer drugs. In this review, we provide an overview of the Hippo pathway and summarize recent advances with respect to the role of YAP and TAZ in Hippo signaling pathway and cancer development. Furthermore, we describe the opportunities and challenges for exploit YAP and TAZ as potential therapeutic targets in cancer. PMID:25652178

  19. Molecularly targeted therapies in cervical cancer. A systematic review.

    PubMed

    Zagouri, Flora; Sergentanis, Theodoros N; Chrysikos, Dimosthenis; Filipits, Martin; Bartsch, Rupert

    2012-08-01

    Cervical cancer represents the third most common cause of female cancer mortality. Even with the best currently available treatment, a significant proportion of patients will experience recurrence and eventually die. Evidently, there is a clear need for the development of new agents with novel mechanisms of action in this disease. A number of biological agents modulating different signal transduction pathways are currently in clinical development, inhibiting angiogenesis, targeting epidermal growth factor receptor, cell cycle, histone deacetylases, cyclooxygenase-2 (COX-2), or mammalian target of rapamycin (mTOR). This is the first systematic review of the literature to synthesize all available data emerging from trials and evaluate the efficacy and safety of molecularly targeted drugs in cervical cancer. However, it should be stressed that relatively fewer molecularly targeted agents have been tested in cervical cancer in comparison with other cancer types; of note, no related phase 3 trials have been published and consequently no agent has been approved for use in clinical practice. Nevertheless, the promising results of bevacizumab in therapeutic trials for cervical cancer have shown that targeting the VEGF pathway is an attractive therapeutic strategy. As knowledge accumulates on the molecular mechanisms underlying carcinogenesis in the cervix, the anticipated development and assessment of molecularly targeted agents may offer a promising perspective for cervical cancer. PMID:22504292

  20. Nasolacrimal duct obstruction following radioactive iodine 131 therapy in differentiated thyroid cancers: review of 19 cases

    PubMed Central

    Al-Qahtani, Khalid Hussain; Al Asiri, Mushabbab; Tunio, Mutahir A; Aljohani, Naji J; Bayoumi, Yasser; Munir, Iqbal; AlAyoubi, Ayman

    2014-01-01

    Background Radioactive iodine 131 (131I) therapy has long been used in the treatment of differentiated thyroid cancers (DTC). While salivary and lacrimal glandular complications secondary to 131I therapy are well documented, there is little in the literature addressing nasolacrimal duct obstruction (NLDO). We aimed to evaluate the frequency of 131I therapy-acquired NLDO, its correlation to 131I therapy doses, and the surgical treatment outcome of this rare side effect. Methods From 2000–2012, a retrospective review of 864 among 1,192 patients with confirmed DTC who were treated with 131I therapy was performed to examine the frequency of NLDO, its causative factors, as well as imaging, surgical intervention, and outcomes. Results Nineteen (2.2%) patients were identified with NLDO. The mean age was 51.9±10.5 years (range: 39–72 years). Fifteen (78.9%) were female and four were male (21.1%). The mean individual 131I doses were 311.1±169.3 millicurie (mCi) (range: 150–600 mCi). The mean duration between the date of 131I therapy and the occurrence of NLDO was 11.6±4.1 months (range: 6.5–20). Fourteen (73.7%) patients had bilateral epiphora. Computed tomography dacryography allowed for the detection of all NLDO. Eighteen (94.7%) patients underwent dacryocystorhinostomy. Complete recovery was obtained in 14 (73.7%) patients. Age >45 years and 131I therapy doses >150 mCi were significantly correlated with NLDO (P=0.02 and P=0.03, respectively). Conclusion NLDO is an underestimated complication of 131I therapy in DTC patients. Clinicians should be aware of this rare complication for prompt intervention. PMID:25525325

  1. Cell-based therapies for experimental chronic kidney disease: a systematic review and meta-analysis

    PubMed Central

    Papazova, Diana A.; Oosterhuis, Nynke R.; Gremmels, Hendrik; van Koppen, Arianne; Joles, Jaap A.; Verhaar, Marianne C.

    2015-01-01

    Cell-based therapy is a promising strategy for treating chronic kidney disease (CKD) and is currently the focus of preclinical studies. We performed a systematic review and meta-analysis to evaluate the efficacy of cell-based therapy in preclinical (animal) studies of CKD, and determined factors affecting cell-based therapy efficacy in order to guide future clinical trials. In total, 71 articles met the inclusion criteria. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcome parameters including plasma urea, plasma creatinine, urinary protein, blood pressure, glomerular filtration rate, glomerulosclerosis and interstitial fibrosis. Sub-analysis for each outcome measure was performed for model-related factors (species, gender, model and timing of therapy) and cell-related factors (cell type, condition and origin, administration route and regime of therapy). Overall, meta-analysis showed that cell-based therapy reduced the development and progression of CKD. This was most prominent for urinary protein (SMD, 1.34; 95% CI, 1.00–1.68) and urea (1.09; 0.66–1.51), both P<0.001. Changes in plasma urea were associated with changes in both glomerulosclerosis and interstitial fibrosis. Sub-analysis showed that cell type (bone-marrow-derived progenitors and mesenchymal stromal cells being most effective) and administration route (intravenous or renal artery injection) were significant predictors of therapeutic efficacy. The timing of therapy in relation to clinical manifestation of disease, and cell origin and dose, were not associated with efficacy. Our meta-analysis confirms that cell-based therapies improve impaired renal function and morphology in preclinical models of CKD. Our analyses can be used to optimise experimental interventions and thus support both improved preclinical research and development of cell-based therapeutic interventions in a clinical setting. PMID:25633980

  2. Common platform of Monte Carlo dose calculation on universal grid interface with Geant4 based particle therapy simulation framework

    NASA Astrophysics Data System (ADS)

    Iwai, G.; Takase, W.; Aso, T.; Watase, Y.; Sasaki, T.; Akagi, T.; Yamashita, T.; Maeda, Y.; Nishio, T.

    2014-03-01

    While Monte Carlo (MC) simulation is believed to be the most reliable method of dose calculation in particle therapy, the simulation time is critical in attaining sufficient statistical accuracy for clinical applications. Therefore, parallelization of simulations is essential. This paper describes a common platform of MC dose calculation in grid-distributed computing environments. The platform is flexible and effective for dose calculation in both clinical and research applications for particle therapy. The platform consists of the universal grid interface (UGI) and the Geant4-based particle therapy simulation framework (PTSIM). The UGI, written in Python, provides a command-line interface for job submission, file manipulation, and monitoring in multiple-grid middleware environments. The PTSIM is a single software application for modeling a treatment port with patient data obtained from CT images. The common platform was constructed in grid computing environments using the computing resources in five institutions. The platform utilized these resources through the NAREGI grid middleware under UGI to provide stable computing resources and a common environment for MC dose calculation in particle therapy.

  3. A review of electron bombardment thruster systems/spacecraft field and particle interfaces

    NASA Technical Reports Server (NTRS)

    Byers, D. C.

    1978-01-01

    Information on the field and particle interfaces of electron bombardment ion thruster systems was summarized. Major areas discussed were the nonpropellant particles, neutral propellant, ion beam, low energy plasma, and fields. Spacecraft functions and subsystems reviewed were solar arrays, thermal control systems, optical sensors, communications, science, structures and materials, and potential control.

  4. EXPERIMENTAL INVESTIGATIONS OF FINE PARTICLE CHARGING BY UNIPOLAR IONS: A REVIEW

    EPA Science Inventory

    The paper gives results of a study relating experimental data to many theories that have been offered in attempts to describe accurately the rate of charge accumulation of fine particles in a unipolar field. The data are reviewed and compiled, and additional particle charging exp...

  5. PHYSICAL REVIEW VOLUME 183; NUMBER 4 20 J ULY 1969 Single-Particle Theory of Fission*

    E-print Network

    PHYSICAL REVIEW VOLUME 183; NUMBER 4 20 J ULY 1969 Single-Particle Theory of Fission* A. BRANDT manuscript received 6 December 1968) The single-particle aspects of nuclear fission theories are investigated and are shown to be significant. A natural framework is provided in which the mass asymmetry of fission arises

  6. Magnetic Resonance-Guided Laser Induced Thermal Therapy for Glioblastoma Multiforme: A Review

    PubMed Central

    Norred, Sarah E.; Johnson, Jacqueline Anne

    2014-01-01

    Magnetic resonance-guided laser induced thermotherapy (MRgLITT) has become an increasingly relevant therapy for tumor ablation due to its minimally invasive approach and broad applicability across many tissue types. The current state of the art applies laser irradiation via cooled optical fiber applicators in order to generate ablative heat and necrosis in tumor tissue. Magnetic resonance temperature imaging (MRTI) is used concurrently with this therapy to plan treatments and visualize tumor necrosis. Though application in neurosurgery remains in its infancy, MRgLITT has been found to be a promising therapy for many types of brain tumors. This review examines the current use of MRgLITT with regard to the special clinical challenge of glioblastoma multiforme and examines the potential applications of next-generation nanotherapy specific to the treatment of glioblastoma. PMID:24527455

  7. Tumor-targeting bacterial therapy: A potential treatment for oral cancer (Review)

    PubMed Central

    LIU, SAI; XU, XIAOPING; ZENG, XIN; LI, LONGJIANG; CHEN, QIANMING; LI, JING

    2014-01-01

    Certain obligate or facultative anaerobic bacteria, which exhibit an inherent ability to colonize solid tumors in vivo, may be used in tumor targeting. As genetically manipulated bacteria may actively and specifically penetrate into the tumor tissue, bacterial therapy is becoming a promising approach in the treatment of tumors. However, to the best of our knowledge, no reports have been published thus far regarding the bacterial treatment of oral cancer, one of the most common types of cancer worldwide. In this review, the progress in the understanding of bacterial strategies used in tumor-targeted therapy is discussed and particular bacterial strains that may have great therapeutic potential in oral squamous cell carcinoma (OSCC) tumor-targeted therapy are predicted as determined by previous studies. PMID:25364397

  8. Tumor-targeting bacterial therapy: A potential treatment for oral cancer (Review).

    PubMed

    Liu, Sai; Xu, Xiaoping; Zeng, Xin; Li, Longjiang; Chen, Qianming; Li, Jing

    2014-12-01

    Certain obligate or facultative anaerobic bacteria, which exhibit an inherent ability to colonize solid tumors in vivo, may be used in tumor targeting. As genetically manipulated bacteria may actively and specifically penetrate into the tumor tissue, bacterial therapy is becoming a promising approach in the treatment of tumors. However, to the best of our knowledge, no reports have been published thus far regarding the bacterial treatment of oral cancer, one of the most common types of cancer worldwide. In this review, the progress in the understanding of bacterial strategies used in tumor-targeted therapy is discussed and particular bacterial strains that may have great therapeutic potential in oral squamous cell carcinoma (OSCC) tumor-targeted therapy are predicted as determined by previous studies. PMID:25364397

  9. Moving from Virtual Reality Exposure-Based Therapy to Augmented Reality Exposure-Based Therapy: A Review

    PubMed Central

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed “safely” to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user’s experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia. PMID:24624073

  10. Review of Occupational Therapy Research in the Practice Area of Children and Youth

    PubMed Central

    Bendixen, Roxanna M.; Kreider, Consuelo M.

    2011-01-01

    A systematic review was conducted focusing on articles in the Occupational Therapy (OT) practice category of Childhood and Youth (C&Y) published in the American Journal of Occupational Therapy (AJOT) over the two-year period of 2009–2010. The frameworks of the International Classification of Functioning, Disability and Health (ICF) and Positive Youth Development (PYD) were used to explore OT research progress toward the goals of the Centennial Vision (CV). Forty-six research articles were organized by research type and were classified within these two frameworks. The majority of reviewed published research investigated variables representing constructs falling within the ICF domains of Body Functioning and Activity. The effect of OT interventions on PYD resided primarily in building competence. In order to meet the tenets of the CV, OTs must document changes in children’s engagement in everyday life situations and build the evidence of OT’s efficacy in facilitating participation. PMID:21675342

  11. Occupational therapy interventions to improve driving performance in older adults: a systematic review.

    PubMed

    Golisz, Kathleen

    2014-01-01

    This systematic review synthesizes the research on interventions used by occupational therapy practitioners to address cognitive and visual function, motor function, driving skills, self-regulation and self-awareness, and the role of passengers and family involvement in the driving ability, performance, and safety of older adults. After a comprehensive search of the research literature, 29 studies were reviewed and synthesized into five themes: (1) educational interventions including family education, (2) cognitive-perceptual training, (3) interventions addressing physical fitness, (4) simulator training, and (5) behind-the-wheel training. Outcome measures used in the studies included changes in knowledge through speed of processing, physical and cognitive skills predicted to reduce crash risk, simulated driving, and real-world driving. The studies demonstrated low to moderate positive effects for interventions used by occupational therapy practitioners to improve older driver performance. PMID:25397761

  12. A review of “music and movement” therapies for children with autism: embodied interventions for multisystem development

    PubMed Central

    Srinivasan, Sudha M.; Bhat, Anjana N.

    2013-01-01

    The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research. PMID:23576962

  13. Antioxidant therapy in the management of acute, chronic and post-ERCP pancreatitis: A systematic review

    PubMed Central

    Monfared, Seyed Sajad Mohseni Salehi; Vahidi, Hamed; Abdolghaffari, Amir Hossein; Nikfar, Shekoufeh; Abdollahi, Mohammad

    2009-01-01

    We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis (AP) or chronic pancreatitis (CP) and in the prevention of post-endoscopic retrograde cholangio-pancreatography (post-ERCP) pancreatitis (PEP) up to February 2009. Twenty-two randomized, placebo-controlled, clinical trials met our criteria and were included in the review. Except for a cocktail of antioxidants which showed improvement in outcomes in three different clinical trials, the results of the administration of other antioxidants in both AP and CP clinical trials were incongruent and heterogeneous. Furthermore, antioxidant therapy including allopurinol and N-acetylcysteine failed to prevent the onset of PEP in almost all trials. In conclusion, the present data do not support a benefit of antioxidant therapy alone or in combination with conventional therapy in the management of AP, CP or PEP. Further double blind, randomized, placebo-controlled clinical trials with large sample size need to be conducted. PMID:19777606

  14. The impact of individual reminiscence therapy for people with dementia: systematic review.

    PubMed

    Subramaniam, Ponnusamy; Woods, Bob

    2012-05-01

    This systematic review aims to review the potential psychosocial benefits of individual reminiscence therapy for people with dementia. Five randomized controlled trials were identified. All were carried out in nursing or care homes, and several different approaches were represented. The studies reported some immediate and longer-term psychosocial benefits to people with dementia of individual reminiscence work, where this involved a life review process or personalized, specific reminiscence work. These benefits included mood, well-being and aspects of cognitive function. There was no evidence that the use of general reminiscence materials was associated with psychosocial benefits. The use of life story books and multimedia alternatives, with or without an associated life review process, does appear to be worth pursuing from both clinical and research perspectives. PMID:22550983

  15. Extracorporeal Shockwave Therapy (ESWT) in the Treatment of Plantar Fasciitis – A Biometrical Review

    Microsoft Academic Search

    I. R. Böddeker; H. Schäfer; M. Haake

    2001-01-01

    :   The application of extracorporeal shockwave therapy (ESWT) as a treatment for conservatively unsuccessfully treated plantar\\u000a fasciitis has experienced a rapid increase over the last years. However, the efficacy of ESWT has not yet been established\\u000a unequivocally, as published studies have led to inconsistent results. Furthermore, reviews on clinical trials on ESWT are\\u000a either not up to date, incomplete, or

  16. Hyperbaric oxygen therapy for stroke: a systematic review of the evidence

    Microsoft Academic Search

    Susan Carson; Marian McDonagh; Barry Russman; Mark Helfand

    2005-01-01

    Objective: To identify the benefits and harms of using hyperbaric oxygen therapy to treat acute or subacute stroke or the chronic effects of a stroke. We aimed to identify any gaps in the evidence to provide guidance for future research.Design: A systematic review of the evidence.Search strategy: We searched MEDLINE, EMBASE, the Cochrane Library, HealthSTAR, CINAHL, MANTIS, bibliographic databases from

  17. Mesenchymal stem cell-based therapy for cartilage repair: a review

    Microsoft Academic Search

    Hideyuki Koga; Lars Engebretsen; Jan E. Brinchmann; Takeshi Muneta; Ichiro Sekiya

    2009-01-01

    Articular cartilage injury remains one of the major concerns in orthopaedic surgery. Mesenchymal stem cell (MSC) transplantation\\u000a has been introduced to avoid some of the side effects and complications of current techniques. The purpose of this paper is\\u000a to review the literature on MSC-based cell therapy for articular cartilage repair to determine if it can be an alternative\\u000a treatment for

  18. Antioxidant therapy in the management of acute, chronic and post-ERCP pancreatitis: A systematic review

    Microsoft Academic Search

    Sajad Mohseni; Salehi Monfared; Hamed Vahidi; Mohammad Abdollahi; Seyed Sajad

    We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis (AP) or chronic pancreatitis (CP) and in the prevention of post-endoscopic retrograde cholangio-pancreatography (post-ERCP) pancreatitis

  19. Cognitive-behavioral therapy for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review

    Microsoft Academic Search

    M. Kathleen B. Lustyk; Winslow G. Gerrish; Shelley Shaver; Shaunie L. Keys

    2009-01-01

    We systematically reviewed empirical studies that investigated the use of cognitive-behavioral therapy (CBT) for premenstrual\\u000a syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Our multi-database search identified seven published empirical reports.\\u000a Three were identified as randomized controlled trials (RCTs). The methods utilized to investigate therapeutic efficacy of\\u000a CBT in these studies varied widely from case reports to RCTs with pharmacotherapy comparison

  20. Over-the-counter nicotine replacement therapy: a methodological review of the evidence supporting its effectiveness

    Microsoft Academic Search

    RAOUL A. WALSH

    Despite optimistic predictions when nicotine replacement therapy (NRT) was switched to over-the-counter (OTC) availability, population surveys have failed to demonstrate a positive impact on long-term smoking cessation. This review examined the strength of the evidence from randomised trials and comparison group studies supporting the effectiveness of OTCNRT. Twelve eligible studies were identified: OTCNRT was compared with placebo in four studies

  1. 4D particle therapy PET simulation for moving targets irradiated with scanned ion beams

    NASA Astrophysics Data System (ADS)

    Laube, K.; Menkel, S.; Bert, C.; Enghardt, W.; Helmbrecht, S.; Saito, N.; Fiedler, F.

    2013-02-01

    Particle therapy positron emission tomography (PT-PET) allows for an in vivo and in situ verification of applied dose distributions in ion beam therapy. Since the dose distribution cannot be extracted directly from the ?+-activity distribution gained from the PET scan the validation is done by means of a comparison between the reconstructed ?+-activity distributions from a PT-PET measurement and from a PT-PET simulation. Thus, the simulation software for generating PET data predicted from the treatment planning is an essential part of the dose verification routine. For the dose monitoring of intra-fractionally moving target volumes the PET data simulation needs to be upgraded by using time resolved (4D) algorithms to account correctly for the motion dependent displacement of the positron emitters. Moreover, it has to consider the time dependent relative movement between target volume and scanned beam to simulate the accurate positron emitter distribution generated during irradiation. Such a simulation program is presented which properly proceeds with motion compensated dose delivery by scanned ion beams to intra-fractionally moving targets. By means of a preclinical phantom study it is demonstrated that even the sophisticated motion-mitigated beam delivery technique of range compensated target tracking can be handled correctly by this simulation code. The new program is widely based on the 3D PT-PET simulation program which had been developed at the Helmholtz-Zentrum Dresden-Rossendorf, Germany (HZDR) for application within a pilot project to simulate in-beam PET data for about 440 patients with static tumor entities irradiated at the former treatment facility of the GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (GSI). A simulation example for a phantom geometry irradiated with a tracked 12C-ion beam is presented for demonstrating the proper functionality of the program.

  2. Efficacy of Auricular Therapy for Pain Management: A Systematic Review and Meta-Analysis

    PubMed Central

    Yeh, Chao Hsing; Chiang, Yi Chien; Hoffman, Samuel L.; Liang, Zhan; Klem, Mary Lou; Tam, Wilson W. S.; Chien, Lung-Chang; Suen, Lorna Kwai-Ping

    2014-01-01

    Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [?2.36, ?0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain. PMID:25165482

  3. Efficacy of auricular therapy for pain management: a systematic review and meta-analysis.

    PubMed

    Yeh, Chao Hsing; Chiang, Yi Chien; Hoffman, Samuel L; Liang, Zhan; Klem, Mary Lou; Tam, Wilson W S; Chien, Lung-Chang; Suen, Lorna Kwai-Ping

    2014-01-01

    Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [-2.36, -0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain. PMID:25165482

  4. A review of gene therapy in canine and feline models of lysosomal storage disorders.

    PubMed

    Bradbury, Allison M; Gurda, Brittney L; Casal, Margret L; Ponder, Katherine P; Vite, Charles H; Haskins, Mark E

    2015-03-01

    Lysosomal storage disorders (LSDs) are inherited diseases that result from the intracellular accumulation of incompletely degraded macromolecules. The majority of LSDs affect both the peripheral and central nervous systems and are not effectively treated by enzyme replacement therapy, substrate reduction therapy, or bone marrow transplantation. Advances in adeno-associated virus and retroviral vector development over the past decade have resurged gene therapy as a promising therapeutic intervention for these monogenic diseases. Animal models of LSDs provide a necessary intermediate to optimize gene therapy protocols and assess the safety and efficacy of treatment prior to initiating human clinical trials. Numerous LSDs are naturally occurring in large animal models and closely reiterate the lesions, biochemical defect, and clinical phenotype observed in human patients, and whose lifetime is sufficiently long to assess the effect on symptoms that develop later in life. Herein, we review that gene therapy in large animal models (dogs and cats) of LSDs improved many manifestations of disease, and may be used in patients in the near future. PMID:25671613

  5. Therapies for Onychomycosis: A Systematic Review and Network Meta-Analysis of Mycological Cure.

    PubMed

    Gupta, Aditya K; Daigle, Deanne; Paquet, Maryse

    2014-07-17

    Abstract BACKGROUND:New therapies for onychomycosis continue to be developed, yet treatments are seldom directly compared in randomized controlled trials. The objective of the current study was to compare the rates of mycological cure for oral and topical onychomycosis treatments using network meta-analysis. METHODS:A systematic review of the literature on onychomycosis treatments published before March 25th 2013 was performed and data was analyzed using network meta-analysis. RESULTS:Terbinafine 250mg was significantly superior to all treatments except itraconazole 400mg pulse therapy, itraconazole 200mg was significantly superior to fluconazole and the topical treatments, while fluconazole, efinaconazole, ciclopirox, terbinafine nail solution and amorolfine were significantly superior only to placebo. CONCLUSIONS:Results support the superiority of 12-week continuous terbinafine 250mg therapy and itraconazole 400mg pulse therapy (one week per month for three months) while suggesting the equivalence of topical therapies. These results reflect findings from the literature as well as treatment efficacy observed in clinical practice. PMID:25032982

  6. Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

    PubMed Central

    Prazeres, Angélica M; Nascimento, Antônio L; Fontenelle, Leonardo F

    2013-01-01

    The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder. PMID:23467711

  7. Review of combination therapy with mTOR inhibitors and tacrolimus minimization after transplantation.

    PubMed

    Peddi, V Ram; Wiseman, Alexander; Chavin, Kenneth; Slakey, Douglas

    2013-10-01

    We evaluated the efficacy and safety of immunosuppressive regimens containing a mammalian target of rapamycin (mTOR) inhibitor with tacrolimus (TAC) minimization therapy in solid organ transplant recipients. A PubMed search was conducted using the terms (mTOR OR sirolimus OR everolimus) AND tacrolimus AND renal AND (low OR reduced OR reduction OR minimization) AND transplant*; limited to title/abstract and English-language articles published from January 1, 2003, through January 28, 2013. Twenty-one relevant studies of TAC minimization therapy were identified and evaluated in the context of known concerns associated with immunosuppressive therapy. Review of these studies suggests that immunosuppressive regimens including an mTOR inhibitor and TAC minimization therapy better preserve renal function versus standard-dose TAC, without significant changes in patient survival or graft rejection rates. Among patients treated with an mTOR inhibitor plus TAC minimization therapy in 12 randomized controlled trials (n=856 kidney, n=190 heart, n=108 lung, n=719 liver patients), reported rates of infection (BK, cytomegalovirus, or Epstein-Barr virus) and malignancy were low (0% to 7%). Other adverse events were more commonly reported including dyslipidemia/hyperlipidemia in up to two thirds of patients, new-onset diabetes mellitus in up to 38%, wound complications in up to 22%, and hypertension in up to 17%. PMID:23932018

  8. BIOLOGICAL EFFECTS OF UTAH VALLEY PARTICLES: A REVIEW

    EPA Science Inventory

    The Utah Valley provided a unique opportunity to evaluate the health effects of particulate matter (PM) in humans. The area has had intermittently high particle levels with the principal point source being a steel mill. Due to a labor dispute, the mill was shut down. The closu...

  9. Automation and uncertainty analysis of a method for in-vivo range verification in particle therapy

    NASA Astrophysics Data System (ADS)

    Frey, K.; Unholtz, D.; Bauer, J.; Debus, J.; Min, C. H.; Bortfeld, T.; Paganetti, H.; Parodi, K.

    2014-10-01

    We introduce the automation of the range difference calculation deduced from particle-irradiation induced ?+-activity distributions with the so-called most-likely-shift approach, and evaluate its reliability via the monitoring of algorithm- and patient-specific uncertainty factors. The calculation of the range deviation is based on the minimization of the absolute profile differences in the distal part of two activity depth profiles shifted against each other. Depending on the workflow of positron emission tomography (PET)-based range verification, the two profiles under evaluation can correspond to measured and simulated distributions, or only measured data from different treatment sessions. In comparison to previous work, the proposed approach includes an automated identification of the distal region of interest for each pair of PET depth profiles and under consideration of the planned dose distribution, resulting in the optimal shift distance. Moreover, it introduces an estimate of uncertainty associated to the identified shift, which is then used as weighting factor to ‘red flag’ problematic large range differences. Furthermore, additional patient-specific uncertainty factors are calculated using available computed tomography (CT) data to support the range analysis. The performance of the new method for in-vivo treatment verification in the clinical routine is investigated with in-room PET images for proton therapy as well as with offline PET images for proton and carbon ion therapy. The comparison between measured PET activity distributions and predictions obtained by Monte Carlo simulations or measurements from previous treatment fractions is performed. For this purpose, a total of 15 patient datasets were analyzed, which were acquired at Massachusetts General Hospital and Heidelberg Ion-Beam Therapy Center with in-room PET and offline PET/CT scanners, respectively. Calculated range differences between the compared activity distributions are reported in a 2D map in beam-eye-view. In comparison to previously proposed approaches, the new most-likely-shift method shows more robust results for assessing in-vivo the range from strongly varying PET distributions caused by differing patient geometry, ion beam species, beam delivery techniques, PET imaging concepts and counting statistics. The additional visualization of the uncertainties and the dedicated weighting strategy contribute to the understanding of the reliability of observed range differences and the complexity in the prediction of activity distributions. The proposed method promises to offer a feasible technique for clinical routine of PET-based range verification.

  10. The Role of Focal Therapy in the Management of Localised Prostate Cancer: A Systematic Review

    PubMed Central

    Valerio, Massimo; Ahmed, Hashim U.; Emberton, Mark; Lawrentschuk, Nathan; Lazzeri, Massimo; Montironi, Rodolfo; Nguyen, Paul L.; Trachtenberg, John; Polascik, Thomas J.

    2014-01-01

    Context The incidence of localised prostate cancer is increasing worldwide. In light of recent evidence, current, radical, whole-gland treatments for organ-confined disease have being questioned with respect to their side effects, cancer control, and cost. Focal therapy may be an effective alternative strategy. Objective To systematically review the existing literature on baseline characteristics of the target population; preoperative evaluation to localise disease; and perioperative, functional, and disease control outcomes following focal therapy. Evidence acquisition Medline (through PubMed), Embase, Web of Science, and Cochrane Review databases were searched from inception to 31 October 2012. In addition, registered but not yet published trials were retrieved. Studies evaluating tissue-preserving therapies in men with biopsy-proven prostate cancer in the primary or salvage setting were included. Evidence synthesis A total of 2350 cases were treated to date across 30 studies. Most studies were retrospective with variable standards of reporting, although there was an increasing number of prospective registered trials. Focal therapy was mainly delivered to men with low and intermediate disease, although some high-risk cases were treated that had known, unilateral, significant cancer. In most of the cases, biopsy findings were correlated to specific preoperative imaging, such as multiparametric magnetic resonance imaging or Doppler ultrasound to determine eligibility. Follow-up varied between 0 and 11.1 yr. In treatment-naïve prostates, pad-free continence ranged from 95% to 100%, erectile function ranged from 54% to 100%, and absence of clinically significant cancer ranged from 83% to 100%. In focal salvage cases for radiotherapy failure, the same outcomes were achieved in 87.2–100%, 29–40%, and 92% of cases, respectively. Biochemical disease-free survival was reported using a number of definitions that were not validated in the focal-therapy setting. Conclusions Our systematic review highlights that, when focal therapy is delivered with intention to treat, the perioperative, functional, and disease control outcomes are encouraging within a short- to medium-term follow-up. Focal therapy is a strategy by which the overtreatment burden of the current prostate cancer pathway could be reduced, but robust comparative effectiveness studies are now required. PMID:23769825

  11. A Review of Discrete Element Method (DEM) Particle Shapes and Size Distributions for Lunar Soil

    NASA Technical Reports Server (NTRS)

    Lane, John E.; Metzger, Philip T.; Wilkinson, R. Allen

    2010-01-01

    As part of ongoing efforts to develop models of lunar soil mechanics, this report reviews two topics that are important to discrete element method (DEM) modeling the behavior of soils (such as lunar soils): (1) methods of modeling particle shapes and (2) analytical representations of particle size distribution. The choice of particle shape complexity is driven primarily by opposing tradeoffs with total number of particles, computer memory, and total simulation computer processing time. The choice is also dependent on available DEM software capabilities. For example, PFC2D/PFC3D and EDEM support clustering of spheres; MIMES incorporates superquadric particle shapes; and BLOKS3D provides polyhedra shapes. Most commercial and custom DEM software supports some type of complex particle shape beyond the standard sphere. Convex polyhedra, clusters of spheres and single parametric particle shapes such as the ellipsoid, polyellipsoid, and superquadric, are all motivated by the desire to introduce asymmetry into the particle shape, as well as edges and corners, in order to better simulate actual granular particle shapes and behavior. An empirical particle size distribution (PSD) formula is shown to fit desert sand data from Bagnold. Particle size data of JSC-1a obtained from a fine particle analyzer at the NASA Kennedy Space Center is also fitted to a similar empirical PSD function.

  12. Cutaneous adverse effects of hormonal adjuvant therapy for breast cancer: a case of localised urticarial vasculitis following anastrozole therapy and a review of the literature.

    PubMed

    Bock, Vanessa L; Friedlander, Michael; Waring, Dale; Kossard, Steven; Wood, Glenda K

    2014-11-01

    Hormonal therapy with either tamoxifen or aromatase inhibitors is commonly used to treat women with breast cancer in both the adjuvant and recurrent disease setting. Cutaneous adverse reactions to these drugs have been rarely reported in the literature. We report an unusual case of urticarial vasculitis following the aromatase inhibitor anastrozole that localised to the unilateral trunk and mastectomy scar, and review the literature on the cutaneous adverse effects of hormonal therapy for breast cancer. PMID:24575835

  13. Proton synchrotrons for cancer therapy

    NASA Astrophysics Data System (ADS)

    Coutrakon, George B.

    2001-07-01

    Synchrotrons have long been recognized for their superior capabilities in proton and heavy ion therapy. Their compactness and ease of beam energy control make them ideally suited to this application. The range of available intensities insures safety against high dose accidents such as have occurred with conventional electron accelerators. For heavy ion and heavy ion therapy, synchrotrons have been the exclusive choice among particle accelerators. In this paper, four synchrotrons designed for dedicated therapy facilities are reviewed and performance data are discussed.

  14. One-step synthesis of gradient gadolinium ironhexacyanoferrate nanoparticles: a new particle design easily combining MRI contrast and photothermal therapy

    NASA Astrophysics Data System (ADS)

    Li, Yichen; Li, Carissa H.; Talham, Daniel R.

    2015-03-01

    A one-step synthesis of Prussian blue nanoparticles possessing a concentration gradient of Gd3+ counterions, g-Gd-PB, has been developed, and the potential for the particles to perform as both MRI positive contrast agents and photothermal therapy agents is demonstrated. The synthesis of potassium/gadolinium ironhexacyanoferrate is performed under increasing concentration of Gd3+ ions forming particles with a higher concentration of gadolinium toward the outer layers. The proton relaxivity (r1) measured for the particles is 12.3 mM-1 s-1, and T1 weighted images of phantoms containing the particles show their potential as MRI contrast agents. In addition, the Prussian blue host can rapidly and efficiently convert energy from near-IR light into thermal energy, allowing g-Gd-PB to be used as a photothermal therapy agent. The photothermal properties are demonstrated by measuring temperature changes of particle suspensions under irradiation and by photothermal ablation of CCRF-CEM cancer cells.A one-step synthesis of Prussian blue nanoparticles possessing a concentration gradient of Gd3+ counterions, g-Gd-PB, has been developed, and the potential for the particles to perform as both MRI positive contrast agents and photothermal therapy agents is demonstrated. The synthesis of potassium/gadolinium ironhexacyanoferrate is performed under increasing concentration of Gd3+ ions forming particles with a higher concentration of gadolinium toward the outer layers. The proton relaxivity (r1) measured for the particles is 12.3 mM-1 s-1, and T1 weighted images of phantoms containing the particles show their potential as MRI contrast agents. In addition, the Prussian blue host can rapidly and efficiently convert energy from near-IR light into thermal energy, allowing g-Gd-PB to be used as a photothermal therapy agent. The photothermal properties are demonstrated by measuring temperature changes of particle suspensions under irradiation and by photothermal ablation of CCRF-CEM cancer cells. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr06481j

  15. Endosomal Trafficking of Nanoformulated Antiretroviral Therapy Facilitates Drug Particle Carriage and HIV Clearance

    PubMed Central

    Guo, Dongwei; Zhang, Gang; Wysocki, Tadeusz A.; Wysocki, Beata J.; Gelbard, Harris A.; Liu, Xin-Ming; McMillan, JoEllyn M.

    2014-01-01

    ABSTRACT Limitations of antiretroviral therapy (ART) include poor patient adherence, drug toxicities, viral resistance, and failure to penetrate viral reservoirs. Recent developments in nanoformulated ART (nanoART) could overcome such limitations. To this end, we now report a novel effect of nanoART that facilitates drug depots within intracellular compartments at or adjacent to the sites of the viral replication cycle. Poloxamer 407-coated nanocrystals containing the protease inhibitor atazanavir (ATV) were prepared by high-pressure homogenization. These drug particles readily accumulated in human monocyte-derived macrophages (MDM). NanoATV concentrations were ?1,000 times higher in cells than those that could be achieved by the native drug. ATV particles in late and recycling endosome compartments were seen following pulldown by immunoaffinity chromatography with Rab-specific antibodies conjugated to magnetic beads. Confocal microscopy provided cross validation by immunofluorescent staining of the compartments. Mathematical modeling validated drug-endosomal interactions. Measures of reverse transcriptase activity and HIV-1 p24 levels in culture media and cells showed that such endosomal drug concentrations enhanced antiviral responses up to 1,000-fold. We conclude that late and recycling endosomes can serve as depots for nanoATV. The colocalization of nanoATV at endosomal sites of viral assembly and its slow release sped antiretroviral activities. Long-acting nanoART can serve as a drug carrier in both cells and subcellular compartments and, as such, can facilitate viral clearance. IMPORTANCE The need for long-acting ART is significant and highlighted by limitations in drug access, toxicity, adherence, and reservoir penetrance. We propose that targeting nanoformulated drugs to infected tissues, cells, and subcellular sites of viral replication may improve clinical outcomes. Endosomes are sites for human immunodeficiency virus assembly, and increasing ART concentrations in such sites enhances viral clearance. The current work uncovers a new mechanism by which nanoART can enhance viral clearance over native drug formulations. PMID:24920821

  16. The Effectiveness of Community-Based Occupational Therapy Education and Functional Training Programs for Older Adults: A Critical Literature Review.

    ERIC Educational Resources Information Center

    Wilkins, Seanne; Jung, Bonny; Wishart, Laurie; Edwards, Mary; Norton, Shelley Gamble

    2003-01-01

    Results of a literature review describing the provision of education and occupational therapy training programs for older adults indicate that programs are effective in three areas: prevention of functional decline and falls, stroke, and rheumatoid arthritis. (Contains 37 references.) (JOW)

  17. Concise review: workshop review: understanding and assessing the risks of stem cell-based therapies.

    PubMed

    Heslop, James A; Hammond, Thomas G; Santeramo, Ilaria; Tort Piella, Agnès; Hopp, Isabel; Zhou, Jing; Baty, Roua; Graziano, Enrique I; Proto Marco, Bernabé; Caron, Alexis; Sköld, Patrik; Andrews, Peter W; Baxter, Melissa A; Hay, David C; Hamdam, Junnat; Sharpe, Michaela E; Patel, Sara; Jones, David R; Reinhardt, Jens; Danen, Erik H J; Ben-David, Uri; Stacey, Glyn; Björquist, Petter; Piner, Jacqueline; Mills, John; Rowe, Cliff; Pellegrini, Giovanni; Sethu, Swaminathan; Antoine, Daniel J; Cross, Michael J; Murray, Patricia; Williams, Dominic P; Kitteringham, Neil R; Goldring, Chris E P; Park, B Kevin

    2015-04-01

    The field of stem cell therapeutics is moving ever closer to widespread application in the clinic. However, despite the undoubted potential held by these therapies, the balance between risk and benefit remains difficult to predict. As in any new field, a lack of previous application in man and gaps in the underlying science mean that regulators and investigators continue to look for a balance between minimizing potential risk and ensuring therapies are not needlessly kept from patients. Here, we attempt to identify the important safety issues, assessing the current advances in scientific knowledge and how they may translate to clinical therapeutic strategies in the identification and management of these risks. We also investigate the tools and techniques currently available to researchers during preclinical and clinical development of stem cell products, their utility and limitations, and how these tools may be strategically used in the development of these therapies. We conclude that ensuring safety through cutting-edge science and robust assays, coupled with regular and open discussions between regulators and academic/industrial investigators, is likely to prove the most fruitful route to ensuring the safest possible development of new products. PMID:25722427

  18. Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review

    Microsoft Academic Search

    Patricia B Neumann; Karen A Grimmer; Yamini Deenadayalan

    2006-01-01

    BACKGROUND: Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT) performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal

  19. Androgen and estrogen-androgen hormone replacement therapy: a review of the safety literature, 1941 to 1996

    Microsoft Academic Search

    Morrie M. Gelfand; Brinda Wiita

    1997-01-01

    The endocrine physiology of the climacteric supports a rationale for the concomitant replacement of androgen and estrogen following menopause. Clinical and research experience with estrogen-androgen hormone replacement therapy, as well as androgen-only therapy, suggests that the health benefit offered by androgen replacement exceeds the potential risk when treatment is properly managed. In this review, we concentrate on the effects of

  20. Interventions to improve delivery of isoniazid preventive therapy: an overview of systematic reviews

    PubMed Central

    2014-01-01

    Background Uptake of isoniazid preventive therapy (IPT) to prevent tuberculosis has been poor, particularly in the highest risk populations. Interventions to improve IPT delivery could promote implementation. The large number of existing systematic reviews on treatment adherence has made drawing conclusions a challenge. To provide decision makers with the evidence they need, we performed an overview of systematic reviews to compare different organizational interventions to improve IPT delivery as measured by treatment completion among those at highest risk for the development of TB disease, namely child contacts or HIV-infected individuals. Methods We searched the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects (DARE), and MEDLINE up to August 15, 2012. Two authors used a standardized data extraction form and the AMSTAR instrument to independently assess each review. Results Six reviews met inclusion criteria. Interventions included changes in the setting/site of IPT delivery, use of quality monitoring mechanisms (e.g., directly observed therapy), IPT delivery integration into other healthcare services, and use of lay health workers. Most reviews reported a combination of outcomes related to IPT adherence and treatment completion rate but without a baseline or comparison rate. Generally, we found limited evidence to demonstrate that the studied interventions improved treatment completion. Conclusions While most of the interventions were not shown to improve IPT completion, integration of tuberculosis and HIV services yielded high treatment completion rates in some settings. The lack of data from high burden TB settings limits applicability. Further research to assess different IPT delivery interventions, including those that address barriers to care in at-risk populations, is urgently needed to identify the most effective practices for IPT delivery and TB control in high TB burden settings. PMID:24886159

  1. Adjuvant endocrine therapy for early breast cancer: a systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline

    PubMed Central

    Freedman, O.C.; Fletcher, G.G.; Gandhi, S.; Mates, M.; Dent, S.F.; Trudeau, M.E.; Eisen, A.

    2015-01-01

    Background Cancer Care Ontario’s Program in Evidence-Based Care (pebc) recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer. The evidence for the guideline was compiled using a systematic review to answer the question “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?” The question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and her2 (human epidermal growth factor receptor 2)–targeted therapy. Methods For the systematic review, the literature in the medline and embase databases was searched for the period January 2008 to May 2014. The Standards and Guidelines Evidence directory of cancer guidelines and the Web sites of major oncology guideline organizations were also searched. The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and results were limited to randomized controlled trials (rcts), guidelines, systematic reviews, and meta-analyses. Results Several hundred documents that met the inclusion criteria were retrieved. Meta-analyses from the Early Breast Cancer Trialists’ Collaborative Group encompassed many of the rcts found. Several additional studies that met the inclusion criteria were retained, as were other guidelines and systematic reviews. Summary The results of the systematic review constitute a comprehensive compilation of high-level evidence, which was the basis for the 2014 pebc guideline on systemic therapy for early breast cancer. The review of the evidence for systemic endocrine therapy (adjuvant tamoxifen, aromatase inhibitors, and ovarian ablation and suppression) is presented here; the evidence for chemotherapy and her2-targeted treatment—and the final clinical practice recommendations—are presented separately in this supplement.

  2. Dosimetric consequences of pencil beam width variations in scanned beam particle therapy

    NASA Astrophysics Data System (ADS)

    Chanrion, M. A.; Ammazzalorso, F.; Wittig, A.; Engenhart-Cabillic, R.; Jelen, U.

    2013-06-01

    Scanned ion beam delivery enables the highest degree of target dose conformation attainable in external beam radiotherapy. Nominal pencil beam widths (spot sizes) are recorded during treatment planning system commissioning. Due to changes in the beam-line optics, the actual spot sizes may differ from these commissioning values, leading to differences between planned and delivered dose. The purpose of this study was to analyse the dosimetric consequences of spot size variations in particle therapy treatment plans. For 12 patients with skull base tumours and 12 patients with prostate carcinoma, scanned-beam carbon ion and proton treatment plans were prepared and recomputed simulating spot size changes of (1) ±10% to simulate the typical magnitude of fluctuations, (2) ±25% representing the worst-case scenario and (3) ±50% as a part of a risk analysis in case of fault conditions. The primary effect of the spot size variation was a dose deterioration affecting the target edge: loss of target coverage and broadening of the lateral penumbra (increased spot size) or overdosage and contraction of the lateral penumbra (reduced spot size). For changes ?25%, the resulting planning target volume mean 95%-isodose line coverage (CI-95%) deterioration was ranging from negligible to moderate. In some cases changes in the dose to adjoining critical structures were observed.

  3. Position statement on ethics, equipoise and research on charged particle radiation therapy.

    PubMed

    Sheehan, Mark; Timlin, Claire; Peach, Ken; Binik, Ariella; Puthenparampil, Wilson; Lodge, Mark; Kehoe, Sean; Brada, Michael; Burnet, Neil; Clarke, Steve; Crellin, Adrian; Dunn, Michael; Fossati, Piero; Harris, Steve; Hocken, Michael; Hope, Tony; Ives, Jonathan; Kamada, Tadashi; London, Alex John; Miller, Robert; Parker, Michael; Pijls-Johannesma, Madelon; Savulescu, Julian; Short, Susan; Skene, Loane; Tsujii, Hirohiko; Tuan, Jeffrey; Weijer, Charles

    2014-08-01

    The use of charged-particle radiation therapy (CPRT) is an increasingly important development in the treatment of cancer. One of the most pressing controversies about the use of this technology is whether randomised controlled trials are required before this form of treatment can be considered to be the treatment of choice for a wide range of indications. Equipoise is the key ethical concept in determining which research studies are justified. However, there is a good deal of disagreement about how this concept is best understood and applied in the specific case of CPRT. This report is a position statement on these controversies that arises out of a workshop held at Wolfson College, Oxford in August 2011. The workshop brought together international leaders in the relevant fields (radiation oncology, medical physics, radiobiology, research ethics and methodology), including proponents on both sides of the debate, in order to make significant progress on the ethical issues associated with CPRT research. This position statement provides an ethical platform for future research and should enable further work to be done in developing international coordinated programmes of research. PMID:24045770

  4. The New Radiation Therapy Clinical Practice: The Emerging Role of Clinical Peer Review for Radiation Therapists and Medical Dosimetrists

    SciTech Connect

    Adams, Robert D.; Marks, Lawrence B. [UNC Department of Radiation Oncology, Chapel Hill, NC (United States); Pawlicki, Todd [Department of Radiation Oncology, University of California, San Diego, CA (United States); Hayman, James [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Church, Jessica, E-mail: jachurch@email.unc.ed [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2010-01-01

    The concept of peer review for radiation therapists and medical dosimetrists has been studied very little in radiation oncology practice. The purpose of this manuscript is to analyze the concept of peer review in the clinical setting for both radiation therapists and medical dosimetrists. The literature reviewed both the percentages and causes of radiation therapy deviations. The results indicate that peer review can be both implemented and evaluated into both the radiation therapist and medical dosimetrist clinical practice patterns.

  5. Review of doped silica glass optical fibre: their TL properties and potential applications in radiation therapy dosimetry.

    PubMed

    Bradley, D A; Hugtenburg, R P; Nisbet, A; Abdul Rahman, Ahmad Taufek; Issa, Fatma; Mohd Noor, Noramaliza; Alalawi, Amani

    2012-12-01

    Review is made of dosimetric studies of Ge-doped SiO(2) telecommunication fibre as a 1-D thermoluminescence (TL) system for therapeutic applications. To-date, the response of these fibres has been investigated for UV sources, superficial X-ray beam therapy facilities, a synchrotron microbeam facility, electron linear accelerators, protons, neutrons and alpha particles, covering the energy range from a few eV to several MeV. Dosimetric characteristics include, reproducibility, fading, dose response, reciprocity between TL yield and dose-rate and energy dependence. The fibres produce a flat response to fixed photon and electron doses to within better than 3% of the mean TL distribution. Irradiated Ge-doped SiO(2) optical fibres show limited signal fading, with an average loss of TL signal of ~0.4% per day. In terms of dose response, Ge-doped SiO(2) optical fibres have been shown to provide linearity to x and electron doses, from a fraction of 1 Gy up to 2 kGy. The dosimeters have also been used in measuring photoelectron generation from iodinated contrast media; TL yields being some 60% greater in the presence of iodine than in its absence. The review is accompanied by previously unpublished data. PMID:22381700

  6. Gene therapy for dyslipidemia: a review of gene replacement and gene inhibition strategies

    PubMed Central

    Kassim, Sadik H; Wilson, James M; Rader, Daniel J

    2012-01-01

    Despite numerous technological and pharmacological advances and more detailed knowledge of molecular etiologies, cardiovascular diseases remain the leading cause of morbidity and mortality worldwide claiming over 17 million lives a year. Abnormalities in the synthesis, processing and catabolism of lipoprotein particles can result in severe hypercholesterolemia, hypertriglyceridemia or low HDL-C. Although a plethora of antidyslipidemic pharmacological agents are available, these drugs are relatively ineffective in many patients with Mendelian lipid disorders, indicating the need for new and more effective interventions. In vivo somatic gene therapy is one such intervention. This article summarizes current strategies being pursued for the development of clinical gene therapy for dyslipidemias that cannot effectively be treated with existing drugs. PMID:22505953

  7. Evaluation of different fiducial markers for image-guided radiotherapy and particle therapy

    PubMed Central

    Habermehl, Daniel; Henkner, Katrin; Ecker, Swantje; Jäkel, Oliver; Debus, Jürgen; Combs, Stephanie E.

    2013-01-01

    Modern radiotherapy (RT) techniques are widely used in the irradiation of moving organs. A crucial step in ensuring the correct position of a target structure directly before or during treatment is daily image guidance by computed tomography (CT) or X-ray radiography (image-guided radiotherapy, IGRT). Therefore, combinations of modern irradiation devices and imaging, such as on-board imaging (OBI) with X-rays, or in-room CT such as the tomotherapy system, have been developed. Moreover, combinations of linear accelerators and in-room CT-scanners have been designed. IGRT is of special interest in hypofractionated and radiosurgical treatments where high single doses are applied in the proximity of critical organs at risk. Radiographically visible markers in or in close proximity to the target structure may help to reproduce the position during RT and could therefore be used as external surrogates for motion monitoring. Criteria sought for fiducial markers are (i) visibility in the radiologic modalities involved in radiotherapeutic treatment planning and image guidance, such as CT and kilovoltage (kV) OBI), (ii) low production of imaging artifacts, and (iii) low perturbation of the therapeutic dose to the target volume. Photon interaction with interstitial markers has been shown to be not as important as in particle therapy, where interaction of the particle beam, especially with metal markers, can have a significant impact on treatment. This applies especially with a scanned ion beam. Recently we commenced patient recruitment at our institution within the PROMETHEUS trial, which evaluates a hypofractionation regime, starting with 4 x 10 Gy (RBE), for patients with hepatocellular carcinoma. The aim of this work is, therefore, to evaluate potential implantable fiducial markers for enabling precise patient and thus organ positioning in scanned ion beams. To transfer existing knowledge of marker application from photon to particle therapy, we used a range of commercially available markers of different forms and sizes, consisting of carbon and gold materials, and evaluated them for their potential use in the clinical setup with scanned ion beams at our institution. All markers were implanted in a standardized Alderson phantom and were examined using CT scans and orthogonal kV OBI in our clinical routine protocol. Impact on beam perturbation downstream of the markers in the plateau region of a spread-out Bragg peak (SOBP) was estimated by using radiographic films for clinical proton and carbon ion beams of high and low energies. All tested markers achieved good visibility in CT and kV OBI. Disturbances due to artifacts and dose perturbation were highest in the arbitrarily folded gold and the thickest gold marker, but especially low in the carbon marker. Dose perturbation was highest in the arbitrarily folded gold marker. In summary, the analyzed markers offer promising potential for identifying target structures in our treatment setup at HIT and will soon be used in clinical routine. However, a careful choice of marker, depending on the tumor localization and irradiation strategy, will need to be made. PMID:23824129

  8. The peer review system (PRS) for quality assurance and treatment improvement in radiation therapy

    NASA Astrophysics Data System (ADS)

    Le, Anh H. T.; Kapoor, Rishabh; Palta, Jatinder R.

    2012-02-01

    Peer reviews are needed across all disciplines of medicine to address complex medical challenges in disease care, medical safety, insurance coverage handling, and public safety. Radiation therapy utilizes technologically advanced imaging for treatment planning, often with excellent efficacy. Since planning data requirements are substantial, patients are at risk for repeat diagnostic procedures or suboptimal therapeutic intervention due to a lack of knowledge regarding previous treatments. The Peer Review System (PRS) will make this critical radiation therapy information readily available on demand via Web technology. The PRS system has been developed with current Web technology, .NET framework, and in-house DICOM library. With the advantages of Web server-client architecture, including IIS web server, SOAP Web Services and Silverlight for the client side, the patient data can be visualized through web browser and distributed across multiple locations by the local area network and Internet. This PRS will significantly improve the quality, safety, and accessibility, of treatment plans in cancer therapy. Furthermore, the secure Web-based PRS with DICOM-RT compliance will provide flexible utilities for organization, sorting, and retrieval of imaging studies and treatment plans to optimize the patient treatment and ultimately improve patient safety and treatment quality.

  9. The metabolic syndrome and mind-body therapies: a systematic review.

    PubMed

    Anderson, Joel G; Taylor, Ann Gill

    2011-01-01

    The metabolic syndrome, affecting a substantial and increasing percentage of the worldwide population, is comprised of a cluster of symptoms associated with increased risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation, have become increasingly popular worldwide. These complementary therapies have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome. However, clinical trial data concerning the effectiveness of these practices on the syndrome as a whole have not been evaluated using a systematic and synthesizing approach. A systematic review was conducted to critically evaluate the data from clinical trials examining the efficacy of mind-body therapies as supportive care modalities for management of the metabolic syndrome. Three clinical trials addressing the use of mind-body therapies for management of the metabolic syndrome were identified. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome. PMID:21773016

  10. Concise Review: Guidance in Developing Commercializable Autologous/Patient-Specific Cell Therapy Manufacturing

    PubMed Central

    Armant, Myriam; Brandwein, Harvey; Burger, Scott; Campbell, Andrew; Carpenito, Carmine; Clarke, Dominic; Fong, Timothy; Karnieli, Ohad; Niss, Knut; Van't Hof, Wouter; Wagey, Ravenska

    2013-01-01

    Cell therapy is poised to play an enormous role in regenerative medicine. However, little guidance is being made available to academic and industrial entities in the start-up phase. In this technical review, members of the International Society for Cell Therapy provide guidance in developing commercializable autologous and patient-specific manufacturing strategies from the perspective of process development. Special emphasis is placed on providing guidance to small academic or biotech researchers as to what simple questions can be addressed or answered at the bench in order to make their cell therapy products more feasible for commercial-scale production. We discuss the processes that are required for scale-out at the manufacturing level, and how many questions can be addressed at the bench level. The goal of this review is to provide guidance in the form of topics that can be addressed early in the process of development to better the chances of the product being successful for future commercialization. PMID:24101671

  11. Mathematical Modeling of HIV Dynamics After Antiretroviral Therapy Initiation: A Review

    PubMed Central

    Moog, Claude H.; Stan, Guy-Bart; Brunet, Cecile; Raffi, François; Ferré, Virginie; Costanza, Vicente; Mhawej, Marie J.; Biafore, Federico; Ouattara, Djomangan A.; Ernst, Damien; Fonteneau, Raphael; Xia, Xiaohua

    2014-01-01

    Abstract This review shows the potential ground-breaking impact that mathematical tools may have in the analysis and the understanding of the HIV dynamics. In the first part, early diagnosis of immunological failure is inferred from the estimation of certain parameters of a mathematical model of the HIV infection dynamics. This method is supported by clinical research results from an original clinical trial: data just after 1 month following therapy initiation are used to carry out the model identification. The diagnosis is shown to be consistent with results from monitoring of the patients after 6 months. In the second part of this review, prospective research results are given for the design of individual anti-HIV treatments optimizing the recovery of the immune system and minimizing side effects. In this respect, two methods are discussed. The first one combines HIV population dynamics with pharmacokinetics and pharmacodynamics models to generate drug treatments using impulsive control systems. The second one is based on optimal control theory and uses a recently published differential equation to model the side effects produced by highly active antiretroviral therapy therapies. The main advantage of these revisited methods is that the drug treatment is computed directly in amounts of drugs, which is easier to interpret by physicians and patients. PMID:25371860

  12. Mathematical Modeling of HIV Dynamics After Antiretroviral Therapy Initiation: A Review.

    PubMed

    Rivadeneira, Pablo S; Moog, Claude H; Stan, Guy-Bart; Brunet, Cecile; Raffi, François; Ferré, Virginie; Costanza, Vicente; Mhawej, Marie J; Biafore, Federico; Ouattara, Djomangan A; Ernst, Damien; Fonteneau, Raphael; Xia, Xiaohua

    2014-10-01

    This review shows the potential ground-breaking impact that mathematical tools may have in the analysis and the understanding of the HIV dynamics. In the first part, early diagnosis of immunological failure is inferred from the estimation of certain parameters of a mathematical model of the HIV infection dynamics. This method is supported by clinical research results from an original clinical trial: data just after 1 month following therapy initiation are used to carry out the model identification. The diagnosis is shown to be consistent with results from monitoring of the patients after 6 months. In the second part of this review, prospective research results are given for the design of individual anti-HIV treatments optimizing the recovery of the immune system and minimizing side effects. In this respect, two methods are discussed. The first one combines HIV population dynamics with pharmacokinetics and pharmacodynamics models to generate drug treatments using impulsive control systems. The second one is based on optimal control theory and uses a recently published differential equation to model the side effects produced by highly active antiretroviral therapy therapies. The main advantage of these revisited methods is that the drug treatment is computed directly in amounts of drugs, which is easier to interpret by physicians and patients. PMID:25371860

  13. Effectiveness of Massage Therapy for Chronic, Non-malignant Pain: A Review

    PubMed Central

    2007-01-01

    Previous reviews of massage therapy for chronic, non-malignant pain have focused on discrete pain conditions. This article aims to provide a broad overview of the literature on the effectiveness of massage for a variety of chronic, non-malignant pain complaints to identify gaps in the research and to inform future clinical trials. Computerized databases were searched for relevant studies including prior reviews and primary trials of massage therapy for chronic, non-malignant pain. Existing research provides fairly robust support for the analgesic effects of massage for non-specific low back pain, but only moderate support for such effects on shoulder pain and headache pain. There is only modest, preliminary support for massage in the treatment of fibromyalgia, mixed chronic pain conditions, neck pain and carpal tunnel syndrome. Thus, research to date provides varying levels of evidence for the benefits of massage therapy for different chronic pain conditions. Future studies should employ rigorous study designs and include follow-up assessments for additional quantification of the longer-term effects of massage on chronic pain. PMID:17549233

  14. Traditional herbal medicine as adjunctive therapy for nasopharyngeal cancer: a systematic review and meta-analysis.

    PubMed

    Kim, Woojin; Lee, Won-Bock; Lee, Jungwoo; Min, Byung-Il; Lee, HyangSook; Cho, Seung-Hun

    2015-05-01

    The effectiveness of traditional herbal medicine (THM) as treatment for nasopharyngeal cancer (NPC) has not been clearly demonstrated. The aim of this study is to assess the effectiveness of THM as adjunctive therapies for NPC using the results of randomized controlled trials (RCTs). Five electronic databases, including English and Chinese databases, were systematically searched up to February 2014. All RCTs involving traditional herbal medicine in combination with conventional cancer therapy for NPC were included. Twenty-two RCTs involving 2,298 NPC patients were systematically reviewed. Of these 22 studies, 15 on 1482 patients reported a significant increase in the number surviving patients with survivals of more than 1, 3, or 5 years. Seven studies on 595 patients reported a significant increase in immediate tumor response, and three studies on 505 patients reported a significant decrease in distant metastasis. This meta-analysis of 22 studies suggests that THM combined with conventional therapy can provide an effective adjunctive therapy for NPC. More research and well-designed, rigorous, large clinical trials are required to address these issues. PMID:25698710

  15. The Effect of Low-level Laser Therapy on Trigeminal Neuralgia: A Review of Literature

    PubMed Central

    Falaki, Farnaz; Nejat, Amir Hossein; Dalirsani, Zohreh

    2014-01-01

    The effect of low intensity laser radiation in the treatment of acute and chronic pain is now established in many studies. Tri-geminal neuralgia is a pain passes through nerve's branches and its trigger is located in skin or mucosa that could lead to pain with a trigger stimulus. The pain involved branches of trigeminal nerve that sometimes has patients to seek the treatment for several years. Nowadays different treatments are used for relief of pain that most of them cause tolerance and various side effects. This paper reviews and summarizes scientific papers available in English literature publishedin PubMed, Scopus, Science Direct, Inter science, and Iran Medex from 1986 until July 2011 about the effect of these types of lasers on trigeminal neuralgia which is one of the most painful afflictions known. In different studies, the effect of laser therapy has been compared with placebo irradiation or medicinal and surgical treatment modalities. Low-level laser therapy (LLLT) is a treatment strategy which uses a single wavelength light source. Laser radiation and monochromatic light may alter cell and tissue function. However, in most studies laser therapy was associated with significant reduction in the intensity and frequency of pain compared with other treatment strategies, a few studies revealed that between laser and placebo group there was not any significant difference according to the analgesic effect. Low-level laser therapy could be considered in treatment of trigeminal neuralgia without any side effects. PMID:25024832

  16. The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review

    PubMed Central

    Hofmann, Stefan G.; Sawyer, Alice T.; Witt, Ashley A.; Oh, Diana

    2009-01-01

    BACKGROUND Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. OBJECTIVES To conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. DATA SOURCES A literature search was conducted using PubMed, PsycInfo, the Cochrane Library, and manual searches. REVIEW METHODS The search identified 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. RESULTS Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’ g = 0.63) and mood symptoms (Hedges’ g = 0.59) from pre to post-treatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’ g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, unrelated to publication year or number of treatment sessions, and were maintained over follow-up. CONCLUSION These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations. PMID:20350028

  17. Effectiveness of enteral nutritional therapy in the healing process of pressure ulcers: a systematic review.

    PubMed

    Blanc, Gisely; Meier, Marineli Joaquim; Stocco, Janislei Giseli Dorociaki; Roehrs, Hellen; Crozeta, Karla; Barbosa, Dulce Aparecida

    2015-01-01

    OBJECTIVE To evaluate the effectiveness of enteral nutritional therapy (ENT) in the healing process of pressure ulcers (PU) in adults and the elderly. METHOD A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs) without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. RESULTS We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. CONCLUSION Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found. PMID:25789655

  18. First Exit Times of Harmonically Trapped Particles: A Didactic Review

    E-print Network

    D. S. Grebenkov

    2014-11-13

    We revise the classical problem of characterizing first exit times of a harmonically trapped particle whose motion is described by one- or multi-dimensional Ornstein-Uhlenbeck process. We start by recalling the main derivation steps of a propagator using Langevin and Fokker-Planck equations. The mean exit time, the moment-generating function, and the survival probability are then expressed through confluent hypergeometric functions and thoroughly analyzed. We also present a rapidly converging series representation of confluent hypergeometric functions that is particularly well suited for numerical computation of eigenvalues and eigenfunctions of the governing Fokker-Planck operator. We discuss several applications of first exit times such as detection of time intervals during which motor proteins exert a constant force onto a tracer in optical tweezers single-particle tracking experiments; adhesion bond dissociation under mechanical stress; characterization of active periods of trend following and mean-reverting strategies in algorithmic trading on stock markets; relation to the distribution of first crossing times of a moving boundary by Brownian motion. Some extensions are described, including diffusion under quadratic double-well potential and anomalous diffusion.

  19. First exit times of harmonically trapped particles: a didactic review

    NASA Astrophysics Data System (ADS)

    Grebenkov, Denis S.

    2015-01-01

    We revise the classical problem of characterizing first exit times of a harmonically trapped particle whose motion is described by a one- or multidimensional Ornstein–Uhlenbeck process. We start by recalling the main derivation steps of a propagator using Langevin and Fokker–Planck equations. The mean exit time, the moment-generating function and the survival probability are then expressed through confluent hypergeometric functions and thoroughly analyzed. We also present a rapidly converging series representation of confluent hypergeometric functions that is particularly well suited for numerical computation of eigenvalues and eigenfunctions of the governing Fokker–Planck operator. We discuss several applications of first exit times, such as the detection of time intervals during which motor proteins exert a constant force onto a tracer in optical tweezers single-particle tracking experiments; adhesion bond dissociation under mechanical stress; characterization of active periods of trend-following and mean-reverting strategies in algorithmic trading on stock markets; relation to the distribution of first crossing times of a moving boundary by Brownian motion. Some extensions are described, including diffusion under quadratic double-well potential and anomalous diffusion.

  20. One-step synthesis of gradient gadolinium ironhexacyanoferrate nanoparticles: a new particle design easily combining MRI contrast and photothermal therapy.

    PubMed

    Li, Yichen; Li, Carissa H; Talham, Daniel R

    2015-03-12

    A one-step synthesis of Prussian blue nanoparticles possessing a concentration gradient of Gd(3+) counterions, g-Gd-PB, has been developed, and the potential for the particles to perform as both MRI positive contrast agents and photothermal therapy agents is demonstrated. The synthesis of potassium/gadolinium ironhexacyanoferrate is performed under increasing concentration of Gd(3+) ions forming particles with a higher concentration of gadolinium toward the outer layers. The proton relaxivity (r1) measured for the particles is 12.3 mM(-1) s(-1), and T1 weighted images of phantoms containing the particles show their potential as MRI contrast agents. In addition, the Prussian blue host can rapidly and efficiently convert energy from near-IR light into thermal energy, allowing g-Gd-PB to be used as a photothermal therapy agent. The photothermal properties are demonstrated by measuring temperature changes of particle suspensions under irradiation and by photothermal ablation of CCRF-CEM cancer cells. PMID:25706057

  1. Clinical- and cost-effectiveness of LDL particle-guided statin therapy: a simulation study.

    PubMed

    Folse, Henry J; Goswami, Devesh; Rengarajan, Badri; Budoff, Matthew; Kahn, Richard

    2014-09-01

    We used the Archimedes Model, a mathematical simulation model (Model) to estimate the clinical- and cost-effectiveness of using LDL particle concentration (LDL-P) as an adjunct or alternative to LDL cholesterol (LDL-C) to guide statin therapy. LDL-P by NMR has been shown to be a better measure of cardiovascular disease (CVD) risk than LDL-C, and may therefore be a better gauge of the need for and response to statin treatment. Using the Model, we conducted a virtual clinical trial comparing the use of LDL-C alone, LDL-P alone, and LDL-C and LDL-P together to guide treatment in the general adult population, and in high-risk, dyslipidemic subpopulations. In the general population, the 5-year major adverse cardiovascular event (MACE) relative risk reduction (RRR) of LDL-P alone compared to the control arm (LDL-C alone) was 5.0% (95% CI, 4.7-5.3; p < .0001); using both LDL-C and LDL-P (dual markers) led to 3.0% RRR compared to the control arm (95% CI, 2.8-3.3; p < .0001). For individuals with diabetes, the RRR was 7.3% (95% CI, 6.4-8.2; p < .0001) for LDL-P alone and 6.9% for dual markers (95% CI, 6.1-7.8; both, p < .0001). In the general population, the costs per quality-adjusted life year (QALY) associated with the use of LDL-P alone were $76,052 at 5 years and $8913 at 20 years and $142,825 at 5 years and $25,505 at 20 years with the use of both markers. In high-risk subpopulations, the use of LDL-P alone was cost-saving at 5 years; whereas the cost per QALY for the use of both markers was $14,250 at 5 years and $859 at 20 years for high-risk dyslipidemics, $19,192 at 5 years and $649 at 20 years for diabetics, and $9030 at 5 years and $7268 at 20 years for patients with prior CHD. In conclusion, the model estimates that using LDL-P to guide statin therapy may reduce the risk of CVD events to a greater extent than does the use of LDL-C alone and maybe cost-effective or cost-saving for high-risk patients. PMID:25050538

  2. review The American Society of Gene & Cell Therapy Molecular Therapy vol. 19 no. 8, 14071415 aug. 2011 1407

    E-print Network

    Schaffer, David V.

    drugs (e.g., siroli- mus) and proteins (e.g., growth hormone),13,14 and these systems may alsoreview© The American Society of Gene & Cell Therapy Molecular Therapy vol. 19 no. 8, 1407­1415 aug. 2011 1407 IntroductIon Gene therapy has shown increasing promise in clinical trials for disorders

  3. Review of technology development and clinical trials of transcranial laser therapy for acute ischemic stroke treatment

    NASA Astrophysics Data System (ADS)

    Catanzaro, Brian E.; Streeter, Jackson; de Taboada, Luis

    2010-02-01

    Stroke is the one of the leading causes of mortality in the United States, claiming 600,000 lives each year. Evidence suggests that near infrared (NIR) illumination has a beneficial effect on a variety of cells when these cells are exposed to adverse conditions. Among these conditions is the hypoxic state produced by acute ischemic stroke (AIS). To demonstrate the impact NIR Transcranial Laser Therapy (TLT) has on AIS in humans, a series of double blind, placebo controlled clinical trials were designed using the NeuroThera(R) System (NTS). The NTS was designed and developed to treat subjects non-invasively using 808 nm NIR illumination. TLT, as it applies to stroke therapy, and the NTS will be described. The results of the two clinical trials: NeuroThera(R) Safety and Efficacy Trial 1 (NEST-1) and NeuroThera(R) Safety and Efficacy Trial 2 (NEST-2) will be reviewed and discussed.

  4. A review on the use of cell therapy in the treatment of tendon disease and injuries

    PubMed Central

    Sawadkar, Prasad; Mudera, Vivek

    2014-01-01

    Tendon disease and injuries carry significant morbidity worldwide in both athletic and non-athletic populations. It is estimated that tendon injuries account for 30%?50% of all musculoskeletal injuries globally. Current treatments have been inadequate in providing an accelerated process of repair resulting in high relapse rates. Modern concepts in tissue engineering and regenerative medicine have led to increasing interest in the application of cell therapy for the treatment of tendon disease. This review will explore the use of cell therapy, by bringing together up-to-date evidence from in vivo human and animal studies, and discuss the issues surrounding the safety and efficacy of its use in the treatment of tendon disease. PMID:25383170

  5. The use of electroconvulsive therapy in atypical psychotic presentations: a case review.

    PubMed

    Montgomery, John H; Vasu, Devi

    2007-10-01

    Convulsive therapy and its progeny, electroconvulsive therapy (ECT), were originally used for the treatment of catatonic schizophrenia, and there is little doubt that ECT remains an effective intervention for the treatment of schizophrenia. However, current practice tends to favor the use of ECT in severe or treatment refractory affective disorders, and its use in schizophrenia and other nonaffective (atypical) psychotic disorders has become controversial.CASE REPORTS HAVE SUGGESTED A ROLE FOR ECT IN TWO SPECIFIC ATYPICAL PSYCHOTIC DISORDERS: Cotard's syndrome and cycloid psychosis. In this article, we review the atypical psychotic disorders and report a series of five case examples that signify the role of ECT in atypical psychotic presentations, particularly when the symptoms resemble those found in Cotard's syndrome and cycloid psychosis. PMID:20428309

  6. Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review

    PubMed Central

    Yin, Ping; Gao, Ningyang; Wu, Junyi; Xu, Shifen

    2014-01-01

    Pain-related massage, important in traditional Eastern medicine, is increasingly used in the Western world. So the widening acceptance demands continual safety assessment. This review is an evaluation of the frequency and severity of adverse events (AEs) reported mainly for pain-related massage between 2003 and 2013. Relevant all-languages reports in 6 databases were identified and assessed by two coauthors. During the 11-year period, 40 reports of 138 AEs were associated with massage. Author, year of publication, country of occurrence, participant related (age, sex) or number of patients affected, the details of manual therapy, and clinician type were extracted. Disc herniation, soft tissue trauma, neurologic compromise, spinal cord injury, dissection of the vertebral arteries, and others were the main complications of massage. Spinal manipulation in massage has repeatedly been associated with serious AEs especially. Clearly, massage therapies are not totally devoid of risks. But the incidence of such events is low. PMID:25197310

  7. Imaging-based treatment selection for intravenous and intra-arterial stroke therapies: a comprehensive review

    PubMed Central

    Yoo, Albert J; Pulli, Benjamin; Gonzalez, R Gilberto

    2011-01-01

    Reperfusion therapy is the only approved treatment for acute ischemic stroke. The current approach to patient selection is primarily based on the time from stroke symptom onset. However, this algorithm sharply restricts the eligible patient population, and neglects large variations in collateral circulation that ultimately determine the therapeutic time window in individual patients. Time alone is unlikely to remain the dominant parameter. Alternative approaches to patient selection involve advanced neuroimaging methods including MRI diffusion-weighted imaging, magnetic resonance and computed tomography perfusion imaging and noninvasive angiography that provide potentially valuable information regarding the state of the brain parenchyma and the neurovasculature. These techniques have now been used extensively, and there is emerging evidence on how specific imaging data may result in improved clinical outcomes. This article will review the major studies that have investigated the role of imaging in patient selection for both intravenous and intra-arterial therapies. PMID:21809968

  8. Particle therapy for clinically diagnosed stage I lung cancer: Comparison with pathologically proven non-small cell lung cancer.

    PubMed

    Fujii, Osamu; Demizu, Yusuke; Hashimoto, Naoki; Takagi, Masaru; Terashima, Kazuki; Mima, Masayuki; Jin, Dongcun; Nagano, Fumiko; Katsui, Kuniaki; Okimoto, Tomoaki; Iwata, Hiromitsu; Niwa, Yasue; Yamashita, Tomohiro; Akagi, Takashi; Daimon, Takashi; Sasaki, Ryohei; Hishikawa, Yoshio; Abe, Mitsuyuki; Murakami, Masao; Fuwa, Nobukazu

    2015-03-01

    Abstract Background. The purpose of the present study was to present the treatment outcomes of particle therapy for indeterminate pulmonary nodules (IPNs) diagnosed as stage I non-small cell lung cancer, including a comparative analysis involving pathologically proven lung cancer (PPLC). Material and methods. A total of 54 patients (57 lesions) who underwent particle therapy for IPNs were enrolled in this study. Median patient age was 76 (range 52-87) years. T-classification was: T1a, 30; T1b, 16; and T2a, 11. Particle therapy using protons or carbon ions was delivered at total doses of 52.8-80 Gy equivalent in 4-26 fractions. The PPLC cohort included 111 patients. Results. The median follow-up time was 41 (range 7-90) months. For all IPN patients, the three-year overall survival, progression-free survival, local control and distant progression-free survival rates were 90%, 72%, 94% and 79%, respectively. Grade 2 toxicities were radiation pneumonitis (19%), dermatitis (9%), rib fracture (2%), chest wall pain (2%) and neuropathy (2%). No ? grade 3 toxicities were observed. In univariate analysis, the IPN group showed significantly better survival relative to the PPLC group. However, after adjustment for baseline imbalances between these two groups in multivariate analysis, pathological confirmation did not correlate with survival. Conclusions. Particle therapy for IPNs provided favorable outcomes with minimal toxicities, which may be comparable to those for PPLC patients. Further studies are needed to clarify the optimal management of IPN patients. PMID:25383445

  9. Gravity particles from Warped Extra Dimensions, a review. Part I - KK Graviton

    E-print Network

    Alexandra Oliveira

    2014-04-01

    On face of the latest LHC experimental results on the direct searches for Beyond Standard Model physics we review the basic of Warped Extra Dimensions scenarios and the physics of the heavy gravity particles, their most unique signature. In this first part we intend to summarize the physics behind the hypothesis of a heavy spin-2 Beyond Standard Model particle on the context of WED and also to address some of the interesting phenomenology issues of model building hypothesis.

  10. T-matrix computations of light scattering by nonspherical particles: A review

    Microsoft Academic Search

    Michael I. Mishchenko; Larry D. Travis; Daniel W. Mackowski

    1996-01-01

    We review the current status of Waterman's T-matrix approach which is one of the most powerful and widely used tools for accurately computing light scattering by nonspherical particles, both single and composite, based on directly solving Maxwell's equations. Specifically, we discuss the analytical method for computing orientationally-averaged light-scattering characteristics for ensembles of nonspherical particles, the methods for overcoming the numerical

  11. Web-based documentation system with exchange of DICOM RT for multicenter clinical studies in particle therapy

    NASA Astrophysics Data System (ADS)

    Kessel, Kerstin A.; Bougatf, Nina; Bohn, Christian; Engelmann, Uwe; Oetzel, Dieter; Bendl, Rolf; Debus, Jürgen; Combs, Stephanie E.

    2012-02-01

    Conducting clinical studies is rather difficult because of the large variety of voluminous datasets, different documentation styles, and various information systems, especially in radiation oncology. In this paper, we describe our development of a web-based documentation system with first approaches of automatic statistical analyses for transnational and multicenter clinical studies in particle therapy. It is possible to have immediate access to all patient information and exchange, store, process, and visualize text data, all types of DICOM images, especially DICOM RT, and any other multimedia data. Accessing the documentation system and submitting clinical data is possible for internal and external users (e.g. referring physicians from abroad, who are seeking the new technique of particle therapy for their patients). Thereby, security and privacy protection is ensured with the encrypted https protocol, client certificates, and an application gateway. Furthermore, all data can be pseudonymized. Integrated into the existing hospital environment, patient data is imported via various interfaces over HL7-messages and DICOM. Several further features replace manual input wherever possible and ensure data quality and entirety. With a form generator, studies can be individually designed to fit specific needs. By including all treated patients (also non-study patients), we gain the possibility for overall large-scale, retrospective analyses. Having recently begun documentation of our first six clinical studies, it has become apparent that the benefits lie in the simplification of research work, better study analyses quality and ultimately, the improvement of treatment concepts by evaluating the effectiveness of particle therapy.

  12. Does yoga therapy reduce blood pressure in patients with hypertension?: an integrative review.

    PubMed

    Okonta, Nkechi Rose

    2012-01-01

    The aim of this article was to present a evidence-based integrative research review that validates yoga therapy as an effective complementary treatment in the management of high blood pressure (BP). The article also uses the theoretical framework of Dr Hans Selye's general adaptation syndrome. Yoga researchers demonstrate that yoga works because it modulates the physiological system of the body, specifically its effect on the heart rate. This review is significant because yoga presents an effective method of treating hypertension that is nonpharmacologic and therefore there are no adverse effects and there are other valuable health benefits. Research suggests that stress is a contributing factor to high BP; hence, the use of the general adaptation syndrome and the most important attribute of yoga, that is, it is a physical and mental exercise program, that is in sync with the philosophy of holistic nursing care where one treats the whole individual and not just the disease. The review was conducted with a search of computerized databases such as OVID, Academic Search Premier, CINAHL, MEDLINE, and Health Source: Nursing/Academic edition, PsychINFO, as well as reliable Web sites such as the cdc.gov, among others. An integrative review search was conducted, and 10 studies met the inclusion criteria. They include a combination of randomized controlled trials, quasi-experimental studies, and pilot studies. Yoga therapy is a multifunctional exercise modality with numerous benefits. Not only does yoga reduce high BP but it has also been demonstrated to effectively reduce blood glucose level, cholesterol level, and body weight, major problems affecting the American society. The completed integrative review provides guidelines for nursing implementation as a complementary treatment of high BP. PMID:22517349

  13. A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis

    Microsoft Academic Search

    Jan Magnus Bjordal; Rene-Jean Bensadoun; Jan Tunèr; Lucio Frigo; Kjersti Gjerde; Rodrigo AB Lopes-Martins

    Purpose  The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer\\u000a therapy-induced oral mucositis (OM).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation\\u000a therapy in head and neck cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Results  We found 11 randomised placebo-controlled trials with a total of 415

  14. SHIELD-HIT12A - a Monte Carlo particle transport program for ion therapy research

    NASA Astrophysics Data System (ADS)

    Bassler, N.; Hansen, D. C.; Lühr, A.; Thomsen, B.; Petersen, J. B.; Sobolevsky, N.

    2014-03-01

    Purpose: The Monte Carlo (MC) code SHIELD-HIT simulates the transport of ions through matter. Since SHIELD-HIT08 we added numerous features that improves speed, usability and underlying physics and thereby the user experience. The "-A" fork of SHIELD-HIT also aims to attach SHIELD-HIT to a heavy ion dose optimization algorithm to provide MC-optimized treatment plans that include radiobiology. Methods: SHIELD-HIT12A is written in FORTRAN and carefully retains platform independence. A powerful scoring engine is implemented scoring relevant quantities such as dose and track-average LET. It supports native formats compatible with the heavy ion treatment planning system TRiP. Stopping power files follow ICRU standard and are generated using the libdEdx library, which allows the user to choose from a multitude of stopping power tables. Results: SHIELD-HIT12A runs on Linux and Windows platforms. We experienced that new users quickly learn to use SHIELD-HIT12A and setup new geometries. Contrary to previous versions of SHIELD-HIT, the 12A distribution comes along with easy-to-use example files and an English manual. A new implementation of Vavilov straggling resulted in a massive reduction of computation time. Scheduled for later release are CT import and photon-electron transport. Conclusions: SHIELD-HIT12A is an interesting alternative ion transport engine. Apart from being a flexible particle therapy research tool, it can also serve as a back end for a MC ion treatment planning system. More information about SHIELD-HIT12A and a demo version can be found on http://www.shieldhit.org.

  15. A Current Review of Multisystemic Therapy: A Social-Ecological Approach to the Treatment of Conduct Problems among Adolescents

    ERIC Educational Resources Information Center

    Harpell, Jody V.; Andrews, Jac

    2006-01-01

    A current empirical review of the treatment efficacy of Multisystemic Therapy (MST) for adolescent conduct problems (CP) was conducted. Conclusions based on this review suggest that MST can be a very powerful alternative to the usual legal and social service approaches (e.g. justice system, day treatment programs) used in the treatment of…

  16. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses

    PubMed Central

    Hofmann, Stefan G.; Asnaani, Anu; Vonk, Imke J.J.; Sawyer, Alice T.; Fang, Angela

    2012-01-01

    Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples. PMID:23459093

  17. Penile traction therapy and Peyronie's disease: a state of art review of the current literature.

    PubMed

    Chung, Eric; Brock, Gerald

    2013-02-01

    In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie's disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews the current literature pertaining to the use of PTT in men with PD, short penises and in the setting of pre- and postprosthesis corporal fibrosis. PMID:23372611

  18. Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review.

    PubMed

    Acosta Felquer, Maria Laura; Coates, Laura C; Soriano, Enrique R; Ranza, Roberto; Espinoza, Luis R; Helliwell, Philip S; FitzGerald, Oliver; McHugh, Neil; Roussou, Euthalia; Mease, Philip J

    2014-11-01

    In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations. PMID:25362711

  19. T-Matrix Computations of Light Scattering by Nonspherical Particles: A Review

    NASA Technical Reports Server (NTRS)

    Mischenko, Michael I.; Travis, Larry D.; Mackowski, Daniel W.

    1996-01-01

    We review the current status of Waterman's T-matrix approach which is one of the most powerful and widely used tools for accurately computing light scattering by nonspherical particles, both single and composite, based on directly solving Maxwell's equations. Specifically, we discuss the analytical method for computing orientationally-averaged light-scattering characteristics for ensembles of nonspherical particles, the methods for overcoming the numerical instability in calculating the T matrix for single nonspherical particles with large size parameters and/or extreme geometries, and the superposition approach for computing light scattering by composite/aggregated particles. Our discussion is accompanies by multiple numerical examples demonstrating the capabilities of the T-matrix approach and showing effects of nonsphericity of simple convex particles (spheroids) on light scattering.

  20. Virtual Reality Therapy for Adults Post-Stroke: A Systematic Review and Meta-Analysis Exploring Virtual Environments and Commercial Games in Therapy

    PubMed Central

    Lohse, Keith R.; Hilderman, Courtney G. E.; Cheung, Katharine L.; Tatla, Sandy; Van der Loos, H. F. Machiel

    2014-01-01

    Background The objective of this analysis was to systematically review the evidence for virtual reality (VR) therapy in an adult post-stroke population in both custom built virtual environments (VE) and commercially available gaming systems (CG). Methods MEDLINE, CINAHL, EMBASE, ERIC, PSYCInfo, DARE, PEDro, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were systematically searched from the earliest available date until April 4, 2013. Controlled trials that compared VR to conventional therapy were included. Population criteria included adults (>18) post-stroke, excluding children, cerebral palsy, and other neurological disorders. Included studies were reported in English. Quality of studies was assessed with the Physiotherapy Evidence Database Scale (PEDro). Results Twenty-six studies met the inclusion criteria. For body function outcomes, there was a significant benefit of VR therapy compared to conventional therapy controls, G?=?0.48, 95% CI?=?[0.27, 0.70], and no significant difference between VE and CG interventions (P?=?0.38). For activity outcomes, there was a significant benefit of VR therapy, G?=?0.58, 95% CI?=?[0.32, 0.85], and no significant difference between VE and CG interventions (P?=?0.66). For participation outcomes, the overall effect size was G?=?0.56, 95% CI?=?[0.02, 1.10]. All participation outcomes came from VE studies. Discussion VR rehabilitation moderately improves outcomes compared to conventional therapy in adults post-stroke. Current CG interventions have been too few and too small to assess potential benefits of CG. Future research in this area should aim to clearly define conventional therapy, report on participation measures, consider motivational components of therapy, and investigate commercially available systems in larger RCTs. Trial Registration Prospero CRD42013004338 PMID:24681826

  1. Role of Ozone Therapy in Minimal Intervention Dentistry and Endodontics - A Review

    PubMed Central

    A, Shilpa Reddy; Reddy, Narender; Dinapadu, Sainath; Reddy, Manoranjan; Pasari, Srikanth

    2013-01-01

    Ozone has been successfully used in medical field since many years owing to its oxidizing property making it an excellent antimicrobial agent. Moreover its potent anti-inflammatory property along with favorable cellular and humoral immune response made ozone an effective therapeutic agent. Also its ability to arrest and reverse carious lesions in a predictable way opened up a new chapter in minimal intervention dentistry. Furthermore its efficacy in curbing resistant poly microbial root canal flora appears very promising. This article is based on information through valid textbooks, peer reviews, journals and medline/pubmed search. How to cite this article: Reddy S A, Reddy N, Dinapadu S, Reddy M, Pasari S. Role of Ozone Therapy in Minimal Intervention Dentistry and Endodontics - A Review. J Int Oral Health 2013; 5(3):102-108. PMID:24155611

  2. Advanced pancreatic adenocarcinoma: a review of current treatment strategies and developing therapies

    PubMed Central

    Teague, Andrea; Lim, Kian-Huat

    2015-01-01

    Pancreatic adenocarcinoma is one of the deadliest solid malignancies. A large proportion of patients are diagnosed with locally advanced or metastatic disease at the time of presentation and, unfortunately, this severely limits the number of patients who can undergo surgical resection, which offers the only chance for cure. Recent therapeutic advances for patients with advanced pancreatic cancer have extended overall survival, but prognosis still remains grim. Given that traditional chemotherapy is ineffective in curing advanced pancreatic adenocarcinoma, current research is taking a multidirectional approach in the hopes of developing more effective treatments. This article reviews the major clinical trial data that is the basis for the current chemotherapy regimens used as first- and second-line treatments for advanced pancreatic adenocarcinoma. We also review the current ongoing clinical trials, which include the use of agents targeting the oncogenic network signaling of K-Ras, agents targeting the extracellular matrix, and immune therapies. PMID:25755680

  3. TOPICAL REVIEW: Microfluidics for flow cytometric analysis of cells and particles

    Microsoft Academic Search

    Dongeun Huh; Wei Gu; Yoko Kamotani; James B. Grotberg; Shuichi Takayama

    2005-01-01

    This review describes recent developments in microfabricated flow cytometers and related microfluidic devices that can detect, analyze, and sort cells or particles. The high-speed analytical capabilities of flow cytometry depend on the cooperative use of microfluidics, optics and electronics. Along with the improvement of other components, replacement of conventional glass capillary-based fluidics with microfluidic sample handling systems operating in microfabricated

  4. Critical review of a quantitative study of a specialty in high energy particle physics

    SciTech Connect

    White, D H; Sullivan, D

    1980-01-01

    A review is made of the authors' series of quantitative, historical, and social studies of the weak interactions of elementary particles. A short intellectual history, the quantitative methodology, and a summary of the papers analyzing specific episodes in this field are presented. The social organization of the field is described, and an overall policy for resource management is discussed. 6 figures, 3 tables.

  5. Review: molecular pathology in adult high-grade gliomas: from molecular diagnostics to target therapies.

    PubMed

    Masui, K; Cloughesy, T F; Mischel, P S

    2012-06-01

    The classification of malignant gliomas is moving from a morphology-based guide to a system built on molecular criteria. The development of a genomic landscape for gliomas and a better understanding of its functional consequences have led to the development of internally consistent molecular classifiers. However, development of a biologically insightful classification to guide therapy is still a work in progress. Response to targeted treatments is based not only on the presence of drugable targets, but rather on the molecular circuitry of the cells. Further, tumours are heterogeneous and change and adapt in response to drugs. Therefore, the challenge of developing molecular classifiers that provide meaningful ways to stratify patients for therapy remains a major challenge for the field. In this review, we examine the potential role of MGMT methylation, IDH1/2 mutations, 1p/19q deletions, aberrant epidermal growth factor receptor and PI3K pathways, abnormal p53/Rb pathways, cancer stem-cell markers and microRNAs as prognostic and predictive molecular markers in the setting of adult high-grade gliomas and we outline the clinically relevant subtypes of glioblastoma with genomic, transcriptomic and proteomic integrated analyses. Furthermore, we describe how these advances, especially in epidermal growth factor receptor/PI3K/mTOR signalling pathway, affect our approaches towards targeted therapy, raising new challenges and identifying new leads. PMID:22098029

  6. Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials

    PubMed Central

    2014-01-01

    This is to our knowledge the first systematic review regarding the efficacy of manual therapy randomized clinical trials (RCT) for primary chronic headaches. A comprehensive English literature search on CINHAL, Cochrane, Medline, Ovid and PubMed identified 6 RCTs all investigating chronic tension-type headache (CTTH). One study applied massage therapy and five studies applied physiotherapy. Four studies were considered to be of good methodological quality by the PEDro scale. All studies were pragmatic or used no treatment as a control group, and only two studies avoided co-intervention, which may lead to possible bias and makes interpretation of the results more difficult. The RCTs suggest that massage and physiotherapy are effective treatment options in the management of CTTH. One of the RCTs showed that physiotherapy reduced headache frequency and intensity statistical significant better than usual care by the general practitioner. The efficacy of physiotherapy at post-treatment and at 6 months follow-up equals the efficacy of tricyclic antidepressants. Effect size of physiotherapy was up to 0.62. Future manual therapy RCTs are requested addressing the efficacy in chronic migraine with and without medication overuse. Future RCTs on headache should adhere to the International Headache Society’s guidelines for clinical trials, i.e. frequency as primary end-point, while duration and intensity should be secondary end-point, avoid co-intervention, includes sufficient sample size and follow-up period for at least 6 months. PMID:25278005

  7. Gene therapy strategies using engineered stem cells for treating gynecologic and breast cancer patients (Review).

    PubMed

    Kim, Ye-Seul; Hwang, Kyung-A; Go, Ryeo-Eun; Kim, Cho-Won; Choi, Kyung-Chul

    2015-05-01

    There are three types of stem cells: embryonic stem (ES) cells, adult stem (AS) cells and induced pluripotent stem (iPS) cells. These stem cells have many benefits including the potential ability to differentiate into various organs. In addition, engineered stem cells (GESTECs) designed for delivering therapeutic genes may be capable of treating human diseases including malignant cancers. Stem cells have been found to possess the potential for serving as novel delivery vehicles for therapeutic or suicide genes to primary or metastatic cancer formation sites as a part of gene-directed enzyme/prodrug combination therapy (GEPT). Given the advantageous properties of stem cells, tissue-derived stem cells are emerging as a new tool for anticancer therapy combined with prodrugs. In this review, the effects of GESTECs with different origins, i.e., neural, amniotic membrane and amniotic fluid, introduced to treat patients with diverse types of gynecologic and breast cancers are discussed. Data from the literature indicate the therapeutic potential of these cells as a part of gene therapy strategies to selectively target malignancies in women at clinically terminal stages. PMID:25760693

  8. Fission reactor neutron sources for neutron capture therapy--a critical review.

    PubMed

    Harling, Otto K; Riley, Kent J

    2003-01-01

    The status of fission reactor-based neutron beams for neutron capture therapy (NCT) is reviewed critically. Epithermal neutron beams, which are favored for treatment of deep-seated tumors, have been constructed or are under construction at a number of reactors worldwide. Some of the most recently constructed epithermal neutron beams approach the theoretical optimum for beam purity. Of these higher quality beams, at least one is suitable for use in high through-put routine therapy. It is concluded that reactor-based epithermal neutron beams with near optimum characteristics are currently available and more can be constructed at existing reactors. Suitable reactors include relatively low power reactors using the core directly as a source of neutrons or a fission converter if core neutrons are difficult to access. Thermal neutron beams for NCT studies with small animals or for shallow tumor treatments, with near optimum properties have been available at reactors for many years. Additional high quality thermal beams can also be constructed at existing reactors or at new, small reactors. Furthermore, it should be possible to design and construct new low power reactors specifically for NCT, which meet all requirements for routine therapy and which are based on proven and highly safe reactor technology. PMID:12749699

  9. Adrenal insufficiency: review of clinical outcomes with current glucocorticoid replacement therapy.

    PubMed

    Johannsson, Gudmundur; Falorni, Alberto; Skrtic, Stanko; Lennernäs, Hans; Quinkler, Marcus; Monson, John P; Stewart, Paul M

    2015-01-01

    Glucocorticoid replacement therapy in patients with adrenal insufficiency (AI), whether primary (Addison's disease) or secondary (due to hypopituitarism), has been established for some 50 years. The current standard treatment regimen involves twice- or thrice-daily dosing with a glucocorticoid, most commonly oral hydrocortisone. Based on previous small-scale studies and clinical perception, life expectancy with conventional glucocorticoid replacement therapy has been considered normal, with a low incidence of adverse events. Data from the past 10-15 years, however, have shown that morbidity remains high and life expectancy is reduced. The increased morbidity and decreased life expectancy appear to be due to both increased exposure to cortisol and insufficient cortisol coverage during infections and other stress-related events. This is thought to reflect a failure of treatment to replicate the natural circadian rhythm of cortisol release, together with a failure to identify and deliver individualized cortisol exposure and to manage patients adequately when increased doses are required. The resulting over- or under-treatment may result in Cushing-like symptoms or adrenal crisis, respectively. This review summarizes the morbidity and mortality seen in patients receiving the current standard of care for AI and suggests areas for improvement in glucocorticoid replacement therapy. PMID:25187037

  10. Dry cow therapy with a non-antibiotic intramammary teat seal - a review

    PubMed Central

    2004-01-01

    Dry cow antibiotic therapy is used to eliminate existing intramammary infections and to prevent new infections in the dry period. It is implemented as part of a total management system known as the 'Five-Point Plan' for mastitis control. Recent public concerns over the widespread prophylactic use of antibiotics, coupled with an increasing interest in organic farming, have lead to a re-evaluation of the treatment of cows at drying-off. As a result, attention has focussed on the use of novel alternatives to antibiotic therapy at the end of lactation. One such therapy involves the application of a non-antibiotic bismuth-based intramammary teat seal designed for use in cows with low cell counts at the end of lactation. Like the keratin plug that forms naturally in teats of cows that have been dried-off, teat seal forms a physical barrier to invading pathogens. To date, a number of independent studies have shown that teat seal is as effective as traditional dry cow antibiotic products in preventing the occurrence of new infection during the dry period in cows with somatic cell counts of ?200,000 cells ml-1 at drying-off. This paper reviews the efficacy of teat seal in preventing dry period mastitis in both conventional and organic dairying systems. PMID:21851660

  11. Macrolide therapy in cryptogenic organizing pneumonia: A case report and literature review

    PubMed Central

    DING, QUN-LI; LV, DAN; WANG, BI-JIONG; ZHANG, QIAO-LI; YU, YI-MING; SUN, SHI-FANG; CHEN, ZHONG-BO; MA, HONG-YING; DENG, ZAI-CHUN

    2015-01-01

    Cryptogenic organizing pneumonia (COP) is a pulmonary disorder associated with nonspecific clinical presentations. The macrolide class of antimicrobial agents is widely used to treat infectious and inflammatory respiratory diseases in humans. The present study reports a case of COP that was effectively treated with azithromycin in combination with glucocorticoid. A literature review of similar cases is also presented. It was found that all COP patients in the literature received macrolide treatment, including six cases with unknown clinical outcomes. For the remaining 29 patients, 20 patients initially received the macrolide as a single therapy and 4/5 of them (16 cases) were cured with a treatment time of 3–14 months, while 1/5 (4 cases) showed no improvement after treatment for 1 month and were switched to a glucocorticoid or combination treatment with a glucocorticoid, after which the disease was finally well-controlled. Side-effects of macrolide were rare. Based on this analysis, it is recommended that macrolides can be used as a first-line therapy in patients with mild COP. For patients with recurrent COP, it is suggested that macrolides should be used as an adjunctive therapy with other treatments, such as a glucocorticoid. PMID:25667636

  12. Prevention and therapy of fungal infections in cancer patients. A review of recently published information.

    PubMed

    Klastersky, J

    1995-11-01

    This review of recent publications in the field of fungal infections in cancer patients clearly confirms that protracted severe granulocytopenia is a major risk factor for their development. Because severe and prolonged granulocytopenia plays such a major predisposing role for fungal infections, it is likely that the use of the colony-stimulating factors, which are able to reduce the duration and the severity of granulocytopenia, might prove effective in decreasing the frequency and the severity of these infections. Another conclusion is that certain categories of patients with granulocytopenia might benefit from antifungal prophylaxis and empiric therapy. Conversely, there are other populations who will benefit only marginally from such strategies. Imidazoles, namely fluconazole, for the prevention of local and systemic Candida infections have been shown to be effective in granulocytopenic patients. So far, the development of resistance has not been a major problem. In patients at the greatest risk of developing severe fungal infections, such as those receiving high-dose corticosteroid therapy for GVHD after allogeneic bone marrow transplantation, early administration of low doses of amphotericin B seems to be effective in reducing the development of systemic fungal infection. In terms of therapy, amphotericin B is still the standard approach, especially for empiric treatment, prior to the recognition of a specific pathogen. PMID:8564343

  13. Acceptance and commitment therapy in the treatment of anxiety: a systematic review.

    PubMed

    Swain, Jessica; Hancock, Karen; Hainsworth, Cassandra; Bowman, Jenny

    2013-12-01

    With a lifetime prevalence of approximately 17% among community-dwelling adults, anxiety disorders are among the most pervasive of contemporary psychiatric afflictions. Traditional Cognitive Behaviour Therapy (CBT) is currently the first line evidence-based psychosocial intervention for the treatment of anxiety. Previous research, however, has found that a significant proportion of patients do not respond to traditional CBT or exhibit residual symptomatology at treatment cessation. Additionally, there is a paucity of evidence among child populations and for the comparative effectiveness of alternative interventions. Acceptance and Commitment Therapy (ACT) has a growing empirical base demonstrating its efficacy for an array of problems. A systematic review was conducted to examine the evidence for ACT in the treatment of anxiety. PsycInfo, PsycArticles, PsycExtra, Medline and Proquest databases were searched, reference lists examined and citation searches conducted. Two independent reviewers analysed results, determined study eligibility and assessed methodological quality. Thirty-eight studies met inclusion criteria (total n=323). The spectrum of DSM-IV anxiety disorders as well as test and public speaking anxiety were examined. Studies were predominantly between-group design and case studies, with few employing control comparisons. Several methodological issues limit conclusions; however results provide preliminary support for ACT. Larger scale, methodologically rigorous trials are needed to consolidate these findings. PMID:23999201

  14. Malignant tumours of the heart: a review of tumour type, diagnosis and therapy.

    PubMed

    Neragi-Miandoab, S; Kim, J; Vlahakes, G J

    2007-12-01

    Primary cardiac neoplasms are rare and occur less commonly than metastatic disease of the heart. In this overview, current published studies concerning malignant neoplasms of the heart are reviewed, together with some insights into their aetiology, diagnosis and management. We searched medline using the subject 'cardiac neoplasms'. We selected about 110 articles from between 1973 and 2006, of which 76 sources were used to complete the review. Sarcomas are the most common cardiac tumours and include myxosarcoma, liposarcoma, angiosarcoma, fibrosarcoma, leiomyosarcoma, osteosarcoma, synovial sarcoma, rhabdomyosarcoma, neurofibrosarcoma, malignant fibrous histiocytoma and undifferentiated sarcoma. The classic symptoms of cardiac tumours are intracardiac obstruction, signs of systemic embolisation, and systemic or constitutional symptoms. However, serious complications including stroke, myocardial infarction and even sudden death from arrhythmia may be the first signs of a tumour. Echocardiography and angiography are essential diagnostic tools for evaluating cardiac neoplasms. Computed tomography and magnetic resonance imaging studies have improved the diagnostic approach in recent decades. Successful treatment for benign cardiac tumours is usually achieved by surgical resection. Unfortunately, resection of the tumour is not always feasible. The prognosis after surgery is usually excellent in the case of benign tumours, but the prognosis of malignant tumours remains dismal. In conclusion, there are limited published data concerning cardiac neoplasms. Therefore, a high level of suspicion is required for early diagnosis. Surgery is the cornerstone of therapy. However, a multi-treatment approach, including chemotherapy, radiation as well as evolving approaches such as gene therapy, might provide a better palliative and curative result. PMID:17693068

  15. Tumor necrosis factor-? inhibitor therapy and fetal risk: A systematic literature review

    PubMed Central

    Marchioni, Renée M; Lichtenstein, Gary R

    2013-01-01

    Tumor necrosis factor-? inhibitors (anti-TNFs) are effective in the treatment of inflammatory bowel disease (IBD) recalcitrant to conventional medical therapy. As the peak incidence of IBD overlaps with the prime reproductive years, it is crucial to establish pharmacologic regimens for women of childbearing age that achieve effective disease control without posing significant fetal harm. A systematic literature review was performed to identify all human studies with birth outcomes data after maternal exposure to infliximab, adalimumab, or certolizumab pegol within 3 mo of conception or during any trimester of pregnancy. Live births, spontaneous abortions or stillbirths, preterm or premature births, low birth weight or small for gestational age infants, and congenital abnormalities were recorded. Fifty selected references identified 472 pregnancy exposures. The subsequent review includes general information regarding anti-TNF therapy in pregnancy followed by a summary of our findings. The benefits of biologic modalities in optimizing disease control during pregnancy must be weighed against the potential toxicity of drug exposure on the developing fetus. Although promising overall, there is insufficient evidence to prove absolute safety for use of anti-TNFs during pregnancy given the limitations of available data and lack of controlled trials. PMID:23674866

  16. REVIEW OF OUTCOME RESEARCH ON MARITAL AND FAMILY THERAPY IN TREATMENT OF ALCOHOLISM

    PubMed Central

    O’Farrell, Timothy J.

    2011-01-01

    This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates our earlier review (XXXXXXX). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better; and Community Reinforcement and Family Training (CRAFT) promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics; and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning. PMID:22283384

  17. doi:10.1155/2012/682480 Review Article Ovarian Cancer: Opportunity for Targeted Therapy

    E-print Network

    Tomoko Tagawa; Robert Morgan; Yun Yen; Joanne Mortimer

    2011-01-01

    Copyright © 2012 Tomoko Tagawa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Ovarian cancer is a common cause of cancer mortality in women with limited treatment effectiveness in advanced stages. The limitation to treatment is largely the result of high rates of cancer recurrence despite chemotherapy and eventual resistance to existing chemotherapeutic agents. The objective of this paper is to review current concepts of ovarian carcinogenesis. We will review existing hypotheses of tumor origin from ovarian epithelial cells, Fallopian tube, and endometrium. We will also review the molecular pathogenesis of ovarian cancer which results in two specific pathways of carcinogenesis: (1) type I low-grade tumor and (2) type II high-grade tumor. Improved understanding of the molecular basis of ovarian carcinogenesis has opened new opportunities for targeted therapy. This paper will also review these potential therapeutic targets and will explore new agents that are currently being investigated. 1.

  18. Combination Therapy of Sorafenib and TACE for Unresectable HCC: A Systematic Review and Meta-Analysis

    PubMed Central

    Zhao, Yan; Cai, Guohong; Qi, Xingshun; Han, Guohong

    2014-01-01

    Background and Aim A large number of studies have tried to combine sorafenib with TACE for patients with unresectable hepatocellular carcinoma (HCC) and the results were controversial. We conducted this systematic review and meta-analysis to evaluate the safety and efficacy of combination therapy of sorafenib and TACE in the management of unresectable HCC. Methods MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Library were searched from January 1990 to October 2013 and these databases were searched for appropriate studies combining TACE and sorafenib in treatment of HCC. Two authors independently reviewed the databases and extracted the data and disagreements were resolved by discussion. Effective value and safety were analyzed. Effective value included disease control rate (DCR), time to progression (TTP) and overall survival (OS). Results 17 studies were included in the study. In the 10 noncomparative studies, DCR ranged from 18.4 to 91.2%. Median TTP ranged from 7.1 to 9.0 months, and median OS ranged from 12 to 27 months. In the 7 comparative studies, the hazard ratio (HR) for TTP was found to be 0.76 (95% CI 0.66–0.89; P<0.001) with low heterogeneity among studies (P?=?0.243; I2?=?25.5%). However, the HR for OS was found to be 0.81 (95% CI 0.65–1.01; P?=?0.061) with low heterogeneity among studies (P?=?0.259; I2?=?25.4%). The common toxicities included fatigue, diarrhea, nausea, hand foot skin reaction (HFSR), hematological events, hepatotoxicity, alopecia, hepatotoxicity, hypertension and rash/desquamation. AEs are generally manageable with dose reductions. Conclusions Combination therapy may bring benefits for unresectable HCC patients in terms of TTP but not OS. Further well-designed randomized controlled studies are needed to confirm the efficacy of combination therapy. PMID:24651044

  19. Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis

    PubMed Central

    Kim, Sung-Hee; Gerver, Sarah M.; Fidler, Sarah; Ward, Helen

    2014-01-01

    Objective: Adolescent and young adult (AYA) populations (12–24 years) represent over 40% of new HIV infections globally. Adolescence is sometimes characterized by high-risk sexual behaviour and a lack of engagement with healthcare services that can affect adherence to antiretroviral therapy (ART). Despite adherence to ART being critical in controlling viral replication, maintaining health and reducing onward viral transmission, there are limited data on ART adherence amongst AYA globally. We undertook a systematic review and meta-analysis of published studies reporting adherence to ART for AYA living with HIV. Design and methods: Searches included Embase, Medline and PsychINFO databases up to 14 August 2013. Eligible studies defined adequate adherence as at least 85% on self-report or undetectable blood plasma virus levels. A random effects meta-analysis was performed and heterogeneity examined using meta-regression. Results: We identified 50 eligible articles reporting data from 53 countries and 10?725 patients. Using a pooled analysis of all eligible studies, 62.3% [95% confidence interval (CI) 57.1–67.6; I2?:?97.2%] of the AYA population were adherent to therapy. The lowest average ART adherence was in North America [53% (95% CI 46–59; I2?:?91%)], Europe [62% (95% CI 51–73; I2?:?97%)] and South America [63% (95% CI 47–77; I2?:?85%] and, with higher levels in Africa [84% (95% CI 79–89; I2?:?93%)] and Asia [84% (95% CI 77–91; I2?:?0%]. Conclusion: Review of published literature from Africa and Asia indicate more than 70% of HIV-positive AYA populations receiving ART are adherent to therapy and lower rates of adherence were shown in Europe and North America at 50–60%. The global discrepancy is probably multifactorial reflecting differences between focused and generalised epidemics, access to healthcare and funding. PMID:24845154

  20. A Critical Review of Diabetes, Glycemic Control and Dental Implant Therapy

    PubMed Central

    Oates, Thomas W.; Huynh-Ba, Guy; Vargas, Adriana; Alexander, Peggy; Feine, Jocelyne

    2011-01-01

    Objectives To systematically examine the evidence guiding the use of implant therapy relative to glycemic control for patients with diabetes and to consider the potential for both implant therapy to support diabetes management and hyperglycemia to compromise implant integration. Material and Methods A systematic approach was used to identify and review clinical investigations directly assessing implant survival or failure for patients with diabetes. A MEDLINE (PubMED) database search identified potential articles for inclusion using the search strategy: (dental implants OR oral implants) AND (diabetes OR diabetic). Inclusion in this review required longitudinal assessments including at least 10 patients, with included articles assessed relative to documentation of glycemic status for patients. Results The initial search identified 129 publications, reduced to 16 for inclusion. Reported implant failures rates for diabetic patients ranged from 0–14.3%. The identification and reporting of glycemic control was insufficient or lacking in 13 of the 16 studies with 11 of these enrolling only patients deemed as having acceptable glycemic control, limiting interpretation of findings relative to glycemic control. Three of the 16 studies having interpretable information on glycemic control failed to demonstrate a significant relationship between glycemic control and implant failure, with failure rates ranging from 0–2.9%. Conclusions Clinical evidence is lacking for the association of glycemic control with implant failure while support is emerging for implant therapy in diabetes patients with appropriate accommodations for delays in implant integration based on glycemic control. The role for implants to improve oral function in diabetes management and the effects of hyperglycemia on implant integration remains to be determined. PMID:22111901

  1. The Prevalence of Root Sensitivity following Periodontal Therapy: A Systematic Review

    PubMed Central

    Lin, Y. H.; Gillam, D. G.

    2012-01-01

    The reported prevalence of dentine/root (hyper)sensitivity (DH/RS) in the published literature varies, and this may be due in part to a) the different study populations and (b) the different methodologies employed in evaluating the pain response. According to von Troil et al. (2002) there are limited data available in terms of the prevalence and intensity of DH/RS following periodontal therapy. Objectives. The aim of the present study was therefore to review the literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of DH/RS following periodontal procedures in the published literature up to 31st December 2009 using an agreed search protocol. Methods. 840 papers were identified, from searching both electronic databases (PUBMED) and hand searching of relevant written journals. Twelve papers were subsequently accepted for inclusion. Results. The results of the present study would indicate that the reported prevalence for DH/RS (following nonsurgical therapy) was between 62.5% and 90% one day after treatment decreasing to approximately 52.6% to 55% after one week. The prevalence of DH/RS following surgical therapy was between 76.8% and 80.4% one day after treatment subsequently decreasing over time to 36.8% after 1 week, 33.4% after 2 weeks, 29.6% after 4 weeks, and 21.7% after 8 weeks. Conclusions. It is evident from reviewing the included studies that patients may suffer from mild discomfort following periodontal procedures although both the prevalence and intensity of DH/RS may vary depending on the duration and the type of procedure involved. Most of the studies included in this paper would tend to suggest that DH/RS may be relatively mild/moderate in nature and transient in duration. PMID:23193405

  2. Postmenopausal hormone therapy and breast cancer: a systematic review and meta-analysis

    PubMed Central

    Shah, Nirav R.; Borenstein, Jeff; Dubois, Robert W.

    2006-01-01

    Objective There is a rapidly evolving debate on the indications and appropriate duration of therapy for postmenopausal hormone therapy. The objective of this meta-analysis was to examine the specific relationships of postmenopausal estrogen therapy (ET), postmenopausal combined (estrogen-progestogen) hormone therapy (CHT), and the incidence of breast cancer. Design We performed computerized searches of MEDLINE and CancerLit through September 2003 and reviewed reference lists of retrieved studies and meta-analyses. We included English-language studies that identified noncontraceptive postmenopausal hormone use; reported on the risks of “current use” of ET and/or CHT and breast cancer incidence; were case-control, cohort, or experimental; and reported either an odds ratio (OR), relative risk (RR), or HR with CIs. Two investigators were involved during all stages of study selection and independently extracted all data selected for inclusion in meta-analyses. Results Meta-analysis of 13 studies of ET and breast cancer (700,000 women) resulted in an OR of 1.16 (95% confidence limits [CL] 1.06, 1.28), with estimates for less than 5 years use 1.16 (1.02, 1.32) and more than 5 years use 1.20 (1.06, 1.37). Meta-analysis of eight studies of CHT and breast cancer (650,000 women) resulted in an OR of 1.39 (95% CL 1.12, 1.72), with estimates for less than 5 years use 1.35 (1.16, 1.57) and more than 5 years use 1.63 (1.22, 2.18). Conclusions Data from observational studies support the association of increased but considerably different risks for breast cancer incidence among current users of ET and CHT. These represent the first pooled estimates for ET. CHT estimates correspond to those from randomized trials. PMID:16278609

  3. Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

    PubMed Central

    Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M

    2012-01-01

    Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962

  4. Management of Calcium Channel Antagonist Overdose with Hyperinsulinemia-Euglycemia Therapy: Case Series and Review of the Literature

    PubMed Central

    Shah, Shiwan K.; Goswami, Sanjeev Kumar; Babu, Rajesh V.; Sharma, Gulshan; Duarte, Alexander G.

    2012-01-01

    Calcium channel antagonists (CCAs) are commonly involved in drug overdoses. Standard approaches to the management of CCA overdoses, including fluid resuscitation, gut decontamination, administration of calcium, glucagon, and atropine, as well as supportive care, are often ineffective. We report on two patients who improved after addition of hyperinsulinemia-euglycemia (HIE) therapy. We conclude with a literature review on hyperinsulinemia-euglycemia therapy with an exploration of the physiology behind its potential use. PMID:24826345

  5. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline

    Microsoft Academic Search

    Amanda Bolderston; Nancy S. Lloyd; Rebecca K. S. Wong; Lori Holden; Linda Robb-Blenderman

    2006-01-01

    Goals of work  To develop a practice guideline report on the questions: What are the optimal methods to prevent acute skin reactions (occurring within the first 6 months of irradiation) related to radiation therapy? What are the optimal methods to manage acute skin reactions related to radiation therapy?\\u000a Materials and methods  Cancer Care Ontario’s Supportive Care Guidelines Group (SCGG) conducted a systematic review

  6. Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials

    PubMed Central

    Drummond, Avril; Leonardi-Bee, Jo; Gladman, J R F; Donkervoort, Mireille; Edmans, Judi; Gilbertson, Louise; Jongbloed, Lyn; Logan, Pip; Sackley, Catherine; Walker, Marion; Langhorne, Peter

    2007-01-01

    Objective To determine whether occupational therapy focused specifically on personal activities of daily living improves recovery for patients after stroke. Design Systematic review and meta-analysis. Data sources The Cochrane stroke group trials register, the Cochrane central register of controlled trials, Medline, Embase, CINAHL, PsycLIT, AMED, Wilson Social Sciences Abstracts, Science Citation Index, Social Science Citation, Arts and Humanities Citation Index, Dissertations Abstracts register, Occupational Therapy Research Index, scanning reference lists, personal communication with authors, and hand searching. Review methods Trials were included if they evaluated the effect of occupational therapy focused on practice of personal activities of daily living or where performance in such activities was the target of the occupational therapy intervention in a stroke population. Original data were sought from trialists. Two reviewers independently reviewed each trial for methodological quality. Disagreements were resolved by consensus. Results Nine randomised controlled trials including 1258 participants met the inclusion criteria. Occupational therapy delivered to patients after stroke and targeted towards personal activities of daily living increased performance scores (standardised mean difference 0.18, 95% confidence interval 0.04 to 0.32, P=0.01) and reduced the risk of poor outcome (death, deterioration or dependency in personal activities of daily living) (odds ratio 0.67, 95% confidence interval 0.51 to 0.87, P=0.003). For every 100 people who received occupational therapy focused on personal activities of daily living, 11 (95% confidence interval 7 to 30) would be spared a poor outcome. Conclusions Occupational therapy focused on improving personal activities of daily living after stroke can improve performance and reduce the risk of deterioration in these abilities. Focused occupational therapy should be available to everyone who has had a stroke. PMID:17901469

  7. Redefining Relative Biological Effectiveness in the Context of the EQDX Formalism: Implications for Alpha-Particle Emitter Therapy

    PubMed Central

    Hobbs, Robert F.; Howell, Roger W.; Song, Hong; Baechler, Sébastien; Sgouros, George

    2014-01-01

    Alpha-particle radiopharmaceutical therapy (?RPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, ?RPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of ?-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by ?-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or ?-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(?/?), has recently been proposed by the ICRU. In concert with EQD2(?/?), we introduce a new, redefined RBE quantity, named RBE2(?/?), as the ratio of the two linear coefficients that characterize the ? particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from irradiation of a breast cancer cell line. Radiobiological parameters are obtained using the linear quadratic model to fit cell survival data for MDA-MB-231 human breast cancer cells that were irradiated with either ? particles or a single fraction of low-LET 137Cs ? rays. From these, the linear coefficient for both the biologically effective dose (BED) and the EQD2(?/?) response lines were derived for fractionated irradiation. The standard RBE calculation, using the traditional single fraction reference radiation, gave RBE values that ranged from 2.4 for a surviving fraction of 0.82–6.0 for a surviving fraction of 0.02, while the dose-independent RBE2(4.6) value was 4.5 for all surviving fraction values. Furthermore, bioeffect modeling with RBE2(?/?) and EQD2(?/?) demonstrated the capacity to predict the surviving fraction of cells irradiated with acute and fractionated low-LET radiation, ? particles and chronic exponentially decreasing dose rates of low-LET radiation. RBE2(?/?) is independent of absorbed dose for ?-particle emitters and it provides a more logical framework for data reporting and conversion to equieffective dose than the conventional dose-dependent definition of RBE. Moreover, it provides a much needed foundation for the ongoing development of an ?-particle dosimetry paradigm and will facilitate the use of tolerance dose data available from external beam radiation therapy, thereby helping to develop ?RPT as a single modality as well as for combination therapies. PMID:24502376

  8. Redefining relative biological effectiveness in the context of the EQDX formalism: implications for alpha-particle emitter therapy.

    PubMed

    Hobbs, Robert F; Howell, Roger W; Song, Hong; Baechler, Sébastien; Sgouros, George

    2014-01-01

    Alpha-particle radiopharmaceutical therapy (?RPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, ?RPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of ?-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by ?-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or ?-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(?/?), has recently been proposed by the ICRU. In concert with EQD2(?/?), we introduce a new, redefined RBE quantity, named RBE2(?/?), as the ratio of the two linear coefficients that characterize the ? particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from irradiation of a breast cancer cell line. Radiobiological parameters are obtained using the linear quadratic model to fit cell survival data for MDA-MB-231 human breast cancer cells that were irradiated with either ? particles or a single fraction of low-LET (137)Cs ? rays. From these, the linear coefficient for both the biologically effective dose (BED) and the EQD2(?/?) response lines were derived for fractionated irradiation. The standard RBE calculation, using the traditional single fraction reference radiation, gave RBE values that ranged from 2.4 for a surviving fraction of 0.82-6.0 for a surviving fraction of 0.02, while the dose-independent RBE2(4.6) value was 4.5 for all surviving fraction values. Furthermore, bioeffect modeling with RBE2(?/?) and EQD2(?/?) demonstrated the capacity to predict the surviving fraction of cells irradiated with acute and fractionated low-LET radiation, ? particles and chronic exponentially decreasing dose rates of low-LET radiation. RBE2(?/?) is independent of absorbed dose for ?-particle emitters and it provides a more logical framework for data reporting and conversion to equieffective dose than the conventional dose-dependent definition of RBE. Moreover, it provides a much needed foundation for the ongoing development of an ?-particle dosimetry paradigm and will facilitate the use of tolerance dose data available from external beam radiation therapy, thereby helping to develop ?RPT as a single modality as well as for combination therapies. PMID:24502376

  9. Redefining Relative Biological Effectiveness in the Context of the EQDX Formalism: Implications for Alpha-Particle Emitter Therapy.

    PubMed

    Hobbs, Robert F; Howell, Roger W; Song, Hong; Baechler, Sébastien; Sgouros, George

    2013-12-30

    Alpha-particle radiopharmaceutical therapy (?RPT) is currently enjoying increasing attention as a viable alternative to chemotherapy for targeting of disseminated micrometastatic disease. In theory, ?RPT can be personalized through pre-therapeutic imaging and dosimetry. However, in practice, given the particularities of ?-particle emissions, a dosimetric methodology that accurately predicts the thresholds for organ toxicity has not been reported. This is in part due to the fact that the biological effects caused by ?-particle radiation differ markedly from the effects caused by traditional external beam (photon or electron) radiation or ?-particle emitting radiopharmaceuticals. The concept of relative biological effectiveness (RBE) is used to quantify the ratio of absorbed doses required to achieve a given biological response with alpha particles versus a reference radiation (typically a beta emitter or external beam radiation). However, as conventionally defined, the RBE varies as a function of absorbed dose and therefore a single RBE value is limited in its utility because it cannot be used to predict response over a wide range of absorbed doses. Therefore, efforts are underway to standardize bioeffect modeling for different fractionation schemes and dose rates for both nuclear medicine and external beam radiotherapy. Given the preponderant use of external beams of radiation compared to nuclear medicine in cancer therapy, the more clinically relevant quantity, the 2 Gy equieffective dose, EQD2(?/?), has recently been proposed by the ICRU. In concert with EQD2(?/?), we introduce a new, redefined RBE quantity, named RBE2(?/?), as the ratio of the two linear coefficients that characterize the ? particle absorbed dose-response curve and the low-LET megavoltage photon 2 Gy fraction equieffective dose-response curve. The theoretical framework for the proposed new formalism is presented along with its application to experimental data obtained from irradiation of a breast cancer cell line. Radiobiological parameters are obtained using the linear quadratic model to fit cell survival data for MDA-MB-231 human breast cancer cells that were irradiated with either ? particles or a single fraction of low-LET (137)Cs ? rays. From these, the linear coefficient for both the biologically effective dose (BED) and the EQD2(?/?) response lines were derived for fractionated irradiation. The standard RBE calculation, using the traditional single fraction reference radiation, gave RBE values that ranged from 2.4 for a surviving fraction of 0.82-6.0 for a surviving fraction of 0.02, while the dose-independent RBE2(4.6) value was 4.5 for all surviving fraction values. Furthermore, bioeffect modeling with RBE2(?/?) and EQD2(?/?) demonstrated the capacity to predict the surviving fraction of cells irradiated with acute and fractionated low-LET radiation, ? particles and chronic exponentially decreasing dose rates of low-LET radiation. RBE2(?/?) is independent of absorbed dose for ?-particle emitters and it provides a more logical framework for data reporting and conversion to equieffective dose than the conventional dose-dependent definition of RBE. Moreover, it provides a much needed foundation for the ongoing development of an ?-particle dosimetry paradigm and will facilitate the use of tolerance dose data available from external beam radiation therapy, thereby helping to develop ?RPT as a single modality as well as for combination therapies. PMID:24377718

  10. AEROSOL THERAPY IMPLICATIONS OF PARTICLE DEPOSITION PATTERNS IN SIMULATED HUMAN AIRWAYS

    EPA Science Inventory

    The efficacy of inhalation therapy may be improved by the selective deposition of aerosolized medicines, by explicitly targeting and delivering drugs to prescribed lung sites. ere, the deposition patterns of test aerosols, mapped in surrogate respiratory tracts consisting of repl...

  11. Mineral derivatives in alleviating oral mucositis during cancer therapy: a systematic review

    PubMed Central

    2015-01-01

    Objectives. Oral mucositis (mouth ulcers) is a cancer therapy side effect. Costly treatment interventions are often neglected in favor of cost-effective agents. This review assessed the general efficacy of mineral derivatives (a cost-effective agent) in alleviating oral mucositis (OM) during cancer therapy compared to the standard care, or placebo—including a decision tree to aide healthcare workers. Data Sources. Electronic searches of MEDLINE via OVID, EMBASE, CENTRAL, CANCERLIT via PubMed, and CINAHL via EBSCO (year 2000 to 11 September 2014) were undertaken for randomised controlled trials. A meta-search strategy extracted content from aggregate online databases. Review Methods. Randomized controlled trials were assessed (participants, intervention, outcome, results, and risk of bias) for inclusion. The author abstracted binary and continuous data synthesised to Hedges’ g in a random effects model. The primary outcome measures were severity (incidence of peak oral mucositis, duration of oral mucositis, and time to onset); secondary outcome measures were the incidence of pain, and analgesic use. Serum mineral levels, total parenteral nutrition, and adverse events were discussed. The decision tree was mapped using sensitivity, specificity, pre-test and post-test Bayesian probability. Results. 1027 citations were identified and 16 studies were included (n = 1120; mean age 49 years). Cancer therapies consisted of chemotherapy, radiotherapy, chemo-radiotherapy, or hematopoietic stem cell transplantation. Outcome mineral derivatives were zinc (n = 549), calcium phosphate (n = 227), povidone-iodine (n = 228), or selenium (n = 116). Severity was measured across variable OM grading systems: In 13 studies, individuals in treatment groups (n = 958) experienced peak OM less than controls (g = ?0.47, 95% CI ?0.7 to ?0.2, p = 0.0006); time to OM onset was significantly delayed in treatment than controls (g = ?0.51, 95% CI?0.8 to ?0.2, p = 0.0002; five studies); OM mean duration, pain incidences, or analgesics use was not significant. The decision analysis favored selenium. Conclusion. The general positive effect trend suggests individuals taking mineral derivatives during cancer therapies are less likely to experience peak OM than those without. However, significant bias and heterogeneity indicates the need for developing further methods in account of diverse protocols and include novel recordings (serum mineral levels and cell signals) in estimating a uniform true effect. PMID:25699212

  12. Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review

    PubMed Central

    Arnal-Gómez, Anna; Arbós-Berenguer, Teresa; González, Ángel Arturo López; Vicente-Herrero, Teófila

    2014-01-01

    Background: Tension-type headache (TTH) is a disease with a great incidence on quality of life and with a significant socioeconomic impact. Objectives: The aim of this review is to determine the effectiveness of physical therapy by using manual therapy (MT) for the relief of TTH. Data sources: A review was done identifying randomized controlled trials through searches in MEDLINE, PEDro, Cochrane and CINAHL (January 2002 – April 2012). Study selection: English-language studies, with adult patients and number of subjects not under 11, diagnosed with episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) were included. Data extraction: Initial search was undertaken with the words Effectiveness, Tension-type headache, and Manual therapy (39 studies). In addition, a search which included terms related to treatments such as physiotherapy, physical therapy, spinal manipulation was performed (25 studies). Results: From the two searches 9 studies met the inclusion criteria and were analysed finding statistically significant results: 1) myofascial release, cervical traction, neck muscles trigger points in cervical thoracic muscles and stretching; 2) Superficial heat and massage, connective tissue manipulation and vertebral Cyriax mobilization; 3) cervical or thoracic spinal manipulation and cervical chin-occipital manual traction; 4) massage, progressive relaxation and gentle stretching, program of active exercises of shoulder, neck and pericranial muscles; 5) massage, passive rhythmic mobilization techniques, cervical, thoracic and lumbopelvic postural correction and cranio-cervical exercises; 6) progressive muscular relaxation combined with joint mobilization, functional, muscle energy, and strain/counterstrain techniques, and cranial osteopathic treatment; 7) massage focused on relieving myofascial trigger point activity; 8) pressure release and muscle energy in suboccipital muscles; 9) combination of mobilizations of the cervical and thoracic spine, exercises and postural correction. All studies used a combination of different techniques and none analyzed treatments separately, also all the studies have assessed aspects related to TTH beyond frequency and intensity of pain. Conclusions: The findings from these studies showed evidence that physiotherapy with articulatory MT, combined with cervical muscle stretching and massage are effective for this disease in different aspects related with TTH. No evidence was found of the effectiveness of the techniques applied separately.

  13. A Systematic Review of Cellular Transplantation Therapies for Spinal Cord Injury

    PubMed Central

    Okon, Elena B.; Karimi-Abdolrezaee, Soheila; Hill, Caitlin E.; Sparling, Joseph S.; Plemel, Jason R.; Plunet, Ward T.; Tsai, Eve C.; Baptiste, Darryl; Smithson, Laura J.; Kawaja, Michael D.; Fehlings, Michael G.; Kwon, Brian K.

    2011-01-01

    Abstract Cell transplantation therapies have become a major focus in pre-clinical research as a promising strategy for the treatment of spinal cord injury (SCI). In this article, we systematically review the available pre-clinical literature on the most commonly used cell types in order to assess the body of evidence that may support their translation to human SCI patients. These cell types include Schwann cells, olfactory ensheathing glial cells, embryonic and adult neural stem/progenitor cells, fate-restricted neural/glial precursor cells, and bone-marrow stromal cells. Studies were included for review only if they described the transplantation of the cell substrate into an in-vivo model of traumatic SCI, induced either bluntly or sharply. Using these inclusion criteria, 162 studies were identified and reviewed in detail, emphasizing their behavioral effects (although not limiting the scope of the discussion to behavioral effects alone). Significant differences between cells of the same “type” exist based on the species and age of donor, as well as culture conditions and mode of delivery. Many of these studies used cell transplantations in combination with other strategies. The systematic review makes it very apparent that cells derived from rodent sources have been the most extensively studied, while only 19 studies reported the transplantation of human cells, nine of which utilized bone-marrow stromal cells. Similarly, the vast majority of studies have been conducted in rodent models of injury, and few studies have investigated cell transplantation in larger mammals or primates. With respect to the timing of intervention, nearly all of the studies reviewed were conducted with transplantations occurring subacutely and acutely, while chronic treatments were rare and often failed to yield functional benefits. PMID:20146557

  14. Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

    SciTech Connect

    Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Straube, William [Advanced Technology Consortium, Imaged-Guided Therapy QA Center, St. Louis, Missouri (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Followill, David [Radiological Physics Center, University of Texas MD Anderson Cancer Centre, Houston, Texas (United States)

    2013-10-01

    Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.

  15. Sleep Disturbances in Individuals with Alcohol-Related Disorders: A Review of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Associated Non-Pharmacological Therapies

    PubMed Central

    Brooks, Alyssa T; Wallen, Gwenyth R

    2014-01-01

    Sleep disturbances are common among alcohol-dependent individuals and are often associated with relapse. The utility of behavioral therapies for sleep disturbances, including cognitive-behavioral therapy for insomnia (CBT-I), among those with alcohol-related disorders is not well understood. This review systematically evaluates the evidence of CBT-I and related behavioral therapies applied to those with alcohol-related disorders and accompanying sleep disturbances. A search of four research databases (PubMed, PsycINFO, Embase, and CINAHL Plus) yielded six studies that met selection criteria. Articles were reviewed using Cochrane’s Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. A majority of the studies demonstrated significant improvements in sleep efficiency among behavioral therapy treatment group(s), including but not limited to CBT-I. While behavioral sleep interventions have been successful in varied populations, they may not be utilized to their full potential among those with alcohol-related disorders as evidenced by the low number of studies found. These findings suggest a need for mixed-methods research on individuals’ sleep experience to inform interventions that are acceptable to the target population. PMID:25288884

  16. State of the art for cardiotoxicity due to chemotherapy and to targeted therapies: a literature review.

    PubMed

    Berardi, Rossana; Caramanti, Miriam; Savini, Agnese; Chiorrini, Silvia; Pierantoni, Chiara; Onofri, Azzurra; Ballatore, Zelmira; De Lisa, Mariagrazia; Mazzanti, Paola; Cascinu, Stefano

    2013-10-01

    Cardiotoxicity is a common complication of many anti-cancer agents and it remains a major limitation, strongly impacting the quality of life and the overall survival, regardless of the oncologic prognosis. Cardiotoxicity may occur during or shortly after treatment (within days or weeks), or it may become evident months, and sometimes years, after completion of chemotherapy. Cardiotoxicity associated with cancer therapies can range from asymptomatic subclinical abnormalities, including electrocardiographic changes and temporary left ventricular ejection fraction decline, to life-threatening events such as congestive heart failure or acute coronary syndromes. The aim of this review is to summarize potential cancer chemotherapeutics-related cardiovascular toxicities in adult cancer-patients and to suggest monitoring and treatment options for each agent, that can serve as a tool in the clinical practice. PMID:23522920

  17. Secondary malignancy after imatinib therapy: eight cases and review of the literature.

    PubMed

    Duman, Berna Bozkurt; Paydas, Semra; Disel, Umut; Besen, Ayberk; Gurkan, Emel

    2012-09-01

    Chronic myeloid leukemia (CML) is a clonal stem cell disorder, and imatinib is a small molecule inhibitor of Bcr-Abl tyrosine kinase (TK) used in cases with CML. Immediate and short-term side effects of this tyrosine kinase inhibitor (TKI) are well known, but the long-term side effects have not yet been clearly identified. Although an increased risk of secondary cancer in cases treated by imatinib was not found in two large series, secondary malignancies have been reported in some cases using TKIs, and this issue is important in daily clinical practice for clinicians. Here we report eight cases with neoplasias that developed during imatinib therapy and review secondary malignant disorders occurring during/after imatinib treatment. PMID:22329351

  18. Converging paths to progress for skull base chordoma: Review of current therapy and future molecular targets

    PubMed Central

    Maio, Salvatore Di; Kong, Esther; Yip, Stephen; Rostomily, Robert

    2013-01-01

    Background: Chordomas of the skull base are rare locally aggressive neoplasms with a predilection for encapsulating critical neurovascular structures, bony destruction and irregular growth patterns, and from which patients succumb to recurrence and treatment failures. Methods: A review of the medical literature is performed, using standard search engines and identifying articles related to skull base chordomas, surgery, radiation therapy, chemotherapy, molecular genetics, and prospective trials. Results: A synthesis of the literature is presented, including sections on pathology, treatment, molecular genetics, challenges, and future directions. Conclusion: Beyond an understanding of the current treatment paradigms for skull base chordomas, the reader gains insight into the collaborative approach applied to orphan diseases, of which chordomas is a prime exemplar. PMID:23776758

  19. Lentiviral vector-based therapy in head and neck cancer (Review)

    PubMed Central

    UPRETI, DEEPAK; PATHAK, ALOK; KUNG, SAM K.P.

    2014-01-01

    Head and neck squamous cell carcinoma (HNSCC) is the sixth most common neoplasm worldwide. Despite advances in multimodality treatments involving surgery, radiation and chemotherapy, the five-year survival rate has remained at ~50% for the past 35 years. Therefore, the early detection of recurrent or persistent disease is extremely important. Replication-incompetent HIV-1-based lentiviral vectors have emerged as powerful and safe tools for gene delivery. Commonly, HNSCC is a locoregional disease that presents at or close to the body surface. Thus, HNSCC is amendable to intratumoral injections of gene therapy vectors aimed at correcting defects associated with tumor suppressor genes to induce the direct cytotoxicity of cancer cells or immune modulation to promote antitumor immunity. Current investigations analyzing HNSCC gene mutations and stem cell markers and the cancer immunoediting concept are creating exciting therapeutic opportunities for lentiviral and other gene transfer vectors. The present review reports specific examples of the current applications of lentiviral vectors in HNSCC. PMID:24348811

  20. Lentiviral vector-based therapy in head and neck cancer (Review).

    PubMed

    Upreti, Deepak; Pathak, Alok; Kung, Sam K P

    2014-01-01

    Head and neck squamous cell carcinoma (HNSCC) is the sixth most common neoplasm worldwide. Despite advances in multimodality treatments involving surgery, radiation and chemotherapy, the five-year survival rate has remained at ~50% for the past 35 years. Therefore, the early detection of recurrent or persistent disease is extremely important. Replication-incompetent HIV-1-based lentiviral vectors have emerged as powerful and safe tools for gene delivery. Commonly, HNSCC is a locoregional disease that presents at or close to the body surface. Thus, HNSCC is amendable to intratumoral injections of gene therapy vectors aimed at correcting defects associated with tumor suppressor genes to induce the direct cytotoxicity of cancer cells or immune modulation to promote antitumor immunity. Current investigations analyzing HNSCC gene mutations and stem cell markers and the cancer immunoediting concept are creating exciting therapeutic opportunities for lentiviral and other gene transfer vectors. The present review reports specific examples of the current applications of lentiviral vectors in HNSCC. PMID:24348811

  1. Nanoparticles and cancer therapy: A concise review with emphasis on dendrimers

    PubMed Central

    Bharali, Dhruba J; Khalil, Marianne; Gurbuz, Mujgan; Simone, Tessa M; Mousa, Shaker A

    2009-01-01

    The emergence of nanotechnology has had a profound effect on many areas of healthcare and scientific research. Having grown exponentially, the focus of nanotechnology has been on engineering diversified novel applications that even go beyond therapeutic activity; nanotechnology also offers the ability to detect diseases, such as cancer, much earlier than ever imaginable. Often, patients diagnosed with breast, lung, colon, prostate, and ovarian cancer have hidden or overt metastatic colonies. With the advent of diagnostic nanotechnology, these numbers are expected to greatly diminish. This review provides a brief description of nanoparticle (liposome, quantum dot, and dendrimer)-mediated cancer therapy in the last decade with an emphasis on the development and use of dendrimers in cancer therapeutics. PMID:19421366

  2. Review of treatment assessment using DCE-MRI in breast cancer radiation therapy

    PubMed Central

    Wang, Chun-Hao; Yin, Fang-Fang; Horton, Janet; Chang, Zheng

    2014-01-01

    As a noninvasive functional imaging technique, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is being used in oncology to measure properties of tumor microvascular structure and permeability. Studies have shown that parameters derived from certain pharmacokinetic models can be used as imaging biomarkers for tumor treatment response. The use of DCE-MRI for quantitative and objective assessment of radiation therapy has been explored in a variety of methods and tumor types. However, due to the complexity in imaging technology and divergent outcomes from different pharmacokinetic approaches, the method of using DCE-MRI in treatment assessment has yet to be standardized, especially for breast cancer. This article reviews the basic principles of breast DCE-MRI and recent studies using DCE-MRI in treatment assessment. Technical and clinical considerations are emphasized with specific attention to assessment of radiation treatment response. PMID:25332905

  3. Concise Review: Immunologic Lessons From Solid Organ Transplantation for Stem Cell-Based Therapies

    PubMed Central

    Csete, Marie

    2013-01-01

    Clinical organ transplantation became possible only after powerful immunosuppressive drugs became available to suppress the alloimmune response. After decades of solid organ transplantation, organ rejection is still a major challenge. However, significant insight into allorecognition has emerged from this vast experience and should be used to inform future stem cell-based therapies. For this reason, we review the current understanding of selected topics in transplant immunology that have not been prominent in the stem cell literature, including immune responses to ischemia/reperfusion injuries, natural killer cells, the adaptive immune response, some unresolved issues in T-cell allorecognition, costimulatory molecules, and the anticipated role of regulatory T cells in graft tolerance. PMID:23349327

  4. Second line systemic therapy options for advanced hepatocellular carcinoma; a systematic review.

    PubMed

    Abdel-Rahman, Omar; Fouad, Mona

    2015-02-01

    This systematic review aims at evaluation of the level of evidence for the use of second-line systemic therapy for patients with hepatocellular carcinoma. Eligible studies were identified using database search. Eligible studies reported efficacy and/or toxicity data for patients with hepatocellular carcinoma receiving second-line systemic chemotherapy. Twenty five studies were eligible and were included in the final analysis. Median progression-free survival was reported in 20 out of the 25 studies and it ranged from 1.8 to 11 months. Median overall survival was reported in 18 out of 25 studies and it ranged from 6.6 months to 16 months. Reported grade 3/4 toxicities were regimen-specific and it includes hepatotoxicity, hypertension, and hematologic toxicities. However, positive results from the use of some agents need further confirmation in prospective studies. PMID:25363192

  5. Computerised cognitive behavioural therapy for psychological distress in patients with physical illnesses: a systematic review.

    PubMed

    McCombie, Andrew; Gearry, Richard; Andrews, Jane; Mikocka-Walus, Antonina; Mulder, Roger

    2015-03-01

    Whilst cognitive behaviour therapy (CBT) has been shown to improve outcomes in patients with chronic physical illnesses, there are barriers to its implementation which computerised CBT (CCBT) may overcome. We reviewed all studies of CCBT for treating psychological distress (PD) in chronic physical illness populations. Systematic searches were undertaken in July, 2013. All articles about CCBT for PD secondary to physical illness were included. Twenty-nine studies (thirty papers) were included. Overall, the quality of evidence was poor. Studies about irritable bowel syndrome demonstrated the best evidence. The evidence for CCBT in the treatment of PD in physical illness patients is modest, perhaps due to the seldom use of PD screening. More robust research designs including longer follow up periods are required. Nevertheless, no studies reported a negative effect of CCBT on any outcome measures. PMID:25666485

  6. Pain and the thermally injured patient-a review of current therapies.

    PubMed

    Retrouvey, Helene; Shahrokhi, Shahriar

    2015-01-01

    Thermally injured patients experience tremendous pain from the moment of injury to months or years after their discharge from the hospital. Pain is therefore a critical component of proper management of burns. Although the importance of pain is well recognized, it is often undertreated. Acute uncontrolled pain has been shown to increase the incidence of mental health disorders and increase the incidence of suicide after discharge. Long-term poor pain control leads to an increase in the incidence of persistent pain. Most burn centers have used opioids as the mainstay analgesic, but recently, the significant side effects of opioids have led to the implementation of new and combined therapeutics. Pharmacological agents such as gabapentin, clonidine, dexmedetomidine, and ketamine have all been suggested as adjuncts to opioids in the treatment of burn pain. Nonpharmacological therapies such as hypnosis, virtual reality devices, and behavioral therapy are also essential adjuncts to current medications. This review aims at identifying the currently available pharmacological and nonpharmacological options for optimal pain management in the adult burn population. PMID:24823343

  7. Review on the demographic and social impact of methadone-medication therapy on Malaysian patients.

    PubMed

    Manan, Mohamed Mansor; Ali, Salmiah Mohd; Khan, Muhammad Anwar Nawab; Jafarian, Sara; Hameed, Mohammed Abdul

    2013-07-01

    This study is an observational cross-sectional study aimed to examine the possible demographic and social characteristics of patients enrolled at the Methadone Maintenance Therapy Adherence Clinic (MMTAC) in Malaysia. Medical records from year 2009 - 2011 were Reviewed. Demographic, social characteristics and laboratory examinations such as age, gender, race, clinic attendances and urine analysis were recorded. Subjects were selected by means of convenient sampling but based on the specified inclusion and exclusion criteria. Data were analyzed by either Chi-square test, Fisher's exact test Mann-Whitney U-test, with the limit of significance was set at p < 0.05. Demographically, this study found that the ratio of Malays, Chinese and Indian enrolled to the MMTAC program is similar to the distribution of races in Malaysia. Their starting age for drug use was between 14-35 years and the age to enrolment between 30-58 years. Socially, many are unemployed, lowly educated and married. Most are drug users with a high percentage of HCV accompanied with impaired liver function. Retention rate was 87% but illicit drug use was at 57.50%. However, percentage of employment increased significantly after therapy. The study managed to identify several demographical and social distributions of patients attending the MMTAC. Although attendance rate was high, many were on illicit drug use. Nevertheless, employment rate improved significantly. PMID:23811468

  8. Molecular-targeted therapy for chemotherapy-refractory gastric cancer: a case report and literature review.

    PubMed

    Kuo, Hung-Yang; Yeh, Kun-Huei

    2014-07-01

    The prognosis of advanced gastric cancer (AGC) remains poor despite therapeutic advances in recent decades. Several recent positive phase III trials established the efficacy of second-line chemotherapy for metastatic gastric cancer in prolonging overall survival. However, malnutrition and poor performance of AGC in late stages usually preclude such patients from intensive treatment. Many targeted-therapies failed to show a significant survival benefit in AGC, but have regained attention after the positive result of ramucirumab was announced last year. Among all targeted agents, only trastuzumab, a monoclonal antibody against Human epidermal growth factor receptor-2 (HER2) protein, has been proven as having survival benefit by addition to first-line chemotherapy. Herein we reported a patient who benefited from adding trastuzumab to the same second-line combination chemotherapy (paclitaxel, 5-fluorouracil, and leucovorin) upon progression of bulky liver metastases. At least five months of progression-free survival were achieved without any additional toxicity. We also reviewed literature of molecularly-targeted therapy for chemotherapy-refractory gastric cancer, including several large phase III trials (REGARD, GRANITE-1, EXPAND, and REAL-3) published in 2013-2014. PMID:24982389

  9. Herbal therapy use by cancer patients: a literature review on case reports.

    PubMed

    Olaku, Oluwadamilola; White, Jeffrey D

    2011-03-01

    Complementary and alternative medicine use is common amongst cancer patients. In many surveys, herbal medicines are amongst the most commonly used group of treatments. Herbal remedies are believed by the general public to be safe, cause less side-effects and less likely to cause dependency. The authors performed a literature review to assess which herbal approaches have had associated cancer case reports and determine which of these have been studied in prospective research. Eighteen case reports of patients having apparent antitumour effects from herbal therapy and 21 case reports of toxic effects of herbs used by cancer patients were identified. Clinicaltrials.gov and MEDLINE (via PubMed) were searched for each of the herbal products identified in these reports. Clinical trials in cancer populations were identified for green tea extracts or compounds (n=34), phytoestrogens (n=27), mistletoe (n=8), Ganoderma lucidum (n=1), noni (n=1) and Silymarin (n=1). Daikenchuto, PC-SPES, Nyoshinsan/TJ and Saw palmetto have also been studied prospectively. In conclusion, some of the herbs with promising case report findings have undergone prospective clinical investigations but many others have either not yet been explored or the results have not been reported in English. Unconventional therapies, such as herbs and minerals, used in ancient medical traditions have led to the identification of active anticancer agents. Mechanisms to support prospective research with such approaches are discussed. PMID:21185719

  10. A systematic review of inhaled intranasal therapy for central nervous system neoplasms: an emerging therapeutic option.

    PubMed

    Peterson, Asa; Bansal, Amy; Hofman, Florence; Chen, Thomas C; Zada, Gabriel

    2014-02-01

    The intranasal route for drug delivery is rapidly evolving as a viable means for treating selected central nervous system (CNS) conditions. We aimed to identify studies pertaining to the application of intranasal drug administration for the treatment of primary CNS tumors. A systematic literature review was conducted to identify all studies published in the English language pertaining to intranasal therapy for CNS neoplasms, and/or general mechanisms and pharmacokinetics regarding targeted intranasal CNS drug delivery. A total of 194 abstracts were identified and screened. Thirty-seven studies met inclusion criteria. Of these, 21 focused on intranasal treatment of specific primary CNS tumors, including gliomas (11), meningiomas (1), and pituitary adenomas (4). An additional 16 studies focused on general mechanisms of intranasal therapy and drug delivery to the CNS using copolymer micelles, viral vectors, and nanoparticles. Inhaled compounds/substances investigated included perillyl alcohol, vesicular stomatitis virus, parvovirus, telomerase inhibitors, neural stem and progenitor cells, antimetabolites, somatostatin analogues, and dopamine agonists. Radiolabeling, CSF concentration measurement, imaging studies, and histological examination were utilized to clarify the mechanism and distribution by which drugs were delivered to the CNS. Successful drug delivery and tumor/symptom response was reported in all 21 tumor-specific studies. The intranasal route holds tremendous potential as a viable option for drug delivery for CNS neoplasms. A variety of antitumoral agents may be delivered via this route, thereby potentially offering a more direct delivery approach and ameliorating the adverse effects associated with systemic drug delivery. PMID:24398618

  11. Physical therapy in heart failure with preserved ejection fraction: A systematic review.

    PubMed

    Palau, Patricia; Núñez, Eduardo; Domínguez, Eloy; Sanchis, Juan; Núñez, Julio

    2014-12-01

    About 50% of patients with heart failure (HF) have preserved ejection fraction (HFpEF) which is especially common in elderly people with highly prevalent co-morbid conditions. HFpEF is usually defined as an ejection fraction equal to or greater than 50%, although some studies have used a limit as low as 40%. The prevalence of this syndrome is expected to increase over the next decades. The associated impact on mortality and hospital readmissions has made of this entity a major public health issue. Despite the fact that mortality and re-hospitalisation rates of HFpEF are similar to the syndrome of HF with reduced ejection fraction (HFrEF), currently there is no available evidence-based therapy as effective as is the case for HFrEF. Exercise intolerance is the principal clinical feature in HFpEF. The pathophysiological mechanisms behind impaired exercise capacity in these patients are complex and not yet fully elucidated. Current guidelines and consensus documents recommend the implementation of exercise training in HFpEF; however, they are based mostly on results from a few small trials evaluating surrogate endpoints such as exercise capacity and quality of life. The aim of this work was to review the current evidence that supports the effect of the different modalities of physical therapies in HFpEF. PMID:25488549

  12. Effect of Preventive Hormonal Therapy on Breast Density: A Systematic Qualitative Review

    PubMed Central

    Lienart, Virginie; Carly, Birgit; Liebens, Fabienne

    2014-01-01

    Breast density (BD) is recognized as one of the strongest independent risk factors of breast cancer (BC). Unlike most other risk factors, BD can be modified, suggesting that it may be a biomarker for preventive interventions. We conducted a qualitative systematic review to address the effect of preventive hormonal therapy on BD. Among the 26 relevant studies, 10 assessed the effect of tamoxifen on BD (TAM: n = 2?877), 9 that of raloxifene (RLX: n = 1?544), and 7 that of aromatase inhibitors (AI: n = 416). The studies were characterized by a large heterogeneity in designs and in methods of BD measurement. BD could be reduced by TAM (10 studies/10). However, the effect of RLX and AI on BD remains unclear due to conflicting results between studies. Consequently, it is crucial to develop practical, accurate, and reproducible methods of measurement in order to be able to compare the effect of preventive hormonal agents on BD and to determine whether change in BD can be used as a predictor of response to therapy. PMID:24895676

  13. A Narrative Review of Yoga and Mindfulness as Complementary Therapies for Addiction

    PubMed Central

    Khanna, Surbhi; Greeson, Jeffrey M.

    2013-01-01

    Summary This paper reviews the philosophical origins, current scientific evidence, and clinical promise of yoga and mindfulness as complementary therapies for addiction. Historically, there are eight elements of yoga that, together, comprise ethical principles & practices for living a meaningful, purposeful, moral and self-disciplined life. Traditional yoga practices, including postures and meditation, direct attention towards one’s health, while acknowledging the spiritual aspects of one’s nature. Mindfulness derives from ancient Buddhist philosophy, and mindfulness meditation practices, such as gentle Hatha yoga and mindful breathing, are increasingly integrated into secular health care settings. Current theoretical models suggest that the skills, insights, and self-awareness learned through yoga and mindfulness practice can target multiple psychological, neural, physiological, and behavioral processes implicated in addiction and relapse. A small but growing number of well-designed clinical trials and experimental laboratory studies on smoking, alcohol dependence, and illicit substance use support the clinical effectiveness and hypothesized mechanisms of action underlying mindfulness-based interventions for treating addiction. Because very few studies have been conducted on the specific role of yoga in treating or preventing addiction, we propose a conceptual model to inform future studies on outcomes and possible mechanisms. Additional research is also needed to better understand what types of yoga and mindfulness-based interventions work best for what types of addiction, what types of patients, and under what conditions. Overall, current findings increasingly support yoga and mindfulness as promising complementary therapies for treating and preventing addictive behaviors. PMID:23642957

  14. Invited review: Stem cells and muscle diseases: advances in cell therapy strategies.

    PubMed

    Negroni, Elisa; Gidaro, Teresa; Bigot, Anne; Butler-Browne, Gillian S; Mouly, Vincent; Trollet, Capucine

    2015-04-01

    Despite considerable progress to increase our understanding of muscle genetics, pathophysiology, molecular and cellular partners involved in muscular dystrophies and muscle ageing, there is still a crucial need for effective treatments to counteract muscle degeneration and muscle wasting in such conditions. This review focuses on cell-based therapy for muscle diseases. We give an overview of the different parameters that have to be taken into account in such a therapeutic strategy, including the influence of muscle ageing, cell proliferation and migration capacities, as well as the translation of preclinical results in rodent into human clinical approaches. We describe recent advances in different types of human myogenic stem cells, with a particular emphasis on myoblasts but also on other candidate cells described so far [CD133+ cells, aldehyde dehydrogenase-positive cells (ALDH+), muscle-derived stem cells (MuStem), embryonic stem cells (ES) and induced pluripotent stem cells (iPS)]. Finally, we provide an update of ongoing clinical trials using cell therapy strategies. PMID:25405809

  15. HERBAL THERAPY USE BY CANCER PATIENTS: A LITERATURE REVIEW ON CASE REPORTS

    PubMed Central

    Olaku, Oluwadamilola; White, Jeffrey D.

    2011-01-01

    Complementary and alternative medicine use is common among cancer patients. In many surveys, herbal medicines are among the most commonly used group of treatments. Herbal remedies are believed by the general public to be safe, cause less side effects and less likely to cause dependency. The authors performed a literature review to assess which herbal approaches have had associated cancer case reports and determine which of these have been studied in prospective research. Eighteen case reports of patients having apparent antitumour effects from herbal therapy and 21 case reports of toxic effects of herbs used by cancer patients were identified. Clinicaltrials.gov and MEDLINE (via PubMed) were searched for each of the herbal products identified in these reports. Clinical trials in cancer populations were identified for green tea extracts or compounds (n = 34), phytoestrogens (n=27), mistletoe (n =8), Ganoderma lucidum (n=1), Noni (n = 1) and Silymarin (n = 1). Daikenchuto, PC-SPES, Nyoshinsan/TJ and Saw palmetto have also been studied prospectively. In conclusion, some of the herbs with promising case report findings have undergone prospective clinical investigations but many others have either not yet been explored or the results have not been reported in English. Unconventional therapies, such as herbs and minerals, used in ancient medical traditions have led to the identification of active anticancer agents. Mechanisms to support prospective research with such approaches are discussed. PMID:21185719

  16. Experimental use of photodynamic therapy in high grade gliomas: a review focused on 5-aminolevulinic acid.

    PubMed

    Tetard, Marie-Charlotte; Vermandel, Maximilien; Mordon, Serge; Lejeune, Jean-Paul; Reyns, Nicolas

    2014-09-01

    Photodynamic therapy (PDT) consists of a laser light exposure of tumor cells photosensitized by general or local administration of a pharmacological agent. Nowadays, PDT is a clinically established modality for treatment of many cancers. 5-Aminolevulinic acid (ALA) induced protoporphyrin IX (PpIX) has proven its rational in fluoro-guided resection of malignant gliomas due to a selective tumor uptake and minimal skin sensitization. Moreover, the relatively specific accumulation of photosensitizing PPIX within the tumor cells has gained interest in the PDT of malignant gliomas. Several experimental and clinical studies have then established ALA-PDT as a valuable adjuvant therapy in the management of malignant gliomas. However, the procedure still requires optimizations in the fields of tissue oxygenation status, photosensitizer concentration or scheme of laser light illumination. In this extensive review, we focused on the methods and results of ALA-PDT for treating malignant gliomas in experimental conditions. The biological mechanisms, the effects on tumor and normal brain tissue, and finally the critical issues to optimize the efficacy of ALA-PDT were discussed. PMID:24905843

  17. Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence.

    PubMed

    Karagülle, Mine; Karagülle, Müfit Zeki

    2015-02-01

    In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects. PMID:25535198

  18. Effectiveness of robot-assisted therapy on ankle rehabilitation – a systematic review

    PubMed Central

    2013-01-01

    Objective The aim of this study was to provide a systematic review of studies that investigated the effectiveness of robot-assisted therapy on ankle motor and function recovery from musculoskeletal or neurologic ankle injuries. Methods Thirteen electronic databases of articles published from January, 1980 to June, 2012 were searched using keywords ‘ankle*’, ‘robot*’, ‘rehabilitat*’ or ‘treat*’ and a free search in Google Scholar based on effects of ankle rehabilitation robots was also conducted. References listed in relevant publications were further screened. Eventually, twenty-nine articles were selected for review and they focused on effects of robot-assisted ankle rehabilitation. Results Twenty-nine studies met the inclusion criteria and a total of 164 patients and 24 healthy subjects participated in these trials. Ankle performance and gait function were the main outcome measures used to assess the therapeutic effects of robot-assisted ankle rehabilitation. The protocols and therapy treatments were varied, which made comparison among different studies difficult or impossible. Few comparative trials were conducted among different devices or control strategies. Moreover, the majority of study designs met levels of evidence that were no higher than American Academy for Cerebral Palsy (CP) and Developmental Medicine (AACPDM) level IV. Only one study used a Randomized Control Trial (RCT) approach with the evidence level being II. Conclusion All the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It is also essential to conduct trials to analyse the differences among different devices or control strategies. PMID:23517734

  19. A Systematic Review of the Effectiveness of Manipulative Therapy in Treating Lateral Epicondylalgia

    PubMed Central

    Herd, Christopher R.; Meserve, Brent B.

    2008-01-01

    Lateral epicondylalgia is a commonly encountered musculoskeletal complaint. Currently, there is no agreement regarding the exact underlying pathoanatomical cause or the most effective management strategy. Various forms of joint manipulation have been recommended as treatment. The purpose of this study was to systematically review available literature regarding the effectiveness of manipulation in treating lateral epicondylalgia. A comprehensive search of Medline, CINAHL, Health Source, SPORTDiscus, and the Physiotherapy Evidence Database ending in November 2007 was conducted. Thirteen studies, both randomized and non-randomized clinical trials, met inclusion criteria. Articles were assessed for quality by one reviewer using the 10-point PEDro scale. Quality scores ranged from 1–8 with a mean score of 5.15 ± 1.85. This score represented fair quality overall; however, trends indicated the presence of consistent methodological flaws. Specifically, no study achieved successful blinding of the patient or treating therapist, and less than 50% used a blinded outcome assessor. Additionally, studies varied significantly in terms of outcome measures, follow-up, and comparison treatments, thus making comparing results across studies difficult. Results of this review support the use of Mulligan's mobilization with movement in providing immediate, short-, and long-term benefits. In addition, positive results were demonstrated with manipulative therapy directed at the cervical spine, although data regarding long-term effects were limited. Currently, limited evidence exists to support a synthesis of any particular technique whether directed at the elbow or cervical spine. Overall, this review identified the need for further high-quality studies using larger sample sizes, valid functional outcome measures, and longer follow-up periods. PMID:19771195

  20. Some recent advances in nanostructure preparation from gold and silver particles: a short topical review

    Microsoft Academic Search

    Mathias Brust; Christopher J Kiely

    2002-01-01

    Recent developments in nanostructure self-assembly from gold and silver particles are reviewed. A brief historical background of the field is given, followed by a selection of topics which are of particular current interest. An overview of the preparation of thiol-stabilised gold and silver nanoparticles and their spontaneous self-organisation into well-ordered superlattices is presented. Distance-dependent metal insulator transitions in ensembles of

  1. Effectiveness of Cognitive Behavioral and Supportive-Expressive Group Therapy for Women Diagnosed with Breast Cancer: A Review of the Literature

    ERIC Educational Resources Information Center

    Boutin, Daniel L.

    2007-01-01

    A review of the literature revealed 20 studies that examined the extent to which cognitive behavioral therapy (CBT), supportive-expressive group therapy (SEGT), and a combination of these two treatments impact women with breast cancer. Based on this review, it is determined that CBT and SEGT have repeated experimental support for positively…

  2. Effectiveness of Cognitive Behavioral and Supportive-Expressive Group Therapy for Women Diagnosed with Breast Cancer: A Review of the Literature

    Microsoft Academic Search

    Daniel L. Boutin

    2007-01-01

    A review of the literature revealed 20 studies that examined the extent to which cognitive behavioral therapy (CBT), supportive-expressive group therapy (SEGT), and a combination of these two treatments impact women with breast cancer. Based on this review, it is determined that CBT and SEGT have repeated experimental support for positively altering certain affective disturbances for this population. However, all

  3. The International Adventure Therapy Conference, (1st, Perth, Western Australia). A Review.

    ERIC Educational Resources Information Center

    Loynes, Chris

    1997-01-01

    The first (1997) international conference on adventure therapy (Perth, Australia) was attended by over 270 participants from 21 countries. Major themes included defining adventure therapy, therapeutic behavior change versus changing attitudes and values, the ethics of therapy, whether adventure therapy must link to a recognized school of…

  4. Accentuating Mode Deactivation Therapy (MDT): A Review of a Comprehensive Meta-Analysis into the Effectiveness of MDT

    ERIC Educational Resources Information Center

    Hollman, Jacquelynn

    2010-01-01

    A recent Meta-Analysis conducted by Apsche, Bass & DiMeo (2010) provided astonishing evidence regarding Mode Deactivation Therapy's (MDT) ability to effectuate change in youth with delinquent traits. Following is a brief review of the results presented in the analysis as a way of highlighting the capacities of MDT and promotes the implementation…

  5. Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review

    ERIC Educational Resources Information Center

    Richardson, Thomas; Stallard, Paul; Velleman, Sophie

    2010-01-01

    Research has shown that computerised cognitive behaviour therapy (cCBT) can be effective in the treatment of depression and anxiety in adults, although the outcomes with children and adolescents are unclear. The aim of the study is to systematically review the literature on the effectiveness of cCBT for the prevention and treatment of depression…

  6. An Evidence-Based Review of the Effectiveness of Cognitive Behavioral Therapy for Psychosocial Issues Post-Spinal Cord Injury

    Microsoft Academic Search

    Swati Mehta; Steven Orenczuk; Kevin T. Hansen; Jo-Anne L. Aubut; Sander L. Hitzig; Matthew Legassic; Robert W. Teasell

    2011-01-01

    Study Design: Systematic review. Objective: To examine the evidence supporting the effectiveness of cognitive behavioral therapy (CBT) for improving psychosocial outcomes in individuals with spinal cord injury (SCI). Method: Electronic databases (MEDLINE, CINAHL, EMBASE, and PsycINFO) were searched for studies published between 1990 and October 2010. Randomized control trials (RCTs) and nonrandomized control trials (non-RCTs) utilizing a CBT intervention to

  7. Using Cognitive Behavior Therapy in Clinical Work with African American Children and Adolescents: A Review of the Literature

    ERIC Educational Resources Information Center

    Wilson, Courtney J.; Cottone, R. Rocco

    2013-01-01

    A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. (Contains 3…

  8. Laser irradiation of ferrous particles for hyperthermia as cancer therapy, a theoretical study.

    PubMed

    Patel, Jigar M; Evrensel, Cahit A; Fuchs, Alan; Sutrisno, Joko

    2015-01-01

    Our recent in vivo animal studies showed the feasibility of using micron sized iron particles to induce physical damage to breast cancer tumors and thereby triggering a localized immune response to help fight the cancer. Combining a hyperthermic treatment with this ongoing study may enhance the immune response. As a result, a novel treatment of inducing hyperthermia using iron particles excited by a continuous wave near-infrared laser was analyzed. In this theoretical study, Mie scattering calculations were first conducted to determine the absorption and scattering efficiencies of the suspended drug coated particles. The resulting heat transfer between the particles and the surrounding tumor and the healthy tissue was modeled using Pennes' Bioheat equation. Predicted temperature changes were satisfactory for inducing hyperthermia (42(?)C), thermally triggering drug release, and even thermal ablation (55(?)C). PMID:25082264

  9. The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis

    PubMed Central

    Thomson, Colin E; Crawford, Fay; Murray, Gordon D

    2005-01-01

    Background There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy. Methods We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004. We included randomised trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo or different doses of extra corporeal shock wave therapy were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomised controlled trial, extracted data and assessed the methodological quality of each trial. Results Six RCTs (n = 897) permitted a pooled estimate of effectiveness based on pain scores collected using 10 cm visual analogue scales for morning pain. The estimated weighted mean difference was 0.42 (95% confidence interval 0.02 to 0.83) representing less than 0.5 cm on a visual analogue scale. There was no evidence of heterogeneity and a fixed effects model was used. Conclusion A meta-analysis of data from six randomised-controlled trials that included a total of 897 patients was statistically significant in favour of extracorporeal shock wave therapy for the treatment of plantar heel pain but the effect size was very small. A sensitivity analysis including only high quality trials did not detect a statistically significant effect. PMID:15847689

  10. Reviews

    NASA Astrophysics Data System (ADS)

    2002-03-01

    BOOK REVIEWS (164) Salters GCSE Science: Teacher and Technician Resource Pack, Year 10 The NEW World of Mr Tompkins The Heinemann Science Scheme: Book 1 Advanced Physics Readers: Astrophysics Using the Internet in Secondary Schools, 2nd edition CD-ROM REVIEW (168) Particle Physics: A Keyhole to the Birth of Time (version 2) WEB WATCH (169) Hunting for new physics sites CORRECTION (171)

  11. Nanofabricated particles for engineered drug therapies: a preliminary biodistribution study of PRINT nanoparticles.

    PubMed

    Gratton, Stephanie E A; Pohlhaus, Patrick D; Lee, Jin; Guo, Ji; Cho, Moo J; Desimone, Joseph M

    2007-08-16

    A novel method for the fabrication of polymeric particles on the order of tens of nanometers to several microns is described. This imprint lithographic technique called PRINT (Particle Replication In Non-wetting Templates), takes advantage of the unique properties of elastomeric molds comprised of a low surface energy perfluoropolyether network, allowing the production of monodisperse, shape-specific nanoparticles from an extensive array of organic precursors. This engineered nature of particle production has a number of advantages over the construction of traditional nanoparticles such as liposomes, dendrimers, and colloidal precipitates. The gentle "top down" approach of PRINT enables the simultaneous and independent control over particle size and shape, composition, and surface functionality, and permits the loading of delicate cargos such as small organic therapeutics and biological macromolecules. Thus, this single tool serves as a comprehensive platform for the rational design and investigation of new nanocarriers in medicine, having applications ranging from therapeutics to advanced diagnostics. Preliminary in vitro and in vivo studies were conducted, demonstrating the future utility of PRINT particles as delivery vectors in nanomedicine. Monodisperse 200 nm poly(ethylene glycol)-based (PEG) particles were fabricated using PRINT methodology and characterized via scanning electron microscopy and dynamic light scattering. Incubation with HeLa cells showed very little cytotoxicity, even at high concentrations. The biodistribution and pharmacokinetics of [(125)I]-labeled particles were studied in healthy mice following bolus tail vein administration. The particles were distributed mainly to the liver and the spleen with an apparent distribution t(1/2) of approximately 17 min followed by slow redistribution with a t(1/2) of 3.3 h. The volume of distribution for the central and peripheral compartments was found to be approximately 3 mL and 5 mL, respectively. PMID:17643544

  12. Physical therapy with drug treatment in bell palsy: a focused review.

    PubMed

    Ferreira, Margarida; Marques, Elisa E; Duarte, José A; Santos, Paula C

    2015-04-01

    The physical therapy (PT) associated with standard drug treatment (SDT) in Bell palsy has never been investigated. Randomized controlled trials or quasirandomized controlled trials have compared facial PT (except treatments such as acupuncture and osteopathic) combined with SDT against a control group with SDT alone. Participants included those older than 15 yrs with a clinical diagnosis of Bell palsy, and the primary outcome measure was motor function recovery by the House-Brackmann scale. The methodologic quality of each study was also independently assessed by two reviewers using the PEDro scale. Four studies met the inclusion criteria. Three trials indicate that PT in association with SDT supports higher motor function recovery than SDT alone between 15 days and 1 yr of follow-up. On the other hand, one trial showed that electrical stimulation added to conventional PT with SDT did not influence treatment outcomes. The present review suggests that the current practice of Bell palsy treatment by PT associated with SDT seems to have a positive effect on grade and time recovery compared with SDT alone. However, there is very little quality evidence from randomized controlled trials, and such evidence is insufficient to decide whether combined treatment is beneficial in the management of Bell palsy. PMID:25785922

  13. Patient Values and Preferences in Decision Making for Antithrombotic Therapy: A Systematic Review

    PubMed Central

    Mulla, Sohail; Akl, Elie A.; Jankowski, Milosz; Vandvik, Per Olav; Ebrahim, Shanil; McLeod, Shelley; Bhatnagar, Neera; Guyatt, Gordon H.

    2012-01-01

    Background: Development of clinical practice guidelines involves making trade-offs between desirable and undesirable consequences of alternative management strategies. Although the relative value of health states to patients should provide the basis for these trade-offs, few guidelines have systematically summarized the relevant evidence. We conducted a systematic review relating to values and preferences of patients considering antithrombotic therapy. Methods: We included studies examining patient preferences for alternative approaches to antithrombotic prophylaxis and studies that examined, in the context of antithrombotic prophylaxis or treatment, how patients value alternative health states and experiences with treatment. We conducted a systematic search and compiled structured summaries of the results. Steps in the process that involved judgment were conducted in duplicate. Results: We identified 48 eligible studies. Sixteen dealt with atrial fibrillation, five with VTE, four with stroke or myocardial infarction prophylaxis, six with thrombolysis in acute stroke or myocardial infarction, and 17 with burden of antithrombotic treatment. Conclusion: Patient values and preferences regarding thromboprophylaxis treatment appear to be highly variable. Participant responses may depend on their prior experience with the treatments or health outcomes considered as well as on the methods used for preference elicitation. It should be standard for clinical practice guidelines to conduct systematic reviews of patient values and preferences in the specific content area. PMID:22315262

  14. Efficacy of localized phototherapy and photodynamic therapy for psoriasis: a systematic review and meta-analysis.

    PubMed

    Almutawa, Fahad; Thalib, Lukman; Hekman, Daniel; Sun, Qing; Hamzavi, Iltefat; Lim, Henry W

    2015-01-01

    Localized phototherapy including topical psoralen plus ultraviolet A (PUVA) and targeted ultraviolet B (UVB), and photodynamic therapy (PDT) have been increasingly used in the treatment of localized psoriasis. Yet, there are no systematic reviews or meta-analyses that scientifically evaluated the pooled efficacy of these treatments in psoriasis. We searched Medline, Embase, and Cochrane databases during the period of January 1980 to June 2012. Our systematic search resulted in 765 studies, 23 of them were included in the review. The primary outcome was 75% reduction in severity score from baseline. A meta-analysis using random effect model found topical PUVA to be more effective than non-laser targeted UVB [odds ratio: 3.48 (95% confidence interval 0.56-21.84), P?=?0.183]. The pooled effect estimate of the efficacy (75% reduction in severity score) of topical PUVA, targeted UVB, and PDT were as follows: 77% (topical PUVA), 61% (targeted UVB), and 22% (PDT). Topical PUVA and targeted UVB phototherapy are very effective in the treatment of localized psoriasis. Topical PUVA seems more effective than non-laser targeted UVB phototherapy. On the other hand, PDT has low efficacy and high percentage of side effects in treating localized psoriasis. PMID:24283358

  15. Photothermal cancer therapy using graphitic carbon-coated magnetic particles prepared by one-pot synthesis.

    PubMed

    Lee, Hyo-Jeong; Sanetuntikul, Jakkid; Choi, Eun-Sook; Lee, Bo Ram; Kim, Jung-Hee; Kim, Eunjoo; Shanmugam, Sangaraju

    2015-01-01

    We describe here a simple synthetic strategy for the fabrication of carbon-coated Fe3O4 (Fe3O4@C) particles using a single-component precursor, iron (III) diethylenetriaminepentaacetic acid complex. Physicochemical analyses revealed that the core of the synthesized particles consists of ferromagnetic Fe3O4 material ranging several hundred nanometers, embedded in nitrogen-doped graphitic carbon with a thickness of ~120 nm. Because of their photothermal activity (absorption of near-infrared [NIR] light), the Fe3O4@C particles have been investigated for photothermal therapeutic applications. An example of one such application would be the use of Fe3O4@C particles in human adenocarcinoma A549 cells by means of NIR-triggered cell death. In this system, the Fe3O4@C can rapidly generate heat, causing >98% cell death within 10 minutes under 808 nm NIR laser irradiation (2.3 W cm(-2)). These Fe3O4@C particles provided a superior photothermal therapeutic effect by intratumoral delivery and NIR irradiation of tumor xenografts. These results demonstrate that one-pot synthesis of carbon-coated magnetic particles could provide promising materials for future clinical applications and encourage further investigation of this simple method. PMID:25565819

  16. Photothermal cancer therapy using graphitic carbon–coated magnetic particles prepared by one-pot synthesis

    PubMed Central

    Lee, Hyo-Jeong; Sanetuntikul, Jakkid; Choi, Eun-Sook; Lee, Bo Ram; Kim, Jung-Hee; Kim, Eunjoo; Shanmugam, Sangaraju

    2015-01-01

    We describe here a simple synthetic strategy for the fabrication of carbon-coated Fe3O4 (Fe3O4@C) particles using a single-component precursor, iron (III) diethylenetriaminepentaacetic acid complex. Physicochemical analyses revealed that the core of the synthesized particles consists of ferromagnetic Fe3O4 material ranging several hundred nanometers, embedded in nitrogen-doped graphitic carbon with a thickness of ~120 nm. Because of their photothermal activity (absorption of near-infrared [NIR] light), the Fe3O4@C particles have been investigated for photothermal therapeutic applications. An example of one such application would be the use of Fe3O4@C particles in human adenocarcinoma A549 cells by means of NIR-triggered cell death. In this system, the Fe3O4@C can rapidly generate heat, causing >98% cell death within 10 minutes under 808 nm NIR laser irradiation (2.3 W cm?2). These Fe3O4@C particles provided a superior photothermal therapeutic effect by intratumoral delivery and NIR irradiation of tumor xenografts. These results demonstrate that one-pot synthesis of carbon-coated magnetic particles could provide promising materials for future clinical applications and encourage further investigation of this simple method. PMID:25565819

  17. Arts therapies for anxiety, depression, and quality of life in breast cancer patients: a systematic review and meta-analysis.

    PubMed

    Boehm, Katja; Cramer, Holger; Staroszynski, Thomas; Ostermann, Thomas

    2014-01-01

    Background. Breast cancer is one of the most common types of cancer. However, only a few trials assess the effects of arts therapies. Material and Methods. We searched the Cochrane Central Register of Controlled Trials, PubMed, and Google Scholar from their start date to January 2012. We handsearched reference lists and contacted experts. All randomized controlled trials, quasi-randomized trials, and controlled clinical trials of art interventions in breast cancer patients were included. Data were extracted and risk of bias was assessed. Meta-analyses were performed using standardized mean differences. Results. Thirteen trials with a total of 606 patients were included. Arts therapies comprised music therapy interventions, various types of art therapy, and dance/movement therapies. The methodological quality ranged from poor to high quality with the majority scoring 3 of 4 points on the Jadad scale. Results suggest that arts therapies seem to positively affect patients' anxiety (standardized mean difference: -1.10; 95%, confidence interval: -1.40 to -0.80) but not depression or quality of life. No conclusion could be drawn regarding the effects of arts therapy on pain, functional assessment, coping, and mood states. Discussion. Our review indicates that arts interventions may have beneficial effects on anxiety in patients with breast cancer. PMID:24817896

  18. Calculation of radiation therapy dose using all particle Monte Carlo transport

    DOEpatents

    Chandler, W.P.; Hartmann-Siantar, C.L.; Rathkopf, J.A.

    1999-02-09

    The actual radiation dose absorbed in the body is calculated using three-dimensional Monte Carlo transport. Neutrons, protons, deuterons, tritons, helium-3, alpha particles, photons, electrons, and positrons are transported in a completely coupled manner, using this Monte Carlo All-Particle Method (MCAPM). The major elements of the invention include: computer hardware, user description of the patient, description of the radiation source, physical databases, Monte Carlo transport, and output of dose distributions. This facilitated the estimation of dose distributions on a Cartesian grid for neutrons, photons, electrons, positrons, and heavy charged-particles incident on any biological target, with resolutions ranging from microns to centimeters. Calculations can be extended to estimate dose distributions on general-geometry (non-Cartesian) grids for biological and/or non-biological media. 57 figs.

  19. Calculation of radiation therapy dose using all particle Monte Carlo transport

    DOEpatents

    Chandler, William P. (Tracy, CA); Hartmann-Siantar, Christine L. (San Ramon, CA); Rathkopf, James A. (Livermore, CA)

    1999-01-01

    The actual radiation dose absorbed in the body is calculated using three-dimensional Monte Carlo transport. Neutrons, protons, deuterons, tritons, helium-3, alpha particles, photons, electrons, and positrons are transported in a completely coupled manner, using this Monte Carlo All-Particle Method (MCAPM). The major elements of the invention include: computer hardware, user description of the patient, description of the radiation source, physical databases, Monte Carlo transport, and output of dose distributions. This facilitated the estimation of dose distributions on a Cartesian grid for neutrons, photons, electrons, positrons, and heavy charged-particles incident on any biological target, with resolutions ranging from microns to centimeters. Calculations can be extended to estimate dose distributions on general-geometry (non-Cartesian) grids for biological and/or non-biological media.

  20. Extracorporeal shock wave therapy as an adjunct wound treatment: a systematic review of the literature.

    PubMed

    Dymarek, Robert; Halski, Tomasz; Ptaszkowski, Kuba; Slupska, Lucyna; Rosinczuk, Joanna; Taradaj, Jakub

    2014-07-01

    Standard care procedures for complex wounds are sometimes supported and reinforced by physical treatment modalities such as extracorporeal shock wave therapy (ESWT). To evaluate available evidence of ESWT effectiveness in humans, a systematic review of the literature was conducted using MEDLINE, PubMed, Scopus, EBSCOhost, and PEDro databases. Of the 393 articles found, 13 met the publication date (year 2000-2013), study type (clinical study), language (English only), and abstract availability (yes) criteria. The 13 studies (n = 919 patients with wounds of varying etiologies) included seven randomized controlled trials that were evaluated using Cochrane Collaboration Group standards. Only studies with randomization, well prepared inclusion/exclusion criteria protocol, written in English, and full version available were analyzed. An additional six publications reporting results of other clinical studies including a total of 523patients were identified and summarized. ESWT was most commonly applied once or twice a week using used low or medium energy, focused or defocused generator heads (energy range 0.03 to 0.25 mJ/mm2; usually 0.1 mJ/mm2), and electrohydraulic or electromagnetic sources. Few safety concerns were reported, and in the controlled clinical studies statistically significant differences in rates of wound closure were reported compared to a variety of standard topical treatment modalities, sham ESWT treatment, and hyperbaric oxygen therapy. Based on this analysis, ESWT can be characterized as noninvasive, mostly painless, and safe. Controlled, randomized, multicenter, blind clinical trials still are required to evaluate the efficacy and cost-effectiveness of ESWT compared to sham control, other adjunctive treatments, and commonly used moisture-retentive dressings. In the future, ESWT may play an important role in wound care once evidence-based practice guidelines are developed. PMID:25019247

  1. Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

    PubMed Central

    Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

    2007-01-01

    Introduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF). Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID)-refractory patients with AS. Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis. Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS. PMID:21221193

  2. Transitioning Insulin Pump Therapy from the Outpatient to the Inpatient Setting: A Review of 6 Years' Experience with 253 Cases

    PubMed Central

    Cook, Curtiss B.; Beer, Karen A.; Seifert, Karen M.; Boyle, Mary E.; Mackey, Patricia A.; Castro, Janna C.

    2012-01-01

    Background We reviewed the care of a large cohort of patients with diabetes mellitus on insulin pump therapy who required an inpatient stay. Methods Records were reviewed of patients hospitalized between January 1, 2006, and December 31, 2011. Results A total of 136 patients using insulin pumps had 253 hospitalizations. Mean (standard deviation) patient age was 55 (16) years, diabetes duration was 29 (15) years, and pump duration was 6 (5) years. Insulin pump therapy was continued in 164 (65%) hospitalizations. Adherence to core process measures improved over time: by 2011, 100% of cases had an endocrinology consultation, 100% had the required insulin pump order set completed, and 94% had documentation of the signed agreement specifying patient responsibilities for continued use of the technology while hospitalized. Documentation of the insulin pump flow sheet also increased but could still be located in only 64% of cases by the end of 2011. Mean glucose was not significantly different among patients who remained on insulin pump therapy compared to those for whom it was discontinued (p > .1), but episodes of severe hyperglycemia (>300 mg/dl) and hypoglycemia (<40 mg/dl) were significantly less common among pump users. No pump site infections, mechanical pump failures, or episodes of diabetic ketoacidosis were observed among patients remaining on therapy. Conclusions With appropriate patient selection and usage guidelines, most patients using insulin pumps can safely have their therapy transitioned to the inpatient setting. Further study is needed to determine whether this approach can be translated to other hospital settings. PMID:23063024

  3. Fundamentals and application of magnetic particles in cell isolation and enrichment: a review.

    PubMed

    Plouffe, Brian D; Murthy, Shashi K; Lewis, Laura H

    2015-01-01

    Magnetic sorting using magnetic beads has become a routine methodology for the separation of key cell populations from biological suspensions. Due to the inherent ability of magnets to provide forces at a distance, magnetic cell manipulation is now a standardized process step in numerous processes in tissue engineering, medicine, and in fundamental biological research. Herein we review the current status of magnetic particles to enable isolation and separation of cells, with a strong focus on the fundamental governing physical phenomena, properties and syntheses of magnetic particles and on current applications of magnet-based cell separation in laboratory and clinical settings. We highlight the contribution of cell separation to biomedical research and medicine and detail modern cell-separation methods (both magnetic and non-magnetic). In addition to a review of the current state-of-the-art in magnet-based cell sorting, we discuss current challenges and available opportunities for further research, development and commercialization of magnetic particle-based cell-separation systems. PMID:25471081

  4. Fundamentals and application of magnetic particles in cell isolation and enrichment: a review

    NASA Astrophysics Data System (ADS)

    Plouffe, Brian D.; Murthy, Shashi K.; Lewis, Laura H.

    2015-01-01

    Magnetic sorting using magnetic beads has become a routine methodology for the separation of key cell populations from biological suspensions. Due to the inherent ability of magnets to provide forces at a distance, magnetic cell manipulation is now a standardized process step in numerous processes in tissue engineering, medicine, and in fundamental biological research. Herein we review the current status of magnetic particles to enable isolation and separation of cells, with a strong focus on the fundamental governing physical phenomena, properties and syntheses of magnetic particles and on current applications of magnet-based cell separation in laboratory and clinical settings. We highlight the contribution of cell separation to biomedical research and medicine and detail modern cell-separation methods (both magnetic and non-magnetic). In addition to a review of the current state-of-the-art in magnet-based cell sorting, we discuss current challenges and available opportunities for further research, development and commercialization of magnetic particle-based cell-separation systems.

  5. Silver (Ag) Transport Mechanisms in TRISO coated particles: A Critical Review

    SciTech Connect

    I J van Rooyen; J H Neethling; J A A Engelbrecht; P M van Rooyen; G Strydom

    2012-10-01

    Transport of 110mAg in the intact SiC layer of TRISO coated particles has been studied for approximately 30 years without arriving at a satisfactory explanation of the transport mechanism. In this paper the possible mechanisms postulated in previous experimental studies, both in-reactor and out-of reactor research environment studies are critically reviewed and of particular interest are relevance to very high temperature gas reactor operating and accident conditions. Among the factors thought to influence Ag transport are grain boundary stoichiometry, SiC grain size and shape, the presence of free silicon, nano-cracks, thermal decomposition, palladium attack, transmutation products, layer thinning and coated particle shape. Additionally new insight to nature and location of fission products has been gained via recent post irradiation electron microscopy examination of TRISO coated particles from the DOE’s fuel development program. The combined effect of critical review and new analyses indicates a direction for investigating possible the Ag transport mechanism including the confidence level with which these mechanisms may be experimentally verified.

  6. Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials

    PubMed Central

    2013-01-01

    Background Testosterone therapy is increasingly promoted. No randomized placebo-controlled trial has been implemented to assess the effect of testosterone therapy on cardiovascular events, although very high levels of androgens are thought to promote cardiovascular disease. Methods A systematic review and meta-analysis was conducted of placebo-controlled randomized trials of testosterone therapy among men lasting 12+ weeks reporting cardiovascular-related events. We searched PubMed through the end of 2012 using “(“testosterone” or “androgen”) and trial and (“random*”)” with the selection limited to studies of men in English, supplemented by a bibliographic search of the World Health Organization trial registry. Two reviewers independently searched, selected and assessed study quality with differences resolved by consensus. Two statisticians independently abstracted and analyzed data, using random or fixed effects models, as appropriate, with inverse variance weighting. Results Of 1,882 studies identified 27 trials were eligible including 2,994, mainly older, men who experienced 180 cardiovascular-related events. Testosterone therapy increased the risk of a cardiovascular-related event (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.09 to 2.18). The effect of testosterone therapy varied with source of funding (P-value for interaction 0.03), but not with baseline testosterone level (P-value for interaction 0.70). In trials not funded by the pharmaceutical industry the risk of a cardiovascular-related event on testosterone therapy was greater (OR 2.06, 95% CI 1.34 to 3.17) than in pharmaceutical industry funded trials (OR 0.89, 95% CI 0.50 to 1.60). Conclusions The effects of testosterone on cardiovascular-related events varied with source of funding. Nevertheless, overall and particularly in trials not funded by the pharmaceutical industry, exogenous testosterone increased the risk of cardiovascular-related events, with corresponding implications for the use of testosterone therapy. PMID:23597181

  7. [Treatment-resistant anxiety disorders: A literature review of drug therapy strategies.

    PubMed

    Ammar, G; Naja, W J; Pelissolo, A

    2014-11-14

    Anxiety disorders are widespread psychiatric conditions with significant social and professional disability, poor quality of life, an increased risk of suicide, and frequent attendance of medical services. Serotonin reuptake inhibitors (SRI) and serotonin and norepinephrine reuptake inhibitors (SNRI) have demonstrated a rather robust efficacy for the treatment of most of anxiety disorders. Nevertheless a substantial number of patients are resistant or still suffer from residual symptoms despite this first line treatment. The objective of our paper is to review relevant studies for the pharmacologic management of anxiety disorders resistant to the first line treatment. For this purpose, we conducted a pubmed/medline search for double-blind placebo-controlled trials of treatment-resistant anxiety disorders. An adequate trial for a SRI in the treatment of obsessive-compulsive disorder (OCD) should continue for at least 12 weeks. Special considerations of the comorbidities and symptom profile could help in the choice of an appropriate pharmacotherapy. Several trials have highlighted the efficacy of antipsychotics as an add-on to SRI in treatment-resistant OCD such as haloperidol more so when comorbid with a tic disorder, or risperidone that can reduce OCD as well as depressive symptoms. Aripiprazole has been shown efficacious in two placebo-controlled double-blind trials, while the efficacy of quetiapine and olanzapine remains controversial. Other trials showed some efficacy of anticonvulsants (lamotrigine, topiramate), pindolol, memantin and N-acetylcystein as an adjunctive treatment to SRI for resistant OCD. Few trials have investigated selective serotonin reuptake inhibitors (SSRI) or SNRI resistant generalized anxiety disorder showing a failure of adjunctive therapy with olanzapine, quetiapine, ziprasidone and risperidone. These studies were underpowered and very limited in number. Adjunctive risperidone for resistant post-traumatic stress disorder (PTSD) showed benefit in some but not all trials. Olanzapine was beneficial for the reduction of the CAPS score in addition to the improvement of sleep disturbances. Furthermore, prazosin was efficacious by reducing PTSD symptoms, sleep disturbances, nightmares, and psychological distress. One double-blind placebo-controlled study was conducted to investigate treatment-resistant social phobia showing no benefit of pindolol add-on paroxetine. Our results demonstrate that the pharmacological management of treatment-resistant anxiety disorders is not sufficiently investigated in double-blind placebo-controlled trials, despite a growing evidence in favor of antipsychotics and some other pharmacological agents in resistant OCD and, to a lesser extent, PTSD. Hence, there is a crucial need for larger double-blind placebo-controlled trials for resistant anxiety disorders. Finally, being out of the scope of our review, we omitted studies of non-pharmacologic therapies. PMID:25439852

  8. Radium-223 dichloride bone-targeted alpha particle therapy for hormone-refractory breast cancer metastatic to bone

    PubMed Central

    2014-01-01

    Background Hormone-refractory breast cancer metastatic to bone is a clinically challenging disease associated with high morbidity, poor prognosis, and impaired quality of life owing to pain and skeletal-related events. In a preclinical study using a mouse model of breast cancer and bone metastases, Ra-223 dichloride was incorporated into bone matrix and inhibited proliferation of breast cancer cells and differentiation of osteoblasts and osteoclasts (all P values?particle therapy for the treatment of symptomatic bone metastases in patients with castration-resistant prostate cancer. On the basis of a strong preclinical rationale, we used Ra-223 dichloride to treat bone metastases in a patient with breast cancer. Results A 44-year-old white woman with metastatic breast cancer who was estrogen receptor–positive, BRCA1-negative, BRCA2-negative, PIK3CA mutation (p.His1047Arg) positive presented with diffuse bony metastases and bone pain. She had hormone refractory and chemotherapy refractory breast cancer. After Ra-223 therapy initiation her bone pain improved, with corresponding decrease in tumor markers and mixed response in 18F-FDG PET/CT and 18F-NaF bone PET/CT. The patient derived clinical benefit from therapy. Conclusion We have shown that Ra-223 dichloride can be safely administered in a patient with hormone-refractory bone metastasis from breast cancer at the US FDA–approved dose for prostate cancer. Furthermore, because the treatment did not cause any drop in hematologic parameters, it has the potential to be combined with other radiosensitizing therapies, which may include chemotherapy or targeted therapies. Given that Ra-223 dichloride is already commercially available, this case report may help future patients and provide a rationale for initiating clinical research in the use of Ra-223 dichloride to treat bone metastasis from breast cancer. A randomized clinical trial is needed to provide evidence of efficacy, safety, and good outcomes. PMID:25243101

  9. Hormonal replacement therapy for postmenopausal women: A review of sexual outcomes and related gynecologic effects

    Microsoft Academic Search

    Mary Walling; Barbara L. Andersen; Susan R. Johnson

    1990-01-01

    The impact of hormonal replacement therapy on sexual behavior and functioning in postmenopausal women was examined. A methodological overview discusses issues of subject characteristics, research design, and the assessment of sexual functioning and related outcomes. Current therapy regimens include estrogen, progestogen, androgen, and combination therapy (e.g., cyclic estrogen and progestogen). With estrogen, significant gynecologic improvement (i.e., reduction in atrophic vaginitis)

  10. Production of low-Z ions in the Dresden superconducting electron ion beam source for medical particle therapy.

    PubMed

    Zschornack, G; Schwan, A; Ullmann, F; Grossmann, F; Ovsyannikov, V P; Ritter, E

    2012-02-01

    We report on experiments with a new superconducting electron beam ion source (EBIS-SC), the Dresden EBIS-SC, with the objective to meet the main requirements for their application in particle-therapy facilities. Synchrotrons as well as innovative accelerator concepts, such as high-gradient linacs which are driven by a large-current cyclotron (CYCLINACS) and direct drive RF linear accelerators may benefit from the advantages of EBISs in regard to their functional principle. First experimental studies of the production of low-Z ions such as H(+), H(2)(+), H(3)(+), C(4+), and C(6+) are presented. Particular attention is paid to the ion output, i.e., the number of ions per pulse and per second, respectively. Important beam parameters in this context are, among others, ion pulse shaping, pulse repetition rates, beam emittance, and ion energy spread. PMID:22380203

  11. Production of low-Z ions in the Dresden superconducting electron ion beam source for medical particle therapy

    SciTech Connect

    Zschornack, G.; Ritter, E. [Dresden University of Technology, Department of Physics, Helmholtzstrasse 10, D-01062 Dresden (Germany); Schwan, A.; Ullmann, F.; Grossmann, F.; Ovsyannikov, V. P. [Dreebit GmbH, Zur Wetterwarte 50, D-01109 Dresden (Germany)

    2012-02-15

    We report on experiments with a new superconducting electron beam ion source (EBIS-SC), the Dresden EBIS-SC, with the objective to meet the main requirements for their application in particle-therapy facilities. Synchrotrons as well as innovative accelerator concepts, such as high-gradient linacs which are driven by a large-current cyclotron (CYCLINACS) and direct drive RF linear accelerators may benefit from the advantages of EBISs in regard to their functional principle. First experimental studies of the production of low-Z ions such as H{sup +}, H{sub 2}{sup +}, H{sub 3}{sup +}, C{sup 4+}, and C{sup 6+} are presented. Particular attention is paid to the ion output, i.e., the number of ions per pulse and per second, respectively. Important beam parameters in this context are, among others, ion pulse shaping, pulse repetition rates, beam emittance, and ion energy spread.

  12. Is manipulative therapy more effective than sham manipulation in adults?: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background Manipulative therapy is widely used in the treatment of spinal disorders. Manipulative techniques are under debate because of the possibility of adverse events. To date, the efficacy of manipulations compared to sham manipulations is unclear. The purpose of the study is: to assess the efficacy of manipulative therapy compared to sham in adults with a variety of complaints. Study design Systematic review and meta-analysis. Methods Bibliographic databases (PubMed, EMBASE, CINAHL, PEDro, Central) along with a hand search of selected bibliographies were searched from inception up to April 2012. Two reviewers independently selected randomized clinical trials (RCTs) that evaluated manipulative therapy compared to sham manipulative therapy in adults, assessed risk of bias and extracted data concerning participants, intervention, kind of sham, outcome measures, duration of follow-up, profession, data on efficacy and adverse events. Pooled (standardized) mean differences or risk differences were calculated were possible using a random effects model. The primary outcomes were pain, disability, and perceived recovery. The overall quality of the body of evidence was evaluated using GRADE. Results In total 965 references were screened for eligibility and 19 RCTs (n?=?1080) met the selection criteria. Eight studies were considered of low risk of bias. There is moderate level of evidence that manipulative therapy has a significant effect in adults on pain relief immediately after treatment (standardized mean difference [SMD] - 0.68, 95% confidence interval (-1.06 to -0.31). There is low level of evidence that manipulative therapy has a significant effect in adults on pain relief (SMD - 0.37, -0.69 to -0.04) at short- term follow-up. In patients with musculoskeletal disorders, we found moderate level of evidence for pain relief (SMD - 0.73, -1.21 to -0.25) immediate after treatment and low level of evidence for pain relief (SMD - 0.52, -0.87 to -0.17) at short term-follow-up. We found very low level of evidence that manipulative therapy has no statistically significant effect on disability and perceived (asthma) recovery. Sensitivity analyses did not change the main findings. No serious adverse events were reported in the manipulative therapy or sham group. Conclusions Manipulative therapy has a clinical relevant effect on pain, but not on disability or perceived (asthma) recovery. Clinicians can refer patients for manipulative therapy to reduce pain. PMID:24274314

  13. Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist.

    PubMed

    Doble, Brett; Tan, Marcus; Harris, Anthony; Lorgelly, Paula

    2015-02-01

    The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics of companion diagnostics into model-based economic evaluations to ensure consistent and transparent reimbursement decisions are made. PMID:25142227

  14. Monitoring of patients treated with particle therapy using positron-emission-tomography (PET): the MIRANDA study

    PubMed Central

    2012-01-01

    Background The purpose of this clinical study is to investigate the clinical feasibility and effectiveness of offline Positron-Emission-Tomography (PET) quality assurance for promoting the accuracy of proton and carbon ion beam therapy. Methods/Design A total of 240 patients will be recruited, evenly sampled among different analysis groups including tumors of the brain, skull base, head and neck region, upper gastrointestinal tract including the liver, lower gastrointestinal tract, prostate and pelvic region. From the comparison of the measured activity with the planned dose and its corresponding simulated activity distribution, conclusions on the delivered treatment will be inferred and, in case of significant deviations, correction strategies will be elaborated. Discussion The investigated patients are expected to benefit from this study, since in case of detected deviations between planned and actual treatment delivery a proper intervention (e.g., correction) could be performed in a subsequent irradiation fraction. In this way, an overall better treatment could be achieved than without any in-vivo verification. Moreover, site-specific patient-population information on the precision of the ion range at HIT might enable improvement of the CT-range calibration curve as well as safe reduction of the treatment margins to promote enhanced treatment plan conformality and dose escalation for full clinical exploitation of the promises of ion beam therapy. Trial Registration NCT01528670 PMID:22471947

  15. Spectroscopy, manipulation and trapping of neutral atoms, molecules, and other particles using optical nanofibers: a review.

    PubMed

    Morrissey, Michael J; Deasy, Kieran; Frawley, Mary; Kumar, Ravi; Prel, Eugen; Russell, Laura; Truong, Viet Giang; Chormaic, Síle Nic

    2013-01-01

    The use of tapered optical fibers, i.e., optical nanofibers, for spectroscopy and the detection of small numbers of particles, such as neutral atoms or molecules, has been gaining interest in recent years. In this review, we briefly introduce the optical nanofiber, its fabrication, and optical mode propagation within. We discuss recent progress on the integration of optical nanofibers into laser-cooled atom and vapor systems, paying particular attention to spectroscopy, cold atom cloud characterization, and optical trapping schemes. Next, a natural extension of this work to molecules is introduced. Finally, we consider several alternatives to optical nanofibers that display some advantages for specific applications. PMID:23945738

  16. Low-Level Laser Therapy in the Treatment of Recurrent Aphthous Ulcers: A Systematic Review

    PubMed Central

    Vale, Fernando Alves; de Almeida, Fernanda Campos Souza

    2015-01-01

    Recurrent aphthous ulcers (RAUs) are the most common lesion found in the oral cavity. There is no definitive cure for RAUs and current treatments are aimed at minimizing symptoms. Since low-level laser therapy (LLLT) modulates inflammatory responses, and promotes pain reduction and cellular biostimulation, LLLT can be suggested as an alternative treatment for RAUs. The literature concerning the potential of LLLT in the treatment of RAUs was evaluated. A systematic literature review identified 22 publications, of which only 2 studies were adopted. The eligibility criteria consisted of randomized controlled trials (RCTs). Both RCTs achieved significant results concerning LLLT and pain-level reductions and reduced healing times. Despite the variance in irradiation conditions applied in both studies, very similar wavelengths were adopted. There is accordingly strong evidence that wavelength plays an important role in RAU treatment. Taking into account the different parameters applied by selected RCTs, it is not possible to suggest that a specific protocol should be used. However, in light of the significant results found in both studies, LLLT can be suggested as an alternative for RAU treatment. Additional RCTs should be performed in order to reach a clinical protocol and better understand the application of LLLT in RAU treatment.

  17. Effects of low-level laser therapy on skeletal muscle repair: a systematic review.

    PubMed

    Alves, Agnelo Neves; Fernandes, Kristianne Porta Santos; Deana, Alessandro Melo; Bussadori, Sandra Kalil; Mesquita-Ferrari, Raquel Agnelli

    2014-12-01

    A review of the literature was performed to demonstrate the most current applicability of low-level laser therapy (LLLT) for the treatment of skeletal muscle injuries, addressing different lasers, irradiation parameters, and treatment results in animal models. Searches were performed in the PubMed/MEDLINE, SCOPUS, and SPIE Digital Library databases for studies published from January 2006 to August 2013 on the use of LLLT for the repair of skeletal muscle in any animal model. All selected articles were critically appraised by two independent raters. Seventeen of the 36 original articles on LLLT and muscle injuries met the inclusion criteria and were critically evaluated. The main effects of LLLT were a reduction in the inflammatory process, the modulation of growth factors and myogenic regulatory factors, and increased angiogenesis. The studies analyzed demonstrate the positive effects of LLLT on the muscle repair process, which are dependent on irradiation and treatment parameters. The findings suggest that LLLT is an excellent therapeutic resource for the treatment of skeletal muscle injuries in the short-term. PMID:25122099

  18. Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients

    PubMed Central

    Garland, Sheila N; Johnson, Jillian A; Savard, Josee; Gehrman, Philip; Perlis, Michael; Carlson, Linda; Campbell, Tavis

    2014-01-01

    Individuals with cancer are disproportionately affected by sleep disturbance and insomnia relative to the general population. These problems can be a consequence of the psychological, behavioral, and physical effects of a cancer diagnosis and treatment. Insomnia often persists for years and, when combined with already high levels of cancer-related distress, may place cancer survivors at a higher risk of future physical and mental health problems and poorer quality of life. The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), a non-pharmacological treatment that incorporates cognitive and behavior-change techniques and targets dysfunctional attitudes, beliefs, and habits involving sleep. This article presents a comprehensive review of the literature examining the efficacy of CBT-I on sleep and psychological outcomes in cancer patients and survivors. The search revealed 12 studies (four uncontrolled, eight controlled) that evaluated the effects of CBT-I in cancer patients or survivors. Results suggest that CBT-I is associated with statistically and clinically significant improvements in subjective sleep outcomes in patients with cancer. CBT-I may also improve mood, fatigue, and overall quality of life, and can be successfully delivered through a variety of treatment modalities, making it possible to reach a broader range of patients who may not have access to more traditional programs. Future research in this area should focus on the translation of evidence into clinical practice in order to increase awareness and access to effective insomnia treatment in cancer care. PMID:24971014

  19. A Review of Gene Delivery and Stem Cell Based Therapies for Regenerating Inner Ear Hair Cells

    PubMed Central

    Devarajan, Keerthana; Staecker, Hinrich; Detamore, Michael S.

    2011-01-01

    Sensory neural hearing loss and vestibular dysfunction have become the most common forms of sensory defects, affecting millions of people worldwide. Developing effective therapies to restore hearing loss is challenging, owing to the limited regenerative capacity of the inner ear hair cells. With recent advances in understanding the developmental biology of mammalian and non-mammalian hair cells a variety of strategies have emerged to restore lost hair cells are being developed. Two predominant strategies have developed to restore hair cells: transfer of genes responsible for hair cell genesis and replacement of missing cells via transfer of stem cells. In this review article, we evaluate the use of several genes involved in hair cell regeneration, the advantages and disadvantages of the different viral vectors employed in inner ear gene delivery and the insights gained from the use of embryonic, adult and induced pluripotent stem cells in generating inner ear hair cells. Understanding the role of genes, vectors and stem cells in therapeutic strategies led us to explore potential solutions to overcome the limitations associated with their use in hair cell regeneration. PMID:24956306

  20. A Review of the Most Promising Biomarkers in Colorectal Cancer: One Step Closer to Targeted Therapy

    PubMed Central

    Baay, Marc; Specenier, Pol; Lardon, Filip; Vermorken, Jan B.

    2010-01-01

    Rapidly growing insights into the molecular biology of colorectal cancer (CRC) and recent developments in gene sequencing and molecular diagnostics have led to high expectations for the identification of molecular markers to be used in optimized and tailored treatment regimens. However, many of the published data on molecular biomarkers are contradictory in their findings and the current reality is that no molecular marker, other than the KRAS gene in the case of epidermal growth factor receptor (EGFR)- targeted therapy for metastatic disease, has made it into clinical practice. Many markers investigated suffer from technical shortcomings, resulting from lack of quantitative techniques to capture the impact of the molecular alteration. This understanding has recently led to the more comprehensive approaches of global gene expression profiling or genome-wide analysis to determine prognostic and predictive signatures in tumors. In this review, an update of the most recent data on promising biological prognostic and/or predictive markers, including microsatellite instability, epidermal growth factor receptor, KRAS, BRAF, CpG island methylator phenotype, cytotoxic T lymphocytes, forkhead box P3–positive T cells, receptor for hyaluronic acid–mediated motility, phosphatase and tensin homolog, and T-cell originated protein kinase, in patients with CRC is provided. PMID:20584808

  1. Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression

    PubMed Central

    Gross, Anita R; Dziengo, Stephanie; Boers, Olga; Goldsmith, Charlie H; Graham, Nadine; Lilge, Lothar; Burnie, Stephen; White, Roger

    2013-01-01

    Purpose: This systematic review update evaluated low level laser therapy (LLLT) for adults with neck pain. Methods: Computerized searches (root up to Feb 2012) included pain, function/disability, quality of life (QoL) and global perceived effect (GPE). GRADE, effect-sizes, heterogeneity and meta-regression were assessed. Results: Of 17 trials, 10 demonstrated high risk of bias. For chronic neck pain, there was moderate quality evidence (2 trials, 109 participants) supporting LLLT over placebo to improve pain/disability/QoL/GPE up to intermediate-term (IT). For acute radiculopathy, cervical osteoarthritis or acute neck pain, low quality evidence suggested LLLT improves ST pain/function/QoL over a placebo. For chronic myofascial neck pain (5 trials, 188 participants), evidence was conflicting; a meta-regression of heterogeneous trials suggests super-pulsed LLLT increases the chance of a successful pain outcome. Conclusions: We found diverse evidence using LLLT for neck pain. LLLT may be beneficial for chronic neck pain/function/QoL. Larger long-term dosage trials are needed. PMID:24155802

  2. Stem cell-based therapy for treating limbal stem cells deficiency: A review of different strategies

    PubMed Central

    He, Hong; Yiu, Samuel C.

    2014-01-01

    The self renewal capability of limbal epithelial stem (LEST) cells is fundamental to the maintenance and healing of corneal epithelium. Limbal stem cell deficiency (LSCD), due to dysfunction or loss of LEST cells, therefore presents as persistent epithelial defects, corneal vascularization, conjunctivalization etc. Stem cell-based therapy, in its simplest form – limbal autograft, has been used successfully for more than a decade. For bilateral LSCD, similar approaches with limbal allografts have been unsuccessful largely due to strong immune rejection. Therefore, as an alternate strategy for treating bilateral LSCD, ex vivo expansion of the remaining LEST cells or autologous stem cells sourced from other potential sites is being explored. Different culture systems (with and without xenobiotic supplements) using substrates like amniotic membrane or fibrin gels have been used successfully for ex vivo LEST cell maintenance and reproduction by imitating the stem cell niche. This paper is organized into sections reviewing the LEST cells, LSCD and various stem cell-based approaches for treating LSCD and discussing future direction and challenges. PMID:25278795

  3. Systemic glucocorticoid therapy: a review of its metabolic and cardiovascular adverse events.

    PubMed

    Fardet, Laurence; Fève, Bruno

    2014-10-01

    The prevalence of use of long-term systemic glucocorticoid therapy in the general adult population is 1 %. This figure increases to up to 3 % in elderly women. Metabolic (i.e. diabetes mellitus, dyslipidemia, weight gain, lipodystrophy) and cardiovascular (i.e. hypertension, cardiovascular events) adverse events are commonly observed in these patients and can be life threatening. Paradoxically, there is very few data on some of these adverse events and many of the available studies remain inconclusive. Incidence of and risk factors for dyslipidemia, weight gain and lipodystrophy are poorly defined. The optimal treatment plan for patients diagnosed with glucocorticoid-induced diabetes or hypertension is undetermined. Finally, there is no medical consensus on the best strategies for the prevention and detection of these complications. However, certain of these questions can be answered by looking at available data on patients with endogenous hypercortisolism (i.e. Cushing's syndrome). This article reviews the pathophysiology, incidence, risk factors, screening, and treatment of glucocorticoid-induced weight gain, lipodystrophy, diabetes, dyslipidemia, hypertension, and cardiovascular events. It also focuses on the possible prevention of these adverse events by targeting the glucocorticoid receptor using selective glucocorticoid receptor modulators. PMID:25204470

  4. Goeckerman Therapy for the Treatment of Eczema: A Practical Guide and Review of Efficacy

    PubMed Central

    Dennis, Madison; Bhutani, Tina; Koo, John; Liao, Wilson

    2013-01-01

    The Goeckerman regimen, consisting of the application of crude coal tar combined with exposure to ultraviolet radiation, was formulated in 1925 for the treatment of psoriasis. While some centers have adapted the Goeckerman regimen for the treatment of eczema, there are no published reports of its efficacy in this condition. Here, we explain how the Goeckerman regimen has been modified for use in an eczema population at the University of California San Francisco (UCSF). We reviewed the treatment records of eczema patients treated with the modified Goeckerman regimen over a 6 year period at UCSF. We found that the Goeckerman regimen was effective in treating patients with severe baseline disease, inducing a mean remission period of 7.2 months. The treatment was tolerated well with mild folliculitis and occasional UVB phototoxicity noted as the only adverse reactions. Since the use of Goeckerman as a treatment for severe eczema is both effective and safe, it should be considered an excellent alternative or adjunct to the systemic therapies currently being used. PMID:21797807

  5. A Comprehensive Review of Head and Neck Cancer Rehabilitation: Physical Therapy Perspectives

    PubMed Central

    Guru, Karthikeyan; Manoor, Udaya Kumar; Supe, Sanjay Sudhakar

    2012-01-01

    Rehabilitation in relation to cancer can be preventative, restorative, supportive, and palliative. It is recognized that patients may have rehabilitation needs throughout their care pathway. The role of physiotherapy in the cancer rehabilitation is less understood and particularly in the head and neck cancer (HNC) patients. This results in various residual deformities and dysfunctions for the patients with HNC. The objective of this review is to provide detailed information regarding the problems faced after the cancer treatments and rehabilitation of patients who suffered with HNC. The fact that cancer patients are facing several months of chemotherapy and/or radiotherapy and usually major surgery, as well as the direct effect of immobility due to pain, means that muscle wasting, joint stiffness, as well as de-conditioning and fatigue are inevitable. The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life. Following any treatment for HNC, physical therapy may play an essential role in preventing various complications and helping patients to mitigate impairments, and restoring function of the shoulder joint, neck, and face. PMID:23093823

  6. Shine on: Review of Laser- and Light-Based Therapies for the Treatment of Burn Scars

    PubMed Central

    Hultman, C. Scott; Edkins, Renee E.; Lee, Clara N.; Calvert, Catherine T.; Cairns, Bruce A.

    2012-01-01

    Restoration of form and function after burn injury remains challenging, but emerging laser and pulsed light technologies now offer hope for patients with hypertrophic scars, which may be associated with persistent hyperemia, chronic folliculitis, intense pruritis, and neuropathic pain. In addition to impairing body image, these scars may limit functional recovery, compromise activities of daily living, and prevent return to work. Three different platforms are now poised to alter our reconstructive algorithm: (1) vascular-specific pulsed dye laser (PDL) to reduce hyperemia, (2) ablative fractional CO2 laser to improve texture and pliability of the burn scar, and (3) intense pulsed light (IPL) to correct burn scar dyschromia and alleviate chronic folliculitis. In this paper, we will provide an overview of our work in this area, which includes a systematic review, a retrospective analysis of our preliminary experience, and interim data from our on-going, prospective, before-after cohort trial. We will demonstrate that laser- and light-based therapies can be combined with each other safely to yield superior results, often at lower cost, by reducing the need for reconstructive surgery. Modulating the burn scar, through minimally invasive modalities, may replace conventional methods of burn scar excision and yield outcomes not previously possible or conceivable. PMID:22778719

  7. [Further aspects of combination antibiotic therapy. Critical review and personal case studies].

    PubMed

    Sorice, F; Ortona, L; Pizzigallo, E

    1975-09-01

    A brief account of the aims sought by multiple antibiotic management is followed by an assessment of the antagonism and synergism displayed by associations of two bactericidal antibiotics, two bacteriostatic antibiotics, and one bactericidal and one bacteriostatic antibiotic. Instances of synergism between bactericides (particularly penicillins and aminosides) are mentioned. Stress is laid on recent studies on the mechanism of action of antibacterial drugs showing unmistakeable synergism between trimethoprim and sulphamethoxazol and between chloramphenicol and tetracycline. The antagonism between bactericides and bacteriostatics noted by Jawetz et Al. has not been confirmed clinically in a number of reported series. The main indications for combined antiobiotic therapy are reviewed: endocarditis, purulent meningitis, staphylococcia, brucellosis, salmonellosis, shigellosis, other Gram-negative infections and fever in the course of blood diseases. References is made to personal experience in the management of 35 cases of bacterial endocarditis, 15 cases of purulent meningitis and various forms of serious Gram-negative infection. Leaving aside exceptional cases, the clinical effects of antibiotic associations are uncertain and influenced by too many variables. The technique is still of importance, however, despite the introduction of many new antibiotics. It must not be thought of as a handy method for indiscriminate use, however; its indications (which are summarised) are quite clear. PMID:1161172

  8. Active targeted therapy for metastatic collecting duct carcinoma of the kidney: a case report and review of the literature.

    PubMed

    Zhao, Rui-ning; Nie, Li-hong; Gong, Rui; Wang, Jian-zhong; Wazir, Romel; Liu, Liang-ren; Song, Tu-run; Wei, Qiang

    2013-08-01

    Collecting duct carcinoma (CDC) is a rare and aggressive renal cell carcinoma (RCC) with extremely poor prognosis, which has been shown to have a poor response to several kinds of systemic therapy. Targeted agents have greatly changed the therapeutic landscape in advanced RCC. Nonetheless, patients with CDC are always excluded from the prospective trials with targeted therapies due to its rarity. We present a case of metastatic CDC that responded favorably to the multiple tyrosine kinase inhibitor, sorafenib, achieving a partial response in both lungs and retroperitoneal lymph nodes metastases. We also reviewed the limited number of reports of metastatic CDC treated with targeted agents and found that 33.33 % (4/12) of patients had favorable clinical activity. These suggest that targeted therapy should be considered for the treatment of metastatic CDC and its prospective evaluation is encouraged. PMID:23686671

  9. A Review of Intraoperative Goal-Directed Therapy Using Arterial Waveform Analysis for Assessment of Cardiac Output

    PubMed Central

    Fernandez-Bustamante, Ana

    2014-01-01

    Increasing evidence shows that goal-directed hemodynamic management can improve outcomes in surgical and intensive care settings. Arterial waveform analysis is one of the different techniques used for guiding goal-directed therapy. Multiple proprietary systems have developed algorithms for obtaining cardiac output from an arterial waveform, including the FloTrac, LiDCO, and PiCCO systems. These systems vary in terms of how they analyze the arterial pressure waveform as well as their requirements for invasive line placement and calibration. Although small-scale clinical trials using these monitors show promising data, large-scale multicenter trials are still needed to better determine how intraoperative goal-directed therapy with arterial waveform analysis can improve patient outcomes. This review provides a comparative analysis of the different arterial waveform monitors for intraoperative goal-directed therapy. PMID:24987744

  10. Single particle and ensemble spectroscopy of conjugated polymer nanoparticles and their development for photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Grimland, Jennifer L.

    Energy transport in conjugated polymers is the combination of energy transfer and exciton diffusion. There is considerable ongoing research in this field, converging to develop better organic photovoltaics, polymer light emitting diodes (PLEDs) and organic solar cells, to name a few. One way these phenomena can be explored is by doing solution dependent studies on conjugated polymer nanoparticles. With experiments on CP dots in an aqueous solution and the addition of a water miscible organic solvent in varying concentrations, dynamics occurring in the folding process can be better understood, and also exciton and fluorescence quenching properties can be extracted as a function of nanoparticle collapse. Steady state and time resolved fluorescence measurements were taken for two types of CP dots in bulk solution under varying solvent environments, including quantum yield, photobleaching and reversible photobleaching. The time-domain technique of time-correlated single photon counting (TCSPC) was used to determine excited state lifetimes and fluorescent decay traces. Simulating the TCSPC data provides insight on the relative number of quenchers that are observed by the polymer in each environment. In addition, single molecule fluorescence spectroscopy measurements were done on CP dots under varying solvent vapor atmospheres. Using the phenomenon of energy transfer, we have proven that doping the singlet oxygen photosensitizer tetraphenylporphyrin (TPP) into our conjugated polymer nanoparticles acts as an efficient and powerful photosensitizer for photodynamic therapy. The nanoparticles exhibit highly efficient collection of excitation light due to the large excitation cross-section of the polymer. A quantum efficiency of 0.5 was determined. Extraordinarily large cross-sections for two-photon absorption were found which is promising for near infrared multiphoton photodynamic therapy, and gel electrophoresis of DNA after irradiation in the presence of CP dots indicated extensive purine base and backbone DNA damage.

  11. A review of measurements and numerical studies for the effect of wall roughness on the gas-particle flow behavior

    NASA Astrophysics Data System (ADS)

    Zhou, Lixing

    2014-04-01

    In earlier studies of gas-particle flows the effect of wall roughness was not taken into account. The present author and his colleagues did detailed PDPA measurements and numerical studies for the effect of wall roughness on the gas-particle flow behavior. This paper gives a review of our studies, showing the following results. The PDPA measurements of backward-facing step gas-particle flows shows that as the wall roughness increases, the longitudinal and transverse particle fluctuation velocities increase. The numerical simulation of swirling gas-particle flows shows that the simulation results accounting for the wall roughness agree well with the measurement results. The numerical simulation of gas-particle channel flows indicates the increase of particle fluctuation velocity with increasing wall roughness.

  12. Economic Evaluation of Pharmaco- and Behavioral Therapies for Smoking Cessation: A Critical and Systematic Review of Empirical Research

    PubMed Central

    Ruger, Jennifer Prah; Lazar, Christina M.

    2014-01-01

    Economic evaluations are an important tool to improve our understanding of the costs and effects of health care services and to create sustainable health care systems. This article critically assesses empirical evidence from economic evaluations of pharmaco- and behavioral therapies for smoking cessation. A comprehensive literature review of PubMed and the British National Health Service Economic Evaluation Database was conducted. The search identified 15 articles on nicotine-based pharmacotherapies, 12 articles on nonnicotine based pharmacotherapies, no articles on selegiline, and 10 articles on brief counseling for smoking cessation treatment. Results show that both pharmaco- and behavioral therapies for smoking cessation are cost-effective or even cost-saving. The review highlights several shortcomings in methodology and a lack of standardization of current economic evaluations. Efforts to improve methodology will help make future studies more comparable and increase the evidence base so that such evaluations can be more useful to public health practitioners and policy makers. PMID:22224889

  13. The effects of oscillating positive expiratory pressure therapy in adults with stable non-cystic fibrosis bronchiectasis: A systematic review.

    PubMed

    Lee, Annemarie L; Williamson, Hannah C; Lorensini, Sarah; Spencer, Lissa M

    2015-02-01

    Airway clearance techniques (ACTs) are recommended for patients with stable non-cystic fibrosis (non-CF) bronchiectasis, but the efficacy of oscillating positive expiratory pressure (PEP) therapy compared to other techniques has not been reviewed. A systematic review of studies was conducted in stable patients comparing the effect of oscillating PEP therapy to other ACTs or a control condition. Data were extracted related to sputum expectoration, lung function, gas exchange, quality of life (QOL), symptoms, and exacerbation rate. Seven studies were included with a total of 146 patients, with a mean (SD) PEDro score of 7(1). Oscillating PEP therapy enhanced sputum expectoration compared to no treatment, but has equivalent benefits as the active cycle of breathing technique with gravity-assisted drainage (mean difference [95% CI] -2.8 g [-8.8 to 3.2 g]). Oscillating PEP has a similar effect as other ACTs on dynamic lung volumes, gas exchange and breathlessness. Use of oscillating PEP improved disease-specific QOL (p < 0.001) and cough-related QOL (p < 0.002) compared to no treatment but did not reduce exacerbation rate. In conclusion, in stable non-CF bronchiectasis, oscillating PEP therapy is associated with improvement in sputum expectoration and QOL compared to no treatment. Compared to other ACTs, the effect upon sputum expectoration, lung function, gas exchange, and symptoms are equivalent. PMID:25518845

  14. Pharmacokinetic drug interactions with clopidogrel: updated review and risk management in combination therapy

    PubMed Central

    Wang, Zhi-Yu; Chen, Meng; Zhu, Ling-Ling; Yu, Lu-Shan; Zeng, Su; Xiang, Mei-Xiang; Zhou, Quan

    2015-01-01

    Background Coprescribing of clopidogrel and other drugs is common. Available reviews have addressed the drug–drug interactions (DDIs) when clopidogrel is as an object drug, or focused on combination use of clopidogrel and a special class of drugs. Clinicians may still be ignorant of those DDIs when clopidogrel is a precipitant drug, the factors determining the degree of DDIs, and corresponding risk management. Methods A literature search was performed using PubMed, MEDLINE, Web of Science, and the Cochrane Library to analyze the pharmacokinetic DDIs of clopidogrel and new P2Y12 receptor inhibitors. Results Clopidogrel affects the pharmacokinetics of cerivastatin, repaglinide, ferulic acid, sibutramine, efavirenz, and omeprazole. Low efficacy of clopidogrel is anticipated in the presence of omeprazole, esomeprazole, morphine, grapefruit juice, scutellarin, fluoxetine, azole antifungals, calcium channel blockers, sulfonylureas, and ritonavir. Augmented antiplatelet effects are anticipated when clopidogrel is coprescribed with aspirin, curcumin, cyclosporin, St John’s wort, rifampicin, and angiotensin-converting enzyme inhibitors. The factors determining the degree of DDIs with clopidogrel include genetic status (eg, cytochrome P540 [CYP]2B6*6, CYP2C19 polymorphism, CYP3A5*3, CYP3A4*1G, and CYP1A2-163C.A), species differences, and dose strength. The DDI risk does not exhibit a class effect, eg, the effects of clopidogrel on cerivastatin versus other statins, the effects of proton pump inhibitors on clopidogrel (omeprazole, esomeprazole versus pantoprazole, rabeprazole), the effects of rifampicin on clopidogrel versus ticagrelor and prasugrel, and the effects of calcium channel blockers on clopidogrel (amlodipine versus P-glycoprotein-inhibiting calcium channel blockers). The mechanism of the DDIs with clopidogrel involves modulating CYP enzymes (eg, CYP2B6, CYP2C8, CYP2C19, and CYP3A4), paraoxonase-1, hepatic carboxylesterase 1, P-glycoprotein, and organic anion transporter family member 1B1. Conclusion Effective and safe clopidogrel combination therapy can be achieved by increasing the awareness of potential changes in efficacy and toxicity, rationally selecting alternatives, tailoring drug therapy based on genotype, checking the appropriateness of physician orders, and performing therapeutic monitoring.

  15. Topical therapies for oral lichen planus management and their efficacy: a narrative review.

    PubMed

    Bagan, José; Compilato, Domenico; Paderni, Carlo; Campisi, Giuseppina; Panzarella, Vera; Picciotti, Maria; Lorenzini, Guido; Di Fede, Olga

    2012-01-01

    Oral Lichen Planus (OLP) is a chronic inflammatory condition implicating T cell-mediated cytotoxicity, and involving oral mucosal surfaces. Several therapeutic regimens have been evaluated to treat OLP and pain related, but often without high level of evidence. Topical formulations are the favourite for the majority of cases; bioadhesive formulations have been considered very useful and practical for local drug delivery in oral mucosa, due to the increased residence time on the oral mucosa of the dosage forms and better therapeutic efficacy. In this narrative review, authors try to illustrate the current topical managements for OLP from the accessible literature on this topic. Steroids are very helpful in discomfort and making better quality of life: they are considered the first-line treatment even if they could cause secondary candidosis, and sometimes bad taste, nausea, dry mouth, sore throat or swollen mouth. Other substances or devices by topical administration are adopted especially when the first line approach is refractory. This is the case when retinol with its synthetic and natural analogues (retinoids), hyaluronic acid, or Aloe Vera are chosen. Recent topical applications for OLP therapy include phototherapy and low/high energy pulsing light; the treatment with extracorporeal photochemotherapy is also reasonable and promising. Finally, calcineurin inhibitors (i.e. cyclosporine, tacrolimus and pimecrolimus), antioxidant and biologics (i.e alefacept, efalizumab, basiliximab, TNF-? inhibitors - infliximab, rituximab) may be alternative approaches when OLP does not respond to the standard protocols. In this scenario, there are several studies on molecules different from glucocorticosteroids, but not sufficient or statistically adequate to justify their evidence-based use in OLP; large randomized placebo controlled trials are required to evaluate the safety and effectiveness of these non conventional therapies. In conclusion, since OLP is a chronic disease and requires long-term management, the dental/medical practitioner, who treats OLP patients, needs to know the natural history of OLP, how to monitor, and how to treat, taking in account all of the available modalities conventional and not, with pros and cons. PMID:22632394

  16. The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review.

    PubMed

    Barlow, Timothy; Downham, Christopher; Barlow, David

    2013-10-01

    Ambulatory knee surgery is a common procedure with over 100,000 knee arthroscopies performed in the U.K. in 2010-2011. Pain after surgery can decrease patient satisfaction, delay discharge, and decrease cost effectiveness. Multi-modal therapies, including complementary therapies, to improve pain control after surgery have been recommended. However, a comprehensive review of the literature regarding the use of complementary therapies to enhance pain control after ambulatory knee surgery is lacking, and this article aims to address this deficit. CINHAL, EMBASE, MEDLINE, AMED and CENTRAL databases were searched. Only Randomised Controlled Trials were included. All eligible papers were quality assessed using the Jadad system, and data was extracted using piloted forms. Two independent reviewers performed each stage of the review. Full details of the study methodology can be found on Prospero, a systematic review register. Five studies satisfied our eligibility criteria: three reporting on acupuncture, one on homeopathy, and one on acupoints. Acupoint pressure was the only study that demonstrated reduced pain compared with placebo. This study was the least methodologically robust. Arnica, although demonstrating a significant reduction in swelling, did not affect post-operative pain. Acupuncture did not affect post-operative pain; however, a reduction in ibuprofen use was demonstrated in two studies. Before recommending complementary therapy for routine use in ambulatory knee surgery, further work is required. Two areas of future research likely to bear fruit are demonstrating robust evidence for the effect of acupoint pressure on post-operative pain, and quantifying the positive effect of homeopathic arnica on post-operative swelling. PMID:24050592

  17. Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials

    Microsoft Academic Search

    Lynn Legg; Avril Drummond; Jo Leonardi-Bee; J R F Gladman; Susan Corr; Mireille Donkervoort; Judi Edmans; Louise Gilbertson; Lyn Jongbloed; Pip Logan; Catherine Sackley; Marion Walker; Peter Langhorne

    2007-01-01

    Objective To determine whether occupational therapy focused specifically on personal activities of daily living improves recovery for patients after stroke.Design Systematic review and meta-analysis.Data sources The Cochrane stroke group trials register, the Cochrane central register of controlled trials, Medline, Embase, CINAHL, PsycLIT, AMED, Wilson Social Sciences Abstracts, Science Citation Index, Social Science Citation, Arts and Humanities Citation Index, Dissertations Abstracts

  18. E-therapy in the treatment and prevention of eating disorders: A systematic review and meta-analysis

    PubMed Central

    Loucas, Christina E.; Fairburn, Christopher G.; Whittington, Craig; Pennant, Mary E.; Stockton, Sarah; Kendall, Tim

    2014-01-01

    The widespread availability of the Internet and mobile-device applications (apps) is changing the treatment of mental health problems. The aim of the present study was to review the research on the effectiveness of e-therapy for eating disorders, using the methodology employed by the UK's National Institute for Health and Care Excellence (NICE). Electronic databases were searched for published randomised controlled trials of e-therapies, designed to prevent or treat any eating disorder in all age groups. Studies were meta-analysed where possible, and effect sizes with confidence intervals were calculated. The GRADE approach was used to determine the confidence in the effect estimates. Twenty trials met the inclusion criteria. For prevention, a CBT-based e-intervention was associated with small reductions in eating disorder psychopathology, weight concern and drive for thinness, with moderate confidence in the effect estimates. For treatment and relapse prevention, various e-therapies showed some beneficial effects, but for most outcomes, evidence came from single studies and confidence in the effect estimates was low. Overall, although some positive findings were identified, the value of e-therapy for eating disorders must be viewed as uncertain. Further research, with improved methods, is needed to establish the effectiveness of e-therapy for people with eating disorders. PMID:25461787

  19. E-therapy in the treatment and prevention of eating disorders: A systematic review and meta-analysis.

    PubMed

    Loucas, Christina E; Fairburn, Christopher G; Whittington, Craig; Pennant, Mary E; Stockton, Sarah; Kendall, Tim

    2014-10-01

    The widespread availability of the Internet and mobile-device applications (apps) is changing the treatment of mental health problems. The aim of the present study was to review the research on the effectiveness of e-therapy for eating disorders, using the methodology employed by the UK's National Institute for Health and Care Excellence (NICE). Electronic databases were searched for published randomised controlled trials of e-therapies, designed to prevent or treat any eating disorder in all age groups. Studies were meta-analysed where possible, and effect sizes with confidence intervals were calculated. The GRADE approach was used to determine the confidence in the effect estimates. Twenty trials met the inclusion criteria. For prevention, a CBT-based e-intervention was associated with small reductions in eating disorder psychopathology, weight concern and drive for thinness, with moderate confidence in the effect estimates. For treatment and relapse prevention, various e-therapies showed some beneficial effects, but for most outcomes, evidence came from single studies and confidence in the effect estimates was low. Overall, although some positive findings were identified, the value of e-therapy for eating disorders must be viewed as uncertain. Further research, with improved methods, is needed to establish the effectiveness of e-therapy for people with eating disorders. PMID:25461787

  20. Psychological Therapies in Patients with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Altayar, Osama; Prokop, Larry J.; Sood, Amit; Murad, Mohammad Hassan

    2015-01-01

    Background. Irritable bowel syndrome (IBS) is a poorly understood disease with few effective treatments. Psychosocial factors are believed to contribute to the pathogenesis of IBS. Objective. To evaluate the evidence for psychological therapies in IBS treatment. Methods. We searched six medical databases through February 6, 2014, for randomized controlled trials (RCTs) of psychological therapies for the treatment of IBS. Two independent reviewers identified the RCTs, extracted the data, and assessed trial quality. We used the random-effect model to pool standardized mean difference (SMD) and 95% confidence interval (CI) across trials. Results. 15 RCTs that mostly evaluated cognitive behavioral therapy were included. Psychological therapies were associated with improvement in IBS symptoms severity scales (SMD ?0.618; 95% CI: ?0.853 to ?0.383), IBS-Quality of Life (SMD 0.604; 95% CI: 0.440 to 0.768), and abdominal pain (SMD ?0.282; 95% CI: ?0.562 to ?0.001). No statistically significant effect was observed on diarrhea or constipation. Limitations. The trials were at increased risk of bias and the overall sample size was small leading to imprecision. Conclusion. Psychological therapies may improve the quality of life and symptom severity in IBS. The effect size noted is moderate to large and is clinically meaningful. PMID:25802514

  1. Stem Cells, Cell Therapies, and Bioengineering in Lung Biology and Diseases. Comprehensive Review of the Recent Literature 2010–2012

    PubMed Central

    2013-01-01

    A conference, “Stem Cells and Cell Therapies in Lung Biology and Lung Diseases,” was held July 25 to 28, 2011 at the University of Vermont to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are rapidly expanding areas of study that provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, to discuss and debate current controversies, and to identify future research directions and opportunities for basic and translational research in cell-based therapies for lung diseases. The goal of this article, which accompanies the formal conference report, is to provide a comprehensive review of the published literature in lung regenerative medicine from the last conference report through December 2012. PMID:23869446

  2. Systematic Review and Meta-Analysis of Combination Therapy with Cholinesterase Inhibitors and Memantine in Alzheimer's Disease and Other Dementias

    PubMed Central

    Muayqil, Taim; Camicioli, Richard

    2012-01-01

    Background N-methyl-D-aspartic acid antagonists (memantine) and cholinesterase inhibitors (ChEIs) are the only two approved classes of drugs to treat dementia; this paper explores the evidence for using these two treatments in combination. Objective To determine the efficacy and safety of using combination therapy with memantine and a ChEI to treat dementia in comparison to monotherapy with either memantine or a ChEI. Methods In March 2012, we systematically searched MEDLINE/PubMed, EMBASE, Cochrane library, and grey literature databases. All study types were included, except for case series or reports, which looked at combination therapy versus monotherapy in various dementing disorders. Data was pooled for blinded randomized controlled trials (RCTs) only; mean differences and standardized mean differences were used to determine effect sizes. Results Thirteen studies were included in this review; 3 were blinded RCTs, with a total of 971 Alzheimer's disease (AD) patients, which were included into the meta-analysis. No papers were found that primarily addressed combination therapy in other dementias. In the meta-analysis, small but statistically significant effect sizes were seen in favor of combination therapy among patients with moderate to severe AD on the scales of cognition (0.45–0.52; p < 0.0001), scales of functional outcomes (0.23–0.3; p < 0.01), and the neuropsychiatric inventory (3.7–4.4; p < 0.0001). Among the open-label studies, 3 out of 6 suggested benefits, as did the 4 included cohort studies. However, the high risk of bias encountered in the latter two study designs limits deducing any conclusions about benefit. Conclusion Although there were statistically significant changes in favor of combination therapy in moderate to severe AD, heterogeneity in scales and patient characteristics exists. However, it is unclear if clinically significant outcomes can be achieved using the combination therapy. More studies are required before a recommendation for combination therapy can be made. PMID:23277787

  3. A review of microfabrication techniques and dielectrophoretic microdevices for particle manipulation and separation

    NASA Astrophysics Data System (ADS)

    Li, M.; Li, W. H.; Zhang, J.; Alici, G.; Wen, W.

    2014-02-01

    The development of lab-on-a-chip (LOC) devices over the past decade has attracted growing interest. LOC devices aim to achieve the miniaturization, integration, automation and parallelization of biological and chemical assays. One of the applications, the ability to effectively and accurately manipulate and separate micro- and nano-scale particles in an aqueous solution, is particularly appealing in biological, chemical and medical fields. Among the technologies that have been developed and implemented in microfluidic microsystems for particle manipulation and separation (such as mechanical, inertial, hydrodynamic, acoustic, optical, magnetic and electrical methodologies), dielectrophoresis (DEP) may prove to be the most popular because of its label-free nature, ability to manipulate neutral bioparticles, analyse with high selectivity and sensitivity, compatibility with LOC devices, and easy and direct interface with electronics. The required spatial electric non-uniformities for the DEP effect can be generated by patterning microelectrode arrays within microchannels, or placing insulating obstacles within a microchannel and curving the microchannels. A wide variety of electrode- and insulator-based DEP microdevices have been developed, fabricated, and successfully employed to manipulate and separate bioparticles (i.e. DNA, proteins, bacteria, viruses, mammalian and yeast cells). This review provides an overview of the state-of-the-art of microfabrication techniques and of the structures of dielectrophoretic microdevices aimed towards different applications. The techniques used for particle manipulation and separation based on microfluidics are provided in this paper. In addition, we also present the theoretical background of DEP.

  4. Cognitive Behavioral Therapy in High-Functioning Autism: Review and Recommendations for Treatment Development

    Microsoft Academic Search

    Jeffrey J. Wood; Cori Fujii; Patricia Renno

    \\u000a Individuals with autism spectrum disorders (ASDs) who have acquired functional communication strategies – particularly more\\u000a cognitively able individuals at or beyond the elementary school age group – may be candidates for talk-based therapies similar\\u000a to those employed with children and adults with mental health disorders, such as anxiety (e.g., cognitive behavioral therapy,\\u000a CBT). While talk-based therapies are widely used in

  5. Low-level laser therapy for orthodontic pain: a systematic review.

    PubMed

    Li, F J; Zhang, J Y; Zeng, X T; Guo, Y

    2014-09-26

    This review aimed to evaluate the clinical outcome of different lasers management on orthodontic pain. Cochrane Library (Issue 7, 2014) and MEDLINE (1966-2014.7) were searched to collect randomized controlled trials on lasers for orthodontic pain. Studies meeting the inclusion criteria were systematically evaluated. The Cochrane Collaboration tools RevMan5.1.7 and GRADEpro 3.6 were used in this systematic review and meta-analysis. As a result, 11 randomized controlled trials (RCTs) studying on low-level laser therapy (LLLT) for orthodontic pain control were included. Meta-analysis and risk of bias assessment were implemented using RevMan5.1.7, and level of evidence assessments was measured by GRADEpro 3.6. In the outcome of the score of the most painful day, the comparison of laser versus placebo (pain associated with tooth movement) demonstrated that LLLT reduced the pain score significantly compared with placebo groups (MD?=?-4.39, 95 % CI range -5.9--2.88, P?

  6. What Is the Evidence for Physical Therapy Poststroke? A Systematic Review and Meta-Analysis

    PubMed Central

    Veerbeek, Janne Marieke; van Wegen, Erwin; van Peppen, Roland; van der Wees, Philip Jan; Hendriks, Erik; Rietberg, Marc; Kwakkel, Gert

    2014-01-01

    Background Physical therapy (PT) is one of the key disciplines in interdisciplinary stroke rehabilitation. The aim of this systematic review was to provide an update of the evidence for stroke rehabilitation interventions in the domain of PT. Methods and Findings Randomized controlled trials (RCTs) regarding PT in stroke rehabilitation were retrieved through a systematic search. Outcomes were classified according to the ICF. RCTs with a low risk of bias were quantitatively analyzed. Differences between phases poststroke were explored in subgroup analyses. A best evidence synthesis was performed for neurological treatment approaches. The search yielded 467 RCTs (N?=?25373; median PEDro score 6 [IQR 5–7]), identifying 53 interventions. No adverse events were reported. Strong evidence was found for significant positive effects of 13 interventions related to gait, 11 interventions related to arm-hand activities, 1 intervention for ADL, and 3 interventions for physical fitness. Summary Effect Sizes (SESs) ranged from 0.17 (95%CI 0.03–0.70; I2?=?0%) for therapeutic positioning of the paretic arm to 2.47 (95%CI 0.84–4.11; I2?=?77%) for training of sitting balance. There is strong evidence that a higher dose of practice is better, with SESs ranging from 0.21 (95%CI 0.02–0.39; I2?=?6%) for motor function of the paretic arm to 0.61 (95%CI 0.41–0.82; I2?=?41%) for muscle strength of the paretic leg. Subgroup analyses yielded significant differences with respect to timing poststroke for 10 interventions. Neurological treatment approaches to training of body functions and activities showed equal or unfavorable effects when compared to other training interventions. Main limitations of the present review are not using individual patient data for meta-analyses and absence of correction for multiple testing. Conclusions There is strong evidence for PT interventions favoring intensive high repetitive task-oriented and task-specific training in all phases poststroke. Effects are mostly restricted to the actually trained functions and activities. Suggestions for prioritizing PT stroke research are given. PMID:24505342

  7. Low-Level Laser Therapy for Fat Layer Reduction: A Comprehensive Review

    PubMed Central

    Avci, Pinar; Nyame, Theodore T.; Gupta, Gaurav K.; Sadasivam, Magesh; Hamblin, Michael R.

    2013-01-01

    Background and Objective Low-level laser (light) therapy (LLLT) is a noninvasive, nonthermal approach to disorders requiring reduction of pain and inflammation and stimulation of healing and tissue regeneration. Within the last decade, LLLT started being investigated as an adjuvant to liposuction, for noninvasive body contouring, reduction of cellulite, and improvement of blood lipid profile. LLLT may also aid autologous fat transfer procedures by enhancing the viability of adipocytes. However the underlying mechanism of actions for such effects still seems to be unclear. It is important, therefore, to understand the potential efficacy and proposed mechanism of actions of this new procedure for fat reduction. Materials and Methods A review of the literature associated with applications of LLLT related to fat layer reduction was performed to evaluate the findings from pre-clinical and clinical studies with respect to the mechanism of action, efficacy, and safety. Results The studies as of today suggest that LLLT has a potential to be used in fat and cellulite reduction as well as in improvement of blood lipid profile without any significant side effects. One of the main proposed mechanism of actions is based upon production of transient pores in adipocytes, allowing lipids to leak out. Another is through activation of the complement cascade which could cause induction of adipocyte apoptosis and subsequent release of lipids. Conclusion Although the present studies have demonstrated safety and efficacy of LLLT in fat layer reduction, studies demonstrating the efficacy of LLLT as a stand-alone procedure are still inadequate. Moreover, further studies are necessary to identify the mechanism of action. PMID:23749426

  8. Adherence to Antiretroviral Therapy in India: A Systematic Review and Meta-Analysis

    PubMed Central

    Mhaskar, Rahul; Alandikar, Vaibhav; Emmanuel, Patricia; Djulbegovic, Benjamin; Patel, Sangita; Patel, Atul; Naik, Eknath; Mohapatra, Shyam; Kumar, Ambuj

    2013-01-01

    Objective: To assess the adherence to antiretroviral therapy (ART) in the human immunodeficiency virus (HIV)-infected population in India. Design: Systematic review and meta-analysis. Materials and Methods: The Medline and Cochrane library database were searched. Any prospective or retrospective study enrolling a minimum of 10 subjects with a primary objective of assessing ART adherence in the HIV population in India was included. Data were extracted on adherence definition, adherence estimates, study design, study population characteristics, recall period and assessment method. For metaanalysis, the pooled proportion was calculated as a back-transform of the weighted mean of the transformed proportions (calculated according to the Freeman-Tukey variant of the arcsine square root) using the random effects model. Results: There were seven cross-sectional studies and one retrospective study enrolling 1666 participants. Publication bias was significant (P = 0.003). Pooled results showed an ART adherence rate of 70% (95% confidence interval: 59–81%, I2 = 96.3%). Sensitivity analyses based on study design, adherence assessment method and study region did not influence adherence estimates. Fifty percent (4/8) of the studies reported cost of medication as the most common obstacle for ART adherence. Twenty-five percent (2/8) reported lack of access to medication as the reason for non-adherence and 12% (1/8) cited adverse events as the most prevalent reason for non-adherence. The overall methodological quality of the included studies was poor. Conclusion: Pooled results show that overall ART adherence in India is below the required levels to have an optimal treatment effect. The quality of studies is poor and cannot be used to guide policies to improve ART adherence. PMID:23878418

  9. Challenges Associated with Scaling up Artemisinin Combination Therapy in Sub-Saharan Africa A Review Article

    PubMed Central

    Njuguna, J; Qader, SS

    2008-01-01

    Malaria is the leading cause of morbidity and mortality in Sub-Saharan Africa. One key strategic intervention is provision of early diagnosis and prompt effective treatment. A major setback has been the development of drug resistance to commonly used antimalarials. To overcome this, most countries in Sub-Saharan Africa have adopted Artemisinin Combination Therapy (ACT) as a first line treatment for uncomplicated malaria. Artemether Lumefantrine (AL) and Artesunate Amodiaquine (ASAQ) are the main drugs of choice. There are key implementation issues, which may have a bearing on the scaling up of this new treatment. This article reviewed the published papers on ACT with focus on sustainability, compliance, and diagnosis. ACTs are costly, but highly effective. Their scaling up is the most cost effective malaria intervention currently available. Most countries rely heavily on the Global Fund for their scaling up. AL has a short shelf life, a complicated six-dose regimen that requires intake with fat to ensure sufficient bioavailability. High rates of adherence have been reported. Use of parasitic diagnosis is advocated to ensure rational use. Parasitic diagnostics like rapid test and microscopy are currently inadequate. The majority of malaria cases may continue to be diagnosed clinically leading to over prescription of drugs. ACTs are currently not available at the community level for home based management of malaria. Issues related to safety and rational use need to be addressed before their use in the informal health sector like community drug sellers and community health workers. The majority of malaria cases at the community level could go untreated or continue to be treated using less effective drugs. We conclude that ACTs are highly effective. A major challenge is ensuring rational use and access at the household level. It is hoped that addressing these issues will increase the likelihood that ACT achieves its intended goals of reducing morbidity and mortality due to malaria, and delaying the onset of drug resistance. PMID:21499481

  10. Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis

    PubMed Central

    Uthman, Olalekan A; Peltzer, Karl; Richardson, Lindsey A; Mills, Edward J; Amekudzi, Kofi; Ouédraogo, Alice

    2015-01-01

    Abstract Objective To assess the association between the employment status of human immunodeficiency virus (HIV)-infected individuals and adherence to antiretroviral therapy (ART). Methods We searched the Medline, Embase and Cochrane Central Register of Controlled Trials databases for studies reporting ART adherence and employment status published between January 1980 and September 2014. Information from a wide range of other sources, including the grey literature, was also analysed. Two independent reviewers extracted data on treatment adherence and study characteristics. Study data on the association between being employed and adhering to ART were pooled using a random-effects model. Between-study heterogeneity and sources of bias were evaluated. Findings The meta-analysis included 28 studies published between 1996 and 2014 that together involved 8743 HIV-infected individuals from 14 countries. The overall pooled odds ratio (OR) for the association between being employed and adhering to ART was 1.27 (95% confidence interval, CI: 1.04–1.55). The association was significant for studies from low-income countries (OR:?1.85, 95% CI: 1.58–2.18) and high-income countries (OR:?1.33, 95% CI: 1.02–1.74) but not middle-income countries (OR:?0.94, 95% CI: 0.62–1.42). In addition, studies published after 2011 and larger studies showed less association between employment and adherence than earlier and small studies, respectively. Conclusion Employed HIV-infected individuals, particularly those in low- and high-income countries, were more likely to adhere to ART than unemployed individuals. Further research is needed on the mechanisms by which employment and ART adherence affect each other and on whether employment-creation interventions can positively influence ART adherence, HIV disease progression and quality of life. PMID:25558105

  11. Towards combinatorial targeted therapy in melanoma: From pre-clinical evidence to clinical application (Review)

    PubMed Central

    GRAZIA, GIULIA; PENNA, ILARIA; PEROTTI, VALENTINA; ANICHINI, ANDREA; TASSI, ELENA

    2014-01-01

    Over the last few years, clinical trials with BRAF and mitogen-activated protein/extracellular signal-regulated kinase (MEK) inhibitors have shown significant clinical activity in melanoma, but only a fraction of patients respond to these therapies, and development of resistance is frequent. This has prompted a large set of preclinical studies looking at several new combinatorial approaches of pathway- or target-specific inhibitors. At least five main drug association strategies have been verified in vitro and in preclinical models. The most promising include: i) vertical targeting of either MEK or phosphoinositide-3 kinase (PI3K)/mammalian target of rapamycin (mTOR) pathways, or their combined blockade; ii) association of receptor tyrosine kinases (RTKs) inhibitors with other pro-apoptotic strategies; iii) engagement of death receptors in combination with MEK-, mTOR/PI3K-, histone deacetylase (HDAC)-inhibitors, or with anti-apoptotic molecules modulators; iv) strategies aimed at blocking anti-apoptotic proteins belonging to B-cell lymphoma (Bcl-2) or inhibitors of apoptosis (IAP) families associated with MEK/BRAF/p38 inhibition; v) co-inhibition of other molecules important for survival [proteasome, HDAC and Signal transducers and activators of transcription (Stat)3] and the major pathways activated in melanoma; vi) simultaneous targeting of multiple anti-apoptotic molecules. Here we review the anti-melanoma efficacy and mechanism of action of the above-mentioned combinatorial strategies, together with the potential clinical application of the most promising studies that may eventually lead to therapeutic benefit. PMID:24920406

  12. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review

    PubMed Central

    Racicki, Stephanie; Gerwin, Sarah; DiClaudio, Stacy; Reinmann, Samuel; Donaldson, Megan

    2013-01-01

    Purpose: The purpose of this systematic review was to assess the effectiveness of conservative physical therapy management of cervicogenic headache (CGH). Introduction: CGH affects 22–25% of the adult population with females being four times more affected than men. CGHs are thought to arise from musculoskeletal impairments in the neck with symptoms most commonly consisting of suboccipital neck pain, dizziness, and lightheadedness. Currently, both invasive and non-invasive techniques are available to address these symptoms; however, the efficacy of non-invasive treatment techniques has yet to be established. Methods: Computerized searches of CINAHL, ProQuest, PubMed, MEDLINE, and SportDiscus, were performed to obtain a qualitative analysis of the literature. Inclusion criteria were: randomized controlled trial design, population diagnosed with CGH using the International Headache Society classification, at least one baseline measurement and one outcomes measure, and assessment of a conservative technique. Physiotherapy evidence-based database scale was utilized for quality assessment. Results: One computerized database search and two hand searches yielded six articles. Of the six included randomized controlled trials, all were considered to be of ‘good quality’ utilizing the physiotherapy evidence-based database scale. The interventions utilized were: therapist-driven cervical manipulation and mobilization, self-applied cervical mobilization, cervico-scapular strengthening, and therapist-driven cervical and thoracic manipulation. With the exception of one study, all reported reduction in pain and disability, as well as improvement in function. Conclusion: Calculated effect sizes allowed comparison of intervention groups between studies. A combination of therapist-driven cervical manipulation and mobilization with cervico-scapular strengthening was most effective for decreasing pain outcomes in those with CGH. PMID:24421621

  13. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review

    PubMed Central

    Kar, Nilamadhab

    2011-01-01

    Background: Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD. Methods: Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites. Results: The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT. Conclusion: There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action. PMID:21552319

  14. Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis

    PubMed Central

    Singh, Balwinder; Parsaik, Ajay K.; Prokop, Larry J.; Mittal, Manoj K.

    2013-01-01

    Objective To consolidate the evidence from randomized trials for the use of endovascular therapy (ET) in patients with acute ischemic stroke. Methods We searched major databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus) from their inception to February 12, 2013, for randomized trials evaluating the efficacy of ET compared with standard of care for acute ischemic stroke. Pooled absolute and relative risk estimates were synthesized by using a random-effects model. Heterogeneity was assessed by using Q statistic and I2 statistic. Subset analysis was performed for patients with severe stroke (National Institutes of Health Stroke Scale score ?20). The study was conducted from January 15, 2013 to April 30, 2013. Results Of the 1252 retrieved articles, 5 randomized trials enrolling 1197 patients with acute ischemic stroke were included. Seven hundred eleven patients received ET, and 486 received intravenous (IV) tissue plasminogen activator. There was no significant improvement in any of the outcomes in patients receiving ET compared with those receiving IV thrombolysis. On subgroup analysis, ET was found to have better outcomes in patients with severe stroke (National Institutes of Health Stroke Scale score ?20), showing a dose-response gradient and improving excellent, good, and fair outcomes by an additional 4%, 7%, and 13%, respectively, compared with IV thrombolysis. Conclusion Overall, ET is not superior to IV thrombolysis for acute ischemic strokes (level B recommendation). However, ET showed promise and improved outcomes in patients with severe strokes, but the evidence is limited due to sample size. There is a need for further trials evaluating the role of ET in this high-risk group. PMID:24079677

  15. Concise Review: Mind the Gap: Challenges in Characterizing and Quantifying Cell- and Tissue-Based Therapies for Clinical Translation

    PubMed Central

    Rayment, Erin A; Williams, David J

    2010-01-01

    There are many challenges associated with characterizing and quantifying cells for use in cell- and tissue-based therapies. From a regulatory perspective, these advanced treatments must not only be safe and effective but also be made by high-quality manufacturing processes that allow for on-time delivery of viable products. Although sterility assays can be adapted from conventional bioprocessing, cell- and tissue-based therapies require more stringent safety assessments, especially in relation to use of animal products, immune reaction, and potential instability due to extended culture times. Furthermore, cell manufacturers who plan to use human embryonic stem cells in their therapies need to be particularly stringent in their final purification steps, due to the unrestricted growth potential of these cells. This review summarizes the current issues in characterization and quantification for cell- and tissue-based therapies, dividing these challenges into the regulatory themes of safety, potency, and manufacturing quality. It outlines current assays in use, as well as highlights the limits of many of these product release tests. Mode of action is discussed, with particular reference to in vitro surrogate assays that can be used to provide information to correlate with proposed in vivo patient efficacy. Importantly, this review highlights the requirement for basic research to improve current knowledge on the in vivo fate of these treatments; as well as an improved stakeholder negotiation process to identify the measurement requirements that will ensure the manufacture of the best possible cell- and tissue-based therapies within the shortest timeframe for the most patient benefit. PMID:20333747

  16. Review Androgen Deprivation Therapy, Insulin Resistance, and Cardiovascular Mortality: An Inconvenient Truth

    Microsoft Academic Search

    SHEHZAD BASARIA

    2008-01-01

    Prostate cancer (PCa) is the most common cancer in men. Androgen deprivation therapy (ADT) is used in the treatment of locally advanced and metastatic PCa. Although its use as an adjuvant therapy has resulted in improved survival in some patients, ADT has negative consequences. Complications like osteoporosis, sexual dysfunction, gynecomastia, and adverse body composition are well known. Recent studies have

  17. Therapies for Treatment-Resistant Depression: A Review of the Research

    MedlinePLUS

    ... for people with depression, eating disorders, anxiety, and personality disorders. What are the side effects of talk therapy? Research has not found any side effects from talk therapy. What else should ... age, race, or personality of the therapist makes you feel. Therapists are ...

  18. Review INSULIN ANALOGS AND INTENSIVE INSULIN THERAPY IN TYPE 1 DIABETES

    Microsoft Academic Search

    Ved V. Gossain

    Unless contraindicated, intensive insulin therapy should b e the treatment of choice for patients with type 1 d iabetes. The principle of intensive insulin therapy is to p rovide a n adequate a mount of basal insulin and also p rovide insulin to p revent t he anticipated hyperglycemia following meals; thus mimicking the \\

  19. Wilderness-Adventure Therapy for Delinquent and Pre-Delinquent Youth: A Review of the Literature.

    ERIC Educational Resources Information Center

    Bandoroff, Scott

    Those in the field of wilderness-adventure therapy (WAT) have come a long way in their attitude toward research, but their methodology has lagged behind their enthusiasm. This paper examines the literature in the field of wilderness adventure therapy for delinquent and pre-delinquent youth in order to evaluate the current state of research. The…

  20. Incidence of HIV-Associated Tuberculosis among Individuals Taking Combination Antiretroviral Therapy: A Systematic Review and Meta-Analysis

    PubMed Central

    Kufa, Tendesayi; Mabuto, Tonderai; Muchiri, Evans; Charalambous, Salome; Rosillon, Dominique; Churchyard, Gavin; Harris, Rebecca C.

    2014-01-01

    Background Knowledge of tuberculosis incidence and associated factors is required for the development and evaluation of strategies to reduce the burden of HIV-associated tuberculosis. Methods Systematic literature review and meta-analysis of tuberculosis incidence rates among HIV-infected individuals taking combination antiretroviral therapy. Results From PubMed, EMBASE and Global Index Medicus databases, 42 papers describing 43 cohorts (32 from high/intermediate and 11 from low tuberculosis burden settings) were included in the qualitative review and 33 in the quantitative review. Cohorts from high/intermediate burden settings were smaller in size, had lower median CD4 cell counts at study entry and fewer person-years of follow up. Tuberculosis incidence rates were higher in studies from Sub-Saharan Africa and from World Bank low/middle income countries. Tuberculosis incidence rates decreased with increasing CD4 count at study entry and duration on combination antiretroviral therapy. Summary estimates of tuberculosis incidence among individuals on combination antiretroviral therapy were higher for cohorts from high/intermediate burden settings compared to those from the low tuberculosis burden settings (4.17 per 100 person-years [95% Confidence Interval (CI) 3.39–5.14 per 100 person-years] vs. 0.4 per 100 person-years [95% CI 0.23–0.69 per 100 person-years]) with significant heterogeneity observed between the studies. Conclusions Tuberculosis incidence rates were high among individuals on combination antiretroviral therapy in high/intermediate burden settings. Interventions to prevent tuberculosis in this population should address geographical, socioeconomic and individual factors such as low CD4 counts and prior history of tuberculosis. PMID:25393281

  1. Occupational therapy interventions to promote driving and community mobility for older adults with low vision: a systematic review.

    PubMed

    Justiss, Michael D

    2013-01-01

    A systematic literature review was conducted to evaluate the effectiveness of interventions within the scope of occupational therapy practice to improve or maintain the driving performance and community mobility of older adults with low vision. The results of this review identified a limited number of articles-eight-that met the inclusion criteria. Identified intervention strategies included the use of bioptics or prisms, multidisciplinary vision rehabilitation for community mobility, driving simulator training, driver education programs, and orientation and mobility training. Evidence is insufficient for the effectiveness of these interventions in improving or maintaining the driving performance or community mobility of older adults with low vision. Key study limitations included heterogeneity of sample characteristics (age, type of vision impairment), lack of standardization of interventions (device type, time, intensity duration), and lack of standardized assessments to measure driving and community mobility. This evidence-based review is informative for discussion of practice, education, and research implications. PMID:23597687

  2. A review of dispersion modelling and its application to the dispersion of particles: An overview of different dispersion models available

    NASA Astrophysics Data System (ADS)

    Holmes, N. S.; Morawska, L.

    This paper provides the first review of the application of atmospheric models for particle dispersion. The different types of dispersion models available, from simple box type models to complex fluid dynamics models are outlined and the suitability of the different approaches to dispersion modelling within different environments, in regards to scale, complexity of the environment and concentration parameters is assessed. Finally, several major commercial and non-commercial particle dispersion packages are reviewed, detailing which processes are included and advantages and limitations of their use to modelling particle dispersion. The models reviewed included: Box models (AURORA, CPB and PBM), Gaussian models (CALINE4, HIWAY2, CAR-FMI, OSPM, CALPUFF, AEROPOL, AERMOD, UK-ADMS and SCREEN3), Lagrangian/Eulerian Models (GRAL, TAPM, ARIA Regional), CFD models (ARIA Local, MISKAM, MICRO-CALGRID) and models which include aerosol dynamics (GATOR, MONO32, UHMA, CIT, AERO, RPM, AEROFOR2, URM-1ATM, MADRID, CALGRID and UNI-AERO).

  3. Ion radiography as a tool for patient set-up and image guided particle therapy: a Monte Carlo study.

    PubMed

    Depauw, Nicolas; Dias, Marta F; Rosenfeld, Anatoly; Seco, Joao C

    2014-02-01

    This study investigate the use of ion radiography as a tool for patient set-up and tumor tracking capabilities for image guided particle therapy (IGPT) using Monte Carlo simulations. One pediatric, two lung and one liver cancer patients were considered in this study. For each patient, 230 and 330 MeV proton, and 500 MeV/nucleon carbon ion pencil beams were simulated through their computed tomography (CT) data set using GEANT4.9.0. Energy, position and direction cosines of each particle were recorded in front and behind the patient. Ion radiographs were subsequently reconstructed using a dedicated in-house software. The image quality was assessed by evaluating the contrast-to-noise ratio of the tumor and its surrounding tissue. In the lung and liver cases, each CT phase of the breathing cycle was treated individually and dynamic sequences were later produced to appreciate tumor motion. Reconstructed radiographs show high spatial resolution. This allows for excellent imaging capabilities in pediatric patients, comparable to X-ray imaging at a fraction of the imaging dose. There is clear visualization of the tumor edges in the lung due to the great contrast-to-noise ratio between the tumor and its surrounding tissues; tumor motion is observed and comparable to 4D CT data thus allowing for on-line tumor tracking during ion radiotherapy. Conversely, tumor edge detection is difficult in liver, and fiducial markers are required to attempt indirect tumor tracking for IGPT. Ion radiographs with high spatial resolution can be generated using the PR-creator software resulting in pediatric patient set-up capabilities at a fraction of the current imaging dose, as well as the capacity to track moving targets in order to achieve IGPT. PMID:23819498

  4. PHYSICAL REVIEW E 86, 056403 (2012) Energy transport in a shear flow of particles in a two-dimensional dusty plasma

    E-print Network

    Goree, John

    particles. Due to their high charges, Coulomb collisions among dust particles have a dominant effect or liquid [8­15]. In other words, the collection of dust particles is said to be a strongly coupled plasmaPHYSICAL REVIEW E 86, 056403 (2012) Energy transport in a shear flow of particles in a two

  5. Systematic review: nutritional therapy in paediatric Crohn’s disease: SYSTEMATIC REVIEW: NUTRITION IN CHILDREN WITH CROHN’S

    Microsoft Academic Search

    A. S. DAY; K. E. WHITTEN; M. SIDLER; D. A. LEMBERG

    2007-01-01

    SUMMARY Background At least 25% of individuals diagnosed with Crohn's disease (CD) have onset of disease in childhood. Almost all children with CD have nutri- tional impairments, such as weight loss or stunting, at diagnosis or sub- sequently. Nutritional therapy (exclusive enteral nutrition) is established as a valid and effective treatment in paediatric CD. The advantages of this approach are

  6. Haemodynamic goal-directed therapy and postoperative infections: earlier is better. a systematic review and meta-analysis

    PubMed Central

    2011-01-01

    Introduction Infectious complications are the main causes of postoperative morbidity. The early timing of their promoting factors is the rationale for perioperative strategies attempting to reduce them. Our aim was to determine the effects of perioperative haemodynamic goal-directed therapy on postoperative infection rates. Methods We performed a systematic review and meta-analysis. MEDLINE, EMBASE, The Cochrane Library and the DARE databases were searched up to March 2011. Randomised, controlled trials of major surgery in adult patients managed with perioperative goal-directed therapy or according to routine haemodynamic practice were included. Primary outcome measure was specific type of infection. Results Twenty-six randomised, controlled trials with a combined total of 4,188 participants met our inclusion criteria. Perioperative goal-directed therapy significantly reduced surgical site infections (pooled OR 0.58, 95% CI 0.46 to 0.74; P < 0.0001), pneumonia (pooled OR 0.71, 95% CI 0.55 to 0.92; P = 0.009), and urinary tract infections (pooled OR 0.44, 95% CI 0.22 to 0.84; P = 0.02). A significant benefit was found regarding total infectious episodes (OR 0.40, 95% CI 0.28 to 0.58; P < 0.00001). Conclusions Flow-directed haemodynamic therapy designed to optimise oxygen delivery protects surgical patients against postoperative hospital-acquired infections and must be strongly encouraged, particularly in the high-risk surgical population. PMID:21702945

  7. Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature

    PubMed Central

    Herpich, Carolina Marciela; Amaral, Ana Paula; Leal-Junior, Ernesto Cesar Pinto; Tosato, Juliana de Paiva; Gomes, Cid Andre Fidelis de Paula; Arruda, Éric Edmur Camargo; Glória, Igor Phillip dos Santos; Garcia, Marilia Barbosa Santos; Barbosa, Bruno Roberto Borges; Rodrigues, Monique Sampaio; Silva, Katiane Lima; El Hage, Yasmin; Politti, Fabiano; Gonzalez, Tabajara de Oliveira; Bussadori, Sandra Kalil; Biasotto-Gonzalez, Daniela Aparecida

    2015-01-01

    The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: “temporomandibular joint laser therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD. PMID:25642095

  8. The health significance of gas- and particle-phase terpene oxidation products: a review.

    PubMed

    Rohr, Annette C

    2013-10-01

    The reactions between terpenes and ozone (or other oxidants) produce a wide variety of both gas- and particle-phase products. Terpenes are biogenic volatile organic compounds (VOCs) that are also contained in many consumer products. Ozone is present indoors since it infiltrates into the indoor environment and is emitted by some office and consumer equipment. Some of the gaseous products formed are irritating to biological tissues, while the condensed-phase products have received attention due to their contribution to ambient fine particulate matter (PM2.5) and its respective health significance. Despite common scientific questions, the indoor and ambient air research communities have tended to operate in isolation regarding this topic. This review critically evaluates the literature related to terpene oxidation products and attempts to synthesize results of indoor and ambient air studies to better understand the health significance of these materials and identify knowledge gaps. The review documents the results of a literature search covering terpene oxidation chemistry, epidemiological, toxicological, and controlled human exposure studies, as well as health studies focused more generically on secondary organic aerosol (SOA). The literature shows a clear role for gas-phase terpene oxidation products in adverse airway effects at high concentrations; however, whether these effects occur at more environmentally relevant levels is unclear. The evidence for toxicity of particle-phase products is less conclusive. Knowledge gaps and future research needs are outlined, and include the need for more consistency in study designs, incorporation of reaction product measurements into epidemiological studies conducted in both indoor and ambient settings, and more focused research on the toxicity of SOA, especially SOA of biogenic origin. PMID:24036325

  9. Review of heavy-ion induced desorption studies for particle accelerators

    NASA Astrophysics Data System (ADS)

    Mahner, Edgar

    2008-10-01

    During high-intensity heavy-ion operation of several particle accelerators worldwide, large dynamic pressure rises of orders of magnitude were caused by lost beam ions that impacted under grazing angle onto the vacuum chamber walls. This ion-induced desorption, observed, for example, at CERN, GSI, and BNL, can seriously limit the ion intensity, luminosity, and beam lifetime of the accelerator. For the heavy-ion program at CERN’s Large Hadron Collider collisions between beams of fully stripped lead (Pb82+208) ions with a beam energy of 2.76TeV/u and a nominal luminosity of 1027cm-2s-1 are foreseen. The GSI future project FAIR (Facility for Antiproton and Ion Research) aims at a beam intensity of 1012 uranium (U28+238) ions per second to be extracted from the synchrotron SIS18. Over the past years an experimental effort has been made to study the observed dynamic vacuum degradations, which are important to understand and overcome for present and future particle accelerators. The paper reviews the results obtained in several laboratories using dedicated test setups, the mitigation techniques found, and their implementation in accelerators.

  10. A review of commuter exposure to ultrafine particles and its health effects

    NASA Astrophysics Data System (ADS)

    Knibbs, Luke D.; Cole-Hunter, Tom; Morawska, Lidia

    2011-05-01

    Ultrafine particles (UFPs, <100 nm) are produced in large quantities by vehicular combustion and are implicated in causing several adverse human health effects. Recent work has suggested that a large proportion of daily UFP exposure may occur during commuting. However, the determinants, variability and transport mode-dependence of such exposure are not well-understood. The aim of this review was to address these knowledge gaps by distilling the results of 'in-transit' UFP exposure studies performed to-date, including studies of health effects. We identified 47 exposure studies performed across 6 transport modes: automobile, bicycle, bus, ferry, rail and walking. These encompassed approximately 3000 individual trips where UFP concentrations were measured. After weighting mean UFP concentrations by the number of trips in which they were collected, we found overall mean UFP concentrations of 3.4, 4.2, 4.5, 4.7, 4.9 and 5.7 × 10 4 particles cm -3 for the bicycle, bus, automobile, rail, walking and ferry modes, respectively. The mean concentration inside automobiles travelling through tunnels was 3.0 × 10 5 particles cm -3. While the mean concentrations were indicative of general trends, we found that the determinants of exposure (meteorology, traffic parameters, route, fuel type, exhaust treatment technologies, cabin ventilation, filtration, deposition, UFP penetration) exhibited marked variability and mode-dependence, such that it is not necessarily appropriate to rank modes in order of exposure without detailed consideration of these factors. Ten in-transit health effects studies have been conducted and their results indicate that UFP exposure during commuting can elicit acute effects in both healthy and health-compromised individuals. We suggest that future work should focus on further defining the contribution of in-transit UFP exposure to total UFP exposure, exploring its specific health effects and investigating exposures in the developing world.

  11. Particle deposition from turbulent flow: Review of published research and its applicability to ventilation ducts in commercial buildings

    SciTech Connect

    Sippola, Mark R.; Nazaroff, William W.

    2002-06-01

    This report reviews published experimental and theoretical investigations of particle deposition from turbulent flows and considers the applicability of this body of work to the specific case of particle deposition from flows in the ducts of heating, ventilating and air conditioning (HVAC) systems. Particle deposition can detrimentally affect the performance of HVAC systems and it influences the exposure of building occupants to a variety of air pollutants. The first section of this report describes the types of HVAC systems under consideration and discusses the components, materials and operating parameters commonly found in these systems. The second section reviews published experimental investigations of particle deposition rates from turbulent flows and considers the ramifications of the experimental evidence with respect to HVAC ducts. The third section considers the structure of turbulent airflows in ventilation ducts with a particular emphasis on turbulence investigations that have been used as a basis for particle deposition models. The final section reviews published literature on predicting particle deposition rates from turbulent flows.

  12. Combination Therapies for the Treatment of Advanced Melanoma: A Review of Current Evidence

    PubMed Central

    2014-01-01

    The treatment of advanced melanoma has been revolutionised in recent years with the advent of a range of new therapies. BRAF inhibitors, such as vemurafenib, have demonstrated improvements in the overall survival of patients with advanced melanoma that harbour a BRAF V600 mutation. Alongside these targeted therapies, novel immune-checkpoint inhibitors, such as ipilimumab, have also been developed and have produced similarly improved outcomes for patients. For the first time in the history of melanoma, monotherapy with each of these drugs has produced improvements in the overall survival of patients with advanced disease. Building on this initial success, there has been intense interest in developing combination therapies predominantly with either dual blockade of the MAPK oncogenic pathway or dual immune-checkpoint blockade. The current evidence for the use of these combination therapies will be presented here. PMID:24693430

  13. The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments

    PubMed Central

    Thase, Michael E; Kingdon, David; Turkington, Douglas

    2014-01-01

    Cognitive behavior therapy (CBT), as exemplified by the model of psychotherapy developed and refined over the past 40 years by A.T. Beck and colleagues, is one of the treatments of first choice for ambulatory depressive and anxiety disorders. Over the past several decades, there have been vigorous efforts to adapt CBT for treatment of more severe mental disorders, including schizophrenia and the more chronic and/or treatment refractory mood disorders. These efforts have primarily studied CBT as an adjunctive therapy, i.e., in combination with pharmacotherapy. Given the several limitations of state-of-the-art pharmacotherapies for these severe mental disorders, demonstration of clinically meaningful additive effects for CBT would have important implications for improving public health. This paper reviews the key developments in this important area of therapeutics, providing a summary of the current state of the art and suggesting directions for future research. PMID:25273290

  14. Concise Review: Adult Mesenchymal Stem Cells, Adult Neural Crest Stem Cells, and Therapy of Neurological Pathologies: A State of Play

    PubMed Central

    Neirinckx, Virginie; Coste, Cécile; Rogister, Bernard

    2013-01-01

    Adult stem cells are endowed with in vitro multilineage differentiation abilities and constitute an attractive autologous source of material for cell therapy in neurological disorders. With regard to lately published results, the ability of adult mesenchymal stem cells (MSCs) and neural crest stem cells (NCSCs) to integrate and differentiate into neurons once inside the central nervous system (CNS) is currently questioned. For this review, we collected exhaustive data on MSC/NCSC neural differentiation in vitro. We then analyzed preclinical cell therapy experiments in different models for neurological diseases and concluded that neural differentiation is probably not the leading property of adult MSCs and NCSCs concerning neurological pathology management. A fine analysis of the molecules that are secreted by MSCs and NCSCs would definitely be of significant interest regarding their important contribution to the clinical and pathological recovery after CNS lesions. PMID:23486833

  15. Nothing but NET: A review of norepinephrine transporter expression and efficacy of 131I-mIBG therapy

    PubMed Central

    Streby, Keri A; Shah, Nilay; Ranalli, Mark A; Kunkler, Anne; Cripe, Timothy P

    2015-01-01

    Neuroblastoma is unique amongst common pediatric cancers for its expression of the norepinephrine transporter (NET), enabling tumor-selective imaging and therapy with radioactive analogues of norepinephrine. The majority of neuroblastoma tumors are avid for 123I-metaiodobenzaguanidine (mIBG) on imaging, yet the therapeutic response to 131I-mIBG is only 30% in clinical trials, and off-target effects cause short- and long-term morbidity. We review the contemporary understanding of the tumor-selective uptake, retention, and efflux of meta-iodobenzylguanidine (mIBG) and strategies currently in development for improving its efficacy. Combination treatment strategies aimed at enhancing NET are likely necessary to reach the full potential of 131I-mIBG therapy. PMID:25175627

  16. The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments.

    PubMed

    Thase, Michael E; Kingdon, David; Turkington, Douglas

    2014-10-01

    Cognitive behavior therapy (CBT), as exemplified by the model of psychotherapy developed and refined over the past 40 years by A.T. Beck and colleagues, is one of the treatments of first choice for ambulatory depressive and anxiety disorders. Over the past several decades, there have been vigorous efforts to adapt CBT for treatment of more severe mental disorders, including schizophrenia and the more chronic and/or treatment refractory mood disorders. These efforts have primarily studied CBT as an adjunctive therapy, i.e., in combination with pharmacotherapy. Given the several limitations of state-of-the-art pharmacotherapies for these severe mental disorders, demonstration of clinically meaningful additive effects for CBT would have important implications for improving public health. This paper reviews the key developments in this important area of therapeutics, providing a summary of the current state of the art and suggesting directions for future research. PMID:25273290

  17. State of the Art in Hadron Therapy

    SciTech Connect

    Jaekel, Oliver [Department of Medical Physics, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280 Heidelberg Ion Therapy Center, INF 400, 69120 Heidelberg (Germany)

    2007-11-26

    Charged particle beams offer an improved dose conformation to the target volume as compared to photon radiotherapy, with better sparing of normal tissue structures close to the target. In addition, beams of ions heavier than helium exhibit a strong increase of the Linear Energy Transfer (LET) in the Bragg peak as compared to the entrance region. These physical and biological properties make ion beams more favorable for radiation therapy of cancer than photon beams. As a consequence, particle therapy with protons and heavy ions has gained increasing interest worldwide. This contribution summarizes the physical and biological principles of charged particle therapy with ion beams and highlights some of the developments in the field of beam delivery, the principles of treatment planning and the determination of absorbed dose in ion beams. The clinical experience gathered so far with carbon ion therapy is briefly reviewed.

  18. Computerised Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: A Systematic Review

    Microsoft Academic Search

    Indra Tumur; Eva Kaltenthaler; Michael Ferriter; Catherine Beverley; Glenys Parry

    2007-01-01

    Background: Computer-guided therapy is an innovative treatment strategy that could have an important role in the future of psychological treatment. This paper summarises the available published evidence that assesses the effectiveness of a computerised cognitive behaviour therapy (CCBT) for obsessive-compulsive disorder (OCD). Methods: Fifteen electronic bibliographic databases including Medline, Embase, the Cochrane Library, Cinahl, PsycINFO, Biological Abstracts, HMIC and NHS

  19. Virtual Reality as a Tool for Cognitive Behavioral Therapy: A Review

    Microsoft Academic Search

    Simona Scozzari; Luciano Gamberini

    \\u000a This chapter describes the deployment of Virtual Reality (VR) for Cognitive Behavioral Therapy (CBT) to treat anxiety and\\u000a other psychological disorders. Regarding anxiety, the most common technique is constituted of Exposure Therapy that, transposed\\u000a to Virtual Reality, allows the patient to face a digital version of the feared object or situation, instead of a real or imaginal\\u000a one. Virtual Reality

  20. Laser therapy for the treatment of Hailey-Hailey disease: a systematic review with focus on carbon dioxide laser resurfacing.

    PubMed

    Falto-Aizpurua, L A; Griffith, R D; Yazdani Abyaneh, M A; Nouri, K

    2014-11-21

    Benign familial chronic pemphigus, or Hailey-Hailey disease (HHD), is a recurrent bullous dermatitis that tends to have a chronic course with frequent relapses. Long-term treatment options include surgery with skin grafting or dermabrasion. Both are highly invasive and carry significant risks and complications. More recently, 'laser-abrasion' has been described as a less invasive option with a better side-effect profile. In this article, we systematically review the safety and efficacy of carbon dioxide laser therapy as a long-term treatment option for HHD, as well as provide a review of other lasers that have been reported with this goal. A total of 23 patients who had been treated with a carbon dioxide laser were identified. After treatment, 10 patients (43%) had had no recurrence, 10 (43%) had greater than 50% improvement, 2 (8%) had less than 50% improvement and 1 (4%) patient had no improvement at all (follow-up period ranged from 4 to 144 months). Laser parameter variability was wide and adverse effects were minimal, including dyspigmentation and scarring. Reviewed evidence indicates this therapy offers a safe, effective treatment alternative for HHD with minimal risk of side-effects. Larger, well-designed studies are necessary to determine the optimal treatment parameters. PMID:25418614